RESET: The Global Tilt - Why You Must Rethink the Future

of Medical Technology

 .

Marcus EvansJune 26, 2014

Thomas M. Loarie, Executive Chairman

eMedonlineMedication Therapy Management Platform

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• Designed from the patient out

• Value propositions • Proven behavior change• Data and analytics

• Scientifically based (Parks)• 98% Compliance • 10 controlled clinical studies • Managing patients taking up to 27 meds/day

eMedonline

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Markets

• Care Transition• Chronic Care Management• Specialty Pharma• Clinical Trials• Analytics for Pharma & Providers

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Road Map

• The Evolution of Healthcare in My Lifetime

• Global Drivers of Transformation• Reactions to Forces• Foundation of Globalization• Future Medtech Opportunities• What Does This Mean for You?

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Transforming Events 1960-2014

House Calls

Hospital

• For Profit Hospitals

• HMOs

• Hospitals M&A

1970 1980 1990 2000 20101960

• Segmentation

• Doc in the Box

Health Reform

Transforming Events 1960-2014

Social Security Act of 1965

• FDA Modernization Act

• CMS takes front seat

Cuts in Funding to AeroDefense

• TEFRA• DRGs• Segmentati

on• Marketing

• Kessler FDA

• M&AGlobalization

• The Great Recession

• Implosion of Venture Capital

• Health Reform

• ACOs• M&A

Hospitals

1970 1980 1990 2000 20101960

• GoldStandard

• Emergence of Multi-National

• FDA ActTransforming Events 1960-2014

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Global Drivers of Transformation

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• Technological advances• Demographic changes• Global Networks• Global economic shifts• Urbanization• Resource scarcity• Climate

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Global Population 1950 - 2050

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Death of Silos & Growth of Global Networks

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Virtual currency and payment systems

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US Companies are BrokenMany Don’t Know It

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Forces Disrupting the Balance in Healthcare

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• > Aging population

• > Chronic disease

• > Public spending

• > Taxpayer revolt

• > Global middle class

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25 %

25 %Of Costs

Big Need - Solutions to Manage Costliest Chronic Diseases

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The Global Middle Class is Booming

P. 2004/07/2023

New Health Care Economy - US

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• FFS to Value Based Pay

• Risk Shifting to Providers

• Care Mgmt Shifting to Doc

• Incomes Tied to Outcome and Volume

• Clinical and Economic Evidence

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Figure 3. Potential points of innovation

Shift delivery from discrete services based organizations (e.g. specialists) to team based models that address a patient’s overall need

Care delivery m odel

Transition from dominant payment models (FFS or Global Capitation) to reimbursement models that reward providers

for improving the value of care

Paym ent model

Value-driven care

Network model

Move from competitive single tier networks to multi- site networks that address adequacy yet support superior

services delivery

Transition from measurement of process based compliance

and cost of charges to activity based cost accounting and

outcomes tracking

Analytics

& outcom es

Clinical

integration

Reorganize provider facilities to focused factories with

defined niche services and concentrated volume to

integrate care

Information Technology Integration technology that transitions from siloed systems leveraging

aggregation of data, connectivity to all stakeholders and experts systems that allow for seamless sharing and engagement

New Entrants

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Of Fortune 50 companies, 24 are new entrants The top companies also include 14 traditional healthcare organizations

Fortune 50 companies 7 Retailers

14 Traditional healthcare com panies 24

New entrants

5 Technology

4 Finance

$$$$

3 Telecommunications

2 Automotive 3 C onsum er products

Disruptors

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D-Rev Non-profit medical product development company

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Designs and delivers products for people living on less than $4 a day.

Disruptors

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Globalization of U.S. Medical Care

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• Global distribution of U.S. developed devices and drugs

• OUS clinical research • Reverse brain drain

• physicians & engineers

• Manufacturing expanded OUS

• U.S. multi-nationals expanding OUS product research

Disruptors - OUS

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Destination Medicine

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Destination MedicineAKA Medical Tourism

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Expansion into Emerging Markets

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Globalization U.S. based > research centers in China

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Generic Therapeutic DevicesA threat to legacy margins

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Globalization China based > U.S. presence

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Globalization of Delivery

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Globalization of Delivery

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eHealthPredicting Asthma Attacks

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“What is the Meaning of Your Life?The World is Asking You That

Question…”-Viktor Frankl

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Shape Your Identity or It Will Shape You

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Global Experience

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The Two Most Important Days In Your Life….

…are the day you are born and the day you find out why! - Mark Twain

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