MEDITECH … Direct Messaging John Valutkevich Michael Henricksen Manager, EHR Initiatives at MEDITECH, Inc.a Michael Henricksen Director, Product Management & Marketing at Forward Advantage, Inc.

What is Direct Messaging? How does it impact healthcare organizations? How does MEDITECH help you comply with Meaningful Use Stage 2 requirements for Direct Messaging? How does Forward Advantage enhance our Direct Messaging offering? JV

MU CCD HIE HISP MU Acronyms CCDA DNS TLS CCD PHI MIME PHI MIME ONC TLS IMAP PHI MIME ONC TLS S/MIME POP SMTP XDM IMAP MU MDN CCDA CCD LDAP API HIE DNS HISP NwHIN CCDA SMTP CCD API POP ONC MU HISP HIE S/MIME LDAP HISP JV: Lot of acronyms tied to Direct. Direct tied to MU as a way to exchange medical summaries, also being tied in to the strategies of many HIEs. HIE DNS XDM NwHIN

What is Direct? Definition Direct: “A simple, affordable way to transport patients’ protected health information (PHI) to a known, trusted recipient via the internet” JV

How did Direct come about? The Direct Project National initiative (ONC/HHS) to benefit patients and providers Improves transport of health information Enables standards-based health information exchange to support MU1 and MU2 measures Policy provided by National Health Information Network (NwHIN), Oversight by HIT standards Committee Now managed by Healtheway which took over from ONC and now operationally supports the eHealth Exchange JV

Secure Message Received How does Direct work? <insert Justin’s diagram> 10010101101010 01000101100101 10010101101010 01000101100101 Secure Message Sent Secure Message Received Dr.A@PCPhisp.com Dr.B@PCPhisp.com Source HISP Destination HISP 10010101101010 01000101100101 10010101101010 01000101100101 Secure Connection Secure Connection Sender/Receiver each have a HISP HISP is your direct email provider HISP validates that parties keys are exchanged The email is sent to the recipient Validation of receipt is sent to the sender JV: HISPs are analogous to your home Internet Service Provider. The entity where you obtain your email account and conduit for messages. HISP is a Health Information Service Provider and functions in the same for a community, state or IDN.

What is Direct’s Impact on my Organization ? Present Day Ability to exchange transitions of care documents (such as CCDs) are part of MU Stage 2 requirements Direct messaging is one way to satisfy this requirement Utilizing an existing Healtheway HIE Exchange is another option Direct can support your HIE initiatives – no matter how big or small Offers ability to exchange info with providers outside of an existing HIE or without an EHR 20 states, 40+ HIEs, 10 IDNs and 3 leading PHR providers are offering pathways to utilize Direct Future State Emerging requirements for MU Stage 3 point to increased importance for Direct JV

How does Direct work with MEDITECH Platforms ? … How does Direct work with MEDITECH Platforms ?

MEDITECH Direct is part of MEDITECH Product Releases: MAGIC 5.66 Client Server 5.66 6.07 6.13 Direct is either an add-on component to your existing CCD Interface Suite or is licensed as a new CCD Interface Suite The payload is a CCDA (Consolidated CDA – which contains a CCD) MEDITECH can be configured to connect to any HISP

MEDITECH Workflows: Stand Alone Routine for Medical Records and Clinicians Bi-Directionally send and receive CCDAs Incorporated into Discharge Routines Available for patients via MEDITECH Portal

Brief Demo of Workflows MEDITECH … Brief Demo of Workflows

Fast Facts Founded – 1993 Privately held 12 Fast Facts Founded – 1993 Privately held Serving over 1,000 MEDITECH hospital customers throughout North America and the EU Locations Corporate Office – Fresno, CA Braintree, MA Westborough, MA 70+ employees overall Copyright © 2013, Forward Advantage, Inc. All rights reserved. CONFIDENTIAL.

Forward Advantage HIE Solutions 13 Forward Advantage HIE Solutions Communication Director (CDS) → Automated Report Delivery Data Express (DX) → HL7 Discrete Data Community HIE Foundations (CHIEF) → Documents (CCDs) GOALS HIE Community HIE Foundations (CHIEF) Documents (CCDs) Data Express (DX) HL7 Discrete Data Communication Director (CDS) Module Automated Report Delivery Solution CCDs HL7 Secure Email MU2 Direct Module Level HIE Goal Health Information Exchange Initiatives Copyright © 2013, Forward Advantage, Inc. All rights reserved. CONFIDENTIAL.

Forward Advantage Communication Director 14 Forward Advantage Communication Director Copyright © 2013, Forward Advantage, Inc. All rights reserved. CONFIDENTIAL.

Forward Advantage Direct Module Add-on to Communication Director 15 Forward Advantage Direct Module Add-on to Communication Director Direct Module Copyright © 2013, Forward Advantage, Inc. All rights reserved. CONFIDENTIAL.

Communication Director Direct Module 16 Communication Director Direct Module <insert Justin’s diagram> Direct Message Sent Secure Message Received Dr.A@PCPhisp.com Secure Message Sent Secure Connection Secure Connection Dr.B@PCPhisp.com Dr.B@PCPhisp.com Source HISP Destination HISP Secure Connection Secure Connection Direct Message Acknowledgement (through MDN) Dr.A@PCPhisp.com 1001010110 0100010110 MDN Service Monitors HISP email box using IMAP or POP Updates activity database w/ successful of failed status MDN Messages Exchanged between HISPs providing status of the disposition of the email Copyright © 2013, Forward Advantage, Inc. All rights reserved. CONFIDENTIAL.

Alignment with MEDITECH 17 Alignment with MEDITECH Two solutions that complement each other to support your HIE initiatives Automated delivery of everything else via Communication Director Direct Module Exchanging CCD’s, On-Demand which will satisfy MU2 requirements Exchanging CCD’s, On-Demand which will satisfy MU2 requirements Automated delivery of everything else you would send via Communication Director Complimentary solutions that support your HIE initiatives Copyright © 2013, Forward Advantage, Inc. All rights reserved. CONFIDENTIAL.

What are the Benefits of CDS-Direct Module? 18 What are the Benefits of CDS-Direct Module? Supports secure information exchange – regardless of where you are in your HIE strategy rollout Affordable – Optimizes your investment in Direct Low impact to organization Leverages your CDS platform Copyright © 2013, Forward Advantage, Inc. All rights reserved. CONFIDENTIAL.

Direct Messaging MEDITECH supports the exchange of CCDAs Forward Advantage supports the exchange of additional documents via Communication Director Interfaces must be licensed in 5.66/6.07/6.13 HISP Agnostic

Contacts John Valutkevich Michael Henricksen Manager EHR Initiatives MEDITECH, Inc. jmvalutkevich@meditech.com (781) 774-1269 Michael Henricksen Director Product Management & Marketing Forward Advantage, Inc. Michael.Henricksen@forwardadvantage.com (559) 447-1777 ext. 1224