FPH provides Investor Event presentation

News Release
STOCK EXCHANGE LISTINGS: NEW ZEALAND (FPH), AUSTRALIA (FPH)

Fisher & Paykel Healthcare provides Investor Event presentation

Auckland, New Zealand, 15 September 2023 – Fisher & Paykel Healthcare Corporation Limited
attaches a copy of its presentation to analysts and investors for its Investor Event held over the
next two days in Tijuana, Mexico and Irvine, California.

There is no new material information contained within the presentation.

About Fisher & Paykel Healthcare

Fisher & Paykel Healthcare is a leading designer, manufacturer and marketer of products and
systems for use in acute and chronic respiratory care, surgery and the treatment of obstructive
sleep apnea. The company’s products are sold in over 120 countries worldwide. For more
information about the company, visit our website www.fphcare.com.

Media & Investor Contacts:

Hayden Brown
Head of Capital Markets & Investor
Relations
hayden.brown@fphcare.co.nz
+64 (0) 27 807 8073
Dan Adolph
Senior Communications & Investor Relations
Manager
daniel.adolph@fphcare.co.nz
+64 (0) 22 511 4050


Authorised by Marcus Driller, VP Corporate.

---

Important notice
This presentation is dated 15 September 2023 and has been prepared by Fisher & Paykel Healthcare Corporation Limited
(FPH).
Disclaimer
The information in this presentation is of a general background nature, is in summary form and does not purport to be
complete.Nothing in this presentation should be construed as an invitation for subscription, purchase or recommendation of
securities in FPH.
This Presentation is intended for investor education purposes only. The views expressed by Matthew Trump DO, Robert
Goldberg MD, James Price MD and Daniel GraviloniRCP are based on their personal experience and their patients and do not
necessarily represent the views of Fisher & Paykel Healthcare or any of its employees, officers or directors. Any medical
information provided is of a general nature and is not intended to be a substitute for medical advice, diagnosis or treatment
of a physician or other qualified healthcare provider.
The content of this Presentation is provided as at the date of this Presentation. Except as required by applicable law, FPH
does not plan to publicly update or revise any information contained in, or provided with, this Presentation whether as a
result of any new information, future events, changed circumstances or otherwise.

Mexico: Culture of
continuous improvement
Malena Ortiz
General Director Mexico Operations

Investor Day agenda
9:30 am Welcome
Overview of F&P Mexico operations
10:00 am Break
10:30 am Business Excellence Model
Purpose, People, Process, Performance
11:00 am Tour of manufacturing areas
12:00 pm Q&A
12:30 pmLunch
2:00 pm Depart for Irvine, California

F&P Mexico manufacturing
10,462 km
Distance from Auckland to Tijuana
39%
Mexico
61%
New Zealand
Mexico facilities:
•Three buildings: 63,000 m
2
/ 690,000 ft
2
.
F&P Mexico overview:
•First breathing circuit shipped in 2010.
•Diversified manufacturing.
•1,900+ collaborators.
•Hospital and Homecare consumables.
•Mexico contributes 39% of manufacturing.

Medical device industry in Tijuana
6
Tijuana is a world leader in the manufacturing of
medical devices.
•90% of medical device companies are certified
under ISO13485, FDA or CE mark.
•+80 medical device manufacturing plants in
Tijuana.
•>74,000 people employed in Tijuana medical
device manufacturing.
F&P benefits of manufacturing in Tijuana:
•Time zones overlap.
•Medical device manufacturing skills.
•Diversified product supply.
•Proximity to major markets.
•Relatively stable manufacturing labor costs.

BajaCaliforniaoffers89public& privateuniversities
9 UniversitieswithCross-BorderPartnerships
Medical device industry driving education
Supporting high-end manufacturing industries, such as medical devices, requires an innovative
workforce and investment in education and research on both sides of the border.
In2021,engineering was the STEMfieldwith
the highest number of degrees conferred at
3,700, followed by health sciences at
2,500degrees in Baja California.
San Diego had nearly
34,000workersdedicated to
scientificresearchanddevelopment services, over
23,000people i n computer systems design and
related services, andnearly
12,000people at
colleges and universities.

