Industry specific cover image Oracle Healthcare Consumer Solutions

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Industry specific cover image Oracle Healthcare Consumer Solutions: Provider Retail and Disease Management Mary Kilmer, NA Executive Director, Healthcare IBU April 2009

Oracle Healthcare Mission Leveraging the power and resources of a top 5 global healthcare company to empower you to deliver: • Operational efficiency and game changing productivity • Collaboration and communication across the healthcare community • Empowered associates • Information management and analytics with real-time information that promote improvement in outcomes • Reaching beyond the artificial boundaries in promoting wellness and safety • Providing a holistic healthcare experience for each patient’s needs and personalizes their care Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 2

Our Client’s Critical Business Issues • Challenged to improve loyalty and satisfaction with patients, medical staff and employees • Inability to develop new sources of revenue • Struggling to reduce cost of healthcare delivery especially for chronic disease • Challenged to embrace the rise in healthcare consumerism • Fragmented consumer delivery value chain • Improve the patient experience Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 3

Its All About The Relationship “The quality of the ongoing relationship between the hospital and its patients (and medical staff) is far and away the dominant determinant of success. ” Gartner Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 4

What is the Patient Experience for Healthcare? Healthcare organizations develop successful high-value, relationships and deliver superior service and more effective experience to their physician, patient, and community constituents Establish a patient centered, collaborative, personal experience where knowledge and care can support the patient, the family, the community, the medical staff Establish the provider as the trusted source of all healthcare support Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 5

Why Now? • Rise in consumerism, demand for a partnership in care • Increase use of internet and call center • More effective technology • Entrants of new “providers” • Need to capture new revenues with predictable streams • Recognition that this new business needs a retail focus Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 6

What Consumers Say They Want From Hospitals Aligns With “Retail” Strategies Quality – Convenience – Lower Cost - Empowerment • Easy access to care • More support from trusted provider • Coordinated treatment • Better health education access • Price & Quality information transparency • Multiple communication pathways • More collaborative disease management Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 8

Providers Are Challenged to Capture Revenues to Stay Viable Average Revenue Breakdown of Retail Pharmacies ‘ 07 Source: Freedonia Healthcare Market Overview 2008, Public Retail Pharmacy corporation annual reports Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 9

. . . Studies Show Quality & Costs Impacts from Improved Discharge Planning & Care Coordination Sources: “Educating Patients Before They Leave the Hospital Reduces Readmissions, Emergency Department Visits, and Saves Money”, AHRQ press release – Feb. 2009. “Community Benefit Strategies for a Changing Economy”, Jeni Williams, HFM Magazine, Feb. 2009 Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 10

Why Oracle? • World class order to cash and retail solution • Market leading CRM and Order Management and Fulfillment • Investment in functionality • Investment and commitment in healthcare industry • Successful solution managing mail order pharmacy for last 7 years • Experience in the retail and payor space • Experience in provider market Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 11

Oracle Healthcare Consumer Solutions • Mail Order • Collaborative tracking, interaction and education pharmacy and DME delivery direct to consumers or to regional locations • Clinical Pathway Post Discharge • Document and communicate online • CRM, ERP and Analytics Solution Disease Management Pharmacy Interaction Center, and Service • Workflow alerts Scalability • Outcomes improved, readmissions reduced, satisfaction increased • Supply Chain and Financials • Pre-Built Analytics Security • Interactive tools to assess patients complaints • Determine right venue • Referrals • Online FAQ and help desk • Reduce cost • Improve quality • Improve satisfaction • Marketing, Sales, Nurse Triage Accuracy Business Intelligence Retail Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential • Utilizing the Oracle Pharmacy solution • Broaden their value chain by offering supplies, meals, prescriptions, DMEs, etc. • Multiple channels • Interactive TV • POS • Web Store 14

Oracle Insight Review of Healthcare Retail Opportunity Oracle Healthcare conducted an Insight review assessing the Healthcare Retail opportunities for a 550 bed, $300 M in revenue community hospital. . Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 17

