1. ©2009 The Enterprise Strategy Group Enterprise Strategy Group | Getting to the bigger truth. TM Taking on the Healthcare Data Challenge Balancing storage costs with compliance and access requirements

2. The Ultimate Objective of Healthcare IT © 2009 Enterprise Strategy Group 2 Improved patient care  10% increase in the use of EMR resulted in a 15% decrease in patient deaths Lower costs  Hospitals that use computerized decision-support systems saved $538 per admission When physicians use health information technology to its full potential, the result is fewer deaths, fewer complications, and lower health care costs… Source: R. Amarasingham, L. Plantinga, M. Diener-West et al., “Clinical Information Technologies and Inpatient Outcomes: A Multiple Hospital Study,” Archives of Internal Medicine, Jan. 26, 2009 169(2):108–14.

3. Achieving the Ultimate Objective © 2009 Enterprise Strategy Group 3 New systems being deployed  Order entry, decision support, etc Transition to EMR  $36B in reimbursements and incentives for providers that implement EHR systems over the next several years Estimated 30,000 MRI and CT scanning systems in place worldwide – a 386% increase from 1995*  More departments using imaging for diagnostic purposes  64 to 256 slices; high resolution scanners *Source: http://www.cdc.gov/nchs/data/hus/hus08.pdf#089.

4. Achieving the Ultimate Objective © 2009 Enterprise Strategy Group 4 New systems being deployed  Order entry, decision support, etc Transition to EMR  $36B in reimbursements and incentives for providers that implement EHR systems over the next several years. Estimated 30,000 MRI and CT scanning systems in place worldwide – a 386% increase from 1995*  More departments using imaging for diagnostic purposes  64 to 256 slices; high resolution scanners *Source: http://www.cdc.gov/nchs/data/hus/hus08.pdf#089. More Systems and Modalities = More Data

5. Compliance Exacerbates Data Growth © 2009 Enterprise Strategy Group 5 Record retention requirements  Common rules (HIPAA, JCAHO, states): Minors - until patient is 18 years old; Adults - 7 years after creation  50.6% and 52.5% of hospitals permanently retained adult and minor medical records, respectively* HIPAA data management requirements  Data backup  Disaster recovery  Emergency mode operation  Contingency plan testing and revision procedures.  Data backup and storage *Source: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2430773&rendertype=table&id=T4.

6. Compliance Exacerbates Data Growth © 2009 Enterprise Strategy Group 6 Record retention requirements  Common rules (HIPPA, JCAHO, states): Minors - until patient is 18 years old; Adults - 7 years after creation  50.6% and 52.5% of hospitals permanently retained adult and minor medical records, respectively HIPPA data management requirements  Data backup  Disaster recovery  Emergency mode operation  Contingency plan testing and revision procedures.  Data backup and storage Data Growth and Retention = Increased Storage Costs *Source: http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=2430773&rendertype=table&id=T4.

7. Examining Storage Costs – Acquisition Costs © 2009 Enterprise Strategy Group 7 PACS EMR Order Entry

8. Examining Storage Costs – Acquisition Costs © 2009 Enterprise Strategy Group 8 PACSEMR Order Entry Primary Capacity Growth -> “Tier 1” Systems

9. Examining Storage Costs – Acquisition Costs © 2009 Enterprise Strategy Group 9 PACSEMR Order Entry Backup / Disaster Recovery -> Systems

10. Examining Storage Costs – Acquisition Costs © 2009 Enterprise Strategy Group 10 PACSEMR Order Entry Backup / Disaster Recovery / Archive -> Software

11. Examining Storage Costs – Operational Costs © 2009 Enterprise Strategy Group 11 Data center floor space Power and cooling Labor Migrations

12. Summary of Storage Costs © 2009 Enterprise Strategy Group 12 Constantly purchasing “Tier 1” storage capacity  Easiest way to meet performance and availability requirements Data management and protection software  Necessary to address compliance mandates Operational expenses  Often 3-5X of initial acquisition costs

