1 Medical Needs for the Electronics Industry; Market Analysis and Electronic Roadmap Needs. Terrance J. Dishongh, Ph.D. Support from: Intel (Brad Needham, Eric Dishman, Jay Lundell, Margie Morris), Plexsus (Bill Bartel), 3M, ITF,

2 Elder care is returning home again Poor Houses / Almshouses pauper Insane Asylum inmate Hospitalpatient Assisted Living resident Homegrandma Nursing Home senior citizen Homegrandma Only way to save costs but increase quality is home care. Home care is fastest growing segment of health industry.

3 Percentage of Population over 60 years old Global Average = 10% Percentage of Population over 60 years old Global Average = 21% SOURCE: United Nations Population Aging 2002 To care for an aging planet

4 Worldwide age wave is coming Today… 34 million elders in U.S. 550 million worldwide 5 U.S. workers to 1 retiree 3 Japan workers to 1 retiree 34 million elders in U.S. 550 million worldwide 5 U.S. workers to 1 retiree 3 Japan workers to 1 retiree By 2025… 74 million elders in U.S. 1.2 billion worldwide 3 U.S. workers to 1 retiree 2 Japan workers to 1 retiree 74 million elders in U.S. 1.2 billion worldwide 3 U.S. workers to 1 retiree 2 Japan workers to 1 retiree Other facts… 80+ years old is fastest growing old old are 2 women : 1 man 80+ years old is fastest growing old old are 2 women : 1 man

5 Nurses/caregivers in short supply Source: Bureau of Labor Statistics, pub in CNN/Money.com, Where the jobs will be Greatest employment growth is likely to be in service industries, according to new labor study. By Jeanne Sahadi, Feb 13, The 10 fastest- growing occupations include medical assistants, jobs for whom are expected to grow by 59 percent, or 215,000 new jobs; network systems and data communications analysts, positions for whom the BLS expects to jump by 57 percent, or 106,000 new jobs; and physician assistants, for whom the BLS projects a 49 percent rise, or 31,000 new jobs.

6 The biggest growth in health- care spending these days isn't coming from today's elderly. It's coming from tomorrow's elderly -- the baby boomers and their younger siblings. The biggest growth in health- care spending these days isn't coming from today's elderly. It's coming from tomorrow's elderly -- the baby boomers and their younger siblings. Per capita spending among Americans aged 30 to 50 rose more than 75% between 1987 and Per capita spending among Americans aged 30 to 50 rose more than 75% between 1987 and Source: WSJ: Tomorrow's Elderly Fuel Health-Care Spending And Strain the System Boomers spending big on health

7 The global challenge simply put Increase the quality of care & of life… Increase the quality of care & of life… for twice the number of seniors… for twice the number of seniors… while reducing healthcare costs. while reducing healthcare costs. -Current healthcare system is optimized for treating disease; innovation is clinic-and-pharma centric -Have to invent system optimized for wellness (prevention, early detection, compliance, caregiver support) -Must put technologies into everyday lives of people; must put the home, consumer, & informal caregivers in the loop and offload formal institutions when appropriate -It will take decades to achieve, but must start R&D (research & debate) now if we ever hope to get there

8 Worldwide healthcare crisis is here -Every major world economy has health as biggest percentage -Nursing shortage in many parts of the world -South Korea and Japan technology infrastructure

9 Healthcares costs, coverage problems and demographic pressures mean system overload; its formal institutions cant cope with the future. What will ease the pain? A major shift, enabled by technology, to self-care, mobile care, home care. - Forrester Report, Dec 2002 Result: Home care inflection point

10 Market Analysis Prismark estimates that medical electronics equipment production will be $39.5Bn in 2004, accounting for about 4% of the global electronics industry. Prismark estimates that medical electronics equipment production will be $39.5Bn in 2004, accounting for about 4% of the global electronics industry. This market is expected to continue to increase at an average rate of 4.4% per year through This market is expected to continue to increase at an average rate of 4.4% per year through Growth is primarily driven by the worldwide demographical shift to an older population, which indicates a continuing increase in medical care spending. Growth is primarily driven by the worldwide demographical shift to an older population, which indicates a continuing increase in medical care spending. Medical care is already the single largest component of the US GDP. Medical care is already the single largest component of the US GDP.

