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(Address of the President of Medicina Clinic Grigory Efimovich Roytberg)

Dear patients, partners and colleagues,
Creating a serious and interdisciplinary clinic is a long and multi-stage process. Since 1990 Medicina Clinic has been
consecutively developing in order to change patients’ perception of the quality of health care provided. We combine
the experience of the best Russian and foreign hospitals thanks to the key value of serving our patients. Introduction of
the world’s best practices aims to help the Clinic to change, improve and always go ahead by keeping the dialogue
with patients going and taking into consideration the issues that are really important for them.
It is not accidental that Medicina JSC is the first Russian clinic accredited by the Joint Commission International (JCI).
Currently, there are a bit more than 440 foreign hospitals that are accredited according to JCI standards, i.e. meet the
world’s highest standards. Joint Commission International Accreditation is the most objective and prestigious health
care certification, which serves as the evidence of conformance of a medical institution to medical and administrative
standards approved at the international level and, also, to the requirements for securing international patient safety
goals.

In 2010 the Clinic became a laureate of the Russian Government Quality Award. Medicina JSC is certified according
to international standards (its Quality management system is certified according to ISO 9001:2008; it is also a winner
of a Recognized for Excellence ***** (5 stars) Award according to the European Foundation for Quality Management
(EFQM) Excellence Model.

The Clinic’ activities are characterized by unprecedented openness and the dialogue we keep with our patients.
Patients can review their health records online, receive videos of surgeries and examinations on DVDs and assess
doctors’ activities at www.medicina.ru. The demand for such dialog is steadily growing.

Medicina Clinic is an organization whose activities are aimed at ensuring social accountability, i.e. accountability for
the quality of patients’ life and tranquility of your near and dear ones as well as accountability for introduction of the
most effective diagnostic and treatment methods that are currently applied throughout the world and for creation of a
favorable environment that would contribute to a treatment process. We give people the opportunity to choose the
quality and service in health care and, what is even more important, the attitude to their health. Certainly, our services
are not affordable for everyone. However, if we speak about the services provided to people living nearby under
mandatory health insurance programs, they are rendered at lower rates and are free for patients.

It is not only care for patients’ desires and demands that characterizes “health care with a human face”. It is important
that the Clinic supports the community where it works. In the first place, we orient towards creating favorable labor
conditions for our staff. Medicina Clinic provides unique opportunities for professional growth and research work. Our
employees get free medical treatment at the clinic.




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We respect the professional medical community, which is like a source of manpower for us, i.e., our colleagues who
control the quality of treatment at our Clinic and our partners. We organize free workshops for doctors from various
medical institutions.

We realize that being among the industry’s leaders we have a real opportunity to help those in need. And, what is
more, we have a big desire to do it. In 2011 the Clinic established a charity foundation providing assistance to medical
professionals - “Healthcare Fraternity”. Its uniqueness lies in the fact that a decision re. the recipients of aid is made by
medical staff on a voting basis.

The areas for the Clinic’s development are chosen on the basis of society’s demands. Thus, to improve Russian cancer
diagnostic and treatment standards it has been agreed that an oncology center of Medicina JSC should be established.
Early 2012 a new building comprising a hi-tech cancer center that is being built with the methodical support of leading
foreign clinics (Memorial Sloan-Cancer Center, USA, and Rabin Medical Center — Davidoff Center, Israel) will be
put into operation. This is going to be a model center that will incorporate all world’s recent innovative cancer
treatment technologies.

Innovations in ensuring the quality of medical care are the result of systematic work performed in all the areas of the
Clinic’s activities and an impetus for further development and improvement. Medicina Clinic’s achievements are
recognized by the most reputable foreign and Russian experts.

I would like to emphasize that all our achievements, awards and diplomas are only the tip of the iceberg at the base of
which there is every day work performed by hundreds of people that are united by an interest in something new, care
about patients and the desire to contribute to tailoring to patients’ needs. The most important thing about it is the
ongoing impetus to become better which makes you go ahead. Such impetus for us is the opinion of our patients.
Therefore, we have been making our best efforts to establish a dialogue with patients, using all possible
communications, for many years.

With thanks and kind regards,




Grigory E. Roytberg
President, Medicina JSC
RAMS academician, M.D., Professor
Honored doctor of the Russian Federation
Laureate of the Russian Government Education Award
Head of Therapy and Family Medicine Chair, RSMU




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(History of success)

History of the Clinic

Medicina Clinic was established in the early 90s of the 20th century. At first it was a small medical cooperative called
“Pulse” (“Puls”) whose doctors were providing emergency medical services using two ambulance vehicles. Then in
1993 after winning tender Medicina JSC moved to the 8-storey building in the heart of Moscow and has never
changed its location since that time. The building was redesigned and rebuilt; now it is a medical center comprising
two buildings, which is equipped with state-of-the-art facilities and which provides all major types of specialized
medical services to patients.

In 2011 Medicina JSC celebrated its 21st birthday. Throughout all the years of its existence caring about health,
extending longevity and improving the quality of life of Muscovites have been the No.1 tasks of the Clinic. To execute
these tasks we have been constantly improving our work and developing. We provide highly qualified medical care to
patients by using the best treatment traditions and most advanced technologies and study and adopt the experience of
the world’s best medical institutions.

Milestones
1990            Establishment of “Pulse” cooperative providing emergency medical services.
1991            Incorporation of Medicina Joint stock company at 31A Mosfilmovskaya St., Moscow
1993            Relocation to a building at 10, 2nd Tverskoy-Yamskoy per. No. of staff: 130 doctors. Opening of
                departments specializing in therapeutics, ophthalmology, X-ray and radiation diagnostics,
                physiotherapy and exercise therapy, dentistry, medical emergency care, laboratory, ENT.
1994            Opening of an acupuncture cabinet and introduction of a computer control system for 24 hour control
                and management over equipment and technological parameters of engineering systems.
1995            Opening of functional and ultrasound diagnostic departments, a pediatric section, a new pharmacy.
1996            Opening of an inpatient facility and surgery, which allowed the Clinic to get inpatient and polyclinic
                treatments interconnected; starting interaction with strategic partners – insurance companies.
1998            Launch of Magnetic Resonance Imaging machine, opening of a Health Center. Therapy and Family
                Medicine Chair of the Russian State Medical University (RSMU) is created on the basis of the clinical
                resources of Medicina JSC.
1999            Opening of the following new departments: Family doctor and Outpatient trauma, Surgery and
                Emergency care. Patients’ health records – kept electronically thanks to a new computer program.
2000            Completing the construction of a 3-storey superstructure of the Clinic’s building, opening of an
                inpatient facility and a surgery unit on the 9th floor, an inpatient section for children as well as
                increasing the number of beds for adults and starting oxygen barotherapy practice.
2001            Opening of an International Fertility and IVF Centre, a Trichology department, an Intravenous laser
                therapy room and an Ophthalmology center. Hi tech cardio-surgeries, extracorporal fertilization and




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auxiliary reproductive technologies – performed and implemented. The parties concerned start to
       elaborate and agree on the main areas of strategic development.
2002   Electronic health records system – fully implemented; statistic reporting – systemized; elaboration of
       own program “Medical Care Quality Management” based on BSC elements – in progress. Launch of
       charity densitometry program.
2003   Medical and economic standards were incorporated into the “Electronic health record” program.
       Territorial principle of rendering medical aid – introduced. Continuity principle (“One doctor – one
       patient at the Polyclinic and at the Inpatient section”) – elaborated and implemented.
       The following methods were introduced: PCR (Polymerase chain reaction), CT (Computer
       tomography), genetic studies, laser treatment methods for ENT, ophthalmology, extracorporal shock
       wave therapy and IVF.
       The Clinic started to organize round table talks with insurance companies. The President of Medicina
       JSC delivered his first report re. review of results and prospects for growth.
2004   Management structure reorganization: upsizing medical services, creating a Service and Information
       Support Section, Purchasing and Quality Management Methodology Departments. The Clinic
       launched external respiratory function tests, virtual and capsule endoscopy, new laboratory methods
       and cryotherapy at RMD of the Clinic. Special gym equipment was installed at the Cardio
       Rehabilitation Center.
2005   Introduction of a health screening program for employees. Providing psychiatric aid and inpatient
       psychiatric treatment to this category of patients. Competition-based staff recruitment; launch of a
       “self-learning company” program.
       ISO 9001:2000 certification. “Designer Clinic” – “theater for single spectator”, all repairs are done
       with the involvement of a designer.
2006   Introduction of new medical technologies becomes a systematic process.
2007   “Swiss” Clinic in Moscow. In 2007 Medicina JSC successfully passed an international audit and
       became an official member of the Swiss Leading Hospitals Association. This milestone event serves
       as the evidence of the high quality of medical services that are rendered by Medicina JSC and meet
       European and international standards as recognized by Swiss experts.
2007   The Clinic started to use EFQM Model as a tool for improving its management system on the way to
       excellence: we study and use the world’s best practices, compare our activities with the best European
       and international clinics, introduce the best management models and technologies. This model helps
       us to evaluate our work using qualitative and quantitative approaches.
2008   Full-time member of the European Foundation for Quality (EFQM), confirmed its Recognized for
       Excellence 5* level according to the EFQM Business Excellence Model. “Dialogue with a patient”
       program.
2008   The Clinic obtained Recognized for Excellence 5* recognition according to the EFQM Excellence
       Model (the first and only five-star clinic in Russia).
2009   Laureate of the Russian Government Quality Award.
2009   Winner of the 5th International Quality Tournament among Central and Eastern European countries.
2009   The first and only Russian clinic that received “Russian quality” Diploma and Mark. This is a
       nationwide certificate confirming the high quality of services provided by Medicina JSC.
2010   The Clinic confirmed its Recognized for Excellence 5* level when it took part in ЕЕА EFQM contest.
2010   The Clinic’s audit to confirm its compliance with SLH (Swiss Leading Hospitals Association)
       membership criteria. One of Switzerland’s leading auditors Mr. Zinniger congratulated all the
       employees of Medicina JSC on passing the successful audit and the score exceeding 85% at the final
       meeting. The Clinic has reconfirmed its rights to be a member of the Swiss Leading Hospitals
       Association.
2011   The first and only Russian Clinic was accredited to the most reliable medical care standards of Joint
       Commission International. As of today, only 440 clinics throughout the world have got this
       accreditation.




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ABOUT THE CLINIC.

International recognition of quality
Medicina JSC is a private interdisciplinary clinic that has provided a wide range of outpatient and inpatient medical
services to patients since 1990. Medicina JSC is the only clinic in Russia accredited by Joint Commission International
(JCI). Currently, there are a bit more than 440 hospitals round the world that are accredited to JCI standards, i.e. meet
the highest world’s standards. JCI Accreditation is the most objective and prestigious international health care
certification which proves the conformance of a medical institution to international healthcare and administrative
standards and its compliance with international patient safety requirements.

For the Clinic’s activities it is important and relevant that Russian and international experts admit that the quality of
health care services provided by the Clinic is high and that the Clinic ensures a high level of safety and protection of
its patients’ rights: long-term compliance with international management quality standards requirements (ISO
9001:2000, ISO 9001:2008), membership in the Swiss Leading Hospitals Association, Recognized for Excellence 5*
level awarded by the European Foundation for Quality Management.

Medicina Clinic is the first and only Russian clinic that has

        received “Russian quality” Diploma and the right to use the “Russian quality” mark.
        become a winner of the 5th International Quality Tournament among Central and Eastern European countries
        organized by EFQM.
        received the Russian Government Quality Award for 2010.
        obtained Recognized for Excellence 5* recognition level (based on EFQM Awards results for 2010).

In its activities the Clinic implements advanced achievements of the world’s healthcare system and performs systemic
work to apply innovative technologies. Medicina JSC is a clinical base for the Chair of Therapy and Family Medicine
of the Doctors Improvement Faculty of N.I.Pirogov Russian National Research Medical University (RNIMU). It is
included into the list of innovatively active healthcare institutions of Moscow on whose base clinical research can be
conducted.

Range of medical services provided by the Clinic.

The Clinic comprises over 20 departments and centers that render a full scope of medical care, namely:

                polyclinic services, incl. therapy and pediatrics;
                diagnostic services, including laboratory, functional, ultrasound and radiation diagnostics and
                endoscopy;
                family medicine services;
                ambulance services;
                supplementary services, such as a pharmacy and opticians’.

Striving for excellence we are always studying and analyzing society’s demands, patients’ satisfaction and the quality
of medical services we render. It allows the Clinic to constantly compare the results of its activities with the indicators
of the world’s leading clinics. By achieving the highest results we set new far reaching goals and criteria for the
assessment of medical care quality and patients’ satisfaction. Aspirations for excellence have no boundaries in time or
space and are viewed as an ongoing impetus for development.
The Clinic’s specialists carry out patients’ examination and treatment in accordance with Medical and Economic
Standards (MES) under WHO recommendations. The quality of treatment and diagnostics is always high, no matter
which expert is visited by the patient. It is all written down in “Guarantees provided by Medicina JSC booklet which is
freely accessible in the Clinic.
Hundreds of big Russian and western companies entrust care about the health of their employees to our doctors.
Patients of Medicina JSC are the clients of more than 90 insurance companies, employees of embassies and
organizations, individuals, many Russian artists, businessmen and politicians

Facts and figures
      Over 2,000 outpatient appointments at the Clinic per day.
      Over 58,000 people get medical care at the Clinic per year.




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       2,000 patients per year receive medical care at the inpatient facility of Medicina JSC.
       Over 2,600 citizens of the Central Administrative Okrug of Moscow obtain medical treatment at
        Medicina JSC under obligatory health insurance programs that are free for patients.

Our team

Being highly competent and friendly the Clinic’s employees make up a strong team whose task is to make the visit of
each patient to Medicina JSC maximally comfortable and effective. All the doctors are first rate health care
professionals that graduated from the world’s best institutions and attended training at American, Israeli and European
clinics.
Medicina JSC is one of the flagships and leaders of Russian socially accountable private medical institutions, which is
confirmed by the numerous diplomas, awards and quality marks it has received.

        2001    Badge of honor “Enterprise with a well-organized accounting system, a note of acknowledgement
                from the Mayor of Moscow for successful work connected with rendering highly qualified medical
                care to Muscovites.
        2002    A note of acknowledgement from the Rector of M.V. Lomonosov Moscow State University for
                providing highly qualified and free medical care services to students and employees of the University.
        2003    Certificate of Merit from Moscow Healthcare Committee for work connected with rendering highly
                qualified medical services to Muscovites.
                Letter of thanks from Svyatoslav Fedorov’s Fund for organizing “Healthy eyes for everyone”
                campaign.
        2005    Diploma of high consumer evaluation of the quality of provided services. “VERIFIED. Russian
                Consumers Union”, Diploma issued by Russian and Moscow Consumer Protection Funds for active
                involvement in the establishment of a civilized consumer market in Russia. Medicina Clinic is the first
                Russian Clinic certified according to ISO.
        2006    Certificate issued by Russian Consumer Protection Fund for active participation in “The Best in
                Russia” contest; Certificate issued by Moscow Consumer Protection Fund: on the basis of a decision
                made by the public council of experts Medicina JSC gets an award as a participant of “The Best in
                Moscow” contest.
        2007    Certificate of Merit from Moscow Healthcare Committee presented to Professor Grigory E. Roytberg
                for his considerable contribution to practical medical care rendered to Muscovites.
                Certificate of membership in the Swiss Leading Hospitals Association.
        2008    President of Medicina JSC Grigory E. Roytberg became a laureate of the “Russian quality leader”
                tournament.
        2009    Diplomas issued by Russian Quality Organization (RQO): quality of inpatient and polyclinic services
                meets the highest level of quality envisaged in RQO’s working program. Winner of the 5th
                International Quality Tournament among Central and Eastern European countries.
        2011    The first and only Russian clinic accredited according to the most reliable Joint Commission
                International medical care standards.

Specialists of Medicina JSC take part in joint scientific projects in collaboration with employees of foreign
universities, publish scientific articles and theses, organize and participate in international conferences. Moreover, the
Clinic’s experts conduct free educational workshops for doctors from Moscow and free seminars on maintaining
health and improving the quality of life for the Clinic’s patients.

Medical care

Integrated approach to maintaining patients’ health is reflected in the structure of rendered medical care. 95% of
medical services are provided to patients of Medicina JSC at the polyclinic, including specialists’ appointments (by
disease and for preventive purposes), outpatient surgery, dental services, diagnostics (diagnostic equipment and
laboratory diagnostics), rehabilitation and restorative care. Inpatient services make up 4% of all services provided by
Medicina JSC. The existing inpatient facilities will be considerably expanded after the new building of the Clinic is
put into operation in early 2012. In addition to hi-tech treatment and diagnostic procedures, the Clinic’s patients also
get domiciliary care services (by disease, diagnostics and preventive examination) which make up 0.6% of the total
number of medical services rendered, and ambulance medical care (0.4%). Share of Medicina JSC in Moscow’s
private health care facilities sector is 2.34%.




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The Clinic implements advanced achievements of the world’s healthcare system in its activities, which is confirmed
by international health care experts, and performs systemic work to apply innovative technologies.




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Medicina Clinic.

All the best in medicine.

Mission

Mission of Medicina JSC is to provide patients with complex personified medical care on condition of partnership and
active involvement of patients in making decisions on their health and well-being. Ensuring that patients have access
to complete and trustworthy information. Meeting requirements re. maintaining and improving health and quality of
life.

Vision

We establish a clinic of international acclaim, which retains its leadership position on the Russian private medical
market. Following changes in society’s demands we are constantly mastering all the aspects of our activities in order
to ensure the maximum customer satisfaction level and the ideal quality of medical services. By achieving the highest
results we set new criteria for the assessment of medical care quality and patients’ satisfaction. Studying and analyzing
society’s demands and patients’ satisfaction. Studying and analyzing society’s demands, patients’ satisfaction and the
quality of rendered medical services allows the Clinic to constantly compare the results of its activities with the
indicators of the world’s leading clinics. Aspirations for excellence have no boundaries in time or space and are
viewed as an ongoing impetus for development.