269
349
448
521
557
671
954
1009
1194
1323
1774
2297
1729
1911
FY11
FY12
FY13
FY14
FY15
FY16
FY17
FY18
FY19
FY20
FY21
FY22
FY23
FY24
0
500
1000
1500
2000
2500
NUMBER OF COLLABORATORS IN MEXICO
Our people
Male
Female
1900+ collaborators
Direct
Indirect
41%
59%
64%
36%

We recognize that
having engaged
collaboratorshas
tangiblebusiness
benefits for our
collaboratorsand
our
patients.
Annual
Turnover
Rate
48%24%34%26%27%35%27%36%
22%
21%22%28%44%24%
32.0%
30.0%
33.5%
32.2%
42.0%
58.4%
77.6%
80.8%
79.3%
63.0%
67.0%
77.0%
131.0%
66.0%
FY11
FY12
FY13
FY14
FY15
FY16
FY17
FY18
FY19
FY20
FY21
FY22
FY23
FY24
F&P Mexico
24%
Tijuana Manufacturing
Industry Average *
66%
Percent per year
Why our people stay
*Source: Ruiz-Morales y Asociados Firm– Tijuana Maquiladora Industry
FY24 is 12 monthrollingaveragetoAug2023

Our journey
19682012
2010
2016
20162017
2022
2022
2023
2023
Beyond
First respiratory
humidifier
prototype
developed
2005
Introduced
Optiflowhigh flow
therapy
Launched Airvo2
and myAirvo2
Treated more than
20 million patients,
including many
patients with COVID-
19 in hospitals
2020
Announced Optiflow
anaesthesiaand
Airvo3
Purchased second
campus in Karaka, New
Zealand
2001
F&P Appliances
spun out and F&P
Healthcare separately listed
on NZX
and ASX
Launched 950
heated
humidification
system
First breathing
circuit
shipped
Started production
of Simplus mask
Land purchased
and contract
agreement for
construction of
Building 1 for MX2.
MX3 completed
Started production
of Evora Full Mask
Construction of
MX4 - MX5
Lease agreement
signed for MX1
2009
We have more
than 50 years
of experience
as a leader in
respiratory
humidification.

Continuous improvement journey
Continuous Improvement
Department
01
Lean Leaders, Six Sigma
Green Belt Certification
02
Operational Excellence
Model
03
2009-201420152016201720182021
2023
Business Excellence
Model
04

Relationships
Commitment
Ideal Results
Require Ideal
Behaviors
Purpose and
Systems Drive
Behavior
PrinciplesInform
Ideal Behaviors
Originality
Internationalism
Life
Integrating our values and our people
We are committed to leading transformation initiatives and driving change.
Develop and overseeing plans and programs toimprove the efficiency, with a key
focus on using continuous improvement culture to analyze, understand and
improve our operating processesthrough principles, systems and tools, in order to
create a culture of ideal behaviors that generatesustainable ideal results.
Our Purpose

Business excellence model
Strategy
Deployment
Performance
Management
Great results are the outcomeof
connection to purpose and a
culture ofcontinuous
improvement.
Performance
Desempeño
Developmanagement systems that
effectively align every value stream
with principles and directions in ways
that are simple, comprehensive,
actionable and standardized.
Purpose
Propósito
Making it possible for people within
the organization to engage in the
transformationjourney, identifying
ideal behaviors and understanding
and building a culture of business
excellence.
People
Personas
Creating long-term solutions not temporary
fixes,simplifying work processes,ensuring
resources that are needed are available when
required and organizing places of work so
potential problems become immediately
visible.
Process
Procesos

Summary of model in Mexico
People:
Process:
Purpose:
Leading our response through daily workstreams focusing on People
Safety, Manufacturing and Distribution
Values Cards
1,836
Raised Ideas
1,817
Projects
1,656

Summary of model in Mexico
Great results are the
outcomeof connection to
purpose and a culture of
continuous improvement.

