Silicon Valley Bank report on Digital Health

1. Digital
Health:
Opportunities for Advancing Healthcare
Steve Allan CFA
Head of SVB Analytics
sallan@svb.com
Scott Winder
Director
swinder@svb.com
Alex Lee
Manager
klee@svb.com
Emily Wengel
Associate
ewengel@svb.com
Written by SVB Analytics:

2. Table of Contents
Digital Health Report 2
3 Overview: What is Digital Health?
6 State of U.S. Healthcare: What Drives Costs and Outcomes
10
Employers and Payers:
Improving Outcomes and Lowering Costs
19
Healthcare Systems and Professionals:
Impacting Care Delivery
26
Healthcare Consumers:
Engaging Consumers, Empowering Patients
31
Digital Health Outlook:
Mapping Digital Solutions for Advancing Healthcare
33 About the Authors
36 About Silicon Valley Bank and SVB Analytics
See Appendix for complete sources and additional information.

3. What is Digital Health?
Digital Health Report 3
Solutions that use
digital technology
to improve
patients’ health
outcomes and/or
reduce the cost of
healthcare
The convergence of healthcare and technology has arrived.
Healthcare stakeholders are seeking solutions to survive and
thrive in a fast-changing regulatory and clinical environment.
At the same time, enabling technologies are becoming widely
adopted. The healthcare ecosystem is aligning around critical
areas to bring widespread advancements through digital
health solutions. SVB Analytics is examining challenges facing
a wide range of stakeholders and identifying opportunities for
digital technology.
This is the first in a series of reports on Digital Health. In this report, we will examine:
• What drives costs and outcomes of the U.S. healthcare system
• How employers and payers struggle to contain healthcare costs
• How healthcare systems and professionals are plagued by inefficiencies in care delivery
• How healthcare consumers find it challenging to be involved in and manage their own healthcare

4. Stakeholder Challenge Example Digital Health Companies
Employers
Lowering healthcare costs and improving
productivity with healthier employees
Payers
Migrating to value-based care and
adjusting risk to maintain profitability
Healthcare
Systems and
Professionals
Reducing operational challenges and
adapting healthcare delivery to the
changing regulatory and clinical landscape
Healthcare
Consumers
Gaining access to information and
guidance to better manage healthcare
decisions and disease treatment
Digital Health Report 4
Healthcare Stakeholders
Face Many Challenges
In this report, we look at the some of the largest
unaddressed markets in which digital technology
can help solve key stakeholder challenges.

5. Digital Health Report 5
State of U.S.
Healthcare:
What Drives
Costs and
Outcomes

6. Digital Health Report 6
High Costs, Dissatisfaction
Drive Demand for Innovation

7. $- $2,000 $4,000 $6,000 $8,000 $10,000
United States
Switzerland
Norway
Netherlands
Sweden
Germany
Denmark
Austria
Canada
Belgium
France
Japan
Iceland
Finland
New Zealand
United Kingdom
Italy
Portugal
Healthcare Expenditure per Capita, PPP* in USD, 2013
U.S. Healthcare Expenditures Far Outpace
Other Countries
Digital Health Report
In many respects, the U.S. healthcare system has fallen behind other developed countries
– costs more but results in less satisfaction.
7*PPP: Purchasing power parity

8. 0% 20% 40% 60%
United States
United Kingdom
Luxembourg
Canada
Finland
Germany
Israel
Netherlands
Sweden
Italy
Switzerland
Japan
Korea
% of Population that is Overweight or Obese
in OECD Countries, 2013
Obese population, >30 BMI Overweight population , 25-30 BMI
0 2 4 6
United States
United Kingdom
Belgium
Netherlands
Switzerland
Israel
France
Ireland
Denmark
Portugal
Australia
Germany
Austria
Spain
Italy
Sweden
Norway
Finland
Iceland
Death per 1000 births
Infant Mortality Rates in OECD Countries,
Death per 1000 Births, 2012
But Health Outcomes Are No Better,
Despite Investment
Digital Health Report 8
Despite higher per capita spending on healthcare in the U.S., the health outcomes are
often no better. The U.S. system remains focused on sick-care rather than upon improving
wellness and providing preventive care.

