Human Care Systems provides comprehensive patient and HCP support programs for biopharm and medtech companies and provider and payer organizations in the rare disease market. We help organizations reach patient and HCP initiation, adherence and retention goals by integrating a proprietary intelligent stakeholder algorithm. The result is Real World Outcomes: optimized patient quality of life, HCP brand preference and brand ROI

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BEHAVIOR SCIENCE EXPERIENCE DESIGN PROVEN RESULTS
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B O S T O N | L O N D O N | S A N F R A N C I S C O

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We Design, Develop and Deploy comprehensive
support PROGRAMS for HCPs and Patients. Our
programs are based in BEHAVIORAL SCIENCE and…
Add More VALUE To Product
 Impact clinician decision making
 De-risk the product
 Impact patient self-management, adherence and QoL
 Improve real world outcomes
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solution.
This is Human Care Systems
deliver.
change
behaviors.
monitor &
measure.
engage.
personalize.

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about.
Locations & Experience
• Asthma
• Back problems
• Chronic Kidney Disease
• COPD
• Diabetes (T1 and T2)
• Heart Failure
• Hemophilia (A & B)
• Hepatitis (B & C)
• HIV
• Kidney Transplant
• Mood disorders
• Multiple Sclerosis
• Lupus
• Oncology (CML, CLL, MBC,
MCL NSCLC, RCC & others)
• Osteoporosis
• Nephrotic Syndrome
• Pain
• Pneumonia
• Pulmonary Hypertension
• Rheumatology
• Stroke
SAN
FRANCISCO
BOSTON
LONDON FRANKFURT
(Opening 2014)
TOKYO
(via partnership)
SINGAPORE
(Opening 2014)
SÃO PAOLO
(via partnership)

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process.
The HCS System
Revenue
 Awareness
 Initiation
 Adherence
 Retention
Events
Time and Trigger
identifiable inflection
points relevant to
clinicians and patients
Barriers
Learn, Gain Insight, Take
Action to impact
clinician and patient
decisions and behaviors
TargetsInputs Results
We use an analytical system to design, deliver and measure high impact service
and support to clinicians and patients.
Behavioral Science
Application of literature and
experience on effective
learning, decision-making
and behavior change.
Experience Design
Integrated customer
experiences across channels
(print, web, mobile,
salesforce, phone, etc.)
Outcomes
 Quality of Life,
 Health Outcomes
 Health Economics
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Map
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Knowledge of
stakeholder
experience from
understand phase
Priorities
of brand
team
Proposed rules-based customized solutions to address
barriers and gaps to fulfill brands objectives and provide a
comprehensive patient, provider, and payor solutions
Identified barriers and gaps
extrapolated from the
synthesized information in the
understand phase
Utilizing the training in psych
evaluation, research, and
analysis and with the
principles of social, cognitive,
and behavior theories of
human behavior as well as
the transtheoretical model,
biopsycho-socio-
environmental theory, health
belief model, and theory of
planned behavior, the
experience map is created in
an iterative fashion.

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Rules based customized solution
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Treatment
initiation
HCP prescribes
Product X
NurseCalls
Email or Mail
Text Reminders
1 2 3 4 5 6 7 8ProductX
Applicatio
ns
Patient self-assessment
R
x
Barrier topics delivered in a multi-channel
program based on patient endorsement and
a pre-determined barrier ranking
(developed from learning in the understand
and map phases)
Treatment
initiation
HCP prescribes
Product X
NurseCalls
Email or Mail
Text Reminders
1 2 3 4 5 6 7 8ProductX
Applicatio
ns
Patient self-assessment
R
x
Barrier
Assessment
Patient Identified
Barriers

