SXSW started as a music and film festival, but has emerged as one of the biggest affairs for the Internet and new interactive technology. Since tech turned the music industry on its head and is in the process of disrupting the film business as well, it makes sense to combine tech with film and music. 2010 also was the first year SXSW had a track dedicated to mobile, which also makes sense as we enter another phase shift with the next billion connections to the internet coming through smart mobile devices.

With such powerful, always on, always connected technology in our hands around the clock, we posed the question of what this means for our brain. How can we use smart mobile technology to become smarter in managing the increased flow of information? With the flood of content generated by others people and important to other people, what is happening to the content that is most important to us?

Snaptic is developing technology to augment your brain, and we are looking to the brain for design inspiration. There are no database schemas, no tables with rows and columns, in your brain. Instead, your brain is a vast network of synaptically connected notes that grows and evolves as you capture and connect information that is important to you.

The information model for Snaptic note-taking applications is a network of interconnected elements of data, retaining and using context so that your notes make more sense and are easier to find with less effort. We have opened our notes platform to developers, making it easy to capture and connect information from any app.

We can’t do it alone, which is why we are open-sourcing more of our technology every day and inviting more developers to work with us to create a new information space designed like the brain and for the brain. Check out http://github.com/snaptic to follow our open source projects, and check out http://snaptic.com/events for information on our upcoming developer challenge and developer conference.

One presenter from Fujitsu demonstrated his around-the-clock blood pressure, heart rate, and blood oxygen monitoring results in an effort to understand which medications influenced his sleep apnea. Esther Dyson showed her 23andMe genetic profile and compared it to her family members and colleagues, while another researcher showed the challenges of posting his genome on Twitter. (Hint: at 140 characters per Tweet and 1000 Tweets per day, it takes two years and you have a high risk of being flagged as a spammer.) Others logged symptoms and environmental factors related to medical issues, analyzed language to passively capture information and insights on mental health, while one person showed his 10 year mind map.

The common denominators at the Quantified Self meeting were that everyone was interested in taking notes on their life experience in a quantifiable way in order to better understand their own experience and to solve problems. In each case, the limiting factor seemed to be the ability and persistence to take notes that could be converted into something useful. It’s just too much darned work.

Simplicity is the key to any kind of self-monitoring and information capture, because no one needs a bunch of extra work. I learned the strength of simplicity working in the field of personal health monitoring for many years as the founder and former CEO of Health Hero Network, the developer of the Health Buddy System, a pioneering effort of electronic “lifestreaming” to improve chronic care.

Initiated over 10 years ago, Health Buddy started as a rather limited pre-scripted four-button survey system to collect symptoms from patients while providing education and motivation on following a treatment plan. Despite its simplicity and limitations (or more likely, because of them), Health Buddy was tremendously successful in positively influencing health behavior and in reducing health complications for complex conditions ranging from diabetes and heart disease to mental health and obesity. Tens of thousands of patients are using Health Buddy daily. The Medicare project that we spent years in winning and implementing is showing great results where many others have failed. The company is now Robert Bosch Healthcare.

Earlier this year, my new company, 3banana Inc., introduced note-taking applications for iPhone and Android smartphones that offered the ability to sync with a free online notebook and share with social networks like Twitter and Facebook. My interest in Quantifed Self is to learn, share and discuss ideas about how to use smartphones to enhance our working memory and augment our brains by capturing information and connecting to useful services that can help us achieve our goals — and to do so with less work.

Can we shape our brains around mobile technologies to expand our working memory in much the same way we do in developing software? In developing software for mobile devices where memory resources are more limited, we don’t store all of the content in short term memory. Instead, we store the links to where we know we can find the rest of the information when needed, wherever it might be on the network. The same can work for our brains. Once we have a trusted memory accessory where we can easily park and retrieve notes, we can free up both short term and long term working memory.

The key to capturing information is simplicity, which is why 3banana Notes is freeform and unstructured. Who needs the work of thinking up titles and categories when you want to jot down a thought? Instead, structure can emerge from inline hashtags (the ubiquitous # sign that gives semantics to Twitter) and from context awareness: Knowing where you were and what you were doing when you took the note can improve pattern matching services that add value to your notes by appending useful information and filling in the blanks. On our Android smartphone app, for example, addresses within notes automatically turn into links to Google maps, and phone numbers automatically link to dialing a call.

The other way that 3banana on Android works to enhance your working memory is to enable you to store links to your content directly on physical objects by generating and scanning your own personalized two dimensional barcodes, or QR Codes. We have brain maps dedicated to the physical objects we find around us every day, and these objects can be powerful cues to recalling the information and actions associated with those objects if we can link to them in context. Simple examples include putting a QR Code on your furnace that you can scan with your phone to recall the logbook about changing the filters, or putting a QR code linking to your music practice chart or exercise log on the music stand or on the exercise bike.

At Quantified Self, I showed the example of scanning bottle of wine with a smartphone to access shared wine notes and wine tasting discussions with friends. Remembering bottles of wine is one of those “note to self” categories that always got lost until I started connecting it to my digital world. Now I can quickly snap a photo into my #wine notes, share with people who like wine, or post to social media sites Twitter and Facebook, using Twitter’s OAuth and Facebook Connect for one-click integration. Perhaps a wine distributor or retailer will want to use 3banana to tag expensive bottles wine so that each sale becomes a potential viral marketing channel leading to new customers and increasing the loyalty of existing customers.

Finally, we know from brain research that emotion is the most powerful trigger in the brain to put something in long term storage — to remember something rather than to forget it. That’s great when we need to remember something for survival, like how to get away from the lions and bears, but it doesn’t serve us well for all the non-life threatening content we might want to remember for business and personal interests. Just as teaching is the best way to learn something, I have found that writing, sharing, and discussing new ideas with real people is the best way to remember something. Sharing with other people using social media connects that information to our brain maps associated with people, and relationships are loaded with emotional content.

In the world of the brain, three is a magic number because we can remember and work with things in threes better than any other number. 3banana has three meanings: In the geeky world of code monkeys, 3banana describes those smart, flexible, fast learners adept with new technology. In the world Twitter and jotting down notes, 3banana is a unit of time that represents the minimum latency to capture and absorb an idea. And if you are looking at three bananas on your kitchen table, you probably know that bananas are brain food. Bananas are rich in potassium, which helps the brain transmit messages. But bananas don’t last long sitting around, so if you are looking at three, better share one.

Our mission at 3banana is to create tools that enhance your working memory and augment your brain. In addition to taking notes, we will keep enhancing these tools to become more and more useful in those areas of your life that you want to improve, both personally and for the planet. Give it a shot and let us know what you think.

Social media is often defined as “people having a conversation online.” In contrast to mass media produced by a few, social media is generated by grass roots efforts of millions of people. It has become the largest and most interesting use of the web.

Despite the fact that health care is one of the most information intensive fields, the health care industry notoriously lags behind every other industry in its adaptation of information technology. To get our initial bearings, we decided to kick off the discussion by asking the audience to describe their own personal use of social media.

I was happily surprised to hear many personal stories, including using the Barack Obama iPhone application to mobilize “get out the vote” efforts, and using Myspace to find band members for weekend gigs—personal examples given by senior leaders of some of the largest and most influential health care organizations in California!

The challenges we face in reforming, modernizing, and improving health care are not for a lack of talented and committed people eager to make things better. Health care is a field full of committed and smart people applying a continuous stream of innovation in addressing difficult challenges.

Efforts to create the more proactive and responsive models of care enabled by the Internet, however, have been stymied for a decade by outdated policies that too often reward inefficiency and penalize prevention.

The health care industry may not need to solve all of its problems, however.

Some of the challenges in chronic care, public health, and wellness that currently seem so intractable to our institutions may have surprising community-based and grass roots solutions, enabled and spread through social media.

Social Media Primer Transcript

1. Social Media Primer for Health Care Executives
   Steve Brown
   Adaptive Business Leaders
   December 11, 2008

   http://brown2020.com

2. Social Media Defined:
   People
   having a conversation
   online
3. What are we sharing?
   Ideas: WordPress and Blogger
   Friends: Facebook
   Photos: Flickr
   Status: Twitter
   Websites: Digg
   Videos: YouTube
   Slides: Slideshare
   Documents: Scribd
   Music: Myspace
   Events: evite
   Books: Amazon
   Restaurants: Yelp
   Travel tips: Tripadvisor
   Articles: ArticlesBase
   Notes: 3banana
4. Social media is growing rapidly
   Wordpress unique users
   Facebook unique users
   Twitter unique users
5. Just for a sense of scale…
   Comparison of Google Trends data
   Global Warming, Football, Sex, Facebook
6. Why are we sharing?
   Because life is richer when we share
7. Why Should Health Care Executives Care About Social Media?
   Social Media is about Connectedness. In Business and in Life, Connectedness Wins
   Barack Obama Case Study
   Connectedness is part of the solution to:
   Wellness challenges including obesity and lifestyle diseases that relate to our own motivation and behavior
   Chronic care management challenges exacerbated by isolation, loneliness, depression
   Aging population challenges resulting from cognitive decline and neurological disease
   Public health and research challenges that depend on the velocity and relevance of real-world information
8. In Google, Winning is a Function of Connectedness
   PageRank: How many pages link to the pages that link to you?
   BarackObama.com Case Study: What was the number one issue of the campaign?
9. The Most Connected Sites Win
   Comparison of BarackObama.com and JohnMcCain.com
   Pages and backlinks as a result of social media
10. Digging Deeper Into Obama vs. McCain. Looking at the 501st page in Google
    JohnMcCain.com content: Campaign generated press releases
    BarackObama.com content: User generated blogs and local groups
11. Traditional Media:Passive, expensive, celebrity driven. People you only think you know.
    From Barbara Walters Presents: The Most Fascinating People of 2008.
12. Social Media:Active, engaged, free.Real people, real conversations.
13. Real Time Activity on Facebook from Palantir
    120 million active users, now 4th most trafficked website
    10 billion photos, adding 30 million per day
14. Social Media and Your Business
    How do people find and judge your organization?
    How do you listen to and motivate your employees?
    How do you listen to and motivate your members?
15. Top Three Barriers To Social Media
    “None of my friends are there”
    “I feel thrust into a public space”
    “It’s too much effort”
16. Overcoming Barriers: Social Media For Adults
    Applications that have value even before you have any “friends” on the network
    Applications that start with private thoughts and share gradually, with clear privacy control
    Applications that effortlessly integrate with what you already know and do
17. For Discussion: Potential Applications of Social Media in Health Care
    Wellness
    Chronic Care
    Brain Fitness
    Public Health
    Research
18. Chronic Care 1.0
    Scripted
    Top Down
    Inherently Limited
    Labor Intensive
    Home health monitoring technology examples
    Honeywell Hommed Genesis
    Intel Health Guide
19. Chronic Care 2.0
    Unscripted
    Grass Roots
    Open-Ended
    Social
    Display of social network of informal caregivers
20. Real Life is Unscripted
    wefeelfine.org
21. Real People are Diverse
    wefeelfine.org
22. Real Needs are Highly Personal
    wefeelfine.org
23. Connectedness and Your Brain: Keep Learning and Stay Engaged – Or Else!
    From “The Coming Neurological Epidemic” TED talk by Biochemist Gregory Petsko
24. Social Networks and Brain Health
    Women who had daily contact with friends and family cut their risk of dementia by almost half.
    If you stay connected, you have a better shot. Whenever we have even the most basic exchange, we have to think about how to respond, and that stimulates the brain—Valerie Crooks, clinical trials administrative director at Southern California Kaiser Permanente Medical Group, lead author.
    American Journal of Public Health 1221-1227, July 2008, Vol 98, No. 7
25. Social Graph on Facebook
    More connected outside = More connected inside
    Brain map from brainmaps.org
26. Social Media: A New Window Into Human Behavior
    Unprecedented ability to measure social and emotional behavior of a populations
    Opportunity to understand problems based on real world data, not from the laboratory!
    Who is currently at the forefront of human behavior research? Social media companies!
27. Every Day Presents a New Way to Connect, Engage, and Learn
    Ocarina iPhone Application from Smule: your phone becomes an electronic flute you can play with people around the world.

Every service industry except health care, that is.

I stumbled across a presentation that I gave on the topic in 2004 together with Harris Miller, then president of the Information Technology Association of America. The ITAA had just released its chronic care improvement paper describing how Medicare could save money and save lives while stimulating an emerging health care information technology industry by adopting approaches that we have come to expect from every other service business.

