1. NextGen® Application Hosting & Support
NextGen® EHR Cloud®
“Your One-Stop Shop for EHR®”
NextGen® Application Hosting & Support

2. A Complete NextGen® Solution…
ITelagen® is the “One-Stop Shop for NextGen®” for Medical Practices
ITelagen is your single point of support contact for all your NextGen® EHR needs.
Single Point of Contact
Certified NextGen® Technicians
Certified IT Specialists
Secure NextGen® Hosting
Certified Implementation Experts
IT SUPPORT
EHR SUPPORT
HOSTING
IMPLEMENTATION
UROWORX™
OPTIMIZATION
EHRANYWHERE™
October 2013
ITelagen® - Healthcare IT Redefined®

3. ITelagen®: Our Clients
ITelagen® services over 400 practices / 1,500 physicians nationwide…
OUR CLIENTS
White Plains Hospital Center
Muir Medical Group IPA
Palisades Medical Associates
Caldwell Memorial Hospital
El Camino Hospital IPA
Asheville Cardiology
Manhattan’s Physician Group
Lenox Hill Medical Group
Staten Island Physician Practice
And over 300 more….
Lets take a look at our client base. Today ITelagen is servicing over 250 physicians nationwide. Our client base and sweet spot is predominantly small medical practices between 1 to 10 providers in size. If you look at the list of clients above such as Muir Medical Group and El Camino Hospital, these and physician member networks consisting of hundreds of small private practices. Therefore a majority of our client base are the small private practices under 10 physicians in size.
October 2013
ITelagen® - Healthcare IT Redefined®

4. EHR Hosting (ASP) – EHR Cloud®
EHR Cloud® NextGen® Hosting & Application Management 
Complete NextGen® EHR Hosting, Monitoring and Management
True ASP Solution - No Hardware Costs
Operates with 99.99% Availability
On-site 24 x 7 x 365 Network Operations Center
HIPAA Certified Network & Infrastructure
SOC 1/SSAE 16 – Annually Performed Audit
Physical, biometric, and electronic data security
Software, Updates & Centralized Management
Cloud Computing Platform Infrastructure
Multi-level Redundancy
Unlimited Scalability
Power: Always-On UPS with backup generators
Connectivity: Multi-vendor Backbone
Cooling: Redundant dry coolers  
April 2013
ITelagen® - Healthcare IT Redefined®

5. ITelagen® - Healthcare IT Redefined®
EHRAnywhere™
Complete NextGen® Mobile Access…Anywhere 
NextGen Full Applications
EHR, EPM, BBP, etc.
Support for iPad Devices
Support for Android Devices
Voice-to-Text Dictation
Leverages Built-in Siri™ or Google® VTT
Dictate Real-Time into Any Field
Reduce Transcription Costs
Other Features/Benefits
Single Sign-on
High Performance / Low Bandwidth
HIPAA Secure: RSA or Password Authentication
Easy Navigation: Familiar iPad/Android gestures  
October 2013
ITelagen® - Healthcare IT Redefined®

6. Traditional Architecture
Antiquated Hosting Model: “Traditional” Hosting Model
Single, Physical server dedicated to each role.
SQL Server
DATA OS
CONFIG
Terminal Server - 1 OS
CONFIG
Terminal Server - 2 OS
CONFIG
Terminal Server - “n” OS
CONFIG
Report Server OS
CONFIG
Interface Server OS
CONFIG
Typical Server Rack
Fax Servers… OS
CONFIG
Other Servers…
DATA OS
CONFIG
April 2013
ITelagen® - Healthcare IT Redefined™

7. Ideal Architecture: EHR Cloud®
EHR Cloud®: “Cloud Based” Computing Platform Architecture
Multi-server – Highly Redundant – Highly Scalable Architecture
NextGen® SQL Server
Terminal Server - 1
Terminal Server - 2
Interface Server
Terminal Server - “n”
Report Server
Other Servers…
SAN
OSs
CONFIGs
DATA
EHR Cloud®
April 2013
ITelagen® - Healthcare IT Redefined®

8. Architecture: NextGen® Optimized
EHR Cloud®: Designed & Tuned to Host NextGen® EHR
Example: SAN Storage for different NextGen® Applications
Solid State Drive (RAM) (FASTEST)
NextGen® SQL Server
PROD
SAS Drives (FASTER)
Terminal Server - 1
Terminal Server - 2
SATA Drives (FAST)
NextGen® Root
NextGen® SQL Server
DEV
TEST
REPORT
NextGen® Optimized SAN
April 2013
ITelagen® - Healthcare IT Redefined®

