Portions of this Exhibit have been omitted pursuant to a request for
confidential treatment. The omitted portions, marked by [****], have been
separately filed with the Commission.
EXHIBIT 10.13
SERVICES AGREEMENT
This Agreement is effective this 13th day of September, 1996, (the "Effective
Date") between Patient Infosystems, 00 Xxxxxx Xxxxxx, Xxxxxxxxx, Xxx Xxxx
00000 ("Vendor") and Health Resources, Inc. Vendor agrees to provide
services to Health Resources, Inc. under the terms set forth below.
A. SERVICES
Vendor will provide the product(s) or service(s) set forth, and to the
specifications set forth in the proposal incorporated herein as Exhibit A.
The product and all elements as set forth in Exhibit A are subject to
prior approval by Health Resources, Inc., such approval not to be
unreasonably withheld.
B. COMPENSATION
1. Health Resources, Inc. shall pay Vendor an operational fee of [****] in
the program described in Exhibit A.
2. Health Resources, Inc. shall pay Vendor for pre-printed materials (e.g.
marketing brochure, business reply mailer, program description) required
for the program. Vendor will furnish estimates for printing costs upon
determination of volumes and specifications.
3. All amounts due under this agreement shall be invoiced monthly to Health
Resources, Inc. by Vendor and payable within thirty days of the date of
the invoice. Payments exceeding thirty days past due shall be subject to a
service charge of [****] per month until paid.
4. In the event that Health Resources, Inc. shall request any changes in
the specifications or scope of the services described in Exhibit A hereto,
Vendor will notify Health Resources, Inc. of the cost of such revisions
and will not proceed without prior written approval.
C. CONFIDENTIALITY
1. Health Resources, Inc. and Vendor acknowledge that certain confidential
and proprietary information may be disclosed by one of them to the other
in the course of this Agreement. For purposes of this Agreement, the term
"Confidential Information" includes the following: (a) All information
regarding the patient, Health Resources, Inc.'s Customer, any patient
medical data and/or status, or provider information; and (b) any other
information identified as confidential in writing by the disclosing party
prior to disclosure. Notwithstanding the confidentiality requirements of
this Agreement, the foregoing shall not prevent Health Resources, Inc. from
retaining information, including any and all information and data
pertaining to any patient which comes to Health Resources, Inc. or to which
Health Resources, Inc. is given access during this Agreement.
2. Should Health Resources, Inc. receive confidential information of
Vendor for use in performing their Services, Health Resources, Inc. agrees
to take all reasonable steps to safeguard the confidentiality of said
information and to prevent unauthorized disclosure thereof by Health
Resources, Inc.'s employees, agents and representatives. Health Resources,
Inc. shall maintain strict security procedures to protect the
confidentiality of any information received, stored, or delivered on
patients in the Health Resources, Inc. or any affiliated or associated
company's database.
-1-
3. The data released hereunder to Vendor regarding patients, patient
medical data, Health Resources, Inc. Customers, and provider information,
is considered sensitive and confidential information. Vendor warrants that
it shall use any information provided by Health Resources, Inc. strictly
for the performance of this Agreement. Vendor acknowledges and agrees to
take all necessary steps to safeguard the confidentiality of all
information and reports, whether oral or written, maintain such information
as strictly confidential and to prevent unauthorized disclosure thereof by
Vendor's employees, agents, representatives and other third parties.
Vendor warrants that all such information and reports will not be disclosed
to any person, organization or entity other than Health Resources, Inc.
4. Each party shall hold the other party, its affiliated companies, the
officers, agents, employees, and independent contractors of the other
party, harmless and shall indemnify and defend such party for any claim
of expense or damage, whatsoever, resulting from the publishing or
release by such party, of information contrary to the above conditions.
5. The obligations of the Paragraph shall not apply to any Confidential
Information which the recipient can demonstrate is or becomes available
to the public though no breach of this Agreement.
6. Neither party to this Agreement shall, except as may be required by law
or federal regulation, or except with express written permission of the
other party, disclose the terms and conditions of this Agreement to
any third party or publicly advertise its contents.