Values/principles for improvement

Serving patients’ needs:
      perceiving patients and their families as partners in the process of treatment;
      constant sincere wish to help each and every patient;
      providing to patients access to the information about the type, diagnostics and treatment of their diseases;
       interaction with patients in support of their intention to be well-informed when making decisions about their
       health and well-being;
      truthfulness and sincerity in our every action;
      exceeding the expectations of patients and their families.
Commitment to quality:
      constant aspiration for the ideal quality of services;
      ongoing improvement of all processes ensuring the highest quality (professionalism, quality of service,
       technologies expertise, management quality);
      everlasting aspiration to achieve the highest results in every action (measuring, monitoring and reporting as
       regards services and quality standards and customer satisfaction, comparison with the best representatives in
       the group).




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Team work:
       interaction of specialists providing medical assistance to patients as a team of highly qualified and committed
        professionals having common corporate culture;
       joint work in the spirit of cooperation, with active participation of everyone and encouragement of personal
        initiatives;
       implementing the succession principle when treating patients;
       constant interest in professional development of each employee;
       establishing and supporting close working relations among employees, with partners and other public
        institutions.
Social accountability:
       work for good of mankind, preserving and improving the health of population and raising the quality of life;
       support of the communities where we live and work;
       support of the needy and assistance in hard financial conditions;
       desire to change in response to the changing demands of society.
Finances and control:
       using a systemic approach to choose and finance projects that contribute to higher efficiency and effectiveness
        of business and help to achieve goals supporting this mission;
       functioning not for mere wealth, but for ensuring sufficient financial feedback, given current and future needs
        and demands;
       achieving high performance results by effectively using resources, including intangible resources;
       reporting re. resources used at all the levels of the company.

Challenges and strategies.
Currently, investments into health are becoming one of the most reliable types of investment, which can have an
impact on long-term demand growth prospects. Medicina JSC orients towards the continuous improvement of medical
care quality and service by attracting the expertise of the world’s best healthcare institutions. By competing with
Russian as well as with the world’s best clinics the Clinic responds to today’s macroeconomic challenges. Medicina
JSC has become a real alternative to foreign clinics for CIS citizens in connection with its accreditation according to
the most reliable international JCI medical care standards in 2011.

Nowadays the Company has three strategic goals:

1. Constant improvement of the Clinic’s activities in order to satisfy patients’ demands in full and retaining leadership
positions for quality in the Russian private medicine market through improvement of a management system.
2. Ensuring a steady growth of the Company’s revenue and income.
3. Well-balanced growth in the scope of rendered medical services, including a wider range of hospital services in
connection with the construction of a new building.

Construction of the Clinic’s new building.

Currently, we are implementing a project of the building’s reconstruction on the territory adjacent to the existing
building, which was started at the end of 2009. The project’s implementation will considerably expand the Clinic’s
opportunities connected with the provision of full-scale medical care to patients and ensure that the Clinic will become
one of the best clinics in Europe as regards the applied technologies, including IT technologies penetrating into and
securing all production processes.

The new treatment facility of Medicina JSC occupying over 20,000 m² will house a 100-bed inpatient section with 4
surgeries, including a cardiovascular hybrid operating room, a big intensive care unit, admissions, single and double
occupancy wards, a VIP section for 5 wards, Therapy and Family Medicine Chair of RSMU and other support
services. A cardiovascular hybrid operating room combines the opportunities of an operating room for cardiac
intervention treatments and open heart surgeries. At this type of operating room one can simultaneously perform such
surgeries as balloon angioplasty, stenting and heart bypass operations. Hi-tech cardiac surgery is one of the most
important areas of the Clinic’s development.




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Moreover, the new building will also house advanced medical equipment: 2 MRI scans of the latest generation, a
Positron Emission Tomography machine and a robotized set of laboratory equipment. The old and the new buildings
will be connected by a sheltered underpass.
The new building will be put into operation step by step in 2012, given the balanced growth of its capacities with a
view to reaching the expected targets within a year from the launch of the inpatient facility.

Business strategy.

The strategy of Medicina JSC is based on mastering its socially accountable activities.

1. Serving patients’ needs. The most important customer-oriented target is to ensure that patients are provided with
high quality medical care and service. For evaluation purposes, we introduced customer satisfaction ratios re. the
quality of service rendered at the polyclinic and at the inpatient facility. We reach our targets by following our own
quality standards and using the best medical practice achievements (MES “Same day practice”, “Doctor-supervisor,
individual assignment of doctors to patients, hospitalizations, patients’ feedback”, Continuity, Health examination,
“Completed case”, “Relation of recurrent appointments to initial appointments”, “Lines”). We exercise control and
review the implementation of JCI international standards re. the quality and safety of medical care; control and analyze
conformity with claims and complaints regulations; have introduced performance indicators for doctors and nurses;
control the operation of medical devices; arrange infection, laboratory and radiation safety management as well as
management over the storage and use of pharmaceuticals. The task of the Advertising and Marketing Departments is
to increase the Clinic’s recognition among patients. We monitor the recognition ratio using the Business Star
methodology and hope to reach 10% by 2014. We connect recognition with the use of innovative solutions in our
activities to ensure patients’ well-being
2. Commitment to quality. The targets of this prospect for ensuring leadership with regard to the quality of medical
services aim at the improvement of internal processes. The targets of this group of goals are implemented through
measures aimed at the development of the Clinic’s innovative potential, use of the quality criteria of the “University
clinic” and introduction of a system that controls and reviews the extent of achieved results. The KPI system ensures
systematic control and individual evaluation of each employee’s performance (be it a doctor or a nurse), review of the
extent of achieved results and creation of educational programs for employees. There are 4 types of control: control of
the 2nd, 3rd, 4th levels (daily, monthly, quarterly control) and control as per check lists. The results are summarized by
the Quality Committee. Based on these results, we elaborate plans for improvement and training programs. Control
measures take account of the percentage of negative marks and their share in the List of comments. The biggest
percentage of comments affects the form of a training program. Medicina Clinic serves as the base for the Chair of
Therapy and Family Medicine of N.I.Pirogov Russian National Research Medical University (RNIMU), with training
provided to doctors specializing in “Therapy” and “General practice” (Family medicine). In collaboration with the
Iowa State University the Clinic organizes international symposiums and scientific and practical international
conferences.
3. Teamwork/Staff/Development. The targets of this prospect aim at increasing employees’ loyalty and commitment.
Indicators: employees’ satisfaction and stability (turnover, percentage of employees working for 7+years),
improvement of staff’s qualifications. The targets are implemented via a system of motivation, considerable increase
in discounts for medical services for employees (additional services) and their family members, social benefits, 100%
health examination, vaccinations. Institute of Consultants started its development as a school of medical art.
Consultants are involved in rounds, councils, consultations, training and scientific events. An attestation program
ensuring the employee’s individual growth has been adopted. The Clinic supports 4 types of training; over the recent
year internal education has come to the foreground. Also, the important indicator is the ratio of doctors of the highest
category as well as the ratio of candidates and doctors of medical sciences.
4. Social accountability. Social development targets are aimed at ensuring the Clinic’s steady development as a
socially accountable company. We create our social strategy on the basis of the 4 following success factors:

- Transparency, openness and social accountability. An open report incorporating socially relevant targets and
indicators is available at www.medicina.ru. The Clinic has been granted “The Best Moscow Employer” Award.

-. Free will to establish relations with professional communities. We reach our targets by disseminating accumulated
knowledge and organizing free lectures and workshops for Moscow doctors. We invite leading Moscow specialists to
provide consultations. Doctors have the opportunity to participate in Clinic’s rounds, clinical debates and conferences.
The Chair’s employees ensure the activities of a free “school of health”.




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- Guarantees of quality combined with best practice standards. Any medical care is rendered in accordance with the
standards of medical care guarantees, which practically secures an equal number of medical services for various
categories of patients. In order to improve the quality of our patients’ life we introduce recent and most advanced
medical technologies. The indicators of innovations are taken into consideration in all areas of medical activities and
each new area represents a new area for consumers.
- Charity. “Healthcare Fraternity” Foundation was established. The Clinic takes part in “Fedorov’s days” Moscow
charity program and helps to equip a district hospital. The charity program orients towards the areas where we are
most competent and where the maximum results for society can be achieved.
5. Finances and control. The main financial targets of the Clinic are company value growth (income and revenue
indicators), capitalization via reinvesting income into the Clinic’s development (min. 50% of net income is invested
into further development of the Clinic), ensuring high profitability and increase in the share of high tech services
provided by the Clinic (since 2011).

Innovative SMART-clinic project

In 2012 Medicina JSC will put into operation a new building whose area exceeds 20,000 m2. The new building is not
only a tool for expanding the scope of rendered services and reaching the best financial results. It is related to the
introduction of qualitative changes in our activities and turning into reality our dream of the Clinic of the 21st century.

In the run up to the opening of a new building, development of technological opportunities and provision of the new
quality of services Medicina JSC has been implementing a smart clinic project in collaboration with IT leaders. This
project is based on a Data Processing Center (DPC) designed in accordance with reliability, safety and fault-tolerance
requirements. The smart clinic project underlies centralized management over the engineering and IT infrastructure of
the building. This is a pilot project that has no analogues in Russia.

The new premises will be used to expand the inpatient section and house a diagnostic department, Therapy and Family
Medicine Chairs of RSMU, engineering services and a cancer center of the international level. These projects should
be implemented in those areas of medicine that lag behind the world’ best practice as far as Russia and Moscow are
concerned. We trust that our choice will improve the quality of life of our patients and will give them hope in
resolving their problems.

An interdisciplinary inpatient facility at the new building of the Clinic is intended for 100 beds. It is going to have 4
modern operating rooms, including a hybrid operating room, and an intensive care unit. Smart operating rooms that
will be put into operation at the new building of the Clinic serve as a vivid example of how hi tech technologies are
implemented in the healthcare sector. In particular, an automatic anesthesia control system is envisaged to be used at
such operating rooms. Once a surgeon enters a smart operating room all the equipment is already adjusted according to
his/her preferences, which cannot but contribute to a successful result of any surgery.




        Cancer centre of Medicina JSC




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In 2012 Medicina JSC will put into operation a new building with a high tech cancer center that is being built with
methodological assistance of foreign clinics (Memorial Sloan Cancer Center, USA, and Rabin Medical Center —
Davidoff Center,Israel). This is a socially relevant project. The Cancer center of Medicina JSC will be a role model
and will implement all the world’s known existing innovative technologies for diagnosis and treatment of cancer
patients.

The cancer center is intended for:
               Improvement and implementation of new radiation technologies for diagnosis and treatment of the
               most serious diseases.
               Provision of a full scope of hi tech treatment and diagnostic services to population.

The cancer center of Medicina JSC will house a Radiation Detection Department (using the first in Moscow PET/CT
Gemini TF Philips and Bright View Gamma Camera), a Radiation Therapy Department equipped with two linear
accelerators of the revolutionary new TrueBeam model produced by VARIAN (the first in Russia) and a
Chemotherapy Department for 25 posts combined with a laboratory preparing chemical agents and an outpatient
center for cancer patients.

Radiation healthcare technologies (diagnostic and therapeutic) are widely used in practically all countries of the world.
As soon as a cancer center of Medicina JSC is put into operation it will allow Medicina JSC to reduce the cancer death
rate by 25%.

We plan to provide high tech treatment to patients suffering from malignant tumors (main localizations) and cardio-
vascular diseases. Treatment of cancer pathologies will be provided both as a separate solution for radical or palliative
care and can be also used as a stage of combined and complex treatment of malignant tumors (main localizations).

The cancer center of Medicina JSC will become a part of a bigger clinical complex. This not just an advantage, this is
a necessity. It is very important for any patient to undergo diagnostics and get treatment at an interdisciplinary clinic,
since any person has his/her own peculiarities as well as aggravating and ancillary diseases. At our center we will
choose the optimal and individual approach to treatment of our patients.

Medicina Clinic implements state-of-the-art visualization technologies with the help of the most advanced equipment:
CT scans, MRI and PET/CT machines that can provide all the information required for treatment recommendations,
including the latest single cancericide dose technology.

Radiotherapy plays an important role in treatment of various types of cancer. Even now cancer patients have to
undergo long radiotherapy procedures that might take 4-6 weeks. This is pretty tiring. We are introducing a technology
that could allow us to reduce the number of sessions from 30-40 to 1. The doctors of the cancer center attended
training in the US and Israel. F.e., among our employees are unique specialists – medical physicists that have
undergone serious studies abroad.

Our approach to diagnostics, treatment and rehabilitation at the cancer center of Medicina Clinic is substantially
different from the common approach. Diagnostics would take 24-28 hours, i.e. we will perform all required
examinations, incl. morphology and biopsy, within two days. Afterwards the council of doctors of various specialties,
with the best foreign consultants involved, if necessary, will work out an individual treatment plan. Then we will keep
an eye on the patient who will get all types of treatment until his/her recovery or disease remittance.

By applying the most effective diagnostic methods and providing integrated treatment of cancer we do our best to
extend the longevity and improve the quality of life of patients. Thus, in Moscow and other metropolises the average
age of men who are diagnosed cancer is 61 years. In Germany and other developed countries they live 12.5-14 years
afterwards, while the figure for Russia is as low as 2.5 years. So, we have been fighting for these 12 years.

Benefits of Medicina Clinic.

In its activities the Clinic implements advanced achievements of the world’s healthcare system, which is confirmed by
international health care experts.




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Quality of medical care in accordance with the world’s best standards.

Medicina JSC is the only clinic in Russia accredited according to Joint Commission International (JCI). This is the
most objective and prestigious international healthcare certification which serves as the evidence of conformance of a
medical institution to the world’s healthcare and administrative standards and, also, to the requirements for securing
international patient safety goals.

In 2010 the Clinic became a laureate of the Russian Government Quality Award. This Award is granted on a
competitive basis for considerable achievements as regards the quality of products and services, ensuring their safety
and introducing highly effective quality management methods.

Moreover, Medicina Clinic is a laureate of the “Russian Quality” program. Having successfully passed the evaluation
of medical services carried out by independent experts in 2009 the Clinic was the first Russian organization to have
received the Certificate of the Russian Quality Organization and “Russian Quality” Diploma as well as the right to use
the “Russian Quality” Mark which is the replica of the Quality mark used in the USSR. RQO takes responsibility for
the quality of medical services provided by the Clinic and therefore reconfirms its right to use the “Russian Quality”
Mark on an annual basis.

As far back as in 2005 the conformance of Medicina Clinic to ISO 9001:2000 requirements was approved by the
certifying organization TNO-Sertification (Netherlands). The Clinic successfully undergoes annual compliance audits
тo prove its conformance to the requirements of the Quality Management System (QMS) ISO 9001:2000. In 2009
during recertification audit the certifying organization Moody International Group acknowledged the conformance of
the Clinic’s quality management to the requirements of QMS standards ISO 9001:2008.

Medicina Clinic has received a Recognized for Excellence ***** (5 stars) Award from the European Foundation for
Quality Management (EFQM). In order to maintain this 5* level, we study and use the world’s advanced experience
and introduce the best practices and management technologies. By establishing relationships with partner
organizations we adhere to the principle of commitment to quality. We are constantly making our best efforts to
improve our work and raise the quality of our health care services on the basis of a dialogue with patients. In 2009 the
Clinic became the winner of the 5th International Quality Tournament among Central and Eastern European countries.

In September 2007 Medicina Clinic joined the Swiss Leading Hospitals Association. SLH members are substantially
different from ordinary clinics, since they ensure the highest European and world’s quality of health care services and,
what is more, such guarantees apply to both medical care and the highest quality of service. Medicina JSC reconfirms
its right to be a member of such an honored association once in 3 years during compliance audits.

Dialogue with a patient. Clinic’s guarantees. We strive to interact with patients as our partners in order to maintain
and improve their health and anticipate their expectations. Medicina Clinic offers its patients detailed Guarantees
(quality evaluation criteria) and is ready to take responsibility for its commitments. Guarantees provided by Medicina
Clinic ensure rights observance and patients’ safety. Guarantees are real obligations for the performance of which the
Clinic can be responsible (material and reputation responsibility). Information on guarantees is open to public.

Best doctors and medical staff. We have established a system for training doctors and exchanging experience with
the world’s best clinics. When medical staff are employed by the Clinic we strictly check their qualifications.
Medicina JSC is a clinical base for the Chair of Therapy and Family Medicine of N.I.Pirogov Russian National
Research Medical University (RNIMU). The building of Medicina JSC houses a training and laboratory base of the
Chair. Medicina Clinic is an interdisciplinary University clinic whose clinical, training and laboratory bases are used
for scientific and clinical developments in various fields of medicine. Within the framework of the Institute of
Consultants (advisory body to ensure agreed actions when resolving medical care provision tasks) consultations are
provided by academicians and corresponding members of RAMS, Professors and leading specialists in various fields
of medicine. President of Medicina JSC Grigory Efimovich Roytberg is a practising physician, RAMS Academician,
Professor, M.D. and Honored doctor of the Russian Federation. He is also a laureate of the Russian Government
Education Award.

Openness to patients. To some extent, the Clinic’s openness is stipulated by the requirements of international
standards. We meet the criteria of the best international clinics, as our readiness to keep the conversation going and
our care about patients have become the philosophy of our Clinic. Thus, any patient can evaluate the Clinic’s doctors




   15
according to several criteria at the Clinic’s web-site. The doctors rating, open to public, is made up in the real time
format. The Clinic’s web-site and medical information system are interconnected. That is why patients can make an
appointment at the web-site and look through their health records, examination results and tests in the Personal cabinet
section. Patients can get a DVD with their examination results in order to receive the so-called second opinion of
doctors from other medical institutions. Patients’ feedback is very important to us, this is the reason why we pay close
attention to consideration of patients’ proposals and questions received via the web-site, when patients refer to the
Clinic’s employees as well as those left at special log books that are kept with cashier-administrators. Registered users
can review the stages of their referral to the Clinic online. Any online visitor can ask doctors his/her question by
calling the “hot line”, receive information using SKYPE, calculate the cost of the annual health contract and pay for
the Clinic’s services with a bank card via the Internet.

