A program that seeks to redefine best practice across the drivers of the GenesisCare business (Quality, Access and Efficiency) in order to deliver on their vision of “Innovating Healthcare. Transforming Lives.”

1. Cancer Care Service of the Future
GC UK Clinical Collaborative
November 2016

3. Genesis CancerCare is the largest private provider in Australia
‒ Provides radiotherapy services at 27 sites, with 55 linear
accelerators across all major Australian states
‒ Medical oncology services in WA and NSW (11 chairs)
‒ c.700 full time employees (incl. doctors)
‒ c.340k attendances p.a.
(1) Includes shared care arrangements in Victoria.
GenesisCare is the leading provider of essential, high quality cancer
services in the Australian market
Strong reputation for clinical excellence
‒ Achieved through continuous improvement and innovation in
technology and treatment
‒ Well-established and defined clinical governance framework
‒ Focus on delivery of quality patient outcomes
Commitment to research
‒ c.47 clinical trials currently in progress
‒ Contribution to over 1,000 peer reviewed publications
‒ Partnership with TROG Cancer Research, a leader in
radiotherapy research
Strong public sector relationships
‒ Partnering with government to deliver unique solutions
‒ 8 State Government public private partnerships(1)
‒ A number of additional PPP opportunities identified

4. 4
What is the CCSOF about?
 The Cancer Care Service of the Future (CCSOF)
─ A program that seeks to redefine best practice across the drivers of our business (Quality, Access
and Efficiency) in order to deliver on our vision of “Innovating Healthcare. Transforming Lives.”
 The project provides a platform to:
─ Ensure sustainability & growth of the network despite declining reimbursement
─ Enhanced service offering to patient and referrers
─ Better and more engaging place for our staff to work
─ Provide opportunities for leaders to live our vision and values
─ Development of our brand around quality, outcomes and research
─ Support the development of a globally scalable service model into regions of need
CancerCare
Service of
the Future
Quality
AccessEfficiency
• Innovative, low-
cost operations
• Easy access for all
• High-quality,
evidence-based care
Page 4

5. Page 5
Our vision for the CCSOF is informed by overseas centres of
excellence who are innovating service delivery
Outcomes Reporting
McLaren / Karmanos
Detroit, USA
Rapid Access
Sunnybrook Hospital
Toronto, Canada
Care Pathways
Laval Integrated Cancer Centre
Montreal, Canada
Research & Quality
The Christie
Manchester, UK
Automation &
Throughput
Private Radiotherapy Centre
Metz, France
Adaptive RT & EPID
Dosimetry
Lake Constance Radiation
Oncology Centre
Singen, Germany

6. CCSOF Vision: What does success look like in 3 years?
Page 6
 Patient satisfaction 90%+ NPS
 Patient outcome reporting (Staging, intent,
QOL, control) for key tumour streams
 5% of patients enrolled in clinical trials
 100% NSQHS and RO Practice Standards
accreditation
 Avg. radical case wait time 5
business days from RFC
 Support existing and pioneer
introduction of new treatment
modalities: e.g. DIBH, SRS/ SBRT,
Dose guided RO, MRI Linac
 Develop Wellness / Survivorship / Allied
Health programs
 High utilisation of VMAT and
IMRT treatments
 Improved Linac utilisation
 Clinical productivity
improvement
 Shared services costs decrease
as % of revenue
 Performance reporting to key referrers (wait times,
patient satisfaction, outcomes)
 Reduction in Other costs (Equip.,
medical, rent, OH, etc.) as a % of
revenue
 Leadership development program for
Staff and Doctors
 Employee engagement 70%
 GenesisCare Foundation to support R&D
and Access
 Rapid Access Palliative Service
(“See, Plan, Treat”)
 Standardised care pathways for
90% of courses
 Measure and report adherence to
clinical guidelines (NCCN, EviQ)
 Comprehensive marketing, communications and education
program to share key messages on services and outcomes