7. The parties agree that Vendor's breach of any of its material obligation
under the applicable Confidentiality provisions of this Agreement, may
cause Health Resources, Inc. irreparable injury for which it would have not
adequate remedy at law, and that Health Resources, Inc. shall be entitled
to specific performance or preliminary or other injunctive relief in
addition to any and all remedies it may otherwise be entitled to at law
or in equity.
8. This Paragraph shall survive the termination of this Agreement.
Vendor shall not duplicate any material containing Health Resources, Inc.
Confidential Information, except in the direct performance of its
services under this Agreement. Vendor shall return all copies of materials
containing Health Resources, Inc. Confidential Information upon Vendor's
completion of services under this Agreement or upon any earlier termination
of this Agreement for any reason whatsoever.
D. INDEMNIFICATION
D1. Each party shall indemnify and hold the other party harmless from and
against all liability, damages, penalties, losses, costs or expenses,
including reasonable attorneys' fees, arising from or in any way related
to its willful or negligent actions or omissions in performing the
responsibilities as described in this Agreement.
D2. "Limitation of Liability"
Neither Health Resources, Inc. nor vendor shall in any way be liable for
any special, indirect, exemplary, incidental or consequential damages,
whether based on contract, tort, or any other legal theory, even if
Health Resources, Inc. or vendor has been previously advised of
the possibility of such damages. This paragraph shall survive the
termination of this agreement.
-2-
E. PROFESSIONAL STANDARDS
Vendor represents that it has facilities, personnel, experience and
expertise sufficient in quality and quality to perform all such
assignments and projects given it by Health Resources, Inc. hereunder
and agrees that it will perform all such assignments and projects in
a manner commensurate with professional standards generally applicable
to its industry.
F. OWNERSHIP OF MATERIALS
The parties acknowledge that any modifications to the printed materials
produced by its asthma program for Health Resources, Inc. are being
created at the insistence of Health Resources, Inc. and shall be deemed
"work made for hire" under the United States copyright law.
Health Resources, Inc. shall have the right to use the whole work, any
part of parts thereof, or none of the work, as it sees fit. Health
Resources, Inc. may alter the work, add to it, or combine it with any other
works, at its sole discretion. Notwithstanding the foregoing, all original
material submitted by Vendor as part of the work or as part of the process
creating the work, including but not limited to listings, printouts,
documentation, notes, reports, shall be the property of Health Resources,
Inc. whether or not Health Resources, Inc. uses such material. No rights
are reserved by Vendor.
All surveys and reports prepared by Vendor in connection with the
performance of its services hereunder will become and remain Health
Resources, Inc.'s sole property.
Vendor agrees it will not disclose to any third party, without the prior
written consent of Health Resources, Inc., any proprietary or confidential
information acquired from Health Resources, Inc. under this Agreement,
including trade secrets, business plans and confidential or other
information which may be proprietary to Health Resources, Inc.
Vendor warrants and represents that it has or will have the right, through
written agreements with its employees, to secure for Health Resources, Inc.
the rights called for in this Section. Further, in the event Vendor uses
any subcontractor, even though subcontracting is not permitted by this
Agreement, or other third party to perform any of the services contracted
for under this Agreement, Vendor agrees to enter into such written
agreements with such third party, and to take such other steps as are or
may be required to secure for Health Resources, Inc. the rights called for
in this Section.
G. DURATION OF AGREEMENT
1. Term
This Agreement is effective as of the Effective Date and shall continue in
full force and effect until the earlier of (i) completion of the project
assigned hereunder, (ii) terminated by at least one hundred eighty (180)
days written notice by either party to the other, sent by registered
mail to the address for each party first set forth above, or to such
other address which a party may designate for its receipt of notices
hereunder. This Agreement may be terminated by Health Resources, Inc.
immediately in the event Health Resources, Inc. is unable to obtain
waivers from its customers regarding Vendor's services.
-3-
2. Payment on Termination
Upon termination of this Agreement Health Resources, Inc. is to pay for all
authorized work in process.