Since 2004, the technology industry has responded to the opportunity to improve health care: Microsoft and Google are breaking the impasse in the electronic medical records field by providing connected online personal health records for free. Global technology giants have entered the home health market: Bosch acquired Health Hero Network, Honeywell acquired HomMed, and Intel launched into telehealth with its Intel Health Guide for home health monitoring, each aiming to bring connected health to the homes of seniors in need of chronic care.

The real barriers to advancing and modernizing health care still remain, however. It has not been a lack of technology, innovation, or insight from the information technology industry. Instead, the culprit has been a lack of imagination and initiative on the part of governments to develop, refine, and improve with policy changes aimed at rewarding the proactive management and prevention of chronic disease.

We know a better model of care and better service for the money is possible with smarter information-based approaches. With a new administration in Washington and a fresh infusion of imagination, determination, and energy into government following the recent elections, maybe we can start to turn health care from a net drain on the economy into a model for the world.

Chronic Care ITAA Transcript

• Slide 1: Chronic Care Improvement: How Medicare Transformation Can Save Lives, Save Money, and Stimulate an Emerging Technology Industry May 10, 2004 Presentation by: Harris N. Miller, President Information Technology Association of America 1
• Slide 2: ITAA and E-Health  ITAA is Committed to Improving the Delivery of Healthcare and Controlling Costs through Transition to E-Health  ITAA E-Health Committee Composed of Leading Companies in Sector  Committee Activities Include White Papers and Webcasts Focused on Public Policy and Practitioner Trends 2
• Slide 3: Our Agenda Today  Trends in E-Health  Overview of New Chronic Care White Paper  Your Questions 3
• Slide 4: Healthcare IT Spending: A Comparison View  Financial Services -spends 7% of revenues on IT  Government – spends 4% of revenues on IT  Healthcare – spends only 2-3% of revenues on IT 4
• Slide 5: An Overview of the Healthcare Industry  IT for healthcare is a very large market, measured in the tens of billions of dollars  Healthcare is already an active user of new technology  Healthcare IT spending is growing rapidly – up 17% in one recent year 5
• Slide 6: The E-Health Challenge  How much could IT help healthcare?  What are the success stories?  What are the barriers or inhibitors to using more IT in healthcare? 6
• Slide 7: How Big is the Healthcare IT Opportunity?  Previous ITAA white paper concluded that an industry-wide investment of $18.1 billion would yield over 6 years gross savings of $120 billion  Roughly half the savings are administrative, half are clinical 7
• Slide 8: Healthcare-Information Technology Opportunities  Trends in Managed Care  Impact on incentive  Impact on integration of care  Technological Solutions  Computer-based Patient Records – a source of opportunity and of concern  Data Warehousing – sophisticated analysis of care 8
• Slide 9: Reducing Healthcare Costs Major Goals:  Improve handling of financial and management information  Decrease needless duplication of records  Decrease duplicative and erroneous tests  Reduce the costs of hospital stays 9
• Slide 10: Improving the Quality of Medical Care Major Goals: – Real-time, data-driven medical decisions – Real-time, data entry by mobile medical personnel – Real-time global transport of complex medical records 10
• Slide 11: Improving the Quality of Medical Care – Increase productivity by shifting time from paperwork to patient care – More efficient patient care management – Automated patient records – Use of expert systems and diagnostic tools to assist professionals 11
• Slide 12: Getting to E-Health: The Opportunities for Using IT in the Healthcare Industry Using network technologies for chronic care is the “poster child” for opportunities in using IT effectively in healthcare. 12
• Slide 13: Chronic Care Delivery System – Shift in Emphasis from Acute to Chronic Care Delivery – Integrate Technology-Based Solutions – Communicate, Coordinate, Evaluate – Save $30 Billion per Year – Prevent 1.7 Million Hospitalizations 13
• Slide 14: Technology-based Chronic Care Improvement Steve Brown, Health Hero May 10, 2004 14
• Slide 15: The Challenge of Chronic Illness  At least 45 percent of Americans – or 132 million people – suffer from chronic diseases  Chronic diseases include heart failure, chronic obstructive pulmonary disease, diabetes mellitus, mental health disorders, asthma, and hypertension  Patients with chronic disease account for 78 percent of U.S. healthcare spending  Spending on chronic disease higher than necessary because healthcare system is oriented toward treating patients who reach a crisis, rather than keeping them healthy 15
• Slide 16: Medicare and Chronic Illness  32 million Medicare beneficiaries have at least one chronic condition  8 million patients have five or more chronic illnesses and account for two- thirds of Medicare spending 16
• Slide 17: 2004 Medicare Inpatient Costs: Select Chronic Diseases Disease Discharges Cost per Total cost Coronary artery disease .9 million $29,000 $25.6 billion Chronic heart failure .8 million $19,000 $15.2 billion Chronic obstructive pulmonary disease .4 million $16,000 $6.2 billion Mental health disorders .2 million $16,000 $3.9 billion Diabetes .2 million $20,000 $3.8 billion Hypertension .1 million $22,000 $3.2 billion Asthma .07 million $13,000 $1 billion TOTAL 2.8 million $21,000 $59 billion 17
• Slide 18: Chronic Care Improvement Program Model for Medicare  Geared toward saving lives and saving money by proactively keeping patients with chronic disease healthier and out of the hospital  Model based on daily monitoring, education, guidance, and management by healthcare providers  Reinforcing patient self-care behaviors – diet, exercise, medication adherence – is critical  Key factor is whether doctors and patients identify and deal with problems early, before patient needs hospitalization 18
• Slide 19: Medicare Chronic Care Improvement “Required Conduct of Programs” A. “(G)uide the participant in managing the participant’s health (including all co-morbidities, relevant health care services, and pharmaceutical needs) and in performing activities as specified under the elements of the care management plan of the participant; B. use decision-support tools such as evidence-based practice guidelines or other criteria as determined by the Secretary; and C. develop a clinical information database to track and monitor each participant across settings and to evaluate outcomes.” 19
• Slide 20: Medicare Chronic Care Improvement “Required Elements of Care Management Plans” “To The Extent Appropriate… B. A designated point of contact responsible for communications with the beneficiary and for facilitating communications with other health care providers under the plan. C. Self-care education for the beneficiary (through approaches such as disease management or medical nutrition therapy) and education for primary caregivers and family members. D. Education for physicians and other providers and collaboration to enhance communication of relevant clinical information. E. The use of monitoring technologies that enable patient guidance through the exchange of pertinent clinical information, such as vital signs, symptomatic information, and health self-assessment. F. The provision of information about hospice care, pain and palliative care, and end-of-life care.” 20
• Slide 21: Proven Model of Technology-based Chronic Care Improvement  In-home monitoring devices that guide patients in exchange of information with providers  Personalized guidance and support through devices  Nurse care managers to manage and coordinate care  Decision-support tools to implement evidence-based practice guidelines  Clinical information databases for accountability 21
• Slide 22: VA Published Results from Technology- Based Chronic Care Improvement  40% reduction in emergency room visits  63% reduction in hospital admissions  60% reduction in hospital bed days of care  64% reduction in nursing home admissions  88% reduction in nursing home bed days of care  Significant improvement in Quality of Life SF36V  Source: Disease Management, Volume 5, Number 2, 2002 22
• Slide 23: VA Results Applied to Medicare If Medicare could achieve results similar to the VA’s with similar patients with a model of care coordination that integrates care coordination services with daily in-home monitoring and clinical information tools, Medicare could save $30 billion a year. 23
• Slide 24: Realizing the Promise of Technology- Based Chronic Care Improvement  Applying technology-based chronic care improvement to Medicare shifts thinking from raising taxes and cutting benefits to increasing quality while cutting costs  Key obstacles are lack of awareness, systemic incentives toward crisis-oriented care  U.S., Japan, EU beginning to see technology-based chronic care improvement as way to meet challenge of aging populations and foster a new industry  Medicare transformation can keep program solvent while spurring innovation in key emerging industry 24

In the most innovative models of care on both continents, health care providers have discovered that delivering better care with fewer resources can be possible with a proactive approach to supporting and monitoring patients at home rather than waiting for the inevitable complications of neglect. On both continents, healthcare providers have discovered that technology can be a useful tool to improve the effectiveness of care providers and to increase rather than replace personal touch.

In the United States, our healthcare system too often still penalizes rather than rewards prevention, especially in the largest fee-for-service system, Medicare. When it comes to innovation in disease management and prevention, we claim that we “can’t afford it,” while in a much poorer country in the heart of Africa, the government and the health system are working together to embrace innovation in home and community-based care because they can’t afford not to do it.

We have something to learn from innovations arising in places like Rwanda, where necessity truly is the mother of invention. Learning from such innovations can help us expose some of our own false dichotomies that too often have become an excuse to stifle innovation.

On Lok High Tech Chronic Care Transcript

• Slide 1: High Tech and Personal Touch: Case Studies in Chronic Care from United States and Africa Steve Brown, Founder and Former CEO, Health Hero Network On Lok Lifeways Conference, October 22, 2008 Sustainable Long Term Care: Ethics, Technology and International Perspectives
• Slide 2: Agenda   Background – Health Hero Network   Chronic Care Models   Example from US   Example from Africa   False Dichotomies in Chronic Care   A Better Mental Model
• Slide 3: Background: Health Hero Network We recognized a problem Too much effort spent treating the complications of chronic disease, and not enough on preventing them We had an idea A technology platform to enable a better model of care based on identifying problems early and changing behavior
• Slide 4: Health Buddy in 2008: Patients receive better support and monitoring at home   Daily check-in starts with “how are you feeling today”   Reporting symptoms and device readings like glucose and weight   Receiving supportive feedback and education
• Slide 5: Health Buddy 2008: Nurses can identify problems early and prevent complications   Dashboard to see how all patients are doing today.   Patients needs are triaged using red, yellow, green coding   Full picture includes symptoms, behavior and knowledge
• Slide 6: Why is innovation addressing the chronic care problem so painfully slow?   It is well known that monitoring high risk patients at home can improve care and reduce hospitalizations.   ABC World News Tonight featured Health Buddy way back in 1999 and predicted a new model of care for the 21st century.   The business of healthcare – especially in Medicare – still rewards treating complications far more than preventing them
• Slide 7: Meanwhile in Rwanda Africa, necessity is the mother of invention   Community health workers support and monitor at-risk patients at home   Focus on the simple things that have the biggest impact   Everything starts with “how are you feeling today”
• Slide 8: Partners in Health is a community-based model focused on prevention and education   The regional hospital sees its mission as preventing hospital admissions   Training community health workers to extend care into the community   Keeping organized and tracking patients with an open source electronic medical record system
• Slide 9: False Dichotomies in Chronic Care   High Tech versus Personal Touch   Improving Care versus Saving Money   Information Technology versus Simplicity
• Slide 10: False Dichotomy: Tech versus Touch. Explain the growth in social media! Life can be richer when we share more of it. 10 Lifeways Conference – Steve Brown 10/22/08
  Slide 11: False Dichotomy: Improving Care versus Saving Money
• Slide 12: False Dichotomy: Hi Tech versus Simplicity How About a Better Mental Model! Value Potential Value Cost Opportunity Realized Value Complexity
• Slide 13: Content can change the shape of the Potential Value Curve   Example: congestive heart failure, the leading hospital admission in Medicare   Focus on areas where you can make a difference.   Start with the simple things first
• Slide 14: Design can change the shape of the Realized Value Curve   Simplicity must be a strength
• Slide 15: Disruptive technology has radically changed the shape of the Price Curve   Cloud computing and resources   Open source tools for everything   Consumer electronics with open APIs   Result: 100x or greater capital efficiency
• Slide 16: Conclusions   High Tech can increase Personal Touch   Technology is just a tool, not a transformation   Apply the mental model to choose wisely   We can gain insights and inspiration in how to improve care and leverage technology from innovative models of care in highly resource constrained environments

Abstract:

In the last century, technological innovation was propelled by a race to conquer nature and spread a modern lifestyle premised on an unspoken belief in unlimited resources. Now we find with ourselves with depleting resources and unsustainable systems for healthcare, energy, agriculture, water, and the environment. As Plato wrote over 2000 years ago, “Necessity is the mother of invention.” The great unmet needs of the current century relate to sustainability: How can we create sustainable systems for quality healthcare, agriculture, energy, and other sectors? These challenges are uniquely appropriate for innovation in life sciences, with new solutions enabled by the convergence of biotechnology and information technology. With the new challenges of our time, a new generation of entrepreneurs, scientists, and inventors will be inspired to apply their energy and ideas by starting new ventures. This talk will describe an entrepreneurial approach to life sciences innovation and will discuss how to create and foster an innovation culture targeting the great needs and challenges of our time.

