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

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Page 1: Care Cyte Slidedeck

CareCyteThe Next Generation of Healthcare

Facilities

© Copyright 2007-9, CareCyte LLC.All rights reserved worldwide.

Page 2: Care Cyte Slidedeck

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Agenda• What we want to accomplish• Introductions: people and

organizations• The CareCyte innovations• Fundamentals of the CareCyte facility• Delivering healthcare services in a

CareCyte facility• Opportunities for a partnership• What’s next?

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

Outline

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•Chris Raftery (CEO; Engineering and construction)

•Chauncey Bell (COO)•Dave Chambers (Chief Architect; Healthcare Architecture)

•Mark Goldberg (SVP Sales; RE Development Concerns)

IntrosCareCyte’s People

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• Clinical and Research Labs:• Genetic Systems, Seattle, WA (first US laboratory to culture live HIV)• Bristol Myer Laboratories, Seattle, WA• Sanofi, Seattle, WA• ProCyte, Seattle, WA• Otsuka Pharmaceutical, Seattle, WA

Chris Raftery, CEOIntros• Lead or principal in the engineering and construction of

high profile projects. Examples:

• Other Technically Demanding Projects:• Fujitsu semiconductor plant, Gresham, OR • Wells Fargo Center, Seattle, WA• Paul Allen’s Experience Music Project, Seattle, WA

• Hospitals and Medical Centers:• Cedars Sinai Medical Center, Los Angeles, CA• Virginia Mason North Tower, Seattle, WA• Sacred Heart Medical Center Spokane, WA• Fred Hutchinson Cancer Research Center, Seattle, WA

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• Led the distinctive study group of doctors, builders, engineers, scientists, architects, and technologists in which CareCyte was born.

• Principal author of the CareCyte facility innovation.• Experience and academic credentials as an

engineer and as a builder.• Projects on-time and on-budget, often at record

paces.• Innovator in use of computers in design and

construction (VBR, Frank Gehry).• Patents for construction materials and processes.

Intros Chris Raftery

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Millennium Tower, Seattle

Fujitsu Semiconductor Plant,Gresham, OR

IDX Tower, Seattle

Chris Raftery: Projects and Successes

Fred Hutchinson Cancer Research CenterCedars-Sinai

Los Angeles

Ste Michelle Winery,

Woodinville, WA

Bellevue Technology Tower, Bellevue

Wells Fargo Center, Seattle

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Chris Raftery: Projects and Successes

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Millennium Tower, Seattle

Paul Allen’s EMP, Seattle

Fred Hutchinson Cancer Research CenterFour Seasons Hotel & Condominiums SeattleWells Fargo

Center, Seattle

Bellevue City Hall, Bellevue

2nd & Seneca Building, Seattle 1111 Third Ave Bldg

Intros

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Chris Raftery: Projects and Successes

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• A healthcare and hospital architect, he has for many years designed healthcare service delivery facilities with greatly improved coordination among patients and caregivers

• Serves as the Director of Planning and Architecture for the Sutter Health Group of hospitals in Northern California, where he supervises a $6.5 billion capital budget

Dave Chambers, Chief ArchitectIntros

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Examples of his work:• Sutter Health System, Sacramento, CA

• California Pacific Medical Center – San Francisco• Sutter Medical Center – Sacramento• Sutter Medical Center – Castro Valley• Alta Bates Medical Center – Oakland

• Legacy Project - Providence Health System, Vancouver B.C., Canada

• Children’s and Women’s Health Centre, Vancouver B.C., Canada• Fairview Hospital, Cleveland Clinic Health System, Cleveland, OH• Central Washington Hospital, Wenatchee, WA• White Memorial Medical Center, Adventist Health, Los Angeles, CA• University Health System, San Antonio, TX• Catholic Health Initiatives, Pacific Northwest – Washington/Oregon

Dave Chambers, Chief ArchitectIntros

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• He invented the method of organizing medical service delivery workflows around patient-provider interactions and care pathways (“cellular design”) that underpins CareCyte service delivery designs and our economical footprints.

• His designs use staff and other resources more efficiently, get patients through procedures faster, and produce higher patient satisfaction. They have been applied to “one-stop” patient intake centers, integrated intervention services platforms, and acuity-adaptable inpatient nursing units.

Dave ChambersIntros

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• He consults to the U.S. Department of Defense, the Department of Veteran’s Affairs, Healthcare Authorities of Canada and the NHS, United Kingdom, and many other healthcare providers.

• Chambers was named one of “Twenty who are making a difference” in 2007 by the Center for Health Design.

