A Business Proposal for a Health Care Treatment Plan

1. A Proposal for Improved HealthviaSmart Treatment Plansusing the Scientific Method for theOptimization of Chronic Illnesses Thomas J. McCullough, M.S., 6 MBB V0.5 May, 2012 U.S.P.O. Patent No.: 7,827,044 B2 Copyright by Thomas J. McCullough©, All Rights Reserved.

2. Today’s Agenda • This presentation will propose a business opportunity for a Health Care Treatment Planning • The case for treatment planning is supported by: • The opportunity is large • The existing Failure modes which are addressed • Two examples, one with existing software app • Approach to market and sales strategy • Summary of the benefits of this approach Accepting feedback and inquiries on business partnerships!

3. Where is the Biggest Opportunity? Let’s use the Pareto Principle to find The Problem… • In the case of the U.S. healthcare system, approximately 80% of all costs are from 20% of the those with chronic illnesses • Concerning the 80% chronic illness costs, what is the main contributor to these high costs? Answer: Those who have multiple chronic illnesses! ~20% Costs ~80% Source: Johns Hopkins Medical Expenditure Panel Survey, 2001.

4. What are the Failure Modes to Fix? Treatment Testing: • Lack of studies or poor experimental design • Comparing new drugs to the placebo • Extrapolating data from results on animals • Extrapolating from group to group i.e. adult data to children Treatment Planning: • One-at-a-time approach • Weak patient involvement • Doctor bias or improper framing Treatment Measures: • Fragmented provider delivery • Delayed monitoring of status • Subjective measures Smart Treatment Planning Addresses These Common Problems!

5. What is the Solution? • Target: persons with (multiple) chronic illnesses • Improve wellness through structured treatment planning • Through an advanced method of testing and documenting over many weeks, or a Smart Test Plan Natural Remedies? International Remedies? Over the Counter? Prescription Drugs? Diet & Nutrients? Solution: Optimal Treatment = Lower Costs = Best Quality of Life

6. Sleep Study Confirms Apnea Frank continues to be tired during the day Frank complains he is tired at work Frank complains he cannot sleep Dr. A Prescribes Trazodone Dr. B Prescribes Mirapex & Amantadine Dr. C Prescribes CPAP Dr. A Prescribes Provolonia Oct’09 Nov’09 Dec’09 Jan’10 Feb’10 Mar’10 Apr’10 May’10 Jun’10 Jul’10 A Case Study Customer: 45 year old male named “Frank” Chronic Conditions: Two Specifics: Parkinson’s (rigidity and bradykinesia or slowness of movement) & Sleep Apnea: (very low oxygen levels due to snoring) Problem: “Very tired” at his day job Problem Duration: 1 Year No. of Rx: 1 2 4 5 STOP!

7. A Test Plan is Developed • Frank works with his doctor(s) to see if there are other treatments: he chose to test a Mandibular Advancement Brace. • After discussion, Frank’s doctor prescribes a new medicine to control the Parkinson’s – Selegiline • Taking into consideration his overall situation, a combined Smart Test Plan was developed: Key:1 = Use, 0 = Do Not Use

8. Running the Test Plan • Frank Recorded… • His finger tap speed each day… • His tiredness rating… • His Stiffness rating…

9. Practices will be held on Tuesday and Thursdays at Bayside (same field) 5:30 to 7:00 <= Optimum Levels in RED Case Study Conclusion • On the last week of documenting, the Treatment Planner shows Frank his report • The best regiment is suggested to be: • Use the Brace, and • Use Selegine at level 10, and • Use Amantatineat level 300 Best Mix Found in 8 Weeks, Not 8 Months! Effect of change as you move from High to Low Supporting Analysis Detail Now Frank feels great and takes fewer treatments!

10. 30% of Older Adults Value Gap Frank’s Case How is this Technology Better? New Process Source: www.itl.nist.gov/div898/handbook/pri/section3/pri3.htm

11. A Case Study with Software Customer: 18 year old female named “McKayla” Chronic Conditions: One Specifics: Acne Problem: “OMG so totally annoying” Problem Duration: Years McKayla chooses the treatments to use in her Test Plan.

12. Software Session (Cont.) McKayladocuments the Treatment results

13. Software Session Conclusion McKayla Receives her Personal Report!

14. Software Session – Review The conventional number of combinations to try would normally be 8 (or 2 3 ). We require only a fraction (½ or ¼) of this time. This saves weeks or months of time! Sometimes, the recommended combination was not included in the original test plan. There is no need to test every combination! The recommended combination rating is better than those tried in all the plan steps. This leads to optimum comfort.

