Consumer-centered digital health solutions are transforming the future of health care. Technologies such as mobile, the web and wireless monitoring are converging to empower patients and offer physicians countless new ways to deliver health care. This breakfast briefing will spotlight emerging business models in the consumer digital health industry as well as the perspectives of different stakeholders. Entrepreneur, investor or interested health consumer? Come and learn more about this growing sector! Want to learn more? Download Consumer Digital Health—the new Market Insight report by MaRS.

2. MaRS Market Insight Series
Michael Matthews
National Health Services

3. Problem Statement
Today patients and their families operate in a predominantly
paper-based health data environment.
What will be the some of the key issues driving change in
2020 that will see the shift to Digital health information?
Deloitte Canadian S&O Template 082407
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4. In 2020 Globalization will drive a different environment for healthcare
Consumer Pandemic
Demand Planning Resource
Resource
Interprofessional
Interprofessional
Shortages
Shortages
Enhanced
Enhanced Demanding
Demanding
Primary Care / /
Primary Care Demographics
Demographics
Medical Home
Medical Home
Converging
Converging
Chronic Disease
Chronic Disease
Relationships
Relationships
Prevention and
Prevention and
Management
Management
Comparative
Comparative
Expanding
Expanding Effectiveness
Effectiveness
Scope of
Scope of
Practice
Practice
Pay for
Pay for
Deloitte Canadian S&O Template 082407
Medical
Medical Private Care
Private Care
Performance
Performance
Tourism
Tourism And more…
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5. Consumers are spurring the demand for digital health
Deloitte’s 2009 Survey of Health Care Consumers revealed that consumers are very interested in
use and benefits of a personal health record:
• Over 65% of respondents feel it would be beneficial to have access to the PHR of a family
member whose care they are helping to manage
• Over 60% of respondents are interested in a PHR or online medical record provided by their
doctor’s office, hospital and government
• 2/3 of respondents are interested in health monitoring technologies that can feed data to PHRs
This calls for a personal decision-support model that…
• Centres around the consumer
• Offers self-care, self-
management and learning
capabilities
• Is offered through a trusted
source and secured from
privacy breaches
• Provides a flexible platform for
Deloitte Canadian S&O Template 082407
a consolidated view of a
patient’s health
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6. How will we get there and what will it look like
• In 2020 PHRs will be in broad use by Canadians and a culture shift will have
occurred (e.g. similar to how we conduct on-line banking today).
• New care models such as ACOs will allow for better interaction and sharing of
health information electronically (PHR / EMR linkages). Pay for Performance
• Government, Providers, Professionals, and other organizations will be
expected to post data to an individual’s PHR in order to help them develop a
longitudinal health record (EHR linkage).
• Patients will have ubiquitous access to their record and will not be bound in the
information they see.
• Patients will now be able to view, edit and update their information through the
PHR making them active participants in the maintenance of their health record.
• Patients may be encouraged to interact and sustain their own information as
part of a care plan.
• PHRs can provide the interactive platform for patient self management and
customized care scenarios (e.g. Chronic Disease, healthy lifestyles).
Deloitte Canadian S&O Template 082407
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7. Getting to 2020
• What is the overall strategy and plan?
• What are the ownership and structure issues?
• How will PHRs be funded and sustained?
• How can adoption be encouraged (providers, professionals and patients)?
• How do we link back the use to digital health to better outcomes?
• What are the plans for consolidation and re-alignment among current players
(PHR, EMR, etc).
Deloitte Canadian S&O Template 082407
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8. Deloitte, one of Canada’s leading professional services firms, provides audit, tax, consulting, and financial advisory services through more than 6,800
people in 51 offices. Deloitte operates in Québec as Samson Bélair/Deloitte & Touche s.e.n.c.r.l. The firm is dedicated to helping its clients and its people
excel. Deloitte is the Canadian member firm of Deloitte Touche Tohmatsu.
Deloitte refers to one or more of Deloitte Touche Tohmatsu, a Swiss Verein, its member firms, and their respective subsidiaries and affiliates. As a Swiss
Verein (association), neither Deloitte Touche Tohmatsu nor any of its member firms has any liability for each other's acts or omissions. Each of the
member firms is a separate and independent legal entity operating under the names “Deloitte,” “Deloitte & Touche,” “Deloitte Touche Tohmatsu,” or other
Deloitte Canadian S&O Template 082407
related names. Services are provided by the member firms or their subsidiaries or affiliates and not by the Deloitte Touche Tohmatsu Verein.
© Deloitte & Touche LLP and affiliated entities.
-8-

