1. 6 October, 2003medXchange©2003 Private & Confidential1 PATIENT CENTRIC META DATABASE AND INFORMATION SYSTEM FOR MEDICAL AND HEALTH MANAGEMENT HOSPITAL & CLINICS

2. 6 October, 2003medXchange©2003 Private & Confidential2 Key Objectives - Rationalization Allow healthcare professionals to work interactive  Tool to optimize the treatment process  Tool to create patient profile and case – disease management  Tool for patient management (e.g. behaviour & lifestyle change)  Tool to avoid redundancy and unnecessary prescriptions 30% reduction of patient history research time 20% reduction in patient diagnosis time 20% reduction of disease emergency treatments 25% reduction of medical exams and tests 30% risk reduction of medications

3. 6 October, 2003medXchange©2003 Private & Confidential3 Key Objectives - Quality Quality of healthcare Enable the delivery of high quality healthcare  Integration of the patient in the healthcare process all medical data are immediately available  Immediate identification of risk patients  Realtime interactive hospital intranet for physicians over open platform  No proprietary systems Provide the highest quality service  24 / 7 Realtime availability of interactive medical information and documentation from trustworthy sources  Patient protection through early warning system

4. 6 October, 2003medXchange©2003 Private & Confidential4 Key Objectives - Hospitals Development of healthcare infrastructure for better quality healthcare Better information and involvement of the healthcare consumer Sharing of healthcare information and experience Comply to healthcare regulations and guidelines Develop programs to rationalize the healthcare process

5. 6 October, 2003medXchange©2003 Private & Confidential5 Innovative Approach to Health & Medical Risk Management 24/7 Availability of patient medical documentation Out of medically credible trustworthy sources (Family / consulting physician, hospital, clinics etc.) Interface to clinical information systems Laboratories, Radiology, Biosensors, etc. Patient disease related profile Dynamic adaptation to state of patient Case – disease and medical risk management EBM for good medical practice - golden standards and guidelines Confidential data exchange point All patient related medical and health data For authorised healthcare professionals both in and out of the hospital

6. 6 October, 2003medXchange©2003 Private & Confidential6 Continuity of medical care Consulting Physician Dispensed Medication Laboratories Second Opinion Medical Call Center Hospital & Clinic Therapists Patient Centric Integrated Electronic Medical Record Physician

7. 6 October, 2003medXchange©2003 Private & Confidential7 Continuity of Healthcare The treating physician, consulting physician, hospital and clinic, dentist, optician, laboratory, therapist and pharmacist can share relevant patient information and documentation.

8. 6 October, 2003medXchange©2003 Private & Confidential8 Continuity of Healthcare Enabling the rationalisation of the healthcare process Reducing unnecessary medical examinations Eliminate redundancy of prescriptions Reduce risk of medication interactions and negative reactions Optimizing the hospital process and reducing hospitalization Avoiding delays in diagnosis and treatments Faster and better medical care at reduced costs Reduce risk of malpractice

9. 6 October, 2003medXchange©2003 Private & Confidential9 Patient Centric Meta Database Meta Database Implant Register Physician Medical Record Health Cards Medical Information & Images Output Input Output Input I E M R Clinical Medical Records Health Profile Dispensed Medication Disease Profile Laboratory Results Medical Call Center

10. 6 October, 2003medXchange©2003 Private & Confidential10 Integrated Electronic Medical Record Intuitively understandable by healthcare professionals worldwide Multi Language Ergonomically structured to physicians working methods Easy to consult by patient

11. 6 October, 2003medXchange©2003 Private & Confidential11 Disease related & health profile Patient group profile IEMR contains patient medical & health data and documentation Patient disease related profiles are created through case – disease support applications (e.g. diabetes, nephrology, cardiology ) Patient health profiles are created through occupational health and human ability building applications Patient group profiles are created for statistical analysis of patient groups IEMR Disease related profileHealth profile