9. ITelagen® - Healthcare IT Redefined®
EHR Cloud® Benefits
Hosting Challenge: Scalability – Overloaded Terminal Servers…
EHR Cloud® Solution: “On-Demand” Scalability – Add or Expand Servers….
CPU
Terminal Server - 1
RAM
EXPAND: Terminal Server - 2 1
Terminal Server - 2
CPU
RAM
Terminal Server - 3
CPU
RAM
CPU
CPU
RAM
RAM
15 Minutes
---- EHR Cloud® ----- 2
30 Minutes
Benefits…
Servers can be expanded easily
Servers can be added easily
Eases and speeds scalability
Delivers true “On Demand” scalability
ADD: Terminal Server - 4
ADD: Terminal Server - 5
April 2013
ITelagen® - Healthcare IT Redefined®

10. EHR Cloud® Benefits Hosting Challenge: Overloaded SQL Server…
EHR Cloud® Solution: “On-Demand” Scalability –Expand SQL Server Limitlessly…. …
CPU
CPU
CPU
CPU
CPU
EXPAND: NextGen® SQL Server …
RAM
RAM
RAM
RAM
RAM
5 Minutes
EHR Cloud®
NextGen® SQL Server
CPU
RAM
Benefits…
Servers can be expanded easily
Not limited to a physical box
Speeds scalability
True “On Demand” scalability
April 2013
ITelagen® - Healthcare IT Redefined®

11. EHR Cloud® Benefits
Hosting Challenge: High Risk – Aging Hardware Failure(s)
EHR Cloud® Solution: Images move *automatically* to other portion of “Cloud” X
NextGen® SQL Server
Instantly – No Human Intervention
EHR Cloud® OK
NextGen® SQL Server
Benefits…
No downtime
Reduces hardware failure risk
Eliminates risk of aging hardware
Speeds recovery from failed hardware
April 2013
ITelagen® - Healthcare IT Redefined®

12. ITelagen®: Partnership
ITelagen® + NetAccess® = Industry Leading Healthcare Hosting Expertise +
IT Experts + Healthcare EHR Experts
IT Expertise
NCP Certified NextGen® Expertise
NCP Certified Partner
SQL Expertise
Network Expertise
Server Management Expertise
*True* Proactive Server Management
Leader in Datacenter Management
Staff: Staffed (Onsite) 24 x 7 x 365
Backbone: multiple carriers, multi-route, multi-homed with no single point of failure
Cooling: Redundant dry coolers and hot aisle / cold aisle configuration
Power: Always-On UPS with backup generators known as 1+1, A and B power.
HIPAA: True SAS-70 Type II Audit
Green Facility: Facility operated with “Green” features
April 2013
ITelagen® - Healthcare IT Redefined®

13. EHR Cloud® Architecture
Our High-Level EHR Cloud® Architecture – Outside of Cloud…
DATACENTER
NAC
Access
Concentrators
NAC
Access
Concentrators
Internet 1
Internet 4
Internet 2
Internet 5
FORTIGATE 1
Internet 3
Internet 6
FORTIGATE 2
EHR Cloud®
NAC
Power Distribution
NAC
Power Distribution
“A” POWER
“B” POWER
POWER B
POWER A
Generator B
Generator A
April 2013
ITelagen® - Healthcare IT Redefined®

14. EHR Cloud® Architecture
Our High-Level EHR Cloud® Architecture – Inside of Cloud…
VPN
FORTIGATE
ROUTER 1
Client
Location
“A”
NextGen® SQL Server
Terminal Server - 1
Terminal Server - 2
Interface Server
Terminal Server - “n”
Report Server
Other Servers…
Virtual Firewall
ROUTER 2
PRIVATE
NextGen Servers
Private Network Bridge
VPN
FORTIGATE
Client
Location
“B”
INTERNET
VPN
DSL
EHR Cloud®
Home
Office
April 2013
ITelagen® - Healthcare IT Redefined®

15. Live Datacenter Tour Scheduling… ITelagen® - Healthcare IT Redefined®
Cedar Knolls, NJ
April 2013
ITelagen® - Healthcare IT Redefined®

16. Our NextGen® Specialists
Our “Techies” have diverse IT + NextGen® Healthcare Knowledge.
Tech•ie also tek•kie (těk’ē)
"Techie" is a term, derivative of the word technology, for a person that displays a great, quite possibly even obsessive, interest in technology, as well as high-tech devices, particularly computers.
Complete IT Certifications…
Microsoft® Certified Professionals
Cisco® Trained & Certified
Apple® Certified Engineers
NextGen® Certified Professionals (NCP)
EPM, EHR, & ICS
SCT - NextGen System Administration
HIPAA Compliant Staff & Support Methodologies
HIPAA Tested & Certified
Physician Environment Sensitive
April 2013
ITelagen® - Healthcare IT Redefined®