7. Page 7
CancerCare Service of the Future case study
Advances in technology and workflow are delivering on Quality, Access and Efficiency
Comparison of treatment options
Situation: 84 y.o. Italian man with extensive metastatic cancer, widespread pain and a poor quality of life
Outcome: The patient received VMAT palliative treatment at GenesisCare less than 2 days after referral
Public facility
GenesisCare
facility
Technique Photons &
Electrons
VMAT
Planning time 2 Weeks, manual 30min,
automated
Quality
Assurance
time
1 week 1 day
Dose
distribution
Non personalised Highly
personalised
Normal tissue
avoidance
Difficult to
achieve
High level of
avoidance
Time on couch 40min/day 5min/day
Doctor
satisfaction
“The VMAT plan on this patient is better than the IMRT plans we see on our curative patients….” – Dr. M
Complex disease,
conformal treatment
Lungs, Heart, Spinal Cord all
protected from higher doses

8. Page 8
The world needs a high quality, efficient radiotherapy provider to
improve access to care for billions of people
Note: “West” defined as North America, Western Europe, and Southern & Western Pacific (ANZ); Blanks are where linac data unavailable; GDP figures normalised (PPP).
Source: World Bank 2015 population and GDP data; IAEA Directory of Radiotherapy Centres (2015)
Linacs per million people
(2015)
People without Australian levels of access
(2015, billions)
GDP per capita
(2015, USD PPP)

9. Reimbursement (Andrew Saunders) Communication (Amy Hallam) Procurement (Finance – Peter Moore)
Leadership & Culture (Natasha Winton, Monica Lonergan)
Business intelligence (Mike McFadden) IT Platforms (Thomas Pinn, Denise Hunt, Fraser Hughes)
CCSOF SteerCo: Keith Hansen (Chair), Aldo Rolfo, Andrew Saunders, Mike McFadden, Project Leads, HR, IT, CC project mgr.
8 key CCSOF workstreams to deliver the program, with several key
supporting enablers
Patient Experience
Access &
Engagement
Centre Structure,
Mgmt. & Tools
Care Pathways &
Outcome
Reporting
Planning Room of
the Future
Research & Trials Quality & Safety
Physics Service of
the Future
Key Driver Access Access Efficiency Quality / Efficiency Efficiency Quality Quality Quality / Efficiency
Project Leads Ada Ryan Andrew Saunders Kate Evans Aldo Rolfo Aldo Rolfo & Mike
McFadden
Peter O’Brien & Sophie
Mepham
Peter O’Brien & Joan
Sheppard
Aldo Rolfo & Brendan
Hill
Key projects /
initiatives
• Best practice patient
experience (“Just
Start” projects)
• Patient journey
mapping and gap
analysis
• Enhanced physical
environment
(Wembley refurb)
• Partnerships with
consumer groups
• Patient portal
• Wellness /
Survivorship
• Project Destiny
(education & comms.)
• Best practice referrer
communication,
including performance
reporting
• Referrer portal
• Service differentiation
• GP education
• GC Foundation
• Org. structure
• Role structure, clarity,
re-design
• Leadership training
• Performance Mgmt. &
Dev.
• Throughput
• Site mgmt. tools
• Lean process review
• Dashboards
• Playbook & Training
• Rapid access workflow
• PS/nursing w’flow
• Care pathways
• RO Portal
• IQ Scripts and
standardized
workflows
• Minimum data sets by
tumour stream
• Outcomes data
reporting
• VMAT implementation
• SMART Planning
validation and
implementation
(GenPlan, DVP+,
GenPrinter,
GenReconciler)
• Sim-to-QA workflow
• Auto contouring
• Planning quality
benchmarks
• Best practice planning
room
• Clinical trials
engagement
• GC Foundation
• Expanding the role of
Radiotherapy
• Partnerships (TROG,
Elekta, ECU etc)
• NSQHS accreditation
• RO practice standards
• Automation of
auditing
• New technology
assessment (e.g.
PerFraction)
• RS reporting and
governance
• Role in planning
• Daily patient specific
QA (e.g. EPID)
Key KPIs  Patient satisfaction
 % sites offering
wellness services
 Partnerships
 Testimonials
• Linac utilisation
• Growth in courses
• Performance reporting
• Referrer satisfaction
• Letters out in 48hrs
• Time to Tx
• Linac utilisation
• DLH / Tx
• Non Dr Rem %
Revenue
• Staff engagement
• Guidelines adherence
• Data capture
• Outcome reporting
• Care path utilization
• IMRT / VMAT rates
• Time to Tx
• Plan quality
• Planning times /
efficiency
• Adaptive treatments
• % patients enrolled in
clinical trials
• Abstracts accepted
• Papers published
• Grant $$$
• Accreditation
• Workforce efficiency
• WHS compliance
• IMRT / VMAT rates
• Workforce efficiency
• Time to Tx
• Plan quality
1 2 3 4 5 6 7 8
a
b c
d e f
Enablers
9

