CareCyte

The Next Generation of Healthcare Facilities Copyright 2007-9, CareCyte LLC.All rights reserved worldwide.

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*AgendaWhat we want to accomplishIntroductions: people and organizationsThe CareCyte innovationsFundamentals of the CareCyte facilityDelivering healthcare services in a CareCyte facilityOpportunities for a partnershipWhats next?

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*What we want to accomplish Establish credibility Introduce a radical innovation Listen to questions and concerns Ground our claims Open the possibility of a partnership Define a path forward

Outline

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*Chris Raftery (CEO; Engineering and construction)Chauncey Bell (COO)Dave Chambers (Chief Architect; Healthcare Architecture)Mark Goldberg (SVP Sales; RE Development Concerns)

IntrosCareCytes People

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* Clinical and Research Labs:Genetic Systems, Seattle, WA (first US laboratory to culture live HIV)Bristol Myer Laboratories, Seattle, WASanofi, Seattle, WAProCyte, Seattle, WAOtsuka Pharmaceutical, Seattle, WA

Chris Raftery, CEOIntrosLead or principal in the engineering and construction of high profile projects. Examples:

Other Technically Demanding Projects:Fujitsu semiconductor plant, Gresham, OR Wells Fargo Center, Seattle, WAPaul Allens Experience Music Project, Seattle, WA

Hospitals and Medical Centers:Cedars Sinai Medical Center, Los Angeles, CAVirginia Mason North Tower, Seattle, WASacred Heart Medical Center Spokane, WAFred Hutchinson Cancer Research Center, Seattle, WA

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*Led the distinctive study group of doctors, builders, engineers, scientists, architects, and technologists in which CareCyte was born.Principal author of the CareCyte facility innovation.Experience and academic credentials as an engineer and as a builder.Projects on-time and on-budget, often at record paces.Innovator in use of computers in design and construction (VBR, Frank Gehry).Patents for construction materials and processes.

IntrosChris Raftery

*Chris Raftery: Projects and Successes*

Chris Raftery: Projects and Successes

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Chris Raftery: Projects and Successes

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*A healthcare and hospital architect, he has for many years designed healthcare service delivery facilities with greatly improved coordination among patients and caregiversServes as the Director of Planning and Architecture for the Sutter Health Group of hospitals in Northern California, where he supervises a $6.5 billion capital budget

Dave Chambers, Chief ArchitectIntros

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*Examples of his work:Sutter Health System, Sacramento, CA California Pacific Medical Center San FranciscoSutter Medical Center SacramentoSutter Medical Center Castro ValleyAlta Bates Medical Center OaklandLegacy Project - Providence Health System, Vancouver B.C., CanadaChildrens and Womens Health Centre, Vancouver B.C., CanadaFairview Hospital, Cleveland Clinic Health System, Cleveland, OHCentral Washington Hospital, Wenatchee, WAWhite Memorial Medical Center, Adventist Health, Los Angeles, CAUniversity Health System, San Antonio, TXCatholic Health Initiatives, Pacific Northwest Washington/Oregon

Dave Chambers, Chief ArchitectIntros

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*He invented the method of organizing medical service delivery workflows around patient-provider interactions and care pathways (cellular design) that underpins CareCyte service delivery designs and our economical footprints.His designs use staff and other resources more efficiently, get patients through procedures faster, and produce higher patient satisfaction. They have been applied to one-stop patient intake centers, integrated intervention services platforms, and acuity-adaptable inpatient nursing units.

Dave ChambersIntros

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*He consults to the U.S. Department of Defense, the Department of Veterans Affairs, Healthcare Authorities of Canada and the NHS, United Kingdom, and many other healthcare providers.Chambers was named one of Twenty who are making a difference in 2007 by the Center for Health Design.

