Gartner ranked Dell the #1 worldwide IT services provider in healthcare in 2014. Dell sees global disruptions in healthcare delivery and continues to invest in strategies to address these rapid changes. They are actively enhancing development, implementation and adoption of novel technologies, services, and applications that will revolutionize information-driven care, resulting in improved patient outcomes and overall cost savings worldwide. Dr. Nick is responsible for providing strategic insight and will discuss some Dell’s strategies to achieve an IT environment that is interconnected, efficient and patient-focused.

1. Healthcare Disruption
Nick van Terheyden, MD
@drnic1
Chief Medical Officer, Dell HCLS

2. In the next 10 years, data
science and software will do
more for medicine than all of
the biological sciences together
Vinod Khosla

3. Dell - Restricted - Confidential
2009 Continua Health Alliance Brigitte Piniewski, MD2008 3
0 25 65
Age
IllnessPre-IllnessWellness
Unpredictable Health
Predictable (Rules-based) Health
Death
60-80% Lifestyle
Modifiable Health

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2008 4
0 25 65
Age
IllnessPre-IllnessWellness
Death
To put it another way….
Fun
No Fun
2009 Continua Health Alliance Brigitte Piniewski, MD

5. Dell - Restricted - Confidential
Source: U.S. Bureau of the Census
The population is aging
Source: Wu, Shin-Yi and Green, RAND Corporation
And getting sicker
Number of People With Chronic Conditions
(in millions)
Over 1 in 4 Americans have multiple
chronic conditions
Source: Medical Expenditure Panel Survey, 2006
Older Adults Are More Likely to
Have Multiple Chronic Conditions
Source: Medical Expenditure Panel Survey, 2006
13%
16%
19%
20% 20%
The problem starts with the chronic disease
epidemic

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Number of Quality Measures exploding…

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Serving more than 50%
of U.S. hospitals
providing care to 90
million Americans
Leading IT provider
for 1st, 2nd and 3rd
generation gene
sequencing
15,000+ Healthcare
associates
300+ MDs, RNs & PhDs
Over 130+Hospitals &750+
Physician Groups use ourSecure
EMRCloud.
#1 Worldwide
Healthcare IT Services
Vendor for the fourth
year in a row
Serving 7 of the top
10 pharmaceutical
companies
Managing over 10 Billion
Medical Images on the
Dell Cloud Enterprise
Archiving Platform
Serving 100+ insurance
organizations supporting
65 million policy holders
Manage14billion security
events adayfor150+clients.
Dell is Leading theWayin
Healthcare &
Life Sciences
Provide OEM services to 70+
Healthcare and Life Sciences
software, medical device and
scientific instrument
providers
Managed 400+ revenue
cycle engagements,
recovering $15 billion for
clients over 7 years

8. Dell - Restricted - Confidential
Dell strategy
Our
customers’
imperatives
Our
End-to-End
Portfolio
Delivering technology solutions that enable people everywhere
to grow, thrive and reach their full potential
Our
purpose
Our
differentiated
strategy
Superior
relationship model
Efficient, simple
and affordable
Practical
innovation
The leading provider of end-to-end scalable solutions
Connecting
END USERS
Integrating and
optimizing the
ENTERPRISE
Simplifying and
securing through
SOFTWARE
Accelerating
innovation with
SERVICES

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High Level Trends
• Consumer Empowerment
• Automation
• Connected Health
• Population Data
• Big Data
• Healthcare IT

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Consumers Taking Charge
• Increasing choice for Health plan selection
• Pre-deductible Spending
– HDHP, HSA and FSA
• Post-deductible Spending
– Amplification
• Consumer Influenced Spending
– The Google Effect, WebMD and DTC Advertising
• Direct Consumer Spending
– Activity Tracking, Wellness and Even Chronic Disease (Diabetes)

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Technology Driving Improvements
• Widening access and Offering of the (Healthcare) Cloud
• Smartphones and Mobile Access
– Not just about the phone but adjunct technology including GPS,
accelerometers, body sensors and cameras (today)
• Drug Development Targeted Therapeutics to Specific Disease
– Managing the Patent Cliff and focusing on Specific Disease (Hepatitis
C, Cohn's, Cancer)
– Targeted groups, messaging to specialists and patient communities

12. Dell - Restricted - ConfidentialGraphic Source: ClinicalTrials.gov, accessed June 6, 2014 at http://clinicaltrials.gov/ct2/resources/trends
Complexity of Modern Medicine
“The complexity of
modern medicine
exceeds the inherent
limitations of the
unaided human mind” –
David Eddy, 1990

13. Dell - Restricted - Confidential
Future Healthcare
• Applied and Predictive Analytics – Dell Population Health Analytics, Boomi
• Telehealth – eVisit, HealthNet Connect, Healthspot and Secure Healthcare
Cloud/Clinical Archive
• Patient Engagement – Social Media, Analytics and Mobile Clinical Computing,
Boomi
• Wearables and Internet of Things – Mobile Clinical Computing, Data Integration
• Genomics and Precision Medicine – Data Archive and Big Data Storage and
backup
• Oh and by the way
Securely

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What is predictive analytics?
Data
Demographic
Social
Behavioral
Financial
DataAggregation
Machine Learning
Machine learning
crunches data to
build a predictive
model
PredictiveModelDeployed
Predictive Model
PredictiveScoreGenerated
The predictive
model acts on
“unseen” data
Buy or Click
Churn or defect
Default or
prepay
Die or become
diseased /
infected
Commit fraud ,
crime or
terrorism
Likelihood to…
Breakdown or
become
defective
The output is a
score

