PRESS KIT

TBS GROUPThe Group, its origins and expansion

TBS Group is a company established in Trieste, Italy, and listed on the AIM Italiamarket for small and mid caps. The company has been working as an outsourcingcontractor for healthcare and public sector organizations for over thirty years, takingcare of their clinical engineering services, global IT, e-Health and e-Governmentrequirements.

The Group is represented in several countries and its core business is the mana-gement of biomedical and IT technologies in healthcare settings. Thisapproach makes it possible to optimize costs, promote efficiency and quality, faci-litate the innovation of technologies and processes, thus also improving the life qualityof end-users, i.e. patients.

Established at the end of the 80's as a clinical engineering spinoff of CNR (ItalianNational Research Centre), the company has been growing at the same pace asthe technology and IT systems of healthcare organizations (including hospitals, localhealth trusts, National Healthcare System, etc.). Technological developmentshave made the management of IT systems in healthcare organizations an increa-singly challenging task. Cutting-edge technologies alone are not sufficient toincrease efficiency. That is why the Group is focusing on both process inno-vation throughout the hospital supply chain and continuous technologicalupgrading.

The provision of consulting and maintenance services to thousands of hospitals andhealth and social care organizations over the years has enabled the company toacquire multidisciplinary competences and expertise in every aspect of its business:biomedical equipment and other devices, medical IT systems and solutions,teleassistance and telemedicine. TBS Group has acquired an in-depth know-ledge of these processes and identified solutions that adapt standard services throughcustomization.

The Group has expanded over time both internally and by means of anumber of strategic acquisitions in Italy and abroad. To achieve this expan-sion, the Group got listed on the AIM Italia market for small and mid caps on Decem-ber 2009. Following its flotation, the Group was able to expand the stockholdingbase and make more investments in key sectors or geographical areas that havebeen crucial for its business development.

TBS Group has more than 2,300 employees and companies in thirteen countriesin Europe – which remains its reference market – but also Asia, Middle East andLatin America, namely: Austria, Belgium, Chile, China, France, Gabon, Germany,India, Italy, the Netherlands, Nigeria, Peru, Portugal, Serbia, Spain, Switzerland,the United Arab Emirates and the United Kingdom. The staff working in its 350workshops and 46 regional operating centers includes over 1,600 IT and bio-medical engineers, as well as highly specialized technicians.

TBS Group is actively involved in cutting-edge research projects worth over 2.7 millioneuro a year; its main focus is to develop suitable solutions and tools for theadvanced management of its sectors of business. Several projects are being deve-loped in collaboration with universities, especially in Italy inside the AREAScience Park, where the headquarters of the company are located. TBSGroup has recently started the first MBA course in Management of Technology andInnovation in collaboration with MIB School of Management of Trieste.

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Origins

From start-up to an internationalgroup

Vision ofbusiness

Research andDevelopment

TBS GROUPComputerization of healthcare in Italy

In general, the Italian healthcare system allocateslimited and actually decreasing budget resourcesto IT development, with significant differencesfrom one region to another. Because of the persistenteconomic downturn and the governmental guidelineson a spending review, the management of social secu-rity and healthcare organizations have given priority tothose IT innovation solutions that deliver structuraland especially measurable benefits in terms of effec-tiveness and efficiency of internal processes, and tan-gibly improve the life quality of both patients and the com-munity at large.

While some consolidated areas of business – admini-strative management, ward management applications,ESF and front-end system integration – will expe-rience a double-digit decline in investments, resourceswill be increased significantly for other purposes, i.e. vir-tualization of ICT resources, business intelligence,electronic health records and disaster recovery. TBSGroup’s top services and products include ICT systems for home care (e-Health), cloud compu-ting and mobile health.

The positive effects of healthcare digitalization

The digital revolution in the healthcare sector is worth some 15 billion euro. According to the analysis ofthe latest Monitoring Report by the School of Management at the Milan Polytechnic, healthcare orga-nizations could save up to 6.8 billion euro each year if they deployed all available ICT solutionsin some key healthcare sectors. Of those savings, 3 billion would derive from the discharge of long-term patients following the introduction of homecare technologies and IT integration solutions tosupport community-based healthcare services.