3. Transfer Upon Termination
Vendor shall transfer, assign and make available to Health Resources, Inc.
or Health Resources, Inc.'s representative all property and materials in
Vendor's possession or control and any copies thereof belonging to and paid
for by Health Resources, Inc., and all information regarding Health
Resources, Inc.'s project(s) covered by this Agreement, as set forth in
Paragraph C herein.
4. Neither Health Resources, Inc. nor Vendor shall be liable to the other for
damages of any kind, including but not limited to lost profits or incidental,
punitive or consequential damages, relative to termination of this Agreement
in accordance with Section 6.2, even if advised of the possibility of such
damages.
H. INDEPENDENT CONTRACTORS
Vendor shall at all times be an independent contractor and shall so represent
itself to all third parties. Nothing in this Agreement shall be deemed to
constitute either party the agent or legal representative of the other nor to
constitute the parties as partners, agents or joint ventures of one another.
I. THIRD PARTY OBLIGATIONS
In connection with this Agreement, Vendor shall make no commitments or
disbursements, incur no obligations nor place any advertising, public
relations or promotional material for itself, Health Resources, Inc.'s,
subsidiaries or affiliate companies, nor disseminate any material of any kind
using the name of Health Resources, Inc. and/or Health Resources, Inc.'s such
parent, subsidiary of affiliate companies or using their trademarks, without
the prior written approval of Health Resources, Inc.
J. GOVERNING LAW
This Agreement is entered into the State of New York and shall be constructed
and governed under and in accordance with the laws of that State.
K. MISCELLANEOUS
1) The terms of this Agreement shall be binding upon Health Resources, Inc.
and Vendor and their respective successors and permitted assigns.
Notwithstanding the foregoing, this Agreement is not assignable in whole or
in part by Vendor without the prior consent of Health Resources, Inc.
2) The failure of either party to take action as a result of a breach of this
Agreement by the other party shall constitute neither a waiver of the
particular breach involved nor a waiver of either party's right to enforce
any or all provisions of this Agreement through any remedy granted by law or
this Agreement.
-4-
3) This Agreement contains the entire understanding of the parties with
respect to the subject matter contained herein, supersedes any prior written
or oral communications and may be modified in writing subject to mutual
agreement of the parties hereto.
4) The headings of each paragraph are for reference only and shall not be
construed as part of this Agreement.
5) Except for the obligation to pay money property due and owing, either
party shall be excused from any delay or failure in performance hereunder
caused by reason of any occurrence or contingency beyond its reasonable
control, including, but not limited to, failure of performance by the other
party, earthquake, labor disputes, riots, governmental requirements,
inability to secure materials on a timely basis, failure of computer
equipment, failures or delays of sources from which information or data is
obtained and transportation difficulties.
-5-
IN WITNESS WHEREOF, the parties hereto, each by a duly authorized officer,
have entered in to this Agreement this 13th day of September, 1996.
Health Resources, Inc. Patient Infosystems, Inc.
00 Xxxxxx Xxxx 00 Xxxxxx Xxxxxx
Xxxxxxx, XX 00000 Xxxxxxxxx, Xxx Xxxx 00000
By: /s/ Xxxxx X. Xxxxxx By: /s/ Xxxxxx X. Xxxxxxxx
-------------------------- -------------------------
Title: President & CEO Title: President & CEO
---------------------- ----------------------
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EXHIBIT A
DIABETES
DISEASE MANAGEMENT
PROPOSAL
-----------------------------------------------------------
PRESENTED BY
Patient Infosystems, Inc.
00 Xxxxxx Xxxxxx
Xxxxxxxxx, Xxx Xxxx 00000
000-000-0000
RATIONALE:
Diabetes places a tremendous burden on patients and health care providers and
demands a significant portion of our nations health care dollars. Patient
Infosystems, Inc. is committed to improving health outcomes through the
application of state of the art technologies to the care and treatment of
diabetes. Our proprietary interactive voice recognition systems, enhanced
database modeling techniques and on-demand publishing combine to provide the
powerful educational intervention necessary to enhance patient adherence to
treatment recommendations, empower patients to self-manage their disease and
provide immediate referrals when specific critical triggers are met.
