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Painsolver,aToolforourTimes|
Vertelogics LLC
Health Care Outcomes Management
Painsolver, a Tool for our Times
Market Report
Executive Summary
Healthcare outcomes management (HOM) is defined as the practice of using information, applications
and technology to evaluate the impact of medical diagnosis and intervention with emphasis on
identifying processes that lead to a desired clinical outcome. HOM systems are a key tool for our times
due to the following:
 The impact of health outcomes has extreme financial implications across both the consumer
and commerce supply chain.
 Governmental regulations and consumer behavior trends are increasing placing HOM as the
driving force behind medical interventions and pay for performance models.
The costs associated with healthcare are substantial and far reaching. In 2012, US healthcare spending
reached a total of $2.8 trillion. This amount does not include indirect costs or annual productivity loss of
workers. Recent years have showed slow growth in spending but many
challenges remain as the US continues to lead in poor health compared to
other wealthy nations despite higher spending on healthcare.
Due to concern regarding the health and economy of the US healthcare
system, expectations have arisen that identify pay for performance systems
as the guiding model for reimbursement in the near future. This system will
likely present a hurdle to healthcare professionals due to significant
limitations in the current medical model. These limitations include the
ways in which healthcare information is accessed, managed and utilized. In
addition, there is a profound lack of patient engagement due to significant
time limitations for patient care. All of which have been identified as having a direct impact on health
care outcomes. It is of no surprise that current healthcare outcomes are poor while costs are extremely
high.
Currently, patients are managed by information that is typically collected by healthcare providers using
technology that draws attention, streamlines workflow or digitizes patient information. This
information drives the medical diagnosis and intervention as well as payment when services are
influenced by medical necessity guidelines. This methodology has not been linked to higher quality of
care or lower costs. Recommendations for improvement include:
 Basing methodology with a foundation in evidence based intelligence.
 Timely and accurate decisions at the point of care.
 Providing support to healthcare providers that is patient specific, filtered to fit a clinical situation
and delivered for optimal impact.
Today’s
organizations
need to address
limitations in the
ways they mange
patient care due
to poor results
with high costs.

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A historical solution for improving outcomes is the use of Clinical Decision Support (CDS) programs. CDS
programs quantitatively have been shown to impact multiple key metrics important to HOM analysis.
However, caution is appropriate here: existence or access to CDS alone is not enough to realize these
results. Getting results requires the use and integration of a CDS so that patients are actually affected
by them. Decreased utilization of CDS systems has been identified due to several barriers. When polled,
providers have outlined that barriers to CDS use include:
 lack a familiarity or awareness
 lack of agreement with guidelines
 lack of outcome expectancy
 lack of self-efficacy
 lack of motivation
 environmental factors such as lack of time,
workflow integration and reimbursement
 CDS do not support the healthcare provider’s
first choice for knowledge seeking which has
been identified as peer to peer interaction
Current best practice recommendations exist for CDS
tools and include the following: the systems should be
built on practice guidelines, empirical knowledge and
values and quality assurance tools. In addition, they
should take into account user preferences and patient
preferences while integrating recommendations into the workflow process, yielding a shared decision
making model that is increasingly patient centric. Results should provide cognitive assistance that can
help the healthcare provider better assimilate knowledge and improve their decision making process
while taking their informed patient’s preference into account.
Essential for surviving in the pay for performance world is an understanding of the key drivers for
improving healthcare outcomes and identifying tools that can assist in improving those outcomes. We
believe that a properly designed and integrated CDS aimed at improving both CDS utilization and
healthcare outcomes management can provide the tools needed to not only survive but thrive in this
changing model.
Enterprise
Vertelogics, LLC, incorporated and domiciled in Louisiana. Stock categories, authorized shares, issued
shares, and dilutive elements described in the attached operating agreement.
In accordance with all policies and regulations, Vertelogics, LLC is in
compliance with all requirements to be titled in good standing. Enclosures
include certificate of good standing, EULA, HIPAA compliance policy, and
liability insurance policies.
CDS:
Reduce medial errors
Control length of stay
Minimize liability exposure
Improve care for specific diseases
Foster adherence to guidelines
Improve referrals, test ordering,
and admissions
Deliver cost effective care
Improve access, quality, and safety
Address increasing patient
numbers
Improve provider performance
Decrease practice variability
Patient
information
management is
not the same as
patient
management.

