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The Continuum of Care

Health Buddy® System for Chronic Care Improvement Empower the Patient Guided self-assessment Personalized education Connection to provider Empower the Provider Timely actionable information Decision support tools Data for research/public health Behavior Modification

Components of Health Buddy System Monitoring Technologies In-home monitoring technologies guide patients in self-care, education and the collection of clinical information including health self-assessment, symptoms, and vital signs. Clinical Information Databases Clinical and patient information is securely transmitted and stored in databases that enable tracking and evaluation of outcomes across settings. Decision Support Tools Web-based patient management tools enable care providers to efficiently monitor groups of patients using reports, trends, and risk stratification. Health Management Programs Interactive scripted content based on standard practice guidelines for major diseases educates patients, enhances medication compliance, and changes patient behavior. Content Development Tools Robust software tools enable health management program development, with dynamic branching logic, flexible question taxonomy and variable patient responses.

4 button self-explanatory action No computer skills required Delivered directly to patient’s home Easy to hook up with telephone Non-intrusive Lifestyle flexible Daily patient partnering Timely patient education Tested with a broad range of patients Port for connection to home medical devices Health Buddy ® Appliance

Medical Device Integration Blood Pressure Monitors* Blood Glucose Monitors Digital Thermometry* Peak Flow Meter*Digital Weight Scale Open architecture can be developed to interface to a variety of home medical devices. * As of 5/2004, Pending FDA approval

Building the Trust Relationship Personalization Treat the patient as an individual, not a “thing” Dynamic Interaction l Branching Logic “Don’t treat me like I’m stupid” l Perceived Variety “Keep my attention, keep it interesting to me” l A Call to Action for the Patient “Don’t treat me like I’m incapably of helping myself” The system works by empowering Human ACTION

Health Buddy ® Appliance

KHKL BHBL SHSL K nowledge B S K B S K B S HML K B S KH BH SL K B S HML K B S KM BL SL K B S HML K B S KL BL SL Risk Assessment Survey ehavior ymptoms Risk Intervention Dialogues motivational informational educational incentives SM BM KM Dynamic Risk Assessment

Challenges of Building the Model How much content is enough on a given day? Language and Culture l Device Limitations l Variety of Choice l International deployment Data Integrity vs. Patient Interaction The Key to Compliance l The human touch

Sample Programs In-Use Congestive Heart Failure Coronary Artery Disease Pediatric Asthma Adult Asthma Hypertension COPD Cystic Fibrosis Co-Morbid Congestive Heart Failure/Diabetes Co-Morbid Hypertension/COPD Diabetes Co-Morbid Diabetes/ Hypertension Depression Bi-polar Disorder Senior Wellness Co-Morbid Congestive Heart Failure/Diabetes Co-Morbid Hypertension/Chronic Obstructive Pulmonary Disease

Program Flesch Index (%) Flesch-Kincaid Grade Level Chronic Heart Failure COPD Diabetes Mellitus Hypertension Major Depressive Disorder Readability of Health Management Programs

Patient Satisfaction

Measure TraditionalHealth Hero Network Patients Managed Per CM 133 Average # Calls / Day27 (based on 1/wk/pt) 10 Average Length of Out Bound Call 20 min2 min 41 sec Total Time / Day for CM9 hours53 min Estimated Nurse:Patient Ratio 1:1001:500 Frequency of Monitoring WEEKLYDAILY Health Hero Technology Realizes 5x Increase in Productivity Improves Productivity & Efficiency