Bio-VC Innovation Transcript

• Slide 1: Creatng
a
Winning
Life
Sciences Innovation
Strategy
in
an
Era
of
Scarcity; Steve
Brown,
Chairman,
Billionlights
Foundation; Founder
and
Former
CEO,
Health
Hero
Network (acquired
by
Robert
Bosch
GmbH);
Saturday,
October
11,
2008
 Dalian,
China
• Slide 2: Necessity, who is the mother of invention.
Plato,
360
B.C.
• Slide 3: Creatng
a
Winning
Innovation
Strategy; An
Entrepreneur’s
Perspective; Roots
of
Life
Sciences
Innovation: 1. Identify
Great
Problems; 2. Seek
New
Connections; 3. Tap
Into
Passion; Questions
to
ask
Innovative
Companies
• Slide 4: Health
Hero
Network
Story;
We
recognized
a
problem: Too
much
effort
spent
treating
the
complications
of
chronic
disease,
and
not enough
on
preventing
them; We
had
an
idea: A
technology
platform
to
enable
a
better model
of
care
based
on
identifying problems
early
and
changing
behavior
• Slide 5: We
Filed
Some Patents
• Slide 6: Raised
Capital
and
Built
a
Technology
Platform
• Slide 7: Won
Key
Customers
and Proved
the
Idea
Worked
• Slide 8: Lobbied
Government
to
Recognize Remote
Monitoring
• Slide 9: Showed
Promise
in
Medicare,
• Slide 10: Then
a
Large
Company
Acquired
Us.
• Slide 11: We
Also
Had
Some
of
This
in
Between…
• Slide 12: Innovation Key #1: Identify Great Problems
• Slide 13: This
is
a
New
Era
with
New
Necessity;
20th
Century:
 Conquer
Nature;  Assume
Unlimited
Resources;  Physical
Sciences
and Industrial Technology; 21st
Century:
 Respect
Nature; Assume
Limited
Resources; Life
Sciences
and Information
Technology
• Slide 14: Emerging
and
Drug
Resistant
Disease
• Slide 15: Lifestyle
that
Begets
Chronic
Disease
• Slide 16: The
Most
Basic
Needs:
Food
and
Water
• Slide 17: Sustainability:
Promise
and
Peril
• Slide 18: Not
Everyone
Agrees
on
Solutions
• Slide 19: Solutions
Include
Technology
and
Behavior
• Slide 20: Every
Problem
is
Part
of
a
Network
• Slide 21: Innovation Key #2: Seek New Connections
• Slide 22: Innovation
Happens
at
the
Connections
• Slide 23: Multiple
Paths
Address
Same
Problems: Both
innovations
improve
diabetes
care; Both
combine
preexistng
elements
in
new
ways; One
is
a
chemical
entity,
the
other
IT; One
treats
the
human
body,
the
other
behavior
• Slide 24: Life
Science
is
Information
Science
Part
of
the
DNA
code
to
determine
eye
color… Part
of
the
binary
code
to
make
an
eye
image…
• Slide 25: Valuable
Innovations
Simplify
Complexity… and
Stand
on
Many
Shoulders
• Slide 26: Beauty is truth, truth Beauty, ‐ that is all ye know on earth, and all ye need to know. John Keats
• Slide 27: Innovation Key #3: Tap Into Passion
• Slide 28: Is
it
Popular
Passion
or
Real
Passion?
• Slide 29: Barometer
of
Popular
Passion
• Slide 30: Pusng
Popular
Passion
in
Perspective
• Slide 31: Pusng
Popular
Passion
in
Perspective
• Slide 32: Pusng
Popular
Passion
in
Perspective
• Slide 33: New
Connections
are
Stirring
• Slide 34: People
Desire
Connection…Passion
is
Infectious
• Slide 35: Why Passion Matters
• Slide 36: Questions
to
ask
Innovative
Companies: What
is
the
big
idea? Does
this
company
address
a
big
problem,
or
is
it
a
 “tuck
in”
to
someone
else’s
big
idea? What
is
the
new connection? Where
is
the
solution
on
the
overall
network
of
 approaches
addressing
the
problem? Do
innovators
stand
on
many
shoulders
to
find
new connections
and
simplify
complexity? Where
is
the
root
of
the
passion? Is
there
a
source
of
passion
strong
enough
to
attract the
best
people
and
enable
them
to
persevere?
• Slide 37: What Passion Looks Like