9. 11.5% 15.7%
0%
10%
20%
30%
40%
50%
60%
70%
80%
90%
100%
1980 2012
Administrative and Insurance Costs
Contribute to Higher Healthcare Costs
$27.1
Billion
$386.3
Billion
Increase
$413.4
Billion
Annual
administrative &
insurance-related
costs
9
U.S. Healthcare Expenditures by Category
in annual administrative
& insurance-related costs
Other (incl. Insurance
and Administrative)*
Nursing Home Care
Other Medical Durables
and Non-Durables
Prescription Drugs
Home Healthcare
Other Professional
Physician Services
Hospital Care
*"Other" includes net cost of insurance and administration, government public health activities and
other personal healthcare. Digital Health Report

10. Digital Health Report 10
Employers
and Payers:
Improve Outcomes
and Lower Costs

11. Challenge Opportunity Example Digital Health Companies
Growing Cost of
Healthcare Benefits
Implement platforms that improve
healthcare benefit management
and lead to employer cost savings
Competition to Attract
and Retain Talent
Provide employees access to
innovative services, such as
telemedicine and genetic testing,
to better manage their health
Productivity Loss Due to
Employee Health Issues
Offer technology-based tools and
services to emphasize wellness and
preventive health
Digital Health Report 11
Overview:
Employers Face High
Healthcare Costs and
Lost Productivity

12. Healthcare Benefits Become Bigger Part
of Employee Compensation
Digital Health Report 12
7.0%
7.2%
7.4%
7.6%
7.8%
8.0%
8.2%
8.4%
8.6%
8.8%
2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015
%ofTotalCompensation
Healthcare Benefits as % of Total Compensation
For most of the last decade, the cost of employer-paid healthcare benefits has been on the
rise when measured as a percentage of total compensation. Implementing digital health
platforms to improve healthcare benefit management and to increase price transparency
will lower the overall cost burden of employers, a primary payer in the U.S. system.

13. 0% 10% 20% 30% 40% 50% 60% 70% 80% 90% 100%
Leveraged Benefits Program to Recruit Employees
Leveraged Benefits Program to Retain Employees
Positively Used Health Care Benefits To Recruit
Positively Used Health Care Benefits To Retain
2015
2014
2013
Employers Increasingly Use Benefits
to Attract and Retain Workers
Digital Health Report 13
Increasingly, employers are leveraging healthcare and preventive/wellness benefits to
attract and retain employees. Employers are providing employees access to innovative
services, such as telemedicine and genetic testing, to better manage their health.
Percentage of Companies

14. Unhealthy Workforce Impacts Productivity
and Bottom Line
Digital Health Report 14
Improving employee health management can help reduce the impact of health-related
productivity loss, which presents opportunities for digital health companies focused on
wellness and preventive care.
Management
Supervisors spend
4.2 hours/week
managing absences
Employees
Replacement
Workers are
36.6% less
productive
Bottom Line
Absences cost
an average
15.4% of payroll

15. Challenge Opportunity Example Digital Health Companies
Consumerism is Changing
Insurance Market
Dynamics, Increasing
Pricing Pressure
Use technology tools to be more
consumer-friendly and competitive
Lack of Insight and
Tools to Accurately
Measure Risk
Use big data and machine learning
to improve risk management
Shift from Fee-Based to
Value-Based Care
Implement population health tools
that manage care delivery and
control costs by risk population
Digital Health Report 15
Overview:
Payers Seek Solutions
in Price Competitive
Marketplace

16. Emergence of Public and Private Exchanges
Increases Pricing Pressure on Payers
Digital Health Report 16*Private Exchanges: Healthcare exchange that is created by employers for their employees.
The Affordable Care Act created public exchanges; now employers are embracing private exchanges.*
Public Exchanges
Public exchanges
are expected to cover
15 million people
by 2017
Private Exchanges
An estimated
20-30% of employers
plan to create private exchanges
within 5 years
Consumers on exchanges tend to choose lower-cost plans, impacting payer revenues.
$322 is the potential annual
savings for consumers actively
shopping for coverage in 2016
As many as 66% of employees choose
plans with lower premiums when switching
to private exchange plans
Exchanges make it easier for consumers to change their health insurance plans, which
creates pricing pressure on payers.

