AVIORR CONSULTING GROUP Dr. Kamle’s PRESCRIPTION BUILDING WORLD CLASS HOSPITALS BUILDING WORLD CLASS HOSPITALS The most advanced design, planning, construction

AVIORR CONSULTING GROUPDr. Kamle’sPRESCRIPTION

BUILDING WORLD CLASS BUILDING WORLD CLASS HOSPITALS HOSPITALS

The most advanced design, planning, The most advanced design, planning, construction and equipment construction and equipment

procurement trends and experience procurement trends and experience sharing from global projectssharing from global projects


Vision and Vision and PrinciplesPrinciples

• Providing our customers with professional consultancy and Providing our customers with professional consultancy and tailored turnkey solutionstailored turnkey solutions Developing affordable hospitals meeting technological Developing affordable hospitals meeting technological

goals whilst respecting social and cultural needsgoals whilst respecting social and cultural needs Investing our knowledge to assist our customers to Investing our knowledge to assist our customers to

achieve their objectives efficiently , guarantee value achieve their objectives efficiently , guarantee value added and minimize risk added and minimize risk

Our people – a team of highly qualified professionalsOur people – a team of highly qualified professionals

• Over 100 years of combined experience Over 100 years of combined experience in Healthcare with in Healthcare with a successful history of reducing capital acquisition costsa successful history of reducing capital acquisition costs

• Offices in MA, San Diego, Athens and LondonOffices in MA, San Diego, Athens and London22


Our MissionOur Mission

• A customized solution with a single customer interfaceA customized solution with a single customer interface

• Integrated design - project management – medical Integrated design - project management – medical

equipment solutions and technologyequipment solutions and technology

• Transparency of process creating trust with clients and Transparency of process creating trust with clients and

investorsinvestors

• Create compatibility between client and our teamCreate compatibility between client and our team

• On time delivery of project and process qualityOn time delivery of project and process quality

• Innovative solutions with proven outcomes leading to Innovative solutions with proven outcomes leading to

maximum gains for our clients delivery of care maximum gains for our clients delivery of care

33


Our Experience and Our Experience and SkillsSkills

• Extensive knowledge of Public and Private sector hospital Extensive knowledge of Public and Private sector hospital

projects in a global contextprojects in a global context

• Design, planning, procurement, installation, Design, planning, procurement, installation,

commissioning with ongoing training and supportcommissioning with ongoing training and support

• We aim to help our clients maximise lifecycle value We aim to help our clients maximise lifecycle value

ensuring compatibility of operating systems with co-ensuring compatibility of operating systems with co-

ordinated implementation programordinated implementation program

• We combine our knowledge and global network with that We combine our knowledge and global network with that

of our local partnersof our local partners

44


The The ApproachApproach

• Provide a one point contact who understands our client’s needs Provide a one point contact who understands our client’s needs

and provides the solution and provides the solution

• We will assist with the business plan and strategic analysis, We will assist with the business plan and strategic analysis,

market volumes and competition, site evaluation and market volumes and competition, site evaluation and

environmental impactenvironmental impact

• We will propose financial alternatives developed from the We will propose financial alternatives developed from the

business plan business plan

• Design, space planning, scheduling and procurement strategiesDesign, space planning, scheduling and procurement strategies

• We will work together to produce a coherent marketing planWe will work together to produce a coherent marketing plan

55


The TeamThe Team

Source Atlantic, Inc. is a leader in turnkey project design, Source Atlantic, Inc. is a leader in turnkey project design, management, equipment planning, forecasting and management, equipment planning, forecasting and procurement for hospitals and medical research facilities procurement for hospitals and medical research facilities worldwide worldwide

Bridgetech Asia Limited is a key player in the transfer of western Bridgetech Asia Limited is a key player in the transfer of western medical technologies into Greater China with offices in Beijing, medical technologies into Greater China with offices in Beijing, Guangzhou, Hong Kong, Taiwan and the U.S.Guangzhou, Hong Kong, Taiwan and the U.S.

