About NeurostarThe Virtual Radiology Network The Virtual Radiology Community NeurostarSolutions.com VirtualRadiologyCommunity.com The Virtual Orthopedic Network

About Neurostar Est by GA Tech graduate students Headquarters in Midtown Atlanta, GA As of Q3/2007… Over 500 sites nationwide 8 regional offices Unique Service Oriented Architecture (SOA): Always available infrastructure 24x7x365 service Broad portfolio of services Pay-as-you-go model Connecting virtual communities of physicians and imaging providers Enabling & leading the market of outsourced clinical image management services!

Service Portfolio Virtual Radiology Network (VRN) Image Distribution Data Archiving Data Archiving – now with Cross-Enterprise Data Sharing NEW!Cross-Enterprise Data Sharing Disaster Recovery/Business Continuity PACS Insurance PACS Insurance NEW! Radiology Reporting Radiology Reporting ENHANCED! Result Distribution Virtual Practice Management (VPM) Virtual Practice Management (VPM) NEW! 3D-Anywhere 3D-Anywhere NEW! Virtual Orthopedic Network (VON) ____________________________________________ Broad portfolio of professional services offered by partners.

The Virtual Radiology Community An online directory of outsourced radiology service providers. Imaging providers can search for and find their match. Once a match is made – we recommend using the VRN to consummate the business relationship.

The Virtual Radiology Network Click on any of the green buttons to learn more! VRN Portal VRN Gateway Service Oriented Architecture (SOA) VRN Viewer PACS PACS Insurance NEW! Cross-Enterprise Data Access (CEDA) NEW! 3D-Anywhere NEW!

Service Oriented Architecture (SOA) Please follow the next few slides to see: A comparison of traditional PACS, ASP PACS and SOA SOAs actual benefits to you!

ASP PACS Neurostars SOA Off-site Data Center Disaster Recovery Customer Site Client Servers Communications Archiving Picture Viewing/3D Web Portal PACS Gateway

Neurostars SOA Off-site Data Center Customer A Disaster Recovery Customer B Disaster Recovery PACSASP PACS Customer ACustomer B Disaster Recovery Communications Archiving Picture Viewing/3D Web Portal Servers Disaster Recovery Communications Archiving Picture Viewing/3D Web Portal Servers Gateway Shared Infrastructure Logically Segmented by Customer

SOAs Benefits to You… Easy cross-enterprise/cross-client connection Unlimited scalability Outsourced radiology practice management Standard Internet connections Only one PC required Cash flow positive from day one Instant implementation Obsolescence protection built-in

Virtual Radiology Service Providers Services: Image Distribution Radiology Reporting VPM Result Distribution Benefits: Access to clients nationwide Single interface across clients Universal data access Workflow, cost & revenue control Faster, controlled turnaround Quick & easy client setup Predictable, affordable costs Co-marketing opportunities

PACS for the Imaging Provider Services: Image Distribution Data Archiving Disaster Recovery Radiology Reporting Result Distribution Benefits: No need to install/maintain system Most effective total cost of ownership (TCO) Cash flow positive from day 1 Instant implementation Obsolescence protection Easy to outsource reads Better service to referring doctors

PACS Insurance Services: Disaster Recovery Data Archiving Result Distribution Benefits: No PACS downtime or data loss Less PACS upgrades/maintenance No future data migrations HIPAA Compliance Secure, no-hassle remote data access (e.g. for outsourced reads, referring doctors, etc.) THE LAST SYSTEM YOU WILL EVER NEED!

Image Distribution Image access anywhere, anytime Intelligent data routing Efficient image streaming on demand

Data Archiving Highlights: Combined on- and off-site storage architecture for redundancy and performance Always online – always available storage Unlimited scalability via the Neurostar Data Center Complete disaster recovery and business continuity ensure HIPAA compliance

Archiving Architecture Local Area Network (LAN) VRN GatewayVRN Backend Imaging Modalities Legacy PACS (if exists) On-site cache 1-24 months Long-term storage Disaster Recovery VRN Portal & Viewer On-site Users VRN Portal & Viewer Off-site Users

On- and Off-site Storage On-site: VRN gateway provides scalable on-site storage cache From 30 days to 24 months (or more) worth of storage Supports and overlays any local storage architecture Overlays legacy PACS Fast retrieval by onsite users and workstations Routing to local users/ workstations Off-site: Neurostars Data Center provides virtually unlimited off- site storage Always online (spinning disks) Redundant Secure Server Infrastructure (RSSI) ensures high availability Complete disaster recovery Business continuity option Fast retrieval by off-site users via Web Routing to off-site users

Cross-Enterprise Data Access (CEDA) On-site cache Customer A Customer B Off-site Data Center Gateway Cache Remote Users Gateway Cache Data Sharing Circle 1. Local access to local data 2. Local access to central data 3. Cross-enterprise access 4. Remote access to central data 5. Remote access to local data

Disaster Recovery (DR) / Business Continuity (BC) Data protection Uninterrupted operations HIPAA compliance Neurostar Data Center Customer Facility Onsite PACS Down Connection Down Remote Users

