1. POMIS Intelligence The Vinson View YOURS Online

2. Industry Overview Ambulatory Medicine Market  2007 Revenue: $8.7 billion; About $4 billion of which was spent by medical group practices  Largest company (McKesson Provider Technologies) garnered 9.9% of ambulatory care setting spending  655 companies were competitors during 2007  2008 HIMSS focus more on ambulatory care

3. Industry Overview Last two years: Just over 11.0% growth  Current growth fueled by adoption of EHR- EMR systems and acceptance of software as a service (SaaS)  National demand for improvement in quality of care and better patient outcomes  Over next 5 years, acquisitions, mergers, and partnerships insist on market share anded profitability

4. Ambulatory Care Spending Trends

5. Ambulatory Care Spending Across Major Market Segments

6. Relaxing Historical Obstacles Interoperability – Standards-based data sharing and integration Moving further toward SaaS More collaboration of IT and medical device companies EHR/PHR alignment –Increasing clinical data integration utility –PHR: provider input vs. patient self-reporting Face-to-face or e-Health patient care

7. Factors Impacting EHR-EMR Systems Adoption Source: The Association of American Physicians and Surgeons, results compiled on 6/9/2008

8. Factors Affecting Buying Behavior Initial Price Total Cost of Ownership Overall Practice Acceptance Physician Acceptance P4P Obstacles & Incentive obstacles Client/Server Versus SaaS Ease of Use Inappropriate Functionality Consolidation of Vendors