1. <Insert Picture Here>
The Data Driven Healthcare Enterprise
The Transformation to Value Based, Personalized Healthcare
Brett J. Davis
Senior Director, Personalized Healthcare
Oracle Health Sciences Global Business Unit

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The following is intended to outline our general product
direction. It is intended for information purposes only, and
may be incorporated into any contract. It is not a
commitment to deliver any material code, or functionality,
and should not be relied upon in making purchasing
decisions. The development, release, and timing of any
features or functionality described for Oracle's products
remains at the sole discretion of Oracle.
Roadmaps previously communicated by Phase Forward are
subject to Oracle review and amendment.

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“To wrest from nature the secrets which
have perplexed philosophers in all ages,
to track to their sources the causes of
disease, to correlate the vast stores of
knowledge, that they are quickly
available for the prevention and cure of
disease – these are our ambitions.”
- Sir William Osler, 1906
Personalized Healthcare:
Bringing a century old vision to reality…

4. © 2010 Oracle and/or its affiliates. All rights reserved. 4
“Supposing is good, but finding out
is better.”
- Mark Twain
…Put More Simply

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A Changing Healthcare
Landscape
5© 2010 Oracle and/or its affiliates. All rights reserved. Oracle confidential

6. © 2010 Oracle and/or its affiliates. All rights reserved. 6
Life Sciences and Healthcare are converging
Predictive, Preventive, Personalized and Participatory
Healthcare
HEALTHCARELIFE SCIENCES
“Trial and Error”
Healthcare
“Evidence Based”
Healthcare
“Precision”
Healthcare
Blockbusters and
mass-production
of novel drugs
Targeted
Therapies
Increased
regulation and
efficacy
standards
Analytics
LIFE SCIENCES HEALTHCARE
DNA chemistry
and advanced
technology
“Managed”
Healthcare
Paper based
Records
Electronic Data
Capture
Pharmacovigilance
and Risk Mgmt
Safety at
Point of Care
Electronic
Medical Records
Paper based
Systems
Personalized
Healthcare
Patient Care and Disease Mgmt
Translational Med

7. © 2010 Oracle and/or its affiliates. All rights reserved. 7
The Future of the Healthcare Industry
Lean. Global. Networked.
A transformation is only possible through the synergy of healthcare
information technology (HIT) with scientific breakthroughs in the molecular
understanding of disease, novel therapeutics and diagnostics, as well as a
redesign of our healthcare delivery models. Leveraging data from multiple
sources and diverse populations from across the healthcare system will be
essential.
Not only is this approach necessary for providing the “best care for
the right patient,” but it has major business model implications for
many constituents in the healthcare ecosystem including
pharma/biotech, health providers, PBMs and payers, and as a result,
their IT strategies.
—Bill Dalton, PhD, MD, President/CEO, Moffitt Cancer Center

8. © 2010 Oracle and/or its affiliates. All rights reserved. 8
The Future of the Life Sciences Industry
Lean. Global. Networked.
Our scientists are working in new ways. By using highly-specialized
techniques, we're aiming to design treatments personalized for the unique
needs of individual people. Science is making this type of personalized
medicine possible for the first time in history… This personalized medicine
approach means new opportunities for people who are sick, for physicians
and for our shareholders.
…finding new treatments depends on collaboration. No company,
hospital, lab, or scientist can do it alone. That's why we've formed
partnerships with governments, independent medical and scientific
groups, companies and advocates….
—Jeff Kindler, CEO
Pfizer Corporation

9. © 2010 Oracle and/or its affiliates. All rights reserved. 9
Systemic Collaboration to Improve Health
These systems supported
individual silos across the health
science ecosystem, but must now
provide data for an integrated view
Investment is shifting towards R&D
and clinical collaboration,
personalized / translational medicine
and care management
Increasing demand and capabilities for
personalized medicine will drive new
business models, including more value-
based healthcare
Initial customer investment focused on
transactional capabilities (EMR, Claims,
EDC, Trial Management, etc.)
The new healthcare delivery
paradigm requires collaboration
Patient
Researcher
Citizen /
Member
Individua
l / Family
Care
Managemen
t
Personalized /
Translational
Medicine
Value-Based
Healthcare
© 2010 Oracle and/or its affiliates. All rights reserved.