Source Atlantic and Bridgetech combine their sector and territorial Source Atlantic and Bridgetech combine their sector and territorial expertise to provide integrated services covering all aspects of expertise to provide integrated services covering all aspects of client projects providing value added hospital consultation client projects providing value added hospital consultation services with their strategic alliance associate WorldCare services with their strategic alliance associate WorldCare Consortium for hospitals and medical research facilities in Consortium for hospitals and medical research facilities in Greater China.Greater China. 66


The TeamThe Team

Aviorr Consulting Group Aviorr Consulting Group is a comprehensive group in is a comprehensive group in healthcare, infrastructure and investments. (www.aviorr.com)healthcare, infrastructure and investments. (www.aviorr.com)

Dr. Kamle’s Prescription Dr. Kamle’s Prescription is a ‘Turn key Solution Provider’ for is a ‘Turn key Solution Provider’ for healthcare industry. (www.drkamle.com)healthcare industry. (www.drkamle.com)

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Strategic PartnerStrategic Partner

• WorldCare consortium member hospitals:WorldCare consortium member hospitals:

• Duke University Health SystemDuke University Health System

• Partners Healthcare System Partners Healthcare System

Massachusetts General HospitalMassachusetts General Hospital

Brigham and Women's HospitalBrigham and Women's Hospital

Dana-Farber/Partners Cancer CareDana-Farber/Partners Cancer Care

McLean HospitalMcLean Hospital

Spaulding Rehabilitation HospitalSpaulding Rehabilitation Hospital

• UCLA HealthcareUCLA Healthcare88


Global ServicesGlobal Services• Over 100 years of combined experience inOver 100 years of combined experience in

Equipment Planning Equipment Planning Project Management Project Management Equipment Procurement Equipment Procurement

• Health Facilities globally benefit from: Health Facilities globally benefit from: shorter plan-buy-delivery cycle by approx. 30%shorter plan-buy-delivery cycle by approx. 30% reduced equipment price fluctuation riskreduced equipment price fluctuation risk value added hospital consultation servicesvalue added hospital consultation services

99


Global Turnkey Project Global Turnkey Project ManagementManagement

• Turnkey Project Management:Turnkey Project Management:

• Integrate and manage all aspects of your project from Integrate and manage all aspects of your project from

planning and design through build-out, procurement and planning and design through build-out, procurement and

value added hospital consultation services value added hospital consultation services

• Each phase can be executed as an individual component or Each phase can be executed as an individual component or

collectively as a comprehensive turnkey project.collectively as a comprehensive turnkey project.

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Turnkey Project Management components:Turnkey Project Management components:• Capital Equipment AssessmentCapital Equipment Assessment

A review all major items of existing inventory leading to equipment A review all major items of existing inventory leading to equipment lifecycle costing. Development of long-term Capital Forecasting and lifecycle costing. Development of long-term Capital Forecasting and Replacement Programs.Replacement Programs.

• Capital Equipment InventoryCapital Equipment Inventory

Compile inventory data to be used for the creation of move strategy, Compile inventory data to be used for the creation of move strategy, qualification of any previous assessments.qualification of any previous assessments.

• CoordinationCoordination

Ensure the client is central to decision making of any project and to Ensure the client is central to decision making of any project and to provide a structured environment for ease in reporting and review. provide a structured environment for ease in reporting and review.

• Schematic DesignSchematic Design

Work closely with our client's management teams, clinicians and Work closely with our client's management teams, clinicians and stakeholders to develop preliminary equipment budgets and space stakeholders to develop preliminary equipment budgets and space equipment lists for each device.equipment lists for each device. 1111



Turnkey Project Management components:Turnkey Project Management components:• With the client - Design & Equipment Installation Specification DevelopmentWith the client - Design & Equipment Installation Specification Development

Complete and sign-off equipment lists and budgets concurrent with the design Complete and sign-off equipment lists and budgets concurrent with the design effort and provide all necessary electrical, mechanical and dimensional data effort and provide all necessary electrical, mechanical and dimensional data required for the engineers and architects to complete space plans.required for the engineers and architects to complete space plans.

• Construction DocumentsConstruction Documents Provide online database of all medical and laboratory equipment for client Provide online database of all medical and laboratory equipment for client

allowing the architect, engineers, and end users to produce their own detailed allowing the architect, engineers, and end users to produce their own detailed reports and cut sheets (itemized operation & installation specification). reports and cut sheets (itemized operation & installation specification).

Create “Plan View” Auto Cad version 2000 drawings with equipment on a Create “Plan View” Auto Cad version 2000 drawings with equipment on a separate layer from Auto Cad version 2000 background floor plans.separate layer from Auto Cad version 2000 background floor plans.

• Value added hospital consultation services – WorldCare Consortium Value added hospital consultation services – WorldCare Consortium case management consultation (second opinion), patient referral & insurance case management consultation (second opinion), patient referral & insurance

services, health information services & CME for existing facilitiesservices, health information services & CME for existing facilities New medical facilities development co-definition of clinical strategy, feasibility New medical facilities development co-definition of clinical strategy, feasibility

study and business plan and introduction to Wellness Center concept.study and business plan and introduction to Wellness Center concept.

