Personal Guidance. Positive Change. SM Secure Access for Web-based Patient Portals and Applications Chris Brooks, Senior Vice President of Technology, WebMD Health Services October 30, 2013

MISSION: To provide expert guidance that inspires people to take charge of their health. WHAT WE DO: We offer health, wellness, and care transparency solutions that help large organizations with complex populations improve people’s health, productivity, and happiness. WHS Key Statistics 500 Employees Over 225 Customers Registered Users: 7.1 million Activated personal health records: 4.7 million Completed health assessments: 1.5 million per year

© WebMD Health Services Group, Inc. All rights reserved. 3 Meaningful Use of Electronic Health Records is a United States National Imperative This mandate isn’t just about improving care coordination and quality … it is also about patient engagement

© WebMD Health Services Group, Inc. All rights reserved. 4 Stage 2 of of the CMS Incentive Program Sets Goals for Patient Engagement  Core Measure 7: Provide patients the ability to view online, download and transmit their health information within four business days of the information being available to the EP.  Core Measure 17: Use secure electronic messaging to communicate with patients on relevant health information.

© WebMD Health Services Group, Inc. All rights reserved. 5 Electronic Health Information Providers Face Stringent Security and Privacy Requirements HIPAA Omnibus Rule for 2013: “Significant risk of harm” test replaced by more objective “probability of compromise” test.  Regulatory (HIPAA, HITECH) drivers  Patient / user trust and brand reputation

© WebMD Health Services Group, Inc. All rights reserved. 6 There are Competing Forces at Play When it Comes to Electronic Health Information Access  Ease of use and access from a wide range of devices (desktops, tablets, smartphones) is key to driving patient engagement Yet  Providers must still ensure robust authentication standards are in place

© WebMD Health Services Group, Inc. All rights reserved. 7 Example: Mobile App Authentication  WebMD Health Services recently shipped a native iOS and Android “tiny habits” app called “Daily Victory”  Key attributes:  No access to or sharing of personal health information  Allows user to share daily wellness activities with WebMD and a small social network  Authentication:  Initial authorization code to provision app  No password or PIN required  Revocable access

© WebMD Health Services Group, Inc. All rights reserved. 8 Evaluate Authentication Needs based on Risk and Engagement Requirements Sensitivity of InformationHighNone Engagement and Frequency of Use High / Frequent Low/ Infrequent Mobile Fitness Tracker Patient / Physician Communication Blood Sugar Tracker Health Information Research Personal Health Record “In Case of Emergency” E-cards? Provider Medical Imaging Mobile Viewer

© WebMD Health Services Group, Inc. All rights reserved. 9 How Might Authentication Approaches Map to this? HighNone Engagement and Frequency of Use High / Frequent Low/ Infrequent PIN auth Multi-factor Auth Strong Password “Remember Me” Risk-based Auth Sensitivity of Information

© WebMD Health Services Group, Inc. All rights reserved. 10 How Might Authentication Approaches Map to this? HighNone Engagement and Frequency of Use High / Frequent Low/ Infrequent PIN auth Multi-factor Auth Strong Password “Remember Me” Risk-based Auth Initial one-time authentication with optional or automatic “remember me” for future visits. Possible remote revocation (e.g., “forget this device”). Sensitivity of Information

© WebMD Health Services Group, Inc. All rights reserved. 11 How Might Authentication Approaches Map to this? HighNone Engagement and Frequency of Use High / Frequent Low/ Infrequent PIN auth Multi-factor Auth Strong Password “Remember Me” Risk-based Auth Short PIN or similar shorter- than-password code for application entry after initial authentication Sensitivity of Information

© WebMD Health Services Group, Inc. All rights reserved. 12 How Might Authentication Approaches Map to this? HighNone Engagement and Frequency of Use High / Frequent Low/ Infrequent PIN auth Multi-factor Auth Strong Password “Remember Me” Risk-based Auth Sensitivity of Information Full (presumably strong) password required for access to any personal information.

© WebMD Health Services Group, Inc. All rights reserved. 13 How Might Authentication Approaches Map to this? HighNone Engagement and Frequency of Use High / Frequent Low/ Infrequent PIN auth Multi-factor Auth Strong Password “Remember Me” Risk-based Auth Variable level of authentication based on pre-determined risk of both the current user session as well as the intended user activity. Sensitivity of Information

© WebMD Health Services Group, Inc. All rights reserved. 14 How Might Authentication Approaches Map to this? HighNone Engagement and Frequency of Use High / Frequent Low/ Infrequent PIN auth Multi-factor Auth Strong Password “Remember Me” Risk-based Auth Use at least two factors (know / has / is) for authentication. Rotating tokens, SMS codes, “dongles”, and biometrics are examples. Sensitivity of Information

© WebMD Health Services Group, Inc. All rights reserved. 15 Closing Thoughts Context is critical! Know your risks and adapt your approach accordingly. Engagement can suffer in the face of enhanced authentication strength. When appropriate, allow the user to manage their own risk.

Personal Guidance. Positive Change. SM Secure Access for Web-based Patient Portals and Applications Chris Brooks, Senior Vice President of Technology, WebMD Health Services October 30, 2013