Smarter Decisions,Better Care

2

Industry Challenges Across the World

1 - http://www.pwc.com/gx/en/healthcare/emerging-trends-pwc-healthcare.jhtml

Although healthcare challenges can vary from region to region, health systems of

every type around the world have the same objective:

to deliver the highest possible quality of care

to the maximum number of people.1

“

”

4

10 500+

Clinical topics

1500+

Patient topics

28 000+

Graphics

160+

Medical calculators

400 000+

Evidence links

What’s New/ Practice Changing

UpDates

22

Specialties

CME/CPD

5 400+

Drug entries

A New Way to Practice Medicine

5 700+

Physician authors

5

A Trusted Resource

21+ yearsFor 21+ years, the most trusted evidence based, peer reviewed editorial content, proven to improve patient care quality

5 700+ authors Expert evidence-based recommendations made by over 5 700+ physician authors from 51 countries

850 000 clinicians29 000 hospitals worldwide rely on UpToDate, including:

95% of medical teaching institutions in Benelux and Germany

90% of medical teaching institutions in Japan 90% of medical teaching institutions in the United States

279 000 000+ searches Clinicians view more than 279 million topics annually in UpToDate, changing 80 million clinical decisions

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What Clinicians Say

Source: 2012 UpToDate individual subscriber survey

indicated they trust UpToDate as a point of care clinical information resource

In an

17 000 individual subscribers

survey of over

95%

I trust UpToDate as an

authoritative point-of-care

clinical information resource.

“

”

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National Adoption

UpToDate has national contracts with the governments of Iran, Norway, Saudi Arabia, Jordan, and Spain, Oman. These countries have standardized the use of UpToDate in public healthcare.In countries such as Luxembourg, the Netherlands and Switzerland use of UpToDate is a de facto standard

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Doctors Have Clinical Questions

Covell, DG. Ann Intern Med 1985; 103:596; Green, ML. AM J Med 2002; 109:218; Osheroff, JA. Ann Intern Med 1991:575; Ely, JW. J Am Med Inform Assoc 2005; 12:217; Gorman, PN. Med Decis Making 1995; 15:113.

Unanswered clinical questions impact patient management decisions Approximately 2 out of 3 clinical encounters generate a questionPhysicians have approximately 11 clinical questions a day

60%

of questions go unanswered

Answering all clinical questions could

change

5to8 patient management

decisions each day

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Clinicians Save Time with UpToDate

Percentage of users who report that UpToDate saves them time in answering clinical questions

Argentina Germany Taiwan UAE UK USA0%

25%

50%

75%

100%

90% 87%92% 95%

86%91%

Source: 2012 UpToDate individual subscriber survey

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Research Demonstrates UpToDate Impacts Outcomes

We invite you to review the study data yourself: http://www.uptodate.com/home/research

Over 60 research studies

UpToDate is the most widely studied point of care clinical decision support tool. To date there have been over 60 studies that have looked at UpToDate as a tool to:

Allow more questions to be answered faster

Change decisions

Improve outcomes

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Clinicians Need Help Making Better Decisions

1Lucas, BP. The impact of evidence on Physicians’ inpatient treatment decisions J Gen Intern Med 2004; 19:402.

Cook County HospitalCook County Hospital, Chicago, IL

Test: Critical decisions assessed before and after providing clinical knowledge support on a random sample of 146 inpatients

Result: Attending physicians changed treatment decisions for 18% of patients

Insight: UpToDate drove most decision changes1

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UpToDate Changes Clinical Decisions

Phua J, See KC, Khalizah HJ, et al. Utility of the electronic information resource UpToDate for clinical decision-making at bedside rounds. Singapore Med J 2012; 53:116.

Researchers at Singapore’s National University Hospital report that bedside use of UpToDate led to changes in patient care decisions…

37%of the time

62%

29%

9%

This reinforced my planThis modified my plan

What Effect Did the Information from UpToDate Have on My Plan…

Data from CME responses

(n = 2,575,145)

(n = 1,187,150)

(n = 388,305)

UpToDate Impact by Clinician Query Type

Other Prognosis Prevention Treatment Diagnosis Clinical Manifestations0%

25%

50%

75%

100%

48%62% 62% 67% 62%

51%

16%

23% 27%26% 30%

39%

36%

14% 12% 6% 8% 10%

This reinforced my plan This modified my plan I need more information

(n= 4.1 Million CME Responses)

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Enstinet Usage Feb 2012 – May 2015