9. Questions
-9-
Deloitte Canadian S&O Template 082407

10. Q1- Who pays and what are the business models for
revenue generation ?
• Current “claim-staking” will not continue and investments will need to be
recovered at some point.
• Some patients may pay (Parents, Care Given/PoA, Chronic Disease Patients)
due to their context.
• Patients will need to experience value (Prescription Refill, Referral, electronic
consult) or their initial interest may fade. Incentive models for use.
• Scale of Canada means that funding sustainment may need to be come from
government to ensure projects continue.
• Accountable Care Organization models are expected to spur innovation in care
delivery and patient self management. Digital Health will be key in linking data
back to outcomes.
• Content linked to health information may provide a new model
• As pressure continues to be applying to health costs, Payers will be looking to
Deloitte Canadian S&O Template 082407
create methods for driving down costs
• Kaiser Permanente – 5 diseases driving over 85% of their health costs.
- 10 -

11. Q2 - What is the role of regulatory agencies ?
• Regulatory Agencies will need to establish expectations on privacy, security
and secondary data use.
• If new operating models are considered like AllScripts in the US, there will be a
need to have oversight to make sure data in not shared inappropriately.
• Balance will need to be struck, medical device-like licensing is a good idea but
does it actually address many of the key risks of digital health.
• Avoid duplication and vendor dominance issues.
• Standards and Compliance
• System Strategy, Investment Plan and Execution
Deloitte Canadian S&O Template 082407
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12. Q3 – How do you assure consistency and accuracy of
data?
• Make sure the foundation is right: Identification and linking of health
information to a person is first point of failure
• Maintain the chain of ownership for health data (HIC) and make it immutable.
• Create audit, testing and re-fresh programs to make sure that the feeds are
working properly.
• Allow patients to see their own information (PHRs or Patient Portals).
Deloitte Canadian S&O Template 082407
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13. Q4 – Who ensures privacy and security of data ?
• The infrastructure has to be trustworthy. Solid applications and technical
foundation is key to being able to manage and secure information.
• The consent and management models have to be clear, understandable and
accepted.
• Caregivers and other key stakeholders who can access the systems have to
understand their responsibilities and penalty structures should be established.
• Privacy Commissioners should be the enforcers in managing any
discrepancies or violations.
• Who audits the information that is “out there” (e.g. physician offices).
Deloitte Canadian S&O Template 082407
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14. For more information, please contact:
Michael Matthews
National e-Health Leader
mmatthews@deloitte.ca
Deloitte Canadian S&O Template 082407
- 14 -

15. Deloitte, one of Canada’s leading professional services firms, provides audit, tax, consulting, and financial advisory services through more than 6,800
people in 51 offices. Deloitte operates in Québec as Samson Bélair/Deloitte & Touche s.e.n.c.r.l. The firm is dedicated to helping its clients and its people
excel. Deloitte is the Canadian member firm of Deloitte Touche Tohmatsu.
Deloitte refers to one or more of Deloitte Touche Tohmatsu, a Swiss Verein, its member firms, and their respective subsidiaries and affiliates. As a Swiss
Verein (association), neither Deloitte Touche Tohmatsu nor any of its member firms has any liability for each other's acts or omissions. Each of the
member firms is a separate and independent legal entity operating under the names “Deloitte,” “Deloitte & Touche,” “Deloitte Touche Tohmatsu,” or other
Deloitte Canadian S&O Template 082407
related names. Services are provided by the member firms or their subsidiaries or affiliates and not by the Deloitte Touche Tohmatsu Verein.
© Deloitte & Touche LLP and affiliated entities.
- 15 -

16. How Pfizer Canada is Earning Trust…
…More Than Medication
Veronica Piacek
Director Consumer Communications & Relations

17. 2

18. That was then…
… this is now.
3

19. Canadians are global connectivity leaders
Globally
Canadians lead
in connectivity
4

20. Web 2.0 is the new health influencer
85% of Canadians are online
! 69% are likely to visit a health website
! 1/4 state that their doctor encourages them to use the Internet to
search for health-related information
! 1/5 agree that they now visit the doctors office less often because of
the information found on the Internet
5

