Physician Utilization: Driving Acceptance & Adoption 9/8/2018 Physician Utilization: Driving Acceptance & Adoption Joanne S. Rickley Project Manager - Physician Computing Sentara Healthcare Norfolk, Virginia June 28, 2005

Discussion Topics Who We Are Our Journey Where We Are Today Future Direction

Sentara Healthcare Sentara Health Foundation 9/8/2018 Sentara Healthcare Sentara Health Foundation Division of Community Health Strategy & Support Care Delivery Health Management Strategy & Planning Hospitals & Facilities Sentara Norfolk General Hospital Sentara Leigh Hospital Sentara Bayside Hospital Sentara Virginia Beach General Hospital Sentara CarePlex Hospital Sentara Williamsburg Community Hospital Optima Marketing & Communication Sentara Family Care Information Technology Mental Health Management Human Resources Long-term Care Nursing Centers: Ches., Norfolk, Hampton, Va. Beach, Portsmouth, Currituck, and Windermere Assisted Living: Norfolk, Va. Beach, Ches. Finance Compliance Decision Support Enterprises Home Health, Hospice, DME, Medical Transport, Personnel Services Medical Groups Sentara Medical Group Williamsburg Community Medical Group

Physician Computing Journey… 9/8/2018 Physician Computing Journey… 1993 1995 1998 1999 2002 1Q 2003 2Q 2003 2Q 2004 3Q 2004 4Q 2004 2Q 2005 Launch of SPIN – Basic Medical Record SPIN Web Intranet MDoffice – Physician Portal Phase I – CareVISION Pilot Phase II – CareVISION general roll-out to community physicians AGFA Web100 Digital Imaging (PACS) Require-ments gathering For Physician Computing Labs / PVLs ED Reports Health Plan Referrals Claims Eligibility Physician Web Scheduler New Signing Module & Print Capabilities MGMT Reports & Carbon Copies Implement Facility – Based Physician Support Model WI-FI Network completed/ Pocket PC’s delivered to Physicians Business @ The Speed Thought Implement Dedicated Physician Support Desk Application Enhancements Support Milestones

Microsoft Case Study “. . .SpinWeb will provide the patient’s medical records online for any medical team with proper authorization. . . “ - Bill Gates Microsoft Chairman March 1999

Physician Portal/ Internet 2002 Key Milestones Physician Portal/ Internet 2002 Single Sign-on MDoffice 2004 Sentara Intranet 1998 E-Care e-Care Modem to Modem 1995

Dedicated Physician Support 9/8/2018 Support Model Facility-Based vs Application Support in Hospitals & Practices Dedicated Physician Support Desk Physician Advocates Support Environment Internet Access thru Physician Portal Hand-Held Access to Patient Records Dedicated Wireless Network for Physicians Growth of Physician Support Calls with Dedicated Support Desk Increased Acceptance & Adoption Targeted Support for Physicians 2002 2003 2004 2005

Sentara’s Value Proposition Direction of Physician Computing Infrastructure Facility Based Physician Support Enhanced Coordination with Physicians Increased Adoption of IT Solutions Ongoing Training & Education Integrated Clinical Solutions Sentara IT Infrastructure Physician Portal RESULT Increased Adoption by Physicians and Their Office Staff Yields More Time for Patient Care, Enhances the Quality of Care, and Reduces Errors

Transformation of Healthcare Enabled by Technology 9/8/2018 Transformation of Healthcare Enabled by Technology Phase 1: Access Phase 2: Enterprise Integration Physician Portal Phase 3: All-Pervasive Physician Computing Ac eCare – EMR / CPOE Clinical Data Repository Continuity of Care Record Interoperability for Community Physicians e-prescribing Patient e-Visits Basic Medical Record Electronic Signing Op Notes Health & Physicals ED Reports Agfa Web1000 (PACS) CareVISION – Secured Message Center Labs, including micro & AP Health Plan - Referrals, Claims, Member Eligibility Hand-Held Access Of course, like any new era, e-business unfolded in stages. And in each one, the Net has transformed the space it moved into. Think of them in three broad categories. Stage 1... access to digital information. This was all about publishing content, most of it of the static “look-up” variety. Don’t just look at your bank account... move some money. Don’t just check a flight departure time... book your seat Simple Pretty easy to get in the game here. All an enterprise needed was a home page. All an individual needed was a browser. The beginnings of web transactions appear. In Stage 2... real transactions... real e-business. . Integrate your processes so they talk to each-other Trade a stock, buy a book, apply for a loan, renew your driver’s license, take a college course. This requires more than a Website. This takes behind-the-scenes integration of technologies and business processes. Finally, Stage 3. If you’ve seen an IBM e-business presentation in the last year or so... this was always called the “Advanced” phase. We’ve now defined this as “on demand.” Most importantly, this is about dynamic end-to-end integration -- of the processes within the enterprise, as well as all the relationships and transactions that anchor that enterprise in markets and industries. It’s broader than a utility computing thought….while the utility factor is important, we’re looking at real business & technology transformation and fusion here – really helping our customers achieve orders of magnitude productivity increases and distancing themselves from their competitors in the process. We all knew this was where everything was headed; and that not that many people had gotten there yet. Before we talk about what this on-demand model is all about... let’s look at the progression of companies through these phases.