TM The Problem We Solve The demand for physical therapy is exploding at such a rate the industry must turn to technology to meet this growing need and expand the tradi8on reach of therapy from the clinic to the home. A rapidly aging popula8on, the increasing incidence of diseases driven by sedentary lifestyles, and stunning medical advances in joint replacement are all contribu8ng factors to this dilemma. Pa8ent engagement required for high eﬃcacy both in clinic and at home is a cri8cal challenge in solu8on design. Armed with low cost sensor technology through the use of Microso;’s Kinect for Windows mo>on sensor, Respondesign has created FitWorld to address these challenges for both the physical therapist and the rehab pa>ent. Kinect for Windows is now a rapidly maturing commercial hardware & middleware plaForm through which we deeply integrate our solu>on for clinic & home therapy delivery. Highly Conﬁden8al – Respondesign Inc. – Copyright 2013
TM Our Solu>on Respondesign’s rehab solu8on provides physical therapists a tool to deliver an engaging, personalized rehab program that includes pa8ent monitoring & clinician repor8ng. Equipped with MicrosoP’s Kinect for Windows mo8on sensor, rehab facili8es are able to deliver a consistent care oﬀering for the pa8ent both in the care facility and at home. Highly Conﬁden8al – Respondesign Inc. – Copyright 2013
TM BePer Rehab Fitworld increases therapist produc8vity through automa8on tools that provide data and results. Therapists can quickly assign a series of therapeu8c exercises. Through deep integra8on with the Kinect for Windows mo8on sensor Fitworld logs evidence of the prescribed treatment documen8ng date, 8me, movement, repe88ons, dura8on and other details, stored in a pa8ent’s secure record on the Fitworld cloud service. For pa8ents, the visual and audio feedback along with scoring for accurate performance is empowering and encouraging of a deeper par8cipa8on in the rehab experience. -‐ Automated Care Delivery -‐ Improved Pa>ent Experience -‐ Evidence Based Tracking & Repor>ng Highly Conﬁden8al – Respondesign Inc. – Copyright 2013
TM Fitworld TM Fitworld was designed for easy access for both the healthcare professional and pa8ent home use as a cloud-‐based app with mul8ple levels of access authority. In a clinical seWng accompanied by a physical therapist Fitworld for rehab requires a Windows computer with MicrosoP’s Kinect for Windows mo8on sensor. At home the client can access Fitworld for Rehab without Kinect on a SmartTV, Mac, Android or Windows PC using any web browser. PT Administered In Facility Pa>ent Performed At Home Without Kinect Highly Conﬁden8al – Respondesign Inc. – Copyright 2013
TM Rehab Demand Drivers Geriatric Elderly Popula8on Orthopedic Rehab Physical Therapist Growth On The Rise Shortage 39.6 Million 262% +27% to Increase in Hip & Knee Replacements 2006 -‐ 2015 72.1 Demand Growth Health and Human Services Administra8on of Aging by 2016 Musculoskeletal Condi8ons $510 Billion 18% Million by 2030 Cost Of Treatment $399 Billion PT Jobs Are Open 19% of US Popula8on by 2015 In Lost Wages Bureau of Labor Sta8s8cs, APTA, Forbes 2009 Na8onwide Inpa8ent Sample (NIS) The Burden of Musculoskeletal Diseases in the United States, 2004 Report These challenges will increase as 30 million new people enter the healthcare system in 2013 via Obamacare. Highly Conﬁden8al – Respondesign Inc. – Copyright 2013
Rehab Market TM Outpa8ent Inpa8ent Home Care Hospital IRF 16K Clinics Skilled Nursing Facility 23K loca8ons Contract Rehab Manager Top 6: 6,927 loca8ons Highly Fragmented Least expensive, Hospitals: 4,900 fastest growth $20B in Revenue Assisted Living: 20K Nursing Homes: 16K $57B in Revenues CCRC: 2,000 Highly Conﬁden8al – Respondesign Inc. – Copyright 2013
TM Rehab Market -‐ Outpa>ent The outpa8ent rehabilita8on therapy industry in the US consists of about 30,000 establishments with combined annual revenue of approximately $20 billion. The industry is highly fragmented, with the top 50 companies accoun8ng for less than 25 percent of total revenue. The outpa8ent rehabilita8on industry accounts for nearly $5 billion of Medicare spending. This ﬁgure has been rising steadily, and has more than doubled since 2000 when annual rehabilita8on expenditures were $2.1 billion.* • Highly fragmented U.S. outpa8ent rehab market, over 16,000 clinics. • No outpa8ent company with more than 6% market share. • Three largest outpa8ent rehab companies: − Select Medical 952 clinics − Physiotherapy Assoc. 657 clinics − USPh 419 clinics * Brocair Partners – Overview of the Outpa6ent Rehabilita6on Market 2011 Highly Conﬁden8al – Respondesign Inc. – Copyright 2013
TM Rehab Market – Inpa>ent Customer Customer: Genesis Rehab Services Objec8ve: Falls Preven8on Solu8on: Balance In Ac8on Otago Exercise Program. Fitworld based version of the Otago exercise rou8nes that are now in use worldwide*. A muscle strengthening and balance-‐retraining exercises of increasing diﬃculty, combined with a walking program. Evidence-‐based: Fall rate was reduced by 35 percent among program par8cipants*. Genesis is currently beginning internal trials. Genesis’ “Balance in Ac.on” (BIA) system will be implemented in over 1,100 cap.ve and outsourced rehab facili.es na.onwide. Source: CDC, Campbell, et al. and Robertson, et al Highly Conﬁden8al – Respondesign Inc. – Copyright 2013
