Open Source Solutions experience, solutions, results Open Source Solutions 1 Misys Open Source Solutions (MOSS) – Healthcare Redwood MedNet Presentation A Practical Application of Open Source Strategies in a Not-So-Conventional Health Care Company Tim Elwell VP, Misys Open Source Solutions May 20, 2009

Open Source Solutions experience, solutions, results Open Source Solutions experience solutions results Treasury & Capital Markets Global Services Banking Health- care Open Source Misys Integrated Businesses – Before Oct $1B revenues, 4,500 employees, – 1st software company listed on FTSE100 Substantial Expertise – 30 years experience in Banking – 25 years experience in Healthcare Installed Base – 1,200 financial institutions, including every one of the world’s top 50 – 110,000 Physician users Global Footprint – Customers in more than 120 countries, – 36 Offices around the World Market Position – Award-winning solutions across each business unit, – Market leader in banking IT worldwide by customer base 2

Open Source Solutions experience, solutions, results Open Source Solutions

experience, solutions, results Open Source Solutions experience solutions results Treasury & Capital Markets Global Services Banking Open Source Misys Integrated Businesses – Post Oct  Allscripts & Misys Healthcare Solutions  NASDAQ: MDRX  Glen Tullman CEO  Mike Lawrie Chairman Health- care MOSS Misys plc FTSE: MSY.L CEO: Mike Lawrie

Open Source Solutions “The Innovator’s Dilemma” by Clayton M. Christensen In doing what a company is expected to do (and is rewarded by the market), that company is preparing a way for its own disruption. BUT, it also is the beginning of the innovator’s solution.

Open Source Solutions 2009 Opportunity ARRA –19.2 –17.2 – 2 –300 –100 CareSpark –18 –40

Open Source Solutions Healthcare and Open Source

Open Source Solutions MOSS Purpose Meaningful disruption Generates Revenue Causes change to happen

Open Source Solutions Open Source Solutions – Healthcare Objective: Committed to improving healthcare delivery using a standards- based, open source approach to build interoperability tools between disparate electronic medical records (EMR) systems and healthcare enterprises. Organization: Independent division inside of Misys plc Community: The team is collaborating with prominent medical informatics, technology companies, and policy influencers to support and develop Health Information Exchange (HIE). Goal: Support US-based Nationwide Health Information Network (NHIN) initiatives to provide lower cost, higher quality options that will result in greater EMR adoption and improved healthcare delivery. Market Opportunity: Estimated that the creation of a NHIN will reduce the cost of healthcare expenditures by $77.8 billion annually. (1) Business Model: HIE organizational consulting, customer application development, hosting, and support. (1) Walker, Jan, Pan, Eric, Johnson, Douglas, Adler-Milstein, Julia, Bates, David W., Middleton, Blackford. The Value of Health Information Exchange and Interoperability. Marketwatch Health Tracking. Jan. 19, 2005.

Open Source Solutions Uses Case Scenarios Ambulatory Specialist Referral Provider to Emergency Department Referral Unplanned Access to Patient Medical Summary Ante-Partum Care Delivery

Open Source Solutions Ambulatory Specialist Referral

Open Source Solutions Unplanned Access to Patient Medical Summary

Open Source Solutions SCALE 2008 – MOSS “Coming Out” Updated Plan Based on Customer Needs – IHE library –A basic set of IHE profiles implemented in Java. –This library has been accepted to and successfully completed the Connectathon for the last three years. – Connect application –A basic eMPI application –A viewer to retrieve and view a patient record that encompasses all practices in the community (the longitudinal patient record). – Server – Side Concentration –PIX-PDQ –XDS Registry and Repository X X X XX X X

experience, solutions, results 14 MOSS - Mission Objectives - Create broad-base adoption of the MOSS Platform -Develop lower cost Health Information Exchange (HIE) -Standard’s based - Support Nationwide Health Information Network (NHIN) initiatives - Improve healthcare delivery by increasing EHR adoption -EHR ‘on-ramp’ through the creation of Clinical Groupware Approaches - Provide standard-based IHE interoperability options - Develop open source IHE infrastructural components - Leverage core – monetize plug-ins and SaaS; Consulting and Support Open Source Solutions

experience, solutions, results 15 IHE Standards Based Healthcare Network Open Source Solutions