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Mill

ion

Eur

os

Period 2010 - 2012

0

200

400

600

800

Spending review effect on ICT budget of healthcare structures

2010 2011 2012

600

320

670

240

625

270

current spending on ICT ICT investments

860 mln €

Dematerialization of reports and images

370 mln €

Reports via web

Savings for healthcare structures

3,000 mln €

Regional healthcare and homecare assistance

1,390 mln €

Electronic patient record

860 mln €

Computerized management of medicines

160 mln €

online booking

150 mln €

Virtualization

Total € 6.8 billion (estimation based stime on 2012 data)

2,200 mln €

Regional healthcare and homecare assistance

640 mln €

Online booking

Savings for citizens

4,600 mln €

Reports via web

170 mln €

Computerized management

of medicines

Total € 7.6 billion (estimation based on 2012 data)

TBS GROUPBusiness Facts & Figures

Since its establishment, TBS Group has reported stea-dily growing economic and financial figures. The turnoverhas increased substantially in the last decade, from 41.8million euro in 2002 to 216.9 million in 2012. At thesame time, the company has also expanded and it cur-rently employs over 2'300 professionals in eighteencountries of Europe, Africa, Asia, the Middle Eastand Latin America.

First half-year data of 2013

In the first half of 2013, the company achieved amodest growth in turnover and consolidated ear-nings amounting to 107 million euro, against 105.8million in the same period of 2012.

A breakdown by business unit shows that87.1% of the consolidated earningswas generated by the Medical Devicesand ICT Systems Business Unit thanksto the increased turnover of the EBMcompany, while the remaining 12.9% wasgenerated by the e-Health and e-Govern-ment Integrated Solutions BusinessUnit.

The consolidated EBITDA amounted to5.6 million euro, i.e. 3.4 million euro lessthan the same period of 2012, while theEBIT was 0.6 million euro with a 3.6million decline that is linked to thedecline in the EBITDA.

The turnover breakdown by geographicalarea shows that Europe remains the refe-rence market with Italy and the other Euro-pean countries accounting for 71.6% and27.4% of the turnover, respectively.Non-European countries account forapproximately 1.0% of earnings.

Stakeholders Composition

The Group stakeholding is divided among several subjects, including large financial companies, insurancecompanies and the corporate management (see pie chart).

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in m

illio

n E

uros

2008 - 2012 turnover

0

50

100

150

200

250

TBS Group

2008 2009 2010 2011 2012

125.4

158.4

190.7197.5

216.9

* Mercato 22.16%

6.65%

Capitol HealthSpecial Fund, L.P.

3.87%

Servizi Integratiper la Sanità - SIS S.r.l.

ITATECH S.r.l. 0.34%

15.86%

Allegro S.a.r.l. per contodi Generali Financial HoldingsFCP-FIS Sub-Fund 1

20.44%

Clinical Engineering& Information Technology S.p.A.

13.17%

Fondo Italianodi InvestimentoSGR

Monte Paschi Fiduciaria S.p.A. 3.77%

Terra Nova Capital S.r.l. 5.17%

EMMEPI S.r.l. 5.72%

Azioni proprie 1.81%

SIPI Investimenti S.p.A. 1.04%

* Free float according to AIM Italia Rules for companies (as from 1 March 2012)

TBS GROUPThe reference market in Italy and abroad

The Group has its headquarters at the AREA Science Park of Trieste and deliversits offering through two Business Units:

• Medical Devices and ICT Systems • Integrated Solutions of e-Health & e-Government

The offering is based on a business model that focuses on three aspects: redu-cing machine downtime, abating maintenance costs of the technological equip-ment and providing integrated services with a strong added value.

Outsourcing is a common practice amongprivate and public hospitals and social or healthcare organizations, because it enables them toreduce and control the costs of health services.Outsourcing also enables the staff of theseorganizations to keep more focused on their mainfield of action.