10. Page 10
KPI: Patient satisfaction 90%
Engaging more deeply with our patients is having a meaningful impact on patient satisfaction
People &
Culture
Distinctly
positive
experience
Coordinated
Care
Expedited
Time to
Treatment
Wembley
refurbishment
and multi-
disciplinary pod
model
“Just Start”
initiatives and
deep patient
engagement

11. Page 11
KPI: Patient outcome reporting and care pathways
Drives continuous clinical improvement
Input of Clinical/Administrative data
(Manually / Automatically)
GC UK DataBase
Input of Clinical/Administrative data
(Manually / Automatically)
Insightive software with a dynamic analysis of data
(Varian & GenesisCare algorithms)
Input of patient data by the patient
(Manuually / Automatically)
Care Pathways &
Outcomes Reporting
Platform
Clinical consensus
on treatment
protocols
Automated Care
Pathway via the
Electronic Medical
Record
Collate structured
patient data
(internal &
external)
Collect patient
reported
outcomes via
portal
Structured big
data accessible in
real time

12. Page 12
KPI: GenesisCare Foundation to support R&D and Access
GenesisCare board have approved the establishment and launch of the GC Foundation
Our new partners CRG and Macquarie Capital have kindly donated $5m of
seed funding to commence the GenesisCare Foundation
• Commitment from GC Board to provide further annual funding
• Foundation will be established to receive tax-deductible gifts
Foundation will have two main focus areas of health promotion:
• Research: Support a strong clinical trials program
• Access to Care: Committed to supporting disadvantaged patients receiving
access to care
More details will be shared in the coming months on this fantastic initiative!

13. Page 13
KPI: 100% NSQHS and RO Practice Standards accreditation
We are building a culture of Quality and Safety
 Accreditation achieved at NSW, QLD; others to be
completed by late 2016
 Self-assessment completed across GCC against
the Tripartite Standards
 All Practices using Riskman to report and manage
clinical and organisational risks
 Risks reported monthly to Board, Clinical Leaders
Forum and state-based Clinical Management
Committees

14. Page 14
KPI: Leadership development program for Staff and Doctors
Leadership development for doctors and leadership across practices is underway
Doctor Development Program
Enrich, support, encourage and challenge doctors
to be better leaders
GC Leadership & Mgmt. Development
Provide training and tools for our leaders and staff
to develop
CC Leadership Team Challenge
Experiential learning to help leaders reflect, coach,
manage, lead and engage
“Benefits of the DDP [include]:
• Empowering others and giving them responsibility
• Being more proactive with [performance management] and
rewards.
• Accepting that I am GenesisCare, [and] I really want
GenesisCare/myself to be successful”
- Radiation Oncologist
LEAD program
Management
Essentials
Program (MEP)
Performance
development &
management
training
Project
management
training
Resilience &
Comms.
Training
Watch this space for
future programs…