Full range of medical care services with a view to saving patients’ life and improving its quality: polyclinic,
diagnostics, interdisciplinary inpatient facility, cancer center.
Organizing medical care. For the purpose of ensuring safety and high effectiveness of treatment, we follow the
principle put forward by the Academician N.A.Semashko “One patient – one physician”. A supervising physician
treats the patient as a family doctor, therapist or pediatrician, coordinates treatment assigned by other specialists and is
involved in treating his/her patients at the inpatient section.

Medical activities are tied to meeting medical and economic standards of rendering medical care existing in Russia.
Patients’ consultations are documented in electronic health records and the results of diagnostic tests carried out by hi
tech equipment are recorded and given to patients on a DVD. Thus, the patient can present a medical assessment
report based on the results of the examination and a video of the examination on a visit to another clinic.

Hi tech medical care. IT-infrastructure. In its activities the Clinic implements advanced achievements of the
world’s healthcare system and performs systemic work to apply innovative technologies. Medicina JSC belongs to the
list of innovatively active healthcare institutions of Moscow whose base can be used for performing clinical research.
Having the best treatment and diagnostic base in Moscow we offer our patients a full range of medical services. We
pay close attention to the introduction of state-of-the-art IT technologies contributing to the improvement of the
quality of medical care provided. The Clinic uses an electronic health record system (EHR) and has also launched
digital archives solutions allowing it to store screening results obtained with the help of various medical devices (CT
scan, MRI scan, X-ray machines, ultrasound and endoscopic equipment). Medicina JSC is implementing a smart clinic
project. This project is based on a Data Processing Center (DPC) designed in accordance with reliability, safety and
fault-tolerance requirements. The modern data transmission network is intended for the transmission of large volumes
of information and meets safety requirements stipulated by law. Smart operating rooms are a vivid example of how hi
tech technologies are implemented in the healthcare sector, f.e. an automatic anesthesia control system. Once a
surgeon enters a smart operating room all the equipment is already adjusted according to his/her preferences, which
cannot but contribute to a successful result of any surgery. The smart clinic project underlies centralized management
over the engineering and IT infrastructure of the building. This is a pilot project that has no analogues in Russia.

Atmosphere of comfort, care and friendliness. We do our best to make our patients feel comfortable. Care about
patients is the core of any our activity. Patients are met by friendly and caring employees that escort them around the
Clinic to the office they need, help to get the required documents prepared and to obtain a desired consultation. It
usually takes no more than 24 hours from the moment when the patient visits the doctor for the first time until the
moment when he/she receives the results of his tests, examinations and doctor recommendations. The styles of the
Clinic’s interiors are developed by designers for individualization of various departments and patients’ comfort.

Clinic’s guarantees
Medicina JSC offers its patients detailed GUARANTEES and quality evaluation criteria and is ready to take material
and moral responsibility for its commitments.

Upon a visit to our Clinic each patient is guaranteed:

                Medical examination in full compliance with medical standards.
                Personal supervising physician
                Escorting around the Clinic
                Lack of lines
                Written recommendations




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Provision of personal access to health records via the Internet
                Provision of all test results and videos of surgeries under anesthesia on a CD
                Provision of information on medications used
                Consideration of patients’ enquiries to the Clinic’s administration, with a written response guaranteed
                Material compensation for unjustified claims or the Clinic’s non-fulfillment of aforementioned
                guarantees

Guarantees of Medicina Clinic ensure the observance of patients’ rights and security of patients. Clinic guarantees are
concrete obligations for whose performance the Clinic bears material and reputation responsibility. Information about
guarantees is publicly available.

Strengths of Medicina JSC
The Clinic can ensure the stable quality of medical care at its inpatient facility and polyclinic for the following
reasons:

 The Clinic provides medical services in practically all areas of medicine.
 Services provision organization and quality management system are standardized.
 We are constantly performing work to introduce and use state-of-the-art technologies and advanced treatment
  methods.
 Our doctors have graduate degrees, have been assigned the highest or first qualification categories. All our
  employees are always improving their qualifications. F.e., doctors and nurses attend training in foreign clinics.
 Medical documentation is maintained in the electronic format, which is convenient for patients and facilitates doctors’
  activities.
 All offices where patients are admitted are equipped with the latest appliances and conform to hygiene rules and
  regulations as well as to medical esthetics requirements.
 Medical services are rendered in accordance with MES, with regular control exercised over the treatment and
  diagnostic process.
 Medications and medical products are purchased only from reliable suppliers on condition of the availability of
  all necessary quality certificates, etc.
 Patients have the opportunity to access their health records online.

Future of the Clinic

We establish a clinic of international acclaim, which retains its leadership position on the Russian healthcare market.
Following changes in society’s demands we are constantly mastering all the aspects of our activities in order to ensure
the maximum customer satisfaction level and the ideal quality of medical services.

By achieving the highest results we set new criteria for the assessment of medical care quality and patients’
satisfaction. Studying and analyzing society’s demands, patients’ satisfaction and the quality of rendered medical
services allows the Clinic to constantly compare the results of its activities with the indicators of the world’s leading
clinics. Aspirations for excellence have no boundaries in time or space and are viewed as an ongoing impetus for
development.

Impact on society
The interaction of Medicina JSC with society is established on the basis of social accountability. The specific feature
of the Clinic’s activities is in its essence connected with preserving and improving population’s health and raising the
quality of life.
                 The Clinic supports the communities where we live and work. In the first place, it orients towards
creating favorable labor conditions for staff, which is confirmed by its regular recognition as the “Attractive
employer” by the Superjob portal.
                 The Clinic has organized and regularly conducts free “Schools of health”, training sessions in the
following areas: gastrointestinal diseases; carbohydrate metabolism disruptions and cardiovascular diseases (subject to
change depending on consumers’ demands). The annual budget is min. RUR 6,5 mil.
                 The Clinic’s interaction with municipal authorities in the area of science, industrial policy and health
care of Moscow underlies R&D activities under state contracts (clinics for performing various types of works are
chosen on a tender basis), providing specific scope of hi tech expensive medical care to the population of Moscow,




   17
elaborating a scientific and technical base for the use of advanced medical technologies in practical activities of
Moscow’s treatment facilities.

                 The Clinic gives charity donations to non-for-profit public organizations. Under the Order of the
Healthcare Department of Medicina JSC has been implementing a number of socially important charity programs for
the citizens of Moscow on a contractual basis, namely:

    CT scanning for patients as per the referrals from Moscow’s healthcare facilities – 1260 examinations performed.
    MRI scanning for patients as per the referrals from Moscow’s healthcare facilities – 5037 examinations
    performed.
    X-ray bone densitometry (536 female patients) and genetic tests to diagnose osteoporosis (5 female patients) as
    per the referrals from all maternity welfare centers of the Central Administrative District of Moscow (for free).
    Hi tech cardiac surgery to low-income citizens of the Central Administrative District of Moscow (16 surgeries).




     Charity Foundation “Medical Fraternity”
                The Clinic renders assistance and support to those in need. A specific area of such assistance is
support provided to Russian medical community. In 2011 the Clinic founded Charity Foundation “Medical
Fraternity” providing assistance to health workers (the Foundation’s capital for 2011-2012 is 10 mil. RUR and its
capital for 2014 is 40 mil. RUR). This is a unique Foundation, as decisions on whom assistance should be rendered are
made by medical staff on the basis of voting. Doctors that save lives often find themselves in a predicament. Charity
Foundation “Medical Fraternity” has been set up by Medicina Clinic to help health workers of Russia. This is a unique
charity project that unites representatives of the medical community, patients, medical institutions and best
organizations of the country. This is a venue where charity providers interested in the development of the Russian
healthcare system and health workers needing help and support meet. It is charity providers, patients and
representatives of the medical society that influence the Foundation’s decision on whom aid should be rendered on a
voting basis.

The basis of any charity project is people developing this project, who are not indifferent. Charity Foundation
“Medical Fraternity” has been set up by Professor Grigory Roytberg. As a doctor he knows the problems of health
workers from inside out; as the organizer of a health care company and the general manager of one of Russia’s most
successful private clinics he can transform general “petty little things” into the powerful stream of support that can
change the situation in the Russian healthcare sector for the better.
                 The Clinic’s activities are characterized by unprecedented openness and dialogue with a patient.
Patients can look through their health records online, get videos of surgeries and examinations on DVDs and evaluate
the activities performed by the Clinic’s doctors at www.medicina.ru.

               Free workshops for doctors from Moscow’s healthcare facilities and their attendance by min. 600
people per annum.




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Opening the cancer center of Medicina JSC with Radiation Detection, Radiation Therapy and
Chemotherapy Departments in September 2011. The new cancer center will allow to increase the number of newly
detected malignant tumors by 15-20%; improve the quality of diagnostics of cardio-vascular diseases by 30-40%;
achieve a five-eightfold reduction in the number of cancer recurrence; achieve cure of locally advanced prostate cancer
in 95-99% cases; reduce cancer neglect rates by 15-20%; reduce cancer death rates by 5-30%.
             Providing services to people living nearby under mandatory health insurance programs, at lower rates
             and on a free basis for patients.
            Contribution to the development of the social infrastructure of Moscow (2006-2011)




                                                    Okrug residents
 This diagram shows the number of residents of the Central Administrative Okrug of Moscow that obtain the Clinic’s
services under mandatory insurance programs. Under mandatory insurance programs, i.e. on a free basis, the Clinic
provides its services to residents of the Central Administrative Okrug of Moscow. The number of residents of Central
    Administrative Okrug is going down due to the natural decline of the population and its migration, changes in
          preferences re. the place of residence (relocation from the city center to Moscow region suburbs)

                  A few research and development projects under the City’s order have been implemented (non-for-
profit activities). F.e., medical equipment was handed over to Taruss hospital and Hospital No.82 for free.




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Medicina Clinic provides dispensary services to World War veterans and invalids.




1- Total, WWV, dispensary services, 2 – Obtained dispensary treatment, 3 – Obtained health resort treatment.




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HR POLICY AND ORGANIZATIONAL CULTURE

HR Policy
        Medicina JSC’s HR policy allows each employee to understand his/her role in the Clinic, feel involved in the
system of values created there and in the Company’s mission, adhere to single standards of behavior and
communication with partners, clients and colleagues and obey corporate culture principles.
        Our patients are people whose life’s top priority is health. We are responsible to our patients, whether adults or
children. By providing highest quality medical aid and applying the widest range of medical services and advanced
technologies we improve our patients’ health, lengthen their life and improve their lifestyle.
        We do our best to make all our employees interested in the successful development of Medicina JSC by
considering it as their professional and personal success, being sure of their future and socially protected. Our
commitment is to make labor compensation fair and reflecting the partnership between Medicina JSC and its
employees.
        Our objective is efficient management. Understanding our responsibility for work in the permanently changing
environment we use best efforts to constantly improve and perfect our activity.
        We are open for stable and efficient partnership and ready for fair competition.
        We respect and strictly adhere to State laws. We are open for partnership with parties and social movements
whose activity is aimed at social health.

Basic Corporate Culture Provisions
Professionalism
         The fundamentals of our work are competency, responsibility and experience. Medicina JSC is a company of
professionals. All our clients are sure to receive maximum attention to their problems. We do not divide clients into
more or less important ones. Each client will receive high quality medical services and may always rely upon the
competent help and consulting of our specialists.
Stability
         Medicina JSC has been working in the medical service market for more than a decade. Our sustained
development throughout the Company’s entire history and the vast experience we have accumulated ensure our
decisive forward movement in the dynamically developing market conditions.
         Medicina JSC does not target achieving short-term success or raising fast money. We prefer establishing long-
term mutually favorable relationships with reliable partners and employees because we plan working in this market
long and stable.
Reliability
         Medicina JSC regularly monitors the market of medical services to be able to competently predict possible
changes in the financial, economic and social segments and work successfully in the new conditions.
         Being keen for its perfect business reputation, Medicina JSC has always fulfilled and will always fulfill all its
obligations to its clients, employees and partners. People trust us, and this trust is well deserved.
Openness
         Practice shows that to be trustworthy a company should be clear and understood for its clients, employees and
partners in it activity. We are therefore committed to maximum possible openness in providing medical aid.

Social Orientation
        The main value of Medicina JSC are people who have trusted it with their careers. The fundamental principle
of the Company’s HR policy is to develop the optimum conditions for the complete implementation of its employees’
capabilities, competence and skills and provide deserved compensation for their work.
        Medicina JSC is a unified team. Success of each employee is a component of the success and prosperity of the
entire Company.
        Medicina JSC has deserved the trust and recognition among its clientele thanks to the principles all its
employees abide by.

Medicina JSC’s General Ethics and Activity Principles
      Medicina JSC’s professional activity is based on the following principles:
                applicable legislation of the Russian Federation, regulatory documents and standards of the
                   Ministry of Health and Social Development of the Russian Federation, Department of Health
                   and State Sanitary and Epidemiological Supervising Body of Moscow and Moscow State Fund
                   for Mandatory Medical Insurance that govern the activity of health institutions;




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 understanding of the civil and professional duty before the society, state and Russian citizens;

                   improvement of corporate management and in-house control;

                   absolute fulfillment of all the obligations and guaranteed high quality of services;

                   full responsibility for the quality and results of our work;

                   fair competition and active opposition to unfair players in the market of medical services.


        Medicina JSC does not accept in its activity:
                  violations of applicable legislation, moral rules and business ethics;

                   infringement of rights, lawful interests and dignity of shareholders, clients and partners and
                    inflicting damage to Company’s image.


Medicina JSC Firm Style
        Medicina JSC has a unified standard style of all printed media and souvenirs making our Company
recognizable, a standard procedure of service provision in all the departments and a regulated procedure of applying
the firm logo and name of Medicina JSC.
        Business printed media of the Company’s departments (forms, envelopes and personnel business cards) are
produced to a unified style using the officially registered symbols and color design. Medicina JSC’s departments are
not allowed to make modifications to the firm logo and the unified form and style of the Company’s business printed
media.
        The design of the Company’s logo and name on the advertising and souvenir media (pens, calendars,
notebooks, leaflets, booklets, ads etc.) conforms to the officially registered reference of the firm logo and the font
style.
        Firm dress style is another component of our corporate culture which is of special importance for medics and
contact persons.

Socio-Psychological Climate
        Medicina JSC’s in-house communication standard is confidence and high mutual exactingness between our
staff members, benevolent and practical criticism, freedom of expressing one’s opinion when discussing maters
important for the entire Company, managerial right to make decisions that are important for respective divisions,
sufficient awareness of employees and satisfaction of being part of the team.
        The establishment of a good business climate in Medicina JSC favored by the employees’ exact knowledge of
their respective responsibility areas which excludes any possible conflicts arising thereupon. The open policy and
transparency of compensations further reinforces the favorable socio-psychological climate of Medicina JSC.

Conflict of Interests Management Principles
        The main conflict management principle employed by Medicina JSC is to prevent a conflict or avoid its
aggravation. Should some conflict develop, our managers attempt to make use of it for the Company and encourage
practical criticism and proposals from employees. A conflict can be taken under control if employees have the will and
experience of such work.
        The Company manages possible conflicts using the conflict party functional separation method and internal
restructuring of the conflict situation. Conflicts are resolved using the ‘through confrontation to cooperation’ approach
(negotiations).

Medicina JSC Employee Business Behavior Code
       It is a good practice in Medicina JSC to respect other colleagues regardless of their position. The Company’s
Management is responsible to its personnel. The Company’s Management builds its relationships with the personnel
based on the following fundamental principles:
                   the Management observes the Labor Code and other laws regulating labor relationships with
                      employees;

                   the Management observes applicable occupational health and safety standards;




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 the Company does not apply any discriminating rules to employee hiring, compensation and
                   promotion. All employees have equal career opportunities in accordance with their competence;

                  the Management grants all the employees equal rights and opportunities in developing and
                   expressing their capabilities;

                  the Management consults employees on labor conditions and other issues affecting the
                   Company’s personnel;

                  the rules relating to compensations, discounts, promotion and other labor conditions have been
                   defined clearly and distinctly for all employees;

                  the Management fulfills its obligations relating to making contributions to retirement funds;

                  the Management has the right to enforce discipline among the employees by any lawful means
                   including dismissal of employees in breach of discipline in accordance with the applicable
                   legislation;

                  the Management takes into account the opinion and personal values of employees;

                  the Management builds its relationships with the employees based on collectiveness and
                   cooperation principles.


Medical Service Quality Management
       There are many definitions of what quality is, yet there’s been no universal one. We believe that in what
concerns medical activity quality should include the following two equivalent components:
    first, this is about every medical aspect such as necessary competence of doctors, low medical error risk, a
       system allowing timely identification and correction of situations bearing the threat of medical errors (e.g.
       mammary gland X-ray images are necessarily analyzed by two radiologists in order to avoid breast cancer
       omission), and a medical and economic standard compliance control system;

    second, these are deontological aspects, i.e. the patients’ perception of medical aid, including its service
     component – this is what patients can evaluate on their own (being not specialists in medicine they cannot
     judge on the correctness of therapeutic approach).

        Furthermore, to ensure sufficient in-house business process quality control, Medicina JSC uses the following
procedures: regulated in-house audit procedures, weekly managerial supervision, systematic checks of sanitary and
epidemic control and medication expiry dates, personnel competency checks and monthly personnel work quality
evaluation. For outsourced processes Medicina JSC appoints the so-called ‘Process Owners’ to bear responsibility for
tendering, contract preparation and partner interaction and ensure necessary controls and contract obligation
fulfillment. The management of such processes is documented.




