Project Visionary Pitch MyGIPAL Anand Jain 9.25.2015

TRUE STORY Ms. X is a 24 yr-old female who suffers from almost daily bloating, crampy abdominal pain, and often diarrhea in the morning. She has missed multiple days at work and is on the verge of being fired. After trying heartburn medication and OTC imodium to no avail recommended by her primary care physician, she gets referred to a gastroenterologist. Dr. J sees Ms. X 2 months later, and not only are her above symptoms worse, but she is also reporting fatigue, trouble sleeping, & nausea. He performs an upper endoscopy and a colonoscopy (1 month later), and instructs her to take an antispasmodic after these come back negative. 2 months later -- 2 ED visits in the interim and only a marginal improvement in her symptoms. Dr. J asks her to keep eliminate lactose from her diet and keep a log of her symptoms. 2 months later – A mild improvement in her symptoms. Dr J places her on a FODMAP diet. 2 months later – A dramatic improvement in her symptoms. She feels like herself again.

Background – IBS & Functional Bowel Disorders 25% of adults, up to 34% of college / graduate students Healthcare costs $1.3 billion per year

The Problem: Data Overload & Need for Frequent Evaluation Medication Patient (symptom) GI practitioner / Nurse Diagnostic testing Dietary change

The Solution 1) Patient accountability 2) Algorithmic, standardized care 3) Patient-provider link

Outcomes Would be studied in our UMHS Gastroenterology Fellows clinic: Healthcare related quality of life Hospitalizations per year Patient satisfaction surveys (HCAHPS) *i.e. MyGIPAL becomes standard-of-care for functional bowel disorders

Key Stakeholders / Value Propositions CEO of Medicaid/Medicare: Decrease in annual expenditure GI Division Head (Tertiary Centers) & Gastroenterologists: Increased revenue related to patient satisfaction, better treatment outcomes Patients: Better treatment outcomes

Market Size Estimation (Subscription Model) 162 academic GI programs, average 20 general gastroenterologists with 100 functional bowel patients x $100/year subscription = $32.4 million / yr

Key Risks/Unanswered Questions Will patients log symptoms and correctly? Assuming above, will good outcomes be demonstrated?