Prognosticheck® Value Proposition Strategy And Focus.

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PROGNOSTICHECK® Value Proposition: Strategy & Focus

STRATEGY & FOCUS Reliable information to base healthcare decisions upon

Scientific knowledge base

Structured multi-media formats

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Excellent training & support

Compassionate caring communication

Pre-Learning Assessment

Specific to: Patient, Physician, Manufacturer

INDIVIDUALLY TARGETED CURRICULUM • Patient’s and Families • Physicians – Ot Other e healthcare ealt ca e p providers ov de s • Nurses

• Facilities F iliti – Phase of care

• Manufacturers – Pharmaceuticals/Other Ph ti l /Oth IInterventions t ti • Prescription • Nonprescription ©2005 IPGDx, LLC

THREE FRONTS OF CHANGE • Chronic disease model – Therapeutic efficacy

• Healthcare delivery system – Changing roles

• Ethical and cultural expectations – Duties and responsibilities within a new decision paradigm

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CHRONIC DISEASE • • • •

Diagnosis established Tx limited/repetitive Course is long/progressive Complications – Anticipation – Avoidance – Mitigation

• Speed of progression • Scope of deterioration ©2005 IPGDx, LLC

CHARACTER OF CHRONIC ILLNESS • Nonfatal (Complication Avoidance) – Occurs with substantial reserve capacity – Progressively long natural course

• Serious then fatal – Progressively worsening – Serial exacerbations to death

• Frailty/prolonged dwindling (Cliff Edge) – Little available reserves p cascades – Small upset ©2005 IPGDx, LLC

Hospitalizations • Severityy of disease – Present on admission – Nosocomial or not

• Overstaying DRG LOS – Complications

• ICU Resource allocation – SIRS

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From: ‘Living Well at the End of Life’; Lynn & Adamson 2003 Rand Health

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~20%

~20% 20%

~40% 40%

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*~20% other and/or undefined

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Of the ~2.5M annual deaths less than fortyy percent p died under hospice care

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THOSE WITH CHRONIC DISEASE

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CHANGES IN HEALTHCARE DELIVERY • Physician – – – –

< economic independence < professional autonomy > external review > administrative oversight

• Called upon to: – Optimize outcome while minimizing costs – Proffer decisions with weighted administrative and clinical consequences ©2005 IPGDx, LLC

CHANGES IN HEALTHCARE DELIVERY • Resource Allocation – – – – –

> need > cost To produce > benefit Comparative metric/risk adjustments Relative levels of illness and treatment • System S t comparisons i

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CHANGES IN HEALTHCARE DELIVERY • Demonstrated Effectiveness – Assessment of the probability of expected course and outcomes • Assumption of therapeutic efficacy

– Intermediate endpoints predictive of long-term outcomes

• Predictive P di i fi findings di • Pre-symptomatic – occult illness • Predicting consequences – Benefit of advanced interventions – Adherence metrics ©2005 IPGDx, LLC

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ETHICAL DECISION MAKING • • • • •

Communication C i i required i d Consumerism Informed consent Risk (cost) / Benefit Resources – Availability – Allocation

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END OF LIFE COSTS

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CULTURAL EXPECTATIONS • Futility of intervention (flogging) • Outcome inevitabilityy – Likelihood of recovery – Effectiveness v trauma of intervention

• Justice • Beneficence • Economy Econom

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END OF LIFE CARE • > Consciousness of EOL care and death • ‘Good Death’ v “BAD” – – – – – –

Control-Comfort-Communication C lC f C i i Discussed with family Planned for Meaningful assessments Management of Home care

• Physical-Spiritual-Emotional-Social-Cost ©2005 IPGDx, LLC

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PROGNOSTICHECK® • If Sick,, How Sick® • Prognosis – Characterization of disease • Presence-Severity-Progression

– Effectiveness of therapies p • Optimized individual response

– Timing of non-acute non acute death • Palliative care and Hospice ©2005 IPGDx, LLC

TARGETED MARKET SEGMENTS Innovators Early y Adopters p Early Majority Late Majority Laggards

First 5% - 10% that adopt the product Next 10% - 15% Next 30% Next 30% Remaining 20%

CHARACTERISTICS: Venturesomeness: the willingness and desire to be daring in trying something new and different Social integration: frequent and extensive contact with others in one’s area Cosmopolitan: point of view extending beyond the immediate neighborhood or community Social mobility: upward movement on the social scale Privilegedness: attitude and possession of money (less risky to try something new) ©2005 IPGDx, LLC

©2005 IPGDx, LLC

©2005 IPGDx, LLC