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CVG Upcoming Events
Boardroom Series 7:30 AM – 9:00 AM
April 12
M&A: Tax Considerations
Glastonbury
Second Thursday 4:30 PM – 7:00 PM
May 9 Financial Services
Stamford
June 13
BioTech/Pharma
Hartford
July 11
Funding
New Haven
April 17
Employment and Immigration Issues
Hartford
May 1
Crowdfunding
Stamford
April 8
Investment by Strategics
New Haven
Marketing at the Speed of Light Welcome
Paul E. Knag
Chair, Health Law Group Murtha Cullina LLP, Attorneys at Law
Three Minute Pitches
Matthew Meier
Jolinda Lambert
David Engelhardt
Yann Beaullan
Marketing at the Speed of Light Electronic Health Records A Look at the Industry and Its Future
Panelists
Daniel J. Barchi SVP and CIO
Yale New Haven Health System,
Yale School of Medicine
Ludwig “Lud” Johnson Vice President, Information Services
Middlesex Hospital
Edward "Ted" M. Kennedy, Jr. Attorney, co-founder and President
Marwood Group
Moderator
Dave Menard Partner
Murtha Cullina LLP
Attorneys at Law
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
New York • Washington, D.C. • London
Tel. 212 • 532 • 3651
www.marwoodgroup.com
Electronic Health Records: A Look At The Industry And Its Future Ted Kennedy, Jr.
Crossroads Venture Group
April 11, 2013
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
General Themes for Presentation
Healthcare Information Technology (HCIT) Industry Update
Drivers and Barriers to EHR Adoption
– Regulatory and Market Dynamics
Regulatory Issues on the Horizon
– Meaningful Use Stage 3 Criteria and Others
HCIT Investment Opportunities
– Near and Long Term
Select HCIT Transactions
– Understanding the Theories and Assumptions Behind the Investment
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
Marwood Group Introduction
Founded in 2000, the Marwood Group is a leading healthcare-focused advisory and financial
services firm with offices in New York City, Washington, D.C. and London
– Professional staff of more than 100 employees including staff of former legislators, regulators and
healthcare operators
– Nationally recognized provider of research and advisory services to institutional investors and
corporations
Provides in-depth healthcare focused research to mutual funds and other investment managers
Completed over 600 advisory engagements for financial sponsors and healthcare companies
Marwood provides advisory services across seven different practice areas:
● Identify areas of
risk for fraud and
abuse
● Assess provider
performance
through review of
regulatory surveys
Financial
Analysis
Market
Analysis
Federal
Analysis
● Competitive
landscape
analysis
● Process
benchmarking
● Market sizing
● Valuation
● Financial
modeling and
projections
● Pro forma
analysis
● Legislative
● Regulatory
● Medicare
reimbursement
● Medicare
coverage
● FDA regulation
Clinical &
Compliance
Diligence
Provider
Research
● Decision making
process mapping
● Purchasing
dynamics
● Product selection
criteria
● Product clinical
differentiation
State
Analysis
● Legislative
● Regulatory
● Medicaid
reimbursement
● Medicaid coverage
● Workers
compensation
Private
Payor
Research
● Reimbursement
outlook
● Coverage outlook
● Medical policy
review
● Clinical
differentiation
Integrated Analysis Provides Holistic Market Perspective
7
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
Marwood has advised clients in over 85 sub-sectors across healthcare services and products
Rehabilitation Managed Care Health IT Pharmaceuticals/Biotechnology
● Inpatient Rehab Facilities
(IRFs)
● Outpatient Rehab
● Physical Therapy
● Occupational Therapy
● Commercial Health Plans
● Medicare Advantage
● Specialty Benefit Managers
● Special Needs Plans
● Disease Management
● E-Claims Disability Processing
● Medicaid Management
Information Systems
● Pharmacy Benefits Administration
● Teleradiology
● Biologics
● Branded/Generic Drugs
● Nuclear Pharmacy
● Pharmaceutical Compounding
● Specialty Pharmacy
Post Acute Care Behavioral Health Care Hospitals Diagnostics
