1. SoCAL TLC Learning Session September 9, 2010 Sergio Bautista, CFO Sbautista@chapcare.org (626) 993-1222

2. About - Community Alliance of Pasadena Community Health Alliance of Pasadena (CHAP) is a nonprofit medical and dental health center providing primary health care and dental services to low-income and uninsured individuals and families. CHAP’s mission is to provide high quality, accessible and culturally sensitive health care in an environment of care and mutual respect to residents of the Pasadena and surrounding communities. CHAP was founded in 1995 by a committed group of community residents, city officials and healthcare agencies that organized to establish primary care health services for the many poor and uninsured residents of Northwest Pasadena. Until that time, there were no affordable primary care services located a convenient distance for low-income residents of the area. After incorporation as an independent non-profit organization in 1995, CHAP launched medical services in early 1998. Our dental clinic opened in June, 2001. In 2009, the CHAP/Lake Primary Care Clinic opened to serve more Pasadena and Altadena residents. The CHAP/Del Mar Primary Care Clinic in east Pasadena, opening in October 2010, will increase health care access for many more San Gabriel Valley residents. In 2009, CHAP provided care to 9,636 individual patients, including 1,144 children and 8,492 adults. We delivered 31,363 medical and 5,806 dental patient visits. More than 98% of CHAP’s patients live below 200% of the Federal Poverty Level. Services are offered on a sliding scale based on one’s ability to pay. No one is ever refused care because they cannot afford it.

3. CHAP EHR - Background Identified Need – 2004 Replace Practice Management System Replace Paper Charts Build Case for New System - 2005 Billing and Reporting Access to Medical Records and Space Better Patient Care Way of the Future Financing Source - 2005 Foundations - Grants Identified System – 2006 Wish list: EPIC – via Kaiser Selected: EPIC via OCHIN – Application Service Provider Model Advantage Non Profit Central Control Network – Federally Funded Low Cost entry – Licensing agreement based on visits Experience with Community Clinic Two Step Implement Practice Management – May 2006 Electronic Medical Record – November 2007

4. EMR Billing PMS CHAP EHR Landscape OCHINCHAP EPIC System BI - Reporting Solutions Pentaho Business Objects Disease Management Finance, Operations, Clinical Electronic Claims External Pharmacy Laboratory Internal Dispensary Surecripts Quest - Links Clearing House

5. OCHIN/CHAP – EPIC System In-System – Epic Care Patient Portal – My Chart Collaboration – Epic Link HIE Meaningful Use Certification Practice Alerts New Payment Mechanism Patient Medical Home Telemedicine/health ACO Network Improvements

6. Key Lessons Learned What is the Best EHR? 1. Meets your Needs 2. Provides Support Services 3.Is there for the long term 4.Flexible to meet Future Needs Assessment Staff Process System Reengineer Staff Scope of Practice As is – To be Integration Redeployment Resources Document Job Description Policies & Procedures Enhancement Reassessment Staff Process Systems