Questions

Thank you

Business
Excellence
model stations

Strategy Deployment
19
Purpose
Developmanagement systems that
effectively align every value stream
with principles and directions in ways
that are simple, comprehensive,
actionable and standardized.
Create Constancy of
Purpose
Think Systemically
Principles

How our strategy works
Improving care
and outcomes
through
inspired and
world-leading
healthcare
solutions.
F&P
Policies
Manufacturing
Expectations
Strategy
“Our plan”
Key
Performance
Indicators
PURPOSE OF F&P

Making it possible for people within
the organization to engagein the
transformationjourney, identifying
ideal behaviors and understanding and
building a culture of business
excellence.
Lead with Humility
Respect Every
Individual
Wellbeing and Cultural Engagement
People
Principles

Our programs
Beach Clean Up
151
Community
Involvement
Donations
80
Nursing Home
230
Reforestation
500
Orphanage
53
Children’s Day
457
3K Family Race
560
Animal Shelter
176
144
Team Fisher
3,120
Father’s Day
4,307
Mother’s Day
5,311
Family Day
1,734
Back to
School
OUR PURPOSE
Improving care and
outcomes through
inspired and world-
leading healthcare
solutions.

A culture of continuous improvement
Kaizen
Blitz
Ideas
generation
Ideas
collection
Feasibility
evaluation
CI Committee
Business
Unit
Recognition for
participation
Execution
DDORA
Deployment
Recognition for
Execution
Kaizen Blitz
Gold
Silver
Bronze
Safety
Gold
Cost
Wastes
5Ss
Quality
Wastes
Cost
5Ss
Safety
Quality
Silver
Bronze
Kaizen
Blitz
Kaizen
Blitz
Building a culture of
continuous improvement
requires an understanding
that every idea is
important and contributes
to
business excellence.

Process Excellence
24
Process
Creating long-term solutions not
temporary fixes,simplifying work
processes,ensuring resources that are
needed are available when required and
organizing places of work so potential
problems become immediately visible.
Embrace Scientific
Thinking
Assure Quality at the
Source
Flow & Pull Value
Focus on Process
Seek Perfection
Principles

Training and certifications
8,000+100+
Lean | Six Sigma CertificationsImprovements
Deploy a culture of continuous improvement that drives the transformation of the
organization through behaviors that are observable, development of lean manufacturing and
six sigma skills, and specialized training of our people through all levels within F&P.
Achievements
Continuous Improvement
Learning & Development Path
•1 Project Development
•Test Approval
•2 Lean Projects Development
•1 Six Sigma Project
Development
•Test Approval
•1 Six Sigma Project
Development
•Test Approval

Problem solving
Culture of problem solving
(DDORA methodology)
+30
Continuous training in
problem solving
methodology
Createa systematicmethodwhichallowsallteammemberstousestructuredproblem-
solvingtools.
Achievements
+400
People trained
+300
Projects
completed by
DDORA
Methodology
Problem solving area
inside production floor

Performance Management
Performance
Create Value for the
Customer
Principles
Great results are the outcomeof
connection to purpose and a
culture of continuous
improvement.

Daily management system
DESCRIBE ESTA ETAPA
DESCRIBE ESTA ETAPA
DESCRIBE ESTA ETAPA
DESCRIBE ESTA ETAPA
DESCRIBE ESTA ETAPA
Tier
5
Tier 5
Tier 4
Tier 3
Tier 2
Tier 1
Global Health Check
NZ-MX
Performance + Strategy
MX Town Hall Meeting-All
Performance + Strategy
Weekly Operations Review
Meeting - BAU
Ops Team + Support Team
Communication
Daily and Weekly Review
Staff
Communication + Strategy
Daily Operations Support Meeting
SU Managers
Support
Daily Execution Review Meeting
Team Leader + Support Team
Execution
Daily Shift Startup Meeting
Team members + Team Leader
Motivation + Communication

Manufacturing tour

How we connect our people to our purpose
FPH College – developing the technical,
operational, and managerial abilities of our
collaborators.
Community– social programs to connect our
people with the local community.
Living our values – values card program
recognizing and rewarding our people for
living the Fisher & Paykel Healthcare values of
Life, Relationships, Internationalism,
Commitment and Originality.

Idea generation
Continuous improvement comes from our collaborators sharing ideas.
Kaizen Blitz
+800
Kaizen
+50
Six Sigma
Projects
+20

Daily management system
DESCRIBE ESTA ETAPA
DESCRIBE ESTA ETAPA
DESCRIBE ESTA ETAPA
DESCRIBE ESTA ETAPA
DESCRIBE ESTA ETAPA
Tier
5
Tier 5
Tier 4
Tier 3
Tier 2
Tier 1
Global Health Check
NZ-MX
Performance + Strategy
MX Town Hall Meeting-All
Performance + Strategy
Weekly Operations Review
Meeting - BAU
Ops Team + Support Team
Communication
Daily and Weekly Review
Staff
Communication + Strategy
Daily Operations Support Meeting
SU Managers
Support
Daily Execution Review Meeting
Team Leader + Support Team
Execution
Daily Shift Startup Meeting
Team members + Team Leader
Motivation + Communication