● Adult Day Care
● Home Health
● Hospice
● Long Term Care Pharmacy
● Skilled Nursing Facilities (SNFs)
● Assisted Living Facilities (ALFs)
● At-Risk Youth
● Care Management
● Autism
● MR/DD
● Residential Treatment Centers
● Acute Care Hospitals
● Long Term Care Hospitals (LTCHs)
● Specialty Surgical Hospitals
● Psychiatric Hospitals
● Hospital Outsourced Services
● In Vitro Diagnostic Multivariate
Index Assays (IVDMIA)
● Clinical Laboratory Improvement
Amendments Labs (CLIA)
Ancillary Care Durable Medical Equipment Other Medical Products
● Enteral Therapy
● Infusion Therapy
● Inhalation Therapy
● Diabetic Testing Supplies
● Power/Complex Wheelchairs
● Diabetic Footwear
● Home Oxygen
● Medical Supply Distribution
● Group Purchasing (GPOs)
● Revenue Cycle Management
● Workers’ Compensation
● Clinical Staffing
● Transportation Services
● Hospitalists
● Pharmacy Benefit Managers
● MSAs/HSAs
● Program Integrity
● Health & Wellness
● Intraoperative Neuromonitoring
● Prison healthcare
● Patient Satisfaction
● Medical Education
● Implantable Devices
● Single Use Devices (SUDs)
● Physician Preference Items
● Capital Equipment
● Other Surgical Instrumentation
● Medical/Surgical Supplies
● Contract Manufacturing
● Durable Medical Equipment
● Blood Monitoring
● Contact Lenses
● Cosmetic Laser Surgery
● Negative Pressure Wound Therapy
● Leg compression Pumps & Sleeves
● Orthotics & Prosthetics
● Precision Guidewire
Physician/Medical Laboratory/Radiology/Dialysis
● Anesthesiology Groups
● Dental Groups
● Dermatology/Dermapathology
● Emergency Medicine
● Ambulatory Surgery (ASCs)
● Pain Management
● Wound Care
● Clinical Labs
● Dialysis Clinics
● Diagnostic Imaging (MRI, CT, PET)
● Pathology Labs
● Radiation Therapy (IGRT, IMRT)
● Sleep Centers/CPAP
● Urine Drug Testing
Healthcare Products Healthcare Services
Broad Healthcare Sector Expertise
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
State of HCIT Industry: Tremendous Growth
Healthcare providers continue to adopt EHR technology, driving tremendous growth in the
HCIT industry
– VC HCIT investment has increased significantly, rising to more than $765 million in 2011, according to
the National Venture Capital Association
Much of the growth has been driven by Government programs (CMS Meaningful Use) and
various market dynamics
– CMS reports that 80% of hospitals and 70% of professionals eligible for the Meaningful Use program
have registered
– As of February 2013, $12.69 billion in Meaningful Use incentive payments has been allocated
Basic EHR Adoption Rate Among Providers
Source: The Office of the National Coordinator for Health Information Technology
10%
15%
20%
25%
30%
35%
40%
2008 2009 2010 2011
Office-
Based
Provider
Hospital
HCIT Industry Revenue & Market Capitalization
$3.99 $4.69
$5.46
$6.23
$7.01
$7.82
$17.0 $18.4
$21.7 $22.4
$26.9
Marwood selected publicly traded company HCIT index, Source: CapIQ
$ in B $ in B
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
Publicly Traded HCIT Revenue Growth & EBITA Multiples Remain Strong With EBITDA Margins Above 25%
AH
ATHN
QSII
CPSI MDRX
CERN
MDAS
EM
0%
5%
10%
15%
20%
25%
30%
35%
8.0x 10.0x 12.0x 14.0x 16.0x 18.0x 20.0x
Revenue Cycle Management EBITDA Multiples Versus Growth
20
12
Re
ve
nu
e G
row
th
2012 EBITDA Multiple
Stock % of Diluted Diluted Enterprise Value as a Multiple of EBITDA Long-Term
Price 52-Wk Equity Ent. Revenue EBITDA Margin 2012E Growth EPS
Company Name Ticker 6/24/11 High Value Value 2011E 2012E 2011E 2012E 2011E Revenue EBITDA Growth
Revenue Cycle Management
Accretive Health AH $24.54 80.1% $2,572 $2,416 2.87x 2.18x 29.4x 18.5x 9.8% 32.0% 58.8% 34.0%
athenahealth ATHN 41.01 81.1% 1,483 1,376 4.43x 3.49x 20.9x 15.6x 21.2% 26.8% 33.4% 35.0%
EMR / Diversified Provider HCIT
Quality Systems QSII 82.49 90.1% 2,420 2,302 5.68x 4.74x 16.8x 13.6x 33.8% 19.7% 23.1% 18.3%
Comp Prog. & Sys. CPSI 58.98 89.4% 648 631 3.63x 3.23x 15.4x 13.2x 23.6% 12.2% 16.3% 16.6%