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Offering
Health outcome management clinical decision support tool specific for low back pain which has been
identified as a primary healthcare condition in the United States yielding substantial financial burden as
well as poor outcomes.
Vertelogics offers a subscription web based application titled Pain Solver that utilizes artificial
intelligence to assist in the diagnosis, treatment and coordination of care of millions of individuals
suffering with back pain. Additional functionality includes resources for
patient education, examination techniques, recommending and tracking
outcomes, communication efficiency, EMR interoperability, coding and medical
necessity optimization as well as reference materials. The end product is a
comprehensive patient centric chart accessible by all patient healthcare
providers promoting comprehensive management, encouraging provider
collaboration and offering a substantial return on investment all while
improving healthcare outcomes.
Goals
Short-term: Develop pioneering software tool for an integrated approach to clinical management of
lumbar spine disease. Our impending success is predicated by passion for clinical excellence, an
established track record for software development, the agility of a start-up company, and recognition of
a void in an expansive and progressing market.
Long-term: To become the internationally recognized, industry-leader in spine-management
software with clients ranging from general practitioners and spine surgeons to healthcare facilities and
payer sources.
Long-term: Expand technology to be inclusive of the primary chronic diseases that have a staggering
financial impact and poor outcomes.
Market
Market- Segmentation- The market can be segmented into three classifications. First, are the individuals
suffering with low back pain. Second, includes the healthcare providers that care for these individuals.
Lastly, the market includes the healthcare organizations that have a strong interest in patient outcomes
and coordination of care.
Market Size and Growth- The patient market includes greater than 116 million Americans suffering with
serious chronic pain and just under half of all adults experiencing some form of acute pain. One of the
most frequent causes of chronic pain includes back pain. Of these numbers, approximately 75% will seek
treatment but only 56% find adequate relief. This short fall of just under half of all individuals seeking
care has led to one of the main causes for healthcare utilization and expense with patients seeking
better outcomes and providers searching for diagnostic and interventional assistance.
Painsolver is a
CDS tool
specifically
designed to
improve
healthcare
outcomes.

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The healthcare providers that care for these patients can include family physicians, specialty physicians,
physical therapists, and other allied health professionals. The total number of these professionals was
near 1,000,000 in 2008 according to the bureau of labor statistics with substantial growth expected.
Healthcare organizations in the United States are moving towards outcome based intervention. It is
expected that this push will not only gain momentum but will be a key driver for policy and procedures
of patient management due to governmental regulations and consumer behavior trends. Accountable
Care Organizations (ACO) formation has been a clear indicator for the push towards providers working
together to coordinate and improve the cost and care that patients receive. The US saw an increase in
the number of MSSP ACOs by 123 in 2014 alone. Consumer behavior has also made a push towards
demanding cost savings, coordination of care and outcomes. They are often faced with a higher portion
of the healthcare expense and wish to maximize care that they receive.
Market Trends- The patient is increasingly demanding information so that informed patient choice is a
component of the overall healthcare plan. They are searching for answers and information from not
only their healthcare providers but also via traditional internet as well as smartphones. Patients are
taking on the role of consumer due to rising out of pocket costs and often inadequate communication
from the provider. They are looking for answers, especially the 44% that do not get adequate relief after
seeking care.
In 2013, pain was the most common reason that a patient saw a physician.
However, many physicians lack the skills required to effectively treat and mange
pain. This lack of skill has been suggested as a primary reason for poor outcomes
with respect to pain, especially low back pain. A key to identifying this lack of skill
came from a 2013 survey of both US and Canadian medical schools that showed
only 1% of schools offered a required course in pain management. In addition, a
survey of physicians resulted in self report that only minimal training was received
on how to manage pain in medical schools.
An avenue of support for healthcare providers to improve outcomes for pain
management includes the use of clinical guidelines. Guidelines have proven to
improve multiple key indicators when implemented. However, those physicians that seek out evidence
based medicine through clinical guidelines appear to be just over 50%. Yet, there are several factors
that play into resistance of adoption of guidelines. These can include lack of ease, lack of time,
unfamiliarity, and lack of value.
Patient consumption and provider care will both be directly affected by the continued push towards
outcome based reimbursement. It is expected that a pay for performance model for healthcare delivery
has the potential to become the dominant model in the country. ACOs have already been providing
some foundation for options regarding what pay for performance may look like. ACOs are providing
payment reform to support better performance and pay for higher value. The goals are intended to
improve quality outcomes, improve the experience of care, improve provider collaboration, and lower
costs.
Success or
failure of a
clinician’s
work
depends on
what the
patient
understands
Successful outcomes have exceptional value in pay for performance
reimbursement models.

