1. Mobile Health & Interoperability Facilitating the Ecosystem for Personal Connected Health AeHIN- August,13 2013

2. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 2 What is Personal Connected Health? Communications & health devices deployed or enabled by healthcare organizations to collect/share individual patient physiologic & Quality of Life (QOL) data Unlike telehealth, allows providers & patients to employ data & communications independently, at their convenience Examples of PCH: Remote home monitoring programs in chronic disease or independent aging PCH allows providers and patients to: –Use technology to collect data conveniently and securely –Communicate more frequently with little manual intervention –Effectively monitor and better understand personal health data

3. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 3 Drivers for Personal Connected Health Pressure on Healthcare Require New Models of Care Source: DB Research 2010 Aging population in industrial countries leads to increase of age-related diseases Care of elder highly correlated to development of population Demographic Change Increase of Chronic Diseases High Health Care Expenses Provision of healthcare Worldwide rise of chronic diseases Compounding impact on expenses due to growing number of chronically ill children Chronic and long- term illnesses account for 75% of health care expenses Decreasing # of regional hospitals Reduction in hospital beds Declining care by general practitioners Housing situation and lack of transportation affect access to care Declining access to quality care for many people with disease Acceler ated increase of chronic disea ses Continuo us rise of health care cost for payers and patients Insufficient number of working population to finance the health care system

4. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 4 Benefits of Personal Connected Health Patient –Remain/return to home – QOL, time & cost savings –New awareness of health status creates understanding & engagement –Improved collaboration with health care provider –Avoidance of unnecessary office and/or ER visits Provider –Automatic updates & alerts on patient status –Improved triage capability & preservation of physician resources for most serious cases –Maximal time for preventive action –Ideal for chronic diseases management

5. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 5 Example 1: Example 2: Cell phones and ATM networks use “interoperable” devices, systems and services– they are connected and capable of inter- communicating Benefits: Ease of use Freedom of choice User satisfaction Quality Innovation Differentiation Scalability Competitiveness Cost (Development, TCO, deployment) Value of Interoperability

6. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 6 Continua Health Alliance The Engine for a Plug-and-Play World International non-profit industry organization enabling end-to-end, plug-and-play connectivity of personal health devices, systems and services in Personal Connected Health 200+ members: technology, medical device, telecom, health tech service & healthcare industry leaders

7. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 7 What We Do Develop and publish Design Guidelines that combine & apply existing standards Certify products, systems and services for compliance with Continua’s Design Guidelines Promote favorable operating climate for PCH through advocacy & coordination Creating a global market for personal connected health Connect leading technology developers, innovators and healthcare organizations

8. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 8 Standards Incorporated in the Design Guidelines Sensors 11073 PAN Transport EHRs Continua End-to-End Architecture Includes these standards, and more

9. 9 Breaking Down an Interoperability Architecture Enabling PCH at the Interface Health Record Network (HRN) Interface Personal Device Weight Scale Pulse Oximeter Independent Living Activity Cardio / Strength Medication Adherence Glucose Meter Pulse / Blood Pressure Thermometer Physical Activity Peak Flow Electrocardiogram Insulin Pump Aggregation Manager Personal Area Network (PAN) Interface Wide Area Network (WAN) Interface Telehealth Service Center Health Records/ Networks EHR PHR NHIN HIE WiFi, 2G, 3G & 4G

10. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 10 Why Interoperability? Compliance with global industry standards is proven to decrease time to market and reduce development costs: Lower Design Costs: saves US$ 40,000-$80,000 in development costs per device* Faster to Market: decreases integration time from three months to just three weeks Increased Efficiency: quicker, less expensive integration to EMR or HIE platforms Forward/backward compatibility: longevity of devices Easy to expand or add new programs/products with plug-and-play *Source: PricewaterhouseCoopers

11. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 11 Development Life Cycle 1.Submission of ideas 2.Use Case development 3.Balloting 4.Use Case sponsorship 5.Decomposition into Work Items 6.Gap Analysis 7.Guidelines Development 8.Balloting 9.Approval 10.Testing 11.Public Release & Comment Period Use Cases Requirements Standards Guidelines Open Process: Developing Design Guidelines

12. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 12 How Does Interoperability Support mHealth? Enables convenient, robust data exchange Facilitates large-scale data sharing – simplifies consolidation of health data from different sources Promotes positive user experience (providers, patients, administrators) Introduces new flexibility for launching & maintaining home health, consumer PCH –Devices guaranteed for forward/backward compatibility with all Continua-ready products –Same-use devices interchangeable –Easy to expand or add new programs with plug-and-play

13. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 13 Where We’re Going: Globally Scalable Products and Services in PCH National adoptions by Denmark, Singapore Regional adoptions by Abu Dhabi, NHS Driving government adoption –Ex: Continua Connects showcase events Expanding presence: China, India, Australia Developing new regional Work Groups: Brazil, Southeast Asia, Middle East Increasing reach: global standards coordinating bodies; trade, adoption & standards development organizations

14. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 14 Continua Design Guidelines on Track to Become Global Health Standard in the ITU The International Telecommunications Union (ITU) is the oldest United Nations organization –ITU-T is dedicated to produce timely, stable, worldwide standards The ITU-T is comprised of 200 national governments and 700 private companies and organizations Continua Design Guidelines accepted as ITU-T SG16 Work Item –Approval: start in Nov 2013 & complete in early 2014

15. 15 Open Source Initiative: Assisting to Develop the PCH ecosystem The Alliance is working with OpenHealthTools.org to publish Open Source code covering all Continua end-to-end interfaces The Open Health Personal Connected Health Project will become a hub for the software and tools used to build the ecosystem and stimulate innovation among entrepreneurs and students Several Continua components already available on OpenHealthTools.orgOpenHealthTools

16. 16 VALUE OF CONTINUA GUIDELINES Source: PricewaterhouseCoopers *Figures based on actual experience, **Estimates Time 12 weeks** incl. 30 days for connectivity Man-weeks (1 FTE per company) 72** Non-Continua 2 weeks* incl. 3 days for connectivity 12* Continua Bring down deployment time down to 1/6 60 man-weeks or $139k saved  Interoperability assured quality because each company could focus on their module in D-CAP $166k** $27k** DISASTER CARDIOVASCULAR PREVENTION NETWORK (D-CAP) Target: 1,500 survivors of Great East Japan earthquake living in evacuee camps, two conditions that put them at risk for cardiac events Tech Objectives: Determine comparative time/cost of implementing Continua-certified devices Method: RPM for pts identified as high risk (400 pt), using devices previously certified by Continua Tech Providers: A&D (Automatic blood pressure monitors), Alive Inc. (Gateway firmware), Ryoto Electro Corp. (data server), Panasonic (PC), Toppan Forms (Patient ID Cards), Intel (Project coordination) Case Study: Time-to-Market Advantages Using Continua DGs: Japan Disaster Cardiovascular Prevention Network (DCAPS)

17. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 17 International Activity Hubs: Adoption & Work Groups UK (NHS Worcestershire ) Japan WG Denmark Singapore SE Asia WG Australia WG India WG Brazil WG Abu Dhabi = Adopting Continua = Continua Work Group US Veterans Administration & US Department of Defense US WG Japan EU WG UAE WG

18. 18 Activity in Asia Interest and cooperation by major companies: Spice Global, China Mobile, Fujitsu, OMRON, etc. Continua Working Groups in Japan, Southeast Asia Leading examples of mhealth cooperation in the market: Ex: DCAP - Disaster Cardiovascular Prevention Network - Established to remotely monitor survivors of Great East Japan earthquake who were at high risk for a cardiovascular event

19. 19 Joining Continua: Benefits to Asian Nations Guidelines, code and test tools worth more than USD $2M –Creates cost savings and simplifies challenges of end-to-end, plug-and-play design Access to Continua and health ministry experts with experience in regional or national rollouts Support for market development –Regional test labs: Taiwan, Seoul, Beijing –Continua Certified Experts: Seoul, Beijing –Continua Working Group support & participation –Continua Connects events

20. Copyright © 2012 Continua Health Alliance ® All Rights Reserved 20 Synergy with AeHIN Shared interests with regard to: –Regional and national adoption of health IT –Dedication to interoperability as a means to improved healthcare –Interest in policy and regulation to support market development –Commitment to open standards –Strategy to promote stakeholder collaboration

21. 21 Continua Health Alliance The Engine for a Plug and Play World Chuck Parker Email: chuck.parker@continuaalliance.org Connect with us on social media!