Conference Programme

Tuesday 28 November 2006
20.00 – 22.00	Welcome Reception – Registration
Wednesday 29 November 2006
08.00 – 09.30	Registration with Coffee and Tea
	Plenary Session 1
09.30 – 09.40	Opening Jack van Gelder • Chairman of the day Well known Dutch TV Journalist, Announcer
09.40 – 09.55	Welcome address Martin Eurlings • Minister Economic Affairs Province of Limburg
09.55 – 10.15	Strengthening the regional silver economy Marion Gierden-Jülich • Secretary of State for Generations, Family, Women and Integration, North-Rhine Westphalia
	Trends 1
10.15 – 10.45	Turn Silver into Gold – creative entrepreneurship Mary Furlong • Professor Entrepreneurship, Santa Clara University California (USA) Mary Furlong was founder of Seniornet (1986), ThirdAge Media (1996) and Mary Furlong and Associates (2002). The 45- to 64-year-olds are among the fastest-growing population of Internet users, and they spend more time on the web than their college-aged kids. Marketers who want to reach this group have to learn the right code. Download presentation (Powerpoint)
10.45 – 11.15	Coffee break
	Plenary Session 2
11.15 – 12.45	Towards a longer working life – ageing and the quality of work life Juhani Ilmarinen • Professor For Age Management and Work Ability Finnish, Institute of Occupational Health Thanks to the pioneering work of Juhani Ilmarinen Finland has won the Bertelsmann Prize this year for outstanding performance in the field of Active Ageing in the Economy and Society. Investments in the Work Ability of workers lead to a return of 12 to 30 times the original investment. Download presentation (Powerpoint) Remote health monitoring and management Stephen Brown • President, Health Hero Network (USA) Stephen Brown is the founder of Health Hero Network, a company now recognized as an industry leading innovator and solution provider for remote health monitoring and management in the USA with cost effectiveness for major healthcare institutions Download presentation (Powerpoint)Chances and choices in an ageing society Dolf van den Brink • former Member of the Board, ABN/AMRO Bank Co-author of the book ‘Vergrijzing Leeft’ on Ageing in The Netherlands – The ABN AMRO Bank is on the forefront of banks who invest in strong relationships with older clients by adapting and developing services. Download presentation (Powerpoint)Bayard: a winning publisher’s strategy targeted to the mature people Maxime de Jenlis • General Manager, Bayard Group Benelux De Jenlis developed six magazines for seniors in European countries, one of which is Plus Magazine in the Netherlands with a total circulation of nearly 1 million and a turnover of approx. 50 million Euros, including brand extension activities. Download presentation (Powerpoint)
12.45 – 14.00	Lunch at Rodahal
	Break Out Sessions 1
14.00 – 15.15	Health and Lifestyle
	Trends in prevention Chairman • Onno van Schayck, Professor Preventive Medicine, co-Director Research Institute CAPHRI Personalized Nutrition – Relevant for the silver generation Rob Beudeker • Business Unit Director/VP Personalized Nutrition, DSM Rob joined Gist-brocades in 1984 and has held various management positions at Gist-brocades and DSM Food Specialties since. At present he is responsible for New Business Development at DSM Food Specialties and acts ad interim as VP Personalized Nutrition at the DSM Innovation Center. Download presentation (Powerpoint) Health creates wealth – meeting the legitimate demands of an ageing population for innovative and high quality health care Rory O’ Connor • Vice President Medical Affairs, Pfizer, Europe/Canada Pfizer is one of the world’s largest enterprises; with 100,000 employees and 12,000 medical researchers. Pfizer manufactures pharmaceuticals for 38 million patients worldwide. Motto: “Adding years to life, and life to years.” Download presentation (Powerpoint) Valueing the 50 plus consumer Klaus Ruhnau • Vice President Marketing Solution Management, Hartmann AG Hartmann AG (yearly turnover 1.2 billion) is known for its variety of products for wound treatment management and skin treatment continence management and for succesful communication with 50 plus consumers. Stay in touch with the older consumer or you will have to learn it the hard way. Download presentation (Powerpoint) Prevention as a challenge for the health care sector Guus Broos • Member of the Board of Orbis Medical and Healthcare Group of Companies Orbis is active in cure, care, independent and assisting living and homecare services. Orbis operates a hospital (Maaslandhospital), 10 independent and assisting living homes, homecareorganisation and a hospice in the region of Limburg. Real estate development for older people. Download presentation (Powerpoint)
14.00 – 15.15	Living and Home Environment
	Living and Home Environment Chairman • Alex Sievers, Senior Consultant, INBO Advisors Real Estate Senior communities: are they the future? Sun City – recreation in the adult community Don Schordje • President, Recreation Centres of Sun City (RCSC) The RCSC manages the seven recreation centres in the first active adult community in the world: Sun City. RCSC is a non-profit organization that operates the Sun City recreational facilities for the benefit of its members. To develop and build for seniors – challenge of the century Rob de Jong • Director, TCN Property Projects TCN Property Projects is one of the Netherlands’ top project developers, distinguishing itself through innovative concepts and creativity in design, management and financing. TCN is involved in the initiative ‘Senior City’. Builders and developers have to acknowledge the preferences and wishes of older people. Download presentation (Powerpoint) Living together – intergenerational living forms Thomas Möller • Manager, Freie Scholle The Freie Scholle is housing corporation, which distinguishes itself in the debate about new living arrangements for seniors with a preference for intergenerational living arrangements. Villages and, cities should offer people of all ages a variety of choice, so that people of all ages can meet, talk, support and serve each other in daily life.
14.00 – 15.15	Work and Income
	Chairman • Paul Staal, Arbo Unie, vice chairman BOA, chairman STECR, platform ReintegrationAge management and return on investment in older workers Juhani Ilmarinen • Professor For Age Management and Work Ability, Finnish Institute of Occupational Health Thanks to the pioneering work of Juhani Ilmarinen Finland has won the Bertelsmann Prize this year for outstanding performance in the field of Active Ageing in the Economy and Society (‘Towards a longer Worklife!’). Investments in the Work Ability of workers lead to a return of approx. 12 to 30 times the original investment. Download presentation 1(Powerpoint) Download presentation 2 (Powerpoint)
14.00 – 15.15	Tourism and Culture
	Travelling Chairman • Dick Knook, Professor of gerontology emeritus, University of Leiden and ‘Senior’ Consultant The future (of tourism) belongs to the seniors: Challenges of a fast growing market Dick Knook • Professor of gerontology emeritus, University of Leiden and ‘Senior’ Consultant Dick Knook published the book Seniors & Tourism. Tourism will become one of the world’s main economic sectors in this century, which will also see a strong ageing of the population in many countries. The confluence of these two trends is opening up numerous opportunities. Download presentation (Powerpoint) A world to win Richard Smits • Director Tour Operator Maaskant Reizen Maaskant Reizen is active in the market for Third Agers in the Netherlands, organising round trips ans excursions throughout Europe. Download presentation (Word) Travelling with a handicap Fini de Paauw • Publisher Blauwe Gids (Accommodation Guide for persons with a handicap) and Vice President of the National Council for the Handicapped and Chronically Ill Handicapped people face numerous barriers in accommodations and transport. They represent a fast growing market segment, also because of the ageing of the population. A chance for entrepreneurs.
14.00 – 15.15	Communication and Networking
	Media and Communication Chairman • Jack van Gelder, Journalist, Announcer Effective communication – how to do it? Maxime de Jenlis • General Manager, Bayard Group Benelux De Jenlis developed six magazines for seniors in European countries (one of which is Plus Magazine in the Netherlands) with a total circulation of nearly 1 million and a turnover of approx. 50 million Euros. Download presentation (Powerpoint) Innovation in the media: the advance of seniors Jan Slagter • Director and Chairman, Max Broadcasting In only a few month’s time, Max´s programmes became the best watched programmes in the Netherlands. The ‘50PlusBeurs’ (50PlusFair): the world’s largest communication platform and market place Alexander van de Kerkhof • Director, 50PlusBeurs With 560 exhibitors and 100,000 visitors the 50PlusFair is THE annual event for 50+ people in the Netherlands. Download presentation (Powerpoint)
15.15 – 15.45	Coffee Break
	Break Out Sessions 2
15.45 – 17.00	Health and Lifestyle
	Chairman • Onno van Schayck, Professor Preventive Medicine, co-Director Research Institute CAPHRICare technology for the silver century Maarten Janknegt • Member of the Board of Directors, Siemens Netherlands NV Arthur de Bos • Project Development, Siemens Siemens´ Medical Solutions division is one of the world’s largest suppliers of the health care industry. The company is reknown for linking innovative medical technology, health care information systems, management consulting, and support services to help customers achieve tangible, sustainable, clinical, and financial outcomes. Download presentation (Powerpoint)Technology as condition and driver for economic participation of senior citizens. Lessons from European comparative studies Lutz Kubitschke • Researcher, Empirica Ingo Meyer • Empirica Empirica is one of Europe’s leading research institutes in the field of technology and ageing. Lutz Kubitschke led programmes such as SeniorWatch which is at the base of many new developments. Scenarios for future independent living Josephine Dries • Researcher TNO Information and Communication, the Netherlands Organisation for Applied Technological Research Josephine Dries has over nine years experience in researching the relationship between ICT and older people and new design concepts of ICT applications (user centered design) involving older persons. Download presentation (Powerpoint)
15.45 – 17.00	Business development
	Master class Entrepreneurship Reaching out successfully to baby boomer and senior consumers Mary Furlong • Professor Entrepreneurship, Santa Clara University California Mary Furlong was founder of Seniornet (1986), ThirdAge Media (1996) and Mary Furlong and Associates (2002). The 45- to 64-year-olds are among the fastest-growing population of Internet users, and they spend more time on the Web than their college-aged kids. Those who want to reach this group have to learn the right code. Download presentation (Powerpoint)
15.45 – 17.00	Work and Income
	Workplace Innovation Chairman • Paul Staal, Arbo Unie, vice chairman BOA, chairman STECR, platform Reintegration Ireland’s National Workplace Strategy – supporting older workers Cathal O’ Regan • Head of Workplace Strategy at Ireland’s National Centre for Partnership and Performance Recent policy developments in Ireland reflect a commitment by Government and the Social Partners to supporting older workers and recognising their vital role in Ireland’s growing knowledge economy. These developments are outlined by Cathal O’ Regan of the NCPP, which acts to support such policy developments. Download presentation (Powerpoint) Age as a part of diversity management: A business case Mike Sharrock • Managing Director, BP Netherlands Demographic change as one real challenge for BP, one of the largest energy suppliers in the world… Download presentation (Powerpoint) Life course policies in organisations: a quick scan Dorinde Brands • Advisor, Expertise Centrum Leeftijd (Expertise Centre on Age and Life course) The Expertise Centre has more than ten years experience of successfully influencing national and European legislation and the legal infrastructure against age discrimination and for the equal treatment of people of all ages. It supports employers and employees in redesigning age strategies and investments following a life course perspective. Download presentation (Powerpoint)
15.45 – 17.00	Tourism and Culture
	Cultural Entrepreneurship Chairman • Conny Groot, Director of Catharsis Producties Amsterdam The silver economy from a film producers view San Fu Maltha • Film Producer San Fu Maltha, one of the Netherland’s key producers, produced a.o. the highly successful features ‘Phileine says sorry’ and ‘In Orange’. Recently he released the biggest Dutch language film ever. Paul Verhoeven’s epic war thriller BLACK BOOK. Download presentation (Powerpoint) Cultural entrepreneurs – exploring the silver market Hans Jörg Schütz • Film-Kommunikation – Agentur für Filmmarketing Weimar The world of the cinema sometimes seems an exclusive world of popcorn chewing youngsters who watch the latest movies. Film Kommunikation developed new marketing concepts to attract older audiences to see high quality film. Download presentation (Powerpoint) Bealtaine Festival Ireland: Celebrating creativity at an older age Sue Russel • Director, Bealtaine Festival This annual event in May involves all of the main Irish cultural and artistic institutions, attracts 35,000 older visitors in hundreds of events and has become one of the largest Irish festivals. Download presentation (Powerpoint)
15.45 – 17.00	Communication and Networking
	Older consumers in focus Chairman • Jack van Gelder, Journalist, Announcer Adapting marketing and product strategies to the untapped silver potential Pieter Paul Verheggen • Trend Watcher, Motivaction A Motivaction survey showed that the web and computer industry left a silver market of 500 million Euros untouched. Download presentation (Powerpoint) Supermarket for all generations Ulrike Stöcker • Manager press and communications, EDEKA Unternehmensgruppe Nordbayern-Sachsen-Thüringen Edeka developed a successful, award-winning supermarket concept aiming at all generations and taking into account the ageing consumer. Download presentation (Powerpoint) Matching staff and consumers: a winning team B&Q (to be confirmed) The most well-known and successful age diversity story is the story of B&Q, warehouse for home and garden. Optimising the match between customers and staff in terms of age leads to a considerable increase of consumer satisfaction and 20% increase of turnover.
19.00 – 22.00	Dine Around Tour, Maastricht
Thursday 30 November 2006
08.00 – 09.00	Registration with Coffee and Tea
	Plenary Session 3
09.00 – 09.05	Opening Jack van Gelder • Chairman of the day Well-known Dutch TV Journalist, Announcer
	Trends 2
09.05 – 09.45	Longevity and pension reform – the silver economic perspective Dick Sluimers • acting chairman of the Board of Directors of ABP ABP: the pension fund for employers and employees in service of the Dutch government and the educational sector. With an invested capital of EUR 160 billion and 2.4 million customers ABP is Europe’s largest and the world’s second largest pension fund. Download presentation (Powerpoint)
09.45 – 10.30	Do’s and dont’s in communicating to aging boomers and seniors – illustrated by TV campaigns from the world Jean-Paul Tréguer • CEO of Senioragency International, the 1st international advertising network dedicated to 50+ consumers, based in 12 countries. Jean-Paul Tréguer is one of the world’s top silver marketers and author of ‘50+ Marketing’ (Palgrave Publisher).
10.30 – 11.00	Coffee Break
	Plenary Session 4
11.00 – 12.45	The AARP global network on business development Ladan Manteghi • AARP (50 plus member organisation USA) AARP has 36 million 50 plus members, issues ‘AARP The Magazine’ with a circulation of 22 million households, offers its members numerous services. AARP launched the AARP Global Network this year as a business to business association aiming at ensuring the needs of the ever growing global ageing population. Download presentation (Powerpoint)Living in Sun City keeps you alive Don Schordje • President, Recreation Centres of Sun City (RCSC) The RCSC manages the seven recreation centres in the first active adult community in the world: Sun City. RCSC is a non-profit organization that operates the Sun City recreational facilities for the benefit of its members.Ageing Society: New Opportunities? Peter van Leeuwen • Managing director, ING Bank, the Netherlands Are we to face a collapse of publicly financed pensions, or will a whole range of new arrangements arise to mitigate these financial problems and give way to new ventures? As Managing Director Institutions at ING Peter is responsible for service and product development for the public health sector and the public sector. Peter van Leeuwen also is Managing Director of ING Medinet, the centre of expertise for public health care. ING Medinet regulary publishes (sector related) research and organises events on various health care topics. Download presentation (Powerpoint) Care technology for the silver century Maarten Janknegt • Member of the Board of Directors, Siemens Netherlands NV Arthur de Bos • Project Development, Siemens Siemens´ Medical Solutions division is one of the world’s largest suppliers of the health care industry. The company is reknown for linking innovative medical technology, health care information systems, management consulting, and support services to help customers achieve tangible, sustainable, clinical, and financial outcomes. Download presentation (Powerpoint)
12.45 – 14.00	Lunch Rodahal
	Break Out Sessions 3
14.00 – 15.15	Health and Lifestyle
	Health Chairman • Paul Staal, Arbo Unie, vice chairman BOA, chairman STECR, platform Reintegration Healthy ageing – a consumers perspective Frans van der Ouderaa • Researcher, Unilever Corporate Research UK As one of the largest food businesses in the world Unilever makes a big impact on people’s health. Its mission is to add vitality to life. Frans van der Ouderaa is a specialist on the impact of food on older persons. Download presentation (Powerpoint) The Funding factor: Vitality & Insurances Alexander Korbee • Business Development Manager Prevention, Achmea Social Security Achmea is one of the largest insurance companies of the Netherlands, investing heavily in health and prevention related services. The core of these services is “The “Vitaliteitshuis” concept. The person responsible for these services and this concept as part of the business development activities of Achmea, is Alexander Kobree. Download presentation (Powerpoint) Technology supporting Health & Lifestyle Jeannette de Noord • Senior Director New Business Creation in the Business Unit Consumer Health & Wellness of Philips Electronics Jeannette’s work has a strong focus on the senior consumer. Royal Philips Electronics (headquartered in the Netherlands; 126.000 employees worldwide) is a global leader in healthcare, lifestyle and technology, delivering products, services and solutions through the brand promise of “sense and simplicity”.
14.00 – 15.15	Living and Home Environment
	Chairman • Alex Sievers, Senior Consultant, INBO Advisors Real EstateKey values and senior living, silver power – stimulation program Kees Penninx • Senior Policy Officer, Netherlands Institute Care and Welfare Zilveren Kracht (Silver Power) is a national stimulation program on civil society and living environment. It supports organisations and persons in staying productive and use their skills, knowledge and experience of seniors for the benefit of the community.Regional planning and development Alex Sievers • Senior Consultant, INBO Advisors Real Estate Walter Brouwers • Province of Gelderland INBO is an independent agency for regional planning and development, future vision development for neighbourhood and local community strategies. Sievers took the initiative for the project Senior City.
14.00 – 15.15	Work and Income
	Financial Services Chairman • Wil Foppen, Director of the Universiteit Maastricht Business School and Associate Dean of the Faculty of Economics & Business Administration of Universiteit Maastricht. Serving the silver economy Norbert Wahl • Director, Sparkassen- und Giroverband Rheinland-Pfalz The savings bank is a major player in the regional economy and takes an active role in developing silver economy strategies. Some building blocs for a sustainable solution of ageing in Belgium Frank Lierman • Chief Economist Dexia Bank, Belgium New financial arrangements for seniors Peter van Leeuwen • Member of the Board of Directors, ING Group, the Netherlands Download presentation (Powerpoint)
14.00 – 15.15	Tourism and Culture
	Health Tourism Chairman • Josef Hilbert, Director health Industries – Institute Work and Technology, Gelsenkirchen Creating a European network on health tourism Josef Hilbert • Research Director Health Industries, Institut Work and Technology, Gelsenkirchen. Josef Hilbert is responsible for development and initiatives on health tourism und “Kurorte” in German regions North Rhine Westphalia and Mecklenburg Vorpommern. Download presentation (Powerpoint) Health and prevention – a new role for spa’s Eberhard Volger • Doctor for Sebastian Kneipp Institut – Europäisches Centrum für Naturheilverfahren Demographic change urges us all to concentrate at prevention. Create better conditions for productive ageing in the future. Health Institutions such as ‘Kurorte’(spa’s) may have a new and important role to play. Download presentation (Powerpoint) Dutch market for spa’s – a work in progress Sjef van der Linden • professor rheumatology Maastricht Long term effects of spa therapy Marlies Sobczak-Boumans • spa expert A future full of chances Download presentation (Powerpoint)
14.00 – 15.15	Communication and Networking
	Doing business through seniors organisations Chairman • Jack van Gelder, Journalist, Announcer The AARP global network on business development Ladan Manteghi • AARP – 50 plus member organisation USA AARP has 36 million 50 plus members, issues ‘AARP The Magazine’ with a circulation of 22 million households, offers its members numerous services. AARP launched the AARP Global Network this year as a business to business association aiming at ensuring the needs of the ever growing global ageing population. Download presentation (Powerpoint) The big deal Arno Heltzel • Seniors Association Unie KBO Paul Mulder • Achmea Insurances The seniors association with 300,000 members and Achmea Insurances provide health insurance for older persons. A success story. Download presentation (Powerpoint) Supporting the silver economy – not just for profit Daniël de Levita • adjunct Director, Seniorweb Raquel Wanrooij • Rabobank – Case Study Seniorweb is a website and computer learning community in The Netherlands with 60,000 members in the 50 plus age groups. Teaching older persons to use the computers and use internet banking is certainly serving the development of the silver economy. Download presentation (Powerpoint)
	Plenary Session 5
15.30 – 16.00	Closing Session Announcement of next conference Award: Winner of the Best Practice Competition Final Conclusions

Transcript

Slide 1: Caring for People with Chronic Illness: The Role of Telehealth Technology Steve Brown CEO, Health Hero Network 29 November 2006

Slide 2: Our Shared Vision A better model of care serving people who struggle with chronic conditions.

