What did the Doctor Say? Concept Overview

May 2009 ConﬁdentialBLAH BLAH
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May 2009 Confidential
Concept Overview

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Concept Overview
What we do
What did the Doctor Say?™ does two basic things:
First we provide a service that records messages from a patient’s doctor to that
patient’s family members regarding the diagnosis and treatment plan for their loved
one. We also record messages from other caregivers; physical therapists, home
nurses, even neighbors--anyone the family wants to hear from.
Then we store these messages in a family medical hub we host on the web. Here
each authorized family member can access an accurate record of “what the doctor
said” about their loved one and discuss it in a blog-type format. They can share
information, make decisions, assign tasks and monitor progress. Family members
can also connect to care giver resources to help them sustain their support over
time.

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Concept Overview
The ProblemThe Problem
Family support is critical to the health care of aging patients…
but the health care system only talks to the patient.
Every patient is supported by two systems: the health care system and their family system. The point of
interface between these two systems is often a simple question asked of every patient after every doctor visit:
“What did the doctor say?” It is at this point where the medical establishment connects to the web of human
relationships behind each patient.
Currently this connection point between the two systems of support doesn’t work very well. Families of
patients lack a systematic way to connect to the medical system to gain the information they need. The
burden is usually on the patient to translate an often technical medical diagnosis to their loved ones, who are
often at a loss as to how they can best work together to support the patient. As a result, costs are higher and
quality of care suffers. This is particularly the case in care for the elderly when the family is geographically
dispersed.

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It wasnIt wasn’’t always this wayt always this way……
Concept Overview
For most of human history, medicine was rooted in the social context of the family as most care was
delivered in the home. The doctor, family and patient were naturally aligned by the simple fact of where
care took place.
The rise of institutional medicine disrupted this natural alliance by shifting the context of care away from
the home. Families were now cut off from a natural proximity to the doctor and often removed from the
delivery of care altogether. Medicine has become a lot more scientific and technological, with myriad
associated benefits. But it has also become a lot less personal.

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The OpportunityThe Opportunity
Concept Overview
Reconnect the family to the health care process.
We see an opportunity to make medicine personal--again--by reconnecting the family to the health care
process. Direct and efficient communication between the doctor and the patient’s family will help activate a
wider system of support to better meet patient needs while saving time and money.
Our mission is to help families get the patient information they need, make meaning out of it
and act on it in a coordinated fashion.

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Concept Overview
Patient visits doctor;Patient visits doctor;
receives diagnosisreceives diagnosis
and treatment plan.and treatment plan.
Patient repeats theirPatient repeats their
version of what theversion of what the
doctor said to familydoctor said to family
members.members.
Family members talkFamily members talk
to patient, talk to eachto patient, talk to each
other, get confused,other, get confused,
call doctorcall doctor’’s ofﬁce.s ofﬁce.
Repeat cycle.Repeat cycle.
Son in DenverSon in Denver
Sister in ChicagoSister in Chicago
Son in NYCSon in NYC
Son in MiamiSon in Miami
Daughter in LADaughter in LAThe Current SystemThe Current System

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They tend to live in a separate city from their parents and have several siblings in other cities as well.
They have a family of their own and struggle to balance their sense of responsibility to their own family
and to their family of origin.
While they tend to lead networked lives themselves, they lack a systematic way to deal with family
health issues. They struggle with how to communicate with their parents about their health, how to
communicate with siblings about what should be done and who should do it, and how to connect with
the medical establishment to get clear information on their parent’s condition.
The resulting time drain gives them an abiding sense they are neglecting their own family or their work.
They often feel overwhelmed, guilty and ineffective.
There are a lot of them: According to the Pew Research Center, between 7 to 10 million adults are caring
for their aging parents from long distance. US Census Bureau statistics indicate that the number of older
Americans aged 65 or older will double by the year 2030, to over 70 million.
Who feels this problem most?Who feels this problem most?
Concept Overview
Baby Boomers
with aging parents

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Concept Overview
Direct input from doctor on how their loved one is doing.
What do families need?What do families need?
A place to share this information, discuss options, coordinate
tasks and connect to a wider community of support.