Allscripts MDRX 18.75 81.1% 3,699 4,058 2.82x 2.55x 12.4x 10.4x 22.7% 10.4% 19.4% 19.9%
Cerner CERN 115.97 92.1% 10,260 9,517 4.58x 4.07x 14.0x 11.6x 32.6% 12.5% 20.6% 18.2%
Diversified
MedAssets MDAS 13.18 52.6% 815 1,738 2.91x 2.66x 9.3x 8.1x 31.2% 9.5% 15.2% 24.1%
Emdeon EM 13.40 79.6% 1,572 2,419 2.35x 2.12x 8.5x 7.8x 27.8% 10.7% 8.5% 14.3%
Mean 3.66x 3.13x 15.8x 12.4x 25.3% 16.7% 24.4% 22.5%
Median 3.27x 2.95x 14.7x 12.4x 25.7% 12.3% 20.0% 19.1%
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
Drivers For EHR Adoption: Regulatory & Market
Market Drivers
ACOs As ACOs come into formation, participating providers will need to adopt
sophisticated HCIT platforms based off EHR data in order to drive savings and
enhanced care
Acquisitions
As large health systems continue to acquire smaller physician practices, such
practices are able to utilize the larger systems EHR platforms
– One of the reasons why physician practices agree to be acquired in the first place
Efficiency & Quality EHRs are a essential tool required to drive operational efficiency, including
maximization of reimbursement, and clinical quality
Regulatory Drivers
Financial Incentives
Medicare incentives include up to $44,000 per year per qualified physician over
5 years
Medicare incentives for hospitals are based on discharges over a 4 year
timeframe
Financial Penalties
Physician penalties are dependent on the total number of physicians that adopt
EHRs as of 2018
– Physicians who do not comply will be cut between 3-5% by 2019 through adjustments to
the physician fee schedule (PFS)
Medicare penalties for hospitals include an increasing market basket reduction
starting at -0.25% in 2015 going as high as -0.75% market basket reduction if
not compliant by 2017
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
Barriers To EHR Adoption
Barriers To EHR Adoption
Up front
Cost
While the Meaningful Use program provides financial incentives to providers, payments are
made in increments over a 5 year period, leaving much of the costs associated with
converting paper records the responsibility of the physician practice
– Companies such as EClinicalWorks, a EHR practice management company, hosts clients EHRs for a fee
reducing up-front costs of computerizing provider EHRs
Purchasing and licensing of software remains a big issue for smaller practices, as systems
typically cost can be $30,000 or more per doctor
EHR
“Learning
Curve”
Even after hospitals implement an EHR system, it often takes considerable time for both
clinicians and administrators to learn how to use the new software
– Physician productivity can drop by 30% as physicians learn how to use the new systems
Physician
Acceptance
Lack of new technology acceptance, especially for older physicians and physicians
practicing in rural areas
– It is estimated that over 25% of the physician workforce is 60 or older
– National Bureau of Economic Research suggests that EHR adoption can be more costly in rural areas
Connectivity The ability for healthcare providers to exchange EHR information across different
healthcare systems and settings of care remains limited
Product
Offering
Currently EHR product offerings remain fragmented, including sub-sectors and health
system specific products, fueling connectivity issues
– Specialized EHR products range from clinical laboratories to wound care-focused products
– In addition, large hospital systems continue to design system-specific specialized platforms
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
What’s Hot In Healthcare IT: Regulatory Concerns and Potential Opportunities For HCIT Providers
15%
16%
21%
21%
22%
24%
24%
26%
29%
45%
0% 10% 20% 30% 40% 50%
Consolidating All IT Functions Using Common
Applications
Adopt/Extend Ambulatory Clinical IT Systems
Enabling Patient Access To Selected Data Via
The Internet
Clinical Communications Infrastructure/Links
to Physicians
Data Privacy & Security
Electronic Health Records
Developing Data Warehouses