VISION CIRCUITS
Integrate
Supply Chain
Process
People
•Growing the Internal Talent in
production.
•Integration of multidisciplinary
team to deliver results.
•Better operational safety by
providing more space and a
more controlled work pace for
our production people.
•Use of Lean tools to analyze
and identify better options to
reach goals.
•Competitive advantage to
meet customer needs in the
delivery of Vision Circuit kits.
•Increase adaptability, resilience
and quick response to any
global demand change.
•Creating value by developing
personnel who are capable of
working as a team in urgent
situations.
Benefits
Global CI Award - Inspiratory Limb Assembly Cycle Time Reduction

In-house manufacturing heater wire project
Integrate
Supply Chain
Process
People
•Internal Talent developing
new processes and
technology.
•Increase Autonomy &
Self-sufficiency in critical
manufacturing process.
•Eliminate/reduce any
riskassociated with
manufacturing process.
•Competitive advantage in
product supply chain,
reducing shipping cost/time.
•Increase adaptability,
resilience and quick
response to any global
demand change.
Benefits

Compact Full Face Mask
EVORA FULL
Integrate
Supply Chain
Process
People
•Developing Internal Talent to
manufacture Evora Full.
•Integration of
multidisciplinary team to
deliver results.
•Increase capacity introducing 43 new
SKUs into MX site.
•Competitive advantage with the
introduction of aninnovative product
with a face mask that seals underneath
the nose, rather than over the nose.
•Competitive advantage in releasing a
second manufacturing source for the
Evora Full Face Mask in Mexico.
•Increase adaptability, resilience and
quick response to any global demand
change.
•Creating value developing local
suppliers to reduce our lead times.
Benefits
Introduction into MX

Human rights
HARMONIOUS LABOR
PRACTICES
•Internal Preventative Committee to
deploy Harassment and Bullying
Policy.
HUMAN RESOURCES CULTURE
•Respect Policies
EMBEDDING
F&P CULTURE
•Constant communication of
organizational culture (Values,
Purpose).
•Communication channel with all
tiers (Suggestion box)
INCLUSION
•Diverse and inclusive workforce
NONDISCRIMINATION
•Psychosocial risk prevention
policy
•Diversity and inclusion
SOCIAL ENVIRONMENT
•Educational support for
collaborators and family
•Recognition programs
ENVIRONMENTAL PROTECTION
•Wastewater treatment plant
•Solar panels
•LEED Certification (Leadership in Energy and Environmental Design)
- All buildings constructed in a sustainable way

NasalHighFlow
Evidence&
Application
Friday,September15,2023
9:30am– 11:30am
MissionConferenceCenter
ConferenceRoomsA/B
26726CrownValley Parkway, MissionViejo,CA92691
EducationalSymposium

Educational Symposium Agenda
9:30am Welcome & Presenter Introduction
9:40am Nasal High Flow: What’s Next?
Matthew W. Trump, DO – UnityPoint Health
10:10am Interviews
Robert Y. Goldberg, MD – Providence Mission Hospital
James B. Price, MD – Providence Mission Hospital
10:40am Nasal High Flow Across the Hospital
Daniel B. Graviloni, RCP –Providence St Jude Medical Center
11:00am Panel Q&A
Hosted by Julie Jackson, RRT - Clinical Affairs Specialist, F&P
11:30am Thank you – Depart for Irvine Office

Welcome to Providence Mission Hospital
•Established in 1971
•State-of-the-art 523-bed acute care hospital
•Level II adult & pediatric trauma center
•Part of Providence, a not-for-profit provider of
integrated health care
•Approx 2800+ caregivers
•Approx 800+ physicians
•Approx 78,000+ Emergency Department visits
•Approx 145,00 Outpatient visits

Presenters
DanielB.Graviloni,RCP
•RespiratoryDirector
•ProvidenceStJudeMedicalCenter,
Fullerton,CA
James B. Price, MD
•Emergency Medicine Specialist
•Providence Mission Hospital,
Mission Viejo, CA
RobertY. Goldberg,MD
•Pulmonology & Critical Care Specialist
Providence Mission Hospital,
Mission Viejo, CA
MatthewW.Trump,DO
•Pulmonology& CriticalCareSpecialist
•TheIowaClinicandUnityPointHealth,
DesMoines,IA AdjunctClinical
AssociateProfessor
•UniversityofIowa,CarverCollegeofMedicine,
IowaCity,IA
Disclosure: Fisher & Paykel Healthcare will make a donation to the Providence Mission Hospital Foundation and will reimburse the
above clinicians for any expenses incurred in connection with participation in today’s event.