12. 6 October, 2003medXchange©2003 Private & Confidential12 IEMR: Ergonomic Structure Structured to follow the medical process and working methods of physicians Comprehensive and up-to-date medical data and documentation Personalised according to existing patient data

13. 6 October, 2003medXchange©2003 Private & Confidential13 IEMR: Disease related data Comments and notes may be entered with each value on a chart Disease related data: Example of diabetes patient Blood sugar Blood pressure Blood coagulation Medication Calorie intake Physical activity

14. 6 October, 2003medXchange©2003 Private & Confidential14 IEMR: Patient Documentation Patient documentation in the Integrated Electronic Medical Record, IEMR may consist of: Physician notes, letters and text documents Laboratory test and examination results X-Rays, scans, MRI, ECG, angiography, Echocardiography, Audiometrie, Visual performance, fundus of the eye, EMG, NCV, other medical imaging, etc.

15. 6 October, 2003medXchange©2003 Private & Confidential15 Case – disease support: Disease related profile A disease related profile of key medical indicators (e.g. blood sugar, blood pressure, insulin intake etc.) can be established and followed over a day, weeks, months or years.

16. 6 October, 2003medXchange©2003 Private & Confidential16 Management of "Risk Patients" Case – Disease management Using Evidence Based Medecin, EBM and good medical practice Interface or data migration out of other medical information systems Bio-sensors, laboratories, hospitals Specialised medical documentation (Orthopedic, cardiology, nephrology, radiology)

17. 6 October, 2003medXchange©2003 Private & Confidential17 Patient support applications: Examples General patient support  Optic-Card  Dental-Card  Audio-Card  Allergy-Card  Cardio-Card  Diabetes-Card  Nephro-Card  Orthopedic-Card

18. 6 October, 2003medXchange©2003 Private & Confidential18 Data Protection & Access Management Patient controls access to record Certain data updated by patient Medical data certified by physician All data traced to source Physician can restrict access to data Physician & Patient notified of updates EC Health Card or USB Key “access key”

19. 6 October, 2003medXchange©2003 Private & Confidential19 24 / 7 access to key medical data in the Integrated Electronic Medical Record Integrated Electronic Medical Record, allows a physician to be much more efficient and secure in the treatment of a patient. Unnecessary medical examinations, treatments and the associated risks are minimized

20. 6 October, 2003medXchange©2003 Private & Confidential20 Healthcare Rationalization 50% efficiency of patient admission processing time 20% reduction of medical exams and tests 30% efficiency in diagnosis time for emergencies Hospital & Clinic 30% reduction of patient history research time 20% reduction in patient diagnosis time 20% reduction of medical exams and tests Physician

21. 6 October, 2003medXchange©2003 Private & Confidential21 Healthcare Rationalization Patient Greater medical security – one IEMR - Improved healthcare treatment Improved quality of healthcare Optimization of healthcare services Early warning system in case of problems with medical implants and drugs Supervision of compliance with medical regulations

22. 6 October, 2003medXchange©2003 Private & Confidential22 20% reduction of disease emergency treatments 25% reduction of medical exams and tests 30% risk reduction of medications Regional Healthcare Healthcare Rationalization

23. 6 October, 2003medXchange©2003 Private & Confidential23 access authorized by patient platform dedicated to healthcare professionals open standard for medical data exchange integrating existing technologies and systems no investment in hardware and software development integration of national and international physicians The patient centric meta database

24. 6 October, 2003medXchange©2003 Private & Confidential24 Designed by physicians for physicians Complete patient medical data and documentation Follows physician working methods Patient disease profile and risk analysis Patient pro-active health support and profile Case – disease management system The IEMR & Medical Knowledge Base

25. 6 October, 2003medXchange©2003 Private & Confidential25 Why integrate with hospitals and medical groups? Continuity of increasing quality of medical care Patient centric medical data and documentation Optimization & increasing efficiency High quality of patient data and documentation availability Integrates the patient in the medical treatment process and pro-active health programs Assist in in efficient medical and health management Identification of risk patients Optimization of examinations and treatments Identification of optimal treatment guidelines, use of EBM