Slide 3: What the world is thinking about right now:

Slide 4: What the world is thinking about right now:

Slide 5: What the world is thinking about right now:

Slide 6: What the world is thinking about right now:

Slide 7: What the world is thinking about right now:

Slide 8: What do we want?

Slide 9: What’s Telehealth Got To Do With It? A Better Model of Care = Change Behavior and Moving Care to the Home

Slide 10: How to Change Behavior and Move Care to the Home • Personal Coaches for Everyone? • Nurses with Phones? • Nurses with Cars? • Doctors with Phones and Cars? Remote Health Management Technology! What Gets Measured Gets Done!

Slide 11: The Market Has Arrived “ r. B ohana, an 82-year-ol W orl W arII M d d vet , has been abl t m ove from l vi i eran eo i ng n hospi underround-t -cl m edi ce he ock cal supervi on t a B rookl st o apart entw i h si o yn udi m t t hel ofa rel i y si pl m oni ori he p at vel m e t ng syst from H eal h H ero N et ork. em t w The hand-hel H eal h B uddy consol , w hi d t e ch pl i o hi phone, del vers hi bl ugs nt s i s ood pressure erans A ffai nurse. and w ei ghtreadi t a V et ngs o rs Ital prom pt hi t answ era seri of so smo es qual t i quest ons abouthi l i at ve i s ung and ci at ai m ent , l ke w het rcul ory l si herhi breat ng s hi i bet erorw orse t t day before. st han he “ s i so si pl a 2-year-ol coul do i , Thi s me d d t” M r. B ohana sai .” d

Slide 12: Success Story: Veterans Administration February 2006 Today • 16,000+ patients enrolled in daily home telehealth with Health Buddy • Deployed in 120+ clinical sites • Over 100 programs for 30+ chronic conditions

Slide 13: Care Management Process with the Health Buddy System Scripted messaging, monitoring and reporting platform Education, monitoring Personalized, remote care and feedback at home management and support.

Slide 14: Technology Enabled Model of Care The Health Buddy System Technology Provider Patient Enabled Directed Centric

Slide 15: Expanding the Reach of the Health Buddy System The Next Step: Platform Independent Content Delivery Solutions

Slide 16: Health Buddy Teleguidance Health Buddy Teleguidance Project Contributors: Health Hero Network • Delivery of Health Buddy Meavita Program content through the Sananet B.V. television with IPTV Impact Media • Pilot Program – Available for Meavita customers in the Netherlands – Initial program for diabetes patients – Health Buddy Teleguidance will Launch in 2007

Slide 17: Care Management Process: Technology-enabled, Provider-directed Model Health Buddy Desktop • Keeps care provider “in touch” with patient – Monitor patient daily – Assess patient risk – Identify change in patient’s health – Intervene before crisis occurs • Improves productivity • EMR Integration • Secure web application

Slide 18: Health Buddy Desktop: Tools to Enable Management by Exception

Slide 19: Health Buddy Programs  Adult Asthma 2  Hyperlipidemia • Library of 100+ programs  Advanced Illness /  Hypertension 1 • Over 30 health conditions  Med. Compliance Palliative Care  Anticoagulation  Myocardial Infarc. • English & Spanish  Bipolar Disorder  Pain Mgt 2 •  Cancer 2  Pediatric Asthma 2 Ready to deploy  Caregiver  Polypharmacy • Customizable  COPD 1  PTSD  Coronary Artery 2  Pre-Diabetes  Cystic Fibrosis  Schizophrenia  Depression 2  Sr. Wellness – Evidence based practice  Diabetes 1  Substance Abuse guidelines  Functional ADLs  Smoking Cessation – Patient education  Heart Failure 1  Spinal Cord Injury – Care management  Hepatitis C  Weight Mgt  HIV

Slide 20: Care Management Process: Personalized Coaching and Monitoring • Dynamic branching logic collects information on: – Symptoms – Behavior – Knowledge • Delivers unique reply to each patient response in the form of – Call to action – Information / education – Further assessment – Reinforcement / reminder – Acknowledgement

Slide 21: Care Management Process: Creating Feedback Loops Knowledge • Identify high risks & potential problems Behavior • Address needs through dynamic content Symptoms H M L Knowledge • Move risks to lower levels Behavior • Stabilize health status Symptoms H M L • Identify changes in status Knowledge early on Behavior • Manage by exception Symptoms H M L Stabilize Patients Over Time

Slide 22: VA Outcomes 2002: Telehealth Reduces Inpatient Utilization* • 40% reduction in ER visits • 63% reduction in hospital admissions • 63% reduction in hospital bed days of care • 64% reduction in nursing home admissions • 88% reduction in nursing home bed days 1-Year Telemedicine Care Coordination • Significantly improved Quality of Life SF36V Demonstration * Published in Disease Management Volume 5, Number 2, 2002.

Slide 23: VA Outcomes 2005: Telehealth Improves Clinical Outcomes* • Hospitalizations declined from 630 inpatient days pre to 122 during intervention period • Bed Days Of Care fell from 8.63 to 1.65 (p < 0.001) • Blood Pressure: 129/73 to 119/69 (p < 0.05) • Weight: 196 to 192 (p < 0.01) • Shortness of Breath 0-10 Scale: 4.0 to 2.7 (p = 0.02) 1-Year Telemedicine • ACE Inhibitor Avg Daily Dose: 24mg/d to 35 (p < 0.01) Care Coordination  -Blocker Avg Daily Dose: 84 mg/d to 94 (p = 0.05) Demonstration * Published in Telemedicine and e-Health Volume 11, Number 1, 2005.

Slide 24: SPAN-CHF II Study 2005: Telehealth Reduces Hospital Readmissions* All Cardiac 2.5 Heart Failure Hospitalizations Re-Hospitalizations 2.0 2.20 63% 1.82 Reduction 72% 1.5 (p=0.029) Reduction 1.0 (p=0.03) 3-Month CHF Study 0.81 0.5 0.51 Hospitalizations PPPY 0.0 Control Health Control Health Buddy Buddy * Presented at American Heart Association Annual Meeting, Scientific Sessions, 2005.

Slide 25: Mercy Study: Compliance Drives Outcomes Medication Compliance as Hospitalization Costs for CHF Measured by Pharmacy Claims patients decreased 52% PPPY and Patient Self-reporting 100% $25 80% $20 $25,013 94% 1-Year Diabetes & 60% $15 HF Study 40% $10 $11,854 34% 20% $5 0% $0 Before Health Buddy Standard Health Buddy

Slide 26: Patient Acceptance Patients enjoy significant improvements in quality of life1 • 95% patient satisfaction2 • 86% better understand their treatment and are better able to manage their health condition • Patients feel more connected to their care provider2 1 Diabetes Technology & Therapeutics, Volume 4, Number 6, 2002. 2. Henry Ford Medical Center, CAD Study, 2004. (n=602)

Slide 27: The People We Serve “Health Buddy is the best thing to come down the pike. When I get up in the morning, I feel confident I am good for another day.” Wally Browning 1941-2006

Slide 28: Contact Information: Steve Brown, CEO Health Hero Network, Inc. 2000 Seaport Blvd. Fourth Floor Redwood City, CA 94063 stevebrown@healthhero.com 650-779-9101

This is the presentation I gave for the Emerging Opportunities in Home Management and Health Applications session of the Connections Digital Living Conference hosted by Parks Associates and CEA, May 4, 2006.

Connections Digital Living Conference Transcript

• Wiring the world for a new model of health care
  Steve Brown, CEO, Health Hero Network
  Emerging Opportunities in Home Management and Health Applications
  Connections Digital Living Conference, May 4, 2006
• Health Hero Network
  Our mission is to create a better system of care serving people who struggle with chronic conditions
• US Healthcare in 2006
  16% GDP
  $2,100,000,000,000
• US Healthcare in 2015
  20% GDP
  $4,000,000,000,000
• Portion of healthcare spending on people with chronic conditions
  78%
• What does it all add up to?
  $69,900,000,000,000
  -Present value of unfunded liabilities in Medicare,
  Federal Reserve Governor Edward Gramlich, April 21, 2005
• What’s Our Diagnosis?
  The current model of institution-centered care, based on crisis response, with inadequate attention to managing chronic conditions, is not sustainable and must change
• Chronic Conditions Defined
  Conditions that can’t be cured but must be managed
  Often caused or made worse through behavior
  Lifestyle factors: Smoking, obesity, stress
  Can be improved through behavior change
  Medication compliance, diet, exercise
  Early detection and intervention
  Patients cannot be passive
• Disease Management Defined
  Disease Management Association of America:
  “Disease management is a system of coordinated health care interventions and communications for populations with conditions in which patient self-care efforts are significant.”
• A Brief Look at the Past … and Future?
  Early-Mid 1990s: Managed Care
  Payers monitoring physicians
• A Brief Look at the Past … and Future?
  Late 1990′ – Present: Disease Management
  Payers monitoring patients
• A Brief Look at the Past … and Future?
  The Future: Physicians monitoring patients
  Accountability to payer
  Technology Supported Chronic Care
• What’s “Telehealth” Got to Do With It?
  Chronic care improvement
  = Moving health care to the home
• How to Move Healthcare to the Home
  Nurses with phones?
  Nurses with cars?
  Doctors with phones and cars?
  Technology!
• VA Chronic Care Model
  Daily education, monitoring and feedback at home
  Personalized care management and support
• Health Buddy – Patient Interface
  Symptom management, education, feedback
  FDA cleared communication hub for third party medical devices
• Health Buddy – Provider Interface
  Daily patient status and reports
  EMR integration
  Content development tools
  Clinical programs include
  CHF*
  COPD*
  Hypertension*
  Diabetes*
  Asthma
  Coronary ArteryDisease
  Post CABG
  Osteoarthritis
  Sleep Apnea
  Obesity
  Cancer
  HIV/AIDS
  Dementia
  Depression
  PTSD
  Schizophrenia
  Bi-polar
  Spinal cord injury
  Palliative care
  *NCQA Certified
• VA Chronic Care Results
  Veterans Administration Community Care Coordination Service, Florida
  63% reduction in hospital admissions
  60% reduction in hospital bed days of care
  Published in: Disease Management, Volume 5, Number 2, 2002
  Veterans Administration Heart Failure Study
  81% reduction in inpatient bed days
  Published in: Telemedicine and e-Health Volume 11, Number 1, 2005
• Model at Work Outside VA
  New England Medical Center SPAN-CHF II
  72% reduction in HF hospitalizations
  63% reduction in cardiac hospitalizations
  Presented at Heart Failure Society of America, 2005
  Henry Ford Health System Obesity Study
  >10 lbs weight loss in treatment group
  <.01 lbs weight loss in control group
  To be Published 2006
• Medicare Modernization Act:Section 721
  Section 721: Chronic Care Improvement Defined for Medicare FFS
  1. ELEMENTS OF CARE MANAGEMENT PLANS.—A care management plan for a targeted beneficiary shall be developed with the beneficiary and shall, to the extent appropriate, include the following:
  (A) A designated point of contact responsible for communications with the beneficiary and for facilitating communications with other health care providers under the plan.
  (B) Self-care education for the beneficiary (through approaches such as disease management or medical nutrition therapy) and education for primary caregivers and family members.
  (C) Education for physicians and other providers and collaboration to enhance communication of relevant clinical information.
  (D) The use of monitoring technologies that enable patient guidance through the exchange of pertinent clinical information, such as vital signs, symptomatic information, and health self-assessment.
  (E) The provision of information about hospice care, pain and palliative care, and end-of-life care.
  2. CONDUCT OF PROGRAMS.—In carrying out paragraph (1)(C) with respect to a participant, the chronic care improvement organization shall—
  guide the participant in managing the participant’s health (including all co-morbidities, relevant health care services, and pharmaceutical needs) and in performing activities as specified under the elements of the care management plan of the participant;
  use decision-support tools such as evidence based practice guidelines or other criteria as determined by the Secretary; and
  develop a clinical information database to track and monitor each participant across settings and to evaluate outcomes.
• Medicare Modernization Act:Section 722
  Section 722: Chronic Care Improvement Required in Medicare Advantage
  (2) CHRONIC CARE IMPROVEMENT PROGRAMS.—As part of the quality improvement program under paragraph (1), each MA organization shall have a chronic care improvement program. Each chronic care improvement program shall have a method for monitoring and identifying enrollees with multiple or sufficiently severe chronic conditions that meet criteria established by the organization for participation under the program.
• A New Hope
  Creative public policy can unlock resources for programs that improve chronic care and save money
  Creative business solutions can enable private sector to take risk and guarantee results
  Information technology can enable systems of care that ensure best practices and measure performance

In this presentation at the World Congress for Health & Human Capital Management in Wasnington DC, I described a new Chronic Care Model based on the Health Buddy system and designed to align incentives and enable health care providers to monitor and support patients at home, identifying problems early and educating patients in order to prevent expensive and painful complications of chronic disease.