15. CT Sim Contouring Planning RT Plan QA
Physics Plan
QA
KPI: Avg. radical case wait time 5 business days from RFC
Automated tools will support increasing VMAT penetration while shortening the work day
Page 15
CT Scan Simulation for
treatment planning
Delineation of tumour
and organs at risk
Plan checking / QA -
Performed by RT
Generation of the
optimal treatment plan
Plan QA - Performed by
Physics
Leverage commercially
available auto-segmentation
software tools MIM Maestro
which uses Atlas based
contouring tools
GC scripts drive a automated
treatment plan through the
Pinnacle Treatment Planning
system
Developed in house plan
checking tools (DVP+,
Reconciler and Printer)
Facilitate a simple traffic
light report for RT review
Automated Phantom free
IMRT QA through direct
measurement of dose on the
EPID Panel
Automated;
• Dose capture
• QA processing
• Alerts
GC
Automation
Projects

16. 20%
30%
40%
50%
60%
70%
80%
31/01/2016 29/02/2016 31/03/2016 30/04/2016 31/05/2016 30/06/2016 31/07/2016
Total Target (month end)
Page 16
KPI: High Utilisation of VMAT and IMRT treatments
Teams around the network have mobilised to shift patients to the best treatment protocols available
“In my public centre I struggle to
get 3DCRT plans for my palliative
patients. I would love to have
VMAT but it seems years away”
Doctor
“Moving to IMRT/VMAT has allowed
us to reduce patient Out of Pocket
costs by up to ~20% (depending on
treatment type, course length, etc.)”
Patient Services Officer
“I can produce a high quality
plan in 30 minutes with VMAT.
3D CRT would not even get
close!”
Planner
Case study: South Terrace ST3
% VMAT Treatments
Average tx time
Combining Quality (more personalised), Access (greater capacity)
and Efficiency (faster treatment times)

17. Page 17
KPI: Support existing & pioneer new treatment modalities
We continue to invest in a wide range of new treatments, including DIBH, SRS/ SBRT, Dose guided RO and MRI Linac
First MRI Linac in Asia
• Supporting Hypofractionation & New Indications
(Pancreas, Liver, Sarcomas)
Roadmap to Adaptive Radiotherapy
• Quality Assurance (QA) for every patient, every day
• Ensures personalised targeting and dose delivery
Deep Inspiration Breath Hold (DIBH)
• 1 site in July 2015, 100% in April 2016
SRS/SBRT treatments
• 2 sites in 2014, 50% in April 2016
2015 - 2016 2017 and beyond

18. Page 18
KPI: Develop Wellness / Survivorship / Allied Health programs
Live Life Get Active FREE Exercise programs with
Olympian Jane Flemming in x3 locations
Cancer Council NSW FREE 8 week survivorship
program launched at Hurstville
Working with PCFA on a trial to investigate the benefits of
exercise for people with cancer
(ECU) Health and Wellness Institute’s exercise clinic at
GenesisCare, Shenton House.

19. KPI: Comprehensive marketing, communications & education
program to share key messages on services and outcomes
Interactive educational content, available via web /ipad, and integrated in the care pathway
Page 19
‘Informed consent’ online tool for doctors
to walk patient through a radiation therapy
treatment consultation
A patient resource website to expand on
radiation therapy treatment information
provided during consultation, to help make it
easier for patients
+
Interactive educational content for
patients, their families and carers
Available on a variety of formats
Integrated as part of the care
pathway
• Used by doctors, nurses, patient services to assist
with engagement around key aspects of care
coordination
• iPads, web, mobile
• Patient stories: actual patients telling it like it is
• Pathway videos to demystify the treatment process

20. Page 20
KPI: Employee engagement 70%
We recognise how important staff engagement is to the patient experience, and we are committed improving it
Employee engagement is trending upwards
67% of CancerCare
employees are proud to
work for GenesisCare
57% of employees believe
GenesisCare is a great
place to work
65% of employees agree
that GenesisCare’s new
vision of “Innovating
HealthCare. Transforming
Lives.” resonates with
them
Why does this matter? There is clear proof that this improves
patient satisfaction
HCP removed from regression due to low number
of responses to patient survey
R2 = 0.50
P values < 0.05
CC
HC
Legend

