The New Generation Product Briefing 5B - PreciseRegistries January 12, 2017 Eric Just Senior Vice President

We Have a Long History With Registries We’ve deployed hundreds of registries at our clients across the country, resulting in outcomes improvements unprecedented in the industry Registry definition: A set of patients—a population—that is defined according to a set of rules or algorithms Along the way, we’ve learned a few things

Pre-Defined PreciseRegistries 1 Pre-Defined PreciseRegistries Catalyst PreciseRegistries product includes: Pediatric Appendectomy Asthma Bronchiolitis Cystic Fibrosis Diabetes Financial Top Utilizers Chronic Diseases Acute / Inpatient Acute coronary syndrome Acute myocardial infarction Acute respiratory failure CABG CLABSI CAUTI GI Bleed Heart failure acute decompensation Labor and delivery Hysterectomy Sepsis Spine Stroke/TIA Asthma Atrial fibrillation Breast cancer Bronchiectasis Chronic kidney disease Colorectal cancer COPD Diabetes Depression Heart failure Hip/pelvic fracture Hyperlipidemia Hypertension Interstitial lung disease Inflammatory Bowel Disease Ischemic heart disease Leukemia Lower respiratory tract Infections Lung cancer Melanoma Osteoporosis Opioid use Peripheral Arterial Disease Prostate cancer Rheumatoid arthritis and osteoarthritis Transplant Based on clinician feedback these are the first pa

Tools to Create and Customize Registries 2 Tools to Create and Customize Registries

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Early Feedback “ This is amazing.  We spent MONTHS on cycles between our analysts and clinicians to develop populations for registries and measures that a tool like this could have accomplished in minutes.   I needed this last year! Neil Wagle, Associate Chief Quality Officer, Partners Healthcare

Tools to Create and Customize Registries 2 Tools to Create and Customize Registries ®

Factor 15X Better Delivery of Registry Content 3 Better Delivery of Registry Content 300 Feet Turn Right Delivering insight to clinicians at the point of care Factor 15X Single application provides patient level insight across all registries. Existing interoperability standards are used to pass context between the registry application and the EHR. The future of the product will be to use SMART on FHIR standards.

Better Delivery of Registry Content 3 Better Delivery of Registry Content Registries have many destinations, and many sources. Point of care decision support Care management Analytic Insight EHR EHR 2 EHR … Claims Clinical Text Risk Algorithms Genomic data Socio-economic data ΣY = ⅖X² / Ω Algorithms and Logic Registries Registries built upon an analytic environment can use more data sources, better algorithms, and reach more destinations.

Predictive Analytics and Machine Learning 4 Predictive Analytics and Machine Learning Risk Registries: Avoiding Disease Prevent progression to disease state Prevent need for inpatient care Monitoring and managing patients at high risk for developing disease Managing chronically ill patients Managing inpatient populations

Predictive Analytics and Machine Learning 4 Predictive Analytics and Machine Learning In Development: Diabetes Risk Registry Key features Predictive algorithm based on: Family history BMI Gestational diabetes Lab values Medications Social determinants Integration into clinical workflow Pat. ID Risk of Diabetes in 1 year Top Risk Factors Risk of Diabetes in 1 year if lose 10% body weight 1 2 3 A 0.75 Hx gestational diabetes BMI NULL 0.68 B 0.2 Family Hx 0.18 C 0.9 Socio-economic Genetic marker 0.85 … Factor 15X

Predictive Analytics and Machine Learning 4 Predictive Analytics and Machine Learning Risk Registries Acute/inpatient risk registries Chronic disease risk registries High risk for breast cancer High risk for chronic kidney disease High risk for colorectal cancer High risk for COPD High risk for diabetes High risk for heart failure High risk for hip/pelvic fracture High risk for ischemic heart disease High risk for lung cancer High risk for melanoma High risk for osteoporosis High risk for opioid abuse High risk for prostate cancer High risk for rheumatoid or osteoarthritis High risk for stroke/TIA High risk for acute coronary syndrome or myocardial infarction High risk for CAUTI High risk for CLABSI High risk for C-Section High risk for heart failure hospitalization High risk for readmission High risk for sepsis

Product Roadmap Version 1.0 Functionality Version 2.0 Functionality Predefined Registry Definitions (Disease states) PreciseRegistry Builder PreciseRegistry Explorer 1 Risk Registry Basic EHR Integration Version 2.0 Functionality Version 1.0 + Point of Care Analytics Expanded Risk Registries Catalog Incorporate feedback from V 1.0 Version 1.0 Early release Version 1.0 GA Version 2.0 Early release Version 2.0 GA PreciseRegistries Community Module Mar 2017 Apr 2017 May 2017 Jun 2017 Jul 2017 Aug 2017 Sep 2017 Oct 2017 Nov 2017 Dec 2017 Jan 2018 Feb 2018 Mar 2018 Apr 2018 May 2018

Key Takeaways Registries should be created in the analytic environment to enable access to multiple data sources and delivery to multiple destination. Rich analytic/machine learning tools will enable disease prevention and learning (e.g. patient flight paths and precision medicine). Most importantly, our strategy will accelerate outcomes improvement for our clients and their patients.