The Complexities and Challenges of Health and Aged Care System​ The three primary goals of healthcare organisations today are: • improve the experience of care • improve the health of the population and • reduce per capita costs of delivery. This requires healthcare organisations to engage and impact the health of one person at a time. This can only be achieved with the right people, processes and information systems in place.

1. Care Coordination
Why?

2. DXC Proprietary and Confidential April 9, 2018
Why?:
The Complexities and
Challenges of Australia’s
Health and Aged Care System

3. April 9, 2018 3DXC Proprietary and Confidential
of Australians
(every 2 in 3) are
overweight and obese
63%
Cardiovascular diseases
(CVDs) such as heart attacks
and strokes, are killing one
Australian every 12
minutes
12 mins
Australians suffer
from CVDs
4.2 m
Australians develop
diabetes every day.
That’s one person every
five minutes
280
Australians experience
a mental illness in
any year of their lives
1 in 5
Depression is the
third highest burden
13.3%
of Australians report
significant levels of stress
in their lives
35%
of Australians are
engaged at work
24%ONLY
Australia’s Health is declining

4. April 9, 2018 4DXC Proprietary and Confidential
Healthcare costs are rising
Total health expenditure has grown each year from
$95 billion in 2003-04 to an estimated $155 billion in 2013-14
Of the $155 billion spent, $145 billion was recurrent
health expenditure
Primary Health Care expenditure was $55 billion,
around 38% of recurrent expenditure in 2013-14, which
was an increase from $35 billion in 2003-4
The Cardiovascular Diseases group was responsible
for the most expenditure for admitted patients
• AI chatbot symptom search
and triaging
Australia’s Health 2016
AIHW

5. April 9, 2018 5DXC Proprietary and Confidential
Global life and health
Insurance market
estimated to grow from
$3.9tn to
$4.6tn
in 2021
The wearables market is
estimated to triple from
84m devices sold
in 2015 to
Global e-learning
market of
$40bn in 2012,
expected to grow to
245m
devices
in 2019
$256bn
in 2017
Consumer healthcare
is a $502bn market
that will grow
by 50% to
$737bn over
the next
5 years
Consumers are spending more

6. April 9, 2018 6DXC Proprietary and Confidential
Sectors
Fragmented Providers of Health and Aged Care
Primary
Health Care
Private
Providers
Community
Health Services
Administration
and Research
Aged Care
Disability
Services
Wellbeing /
Corporate
State Health
Public
Local
State
Territory
Federal
Private
Hospitals
Practices
Pharmacies
Public Health
Community Services
Preventative Services
Emergency Health
Hospital Based Treatment
Rehabilitation
Aged Care
Disability Services
Palliative Care
Providers Deliverables

7. April 9, 2018 7DXC Proprietary and Confidential
For a person aged 85+, the
Australian Govt’s average
expenditure per person on
PBS is four times the average
expenditure per person.
In the next 30 years, the
number of Older
Australians will double
from 3.7 Mil to 7.5Mil
(ABS 2013)
The yearly increase in hospitalisations of
people aged 65 and over in private
hospitals was 6.3% from 1m
hospitalisations in 2004-05 to 1.7million
in 2013-14.
In 2013, older
Australians
represented 19.6% of
all ED presentations
Acute care (medical, surgical and
other) was the most broad type of care
in 2013-14 accounting for 92% of
hospitalisations in the age group,
followed by Rehabilitation
Ageing Australian’s is expected to contribute around 10% of the projected increase in Australian
Government spending per person over the next 40 years
APRA 2017, Private Insurance Statistical Trends – Benefit Trends June 2017
Our ageing population is ever increasing the burden
and expectation surrounding chronic care management

8. April 9, 2018 8DXC Proprietary and Confidential
We are being asked to age at home in a fragmented,
confusing system
Currently over one million older Australians receive aged care services, by 2050 this will increase to
over 3.5 million. Key weaknesses of the current aged care system include:
• Navigating both home based and residential care is difficult. Families are often trying to achieve this under
duress have limited insight into the complexity they face, are very concerned in regards to the ongoing
fees and charges and minimal, if any, guidance or information
• Services are limited, and often presented in such a way that consumer have very limited if any choice
• Quality is variable
• Funded services are often unavailable when consumer requires them
• Coverage of needs, pricing, subsidies and user co-contributions are inconsistent or inequitable
• Workforce shortages are exacerbated by low wages and some workers have insufficient skills
• Rising expectations about the type and flexibility of care that is received
• Approximately 25% of admissions into permanent care are via an acute hospital admission when the
individual or family can no longer cope

9. April 9, 2018 9DXC Proprietary and Confidential
The impact of ineffective Care Management
on Older Australians
Qualitative
- Disempowerment for self-
care
- Inability to have the best
care methods
- No independence
- Fragmented Care
- Impact of ineffective
management of Chronic
Disease
Quantitative
- Excessive spending to
manage chronic
conditions that could
have been improved by
care management
- Increased Days in
Hospital
- Increased avoidable
Readmissions
- Increased Chronic
Disease Risk

