The Diabetes Community Sentinel Project

1. The Diabetes Community Sentinel Project

2. Our Conversation Today • Introduce the National Health Index • Diabetes and The Revolution in Health Information • Managing Population Health Through Cloud Based Analytics • Introduce the Diabetes Community Based Sentinel Project • How We Might Collaborate

3. The National Health Index LLC (NHI) NHI integrates disparate health data sets into easily accessible information systems to create powerful community-based tools to promote well being.

4. The World of Analog Medicine

5. The Dawn of Digital Medicine

6. Digital Medical Information Revolution

7. 300 Million Americans Will Have Health Data in the Cloud

8. Digitized Medical Information Must Be Curated

9. Managing Population Health through Cloud-Based Analytics

10. Diabetes Community Sentinel Project The Future is Now DCSP is an example of how to use cloud analytics to manage the health of a population with a chronic disease

11. Diabetes Community Sentinel Project The purpose of the Diabetes Community Sentinel Project (DCSP) is to deploy and commercialize a national diabetes information system whose purpose is to measure the incidence and prevalence of diabetes by zip code, to provide historic information (outcomes, cost, etc.) on how people with the disorder have used medical services to manage the disease, and to predict how those residents will use care in the near term.

12. DM in the Age of Digital Health Key Findings

13. The DM Market can be Defined Geographically • 80% of those living with DM reside in 9,000 zip codes (diabetes communities) out of 38,000 zip codes. • Half of these zip codes are minority zip codes, where over 50% of the resident population is minority • Within these diabetes communities the prevalence and number of people with the disease is increasing • DM communities tend to be medical deserts with a limited number of points of care (physicians’ office, hospitals and clinics) to meet the needs of those living with the disease.

14. We Are Already Collecting Massive Amounts of Data on the DM Market by Geography • Data from Points of Care (physicians’ offices, hospitals, payer data, • pharmacies) • Medical Devices (glucose monitors, insulin pumps, heart and sleep monitors) • Consumer data (internet traffic, home devices)

15. The DM Market is Stable Within DM Communities, people with DM exhibit stable consumption patterns from one year to the next.

16. Forces that Shape the DM Market DM consumption patterns are the product of consistencies in the incidence and prevalence of disease, underlying consistencies in patient response to DM, practices variation, and uniformity in the ways in which the health care financing and delivery system responds to patient needs.

17. How to use this Critical Intelligence About the DM Market This stability is knowable, predictable and algorithms can be built that can anticipate consumption patterns. The Information must be shared across health systems

18. DCSP Value Proposition Aggregating heretofore disaggregated data into a central cloud based location Curating and analyzing data from millions of people living with diabetes Delivering to users on demand, actionable intelligence about diabetes communities and their residents who have the disorder

19. DCSP Subscribers • Payers • Health systems • Investors, manufacturers and distributors of diabetic products and services • Government • Researchers • Volunteer Organizations

20. DCSP Subscriber Environment DCSP will bring to the subscribers’ desktop a powerful array of communications, data and analytical services, providing actionable, community-based, information about people living with diabetes, their care, and evidence-based reports about their future use of health services all delivered in a familiar Microsoft environment.

21. How Can We Collaborate

22. Sanofi’s Information Dilemma As a direct function of its business, Sanofi does not directly produce or own big data sets, with the notable exception of clinical trials, but the use of its products are captured in large data sets that are owned by others. Those large data sets are being aggregated in the cloud and will be publically available. To survive in this sea of information, Sanofi will need data aggregation and cloud based analytics

23. The Question How does Sanofi’s cross-functional product teams use the revolution in medical information (big data, cloud analytics, social and business networks) to drive product development, marketing, sales and advocacy?

24. DCSP a Really World Laboratory for Sanofi Internally Lessons to be learned in doing business in the world of digital medicine where Sanofi remains highly regulated, but there is a blizzard of analysis driving safety and efficacy consideration about its products Consider: Avandia, PCORI, European Union on Clinical Trials

25. DCSP a Really World Laboratory for Sanofi • Externally • Major leadership in transforming diabetes quality improvement • Leadership role in ending the acute care paradigm in diabetes care • Educating regulators, payers and the general public about community-based solutions to the challenge of driving down cost while improving outcomes.

26. Where Can We Partner • Translate findings from administrate data to clinical equivalents (that is replace annual cost profiles with clinical profiles) by working with the American College of Physicians and others to collect additional data from EMRs, administrative and consumer data (including prescription drug) in the 9,000 zip codes to create a representative sample of the diabetes population • Create zip code level clinical profiles of consumers (in particular, low consumers) to stratify their risk for an acute event by time, including time sequencing adherence to medical therapy • Launch DCSP as a subscription service

27. DCSP Launch 1st Quarter 2014 DCSP will benchmark diabetes by community, the quality of care diabetes residents are receiving. It will offer twelve-month projections on: medication adherence, the number of inpatient stays, emergency-room visits, the cost of care and other metrics. The information will be delivered to subscribers online via the World Wide Web, mobile devices , e‑mail, and print. A national press conference will be held to announce the projections.

28. DCSP Partners American College of Physicians American College of Cardiology American Association of Clinical Endocrinologists Microsoft Health Choice Network

29. “To measure is to know” • Sir William Thomas, Lord Kelvin • .