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Value added services with strategic partner WorldCare Value added services with strategic partner WorldCare International:International:

Services for Existing FacilitiesServices for Existing Facilities Review programs. Review programs. Audit clinical, technical, Audit clinical, technical,

administrative.administrative. Process improvement.Process improvement. Vendor selection.Vendor selection. Educational programs for staff.Educational programs for staff. Introduce new services.Introduce new services. 1313



What you should be considering:What you should be considering:

• How to customize recurring and construction capital.How to customize recurring and construction capital.

• How to establish accurate multiyear forecasting programs.How to establish accurate multiyear forecasting programs.

• How to standardize and automate the capital planning & How to standardize and automate the capital planning &

requisition process.requisition process.

• How to provide access to real time needs information.How to provide access to real time needs information.

• How to minimize errors and omissions with drawings & document How to minimize errors and omissions with drawings & document

revisions and control.revisions and control.

• How to standardize of recurring/project capital workflow.How to standardize of recurring/project capital workflow.

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A r c h I t e c t u r e

INOVATIOn

E Q U I P M E N T P L A N N I N G

QUALITY

of

CARE

Plan and Design for Outcomes Plan and Design for Outcomes and Cost Effectiveness and Cost Effectiveness

Capital Cost Reduction and Capital Cost Reduction and Control MeasuresControl Measures

Recurrent Capital Cost Recurrent Capital Cost Planning Planning

and Controland Control

Value Added Hospital Value Added Hospital Consultation for existing & Consultation for existing &

new facilitiesnew facilities

Key Ingredients of Turnkey Hospital Project Key Ingredients of Turnkey Hospital Project Management Services:Management Services:

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Budget DevelopmentActive Staff InvolvementActive Vendor ParticipationEngagement of Planners / Cost EstimatorsAccountantsArchitects

Space PlanningSchematic DesignDesign DocumentsConstruction Documents

Procure Install Packaging Case by Case Negotiations Leverage on Going Service Enter into contract discussion

Commissioning

Annual Recurrent Procurement Plan

Operations budget support planning

The implementation process:The implementation process: Schedule

Equipment Space Report

A.E.M

Cut Sheet

Cost Summary

Specification Sheet

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Annual Recurrent Procurement Planning:Annual Recurrent Procurement Planning:

1.1. Forecasting & Development of long Forecasting & Development of long term Strategic Procurement Modelsterm Strategic Procurement Models

2.2. Establish Aggressive, Accurate & Establish Aggressive, Accurate &

Manageable BudgetManageable Budget

3.3. Standardize Items / VendorsStandardize Items / Vendors

4.4. Aggregate opportunities with Aggregate opportunities with Construction Related Equipment Construction Related Equipment purchases and other facilitiespurchases and other facilities

5.5. Prioritization of departmental Prioritization of departmental purchasing needspurchasing needs

6. Collection and Distribution of Data6. Collection and Distribution of Data

The Capital Process

Manage

Install

Replace

Evaluate

Procure

Source

Specify

Plan

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GMPP – Guaranteed Maximum Pricing ProgramGMPP – Guaranteed Maximum Pricing Program

A variety of procurement services to support of client’s purchasing A variety of procurement services to support of client’s purchasing team. team.

• Components of our turnkey solutions include but not limited to:Components of our turnkey solutions include but not limited to:

Develop overall product procurement package planDevelop overall product procurement package plan Develop project equipment specificationDevelop project equipment specification Develop ‘Request For Proposal’ documentationDevelop ‘Request For Proposal’ documentation Review Tender proposals from VendorsReview Tender proposals from Vendors Develop comparative matrix of equipment operation specification, Develop comparative matrix of equipment operation specification,

product capability & pricing from different vendorsproduct capability & pricing from different vendors Scheduling & management of vendor demonstrationsScheduling & management of vendor demonstrations Coordinate with vendors to build Mock Room Coordinate with vendors to build Mock Room Negotiation with competitive vendorsNegotiation with competitive vendors Procurement based on client’s decisionProcurement based on client’s decision

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Essential equipment procurement components:Essential equipment procurement components:

• Control the procurement processControl the procurement process

• Plan generically - buy specifically emphasis on operational Plan generically - buy specifically emphasis on operational

capabilitycapability

• Aggregate purchases of similar products or vendorsAggregate purchases of similar products or vendors

• Develop simple – generic product specification that encourages Develop simple – generic product specification that encourages

vendor participation on an equal footingvendor participation on an equal footing

• Look outside a vendor’s brochure for added value including Look outside a vendor’s brochure for added value including

accessories, maintenance, extended warranty, training, etc.accessories, maintenance, extended warranty, training, etc.