17. Data Remains in Silos, Making Claims and
Costs Difficult to Predict
Electronic
Health Records
Medical
Claims Data
Lab Data
Government regulations and standards are
adding to challenges of controlling medical
claims and costs.
Disparate data sources impact payers’
ability to accurately access risk.
Regulatory Changes May Increase
Medical Claims and Costs
Payers Face New Challenges in Cost Control
and Risk Management
Digital Health Report 17
Ongoing difficulty in capturing and measuring standardized data remains the biggest
challenge for payers when assessing risk and medical claim costs. An opportunity exists
for digital health companies that specialize in providing risk and analytics solutions.
@
@
@
@
@
@
World Health Organization:
Implementation of ICD-10
U.S. Government:
Minimum Medical Loss Ratio

18. Payers Struggle in Shift to Value-Based Care
Digital Health Report 18
Payers Rate Value-Based Care Payment Models as More Difficult to Implement
0% 2% 4% 6% 8% 10% 12% 14% 16%
Pay for Performance
Episode of Care / Bundled Payments
Capitation
Global Payment
Other (i.e.Shared Savings)
Fee For Service
% of Payers Rating Model as Difficult to Implement
Value-Based
Care
Traditional
Payment
Model
Payers cite data standardization and analysis measures as major challenges in
implementing value-based care, especially in pay for performance and shared savings
models. Digital health solutions can help more accurately assess medical claims.
Fee for Service – Fixed fee payment for service rendered
Pay for Performance – Incentives to providers based on KPIs
Global Payments - Fixed budget of care for population of patients with sophisticated risk adjustments incorporated
Capitation – Fixed budget of care for population of patients
Bundled Payments – Single payment per episode of care
Other (Shared Savings) –Incentives to encourage cost saving

19. Digital Health Report 19
Healthcare
Systems and
Professionals:
Impacting Care Delivery

20. Challenge Opportunity Example Digital Health Companies
High Administrative
Costs
Digitize records and improve
communications and workflows
Shift to
Value-based Care
Develop new ways to analyze costs
and patient population risks to
deliver more efficient care
Explosion of Data in
Clinical Decision-Making
Implement clinical outcomes
analysis and personalized medicine
Digital Health Report 20
Overview:
Healthcare Systems and
Professionals Face Pressure
to Improve Care Delivery

21. $128 $35
$192
$131
$177
$248 Failures of Care Delivery
Failures of Care Coordination
Overtreatment
Pricing Failures
Fraud and Abuse
Administrative Complexity
Healthcare Systems and Professionals Are
Plagued by Operational Challenges
Digital Health Report 21
Lack of automation is prevalent in the industry. The majority of the inefficiencies and waste
in the healthcare system relates to administrative complexity, pricing failures and fraud and
abuse. Overlaying electronic documentation support and data analytics tools across these
disparate data silos will better identify outliers and lower total systematic costs.
Estimated Annual Cost of Operational
Inefficiencies on Healthcare System ($B)
$910 Billion
Estimated annual cost
of inefficiencies in the
U.S. healthcare system
Provision of Care
Failure of Health System

22. Healthcare Systems and Professionals Struggle
with Basic Communications
Digital Health Report 22
0 10 20 30 40
Prescribing and/or
Administering Medications
Completing Documentation
Communicating and Consulting
with Colleagues
Conducting Patient Care
Minutes per Day Wasted
Estimated Time Wasted by Care Providers Due to
Inefficient Systems and Workflow
Main Reasons Time is Wasted in
Communicating with Colleagues
Inefficient and outdated communications systems in clinical settings waste, on average, an
estimated $1.7 million annually per hospital. Deploying and mandating modern digital
health communication tools will improve health system profitability.
Text messaging is not allowed
Pagers are not efficient
Wi-Fi is not available
Email is not efficient