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Concept Overview
Our approach: Technology + Personal connectionOur approach: Technology + Personal connection
Offer a simple, easy to use, HIPAA compliant service that
provides caregiver reports in a confidential setting.
Provide digital/social-networking tools so that the family can
create value for each other with this information; an active
family medical hub ensues from this.
Build follow on offerings to continue adding value to the hub
and create additional revenue streams.
Combine personalized patient information with social
networking tools

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Concept Overview
Patient visits doctor;Patient visits doctor;
receives diagnosisreceives diagnosis
and treatment plan.and treatment plan.
Patient repeats theirPatient repeats their
version of what theversion of what the
doctor said to familydoctor said to family
members.members.
Family members talkFamily members talk
to patient, talk to eachto patient, talk to each
other, get confused,other, get confused,
call doctorcall doctor’’s ofﬁce.s ofﬁce.
Repeat cycle.Repeat cycle.
Son in DenverSon in Denver
Sister in ChicagoSister in Chicago
Son in NYCSon in NYC
Son in MiamiSon in Miami
Daughter in LADaughter in LAThe Old WayThe Old Way

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Concept Overview
Patient visitsPatient visits
doctor per usual.doctor per usual.
Doctor's ofﬁceDoctor's ofﬁce
phones or emailsphones or emails
summary of visit tosummary of visit to
the family hub.the family hub.
WDTDSWDTDS ““familyfamily
advocateadvocate”” ensuresensures
report is delivered.report is delivered.
Authorized familyAuthorized family
members are alertedmembers are alerted
a new doctor messagea new doctor message
isis in the hub. They login the hub. They log
on to see report,on to see report,
discuss options,discuss options,
develop action plansdevelop action plans
andand access services.access services.

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Our initial launch strategy will focus on connecting first to the family and then from the family to their care
providers through our Family Advocate. The Advocate is the connector between the family and care
providers, easing the path for families to hear directly from those providing care to their loved ones.
Empowered by the patient’s authorization, the Family Advocate will contact care providers on the family’s
behalf and help them contribute to the family hub. The Advocate will then submit questions from the family
to the provider in advance of the next patient visit.
The Family Advocate can provide additional services to the family such as working with providers to establish
a Personal Health Record for the patient and helping the family devise a care plan for the situation they are
facing.
This approach recognizes two fundamental truths of the heath care system today: Providers are highly
fragmented and they are mostly analog.
• 75% of doctors work in small practices of 10 doctors or less.
• Only 17% of doctors use an electronic medical records system.*
To best serve our families, we have to be prepared to go “fetch” the data in whatever form it exists. This is
the role of the Family Advocate. Over time, as EMR usage expands we hope to enroll most practices in our
community, so that families will be able to link directly to their patient’s providers. But for now we will
address the world as it exists.
*“How to Make Electronic Medical Records a Reality”,The New York Times, February 28, 2009.
Concept Overview
The Family AdvocateThe Family Advocate
The human connector between families and health care providers

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Concept Overview
The Family Medical HubThe Family Medical Hub
View reports, discuss
options, share links,
make decisions and
assign tasks.
Healthcare provider
reports on patient
Connected Family
actions in support
of the patient.
Family Members

