1. January 2012 Bill Beighe, CIO CaleConnect BOD CalHIPSO BOD

2. PMG & Santa Cruz County Only IPA Enjoy Excellent Relationship with Santa Cruz Medical Society – Many members in common – Co-sponsor the Medical Society EHR Demo Day for 3 years – Collaborate on Health Improvement Projects Collaborate on care with virtually all in the community – Exchange is open to all Sutter / PAMF has a large presence

3. Point to Point Interfaces $$$ Scanning/Faxing Re-Keying Data Single Bi-directional Interface Scanning/Faxing Automated Entry Structured Data Connectivity: Community Level Traditional vs HIE

4. HIE Is Key HealthCare Reform “Bending the Cost Curve” Prevention Inform Quality Outcomes Deliver Information about the patient to the provider at the point of care Challenge – How will we Enable, Promote, Accelerate HIE in the State of CA

5. Regional HIO Started in 1996 County Population 270,000 95% in Patient Index Bi-directional Exchange 130,000 + clinical documents / month Two full-service hospitals 367+ MDs – 900+ Users Web & EHR Interfaces 4 Outpatient Laboratories 5 Radiology Centers County Health Services & Jail Safety Net Clinics Monterey Bay California

6. Timeline of HIE in Santa Cruz Community Collaboration PMG Dominican Hospital Unilab (Quest) 1995 1 st Exchange of Clinical Data 1996 Web-based HIE interface EMR Lite County Clinics 2001 3 HIE to EMR Interfaces NHIN Safety Net Clinics 4 Additional Labs 2004- 2006 1 st Partner Connection to HIE 2007 EMR Lite 600+ electronic NHIN at Redwood MedNet 2009 7 Connected EMR’s 750+ electronic NHIN at HIMSS 2010 9 Connected EHR’s 4 Certified EHR’s 2011

7. Lab Radiology Transcription 2 Hospitals - 8 Feeds

8. Santa Cruz HIE Stats Increase in Data Traffic Usage increase over past 6 Years 600% Clinical Page Views Monthly 1.3M SureScripts per Month Including eRx from EHR and HIE 23,000 Rx Referrals Transitions of Care per Month 3,400+ Electronic Lab Results per Month 28,000+ VHR Views per Month Longitudinal Patient Record 17,000+ EMR / EHR Interfaces to 90 + MD’s 9

9. Data Types & Features Lab Results Radiology Reports from Hospitals and Independent ADT feeds Chart Notes Referrals and Authorizations Hospital – Dictations, Op Reports, ED, H&P etc Discharge Summaries Consultant Reports Patient Summary (Print and CCD) EHR / EHR Interface (McKesson Practice Partner and 8 others) Problems, Allergies, Immunizations, Consent Provider to Provider Secure Communications Community Patient Index (MPI) Virtual Health Record

11. Infrastructure & Resources HIE ( $2.25 per patient per year – hard costs across community – Hospitals, Labs, Users Pay) The SC HIE core infrastructure is hosted by Axolotl Locally PMG provides – EMR Interface Implementation, Operational and User Support, and Reporting – 2 FTE at PMG – 1 st Line Support, MPI Administration, User Administration and Training 2 FTE at PMG Management / Oversight / Marketing / Governance.5 FTE at PMG Tech Support, EHR Implementation, Hosting, REC Services 9 FTE at PMG

12. PMG Services in Santa Cruz County Insurance and Health Plan Contracting and Administration Claims Payment Case Management Credentialing Billing Service Technology Support Service Partner to CalHIPSO – ARRA REC Services Electronic Health Records Deployment and Hosting Health Information Exchange (SCHIE) Axesson, LLC Owned by PMG Interface & Interoperability Services Nationwide HIO Operations

13. Bill Beighe, CIO bbeighe@pmgscc.com 831.465.7874bbeighe@pmgscc.com