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Product Value Proposition
Successful outcomes in managing low back pain have exceptional value in pay for performance
reimbursement models. However, healthcare outcomes management aimed at monitoring and
affecting both short and long term outcomes will have an impact beyond point of care reimbursement
by potentially affecting utilization of healthcare dollars over the life of the patient. Costs associated
with care can be substantial beyond the initial medical interaction and intervention due to the natural
history of low back pain. This natural history is defined as a reoccurrence of signs and symptoms over
the years following the initial onset of pain. By utilizing a tool that focuses patients, providers and payers
on healthcare outcomes management for both the short and long term, value exponentially increases.
Improved
Outcomes
Lower Lifetime
Healthcare
Cost
Painsolver drives
Improved experience of care Multidisciplinary provider collaboration
Accurate diagnosis Patient preferences accounted for Informed consent
Quality assurance Recommendations integrated into workflow Reduced liability
Provider preferences accounted for Shared decision making Patient Satisfaction
Multidisciplinary integration Decreased utilization Improved decision making
Active Participation Enhanced throughput Improved Reimbursement
Best practice guidance Improved treatment recommendations
Provider satisfaction Reduced staff utilization Increased referrals
Support utilization Review procedures Decreased remittance rates
Improved
Reimbursement
by addressing best practice
recommendations for the
patient , provider, and payer

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Painsolver,aToolforourTimes|
Risk Factor Position for Industry analysis (Rivalry- Distribution of market share)
(Low, Medium, High)
Number of firms- low
Programs that provide some degree of clinical decision support have been in the medical industry for
over 30 years. However, many are not utilized nor or they comprehensive for having the impact on
outcomes that will offer the biggest ROI.
Market growth- medium
Change is progressing at an increased pace compared to previous years. Patient healthcare utilization is
increasing as well as the demand for more informed decision making. Provider numbers are also
increasing although skill to treat pain is not. Healthcare organizations and payers are moving to align
with outcomes metrics.
As an industry, it is clear where healthcare is headed as organizations move over to an outcomes based
model. A sound recommendation is to be proactive rather than reactive to the changes that are coming.
Fixed costs- low
Costs for implementing a web based application are low to the user. Costs primarily include access to
the system. Costs for the HOM tool storage and upgrades are also low with respect to FTE and support.
Storage costs- low
Low secondary to tool is web based application that is housed on a main server.
Switching costs- low
No monetary barrier to switching is identified. However, the monetary and time savings for the user
does represent an incentive for utilizing the tool.
Level of product differentiation- high
CDS programs with outcome reporting tools currently are on the market. However, these tools do not
include clinical decision support that is specifically aimed at effecting patient and clinical outcomes, all
of which have been linked to many factors. These factors can include obvious metrics such as accurate
diagnosis and treatment but just as important include patient education, informed decision making, and
active patient participation to list a few. In addition, multidisciplinary care and identifying barriers to
successful outcomes have also proven to be vital. These barriers include metrics such as identifying
prognostic indicators for poor outcomes.

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Strategic stakes- high
There is potential for great gains with respect to reimbursement and maximizing impact of care. This
tool is designed to help individuals and organizations to thrive in a pay for performance model. Without
the tools necessary to achieve quality outcomes, it is expected that survival will be affected.
Exit barriers- high
A high cost for abandoning the product due to loss of impact is expected. In addition to monetary and
outcome impact healthcare providers face exit barriers through the loss of defined preferences. A
primary example includes access to peer to peer interaction through the HOM tool. Healthcare
providers have identified that their first choice for gathering healthcare information is through peer to
peer collaboration. The expectation is that meeting this desire among others, will increase use of a tool
that offers that feature.
Diversity of rivals- low
Many other tools offer functionality with respect to drawing attention, streamlining workflow and
digitizing patient information. However, they fail to specifically address the diversity of factors that
influence use of the tool as well deliver improved outcomes and outcomes management.
Threat of Substitutes- medium
In today’s market, threat of substitutes is a reality. However, creating a substitute would take a
comprehensive understanding of what it takes to improve outcomes. In addition, no current tool is as
comprehensive and robust as this Painsolver and getting to market will play a role in the anticipated
success of the tool.
Buyer Power- medium
We are in an era of increased patient financial responsibility, declining reimbursement, and increased
expense. Based on this reality a clear ROI is expected for any buyer to open their pocket book.
Key strategic advantage over rivals: High
 Tool that significantly impacts healthcare outcomes.
 Tool designed to take into consideration user preferences to optimize utilization.
Is the market ready for a solution?
The current healthcare model is unworkable and change is unavoidable. Preparing for these changes is
urgent and solutions are underserved.
Unworkable- The current healthcare model for managing chronic disease is broken and there are real
and measurable consequences to inaction.