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Clinic’s guarantees.

Looking through patients’ eyes

The major problem on the way to excellence encountered by everyone who has ever worked in this field is to look at
your company through your customers’ eyes, through your patients’ eyes, in our case. We can improve in various
aspects of our activities. However, if our patients do not feel it, it means that we have either chosen the wrong strategy
or the wrong tactics. For us to be confident that we have chosen the proper and effective way we have been constantly
monitoring our patients’ satisfaction. A satisfaction review is carried out regularly. Moreover, we are doing our best to
get rid of many negative moments and are being a success in this respect. During 20 years we asked our patients
questions about the factors that determined their choice, studied the world’s best health practice and improved our
activities to ensure our patients the maximum level of safety and protection of their rights. As of today, we have
elaborated the system “Guarantees provided by Medicina JSC on the basis of which our patients can evaluate our
clinic.

GUARANTEES re. the scope of medical care
    You will be offered a full and sufficient range of diagnostic and treatment programs allowing one to make a
    diagnosis and ensure the high quality of treatment at an interdisciplinary University clinic for adults and
    children, including a polyclinic, an inpatient section and emergency care.
    Over 340 physicians and consultants, including 60 academicians, corresponding members of the Russian
    Academy of Medical Sciences and Professors – leading medical experts - take an active part in your recovery
    process.
    Annual health programs provided by Medicina JSC offer the widest range of medical services in Moscow as
    compared to their counterparts.

GUARANTEES re. the organization of medical care
    Our physicians treat a patient rather than a disease. Patients are provided with highly qualified medical
    assistance in accordance with medical standards, and the doctor explains what it means for patients.
    We follow the principle put forward by the Academician N.A.Semashko “One patient – one physician”. A
    supervising physician treats the patient as a family doctor, GP or pediatrician, controls treatment assigned by
    other specialists and takes part in treating his/her patients at inpatient facilities.
    Consultations provided to customers are documented in a reliable electronic medical record system. Patients
    can get access to their personal medical records on line via Personal Cabinet at the Clinic’s web-site.
    After the appointment the doctor is obliged to provide the patient with written recommendations.
    The results of diagnostic tests carried out with the use of hi-tech equipment are recorded on CDs and provided
    to patients. It gives them the opportunity to obtain a second opinion and present both a Medical assessment
    report based on the results of the examination and a video of the examination on a visit to another clinic.

GUARANTEES re the quality of service




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One of the elements of our customer service style is the escorting of patients. Our employee takes a patient to the
required office and helps with directions.
We save our patients’ time and do our best to render them required medical services as soon as possible, namely:
     ensure the opportunity of providing all necessary services on the day of visit.
     see to it that patients visit the doctor, undergo assigned diagnostic tests required for making a diagnosis and
        recurrently visit their ailing physician within 24 hours;
     guarantee that patients will not have to wait for their appointments for more than 20 minutes.

We create and sustain the atmosphere of care, commitment and consideration for your comfort and tranquility whilst
in Clinic.

GUARANTEES re. safety
    Patients can be assured that all medical equipment, furniture and appliances we use are in good working order.
    The territory of the Clinic is under security surveillance.
    In addition, we pay special attention to infection control, origin of medicines and safety of applied
    technologies.

GUARANTEES to be heard out
    We do recognize that it is our patients who are our final arbiters that evaluate the quality of our services. All
    their wishes, recommendations and opinions will be taken into consideration; not a single enquiry would
    remain unattended.
    We guarantee that in case a patient raises a well-grounded claim or the Clinic fails to execute the above
    mentioned guarantees a patient can be entitled to a material compensation.

Certified quality management program
Since 2005, on the annual basis, Medicina JSC has successfully passed certification according to ISO 9001:2000 and
since 2009 – certification according to ISO 9001:2008.

Interaction with the Swiss Leading Hospitals Association allows us to receive and analyze information on state-of-the-
art management methods. Awaiting admittance to the SLH Association in 2006-2007 Medicina Clinic carried out self-
evaluation according to the proposed criteria, which then pushed us to conduct further self-evaluation under EFQM
criteria and afterwards helped us to obtain the Russian Government Quality Award.

By implementing our strategic goals and striving for excellence, the Clinic has started to carry out self-evaluation on
the basis of the EFQM model with a view to finding the areas for improvement and reaching the best results, as
compared to others.

The corporate culture of Medicina JSC and principles all the employees follow imply the perception of patients and
their families as partners in the process of treatment, a constant and sincere with to help each and every patient,
contribution to patients in their desire to be well aware when making decisions concerning their health and well-being
and honesty and sincerity with regard to patient-related activities.

By following these principles Medicina JSC is constantly striving for the ideal quality of services, ongoing
improvement of all processes that can ensure high quality: professional skills, quality of service, technology craft,
quality of management; achievement of high results: measurement, monitoring and reporting re. services and standards
of quality, patients’ satisfaction, comparison with the best representatives of the group.




   26
Corporate social responsibility

The Clinic’s management views corporate social responsibility as one of the most important principles of adherence to
the concept of sustained economic growth in cooperation with its employees, their families, population and entire
society with a view to improving their life.

Social policy of Medicina JSC

Management of Medicina JSC voluntarily undertakes a social responsibility obligation with regard to its staff and
creates necessary conditions for highly productive activities, study of advanced experience and achievements in
science and technology, ensures relevant pay for their work, rest and safe labor conditions, takes measures aimed at
the reduction of the impact of harmful factors on employees’ health, organizes retraining and qualification
improvement programs, secures the insurance of professional risks and other social rights and guarantees.

To establish employees’ assurance of tomorrow Medicina JSC has elaborated a system of measures aimed at ensuring
heir social support guarantees. As a rule, such measures relate to staff-related social measures concerning beyond set
legislative requirements and department regulations.

Medicina JSC provides its employees stable work at a clinic of the European level which is conveniently located in the
heart of Moscow and equipped with state-of-the-art medical appliances, which can ensure the provision of medical
care with the use of the most advanced technologies in all areas of medical activities and which has well-equipped
offices and nice interior design.




   27
28
PERSONNEL SOCIAL RIGHTS
1. Salary
        In accordance with the requirements of the Labor Code of the Russian Federation, the Clinic has a
Personnel Compensation and Incentive Provision. This document regulates the fundamentals of labor
compensation, calculation of compensation amounts and labor evaluation criteria and procedures.
        Salaries are paid in cash either through the Clinic’s cash department or by transferring to personnel’s
accounts, at least twice a month on the dates specified by the duly approved In-House Labor Rules (the
advance payment for the first half of the ensuing month is paid on the last day of the current month, and the
remainder of the monthly salary is paid on the 15th day of the ensuing month less the advance payment
amount). Salary deductions are only allowed in cases stipulated by the Labor Code of the Russian Federation
or other Federal Laws. After the calculation of their monthly salaries, Company’s employees receive the
complete information on their salary components, each employee receiving a past month payroll.
        Company’s personnel salary consists of two components:
        - the basis component, i.e. the official salary, is the guaranteed monetary compensation paid to the
personnel for the fulfillment of their respective job duties depending on the skills level and the quantity and
quality of labor;
        - the bonus component which can be paid as a reward for high quality labor and remarkable results.
        Personnel labor results are evaluated by their respective direct managers, and any bonus payment
decisions are made by department directors and approved by Company’s President or Financial Director.

2. Working Day Duration
        Workloads for different personnel categories have been designed depending on business process
structure and type of work and adhere to the applicable regulatory limitations, i.e. max. 40 hours weekly
(further regulated by Medicina JSC’s In-House Labor Rules). The following hour workloads have been
designed for different personnel categories:
     40 h week for administrative personnel;
     39 h week for medics, paramedical personnel and ultrasonographers;
     36 h week for pharmacists and infectiologists;
     35 h week for underage (no such personnel in the Clinic);
     33 h week for dentists;
     30 h week for radiologists and manual therapists;
     20 h week for the logopedist.
        Workloads have been designed in accordance with the following applicable industry regulatory
documents:
Order of the Health and Social Development Ministry of Russia No. 588N as of 13.08.2009, Approval of Workload Standard Calculation Procedure for Specific
Calendar Terms (Month, Quarter, Year) Depending on Approved Weekly Workload Standard.
Directive of the Labor Ministry of Russia No. 41 as of 30.06.2003, Job Combination Rules for Pedagogical, Medical, Pharmaceutical and Culture Workers.
Directive of the Government of Russia No. 101 as of 14.02.2003, Workloads of Medical Workers Depending on Position and/or Speciality.
Directive of the Health and Social Development Ministry of Russia No. 41 as of 30.06.2003, Job Combination Rules for Pedagogical, Medical, Pharmaceutical and
Culture Workers.


3. Disciplinary Punishment
        The Clinic does not apply or support disciplinary punishments implying any types of oppression or
personal offense.
        Company’s Management has the right to apply the following types of disciplinary punishment for
disciplinary violations, failure to fulfill or undue fulfillment of job duties:
        - reprimands;
        - reproofs;
        - dismissal for appropriate reasons (Labor Code of the Russian Federation, Article 192).
        The application of disciplinary punishment is strictly limited by the existing labor legislation (Labor
Code of the Russian Federation, Articles 189-195).




    29
4. Non-Discriminative Provision
         Company’s hiring, compensation, education access granting, promotion, upgrading, dismissal and
retirement procedures clearly exclude and disapprove any race, nationality, confession, limited capability,
gender, skin color, language, organization participation, political opinion, age or domicile related personnel
discrimination.
         The Company does not hinder its employees’ endeavors to abide by their existential concepts or
habits or fulfill their race, nationality, confession, limited capability, gender, organization participation or
political opinion related requirements to the extent that this does not compromise their and other employees’
ability to fulfill their job duties and does not violate other employees’ rights.
         The main personnel admission criteria are conformity of a candidate’s education and competency to
the job requirements, professional capabilities, business qualities and the availability of necessary
documents.

5. Occupational Health and Safety
        The Company has established an occupational health management system aimed at protecting the life
and health of its personnel.
        The Clinic has the Occupational Health Arrangement Provision – an enterprise standard regulating
the in-house occupational health management system, the functional duties of the occupational health
officers, the occupational health training procedure and the occupational health and safety monitoring and
supervision arrangements.

                                         Workplace Evaluation
       Workplace labor condition evaluations have been scheduled as per Article 209 of the Labor Code of
the Russian Federation and Order of the Health and Social Development Ministry of Russia No. 569 as of
31.08.2007, Approval of the Workplace Labor Condition Evaluation Procedure.

                          2009-2011 Workplace Labor Condition Evaluation Statistics


                                                                Total Number    Number of Workplaces Evaluated, Including by
   Year of       Name of Structural Divisions where Workplace
                                                                of Workplaces           Labor Condition Categories:
  Evaluation      Labor Condition Evaluation was Conducted
                                                                  Evaluated
                                                                                  Total     1 & 2 Cats.     3.1       3.2
    2009       Diagnostic Department                                 77            13            6           7          -
               2 Diagnostic Department                                             15            10          5          -
               Reconstructive Department                                           23            15          8          -
               Dental Department                                                   24            20          2         2
               1 Clinical Department                                                2            2           -          -
    2010       In-Patient Department                                               44            5           34        5
               Family Medicine Department                                          10            10          -          -
               Information Service Department                                      41            36          5          -
               Security Department                                                  6            5           1          -
                                                                    149
               Information Technology Department                                   10            10          -          -
               2 Clinical Department                                                8            8           -          -
               2 Diagnostic Department                                              4             -          4          -
               3 Clinical Department                                               24            21          3          -
                          Medical Service Office                                    5            5           -          -
                           1 Clinical Department                                   30            21          4         5
                           2 Clinical Department                                   50            36          13        1
                           3 Clinical Department                                   17            13          4          -




  30
Total Number        Number of Workplaces Evaluated, Including by
   Year of        Name of Structural Divisions where Workplace
                                                                 of Workplaces               Labor Condition Categories:
  Evaluation       Labor Condition Evaluation was Conducted
                                                                   Evaluated
                                                                                       Total         1 & 2 Cats.    3.1      3.2
    2011                      Executive Department                   138                 2               2           -           -
                    Engineering and Security Department                                  9               8           1           -
                           Procurement Department                                       20               1           8           -
                     Financial and Economic Department                                   5               2           3           -


        Workplace evaluation statistics: a total of 518 workplaces were evaluated (100% of the overall
number), of which 179 were evaluated repeatedly (once in 5 years) in 2010-2011.
        Laboratory measurements and workplace hazardous factor assessments were contracted to the
Laboratory Center of the Labor Research Institute. The results were included in hazardous occupational
factor assessment reports, workplace evaluation cards and hazardous occupational factor assessment tables.
The tests showed that most workplaces have optimum labor conditions (1 & 2 Categories). Assessment
results were used for the development and implementation of Cat. 3 workplace labor condition improvement
annual schedules. Workplace evaluation cards were made available for personnel upon the completion of
workplace evaluation and for newly hired employees during the admission safety drill.
        Occupational health and safety proposals made by Medicina JSC’s personnel generally seek
improvement of labor conditions in specific divisions (development of optimum microclimate and
temperature and laboratory measurement of hazardous occupational factors e.g. noise, vibration, illumination
etc.).
        All proposals are analyzed by the Clinic’s Management and forwarded as memo requests to
respective utility departments for execution. In 2011 the Medicina Clinic won the District Stage of the City’s
Best Occupational Health and Safety Arrangement Competition under the nomination Moscow’s Best
Occupational Health and Safety Non-Production Organization.

Health and safety proposal statistics
                                                                      2009                   2010                  2011
Number of health and safety proposals                                  84                      125                 64
All these proposals have been implemented.

Occupational Accident Statistics and Cooperation with Occupational Health and Safety Supervising
Bodies
No occupational health and safety related comments or recommendations have been received from the
supervising bodies over the reported period. Occupational accident statistics are summarized in the Table
below:
                Number of
                                                                    Number of Affected          Number of Sick
  Year         Occupational               Type of Accident                                                           Accident Severity
                                                                        Persons                  Leave Days
                Accidents
 2009               1            Falling on stairs                               1                       40               Slight
 2010               1            Falling on even surface                         1                       72               Slight
 2011               0                             -                              -                        -                  -

        Accident analysis suggests that the origin of the injuries is human factor, i.e. incautious behavior of
the affected persons.
        All the accidents have been investigated as per Article 229 of the Labor Code of the Russian
Federation and the Provision for Occupational Accident Investigation in Industries and Organizations
approved by Order of the Russian Ministry of Labor No. 73 as of 24.10.2002. The sick leave periods were
compensated to the affected persons at the 100% monthly salary rate.




  31
In compliance with the Labor Legislation of the Russian Federation, Medicina JSC’s personnel have
been fully insured against occupational accidents and job related diseases through the Social Insurance Fund.
        To prevent occupational accidents, heads of the Clinic’s divisions carry out occupational health and
safety drills with all the employees following the approved workplace drill schedules and in accordance with
health and safety instructions for each job.

Health and Safety Costs
                                       2009                       2010                       2011
    Health and Safety                212,005                    222,706                    226,050
      Costs, Rbls.

6. Maternity Support
                           2008                       2009                       2010                       2011
                 No. of    No.    Amount      No.     No.    Amount      No.    No.     Amount      No.    No.     Amount
                 Days      of      Paid,       of     of      Paid,       of     of      Paid,       of     of      Paid,
                          Perso    Rbls.      Days   Perso    Rbls.      Days   Pers     Rbls.      Days   Pers     Rbls.
                           ns                         ns                        ons                        ons
 Maternity
                 2252      16     1,640,321   3316    23     2,494,226   3644   26      3,390,551   2686   19      2,654,005
    Leave
<1.5 Yr. Old
Child Support     397      44     2,381,681    307    41     2,030,050    398   47      3,899,503   321    50      3,475,330

 Temporary
Disability Pay
                 4988     758     2,336,172   4651   873     2,798,760   8375   965     6,637,255   4298   628     6,691,320




7. Labor Legislation Comments and Claims from Supervising Bodies
      No occupational health and safety related remarks were received from the State Occupational Safety
Supervising Office in 2011.

                                    PERSONNEL SOCIAL GUARANTEES

Personnel Social Guarantee Objectives and Programs
Personnel social guarantee programs include Clinic Management’s initiatives for the implementation of
further personnel social support measures in addition to the regulatory ones, i.e.:
     in-house job combination options;
     annual work result bonuses;
     career possibilities;
     medical error responsibility insurance;
     central catering at reduced prices;
     free beverages (coffee, chocolate, tea);
     medical servicing at the Clinic;
     medicines at reduced prices;
     annual medical examination;
     sanatorium and child health camp vouchers;
     free vaccination;
     payments on jubilees, retirement, child birth and other occasions;
     certification and upgrading at the Clinic’s expense;
     training opportunities in leading European, US and Israel clinics;
     research, Ph.D. and Dr. Med. thesis opportunities;
     Russian and international conference, seminar and workshop participation opportunities;




   32
   free corporate training seminars;
       medical library access;
       Clinic’s corporate life participation: holiday events and gifts for personnel and children;
       Medicina JSC’s Honorable Worker Title awarding;
       adequate compensations adjusted to the market level, regularly paid (twice a month) and annually
        revised in accordance with the top market salaries.

Personnel Social Support
Personnel Aids
        Aids are paid to employees having worked for Medicina JSC during at least 1 year and having no
disciplinary reproofs. Aids are approved by the President based on applications from heads of divisions. In
extraordinary situations, e.g. where the aid candidate has former disciplinary reproofs, aids can be paid based
upon an application from the Social Assistance Committee.

