Presentation by Micaela Seeman Monteiro, Chief Medical Officer for digital transformation at Jose de Mello Saude, the largest private health system in Portugal. Includes an overview of Portugal's private healthcare sector, introduction to Jose de Mello Saude, Digital Health market- drivers, barriers, opportunities, take-aways. Presented on June 2, 2020 to the mHealth Israel community.

1. Challenges and opportunities for
digital health – private sector
Micaela Seemann Monteiro, MD
Chief Medical Officer for Digital Transformation

2. AGENDA
2
Portuguese Private Healthcare Sector 01
José de Mello Saúde / 02
& Digital Health 03
Digital Health Market - Barriers 04
Digital Health Market - Opportunities 05
Digital Health Market - Take Aways 06

3. 3
20,4 M
Público: 12,2 M
Privado: 8,2 M
18 345 M€
Público: 12 193 M€
Privado: 6 152 M€
230
Público: 111
Privado: 119
Number of Beds1
35 429
Público: 21 095
Privado: 14 334
Number of Hospitals1
Outpatient
Consultations1
Current expenditure on
health care1
Dados de 2018 | Fonte: PORDATA, INE e Relatório do SNS 2018 | (1) Apenas contabilizadas as consultas hospitalares
PORTUGUESE HEALTHCARE SECTOR
ACCELERATED GROWTH OF THE PRIVATE MARKET

4. Ageing Population Under capacity of the Public System
Health Insurance Market Consolidation
Elderly Dependence Index Patients on wating list for Surgery (thousands)
% of the population that benefits from health insurance Weight of the top 4 Private Players1 (%)
Key Growth Drivers of the Private Healthcare Market in Portugal
1) Provision of Services of the top 4 Players / Hospital Private Health Expenditure and Ambulatory
Source: INE; PORDATA; Annual reports
HEALTHCARE MARKET IS EXPECTED TO CONTINUE TO GROW
SUPPORTED BY ITS DRIVERS AND INELASTIC DEMAND

5. WITH JMS MAINTAINING ITS LEADERSHIP POSITION
REVENUES INCREASED MORE THAN 12% IN THE PRIVATE SECTOR IN 2019
5
Private Sector Historical Revenues (m€)
Note: Only considers revenue from the private business (2018 accounts for other market players not available yet)
Source: Annual reports – excludes PPPs
CAGR 2013-18
+9%
+8%
+11
%
+17
%
Top-4 players +10
%
2018-19
+12
%
+9%
-
-
-

6. PPP
PPP
JOSÉ DE MELLO SAÚDE – 2019 IN
NUMBERS
www.josedemellosaude.ptI&D +I
2,4 M €

7. App Users
> 500 k
Appointments
booked by App
Call Center
calls
> 500 k > 3.4 M
Best Digital
Engagement
Best Digital
Transformation
DIGITAL IS INCREASINGLY A STRATEGIC INSTRUMENT FOR OUR COSTUMER
EXPERIENCE MyCUF APP REMAINS A KEY TOOL TO ENHANCE QUALITY
SERVICE
7
Note: Statistics refer to 2018 total activity.
Source: JMS internal.
X X
+ 30% per
annum
50%
remotely
(CC & App)

9. Corona Crisis – Highlights need for digital transformation
- 80%
Production
• Outpatients appointments
• Surgeries
• Exams
• Urgent care

11. TELECONSULTATIONIMPLEMENTATION TIMELINE
16th March 23rd May
Decision to implement
teleconsultation
1st teleconsultation (test) GP, Internal Medicine &
Pediatrics start first and
follow-up consultations; all
other specialties start
follow-ups
All specialties that agree to
first consultations start first
consultations
• 20 896 TCs
• Up to 900/ day
• > 1.200 doctors
• > 30 specialties
18th March 23rd March 30th March

12. Patient’s Portal &App
2014.
1st Chief MedicalOfficer for Digital Transformation
2020.
“Grow Health “ Start-up program
2017.
Teleconsultations
2020
Road to Digital Health

13. Hybrid Patient Journey
Prevention AmbulatoryCare Exams / Surgery Inpatient Care Monitoring
DIGITAL TOUCHPOINTS HUMANTOUCHPOINTS
REMOTE
home,work,holiday
ON-SITE
cufunit
©Micaela Monteiro

14. Barriers
FINANCING
Pay for service model still dominates. Long term health results , VBH
or population health approaches are not yet financially rewarded by
insurance companies .
WEAK SENSE OF URGENCY
Market and revenues have been growing with traditional approach.
COVID 19 pandemic may have changed perception recently. It is too
early to know whether this perception will endure.
HESITATION INTAKING RISK
Recent economic crisis and current corona crisis increase financial
uncertainty.

15. Main areas of opportunity
Assisted Living/ Telemonitoring / IoT
Ageing and the growth of chronic diseases create a need for solutions
to better manage disease and disability from home and to prevent
institutionalization.
AI toincrease clinical efficiency
Automation, " augmented information" and clinical decision support
leveraged by AI promise gains in efficiency , quality and safety.
POC/ sampling at home
Shifting on-site care to remote care is a strong global tendency. The
possibility of taking blood samples performing point-of-care test
yourself at home is still limited.

16. PORTUGUESE MARKETIS TECHSAVY & START-UP FRIENDLY
QICKWINS AND CAPABILITY OF MONETIZATION APPRECIATED
INTEROPERABILITY & SCALABILITY
“Take-Aways”

17. ‫תודה‬!
Findme here micaela.monteiro@jmellosaude.pt