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Unavoidable- There is clear momentum moving in the direction of pay for performance. Based on
current outcomes for chronic disease management, governmental push and consumer behavior, it is
clear that change is coming.
Urgent- The problem is real for many companies as well as providers. The push for pay for performance
will not happen tomorrow but preparation for the changes that are to come should be a priority.
Underserved- There is an absence of viable solutions to this problem. The tools that do exist are not
appropriate because they fail to address what the consumers are asking for and are not aimed at the
factors specific to healthcare outcomes management.
Conclusion of Executive Summary
The United States healthcare system is progressively moving towards a payment model that is strongly
influenced by performance driven outcomes. Based on the data that the United States has
unacceptable healthcare outcomes, especially with managing chronic disease such as low back pain, it is
expected that a shift to reimbursement based on outcomes will be a hurdle for many providers and
organizations.
Supports for providers such as Clinical Decision Support (CDS) tools have shown promise in improving
outcomes. However, there is not currently a comprehensive tool that addresses the barriers to use and
implementation of the CDS systems on the market. Based on this void, Vertelogics LLC has developed
application based software as a viable solution to overcoming these barriers.
Painsolver is a clinical decision support tool that is designed to assist in positively affecting health
outcomes management. Considerations have been given to barriers to use and implementation of a CDS
tool but also to specific criteria that influence positive outcomes as well as prognostic indicators for poor
outcomes.
We believe that a properly designed and integrated CDS aimed at improving both CDS utilization and
healthcare outcomes management can provide the tools needed to not only survive but thrive in this
changing healthcare model.
Summary of Executive Management
Chairman: Erich W. Wolf II M.D., Ph.D., F.A.C.S., F.A.A.N.S
In addition to being a board-certified, fellowship-trained neurosurgeon specializing in
minimally invasive spinal surgery, Dr. Wolf is an inventor and entrepreneur. With a Ph.D. in Biomedical
Engineering, he has extensive experience with the biomedical product development cycle. Dr. Wolf is
founder of several high-technology start-up ventures and also acts as a consultant to several multi-
national medical device manufacturers. Dr. Wolf holds multiple U.S. Patents. He serves as Chairman
and Chief Scientific Officer at Vertelogics.

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CEO: Katie Brittain PT, DPT, MBA, CLT
Dr. Brittain earned a Masters of Business Administration from Texas Woman's University and a
doctorate in physical therapy from Duke University School of Medicine where she was awarded for
academic, leadership, and research achievements. Dr. Brittain’s academic achievements have laid the
foundation for her Instrumental work in developing programs for small business healthcare quality
improvement, strategic planning, and business development.
During her tenure as CEO she has been a part of Vertelogics development of the potential leading
software platform for diagnosis and management of low back pain-related health conditions. In
addition to musculoskeletal clinical practice, Dr. Brittain’s professional interests include combining
diagnostic and treatment policy with the business model of cost analysis as it relates to best practice
and long term outcomes.
CTO: Curtis McBroom
As Chief Technology Officer at Vertelogics, Mr. McBroom has primary responsibility for the deployment
of the Vertelogics ASP product. McBroom has over 15 years of extensive intranet and internet site
development experience. He is a veteran, with 23 years of military service in the U.S. Navy Submarine
Force, where he retired as a Lieutenant Commander with 10 years enlisted service and 13
years commissioned. He personally developed an impressive 2200+ page website for use by U.S. Navy
submarine crews to manage all personnel, training, and qualification information. This site has been in
use for over 7 years. Program languages include: html, shtml, dhtml, java, javascript, vbscript, asp, and
asp.net. He is a Microsoft Certified Systems Engineer and has a vast background in systems management
and hardware maintenance. He currently manages numerous small networks and has been responsible
for networks as large as 8000+ users. He currently holds a U.S. Government Top Secret clearance.
Chief Content Officer: Lauren Thompson MA
Ms. Thompson attended Loyola University New Orleans, where she studied English and Sociology. She
completed her M.A. in English, and is currently pursuing an advanced degree in Psychology, at McNeese
State University. Ms. Thompson is responsible for writing, research, and content development at
Vertelogics. She has over 10 years’ experience in the field and has been employed in diverse specialties
including technical and grant writing, publishing, and public relations. She has assisted on campaigns for
several fortune 500 companies and her work has been featured in regional and national publications.
Professional Staff:
Accountant: Robert Ehlers
Ehlers and Associates CPA LLC
800 Ryan St # A,
Lake Charles, LA 70601
(337) 493-3331
Banker: Jackie Roe
Vice President
Whitney National Bank
3401 Ryan Street
Lake Charles, LA 70605
(337) 480-2054

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IP Attorney: George R. Schultz
Schultz & Associates, P.C.
One Lincoln Centre
5400 LBJ Freeway
Suite 1200
Dallas, TX 75240
(214) 210-5940
Attorney: Rick J. Norman
Norman Business Law Center
145 East Street
Lake Charles, LA 70601
(337) 436-7787
FDA 510K Elisa Maldonado-Holmertz
Consultant: Obelix Healthcare & Biotech
Consulting
Clinical Christopher Weaver Psy. D.
Psychologist: Comprehensive Psych Services
3560 Delaware St
Beaumont, TX 77706