       Aids are paid in the following cases:
       a) jubilees:
       - for men: 50, 60 and 70 jubilees;
       - for women: 50, 55, 60 and 70 jubilees;
       b) retirement;
       c) child birth;
       d) employee or employee’s close person death. Close persons include spouses, children and parents;
       e) financial difficulties (only based upon the Social Assistance Committee’s decision).
       Retirement aids (if the retiring employee stops working for Medicina JSC and the pension is filed
through Medicina JSC) are paid in an amount of double salary rate.
       Child birth aids are paid to women in an amount of single salary rate based on a birth certificate
copy.
       Aids are also paid to Medicina JSC employee families in case of employee’s or his/her close person’s
death.
       Aids are paid to Medicina JSC employees suffering financial difficulties due to diseases causing
long-term disability or in Force Majeure.
Examples:
  Corporate Events and Gifts             2007           2008           2009          2010          2011
Cost, Rbls.                          3,407,265       4,391,662      1,640,376      10,085,652      7,927,357
     Library Subscription              2007             2008           2009            2010           2011
Cost, Rbls.                           392,597         456,461        470,637        1,045,049       816,650

        In 2011 the Clinic established the Medical Brotherhood Charity Fund aimed at providing financial
aid to medical workers. The Fund has already started its activity. It is planned that aids will be distributed
based upon medical society decisions through voting, including via the Internet.
        The Clinic insures professional civil responsibility of medical personnel. Overall insurance costs and
their percentage of Company’s overall proceeds and costs are presented in the Table below.
     Medical Personnel Insurance                2007            2008       2009       2010         2011
 Cost, Rbls.                                  110,798          76,737    128,641     147,316     132,664

Personnel Medical Servicing
       All Medicina JSC employees who have passed the probation have the right for medical servicing at
Medicina JSC within the Mandatory Medical Insurance Program. Medicina JSC employee family members
have discounts for medical service at Medicina JSC.
 Personnel Medical Servicing           2007         2008     2009          2010         2011
 Number of Employees                    764          798      882           988          980
 Costs of Services                    39,343      43,704    62,976        74,984       73,269




   33
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Social Responsibility Report