Primary Service Lines Studied : These areas were agreed on with senior management at the outset of the project • Discharge-related DME, pharmacy and other services “bundled” to increase revenues & patient satisfaction in the following areas: – OB/GYN – Oncology – Psychiatric – E. D. – Cardiology – Sleep Lab • Retail / Out-Patient Pharmacy – Potential for re-fill & “smart-switch” business related to discharges – Related OTC business – Employee prescription service – Possible pharmacies in MOB’s or other remote locations – Other • Expanded Gift Shop products & services – Existing gift shop – Greatly expanded web offerings – Additional retail shops Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 18

Patients were Surveyed to Validate Patient/Consumer Receptivity & Interaction Preferences for the Contemplated Services • The great majority of patients indicated they would use these services – if offered: • • 84% said they’d purchase DME/HME items if offered 84% said they’d purchase discharge medications if offered 75% said they were comfortable ordering via in-room interactive TV devices 66% said they’d order refills of medications initially purchased at discharge • Patients view hospital as a trusted source of medical information, second only to their physician! • Preferences for communication & information exchange lend strongly to anticipated program execution plans Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 19

Extremely Conservative Estimates Used We used lower anticipated business capture rates & margin estimates than both industry & patient survey data prove are likely Product / Service % Capture of Available Business Industry Hosp Pts. We Used Assumed Gross Margins Industry We Used DME & Daily Living Products 60% 84% 40 -70% 50% 25 – 35% Discharge Medications 60% 84% 30 -70% 24% 22% Refills on above 40% 66% 35 -50% 10 -20% 7% Employee Medications 80% 10% 7% 60% Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 20

Detailed Opportunity Summary Example: Women’s Health Services New Products / Services Annual Revenues Gross Margins Related DME/HME sales $0. 9 – 1. 5 M $0. 6 – 0. 9 M - Breast pumps/rentals, bras, diapers, 15% bottle feeder items (Note current pump sales/rentals only 320/yr. – vs. 34000 total!) Related Pharmacy sales $0. 5 – 1. 9 M $0. 05 – 0. 15 M - Percoset, Lanolin, “Easy Switch Conversion” Other products & services $0. 6 – 1. 2 M $0. 3 – 0. 5 M - Specialty formula, car seats, Baby Registry Services Total Annual Revenue Potential Reimbursable = $0. 7 -1. 7 M $ 2. 0 – 4. 6 M Non-Reimbursable = $1. 2 -2. 3 M $0. 95 – 1. 5 M Home Service Related = $0. 6 -. 08 M Key enablers: • • • End-to-end re-design of communication & coordination activities with physicians & patients Clinical system integration to trigger appropriate workflows based on diagnosis, procedural, or other drivers. Standardized discharge order sets for target groups, with physician buy-in. Modified nursing discharge procedures to accommodate. Potential use of interactive TV offerings to enable easy patient education & ordering. Proposed retail system components to manage orders, fulfillment, billing, collections, reporting, etc. Dependencies: • • Gaining physician support outside core advisory group. Additional retail & education space Coordination of “sales” efforts at all touch points. Related “Discharge” pharmacy dependencies. Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 21

Executive Summary - Key Findings for Hospital § Increase annual revenues of $21 to 40 M per year, with margins ~$8. 1 M (additional $20 -30 M in areas we didn’t study) § Extrapolated to Health System level, between $500 M and $1 B annually § Most attractive areas to start will be additional DME sales in Women’s services, Pulmonary, Cardiology, Sleep Lab and E. R. – § Discharge pharmacy sales is next most attractive opportunity § These new services will also satisfaction § Enhance hospital comprehensive patient care & service innovation Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 22

OHCS Retail Footprint: Order-To-Cash Flow Applications Channels Shared Components Analytics Disease Mgt Customer Relationship Management Order placed Telephony e. Mail Supply Chain Management Order managed and fulfilled Web SOA Suite Task Manager Business Intelligence/Reporting Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential Mobile Financials Order paid for Fax

