1. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 1:00 pm EST, January 9, 2015 https://global.gotomeeting.com/meeting/join/930802605 (626) 521-0013 -- 930-802-605# 1

2. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Agenda: First 2015 Meeting Welcome and new member greetings Upcoming events DTAAP, industry update, and news from members. “The Business Case for Interoperability and Direct Exchange,” brief presentation. Workgroup updates Open discussion and comment 2 “You are the most trusted names in Healthcare Exchange”

3. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 DirectTrust Members 155 and Counting….. 3 3 Lucy Johns, MPH

4. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 DirectTrust Members 155 and Counting…. 4

5. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 New Members eSolutions MyTherapySession, Inc. Pending New Members Konica Minolta Business Solutions U.S.A., Inc IdenTrust ID.me INTEGRIS Health, Inc Enable Healthcare Inc Virtua Information Services Indiana Health Information Exchange 5

6. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Renewing Members 6 Lucy Johns, MPH

7. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Calendar of Events 7 March 22, 2015

8. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Mini-Conference Agenda 8

9. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Fully Accredited 9

10. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 10 The DirectTrust network of networks continues to grow exponentially  29 fully accredited and audited HISPs, 19 CA/Ras  19 candidate status HISPs, 1 RA: 8 applicants  39 HISPs in trust anchor bundles  50+ HIEs and 350+ certified EHRs supported  33,166 health care organizations supported  655,413 Direct accounts/addresses provisioned  21+ million Direct messages past 24 months  75,363 patient/consumer Direct accounts/addresses provisioned note

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12. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 David C. Kibbe, MD MBA President and CEO, DirectTrust Senior Advisor, AAFP 12

13. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Mark L. Braunstein, MD “Producing sharable digital data from care delivery and actually sharing it is arguably the single most important contribution health informatics can make to better healthcare in our country.” From “The Informatics Prescription: Treating America’s Health Care System” 13

14. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Care Coordination Facts More than a quarter of Americans live with one or more chronic conditions cared for across multiple settings. They account for two-thirds of $$ spent. Care coordination can avoid conflicting advice, duplications of testing, and unnecessary services. A recent survey reports one third of Americans experienced a gap in exchange of information between themselves and their providers. Health IT can make a significant difference, IF information can be accessed and/or exchanged in a timely manner via Direct. 14

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16. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 16 Health care spending increases with the number of chronic conditions

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21. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Care Coordination – It’s not not happening! A study of clinicians that attested to the MeaningfulUse program in 2011-2013 found that less than half (37%) distributed clinical summaries to almost all patients and only 16.3% reported that they sent a summary of care record for more than 50% of transitions of care and referrals. Wright A, Feblowitz J, Samal L, McCoy AB, Sittig DF. The Medicare Electronic Health Record Incentive Program: provider performance on core and menu measures. Health Serv Res. 2014; 49(1 Pt 2):325-46. 21

22. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 The problem is fragmentation of care, and almost no exchange of information across EHRs near Phoenix, Az.

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24. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 In summary… The business case for interoperability via Direct exchange is real and strong. – If you are a purchaser or payer for health care services, interoperable exchange of health information via Direct should be a requirement of your contracted suppliers. – If you are a provider of health care services, care coordination supported by Direct exchange should be a requirement of all professionals, their practices, hospitals, and outreach facilities. – If you are a patient or consumer, you should expect to be able to exchange health information with your providers and provider organizations via Direct. 24

25. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Workgroup Reports Patient and Consumer Participation in Direct – Lucy Johns and Leslie Kelly Hall Directory Policy – Bruce Schreiber and Jim Fisher Security and Trust Compliance – Luis Maas and Jeff McDonald Trust Anchor Bundle Operations – Greg Meyer Certificate Policy and Practices – Don Jorgenson Clinical Transitions of Care – Holly Miller and David Kibbe 25

26. www.DirectTrust.org 1101 Connecticut Ave NW, Washington, DC 20036 Discussion 26 David C. Kibbe MD MBA President and CEO DirectTrust.org David.Kibbe@DirectTrust.org kibbedavid@mac.com 913.205.7968