  • 1. (Address of the President of Medicina Clinic Grigory Efimovich Roytberg) Dear patients, partners and colleagues, Creating a serious and interdisciplinary clinic is a long and multi-stage process. Since 1990 Medicina Clinic has been consecutively developing in order to change patients’ perception of the quality of health care provided. We combine the experience of the best Russian and foreign hospitals thanks to the key value of serving our patients. Introduction of the world’s best practices aims to help the Clinic to change, improve and always go ahead by keeping the dialogue with patients going and taking into consideration the issues that are really important for them. It is not accidental that Medicina JSC is the first Russian clinic accredited by the Joint Commission International (JCI). Currently, there are a bit more than 440 foreign hospitals that are accredited according to JCI standards, i.e. meet the world’s highest standards. Joint Commission International Accreditation is the most objective and prestigious health care certification, which serves as the evidence of conformance of a medical institution to medical and administrative standards approved at the international level and, also, to the requirements for securing international patient safety goals. In 2010 the Clinic became a laureate of the Russian Government Quality Award. Medicina JSC is certified according to international standards (its Quality management system is certified according to ISO 9001:2008; it is also a winner of a Recognized for Excellence ***** (5 stars) Award according to the European Foundation for Quality Management (EFQM) Excellence Model. The Clinic’ activities are characterized by unprecedented openness and the dialogue we keep with our patients. Patients can review their health records online, receive videos of surgeries and examinations on DVDs and assess doctors’ activities at www.medicina.ru. The demand for such dialog is steadily growing. Medicina Clinic is an organization whose activities are aimed at ensuring social accountability, i.e. accountability for the quality of patients’ life and tranquility of your near and dear ones as well as accountability for introduction of the most effective diagnostic and treatment methods that are currently applied throughout the world and for creation of a favorable environment that would contribute to a treatment process. We give people the opportunity to choose the quality and service in health care and, what is even more important, the attitude to their health. Certainly, our services are not affordable for everyone. However, if we speak about the services provided to people living nearby under mandatory health insurance programs, they are rendered at lower rates and are free for patients. It is not only care for patients’ desires and demands that characterizes “health care with a human face”. It is important that the Clinic supports the community where it works. In the first place, we orient towards creating favorable labor conditions for our staff. Medicina Clinic provides unique opportunities for professional growth and research work. Our employees get free medical treatment at the clinic. 1
  • 2. We respect the professional medical community, which is like a source of manpower for us, i.e., our colleagues who control the quality of treatment at our Clinic and our partners. We organize free workshops for doctors from various medical institutions. We realize that being among the industry’s leaders we have a real opportunity to help those in need. And, what is more, we have a big desire to do it. In 2011 the Clinic established a charity foundation providing assistance to medical professionals - “Healthcare Fraternity”. Its uniqueness lies in the fact that a decision re. the recipients of aid is made by medical staff on a voting basis. The areas for the Clinic’s development are chosen on the basis of society’s demands. Thus, to improve Russian cancer diagnostic and treatment standards it has been agreed that an oncology center of Medicina JSC should be established. Early 2012 a new building comprising a hi-tech cancer center that is being built with the methodical support of leading foreign clinics (Memorial Sloan-Cancer Center, USA, and Rabin Medical Center — Davidoff Center, Israel) will be put into operation. This is going to be a model center that will incorporate all world’s recent innovative cancer treatment technologies. Innovations in ensuring the quality of medical care are the result of systematic work performed in all the areas of the Clinic’s activities and an impetus for further development and improvement. Medicina Clinic’s achievements are recognized by the most reputable foreign and Russian experts. I would like to emphasize that all our achievements, awards and diplomas are only the tip of the iceberg at the base of which there is every day work performed by hundreds of people that are united by an interest in something new, care about patients and the desire to contribute to tailoring to patients’ needs. The most important thing about it is the ongoing impetus to become better which makes you go ahead. Such impetus for us is the opinion of our patients. Therefore, we have been making our best efforts to establish a dialogue with patients, using all possible communications, for many years. With thanks and kind regards, Grigory E. Roytberg President, Medicina JSC RAMS academician, M.D., Professor Honored doctor of the Russian Federation Laureate of the Russian Government Education Award Head of Therapy and Family Medicine Chair, RSMU 2
  • 3. (History of success) History of the Clinic Medicina Clinic was established in the early 90s of the 20th century. At first it was a small medical cooperative called “Pulse” (“Puls”) whose doctors were providing emergency medical services using two ambulance vehicles. Then in 1993 after winning tender Medicina JSC moved to the 8-storey building in the heart of Moscow and has never changed its location since that time. The building was redesigned and rebuilt; now it is a medical center comprising two buildings, which is equipped with state-of-the-art facilities and which provides all major types of specialized medical services to patients. In 2011 Medicina JSC celebrated its 21st birthday. Throughout all the years of its existence caring about health, extending longevity and improving the quality of life of Muscovites have been the No.1 tasks of the Clinic. To execute these tasks we have been constantly improving our work and developing. We provide highly qualified medical care to patients by using the best treatment traditions and most advanced technologies and study and adopt the experience of the world’s best medical institutions. Milestones 1990 Establishment of “Pulse” cooperative providing emergency medical services. 1991 Incorporation of Medicina Joint stock company at 31A Mosfilmovskaya St., Moscow 1993 Relocation to a building at 10, 2nd Tverskoy-Yamskoy per. No. of staff: 130 doctors. Opening of departments specializing in therapeutics, ophthalmology, X-ray and radiation diagnostics, physiotherapy and exercise therapy, dentistry, medical emergency care, laboratory, ENT. 1994 Opening of an acupuncture cabinet and introduction of a computer control system for 24 hour control and management over equipment and technological parameters of engineering systems. 1995 Opening of functional and ultrasound diagnostic departments, a pediatric section, a new pharmacy. 1996 Opening of an inpatient facility and surgery, which allowed the Clinic to get inpatient and polyclinic treatments interconnected; starting interaction with strategic partners – insurance companies. 1998 Launch of Magnetic Resonance Imaging machine, opening of a Health Center. Therapy and Family Medicine Chair of the Russian State Medical University (RSMU) is created on the basis of the clinical resources of Medicina JSC. 1999 Opening of the following new departments: Family doctor and Outpatient trauma, Surgery and Emergency care. Patients’ health records – kept electronically thanks to a new computer program. 2000 Completing the construction of a 3-storey superstructure of the Clinic’s building, opening of an inpatient facility and a surgery unit on the 9th floor, an inpatient section for children as well as increasing the number of beds for adults and starting oxygen barotherapy practice. 2001 Opening of an International Fertility and IVF Centre, a Trichology department, an Intravenous laser therapy room and an Ophthalmology center. Hi tech cardio-surgeries, extracorporal fertilization and 3
  • 4. auxiliary reproductive technologies – performed and implemented. The parties concerned start to elaborate and agree on the main areas of strategic development. 2002 Electronic health records system – fully implemented; statistic reporting – systemized; elaboration of own program “Medical Care Quality Management” based on BSC elements – in progress. Launch of charity densitometry program. 2003 Medical and economic standards were incorporated into the “Electronic health record” program. Territorial principle of rendering medical aid – introduced. Continuity principle (“One doctor – one patient at the Polyclinic and at the Inpatient section”) – elaborated and implemented. The following methods were introduced: PCR (Polymerase chain reaction), CT (Computer tomography), genetic studies, laser treatment methods for ENT, ophthalmology, extracorporal shock wave therapy and IVF. The Clinic started to organize round table talks with insurance companies. The President of Medicina JSC delivered his first report re. review of results and prospects for growth. 2004 Management structure reorganization: upsizing medical services, creating a Service and Information Support Section, Purchasing and Quality Management Methodology Departments. The Clinic launched external respiratory function tests, virtual and capsule endoscopy, new laboratory methods and cryotherapy at RMD of the Clinic. Special gym equipment was installed at the Cardio Rehabilitation Center. 2005 Introduction of a health screening program for employees. Providing psychiatric aid and inpatient psychiatric treatment to this category of patients. Competition-based staff recruitment; launch of a “self-learning company” program. ISO 9001:2000 certification. “Designer Clinic” – “theater for single spectator”, all repairs are done with the involvement of a designer. 2006 Introduction of new medical technologies becomes a systematic process. 2007 “Swiss” Clinic in Moscow. In 2007 Medicina JSC successfully passed an international audit and became an official member of the Swiss Leading Hospitals Association. This milestone event serves as the evidence of the high quality of medical services that are rendered by Medicina JSC and meet European and international standards as recognized by Swiss experts. 2007 The Clinic started to use EFQM Model as a tool for improving its management system on the way to excellence: we study and use the world’s best practices, compare our activities with the best European and international clinics, introduce the best management models and technologies. This model helps us to evaluate our work using qualitative and quantitative approaches. 2008 Full-time member of the European Foundation for Quality (EFQM), confirmed its Recognized for Excellence 5* level according to the EFQM Business Excellence Model. “Dialogue with a patient” program. 2008 The Clinic obtained Recognized for Excellence 5* recognition according to the EFQM Excellence Model (the first and only five-star clinic in Russia). 2009 Laureate of the Russian Government Quality Award. 2009 Winner of the 5th International Quality Tournament among Central and Eastern European countries. 2009 The first and only Russian clinic that received “Russian quality” Diploma and Mark. This is a nationwide certificate confirming the high quality of services provided by Medicina JSC. 2010 The Clinic confirmed its Recognized for Excellence 5* level when it took part in ЕЕА EFQM contest. 2010 The Clinic’s audit to confirm its compliance with SLH (Swiss Leading Hospitals Association) membership criteria. One of Switzerland’s leading auditors Mr. Zinniger congratulated all the employees of Medicina JSC on passing the successful audit and the score exceeding 85% at the final meeting. The Clinic has reconfirmed its rights to be a member of the Swiss Leading Hospitals Association. 2011 The first and only Russian Clinic was accredited to the most reliable medical care standards of Joint Commission International. As of today, only 440 clinics throughout the world have got this accreditation. 4
  • 5. 5
  • 6. 6
  • 7. ABOUT THE CLINIC. International recognition of quality Medicina JSC is a private interdisciplinary clinic that has provided a wide range of outpatient and inpatient medical services to patients since 1990. Medicina JSC is the only clinic in Russia accredited by Joint Commission International (JCI). Currently, there are a bit more than 440 hospitals round the world that are accredited to JCI standards, i.e. meet the highest world’s standards. JCI Accreditation is the most objective and prestigious international health care certification which proves the conformance of a medical institution to international healthcare and administrative standards and its compliance with international patient safety requirements. For the Clinic’s activities it is important and relevant that Russian and international experts admit that the quality of health care services provided by the Clinic is high and that the Clinic ensures a high level of safety and protection of its patients’ rights: long-term compliance with international management quality standards requirements (ISO 9001:2000, ISO 9001:2008), membership in the Swiss Leading Hospitals Association, Recognized for Excellence 5* level awarded by the European Foundation for Quality Management. Medicina Clinic is the first and only Russian clinic that has received “Russian quality” Diploma and the right to use the “Russian quality” mark. become a winner of the 5th International Quality Tournament among Central and Eastern European countries organized by EFQM. received the Russian Government Quality Award for 2010. obtained Recognized for Excellence 5* recognition level (based on EFQM Awards results for 2010). In its activities the Clinic implements advanced achievements of the world’s healthcare system and performs systemic work to apply innovative technologies. Medicina JSC is a clinical base for the Chair of Therapy and Family Medicine of the Doctors Improvement Faculty of N.I.Pirogov Russian National Research Medical University (RNIMU). It is included into the list of innovatively active healthcare institutions of Moscow on whose base clinical research can be conducted. Range of medical services provided by the Clinic. The Clinic comprises over 20 departments and centers that render a full scope of medical care, namely: polyclinic services, incl. therapy and pediatrics; diagnostic services, including laboratory, functional, ultrasound and radiation diagnostics and endoscopy; family medicine services; ambulance services; supplementary services, such as a pharmacy and opticians’. Striving for excellence we are always studying and analyzing society’s demands, patients’ satisfaction and the quality of medical services we render. It allows the Clinic to constantly compare the results of its activities with the indicators of the world’s leading clinics. By achieving the highest results we set new far reaching goals and criteria for the assessment of medical care quality and patients’ satisfaction. Aspirations for excellence have no boundaries in time or space and are viewed as an ongoing impetus for development. The Clinic’s specialists carry out patients’ examination and treatment in accordance with Medical and Economic Standards (MES) under WHO recommendations. The quality of treatment and diagnostics is always high, no matter which expert is visited by the patient. It is all written down in “Guarantees provided by Medicina JSC booklet which is freely accessible in the Clinic. Hundreds of big Russian and western companies entrust care about the health of their employees to our doctors. Patients of Medicina JSC are the clients of more than 90 insurance companies, employees of embassies and organizations, individuals, many Russian artists, businessmen and politicians Facts and figures  Over 2,000 outpatient appointments at the Clinic per day.  Over 58,000 people get medical care at the Clinic per year. 7
  • 8. 2,000 patients per year receive medical care at the inpatient facility of Medicina JSC.  Over 2,600 citizens of the Central Administrative Okrug of Moscow obtain medical treatment at Medicina JSC under obligatory health insurance programs that are free for patients. Our team Being highly competent and friendly the Clinic’s employees make up a strong team whose task is to make the visit of each patient to Medicina JSC maximally comfortable and effective. All the doctors are first rate health care professionals that graduated from the world’s best institutions and attended training at American, Israeli and European clinics. Medicina JSC is one of the flagships and leaders of Russian socially accountable private medical institutions, which is confirmed by the numerous diplomas, awards and quality marks it has received. 2001 Badge of honor “Enterprise with a well-organized accounting system, a note of acknowledgement from the Mayor of Moscow for successful work connected with rendering highly qualified medical care to Muscovites. 2002 A note of acknowledgement from the Rector of M.V. Lomonosov Moscow State University for providing highly qualified and free medical care services to students and employees of the University. 2003 Certificate of Merit from Moscow Healthcare Committee for work connected with rendering highly qualified medical services to Muscovites. Letter of thanks from Svyatoslav Fedorov’s Fund for organizing “Healthy eyes for everyone” campaign. 2005 Diploma of high consumer evaluation of the quality of provided services. “VERIFIED. Russian Consumers Union”, Diploma issued by Russian and Moscow Consumer Protection Funds for active involvement in the establishment of a civilized consumer market in Russia. Medicina Clinic is the first Russian Clinic certified according to ISO. 2006 Certificate issued by Russian Consumer Protection Fund for active participation in “The Best in Russia” contest; Certificate issued by Moscow Consumer Protection Fund: on the basis of a decision made by the public council of experts Medicina JSC gets an award as a participant of “The Best in Moscow” contest. 2007 Certificate of Merit from Moscow Healthcare Committee presented to Professor Grigory E. Roytberg for his considerable contribution to practical medical care rendered to Muscovites. Certificate of membership in the Swiss Leading Hospitals Association. 2008 President of Medicina JSC Grigory E. Roytberg became a laureate of the “Russian quality leader” tournament. 2009 Diplomas issued by Russian Quality Organization (RQO): quality of inpatient and polyclinic services meets the highest level of quality envisaged in RQO’s working program. Winner of the 5th International Quality Tournament among Central and Eastern European countries. 2011 The first and only Russian clinic accredited according to the most reliable Joint Commission International medical care standards. Specialists of Medicina JSC take part in joint scientific projects in collaboration with employees of foreign universities, publish scientific articles and theses, organize and participate in international conferences. Moreover, the Clinic’s experts conduct free educational workshops for doctors from Moscow and free seminars on maintaining health and improving the quality of life for the Clinic’s patients. Medical care Integrated approach to maintaining patients’ health is reflected in the structure of rendered medical care. 95% of medical services are provided to patients of Medicina JSC at the polyclinic, including specialists’ appointments (by disease and for preventive purposes), outpatient surgery, dental services, diagnostics (diagnostic equipment and laboratory diagnostics), rehabilitation and restorative care. Inpatient services make up 4% of all services provided by Medicina JSC. The existing inpatient facilities will be considerably expanded after the new building of the Clinic is put into operation in early 2012. In addition to hi-tech treatment and diagnostic procedures, the Clinic’s patients also get domiciliary care services (by disease, diagnostics and preventive examination) which make up 0.6% of the total number of medical services rendered, and ambulance medical care (0.4%). Share of Medicina JSC in Moscow’s private health care facilities sector is 2.34%. 8
  • 9. The Clinic implements advanced achievements of the world’s healthcare system in its activities, which is confirmed by international health care experts, and performs systemic work to apply innovative technologies. 9
  • 10. Medicina Clinic. All the best in medicine. Mission Mission of Medicina JSC is to provide patients with complex personified medical care on condition of partnership and active involvement of patients in making decisions on their health and well-being. Ensuring that patients have access to complete and trustworthy information. Meeting requirements re. maintaining and improving health and quality of life. Vision We establish a clinic of international acclaim, which retains its leadership position on the Russian private medical market. Following changes in society’s demands we are constantly mastering all the aspects of our activities in order to ensure the maximum customer satisfaction level and the ideal quality of medical services. By achieving the highest results we set new criteria for the assessment of medical care quality and patients’ satisfaction. Studying and analyzing society’s demands and patients’ satisfaction. Studying and analyzing society’s demands, patients’ satisfaction and the quality of rendered medical services allows the Clinic to constantly compare the results of its activities with the indicators of the world’s leading clinics. Aspirations for excellence have no boundaries in time or space and are viewed as an ongoing impetus for development. Values/principles for improvement Serving patients’ needs:  perceiving patients and their families as partners in the process of treatment;  constant sincere wish to help each and every patient;  providing to patients access to the information about the type, diagnostics and treatment of their diseases; interaction with patients in support of their intention to be well-informed when making decisions about their health and well-being;  truthfulness and sincerity in our every action;  exceeding the expectations of patients and their families. Commitment to quality:  constant aspiration for the ideal quality of services;  ongoing improvement of all processes ensuring the highest quality (professionalism, quality of service, technologies expertise, management quality);  everlasting aspiration to achieve the highest results in every action (measuring, monitoring and reporting as regards services and quality standards and customer satisfaction, comparison with the best representatives in the group). 10
  • 11. Team work:  interaction of specialists providing medical assistance to patients as a team of highly qualified and committed professionals having common corporate culture;  joint work in the spirit of cooperation, with active participation of everyone and encouragement of personal initiatives;  implementing the succession principle when treating patients;  constant interest in professional development of each employee;  establishing and supporting close working relations among employees, with partners and other public institutions. Social accountability:  work for good of mankind, preserving and improving the health of population and raising the quality of life;  support of the communities where we live and work;  support of the needy and assistance in hard financial conditions;  desire to change in response to the changing demands of society. Finances and control:  using a systemic approach to choose and finance projects that contribute to higher efficiency and effectiveness of business and help to achieve goals supporting this mission;  functioning not for mere wealth, but for ensuring sufficient financial feedback, given current and future needs and demands;  achieving high performance results by effectively using resources, including intangible resources;  reporting re. resources used at all the levels of the company. Challenges and strategies. Currently, investments into health are becoming one of the most reliable types of investment, which can have an impact on long-term demand growth prospects. Medicina JSC orients towards the continuous improvement of medical care quality and service by attracting the expertise of the world’s best healthcare institutions. By competing with Russian as well as with the world’s best clinics the Clinic responds to today’s macroeconomic challenges. Medicina JSC has become a real alternative to foreign clinics for CIS citizens in connection with its accreditation according to the most reliable international JCI medical care standards in 2011. Nowadays the Company has three strategic goals: 1. Constant improvement of the Clinic’s activities in order to satisfy patients’ demands in full and retaining leadership positions for quality in the Russian private medicine market through improvement of a management system. 2. Ensuring a steady growth of the Company’s revenue and income. 3. Well-balanced growth in the scope of rendered medical services, including a wider range of hospital services in connection with the construction of a new building. Construction of the Clinic’s new building. Currently, we are implementing a project of the building’s reconstruction on the territory adjacent to the existing building, which was started at the end of 2009. The project’s implementation will considerably expand the Clinic’s opportunities connected with the provision of full-scale medical care to patients and ensure that the Clinic will become one of the best clinics in Europe as regards the applied technologies, including IT technologies penetrating into and securing all production processes. The new treatment facility of Medicina JSC occupying over 20,000 m² will house a 100-bed inpatient section with 4 surgeries, including a cardiovascular hybrid operating room, a big intensive care unit, admissions, single and double occupancy wards, a VIP section for 5 wards, Therapy and Family Medicine Chair of RSMU and other support services. A cardiovascular hybrid operating room combines the opportunities of an operating room for cardiac intervention treatments and open heart surgeries. At this type of operating room one can simultaneously perform such surgeries as balloon angioplasty, stenting and heart bypass operations. Hi-tech cardiac surgery is one of the most important areas of the Clinic’s development. 11
  • 12. Moreover, the new building will also house advanced medical equipment: 2 MRI scans of the latest generation, a Positron Emission Tomography machine and a robotized set of laboratory equipment. The old and the new buildings will be connected by a sheltered underpass. The new building will be put into operation step by step in 2012, given the balanced growth of its capacities with a view to reaching the expected targets within a year from the launch of the inpatient facility. Business strategy. The strategy of Medicina JSC is based on mastering its socially accountable activities. 1. Serving patients’ needs. The most important customer-oriented target is to ensure that patients are provided with high quality medical care and service. For evaluation purposes, we introduced customer satisfaction ratios re. the quality of service rendered at the polyclinic and at the inpatient facility. We reach our targets by following our own quality standards and using the best medical practice achievements (MES “Same day practice”, “Doctor-supervisor, individual assignment of doctors to patients, hospitalizations, patients’ feedback”, Continuity, Health examination, “Completed case”, “Relation of recurrent appointments to initial appointments”, “Lines”). We exercise control and review the implementation of JCI international standards re. the quality and safety of medical care; control and analyze conformity with claims and complaints regulations; have introduced performance indicators for doctors and nurses; control the operation of medical devices; arrange infection, laboratory and radiation safety management as well as management over the storage and use of pharmaceuticals. The task of the Advertising and Marketing Departments is to increase the Clinic’s recognition among patients. We monitor the recognition ratio using the Business Star methodology and hope to reach 10% by 2014. We connect recognition with the use of innovative solutions in our activities to ensure patients’ well-being 2. Commitment to quality. The targets of this prospect for ensuring leadership with regard to the quality of medical services aim at the improvement of internal processes. The targets of this group of goals are implemented through measures aimed at the development of the Clinic’s innovative potential, use of the quality criteria of the “University clinic” and introduction of a system that controls and reviews the extent of achieved results. The KPI system ensures systematic control and individual evaluation of each employee’s performance (be it a doctor or a nurse), review of the extent of achieved results and creation of educational programs for employees. There are 4 types of control: control of the 2nd, 3rd, 4th levels (daily, monthly, quarterly control) and control as per check lists. The results are summarized by the Quality Committee. Based on these results, we elaborate plans for improvement and training programs. Control measures take account of the percentage of negative marks and their share in the List of comments. The biggest percentage of comments affects the form of a training program. Medicina Clinic serves as the base for the Chair of Therapy and Family Medicine of N.I.Pirogov Russian National Research Medical University (RNIMU), with training provided to doctors specializing in “Therapy” and “General practice” (Family medicine). In collaboration with the Iowa State University the Clinic organizes international symposiums and scientific and practical international conferences. 3. Teamwork/Staff/Development. The targets of this prospect aim at increasing employees’ loyalty and commitment. Indicators: employees’ satisfaction and stability (turnover, percentage of employees working for 7+years), improvement of staff’s qualifications. The targets are implemented via a system of motivation, considerable increase in discounts for medical services for employees (additional services) and their family members, social benefits, 100% health examination, vaccinations. Institute of Consultants started its development as a school of medical art. Consultants are involved in rounds, councils, consultations, training and scientific events. An attestation program ensuring the employee’s individual growth has been adopted. The Clinic supports 4 types of training; over the recent year internal education has come to the foreground. Also, the important indicator is the ratio of doctors of the highest category as well as the ratio of candidates and doctors of medical sciences. 4. Social accountability. Social development targets are aimed at ensuring the Clinic’s steady development as a socially accountable company. We create our social strategy on the basis of the 4 following success factors: - Transparency, openness and social accountability. An open report incorporating socially relevant targets and indicators is available at www.medicina.ru. The Clinic has been granted “The Best Moscow Employer” Award. -. Free will to establish relations with professional communities. We reach our targets by disseminating accumulated knowledge and organizing free lectures and workshops for Moscow doctors. We invite leading Moscow specialists to provide consultations. Doctors have the opportunity to participate in Clinic’s rounds, clinical debates and conferences. The Chair’s employees ensure the activities of a free “school of health”. 12
