The Changing Dimensions of Cloud Alex Candelaria Global Technology Office ACME Health Objectives Vision 2025 Affordability Consumers of 2025, Making healthcare health model alternatives, easier for all to obtain strategic roadmap Consumer Digital Strategy OneAH Ubiquity of information over any Unifying ACME’s culture medium the member chooses OneAHand business entities • Information security • Digital strategy ACME Health’s • Cloud 2017 Technology Goals: • Telehealth • Data and analytics • Artificial intelligence 2 of 33 Dell Technologies—Confidential CIO Focus Areas Next 3 Years • Analytics • Machine Learning Resulting • Cognitive computing in more than • Patient NOC—pro-active care delivered off-site 40% of AH • Cohesive security strategy, tools, and roadmap staff will need • Single box to manage devices and sites to be retooled • Deliver as a Service • IoT 3 of 33 Dell Technologies—Confidential IT Imperatives Modernize People empowerment Speed development Strengthen reliability & security Increase productivity • Knowledge of IT environment • Effectiveness through automation • Technology asset management • Monitoring through instrumentation • Operational excellence • Reinforced controls by eliminating deficiencies • Security assessment & threat detection deployed 4 of 33 Dell Technologies—Confidential Impact of Digitization of Clinical Workforce • ER physicians spend 44% of their day doing data entry, with 4,000 EHR clicks per day; only 28% of the day is spent with patients1 % % 58 14 • In the exam room with patients, PCPs spend from 25% to 50% of the time attending to the computer1 • “I am no longer a physician but the data manager, data entry clerk and steno girl… I became a doctor to take care of patients. I 58% Healthcare leaders placed Median 13.8% turnover rate have become the typist.” 1 high priority on digital tools to in 2016, up from 9.9% in enable consumer engagement, but 2010. Potential cost of • Sentinel event alert #54 by the Joint just 14% have those capabilities3 $250,000 per physician2 Commission shows that ergonomics and usability issues resulting in data entry errors is the #1 cause of Health IT related adverse events5 1. *Src: Annals of Family Medicine: From Triple to Quadruple Aim: Care of the Patient Requires Care of the Provider. Thomas Bodenheimer, MD Christine Sinsky, MD 2. https://www.advisory.com/daily-briefing/2016/06/20/millennial-turnover 3. https://www.kaufmanhall.com/sites/default/files/2017-State-of-Consumerism-in-Healthcare.pdf 5 of 33 Dell Technologies—Confidential4. **Analysis of 120 health IT-related sentinel event reports received by The Joint Commission between January 1, 2010 and June 30, 2013 http://www.jointcommission.org/assets/1/6/SEA_54_HIT_4_26_16.pdf 5. www.healthit.gov/SAFERGuide. Company Overview The most complete portfolio of technology solutions: software, hardware, and services DIGITAL IT WORKFORCE SECURITY Cloud Native Server, Client, Software- Managed Multi-Cloud Software Storage, Software, and Defined Security Management Development HCI Peripherals Data Center Services 6 of 3329 DellDell Technologies Technologies——ConfidentialConfidential High Order Outcomes of a Strategic Partnership with Dell Technologies Consolidation of suppliers Drive agility & scale Flexible consumption models Cost improvements Affordability Drive economy of scale Improve time to market Consumers of 2025 Transform IT operations Transparency into discounts OneAH Meet customer demand/ requirements Improve automation Standardization & simplification 7 of 3329 DellDell Technologies Technologies——ConfidentialConfidential Proposed AH Multi-Cloud Native IBM Marketplace Azure IBM Cloud IoT Native Azure ROCs Marketplace Consistent security Consistent network Native GCP Data control and mobility Marketplace Napa Consistent data protection GCP Consistent cloud management services Google Health Controlled access to marketplace services Services— Cognitive APIs Corona One application platform (apps, containers, functions) Native Illumina AWS Silver Springs Marketplace Boulder AWS 8 of 33 Dell Technologies—Confidential Modernize USE CASE SOLUTION Multi-cloud operating model Expand the definition and evolution of AH Cloud into a AH controlled, consistent operating environment and infrastructure across public cloud providers, SaaS, and AH premises • AH will need to connect everything to multiple cloud • All Dell Technologies products are or will be available in every and SaaS providers cloud and are easy to move away from should AH choose— there is no lock in—we must continually earn AH’s business • Organic growth into external providers’ proprietary interfaces leads to “cloud sprawl” • Consistency across providers and extensive automation will materially reduce operating costs • A consistent interface