Dave ChambersIntros

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St. Joseph Medical Center, Tacoma, WA

Sutter Medical Center,

Sacramento, CA

Fairview Hospital, Cleveland Clinic Health

System

White Memorial Medical Center, East Los Angeles,

CA

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IntrosDave Chambers: Projects and Successes

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• He has led successful design and development programs, bringing together diverse teams and producing historic changes in several industries

• Better-known examples of his work include:• On-time delivery of concrete in Mexico City, Guadalajara, and other

cities around the world (CEMEX)• Dramatically shortened delivery times for power plants built in India

and China (ABB)• The design and construction of a new bank, Intelligent Finance, in

the United Kingdom• He has made distinctive theoretical contributions to the

literature of human coordination and innovation, and has been awarded half a dozen patents for his software designs

• Before coming to CareCyte he worked as a senior consultant for more than 25 years (in his own and other firms), and served as the president of a successful software company

Chauncey Bell, COOIntros

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• Real estate advisor and developer in the Northwest for 30 years

• His projects have been featured in state and national publications

• For the last 24 years he has served as the Chairman of the M.S. Cavoad Co., Incorporated

• Deep experience with the complex world of business arrangements underpinning the intersection of healthcare, land, permits and regulations, and construction

• Has negotiated agreements with a diverse group of individuals and companies, including REITs, major insurance companies, Wall Street investments firms, and the Catholic Church

Mark Goldberg, Sr VP Marketing & SalesIntros

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The CareCyte Story• In 2005 the Seattle Science Foundation commissioned

a study group to produce a breakthrough in the realm of healthcare service delivery.

• Their goal was to invent a way to design and economically produce facilities that allowed healthcare professionals to deliver care wherever it was needed with lead times of weeks or months rather than years.

• Many people have been working on ways to reduce costs and increase access to healthcare services.

• No one realized that a different kind of facility, designed specifically for healthcare and delivered quickly and economically, could serve as a platform for new care models and critical improvements to healthcare access, costs, and quality.

Story

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Two Breakthroughs from the Study Group• A new and radically different way of designing and

delivering customizable healthcare facilities, using the latest computer-aided design and manufacturing technologies, and high-tech materials (steel and polymers)

• A complementary approach to optimizing clinical workflows, service configurations, and unit capacities

Story

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New Capacities for Medical Professionals• Invent and implement new and more efficient clinical

practices and service delivery models• Treat medical facilities as manageable tools rather

than epic endeavors• Rapidly incorporate new medical and communications

technology as it becomes available• Easily locate facilities wherever they are needed,

configured to deliver whatever services are needed at that time

Story

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Chris Raftery’s Inspirations• An abiding commitment to do better engineering, to have every

component do as many things as possible, to get more for the money, go faster, and build better buildings

• The challenge of building a semiconductor “FAB” for Fujitsu in Gresham, Oregon (1,000,000 square feet, $1.3 billion construction, completed in 13 months) required …

• Designing and building clean room environments with far higher requirements than healthcare

• Learning how to produce and manage airflows with very high volumes (e.g., clearing all the air in a large room every minute) and low airflow velocities (e.g., no experience of air blowing around)

• Fanatical attention to controlling particulates, … …which in turn led to the invention of a new approach to

managing airborne pathogens

Innovation

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• The challenge of building Paul Allen’s Experience Music Project (EMP) with Frank Gehry as architect (a building that could not have been built without CATIA computer design tools) yielded …

• The first ever realization of full digital integration of the entire process of delivering an entire facility, from first idea to final product

• The resulting 100% engineering and 100% fit produced huge time and money savings

• The EMP was an “extreme proof of concept” – ‘If we can build that, we certainly can build medical facilities with the same methods.’

Chris Raftery’s InspirationsInnovation

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A New Kind of Healthcare Facility, and a New Way of Building It

• Instead of deploying an army of skilled designers and craftspeople, contractors, project managers, bookkeepers and accountants, lawyers and others, who hand-craft each facility uniquely...

• CareCyte uses the computer-assisted design and manufacturing tools and processes used to build aircraft and the most technologically advanced buildings in the world to deliver customized, integrated healthcare facilities.

Facility

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

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Bilbao, Spain

EMP: Seattle, Washington

Dusseldorf, Germany

22A Revolution in Architecture

DigitalDesign& Mfgr’g

CATIA made these projects possible for Frank Gehry; nothing like them had ever been built before.

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Paul Allen’sExperienceMusic Project

Engineer

First, Design and Engineer

Envision

Design & Model

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

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Finally, “Wrap” the Structure

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From the EMP to the CareCyte Facility• In constructing the Experience Music Project,

it became clear that a systematic approach to customized mass production of vastly simpler buildings (composed mostly of right angles and straight lines) was now possible.

• Building from a set of standardized components, the CareCyte System yields radically shorter construction times and lower costs, and a flexible, adaptable building superbly suited to today’s healthcare challenges.

