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3. © 2014 CHARTSaaS.org32/17/2014 http://www.youtube.com/watch?v=SNSQTJmGoE4

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5. © 2014 CHARTSaaS.org5  CHARTSaaS.org, a not-for-profit corporation, administers the funding, development and operation of Cloud Healthcare Appliance Real-Time (CHART) software as a service (SaaS) information technology (IT) to automate processes and decisions for evidence- based health management, medical practice and healthcare delivery with intelligence accrual and knowledge management to facilitate process optimization.  CHART enables medical practice and healthcare delivery performance transformation using (IT) to improve process economy, efficiency and effectiveness.  CHART facilitates Robust Process Improvement™ (RPI) advocated by Mark Chassin, M.D., President and CEO, The Joint Commission through its Center for Transforming Healthcare by providing IT tools and methods for RPI implementation and operation.  CHART is designed for use by medical and healthcare subject matter experts (SMEs) in a collaborative manner, with minimal IT support, to design and operate cloud-based and continuously available secure software for process and decision management.

6. 2/17/2014© 2014 CHARTSaaS.org6 1.Not knowing what to do Scientific evidence about presenting pathology is unavailable at point of care Either the practitioner doesn’t know or no one knows diagnosis or treatment 2.Not doing what is known “Interventions demonstrably without benefit continue to be delivered, and known beneficial therapies are under prescribed, both resulting in measurable patient harm.” 3.Not doing what is know correctly “Health care delivery remains fraught with errors, of commission and omission.” “Estimates of harm resulting from medical error place it as a leading cause of death, ahead of motor vehicle accidents, breast cancer and AIDS.” “All three of these problems relate to the creation and application of medical knowledge to solve individual patients’ health problems …” * Bohmer MD, Richard M. J., Designing Care: Aligning … Health Care (Boston: Harvard Business Press, 2009): 2 - 3.

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10. 2/17/2014© 2014 CHARTSaaS.org10  Personal Health Management (PHM)  Medical Practice Support (MPS)  Healthcare Delivery Operations (HDO) Conception Death Begin care & treatment episode End care & treatment episode Admit to hospital Discharge from hospital Lifetime well and/or “walking wounded” Medical Episode Length of Stay

11. 2/17/2014© 2014 CHARTSaaS.org11  The Joint Commission has announced the Center for Transforming Healthcare in 2010. The Joint Commission Center for Transforming Healthcare  The Joint Commission President and CEO Mark R. Chassin, M.D., FACP, M.P.P., M.P.H., … suggests that the task requires … three strategies:Mark R. Chassin “Eliminating overuse of health services …” “Recognizing that one size does not fit all – Using process improvement tools and methods, such as Six Sigma, Lean, and change management (known together as Robust Process Improvement™ or RPI), could offer hospitals and other health care organizations solutions that are unique to their circumstances …” Creating a culture of safety – Putting a stop to intimidating and disrespectful behaviors … reporting and learning from blameless errors and unsafe conditions … accountability for adhering to agreed-upon safe practices …” * Improving Health Care Quality, Safety Defies Simple Solutions, http://www.jointcommission.org/improving_health_care_quality_safety_defies_simple_solutions/ (August, 2011).

12. 2/17/2014© 2014 CHARTSaaS.org12  CHARTSaaS.org and CHART are described in detail at the CHART web site.CHART web site  CHART is a SaaS suite of interoperable application and integration middleware (AIM) and predictive analytics IT tools and methods, securely accessible via the Internet for use by licensed/accredited medical/healthcare subscribers, payable periodically.  CHART is comprised of application and integration middleware (AIM) and analytics software that is commercially available from global independent software vendors (ISVs) such as International Business Machines (IBM) Corporation® and being used by for-profit and not-for-profit enterprises worldwide, on premises and also in the Cloud.  CHART implements business process, decision management, predictive analytics and connectivity software to design and operate medical practice and healthcare delivery processes in the cloud, interoperable with subscriber IT systems and sources of data via secure connectivity adequate to comply with the HIPAA Security Rule.* * The Health Insurance Portability and Accountability Act of 1996 (HIPAA; Pub.L. 104–191, 110 Stat. 1936, enacted August 21, 1996; 45 CFR Part 160 and Subparts A and C of Part 164).Pub.L. 104–191Stat.1936Part 160Part 164

13. 2/17/2014© 2014 CHARTSaaS.org13  CHART intellectual property (IP) includes configuration and utilization of proprietary software licensed from ISVs and hosted under contract by cloud services provider (CSP) Soft Layer®, including at least the following:Soft Layer® IBM Blueworks Live® collaborative process modeling and simulation tools, and also importability to process and integration design-time software. IBM Blueworks Live® IBM Business Process Manager v8.5® business process management (BPM) process implementation, execution, monitoring and optimization. IBM Business Process Manager v8.5® IBM Operational Decision Manager v8.0® for ILOG® business rules management and complex, time-dependent event management. IBM Operational Decision Manager v8.0® IBM Cast Iron Live® for relatively simple and secure connectivity between cloud- based CHART software and subscriber premise systems and sources of data. IBM Cast Iron Live® Cohesive FT® VNS3® for software-defined networking (SDN) to enable network security and control adequate to obtain HIPAA Security Rule certification. Cohesive FT® VNS3® IBM SPSS® Predictive Analytics for similarity identification and prediction re patient/case identification, care/treatment recommendations and the like. IBM SPSS® Predictive Analytics

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