PROGRAM DEVELOPMENT:
Patient Infosystems, Inc.'s staff, clinical experts and physician consultants
performed a comprehensive review of diabetes to insure that the American
Diabetes Association's guidelines form the program's foundation. Recognized
leaders in outcomes management provided guidance throughout the project
development process.
PATIENT INTERVENTION STRATEGIES:
Patient Infosystems, Inc.'s core diabetes patient intervention program
consists of six interactive voice response based telephone interventions.
Each contact generates an on-demand personalized patient report targeting the
patient's status in relation to the specifics of their diabetes condition.
The patient will also receive patient educational materials designed to
reinforce their awareness and knowledge regarding their condition and promote
their treatment adherence. Additionally, the patient's physician/health care
provider will receive an at-a-glance formatted report for review and
inclusion in the patient's medical records. These reports highlight specific
areas of concern of the patient and demonstrate areas of a patient's
adherence to the prescribed therapy.
Each intervention is uniquely structured to target specific behaviors such
as: compliance with diet and medication, exercise, diabetes self-management
and knowledge base, awareness of critical symptoms and the self treatment of
such, Quality of Life measurements and improved communication with health
care providers. By providing unique, individually tailored intervention
strategies, Patient Infosystems, Inc. highlights areas where noncompliance
and poor self management are impacting the plan's expenditures and also
provides an active intervention to modify "at risk" behavior before an
emergency room visit or hospitalization occurs. These intervention
strategies also provide the patient with encouraging feedback and positive
reinforcement with respect to their personal health management.
CRITICAL EVENTS:
As an extra feature, Patient Infosystems, Inc.'s clinical staff establishes
specific critical event triggers that are monitored at each intervention.
Patients meeting specified criteria demonstrating an increased risk of
hospitalization, emergency services or other costly intervention will have
their physician/health care provider notified the day of the intervention by
means of a faxed report. This critical event notification and tracking of
key indicators has demonstrated a reduction in the global cost of managing
chronically ill patients.
DATA MEASUREMENTS:
In addition to providing ongoing support for patients, Patient Infosystems,
Inc.'s fully integrated systems approach allows for immediate on-line data
collection and evaluation. Programs may be customized to include
administration of HEDIS, Health Quality, patient satisfaction, NCQA and
Quality of Life surveys without operation induced bias. The process
streamlines data collection and provides a cost effective method to query
patients.
2
PROGRAM OVERVIEW
The following intervention schedule will be delivered to patients who are
enrolled in the program. See the "Program Intervention Description" section
for details about each of the interventions. See the "Program Schedule
Summary" for the delivery schedule of each intervention. Note that the term
"physician/health care provider" is used to denote a physician, case manager
or other health care provider designated to receive communications regarding
the patient.
I. COMPONENTS
- Enrollment form
- Patient diary
- Program description/overview brochure
- Six (6) Interactive Voice Response (IVR) telephone contacts
- Six (6) on-demand published personalized patient reports
- Patient educational materials - one per call
- Six (6) on-demand published physician/health care provider reports
- Critical trigger notification
- Voice demonstration line
- Logo integration
II. PROGRAM INTERVENTION SCHEDULE:
CALL #1:
- Patient enrollment via enrollment form
- Initial telephone intervention within ten days of enrollment
- Patient receives on-demand published report following IVR intervention
- Appropriate patient educational materials and diary sent to patient
- Physician/health care provider receives on-demand published, patient
specific report for review and inclusion in patient record following IVR
intervention
- Additionally physician/health care provider receives same day
notification via fax for any patient reporting status indicating a critical
trigger has been met
CALL #2, 3, 4, 5, 6:
- Patient receives an IVR based telephone intervention per program schedule
summary
- Patient receives on-demand published report following each IVR
intervention
- Appropriate patient educational materials sent to patient
- Physician/health care provider receives on-demand published, patient
specific report for review and inclusion in patient record following each
IVR intervention
- Additionally physician/health care provider receives same day notification
via fax for any patient reporting status indicating a critical trigger has
been met
3
III. INTERVENTION SCHEDULE SUMMARY:
The program consists of a schedule including 6 telephone interventions, 6
patient reports, 6 physician/health care provider reports, 6 patient
educational materials and critical trigger reporting when a patient reports a
crisis. The schedule is carried out over an 8 month period.
