Executive View on Advancing eHealth Tuesday, January 29th 2008

1. Executive View on Advancing eHealthTuesday, January 29th 2008 Craig Mundie Chief Research and Strategy Officer Microsoft Corporation

2. Opening remarks [Note: Speech follows 3-minute “Health Future Vision Video”] • It’s a pleasure and honor to be here with you today. • I think the video we’ve just seen illustrates exactly the kind of healthcare we’d all like to receive. • But as we’re all aware, the healthcare industry faces many challenges in getting from here to there. • I’d like to talk about some of those challenges – about our vision for solving them, and how we’re investing in that vision.

3. Immense progress… • We live in an era that has seen our knowledge of medical science and treatment increase at a rate unprecedented in human history. • Today we can cure illnesses that used to be untreatable and prevent diseases that once seemed inevitable. • Patients increasingly empowered with technology that helps them cope with chronic conditions and maintain lifelong wellness (e.g., glucometers that help manage diabetes, exercise equipment that monitors vital signs). • Machine learning and other techniques borrowed from computer science are helping scientists conduct more effective research and quickly develop new life-saving drugs. • Progress in genetics and our understanding of human biomarkers promise even more dramatic advances in the years ahead.

4. Immense challenges • At the same time, however, the entire health ecosystem – patients, providers, funders of care, health and social service agencies, and life-science organizations – is facing unprecedented challenges: • ACCESS: Only 1.5 billion of our planet’s citizens have adequate health coverage, an issue that governments worldwide are struggling with. • COST: Healthcare costs are soaring across the board, impacting everyone from patients and providers to governmental funders of care. (This year in the U.S., health insurance costs will be greater than corporate profits, and are rising at 7%+ a year.) • QUALITY: Increasing regulations, together with customer demand, are forcing greater transparency and data interoperability. Challenge is that the healthcare system is highly fragmented, both organizationally and in terms of health data silos). • DEMOGRAPHICS: Mature markets face rapidly aging populations, and there is a growing middle class in developing + emerging markets. Both increase the demand for healthcare. • LABOR SHORTAGES: A global shortage of qualified healthcare workers, at every level. • CONSUMERISM: In mature markets, thanks to shifting expectations and growing cost pressures, individuals want to take greater responsibility for their health and wellness (8 million people a day now do health-related searches online). • All this calls for a new paradigm in healthcare: a transformation that we believe will help ensure the best quality of life – and care – for everyone.

5. Transforming healthcare • The health care universe has traditionally revolved around the physician, who we have relied on to guide us and make health-related decisions for us; serve as our gatekeeper to treatments and therapies. • And health-information systems have traditionally centered around the “facility” – whether that is the hospital, or doctor office or care-management protocol. None of these systems create a complete view of the patients real problems. • But we are now starting to see a “Copernican shift”: • The patient is moving to the center of the healthcare universe, requiring individuals to navigate the health care system and make key decisions about their health. • This doesn’t mean doctors and/or advocates are less important – they aren’t – but it does mean consumers now know they must be actively involved in their own care. • This shift has the potential to drive personalized medicine, as consumers take more ownership and provide more input to their health and wellness plans. • With individual citizens as the driving catalyst for change, health services will have to compete for the attention of the individual – resulting in a system that (1) increasingly competes on quality of care; (2) is increasingly transparent; (3) has lower costs and (4) enables much greater access to and transfer of information.

6. The role of IT • IT will drive much of this transformation: • Advanced software that connects a wide range of medical technologies and data sources into a seamless whole will give patients, providers and funders of care a complete picture of health. • This will enable a data-centered approach to medicine that shifts the priorities of healthcare from treatment and cure to prevention and life-long wellness. • Advanced software will put individuals at the center of the healthcare system, empowering them with the info they need to take control of their own well-being. • It will also create a rich marketplace of resources and services that will increase efficiency and cut costs across the spectrum of care.

7. A total eHealth solution • A consumer or citizen-centric solution requires two things: • A private and secure data storage and sharing platform that enables the seamless exchange of data between thousands of health applications and devices. • An online solution tied to the platform that makes it easier for consumers to collect, persistently store, share and act on their health data – private data which is entirely under their control. • This platform must be inclusive of standards, and it needs to have the privacy principles in place to earn the trust of consumers – while enabling the re-use of data across the health ecosystem. • The same platform has to connect citizens with information from their physicians and extended care team – and will soon have to connect them to the data being generated through advances in biotech. • • • • • • This kind of connected technology solution helps manage the deluge of data, while also addressing the pressures being placed on our healthcare system by the rapid growth in our aging population. • And it will enable a greater amount of care – especially of the elderly and chronically ill – to take place at home, not in a costly hospital environment.

8. Microsoft’s eHealth investments We are investing across the healthcare spectrum: • Azyxxi , our Unified Intelligence System – solving the health-data silo problem: • Aggregates all types of patient data from hundreds of sources, making it instantly available at point of care. • A central repository for all of a patient’s clinical information, offering providers a comprehensive view of each individual that includes medical history, insurance records and diagnostic information, etc. • Thrives in heterogeneous environments, working on top of dozens of disparate systems. • Global Care Solutions – end-to-end enterprise-class health information systems: • System developed in collaboration with Bumrungrad, an internationally accredited Bangkok hospital that treats more than 1.3 million patients each year (400,000 from overseas). • Bumrungrad uses the Global Care Solution to efficiently manage clinical workflow, billing, regulatory compliance and medical records. • Global Care Solution already implemented and in use in 7 hospitals around the Asia-Pacific region. • HealthVault – health information at your fingertips: • A private and secure shared data repository and online service for individuals/families to collect, store, gather and share their health information. • Advanced search designed to help individuals navigate the rich + complex health information on the Web. • HealthVault Connection Center – client application that enables connectivity to a new set of personal home health devices … and creates a new class of user-generated health data.

9. We are committed for the long-term • Microsoft thrives on big challenges. Over the past 30+ years, we have taken a vision for computing and made it a reality many times over. Doesn’t happen overnight: e.g., it took 11 years for Word to become the best-selling word processor. We persevere until we succeed. • Our Health team is already in its 10th year, with 700+ employees focused on health worldwide. Includes doctors, nurses, pharmacists, clinicians, developers and researchers.  • We have an extensive network of healthcare IT partners using Microsoft technology to solve parts of the healthcare puzzle, with 1,000+ ISVs and systems integrators building solutions on our platform today. • Microsoft invests more than $7 billion a year in research and development, including healthcare-related R&D that seeks to integrate all kinds of medical data to empower scientists, doctors and patients: • As today’s science evolves into tomorrow’s technology, physicians will be able to determine a patient’s disease-risk based on an analysis of his or her genes or environmental factors. • By integrating this data with the other medical information, doctors would be able to develop a personalized treatment plan and guide clinical trial participation and stratification based on a patient’s genomic and biochemical makeup. • Our goal : to improve health around the world through software innovation. • We are partnering with health organizations and governments around the world to understand their needs and help realize this vision.

10. To conclude • We know there are no simple answers – healthcare is a big and complex issue, and no single entity is going to fix it alone; a collaborative approach is the only way to get there. • We are eager to learn more, and we understand that governments will face some major challenges in helping these technologies be adapted. • By working together we believe we can help people around the world live longer, healthier and more fulfilling lives.