Rehab Market -‐ Inpa>ent TM Long Term Acute Care Hospitals & Inpa>ent Rehab Facili>es Currently there are 47.6 million Medicare beneﬁciaries with an es8mated 9,100 individuals added to the program each day 35% of Medicare Beneﬁciaries Are Skilled Nursing & Discharged From Acute Hospitals to Post-‐ Rehab Centers Acute Care Pa8ents ﬁrst Pa8ent use of site of discharge site during 90-‐ aPer acute day episode: care: 52% Skilled Contract Rehab 41% Skilled Nursing Nursing Manager RTI, 2009: Examining Post Acute Care Relationships in an Integrated Hospital System Kindred Healthcare, November 2012 Highly Conﬁden8al – Respondesign Inc. – Copyright 2013
TM Rehab Market – Home Care Home Health care industry includes about 23,000 establishments (single loca8on companies and branches of mul8-‐loca8on companies) with combined annual revenue of $57 billion. Demand Drivers Include: • Aging popula8on: 10K US ci8zens become eligible for Medicare each day • High cost of skilled nursing facili8es • Rise of accountable care organiza8ons (ACO) that coordinate care to increase eﬃciency and reduce costs • Innova8on and leveraging the use of technology is a repeated industry theme Gen6va Corp. Investors Presenta6on , December 2012 Pa8ents ﬁrst Pa8ent use of Lower Cost Per Day site of discharge site during 90-‐ vs. Hospital & SNF aPer acute day episode: care: 61% Home 37% Home Health Care Health Care Kindred: RTI, 2009: Examining Post Acute Care Rela8onships in an Integrated Hospital System CMS HCIS data ﬁles for 2006. Hospital data includes PPS and non-‐PPS. Home health day Highly Conﬁden8al – Respondesign Inc. – Copyright 2013 calculated based on 60-‐day episode
TM Fitworld -‐ Business Model Learning from the Genesis deal and understanding their model for care delivery we have developed a license based business model for Fitworld. This model is based on a site/seat based license fee along with professional services fees for content and feature customiza8on. Home use of Fitworld with repor8ng to their rehab clinician and popula8on repor8ng to Genesis Rehab administra8on could be billed to user directly or to the user’s “payor” based on monthly usage. The Genesis deal was ground breaking and ﬁnancial terms were not op8mal. They are a strategic partner and we agreed to exclusivity for one year for “elder care falls preven8on” rehab category. Highly Leveragable Architecture The Fitworld plarorm is purpose built to allow for the integra8on of several categories of proscribed rehab ﬁtness as well as general ﬁtness & injury preven8on. With its’ cloud app architecture and real-‐8me content delivery model, Fitworld is highly customizable for both features and content allowing for rapid deployment and single point of delivery for new feature deployment. Compe>>ve Advantage Respondesign’s advantage is our speed to market, ﬂexible architecture and support for rehab clinician program design and publishing. We have deep integra8on with the Kinect mo8on sensing technology through a deep technical and market development partnership with MicrosoP’s Kinect for Windows group. Our management team has signiﬁcant soPware start up thru public company experience in developing and deploying consumer facing enterprise plarorm soPware. Highly Conﬁden8al – Respondesign Inc. – Copyright 2013
TM Management Team Ted Spooner -‐ CEO: Co-‐founder of RDI with company development experience ranging from start-‐up to IPO. SoPware development experience in both enterprise and consumer facing applica8ons. As founder and CEO, Ted took Corillian, Inc. public in 2000 (Nasdaq: CORI). Corillian was sold to CheckFree (Nasdaq: CKFR) in 2007 for $245m. John Grispon – EVP Sales, Marke>ng & Business Development: Co-‐founder with a demonstrated capacity to lead organiza8ons ranging from a ﬁrst-‐year start-‐up to a global soPware giant. Previously he founded Brain Thaw, a marke8ng consultancy for start-‐ups, ran the business development division of Corillian, Inc., the online banking pioneer now part of Fiserv, and spent nearly 12 years at MicrosoP Corpora8on with his last post as Worldwide Banking Industry Manager. Jason Leighton -‐ CTO: RDI co-‐founder and game industry veteran of over 15 years, Jason has been at the forefront of emerging technologies right from the beginning of his career. The ﬁrst game series he worked on, "Descent", went on to become one of the bestselling and most iconic games of a genera8on. Jason has worked for THQ, Atari, and Interplay, in both management and senior developer roles. He has been Respondesigns Chief Technology Oﬃcer since 2003 where he directed the eﬀorts that led to "Yourself Fitness" and the mul8-‐million selling UbisoP 8tle "My Fitness Coach". Highly Conﬁden8al – Respondesign Inc. – Copyright 2013
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