13. Opportunities to Control Storage Costs © 2009 Enterprise Strategy Group 13 Implement “tier 2 or tier 3” storage $2,000 - $7,000 per terabyte in savings Denser devices consume less floor space Fewer systems to manage

14. Opportunities to Control Storage Costs © 2009 Enterprise Strategy Group 14 Consolidate data management functions Facilitates data movement between storage “tiers” Centralize backup, disaster recovery and archive policies Transparent to the application and user

15. Key Considerations © 2009 Enterprise Strategy Group 15 Data management software  Support: DICOM and HL7 formats  Integration: variety of storage platforms  Features: Retention and recovery optimization Storage tiers  Balance: performance and availability with cost  Flexibility and choice: some data will be kept for a while

16. Summary © 2009 Enterprise Strategy Group 16 Healthcare information delivers significant benefits  Storage requirements will increase Nearly one-third of IT budgets are spent on storage systems, software and services  IT must control these expenses while maintain compliance Now is ideal time to seek out alternatives  Opportunities exist with tiered storage; consolidated data management *Source: ESG Research Report, Enterprise Storage Systems Survey, November 2008

17. Getting to the bigger truth. © 2009 Enterprise Strategy Group TM Thank You For more information, please contact Brian Babineau, Senior Analyst 508.381.5172 | brian.babineau@esg-global.com

18. Jamie Clifton Director of Product Management HEAT Medical Archiving Appliance

19. Enterprise Data Repository BH MediStore HT Backup Agent for OfficeStore Storage Integration Multi Copy Native offline support Data Transformations De-duplication Compression Encryption Data Management Indexed Retention Management Self Protecting Access to Archived Content Archiving Targets – Clinical Data PACS Data Scanned Records Electronic Records Portal Integration DICOM Viewer File System

20. Does this meet your needs? “Consolidate data management functions” “Implement ‘tier 2 or tier 3’ storage” √?√? Huge Degree of flexibility but flexibility can cost Requires several vendors and applications – lower ROI Several systems means increased management Unlikely to reduce impact of items such as floor space X

21. HEAT Archiving Appliance

22. HEAT: Complete Solution to Archive Data Management  Plug in and go!  Low TCO  Right tiers of storage  Low power  Little training  Passive archive  Location for new content  Active Archive  Reach out and control existing content Hardware Solutions Software Solutions HEAT

23. SUN and BridgeHead HEAT Storage Integration Multi Copy Native offline support Data Transformations De-duplication Compression Encryption Data Management Indexed Retention Management Self Protecting DICOM Aware Active File Archiving DICOM / HL7 Interfaces Tier Two Storage Low cost SATA disk system The majority of long term storage Fully managed by BridgeHead 12, 24, 48 TB SUN ‘Thor’ X4540 Server (soon 7000 Open Storage) Tier Three Storage At least two copies SUN SL 48 / SL500

24. HEAT Data Management Passive Archiving  HEAT presents a managed disk to the network  Content is automatically & invisibly moved between storage tiers Active Archiving  Locate content in its original location Unlimited virtual storage space  Online content can be moved offline but still available Fully Self Protecting  Multiple copies of archived data  Dataset removed from the unit to ‘offsite’  Meta data backed-up

25. HEAT Benefits Low purchase cost  Built on Sun’s open storage standards No lock-in – you always own your data  No need to use APIs Low costs of ownership  Low power, small footprint, easy to manage Active and passive archiving  Not just a new place for data but a system to manage existing data Fully self-protecting out of the box Ideal appliance for the management of archival data

26. Increased Savings

28. BridgeHead Customer Validation 300 Healthcare organizations worldwide rely on us 1000+ individual hospitals for Data Management

29. Thank You jamie.clifton@bridgeheadsoftware.com USA BridgeHead Software, Inc. 400 West Cummings Park Suite 6050 Woburn, MA 01801 +1 - 781 - 939 - 0780 +1 - 781 - 939 - 5607 fax UK BridgeHead Software Ltd. BridgeHead House 215 Barnett Wood Lane Ashtead Surrey KT21 2DF +44 (0) 1372 - 221950 +44 (0) 1372 - 221977 fax