©2018 WellDoc, Inc. Intellectual Property. All rights reserved

The Power and Promise of Digital Health

Laurel Pickering, MPHEVP, Enterprise SolutionsWelldoc, Inc.

Agenda• Problem are we trying to solve• Changing consumer and healthcare system• Digital health and digital therapeutics• Artificial intelligence • Diabetes and BlueStar as an example

What problem are we trying to solve?

Problems• Increasing health care costs• Increase in prevalence of chronic conditions (New CDC

numbers: 14% of Americans have diabetes)• Hard to get employees to take care of themselves and

engage in their health• Tried multiple programs; many don’t work

and employees don’t engage

Your employees are changing and so is healthcare

• The New Consumer

• Care is moving to virtual and on-demand

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Meet LaraToday’s Healthcare Consumer

Music

MUSIC SPOTIFY

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COMMUTE UBER

Music

EXERCISE PELOTON

Music

DOCTOR TELEDOC

Characteristics of Lara’s Tools

©2018 WellDoc, Inc. Intellectual Property. All rights reserved

Personalized

©2018 WellDoc, Inc. Intellectual Property. All rights reserved

On-Demand

©2018 WellDoc, Inc. Intellectual Property. All rights reserved

Virtual

©2018 WellDoc, Inc. Intellectual Property. All rights reserved

24/7

1919

How do your tools fit into Lara’s expectations?

2020Diabetes Space

Confusion

314 Wearables available worldwide

60% of apps are just general wellness

Patie

nt C

hurn200 new apps each day

20% of large health systems have full-scale digital health programs

Digital Health Space

2121

Investor Trends: 2018 biggest year• Digital health is key focus of investors time and

money

• Healthcare at home/on-demand health tools

• Significant digital therapeutics fundraising:

• Pear Therapeutics ($46M)

• Click Therapeutics ($17M)

• Akili Interactive Labs ($68M)

• Virta Health ($45M)

• Propeller Health ($20M)

• Hinge Health ($26M)

• Focus on companies making care continuous, accessible, convenient

• 31 FDA approvals in digital health

• Big tech pushes into healthcare

• Amazon acquires PillPack

• Apple Watch Series 4

SVB Analytics, “Consumer Digital Health: How Market Shift is Leading to New Opportunities”, 2016

Software as Medicine: Digital Therapeutics

1. Data analysis and feedback is evidence and theory based and tailored to the individuals clinical needs, goals, and lifestyle

2. Connects the patient with their own health care team (integrate into practice)

3. Has demonstrated safety and efficacy in randomized clinical trials

4. Ensures the safety and security of the patient-generated health data

5. Obtained regulatory clearance when used as medical device and are developed in accordance with appropriate QA/RA standards

6. Designed to be user friendly and engaging

Digital therapeutics are at the forefront of a new era in digital health.

These clinically validated solutions may be used as standalone interventions or in association with other treatments to engage patients and improve the overall quality, cohesion, outcomes and value of healthcare delivery.

Criteria:

Where Does AI Fit In?

It’s a new world, where artificial intelligence (AI) is moving beyond a back-end tool for the healthcare enterprise to the forefront of the consumer and clinician experience.

AI is the New UI: Healthcare Experience Above All, Accenture, 2017

3434Spotlight on Diabetes

N O I S E I N T H E S Y S T E M

K E Y P L A Y E R S

People with Type 2 Diabetes Need a 24/7 Personal Assistant

*Turning the tide on diabetes management: How leaders in health care are using multi-faceted approaches, Deloitte, 2016

*

…and people need a digital assistant they can trust

“Yet this miracle of modern science is not a new pill. It is a smartphone app called BlueStar.”

”The BlueStar app…is one of only a few apps backed by data from clinical trials.”

“Adults with diabetes can use sophisticated mobile technology, such as Welldoc to effectively manage their lifestyles and conditions, reducing the need for in-person encounters.”

April 2018 January 2018April 2015

BlueStar Powered by WellDoc

• 1st digital therapeutic for diabetes

• 30 peer reviewed publications/posters including clinical outcomes in randomized controlled studies and real-world.

• Experience with 30,000 people with diabetes

• FDA Registered as a Class 2 Medical Device, works online & offline.