Transcript

• Slide 1: Breaking the Deadlock: New Partnership Models to Improve Chronic Care Steve Brown, Founder and CEO, Health Hero Network Inc. Health & Human Capital Management Congress, January 25, 2006
• Slide 2: Health Hero Network We develop and market the Health Buddy® System: A patient-centered technology and service platform that empowers individuals to manage chronic conditions at home – with professional monitoring and support.
• Slide 3: Deadlock: Human, Social Costs “Insurers, for example, will often refuse to pay $150 for a diabetic to see a podiatrist, who can help prevent foot ailments associated with the disease. Nearly all of them, though, cover amputations, which typically cost more than $30,000.” – New York Times, January 11, 2006
• Slide 4: The Price of Deadlock $69,900,000,000,000 -Federal Reserve Governor Edward Gramlich, April 21, 2005
• Slide 5: Something’s Got to Give •  Institution-centered care based on crisis response, inadequate attention to care management or prevention •  “Global Aging” combined with “Global Gaining” forcing payers to deal with largest cost driver, chronic illness •  To address these needs, healthcare is going electronic, focusing on the home, reorienting around the patient •  Deadlock persists because of misaligned incentives
• Slide 6: A New Hope •  Creative public policy can unlock resources for programs that improve chronic care and save money •  Creative business solutions can enable private sector to take risk and guarantee results •  Information technology can enable systems of care that ensure best practices and measure performance
• Slide 7: VA Chronic Care Model Daily education, monitoring and feedback at home Personalized care management and support
• Slide 8: VA Chronic Care Results Veterans Administration Community Care Coordination Service, Florida •  63% reduction in hospital admissions •  60% reduction in hospital bed days of care Published in: Disease Management, Volume 5, Number 2, 2002 Veterans Administration Heart Failure Study •  81% reduction in inpatient bed days Published in: Telemedicine and e-Health Volume 11, Number 1, 2005
• Slide 9: Model at Work Outside VA New England Medical Center SPAN-CHF II •  72% reduction in HF hospitalizations •  63% reduction in cardiac hospitalizations Presented at Heart Failure Society of America, 2005 Henry Ford Health System Obesity Study •  >10 lbs weight loss in treatment group •  <.01 lbs weight loss in control group To be Published 2006
• Slide 10: ACCENT / Health Buddy Program •  Consortium of Physician Groups •  Bend Memorial Clinic, Oregon •  Wenatchee Valley Medical Center, Washington •  AMGA oversees clinical protocols, quality management •  Care management process based on Health Buddy® system •  Begins Feb. 1, serving 1,600 high- cost patients with CHF, diabetes, COPD, and co-morbidities
• Slide 11: ACCENT Incentive Model • CMS pays consortium flat monthly fee based on program enrollment • Consortium assumes risk for fees against delivering 5 percent net savings • Consortium receives bonus if savings exceed target
• Slide 12: The Model Revisited •  Organize physicians to take risk, guarantee performance in chronic care •  Technology enables patient self-management / monitoring, ensures accountability •  Model could work for any payer segment •  Opportunity for disease management organizations to work through physicians

HEALTH HERO NETWORK CEO STEVE BROWN TO ADDRESS
ASIA-EUROPE MEETING IN LONDON
Home Health Monitoring Pioneer to Demonstrate how the Health Buddy® System
Is Being Globally Adopted to Improve Chronic Care

London – February 22, 2005 – Nations around the world can use similar approaches – including deploying home health monitoring technologies for people with chronic illness – in dealing with the challenge of aging populations, Health Hero Network CEO Steve Brown will tell an audience of European and Asian government and business leaders today.

Brown will deliver his address, “Advancing Chronic Care with eHealth Technologies in Japan: Proving Global Solutions for an Aging Population” at the annual Asia-Europe Meeting (ASEM) Conference on eCommerce in London. Health Hero Network markets the Health Buddy® system, a comprehensive technology solution for home health monitoring of people with chronic illness. In his speech, Brown will compare the implementation of home health monitoring in Japan in partnership with Yamatake and the deployment of the Health Buddy system in the Netherlands in partnership with Sananet.

“The need to improve chronic care for aging populations is driving very different health care systems to adopt very similar technology solutions,” Brown will say in his speech. “The Health Buddy system has led to dramatic improvements in the health of chronically ill patients in the U.S. and reductions in cost, and our partners are starting to experience similar successes in their initial efforts in their countries.”

ASEM is a multilateral forum for action-orientated debate between the EU Member States and Asian partner countries: Brunei, Burma, Cambodia, China, Indonesia, Japan, Korea, Laos, Malaysia, the Philippines, Singapore, Thailand, and Vietnam. The objective of this conference is to identify ways of increasing trade and investment through the use of online technologies.

About Health Hero Network
Health Hero Network develops and markets the Health Buddy® system for health improvement. The Health Buddy system serves as the interface between patients at home and care providers, facilitating patient education and monitoring of chronic conditions. The system includes monitoring technologies, clinical information databases, Internet-enabled decision support tools, health management programs and content development tools. Through increased communication, behavior modification, and prevention, the Health Buddy system improves the quality of care. Based in Mountain View, California, Health Hero Network’s systems are protected by over 55 issued US patents. http://www.healthhero.com

eHealth Programme

Monday 21 February 2005

08.30 Arrival and Registration

09.30 Plenary Session. Oficial Opening & Introduction
Conference Chairperson: Prof. John OÕReilly, CEO, Engineering and Physical Sciences Research Council

Keynote Speakers:
The Hon. Mike O’Brien, the UK Minister for eCommerce
Sir Richard Sykes, Rector Imperial College, London
Mr Takeshi Natsuno, Managing Director of Planning, i-mode Business Division, NTT DoCoMo Inc. Japan

Summary & Information on Streams

11.00 Coffee Break

11.30 eHealth Stream Session 1
Theme: Medical & Technology Future Convergence.
Chairperson: Professor Ricky Richardson: Vice President, ISFT, Chairman, UK eHealth Association

11.35 AneHealth, Anywhere. Professor Ricky Richardson, Chairman, UK eHealth Association

11.55 The Biological Continuum. Professor Richard Kitney, OBE, Professor of Biomedical Systems Engineering, Imperial College

12.15 The Impact of Molecular Biology on the Practice of Medicine.
Professor Stephen Smith, Dean of Medicine, Imperial College, London

12.35 Interactive Discussion. Chairperson: Professor Ricky Richardson, Vice President, ISFT, Chairman, UK eHealth Association

Professor Ricky Richardson
Professor Richard Kitney, OBE
Professor Stephen Smith

13.00 Lunch – Buffet in Conference Centre

14.00 eHealth Stream: Session 2
Theme: Telemedicine and International Outcomes.
Chairperson: Dr Niels Rossing, Danish Society of Clinical Telemedicine, Hon. Fellow of the European Federation for Medical Informatics

14.05 A European Perspective on eHealth as an agent for reform
Mats Larson; President European Health Telematics Association

14.20 Asian Perspectives on eHealth as an agent for reform
Ki-Chan Ahn, Korean eHealth Association
Tan Sri Dató Dr Abu Bakar bin Suleiman, President, International Medical University, Malaysia
Dr Sablee Aspar – Brunei
Prof. Wang Cai-you, Deputy Director of the Centre for Health Statistics and Information, Department of Health, The Peoples Republic of China

15.30 Interactive Discussion

15.45 Afternoon Tea

16.00 eHealth Stream: Session 3
Theme: Global Applications for eHealth.
Chairperson: Professor Ricky Richardson: Vice President, ISFT, Chairman, UK eHealth Association

Professor Jean-Claude Healy; World Health Organisation
WHO eHealth Strategy
The WHO Health Academy
eHealth for Crisis Management

16.30 Interactive Discussion

17.00 Streams Close. Exhibition and Networking.

17.30 Close of day 1

18.30 Meet and Travel to Dinner

19.30 Conference Reception & Dinner; The Royal Naval College, Greenwich

23.00 End

Tuesday 22 February 2005

08.30 Arrival, coffee, exhibitions

09.00 eHealth Stream Session 4
Theme: Putting eHealth Into Practice.
Chairperson: Professor Richard Kitney (OBE), Professor of Biomedical Systems Engineering, Imperial College

09.05 The National Programme for Information Technology (NPfIT):
Implementation and beyond. Richard Granger, Director General of IT for the NHS

09.20 NPfIT Local Service Providers: Perspectives on Achieving Successful Implementation.
Tim Smart – President, Consulting & Systems Integration, British Telecomm
Ken Lacey – Global Managing Partner Health & Life Sciences, Accenture
David Baker – NHS Account Director, CSC Alliance
Peter Hutchinson – Managing Director, UK Public Sector, Fujitsu Alliance

10.20 Interactive Discussion
Richard Granger
Tim Smart
Ken Lacey
David Baker
Peter Hutchinson

Conor Ward – Partner, Lovells Solicitors

10.40 Morning Coffee

11.00 eHealth Stream: Session 5
Theme: Realising Benefits from eHealth – Europe.
Chairperson: Mats Larson, President, European Health Telematics Association

Selected Case Studies:
The Danish eHealth Experience – Dr Arne Kverneland, Head of Department of Health Informatics, National Board of Health in Denmark.
Telemedicine Clinic, Barcelona – Dr Henrik Agrell, Vice President, European Telemedicine Clinic,
Current Finnish eHealth experiences and International Society for Telemedicine update – Dr Jarmo Reponen, President, Finnish Society of Telemedicine
Provision of regional cross-border eHealth programmes in Europe – Mark Simon, Chief Executive, ComMedica
NHS Direct New Media – Prof. Bob Gann, Director, NHS Direct New Media
HINE European eHospital Survey – Murray Bywater, Silicon Bridge Research

12.45 Lunch – Buffet in Conference Centre

14.00 eHealth Stream Session 6
Theme: Realising Benefits from eHealth – Asia
Chairperson: Tan Sri Dató Dr Abu Bakar bin Suleiman, President, International Medical University, Malaysia

Selected Case Studies:
The Ministry of Health hospital IT project, Malaysia – Dató Dr A Jai Mohan, Vice-President, Malaysian Health Informatics Association
Longitudinal population health records on a single platform in Hong Kong – Dr Chun Por Wong, Immediate past President of the Asia Pacific Association for Medical Informatics
An eHealth solution in Japan – Steve Brown, President and CEO, Health Hero Network Ltd

15.00 eHealth Stream Session 7
Theme: Looking To The Future; eHealth Innovation
Chairperson: Professor Ricky Richardson, Chairman, UK eHealth Association

Microwave Endometrial Ablation To Treat Heavy Menstrual Bleeding – Mr Ellis Downes MRCOG, Consultant Gynaecologist & Obstetrician, Chase Farm Hospital, North London UK
Technology & The Patient – Jo Wright, Managing Director of Global Health Business, British Telecom & Dr William Rutter, Chairman, iMetrikus
DVD-based training in the recognition of autism and Asperger syndrome
Prof. David Skuse; Institute of Child Health, Great Ormond Street Hospital for Children

16.00 Afternoon Tea

16.30 Plenary

Keynote Speakers:
European Commission: tbc
Mr Wang Zhong Min, Vice Administrator of the Standards Administration of China

Conference Chairman’s Summary:
Prof. John O’Reilly, CEO, Engineering and Physical Sciences Research Council

18.00 Official Close of Conference

18.30 Reception at ExCel, Exhibition and Conference Centre

20.30 End

Transcript

Slide 1: Mainstreaming eHealth

Slide 2: Advancing Chronic Care with eHealth Technologies in Japan: Proving Global Solutions for an Aging Population Steve Brown CEO Health Hero Network Ltd Mainstreaming eHealth

Slide 3: The Aging Population Challenge in Japan • Total population drops from 120M (2000) to 100M (2050) • Population over 65 rises from 18% (2000) to 37% (2050) • Traditional familial care of elderly declining rapidly • • New solutions needed for chronic care Mainstreaming eHealth

