Forum CISPau Planas, CEOFebruary 2003

Mission

In an attempt to exploit these opportunities, e-MedicalMonitor aims at:

… becoming the reference provider of servicesfor the management of chronic disease,… through the application of state-of-the art computer and communications technologies,… in co-operation with patients, doctors and healthcare organizations,… with the ultimate goal to improve the patient’s quality of life.

Current trends in the OAT management

The centralized “OAT clinic” management model is in crisis, due to:

the tremendous increase in the amount of anti-coagulated patients, currently estimated to be around 0.8-1% of the total population in EU / USA.the rather modest level of resources available to OAT clinics.

In an attempt to address this crisis, several alternative management models are being proposed, based on:

the decentralization towards primary care practices and / or family doctors.the patient self-testing and / or self-management.

Report

After a routine INR control (1), the doctor adjusts the drug dosage (2) and the patient receives the information automatically at home (3).Once the blood sample is extracted, the patient may go back home without worrying about unnecessary waits, travels and calls.

Fax / e-mail reporting

Cellular phone (SMS) reporting

easyTAO Report38506900R05.08.2000INR 2.22COUMADIN 528.75 mg/wkM 1Tu 3/4W 3/4Th 1F 3/4Sa 3/4Su 3/4App. 14-09-2000

www.e-medicalmonitor.com

FAX

GSM PHONE

BROWSER

E-MAILPC

PCBROWSER

PATIENTSPATIENTS

INTERNETINTERNETPMS

PHONE OPERATOR

GSM/SMS OPERATOR

easyTAO SERVEReasyTAO SERVER

E-MAIL

DUNAAPLICATIONS

ORACLEDBMS

ENGINE

DUNAWEB

APLICATION

DUNAHTTP / HTTPS

SERVER

FIR

EWA

LL

DUNASOCKET / FEEDER

OAT CENTEROAT CENTER

The easyTAO system

SMS

FAX

One system, several services

ANTHEMA

ASP

easyTAO

homeTAOe-MM

systems

Patient & relatives

at home

Healthcare

professionals

ANTHEMA ASP for OAT clinics / practices

Application Service Provider (ASP) model:outsourcing of IT operationsservice vs. product

ANTHEMA ASP services lets clinics / practices benefit:by letting them focus on high added-value activities.by facilitating the implementation of systematic, high quality OAT management programs for decentralized / home patients.by offering easyTAO and homeTAO services to patients.

ANTHEMA ASP lets clinics / practices manage all types of OAT programs in an integrated, cost-effective way.

homeTAO reminds the patient that a new control should be performed (1). After the test, the patient enters the INR value into the system. homeTAO alerts doctors about patients requiring drug dosage adjustment on a daily basis (2). Following the doctor’s intervention, the patient receives the control report automatically at home (3).

Patient self-testing services

Italian pilot test

From September 2001 to September 2002, e-MM offered easyTAO experimental services in five of the most reputed Italian OAT clinics:

Ospedale S. Orsola, BolognaOspedale Maggiore, ParmaOspedale Ex Busonera, PadovaOspedale Policlinico, MilanoOspedale Eugenio Morelli, Sondalo

The pilot test was carried out with the full support of Italian OAT clinic and patient federations (FCSA and FederAIPArespectively).250 “real” patients used easyTAO. The system processed more than 6000 therapy reports with no major incidents.

easyTAO pilot test: the OAT clinic’s view

Traditional reporting easyTAO reporting

Reliability in the delivery Excellent ExcellentErrors Poor ExcellentReporting clarity Excellent GoodCommunication with patients Excellent GoodPatient comfort Very poor ExcellentPatient monitoring Poor PoorPrivacy Poor ExcellentAvailability Very poor ExcellentWorkload Poor GoodCosts Very poor Excellent

By Dr Pattacini, Parma OAT Centre, as presented at the FCSA 2002 Congress, Abbano Terme (Italy), 12 March 2002

easyTAO pilot test: the patient’s point of view

Excellent Good Poor Very poor

Usability / simplicity 77% 22% 0% 1%

Daily life improvement 28% 40% 25% 7%

Therapy quality improvement 16% 55% 15% 14%

Overall service rating 37% 59% 3% 1%Data obtained from easyTAO pilot test poll to 70 participant patients, as presented at the FCSA 2002 Congress, Abbano Terme (Italy), 12 March 2002

To conclude:

e-MM goes beyond the traditional R&D driven telemedicine model:

providing services, not systems matching the clinical organizations’ needsdeveloping viable commercial models