10. April 9, 2018 10DXC Proprietary and Confidential
Consumers are frustrated
Disempowerment
Frustration
Disengagement
FRAGMENTED
SYSTEMS
DUPLICATION
OF SERVICES
DIFFICULTY
FINDING AND
ACCESSING
SERVICES
LACK OF
TRANSPARENCY
LIMITED
CONNECTIVITY
OF DATA
SUBOPTIMAL
HEALTH AND
SOCIAL
OUTCOMES
WAIT TIMES
FOR CARE
SERVICES
UNCOORDINATED
CARE
ISOLATED
PROVIDERS
AND SERVICES

11. April 9, 2018 11DXC Proprietary and Confidential
Increased Patient
Expectations of Care
Fragmentation and lack
of care continuity
Aging
Population
Increasing Unplanned
Admissions
Financial
Constraints
Key factors must be acknowledged to alleviate current health costs and quality, including:
Plan
Management
Leverage planning tools
to limit avoidable costs
Partner
Engagement
Engage Care partners to
reduce avoidable costs
Care
Coordination
Improve patient management
and engagement
To effectively manage heath and aging across the continuum, Care Coordination must become a strategic
imperative and core competency.
Healthcare Funders and Providers are challenged
with a number of issues

12. DXC Proprietary and Confidential April 9, 2018
The Role of Care
Coordination

13. April 9, 2018 13DXC Proprietary and Confidential
Care Coordination
Care Coordination is the deliberate organisation of
an individuals care activities between multiple
providers and services involved in an individual’s
care to facilitate efficient and effective delivery of
health care systems.
It has a crucial role in integrating and influencing the
care pathway in the best interests of the individual, by
recognising the holistic needs of the person.

14. April 9, 2018 14DXC Proprietary and Confidential
Components of Care Coordination
Physicians Nurses Care Givers Community + Allied Psychologists Pharmacists
Providers
Collaboration
Cooperative problem
solving and decision
making
Care Continuity
Patient Centred Care, where
information exchange and relationships
bind together episodes of care
Care Coordination
Enables proactive planning and facilitation of
patient management, using available services and
resources to ensure an improved and cost
effective outcome
Care Coordinator
Ensures a patients journey within a
case and links necessary services,
personal and resources to deliver
care
Assess Patient
Develop Care Plan
Identify Participants
in Care and Specify
Roles
Communicate to all
Participants
Execute Care Plans
Evaluate Health
Outcomes
Monitor and Adjust
Plan
Care Coordination Platform

15. April 9, 2018 15DXC Proprietary and Confidential
Assist and aged
care transitioning
Social and Emotional
Awareness
Infectious Disease
Screening
First Routine Medical
Checks (Pap Smear,
Pelvic Examination and
Breast Screen)
Chronic
Disease
Management
Mental Health
Safety – Falls
Prevention and
Location
Routine
Care and
Care
Planning
Primary School –
Extracurricular
Activities Accidents
Routine
Immunisations
Routine
Cancer
Screening
Nutrition and Dietary
Awareness
Mammogram
Pregnancy
Post Partum
Depression
Routine
Tests
Illness.
0-9 20-24 25-44 45-64 65+10-19
Medical Procedure
Birth
Life events that could benefit from Care Coordination
Family
Challenge
Big Data Analytics Machine LearningArtificial Intelligence

16. April 9, 2018 16DXC Proprietary and Confidential
Care Coordination for the Older Population
The goal is to enable Older Australians to live
proactively and independently by allowing support from
a Care Coordinator that provides the single connection
within our complex healthcare system. This involves:
• Providing effective referral pathways and information sharing between
health care service providers
• Improve level and quality of connections between providers involved
in care
• Improving access to health care
• Improving quality and timeliness of health care services which
reduces unnecessary hospital admissions / shortens length of
hospital stays
• Achieve consistency of care between acute and community based
services
• Provision of expert support from a care coordinator who understands
and is across their entire care plan
In a study to analyse successful
interventions and their ability to reduce
hospitalisation rates, common features
include:
• Face to face and follow up calls
• Frequent communication between
care coordinators and providers
• Using behaviour changing
techniques and motivational
interviewing to improve medicine
adherence and self management
Brown RS et al 2012, Six Features of Medicate Coordinated Care demonstration
programs that cut hospital admissions of high risk patients

17. April 9, 2018 17DXC Proprietary and Confidential
Care Coordination for Transitional Care: The impact of
ineffective transitions
Provision of high quality transitional care is a challenge, as well as the implications it
causes when they are conducted ineffectively.
In particular, older people are frequently required to transition between hospital and place
of stay due to acute illness.
Key indicators that increase the risk of readmission for older people include:
• Preventable adverse events
• Medication errors
• Falls
• Errors in diagnosis
• Post-operative infections
• Confusion and lack of discharge information

18. April 9, 2018 18DXC Proprietary and Confidential
Benefits of Transitional Care Coordination
People transitioning from the community into
permanent residential care via hospital had
the longest stays, averaging 28 days with single
episode stays
91% of 1.1million
hospitalisations
comes from the
home
9% of hospitalisations are
from residential care, and
11% of discharges were to
aged care
Reduction in Readmissions
Studies have shown that a receipt of a discharge call was
associated with reduced rates of readmission, where intervention
group members were 23.1% less likely than the comparison
group to be readmitted within 30 days of hospital discharge
Increase in functional improvement and reduction of
likelihood to enter residential care prematurely
In 2004-05, the Australian Government launched the Transition
Care program to help older people leaving hospital to return
home, rather than enter residential care prematurely. An
evaluation of the program showed functional improvement in
older people, as well as fewer readmissions and decrease in
likelihood to move into permanent residential aged care.

