1. esMD Pilots Workgroup April 30 th, 2015

2. Meeting Etiquette Please announce your name each time prior to making comments or suggestions during the call Remember: If you are not speaking keep your phone on mute Do not put your phone on hold – if you need to take a call, hang up and dial in again when finished with your other call –Hold = Elevator Music = very frustrated speakers and participants This meeting, like all of our meetings, is being recorded –Another reason to keep your phone on mute when not speaking! Feel free to use the “Chat” or “Q&A” feature for questions or comments NOTE: This meeting is being recorded and will be posted on the esMD Wiki page after the meeting From S&I Framework to Participants: Hi everyone: remember to keep your phone on mute 2

3. Agenda 3 TopicPresenter AnnouncementsNeil Saha Enrollment StatusNeil Saha/ Pilot Sites Site Progress UpdatesNeil Saha/ Pilot Sites Opie Software LLP Pilot PresentationPaul Prusakowski, Scott Williamson Discussion / Next StepsesMD Leads/ Pilot Sites

4. Announcements Opie Software eClinical Template for LLP Demo (Presentation Today) No upcoming presentations scheduled for now

5. Pilot Sites Pilot SiteProvider Registration Digital Signatures E-Clinical Template for PMD E-Clinical Template for LLP Active Sites 1PAHISP LLC & NHDSXXX 2IBEZA LLCX 3MEAXX 4MaxMDXXX 5Quality OutcomesX 6DigiCertXX 7Strategic Healthcare SolutionsXXX 8NumotionX 9University of PittsburghX 10Colonial MedicalX 11MediProfitXX 12Syracuse Prosthetic CenterX 13MedAZ.Net, LLCXX 14Opie SoftwareX 15InprivaXX Inactive Sites 1Secure Exchange SolutionsXX 2eSolutions, Inc.XXX 3qliqSOFTX 4Monroe WheelchairX 5MedStar National Rehabilitation HospitalX

6. Pilot Sites OrganizationPOCEmailPilot Work StreamsType of Organization Provider Profiles Authentication Digital Signatures E-Clinical Template for PMD E-Clinical Template for LLP HIEHIHRHIOHISPEHRPHR CMS Contract or DME/ Suppli er Provid er Org Secure Exchange SolutionDan Kazzaz dkazzaz@secureexsolutions.com XX XXX PAHISP LLC & NHDSPeter Bachman peterb@pahisp.org XXX XXX IBEZA LLCVictor Berajavictor@ibeza.net X XX MEAVijay Patelvijay.patel@mea-fast.com XX XXXX Inpriva Ginna Yost Don Jorgenson gyost@inpriva.com djorgenson@inpriva.com XX X MaxMDBruce Schreiberbschreiber@max.mdXXX X eSolutions, Inc.Greg Beechgbeech@esolutionsinc.comXXX XXX MRO Corporation & DigiCert David Borden Scott Rea dborden@mrocorp.com scott@digicert.com XX XXX Strategic Healthcare Solutions Dr. Mark Pilleym.pilley@strategichs.comXXX X NumotionMike Gohrmichael.gohr@numotion.com X X University of PittsburghBrad Diciannodicianno@pitt.edu X X Colonial MedicalDavid Bruinsmadavid@colonialmed.com X X Monroe Wheelchair Doug Westerdahl dwesterdahl@monroewheelchair.com X X MedStar National Rehabilitation Hospital Ginger Wallsvirginia.st.walls@medstar.net X X Med A-Z Gita Reddy Vijaya Vasu gita@medaz.net vasu@medaz.net XX X Opie SoftwareSean Doddssean@oandp.com XXX Quality Outcomes Scott Williamson scott@qualityoutcomes.com X qliqSOFT Krishna Kurapati kkurapat@gmail.comX MediProfitMark Kimmel mark.codeablelanguage@gma il.com XX Syracuse Prosthetic Center Michael Mahar michael@syracuseprostheticc enter.com X

7. Pilot Site Progress Status Activation: Shown interest in working as a pilot site Registered for pilot through esMD Pilots website Scheduled kick-off meeting with pilot leads Start-up: Determine pilot stream(s) for participation Forming partnerships Developing ecosystem and timeline Regular meetings schedule with pilot leads Development: Actively working on pilot process Resolving issues/barrier Working with pilot partners (if applicable) Meeting regularly with pilot leads Production Ready Capability: Pilot complete Completed an end-to-end production product Scheduled final meeting with pilot leads

8. Pilot Site Progress Status Pilot Stream PilotStatus PMD MediProfitProduction Ready Capability UPMC/NumotionDevelopment MedAZ/Colonial Medical/DigiCertDevelopment PAHISP/NHDSDevelopment MaxMDStart-up Inpriva/DigiCertActivation HoveroundActivation LLPOpie/QO/SPC/MEADevelopment

9. Discussion / Next Steps LLP Presentation by Opie Software & Quality Outcomes Lessons Learned Next Steps Questions, General Discussion

10. Workflow Diagram 1 Original workflow without a second physician involved. This is the ideal scenario from an efficiency standpoint, but in practical experience, it has typically not resulted in documentation that meets CMS requirements because it relies on the treating physician to have the time, knowledge and motivation to perform a functional level assessment and provide the necessary documentation to support the prosthetic intervention. Diagram from OPIE Software’s esMD LLP Pilot Report

11. Workflow Diagram 2 Alternative model in which a second physician, typically a physiatrist, is consulted by the treating physician to perform a comprehensive functional level assessment and collaborate with the prosthetist and the treating physician in determining and documenting the appropriate prosthetic intervention for the patient. Diagram from OPIE Software’s esMD LLP Pilot Report

12. Workflow Diagram 3 A variation on the functional assessor model in which the physician performing the functional assessment takes over the long term care of the patient at the request of the original treating physician. Diagram from OPIE Software’s esMD LLP Pilot Report