17. Proactive Server Management
ITelagen’s management of the EHR servers is Proactive (Not Reactive). 
Unlimited Technical Support
Telephone & Remote Server Control (Primary)
On-Site (Secondary)
Proactive “Health” Management
Automated Proactive Maintenance
Automated Proactive Server Updates
Microsoft Security Patch Management
System Monitoring - Proactive
Disk Space
Terminal Server Availability Monitoring
SQL Server Performance Monitoring  
April 2013
ITelagen® - Technology Empowered

18. Offsite Backup Solution
ITelagen’s leverages Seagate eVault for offsite data protection…
NJ-1
NJ-1
NJ-2
Industry Leading
Powered by eVault®
Redundant
Data Mirrored Offsite
Fast Restore
Same-day delivery of Data
Delivered via External Drives
Regularly Schedule Testing
Mutually Agreed to Test Plan
Verifies Integrity of Data
ITelagen
SAN 1
ITelagen
SAN 2
QUESTION 8
Cedar Knolls, NJ
Cedar Knolls, NJ
Parsippany, NJ
April 2013
ITelagen® - Healthcare IT Redefined™

19. NextGen® Performance Monitoring
ITelagen® provides NextGen® performance analytics… 
Identify Root Cause of Performance Issues
Historical CPU Utilization Reports
Historical Memory Utilization Reports
SQL Tracing
Template Issue Debugging
Shadowing Providers
Measure Functionality Timing
Identify Problem SQL Statements 
April 2013
ITelagen® - Technology Empowered

20. ITelagen®: Support Technologies
Patent-Pending Management Technologies Enable Superior Service…
ITAgent® Remote Agent
Patent-Pending - Artificial Intelligence
Proactive Alerting/Monitoring
Software Deployment / Patch Management
System Health Monitoring
128-bit SSL Encryption
SAS-70 Type II Compliant Data Center
ITAgent® Leverages Technologies from
Solarwinds®
Kaseya®
Fortigate®
Salesforce.com®
What Do We Monitor?
Hardware: Disk space, CPU, Memory, etc.
Services: SQL, NextGen
Load Balancing: SQL, Terminal Servers
Network: Device Availability (Ping or SNMP)
Others: Custom Scripts (ex. DB Tables)
April 2013
ITelagen® - Healthcare IT Redefined®

21. ITelagen®: Network Monitoring
Monitoring & Management of your ISP, Routers, Firewall and Network. 
Unlimited Technical Support
Telephone & Remote Control (Primary)
On-Site (Secondary) (Part of Desktop Support Service)
Network & Device Uptime Monitoring/Alerting
Internet Connection
Applications: & Web (HTTP & HTTPS)
Instant Alerting for Issues
ISP/Internet Connection Management
Interface with your ISP & Support Department
Internet Infrastructure Management
Router/Modem Management
VPN & Firewall Management (Optional)
& Web Application Hosting (Optional)   
April 2013
ITelagen® - Healthcare IT Redefined®

22. ITelagen®: Ticketing System
ITelagen leverages Salesforce.com Service Cloud2 Support Ticketing…
Complete Trouble Ticketing
Automated tickets with alerts
Complete issue documentation
ITIL process management
Change Request Management
Client Accessible
Reporting
Custom Reporting / Dashboards
Custom Metrics
Documentation Management
Escalations/Process
Infrastructure documentation
April 2013
ITelagen® - Healthcare IT Redefined®

23. ITelagen®: Differentiator
ITelagen is better positioned to provide hosting than “large" companies.
What is Needed to be Successful with NextGen Hosting?
Large NCP Certified Engineering Staff
Ability to Ramp-up NCP Certified Staff (Staff will be added small or large)
Experience in managing, “fixing” & supporting NextGen
What About the “Other” Vendors?
Small NCP Staff (1 NCP Engineer – at best) Others are NOT NCP Certified
Reactive / Limited Monitoring
No Implementation/Template Expertise
Not “Managing” NextGen
What does ITelagen Offer?
Additional Staff Required
Over 12+ NCP Engineers 100% of Support Staff
In-house NCP training
Ability to ramp quickly
Implementation/Template Expertise
Workarounds/Fixes for NextGen
Employee Owned Business
April 2013
ITelagen® - Healthcare IT Redefined®