23. Digital Health Report 23
High Workload
Leads to Increased
Risk of Medical Error
Today the healthcare professional…
Healthcare professionals often work long shifts, which correlates with a higher frequency of
medical errors. Digital health opportunities include electronic medical records, improved
workflow management and better communications tools to help reduce medical errors.
74% of Nurses
cite stress and overwork as top concerns
Is Stressed
Only 6% of Doctors
describe their morale as positive
Faces High Workload
Over 20% of Physicians
report workload has likely contributed to patient
transfers, morbidity or even mortality
Adding a nurse FTE
leads to a 16% reduction in the odds of death
in a surgical setting

24. Value-Based Care Creates New Challenges
for Systems
Digital Health Report 24
Healthcare Systems Rate Value-Based Care
Payment Models More Difficult to Implement
0% 5% 10% 15% 20%
Pay for Performance
Episode of Care / Bundled Payments
Capitation
Global Payment
Other (i.e.Shared Savings)
Fee For Service
% of Payers Rating Model as Difficult to Implement
Episode of Care /
Bundled Payments
Other
(e,g, Shared Savings)
Value-
Based
Care
Traditional
Payment
Model50% of Medicare payments
expected to be value-based in 2018
Only 20% of healthcare CEOs
say they are ready to fully implement
value-based care
Shift to value-based care is coming…
But healthcare systems are unprepared:
Adopting value-based care requires improving outcomes while controlling costs. Healthcare systems also face
difficulty in allocating payments in value-based care models. Digital health companies can help create tools to
analyze patient risk and generate actionable insight on how to provide more efficient care.
Fee for Service – Fixed fee payment for service rendered
Pay for Performance – Incentives to providers based on KPIs
Global Payments - Fixed budget of care for population of patients with sophisticated risk adjustments incorporated
Capitation – Fixed budget of care for population of patients
Bundled Payments – Single payment per episode of care
Other (Shared Savings) –Incentives to encourage cost saving

25. Clinicians Face a Deluge of Medical Information
Increasing drug approvals
(~1600 cumulative in 2015)
Alert fatigue
More treatment &
diagnostic options
Impacts decision-making, causing errors
Over 80% of primary care
physicians believe they receive an
excessive number of alerts.
Clinicians Need Tools to Tackle
Information Overload
Digital Health Report 25
Increased academic
literature & research
~2M articles published in a
single year
Increased genomic &
mutation data
>187M DNA sequences recorded
(200 terabytes of data)
Increased
clinician stress
Imprecise
clinical judgment
Clinicians struggle to keep up with rapidly advancing medical research. They and their patients can benefit
from effective data analysis and personalized medicine to improve clinical outcomes.

26. Digital Health Report 26
Healthcare
Consumers:
Engaging Consumers,
Empowering Patients

27. Challenge Opportunity Example Digital Health Companies
Lack of Choice and
Price Transparency
Provide tools and services to
access quality healthcare at a
reasonable cost
Poor Health Literacy
Create access to online educational
material and training to improve
decision-making
Lack of Tools to Manage
Health and Wellness
Empower patients to manage their
own health, including disease
treatment and wellness
Digital Health Report 27
Overview:
Empowering Patients
Is Key to Fixing
Healthcare System

28. Digital Health Report 28
Patients Are Often
Uninformed on Costs,
Treatment Options
Healthcare consumers and patients struggle to manage their own healthcare due to limited
access to relevant healthcare information. Digital health companies can empower patients
through better search tools, pricing transparency solutions, disease management apps and
other patient engagement solutions.
Lacks information on disease As few as 13% of patients
with chronic disease were provided health education
Only 13% of patients
were given a range of treatment prices
Lacks information on cost
Lacks health literacy Up to 35% of patients
have no or only basic health literacy
Today the patient…