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Return on Investment
DIABETES RARE KIDNEY
DISORDER
ORAL
ONCOLYTIC
• Reduced 6 month attrition
rate from 22% to 5%
• Improved Market Share by
2 points
• Improved adherence by 8
additional infusion sets per
year
• Improved 6 month A1C by
24%
• 15 point Net Promoter
Score Improvement
• Initiation rates have
increased from 70% to
85% after
implementation of this
program
• Discontinuation rates
have dropped from 40%
to 15%.
• 90% of eligible
countries have
implemented program
• Measured adherence
improvements have
ranged from 10%-38%
across countries

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Our Clients Include…

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Clinical Health
Psychologists
Experience
Designers
Software
Platform
Multi-Channel
Delivery
Field Clinicians
• Trained in Clinical
Psychology with
subspecialty in
Health
Psychology
• Health
Psychology is the
application of
behavioral
science to
medical health
management
• Information
Architects and
User Experience
Experts (IA/UX)
• Print and
interactive
designers
• Software
architects and
developers
• Salesforce.com
administrators
• Nurse phone
coaches
• Web
• Mobile
• Text
• Email
• Mail house
• Trained and
Certified
• Provide in person
training (i.e.
home infusions,
product
management,
etc.)
Management:
• Business unit and geographic leadership
• Company leadership
• Guide Medical Regulation Review
about.
Team Expertise
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solution.
This is Human Care Systems
We design, develop, and deploy service & support solutions to modify behavior and drive higher rates of adherence, improved health outcomes,
and increased patient and HCP satisfaction. The HCS system is based on the following pillars:
Behavioral science. HCS’ team of health psychologists use behavioral science to deliver programming to change adherence, patient/clinician
communications, and other self-managing and self-monitoring behaviors.
o Deep and actionable understanding of patient pain points based on existing knowledge and research + systematic literature review +
ethnographic research.
o Most effective programming to change behaviors:
 High impact education to support learning.
 Cognitive behavioral exercises to change relationships between thoughts, feelings and actions.
 Motivational interviewing techniques to build self-efficacy and motivation.
Personalized, high-impact experiences. HCS’ technology platform personalizes program content and timing to individual patient’s events and
barriers as well as evolving over time as patient progresses through therapy.
o The HCS platform combines a personalization rules engine + CRM database + interfaces to deliver personalized and integrated programs
through multiple channels.
o Multichannel solutions, that feel to the patient like a coherent and personalized experience, are the most effective way to reach and
impact patient behaviors.
Change, measure and communicate outcomes. HCS’ measurement, analysis and publishing support capabilities ensure that the results of the
support program are best captured and communicated.
o Measured impact on Trx (brand choice + initiation + adherence).
o Real world outcomes.
o Studies and publishing.

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B O S T O N | L O N D O N | S A N F R A N C I S C O
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How We Work

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v v
Approach
Define Current
Experience Map
Map Ideal
Experience
Build & Deliver
Solution
• All stakeholders
• Existing research and
knowledge
• Patient and Clinician &
Patient Ethnography
• Literature review
• Netnography
• Mine data sets
• Barriers & Events
• Specific to the
needs of each
stakeholder
• Personalized
experiences for
each patient
• Integrated and
coherent across
multiple channels
• Customize
experience for each
population and
indication
• Deliver integrated
support across
multiple channels
• Change patient and
clinician behaviors
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HCS Solution Framework
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Events Barriers Triggers
• Logistic
• Social
• Physical and Cognitive
• Emotional
• Attitudinal/Cultural
• Side effects
• Provider
• Health Literacy
• Regimen requirements
• Financial
Key milestones that occur
along a timeline such as:
• Symptom Onset
• Diagnosis
• Decision to Treat
• Onset of Side Effects
• Symptom Improvement
• Treatment Fatigue
Things that happen that may foreshadow
non adherence or discontinuation:
• Severity of side effects
• Financial event
• Health or Personal Crisis
• Missed or Delayed Refill
• Patient Feels Lack of Progress
• Patient Feels They Are Doing Better
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• To HCP about their patients
• To reps about enrollment
• To patients about adherence
• To the client and HCS about the program
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Level of Support Infrastructure Complexity of Treatment
Feedback