Slide 4: What can eHealth do? • Tools to support and educate patients to improve self- care, wellness, and health behavior • Tools to support caregivers in the monitoring and management of patients with chronic disease • Value to patients, caregivers, and society: Prevent the worsening of chronic disease Increase access to chronic care Lower the burden and cost of chronic care Mainstreaming eHealth

Slide 5: Tools to support and educate patients • Easy-to-use interactive countertop device • Daily personalized dialogue and guidance • Communication hub for home medical devices Behavior modification Mainstreaming eHealth

Slide 6: Personalized daily guidance and feedback • Congestive Heart Failure • Chronic Obstructive Pulmonary Disease • Coronary Artery Disease • Diabetes • Hypertension • Asthma • Depression • Senior Wellness (diet, activity, medications) Development tools and platform approach enables adaptation to local needs Mainstreaming eHealth

Slide 7: Fully customizable dialogue content • Example from Dutch COPD program operated by Sananet BV in Netherlands Mainstreaming eHealth

Slide 8: Communication hub for home medical devices * Subject to appropriate regulatory approvals Open system can serve devices from many different vendors Mainstreaming eHealth

Slide 9: Tools to support caregivers • Web-based application services for caregivers • Daily patient status and needs stratification • Symptoms, behavior, knowledge Monitor everyone but manage by exception Mainstreaming eHealth

Slide 10: Systems approach Enabling an improved model of chronic care Mainstreaming eHealth

Slide 11: Yamatake Corporation – Pioneer of chronic care improvement in Japan • Over 90 years experience in innovating in process automation and factory automation • Develops new business in the fields of health care, energy conservation and food safety and agriculture • 7,100 employees, over 1.4 billion (USD) in sales – 2003 • Created the Safety Service Centre which runs a personal emergency response service • Developed chronic care improvement system and service based on Health Buddy® system in partnership with Health Hero Network • Chronic care improvement services through Safety Service Centre Mainstreaming eHealth

Slide 12: Obstacles to improving chronic care in Japan • Insufficient economic incentives for healthcare providers to focus on prevention • Entrenched healthcare interests and institutions are slow to change • Population health factors are moving in the wrong direction (obesity, diabetes, lung disease all rising) Does this sound familiar? Mainstreaming eHealth

Slide 13: Situation in Japan is model for global needs to improve chronic care for aging population • Very different healthcare systems in Japan, Europe, USA • Very similar needs to improve chronic care for aging populations Leading toward similar eHealth solutions Mainstreaming eHealth

Slide 14: Video example is from Health Buddy® program in Netherlands operated by Sananet BV Mainstreaming eHealth

Slide 15: Similar chronic care improvement programsand pilots underway in 2005 • Japan (Yamatake) • Netherlands (Health Ministry, hospital pilots with Sananet) • USA (Veterans Affairs national program, Medicare pilots) Opportunity to learn from examples around the world New body of evidence being generated to support systems approach to improving chronic care for aging patients Based on eHealth enabling tools Mainstreaming eHealth

Slide 16: Future developments will further increase capabilities applications globally Health Buddy® 2 Processor: Samsung ARM 2410 Memory: 64MB Persistent Storage: 32 MB Operating System: Linux Screen: 640 x 240 Color LCD Ports: 4 USB, 1 RJ45 Serial Modem: 33.6 kbs Multiple languages Remote configuration 45 health applications Mainstreaming eHealth

Slide 17: Contact Information Steve Brown CEO Health Hero Network Ltd 40 Abbey Road Monkstown, Co. Dublin Ireland Tel: 00353 1 280 3997 Fax: 00353 1 280 9806 stevebrown@healthhero.com Mainstreaming eHealth

You can find the presentation on the eHealth International website at: http://www.ehealthinternational.org/pdfs/Brown.pdf

London, England and Mountain View, CA – October 15, 2003 – Health Hero Network, Inc. Chief Executive Officer Steve Brown will speak tomorrow at the eHealth 2003 Conference in London, England. Mr. Brown is participating in the “eHealth and Patient Centred Care” session at 11:30 am on October 16.

In a presentation entitled “Networks for Patient Centred Care in Chronic Disease,” Mr. Brown will describe how health care providers can help patients prevent the worsening of chronic disease by proactively monitoring and educating patients in a model of care enabled by eHealth networks and technologies. Mr. Brown will review chronic care programs in the United States that have resulted in improved quality of care, increased patient and provider satisfaction, and reduced cost. Mr. Brown also will discuss policy initiatives that will encourage wider adoption of patient centred chronic care by emphasizing continuity of care for patients with chronic illness rather than episodic, crisis-driven care.

Health Hero Network Ltd, the European subsidiary of Health Hero Network Inc, also will exhibit the Health Hero® technology solutions for chronic care, including the Health Buddy® appliance for in-home monitoring and communications and the iCare Desktop™ application, a web-based care management tool for care providers. The Health Hero Network approach has been demonstrated to improve chronic care by guiding patients through the exchange of clinical information with their care coordinator, including vital signs and health self-assessment, resulting in improved medication compliance and self-care behaviors. Care coordinators receive timely, actionable information in order to detect and prevent problems before they become acute for a range of chronic conditions including congestive heart failure, diabetes, hypertension, chronic obstructive pulmonary disease, and asthma.

About Health Hero Network

Health Hero Network, Inc., founded in 1988, develops and licenses technology solutions for health monitoring and management. The Health Hero® technology platform offers Internet-enabled care management tools, multiple patient interfaces, and a secure environment for data communications. The Company’s products include the Health Buddy® appliance, featuring Buddylink™ device connectivity, Health Buddy® Web, other licensee devices for data collection and communications with patients, and iCare Desktop™, an Internet-based care management and research tool for health care professionals. Health Hero Network offers over a dozen standard health management programs delivering daily monitoring & education, and promoting positive behavioral change for better chronic care with lower costs to the health care system. Buddylink connectivity allows patients to upload device-reported data from a variety of peripherals. The Health Hero technology platform is protected by over 50 issued U.S. patents. Company headquarters are in Mountain View, California. On the Net: http://www.healthhero.com.

Presentation Transcript

• Slide 1: Steve Brown, CEO Health Hero Network, October 16, 2003
• Slide 2: Health Hero Network Inc. q 5 years of experience in implementing chronic care improvement programs in 50 medical centers and 2 languages q Patient education and management content for 15 of the most expensive and prevalent chronic diseases q Secure, robust systems and monitoring technologies adaptable to each client’s best practices and medical knowledge q Fundamental chronic care and remote monitoring patents dating back to 1992
• Slide 3: Networks for Patient Centered Care in Chronic Disease 3. Why this is important 4. How to do it 5. Success stories and results 6. Why it is good business today 7. Incremental policy changes to inspire adoption
• Slide 4: 2001 U.S. Hospital Stays By Condition Condition Discharges Expenditure • Congestive heart failure 1,049,818 $17.6 Billion • Chronic obstructive pulmonary disease 603,352 $8.2 Billion • Diabetes mellitus with complications 461,161 $7.2 Billion • Hypertension with complications 244,320 $4.6 Billion • Asthma 389,530 $3.3 Billion Source: Healthcare Cost and Utilization Project, US Agency for Healthcare Research and Quality
• Slide 6: 2001 California hospital costs for ambulatory care sensitive chronic diseases ($) Commercial Uninsured Medicare Medicaid Other Total Congestive Heart Failure 2,337,745,702 1,617,662,367 317,364,720 317,125,495 31,921,050 53,672,070 Chronic obstructive pulmonary disease 1,164,626,294 796,343,340 175,002,632 152,248,368 14,498,748 26,533,206 Diabetes with complications 1,126,010,626 529,606,510 249,102,139 238,704,453 40,560,566 68,036,958 Hypertension with complications 826,010,222 512,530,192 159,665,770 116,031,548 12,953,115 24,829,597 Asthma 495,632,558 141,085,020 160,507,413 149,895,954 16,945,280 27,198,891 200,270,72 Total 3,597,227,429 1,061,642,674 974,005,818 116,878,759 2 ,950,025,402 Source: Healthcare Cost and Utilization Project, US Agency for Healthcare Research and Quality
• Slide 7: Why the current model must change: the age wave is a tidal wave 73% 80% U.S.2000-2020 70% Source: U.S. Census, 2000; Age Wave, 2003 60% 54% 50% 40% 30% 20% 10% 8% 7% 7% 3% 0% -10% -20% -10% Under 14 15-24 25-34 35-44 45-54 55-64 65+
• Slide 8: How to do it #1 Focus your attention on chronic patients at risk of being hospitalized • Diagnosis of congestive heart failure, chronic obstructive pulmonary disease, diabetes, hypertension, asthma • Hospitalized in the past 12 months for a complication related to their chronic illness • Over $25,000 in claims in the past 12 months
• Slide 9: How to do it #2 Change your behavior so your high risk patients can change theirs q Provide chronic patients with a support network that includes a care coordinator  break the cycle of isolation and crisis q Guide patients in daily health self-assessment while collecting timely, relevant, actionable data  before the next crisis starts q Use a systems approach to embed your best knowledge into decision support tools  continuously improve quality
• Slide 10: Networks for Patient Centered Care enabled by eHealth Technologies
• Slide 11: Guided Self-Assessment: the key to patient self-improvement
• Slide 12: Additional Data Collection Options Health Buddy® Personal Telehealth Appliance Blood Blood Peak Coagulation Digital Glucose Pressure Flow Meters* Weight Monitors Monitors* Meters* Scale
• Slide 13: Informed Caregivers: Decision Support Systems iCare Desktop™ Risk Stratified View of Daily Patient Status
• Slide 14: Informed Caregivers: Detailed Results Detailed View of Patient Results
• Slide 15: Informed Caregivers: Trend Reports View of Key Clinical Indicators Over Time, and Many Other Reports
• Slide 16: Veterans Administration Demonstration • Veterans Health Administration Community Care Coordination Office, Florida • Telemedicine-based care coordination demonstration project • 791 chronically ill veterans enrolled for 1 year, compared to comparison group data
• Slide 17: VA – Patient Selection • “High Cost (>$25,000) and High Use” patients • High Use is defined as: • Two or more hospital admissions or • Frequent emergency room visits and/or walk in visits or • 10 or more prescriptions • Most common diagnoses: Congestive Heart Failure, COPD, Diabetes, Hypertension
• Slide 18: Veterans Administration Clinical Outcomes • 40% reduction in emergency room visits • 63% reduction in hospital admissions • 60% reduction in hospital bed days of care • 64% reduction in nursing home admissions • 88% reduction in nursing home bed days of care • Significant improvement in Quality of Life (SF36V) Published in: Disease Management, Volume 5, Number 2, 2002
• Slide 19: VA – Patient Satisfaction • 96% of the population said “Yes” to the following questions: • Do you think the Health Buddy technology has helped you stay healthy? • Has having staff monitor you make you feel more comfortable? • Would you recommend this project to other Veterans? • Questions aggregated over multiple locations and disease states
• Slide 20: VA – Provider Satisfaction • 90% of providers reported that communication between themselves and the care coordinators was timely and appropriate • 92% of providers believed the program was beneficial to their patients • 95% of providers would refer patients to the program Published in: Telemedicine Journal and e-Health, Volume 9, Number 2, 2003
• Slide 21: VA – Project Growth • Currently over 1000 patients using the technology platform in Florida alone • VISN 8 renewed program for addition 3 years • Program has been expanded to the Midwest (VISN 19), West (VISN 21), Great Lakes (VISN 10) and upstate New York (VISN 2), with several other sites joining in next sixty days • National VA Office for Care Coordination established in Washington, D.C.
• Slide 22: Chronic Care is Good Business Today q Treat chronic patients in an outpatient setting, freeing hospital beds for higher DRG patients q Informed caregivers can be more effective with their time and focus on the right patients at the right time q Reduce liabilities: failure to monitor known high risk patients is starting to be viewed as a patient safety issue q Increase revenues: Chronic care improvement programs are starting to be paid for by public health agencies and insurance q Provide higher quality care in your community
• Slide 23: Small incremental policy changes can alter the behavior of the entire system Hospital Admissions Over Time
• Slide 24: Small incremental policy changes can alter the behavior of the entire system Hospital Admissions Over Time Diagnostic Related Group (DRG) includes 30 day readmission
• Slide 25: Small incremental policy changes can alter the behavior of the entire system Hospital Admissions Over Time Diagnostic Related Group (DRG) includes 30 day readmission #1 Extend existing DRG to 60 or 90 days
• Slide 26: Small incremental policy changes can alter the behavior of the entire system Hospital Admissions Over Time Diagnostic Related Group (DRG) includes 30 day readmission #1 Extend existing DRG to 60 or 90 days #2 Offer monthly care coordination fee
• Slide 27: Small incremental policy changes can alter the behavior of the entire system Hospital Admissions Over Time Diagnostic Related Group (DRG) includes 30 day readmission #1 Extend existing DRG to 60 or 90 days #2 Offer monthly care coordination fee #3 Redefine patient safety issues and medical errors to include preventable complications in unmonitored high risk patients
• Slide 28: Why are all we here today? • We are dedicated to transforming our healthcare systems for the better while facing one of the greatest challenges of our century • We know that the current crisis driven models of care are no longer sustainable and must change to models that offer continuity of care and prevention • We believe eHealth Networks and Technologies are a key enabler of the modernization of this vital public service
• Slide 29: Empowering eHealth Patients and Innovations Caregivers
• Slide 30: Contact Information Steve Brown, CEO Health Hero Network, Inc.

