Microsoft’s point of view

2

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The Internet of Things starts with our partners’ things

Build solutions on the infrastructure you already have and customers already own

Add more devices to the ones your customer already owns

Act and coordinate on data that already exists

“…the value of improved health of chronic disease patients through remote monitoring alone could be as much as $1.1 trillion per year in 2025.”

2015 Mckinsey & Company Unlocking the potential of the Internet of Things

Azure IoT Services – Healthcare

HOSPITAL ROOM MEDICAL RESEARCH PATIENT HOME

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2. Enable innovation by conducting data science driven clinical studies and providing tailored care through patient data analytics.

1. Improve efficiency and provide better patient care by accessing secure patient data remotely, seeing vitals in real time and ordering prescription changes to minimize errors.

3. Drive business transformation by treating patients in their home through secure remote care solutions.

Program Description ISO/IEC 27001 ISO/IEC 27018

The ISO/IEC 27001:2005 certificate validates that Azure has implemented the internationally recognized information security controls defined in this standard.

SOC 1 SSAE 16/ISAE 3402

Azure has also been audited against the Service Organization Control (SOC) reporting framework for SOC 1 Type 2 (formerly SAS 70), attesting to the design and operating effectiveness of its controls.

SOC 2 Security, availability, confidentiality

Azure has been audited for SOC 2 Type 2, which includes a further examination of Azure controls related to security, availability, and confidentiality.

FedRAMP/FISMA Azure has received Provisional Authorization to operate from the Federal Risk and Authorization Management Program (FedRAMP) Joint Authorization Board (JAB), having undergone the assessments necessary to verify that it meets FedRAMP security standards.

PCI DSS Level 1 Azure has been validated for PCI-DSS Level 1 compliance by an independent Qualified Security Assessor (QSA).

UK G-Cloud IL2 In the United Kingdom, Azure has been awarded Impact Level 2 (IL2) accreditation, further enhancing Microsoft and its partner offerings on the current G-Cloud procurement Framework and CloudStore.

HIPAA BAA To help customers comply with HIPAA and HITECH Act security and privacy provisions, Microsoft offers a HIPAA Business Associate Agreement (BAA) to healthcare entities with access to Protected Health Information (PHI).

Certifications & Compliance Programs

Certifications & Compliance ProgramsISO 27018

The new standard, ISO/IEC 27018 (ISO 27018), strengthens data privacy by adding key protections for sensitive customer information stored in the cloud. Published July 30, 2014 by the International Organization for Standardization (ISO), it sets forth guidelines for cloud service providers concerning Personally Identifiable Information (“PII”). The standard was developed in consultation with contributors from 14 countries and five international organizations.

Cloud service providers adopting ISO 27018 must operate under a stronger, industrywide framework of six key principles: 1. Consent. Cloud providers must not process the personal data they receive for purposes other independent of the instructions customer, and

they must not use that personal data for advertising and marketing unless expressly instructed to do so by the customer. Moreover, it must be possible for a customer to use the service without submitting to such use of its personal data for advertising or marketing.

2. Control. Customers have explicit control of how their information is used. 3. Transparency. Cloud providers must inform customers where their data resides and make clear commitments about how that data is

handled. 4. Accountability. The standard asserts that any breach of information security should trigger a review by the service provider to determine if

there was any loss, disclosure, or alteration of PII. 5. Communication. In case of a breach, cloud providers should notify customers and regulators, and keep clear records about the incident and

the response to it. 6. Independent and periodic audit. A successful third-party audit of a cloud service’s compliance with 27018 documents the service’s

conformance with the standard, and can then be relied upon by the customer to support their own regulatory obligations. To remain compliant, the Cloud service provider must subject itself to periodic third-party reviews.

