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Outcomes Data

Outcomes Data . Seven parameters tested in Care Kit studies to date. 1. LOWER READMISSIONS 2. LESS ER USE 3. SATISFACTION Patient Staff 4. IMPROVED BIOMETRICS Diabetes Blood Pressure Weight Loss 5. BEHAVIOR CHANGE 6. STAFF PRODUCTIVITY 7. COST SAVINGS.

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Outcomes Data

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  1. Outcomes Data Seven parameters tested inCareKit studiesto date • 1. LOWER READMISSIONS2. LESS ER USE • 3. SATISFACTION • Patient • Staff • 4. IMPROVED BIOMETRICS • Diabetes • Blood Pressure • Weight Loss • 5. BEHAVIOR CHANGE • 6. STAFF PRODUCTIVITY • 7. COST SAVINGS

  2. What MakesanOutcomeCompelling? >99% Statistical reliability: The probability that the results were due to chance is less than 1% On the outcomes report slides that follow, watch for a Ribbon Symbol to see which of these 5 reasons make that outcome compelling An improvement greater than 15%. The American Society of Quality Control says this level of change is breakthrough innovation >15% ✔ A validated measurement. When you measure one way, then measure another way and get the same result, your initial measurement is valid. Success where others have failed. If you achieve results where national authorities say results are hardest to achieve Results are replicated. When you not only do it once, but over and over and over and over and…

  3. BEFORE: Vitas Medical Center NJ had used books from the American Lung Association, so clinical accuracy was assured. WITH CARE KITS: Distributing the Care Kits, with no other changes or interventions, More than doubled adherence Eliminated readmissions Reduced ER use by 72% Asthma Care Kits aloneEliminated Readmissions EVIDENCE that CLINCAL ACCURACY by itself is not adequate for effective PATIENT COMMUNICATION BEFORE AFTER >99% Persistence 6 mo44% Readmissions 16% Use of the ER 26% 95% 0 7.4% The probability that the outcome was chance is less than 1%. That means if you adopt Care Kits, it’s 99% likely you’ll see comparable results See Appendix for calculations

  4. Heart Failure Care Kits Changed Behavior BEFORE: Northwest Community Medical Center had failed to change behavior with a year-long Disease Management program BEFOREAFTER BEFOREAFTER IMPROVEMENT 185% 27% 77% Weighing Daily Taking Blood Pressure Medication Compliance 86% 514% 14% >99% 59% 14% 321% • Data collected from each group at 6 months • Study designed & conducted by hospital staff EVIDENCE: CARE KITS ARE MORE EFFECTIVE AT ENGAGEMENT The probability that the outcome was chance is less than 1%. That means if you adopt Care Kits, it’s 99% likely you’ll see comparable results See Appendix for calculations

  5. Multiple Conditions in a Medical Home Care Kits saved $1.5million COMPARED TO BASELINE YEAR 712 participants 24 months 23%lower TOTAL MEDICAL COST Blood pressure Cholesterol Blood sugar Emergency Room visits In-hospital days Health Plan net savings exceeded $56 PMPM $1.5 million / 1000 members Member savings = 30% lower out-of-pocket cost than the alternate PPO plan 85% better scores J Reeves, MD Director Nevada State QIO J Ambulatory Care Management V36, No. 2, pp. 108-120 March 2013 16%fewer visits 54% fewer days Imaging services 35% lower use Prescription cost per member >15% 18% lower cost “Breakthrough Innovation” says the American Society for Quality

  6. Discharge Teaching Time Care Kits Improve Quality & Productivity 144% improvement in standardization of time spent at discharge Care Kits Care Kits Care Kits >15% “Breakthrough Innovation” says the American Society for Quality

  7. After Prostate Surgery Care Kits eliminated ER Returns and Readmits Control and Intervention Groups were concurrent Readmissionsin less than 31 days ER Returns in less than 31 days St. Joseph Mercy HospitalAnn Arbor Michigan 92% >15% 17% “Breakthrough Innovation” says the American Society for Quality 0% 0% BEFORE AFTER BEFORE AFTER

  8. TIME OUT! “These results are not credible. They’re too good.” “There must be flaws in the study designs.” Communication Science researchers shadow hundreds of patients at home, in the workplace and around the community. For each condition, they find the problem preventing adherence and they fix itjust as the consumer products industry has done for decades. Observational research increases consumer products sales by giant proportions. Why not health care? The model for fixing adherence is not clinical, where a new treatment may improve a condition by a small percentage. The model is mechanical, where you take a broken machine to mechanics and they fix it. Set up your own study for Care Kits. See for yourself, on your own terms.