21. We Surveyed Our Public Image…
…to get to the root of the distrust
! Controversy over DTC advertising
! The expense of healthcare
! Drug recalls
! Big profits
! Big payouts
! US media spill-over

22. 7

23. Here’s what they said:
Pfizer?
«I think this person is cold not warm. Pushing pills. Only interested
in profits not people »
«!I imagine a passionate scientist but I don’t understand anything
he is saying. He doesn't speak my language. He is not connected
with the reality of this world. »
CONSUMERS ONLY SEE US AS SELLERS OF PILLS
Consumers in Focus Groups 2007
8

24. From being in the
Selling Pills Business
To being in the
Healthcare Business
9

25. 10

26. Web Demo Video
11

28. Consumer Health
MaRS Market Insight Series
January 26, 2011

29. Introduction
84%of Canadians consistently respond2 in favour of being able to access their own
health information summary, they will no doubt be even more interested in the
opportunities online PHRs may be able to deliver Privacy commissionners of Canada
Consumer health is
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TELUS plan is about
Removing the logjams
Creating critical mass
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30. Consumers are looking for new tools and services
Willing to pay for more services
More than half of all Canadians are willing
to pay more for a wider range of services
and improved timelines
Want better connections
72-78% of consumers want access to
online medical records, test results,
scheduling and appointments, home
monitoring, and communication with
doctors
65% of Canadian want a PHR for
family members they take care of
Up to 26% would pay for these
Want home care
80% Canadian want more home and
community care programs
33

31. Consumers are active online
Over 5M Canadians are searching for Health news online, 30% of which
are between 29-42.
44

32. Lessons learned worldwide
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#,%/6'$)0,/%/6( 5,%.0*)'5$0:),('5),().),)'0/-'5$0/'-)5$+:3)/*'%/%*%0*%.)(';+,$-;%-)
US Kaiser Permanente: Success
stories around PHR
Denmark : High value attached
to patient-MD communication
US: Value and importance of
email consultation EF$/#&'0"%&('0
8)(.0,=$GH$8/$?,)I#20
Germany: Value of subsidies
from insurers
!"#$%&' UK MSFT direct market entry. Just sold healthvault to NHS as sponsor
I srael: Consumer need for ()&*+, Australia After 2 national effort failure, lead is now at regions level w/ private
advice, and personalized Denmark Ongoing progress with National Patient register. 15% usage.
recommendations -,%.)/
China - $128B improvement in healthcare productivity, including PHR
Brazil Ambitious national PHR rollout plans, drives EHR adoption and funding
Spain: Positive impact of SMS Russia Performing technology refresh, then planning PHR rollout
functionality when properly
Malaysia Centralising data centers, then planning PHR rollout
utilised
!,%.0*) Germany Siemens wants to sell to private insurers and other sponsors
US: Cloud model shows slow ()&*+, France Orange « Voute Santé » sold top insurers. Focus on vaccination.
take-off Singapore Infrastructure upgrade by Accenture & DBMotion, PHR included
-,%.)/
I ndia Largest Hospital chain, Appolo, planning PHR rollout
USA 7% Americans used consumer health eTools for. Source of these tools: 50% from
payers, 25% from providers. <10% from GoogleHealth or HealthVault.
USA - Google Health recently redesigned and relaunched.
5

33. Industry dynamics create tangible opportunities
Pharmacy
chains
Ministries
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Pain points:
-Ease of use
-Universality
Regions -Accessibility
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- Portability
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-Security
-Connectivity
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Private and public institutions focus on Shift of roles Consumers look to address pain points,
efficiency gains, new $, and quality of PUSH between institutions and consumers PULL and want to be better participants in the
care drives search for new tools management of their health
6

34. Emerging Portfolio
Mobile Apps
Devices
An online
Content
consumer
destination
Upopolis
MedPals
7

35. Summary
Role of the consumer is changing
Consumers are central to their care
Consumer health solutions are here tools are now available
99

36. Consumer Health
Thank You
Zak Bhamani
member of the TELUS team

37. Your Evidence-Based Medical News
Channel
Sanjay Sharma MD, MSc, MBA
By PresenterMedia.com

38. ON TARGET
Agenda
Overview of Insidermedicine.com
Our Story
Insidermedicine’s Content
IM Social Network Distribution + Hardware Platform
Case Studies

39. ON TARGET
From the basement….

40. ON TARGET
Insidermedicine.com
Insidermedicine is a physician-led news and
knowledge-translation organization
providing credible, fair balance reporting
on key medical interest issues and topics.
Our goal is to reach consumers, patients,
medical doctors and students to ensure that
each has access to and receives "evidence
based" health and medical updates.