Dave ChambersIntros

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13IntrosDave Chambers: Projects and Successes

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*He has led successful design and development programs, bringing together diverse teams and producing historic changes in several industriesBetter-known examples of his work include:On-time delivery of concrete in Mexico City, Guadalajara, and other cities around the world (CEMEX)Dramatically shortened delivery times for power plants built in India and China (ABB)The design and construction of a new bank, Intelligent Finance, in the United KingdomHe has made distinctive theoretical contributions to the literature of human coordination and innovation, and has been awarded half a dozen patents for his software designsBefore coming to CareCyte he worked as a senior consultant for more than 25 years (in his own and other firms), and served as the president of a successful software company

Chauncey Bell, COOIntros

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*Real estate advisor and developer in the Northwest for 30 yearsHis projects have been featured in state and national publicationsFor the last 24 years he has served as the Chairman of the M.S. Cavoad Co., IncorporatedDeep experience with the complex world of business arrangements underpinning the intersection of healthcare, land, permits and regulations, and constructionHas negotiated agreements with a diverse group of individuals and companies, including REITs, major insurance companies, Wall Street investments firms, and the Catholic Church

Mark Goldberg, Sr VP Marketing & SalesIntros

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*The CareCyte StoryIn 2005 the Seattle Science Foundation commissioned a study group to produce a breakthrough in the realm of healthcare service delivery.Their goal was to invent a way to design and economically produce facilities that allowed healthcare professionals to deliver care wherever it was needed with lead times of weeks or months rather than years.Many people have been working on ways to reduce costs and increase access to healthcare services.No one realized that a different kind of facility, designed specifically for healthcare and delivered quickly and economically, could serve as a platform for new care models and critical improvements to healthcare access, costs, and quality.

Story

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*Two Breakthroughs from the Study GroupA new and radically different way of designing and delivering customizable healthcare facilities, using the latest computer-aided design and manufacturing technologies, and high-tech materials (steel and polymers)A complementary approach to optimizing clinical workflows, service configurations, and unit capacities

Story

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*New Capacities for Medical ProfessionalsInvent and implement new and more efficient clinical practices and service delivery modelsTreat medical facilities as manageable tools rather than epic endeavorsRapidly incorporate new medical and communications technology as it becomes availableEasily locate facilities wherever they are needed, configured to deliver whatever services are needed at that time

Story

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*Chris Rafterys InspirationsAn abiding commitment to do better engineering, to have every component do as many things as possible, to get more for the money, go faster, and build better buildingsThe challenge of building a semiconductor FAB for Fujitsu in Gresham, Oregon (1,000,000 square feet, $1.3 billion construction, completed in 13 months) required Designing and building clean room environments with far higher requirements than healthcareLearning how to produce and manage airflows with very high volumes (e.g., clearing all the air in a large room every minute) and low airflow velocities (e.g., no experience of air blowing around)Fanatical attention to controlling particulates,

which in turn led to the invention of a new approach to managing airborne pathogensInnovation

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*The challenge of building Paul Allens Experience Music Project (EMP) with Frank Gehry as architect (a building that could not have been built without CATIA computer design tools) yielded The first ever realization of full digital integration of the entire process of delivering an entire facility, from first idea to final productThe resulting 100% engineering and 100% fit produced huge time and money savingsThe EMP was an extreme proof of concept If we can build that, we certainly can build medical facilities with the same methods.

Chris Rafterys InspirationsInnovation

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*A New Kind of Healthcare Facility, and a New Way of Building ItInstead of deploying an army of skilled designers and craftspeople, contractors, project managers, bookkeepers and accountants, lawyers and others, who hand-craft each facility uniquely...CareCyte uses the computer-assisted design and manufacturing tools and processes used to build aircraft and the most technologically advanced buildings in the world to deliver customized, integrated healthcare facilities.

FacilityBoeing 777: The first 100% digital aircraft with over 3 million parts designed and pre-assembled on computers with CATIA

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*A Revolution in ArchitectureDigitalDesign& MfgrgCATIA made these projects possible for Frank Gehry; nothing like them had ever been built before.

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*Paul AllensExperienceMusic ProjectFirst, Design and Engineer

Design & Model

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*Next, Manufacture, Ship, Assemble; Everything Fits!!!

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Finally, Wrap the Structure

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*From the EMP to the CareCyte FacilityIn constructing the Experience Music Project, it became clear that a systematic approach to customized mass production of vastly simpler buildings (composed mostly of right angles and straight lines) was now possible.Building from a set of standardized components, the CareCyte System yields radically shorter construction times and lower costs, and a flexible, adaptable building superbly suited to todays healthcare challenges.

