2. THE SHIFT TO PRECISION MEDICINE HEALTHIER POPULATIONS | DAVE BENNETT JUNE 2016

3. Page 3 2016 © Orion Health™ group of companies ▸ From Disease-Centric to Prevention-Centric ▸ Age of Consumerization – Promotion, Cognitive Support and Wellness are demanded ▸ Precise Medicine and Genomics ▸ Social Determinants of Health Industry Trends | New Models for Medicine

4. Page 4 2016 © Orion Health™ group of companies Industry Trends | Determinants of Health - Most Data Exists Outside Medical Systems 60% from exogenous sources 30% from genomic sequencing 10% from health systems A vast amount of untapped data could have a great impact on our health 80%-90% of health determinants are NOT related to health care Other Determinants of Health: ONC Shared nationwide interoperability roadmap Source: Health Aff (Millwood). 2002 Mar-Apr;21(2):78-93. The case for more active policy attention to health promotion. McGinnis JM, Williams-Russo P, Knickman JR. Environmental Economic Activities Nutrition Social

5. Page 5 2016 © Orion Health™ group of companies Perhaps 2Tb of Data Factors Influencing Health Social Data Environment Device Data Transcriptome Proteome Epigenetic Metabolome Microbiome Genome Imaging Clinical Data McGinnis et. al. Human Affairs, Vol 22 (2) Industry Trends | Digital Me

6. Page 6 2016 © Orion Health™ group of companies Industry Trends | Result is a Health Data Explosion 2012 500 Petabytes = 10 billion Four drawer cabinets 2020 25,000 Petabytes = 500 billion Four drawer cabinets The amount of healthcare data worldwide is expected to grow by 50 times in 8 years

7. Page 7 2016 © Orion Health™ group of companies The Impossible Job of a Clinician… Missing Clinical Data Soon…a Tsunami of new data 17 New Academic research papers/day 15 Minutes to make a decision Info from Dr Google 10101011010101010101011010101010101001101 11010100010110101010101111101010110101010 101010110101010101010101011010101011010 “Evidence Based Medicine” decision making…?? ? ? ??

8. Page 8 2016 © Orion Health™ group of companies Precise medicine is here today 8 th grader 7 th grader

9. Page 9 2016 © Orion Health™ group of companies Junior Year 600lbs Tire Flips

10. Page 10 2016 © Orion Health™ group of companies Senior Year: Captain of Football Team

11. Freshmen in College

12. Page 12 2016 © Orion Health™ group of companies Actionable & dynamic patient record Dynamic patient decision support Precise physician decision support Real-time case and care management Individualized care plans and goals Adherence to medication and care plan/pathway What’s Needed?

13. Page 13 2016 © Orion Health™ group of companies Amadeus | How Big Data is Handled in Other Industries < FUTURE-PROOF ARCHITECTURE HIGH VOLUME AND VELOCITY FLEXIBILITY AND SCALABILITY OF DATA MODEL DATA LIQUIDITY PRIVACY AND SECURITY

14. Amadeus | Open APIs for a Secure, Scalable & Distributed Solution Open APIs Management Layer Domain Logic Layer Web App Layer Data Access Layer Database Device Mobile Browser Mobile Unlimited third party apps Unlimited third party plugins Care Coordination Applications Wellness & Patient Devices Applications Reporting Applications Patient Engagement Applications < FUTURE-PROOF ARCHITECTURE