21. Page 21
KPI: Clinical productivity improvement of 30%
Improving our processes to allow us to work “smarter not harder” will provide faster access to treatment for patients and
allow us to improve clinical productivity
PATIENT SERVICES AUTOMATION
Replacing manual processes with automation to allow for
greater productivity and better patient experience
BEST PRACTICE PLANNING ROOM
Ensuring quick turnaround of plans so that no patient is
delayed for non-clinical reasons
PLAYBOOK / LEAVE PLANNER / BI TOOLS
Regular, consistent approach for our leaders to
review & improve operations
Practice
Playbook
Leave
planner
BI
dashboards
One team’
approach to
planning through
VPR
RO engagement
Quality and
efficiency KPI
management
Enabled by SMART
planning tools and
automated QA
EMDAT
Notification
Manager
Validation Engine PBRC automation
“A lot of administrative time is saved
by using EMDAT which will result in
more time spent on patient services
and efficiency in running a busy
practice.”
Patient services team CWA
Workstation model
Integration with
ePathology

22. CURRENT STATE
8am-5pm
~75-80% Utilisation
3 RT FTE
FUTURE STATE
8am-3pm
~95-100% Utilisation
3 RT FTE, with ½ day Planning / Training /Project
WHAT IT WILL TAKE
Smart Scheduling
No gaps in day, PSOs own bookings
Review treatment rosters
Workstation model for treatment staff
Activity codes Phase1
Matching scheduled treatment times to actual treatment time
National Best Practice Tx times
LEAN review of treatment process
Utilisation management
Dashboards, CL ownership
KPI: Ave. Linac utilisation 45 patients / machine / day
Ensuring our machines are fully utilised and have high ‘throughput’ to provide timely access to all patients
Improving our treatment times by just 1 minute per patient would provide ~24 hours of additional time across the network every day leading to:
 Capacity to treat over 100 more patients within our current working hours
 More time for project work/research
 Enhanced patient experience (less time on the couch)
WHY?

23. Page 23
KPI: 10% reduction in Other costs as a % of revenue
Through better coordination and innovation, we are taking advantage of our national scale to deliver better service and
cost savings
•Global procurement deal
for linear accelerators
•Improved EMR service
Equipment procurement
•Group ordering of key
medical consumables
•3D Printing of electron
shields & wax blocks to
reduce dependence on the
need for mould rooms
Medical consumables
•Telstra contract
renegotiation
•Concur Expense
Management
•BidEnergy energy bill
consolidation
•Travel
•Other national procurement
initiatives
National procurement
initiatives

24. Efficiency:
Innovative, low cost
operations
Quality:
High-quality,
best in class shared services
Culture:
Collaboration
Compassion
Innovation
Outcomes
Access:
Easy access
for all
 Payroll processing accuracy > 99.61%
 Shared service feedback score > 8/10
 Mosaiq uptime 99.99% (from 99.86%)
 Shared services costs as % of revenue
4.5% (from 5%)
 Automated, self-service site-
based P&L’s and per patient cost
of delivery
 Month end close of 3 days (from 15 days)
 HBO Cost per employee $2,000 (from
$2,700)
 BI: dashboards for activity reporting, time-to-treat, HC
quality data
 Comprehensive clinical outcomes
reporting
 Insights and analytics for the top 200 actual and
potential CC referrers and 20,000+ HC referrers
to enable increased share of wallet
 Labour utilisation reporting to drive
Non-Dr Labour cost as % of revenue
21% (from 32%)
 Patient satisfaction 90%
 Leadership development program for
Staff and Doctors
 Staff engagement 80%
 Service Desk response & resolution
time met 95% of SLA
 Finance Accuracy rate 9/10
 Performance reviews
undertaken for 100% of staff
New Finance System (ERP). HR Systems (HRIS)
BI Project Management (PM)
KPI: Shared services costs decrease by 15% (as % of revenue)
Project Monarch will deliver improved service levels, efficiency and scalability for Shared Services