41. ON TARGET
Quick Facts about Insidermedicine
QUICK FACT
QUICK FACT
- Established in 2006 to bring “high quality,
unbiased health information” to the market - July 2009, IM was awarded a Public
Education Award from the Canadian
- Our editorial board includes leading medical
doctors, noted researchers, and experienced Dermatology Association for its “If I Had a”
biostatisticians and epidemiologists dermatology video series
- As a news and knowledge translation
organization, we get access to embargoed - IM site acknowledged by YouTube as one
information from various medical journals (such as of the their TOP 10 News Sites
the NEJM and JAMA).
- IM has established relationships with Key Thought
Leaders at leading universities throughout North
America
- IM has created medical content with over 100
research intensive organizations, including
Harvard and Stanford Universities and the CDC.
- IM has created over 4,500 education based
videos over the past 4 years

42. ON TARGET
INSIDERMEDICINE– A NEW VOICE
Feed business
Distribution business

43. ON TARGET
Using Insidermedicine (IM) News Story
Moving beyond the traditional PR release
o The IM News Story solution is the combination of a press release in Video
format with distribution via social networks and SEOs
o IM News Story converts your pre-embargoed Press Release into a high quality
video news story that “goes live” at the time of the embargo
lift and with the potential to go viral
o IM News Story goes live on Insidermedicine.com (crawled by Google spiders
every 5 min.)

44. ON TARGET
IM Social Network Distribution
o IM News Story video is distributed through a proprietary IM Platform
o Your message is tied to specific search terms ensuring faster pick up/
recognition

45. ON TARGET
The Stats Speak for themselves...
o Over 200,000 views per month on
o Over 20,000 views per month on the Insidermedicine TV Network
located in doctor’s offices and hospitals
o Insidermedicine’s channel has had over 800,000 views
o Insidermedicine’s is one of and
Partner sites
o Insidermedicine’s content is featured on
OVER 3,000,000 views per year

46. ON TARGET
InsidermedicineTV
IPTV
+ Signal box
+

47. IM Touch
ON TARGET

48. ON TARGET
CASE STUDY – LUCENTIS

49. ON TARGET
Case Study – Lucentis
o Manuscript showing effectiveness of Lucentis for diabetic retinopathy;
potentially a $1B market
Goals:
o Deliver a high quality, evidence based video (consistent with brand), with a
3D animation within 7 days
o Gain high search relevance for “Lucentis video” on search engines
o Deliver high viewer reach
o Gain access for video on social networks including iTunes, Facebook and
You Tube

50. ON TARGET
Case Study - Lucentis

51. ON TARGET
Case Study – Lucentis - Results
o #1 video - within 6 minutes of posting
o Overall views = 15,773 on insidermedicine
o Estimated views on InsidermedicineTV = 16,320 over 3 week period
o 3 months post release - Google search for “lucentis video” –
#1 url (denominator = 243,000)
o Client signed 4 video deal for further video knowledge translation
o 2 videos created within 7 days; including 3D MOA

52. ON TARGET
CASE STUDY – CMAJ

53. ON TARGET
Case Study – CMAJ
Goals:
o Create high quality evidence based video of OPALS with CMAJ branding
o Creation of two videos – one for patients, one for physicians
o Generation of CMAJ presence on

54. ON TARGET
Case Study – CMAJ - Results
o #1 video (April 20, 2008)- within 5 minutes of posting
o Overall views = 22,353 on insidermedicine
o 2 years post release - Google search for “OPALS video” –
#3 url (denominator = 20,000,000)
o 2 years post - both videos sit in top 5 viewed search
“CMAJ” - #1 result (2606 views) and #4 (905 views)
o 2 videos created within 7 days; including intubation animation

55. ON TARGET
Final Thoughts
o Insidermedicine has become a leading EBM news and KT
channel
o Source of differentiation on content is MD-led
o Invested heavily in partnership
o Leveraging emerging distribution channels
o Using different biz models