  • 13. - Guarantees of quality combined with best practice standards. Any medical care is rendered in accordance with the standards of medical care guarantees, which practically secures an equal number of medical services for various categories of patients. In order to improve the quality of our patients’ life we introduce recent and most advanced medical technologies. The indicators of innovations are taken into consideration in all areas of medical activities and each new area represents a new area for consumers. - Charity. “Healthcare Fraternity” Foundation was established. The Clinic takes part in “Fedorov’s days” Moscow charity program and helps to equip a district hospital. The charity program orients towards the areas where we are most competent and where the maximum results for society can be achieved. 5. Finances and control. The main financial targets of the Clinic are company value growth (income and revenue indicators), capitalization via reinvesting income into the Clinic’s development (min. 50% of net income is invested into further development of the Clinic), ensuring high profitability and increase in the share of high tech services provided by the Clinic (since 2011). Innovative SMART-clinic project In 2012 Medicina JSC will put into operation a new building whose area exceeds 20,000 m2. The new building is not only a tool for expanding the scope of rendered services and reaching the best financial results. It is related to the introduction of qualitative changes in our activities and turning into reality our dream of the Clinic of the 21st century. In the run up to the opening of a new building, development of technological opportunities and provision of the new quality of services Medicina JSC has been implementing a smart clinic project in collaboration with IT leaders. This project is based on a Data Processing Center (DPC) designed in accordance with reliability, safety and fault-tolerance requirements. The smart clinic project underlies centralized management over the engineering and IT infrastructure of the building. This is a pilot project that has no analogues in Russia. The new premises will be used to expand the inpatient section and house a diagnostic department, Therapy and Family Medicine Chairs of RSMU, engineering services and a cancer center of the international level. These projects should be implemented in those areas of medicine that lag behind the world’ best practice as far as Russia and Moscow are concerned. We trust that our choice will improve the quality of life of our patients and will give them hope in resolving their problems. An interdisciplinary inpatient facility at the new building of the Clinic is intended for 100 beds. It is going to have 4 modern operating rooms, including a hybrid operating room, and an intensive care unit. Smart operating rooms that will be put into operation at the new building of the Clinic serve as a vivid example of how hi tech technologies are implemented in the healthcare sector. In particular, an automatic anesthesia control system is envisaged to be used at such operating rooms. Once a surgeon enters a smart operating room all the equipment is already adjusted according to his/her preferences, which cannot but contribute to a successful result of any surgery. Cancer centre of Medicina JSC 13
  • 14. In 2012 Medicina JSC will put into operation a new building with a high tech cancer center that is being built with methodological assistance of foreign clinics (Memorial Sloan Cancer Center, USA, and Rabin Medical Center — Davidoff Center,Israel). This is a socially relevant project. The Cancer center of Medicina JSC will be a role model and will implement all the world’s known existing innovative technologies for diagnosis and treatment of cancer patients. The cancer center is intended for: Improvement and implementation of new radiation technologies for diagnosis and treatment of the most serious diseases. Provision of a full scope of hi tech treatment and diagnostic services to population. The cancer center of Medicina JSC will house a Radiation Detection Department (using the first in Moscow PET/CT Gemini TF Philips and Bright View Gamma Camera), a Radiation Therapy Department equipped with two linear accelerators of the revolutionary new TrueBeam model produced by VARIAN (the first in Russia) and a Chemotherapy Department for 25 posts combined with a laboratory preparing chemical agents and an outpatient center for cancer patients. Radiation healthcare technologies (diagnostic and therapeutic) are widely used in practically all countries of the world. As soon as a cancer center of Medicina JSC is put into operation it will allow Medicina JSC to reduce the cancer death rate by 25%. We plan to provide high tech treatment to patients suffering from malignant tumors (main localizations) and cardio- vascular diseases. Treatment of cancer pathologies will be provided both as a separate solution for radical or palliative care and can be also used as a stage of combined and complex treatment of malignant tumors (main localizations). The cancer center of Medicina JSC will become a part of a bigger clinical complex. This not just an advantage, this is a necessity. It is very important for any patient to undergo diagnostics and get treatment at an interdisciplinary clinic, since any person has his/her own peculiarities as well as aggravating and ancillary diseases. At our center we will choose the optimal and individual approach to treatment of our patients. Medicina Clinic implements state-of-the-art visualization technologies with the help of the most advanced equipment: CT scans, MRI and PET/CT machines that can provide all the information required for treatment recommendations, including the latest single cancericide dose technology. Radiotherapy plays an important role in treatment of various types of cancer. Even now cancer patients have to undergo long radiotherapy procedures that might take 4-6 weeks. This is pretty tiring. We are introducing a technology that could allow us to reduce the number of sessions from 30-40 to 1. The doctors of the cancer center attended training in the US and Israel. F.e., among our employees are unique specialists – medical physicists that have undergone serious studies abroad. Our approach to diagnostics, treatment and rehabilitation at the cancer center of Medicina Clinic is substantially different from the common approach. Diagnostics would take 24-28 hours, i.e. we will perform all required examinations, incl. morphology and biopsy, within two days. Afterwards the council of doctors of various specialties, with the best foreign consultants involved, if necessary, will work out an individual treatment plan. Then we will keep an eye on the patient who will get all types of treatment until his/her recovery or disease remittance. By applying the most effective diagnostic methods and providing integrated treatment of cancer we do our best to extend the longevity and improve the quality of life of patients. Thus, in Moscow and other metropolises the average age of men who are diagnosed cancer is 61 years. In Germany and other developed countries they live 12.5-14 years afterwards, while the figure for Russia is as low as 2.5 years. So, we have been fighting for these 12 years. Benefits of Medicina Clinic. In its activities the Clinic implements advanced achievements of the world’s healthcare system, which is confirmed by international health care experts. 14
  • 15. Quality of medical care in accordance with the world’s best standards. Medicina JSC is the only clinic in Russia accredited according to Joint Commission International (JCI). This is the most objective and prestigious international healthcare certification which serves as the evidence of conformance of a medical institution to the world’s healthcare and administrative standards and, also, to the requirements for securing international patient safety goals. In 2010 the Clinic became a laureate of the Russian Government Quality Award. This Award is granted on a competitive basis for considerable achievements as regards the quality of products and services, ensuring their safety and introducing highly effective quality management methods. Moreover, Medicina Clinic is a laureate of the “Russian Quality” program. Having successfully passed the evaluation of medical services carried out by independent experts in 2009 the Clinic was the first Russian organization to have received the Certificate of the Russian Quality Organization and “Russian Quality” Diploma as well as the right to use the “Russian Quality” Mark which is the replica of the Quality mark used in the USSR. RQO takes responsibility for the quality of medical services provided by the Clinic and therefore reconfirms its right to use the “Russian Quality” Mark on an annual basis. As far back as in 2005 the conformance of Medicina Clinic to ISO 9001:2000 requirements was approved by the certifying organization TNO-Sertification (Netherlands). The Clinic successfully undergoes annual compliance audits тo prove its conformance to the requirements of the Quality Management System (QMS) ISO 9001:2000. In 2009 during recertification audit the certifying organization Moody International Group acknowledged the conformance of the Clinic’s quality management to the requirements of QMS standards ISO 9001:2008. Medicina Clinic has received a Recognized for Excellence ***** (5 stars) Award from the European Foundation for Quality Management (EFQM). In order to maintain this 5* level, we study and use the world’s advanced experience and introduce the best practices and management technologies. By establishing relationships with partner organizations we adhere to the principle of commitment to quality. We are constantly making our best efforts to improve our work and raise the quality of our health care services on the basis of a dialogue with patients. In 2009 the Clinic became the winner of the 5th International Quality Tournament among Central and Eastern European countries. In September 2007 Medicina Clinic joined the Swiss Leading Hospitals Association. SLH members are substantially different from ordinary clinics, since they ensure the highest European and world’s quality of health care services and, what is more, such guarantees apply to both medical care and the highest quality of service. Medicina JSC reconfirms its right to be a member of such an honored association once in 3 years during compliance audits. Dialogue with a patient. Clinic’s guarantees. We strive to interact with patients as our partners in order to maintain and improve their health and anticipate their expectations. Medicina Clinic offers its patients detailed Guarantees (quality evaluation criteria) and is ready to take responsibility for its commitments. Guarantees provided by Medicina Clinic ensure rights observance and patients’ safety. Guarantees are real obligations for the performance of which the Clinic can be responsible (material and reputation responsibility). Information on guarantees is open to public. Best doctors and medical staff. We have established a system for training doctors and exchanging experience with the world’s best clinics. When medical staff are employed by the Clinic we strictly check their qualifications. Medicina JSC is a clinical base for the Chair of Therapy and Family Medicine of N.I.Pirogov Russian National Research Medical University (RNIMU). The building of Medicina JSC houses a training and laboratory base of the Chair. Medicina Clinic is an interdisciplinary University clinic whose clinical, training and laboratory bases are used for scientific and clinical developments in various fields of medicine. Within the framework of the Institute of Consultants (advisory body to ensure agreed actions when resolving medical care provision tasks) consultations are provided by academicians and corresponding members of RAMS, Professors and leading specialists in various fields of medicine. President of Medicina JSC Grigory Efimovich Roytberg is a practising physician, RAMS Academician, Professor, M.D. and Honored doctor of the Russian Federation. He is also a laureate of the Russian Government Education Award. Openness to patients. To some extent, the Clinic’s openness is stipulated by the requirements of international standards. We meet the criteria of the best international clinics, as our readiness to keep the conversation going and our care about patients have become the philosophy of our Clinic. Thus, any patient can evaluate the Clinic’s doctors 15
  • 16. according to several criteria at the Clinic’s web-site. The doctors rating, open to public, is made up in the real time format. The Clinic’s web-site and medical information system are interconnected. That is why patients can make an appointment at the web-site and look through their health records, examination results and tests in the Personal cabinet section. Patients can get a DVD with their examination results in order to receive the so-called second opinion of doctors from other medical institutions. Patients’ feedback is very important to us, this is the reason why we pay close attention to consideration of patients’ proposals and questions received via the web-site, when patients refer to the Clinic’s employees as well as those left at special log books that are kept with cashier-administrators. Registered users can review the stages of their referral to the Clinic online. Any online visitor can ask doctors his/her question by calling the “hot line”, receive information using SKYPE, calculate the cost of the annual health contract and pay for the Clinic’s services with a bank card via the Internet. Full range of medical care services with a view to saving patients’ life and improving its quality: polyclinic, diagnostics, interdisciplinary inpatient facility, cancer center. Organizing medical care. For the purpose of ensuring safety and high effectiveness of treatment, we follow the principle put forward by the Academician N.A.Semashko “One patient – one physician”. A supervising physician treats the patient as a family doctor, therapist or pediatrician, coordinates treatment assigned by other specialists and is involved in treating his/her patients at the inpatient section. Medical activities are tied to meeting medical and economic standards of rendering medical care existing in Russia. Patients’ consultations are documented in electronic health records and the results of diagnostic tests carried out by hi tech equipment are recorded and given to patients on a DVD. Thus, the patient can present a medical assessment report based on the results of the examination and a video of the examination on a visit to another clinic. Hi tech medical care. IT-infrastructure. In its activities the Clinic implements advanced achievements of the world’s healthcare system and performs systemic work to apply innovative technologies. Medicina JSC belongs to the list of innovatively active healthcare institutions of Moscow whose base can be used for performing clinical research. Having the best treatment and diagnostic base in Moscow we offer our patients a full range of medical services. We pay close attention to the introduction of state-of-the-art IT technologies contributing to the improvement of the quality of medical care provided. The Clinic uses an electronic health record system (EHR) and has also launched digital archives solutions allowing it to store screening results obtained with the help of various medical devices (CT scan, MRI scan, X-ray machines, ultrasound and endoscopic equipment). Medicina JSC is implementing a smart clinic project. This project is based on a Data Processing Center (DPC) designed in accordance with reliability, safety and fault-tolerance requirements. The modern data transmission network is intended for the transmission of large volumes of information and meets safety requirements stipulated by law. Smart operating rooms are a vivid example of how hi tech technologies are implemented in the healthcare sector, f.e. an automatic anesthesia control system. Once a surgeon enters a smart operating room all the equipment is already adjusted according to his/her preferences, which cannot but contribute to a successful result of any surgery. The smart clinic project underlies centralized management over the engineering and IT infrastructure of the building. This is a pilot project that has no analogues in Russia. Atmosphere of comfort, care and friendliness. We do our best to make our patients feel comfortable. Care about patients is the core of any our activity. Patients are met by friendly and caring employees that escort them around the Clinic to the office they need, help to get the required documents prepared and to obtain a desired consultation. It usually takes no more than 24 hours from the moment when the patient visits the doctor for the first time until the moment when he/she receives the results of his tests, examinations and doctor recommendations. The styles of the Clinic’s interiors are developed by designers for individualization of various departments and patients’ comfort. Clinic’s guarantees Medicina JSC offers its patients detailed GUARANTEES and quality evaluation criteria and is ready to take material and moral responsibility for its commitments. Upon a visit to our Clinic each patient is guaranteed: Medical examination in full compliance with medical standards. Personal supervising physician Escorting around the Clinic Lack of lines Written recommendations 16
  • 17. Provision of personal access to health records via the Internet Provision of all test results and videos of surgeries under anesthesia on a CD Provision of information on medications used Consideration of patients’ enquiries to the Clinic’s administration, with a written response guaranteed Material compensation for unjustified claims or the Clinic’s non-fulfillment of aforementioned guarantees Guarantees of Medicina Clinic ensure the observance of patients’ rights and security of patients. Clinic guarantees are concrete obligations for whose performance the Clinic bears material and reputation responsibility. Information about guarantees is publicly available. Strengths of Medicina JSC The Clinic can ensure the stable quality of medical care at its inpatient facility and polyclinic for the following reasons:  The Clinic provides medical services in practically all areas of medicine.  Services provision organization and quality management system are standardized.  We are constantly performing work to introduce and use state-of-the-art technologies and advanced treatment methods.  Our doctors have graduate degrees, have been assigned the highest or first qualification categories. All our employees are always improving their qualifications. F.e., doctors and nurses attend training in foreign clinics.  Medical documentation is maintained in the electronic format, which is convenient for patients and facilitates doctors’ activities.  All offices where patients are admitted are equipped with the latest appliances and conform to hygiene rules and regulations as well as to medical esthetics requirements.  Medical services are rendered in accordance with MES, with regular control exercised over the treatment and diagnostic process.  Medications and medical products are purchased only from reliable suppliers on condition of the availability of all necessary quality certificates, etc.  Patients have the opportunity to access their health records online. Future of the Clinic We establish a clinic of international acclaim, which retains its leadership position on the Russian healthcare market. Following changes in society’s demands we are constantly mastering all the aspects of our activities in order to ensure the maximum customer satisfaction level and the ideal quality of medical services. By achieving the highest results we set new criteria for the assessment of medical care quality and patients’ satisfaction. Studying and analyzing society’s demands, patients’ satisfaction and the quality of rendered medical services allows the Clinic to constantly compare the results of its activities with the indicators of the world’s leading clinics. Aspirations for excellence have no boundaries in time or space and are viewed as an ongoing impetus for development. Impact on society The interaction of Medicina JSC with society is established on the basis of social accountability. The specific feature of the Clinic’s activities is in its essence connected with preserving and improving population’s health and raising the quality of life. The Clinic supports the communities where we live and work. In the first place, it orients towards creating favorable labor conditions for staff, which is confirmed by its regular recognition as the “Attractive employer” by the Superjob portal. The Clinic has organized and regularly conducts free “Schools of health”, training sessions in the following areas: gastrointestinal diseases; carbohydrate metabolism disruptions and cardiovascular diseases (subject to change depending on consumers’ demands). The annual budget is min. RUR 6,5 mil. The Clinic’s interaction with municipal authorities in the area of science, industrial policy and health care of Moscow underlies R&D activities under state contracts (clinics for performing various types of works are chosen on a tender basis), providing specific scope of hi tech expensive medical care to the population of Moscow, 17
  • 18. elaborating a scientific and technical base for the use of advanced medical technologies in practical activities of Moscow’s treatment facilities. The Clinic gives charity donations to non-for-profit public organizations. Under the Order of the Healthcare Department of Medicina JSC has been implementing a number of socially important charity programs for the citizens of Moscow on a contractual basis, namely: CT scanning for patients as per the referrals from Moscow’s healthcare facilities – 1260 examinations performed. MRI scanning for patients as per the referrals from Moscow’s healthcare facilities – 5037 examinations performed. X-ray bone densitometry (536 female patients) and genetic tests to diagnose osteoporosis (5 female patients) as per the referrals from all maternity welfare centers of the Central Administrative District of Moscow (for free). Hi tech cardiac surgery to low-income citizens of the Central Administrative District of Moscow (16 surgeries). Charity Foundation “Medical Fraternity” The Clinic renders assistance and support to those in need. A specific area of such assistance is support provided to Russian medical community. In 2011 the Clinic founded Charity Foundation “Medical Fraternity” providing assistance to health workers (the Foundation’s capital for 2011-2012 is 10 mil. RUR and its capital for 2014 is 40 mil. RUR). This is a unique Foundation, as decisions on whom assistance should be rendered are made by medical staff on the basis of voting. Doctors that save lives often find themselves in a predicament. Charity Foundation “Medical Fraternity” has been set up by Medicina Clinic to help health workers of Russia. This is a unique charity project that unites representatives of the medical community, patients, medical institutions and best organizations of the country. This is a venue where charity providers interested in the development of the Russian healthcare system and health workers needing help and support meet. It is charity providers, patients and representatives of the medical society that influence the Foundation’s decision on whom aid should be rendered on a voting basis. The basis of any charity project is people developing this project, who are not indifferent. Charity Foundation “Medical Fraternity” has been set up by Professor Grigory Roytberg. As a doctor he knows the problems of health workers from inside out; as the organizer of a health care company and the general manager of one of Russia’s most successful private clinics he can transform general “petty little things” into the powerful stream of support that can change the situation in the Russian healthcare sector for the better. The Clinic’s activities are characterized by unprecedented openness and dialogue with a patient. Patients can look through their health records online, get videos of surgeries and examinations on DVDs and evaluate the activities performed by the Clinic’s doctors at www.medicina.ru. Free workshops for doctors from Moscow’s healthcare facilities and their attendance by min. 600 people per annum. 18
  • 19. Opening the cancer center of Medicina JSC with Radiation Detection, Radiation Therapy and Chemotherapy Departments in September 2011. The new cancer center will allow to increase the number of newly detected malignant tumors by 15-20%; improve the quality of diagnostics of cardio-vascular diseases by 30-40%; achieve a five-eightfold reduction in the number of cancer recurrence; achieve cure of locally advanced prostate cancer in 95-99% cases; reduce cancer neglect rates by 15-20%; reduce cancer death rates by 5-30%. Providing services to people living nearby under mandatory health insurance programs, at lower rates and on a free basis for patients. Contribution to the development of the social infrastructure of Moscow (2006-2011) Okrug residents This diagram shows the number of residents of the Central Administrative Okrug of Moscow that obtain the Clinic’s services under mandatory insurance programs. Under mandatory insurance programs, i.e. on a free basis, the Clinic provides its services to residents of the Central Administrative Okrug of Moscow. The number of residents of Central Administrative Okrug is going down due to the natural decline of the population and its migration, changes in preferences re. the place of residence (relocation from the city center to Moscow region suburbs) A few research and development projects under the City’s order have been implemented (non-for- profit activities). F.e., medical equipment was handed over to Taruss hospital and Hospital No.82 for free. 19
  • 20. Medicina Clinic provides dispensary services to World War veterans and invalids. 1- Total, WWV, dispensary services, 2 – Obtained dispensary treatment, 3 – Obtained health resort treatment. 20
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  • 22. HR POLICY AND ORGANIZATIONAL CULTURE HR Policy Medicina JSC’s HR policy allows each employee to understand his/her role in the Clinic, feel involved in the system of values created there and in the Company’s mission, adhere to single standards of behavior and communication with partners, clients and colleagues and obey corporate culture principles. Our patients are people whose life’s top priority is health. We are responsible to our patients, whether adults or children. By providing highest quality medical aid and applying the widest range of medical services and advanced technologies we improve our patients’ health, lengthen their life and improve their lifestyle. We do our best to make all our employees interested in the successful development of Medicina JSC by considering it as their professional and personal success, being sure of their future and socially protected. Our commitment is to make labor compensation fair and reflecting the partnership between Medicina JSC and its employees. Our objective is efficient management. Understanding our responsibility for work in the permanently changing environment we use best efforts to constantly improve and perfect our activity. We are open for stable and efficient partnership and ready for fair competition. We respect and strictly adhere to State laws. We are open for partnership with parties and social movements whose activity is aimed at social health. Basic Corporate Culture Provisions Professionalism The fundamentals of our work are competency, responsibility and experience. Medicina JSC is a company of professionals. All our clients are sure to receive maximum attention to their problems. We do not divide clients into more or less important ones. Each client will receive high quality medical services and may always rely upon the competent help and consulting of our specialists. Stability Medicina JSC has been working in the medical service market for more than a decade. Our sustained development throughout the Company’s entire history and the vast experience we have accumulated ensure our decisive forward movement in the dynamically developing market conditions. Medicina JSC does not target achieving short-term success or raising fast money. We prefer establishing long- term mutually favorable relationships with reliable partners and employees because we plan working in this market long and stable. Reliability Medicina JSC regularly monitors the market of medical services to be able to competently predict possible changes in the financial, economic and social segments and work successfully in the new conditions. Being keen for its perfect business reputation, Medicina JSC has always fulfilled and will always fulfill all its obligations to its clients, employees and partners. People trust us, and this trust is well deserved. Openness Practice shows that to be trustworthy a company should be clear and understood for its clients, employees and partners in it activity. We are therefore committed to maximum possible openness in providing medical aid. Social Orientation The main value of Medicina JSC are people who have trusted it with their careers. The fundamental principle of the Company’s HR policy is to develop the optimum conditions for the complete implementation of its employees’ capabilities, competence and skills and provide deserved compensation for their work. Medicina JSC is a unified team. Success of each employee is a component of the success and prosperity of the entire Company. Medicina JSC has deserved the trust and recognition among its clientele thanks to the principles all its employees abide by. Medicina JSC’s General Ethics and Activity Principles Medicina JSC’s professional activity is based on the following principles:  applicable legislation of the Russian Federation, regulatory documents and standards of the Ministry of Health and Social Development of the Russian Federation, Department of Health and State Sanitary and Epidemiological Supervising Body of Moscow and Moscow State Fund for Mandatory Medical Insurance that govern the activity of health institutions; 22
