1. Synapse - An Integrated Healthcare Application for Patient Engagement ISMT E-200 Spring 2012 Team 3 Kadie Chen Jerry Lee Savita Sahgal Anthony Shifflett Shaun Wong

2. iMatrix Consulting Specialize in developing customized medical informatics (MI) solutions. Expertise: Successful integration of MI systems Patient Portal usability and web design In-depth knowledge of MI software industry standards Collaboration tools for distributed enterprises 1

3. Horizon Healthcare Group 3 Hospitals 6 Multi-specialty Clinics 650 Physicians 350,000 Annual Patient Visits $1.2 Billion 2011 Revenue 2

4. $3.5 million revenue decline in 2011 Losing patients to competitors Declining patient loyalty and engagement levels HHG's Business Problem 3

5. IMatrix Solution 4

6. Benefits to HHG Enhanced Patient Experience - Access up-to-date health care information - Self monitor chronic illness condition - Choice of e-visit or office visit - Secure means of communication - Access to personal medical history, records, and test results - Self service tools such as appointment management, prescription refill, registration and medical history forms 5

7. Benefits to HHG Efficiency - Single access point vs. multiple systems sign-on - Integrated quality data vs. disparate data source - Reduced support staff's administrative burden i.e. phone calls, forms, mailing, appointments Convenience - 24/7 availability - Accessible anywhere via web browser - Accessible via mobile devices "Green" - Reduced printing, mailing supplies, and delivery 6

8. Implementation Costs COSTTOTAL Software Development Licensing fees$120,000 Hardware Costs for Development & Production$120,000 Production Operating System & DB License Fees$70,000 License Runtime and Maintenance Fees$102,000 Professional services$1,620,000 Internal Implementation$120,000 Training and Continuing Education$39,000 TOTAL COSTS$2,181,000 7

9. Business Benefit Justification CategoryAmount Revenue from E-Visits$3.4 MM Revenue from Additional Appointments$3.1 MM Total Increase in Annual Revenue$6.5 MM Administrative Costs Reduction$1.1 MM Total Financial Gain to HHG$7.6 MM Costs for Synapse Development$2.2 MM Return On Investment$5.4 MM 8

10. No Integrated View of Patient Data Electronic Medical Record (EMR) Radiology Information System (RIS) Laboratory Information System (LIS) Physically navigating multiple systems is frustrating and wastes time. Entering 6 to 10 passwords a day is inconvenient and poses security risk. Once logged into each application Manually select patient’s ID Wait for system to access data. Navigate through 8-10 screens Data is often not synchronized across systems leading to diagnosis errors 9

11. Integrated View for Physicians Integrated view of patient-centric data from diverse medical information systems. View patient's self-monitored health trends Flexible communication tools like e-visits Decision support which searches patient-specific data 10

12. Patients can't view records 24/7 Inaccessibility of Lab results leaves patients anxious Getting copies of medical records takes weeks. What if you need to travel or seek a second opinion? Prescription renewal or changes can only happen during business hours 11

13. Patients can access records 24/7 12

14. No tools to track self-monitored health data Write records of self-monitored health data like blood sugar levels Wait till next visit to convey results to physician. What if you lose your written records or print the wrong one? Patients is unaware of any abnormal patterns till next visit. 13

15. Online tools to track self-monitored data 14

16. No effective way to communicate 24/7 Urgent questions like bad reactions to medicine require immediate communication not limited to business hours. Generally, emails are not HIPAA compliant. Patients skip visits due to schedule conflicts or distance 15

17. Secure communication 24/7 and E-visits 16

18. Architectural Approach Service-oriented architecture Loosely coupled modular services which support business requirements Enhanced interoperability and re-usability Reusable components lead to cost reductions, business agility and flexibility 17

19. Module View 18

20. Component Connector View 19

21. Deployment Model Hosted inside HHG’s internal data center Sensitive patient data Existing IT infrastructure Experienced IT Staff All Internet traffic goes through HHG’s firewall 20

22. Allocation View 4 hardware units for Web Server, Application Server, Integration server and Data Server hosted within HHG All Internet data traffic goes through firewall and uses encryption to ensure security 21

23. System Metrics 89,000 users in first year 1185 daily end-user sessions 355,500 database transactions 1-2 sec per message round-trip 120 GB of image data per day 99.7% availability 22

24. Governance Structure 23

25. Implementation Timeline with Deliverables 24

26. Training Plan 25

27. Iterative Rollout 26

28. Solution Demonstration - Physician View 27

29. Solution Demonstration - Patient View 28

30. Success Metrics MetricsSuccess Criteria Patient visit durationDecrease 4 to 5 minutes on average per visit Annual patient count15% increase in annual patient visits e-Visit countAverage of 278 e-Visit sessions daily Front desk call volumeAt least 20% decrease in call volume Administrative functions25% decrease in mailing, paper, phone costs User satisfaction rateOver 60% satisfaction on survey questions Patient engagementAverage session frequency is once every week 29

31. Conclusion Engaged Patient + Empowered Physician = $$$ for HHG and Improved Quality of Care 30

32. Q&A