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Concept Overview
Sample family discussionSample family discussion
Physician Name, Robert M. Barry, MD (Internal Medicine)
Date of Visit, 1/9/09
Physician Comments
““Jane complains of fatigue, shortness of breath and ankle swelling. She also has high blood pressure atJane complains of fatigue, shortness of breath and ankle swelling. She also has high blood pressure at
160/95160/95. Her ECG results, along with these other symptoms, suggests she may be experiencing the early. Her ECG results, along with these other symptoms, suggests she may be experiencing the early
stages ofstages of chronic heart failurechronic heart failure. As a result, I will be prescribing Jane a. As a result, I will be prescribing Jane a calcium channel blockercalcium channel blocker and aand a
diureticdiuretic. If her symptoms do not improve over the next two weeks, I will refer her to a cardiologist, Dr. Ken. If her symptoms do not improve over the next two weeks, I will refer her to a cardiologist, Dr. Ken
Jones, for additional workup including anJones, for additional workup including an echocardiogramechocardiogram andand BNPBNP test to refine her therapeutic treatment.test to refine her therapeutic treatment.””
1/15/09, Tom1/15/09, Tom
Fine Ben, you go ahead and do your research on natural remedies and IFine Ben, you go ahead and do your research on natural remedies and I’’ll make sure to ask the Doctor nextll make sure to ask the Doctor next
time. Itime. I’’m scheduled to arrive on the 23m scheduled to arrive on the 23rdrd of January. I will plan to go with her to the doctor for her next visit.of January. I will plan to go with her to the doctor for her next visit.
Also, please donAlso, please don’’t forget to post any questions that you may have for the doctor prior to her visit.t forget to post any questions that you may have for the doctor prior to her visit.
1/09/09, Ben1/09/09, Ben
II’’ve heard that Calcium Channel Blockers can have some pretty bad side effects. Maybe we should ask theve heard that Calcium Channel Blockers can have some pretty bad side effects. Maybe we should ask the
doctor about pursuing some natural remedies.doctor about pursuing some natural remedies.
1/09/09, Liz1/09/09, Liz
I talked to Mom and she down played it, as usual. She is resting fine. The drugs seem to be making her feelI talked to Mom and she down played it, as usual. She is resting fine. The drugs seem to be making her feel
better and her ankle swelling has gone down. Ibetter and her ankle swelling has gone down. I’’ll be staying with her for the next couple of days to make surell be staying with her for the next couple of days to make sure
she is stable.she is stable.
Who is coming out next to see her??Who is coming out next to see her??

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Concept Overview
View of Family HubView of Family Hub
The Hub
- Doctor Update on Wednesday- Doctor Update on Wednesday
-- Family phone conference Thursday 6PM MSTFamily phone conference Thursday 6PM MST
Patient, Mom in BoulderPatient, Mom in Boulder
•• Event: Hip ReplacementEvent: Hip Replacement
Son, Paul, in MiamiSon, Paul, in Miami
•• Tasks:Tasks:
-- Call on SundayCall on Sunday
-- Research walking shoesResearch walking shoes
-- Look intoLook into
Family CruiseFamily Cruise
in Januaryin January
Daughter, Janice in L.A.Daughter, Janice in L.A.
•• Tasks:Tasks:
-- Call on FridayCall on Friday
-- Follow up onFollow up on
Medicare ClaimsMedicare Claims
-- Research AcupunctureResearch Acupuncture
Son, Dan, in NYCSon, Dan, in NYC
•• Tasks:Tasks:
-- Call ThursdayCall Thursday
-- Find articles on HipFind articles on Hip
Replacement RecoveryReplacement Recovery
-- Order CaneOrder Cane
Sister, Liz, in ChicagoSister, Liz, in Chicago
•• Tasks:Tasks:
-- Call on WednesdayCall on Wednesday
-- Send ﬂowers from familySend ﬂowers from family
““Key ContactKey Contact”” Son, Tom, in DenverSon, Tom, in Denver
•• Tasks:Tasks:
- Arrange Rehab facility- Arrange Rehab facility
-- Follow up on In-home nurse/caregiver visitsFollow up on In-home nurse/caregiver visits
-- Arrange meal delivery serviceArrange meal delivery service