Matthew W. Trump, DO
MatthewW.Trump,DO
•Pulmonology& CriticalCareSpecialist
•TheIowaClinicandUnityPointHealth,
DesMoines,IA AdjunctClinicalAssociateProfessor
•Universityof Iowa,CarverCollegeof Medicine,IowaCity,IA
Nasal High Flow ... Now What?

Nasal High Flow...
Now What?
Dr. Matthew TrumpDO FACP FCCP

Iowa Methodist
Medical Center
•Level I Trauma Center
•370 staffed beds
•Mixed medical/surgical ICU

•UnityPoint Health

Meta
Analysis
Findings
4% absolute reduction
in need for intubation
NNT = 23

Updated systematic review
•Less heterogeneity by excluding: ED, post op, AECOPD, pulmonary edema

Improved outcomes
and tolerance
•Reduced mortality
•Reduction in intubation
•Increased ventilator free days
•Better tolerated than NIV

What we do

Began
with a
protocol

Lamb et al.
•Summary:
•No increased adverse outcomes
•Earlier recognition of respiratory failure and faster escalation of therapy
•Efficacious protocol generalizable to broad, critically ill populations
•Shorter hospital and ICU lengths of stay for patients with increasing need for
respiratory support
•Respiratory infection rates were lower when NHF is primarily used in post-
extubated patients
•NHF managed care per protocol may reduce unnecessary medication use

Why go beyond
ICU?
•ICU and ED beds are a scarce and costly
resource
•Review of internal data (MET team)
demonstrated potential benefit in
respiratory distress +/- acute hypoxic
respiratory failure
•Not requiring invasive mechanical
ventilation
•Patients who meet strict criteria could be
effectively and safely managed on therapy
on outside the ICU

UPH DM Inclusion Criteria for Outside ICU
Traditional nasal
cannula does not meet
patient flow demand
and/or FiO2
requirement.
COPD, asthma,
respiratory infections
causing AHRF, and other
cardiopulmonary
conditions
Rib fractures or
pulmonary contusions
• Splint open of the airways
during healing process
Dyspnea and/or
increased work of
breathing
Hypoxemia requiring >4
lpm oxygen
P/F ratio >150
ED: Above criteria used
• Intolerance to noninvasive
mechanical ventilation or
CPAP via EMS at 7 cm H20 or
less

UPH DM Inclusion Criteria for Outside ICU
Hydration of thickened secretions
Tracheostomy patients:
• Requiring higher flows
• Heat and humidity benefit
• Evidence for faster decannulation
Palliation for air hunger, dyspnea, and/or hypoxia at the end of life

UPH DM
Exclusion
Criteria for
outside ICU
•Obtunded and unable to maintain airway
•Severe respiratory acidosis (ventilatory
failure)
•Suspected facial fractures or skull
fractures
•Shock
•Upper airway obstruction

Our results

Use Outside
the ICU is Safe
and Effective

Use Outside the ICU is Safe and Effective
•66% avoided ICU
•486 hospital days outside ICU
•44h duration
•Escalation of care
•5% intubated
•6% NIV
•13h to escalation
•Low mortality 13%

Our Experience
Received NHF (N=998*)
No study cohort
(n=674)
COPD (n=90)
Trauma (n=63)
ED cohort (n=171)

COPD COHORT
Study Inclusion Criteria:
•Hypoxemia requiring > 4 LPM Oxygen
•Admitted directly to floor from ED or direct admission
•History of COPD
•Must have consult from Pulmonology team
•Trach dependent
•Palliation only
•NHF < 1 hour
•ICU before floor
Study Exclusion Criteria:
Clin Respir J. 2021;1–7.