-------------------------------------------------------------------------------
CALL # 1 2 3 4 5 6
-------------------------------------------------------------------------------
MONTH # 1 2 3 4 6 8
-------------------------------------------------------------------------------
-------------------------------------------------------------------------------
IVR Intervention * * * * * *
-------------------------------------------------------------------------------
Patient Report * * * * * *
-------------------------------------------------------------------------------
Physician/Health * * * * * *
Care Provider
Report
-------------------------------------------------------------------------------
Patient * * * * * *
Educational
Materials
-------------------------------------------------------------------------------
Critical Trigger * * * * * *
Reporting
(faxed as needed)
-------------------------------------------------------------------------------
4
PROGRAM INTERVENTION DESCRIPTION
See the "Program Schedule Summary" section for an outline of the schedule for
delivering these program components. Note that the term "physician/health
care provider" is used to refer to a physician, case manager or other health
care provider designated to receive communications regarding the patient.
ENROLLMENT FORM/PROGRAM DESCRIPTION
- Two (2) page mailer to be distributed by providers to patients and
return via postage paid mail
- Provides brief assessment for identifying patient data (e.g., name,
phone number, best time to contact, physician/health care provider fax
number, and identification number) necessary for Patient Infosystems, Inc.
to initiate a telephone call to patient
- Program description includes a brief program overview for patient
INTERACTIVE VOICE RECOGNITION BASED TELEPHONE INTERVENTIONS
- Six interactive voice recognition based telephone interventions
initiated by live operators to patients at perferred contact times
- Patient receives personalized questions and clinically appropriate
feedback driven by expert system to promote awareness of condition and
adherence to treatment regimen
- Follow-up assessment of relevant medical and behavioral factors:
update on disease status, prescribed treatment including diet, exercise,
and medications, patient motivation, treatment barriers, patient knowledge
indicators regarding symptom identification and disease self-management
- Allows identification of patient concerns
- Operator-initiated contact to identify patient and transfer to
automated, voice response system
- High appeal voice response system using a recorded human voice versus
computer synthesized speech
- Patient responds in normal speaking voice versus pushing touch tone
buttons
- Adds vital progress information to the longitudinal patient database
PESONALIZED PATIENT REPORTS
- Laser printed, on-demand published report including personalized
self-reported response data
- Mailed to patient within a week after each telephone intervention
- Black and white/grayscale logo to be used on report as program
identifier
PATIENT EDUCATIONAL MATERIALS
- Educational materials designated to reinforce patient awareness and
knowledge regarding their condition and promote treatment adherence
5
PHYSICIAN/HEALTH CARE PROVIDER REPORTS
- One page laser printed, on-demand published report integrating
patient's self-reported response data
- Mailed to patient's physician/health care provider within a week after
each patient intervention
- "At-a-glance" format provides efficient documentation of critical
patient data, ready for review and inclusion into the patient's medical
record
- Highlight notification that the patient is not following specific
treatment guidelines
- Black and white/grayscale logo to be used on report as program
identifier
- Facilitates identification of patient education needs and
hard-to-manage patients and appropriate allocation of health care
resources
- Enhances patient-physician/health care provider communication
CRITICAL TRIGGER REPORTING
- Physicians/health care providers will be notified via fax when patient
reports symptoms, noncompliance or other critical factors indicating an
increased risk for an acute event, hospitalization or emergency procedure
- Notification will occur the day of the intervention
- Notification will be a faxed critical physician/health care provider
report
- Black and white/grayscale logo to be used on report as program
identifier
CLIENT REPORTING
- Patient Infosystems, Inc. will provide standard aggregate outcomes and
demographic reports quarterly
CUSTOMIZATION
Customization and modifications to the core program features and schedules
are available. Cost estimates for alterations will be furnished upon
identification of revised program specifications.
6