• Negotiate all aspects of the procurement deal Negotiate all aspects of the procurement deal 1919


A Success FormulaA Success Formula By Combining:By Combining:

Experienced & Experienced & Non-vendor Specific Non-vendor Specific Staff of:Staff of:

Architects / Project Managers / Engineers / Architects / Project Managers / Engineers / Scientists/ Clinicians / Supply Chain ManagersScientists/ Clinicians / Supply Chain Managers

Leading Edge TechnologyLeading Edge Technology

Web Web bbased ased ccapital apital eequipment quipment pplanning & lanning & fforecasting orecasting ssystem ystem

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Our Strengths

• Integrate and manage all aspects of client projects from planning Integrate and manage all aspects of client projects from planning

and design through build-out and procurement and design through build-out and procurement

• Vendor Independent - focus only on client’s best interest and Vendor Independent - focus only on client’s best interest and

purchase the best technologies at the best price purchase the best technologies at the best price

• Value added hospital consultation services – effective aggregationValue added hospital consultation services – effective aggregation

• Access leading edge web based capital equipment planning and Access leading edge web based capital equipment planning and

forecasting system forecasting system

• Achieve shorter plan-buy-delivery cycle - reduces risk of capital Achieve shorter plan-buy-delivery cycle - reduces risk of capital

equipment price fluctuationequipment price fluctuation2121


ClientClient Case Study: Case Study: Aggregation of 3 independent projectsAggregation of 3 independent projects

Our StrengthsBoston Children's Hospital

450 Bed Children's HospitalUSD 300M Replacement FacilityUSD 60M Capital Budget

ImagingMRI, CT, Angio, US,

ORLights, Tables, Columns, Monitors

EDLights, Stretchers, Columns, Monitors

NICUIncubators, Case Work, Columns,Monitors

Greenwich in New York

135 Bed Cancer CenterUSD100M ExpansionUSD 20M Capital Budget




NICUIncubators, Case Work, Columns, Monitors

South Shore Community Hospital450 Bed Community Hospital

USD 50M ExpansionUSD 17M Capital Budget




NICUIncubators, Case Work, Columns, Monitors

• Common Packages by Vendor / Product TypeCommon Packages by Vendor / Product Type• Identify Vendors with Cross Package ProductsIdentify Vendors with Cross Package Products

Vendors selection process:Vendors selection process:

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Procurement Process:Procurement Process:1)1) AggregateAggregate2) Generic Specification Development2) Generic Specification Development3) Packaging3) Packaging4) Generic RFP Development & Submission4) Generic RFP Development & Submission5)5) Vendor DemonstrationsVendor Demonstrations6) Case by Case Negotiations6) Case by Case Negotiations7) Equipment installation & commissioning7) Equipment installation & commissioning

Effectiveness of aggregationEffectiveness of aggregation

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Total Cost Savings: USD16.45M

ListList Budget Budget ActualActual VarianceVariance ListList Budget Budget ActualActual VarianceVariance

AccessoriesAccessories $262.50 $262.50 $350 $350 $193 $193 $70 $70 Materials HandlingMaterials Handling $272,338 $272,338 $363,117 $363,117 $199,714 $199,714 $72,623 $72,623

AllowanceAllowance $131,250.00 $131,250.00 $175,000 $175,000 $96,250 $96,250 $35,000 $35,000 Misc.Misc. $841,212 $841,212 $1,121,616 $1,121,616 $616,889 $616,889 $224,323 $224,323

AnesthesiaAnesthesia $497,250.00 $497,250.00 $663,000 $663,000 $364,650 $364,650 $132,600 $132,600 MonitoringMonitoring $3,316,656 $3,316,656 $4,422,208 $4,422,208 $2,432,214 $2,432,214 $884,442 $884,442

CabinetsCabinets $135,843.00 $135,843.00 $181,124 $181,124 $99,618 $99,618 $36,225 $36,225 PACSPACS $3,015,000 $3,015,000 $4,020,000 $4,020,000 $2,211,000 $2,211,000 $804,000 $804,000