Adopt/Upgrade Financial & Clinical Systems For
ACO or Medical Home Readiness
Achieve Stage 1 Meaningful-Use Criteria
Achieve ICD-10 Readiness
Ranked by % of respondents, based on 110 responses (Source: Modern Healthcare, March 4, 2013)
Regulatory Issues
Near Term Opportunities
Long Term Opportunities
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
Regulatory Issues On The Horizon: Meaningful Use Criteria Stage 3 Definition
“Meaningful Use” is a series of functional benchmarks which need to be met in order to be compliant
under the Health Information Technology for Economic and Clinical Health (HITECH) Act
Key “Meaningful Use” questions for providers:
– What new criteria/requirements will Stage 3 mandate?
– Will the implementation of Stage 3 be delayed, similar to Stage 2 delays?
– Will Congress, specifically House Republican members, continue to support the program?
Recent studies suggest that EHRs may not be as successful in reducing costs, such as reducing unnecessary diagnostic tests, as
previously predicted
Meaningful Use Criteria By Stage
Stage Description Regulation
Finalized Implementation Criteria Examples
1 Basic HIT structure
and foundation 2010 2011
Recode demographics, vital signs, smoking status and
medication list
2
Focus on information
exchange quality of
care
2012
Planned
Implementation in
2014
Generate patient lists for quality improvements, send
reminders to patients on follow-up care, provide
electronic clinical summary for each office visit
3
Promote further
improvements in
quality, safety and
efficiency
Possibly
mid-2014 Possibly in 2016
Proposed: Identify possible medication allergies, provide
decision support regarding medication requirements and
diagnostic testing, electronically submit information to
other entities, such as HIEs or ACOs*
* Stage 3 criteria examples are based off proposed criteria from the Health IT Policy Committee which have not been finalized in regulation
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
Other Regulatory Issues On The Horizon
Issue Description
Privacy &
Security (HIPPA
Compliance)
HHS continues to release additional privacy and security regulations, including
limitations on the disclosure of personal health information (PHI)
Increased privacy safeguards may inhibit innovative HCIT companies’ ability to
analyze EHR data
– On January 17, 2013, HHS issued additional rules adding numerous new privacy and
security requirements
EHRs: A
Tool For
Upcoding?
HHS continues to investigate EHRs’ role in enabling hospitals to “upcode” for
greater reimbursement
– Examples include “cloning” medical records and upcoding the intensity of care in order
to inflate provider reimbursement
On September 24, 2012, HHS sent a letter to 4 major hospital associations voicing the agency's concern such practices
FDA
Regulation
While the FDA has largely refrained from enforcing its regulatory authority over
medical software, regulators continue to investigate the agency’s jurisdiction
over EHRs
ACA Device
Tax
Under ACA, all devices registered by the FDA are subject to the device tax,
which recently went into effect earlier this year
– It remains unclear how many EHR companies are registered with the FDA
– Potential for device tax repeal, although would need $29B in offsets
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
Outsourcing day-to-day services:
HCIT Opportunities
Marwood has identified the following near and long term opportunities
though our own proprietary industry surveys focused on the HCIT space
Registration/
Eligibility
Data Center Server
Management
Claims Coding,
Including ICD-10
Transition
Disaster
Recovery/Back-up
Processes
Travel And Expense
Reimbursement
EHR System
Implementation
Collections/
Bill Scrubbing/
Quality Assurance
Data Warehouse
Development/
Maintenance
Long Term Opportunities
While there was little directly related to
HCIT in healthcare reform (ACA), advanced
data analytics will play a critical role in
delivering higher quality and lower cost
care.
