Leveraging technology to create an information eco-system that supports and drives a successful lab outreach program

Today’s Agenda Outreach Laboratory Programs PAML background Opportunities and challenges Outreach Advantage The tool set – products and services How the workflow is improved and information is exchanged New product offerings and patient engagement strategies

Pathology Associates Medical Laboratories Based in Spokane, WA 1,300 employees $200 million in Enterprise revenue 5 state core service area, 6 joint ventures Virtual lab running 9 LIS, 18 databases 90 IT staff – 8 integration engineers, 14 in physician connectivity $12 million operating $3 million capital IT budget 17 different EMR interfaces – total and growing quickly 12 different LIS interfaces – 48 total 4 web products – 700+ practices 5 hospital portals integrated – fed from CDR with 170 million results 57 active connectivity cases – 4 months of work – complete Regional data sharing collaborative – outpatient lab, radiology and inpatient data EMPI with 7.2 million patients – 46% of core service area population

Outreach Laboratory Programs Opportunities: –Incremental lab testing can be highly profitable –Hospitals and IDNs can leverage brand –Combined inpatient and outreach data is a competitive advantage Challenges: –Investment capital for business expansion is tight –Lack technology tools – resources and implementation risk –Genetic and molecular testing proliferation, consumer driven healthcare As Managing Partner of several JV’s, PAML needed to develop a set of products and services to ensure the success of her Partnerships

LOGISTICS MANAGEMENT OE / REPORTING / EMPI CUSTOMER RELATIONSHIP MANAGEMENT SALES AND MARKETING DEPARTMENT SCHEDULING OAMobile OAConnect OACRM OASFA Schedule Labs OAMobile OAConnect OACRM OASFA Schedule Labs

OA Mobile  What is it: Integrated route planning, scheduling, dispatch and specimen tracking system  Value: improved efficiency in logistics combined with specimen integrity process. When paired with OAConnect and OA CRM, laboratories can reconcile ordered tests to specimens received.

OA Connect What is it: A set of integration tools and web products to provide flexible connectivity for diagnostic orders and results in a patient centric fashion Value: flexible branded products and integration suite that includes EMPI support and robust EMR interfaces, greatly improves outreach program effectiveness and competitive positioning OA has established a comprehensive library of electronic interfaces with advanced architecture and integration resources

Billing Edits Connectivity workflow and process with EMRs 1.Client orders in EMR JavaCAPS Interface Engine 2.Order goes to JavaCAPS LMRPs EMPI MCDB UMCT 3.JavaCAPS validates order using web services Exceptions 4.Exceptions are returned to the EMR, if applicable 5.Test codes and message structure are denormalized 6.Orders go to LIS systems in native format PAML or Testing Partner LIS Order for CBC 7.Testing is performed and results entered Results for CBC 8.Results go to JavaCAPS 9.JavaCAPS translates and normalizes results 10.Normalized results go to client EMR

OA CRM What is it: Customized laboratory CRM with end to end workflow and business analytics tools that document client activities and patterns Value: intimate client relationships and business intelligence that assists management with the appropriate monitoring and analysis of operational trends and client issues

CRM OACRM Case Study

OA Sales Force Automation “SFA” What is it: Sales and marketing system to target and obtain customer accounts and build outreach market share within a given region Value: incremental revenues over a highly fixed cost structure drives improved financial performance; Sales Force Automation provides management tools, forecasting and sales campaign utility

Schedule Labs What is it: automated platform to create, change and communicate your lab department schedules Value: reduced workload, saves time, optimized scheduling and credentialing and competency feature ensures appropriate resources are available for scheduling

OAConnect The information eco-system 1.CRM SFA Targets prospects Documents sales process Administers & approves pricing in an EMR, web Product, or Sunquest Lab Specimen detail 3.The client places an order 2.A new client is set up 4.OAConnect Normalizes codes Matches ID Applies business rules for clean orders 6.OA Mobile Receives order detail Courier tracks & reconciles Aggregates data Provides accessioning dashboard for specimen volume by route completion 10.Reports route back to the client 5.PAML or Partner LIS Specimens tracked & racked Reports generated 7.Automation line Orders to/results from instruments 80% of volume Testing & reporting Exceptions 8.OACRM Contains all customer service cases & activities Drives customer contact Client report 11.Periodic publication to data warehouse Data marts Business intelligence Analytics & dashboards Data Exceptions Data BillingSystem LIS OAMobile OACRM Order for CBC Results for CBC Claims Data EDI ERA EOB ERA ADR Sharepoint 9.LIS sends claims data to Billing

OA Business Intelligence Ensure that all appropriate clinical and member elements are correlated for each result (CPT, ICD9, NPI, Payer ID, Member ID, Age, Sex, Result) Consolidate provider data to mine utilization trends and benchmark payers (NPI, specialty, procedures, payer distribution, abnormal/normal result ratio, avg. age of patients, ICD9 frequency) Ensure that key elements from external systems populate data in discrete data marts (Billing, Supplies, logistics, CRM, EMPI/PMPI) for full picture of all touch points throughout our Enterprise The result – rich information on all of our customer behaviors, patterns, profitability and relationships to better target services and proactively provide an optimum set of lab services that are relevant to them

PAML, like other laboratories in the United States is also pursuing strategies to further link the patient to their Laboratory Joint Ventures and help their physician customers manage health in partnership with the patient

16 HealthVault: Software + Services Platform SOFTWARE SERVICES HealthVault Connection Center is a utility that allows users to add data from health and fitness devices such as heart rate monitors, blood pressure monitors, peak flow meters, glucometers, and pedometers. Microsoft HealthVault is an online personal health database with a set of XML interfaces that allows third parties to create valuable health, wellness, and fitness services for HealthVault users.

17 Devices Partner Applications HealthVault Platform Architecture

18 Application Companies Signed and Live as of 07/22/08

19 Device Companies Signed as of 07/22/08

20 Consumers As The Aggregators

21 Health Information labs, images, procedure notes scheduling, contact information, medication history manage my health

22 Health Information labs, images, procedure notes scheduling, contact information, medication history manage my health

23 Health Information labs, images, procedure notes scheduling, contact information, medication history manage my health

24 The IDN Model Tools that are personal Data that is actionable Top consumer preferred tools: Lab results online Talk to my doctor via After-visit summary (handed out at the end of each visit, but also available online in case you lose it) Kaiser Learnings: At KP they are signing up new portal users at the rate of 80K / month – by eoy they will have 3MM users, or 47% of their base. They are 25% overdeveloped from an adoption standpoint amongst younger users. KP did a survey recently and found that their ratings on trust, usefulness, and privacy were really high – and their conclusion is that because it’s your personal information, as a user you find it relevant and powerful.

Summary take away points Technology is driving business growth, efficiency, insight and further brand recognition with patients and providers Outreach support tools to ensure specimen integrity, seamless data exchange and integrated reporting CRM and SFA are driving better customer relationships and targeted marketing of services and diagnostic campaigns Business intelligence tools are providing managers and customers with comprehensive views of business process, operations and diagnostic trends Patient engagement strategies are an important way to build brand and empower consumers to manage their health