16 PIX/PDQ Server - OpenPIXPDQ Open Source Solutions

experience, solutions, results 17 IHE Standards Based Healthcare Network Open Source Solutions

experience, solutions, results Open Source Solutions IHE Profiles: Server Components April 2009 Pressures: Moving project from Source Forge Continue harmonization work with the IHE Profiles project Demonstrate community value, establish precedent for committer status Tooling harmonization Dependencies: JDK 1.5 or 1.6 JBoss: or above Hapi: Braid: 1.1 PostgreSQL 8.3 Apache: Commons, Log4J, Xerces, Axis2 OpenEMPI Beepcore Jaxb Milestones: Jan ’09 – go-live for project home Jan 16 - pre-connectathon MESA testing for openPIXPDQ March 31 - post connectathon milestone: move openPIXPDQ from Source Forge April 15 - HIMSS milestone 2Q09 – XDS Repository/Registry development begins 3Q09 – IHE Client Library harmonization Plan Content: Committed: PIX Manager (PIX Feed, PIX Query & PIX update notification) PDQ Supplier (PDQ Query) ATNA transactions specific to PIX/PDQ Audit Log (Audit Trail Client) TLS Secure Transaction Actor Configuration eMPI & eMPI Adapter XDS Repository XDS Registry Proposed: PIX v3 Manager (PIX Feed, PIX Query and PIX Update Notification) PDQ v3 Supplier (PDQ Query) Deleted/Changed: Full ATNA/CT moved to post 2Q09 (may use Connect Code) Configurations: JBoss PostgreSQL 8.3 Braid 1.1 JDK 1.5/1.6 Added: IHE Client Libraries harmonization IHE Profiles roadmap harmonization XCA Open Health Tools Presentation: BOCA Chart

Open Source Solutions experience, solutions, results Open Source Solutions MOSS – (OHT) Roadmap OHT Charter Project Approval December ‘08 Connect-a-thon February ‘09 IHE Project harmonization January ‘09 Move OpenPIXPDQ to OHT March ‘09 IHE Client library harmonization 3Q 2009 HIMSS Showcase April ‘09 Begin OpenPIXPDQ Development October ‘08 Begin XDS Development 2Q 2009 ATNA/CT/XCA 2009 Connect Gateway Code Review 2Q 2009

Open Source Solutions experience, solutions, results World Congress 20 Portal Decomposition 20 Viewer—Liferay Misys SaaS Platform Value-Add Components & Portal E-Prescribing Encounter Mgmt. Document Mgmt. Lab Orders Mgmt. Scheduling Billing CRM Reporting Clinical Data Repository PIX/PDQ eMPI XDS Registry & Repository ATNA IHE CORE Misys Connect Server Platform: SaaS Core Open Source Infrastructure Clinical Groupware

Open Source Solutions Fundamentally Different EMR Strategy Outside-IN EMR Afterthought

Open Source Solutions Mashable Universe Strategy INSIDE--OUT Meaningful Use as defined By our customer

Information and Related Technology Governance Open Source Solutions The CoBIT framework is the property of the Information Systems Audit and Controls Association and has been referenced with permission.

Consulting Plan Solution approach Collect and translate business As-is  To-be Map requirements to technical utility Introduce “best practices” Create detailed milestone development Recommend architectural platform Leverage open source components Utilize standards-based approach Include customer resources Development Approach Leverage open source center of competence Iterate with continuous feedback Leverage customer resources Value Alignment Approach Multi-stakeholder strategic planning session Identify Stakeholder value Milestone development Governance Framework Policies and Procedures Funding resources Business model analysis Open Source Solutions

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