Streamlined
Reporting/Data
Analytics
Data Analytics To
Drive Outcomes
/Clinical Support
Technology
Advanced Cloud
Technology
Integration
Management
Near term Opportunities
Advanced data analytics in order to drive
operational efficiency:
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
Select HCIT Transactions: Different Approaches To Enhance Communication Between Payors & Providers
Year Acquisition Strategy Size ($mm)
Aetna 2010 Medicity
At the time, many thought that HIEs were going to be an essential
part of the information flow solution, reflected in the acquisition
purchase price (10x revenue)
Even in 2013, the amount of information actually flowing through
HIEs remains limited, leaving some in the market to question the
value of HIEs
$500
Conifer
(Tenet) 2012 InforMed
InforMed combines both provider claims and EMR, essentially
creating their own self made version of a HIE
– The acquisition supports hospital trends in providing care management
-
TriZetto 2011 Gateway
EDI
Places both provider (Gateway EDI) and payor (TriZetto) RCM
business lines under one corporate umbrella -
Blackstone 2011 Emdeon Emdeon is already entrenched in both provider and payor
markets $3,000
A wide range of strategies have been used to enable providers and payors across
the healthcare spectrum to communicate with each other, including:
– Healthcare Information Exchanges (HIEs)
– Advanced data analytics and care management platforms
– Merging of payor and provider Revenue Cycle Management (RCM) companies
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
Other Acquisitions Of Note: Continued Focus On Advanced Data Analytics And IT Infrastructure
Year Acquisition Strategy Size ($mm)
United 2013 Humedica
Provides United’s healthcare services arm (Optum Health) with a
position in the growing health data mining market
– The acquisition follows Optum’s partnership with Mayo Clinic, known as
Optum Labs, a research center that will mine clinical and claims data in order
to enhance the quality of care
-
Athena
Health
2013 Epocrates
Enables Athena to further penetrate the physician market, selling its
cloud-based network technology to Epocrates’s strong network of
physician customers
– Epocrates is primarily know for its point of care mobile applications
Largest acquisition in Athena’s corporate history representing a 22%
premium over Epocrates closing stock price
$293
2012
Healthcare
Data
Services
Expands Athena’s cloud-based services strategy
Expands population-based cost and quality data analysis and
reporting capabilities, essential as value-based payment models are
implemented
$5.8
Recent M&A activity reflects a change in priorities of healthcare executives from
“day-to-day” IT to more advanced data analytics and IT infrastructures
© Marwood Group Advisory, LLC 2013 Unauthorized reproduction or distribution of this copyrighted work is prohibited
Marwood Group Contact Information
Ian Adler
Senior Managing Director of Healthcare
(212) 532-3651
New York, NY
733 Third Avenue
11th Floor
New York, NY 10017
Washington, DC
1025 Connecticut Ave, N.W.
6th Floor
Washington, D.C., 20036
For additional information, please contact:
19
Healthcare IT Market
User Perspective
Lud Johnson, CIO
Middlesex Health System
April 11, 2013
Middlesex Health System
• Health System - most parts of the continuum
• About the 12 largest Hospital in CT
• Highly Automated
o Most Wired Hospital 2012
o HIMSS Analytics Automation top 10% of Country
• Meaningful Recipient
• ACO Participant
• Actively hooking up the continuum
• IT Operating cost $9.4 Million: 2012
• Capital cost $5 million: 2012
Healthcare IT Market
• Growing much faster than economy
• Fueled by: o Healthcare Transformation
o Government Stimulus
• Complexity of need
• Technology rapid advancements
• Growing demand
• Need to achieve great quality
• Solve the National Economic Fiscal Crisis
Healthcare is in Transformation
• Fee for service
• Volume matters
• Care is local
• Third party payors
• Quality unknown
• Disconnected
providers
• Independent providers
• Independent Clinical
Device
Current State
• Population mgmt.