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Concept Overview
Family Medical Hub: Initial Feature SetFamily Medical Hub: Initial Feature Set
- Immediate text and e-mail updates to all family hub members when new information arrives
- Phone-in chat rooms for families at a distance to discuss health emergencies
- Links to Wiki content to provide further information on a diagnosis and medication
- Social networking tools to help families connect to others who have dealt with their situation
- Voice recognition tool that can transcribe the doctor’s/nurse’s voice message to text
- Physician visit preparation, notes and questions
- iPhone App to allow patient to record and send doctor visits to their family hub
- Care Planner engine (premium feature) helps family members determine the tasks required
to provide proper care of the patient, including medical, financial, insurance and advocacy
group connection
-“Ask an Expert” (premium feature) provides family members an opportunity to chat with an
expert on family support for their specific patient condition
- Links to insurance companies for claims information and questions on Medicare
- Links to extended care options and local services
- Links to financial planning resources for wills and estates

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What did the Doctor Say?What did the Doctor Say?™™ VALUEVALUE
Concept Overview
Family VALUE
•Improved sense of order and control
•Sense of teamwork and connection
•Ability to sustain support over time
• Reduced worry
• Reduced costs
Patient VALUE
•Release from being the primary source of info
•Release from always having to ask for help
•Conﬁdence family stands behind them
•Ability to maintain independence
•Improved quality of care/life
Healthcare Providers VALUE
• One-stop connection to family eliminates phone tag; saves time
• Reduced risk of patient misunderstanding diagnosis
• Better care coordination between patient visits
• Efﬁcient way to deliver better customer service

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Concept Overview
The original social networkThe original social network
A powerful newspaper publisher once beseeched Mark Zuckerberg, the founder of Facebook for advice on
how he could build his own on-line community. The famously laconic Zuckerberg replied, "You can't."
Zuckerberg went on to explain that communities already exist--you can't artificially create them. The task
is to provide them with "elegant organization" to do better what they already want to do.
Families are our first social network; it is deep in our nature to support a family member in need.
We help families perform this vital function by giving them the tools, information and “elegant
organization” to do better what they already want to do.

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Concept Overview
I. Launch What did the Doctor Say?™ service and family hub
- Beta test live in August 2009
- Full version site launched in ﬁrst quarter 2010
- Economic model centered around caregiver reports
II. Add monitoring applications to help the family stay connected
to the patient and each other
- Interactive medication management
- Monitoring (location/movement and vital signs)
- Fall monitoring and prevention
- Chronic disease management
III. Expand role of Family Advocate
- Premium services to help the family develop and implement
patient care plans
Strategic Plan

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Concept Overview
Where we are nowWhere we are now
I. Beta site live in August 2009
- Private family hub
- Doctor/HCP/Family posting log
- Simple calendar and task lists
- Basic account functionality
II. Begin private beta test in August
- twenty families
- learn how families decide to join, how they use the hub and what services they need
- get insight on pricing plans and the viral potential of the business
- understand how to best work with care providers to get patient information

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Why Now? Converging TrendsWhy Now? Converging Trends
Concept Overview
Med IT
Advances in:
-- monitoring devices
-- remote sensing
-- social networks
-- smart phone
-- shared data (PHR)
Healthcare environment
-- cost containment pressure
-- quality concerns
-- consumerism; Health 2.0
-- less third-party reimbursement
-- increasing patient involvement
Our “Sweet Spot”
Population Demographics
-- aging population
-- digitally aware and empowered
-- chronic conditions
-- “family caregivers”

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The convergence of the empowered patient with the free flow of accurate, timely and relevant medical
data is inevitable. What interests us about this brave new world is how this free flow of information and
connectivity can be used to improve the caring side of health care: The patient’s sense that they are
supported by a unified web of people—both professionals and family members-- acting toward their well
being. We believe this type of coordinated, active family involvement is the best way to meet the
challenge of improving quality of care while lowering costs.
That’s a future we want to create. To get there we will focus on strengthening the connective tissue
between doctors, patients and families-- the three legs of the health care stool. We’ll help families and
patients make meaning out of all the information they’re getting, and we’ll facilitate the conversations
that need to happen so that real human care can occur. By doing these things we will create a thriving
business and a way for families to thrive while coping with the health and aging challenges we all must
face.
Concept Overview
Toward the futureToward the future