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Design All Touchpoints vs. Events & Barriers
Event Focused Barrier Focused
Time Based
• Mailing, e-mail, SMS, Phone
calls at time based inflection
points.
• E.g. educate on week 4 test
results.
Trigger Based
• Use passive data collection
techniques, questionnaires,
and HCP inputs to trigger
communications.
• E.g. congratulations phone call
when glucose targets reached
on connected meter.
Learn
• Bite-sized, personally relevant education tailored to
learning style.
Gain Insight
• Cognitive-behavioral exercises to help people understand
and take control of thoughts, feelings and actions.
Take Actions
• Guided experiences to build and sustain motivation, self-
confidence and resilience.
Get Feedback
• Help patients & HCPs monitor progress towards goals.
Help patients gain insight from remote monitored data
when available.
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Creating a Whole Experience
Goal: Design and deploy integrated individual touchpoints to deliver a
coordinated, high-value experience to all treatment stakeholders
Comprehensive,
differentiated
solution
Cohesive and High-Impact
Experience for Patient, Clinician,
Caregiver, Office Staff
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Individual Brand
Tactics

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Solution Architecture
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Tools & Support

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HCS Confidential
results.
Case Study: Biologic Adherence for Rare Kidney Condition
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Key Barriers / Unmet needs Surrounding Taking Treatment:
• Injecting with Disability
• Education on Condition
• Building Treatment Routines
• Financial Concerns
• Side Effects
• Disability and Emotional Concerns
results.
Case Study (Biologic Adherence for Rare Kidney Condition):
Challenge & Situation
Challenge:
• Low initiation and completion rates during the 6 month course of therapy: 70%
• Discontinuation Rate: 40%
• Overcome treatment barriers in a rare kidney condition including injection fears, confusion, questioning value of
treatment, side effects, and psycho-social concerns.
Ongoing treatment1st injectionCan I afford it?Pre-RxEvents
Barriers
• Poor health
from primary
diagnoses
• Lack of
knowledge
• Cost
• Why me?
• Lack of urgency
• Side effects
• Confused about process
• Difficult regimen
• Side effects
• Needle anxiety
• Cost
• Side effects
• Treatment fatigue
• Uncertain of benefits vs. costs
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Ongoing treatment1st injectionCan I afford it?Pre-RxPatient
Journey
Tactics
HCP
DTP
Enrollment brochure
Nurse line
PSK
ASAP
ASAP
Topic-specific mailings: initiation and adherence support
Printed materials Electronic Phone LogisticsKey:
Interactive website: initiation and adherence support
Schedule calls
Assess
readiness
Initial
injection
support
Trouble-
shooting
follow up.
Overcoming
barriers to
adherence
Building a
support
network
Planning to
complete
treatment
Lifelong health
management
habits
Messaging
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results.
Case Study (Biologic Adherence for Rare Kidney Condition):
Touchpoints

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The Nurse Coach provides human, personalized
support to patients.
• Leads them through the Barrier Assessment,
a survey tool that identifies key obstacles to
initiating and continuing Acthar
• Provides tailored support and guided steps to
help each patient overcome his/her barriers
• Monitors the progress of each patient and
provides appropriate help:
– information/resources
– emotional support
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results.
Case Study (Biologic Adherence for Rare Kidney Condition):
Solution: Customized Nurse Phone Interactions

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Print Materials
Nurse coach mails patients
targeted print materials that
supplement their discussions by
providing additional information
for patients to refer to in between
coaching calls.
Print materials:
• Focus on specific barriers
• Offer practical advice
• Invite engagement
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results.
Case Study (Biologic Adherence for Rare Kidney Condition):
Solution: Customized Print Materials