15. Software Session - Safety Drugs include only those that have been already approved by the FDA Safety checks for dual therapy Safety checks for adverse reactions on-line!

16. Solution System Process Current Traditional Process: OK ? Chronic Condition Choose a Treatment Use Treatment Done Y N This may not be the best treatment Multiple “go backs“ cause a waste of time and additional pain New Smart Treatment Process: Get the Best Med Mix Choose a Treatment Test Plan Use Test Plan Chronic Condition Log Results Done

17. This Tool is Not… • Meant to replace advice from your Doctor • Meant to replace instructions from your Pharmacist • To be a sole source of information to which decisions or diagnoses are made • Always accurate – it is as good as your data--and just like the X-ray for example, the results must be read and verified • A tool where you can copy the results and use on another person • An ‘expert’ system to cure all • A rationing system Smart Plan + Medical Knowledge = Optimal Comfort

18. Why Optimization? • On-target Smart Treatment Planning will result in: • Comfort • Reduced clinic visits • Quality of life • High functioning • Lower Costs! • Traditional approaches miss the mark, often resulting in: • Pain • Increased clinic visits • Poor quality of life • Loss of work Developing the Smart Test Plan is finding where your target is, and taking aim

19. Market Opportunity - Size • Target customers are the chronically diagnosed who are starting or altering their treatment regiment. They need to know… • what treatment options are effective (Screening)? • If there are treatment levels with better efficacy? • If there is effective natural alternatives? • if there are options which are just as effective but at a lower cost? • Sample Target Community and Market Size: Source of Quantity: "The Essential Guide to Chronic Illness" by J.W. Long M.D.

20. Market Opportunity - Trends • According to a survey by the AMA: • 68% of older adults who regularly take at least one prescription drug also use over-the-counter medication, dietary supplements, or both • 30% of older adults use at least 5 prescription drugs • One in 25, or 2.2 million older adults, are taking drug combinations that place them at some level of safety risk. • People want to know more information about their treatments: • 25% of U.S adults who are internet users “often” look for information online about health topics (Harris Interactive’s Healthcare News, Volume 8, Issue 8, August 2008) • Smart Planning – Solution to an Information Problem • A solution for the active and involved patient • Efficient planning, data driven and unbiased • Personal Report leads to comfort

21. Market Opportunity - Segmentation This Tool is the Key to a Successful Disease Management Program!

22. Potential Sales Model • Distribution Channels • Individual consumer market – users of internet, active patients seeking better comfort • Physicians, Nurse advocates, and other health care providers interested in getting health care information on their patient and possibly decreasing costs • Sales cycle • The customers will come directly to the website, register, pay online, and use the service for a year • The ‘subscription fee’ approach allows for longer steps and better quality results • Returning users will include clients with any changes to their conditions or treatments

23. Competition Vs. Smart Planning • Competition or Risks: • The current process: visits to physicians offices where one-at-a-time method is de facto • Customer Focus: Smart Test Plans, especially a plan with natural remedies, may take months, requiring data record keeping and recording • Health Information web sites offer symptom checkers: • WebMD.com • Medicinenet.com • Future personalized treatment planning analysis based on individual DNA • Smart Planning: • A personal report on the effects of treatments • Non-biased aggregator of information, include Rx and natural options side-by-side • Only health information site which provides effect of a treatment on an individual • Optimal med mix is found – faster!

24. A Competitor Compared

25. Summary • Of all the areas to make an impact, chronic illnesses have the highest overall opportunity • There are currently many different failure modes in the treatment of chronic illnesses – which we fix! • Use of patented software for health treatment planning has a clear technology advantage over the often used one-at-a-time method • The case studies and software prototype indicate that a Smart Treatment Plan App is feasible to develop • Market size and health trends support the idea that this project will see success entering the marketplace • The optimal treatment mix found as the result of a Test Plan, will lower healthcare costs to an individual, and therefore to society as a whole

26. Questions? Send feedback to mailto:tmccullough@wi.rr.com

27. Back-up Reference • Average per capita spending on people with one or more chronic conditions is more than five times greater than spending on people without any chronic conditions. ($850 for people with no conditions compared to $4,398 for people with one or more conditions.) • Compared to individuals with no chronic conditions: • Spending is over two and a half times greater for someone with one chronic condition. • Spending is over seven times greater for someone with three chronic conditions. • Spending is almost 15 times greater for someone with five or more chronic conditions. Johns Hopkins University, Partnership for Solutions Source: Medical Expenditure Panel Survey, 2001.

28. Back-up Reference