CartsCarts $864,311.25 $864,311.25 $1,152,415 $1,152,415 $633,828 $633,828 $230,483 $230,483 Patient CarePatient Care $1,958,935 $1,958,935 $2,611,913 $2,611,913 $1,436,552 $1,436,552 $522,383 $522,383

CaseworkCasework $56,250.00 $56,250.00 $75,000 $75,000 $41,250 $41,250 $15,000 $15,000 Patient ExamPatient Exam $683,123 $683,123 $910,830 $910,830 $500,957 $500,957 $182,166 $182,166

EndoscopyEndoscopy $966,167.25 $966,167.25 $1,288,223 $1,288,223 $708,523 $708,523 $257,645 $257,645 RadiologyRadiology $27,594,341 $27,594,341 $36,792,455 $36,792,455 $20,235,850 $20,235,850 $7,358,491 $7,358,491

Eye CareEye Care $1,015,038.00 $1,015,038.00 $1,353,384 $1,353,384 $744,361 $744,361 $270,677 $270,677 Rad. AccessoriesRad. Accessories $208,754 $208,754 $278,339 $278,339 $153,086 $153,086 $55,668 $55,668

Flow Reg'Flow Reg' $339,489.00 $339,489.00 $452,652 $452,652 $248,959 $248,959 $90,530 $90,530 RefrigerationRefrigeration $221,349 $221,349 $295,132 $295,132 $162,323 $162,323 $59,026 $59,026

Fume HoodsFume Hoods $240,518.25 $240,518.25 $320,691 $320,691 $176,380 $176,380 $64,138 $64,138 Stainless SteelStainless Steel $534,717 $534,717 $712,956 $712,956 $392,126 $392,126 $142,591 $142,591

FurnitureFurniture $7,291,098.75 $7,291,098.75 $9,721,465 $9,721,465 $5,346,806 $5,346,806 $1,944,293 $1,944,293 SterilizationSterilization $2,131,736 $2,131,736 $2,842,315 $2,842,315 $1,563,273 $1,563,273 $568,463 $568,463

Gas DeliveryGas Delivery $855,151.50 $855,151.50 $1,140,202 $1,140,202 $627,111 $627,111 $228,040 $228,040 SurgerySurgery $2,071,349 $2,071,349 $2,761,799 $2,761,799 $1,518,989 $1,518,989 $552,360 $552,360

LabLab $1,877,849.25 $1,877,849.25 $2,503,799 $2,503,799 $1,377,089 $1,377,089 $500,760 $500,760 $42,849,510 $42,849,510 $57,132,680 $57,132,680 $31,422,974 $31,422,974 $11,426,536 $11,426,536

LightingLighting $1,009,135.50 $1,009,135.50 $1,345,514 $1,345,514 $740,033 $740,033 $269,103 $269,103

CardiologyCardiology $3,566,035.50 $3,566,035.50 $4,754,714 $4,754,714 $2,615,093 $2,615,093 $950,943 $950,943

$18,845,650 $18,845,650 $25,127,533 $25,127,533 $13,820,143 $13,820,143 $5,025,507 $5,025,507 TotalTotal $61,695,160 $61,695,160 $82,260,213 $82,260,213 $45,243,117 $45,243,117 16,452,04316,452,043

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Client Project & AchievementsClient Project & Achievements

South Shore Hospital, Weymouth, MA South Shore Hospital, Weymouth, MA

ARCH: The Ritchie Organization ARCH: The Ritchie Organization

CON: 1999, Occupation: 2002CON: 1999, Occupation: 2002

• USD 70M Construction budgetUSD 70M Construction budget

• USD 12M Capital / Furniture budgetUSD 12M Capital / Furniture budget

Source Atlantic provided project planning, management and procurement Source Atlantic provided project planning, management and procurement services:services:

•Achieved cost savings of approximately USD 6MAchieved cost savings of approximately USD 6M

•Meet client project completion schedule Meet client project completion schedule

•Project well planned & coordinated - avoided extra cost on order revisionProject well planned & coordinated - avoided extra cost on order revision

•Obtained extended warranty from vendorsObtained extended warranty from vendors

•Delivered client’s first choice vendor product Delivered client’s first choice vendor product 2525



Fletcher Allen Health Care, Burlington, Fletcher Allen Health Care, Burlington, Vermont Vermont

ARCH: Tsoi KobusARCH: Tsoi KobusCON: 2000, Occupation: 2005CON: 2000, Occupation: 2005

