1. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems RALS-TGCM Web-based Graphical Reports for Glycemic Control Protocols ®

2. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Review TGCM Program at the Patient Level Reports Glucose results for a patient over a period of time Glucose results by unit Glucose values out of the protocol range Patients with and without readings over a specified period of time 1 1

3. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Results for a Patient Over Time Glucose Results for Patient 005187410 9/9/2005 – 9/17/2005 600 550 500 450 400 350 300 250 200 150 100 50 0 9/9/2005 12:00AM 9/11/2005 12:00AM 9/13/2005 12:00AM 9/15/2005 12:00AM 9/17/2005 12:00AM 9/18/2005 12:00AM Date and Time Glucose Value (mg/mL) Value: 150 mg/mL Date: 9/13/2005 6:19 PM Operator: 1093940003 Location: 12_ICU RALS TGCM ®

4. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Results for a Patient Over Time REPORT DESCRIPTION Visually review a specific patient’s historical blood glucose results to assess how well the protocol performed at the patient's bedside, for a given period of time (in this case, from 9/9/2005 to 9/17/2005) The time period and patient are previously specified by the operator on the Report Setup Menu The mouse-over feature can be used to view: –a blood glucose value –the time the blood glucose test was performed –ID of the provider who performed the blood glucose test –location where the blood glucose result was performed MAIN USER Clinician level professionals that oversee and monitor the glycemic control program Implementers of glycemic control protocols, such as nursing level professionals (Critical Care Registered Nurse (CCRN), Critical Care Nurse Manager (CCNM)) REPORT BENEFITS RALS-TGCM allows the user to easily review a patient’s historical glucose trends to determine how effectively that patient blood glucose was kept within the protocol range The healthcare provider can easily determine the point in time where the patient experienced episodes of hypoglycemia and hyperglycemia

5. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Results for I2_3West 2005 100 90 80 70 60 50 40 30 20 10 0 < = 8081-140141-160161-180> 180 Percent (%) RALS TGCM ® 38.65% Glucose Groups (mg/mL) Total 82.1971.985.735.4815.9713.93SD 149.00237.00171.00150.00111.0066.00Median 168.89258.93170.65150.00110.9463.42Mean 2,6789322572841,035170n Glucose Results by Unit RALS TGCM ® Glucose Results for I2_West 2005 82.19149.00168.892,678100.00%Total 71.98237.00258.9393234.80%> 180 5.73171.00170.652579.60%161-180 5.48150.00 28410.60%141-160 15.97111.00110.941,03538.65%81-140 13.9366.0063.421706.35%< = 80 SDMedianMeann%Range The counts for this report include values that were determined to be above the maximum or below the minimum detectable range of the device or collection method. These values are not included in the mean, median or standard deviation calculations.

6. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Results by Unit REPORT DESCRIPTION Visually assess the percentage of all patient glucose results in a specific unit, within predefined blood glucose ranges The specific unit and time period is previously chosen by the operator on the Report Setup Menu The blood glucose ranges are also specified by the operator on the Application Settings Menu: Hypoglycemia range, Protocol glucose range, mild-hyperglycemia range, moderate hyperglycemia range and severe hyperglycemia range The table format provides the blood glucose ranges, the number of patients in each glucose range, the percentage of glucose results performed that fall under each range, the mean, median and standard deviation MAIN USER Clinician level professionals that oversee and monitor the glycemic control program Implementers of glycemic control protocols, such as nursing level professionals (Critical Care Registered Nurse (CCRN), Critical Care Nurse Manager (CCNM)) REPORT BENEFITS RALS-TGCM provides CCRNs with feedback on protocol implementation success in their unit RALS-TGCM allows clinicians to monitor the implementation of glycemic control program by assessing compliance level of their unit(s) This report can be posted in places such as the nurse station, for periodic feedback to personnel on success in achieving glycemic control

7. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Value Extremes Glucose Value Extremes ( 180 mg/dL) I2_3FHAL 1/30/2005 721/30/2005 12:10:13 PM2261/30/2005 7:27:20 AM 1231/30/2005 4:54:30 PM721/30/2005 12:10:13 PM 2811/30/2005 7:52:32 PM1231/30/2005 4:54:30 PM 2261/30/2005 7:27:20 AM1831/30/2005 4:29:58 AM 2811/30/2005 7:52:32 PM 1831/30/2005 4:29:58 AM691/30/2005 3:48:42 AM 0014300581 1741/30/2005 9:05:13 PM1911/30/2005 5:20:03 PM0014300815 2351/30/2005 8:56:10 AM 2351/30/2005 8:56:10 AM2381/30/2005 5:07:50 PM 2381/30/2005 5:07:50 PM3201/30/2005 11:04:06 AM 3201/30/2005 11:04:06 AM2781/30/2005 8:02:32 AM 2781/30/2005 8:02:32 AM2771/30/2005 4:03:48 AM 0014300135 Subsequent Glucose Value (mg/dL) Subsequent Value Date and Time Glucose Value (mg/dL) Value Date and TimePatient ID RALS TGCM ®

8. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Value Extremes REPORT DESCRIPTION Easily review the patients whose glucose results were out the glycemic control range established by the protocol The healthcare provider previously specifies the unit and time period of the glucose value extremes to be displayed (options include glucose extremes experienced today, during the last 48, 24, 12 and 1 hour) In this case, the glycemic control protocol was 80-180 mg/dL. The glucose value extremes report will show all glucose values that were out of this range, for the defined time period MAIN USER Implementers of glycemic control protocols, such as nursing level professionals (Critical Care Registered Nurse (CCRN), Critical Care Nurse Manager (CCNM)) REPORT BENEFITS RALS-TGCM allows nursing to review the patients that experience hypoglycemia or hyperglycemia events at a specific period of time, providing them with awareness of: – the patients that need to be monitored more frequently – the nurses that may need more training in appropriate protocol implementation Column #Description 2ID of the patient who has a blood glucose measurement out of the protocol range 3Date and time when the glucose measurement was performed 4Value of the glucose result out of range 5Time that the subsequent glucose measurement was performed 6Value of the subsequent glucose result performed

9. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Values Hierarchy

10. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Value Hierarchy REPORT DESCRIPTION (1) Patients With Glucose Values within the Last Hour Visually track patients that have been tested within the last hour during a predefined time period (for a fixed day, today, last 48/ 24/ 12/ 6/ 3/ 2 or 1 hour) The healthcare provider previously defines this time period and the location Patient IDs of all patients that were tested within the last hour are listed in the first column. Their last glucose value and previous value are shown in columns 2, 3 and 4, respectively. The ID of the healthcare provider that conducted the glucose test is listed in the last column of the report (2) Patients With No Glucose Values within the Last Hour Visually track patients that have NOT been tested within the last hour Patient IDs of all patients that were not tested within the last hour are listed in the first column. Their last glucose value, the date and time when it was performed and the ID of the healthcare provider that conducted the glucose test are listed in the subsequent columns, respectively MAIN USER Implementers of glycemic control protocols, such as nursing level professionals (Critical Care Registered Nurse (CCRN), Critical Care Nurse Manager (CCNM)) REPORT BENEFITS RALS-TGCM allows CCRNs to track the patients that require a glucose test, according to protocol guidelines RALS-TGCM provides CCNMs with feedback on patients that should have received a glucose test, according to protocol guidelines, helping them rationalize CCRN’s level of workload

11. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Track Operator Compliance Reports Summary of glucose values by operator 2 2

12. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Summary of Glucose Values by Operator

13. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Summary of Glucose Values by Operator REPORT DESCRIPTION Visually review the level of success that CCRNs had in keeping patients’ glycemic levels in protocol range The healthcare provider previously specifies the period of time of the operators’ performance to be displayed (fixed date/ last year/ year to date/ last month/ month to date/ last 7 days), and the protocol range MAIN USER Implementers of glycemic control protocols, such as nursing level professionals (Critical Care Registered Nurse (CCRN), Critical Care Nurse Manager (CCNM))REPORT BENEFITS RALS-TGCM lets CCRNs know how successful they have been in keeping their patient in the glycemic range REPORT BENEFITS RALS-TGCM provides CCNMs with feedback on the level of compliance of their CCRNs, helping them determine the ones that may need further education on how to implement a glycemic control program Column #Description 1ID of the healthcare provider (CCRN) 2Number of glucose measurements performed by each healthcare provider 3Average of all glucose results performed 4Glucose results range 5Percentage of glucose results that were in the protocol range 6Percentage of glucose results that were out of the protocol range

14. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Generate Intra/Inter Site Assessment Reports Retrospective aggregate glucose results by: Unit Location Institution Enterprise 3 3

15. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Results by Hospital Glucose Results for I2_3West 2005 100 90 80 70 60 50 40 30 20 10 0 < = 8081-140141-160161-180> 180 Percent (%) RALS TGCM ® 38.65% Glucose Groups (mg/mL) Total 82.1971.985.735.4815.9713.93SD 149.00237.00171.00150.00111.0066.00Median 168.89258.93170.65150.00110.9463.42Mean 2,6789322572841,035170n RALS TGCM ® Glucose Results for I2_West 2005 82.19149.00168.892,678100.00%Total 71.98237.00258.9393234.80%> 180 5.73171.00170.652579.60%161-180 5.48150.00 28410.60%141-160 15.97111.00110.941,03538.65%81-140 13.9366.0063.421706.35%< = 80 SDMedianMeann%Range The counts for this report include values that were determined to be above the maximum or below the minimum detectable range of the device or collection method. These values are not included in the mean, median or standard deviation calculations.

16. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Results by Hospital REPORT DESCRIPTION Visually assess the percentage of all patient glucose results in a specific unit, within predefined blood glucose ranges The specific unit and time period (year to date/last month/month to date/last 7 days) is previously chosen by the operator on the Report Setup Menu The blood glucose ranges are also specified by the operator on the Application Settings Menu: Hypoglycemia range, Protocol glucose range, mild-hyperglycemia range, moderate hyperglycemia range and severe hyperglycemia range MAIN USER Clinician level professionals that oversee and monitor the glycemic control program REPORT BENEFITS RALS-TGCM allows clinicians to monitor the hospital’s level of success in achieving glycemic control This report can be posted for periodic feedback to personnel, glycemic control committee and administration on success in achieving glycemic control

17. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Results by Enterprise Glucose Results for Demo Health System 2005 100 90 80 70 60 50 40 30 20 10 0 < = 8081-140141-160161-180> 180 Glucose Groups (mg/mL) Percent (%) RALS TGCM ® 37.82% Total 82.1971.985.735.4815.9713.93SD 149.00237.00171.00150.00111.0066.00Median 168.89258.93170.65150.00110.9463.42Mean 2,6789322572841,035170n RALS TGCM ® Glucose Results for Demo Health System 2005 80.39147.00165.96633,087100.00%Total 72.02235.00256.24209,90733.16%> 180 5.75170.00170.1160,2149.51%161-180 5.75150.00150.1874,74311.81%141-160 16.38113.00112.39239,42637.82%81-140 13.9966.0062.6248,7977.71%< = 80 SDMedianMeann%Range The counts for this report include values that were determined to be above the maximum or below the minimum detectable range of the device or collection method. These values are not included in the mean, median or standard deviation calculations.

18. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Results by Enterprise REPORT DESCRIPTION Visually assess the percentage of all patient glucose results in a specific unit, within predefined blood glucose ranges The blood glucose ranges are also specified by the operator on the Application Settings Menu: Hypoglycemia range, Protocol glucose range, mild-hyperglycemia range, moderate hyperglycemia range and severe hyperglycemia range MAIN USER Clinician level professionals that oversee and monitor the glycemic control program REPORT BENEFITS RALS-TGCM allows clinicians to monitor the enterprise’s level of success in achieving glycemic control This report can be posted for periodic feedback to personnel, glycemic control committee and administration on success in achieving glycemic control

19. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Comparison by Location 12_3FHN 12_4800PCU 12_3FHAL 12_EDTriage 100 90 80 70 60 50 40 30 20 10 0 < = 8081-140141-160161-180> 180 Glucose Groups (mg/mL) Percent (%) RALS TGCM ® 25.53% The counts for this report include values that were determined to be above the maximum or below the minimum detectable range of the device or collection method. These values are not included in the mean, median or standard deviation calculations. Glucose Comparison by Location 1/1/2005 – 1/31/2005

20. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Comparison by Location REPORT DESCRIPTION Visually compare aggregated glucose results of up to 4 units or hospitals, within predefined blood glucose ranges The units or hospitals to compare and the blood glucose ranges are previously specified in the Report Setup Menu This report is also available in a table format MAIN USER Clinician level professionals that oversee and monitor the glycemic control program REPORT BENEFITS RALS-TGCM allows clinicians to make intra-site comparisons, determining the units that are more successful in protocol implementation This report can used as a tool to foster protocol adoption throughout the institution by comparing glucose control between units that have a protocol and those that do not

21. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Comparison by Date Period 1/1/2005- 6/30/2005 1/7/2005- 12/31/2005 100 90 80 70 60 50 40 30 20 10 0 < = 8081-140141-160161-180> 180 Glucose Groups (mg/mL) Percent (%) RALS TGCM ® The counts for this report include values that were determined to be above the maximum or below the minimum detectable range of the device or collection method. These values are not included in the mean, median or standard deviation calculations. Glucose Comparison by Date Period I2_4800PCU 37.04%

22. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems Glucose Comparison by Date Period REPORT DESCRIPTION Visually compare aggregate glucose results from two time periods (Last year/ YTD/ Last month/ Month to date/ Last 7 days) The time periods are previously specified in the Report Setup menu MAIN USER Clinician level professionals that oversee and monitor the glycemic control program Implementers of glycemic control protocols, such as nursing level professionals (Critical Care Registered Nurse (CCRN), Critical Care Nurse Manager (CCNM)) REPORT BENEFITS RALS-TGCM provides clinicians with feedback on protocol implementation improvement in a unit from one predefined time period to another This report can be used as a feedback tool that helps hospital’s committee understand the level of improvement in achieving glycemic control and potentially help determine if any changes need to be made in the protocol implementation

23. The Leader in Point-of-Care Informatics MEDICAL AUTOMATION SYSTEMS © 2006 Medical Automation Systems For more information… To arrange an in-depth look at RALS-TGCM, click here to contact the MAS Regional Business Manager in your area. click here