Integrated Health System Planning An exclusive Executive Circle Briefing

2 Healthcare is undergoing a “Copernican Shift” Microsoft Corporation Confidential and Privileged

3 FACILITY The Traditional Healthcare Universe Consumers (C1 to C5) are forced to interact with facilities – focused around the needs of the provider, not the consumer In 1543, Copernicus was the first to propose that the Earth rotated around the sun, while accepted scientific thought at the time believed that the Earth was the center of the universe. Copernicus effectively “changed the center of the universe”. C2 C5 C4 C1 C3

4 Healthcare’s “Copernican Shift” Healthcare is undergoing a “Copernican Shift” – with the consumer now placed at the center of the orbits of various healthcare strategies Home Prevention Knowledge (Search) Fitness (PHR) Wellness (PHR) Home Chronic Care Knowledge (Search) MTM (PHR) Senior Care (Devices) Clinic Convenience (PHR) Access (PHR) Home Outpatient MTM (PHR) Monitoring (PHR) Hospital Hospital ERP (Azyxxi) Full Enterprise CONSUMER

Implications of the “Copernican Shift” The Copernican Shift is being driven by cost & access to information – consumer behavior and attitudes are changing as increasing numbers of consumers are being forced to take on more personal financial responsibility for their health Importantly, the Copernican Shift displaces both providers and consumers. Both parties are now in new orbits, without necessarily having access to the tools they need to fulfill their new roles This has created a “Healthcare Gap” between providers and consumers How can Microsoft make a positive difference in this evolving healthcare industry? 5

How Can Microsoft Help? Microsoft is unusually well positioned to help solve both the enterprise and consumer challenges of the healthcare industry Our strong enterprise footprint, products, and relationships put us in a unique position to aid the enterprise Our excellent consumer trust and ubiquity put us in a position of responsibility with the consumer Microsoft will be the company that helps providers and consumers span the healthcare gap 6

Why Microsoft? When Microsoft makes an investment, we take a long-term view Seven years ago we recognized the need to invest in the health industry Today it represents a $1 billion U.S. growth market for Microsoft History of innovation; We invest $7 billion every year in R&D – the largest R&D budget in the software industry A significant amount of R&D spending is now focused on healthcare employees, 115 customers $320 million in sales 600 dedicated employees Pervasive in health around the world $1 billion in sales Microsoft Corporation Confidential and Privileged

Our Footprint 600 million people around the world start the day with Windows when they turn on their computers MSN Health + Fitness is the number two portal in the U.S. – a strong foundation for future health offerings 8 MSN Health & Fitness What’s Next? Microsoft can be a cornerstone for our long-term health strategy, transforming how healthcare is managed and delivered Microsoft Corporation Confidential and Privileged

9 Provider Challenges Microsoft Corporation Confidential and Privileged

10 Library Search Revenue Cycle Scanned Charts Labs Radiology Old Records EKGs Challenges in Enterprise Healthcare Microsoft Corporation Confidential and Privileged Medication Management OR Management Ambulatory Emergency Department Registration CPOE

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15 What is Azyxxi? 15 EMR Systems Lab OR Management Imaging Medication Management AmbulatoryEmergency Revenue Cycle CPOE Azyxxi DB Personalized Views

16 Configurable by User Orthopaedic Unit NurseFinanceQuality Resource PlanningCardiologistRegulatory

Configurable by User 17 Orthopaedic Unit Nurse Customized for an orthopaedic nurse to view patients assigned to their unit, their surgical status and key labs. Snapshot of pre- and post-op patients Anticipated date of surgery Quickly scan latest platelet count in post-op patients on blood thinners Nurses just one click away from past medical history Easily see admission diagnosis and attending physician

18 Configurable by User Finance Views customized by finance users to integrate and collect data from across all information systems to improve co-pay collections at the time of service. Track success at collecting co-pays

19 Benefits of Azyxxi What You Have Hard working, disparate information systems that aren’t feeding you the best results What You Need A single version of the truth Azyxxi doesn’t replace, but sits on top of existing information systems It provides integrated and customized views + analysis of clinical, financial, and administrative data Why You Need Azyxxi Azyxxi aggregates and analyzes all relevant data for one, nearly instantaneous view Health workers can maximize the value of information and make the most informed decisions Informed decisions save your business money and most importantly, save patient lives

20 Consumer Challenges Microsoft Corporation Confidential and Privileged

21 Health: Advances Require a “Shift Left” The “total-system healthcare win” is in the home Lower cost (good for plans, employers) Higher quality of life (good for consumers) The key focus for all competitors will be on home-based, consumer-centric healthcare solutions HOME CARE FOCUS: Prevention Knowledge Fitness Wellness Dr Communications Chronic Care and Outpatient Medications Monitoring Community Medical Communications Source: Intel.com Cost of Care per Day $1$10$100$1,000$10,000 0% Quality of Life COMMUNITY CARE Healthy, Independent Living Chronic Disease Management Community Clinic Doctor’s Office 100% Assisted Living Skilled Nursing Facility Specialty Clinic Community Hospital ICU HOME CARE ACUTE CARE Specialty Pharmacy SHIFT LEFT

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23 “Walled”“Open” VS PHR Philosophies

24 My Health Data Consumer Health Platform Device s My Health Data Platform Services User authentication User mapping / identity Data storage and access Personalized search Branded data and tools Community building Incentive infrastructure Integration with other devices and services Advertising infrastructure 3rd Party Applications MS Apps

Family Health Record (FHR) 25 FHR PHR Self FHM has FULL ACCESS Spouse FHM has PARTIAL ACCESS Senior FHM may have FULL or PARTIAL ACCESS Minor FHM has FULL ACCESS Minor FHM has FULL ACCESS The “Family Health Manager” or FHM runs the FHR PHR Pet FHM has FULL ACCESS “Seventy percent of our users are women storing information about kids, spouses, aging parents and themselves,” says Fotsch, who runs Medem Inc., on online business that links the needs of patients and doctors through the Web at iHealthRecord.com Source: USA Today – Saturday, January 6, 2006

Bridging the Healthcare Gap 26 Healthcare Gap Consumers Providers Keystone

Microsoft Health Q&A Discussion

28 Microsoft Corporation Confidential and Privileged