1. The Sanford World Clinics October, 2011

3. Brief History 116-year history with foundations in Sioux Falls, South Dakota and Fargo, North Dakota Sanford Health and MeritCare merged in November 2009 to create the largest rural health care organization in the United States Community owned, private non profit charitable, volunteer board representing entire region Model of integration: hospitals, physicians, health plan, research education

4. Sanford Health Today 20,000 employees 1,000 Physicians in more than 70 subspecialty areas Serving 2 million people in 120 communities over 130,000 square miles and 5 states Each year, Sanford provides more than… – 2 million clinic visits – 150,000 inpatient visits – 7,300 births 35 hospitals 33 long-term care facilities 175 clinic locations 70,000 health plan members $2.3 billion in annual net operating revenue

5. Sanford Health One of the top 50 largest not-for-profit healthcare organizations in the U.S. Largest rural healthcare system in the U.S. 130,000-square mile service area More sq. miles than 46 U.S. States except Alaska, Texas, California and Montana

7. Health Services Development & Research Sanford Medical Center, Fargo Sanford USD Medical Center Sanford Clinic, Fargo Sanford Clinic, Sioux Falls Sanford Health Network, Fargo Sanford Health Network, Sioux Falls Sanford Research/USD The Sanford Initiatives Sanford Health Plan Information Technology Sanford Health Foundation Business Development & Commercialization

8. Sanford Children’s Health Research Ctr Sanford Children’s Hospital Sanford Project Type 1 Diabetes Sanford Project Type 1 Diabetes Healthcare Campus of the Future Sanford fit Edith Sanford Breast Cancer Initiative Sanford World Clinics Sanford World Clinics Sanford Children’s International Board Advancing Healthcare Education

9. International Initiatives Sanford World Clinics – Providing permanent healthcare infrastructure where it is otherwise unavailable Research – A cure is universal Research – Translational focus, trials can be conducted across borders Programmatic: – Sports Medicine – fit

11. Sanford Children’s CARE Model Our physicians and scientists in each of the Sanford Children’s entities strive for excellence in CARE: – Clinical Services – Advocacy – Research – Education The Department Chair has appointed leaders (Associate Chairs) in each of these categories: – Clinical Services: Jim Wallace, MD – Advocacy: Jerry Blake, MD – Research: David Pearce, PhD – Education: Joe Zenel, MD Our educational partner is the Sanford School of Medicine of The University of South Dakota

12. Sanford Children’s Hospital Opened for patients March 2009 128 beds, 168,000 square feet Full electronic medical record connectivity, including advanced imaging capabilities

13. Sanford Children’s Hospital Designed to promote healing in children

14. Sanford World Clinics Build more than five new facilities over the next decade in areas where primary pediatric care is unavailable Seeking approximately 10 domestic and 10 international locations Model – 3-to-7 full-time pediatricians – 7,000-11,000 square feet

15. Sanford Children’s Clinics Selection Criteria 1.Relationship with existing healthcare providers, including subspecialists 2.Demonstrated community need 3.The donation of land, approximately 3-5 acres, and philanthropic support matching Sanford’s initial capital investment in the community 4.Ability to recruit physicians and staff

16. Sanford World Clinics Organizational Commitments to Sustainability Subspecialty Consultation (more than 40 pediatric subspecialists available for counsel) Management Structure Business Services Electronic Medical Record System

22. International Criteria 1.Staff safety 2.Political stability 3.Economic balance and stability 4.Ease of communication (language barriers, time zone, technology infrastructure, etc.) 5.Extra emphasis on mission, capability and goal of partner organization(s)

25. Ghana Hub, Spoke and Micro Clinic Model Provide services to children and their families Scalable in order to develop ten or more sites in short period of time Expanded model will create access and availability of primary care in a variety of communities

28. The Sanford World Clinics Shifting the Process – Now, designing a model with more than 100 facilities around the world – Further emphasis on the benefits of relationship/partnership – Seeking “pre-qualified” locations meeting basic criteria (need, philanthropy, health care partner, sustainability)

29. The Sanford World Clinics Accelerating the Process – Developing a multi-channel communication strategy Health Organizations Development Foundations and Chambers of Commerce Affinity Groups – Engaging New Partners We need YOU to help us establish connections and opportunities in areas of need

30. 1,000,000 Children Each Year