25. Thank-you

26. Page 26
This year’s Collaborative is about showcasing the efforts
that all of you are making to drive the CCSOF
Patient
Experience
Access & Engagement
Centre Structure,
Mgmt. & Tools
Care Pathways &
Outcome
Reporting
Planning Room of
the Future
Research & Trials
Quality &
Safety
Physics Service of the
Future
Key Driver Access Access Efficiency Quality/Efficiency Efficiency Quality Quality Quality/Efficiency
Project Leads Ada Ryan Andrew Saunders Kate Evans Aldo Rolfo Aldo Rolfo & Mike
McFadden
Peter O’Brien & Sophie
Mepham
Peter O’Brien &
Joan Sheppard
Aldo Rolfo & Brendan Hill
Presentations • An Oxford-
based case
study on the
initial clinical
and patient
experience of
the
Information-
Guided Care
Coordination
(IGCC) system
• Consumer
Engagement
Journey &
Wembley re-
development
case study
• Improving
patient care
through
resilience
training for
staff
• Spanish Cyberknife
experience in Stereotactic
Body Radiation Therapy
• DIBH in Victoria: 12 months
post implementation
review
• 11.40am The development
of an iPad application to
educate paediatric cancer
patients about radiation
therapy
• AccessiBull radiotherapy for
Central Queensland
Patients
• Sequence Reversal:
Preoperative Radiotherapy
for Breast Cancer patients
• Prone Breast technique
implementation and the
verification of medial
breast dose
• Rapid Access at Nambour –
our experience so far and
future directions
• From Rock Bottom to Rock
Stars: The effect of
improving workplace culture
on patient satisfaction
• Stress, satisfaction and
burnout amongst Australian
and New Zealand Radiation
Oncology trainees: what
next?
• Breaking New Ground:
Reflections from our first
Cancer Care Nurse
Consultant
• Managing increasing patient
numbers with decreased
time slots
• Collaborative Continuing
Professional Development
• New Paradigm in
Leadership: non-RT Centre
Leaders “The good news is,
great minds don’t think
alike…”
• Improving communication
between Physics,
Engineering and RTs
• RO Portal
Demonstration and
Care Pathways
• Breast Hypo-
fractionation and
Breast Care Pathways
• A Demonstration of
MIM Maestro
• Planning room of the
future – Centralized
Planning in action
• GenPlan - The Next
Generation
• Audit of Palliative
VMAT utilization at St
Vincent’s Sydney from
2008
• How can we evaluate
advanced MIM
modules using
deformable image
registration
applications? Any
ideas?
• Cost minimalisation
analysis (CMA) comparing
adjuvant radiotherapy
(RT) with endocrine
therapy (ET) in elderly
patients with oestrogen-
receptor positive, low
risk, early breast cancer.
• MRI for Breast
Lumpectomy Cavity
Delineation: CT
Comparison and
Sequence Variation
• An update on the
prospective analysis of
SpaceOAR hydrogel rectal
spacing and rectal toxicity
in the treatment of
prostate cancer at
Genesis Cancer Care
Victoria
• A Comparative Analysis of
FB-IMRT to DIBH-IMRT
Left Breast Irradiation:
Exploring Cardiac and
Lung Dose
• Impact of research on
workspace culture
• Zooming in on
Clinical
Governance
• Training of future
Physicists at
ARC/GenesisCare
• PerFraction - EPID based
IMRT/VMAT QA of the
future
• Treatment planning QA
models
• Moving to standardization
for acceptance and
commissioning for Elekta
linear accelerators
• Clinical case study with
implementing deformable
dose accumulation
strategy: An example of
4D evaluation in the case
of liver SBRT
• Physicists in the planning
room – insights from a 3-
month placement
• Why do we “Care”?
Insights from quantum
cosmology and
applications in the
CancerCare Physics
Service of the Future
1 2 3 4 5 6 7 8

27. Page 27
Appendix