Today Public Azure

July 2015 Public Azure Roadmap can be disclosed without NDA

August 2015 Azure Government Roadmap can be disclosed without NDA

October 2015 Public Azure Roadmap can be disclosed without NDA

December 2015 Public Azure NDA disclosure only – list may change based on service GA dates

• Cloud Services • Virtual Machines • Storage • Virtual Network • Traffic Manager • Web Sites • BizTalk Services • Media Services • Mobile Services • Service Bus • Multi-Factor Authentication • Active Directory • Rights Management Service • SQL Database

14 services

• Batch • Notification Hub • Workflow Manager • Express Route • Scheduler • HDInsight +6 services 20 services total

• Virtual Machines • Cloud Services • SQL Database • Storage • Virtual Network • Traffic Manager • Azure Active Directory • Multi-Factor Authentication

8 services

• Redis Cache • Resource Manager • API Management Services • Ibiza • IAM AADSF Sync Fabric • IAM AP SSO • IAM SSGM • IAM ADIUX • Key Vault • Policy Administration Service • OpInsights • Automation • RemoteApp

+14 services 34 services total

• Doc DB • Stream Analytics • PowerBI • Machine Learning • StorSimple • Cloud DNS • Azure Big Data Compute • Azure Data Lake

+8 services 42 services

6

In FY16 only core services will list in the OST, not in the BAA. We will move to a monthly rhythm of updating the OST. Once we update the Trust Center we are legally bound to cover the services under the BAA

The journey to an Internet of Things world starts with a typical health mission statement

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Innovation and research

Lower costs and streamlined operations

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Maximum quality of care

Patient involvement

Improve efficiency to maximize quality of care

Collect and secure large amounts of data from your assets in the cloud for analysis

Monitor and track the health of your assets to reduce costs

Connect disparate medical assets to automate and improve business and patient care processes

Things

Create operational intelligence to improve performance and decision making

Apply historical data to new problems to successfully predict future behavior of treatments

Analyze data from multiple sources in near real time to help taking medical decisions

Enable innovation in health

Things

Leverage advanced analytics to create new patient care models and revenue streams

Create insights for the right people in your health organization to access and act on

Convert the raw data from your “things” into actionable insights and business results

Things

Transform your health organization to reduce cost

Target high impact scenarios

Improve margins, speed, & satisfaction

Transform care delivery & population health

Reduce operating costs

1. In/Out patient flow management Add 1-2 Operation Room cases per day Streamline Emergency Department workflow Decrease ED wait times by 50% Increase patient satisfaction by 10-20% Reduce number of patients leaving without being seen by 25-50%

2. Equipment/device management /predictive maintenance

Reduce on-site servicing costs, improve up-time and increase capacity utilization, customer satisfaction

3. Mobile asset tracking Track mobile equipment in real-time such as tablets, phones, beds, wheelchairs, Intravenous pumps, monitors Quickly locate equipment, reduce wasted time searching, reduce equipment inventory, maintenance, labor, LOS

4. Care without walls Reduce outpatient visits, avoidable admissions, readmissions, complications Improve customer retention, satisfaction

5. Wellness without walls Engage consumers by empowering them to understand their health, their conditions, their risks and take the actions they need to maximize their health, self-manage their conditions and maximally benefit from care

6. Facilities management Remotely monitor facility’s energy usage to reduce cost, optimize environment, and benchmark against other buildings

The Internet of Things – Healthcare

HOSPITAL PATIENT HOME OUTPATIENT FACILITY

Connect patient data to contextual data, so the latest patient data automatically displays on care provider devices based on their location and role.

Transform the vehicle into a smart environment that monitors health indicators.

Monitor patient conditions with in-home medical devices that alert care team staff when a health event occurs.

Make authorized patient data accessible from a unified point, enabling a holistic view of the patient’s journey so providers can optimize each care interaction.

Integrate data from existing and non-traditional sources to drive Big Data analytics, enabling care process innovation and healthcare transformation.

HEALTHCARE ECOSYSTEM Combine data from various sources to uncover insights that enable an enhanced patient journey, improved operational efficiency, and better risk management.

