Continua Health Alliance

1. Continua Health Alliance The Engine for a Plug-and-Play World August 2013

2. What is Personal Connected Health? Communications & health devices deployed or enabled by healthcare organizations to collect/share individual patient physiologic & Quality of Life (QOL) data Unlike telehealth, allows providers & patients to employ data & communications independently, at their convenience – non linear Examples of PCH: Remote home monitoring programs in chronic disease or independent aging; Employer sponsored wellness PCH allows providers and patients to: Use technology to collect data conveniently and securely Communicate more frequently with little manual intervention Effectively monitor and better understand personal health data

3. Drivers for Personal Connected HealthPressure on Healthcare Requires New Models of Care Demographic Change Increase of Chronic Diseases High Health Care Expenses Provision of healthcare Aging population in industrial countries leads to increase of age-related diseases Care of elder highly correlated to development of population Worldwide rise of chronic diseases Compounding impact on expenses due to growing number of chronically ill children Chronic and long-term illnesses account for 75% of health care expenses Decreasing # of regional hospitals Reduction in hospital beds Declining care by general practitioners Housing situation and lack of transportation affect access to care Insufficient number of working population to finance the health care system • Accelerated • increase of • chronic diseases Continuous rise of health care cost for payers and patients Declining access to quality care for many people with disease Source: DB Research 2010

4. Benefits of Personal Connected Health Patient/Consumer Remain/return to home – QOL, time & cost savings New awareness of health status creates understanding & engagement Automatic nature allows for ease of use and better retention Improved collaboration with health care provider Avoidance of unnecessary office and/or ER visits Provider Automatic updates & alerts on patient status Data can be trusted coming from device rather than patient Improved triage capability & preservation of physician resources for most serious cases Maximal time for preventive action Ideal for chronic diseases management

5. Value of Interoperability Example 1: • Benefits: • Ease of use • Freedom of choice • User satisfaction • Quality • Innovation • Differentiation • Scalability • Competitiveness • Cost (Development, TCO, deployment) Other Examples Cell phones and ATM networks use “interoperable” devices, systems and services–they are connected and capable of inter- communicating Example 2:

6. Continua Health AllianceThe Engine for a Plug-and-Play World International non-profit industry organization enabling end-to-end, plug-and-play connectivity of personal health devices, systems and services in Personal Connected Health 200+ members: technology, medical device,telecom, health tech service & healthcare industry leaders

7. What We Do Develop and publish Design Guidelines that combine & apply existing standards Certify products, systems and services for compliance with Continua’s Design Guidelines Promote favorable operating climate for PCH through advocacy & coordination Creating a global market for personal connected health Connect leading technology developers, innovators and healthcare organizations

8. How We’re Different Only organization convening global technology standards in Personal Connected Health (PCH) Uniquely focused on end-to-end, plug-and-play connectivity to advance the PCH ecosystem Wide based consortium of Healthcare, Device manufacturers, and Governmental bodies developing Guidelines for deployments Can hand off data to EHR, PHR, HIE or to local apps run by consumers all with same infrastructure and devices

9. Standards Incorporated in Continua Design Guidelines 11073 Sensors PAN EHRs Transport Continua End-to-End Architecture Includes these standards, and more

10. Continua Annual Process: Developing Design Guidelines • Development Life Cycle • Submission of ideas • Use Case development • Use Case Commenting – Open process • Balloting • Use Case sponsorship • Decomposition into Work Items • Gap Analysis • Guidelines Development • Guidelines Commenting – Open Process • Balloting • Approval • Testing • Public Release & Comment Period Use Cases Requirements Standards Developed annually to include new technologies Guidelines

11. Continua Architecture EnablingPCH at the Interface Personal Device Aggregation Manager Telehealth Service Center Health Records/Networks Thermometer Pulse Oximeter Pulse /Blood Pressure Weight Scale Glucose Meter WiFi, 2G, 3G & 4G Cardio / Strength PHR Independent Living Activity EHR Peak Flow Personal Area Network (PAN) Interface Wide Area Network (WAN) Interface NHIN Health Record Network (HRN) Interface Medication Adherence HIE Physical Activity Electrocardiogram Insulin Pump New Technologies in current release – Hdata, Restful components, bi-directional data exchange and Oauth. (Working with HL7 to complete these)