VRN – Radiology Reporting Features: Digital dictation using attached Philips SpeechMike Web based transcription tools Electronic sign-off Customized report templates Speech recognition options Benefits: Dictated report immediately available with study Can use any web based transcription service Efficient report approval Quick reporting on standard cases Simpler workflow - shorter turnaround time

Virtual Practice Management (VPM) Features: Web based order entry Cross-client worklists Provider-specific or shared worklists Resource analysis tools Billing reports Benefits: Better control of work Optimized throughput Workload balancing Better resource management Enhanced revenue capture

3D-Anywhere Interactive 3D anywhere, anytime! No image download! No workstation software or server necessary! Pay per reconstruction Neurostar Data Center Users Anywhere 3D-Anywhere Backend Infrastructure Standard PCs and Internet Connections Interactive 3D reconstruction Imaging Facility VRN Gateway Study upload

Features: Built-in data encryption On-the-fly compression Data integrity checks Standard PC hardware Web installation & maintenance Quality Assurance tools Scan tools Modality Worklist Benefits: Internet safe Optimizes bandwidth use Connection tolerant Software only available Fast & easy to install and maintain Verify data accuracy Eliminate paper/film Save technicians time Your Gateway to a New World of Radiology Outsourcing! The VRN Gateway

Black-Box ModeInteractive (QA) Mode Advanced auto-routing capabilities On-the-fly compression optimizes bandwidth utilization On-the-fly encryption of data (built-in VPN) Data integrity control Fault tolerance for unstable connections Easy to install and maintain over the Web All the functionality of the Black-Box mode PLUS: Quality assurance (QA) of patient demographics & images Scanning documents (Requisitions/History forms) Scanning prior films Modality Worklist display CD/DVD-ROM burning function Film printing Simple Upgrade Configuration Options

Local Area Network (LAN) VRN Gateway CT MR CRNMUS VRN Backend (Neurostar Data Center) Site Setup Fix lines and arrows

Paper Scanner Film Digitizer Scan: Requisition forms Prior reports Patient history, etc. Scan prior films Receive DICOM Studies and MWL Send out complete DICOM dataset Interactive (QA) Mode

Generate CD/DVD-ROMs w/embedded VRN Viewer-Lite Verify and/or edit patient demographics and study data; add notes or custom fields for later review by physicians, study routing to worklists and workstations. Launch film/paper scan Display Modality Worklist Manipulate images (windowing, zoom, add annotations, etc.) QA Mode – User Interface

The VRN Portal Features: Single web portal for all Personal worklist Personal tools Multi-archive search Data at fingertips… Complete patient timeline Study status Reports (audio & text) Images (clinical/diagnostic) Benefits: Easy to maintain Users work anywhere User-friendly interface Overlays legacy PACS Clinical user efficiency Easy collaboration among users

The VRN Viewer Key Features: Push/pull paradigm with streaming on demand Compare mode Personal tools Personal hanging protocols Integrated 3D tools (optional) Integrated specialty (e.g. orthopedic) tools Benefits: Fast retrieval of images anywhere Quick patient history User-friendly interface Efficient, standardized radiology reading Just-in-time diagnostic aids for all modalities Ideal for all specialty practices

(1) Single Monitor (2) Dual Monitor (3) Three Monitors (4) Three Monitors w/ Diagnostic Panels Typical Display Configurations Text needs to be aligned properly with bitmaps and each other

Personalized toolbar allows user to select desired tools Configurable image titles Personalized hanging protocols determine all aspects of the display Detailed Feature Listings User Interface Personalized windowing presets Cross-reference lines for easy navigation Series synchronization Integrated 3D tools (optional)

Result Distribution Highlights: Multiple distribution options, including: Electronic faxing to multiple destinations Secure to multiple addresses On-demand access via VRN Portal Additional softcopies via VRN Portable Fast distribution of reports (audio & text) Easy access to clinical (key) and diagnostic quality images.

IBM Data Center (Secondary) Internap® Data Center (Primary) The VRN infrastructure is co-located within two world-class data center facilities The Neurostar Data Center

100% Network Availability Guarantee Biometric Security Multiple layers of hardened physical security Multiple layers of electronically controlled card access 24x7x365 security presence Closed-circuit TV surveillance with digital storage Six redundant network backbones (155 Mb link each): Sprint MCI/UUNET Global Crossing SAVVIS Verio Climate controlled (64-78 degrees) Very Early Warming Smoke Detection (VESDA) Environment

5,680 Ton Capacity Chillers w/ 2 Units on Emergency Bus 3,000 KVA UPS. N+2 backup Backup Turbine Generators w/ N+3 backup Batteries w/ 45 minutes run-time. Tested regularly under full load Power

Intelligent Routing is a patented technology that selects the best path out of nine backbones to deliver your data quickly and reliably. This innovative technology avoids all problem areas and routing gridlocks, judiciously selecting the least congested conduit. Telecommunications

Redundant storage and server architecture with no single point of failure Clustered processing servers and Oracle 10g database grid Open Systems standard equipment High security and high speed network infrastructure 24x7x365 remote monitoring and on-site technical staff Redundant Secure Server Infrastructure

Virtual Orthopedic Network (VON)