1. © 2015 Intermedix Corporation. Proprietary and Confidential. Simulation in the Wild Global Applications of Optima Predict

2. 2 5 trusts 25 million people 54,000 square miles 3.8 million incidents

3. 3 7 Safety Regions 5.2 million people 7,000 square miles 370,000 incidents

4. © 2015 Intermedix Corporation. Proprietary and Confidential. Scottish Ambulance Service 4

5. © 2015 Intermedix Corporation. Proprietary and Confidential. Welcome to Scotland 5.3 million population, 78,772 sq km 14 territorial health boards 8 special boards Devolution 1 Ambulance Service 3 control centres 150 stations 5 operational divisions 4,000 staff 5

6. © 2015 Intermedix Corporation. Proprietary and Confidential. Current Model Focus on Cat-A 8 minute response STOP THE CLOCK Demarcation of resources Emergency, urgent, non-emergency Focus on marginal improvements in time response Is it really about patients? 6

7. © 2015 Intermedix Corporation. Proprietary and Confidential. New Clinical Model

8. © 2015 Intermedix Corporation. Proprietary and Confidential. Rebuilt Model New Clinical Codes New Roles New Rules Urban/Rural Conveyance See and Treat 8

9. What is the number of staff needed to achieve the new clinical model for 2020 across Scotland? Supporting Vision 2020

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11. © 2015 Intermedix Corporation. Proprietary and Confidential. Where are Scotland now? Initial modelling completed 2015 Support and evidence transition funding Strategic workforce planning to 2020 Fleet procurement Transition plans year on year being developed Use Optima to sense check and revisit plans each year to 2020

12. © 2015 Intermedix Corporation. Proprietary and Confidential. South Central Ambulance Service 12

13. Performance = f(utilisation) Utilisation = f(resources,demand) What drives performance?

16. © 2015 Intermedix Corporation. Proprietary and Confidential. Data and Analysis Use Optima Predict to clean and geolocate 18 months data Calculate over 100 variables for operation Demand levels Resource levels Performance Utilization Correlated all variables to find significant relationships

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21. © 2015 Intermedix Corporation. Proprietary and Confidential. Friesland and Drenthe

22. Where to locate ambulance posts? Where, when and how many ambulances (staff) are needed? Relocate ambulance stations? How to adapt the network

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24. © 2015 Intermedix Corporation. Proprietary and Confidential. Key Statistics Calls per ambulance, station, day, hour, hour of day, etc. Distribution response, transport, time to hospital, etc.

25. © 2015 Intermedix Corporation. Proprietary and Confidential. Identify Weaknesses 25

26. © 2015 Intermedix Corporation. Proprietary and Confidential. Linking Insights to Solutions Problems occur because No staff capacity available (end of shift) Misfit demand and location of supply (stations, #stations, #ambulances) ±100 scenario’s simulated Solution Four additional stations Relocate ambulance capacity Additional ambulance capacity -> additional staff capacity (21,5 Fte) 26

27. © 2015 Intermedix Corporation. Proprietary and Confidential. Solution 27 A1 performance <85% >95% Relocate and extend capacity 24/7 Relocate capacity Additional capacity day Relocate and extend capacity 24/7 Additional capacity 24/7

28. © 2015 Intermedix Corporation. Proprietary and Confidential. Solution Before 28 After