Clin Respir J. 2021;1–7.
•Less ICU days in study vs control
•19% vs 49%
•No difference in intubation
•No mortality difference

TRAUMA COHORT
Study Inclusion Criteria:
•Hypoxemia requiring > 4 LPM Oxygen
•Therapy initiated in ED, ICU, or floor
•Significant chest wall trauma (3 >rib fractures)
•Part of multi-modal pain management regimen
•NHF < 1 hour
•Received mechanical ventilation prior to NHF
•Old or age-indeterminate rib fractures
•Tracheostomy
Study Exclusion Criteria:

More started
outside ICU
More
completed
outside ICU

Avoided
ICU
No difference in
complications

Savings and
Conclusions
•Ward patients:
•27% avoided the ICU
•47% vs 59% of days spent in
ICU
•11% reduction in health care
costs
•$481,663 (US) saved
•No difference
•Mortality
•Intubation rates

Our COVID experience

Summer 2020
•Respiratory CareOctober 2020,65(Suppl 10)3448481

Our COVID
Experience
Locally in 2020-21
-220+ started on NHF
-14% intubation rate
-68% started on medical floor
-med duration 3.3 days
-55% survival
-Av ROX intubated 2.91
-70% mortality if escalated to IMV

COPD

COPD
•Global prevalence 10.3%
•11.8% Men
•8.3% women
•3
rd
leading cause of death worldwide
•3 million deaths annually
•$40 billion/year by 2043 in US
•AECOPD greatest proportion of total
COPD cost burden in US

AECOPD
•NHF noninferior to NIV for
CO2 reduction
•6.8 mm Hg vs 9.5 mm Hg (p =
0.4) at 2h
•60 lpm flow used
•1/3 NHF required NIV in 6h
•57% NHF required NIV
entire hospitalization
•2 (5% ) intubated in NHF
group
•3 (7.6%) switched from NIV
to NHF
•No differences in mortality,
hospital LOS, duration of IMV

AECOPD
•Ward patients
•pH > 7.35, PaO2 < 60 mmHg, PaCO45 mm Hg
International Journal of Chronic Obstructive Pulmonary Disease 2020:15

Clin Respir J. 2021;1–7.
•Less ICU days in study vs control
•19% vs 49%
•No difference in intubation
•No mortality difference

Conclusions

Conclusions
•Nasal high flow is a well
established, effective mode of
support for patients with acute
hypoxic respiratory failure
•Nasal high flow is an effective
therapy for hospitalized patients
with COPD and other respiratory
conditions
•Patients supported with nasal high
flow can be safely managed outside
the ICU reducing costs and sparing
vital resources

Robert Y. Goldberg, MD
Pulmonary & Critical Care Specialist, Providence Mission Hospital
Using Nasal High Flow in the Critical Care environment
Julie Jackson, RRT
Fisher & Paykel Healthcare, Clinical Affairs Specialist

Introduction
•Can you please describe the Critical Care services at Providence
Mission Hospital along with your role and typical patients the
hospital serves?
•Can you describe your journey of adoption of high flow? What
patients now routinely start on high flow? How has this changed
your use of COT and NIV?
•How have these changes affected your patient outcomes and
performance metrics?

Impact of the pandemic
•Can you describe the impact of high flow for you during COVID-19?
•What were the challenges of using high flow during COVID-19 and how
were these addressed?
•How were other respiratory support strategies affected during COVID-
19?
•How has COVID-19 changed the way you treat respiratory compromised
patients?

Today and beyond
•How do you see high flow therapy expanding across your hospital?
•Where do you see research and education gaps with high flow?

James B. Price, MD
Emergency Medicine Specialist, Providence Mission Hospital
Using Nasal High Flow in the Emergency Department
Julie Jackson, RRT
Fisher & Paykel Healthcare, Clinical Affairs Specialist

Introduction
•Can you please describe the Emergency Department services at
Providence Mission Hospital along with your role? What are your ED
goals? How is your performance measured?
•What ED patient types typically receive high flow?
•How does an ED physician decide when to implement high flow? What
is your primary goal for these patients?

Impact of the pandemic
•How were you using high flow in your ED prior to COVID-19?
•During the COVID-19 pandemic, what were your challenges with
using high flow in your ED? Physician/RT acceptance etc?
•How has your clinical practice with high flow changed post-COVID-
19?

