©2005 IPGDx, LLC

PROGNOSTICHECK®
Value Proposition:
Strategy & Focus
 STRATEGY & FOCUS
Reliable
information to
base healthcare
decisions upon

Scientific Excellent Compassionate

knowledge training & caring
base support communication

Structured Specific to:

Pre-Learning
multi-media formats Patient, Physician,
Assessment
Manufacturer

©2005 IPGDx, LLC

 INDIVIDUALLY TARGETED CURRICULUM
• Patient’s and Families
• Physicians
– Ot
Other
e healthcare
ealt ca e p
providers
ov de s
• Nurses
• Facilities
F iliti
– Phase of care
• Manufacturers
– Pharmaceuticals/Other
Ph ti l /Oth IInterventions
t ti
• Prescription
• Nonprescription
©2005 IPGDx, LLC
 THREE FRONTS OF CHANGE

• Chronic disease model

– Therapeutic efficacy
• Healthcare delivery system
– Changing roles
• Ethical and cultural expectations
– Duties and responsibilities within a new
decision paradigm

©2005 IPGDx, LLC

 CHRONIC DISEASE
• Diagnosis established
• Tx limited/repetitive
• Course is long/progressive
• Complications
– Anticipation
– Avoidance
– Mitigation
• Speed of progression
• Scope of deterioration

©2005 IPGDx, LLC

 CHARACTER OF CHRONIC ILLNESS

• Nonfatal (Complication Avoidance)

– Occurs with substantial reserve capacity
– Progressively long natural course
• Serious then fatal
– Progressively worsening
– Serial exacerbations to death
• Frailty/prolonged dwindling (Cliff Edge)
– Little available reserves
p
– Small upset cascades

©2005 IPGDx, LLC

 Hospitalizations
• Severityy of disease
– Present on admission
– Nosocomial or not
• Overstaying DRG LOS
– Complications
• ICU Resource allocation
– SIRS

©2005 IPGDx, LLC

 From:
‘Living Well at the End of
Life’;
Lynn & Adamson
2003 Rand Health

©2005 IPGDx, LLC

 ~20%

~20%
20%

~40%
40%

©2005 IPGDx, LLC *~20% other and/or undefined

©2005 IPGDx, LLC
 Of the ~2.5M annual deaths
less than fortyy percent
p died
under hospice care

©2005 IPGDx, LLC

 THOSE WITH CHRONIC DISEASE

©2005 IPGDx, LLC

 CHANGES IN HEALTHCARE DELIVERY

• Physician
– < economic independence
– < professional autonomy
– > external review
– > administrative oversight
• Called upon to:
– Optimize outcome while minimizing costs
– Proffer decisions with weighted
administrative and clinical consequences

©2005 IPGDx, LLC

 CHANGES IN HEALTHCARE DELIVERY

• Resource Allocation
– > need
– > cost
– To produce > benefit
– Comparative metric/risk adjustments
– Relative levels of illness and treatment
• System
S t comparisons
i

©2005 IPGDx, LLC

 CHANGES IN HEALTHCARE DELIVERY

• Demonstrated Effectiveness
– Assessment of the probability of
expected course and outcomes
• Assumption of therapeutic efficacy
– Intermediate endpoints predictive of
long-term outcomes
• Predictive
P di i fi findings
di
• Pre-symptomatic – occult illness
• Predicting consequences
– Benefit of advanced interventions
– Adherence metrics
©2005 IPGDx, LLC
©2005 IPGDx, LLC
 ETHICAL DECISION MAKING

• Communication
C i i required i d
• Consumerism
• Informed consent
• Risk (cost) / Benefit
• Resources
– Availability
– Allocation

©2005 IPGDx, LLC

©2005 IPGDx, LLC
 END OF LIFE COSTS

©2005 IPGDx, LLC

 CULTURAL EXPECTATIONS

• Futility of intervention (flogging)

• Outcome inevitabilityy
– Likelihood of recovery
– Effectiveness v trauma of intervention
• Justice
• Beneficence
• Economy
Econom

©2005 IPGDx, LLC

 END OF LIFE CARE

• > Consciousness of EOL care and death

• ‘Good Death’ v “BAD”
– Control-Comfort-Communication
C lC f C i i
– Discussed with family
– Planned for
– Meaningful assessments
– Management of
– Home care
• Physical-Spiritual-Emotional-Social-Cost

©2005 IPGDx, LLC

©2005 IPGDx, LLC
©2005 IPGDx, LLC
©2005 IPGDx, LLC
©2005 IPGDx, LLC
©2005 IPGDx, LLC
 PROGNOSTICHECK®
• If Sick,, How Sick®

• Prognosis
– Characterization of disease
• Presence-Severity-Progression
– Effectiveness of therapies
p
• Optimized individual response
– Timing of non-acute
non acute death
• Palliative care and Hospice

©2005 IPGDx, LLC

 TARGETED MARKET SEGMENTS
Innovators First 5% - 10% that adopt the product
Early
y Adopters
p Next 10% - 15%
Early Majority Next 30%
Late Majority Next 30%
Laggards Remaining 20%
CHARACTERISTICS:
Venturesomeness: the willingness and desire to be daring in trying
something new and different
Social integration: frequent and extensive contact with others in
one’s area
Cosmopolitan: point of view extending beyond the immediate
neighborhood or community
Social mobility: upward movement on the social scale
Privilegedness: attitude and possession of money (less risky to try
something new)
©2005 IPGDx, LLC
©2005 IPGDx, LLC
©2005 IPGDx, LLC