Innovate

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*A System of Integrated Building ElementsTheFacility

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*For Example, in Your Neighborhood TheFacility

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*Scalable, Flexible FacilitiesDeliveringHealthcareServices80x80 Treatment Module:3 multipurpose interventionrooms with supply / storageL1 recovery room5 multipurpose exam/prep/ L2 recovery roomsMD office / work spaces

80x80 Clinic/Primary Care Module:10 multipurpose exam/prep/ L2 recovery/emerg. treatmt1 major Dx/Tx room1 large conference/classroom3 offices, 3 nurse / workstationsLobby / reception / waiting

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*Service Delivery in a CareCyte FacilityHow? Cellular design around care pathways and interactions between patients and practitioners.Value-Streaming Patient FlowsShift from this... to this

Operational BenefitsReduced steps and cycle timesFewer handoffsIncreased predictabilityClearer commitmentsSmaller staffsImproved outcomes

Facility ImpactsSmaller footprintFewer dedicated spacesDissolve departmental fragmentation

DeliveringHealthcareServices

Enter for services

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ORimagingclinicERadmittingClick and follow the green dot (a patient) as s/he interacts with administrators (yellow) and clinicians (blue).*Patient Flow for Pre-Admission Testing in a Superior Conventional Facility

room typecapacityoperating rooms2diagnostic modalities4exam/observ (incl. emergency/OR/clinic)15beds24total area (sf)59,276

servicesmetricsadmission1steplab/ECG/PFT/x-ray12 stepsconsult2 stepstotal steps15 stepspatient movement680 feettotal patient time200 mins

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ORClinic/ER/Dx30 BED Acuity Adaptable Unit single bed rms(shown)

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42 BED Inpatient Unit Incl. 6 single bed rms and 12 three bed rms Half the size

Patient Flow for Pre-Admission Testing in a CareCyte Facility*

room typecapacityoperating rooms3diagnostic modalities(not including portable modalities)2exam/observ (incl. emergency/OR/clinic)15beds30total area (sf)28,750

servicesmetricsadmission1steplab/ECG/PFT/x-ray3 stepsconsult2 stepstotal steps6 stepspatient movement170 feettotal patient time80 mins

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*Dave Chambers Prototype Hospital Initiative - Resetting Expectations for Traditional Hospital ConstructionEfficiency& CostsBased on the outcomes of this effort, Sutter Health is now building five facilities implementing the same principles.

Goal MetricCurrent BaselinePrototype Hospital Team ExpectationsStaffing Efficiency-Total FTEs442253.2-Adjusted Patient Discharges (APDs)71358742.3-FTEs per APD (CMI modified)0.0540.029Area (Efficiency of Program)-Area (BGSF)114.660100.611-Area per Bed1,9111,677-Area per APD16.0710.44Construction Cost-Construction Cost per SF$650.00$370.00-Construction Cost per Bed$1.242M$0.62MOther Measures-Time to Build (Design, Permitting, Construction)72 months plusLess than 48 months-Energy UseMeasures include Electrical and Natural Gas25% decrease

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*CareCytes Next-Generation Healthcare FacilitiesOur radical innovation enables new care delivery models Smaller and less expensive to build and operateCut 60% or more from the cost of constructing a healthcare facility Cut 35% or more from the overall operational costs of delivering services Adjust the configuration of the facility as practices changeIncreased care delivery efficiency and efficacyLayouts and configurations based on value streams of patient flowImprove staff productivity and minimize patient movement Increase patient (and staff) safetyDesigns optimized for healthcare service deliveryService the entire facility without interrupting patient careNear laminar air flows offer superior control of airborne pathogensPlug and play for networking, telemedicine, and other coming technologies

Summary

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*OpportunitiesMeet the challenges of building your new facilityA state-of-the-art facility that will remain up-to-date by accommodating new practices and technology, and through easy modification and expansionEstablish your identity as an industry leader and innovatorIncrease your scope of services through lower capital and operating costsA simple and elegant solution to difficulties in fund-raising

Partners

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*Whats Next? What possibilities does CareCyte open for you? Plans for new facilities? Renovations planned? Service delivery productivity? Opportunities for new/expanded services? Expanded market reach? What would you like to do next?

Action

CareCyte

The Next Generation of Healthcare Facilities Copyright 2007-9, CareCyte LLC.All rights reserved worldwide.

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