19. April 9, 2018 20DXC Proprietary and Confidential
Connecting people, processes,
technology and information is
essential in improving care
continuity and experience for
individual patients, enabling
effective care coordination while
sustaining financial value.
Care Coordination
Reduce
Further
Health Care
Costs
$
Earlier
identification
of at risk
patients
Targeted interventions
for the right
patients
Case
management
and Care
Coordination
Risk
stratification
new data
sources
Data Driven, Continuous
Approach
Platform, Partner, Approach

20. April 9, 2018 21DXC Proprietary and Confidential
Health360: Embracing Population Health Management
Health360 is a cloud-based, CRM-powered Population Health Management solution, enabling providers and payer to
personalize care experience to ensure quality, improve patient care and lower costs.
Patient-Centred data model for Microsoft
Dynamics 365 and Azure acknowledging
Healthcare Requirements
Personalise care experience by engaging
patients using mobile apps, whilst
monitoring them using patient-sponsored
and IoT health data in real-time
Proactively plan and coordinate care
to improve patient outcomes, quality
of care whilst reducing cost
Optimise your provider network with
Physician Relationship Management,
onboarding, training and referral
management
Personalise interactions with
Health360’s Next Best Action guidance
on what is known about the consumer

21. April 9, 2018 22DXC Proprietary and Confidential
DXC Care Coordination Capabilities
The DXC Care Coordination
Platform Solution allows for
immediate values and
enables future
customisation over time

22. April 9, 2018 23DXC Proprietary and Confidential
Digital Health Architecture

23. April 9, 2018 24DXC Proprietary and Confidential
Benefits
Improved Outcomes
Demonstrate improved
outcomes for individual
and health populations
patients in each category
(low, rising an high risk)
across communities
Reduce Fragmentation
Provide a 360 degree view
on patients and members
with those involved to
provide safer and more
effective care
System-Wide Efficiency
Build interoperable
systems that allow for
modularity, enabling
effective and efficient care
across the health care
continuum
Predictive Analytics and
Machine Learning
Utilise data to enable real-
time identification of
patients/members at all
risk levels who require
proactive intervention or
prevention management.
Engage and assign
necessary tasks and
actions to ensure that they
receive appropriate and
timely services and care

24. April 9, 2018 25DXC Proprietary and Confidential
Customer Results/BenefitsSolution
Customer Case Study
• Launched in January 2013 with 80
physicians and 14,000 Medicare
patients growing to supporting more
than 150,000 patients
• Favorable trends for meeting clinical
goals including appropriate care for
chronic conditions and greater
patient engagement
• Microsoft Dynamics CRM
• Health 360 – Care Coordination
Business Challenge
• Visibility into Patient data
• No single source of the truth
• Create Alerts after listening to the
data to see what was happening.
The customer
Virtua is one of New Jersey’s largest, non-profit health systems, they
operate a network of hospitals, surgery centres, physician practices,
fitness centres, and more. Comprising 450 clinicians, 1500 providers at
its urgent care centres, hospitals, health and wellness centres. Virtua
delivers 8,000 babies a year.

25. April 9, 2018 26DXC Proprietary and Confidential
Customer Results/BenefitsSolution
Customer Case Study
• Integrated Platform ensures Data
is not ‘lost’ between systems when
a patient moves to someone
else’s care
• Provided unexpected insights
from the data collected. Harness
the power of the data
• More than 72% of Patients
abstained for a period of greater
than 12 months
• Microsoft Dynamics CRM +
Health 360 Care Coordination
Business Challenge
• The biggest challenge is the fact
that recovery from behavioural
conditions requires ongoing
maintenance
• Fee-for-Service Model is changing
- patient pays a fee, Provider
provides a service and transaction
is over
The customer
AiR is an international provider of disease management and telephone-
based care coordination solutions for chronic behavioural health
conditions. AiR is now planning, coordinating, and personalizing care
for its clients using Health360 Care Coordination

26. DXC Proprietary and Confidential
Thank you.
About DXC Technology
DXC Technology (DXC: NYSE) is the world’s leading independent, end-to-end IT services company, helping clients harness the power of innovation to thrive on
change. Created by the merger of CSC and the Enterprise Services business of Hewlett Packard Enterprise, DXC Technology serves nearly 6,000 private and
public sector clients across 70 countries. The company’s technology independence, global talent and extensive partner network combine to deliver powerful
next-generation IT services and solutions. DXC Technology is recognized among the best corporate citizens globally. For more information, visit www.dxc.com.