Innovate

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A System of Integrated Building Elements The

Facility

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For Example, in Your Neighborhood … The

Facility

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Scalable, Flexible FacilitiesDelivering

HealthcareServices

80x80 Treatment Module:• 3 multipurpose intervention

rooms with supply / storage• L1 recovery room• 5 multipurpose exam/prep

/ L2 recovery rooms• MD office / work spaces

80x80 Clinic/Primary Care Module:

• 10 multipurpose exam/prep/ L2 recovery/emerg. treatmt

• 1 major Dx/Tx room• 1 large conference/classroom• 3 offices, 3 nurse / workstations• Lobby / reception / waiting

Scalability• Suitable for

clinical/primary care services, therapeutic/ intervention programs, inpatient care, laboratories

• Standardized kit of parts• Easy to expand.Flexibility• Single bed service-line-

adaptable rooms support a broad spectrum of services

• Modules can be reconfigured as demands or practices change; with 80 foot free-spans, layouts can be adjusted without structural constraints.

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Service Delivery in a CareCyte Facility

How? Cellular design around care pathways and interactions between patients and practitioners.Value-Streaming Patient Flows™

Shift from this… ... to this

Operational Benefits

Reduced steps and cycle times

Fewer handoffs Increased

predictability Clearer

commitments Smaller staffs Improved outcomesFacility Impacts Smaller footprint Fewer dedicated

spaces Dissolve

departmental fragmentation

DeliveringHealthcare

Services

Enter for services

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OR

imaging

clinic

ER

admitting

room type capacity

operating rooms 2diagnostic modalities 4exam/observ (incl. emergency/OR/clinic)

15

beds 24

total area (sf) 59,276

services metrics

admission 1steplab/ECG/PFT/x-ray 12 stepsconsult 2 stepstotal steps 15 steps

patient movement 680 feettotal patient time 200 mins

Click and follow the green dot (a patient) as s/he interacts with

administrators (yellow) and clinicians (blue).

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Patient Flow for Pre-Admission Testing in a Superior Conventional Facility

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OR

Clinic/ER/Dx

30 BED Acuity Adaptable Unit – single bed rms(shown)

Or

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

room type capacity

operating rooms 3

diagnostic modalities

(not including portable modalities)

2

exam/observ (incl. emergency/OR/clinic)

15

beds 30

total area (sf) 28,750

services metrics

admission 1step

lab/ECG/PFT/x-ray 3 steps

consult 2 steps

total steps 6 steps

patient movement 170 feet

total patient time 80 mins

Half the size

3 ORs & 6 more beds

Much more efficient:75% less patient travel;60% less time!

Patient Flow for Pre-Admission Testing in a CareCyte Facility

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Click and follow the green dot (a patient) as

s/he interacts with administrators (yellow)

and clinicians (blue).

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Dave Chambers’ Prototype Hospital Initiative - Resetting Expectations for Traditional Hospital Construction

Efficiency& Costs

Goal – MetricCurrent Baseline

Prototype Hospital Team Expectations

Staffing Efficiency- Total FTEs 442 253.2- Adjusted Patient Discharges (APDs) 7135 8742.3- FTEs per APD (CMI modified) 0.054 0.029

Area (Efficiency of Program)- Area (BGSF) 114.660 100.611- Area per Bed 1,911 1,677- Area per APD 16.07 10.44

Construction Cost

-Construction Cost per

SF $650.00 $370.00

-Construction Cost per

Bed $1.242M $0.62MOther Measures

-Time to Build (Design,

Permitting, Construction)

72 months plus Less than 48 months

- Energy Use Measures include Electrical and Natural Gas 25% decrease

46% fewer FTEs required

35% less space

required

44-50% less const.

cost

Based on the outcomes of this effort, Sutter Health is now building five facilities implementing the same principles.

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CareCyte’s Next-Generation Healthcare Facilities• Our radical innovation enables new care delivery models • Smaller and less expensive to build and operate

• Cut 60% or more from the cost of constructing a healthcare facility • Cut 35% or more from the overall operational costs of delivering

services • Adjust the configuration of the facility as practices change

• Increased care delivery efficiency and efficacy• Layouts and configurations based on value streams of patient flow• Improve staff productivity and minimize patient movement • Increase patient (and staff) safety

• Designs optimized for healthcare service delivery• Service the entire facility without interrupting patient care• Near laminar air flows offer superior control of airborne pathogens• Plug and play for networking, telemedicine, and other coming

technologies

Summary

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Opportunities• Meet the challenges of building your new facility• A state-of-the-art facility that will remain up-to-date by

accommodating new practices and technology, and through easy modification and expansion

• Establish your identity as an industry leader and innovator

• Increase your scope of services through lower capital and operating costs

• A simple and elegant solution to difficulties in fund-raising

Partners

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What’s Next?• What possibilities does CareCyte open for you?

• Plans for new facilities?• Renovations planned?• Service delivery productivity?• Opportunities for new/expanded services?• Expanded market reach?

• What would you like to do next?

Action

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CareCyteThe Next Generation of Healthcare

Facilities

© Copyright 2007-9, CareCyte LLC.All rights reserved worldwide.