29. $966
$840
$783 $799
$500
$600
$700
$800
$900
$1,000
PredictedcostsperpatientEngaged Patients Correlate with Lower Costs and
Better Outcomes
Digital Health Report 29
 Lower readmission rates
 Higher survival rates
• Higher rates of medical errors
• Less likely to follow healthcare
professional’s advice
Poorer Outcomes Better Outcomes
Higher Costs Lower Costs
Healthcare costs for the least-engaged patients are
21% higher than those for the most-engaged patients
Least Engaged Most Engaged

30. 24%
38%
31%
6%
1%
To be Completely in Charge
To Make Final Decision with Doctor input
To Make Joint Decision with Doctor
To Give Input with Decision made by
Doctor
For Doctor to be Completely in Charge
Patients Want to Be Active Decision-Makers
Digital Health Report 30
More than 90 percent of adults say they want to be actively involved in decision-making with their doctors, and
24 percent want to be completely in charge. Looking ahead, patients’ interest in their own healthcare
represents opportunities for digital health technologies that empower patients.
Asked how much they want to be involved in their
healthcare decisions, patients wanted…
For Doctor to Be
Completely in Charge
To Give Input with Decision
Made by Doctor
To Make Joint Decision
with Doctor
To Make Final Decision
with Doctor Input
To Be Completely in Charge
Patient Actively
Involved
Doctor Makes
Final Decision

31. Digital Health Report 31
Digital Health
Outlook:
Mapping Digital Solutions
for Advancing Healthcare

32. Clinical Operations
Patient Surveillance
Image Management /
Analytics
Electronic Medical Records
Decision Support & Analytics /
Predictive Medicine
Marketing / Customer
Experience
Networking /
Education
Care Coordination /
Communication
Population Health Management Practice Management &
Operational Workflows
Digital Health Companies Are Changing the Face of Healthcare
Digital Health Report
Patients / Consumers
32
Digital health companies are innovating in the healthcare space by focusing on improving outcomes and reducing costs. In the next report,
we will evaluate the most promising opportunities and solutions that address the needs of patients and healthcare consumers.
FocusonHealthOutcomes
Employers / Payers
Life Science / Other Systems / Healthcare Professionals
FocusonHealthcareCosts
TelemedicineRemote
Monitoring
Patient-Clinician
Communication
Digital Therapeutics /
Pill Plus
Patient /
Professional
Interaction
Fitness / Wellness /
Wearables / Tracking
Insurance SearchGenetic Screening
Education
Social Support Professional Search
Disease / Medication
Management
Enterprise Wellness
Risk Adjustment / Payer
Administration
Value-Based Care
Enterprise Health
Management
Data Driven PayersPatient Engagement /
Benefits
R&D
Operational

33. About the Authors
Digital Health Report 33
Steve Allan, CFA
Steve Allan is the Head of SVB Analytics, responsible for the
three areas of information services provided to the
innovation economy: Strategic Advisory Services,
Compliance Valuations, and Insights. Strategic Advisory
Services provides consultative guidance around valuations,
benchmarking and inorganic growth strategies. Compliance
Valuations issues valuation opinions for private companies.
Insight focuses on studying trends and opportunities in the
private venture-backed innovation ecosystem. Steve brings
a strong financial background and passion for
entrepreneurship to his role at SVB Analytics.
Steve earned a master’s in business administration
from Duke University's Fuqua School of Business and a
bachelor's degree in finance from the University of
Notre Dame.
Head of Analytics
sallan@svb.com
Emily Wengel
Emily Wengel is a Valuation Associate with SVB Analytics,
responsible for conducting due diligence and financial analysis
on valuation engagements for early-stage, venture-backed life
sciences companies.
Prior to joining SVB Analytics, Emily worked as a business analyst
at BioMotiv, an early stage biotech accelerator. Emily graduated
cum laude from University of Pennsylvania, where she earned a
bachelor of science in economics and a bachelor of arts in
biology.
Associate
ewengel@svb.com
Alex Lee
Alex Lee is a Valuation Manager at SVB Analytics,
responsible for conducting due diligence and financial
analysis on valuation engagements for venture-backed
companies in the Life Science sectors.
Prior to joining SVB Analytics, Alex worked as a consultant
for biopharmaceutical companies, diagnostic companies
and medical research institutions, assisting in corporate
development, product commercialization and strategic
advisory activities. Alex holds a master’s of bioscience
degree from Keck Graduate Institute and a bachelor’s of
science degree in biochemistry from the University of
Nebraska-Lincoln.
Manager
klee@svb.com
Scott Winder
Scott Winder is a Director at SVB Analytics, responsible for
managing client valuation assignments and issuing valuation
opinions. Prior to joining SVB Analytics, Scott was a manager in
the Business Valuation practice of Deloitte Financial Advisory
Services LLP based in San Francisco. While at Deloitte, Scott
provided financial advisory services related to mergers and
acquisitions, accounting compliance, tax reporting and strategic
planning for clients in the technology and life sciences industries,
with particular experience in the biotechnology and
biopharmaceutical industry segments.
Scott holds a master's degree in business administration from
the Haas School of Business (University of California at Berkeley),
and a bachelor’s degree in human biology from Occidental
College.
Director
swinder@svb.com