16

Enstinet Usage Feb 2012 – May 2015

Enstinet Usage Analysis

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Series10%

25%

50%

75%

100%

0.620000000000001

0.3

0.08

This reinforced my plan This modified my plan I need more information

This reinforced my plan: 136,400 /year, 11,366/Month, 2,841/Week

This modified my plan: 66,000/year, 5,500/Month, 1,375/Week

I need more information:17,600/year, 1,466/Month, 366/Week

2014 – 2015 Usage = 220,000

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Top Specialty

Facility Name - ENSTINET

Date Range From 05/01/2014 To 05/01/2015

  Rank   Topic Specialty     Total Topic Hits      

1 Drug Information 29,595  2   Obstetrics, Gynecology and Women's Health   21,039       

3 Pediatrics 18,837  4   Infectious Diseases   17,862       

5 Gastroenterology and Hepatology 15,985  6   Nephrology and Hypertension   13,356       

7 Endocrinology and Diabetes 11,967  8   Cardiovascular Medicine   11,642       

9 Hematology 11,155  10   Oncology   11,154       

11 Pulmonary and Critical Care Medicine 9,491  12   Neurology   7,829       

13 Rheumatology 6,266  14   Adult Primary Care and Internal Medicine   5,107       

15 Adult and Pediatric Emergency Medicine 4,962  16   Allergy and Immunology   4,932       

17 General Surgery 4,171  18   Patient Information   3,054       

19 Dermatology 2,340  20   Psychiatry   1,801       

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Use of UpToDate Associated with Improved Outcomes

1. Solucient maintains the nation's largest healthcare database, comprised of more than 26 million discharges per year from 2,900 hospitals.

2. Bonis PA. Association of a clinical knowledge support system with improved patient safety, reduced complications and shorter length ofstay among Medicare beneficiaries in acute care hospitals in the US. Int J Med Inform 2008; 77:745.

Significantlyshortens

lengths of stay

Significantly lowers complication rates

Significantlylowers adverse outcome rates

Solucient1 studied the impact of UpToDate on length of stay,

patient complications and patient safety2

148 403 1096 29800.00000000

0.25000000

0.50000000

0.75000000

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Quality Indicators Improve with Increased Use of UpToDate

Bonis PA. Association of a clinical knowledge support system with improved patient safety, reduced complications and shorter length of stay among Medicare beneficiaries in acute care hospitals in the United States. Int J Med Inform 2008; 77:745.

Complications

UpToDate Usage Levels and Impact on Patient Complications, Patient Safety and Mortality

Imp

rovem

en

t in

Ris

k P

erc

en

t

Patient Safety Length of Stay

UpToDate Topic Reviews Per Week

148 403 1096 2980

0%

20%

40%

60%

80%

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Researchers at Harvard University FindUpToDate Associated with Improved Outcomes

Isaac T, Zheng J, Jha A. Use of UpToDate and outcomes in US hospitals. J Hosp Med 2012; 7:85.

Use of UpToDate Associated with...

Improved Quality Every condition on Hospital Quality Alliance

Metrics

Shorter Lengths of Stay 372 000 days over 1 year

Lower Mortality Rates 11 500 lives over 3 years

Using UpToDate Increases Medical Knowledge

20 Minutes a day

McDonald, F, Zeger, SC, Kolars, JC. Factors Associated with Medical Knowledge Acquisition During Internal Medicine Residency J Gen Intern Med 2007. 22

Equals an Entire Year of Residency

UpToDate is recognized and accredited for CPD American Academy of Family Physicians

American Academy of Nurse Practitioners American Academy of Pediatrics American College of Emergency Physicians American College of Obstetricians and

Gynecologists American Osteopathic Association Australasian College for Emergency Medicine Austrian Academy of Physicians Federación Mexicana de Colegios de

Obstetricia y Ginecología Colegio de Medicina Interna de México College of Family Physicians of Canada Dubai Health Authority Health Professions Council of South Africa Oman Medical Specialty Board Postgraduate Medical Training Bodies in

Ireland Royal College of Physicians and Surgeons of

Canada Royal Australian Australasian College of

Physicians Royal Australasian College of General

Practitioners Royal Australian and New Zealand College of

Obstetricians and Gynecologists Royal New Zealand College of General

Practitioners Singapore Medical Council 23

Accreditation Council for Continuing Medical Education

AMA PRA Category 1 Credit(s)TM

Accreditation with Commendation

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Economic Impact of UpToDate at Salford Royal NHF Foundation

Source: November 2011, Forrester Research: The Total Economic Impact Of UpToDate’s Clinical Decision Support System For Healthcare Institutions: A Case Study Of Salford Royal NHS Foundation Trust in the UK

Benefits Included: Staff productivity Diagnostic test

efficiencies Improvements in the

quality of care

Forrester Research found Salford Royal NHS Foundation Trust (SRFT)recovered the costs of UpToDate in 90 days

90=

ROI

days

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For More Information [Presenter to customize for particular audience]

Phone: Institutions outside of the US/Canada+31 172 641440Email: international@uptodate.com

www.linkedin.com/company/uptodate?trk=hb_tab_compy_id_21924

www.twitter.com/UpToDate

www.facebook.com/UpToDateEBM

www.youtube.com/uptodateebm