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Applied and Predictive Analytics
• Unstructured sources are diverse and distributed
– Clinical Notes, Medical Records
– Healthcare systems (laboratory, imaging, diagnostic)
– Communication channels that can include
› Social Data, blogs, sentiment
› Video content
› Audio files
› Text, email, word documents
› Support and on call, customer service, home visit
– Future data from “-omics”
– Helping Customers capture, process, integrate and store

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300K
Annual deaths as a result of
“preventable harm” in
hospitals
University of Iowa transforms
the operating room with real-
time analytics
Goals:
• Predict patients with the biggest risk of surgical site
infections
• Reduce infection rate to improve patient care and decrease
costs
Solutions:
• Merge historical EHR data and live patient vital signs to
predict infection likelihood
• Provide doctors with real-time, predictive decisions, using
Dell Statistica, during surgical procedures so they can
create a plan to reduce risk
Results:
• 58% reduction in occurrence of surgical site infections
• Personalize healthcare based on patient’s own
characteristics
• Reduce cost of patient care

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Taking action on critical asthma
events
Goals:
• Deliver SMS alerts to patients about impending asthma
events
• Dashboards delivered to alert case managers of the status of
their registry of asthma patients
• Email notification to emergency rooms forecasting volume
and specific patients likely to present for the coming week
Solutions:
• Integrate and correlate EHR and other data (air quality,
weather details and pollen count) using Dell Boomi
• Aggregate and virtualize data with Toad Intelligence Central
• Analyze and predict the likelihood of these events and
provide patient level scores using Dell Statistica
Results:
• Patients engaged with information for self care
• Case managers can provide best quality of care at the lowest
cost for their patients
• Emergency rooms can effectively staff and allocate resources
>3,000
Annual deaths due to
asthma. Many of which
are avoidable.

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Genomics, Sequencing and Data
• Took $3 Billion and 10 years to sequence one
genome
• Sequence in days even hours and for
<$1,000
• Explosion of data just to sequence the
genome
– Plans to sequence 14M new cancer patients
every year which would generate 5.6 Exabytes
of information.
• But there’s even more data in -omics
18
Global bioinformatics
market to reach $13B by 2020
21% CAGR1
>5.6 Exabytes
to sequence 14M new cancer
patients worldwide per year2
Sources:
1. Allied Market Research, Global Bioinformatics Market, 2013-2020
2. http://www.cancerresearchuk.org/cancer-info/cancerstats/world/incidence/
3. http://www.technologyreview.com/news/531091/emtech-illumina-says-
228000-human-genomes-will-be-sequenced-this-year/
228,000 whole human
genomes sequenced in 2014
1.6M by 20173

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Mobile healthcare helps reach more patients
Outside the hospital, telehealth and the Internet of Things (IoT) help improve
patient outcomes and avoid costly readmissions

20. Source: Qmee July 2014, http://blog.qmee.com/online-in-
60-seconds-infographic-a-year-later/
Every minute
of every day…

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The Quantified Self
Meet Chris Dancy and His 10 devices he wears or carries and
13 more in his home and car

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Wearable's and Internet of Things will surpass
smartphones and personal computers by 2018
Internet of Things
Tablets
Smartphone
Personal
Computers

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Number of health apps available
for smart phones 100,000
Devices and applications are going to flood the market
2020 – 25 billion
devices expected to
be on the Internet of
Things

24. Dell - Restricted - Confidential
Serving more than 50%
of U.S. hospitals
providing care to 90
million Americans
Leading IT provider
for 1st, 2nd and 3rd
generation gene
sequencing
15,000+ Healthcare
associates
300+ MDs, RNs & PhDs
Over 130+Hospitals &750+
Physician Groups use ourSecure
EMRCloud.
#1 Worldwide
Healthcare IT Services
Vendor for the fourth
year in a row
Serving 7 of the top
10 pharmaceutical
companies
Managing over 10 Billion
Medical Images on the
Dell Cloud Enterprise
Archiving Platform
Serving 100+ insurance
organizations supporting
65 million policy holders
Manage14billion security
events adayfor150+clients.
Dell is Leading theWayin
Healthcare &
Life Sciences
Provide OEM services to 70+
Healthcare and Life Sciences
software, medical device and
scientific instrument
providers
Managed 400+ revenue
cycle engagements,
recovering $15 billion for
clients over 7 years

25. Patient Engagement is the
blockbuster drug of the century
Leonard Kish
Principal and Co-Founder at VivaPhi

26. Dell - Restricted - Confidential
Hi Tech Medicine

27. Dell - Restricted - Confidential
Nick van Terheyden, MD CMO, Dell Health and Life Sciences
AboutMe http://about.me/obiwan
Twitter http://twitter.com/drnic1
LinkedIn http://www.linkedin.com/in/nickvt
Blog http://drnick.vanterheyden.com/
FaceBook http://profile.to/drnick
E-Mail DrNick@dell.com, drnic1@gmail.com
Google Voice (301) 355-0877
Where you can find me

28. Do more.
Healthcare.
Are you ready to…
Do more of what’s possible,
Do more of what matters,
Do more of what brings success?

29. Healthcare Disruption
Nick van Terheyden, MD
@drnic1
Chief Medical Officer, Dell HCLS