34. Appendix: Sources
Digital Health Report 34
Slide 7: U.S. Healthcare Expenditures Far Outpace Other Countries
• “OECD Health Statistics 2015.”
Slide 8: But Health Outcomes Are No Better, Despite Investment
• “OECD Health Statistics 2015.”
Slide 9: Administrative and Insurance Costs Contribute to Higher
Healthcare Costs
• Centers for Medicare & Medicaid Services, Office of the Actuary. Data
released January 7, 2014
Slide 12: Healthcare Benefits Become Bigger Part of Employee
Compensation
• “Employment Cost Trend.” US Bureau of Labor Statistics. Last
modified June 30, 2015.
Slide 13: Employers Increasingly Use Benefits to Attract and Retain
Workers
• “2015 Strategic Benefits Survey – Leveraging Benefits to Recruit
Employees.” Society For Human Resource Management (SHRM).
Slide 14: Workforce Impacts Productivity and Bottom Line
• “Total Financial Impact of Employee Absences in the U.S, 2014.”
Society For Human Resource Management (SHRM).
Slide 16: Emergence of Public and Private Exchanges Increase
Pricing Pressure on Payers
• “Potential Savings from Actively Shopping for Marketplace Coverage
in 2016.” Kaiser Family Foundation.
• “Examining Private Exchanges in the Employer-SponsoredInsurance
Market” Kaiser Family Foundation. September 2014.
• “Private Health Insurance Exchanges.” Kaiser Family Foundation.
• “The Budget and Economic Outlook: 2016 to 2026.” Congressional
Budget Office.
Slide 18: Payers Struggle in Shift to Value-Based Care
• “The 2014 State of Value-BasedReimbursement and the Transition
from Volume to Value in 2014.” McKesson Corporation.
Slide 21: Healthcare Systems and Professionals Are Plagued by
Operational Challenges
• Donald M. Berwick and Andrew D. Hackbarth, “Eliminating Waste in
US Health Care,” JAMA 307, no. 14 (April 11, 2012):1513–6.
Slide 22: Healthcare Systems and Professionals Struggle with Basic
Communications
• “The Imprivata Report on the Economic Impact of Inefficient
Communications in Healthcare.”June 2014.
Slide 23: High Workload Leads to Increased Risk of Medical Error
• Sandeep Jauhar. “Why Doctors Are Sick of Their Profession.” Wall
Street Journal. August 29, 2014. http://www.wsj.com/articles/the-u-
s-s-ailing-medical-system-a-doctors-perspective-1409325361
• Paul G Shekelle. ”Effect of Nurse-to-Patient Staffing Ratios on
Patient Morbidity and Mortality.” in Making Health Care Safer II: An
Updated Critical Analysis of the Evidence for Patient Safety
Practices. Rockville (MD): Agency for Healthcare Research and
Quality (US); 2013 Mar. (Evidence Reports/Technology Assessments,
No. 211.)
• Henry J. Michtalik. et al. “Impact of Attending Physician Workload on
Patient Care: A Survey of Hospitalists.” JAMA Intern Med.
2013;173(5):375-377. doi:10.1001/jamainternmed.2013.1864.