Make patient data visible and actionable in near real-time, enabling improved outcomes through data-driven decision making, better coordination and error reduction.

PHARMACY

GOVERNMENT

RESEARCH

INSURANCE COMPANIES

DEMOGRAPHICS

WEATHER RETAIL

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Enable an interactive experience between patients and collaborative care teams, and reduce response times by providing remote access to the latest patient data.

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Gartner Hype Cycle for the Internet of Things, 2014

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Source: http://www.gartner.com/technology/reprints.do?id=1-27LJLAK&ct=150119&st=sb

Many of the IoT technologies are in the early part of their life cycle and adoption Advances in smartphone platforms,

sensor technologies, cellular networks, cloud computing and mobile and wearable medical devices have removed many of the technical barriers to mobile health monitoring. If deployed appropriately, mobile

health monitoring will enable closer monitoring and faster intervention in the care of certain groups of patients. Mobile health monitoring can improve patient engagement, enhance the patient experience and increase adherence to care plans. The healthcare market stands to

benefit from wearable user interfaces that enable mobile health monitoring, especially for heart conditions.

What is the Internet of Things in a health context?

Data Analytics Connectivity Things

IoT can be unpacked into four areas: 1. Physical “things” to monitor the health of patients such as medical image scanners, glucometer, blood pressure

meters and other devices Physical “things” to track the location of patients and material

2. Those “things” have connectivity to the hospital infrastructure, to the internet, to each other, and to people

3. Those “things” collect and communicate data—this may include information gathered from the environment or inputted by patients or health workers

4. And then there are analytics performed on that data that enable people or machines to take action

Legacy IOT

Applications

IP capable devices

Low power devices

Event Hubs scenario Processing Collection Producers

App insights

Data analytics

State over time

Dashboard

Service

Search

Distributed tracing

-

Azure DBs

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Azure Storage

Service Bus

HDInsight

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Field gateway

Custom Cloud gateway

Storage Adapters

Custom Code Stream Analytics

Document DB, Streaming analytics, HD Insight, Machine Learning, Notification hubs and Power BI are expected in the BAA by the end of 2015.

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Move from IoT-hype to data insight & new values

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• By leveraging Microsoft’s IoT infrastructure Aerocrine has started a transformation toward a data culture

New values • New type of SLA due to predictive

analytics and remote monitoring • Supply management support • Up-sell trough analytics of usage

patterns • Care can move outside the

hospital

IoYT • Telemetry data is

collected in real-time from the devices…

• …and combined with data from Microsoft Dynamics by the use of PowerBI

Insights • Real-time awareness

by the use of Azure Stream Analytics…

• …as well from predictive analytics delivered in the cloud

“A cloud-based solution allowing us to collect data on device performance in real-time helps us to be more proactive in our customer support and ensure that our NIOX devices help the physicians deliver the best possible outcome for the patient,” – Scott Myers, CEO of Aerocrine

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Cloud

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Making the Internet of Things real today Connected clinicians to multiple applications automatically and securely through thin clients as well as doctors’ own mobile devices.

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Created a connected operating room that optimizes patient care, enhances medical training, and improves efficiency and workflow.

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Automated business processes by upgrading existing medication cabinets and connecting them with a pharmacy carousel and anesthesia workstations.

Enabled patients to video chat with family, order meals, and communicate with nurses, while also providing clinicians access to patient records and images.

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Improved healthcare, insight, and workflow by connecting medical devices with existing IT infrastructure including EMR systems.

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Create the Internet of Your Things www.InternetofYourThings.com

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CHALLENGE Clermont-Ferrand University Hospital has 7,000 employees, nearly 2,000 beds, and provides healthcare services to 1.3 million people in France’s Auvergne region. The hospital wanted to enhance patient care by automating data collection from medical devices and connecting disparate electronic medical records (EMR) systems.

o Improved patient care and optimized efficiency by cutting data collection time by more than 164 hours annually

o Increased data collection by 56 percent and gains better insight

o Reduced error rate

o Enhanced workflow and employee satisfaction

BENEFITS SOLUTION Clermont-Ferrand implemented an intelligent system from Capsule Technologie and Microsoft that connects 150 medical devices in 30 rooms, mobile equipment such as anesthesia carts, and an EMR system. The innovative system automatically collects vital signs and provides a secure interface for monitoring patient records.