• USD 340 M Construction BudgetUSD 340 M Construction Budget• USD 80 M Capital / Furniture BudgetUSD 80 M Capital / Furniture Budget• Bench Marked Group Purchasing Discount of Bench Marked Group Purchasing Discount of

30%30%

• Achieved Cost Savings approx. USD 15M Achieved Cost Savings approx. USD 15M • Achieved 50% discount from vendorsAchieved 50% discount from vendors

• Met client project completion schedule Met client project completion schedule • Project well planned & coordinated - avoided Project well planned & coordinated - avoided

extra cost on order revisions extra cost on order revisions • Obtained extended warranty, free freight & Obtained extended warranty, free freight &

installation from vendorsinstallation from vendors• Delivered client’s first choice vendor productDelivered client’s first choice vendor product

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Novartis Institute for Bio-Medical Research World HQ,Novartis Institute for Bio-Medical Research World HQ,Cambridge Massachusetts Cambridge Massachusetts ARCH: Stubbins AssociatesARCH: Stubbins AssociatesCON: 2001 Occupation: 2005CON: 2001 Occupation: 2005

**2005 Lab of the Year Award Adaptive ReuseTenant improvements to existing 500,000 sq. ft facilityTransition from existing New England Confectionary Company, into a state-of-the-art research laboratory Source Atlantic was engaged in November of 2002 to provide:

Equipment BudgetsEquipment Budgets Room by Room Equipment listsRoom by Room Equipment lists Vendor Data and Specification sheetsVendor Data and Specification sheets Review of User comments with ArchitectReview of User comments with Architect Engineer ReviewEngineer Review User Review ManagementUser Review Management Equipment Planning and ManagementEquipment Planning and Management Resource CoordinationResource Coordination Specification DevelopmentSpecification Development ProcurementProcurement InstallationInstallation LogisticsLogistics

** Awarded for overall effective design of the facility including equipment layout & configuration 2727



New 300,000 GSF facilityNew 300,000 GSF facility

Source Atlantic engaged November 2002 to provide project Source Atlantic engaged November 2002 to provide project planning, management and procurement services:planning, management and procurement services:

Capital Equipment Budget: USD 27MCapital Equipment Budget: USD 27M• Achieved cost savings of approx. USD 7MAchieved cost savings of approx. USD 7M• Meet client project completion schedule Meet client project completion schedule • Project well planned & coordinated – avoidedProject well planned & coordinated – avoided

extra cost on order revisions extra cost on order revisions • Obtained extended warranty from vendorsObtained extended warranty from vendors• Delivered client’s first choice vendor Delivered client’s first choice vendor

product and better than specified product and better than specified technology at lower pricetechnology at lower price

Cardiovascular Research Foundation - Cardiovascular Research Foundation - Completed May 2006 Completed May 2006

Columbia University Medical Center ARCH: Hillier2828



Brigham & Women’s HospitalBrigham & Women’s HospitalBoston, MassachusettsBoston, MassachusettsCON: 2001 Occupation: 2008CON: 2001 Occupation: 2008

• Source Atlantic provided medical equipment Assessment, Source Atlantic provided medical equipment Assessment, Inventory, Planning & Coordination services for a 270,690 Inventory, Planning & Coordination services for a 270,690 DGSF state of the art ambulatory care facility. DGSF state of the art ambulatory care facility.

• In addition, we are providing administrative and clinical In addition, we are providing administrative and clinical support for this 10-story outpatient facility for various support for this 10-story outpatient facility for various departments including new OR’s, Central Sterile, departments including new OR’s, Central Sterile, Laboratory, and Radiation Oncology.Laboratory, and Radiation Oncology.

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Massachusetts General Hospital “Yawkey CenterMassachusetts General Hospital “Yawkey Centerfor Outpatient Care”for Outpatient Care”Boston, MassachusettsBoston, MassachusettsCON: 2001 Occupation: 2005CON: 2001 Occupation: 2005

The Yawkey Center for Outpatient CareThe Yawkey Center for Outpatient Care

The new home of many of the hospital’s major patient-care services. The new home of many of the hospital’s major patient-care services.

• It houses the Cancer Center, the Cardiovascular Program, and It houses the Cancer Center, the Cardiovascular Program, and Massachusetts General Hospital for Children, the Musculoskeletal Massachusetts General Hospital for Children, the Musculoskeletal Program, and the Women’s Health Program. Program, and the Women’s Health Program.