for applications, network, data, resiliency, management, security, and compliance will • Industry leading R&D investment ratios and a history of help AH avoid high costs successfully integrated M&A mitigate temporary gaps in product features or maturity available elsewhere • Fewer management points and comprehensive automation allow for new security and resiliency paradigms • AI and Machine Learning are already built into some cloud management products to self optimize and self manage OUTCOMES • Reduced operational expense • Cost efficient placement of workloads • Enhanced security • Avoid lock-in • Simplification through consistency • Integrated site resiliency (always on) across providers 9 of 33 Dell Technologies—Confidential ACME Health Modernize USE CASE SOLUTION Data center modernization Modernize, migrate, automate, and consolidate and migration data center architecture and infrastructure • ACME Health is moving to the world of digital transformation and things • We believe we can modernize the infrastructure in the data center to are going to be very different consolidate the entire existing x86 footprint into 40 racks and obviate the • Looking back at the last 10 years AH and Dell have been doing business together, need for the Boulder data center AH focused on systems of record and traditional applications—mostly focused on • Legacy workloads (until re-platformed) can be consolidated into the most storing and reporting transactional data modern, industry leading infrastructure leveraging true end-to-end NVMe • Over the next 10 years technology will move beyond systems of record to systems and machine learning to reduce operational expense and enhance resiliency of engagement and systems of insight. AH is going to engage with customers • These modern systems eliminate the toil, expense, and disruption of through innovative, new applications on mobile devices and other end points. migrations that have been so costly to AH Applications are going to be built for the cloud • We can simplify the transition from “data centers” to “centers of data” as next • We are going to see greater analysis of the streams of data these applications generation compute allows for dynamic allocation of resources based on generate. And AH is not just going to connect phones, PCs, and tablets to the application and data needs Internet, AH is going to connect everything OUTCOMES • Massive data center consolidation • Eliminate application disruption for • Analytics/ML native to platform(s) • Mission critical systems availability migrations, faster lifecycle time, and • Automated & scalable management maintenance avoidance • Fastest, most efficient deployment • #1 Next-Gen compute & storage 10 of 33 Dell Technologies—Confidential ACME Health Modernize USE CASE SOLUTION Provide dynamic end-user computing technology, Increase end-user productivity to optimize user experience, increase productivity, and ensure security across all data points • AH will need to acquire and manage an ever • Dell Technologies has the most industry awards for growing and diverse fleet of computing devices engaging end point devices • Devices and engagement aligned to personas leads • Virtual workspaces and security are industry leading, to increased productivity and user satisfaction automated and cover all devices and operating systems • Studies are showing that attracting the younger workforce is • Provisioning and lifecycle management have been increasingly tied to the technology they want to use at work matured into consumer like experiences • End point security management across a large and • End-user solutions are complete end-to-end from diverse ecosystem requires automation, simplification, a single entity and a single support infrastructure and intelligent threat management • Consolidation of vendors, lifecycle processes OUTCOMES and provisioning provide substantial savings • Minimize IT costs and workloads • Attract and retain top talent • Protect data everywhere • Increase employee engagement • Automatic updates/patching across all • Save labor hours spent on and productivity device types and operating systems deployment and support 11 of 33 Dell Technologies—Confidential ACME Health Modernize USE CASE SOLUTION Jointly engineer new solutions for precision New technology healthcare, research, machine learning, virtual reality, and blockchain • The pace of technology change in healthcare will continue • Dell Technologies has invested and co-innovated solutions to accelerate with leading healthcare providers • The diversity of technology will require management • Dell Technologies partners with an extensive ecosystem infrastructure that provides consistency across the ecosystem of healthcare technology and application providers • AH will innovate