11 Prismark estimates that 62% of medical electronics equipment will be assembled in the Americas in This region is followed by Europe 21%, Japan 10%, and the Rest of Asia 7%, Most medical electronics systems (by value) are produced in the region where the products are consumed. However, several major medical electronics companies, such as Siemens and GE, are increasing design and assembly activities in lower-cost regions, such as China. As the percentage of medical electronics consumed in developing economies increases, a greater percentage of medical electronics systems will be produced there. Market Analysis Outsourcing and R&D

12 Market Analysis

13 Product 2004 Units (Est.) Major Suppliers Hearing Aids 6M Siemens, GN Resound Pacemakers0.8M Phonak, Starkey, Oticon, Widex Implantable External Defibrillator (ICD) 0.2M Medtronic, St. Jude, Guidant Automated External Defibrillator (AED) 0.13M Philips, Medtronic, Zoll Medical, Cardiac Science Ultrasound0.06M Philips, GE, Siemens, Toshiba Magnetic Resonance Imaging (MRI) 0.003M GE, Siemens, Philips, Hitachi, Toshiba Market Analysis

14 NEMI Roadmap Issue Situation Analysis Situation Analysis –NEMI is addressing the rise in the electronic healthcare sector. –Convergence of Market Demands and Regulatory Issues are Driving Action in two different directions. Critical (Infrastructure) Issues – Critical (Infrastructure) Issues – –American Retirees should double by 2025 putting excessive demand on the healthcare system. –Demand for Healthcare is outpacing the supply. Especially as boomers age. –No-lead issues with chlorine bleach.

15 Convergence = new home health platform Digital home entertainment infra can be used for healthDigital home entertainment infra can be used for health Everyday health through everyday devicesEveryday health through everyday devices Personalized, proactive health info/reminders/agentsPersonalized, proactive health info/reminders/agents

16 NEMI Roadmap Issue Needs in the Industry 1.Greater IT infrastructure to drive diagnostics and patient records. (Bush has $100M into Patient Electronic Records Research) 2.There is not a complete architecture between POC, monitoring, compliance, diagonistics and records. (New Technology is not needed as much as integration). 3.Growing number of PAN based companies show constant monitoring and sensor networks are close at hand.

17 Issues and Future Trends MEMs and Implantable Devices are a growing market segment. MEMs and Implantable Devices are a growing market segment. –New Research near to market –Ion Sensitive Field Effect Transistors –Inductive recharging Impact to national economy on healthcare will force the need for less expensive systems. Impact to national economy on healthcare will force the need for less expensive systems. –74 million elders in 2025 –Impact is a national trend toward home health technologies in the long term Integration and Interface Design are strongly needed. Eric Dishman Testimony to House Subcommittee on Aging. Integration and Interface Design are strongly needed. Eric Dishman Testimony to House Subcommittee on Aging.

18 Why is Intel here? Grow our markets : supply computing and communications technologies to a broadly defined home health & wellness market which is poised for massive growth worldwide Grow our markets : supply computing and communications technologies to a broadly defined home health & wellness market which is poised for massive growth worldwide Healthy workforce : insure our own 80,000 employees worldwide have tools, technologies, and training to care for their own aging parents Healthy workforce : insure our own 80,000 employees worldwide have tools, technologies, and training to care for their own aging parents Healthy economy for business : catalyze new paradigms of health care to head off looming worldwide economic crisis from high-cost, clinic-centric care that cannot scale to meet the needs of the age wave Healthy economy for business : catalyze new paradigms of health care to head off looming worldwide economic crisis from high-cost, clinic-centric care that cannot scale to meet the needs of the age wave We will never be a healthcare company. We supply technology ingredients. But we continue to lead R&D in new areas. And some new players will shape next generation technologies for the next generation of seniors.

19 Intels Proactive Health Lab Evidenced-Based Technology Research Evidence-Based Technology Research

20 Intels Proactive Health Lab

21 Intels Proactive Health Lab

22 Ion Sensitive Field Effect Transistor (ISFET) Purushothaman and Toumazou IEEE PROC 2001 DNA Polymerase Marker for ACGT Nucleotides by pH changes

23 Intels Precision Biology Lab

24 Intels Research Council grants

25 CAST partnership with AAHSA

26 CAST partnership with AAHSA

27 ETAC consortium with Alz Assoc

28 Health care is the mother of all big businesses …. this is life and deathsome people will get access to this health-care mainframe, and everybody else dies. - Andy Grove - Andy Grove Source: Intel's Andy Grove: The Next Battles in Tech: The IT visionary says tech needs to learn to think bigger, by Brent Schlender, FORTUNE, Monday, April 28, 2003