CLERMONT - FERRAND UNIVERSITY HOSPITAL

A healthy dose of data transforms hospital efficiency

“Better connectivity between medical devices and EMR systems improves patient safety, increases traceability,

and helps hospitals get certified faster.”

Alain Barres IT Project Leader

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Create the Internet of Your Things www.InternetofYourThings.com

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CHALLENGE Lille Regional Teaching University Hospital (Lille CHRU), a provider of healthcare for 4 million residents in northern France, wanted to provide a better experience for patients and improve workflow for staff by connecting media services, communications tools, and patient records in a centralized interface at the bedside.

o Improved patient care and operational efficiency with centralized access to data

o Cut patient adoption time from four hours to five minutes with customizable, touchscreen interface

o Improved scalability and gained simplified, remote management

BENEFITS SOLUTION The hospital replaced standalone TVs with interactive, touchscreen bedside terminals from Care and Comfort based on Microsoft technology. Patients use the terminals to video chat with family, order meals, communicate with nurses, and work with office apps. The solution is designed to provide a separate interface for clinicians to access patient records and scans.

LILLE REGIONAL TEACHING UNIVERSITY HOSPITAL

A better bedside manner, courtesy of the Internet of Things

"We like working with Microsoft technology for several reasons [because] we can integrate our terminals more easily into an existing IT environment, and we can also take advantage of

built-in functionality such as multilingual support." Sacha Devillers

Vice President of International Sales

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Create the Internet of Your Things www.InternetofYourThings.com

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CHALLENGE Henry Mayo, a leading regional 238-bed community hospital and trauma center, wanted to provide faster and more flexible access to patient data in order to accelerate adoption of its new electronic medical record (EMR) system

o Enabled data access from multiple devices including tablets, smartphones, and thin clients

o Cut logon time by 95 percent—from two minutes to six seconds—which provides more time for patient care

o Improved manageability by reducing password-related support calls by 70 percent and device imaging time by 83 percent.

BENEFITS SOLUTION The hospital implemented a single sign-on system from HealthCast that connects mobile devices as well as thin clients with back-end infrastructure. Now clinicians can automatically log on to multiple applications with a single password and provide care from anywhere.

HENRY MAYO MEMORIAL HOSPITAL

Enabling better patient care with data

“With an intelligent system anchored by Microsoft technology, people can use multiple types of devices

and still have the same user experience and quick, secure access to patient information.”

Paul Jriyasetapong Project Manager

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Create the Internet of Your Things www.InternetofYourThings.com

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CHALLENGE Great River Health Systems, a leading regional healthcare provider with a 378-bed hospital that admits 6,000 patients each year and performs 180,000 outpatient procedures, wanted to improve medication distribution and management without adding employees.

o Reduced medication delivery time from 1.5 hours to 30 minutes

o Cut pharmacy inventory costs by US$400,000

o Gained two-year ROI

o Achieved annual savings of $300,000

BENEFITS SOLUTION Great River turned to Omnicell to implement a solution built on Microsoft technologies that connects barcode readers, label printers, anesthesia workstations, a pharmacy carousel, and medication-dispensing cabinets with back-end servers that manage electronic medical records, inventory, and billing. The new system manages the flow of data throughout the hospital—from the pharmacy to the nursing station to the patient’s bedside.

GREAT RIVER HEALTH SYSTEMS

A healthy dose of data

"The solution…automatically prepares the order, then sends it directly to the wholesaler without manual

intervention, which reduces the incidence of overstocks, outages, and waste from outdated drugs.”

Darwin Cooley Pharmacy Director

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