Plenary Presentation at the DMAA – Disease Management Association of America Annual Meeting entitled New Models of Disease Management: Improving Quality and Access through Remote Health Monitoring Technology

DMAA Transcript

• Slide 1: New Models of Disease Management: Improving Quality and Access through Remote Health Monitoring Technology Presented by: Steve Brown President and CEO Health Hero Network Inc. Saturday, October 26, 2002 DMAA Annual Meeting, San Antonio TX
• Slide 2: Technology Advances… “In the old days we would do nothing and he had a 50-50 chance. With all this high tech equipment the odds are even.” From OKBridge HMO DMAA Keynote – Health Hero Network 2
• Slide 3: The Promise • A better model of care is possible • Crisis care  Coordinated care • Higher quality with lower cost DMAA Keynote – Health Hero Network 3
• Slide 4: Role of Technology •  Move the point of service closer to the user -  Convenience -  Timeliness -  Access •  Increase productivity of service providers -  Timely, relevant, actionable information -  Process improvement -  Quality assurance •  Change behavior -  Better self-care -  Better treatment compliance -  More appropriate utilization DMAA Keynote – Health Hero Network 4
• Slide 5: Changing Behavior… DMAA Keynote – Health Hero Network 5
• Slide 6: Health Hero Network Example: Internet- Based Services for Disease Managers Secure Data Center DMAA Keynote – Health Hero Network 6
• Slide 7: Health Hero Network Example: Daily Dialogues with the Patient DMAA Keynote – Health Hero Network 7
• Slide 8: Health Hero Network Example: Patient Stratification and Management Tools DMAA Keynote – Health Hero Network 8
• Slide 9: AMAC Example: Disease Management with Personal Emergency Response *American Medical Alert is a Licensee of Health Hero Network DMAA Keynote – Health Hero Network 9
• Slide 10: Philips Telehealth Solutions Example: Comprehensive CHF Solution with Peripheral Devices * *Philips is a Licensee of Health Hero Network DMAA Keynote – Health Hero Network 10
• Slide 11: TheraSense Example: FreeStyle Tracker Diabetes Management System *Therasense is a Licensee of Health Hero Network DMAA Keynote – Health Hero Network 11
• Slide 12: Some Results DMAA Keynote – Health Hero Network 12
• Slide 13: Oakland Asthma Study •  Oakland Children’s Hospital, Oakland, California •  Asthma self-management program using telemedicine technology for high-risk population with asthma •  Randomized controlled trial compared to traditional patient education for 90 day intervention •  66 patients in intervention group, 68 in control group, ages 8-16 DMAA Keynote – Health Hero Network 13
• Slide 14: Oakland Asthma Results •  Significant reduction in Activity Limitation (p = .03) •  Significant reduction in reported high peak flow readings (p = .01) •  Significant reduction in urgent calls to hospital (p = .05) •  Improved self-care behaviors •  Published in: Arch Pediatr Adolesc Med. 2002; 156:114-120 DMAA Keynote – Health Hero Network 14
• Slide 15: Veterans Demonstration •  Veterans Health Administration Community Care Coordination Service, Florida •  Telemedicine-based care coordination demonstration project •  791 veterans enrolled for 1 year, compared to comparison group data •  Elderly, high-risk, high-cost veterans with hypertension, heart failure, COPD, and diabetes DMAA Keynote – Health Hero Network 15
• Slide 16: Veterans Results •  40% reduction in Emergency Room visits •  63% reduction in Hospital Admissions •  60% reduction in hospital bed days of care •  64% reduction in nursing home admissions •  88% reduction in nursing home bed days of care •  Significant improvement in Quality of Life SF36V •  Published in: Disease Management, Volume 5, Number 2, 2002 DMAA Keynote – Health Hero Network 16
• Slide 17: Mercy Diabetes Study •  Mercy Health System in Laredo, Texas •  Home-based telemedicine program for uninsured, high- risk, underserved population with diabetes •  One year study period using comparative cohort data from previous calendar year •  Total of 169 patients – 130 females and 39 males with average age of 53 years in both genders DMAA Keynote – Health Hero Network 17
• Slide 18: Mercy Diabetes Results •  Inpatient Admissions reduced 32% (p < 0.07) •  Emergency Room Encounters reduced 34% (p < 0.06) •  Outpatient visits reduced 49% (p < 0.001) •  In press: Diabetes Technology & Therapeutics Journal, December 2002 DMAA Keynote - Health Hero Network 18
• Slide 19: Mercy Results: Patient Satisfaction DMAA Keynote – Health Hero Network 19
• Slide 20: Mercy Results: Patient Compliance DMAA Keynote – Health Hero Network 20
• Slide 21: Traditional Process •  Scheduled calls based on diagnosis and initial assessment: “hit or miss” •  Technology used for scheduling, documentation, reporting •  More time spent on assessment than on intervention: -  Care manager with 100 patients -  Scheduled call once per week to assess patient status and needs -  20 successful calls per day -  20 – 30 minutes per call, including set-up, rapport building, etc. -  7 – 10 hours per day, no time for lunch DMAA Keynote – Health Hero Network 21
• Slide 22: Technology-enabled Process •  Communicate with patients daily, especially those with complex conditions and the frail elderly •  Encourage, teach, reinforce, and remind patients to improve self-care and change behavior •  Stratify patients by risk and need in order to and target calls and interventions on those most in need: -  Care manager with 400 patients -  Monitor once per day and risk stratify results -  20 – 40 calls per day to check in with patients who report elevated risk -  3 – 6 minutes per call because most patients have already taken action -  2 – 4 hour job to coordinate care DMAA Keynote – Health Hero Network 22
• Slide 23: Criteria for Success Simplicity and Focus [Remember who needs care the most] Personal, Relevant, Actionable Information [What matters most to care providers] Support Self-Care and Behavior Change [What makes the biggest difference to quality of life and overall outcomes] DMAA Keynote – Health Hero Network 23
• Slide 24: DM and Technology: Empower Patients and the People Who Care for Them DMAA Keynote – Health Hero Network 24

Telemedicine in Care Delivery Presentation Transcript

• Slide 1: Model Telemedicine Program Shows Improved Care and Cost Savings for Congestive Heart Failure Patients Steve Brown President and CEO Health Hero Network Inc. Telemedicine in Care Delivery Conference Thursday, June 13, 2002 Pisa, Italy
• Slide 2: Health Hero Network •  Pioneer of health information and communications technology since 1988 with 55 patents issued. •  Developer of remote monitoring technology and web services to collect, analyze and report data. •  Proven reliability and results with Veterans Health Administration, Hospitals, and Medical Groups. Telemedicine – Health Hero Network 2
• Slide 3: Selected Customers Telemedicine – Health Hero Network 3
• Slide 4: Recent Recognition Health Hero Awards Health Hero Customer Awards Health Hero Network, Inc. awarded The Home & Community Care the Best Enabling Tool for Disease Pfizer Health Solutions (HCCSL) Service Line of VISN 8 Management, 2001 received the Pfizer Health Solutions e-Health Leadership Award at the DMAA Leadership Forum Health Hero Network, Inc. awarded the Best TeleHealth Vendor, 2001 The HCCSL of VISN 8 received the 2001 Best Telehealth Provider Award at the Association of Telehealth Service Providers (ATSP) and the Healthcare Information Management The Health Hero® Health Buddy® Systems Society (HIMSS) conference highlighted as one of the Best for their program utilizing the Health Products of 2000 Hero® platform The Health Hero® Health Buddy® won the Medical Design Excellence Award, 2000, for collecting and transmitting patient data Telemedicine – Health Hero Network 4
• Slide 5: Technology Platform Telemedicine – Health Hero Network 5
• Slide 6: Value Propositions Deliver high quality care at lower cost   Eliminate or reduce ER & hospital utilizations by detecting patient problems before they become acute Improve patient education and compliance   Improve self care and patient compliance with physician prescribed regimens by educating, motivating, and monitoring patients daily Increase organizational efficiency   Standardize processes, monitor quality, and increase staff’s ability to manage more patients with existing resources Improve understanding of disease   Research daily symptoms, behavior, drug response, disease progression, and environment Telemedicine – Health Hero Network 6
• Slide 7: Health Buddy® Telemedicine – Health Hero Network 7
• Slide 8: iCare Desktop™ Telemedicine – Health Hero Network 8
• Slide 9: Home Page Telemedicine – Health Hero Network 9
• Slide 10: Work List Telemedicine – Health Hero Network 10
• Slide 11: Detailed Results Telemedicine – Health Hero Network 11
• Slide 12: Trends Telemedicine – Health Hero Network 12
• Slide 13: Notes Telemedicine – Health Hero Network 13
• Slide 14: Documentation Telemedicine – Health Hero Network 14
• Slide 15: BuddyLink™ Blood Blood Peak Coagulation Digital Glucose Pressure Flow Meters* Weight Monitors Monitors* Meters* Scale Telemedicine – Health Hero Network 15
• Slide 16: Platform Extensions Telemedicine – Health Hero Network 16
• Slide 17: Programs Currently Available •  Congestive Heart Failure •  Co-Morbid Diabetes and •  Coronary Artery Disease Hypertension •  Co-Morbid Congestive Heart •  Co-Morbid CAD and Angina Failure and Diabetes •  Anti-Coagulation Therapy •  Co-Morbid Hypertension and •  Pediatric Asthma Chronic Obstructive •  Adult Asthma Pulmonary Disease •  Depression •  Hypertension •  Bi-polar Disorder •  COPD •  Senior Wellness •  Type I Diabetes •  Cystic Fibrosis •  Type II Diabetes Telemedicine – Health Hero Network 17
• Slide 18: Mercy Case Study •  Case study results as reported by customer, not a randomized control trial •  Hospital-based “Mercy Telemedicine Disease Management Program in Laredo Texas, funded by State of Texas •  57 patients enrolled in 2000 for 1 year: 36 Female, mean age 68; 21 Male, mean age 61 •  Matched comparison group pulled from 1999 data before disease management program started •  Current enrollment: 440 patients, CHF and Diabetes Telemedicine – Health Hero Network 18
• Slide 19: Mercy Results Telemedicine – Health Hero Network 19
• Slide 20: Mercy Results Telemedicine – Health Hero Network 20
• Slide 21: Mercy Results Telemedicine – Health Hero Network 21
• Slide 22: Mercy Results Telemedicine – Health Hero Network 22
• Slide 23: Mercy Results Telemedicine – Health Hero Network 23
• Slide 24: Veterans Affairs Results Telemedicine – Health Hero Network 24
• Slide 25: CHW Results Telemedicine – Health Hero Network 25
• Slide 26: Productivity Analysis Measure Traditional Health Hero Patients Managed Per CM 133 133 Average # Calls/Day 27 (based on 1/wk/pt) 10 Average Length of Out 20 min 2 min 41 sec Bound Call Total Time / Day for CM 9 hours 53 min Estimated Nurse:Pt Ratio 1:100 1:500 Frequency of Monitoring WEEKLY DAILY Telemedicine – Health Hero Network 26
• Slide 27: Conclusions •  Telemedicine can help clinicians improve patient education, improve patient compliance, and reduce hospital admissions by identifying problems early. •  Telemedicine can improve productivity in monitoring high risk patients by enabling clinicians to focus on targeted intervention rather than blind assessment. •  Telemedicine can enable disease management programs to be scaled and extended to multiple diseases while assuring quality processes. Telemedicine – Health Hero Network 27