Today and beyond
•Do all ED physicians follow the same or similar treatment
approach when using high flow (ie. flowrate & FiO
2
) – has the
therapy become protocolized or is it still variable?
•Similar to the question to Dr Goldberg but now in the ED, where do
you see research and education gaps with high flow in the ED?

Daniel B. Graviloni, RCP
DanielB.Graviloni,RCP
•Executive Director of Respiratory Care, Providence California Division
•ProvidenceStJudeMedicalCenter,Fullerton,CA
Nasal High Flow Use Across the Hospital

Nasal High Flow Use
Across the Hospital
Daniel Graviloni, RCP
September 15, 2023

•Providence / St Jude Medical Center HF Experience
•How we adopted High Flow
•Future utilization opportunities
89
Focus Topics

FACTS:
•Established 1957
•320-bed, acute care hospital
•Approx 2400+ caregivers
•Approx 700+ physicians
•70,000+ ED visits
•Approx 450,000 OP visits
90
Providence St Jude Medical Center

Understood Clinical Need
91
How we adopted High Flow

Reviewed Available Clinical Research
92
How we adopted High Flow
Roca -HF Oxygen Therapy
Respiratory Care, April 2010
HFNC was better tolerated and more comfortable than face mask; was
associated with better oxygenation and lower respiratory rate; could have an
important role in treatment of patients with acute respiratory failure.
Parke -RCT
Respiratory Care, March 2011
NHF is more successful than the gold standardHigh Flow Face Mask in the
management of mild to moderate hypoxemic respiratory failure.
Corley - NHF EIT
British Journal Anesthesia, June 2011
HFNC reduces respiratory rate and improve oxygenation by increasing both
EELV and tidal volume and are most beneficial in patients with higher BMI’s.
Sztrymf - Pilot HFNC
Intensive Care Medicine, September 2011
HFNC has a beneficial effect on clinical signs and oxygenation in ICU
patients with acute respiratory failure.

Conducted Evaluations & Implemented in ICU - Defined the Target Patient Population
• Patients using oxygen masks
• Patients using Oximizer
• Borderline post extubation patients
• Mild-Mod respiratory distress
• Combo NIV/HF therapy
93
How we adopted High Flow

Conducted Evaluations & Implemented in ICU – Prepared equipment
94
How we adopted High Flow
•MR850 Humidifier
•Temp Probe & Pigtail
•RT202 Circuit
•F&P Cannula
•IV Pole w/ Basket
•High Flow Blender
•70 L/min Flowmeter & Gas
Hoses

Hospital wide adoption prior to, during and after COVID-19
95
How we adopted High Flow
CONVENTIONAL
OXYGEN THERAPY
NONINVASIVE
VENTILATION

•Increased high flow use outside Critical Care / Emergency Dept.
•Increased use on higher acuity patients as additional research is available
•Increased flow rate for added patient benefit and improved outcomes
•Increased transport/procedure use; Emergency dept, Post-Op
•Increased use for humidity therapy purposes
96
Future Utilization

Panel Q&A Session
DanielB.Graviloni,RCP
•RespiratoryDirector
•ProvidenceStJudeMedicalCenter,
Fullerton,CA
James B. Price, MD
•Emergency Medicine Specialist
•Providence Mission Hospital,
Mission Viejo, CA
RobertY. Goldberg,MD
•Pulmonology & Critical Care Specialist
Providence Mission Hospital,
Mission Viejo, CA
MatthewW.Trump,DO
•Pulmonology& CriticalCareSpecialist
•TheIowaClinicandUnityPointHealth,
DesMoines,IA AdjunctClinical
AssociateProfessor
•UniversityofIowa,CarverCollegeofMedicine,
IowaCity,IA

Thank you
EducationalSymposium

North America
Operations
Justin Callahan
President North America and Europe

North American medical device market
•Complex structure
•Dynamic
•Regulated
•Strong demographics
•Underpenetrated
North America is the largest
medical device market in the
world
~$180B
US medical device industry
Our largest market
accounting for
43%
of revenue FY23
3,000+
Homecare dealers in
US and Canada
6,500+
Hospitals in US and
Canada

Overview of our North American business
0
50
100
150
200
250
300
350
400
NORTH AMERICAN EMPLOYEESNORTH AMERICAN REVENUE NZD $M
0
100
200
300
400
500
600
700
800
900
400+
F&P employees
supporting
8,000+
customers in
Hospital and Homecare
Proven successful team
in changing clinical
practice and driving
Sustainable, Profitable
Growth