Clinical engineering multivendor services are adistinguishing asset of TBS Group, which hasacquired a unique expertise over the yearsand a sound knowledge of innumerable devices from several manufacturers,delivering services to healthcare organizations and managing over 880,000 bio-medical devices in more than 1,000 hospitals and care organizations in severalcountries. TBS Group also makes sure that its technical staff receives vocationaland educational training on an ongoing basis.

The technical capacity and continuity of operations are ensured by a highly qua-lified staff providing services in specific fields, such as:

• Endoscopy• Diagnostic Imaging• Global IT • Surgical instruments, medical supplies and aids• From hospital to community and home care: Contact Center• Supply of biomedical equipment• Equipment rental & lease back

The maintenance of endoscopic equipment is acritical factor for hospitals and diagnostic centers,because it has an impact on the quality and con-tinuity of service delivery. A company network ofnine labs meets the needs of customers andprovides tailored services in the shortest interventiontime.

Every year, over 700 public and private hospi-tals choose the high competence and quality ofthe dedicated TBS Group workshops; in 2012 over13,500 flexible and rigid endoscopic instruments were managed in Italy andabroad.

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Business model

Medical Devicesand ICT Systems

Endoscopy

The management of diagnostic imaging technologies and their output (data/fin-dings) is a market with a huge growth potential. Any private or public healthcareentity uses several of these instruments and an ongoing control on their seamlessfunctioning is crucial for the safety of patients and the quality of the diagnostic output.

The purchase and maintenance costs borne by healthcare organizations for thisequipment are quite high. Price competitiveness and a drastic reduction in machinedowntimes are the keys to acquire a dominant position in this market.

As technology continues to develop, the technological fleet of hospitals hasexpanded over time and its management has become increasingly complex. Thehighest costs derive from the upgrading of front office and back-end software andrefresh of machines.

Inefficiencies, slow processes and contin-gencies are often due to the variety of diffe-rent computer languages used, the diver-sity of biomedical and IT technologies, theirneed for mutual integration and the fact thata customer has to work with a plethora of dif-ferent providers for one or the other techno-logy.

TBS Group believes that having a single partner taking care of all the equip-ment and the IT system of a customer can result in a drastic reduction of costs,improved workflow efficiency and enhanced customer satisfaction. The local or remotecontrol of infrastructures and the maintenance of all the technological equipmentavailable in a healthcare organization is a further strength of our offering that inclu-des:

• Preventive, corrective and perfective maintenance of IT hardware;

• On-site software assistance to ensure proper functioning of workstations,servers, networks, etc.

• System integration to maximize the availability of IT resources and use of ITservices.

The Group can count on the expertise of some controlled companies that have beenworking in this market for decades, like Erre Effe Informatica and TBS IT.

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Global IT

Unique supplier for IT & biomedical services

DiagnosticImaging

Nowadays, it is a consolidated practice among European hospitals to outsourcethe maintenance of the biomedical equipment. TBS Group also manages some "minor"instruments that are equally important, like surgical instruments, medical suppliesand aids that have a significant impact on running costs.

In a mid-sized European hospital, the average cost for the turnover of the bio-medical equipment – corresponding to 5% of the installed fleet – amounts to30-50 million euro, the cost for temporary replacements amounts to about 15million euro. This field of activity has a strong growth potential and TBS Group isrepresented in this business by its controlled companies EBM and Crimo.

Healthcare services are tending to become more community-based and thisimplies that social and healthcare services must ensure the continuity of all typesof care for their patients. Homecare often proves to be a viable alternative tohospitalization, provided that the different service providers are suitably coor-dinated. Likewise, telecontrol systems have reduced the unnecessary use ofhealthcare resources in the case of chronic patients or frail subjects.

In order to achieve this change, service delivery should be no longer emergency-based but rather prevention-centered and supported by an infrastructure likea Contact Center that liaises all involved parties. The Contact Center is basedon a new model of care and an IT network that is designed as a hub between citi-zens and community services, the contact point to access all available resourcesand address any type of social and health care emergency.