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Interactive Web Portal provides a private
space for patients to overcome their barriers at
their leisure. Features:
• Educational information about the kidneys
and proteinuria
• Interactive activities that help patients cope
with taking and living with Acthar
• Guided tools that help patients develop
specific plans for staying adherent
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results.
Case Study (Biologic Adherence for Rare Kidney Condition):
Solution: Digital Support

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Tear SheetsPocket Guide
HCP Skills Training
• Virtual/Print Tool training
• Listening like a detective
• Identifying nonadherence
• Giving effective direction
• Responding to emotional
patients
• Motivational interviewing
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results.
Case Study (Biologic Adherence for Rare Kidney Condition):
Solution: HCP Training & Tools

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Schedule calls
Assess
readiness
Initial
injection
support
Trouble-
shooting
follow up
Overcoming
barriers to
adherence
Assess final
status & discuss
next steps
Building a
support
network
Planning to
complete
treatment
Lifelong health
management
habits
RESULTS: 10:1 Return on Investment
Initiation rates have increased from 70% to 85% after implementation of this program
Discontinuation rates have dropped from 40% to 15%.
100% of patients enrolled in program are injecting on schedule.
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results.
Case Study (Biologic Adherence for Rare Kidney Condition):
Output and Results

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HCS Confidential
results.
Case Study: Insulin Pump and CGM Adherence
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Decide to
Pursue Pump
• Reimbursemen
t
• Psychosocial
issues
Order and
Shipment
• Big box of
supplies can be
overwhelming
Training
• Lack of
knowledge
• Information
Overload
• Hypoglycemic
events,
adjusting to
wearing pump
Start Pump
• Carb counting
• Insulin rare
adjustments
Infusion Set
Change
• Difficulty with
supply orders
or Billing
• Fragmented
support
See Progress
• Think no
longer need
treatment
Pump
Problem
• Frustration
Achieve Goal
• To feel healthy,
have better focus,
more energy
(through better
glycemic control)
• More freedom in
their schedule
(eating, sleeping)
• Fewer hypos
• Prevent
complications
Events
Barriers
results.
Case Study (Insulin Pump and CGM Adherence):
Challenge & Insights
Challenge:
• Pump users experience many barriers, particularly in the first 90 days.
• 22% of pump users quit within 6 months/ 65% CGM
• Poor adherence
Key Needs based off of Insights:
• Less fragmentation
• Small actionable bits of information
• More connection to patient’s purpose for using pump
• Proactive support 28

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results.
Case Study (Insulin Pump and CGM Adherence):
Touchpoints
Pre Start Post Start
Field Clinician
Phone Coach
Ship
Orientation
Call (N)
+7D +30D
In Person
Training
+24H +3D +6D +14D +30D +60D +90D +120D +180D
CareLink Data
HL Calls
Assessments
Advanced
Classes Available
Pre Training
Call (N) Attrition Risk
Score
CareLink
Review
Transition of Care
Document
MONITOR
CELEBRATE
Monitoring Software
StartRight Patient Support Program

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results.
Case Study (Insulin Pump and CGM Adherence):
Solution: Multichannel Support

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Decide to pursue
pump
Pump and training
materials arrive
Receive training
and start pump 1st infusion set
change
Adjustment
period
INSULIN PUMP
RESULTS
 Reduced 6
month attrition
rate for insulin
pump from 22%
to 5%
 Improved
Market Share
by 2 ppts
 Improved
adherence by 8
additional
infusion sets
per year
 Improved 6
month A1C by
24%
 15 point Net
Promoter Score
Improvement
CGM RESULTS
 Reduced 6
month attrition
rate for insulin
pump from 61%
to 23%
 Improved
adherence by
20 additional
sensors per
year
results.
Case Study (Insulin Pump and CGM Adherence):
Output and Results
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BEHAVIOR SCIENCE EXPERIENCE DESIGN PROVEN RESULTS
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B O S T O N | L O N D O N | S A N F R A N C I S C O