The Right “Retail” Strategy Can Bring Multiple Positive Outcomes • New revenues with higher margins • Improved patient care & wellness • Improved patient satisfaction and physician • Lower total cost of care • Building of “Brand” loyalty • Reduced operating costs • Improved disease management Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 24

Oracle Healthcare Consumer Solution • Supports: the ordering and fulfillment of – Pure retail – e. Commerce gift shop – Pharmaceuticals, discharge and refill – DME discharge and refill • Also supports: – Disease Management – Marketing and Branding – Loyalty Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 25

Multiple Channels Can Deliver the Message • Personal Content Delivery Tool • Interactive TV • Patient Concierge • Discharge Planner/Nurse • Fax • Call Center • Email • Portal • Paper/Mail Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 26

Disease Management What is DM Who Is it for? • Health Screening • Health Education • Health Coordination • Health Choices • Health Support in and out of the • Patients • Families • Communities • Providers • Payors • Provinces • States • Countries Hospital Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 37

Why Focus on Chronic Conditions? As of 2006, patients with chronic conditions accounted for: 83% of US healthcare spending 81% of inpatient stays 91% of prescriptions 76% of physician visits 98% of home healthcare visits Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 38

Why Focus on Disease Management? Chronic Disease Management • Cost of CDM in the US 2008 -$1. 3 Trillion with and estimated increase to $4. 2 Trillion in 2023 • 80 Million people have multiple CDs • Canada’s annual spend for CDM is over $80 Billion • CD accounts for 44% of the population but 78% of all healthcare expenditures • CHF the number three admission due to lack of coordination of care at home Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 39

What is the Cost of Chronic Disease? Chronic Disease Management • Frequent readmissions • Burden on patient who has to manage complicated treatments and medications on their own • CHF the number three admission due to lack of coordination of care at home • Burden on family and healthcare system Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 40

Oracle is Invested in Supporting Chronic Disease Management Health Awareness and Prevention Connected Healthcare OHCS: CDM Solution Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 41

Implications for Clinical Quality • OHCS supports Disease Management initiatives to help push the clinical pathways post discharge or after initial diagnosis – Channel for provider/patient/caregiver collaboration with access for patient interaction thru portal, email, phone etc. • i. e. Daily glucose check with workflow based on tolerances to physicians • i. e. track daily weight of CHF patients – Supports more directly the treatment plan with direct control of medication, meals, DMEs, services – Meals for CHF patients – Supports pathway management thru Online Learning tool to support compliance • Comprehensive analytics and reporting to track and improve patient and aggregate clinical outcomes Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 42

The Right Consumer/Disease Management Strategy Can Bring Multiple Positive Outcomes 1. Improved patient care & wellness 2. Improved patient satisfaction and physician 3. Improved support to patient and family 4. Closer relationship between provider and patient 5. Lower total cost of care 6. Improved health awareness and prevention 7. Health prevention and population screening Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 43

OHCS: DM Solution Footprint Disease Management • OHCS: Disease Management – Siebel Interaction Center • Web • Email • Call Center • Smart Scripting – Siebel Marketing – i. Learning – Oracle Technology Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 45

Oracle Disease Management • Utilizing CRM Interaction Center and learning to establish a more collaborative relationship between Patients and Providers and between the care team – Programmatic approach to Disease Management thru Marketing and Interaction Center • Call Center • Email • FAQ • Portal support • Learning • Expansion of outreach Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 46

Oracle Disease Management • Chronic Disease Management – Diabetes • Classes • Glucose communication • Education • Meals, pharma, DMEs, etc support • Call Center support • FAQ online • Email • Communities Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 47

OHCS is the Only Solution That Will Bring Results and Build the Relationship • New revenues with higher margins • Improved patient care, disease management, & wellness • Improved satisfaction and experience • Lower total cost of care • Building of “Brand” loyalty • Reduced operating costs Copyright © 2009, Oracle. All rights reserved. Oracle Healthcare Confidential 50