June 22, 2009 presentation to Cambridge Health Network at King's Fund by Molly Joel Coye, MD, MPH, Founder and CEOHealth Technology Center

1. Cambridge Health Network Molly Joel Coye, MD, MPH Founder and CEO Health Technology Center June 22, 2009 Transformation In Chronic Disease Management Through Technology: Improving Productivity And Quality In The Shift From Acute To Home Based Settings

2. A “Blockbuster” Is Discovered… 72% reduction in HF hospitalizations 63% reduction in cardiac-related hospitalizations 0.51 1.82 0.81 2.20 2.18 2.73 RR=0.28 p=0.03 RR=0.37 p=0.029 RR=0.80 p=NS Heart Failure All Cardiac All Reason for Hospitalization Hospitalizations/Patient-Yr Intervention Control

3. Frustrated Deployment of a Transformational Technology 72% reduction in HF hospitalizations 63% reduction in cardiac-related hospitalizations SPAN-CHF II: Tufts-New England Medical Center; Lahey Clinic; Beth Israel-Deaconess Medical Center; Rhode Island Hospital. Weintraub et al AHA 2005 0.51 1.82 0.81 2.20 2.18 2.73 RR=0.28 p=0.03 RR=0.37 p=0.029 RR=0.80 p=NS Heart Failure All Cardiac All Reason for Hospitalization Hospitalizations/Patient-Yr Intervention = Remote Patient Management Control

9. Health Buddy Project Lessons Ratan (MKR-A) | 5/12/2009 | © 2009 Robert Bosch LLC and affiliates. All rights reserved. RPM Impact On > 30 Conditions In The VA VA Care Coordination/Home Telehealth Studies 2004-007, in Darkins et al. Telemedicine and e-Health, Dec 2008 Credit: HealthHero Bosch Condition # of Patients % Decrease Utilization Diabetes 8,954 20.4 Hypertension 7,447 30.3 CHF 4,089 25.9 COPD 1,963 20.7 PTSD 129 45.1 Depression 337 56.4 Other Mental Health 653 40.9 Single Condition 10,885 24.8 Multiple Conditions 6,140 26.0

13. February 2009: The State Of The Union And Budget Proposal “… Hospitals with high rates of readmission will be paid less if patients are re-admitted to the hospital within the same 30-day period… saving roughly $26 billion of wasted money over 10 years .”

16. Molly Joel Coye, MD, MPH Founder and CEO 415.537.6960 phone 415.537.6969 fax [email_address] Health Technology Center 524 Second Street, 2 nd floor San Francisco, CA 94107 www.healthtech.org