• Appropriate vol.
• Care is everywhere
• Patient involvement
• Quality discernible
• Seamless
information sharing
• Consolidation
• Smart Connected
Devices
Future State
Opportunities
1. Health management
2. Connecting the providers
3. Intelligent diagnostic support
4. Engaging the patient
5. Point of service devices
6. Work process improvement tools
7. Clinical Intelligence (Pop. mgmt)
8. Mobile computing
9. IT Services and Resources
10.Smart Clinical Devices
Healthcare and EMR Adoption Daniel J. Barchi, SVP & CIO
Yale New Haven Health System
Yale School of Medicine
Yale School of Medicine
Current State of Healthcare
Technology
National EMR Use
• Institute of Medicine (1999)
• Preventable medical errors
• 44,000 deaths annually
• Motor vehicle accidents 43,468
• Breast cancer 42,297
• AIDS 16,516
Isordil –
Prevents angina
attacks
Plendil –
Calcium channel
blocker
National Electronic Medical
Records Initiative
January 8, 2009
National Electronic Medical
Records Initiative
Aspirational
May 25, 1961
April 12, 1961 May 5, 1961
January 8, 2009
2008 EMR Use
Physician Practices
4% had fully functioning EMRs
in their office
Hospitals
1.5% had fully implemented
comprehensive EMRs in all
units
American Recovery and
Reinvestment Act
• $19 B Incentive Grant
• $44 K for physicians
• $8 M baseline for hospitals
• Meaningful use on an EMR
• Stage I
• Stage II
• Stage III
Federal Stimulus Program
Year of
AdoptionFY2011 FY2012 FY2013 FY2014 FY2015 FY2016 FY2017
2011 100% 75% 50% 25%
2012 100% 75% 50% 25%
2013 100% 75% 50% 25%
2014 75% 50% 25%
2015 50% 25%
None
75% of
percentage
increase
reduced by
33.3%
75% of
percentage
increase
reduced by
66.63%
75% of
annual
increase
reduced by
100%
Stimulus Funding
Bed Days 171,569 Discharges 32,281
Medicare Days 73,862 Charity Care 4.94%
Year 1 $2.88 M
Year 2 $2.16 M
Year 3 $1.44 M
Year 4 $0.72 M
Total $7.21 M
Specialty Practice
Pharmacy OR
ED
Imaging
Lab Inpatient Care
Specialty Practice
Pharmacy OR
ED
Imaging
Lab Inpatient Care
875
3M
Coding
Siemens
Invision
Lawson
Sybase
Integration
Engine
125, 135, 219, 223, 245, 760,
594, 676, 765, 1029, 1039, 1093, 1095
780, 805, 808, 814, 816, 830, 837, 842, 844, 849, 856, 858, 860, 862, 864
866, 900, 907, 915, 927, 935, 955, 962, 970, 976, 992, 1000, 1005
840
839
20
Misys
Vision1 of 2
850, 1015
1020
155
864
612, 620
624, 639
641
127, 170
185, 221
695, 866
1026
145,146,147
148,149 150
152,153,154,
155,158,159
160
915
158,
641, 970
962
808
730
390
CPSI2 of 2
95, 126,
154, 220
266, 862
1025 263, 556, 558,
562, 564, 568,
570, 572,
582, 594, 596,
583, 597,604
500
1036
Various
Datasets
PerSe1 of 3
TSG Application Interface Chart
725
1070995950
Financial
Services
Restricted
WebSite
Planning
& Budget
Financial
Support
Softmed2 of 2
873
778
843
925 930
792, 800,
886, 890
825
826
878
McKesson
Horizon(Pathways)
760
762
765
Updated: December 1, 2006
TOTAL Number of Interfaces: 509
75
975
149
842
660, 662
674, 676
682, 666
668, 670
677
810
626
628
161
35, 133
148, 520,
564, 624
670
121, 132,
515, 562
1091
410 402
405
Sovera
PFS1 of 2
632
640
600
960
206
622
689
920
175
Datis
812
1040
1050
HBO
REV3
HBO-CDM
Siemens
Financial
RMHIS
Softwise
530
Dynamedix
Genesys
Hyperion
Trendstar
KRONOS
OneStaff
Sanitas
RescueNet
Medicaid
HQM
SSI 2 of 3
Medicare
MedQuestTranscription
Sovera
HIM2 of 3
Novius
Radiology
PACS
(IMPAX)180
660510, 515,
520
FACS1 of 2
Wellsoft
EDIS
159,263,
189,604,
682,1000,
1027
184
837
Pyxis1 of 2
Eclipsys
EMPI1 of 2
180, 181
183, 184
185, 186
187, 189
147, 201
620, 814
Credit
Card
Payment
Coro-metics
Fetal Mon.