North America -our people and our culture
Total People: 411
•We value diversity of thought and
people. We strive to create a positive and
inclusive environment where everyone
can contribute the most they can over
the long term
•Sales teams focused on changing clinical
practice. Working closely with clinicians
across the healthcare continuum as
Trusted Advisors
•Sales teams are a balance of sales and
medical professionals with average
tenure of 5+ years
•Strong operations team supporting sales
growth with a continuous improvement
culture

Our technology
Humidification
Technologies
Enables Core Therapy
Capital + Dedicated
Consumables

US Hospital
Overview
Steve Lacke, VP Marketing and Clinical Affairs
Steve Wilson, VP Sales and Marketing North America

US Hospital business model
+6,500 Hospitals
GPO
Pricing
agreements
Product
Distribution
•Works on behalf of its Hospital
members
•Establishes pricing agreements
•Typically funded by admin fees
•Consolidated delivery of
Hospital supplies
•Just in time deliveries
Inventory management
•Funded by distribution
fees from both Hospital
and supplier
DIRECT SALES
OPERATION

Opportunity across all areas of the hospital
Our product range allows us to treat
respiratory patients across all areas of the
hospital
•Medical Intensive Care Units
•Surgical Intensive Care Units
•Emergency Departments (ER)
•Floor/Ward
•Operating Room
Our sales teams become experts in the clinical
application of our products focused on
changing clinical practice

The sustainable sales process
Implementation
Changing
clinical
practice
Clinical
evidence
Demonstrated
value
Adoption
Customer experience
Multiple
stakeholders
Value analysis

Post-COVID hospital environment
Rapid exposure to a new tool – Many steps in the
educational process of utilizing a new clinical tool were
skipped during the COVID pandemic.
Access to clinicians – Our teams are re-engaging with
clinicians to build on the knowledge and understanding for a
more comprehensive usage of High Flow Therapy.
Clinical practice guidelines – Clinical practice guidelines
have now been published. These guidelines assist our sales
teams in changing clinical practice.
Steady progress – We see ongoing signs of increasing
utilization and our sales teams are focused on the journey of
changing clinical practice within the Hospital.

Case studies
Case study –Mark Miller
Case study –Margaret Murphy

Health system standardization -case study
−A 40 hospital system, 8,000 beds
−F&P Active Humidification has been the Gold
Standard
−Nasal High Flow journey began in 2017
−2018 & 2019 began expanding and investing in the
therapy systemwide
−Post pandemic understand the need to
standardize Nasal High Flow Policies systemwide
−What’s ahead:
•Working to implement Nasal High Flow Policies
(ED, ICU & Floor) systemwide
•Standardizing NIV platform to Fisher & Paykel
Presented by Megan Hadley – East Regional Manager

The sustainable sales process
•Market leading position in Humidification
Technologies
•Strong partnerships with GPOs and
distribution networks that capture our entire
portfolio
•Utilizing clinical evidence to build confidence
and demonstrate value
•Working closely with clinicians to support
and provide solutions across the care
continuum
•Steady progression of acceptance and usage
across our customer base
Changing
clinical
practice

US Homecare
Overview
Steve Polgar
VP Sales & Marketing Homecare

US Homecare business model
Sleep Physicians & Sleep
Testing facilities
Homecare
Providers
Patient
Insurance
Provider
Same feedback as
hospital slide

Over 20 years of mask innovation
Adjustment
Bezel
StretchWise™
AirPillows™
CapFit™
Stability Wings
FlexiFoam™
Diffuser
VentiCool™
RollFit™

Comprehensive approach to Physician, Patient & Provider
Dynamic Support
Technology
Performance
Freedom of movement
while keeping the mask in
place.
CapFit
Ease of use
Just like putting
on a cap. Intuitive.
VentiCool
Comfort
Breathable headgear
designed to allow
for heat and moisture
to escape.
myMask™App
Initial setup and
support
Support patient mask
setup. Fit, fine-tune
and clean.

Our focus in OSA
Building on 20 years of innovation to
develop market leading OSA Mask
technologies that focus on:
•Improving Homecare Provider
efficiencies
•Referral source satisfaction
•Patient satisfaction

Questions

Thank you