1. Mount Auburn Hospital / MAPS / MACIPA One IS Journey to an Integrated Database October 2014 1

2. 2 Journey to an Integrated Database  Phase I –Assessment FY13-15 Assessment of various information systems: Surveys, Demos, System Reviews Market Assessment Total Cost of Ownership Scope of Project Evaluate options for financing Approvals  Phase II Planning and Preparation FY 14-15  Phase III Implementation FY 16-17  Phase IV Optimization FY 17- 2

3. 3 Journey to an Integrated Database  Phase I –Assessment FY13-15  Phase II Planning and Preparation FY 14-15 Contracts for software (Epic and 3 rd party) Determine hosting Determine staffing needs Determine legacy system strategy 3 rd Party Application implementation Determine data conversion/archiving strategy Begin hiring/training  Phase III Implementation FY 16-17  Phase IV Optimization FY 17- 2

4. 4 Journey to an Integrated Database  Phase I –Assessment FY13-15  Phase II Planning and Preparation FY 14-15  Phase III Implementation FY 16-17 Data conversion, archiving “Big bang” go-live Implement practices in several waves Legacy Strategy  Phase IV Optimization FY 17- 2

5. IS Assessment Process  Press Ganey – 2011  CMIO Hire – Feb 2013  User Survey – March 2013  RFP – May-July 2013  Demo Evaluations – August 2013  One IS Summit – September 2013  Epic Visits – November 2013  TCO Development – September – December 2013  ROI Development – February 2014  Private Practice Assessment – July – September 2014  End-to-end Functional Assessment – July – September 2014 3

6. IS Assessment  Multiple systems, multiple instances, multiple data sources Currently 130 software applications in MAH 50+ instances of eCW 3

7. IS Assessment

8.  Strong Dissatisfaction with current systems  Strong Desire to share records more efficiently  Many systems need immediate replacement 3

9. IS Assessment  Strong desire for integration  Strong willingness to switch to a new platform 3

10. IS Assessment  Epic Clear winner in RFPs in every category 3

11. IS Assessment  Fragmented Network  Complex IS Service Delivery System  Multiple Helpdesk  Communication challenges  Limited training  Desire for more physician involvement  Excitement for a new IS system 3

12. Market Assessment  Epic dominant platform in the United States (54% of population)  Epic late to market in Boston but will become dominant EHR in Boston market 3

13. Market Assessment  Epic interoperability capabilities has become standard of health information interchange Care Elsewhere - Information can come from a non-Epic EMR that complies with industry standards, or directly from the patient. Care Epic - Epic system is on both sides of the exchange, a richer data set is exchanged and additional connectivity options, such as cross- organization referral management, are available. 3

14. Physician referrals to MAH MACIPA, Atrius, CHA, etc.

15. 276,500 EHR physicians 158M-188M patients, 50% to 59% 54% of the U.S. population 173M people will be cared for by EpicCareRED > 40% of patients are or will be covered by EpicCarePINK 1-40% of patients are or will be covered by EpicCareGREY Non-Clinical Customers

16. TCO Modeling  Examining true IT costs of combined costs at MAH, MACIPA, Caregroup and non-IT departments  Software licensing, hardware, labor, etc.  Includes back-end replacement and 3rd party software associated with Epic, legacy costs  EVERY department analyzed  5 year modeling  Does not account for possible discounts from negotiating  Does not include potential revenue and expense improvements  Examined: Status Quo: Meditech 5.66 + eCW v9 Meditech 6.1 eCW v10 Epic (hosted by self) Epic (hosted by Epic) Epic (hosted by 3rd party) 3

17. 5 Year Cost Scenario 1: Status Quo (MEDITECH Magic + eCW + Athena) Scenario 2: MEDITECH 6.x + eCW.v10 Scenario 3a: Epic (on-premise) Scenario 3b: Epic (partner-hosted) Scenario 3c: Epic (vendor-hosted) Total Capital Expenses$6,377,978.65$39,396,731.49$63,080,705.22$69,361,254.12$61,151,382.62 Total Operating Expenses$62,266,165.72$74,294,253.95$65,584,337.49$64,794,816.29$70,697,311.29 TOTAL$68,644,144.37$113,690,985.44$128,665,042.71$134,156,070.41$131,848,693.91 15% Contingency$78,940,766.03$130,744,633.26$147,964,799.11$154,279,480.97$151,625,997.99 Back-end Financials$0.00 $9,195,222.07 Legacy System Support & Sunsetting$0.00$25,433,439.28 GRAND TOTAL$78,940,766.03$156,178,072.54$182,593,460.46$188,908,142.32$186,254,659.34

18. TCO Findings  Continuing current state non-sustainable—high degree of dissatisfaction with current systems, does not meet future needs for population management, quality, reporting, coordination of care  Costs to maintain status quo with no improvements is expensive ($80M)  Costs to upgrade to Meditech 6.1 are very expensive and new platform brings risks  Costs to implement Epic similar to Meditech but will be implementing top rated product  ROI not included in TCO modeling 3

19. Why Epic?  Alignment with business strategy/improve communications Within MAH/MACIPA With other providers  Atrius (22% of volume)  CHA  Lahey  Partners  Best strategic product for MAH/MACIPA needs  RFP/demo winner  Best product by KLAS ratings  Superior Performance/Quality reporting  Superior Patient Engagement (Patient portal)  Integrated Data for business/clinical intelligence and data mining  Standardize workflows  Superior Clinical Decision Support  Superior Population Management Capabilities  Improve Efficiencies  Platform for Performance/Quality Improvement  Other expense/revenue improvement

20. Questions?