  9. HypertensionCareKitsperformed 6X better than face-to-face visits XX CSI Employer Wellness Initiative: Prior year home visit program had failed Home visit outcome: 12% in controlCare Kit outcome: 88% in control BEFORE AFTER 6% 88% Over 140/90 88% Below 140/80 12% ✔ All readings confirmed at clinic after six months Results were measured one way, then confirmed by measuring a different way = valid results

  10. Multiple Conditions Care Kits are the first to achieve ROI with Truckers CMS: “Truckers are the most difficult employee group to effect behavior change.” We took them on in South Carolina using outcomes analysis software • Return on InvestmentFor every $1 the trucking • company invested, they • received $1.79 in savings • --to our knowledge, the first successful • trucker health intervention Success exceeding levels previously achieved by all others

  11. DiabetesCareKitscouldserve well as curriculum for classes Head-to-Head with Diabetic Education Classes CLASSES CARE KIT Cleveland, OH Care Kits were >90% better at preventing readmits 39% better at preventing ER returns Readmissionsin 30 days 10.4%<1% Emergency in 30 days 9.6% 5.9% Impact after three months New York City Care Kits brought down A1C numbers after classes had not impacted population CLASSES CARE KIT 9.3 8.7 A1c Score P= 97% Success exceeding levels previously achieved by all others

  12. “Were you satisfied with the materials for self care?” “Did they help you manage your condition?” Press-Ganey national 5-year average = 72% Care Kit UPMC 5-year average = 96% Patient Satisfaction CareKitsachieved 33% higher scores Hypertension Yes – 94.9% No – 2.9% Diabetes Yes – 93.6% No – 6.4% CAD Yes –100% Heart Failure Yes – 97.3% No – 1.8% Asthma Yes – 92.5% No – 2.5% Success exceeding levels previously achieved by all others University of Pittsburgh Health Plan

  13. Post Surgical Dressings Care Kits outperformed Education Committee • AMA said getting >33% of the population to comprehend = impossible • 154 Patients from Orthopedic and Abdominal Surgery • Nurses called one week after discharge, “Were you able to follow your instructions without asking anyone for help or calling back the doctor or the hospital?” • BeforeCare Kits • AfterCare Kits • “How satisfied were you with discharge?” • BeforeCare Kits • AfterCare Kits 92% 4% 100% RUSH Medical Center “Patient Satisfaction” Hospital Peer Review Journal September 2000 35% Success exceeding levels previously achieved by all others

  14. Heart Failure Care Kits Reduce or Eliminate Readmissions BEFOREAFTER REDUCED BY 6.4% 4.0% 38% St. Joseph, Lexington KY St. Joseph, Elgin IL NWC, ArlingtonHts. ILDRG 127 ONLY NWC, Arlington Hts. IL ALL CHF-RELATED DRGs Aurora, Milwaukee WI Great Plains, ElkCity OK Mercy Hospital, Chicago VA, AnnArbor MI 16.7% 7.7% 54% 13.2% 8.7% 34% 30 days 23.4% 6.9% 74% 22.2% 6.3% 72% 8.6% 2.2% 73% 60 days >28% 0%100% 90 days 58.2%35.5%39% Thompson-Reuters Statistical Analysis When you achieve outcomes over and over and over and over again

  15. Summary: Compelling Results We have achieved >99% reliability in Diabetes, Hypertension, HF, Asthma, Post-Surgery, et.al. Statistical Reliability >99% Our worst performance, 34%= more than double the “breakthrough” definition. Many outcomes >70%, even 100% Breakthrough Innovation >15% Self-reported confirmed by clinic measurement Self-reported confirmed by software analysis Self-reported confirmed by Thompson-Reuters Validated Measurement ✔ CMS: Truckers most resistant; achieved ROI National average 72%; Care Kit average 96% AMA prediction = 66%;CareKit result = 92% Exceeded authorities’ threshholds for success Dozens of studies, all with breakthrough results Replicated Results “If you were a drug, you’d be approved” --F. I. Orkin, former Corporate Director of Quality and Regulatory, Baxter Healthcare

  16. 1550 Barclay Boulevard Buffalo Grove IL 60089 847-850-7500 www.carekit.com Come take a closer look! Michael Weiss President Shirley Grey RN MSN VP Health Plans Carol Outland RN MSN VP Home Care Judith Farah Director of Operations Sylvia Aruffo PhD Chief Content Officer

  17. Appendix: Statistical Reliability READMISSIONS As many times as you repeat a study, statistics says 99% of the outcomes will fall within + or – 3 standard deviations of the initial result. The chance of a result outside ±3Σ is less than 1% √ P >99% PERSISTENCE at 6 MONTHS P >99% USE OF THE ER P >99%

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