1. Making the Difference in Referral & Communication Systems September 2012 Emerald Health Exchange

2. PEDRO FALLA, M.D. www.emeraldhealthllc.com 88 Faunce Corner Mall Road, Suite 230 | North Dartmouth, MA 02747 | 855.650.9906

3. Confidential and Proprietary Typical PCP Office Medical Office PCP Phone Calls Faxes Mail Fax Back Scan Files Sort Faxes Sort Mail Triage Phone Calls Return Phone Calls Mail Back

4. Confidential and Proprietary Current Referral System Medical Office PCP Hospital Specialist Medical Group/Network Patients sent to other MDs outside of the network Consult is faxed Consult is mailed No Consult at all No confirmation of appointment No Show Results: faxed mailed phoned Ancillary Services Faxes not received Fax Phone Forms Reason for consult No Shows Discharged patient: No notification No comments D/C summary sent by mail or fax Referral outside of the network Ancillary Services outside of the network

5. Confidential and Proprietary Impact of EHE on PCP Office Medical Office PCP Employees EMR EHE Communication Fax, phone, and mail usage decreases Smooth flow of electronic information increases

6. Confidential and Proprietary Impact of EHE on Referral System Medical Office PCP Hospital Specialist Ancillary Services Confirmation is received Decrease no shows Results sent by EHE Confirmation sent to hospital Confirmation is received Consults are received No show info is sent Referral sent by EHE Patient is sent back with discharge info and comments through EHE Ancillary Services out of network decrease Referrals outside of the network decrease Medical Group/Network

7. Confidential and Proprietary Current Network Communications Hospital Medical Group/Network ER PT NH Provider Medical Group PCPVNA Specialist

8. Confidential and Proprietary Impact of EHE on Communication Within the Network PT NH Provider Medical Group PCPVNA Specialist Hospital Medical Group/Network ER

9. Confidential and Proprietary Summary of Benefits for Referring Physicians Cut costs/expenses. Improve work flow efficiency. Better documentation in EMR after consultant reports are received. Decrease liability. Improve access to consultants. Reduce or eliminate overwhelming paperwork load.

10. Confidential and Proprietary Summary of Benefits for Consultant Physicians Increase referral base. Enhanced communication with referring physicians. Excellent platform to project growth. Less administrative/labor work by receiving referrals via EHE.

11. Confidential and Proprietary Summary of Benefits for Medical Groups/Networks Create a cohesive and strong relationship with all physicians by improving communication among them. Track referral pattern inside/outside network. Control of network leakage. Improvement of communication with other health care providers (VNA services, home services, hospice care, nursing homes, physical therapy..Etc). Integration of all physicians within the network despite use of different EMRs.

12. Confidential and Proprietary Summary of Benefits from EHE Cut cost/expenses Increase referral base Enhanced communication within the network Tracking referral within the system

13. Confidential and Proprietary Cost Savings Potential The cost savings illustrated are typical of what a FT physician can expect based on workflow improvements 60-70% of referrals go unscheduled 25% of scheduled appointments are missed 68% of specialists receive no information from PCPs prior to referral visits 25% of PCPs do not receive timely information from specialists post referral Paperwork costs a national average of over $23,000/year per physician

14. ARUN B. RAJAN, M.D

15. Confidential and Proprietary EMERALD REFERRAL &COMMUNICATION SYSTEM FEATURES Hosted System-SaaS Model HIPPA Compliant Comprehensive Referral System Document Management Communication Tool For Physicians & Users

16. Confidential and Proprietary EMERALD REFERRAL &COMMUNICATION SYSTEM FEATURES Designed For Quick Implementation Minimal Learning Curve Customizable Features Any Size Network No Paper No Faxing Documents/Phone Calls

17. Confidential and Proprietary REFERRAL MODULE Send referrals Receive referrals Request reports- automated and manual requests Track the life history of referrals Capture key data points Generate report based on predefined data points

18. Confidential and Proprietary COMMUNICATIONS MODULE Communicate securely within the portal Send secure emails to recipients out of portal Receive emails (may not be secure) SMS to recipients

19. Confidential and Proprietary DOCUMENT MANAGEMENT Customization of documents in HTML or XML to track data Send documents attached to referrals Receive reports within portal Manage documents that require receiver responses more efficiently Capture electronic signature or image signature Analyze, create reports of customized documents Store documents

20. Confidential and Proprietary SECURITY Access Control. Technical policies and procedures that allow only authorized persons to access electronic protected health information (e-PHI). Audit Controls. Software and procedural mechanisms to record and examine access and other activity in information systems that contain or use e-PHI. Integrity Controls. Electronic measures in place to confirm that e-PHI has not been improperly altered or destroyed. Transmission Security. Technical security measures that guard against unauthorized access to e-PHI that is being transmitted over an electronic network.

21. Confidential and Proprietary SECURITY (cont’d) Facility Access and Control. Limit physical access to facilities while ensuring that authorized access is allowed. Workstation and Device Security. Implement policies and procedures to specify proper use of and access to workstations and electronic media. * Above security measures to be defined by applications and end users