1. PRIMARY CARE PHYSICIANS Practice Management EMR How Do We Connect Silos of Data? PATIENT Personal Health Records LAB Results PUBLIC HEALTH Registries PHARMACY/PBMs RX History SPECIALTY PRACTICE Practice Management EMR HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data

2. Patient ID Manager Document Registry PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR HITSP/IHE Standards-based HIE Key Components Document Repositories LAB Results PUBLIC HEALTH Registries PHARMACY/PBMs RX History SPECIALTY PRACTICE Practice Management EMR HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data

3. PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR Patient Identity Feed IHE PIX Patient ID Manager John DoePCP11199 John DoeSpecialty22299 J. DowHospital 233330 NameSiteMRN% MRN 111 MRN 222 MRN 333 PUBLIC HEALTH Registries PHARMACY/PBMs RX History SPECIALTY PRACTICE Practice Management EMR HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data HOSPITAL 2 EMR/PM’s Lab PACS Archive SPECIALTY PRACTICE Practice Management EMR PRIMARY CARE PHYSICIANS Practice Management EMR LAB Results

4. PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR Patient Identity Cross-Reference IHE PIX PIX QUERY: MRN 111 PIX QUERY: MRN 111 Patient ID Manager John DoePCP11199 John DoeSpecialty22299 J. DowHospital 233330 NameSiteMRN% PIX RESPONSE: MRN 222 PIX RESPONSE: MRN 222 LAB Results PUBLIC HEALTH Registries PHARMACY/PBMs RX History SPECIALTY PRACTICE Practice Management EMR HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data SPECIALTY PRACTICE Practice Management EMR

5. PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR Publish Documents IHE XDS PUBLISH PUBLISH REGISTER DOCUMENT REGISTER DOCUMENT Patient ID Manager Document Registry SPECIALTY PRACTICE Practice Management EMR HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data PRIMARY CARE PHYSICIANS Practice Management EMR LAB Results PHARMACY/PBMs RX History PUBLIC HEALTH Registries CCD Allergies Problems Meds Etc, Etc.

6. PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR Query for Documents IHE XDS REQUEST DOCUMENT 1 REQUEST DOCUMENT 1 Patient ID Manager Document Registry RETRIEVE DOCUMENT 1 RETRIEVE DOCUMENT 1 RETRIEVE RETRIEVE REQUEST REQUEST LAB Results PUBLIC HEALTH Registries PHARMACY/PBMs RX History SPECIALTY PRACTICE Practice Management EMR HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data SPECIALTY PRACTICE Practice Management EMR CCD Allergies Problems Meds Etc, Etc.

7. PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR Engage Patients PRIMARY CARE PHYSICIANS Practice Management EMR PATIENT Personal Health Records Patient ID Manager Document Registry LAB Results PUBLIC HEALTH Registries PHARMACY/PBMs RX History HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data PATIENT RETURNS HOME PATIENT VISITS PCP PCP PUBLISH PHR REQUEST / SUBSCRIBE PHR RETRIEVED DATA SPECIALTY PRACTICE Practice Management EMR

8. PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR Care Coordination PRIMARY CARE PHYSICIANS Practice Management EMR PATIENT Personal Health Records Patient ID Manager Document Registry LAB Results PUBLIC HEALTH Registries PHARMACY/PBMs RX History HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data PATIENT VISITS PCP Patient Prescribed Meds Rx SPECIALTY PRACTICE Practice Management EMR

9. Care Coordination SPECIALTY PRACTICE Practice Management EMR PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR PRIMARY CARE PHYSICIANS Practice Management EMR PATIENT Personal Health Records Patient ID Manager Document Registry LAB Results PUBLIC HEALTH Registries PHARMACY/PBMs RX History HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data PCP PUBLISH Patient Prescribed Meds Rx REQUEST DATA RETRIEVE DATA HOSPITAL 1 EMR/PM’s Lab PACS Archive Patient Prescribed Meds Rx PATIENT VISITS HOSPITAL

10. Care Coordination SPECIALTY PRACTICE Practice Management EMR PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR PRIMARY CARE PHYSICIANS Practice Management EMR PATIENT Personal Health Records LAB Results PUBLIC HEALTH Registries PHARMACY/PBMs RX History HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data PUBLISH HOSPITAL 1 EMR/PM’s Lab PACS Archive PATIENT RETURNS TO PCP PCP REQUEST DATA Patient ID Manager Document Registry DATA RETRIEVED Patient Prescribed Additional Meds Rx Patient Prescribed Meds Rx Patient Prescribed Additional Meds Rx

11. Care Coordination PCP REQUESTS EKG PCP PUBLISHES DATA PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR PRIMARY CARE PHYSICIANS Practice Management EMR PATIENT Personal Health Records LAB Results PUBLIC HEALTH Registries PHARMACY/PBMs RX History HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data PATIENT VISITS PCP SPECIALTY PRACTICE Practice Management EMR SPECIALTY PRACTICE Practice Management EMR SPECIALISTS NOTE EKG DELIVERED REFERRAL TO SPECIALIST EKG DOCUMENT Patient ID Manager Document Registry

12. Care Coordination PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR PRIMARY CARE PHYSICIANS Practice Management EMR PATIENT Personal Health Records LAB Results PUBLIC HEALTH Registries PHARMACY/PBMs RX History HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data PATIENT VISITS PCP SPECIALTY PRACTICE Practice Management EMR PCP ORDERS LAB LAB Results LAB RESULTS Patient ID Manager Document Registry

13. Public Health PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR PRIMARY CARE PHYSICIANS Practice Management EMR PATIENT Personal Health Records LAB Results PUBLIC HEALTH Registries PHARMACY/PBMs RX History HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data PATIENT VISITS PCP SPECIALTY PRACTICE Practice Management EMR IMMUNIZATION RECORD Patient ID Manager Document Registry PUBLIC HEALTH Registries IMMUNIZATION REQUESTED IMMUNIZATION RECORD

14. Improve Quality PATIENT Personal Health Records PRIMARY CARE PHYSICIANS Practice Management EMR PRIMARY CARE PHYSICIANS Practice Management EMR PATIENT Personal Health Records LAB Results PUBLIC HEALTH Registries PHARMACY/PBMs RX History HOSPITAL 1 EMR/PM’s Lab PACS Archive HOSPITAL 2 EMR/PM’s Lab PACS Archive PAYERS Claim Data PATIENT VISITS PCP SPECIALTY PRACTICE Practice Management EMR QUALITY DATA Patient ID Manager Document Registry PAYERS Claim Data QUALITY DATA