35. Appendix: Sources (continued)
Digital Health Report 35
Slide 24: Value-Based Care Creates New Challenges for Systems
• “The 2014 State of Value-BasedReimbursement and the Transition
from Volume to Value in 2014.” McKesson Corporation.
• “The State of Population Health: Numerof Survey Report.” 2016.
• “Just 20% of health care CEOs are ready to get rid of fee-for-service.”
The Advisory Board Company. 2015
Slide 25: Clinicians Need Tools to Tackle Information Overload
• Amanda Hall and Graham Walton. “Information overload within the
health care system: a literature review.” Health Information &
Libraries Journal, 21: 102–108. doi: 10.1111/j.1471-
1842.2004.00506.x
• Information Overload and Missed Test Results in Electronic Health
Record–BasedSettings JAMA Intern Med. 2013;173(8):702-704.
doi:10.1001/2013.jamainternmed.61.
• FDA
• “GenBank and WGS Statistics.” National Center for Biotechnology
Information. August 2015.
• Lutz Bornmann and Rüdiger Mutz. “Growth rates of modern science:
A bibliometric analysis based on the number of publications and
cited references.” Journal of the Association for Information Science
and Technology. 66: 2215–2222. doi: 10.1002/asi.23329
Slide 28: Patients Are Often Uninformed on Costs, Treatment
Options
• Ritsema TS, Bingenheimer JB, Scholting P, Cawley JF. Differences in
the Delivery of Health Education to Patients With Chronic Disease by
Provider Type, 2005–2009. Prev Chronic Dis 2014; ;11:130175. DOI:
http://dx.doi.org/10.5888/pcd11.130175
• Blumenthal-Barby, et al. The NeglectedTopic: Presentation of Cost
Information in Patient Decision Aids. Med Decis Making May 2015
vol. 35 no. 4 412-418
• “America’s Health Literacy: Why We Need Accessible Health
Information.” US Department of Health and Human Services. 2008.
Slide 29: Engaged Patients Correlate With Lower Costs and Better
Outcomes
• “Chronic Care: A Call to Action for Health Reform.” AARP Public
Policy Institute.
• Suzanne Mitchell, et. al. Patient Activation and 30-Day Post-
Discharge Hospital Utilization. Jornal of General Internal Medicine.
2013. 2014 Feb;29(2):349-55. doi: 10.1007/s11606-013-2647-2.
• Judith H. Hibbard, et. al. “Patients With Lower Activation Associated
With Higher Costs; Delivery Systems Should Know Their Patients’
‘Scores.’” Health Aff February 2013 vol. 32 no. 2 216-222. doi:
10.1377/hlthaff.2012.1064
• David H. Gustafson et al. An eHealth System Supporting Palliative
Care for Patients with Non-small Cell Lung Cancer: A Randomized
Trial. Cancer. 2013 May 1; 119(9): 1744–1751; doi:
10.1002/cncr.27939.
Slide 30: Patients Want to Be Active Decision-Makers
• “The State of Patient Engagement and Health IT” HIMSS. 2014.

36. About Silicon Valley Bank
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innovative companies and their investors move bold ideas
forward, fast. SVB provides targeted financial services and
expertise through its offices in innovation centers around the
world. With commercial, international and private banking
services, SVB helps address the unique needs of innovators.
Digital Health Report 36
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About SVB Analytics
SVB Analytics, a non-bank affiliate of Silicon Valley Bank, serves the
strategic business needs of entrepreneurs, corporates and investors
in the global innovation economy. For more than a decade, SVB
Analytics has helped global business leaders make informed
decisions by providing market intelligence, research, and consulting
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