12. Continua Certification Continua Certification signifies compliance with global industry standards, and is proven to decrease time to market and reduce development costs: Lower Design Costs: saves US$ 40,000-$80,000 in development costs per device* Faster to Market: decreases integration time from three months to just three weeks Increased Efficiency: quicker, less expensive integration to EMR or HIE platforms *Source: PricewaterhouseCoopers

13. Continua Certification, cont’d. Certified devices guaranteed for forward/backward compatibility with all Continua-ready products Same-use devices are interchangeable Easy to expand or add new programs/products with plug-and-play Health Records Network interface is standardized Consolidated CDA document. Interoperability shown at HIMSS,IHE ConnectaThonsand directly with NIST.

14. International Activity Hubs: Continua Adoption & Work Groups = Adopting Continua = Continua Work Group EU WG Denmark UK (NHS Worcestershire) Japan US WG US Veterans Administration Abu Dhabi Japan WG India WG SE Asia WG Singapore Brazil WG Australia WG

15. Where We’re Going: Globally Scalable Products & Services National adoptions by Denmark, Singapore Regional adoptions by Abu Dhabi, NHS Commercial deployment in Japan Becoming a global standard Accepted as a Work Item by the International Telecommunications Union (ITU), the oldest international telecommunications standards organization Comprised of 193 national governments and 700 private companies and organizations Scheduled for completion in early 2014 Driving government adoption Ex: Continua Connects showcase events

16. Continua Design Guidelines on Track to Become Global Health Standard in the ITU • The International Telecommunications Union (ITU) is the oldest United Nations organization • ITU-T is dedicated to produce timely, stable, worldwide standards • The ITU-T is comprised of 200 national governments and 700 private companies and organizations • Continua Design Guidelines accepted as ITU-T SG16 Work Item • Approval: start in Nov 2013 & complete in early 2014

17. Evidence of Cost & Time-to-Market Advantages Using Continua DGs: Japan Disaster Cardiovascular Prevention Network (DCAPS) DISASTER CARDIOVASCULAR PREVENTION NETWORK (D-CAP) • Target: 1,500 survivors of Great East Japan earthquake living in evacuee camps, two conditions that put them at risk for cardiac events • Tech Objectives: Determine comparative time/cost of implementing Continua-certified devices • Method: RPM for pts identified as high risk (400 pt), using devices previously certified by Continua • Tech Providers: A&D (Automatic blood pressure monitors), Alive Inc. (Gateway firmware), Ryoto Electro Corp. (data server), Panasonic (PC), Toppan Forms (Patient ID Cards), Intel (Project coordination) VALUE OF CONTINUA GUIDELINES Continua Non-Continua Time Bring down deployment time down to 1/6 2 weeks*incl. 3 days for connectivity 12 weeks**incl. 30 days for connectivity  Man-weeks(1 FTE per company) 60 man-weeks or $139k saved $166k** 12* $27k** 72** • Interoperability assured quality because each company could focus on their module in D-CAP Source: PricewaterhouseCoopers *Figures based on actual experience, **Estimates

18. Continua Health AllianceThe Engine for a Plug and Play World Connect with us on social media! Chuck Parker, Executive Director Email: chuck.parker@continuaalliance.org

19. Continua Health Alliance Additional information and Power Matrix

20. Open Source Opportunities: Assisting to Develop the PCH industry The Alliance is working with OpenHealthTools.org to publish Open Source code covering all Continua end-to-end interfaces The Open Health Personal Connected Health Project will become a hub for the software and tools used to build the ecosystem, and stimulate innovation among entrepreneurs and students The following components are now available from Continua on OpenHealthTools.org: WAN IEEE-20601 Encoder implementation, written in Java WAN Sender & Receiver implementation, written in Java Binary Object package of  the core WAN implementation suitable for Mobile implementations,  written in Java WAN Encoder and Sender Android Example , written in Java

21. Unique Role: Coordination With Key Industry Partners & Liaisons Global Certification Global Adoption Industry Trade Groups Promotional & Policy Support Regional Adoption

22. Metrics for Maturity

23. Metrics of Maturity for Underlying Tech

24. Attributes of Market Adoption

25. Attributes of Market Adoption - cont’d.

26. Metrics for Ease of Operation

27. Attributes of Intellectual Property