The Contact Center is a multi-purpose service that can also monitor clinical para-meters remotely and take action, thus avoiding or limiting hospital admissions. TheContact Center contributes to the maximum safety and effectiveness of care, thusimproving the life quality of individuals.

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From hospitalcareto homecareservices. Contact Centre

Surgicalinstruments,medical suppliesand aids

TBS Group and its controlled companies Caribel Programmazione, EBM, Insiel Mercato,Tesan, Tesan-Televita provide services and solutions aimed at monitoring prevention,access, diagnosis, care and treatment during the healthcare process. These ser-vices ensure full integration of information systems. The offering includes the following services and solutions:

• clinical engineering for home devices • medical IT• Teleassistance and telemedicine

The competences acquired in the health technology assessment and the continuouslearning from the field over the years have turned TBS Group into a reliable con-tractor also for the supply of biomedical equipment to top quality health organizationsworldwide. Recently, TBS Group has signed three supply contracts in China andone in Honduras for 14 million euro in total.

Beside project financing mechanisms that have been traditionally used to plan andconstruct new healthcare complexes, new forms of financing are starting to be used,e.g. rental, lease-back or tariff-based fees for services. TBS Group is ready to supportprivate and public entities also in financing issues.

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Rental & Lease Back

Supply of biomedicalequipment

TBS GROUPIntegrated Solutions of e-Health & e-Government

TBS Group's goal is to break the barrier sepa-rating the hospital from the community andto promote the rationalization of expenditurethrough innovation.

Like health professionals, also TBS Grouphas acknowledged the need to change therole of IT and make it more directly instru-mental to clinical and care activities, inorder to have hospitals that are more cen-tered on the needs of patients and cliniciansand community-based services that play anactive and integrated role in prevention,diagnosis and treatment.

This vision is reflected in an innovativeoffering of totally integrated solutions andservices that cater for the administrativeand clinical requirements of public andprivate health organizations at different administrative levels.

The offering is based on the open source phi-Technology framework createdin-house, where all the functional experiences of the Group and the available pro-ducts for the health IT system converge.

TBS Group delivers products and services modelled on the principles of interoperability,cooperation, streamlining and transparency. The aim is to promote the digitaliza-tion of the public authorities, optimize functional processes and improve servicesto the citizens.

• Lisa - access systems: solutions for emergencies (ambulance and Unified Emer-gency Centre, A&E Unit), ward admission software, Choose & Book, based onmultiple channels, transparent services and streamlining;

• Lisa - clinical hospital systems: solutions for out-patient surgeries, diagnostics(RIS, PACS, EmoNet transfusion IT system, a leading solution in Italy and Slo-venia), wards (clinical record, nursing record, prescription and administrationrecord, order entry, etc.), aimed at ensuring the appropriateness of treat-ments and abating the clinical risk;

• AsTer – systems for community-based care: solutions for local healthcare units,family counselling and planned parenthood centers, mental health services, on-duty medical units, GP/pediatricians, forensic medicine, prevention services forcontinuity of care;

• Ascot – administrative and management systems: solutions for accounting, mana-gement controlling, orders and purchases, warehousing, human resources, archi-ving, aimed at supporting the staff in all their administrative tasks.

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A new hospital process

Digitization of publicadministration

TBS Group can also provide Ascot, a wide range of software solutions modelledon the principles of interoperability, dematerialization, streamlining and transpa-rency. The aim is to promote the digitalization of public sector entities, optimize func-tional and organizational processes and improve services to the citizens:

• solutions for: administration, human resources, population services, taxesand social security;

• solutions for document management: computerized recording of documents,decisions and document management;

• solutions for employees: IT system of employment services and compulsorynotifications, on-line services from specialized portals;

• front-end and web application solutions: including the creation of websites andportals, e-Government solutions and knowledge management 2.0.

Ascot is based on a detailed knowledge of the industry's processes and regulations;it combines an ERP-based project with the web technology and is characterizedby modularity, customization, integration and ability to interact with externalsystems.