10. © 2010 Oracle and/or its affiliates. All rights reserved. 10
The new drug development paradigm
A networked healthcare and life science model
Basic Research Discovery &
Development
Point of Care
CRO
Source: adapted from DataMonitor
Academia,
CRO &
Sponsor
Sponsor Healthcare

11. © 2010 Oracle and/or its affiliates. All rights reserved. 11
Aerospace transformation…
Boeing has rapidly shifted the company to embrace a “network” of partners
Aerospace transformation…
Boeing has rapidly shifted the company to embrace a “network” of partners
Partners Across the Globe Are Bringing the Boeing 787 Together
Clinical development transformation…
Merck is shifting drug development toward embracing a “network” of partners
Clinical development transformation…
Merck is shifting drug development toward embracing a “network” of partners
Merck External Basic Research (EBR) team expects to deliver 25% of early
pipeline from external partners by 2013 (Source: Pharma Focus Asia)
The new drug development paradigm
Piramal
PoC Oncology Drug
Discovery
Patheon
• Commercial
Manufacturing
• Pharmaceutical
Dev. Services
PPD
• Vaccine Testing
• Central Lab and
Sample Storage
Moffitt Cancer Center
Total Cancer Care
Advinus
Candidate Drugs for
Metabolic Disorders
Orchid
Chemicals
Bacterial and Fungal
Infection Dev
WuXi AppTec
Discovery Chemistry
Ranbaxy
Antifungal and Antibiotic
Target Programs

12. © 2010 Oracle and/or its affiliates. All rights reserved. 12
Patient-centered, collaborative care
Reid, Compton, Grossman, and Fanjiang, Editors, Committee on Engineering and the
Health Care System, National Academy of Engineering and the Institute of Medicine,
National Academies Press, 2005, pg. 20. Adapted from Ferlie and Shortell, 2001,
Improving the quality of health care in the United Kingdom and the United States: A
framework for change, Milbank Quarterly 79(2): 281-315
“Care that is safe, effective, patient-
centered, timely, efficient, and equitable.”
-- Institute of Medicine, 2001

13. © 2010 Oracle and/or its affiliates. All rights reserved. 13
What is the data driven
healthcare enterprise?
13© 2010 Oracle and/or its affiliates. All rights reserved. Oracle confidential

14. 14Page 14
The Learning
Healthcare
Organization
Accountable Care
Organizations
Enterprise
Quality
Standards
Clinical Effectiveness
Comparative Effectiveness
Automating “Today’s”
Healthcare Enterprise
Need for Secure, Interoperable
Healthcare Data and Analytics
Impact on HC
Transformation /
Value to
Healthcare
System
Today
Performance Management
Implications for healthcare providers
This evolution has both clinical and operational implications
Core Transactional
Systems
Clinical & Enterprise
Integration
Enterprise Data Warehouse
Context Specific Analytics and
Applications
Core Systems
Requirements:
Today’s
“Transactional”
Systems Were
Not Designed to
Enable this
Transformation
Evidence Based
Medicine
Evidence Based
Medicine
Value-based,
Personalized
Healthcare
Value-based,
Personalized
Healthcare
Trial and Error
Medicine
Trial and Error
Medicine

15. 15
-Basic / Translational Research
-Clinical Research/Trials
-CER
-Deep Analytics / Informatics
Framework for PHC Enabled by HIT
Achieving this will create a “learning healthcare”
paradigm
“Learning Healthcare” Paradigm Supported by Robust, Interoperable Informatics
-Trustworthy data
from EHRs
-Longitudinal
Biobank data
-Imaging
Translate
guidelines and
empirical results
into specific
process steps
Leverage workflow
driven informatics
processes to drive
to point of care with
decision support
analytics
Trustworthy data to
measure protocol
with analytics to
track outcomes or
deviations
Employ analytics to
measure results
and teach people,
activate patients
and transform care

16. 16
-Basic / Translational Research
-Adaptive Clinical Research/Trials
-CER
-Deep Analytics / Informatics
“Learning Healthcare” Paradigm Supported by Robust, Interoperable Informatics
-Trustworthy data
from EHRs
-Longitudinal
Biobank data
-Imaging
Translate
guidelines and
empirical results
into specific
process steps
Leverage workflow
driven informatics
processes to drive
to point of care with
decision support
analytics
Trustworthy data to
measure protocol
with analytics to
track outcomes or
deviations
Employ analytics to
measure results
and teach people,
activate patients
and transform care
Health Management PlatformEnterprise
Health
Analytics Context Specific Analytics
Existing
Clinical
Systems
Novel Research Methods for
Enabling Rapid Learning
Networks
(e.g. adaptive trial design, signal detection)
Real-time
Feedback
Framework for PHC Enabled by HIT
Achieving this will create a “learning healthcare”
paradigm