Siemens
Pharmacy1 or 2
CPSI1 of 2
GE
Centricity
Pillbox
CTVision
SSI1 of 3
Antrim MisysLab
Sovera
HIM1 of 3
1030
CoPath
140
560
130. 131
132, 133
134, 135
136, 137
138, 139
141, 142
265
GE Cardiology
MUSE183
755
710
965
971
Rauland Borg -
Nurse Call900
415OASIS
SunTrust
1045
592 MAK
639
955
Siemens
Soarian1 of 2
136
186
596
677
927
1105
1025
1026
1027
207, 210
SCA
735 1035
Internal
Audit846
225
PaWS
1110
Sovera
PFS2 of 2
MEMS
Rosebud
540860
25
702
704
GE
ORIS
NC AVAYA
NC CRMH
720
722
Common
Master Tool Kit
GroupWise
120, 121, 123
124, 125, 126
127, 128
123
Pharmacy
OneSource876
1090
1091
1093
1095
1105
Power
Scribe
674
Delta Dential375
Automated
Mailing
Service100
164
FACS2 of 2
162
Various Clients
& Web212
215
68
Atlas
Labworks
HEDIS
130, 260
556,
134
568
240
Wachovia 401
SHPS400
Sovera HIM
3 of 3
638
OmniCell
685
PerSe2 o f 3672
750
777
Quantum Med
CarePort
120, 131,145
181, 200, 510,
558, 612 662,
780, 1090,1075
Teletracking992
580
VA
Medical680
35
90
95
Intergual
124,849
150
Harford
Decision
Support
PR Dept
377
693
397
399
695
586
Dublin Family
Practice666
Pyxis
2 of 2716
IDS
Carousel
714
HEDIS
DB
Internet
Web
Sites
870, 795,
820, 770,
848, 776
Computrition
Dietary805
IMPAC844
907
65
PaWS2 of 2
708
Anthem
50
55
151
153
858
245
Digisonic170
668
250
Eclipsys
EMPI2 of 2
188
220
221
222
Lab
Outreach
eMPI Helper
260
200
201softmed
1 of 2
187
1029
Health Stream 380
LabPort266
394
SSI3 of 3
505
572
138, 90
128, 139
265, 582
MS4650
678
712
eDischarge
LBS142
583
146
816
Xtend160
1005
137, 935
597, 762
Professional
Research
Professional
Billing
880
882
Soarian2 of 2
1028
1078
VA Dept
Health
1077
1075
1078
Power
Campus
387
PerSe
3 of 3
630
LabCorp
262
156205
217
235
Quantum
Billing141
Various
Websites
Anthem
Centricity
379
374
396
b2b Vision
CASB 616, 618
610
CASB-FS
CCL&PA
NCHS
785
790
865
B2b Optma
230
Interfaces not on diagram: 103, 105, 110, 195, 196, 525, 550, 584,
636, 687, 692, 700, 1041, 1112
223Lawson
2 0f 2
Paitent Keeper
102
MDAssociates152
856
838
223
625
222
1038
Vision
2 or 2997
GE Centricity
Cardiology
218
219
Trendstar
2 of 2
643
Wellsoft
EDIS
2 or 2
1094
642
830
157
Pharmacy2 of 2
761
976
1039
BPI.net101
779
Total
Interfaces: 509
Integrated EMR Benefits
ACO Diabetes Program - Dashboard
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