• Source Atlantic provided equipment planning and project Source Atlantic provided equipment planning and project coordination services and access to “Hourglass”, Source Atlantic's coordination services and access to “Hourglass”, Source Atlantic's web-based planning application.web-based planning application.

• Source Atlantic worked closely with MGH to develop processes Source Atlantic worked closely with MGH to develop processes that assisted with the implementation of MGH capital standards.that assisted with the implementation of MGH capital standards. 3030


Other Client ProjectsOther Client Projects

US Projects:US Projects:

Yale UniversityYale University: A new six-story, 330,000 sq ft Molecular, Cellular & : A new six-story, 330,000 sq ft Molecular, Cellular & Developmental Biology Laboratory: provides turnkey project Developmental Biology Laboratory: provides turnkey project management and procurement services (project in progress)management and procurement services (project in progress)

Stony Brook University Hospital in Long Island, NY. Stony Brook University Hospital in Long Island, NY. a USD 300M a USD 300M comprehensive medical center: provides inventory planning comprehensive medical center: provides inventory planning services and manages procurement and installation of medical services and manages procurement and installation of medical equipment (project in progress) equipment (project in progress)

Clarion HealthcareClarion Healthcare ($175M construction budget. $30M equipment ($175M construction budget. $30M equipment budget): to be completed in Oct/2008. Saved Clarion almost 50% budget): to be completed in Oct/2008. Saved Clarion almost 50% equipment budget via negotiations with vendors.equipment budget via negotiations with vendors.

Orange - New YorkOrange - New York ($275M construction budget. $50M equipment ($275M construction budget. $50M equipment budget): to be completed in 2010. Equipment procurement is budget): to be completed in 2010. Equipment procurement is under planning development stage.under planning development stage.

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Other Client ProjectsOther Client Projects

International Projects:International Projects:

• Greenfield HospitalGreenfield Hospital (250 bed new construction. $50M (250 bed new construction. $50M equipment budget): Planning & procurement servicesequipment budget): Planning & procurement services

• King Hussien Cancer Center in Amman JordanKing Hussien Cancer Center in Amman Jordan ($60M USD ($60M USD equipment budget): planning & procurement servicesequipment budget): planning & procurement services

• Midland Group Hospital in IndiaMidland Group Hospital in India ($350M USD Construction ($350M USD Construction budget, $60M to $70M USD equipment budget): planning and budget, $60M to $70M USD equipment budget): planning and procurement services for a "Medical City" which has 175 acres procurement services for a "Medical City" which has 175 acres of land which includes a hospital, hotel, medical school, of land which includes a hospital, hotel, medical school, residential housing, etc. residential housing, etc.

• WorldCare Wellness Center in DubaiWorldCare Wellness Center in Dubai ($15M USD equipment ($15M USD equipment budget)budget)

• Hua Shan Hospital Network (Shanghai)Hua Shan Hospital Network (Shanghai) equipment equipment planning services provided by Source Atlantic & Harvard planning services provided by Source Atlantic & Harvard Medical InternationalMedical International

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Disaster PlanningDisaster Planning

3333


Why Hospitals and Not Other Kinds Why Hospitals and Not Other Kinds of Structures?of Structures?

Hospitals must remain functional during and afteran earthquake for the safety of patients and staff

AND To provide medical assistance to earthquake victims during and immediately after a disaster

Hospital buildings are the beacon of life and hope for a community.

Hospitals occupy a unique place in society’s survival

3434


Why Hospitals and Not Other Kinds Why Hospitals and Not Other Kinds of Structures?of Structures?

Without functioning hospitals, it takes much longer for a community to recover from an earthquake. This prolonged recovery seriously retards the area’s economic and social renewal.

•Because the evacuation of seriously ill patients can be detrimental and sometimes fatal, hospitals cannot be evacuated like other buildings, making it imperative that they survive earthquakes intact.

•Replacing a heavily damaged hospital building can take a Decade or more - depriving the community of sorely needed healthcare resources.

It is important to protect the investment of taxpayer money in many hospitals rebuilt with public money.