17. 17
Personalized Healthcare Requires Deep Analytics
Departmental “Dashboards”are Insufficient
DASHBOARDS
• “Visible”
PLUMBING
• Mappings to applications and data
transformations take expertise &
time
• The technology infrastructure has
its own complexities

18. 18
Personalized Healthcare Requires An Integrated View
Insights From Combining Clinical, Biomedical, Operational and
Financial Data
“How is our nurse overtime
policy affecting our ICU
quality measures? Patient
satisfaction?”
FINANCIAL
HR
SUPPLY CHAIN
CLINICAL
“Do our cardiac care
reimbursements reflect our
improved quality measures?”
“How many patients with a
particular molecular profile
and clinical attributes are in
our system?”
“INTEGRATED
VIEW
ANALYTICS”
“GENOTYPE”“SILO ANALYTICS”
“What’s our overall
performance? Our quality
performance and cost to
deliver that quality?”

19. 19
What does this ultimately mean for a health system?
Data and applications must be decoupled for robust use of the data and for
applications to draw upon multiple data sources
Fulfill Health
Information Request
Health Information
Services Agreement
For Secondary Use
Health
Information
RequestAuthenticate
Requester
Transform
and
Normalize
Health
Informatio
n
Patient Health
Information
Aggregated
for
Normalization
Transformed
into
Information
Service Format
Patient Health
Information
Gathered
Clinical Innovations
Clinical &
Operational
Benefit

20. Copyright © 2010, Oracle. All rights reserved.
Oracle & [customer] Confidential 20
Analytics coupled with the right health management
platform can support longitudinal care
Focus for Today: Citizen/Patient Care Cycle
• Identifying, stratifying and targeting patients
• Attracting patients
• Improving administrative processes to
– Improve utilisation of resources
– Help Patients get treatment
– Improve patient experience
Unaware Patient
Aware
Patient
Patient
Visits HC
Professional
Get
Treatment
Patient
Discharged
Patient is
Compliant
Patient is
Stable
• Support after discharge
• Adherence
• Patient monitoring
• Supporting patient behavior modification
Health
Consumer
Gateway
Pre-Acute
Acute
Intervention
Post-Acute/
Disease
Management

21. Copyright © 2010, Oracle. All rights reserved.
Oracle & [customer] Confidential 21
Effective Care Cycle Management Has a Positive
Impact on Both Cost and Quality
Source: Intel Corp 2006
Cost of Care/Day
0%100%
$1 $10 $100 $1,000 $10,000
Acute CareResidential Care
Home Care
ICU
Community
Hospital
Specialty
Clinic
Assisted
Living
Skilled Nursing
Facility
Doctor’s
Office
Community
Clinic
Chronic Disease
Management
Healthy
Independent Living
QualityofLife

22. © 2010 Oracle Corporation Confidential
These platforms also create opportunities for biopharma
industry innovation and novel collaboration
Real-time Clinical Information Exchange Across the System
Patient RecruitmentClinical Data
PROVIDERSHospital
Clinics
Bio-banks
CRO
Pharma/
Biotech
Life Sciences
Clinical Trials
Safety & Pharmacovigilance
Learn
Confirm
Learn
Confirm
HEALTHCARELIFE SCIENCES

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© 2010 Oracle Corporation – Proprietary and Confidential

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Oracle Health Sciences Institute
In Partnership With Sun Labs
• Focused on research that will accelerate IT
innovation to advance personalized medicine and
the delivery of safe and effective treatments and
health care services to patients around the globe
• Works in collaboration with academic research centers. Current
collaborations include:
• Dana Farber Cancer Center (translational research)
• The Cleveland Clinic (cardiac decision support)
• St. Francis Xavier University (parallelizing ontological reasoning)
• Focuses on areas fundamental to the challenges facing health
sciences organizations. Research priorities include:
• Artificial intelligence and semantic technology
• Genomic, genetic and phenotypic data analysis
• Data mining to support optimization of clinical trials
• Predictive algorithms to enable earlier detection of adverse events
• Advanced decision support at the point of care