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TBS GROUP1987-2013: some milestones

After consolidating its position with outsourced clinical engineering services, TBSGroup invested in growth and expanded through numerous strategic acquisi-tions, both in Italy and abroad, aimed at broadening its range of activities, also inclu-ding e-Health & e-Government products and services.

1987 • TBS Group was founded

1991 - 2000 • First clinical engineering outsourcing contract from the AREA Science Park of

Trieste, to manage the Biomedical Equipment Information and Assessment Centre(Centro di Informazione e Valutazione delle Apparecchiature - CIVAB).

• Acquisition of PCS in Austria, a company specialising in hospital IT clinical systems,also active in Germany.

2002 – 2005 • Acquisition of the Faro group (later TeSAN) of Vicenza. The Group therefore

expanded its offering of services to the telemedicine and telecare sectors.

• Acquisition of the European business of GE Healthcare Technologies in the cli-nical engineering services segment (excluding diagnostic imaging). Compa-nies are established in the United Kingdom, Spain, France, Portugal andBelgium.

• Acquisition of 3 companies from the Cardinal group working in Germany,Italy and the Netherlands, dedicated to multi-vendor maintenance of endoscopyequipment.

2006 - 2011• Acquisition of the German company Subitec GmbH, active in the clinical engi-

neering sector.

• Acquisition of the Spanish company NCA, active in radiology and nuclear medi-cine equipment maintenance.

• Acquisition of Crimo Italia, operating in clinical engineering services, and in par-ticular the areas of surgical and endoscopy instruments.

• Acquisition of Caribel Programmazione who specialises in managing social andhealthcare activities outside hospitals.

• Acquisition of EBM, the second Italian clinical engineering services provider.Acquisition of MSI MedServ International Deutschland GmbH, active in endo-scopy services.

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• Establishment of TBS SE in Serbia and Arabian Healthcare TBS Saudi in SaudiArabia.

• Listing of TBS Group on the exchange stock AIM Italia (December 2009).

• Acquisition of Insiel Mercato, specialised in e-Health & e-Government servicesand solutions.

• Acquisition of MNE Technologies Private Ltd, an Indian company working inclinical engineering services.

• Acquisition of Delta X, a company active in the diagnostic imaging sector.

• Acquisition of Erre Effe Informatica of Arezzo, operating in the medical IT sector.

• Establishment of JV Sinopharm TBS (Beijing) Clinical Engineering TechnologyCo Ltd., headquartered in Beijing, to develop clinical engineering services.

• Fondo Italiano di Investimento SGR invests in the TBS Group to support its expan-sion and internationalisation projects.

2012• Acquisition of the IT and Call Centre business units of Agile in extra-ordinary

administration.

• TBS Group invests in REM, the first Italian company in multi-vendor diagno-stic imaging services.

• Acquisition of healthcare business unit of HiWeb S.r.l., through the subsidiaryInsiel Mercato, with the headquarter in Bologna (Italy), active in medical IT sector.

• The subsidiary TBS GB established its branch in Dubai to promote Group’s acti-vities in Gulf area.

• The subsidiary TBS ES established two branches in Chile e Peru.

• First contract signed in Peru through its Spanish subsidiary TBS ES.

• Establishment of REM DI, active in DI services.

2013• TBS Group promotes the first Executive MBA in Management of Technology

and Innovation in Italy together with MIB School of Management, and in part-nership with INSIEL, Sincrotrone Trieste, ICGEB and with the patronage of AreaScience Park.

• First contract signed in Honduras for the supply of biomedical equipment.

• Important contracts signed in China for the supply of biomedical equipment.

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TBS GROUPSummary sheet

Headquarters: Trieste, Italy

Year of foundation: 1987

Companies in the world: More than 20

2012 Turnover: 216.9 million euros

2012 Staff : over 2,300

Management:Diego BravarChairman

Paolo SalottoCEO

Fabio FaltoniGeneral Manager, BU Medical devices & ICT Systems - Italy operations

Nicola PangherGeneral Manager, BU Medical devices & ICT Systems - foreign operations

Alberto SteindlerGeneral Manager, BU Integrated Solutions of e-Health & e-Government

Website: www.tbsgroup.com

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