1 Alarm Management Solutions for Point-of-Care Connectivity Presented by: Emergin

2 General Overview Presentation Agenda Healthcare Challenges Emergin Solution Hospital Wide Benefits About Emergin, Inc. Q & A Recap & Action Items

3 Healthcare Challenges

4 Communication is KeySource: Root Causes of Delays in Treatment ( ) 86% 66% Root Causes of Sentinel Events ( ) Root Causes of Sentinel Events ( )

5 Current Challenges Business need Desire to improve patient satisfaction Patient complaints about high noise levels, particularly in ICU’s Perceived response time delays Quality improvement initiatives Solution and value delivered FTE’s seeking greater efficiency Desire to reduce # of devices (“Toolbelt”) Staff complaints about workload, workflow duplications Too much time away from the bedside Inefficient paths of communication Lack of standard practices National patient safety goals Improve the effectiveness of communications among caregivers Improve the effectiveness of clinical alarm systems Healthcare systems operate using variety of closed, proprietary systems Integration and connectivity difficult Interoperability challenging Care across units not standardized Proliferation of clinical alarms/alerts Improving Patient CareIncreasing Staff Satisfaction Industry ComplianceControlling Costs

6 Problem - “Accidental Architecture”

7 Emergin Solution Overview

8 Solution Background Who We Are Emergin is recognized as the market leader of automated event notification and alarm management solutions for the healthcare enterprise. What We Do We support process improvements in healthcare through a combination of a unique software platform and experience-based client services.

9 Solution – Emergin Integration Suite A Service Oriented Architecture (SOA) Standards-based, holistic approach to systems design and interoperability Modular and scalable. Begin with a single system and add service components incrementally.

10 Solution Highlights Open, vendor-neutral, and device-independent Highly scalable architecture Extensive set of 3 rd party interfaces using off-the-shelf adapters Centralized view of all connected, disparate systems Validated w/ nearly all best-in-class clinical system vendors

11 Nurse Call Patient Monitoring Nurse Call Adapter Monitoring Adapter Enterprise Service Bus Topology Overview Application Layer Integration Layer Communication Layer

12 Interoperable with more than 200 best-in-class vendors Platform Adapters & Key Partnerships

13 Emergin SOA Module

14 What is SOA? Not a technology per-se SOA is an architectural style that manages services throughout the enterprise A planning and design guide for integrating best-in-class systems A process-centric approach for driving a standards-based infrastructure

15 Why SOA? Unites departments and communications Leverages existing legacy systems Drives standardization and interoperability across the healthcare enterprise Focuses on process flow Enables healthcare organizations to pick and choose any technology

16 ‘Point-to-Point’ vs. an SOA Service Focus on single application only (event sources) and destination Focus on point-to-point connectivity – get data from monitor to a pager, phone, sign Focus primarily on nurse only Managing the assignment process is typically not an issue Clinical process and workflow is not typically a big concern (“Gateway”) Focus on multiple applications (event sources) and destinations Focus on management of end-to-end process of managing alarms Focus on nurses, but also all clinicians and staff (biomeds, RT’s, security officer, etc.) Managing the assignment process is often a primary issue Improvements in clinical process and workflow is a key driver (“ESB”) Point-to-Point ConnectivityService-Oriented Integration

17 Event Driven SOA Project Framework Process-Centric Approach - Focus on Workflow and Clinical Processes Project Preparation Project Design Installation & Integration TrainingGo Live SOA Constitution Project Requirements Process Design System Design Functional Design Testing/Staging UAT Production Roll-Out Clinical Administrative Project Plan Optimization SOA Assessment- Readiness Consulting SOA Service Library

18 Conclusion Evaluate service performance Change process flows based on best practices and learning lessons Filter nuisance alarms/reduce alerting fatigue Identify, mitigate and prevent repeatable communication errors Integrate reporting for real-time scorecards/dashboards Optimize PerformanceDrive Standardization A service-oriented architecture enables hospitals to pick and choose any combination of technologies without compromise An IT framework and architecture will help drive standardization, efficiencies and patient outcomes Communications will be continuously optimized because it is measurable

19 Emergin Orchestrator Client (EOC)

20 Message Dispatch

21 Staff Assignments

22 Staff Assignments (Con’t)

23 Whiteboard

24 Command Center

25 The Nursing Reports provide the following to evaluate staff-patient ratios and nurse vigilance: Total Alarms Per Vendor Total Alerts Per Vendor Alarms Per Location Alarms Per Sensitivity The IT/Communication QoS Reports provide the following to monitor IT Quality of Service: System Malfunctions Total Successes/Failures Per Vendor Total Messages Per System Type Total Messages Per Carrier Total Messages Per Recipient A Patient Safety Officer can review an root cause analysis transcript of activity to trace errors and omissions to the second: Alarm Set Delivered to Communication System Delivered to Communication Device Delivered to Recipient Read by Recipient Acknowledged by Recipient Alarm Reset Reporting – Dashboards & Scorecards Nursing LeadershipInformation TechnologyPatient Safety Officer

26 Reporting – Root Cause Analysis

27 Hospital Wide Benefits

28 Benefits for Clinicians Clinical alarms sent to caregivers’ device (ECG, SPO2, Vent, IV Pump) Auto-escalation “safety net” to ensure alarms are not missed Code team dispatch More time with patients Less walk time Elimination of “nurse tool belt”