  • 23.  understanding of the civil and professional duty before the society, state and Russian citizens;  improvement of corporate management and in-house control;  absolute fulfillment of all the obligations and guaranteed high quality of services;  full responsibility for the quality and results of our work;  fair competition and active opposition to unfair players in the market of medical services. Medicina JSC does not accept in its activity:  violations of applicable legislation, moral rules and business ethics;  infringement of rights, lawful interests and dignity of shareholders, clients and partners and inflicting damage to Company’s image. Medicina JSC Firm Style Medicina JSC has a unified standard style of all printed media and souvenirs making our Company recognizable, a standard procedure of service provision in all the departments and a regulated procedure of applying the firm logo and name of Medicina JSC. Business printed media of the Company’s departments (forms, envelopes and personnel business cards) are produced to a unified style using the officially registered symbols and color design. Medicina JSC’s departments are not allowed to make modifications to the firm logo and the unified form and style of the Company’s business printed media. The design of the Company’s logo and name on the advertising and souvenir media (pens, calendars, notebooks, leaflets, booklets, ads etc.) conforms to the officially registered reference of the firm logo and the font style. Firm dress style is another component of our corporate culture which is of special importance for medics and contact persons. Socio-Psychological Climate Medicina JSC’s in-house communication standard is confidence and high mutual exactingness between our staff members, benevolent and practical criticism, freedom of expressing one’s opinion when discussing maters important for the entire Company, managerial right to make decisions that are important for respective divisions, sufficient awareness of employees and satisfaction of being part of the team. The establishment of a good business climate in Medicina JSC favored by the employees’ exact knowledge of their respective responsibility areas which excludes any possible conflicts arising thereupon. The open policy and transparency of compensations further reinforces the favorable socio-psychological climate of Medicina JSC. Conflict of Interests Management Principles The main conflict management principle employed by Medicina JSC is to prevent a conflict or avoid its aggravation. Should some conflict develop, our managers attempt to make use of it for the Company and encourage practical criticism and proposals from employees. A conflict can be taken under control if employees have the will and experience of such work. The Company manages possible conflicts using the conflict party functional separation method and internal restructuring of the conflict situation. Conflicts are resolved using the ‘through confrontation to cooperation’ approach (negotiations). Medicina JSC Employee Business Behavior Code It is a good practice in Medicina JSC to respect other colleagues regardless of their position. The Company’s Management is responsible to its personnel. The Company’s Management builds its relationships with the personnel based on the following fundamental principles:  the Management observes the Labor Code and other laws regulating labor relationships with employees;  the Management observes applicable occupational health and safety standards; 23
  • 24.  the Company does not apply any discriminating rules to employee hiring, compensation and promotion. All employees have equal career opportunities in accordance with their competence;  the Management grants all the employees equal rights and opportunities in developing and expressing their capabilities;  the Management consults employees on labor conditions and other issues affecting the Company’s personnel;  the rules relating to compensations, discounts, promotion and other labor conditions have been defined clearly and distinctly for all employees;  the Management fulfills its obligations relating to making contributions to retirement funds;  the Management has the right to enforce discipline among the employees by any lawful means including dismissal of employees in breach of discipline in accordance with the applicable legislation;  the Management takes into account the opinion and personal values of employees;  the Management builds its relationships with the employees based on collectiveness and cooperation principles. Medical Service Quality Management There are many definitions of what quality is, yet there’s been no universal one. We believe that in what concerns medical activity quality should include the following two equivalent components:  first, this is about every medical aspect such as necessary competence of doctors, low medical error risk, a system allowing timely identification and correction of situations bearing the threat of medical errors (e.g. mammary gland X-ray images are necessarily analyzed by two radiologists in order to avoid breast cancer omission), and a medical and economic standard compliance control system;  second, these are deontological aspects, i.e. the patients’ perception of medical aid, including its service component – this is what patients can evaluate on their own (being not specialists in medicine they cannot judge on the correctness of therapeutic approach). Furthermore, to ensure sufficient in-house business process quality control, Medicina JSC uses the following procedures: regulated in-house audit procedures, weekly managerial supervision, systematic checks of sanitary and epidemic control and medication expiry dates, personnel competency checks and monthly personnel work quality evaluation. For outsourced processes Medicina JSC appoints the so-called ‘Process Owners’ to bear responsibility for tendering, contract preparation and partner interaction and ensure necessary controls and contract obligation fulfillment. The management of such processes is documented. 24
  • 25. Clinic’s guarantees. Looking through patients’ eyes The major problem on the way to excellence encountered by everyone who has ever worked in this field is to look at your company through your customers’ eyes, through your patients’ eyes, in our case. We can improve in various aspects of our activities. However, if our patients do not feel it, it means that we have either chosen the wrong strategy or the wrong tactics. For us to be confident that we have chosen the proper and effective way we have been constantly monitoring our patients’ satisfaction. A satisfaction review is carried out regularly. Moreover, we are doing our best to get rid of many negative moments and are being a success in this respect. During 20 years we asked our patients questions about the factors that determined their choice, studied the world’s best health practice and improved our activities to ensure our patients the maximum level of safety and protection of their rights. As of today, we have elaborated the system “Guarantees provided by Medicina JSC on the basis of which our patients can evaluate our clinic. GUARANTEES re. the scope of medical care You will be offered a full and sufficient range of diagnostic and treatment programs allowing one to make a diagnosis and ensure the high quality of treatment at an interdisciplinary University clinic for adults and children, including a polyclinic, an inpatient section and emergency care. Over 340 physicians and consultants, including 60 academicians, corresponding members of the Russian Academy of Medical Sciences and Professors – leading medical experts - take an active part in your recovery process. Annual health programs provided by Medicina JSC offer the widest range of medical services in Moscow as compared to their counterparts. GUARANTEES re. the organization of medical care Our physicians treat a patient rather than a disease. Patients are provided with highly qualified medical assistance in accordance with medical standards, and the doctor explains what it means for patients. We follow the principle put forward by the Academician N.A.Semashko “One patient – one physician”. A supervising physician treats the patient as a family doctor, GP or pediatrician, controls treatment assigned by other specialists and takes part in treating his/her patients at inpatient facilities. Consultations provided to customers are documented in a reliable electronic medical record system. Patients can get access to their personal medical records on line via Personal Cabinet at the Clinic’s web-site. After the appointment the doctor is obliged to provide the patient with written recommendations. The results of diagnostic tests carried out with the use of hi-tech equipment are recorded on CDs and provided to patients. It gives them the opportunity to obtain a second opinion and present both a Medical assessment report based on the results of the examination and a video of the examination on a visit to another clinic. GUARANTEES re the quality of service 25
  • 26. One of the elements of our customer service style is the escorting of patients. Our employee takes a patient to the required office and helps with directions. We save our patients’ time and do our best to render them required medical services as soon as possible, namely:  ensure the opportunity of providing all necessary services on the day of visit.  see to it that patients visit the doctor, undergo assigned diagnostic tests required for making a diagnosis and recurrently visit their ailing physician within 24 hours;  guarantee that patients will not have to wait for their appointments for more than 20 minutes. We create and sustain the atmosphere of care, commitment and consideration for your comfort and tranquility whilst in Clinic. GUARANTEES re. safety Patients can be assured that all medical equipment, furniture and appliances we use are in good working order. The territory of the Clinic is under security surveillance. In addition, we pay special attention to infection control, origin of medicines and safety of applied technologies. GUARANTEES to be heard out We do recognize that it is our patients who are our final arbiters that evaluate the quality of our services. All their wishes, recommendations and opinions will be taken into consideration; not a single enquiry would remain unattended. We guarantee that in case a patient raises a well-grounded claim or the Clinic fails to execute the above mentioned guarantees a patient can be entitled to a material compensation. Certified quality management program Since 2005, on the annual basis, Medicina JSC has successfully passed certification according to ISO 9001:2000 and since 2009 – certification according to ISO 9001:2008. Interaction with the Swiss Leading Hospitals Association allows us to receive and analyze information on state-of-the- art management methods. Awaiting admittance to the SLH Association in 2006-2007 Medicina Clinic carried out self- evaluation according to the proposed criteria, which then pushed us to conduct further self-evaluation under EFQM criteria and afterwards helped us to obtain the Russian Government Quality Award. By implementing our strategic goals and striving for excellence, the Clinic has started to carry out self-evaluation on the basis of the EFQM model with a view to finding the areas for improvement and reaching the best results, as compared to others. The corporate culture of Medicina JSC and principles all the employees follow imply the perception of patients and their families as partners in the process of treatment, a constant and sincere with to help each and every patient, contribution to patients in their desire to be well aware when making decisions concerning their health and well-being and honesty and sincerity with regard to patient-related activities. By following these principles Medicina JSC is constantly striving for the ideal quality of services, ongoing improvement of all processes that can ensure high quality: professional skills, quality of service, technology craft, quality of management; achievement of high results: measurement, monitoring and reporting re. services and standards of quality, patients’ satisfaction, comparison with the best representatives of the group. 26
  • 27. Corporate social responsibility The Clinic’s management views corporate social responsibility as one of the most important principles of adherence to the concept of sustained economic growth in cooperation with its employees, their families, population and entire society with a view to improving their life. Social policy of Medicina JSC Management of Medicina JSC voluntarily undertakes a social responsibility obligation with regard to its staff and creates necessary conditions for highly productive activities, study of advanced experience and achievements in science and technology, ensures relevant pay for their work, rest and safe labor conditions, takes measures aimed at the reduction of the impact of harmful factors on employees’ health, organizes retraining and qualification improvement programs, secures the insurance of professional risks and other social rights and guarantees. To establish employees’ assurance of tomorrow Medicina JSC has elaborated a system of measures aimed at ensuring heir social support guarantees. As a rule, such measures relate to staff-related social measures concerning beyond set legislative requirements and department regulations. Medicina JSC provides its employees stable work at a clinic of the European level which is conveniently located in the heart of Moscow and equipped with state-of-the-art medical appliances, which can ensure the provision of medical care with the use of the most advanced technologies in all areas of medical activities and which has well-equipped offices and nice interior design. 27
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  • 29. PERSONNEL SOCIAL RIGHTS 1. Salary In accordance with the requirements of the Labor Code of the Russian Federation, the Clinic has a Personnel Compensation and Incentive Provision. This document regulates the fundamentals of labor compensation, calculation of compensation amounts and labor evaluation criteria and procedures. Salaries are paid in cash either through the Clinic’s cash department or by transferring to personnel’s accounts, at least twice a month on the dates specified by the duly approved In-House Labor Rules (the advance payment for the first half of the ensuing month is paid on the last day of the current month, and the remainder of the monthly salary is paid on the 15th day of the ensuing month less the advance payment amount). Salary deductions are only allowed in cases stipulated by the Labor Code of the Russian Federation or other Federal Laws. After the calculation of their monthly salaries, Company’s employees receive the complete information on their salary components, each employee receiving a past month payroll. Company’s personnel salary consists of two components: - the basis component, i.e. the official salary, is the guaranteed monetary compensation paid to the personnel for the fulfillment of their respective job duties depending on the skills level and the quantity and quality of labor; - the bonus component which can be paid as a reward for high quality labor and remarkable results. Personnel labor results are evaluated by their respective direct managers, and any bonus payment decisions are made by department directors and approved by Company’s President or Financial Director. 2. Working Day Duration Workloads for different personnel categories have been designed depending on business process structure and type of work and adhere to the applicable regulatory limitations, i.e. max. 40 hours weekly (further regulated by Medicina JSC’s In-House Labor Rules). The following hour workloads have been designed for different personnel categories:  40 h week for administrative personnel;  39 h week for medics, paramedical personnel and ultrasonographers;  36 h week for pharmacists and infectiologists;  35 h week for underage (no such personnel in the Clinic);  33 h week for dentists;  30 h week for radiologists and manual therapists;  20 h week for the logopedist. Workloads have been designed in accordance with the following applicable industry regulatory documents: Order of the Health and Social Development Ministry of Russia No. 588N as of 13.08.2009, Approval of Workload Standard Calculation Procedure for Specific Calendar Terms (Month, Quarter, Year) Depending on Approved Weekly Workload Standard. Directive of the Labor Ministry of Russia No. 41 as of 30.06.2003, Job Combination Rules for Pedagogical, Medical, Pharmaceutical and Culture Workers. Directive of the Government of Russia No. 101 as of 14.02.2003, Workloads of Medical Workers Depending on Position and/or Speciality. Directive of the Health and Social Development Ministry of Russia No. 41 as of 30.06.2003, Job Combination Rules for Pedagogical, Medical, Pharmaceutical and Culture Workers. 3. Disciplinary Punishment The Clinic does not apply or support disciplinary punishments implying any types of oppression or personal offense. Company’s Management has the right to apply the following types of disciplinary punishment for disciplinary violations, failure to fulfill or undue fulfillment of job duties: - reprimands; - reproofs; - dismissal for appropriate reasons (Labor Code of the Russian Federation, Article 192). The application of disciplinary punishment is strictly limited by the existing labor legislation (Labor Code of the Russian Federation, Articles 189-195). 29
  • 30. 4. Non-Discriminative Provision Company’s hiring, compensation, education access granting, promotion, upgrading, dismissal and retirement procedures clearly exclude and disapprove any race, nationality, confession, limited capability, gender, skin color, language, organization participation, political opinion, age or domicile related personnel discrimination. The Company does not hinder its employees’ endeavors to abide by their existential concepts or habits or fulfill their race, nationality, confession, limited capability, gender, organization participation or political opinion related requirements to the extent that this does not compromise their and other employees’ ability to fulfill their job duties and does not violate other employees’ rights. The main personnel admission criteria are conformity of a candidate’s education and competency to the job requirements, professional capabilities, business qualities and the availability of necessary documents. 5. Occupational Health and Safety The Company has established an occupational health management system aimed at protecting the life and health of its personnel. The Clinic has the Occupational Health Arrangement Provision – an enterprise standard regulating the in-house occupational health management system, the functional duties of the occupational health officers, the occupational health training procedure and the occupational health and safety monitoring and supervision arrangements. Workplace Evaluation Workplace labor condition evaluations have been scheduled as per Article 209 of the Labor Code of the Russian Federation and Order of the Health and Social Development Ministry of Russia No. 569 as of 31.08.2007, Approval of the Workplace Labor Condition Evaluation Procedure. 2009-2011 Workplace Labor Condition Evaluation Statistics Total Number Number of Workplaces Evaluated, Including by Year of Name of Structural Divisions where Workplace of Workplaces Labor Condition Categories: Evaluation Labor Condition Evaluation was Conducted Evaluated Total 1 & 2 Cats. 3.1 3.2 2009 Diagnostic Department 77 13 6 7 - 2 Diagnostic Department 15 10 5 - Reconstructive Department 23 15 8 - Dental Department 24 20 2 2 1 Clinical Department 2 2 - - 2010 In-Patient Department 44 5 34 5 Family Medicine Department 10 10 - - Information Service Department 41 36 5 - Security Department 6 5 1 - 149 Information Technology Department 10 10 - - 2 Clinical Department 8 8 - - 2 Diagnostic Department 4 - 4 - 3 Clinical Department 24 21 3 - Medical Service Office 5 5 - - 1 Clinical Department 30 21 4 5 2 Clinical Department 50 36 13 1 3 Clinical Department 17 13 4 - 30
  • 31. Total Number Number of Workplaces Evaluated, Including by Year of Name of Structural Divisions where Workplace of Workplaces Labor Condition Categories: Evaluation Labor Condition Evaluation was Conducted Evaluated Total 1 & 2 Cats. 3.1 3.2 2011 Executive Department 138 2 2 - - Engineering and Security Department 9 8 1 - Procurement Department 20 1 8 - Financial and Economic Department 5 2 3 - Workplace evaluation statistics: a total of 518 workplaces were evaluated (100% of the overall number), of which 179 were evaluated repeatedly (once in 5 years) in 2010-2011. Laboratory measurements and workplace hazardous factor assessments were contracted to the Laboratory Center of the Labor Research Institute. The results were included in hazardous occupational factor assessment reports, workplace evaluation cards and hazardous occupational factor assessment tables. The tests showed that most workplaces have optimum labor conditions (1 & 2 Categories). Assessment results were used for the development and implementation of Cat. 3 workplace labor condition improvement annual schedules. Workplace evaluation cards were made available for personnel upon the completion of workplace evaluation and for newly hired employees during the admission safety drill. Occupational health and safety proposals made by Medicina JSC’s personnel generally seek improvement of labor conditions in specific divisions (development of optimum microclimate and temperature and laboratory measurement of hazardous occupational factors e.g. noise, vibration, illumination etc.). All proposals are analyzed by the Clinic’s Management and forwarded as memo requests to respective utility departments for execution. In 2011 the Medicina Clinic won the District Stage of the City’s Best Occupational Health and Safety Arrangement Competition under the nomination Moscow’s Best Occupational Health and Safety Non-Production Organization. Health and safety proposal statistics 2009 2010 2011 Number of health and safety proposals 84 125 64 All these proposals have been implemented. Occupational Accident Statistics and Cooperation with Occupational Health and Safety Supervising Bodies No occupational health and safety related comments or recommendations have been received from the supervising bodies over the reported period. Occupational accident statistics are summarized in the Table below: Number of Number of Affected Number of Sick Year Occupational Type of Accident Accident Severity Persons Leave Days Accidents 2009 1 Falling on stairs 1 40 Slight 2010 1 Falling on even surface 1 72 Slight 2011 0 - - - - Accident analysis suggests that the origin of the injuries is human factor, i.e. incautious behavior of the affected persons. All the accidents have been investigated as per Article 229 of the Labor Code of the Russian Federation and the Provision for Occupational Accident Investigation in Industries and Organizations approved by Order of the Russian Ministry of Labor No. 73 as of 24.10.2002. The sick leave periods were compensated to the affected persons at the 100% monthly salary rate. 31
  • 32. In compliance with the Labor Legislation of the Russian Federation, Medicina JSC’s personnel have been fully insured against occupational accidents and job related diseases through the Social Insurance Fund. To prevent occupational accidents, heads of the Clinic’s divisions carry out occupational health and safety drills with all the employees following the approved workplace drill schedules and in accordance with health and safety instructions for each job. Health and Safety Costs 2009 2010 2011 Health and Safety 212,005 222,706 226,050 Costs, Rbls. 6. Maternity Support 2008 2009 2010 2011 No. of No. Amount No. No. Amount No. No. Amount No. No. Amount Days of Paid, of of Paid, of of Paid, of of Paid, Perso Rbls. Days Perso Rbls. Days Pers Rbls. Days Pers Rbls. ns ns ons ons Maternity 2252 16 1,640,321 3316 23 2,494,226 3644 26 3,390,551 2686 19 2,654,005 Leave <1.5 Yr. Old Child Support 397 44 2,381,681 307 41 2,030,050 398 47 3,899,503 321 50 3,475,330 Temporary Disability Pay 4988 758 2,336,172 4651 873 2,798,760 8375 965 6,637,255 4298 628 6,691,320 7. Labor Legislation Comments and Claims from Supervising Bodies No occupational health and safety related remarks were received from the State Occupational Safety Supervising Office in 2011. PERSONNEL SOCIAL GUARANTEES Personnel Social Guarantee Objectives and Programs Personnel social guarantee programs include Clinic Management’s initiatives for the implementation of further personnel social support measures in addition to the regulatory ones, i.e.:  in-house job combination options;  annual work result bonuses;  career possibilities;  medical error responsibility insurance;  central catering at reduced prices;  free beverages (coffee, chocolate, tea);  medical servicing at the Clinic;  medicines at reduced prices;  annual medical examination;  sanatorium and child health camp vouchers;  free vaccination;  payments on jubilees, retirement, child birth and other occasions;  certification and upgrading at the Clinic’s expense;  training opportunities in leading European, US and Israel clinics;  research, Ph.D. and Dr. Med. thesis opportunities;  Russian and international conference, seminar and workshop participation opportunities; 32
  • 33. free corporate training seminars;  medical library access;  Clinic’s corporate life participation: holiday events and gifts for personnel and children;  Medicina JSC’s Honorable Worker Title awarding;  adequate compensations adjusted to the market level, regularly paid (twice a month) and annually revised in accordance with the top market salaries. Personnel Social Support Personnel Aids Aids are paid to employees having worked for Medicina JSC during at least 1 year and having no disciplinary reproofs. Aids are approved by the President based on applications from heads of divisions. In extraordinary situations, e.g. where the aid candidate has former disciplinary reproofs, aids can be paid based upon an application from the Social Assistance Committee. Aids are paid in the following cases: a) jubilees: - for men: 50, 60 and 70 jubilees; - for women: 50, 55, 60 and 70 jubilees; b) retirement; c) child birth; d) employee or employee’s close person death. Close persons include spouses, children and parents; e) financial difficulties (only based upon the Social Assistance Committee’s decision). Retirement aids (if the retiring employee stops working for Medicina JSC and the pension is filed through Medicina JSC) are paid in an amount of double salary rate. Child birth aids are paid to women in an amount of single salary rate based on a birth certificate copy. Aids are also paid to Medicina JSC employee families in case of employee’s or his/her close person’s death. Aids are paid to Medicina JSC employees suffering financial difficulties due to diseases causing long-term disability or in Force Majeure. Examples: Corporate Events and Gifts 2007 2008 2009 2010 2011 Cost, Rbls. 3,407,265 4,391,662 1,640,376 10,085,652 7,927,357 Library Subscription 2007 2008 2009 2010 2011 Cost, Rbls. 392,597 456,461 470,637 1,045,049 816,650 In 2011 the Clinic established the Medical Brotherhood Charity Fund aimed at providing financial aid to medical workers. The Fund has already started its activity. It is planned that aids will be distributed based upon medical society decisions through voting, including via the Internet. The Clinic insures professional civil responsibility of medical personnel. Overall insurance costs and their percentage of Company’s overall proceeds and costs are presented in the Table below. Medical Personnel Insurance 2007 2008 2009 2010 2011 Cost, Rbls. 110,798 76,737 128,641 147,316 132,664 Personnel Medical Servicing All Medicina JSC employees who have passed the probation have the right for medical servicing at Medicina JSC within the Mandatory Medical Insurance Program. Medicina JSC employee family members have discounts for medical service at Medicina JSC. Personnel Medical Servicing 2007 2008 2009 2010 2011 Number of Employees 764 798 882 988 980 Costs of Services 39,343 43,704 62,976 74,984 73,269 33