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					Chronic Disease Manager – Improving Disease Management Outcomes

Chronic Diseases – $1 Trillion Health Burden, Still Growing

Chronic diseases are an inordinate part of the United States and the world’s health care costs. A study
by the Milken Institute estimated that the annual economic impact on the U.S. economy of the most
common chronic diseases is calculated to be more than $1 trillion per year. This cost is projected to
further explode to an astounding $6 trillion by 2050. Approximately seventy-six percent (76%) of
Medicare spending is spent on patients with five or more chronic diseases.

Chronic diseases place an enormous burden on untold millions of lives around the world. Given the
scope and impact of this challenge the medical community is continuously working to develop new
practices and innovations to improve the quality and coordination of care for chronic conditions.

Meeting the Challenge – WellDoc’s Innovation

WellDoc co-founder and CEO, Ryan Sysko has boldly stated, “The inability to effectively and efficiently
manage chronic disease is a global pandemic of unsustainable proportions.” Yet, there is certainly hope
in this new age of medical innovation.

      1   © 2012, Endeavour Software Technologies
Mr. Sysko and his leadership team at WellDoc, Inc. ( firmly believe in a vision
where mobile technology can dramatically improve the delivery of care for chronic diseases. A vision
where the participants in the delivery of care also includes perhaps the most important and often
overlooked participant: the patient.

The genesis of the WellDoc solution occurred when co-founder Dr. Suzanne Sysko Clough, an
endocrinologist at University of Maryland, became frustrated with traditional methods for treating her
Type 2 diabetes patients. These methods included a series of office visits, weeks apart, in which
patients shared their conditions and behavior using handwritten diaries. During this care Dr. Clough
could not retrieve current data on patient’s conditions nor could she provide ongoing advice to alter her
patient’s behavior and treatment regimen. Therefore ongoing adjustments to care (e.g., titrating
medications) occurred less frequently with less data to aid the decision making.

Endeavour The Mobility Company – A Partner
In 2004, WellDoc engaged Endeavour – The Mobility Company to work with the WellDoc team to
develop the innovative “patient coaching” mobile solution. Endeavour provided a range of services
       Enterprise Mobile Strategy/Assessment
       Mobile Architecture Design
       Application Development Mobile Application
       Mobile Security Design/Development
       Integration Services
       FDA Approval/HIPAA Compliance

The Solution – Mobile Patient Coach

After years of design, development, and testing WellDoc, Inc. produced a new innovative solution to
give patients real-time coaching and feedback on how to manage their disease by giving physicians
ongoing data captured by using a mobile phone. The product known as DiabetesManager® uses a
mobile phone with an individualized patient coaching mobile application.

DiabetesManager® improves the delivery of care by helping patients understand their own illness.
Using a mobile phone, patients input personal health information, such as medications taken, diet,
exercise, and for diabetics, data on glucose. They receive immediate feedback from physicians, and
case managers via the WellDoc application in real time. The feedback is personalized and relevant to
their condition. Doctors have access to the data and use it to monitor and communicate with their
patients. The feedback-to-behavior change cycle is dramatically improved.

WellDoc’s product teaches patients how to manage their chronic disease in real time, at what CEO
Ryan Sysko calls “the right teachable moment.” It engages patients in positive behavioral change and
helps doctors provide real time treatment recommendations outside office visits.

        2   © 2012, Endeavour Software Technologies
WellDoc’s solution impacts the coordination of care on many levels. Three critical areas of importance

    1. Patient Coach – patients become engaged in their illness by using a mobile “Patient Coach”
       application to track their health and receive real time feedback on their condition. The system
       provides real time coaching with alerts, reminders and patient education.

    2. Expert System - a software system that uses complex clinical, behavioral and psychosocial
       algorithms to trend patient data and provide real-time advice and support. The system includes
       predictive modeling and analysis of longitudinal data.

    3. Decision Support - data collected from patients is collected in a decision support system that is
       used physicians and care managers to improve coordination of care. Clinical data analysis and
       outcome based support is provided with integration to case management and EHR

Results – FDA Approval and Clinical Trial
WellDoc received a 501(k) clearance from the FDA for its Diabetes Manager System in 2010 which gave
approval to use the product as a viable alternative to treating the chronic disease.

In 2011, a large randomized controlled clinical trial study funded by University of Maryland, WellDoc,
Sprint, and CareFirst found that users of the WellDoc system had significantly lower A1c values than
control patients. The published findings were very well received in the health care community and now
serve as an exemplary case for other innovators seeking to improve the coordination of health care
through the use of new mobile technologies. .

Our Value Add
Endeavour and our clients believe we deliver unique value in several areas:

       Our Mobility Expertise – We have developed deep expertise in mobile technology, starting in
        2002. We have over 250 mobility experts worldwide.

       End to End Enterprise Capability - We have experience supporting the unique challenges of
        large enterprises. We have experience with developing mobile applications, selecting mobile
        enterprise application platforms, and integrating legacy systems.

       Partnering Approach – We act as partners with our clients enabling them to address difficult
        challenges and achieve market goals. Our focus is not on selling our own products but, first and
        foremost, on making our clients successful.

       Domain Specialization – We recognize the importance of understanding a client’s business.
        We have domain expertise in health care, banking and other key industries. We work closely

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       with clients to not only adopt mobile tools but to transform their business into a new and
       mobile-enabled enterprise.

      Global Cost Advantage – We utilize resources from delivery centers across the globe. This
       allows us to optimize resource and offer cost advantages to our clients.

Our Partnership
WellDoc, Inc. and Endeavour have worked together on the development of WellDoc’s innovative
platform since 2004 and have formed a strategic partnership to bring further innovation to the WellDoc
platform. In a recent press release, Anand Iyer, WellDoc's President and COO stated, "We've
established a very strong and supportive relationship with Endeavor and we are excited to see it

       4   © 2012, Endeavour Software Technologies

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