• HIPAA compliant. SOC 2 Certified. ISO 13485 for International Business

Our Solution

Digital Personal Assistant

Data-driven user experience and artificial intelligence combined with evidence-based medicine

Named

“Top App” for type 2diabetes treatment

by IQVIA November 2017

Source: IQVIA 2017 Report “The Growing Value of Digital Health”

BlueStar Ecosystem

Tailored, Comprehensive Experience

Symptoms(Surveys, Notes)

Psycho-social(Distress, Disability,

Economic Conditions)

Labs(BG, BP, Weight)

Activity(Sleep/Exercise)

Meds(Adherence, Insights)

Diet(Carbs, Calories, Sodium,

Water)

Unique, real-time feedback messages given within each dimension

Tracks and analyzes the 6 critical dimensions impacting diabetes, inclhypertension & weight management

Provider Smart Visit Report

Weekly Insights Longitudinal Patterns

Medication Reminders

Real-time Feedback

Plan & Track

A Closer Look at BlueStar

Connect

Key BlueStar Stats

24 weekly in-app actions

Engagement

Average Savings of $251-$274 per month

Time to ResultsMost A1C reductions seen in first 3 months

Clinical Results

1.7-2.0 Reduction in A1C

Cost Savings

Quinn CC, Shardell MD, Terrin ML, Barr EA, Ballew SH, Gruber-Baldini AL. Cluster-randomized trial of a mobile phone personalized behavioral intervention for blood glucose control. Diabetes Care. 2011 Sep;34(9):1934-42. Erratum in: Diabetes Care. 2013 Nov;36(11):3850.Tang, P. Peeples, M. Duni, J. Peskin,S. Macleod, J. Kowitt, S. Fisher, E. eHealth-Assisted Lay Health Coaching for Diabetes Self-Management Support. ADA, New Orleans, 2016. Poster

1.9 Point A1C Improvement (mean)12 month RCT

2.0 Point A1C Improvement (mean)3 month RCT

58% Reduction in Hospitalizations & ER Visits

Peer-Reviewed Journals

OutcomesOver 32 peer reviewed posters and

presentations

Comparison of A1C ReductionT2D Treatment Average A1C Reduction

Insulin 1.5 - 2.5

BlueStar 1.7 - 2.0

Metformin 1.5

Sulfonylureas 1.5

SGLT-2s .5 - 1.0

GLP-1R Agonist .5 - 1.0

DPP-4 Inhibitor .6 - .8

BlueStar is second only to insulin in terms of ability to reduce A1C

No side effects

Fully scalable

Financial Outcomes

WellDoc Validates Potential of Its Digital

Therapeutic, BlueStar®, to Significantly Reduce

Healthcare Costs.

Cost savings based on:

• Reductions in hospitalizations• Emergency room visits• Supplies and medications• Co-morbid conditions

3-5xAverage ROI

$254-$271 Average Savings

per User per

Month

How Does it Work?• You purchase BlueStar for your employees/patients/members• We provide you with a unique code• We work with you to market the tool and target, if possible

• Email blast, posters, phone outreach, onsite enrollment, website, existing platform, clinician education, workflow

• Employees/members/patients download the app from app store• They use your unique code to activate • You provide eligibility file• We provide you with regular reporting: how many are using BlueStar, how often, what

features are they using, blood glucose values, medication adherence, preventive exams, etc.

Keeping BlueStar Users Engaged

“In-App” Engagement

“Out-of-App” Engagement

Dynamic Emails

Mobile Notifications

Targeted Re-Engagement Emails

BlueStar Team/Care Team Phone Outreach

Real-Time Feedback Messages

Longitudinal Feedback Messages

Weekly Challenges

Weekly Summaries

Diabetes Curriculum

In-app and out-of-app engagement methods

Helping people live their best life

“I can’t live without BlueStar!”

• 5.8 A1C reduction in about 7 months

• Lost weight (over 70 pounds)

• More active and living a healthy lifestyle

• Feels BlueStar helped her get her life back

• BlueStar helps her keep her diabetes in control

5.8 A1C reduction in ~7 monthsRecent A1C of 5.7 was recorded early Nov. 2017

Candy K. Barnes62 year old - ManagerMarch 2017 - Diagnosed with T2DApril 2017- Began BlueStar

Starting A1C: 11.5 Ending A1C: 5.7

11.5 5.7

It is amazing what a digital personal assistant can do for population health.

Laurel Pickering, MPHEVP, Enterprise Solutionslpickering@welldoc.com