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Who we areWho we are
Concept Overview
What did the Doctor Say?™ is a project of Patients + Families LLC, based in Boulder, Colorado. We are a
veteran team that combines deep knowledge of health care with entrepreneurship and branding. More
importantly, we have each been through the experience of supporting a parent in decline from afar.
We are the consumer we wish to serve.
Brian Lanahan is an expert at connecting brands to people, having worked on more than sixty consumer
products in his twenty-year career.Brian began his marketing career at the Coca-Cola Company, where he
spent eight years in brand management, strategic planning and new product development. He then
served as Managing Director and co-founder of Character LLC, a Portland Oregon based consultancy that
develops story frameworks for brands in consumer products, media and retail. Brian has a BA in History
from Duke University and an MBA in Marketing and Human Resources from Northwestern’s Kellogg
Graduate School of Management.
Phil Siegert is an accomplished interactive strategist. He’s worked at larger advertising agencies such as
Leo Burnett, was a founding partner of The Royal Order of Experience Design, a cross media boutique,
and is a partner in Twiss, a consultancy focused on shaping how brands transact directly with consumers
across multiple channels.Phil’s talent is understanding customer expectations, envisioning the ideal user
experience and applying his knowledge of the growing variety of media and technologies to bring complex
transactional concepts to life. He has developed solutions ranging from multiplayer online games to
ecommerce platforms for numerous well-known brands such as Patagonia, Kohler, Naturopathica,
Seventh Generation, Burton Snowboards, Revolution Living, and Kiehl’s since 1891. He possesses an MFA
(Painting) and BFA from the School of the Art Institute of Chicago in addition to a BA in Art and
Architectural History from the University of Illinois at Chicago.

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Who we are, continuedWho we are, continued
Concept Overview
Marc Silverman is a seasoned corporate executive with over twenty-five years experience in the
healthcare industry. He has conceived, developed and successfully brought to market a variety of medical
devices and medical information technologies. His business experience includes large and small
companies and startup endeavors, including Bayer/Cutter Laboratories, Hexcel, Technicon, Baron Medical
Systems, Performance Factors, and Performance Health. He is a successful entrepreneur (two exits, incl.
IPO), angel investor, and advisor. He currently serves on the boards of the Deming Center for
Entrepreneurship at the University of Colorado at Boulder, and the advisory board of the Metropolitan
State College of Denver Center for Innovation. Mr. Silverman is an engineering graduate of the University
of California, Los Angeles, The San Francisco Art Institute, and the Stanford University Executive Program.
Gina Simmering is a highly motivated health and wellness professional with over twenty four years of
experience in the fields of nursing, fitness, nutrition and self and family care. She has founded and
published a successful wellness magazine and advised numerous organizations on health advocacy,
including Stanford University Hospital and Hospice of Boulder and Broomfield Counties. Gina holds a
Bachelors of Science from West Chester University in Corporate Wellness as well of a Bachelors of Science
from the University of San Francisco in Nursing.
Gordon Van Dusen has over twenty years of experience in business development, marketing, product
management and strategic planning in the healthcare industry. His business experiences encompass large
and small, earlier staged healthcare companies including Baxter Healthcare, Myogen, Somatogen,
Hiberna and RxKinetics. Gordon has been on the founding management team of four healthcare startups,
most recently as a founder and CEO of Hiberna Corporation and Vice President of Business Development
for Myogen, Inc. He currently serves on the advisory board for Fitzsimon’s BioBusiness Partners, Inc and
has been an angel investor, advisor and consultant to several startup businesses. Mr. Van Dusen holds a
B.S.E. in Biomedical Engineering from Duke University, an M.S. in Bioengineering from the University of
Michigan and an MBA in Finance and Marketing from the Kellogg Graduate School of Management.

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