The US Federal Emergency Management Agency (FEMA) paid over $3 billion to repair hospital damage caused by the 1994 California Northridge earthquake. 3535

AVIORR CONSULTING GROUPDr. Kamle’sPRESCRIPTIONDisaster Disaster

ManagementManagement

Your speaker has experience in working Your speaker has experience in working with UN and World Bank rebuilding and with UN and World Bank rebuilding and equipping hospitals in other earthquake equipping hospitals in other earthquake prone areas Greece, Iran and Turkeyprone areas Greece, Iran and Turkey

California’s California’s Hospital Seismic Safety Law Hospital Seismic Safety Law 2005 sets the standard 2005 sets the standard

3636


Project Trade Financing Structure

3737


Trade Finance Trade Finance SolutionsSolutions

• Financing for cross border Equipment TransactionsFinancing for cross border Equipment Transactions

• Affordable solutions for both Public and Private sector Affordable solutions for both Public and Private sector

clientsclients

• Loans - Bi-lateral / Multi-lateralLoans - Bi-lateral / Multi-lateral

- Mixed credit- Mixed credit

- Commercial loans in USD or Yuan- Commercial loans in USD or Yuan

• Leasing - Local and cross borderLeasing - Local and cross border

• Investor - Equity and debt participationInvestor - Equity and debt participation3838



Project Finance US Ex-Im BankProject Finance US Ex-Im Bank

• Financing from $500,000 to $10 Million Financing from $500,000 to $10 Million ++

• Quick turnaroundQuick turnaround

• Variable rates based on LiborVariable rates based on Libor

• Typically 85% of equipment value (100% in some cases)Typically 85% of equipment value (100% in some cases)

• 10 year terms longer if over $10 Million10 year terms longer if over $10 Million

• Attractive rates for US goods and servicesAttractive rates for US goods and services

3939



International Finance Corporation International Finance Corporation (World bank)(World bank)• New pressures emerging to improve public services to New pressures emerging to improve public services to

enhance the quality of lifeenhance the quality of life

• IFC supports sustainability of private sector in IFC supports sustainability of private sector in

infrastructural projects – mitigates riskinfrastructural projects – mitigates risk

• Help develop local government and/or private sector Help develop local government and/or private sector

bond transactionsbond transactions

• Adds value and funding to public/private partnershipsAdds value and funding to public/private partnerships4040



World bank - MIGAWorld bank - MIGA

• MMultilateral ultilateral IInvestment nvestment GGuaranty uaranty AAgencygency

• MIGA – will guarantee against non-commercial MIGA – will guarantee against non-commercial

risk risk

• Needs host country approvalNeeds host country approval

• Applies to new investments contributing to Applies to new investments contributing to

development goals – up to $180Million for a development goals – up to $180Million for a

single projectsingle project

• Provides long term cover up to 15 years Provides long term cover up to 15 years 4141



WHO and UNICEFWHO and UNICEF

• Less than 7% of Budget spent on equipmentLess than 7% of Budget spent on equipment

• Mother & child healthMother & child health

• HIV – TB and other infectious diseasesHIV – TB and other infectious diseases

• Geared to disaster funding such as at SichuanGeared to disaster funding such as at Sichuan

• SARS epidemic – provided ventilatorsSARS epidemic – provided ventilators

• Neonatal support world wide from UNICEFNeonatal support world wide from UNICEF

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Building World Class HospitalsBuilding World Class Hospitals

SummarySummary

Enhances Operational & Financial ControlEnhances Operational & Financial Control

Reduces Capital Equipment CostsReduces Capital Equipment Costs

Aggregation Savings BenefitAggregation Savings Benefit

Standardizes the process of:Standardizes the process of:

Project Planning Project Planning

Capital Budgeting Capital Budgeting

Equipment Requisitioning Equipment Requisitioning

Technology Peer Review Technology Peer Review

4343


Technical SessionTechnical Session

4444


Points of DiscussionPoints of Discussion•Capital EquipmentCapital Equipment

Annual RecurringAnnual Recurring

Construction / Renovation RelatedConstruction / Renovation Related

Procurement Made EasyProcurement Made Easy

Case StudyCase Study

How to combine / Link Capital with How to combine / Link Capital with

ConsumablesConsumables

Expected ResultsExpected Results

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Communication & Management ProcessCommunication & Management Process

Owner

ProjectManager

Support

SeniorEquipment Planner

Team Source Atlantic

Project Principal

Support

ExistingProjectTeam

Admin

Clinicians

End Users

Architect

Contractor

Con. MGT

Contractor ArchitectConstruction

ManagerSource Atlantic

Communication Channel * User Reviews * Web Based Collaboration * Structured Processes and Communication

Data In

Move Plans

Bid PackagePrograms

BudgetDevelopment

Elec. MechRequirements

EquipmentLocation Reports

Cut Sheets

Space EquipmentReports

Actualvs.

Planned

ResultsOut

Installation &Logistics

Contract Manager

4646


4747


4848


4949


5050


5151


5252


5353


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