29 Benefits for Laboratory Provides automatic alert for critical values or abnormals Automatic notification for STAT blood draws Immediate communication on test results Redirect mobile staff while on the move Supports Joint Commission for CTRM - closing the loop within 1 hour

30 Benefits for Information Technology Greater appreciation from hospital for IT staff Maximize/leverage existing technologies Build interoperability by design Cost Savings – leave, leverage and extend the life of existing point-of-care systems

31 Benefits for Administration Cost Avoidance – eliminate duplicate technology purchases Process Improvements – eliminate duplicate job functions and data entry errors Patient Outcomes – Improve hospital care by continuously improving communications RCA Time – Significantly reduce investigation times

32 Return on Investment Leverage Existing Technologies – Do not “rip- and-replace” them Technology Cost Avoidance – Assignments, management reports, communication systems Nurse Productivity Gains 51% improvement in completing patient tasks, $37,700 per care unit per year (*U of Maryland Study) Patient Safety – Root cause analysis transcripts for adverse events including sentinel events Patient Satisfaction – Raise scores by improving response time Staff Satisfaction/Retention Improve the clinical processes to reduce workload Quantitative ROIQualitative ROI

33 Conclusion Business need Managing the patient experience in real- time Improved response times Noise reduction Communication of critical clinical communication Solution and value delivered Objective data generation of decision- making More satisfied patients equals more satisfied staff Noise reduction National patient safety goals Improve the effectiveness of communications among caregivers Improve the effectiveness of clinical alarm systems Service-oriented architecture enables hospitals to pick and choose any combination of technologies without compromise An IT Framework and architecture will help drive standardization, efficiencies and safety Improved Patient CareIncreased Staff Satisfaction Compliance with IndustryControlled Costs

34 Corporate Overview

35 Emergin Background Who We Are Emergin is recognized as the market leader of automated event notification and alarm management solutions for the healthcare enterprise. What We Do We support process improvements in healthcare through a combination of a unique software platform and experience-based client services.

36 Emergin Fact Sheet Began in 1995, contract services firm Outgrowth of Motorola, chief architect for Air Apparent software Ranked top 25% Inc (8/07) Global Frost & Sullivan Award Winner for Patient Monitoring Integration (2006) “The solution offers flexibility through modularity and scalability that are required to meet ever-changing customer needs.” Antonio Garcia - Frost & Sullivan Research Manager

37 Quality and Regulatory Emergin has achieved ISO 9001:2000 and ISO 13485:2003 certification Internationally recognized quality standards Audit conducted by TUV America Passed rigorous quality requirements and standards, regular audits

38 Customer Scorecard Recognized as a Leader Emergin has helped more than 1,000 healthcare organizations achieve their satisfaction and quality goals. Key Customer Stats 5 Malcolm Baldrige Award Winners 35% of the Nation’s Magnet Hospitals 43% of the 100 Most Wired 6 of Top 10 Children’s Hospitals

39 Partial Customer List Allina Health Systems Baptist Health System Boca Raton Community Hospital Boston Medical Center Central Baptist Hospital Concord Hospital Doctor’s Community Hospital Douglas County Fairmont General Florida Hospital Gundersen Lutheran Johns Hopkins – Bayview Memorial Hermann Methodist Hospital – Houston Riverview Medical Center Ochsner Foundation St. Luke’s Hospital Univ. of Pennsylvania Medical Center Washington Hospital Wesley Medical Center Key Enterprise Customers

40 Emergin Client Services Full spectrum of implementation services We manage projects from start to finish Emergin assigns a Project Manager as central point of contact with hospital Joint, collaborative effort between hospital, Emergin, and third party vendors Detailed project phases essential in the delivery of a successful project

41 Client Services – Five Project Phases Project Preparation (4 weeks) Project Design (8 weeks) Installation & Implementation (2 weeks) Training (1 week) Go Live (1 week)

42 Contact Emergin White Papers Brochures Case Studies Data Sheets Thank you for your time! Web site: Tel: (866) EMERGIN ext. xxxx

43 Q & A

44 Communication Integration Supporting Slides

45 Output Devices Cisco CallManager Wireless VoIP –Cisco 7920 Wireless Handsets Vocera Wirelesss VoIP –Voice Activated Communication Badges SpectraLink Wireless Telephone System –Link – separate, proprietary wireless infrastructure –NetLink – VoIP, common WLAN infrastructure –Also rebranded under Nortel, Avaya and others Ascom Wireless Telephone System –Freeset – separate, proprietary wireless infrastructure –FreeNET – VoIP, common WLAN infrastructure

46 TAP “Pocket Page” – many, many systems –Very standard input/output protocol XML/SOAP – Emergin developed standards based alarm/event input protocol, 2-way HL7 – Hospital and Clinical Information System (HIS/CIS) SMTP – Intranet integration ASCII – Various systems, strong and flexible fall back OAI – SpectraLink OAP – Ascom VMI – Vocera IP/XML – Cisco Wide Area Protocols – WCTP, SNPP, TNPP, SMS, SMTP Common Integration Protocols

47 Alarm Samples Sample Alarms: V-TACH, ASYSTOLE, CODE BLUE

48 Workflow Demonstration