1. Copyright © 2010 Accenture All Rights Reserved. 1 Copyright © 2009 Accenture All Rights Reserved.Copyright © 2009 Accenture All Rights Reserved.Copyright © 2009 Accenture All Rights Reserved.Copyright © 2009 Accenture All Rights Reserved.Copyright © 2009 Accenture All Rights Reserved.. Copyright © 2009 Accenture All Rights Reserved.Copyright © 2009 Accenture All Rights Reserved.Copyright © 2009 Accenture All Rights Reserved.Copyright © 2009 Accenture All Rights Reserved.. Copyright © 2009 Accenture All Rights Reserved.Copyright © 2009 Accenture All Rights Reserved.Copyright © 2009 Accenture All Rights Reserved..Copyright © 2009 Accenture All Rights Reserved.Copyright © 2009 Accenture All Rights Reserved..Copyright © 2009 Accenture All Rights Reserved..Copyright © 2009 Accenture All Rights Reserved.Copyright © 2009 Accenture All Rights Reserved.Copyright © 2009 Accenture All Rights Reserved. 2009 EMR Study Discussion UNC Gillings School of Global Public Health EMR Forum January 12, 2010

2. Copyright © 2010 Accenture All Rights Reserved. The Accenture 2009 EMR Study began as a follow-up to a 2007 survey of EMR organizations 2009 Accenture EMR Study Objectives Review and assess the maturity of EMRs Score participating health care provider organization’s EMR progress against the Accenture EMR Maturity Framework Compare participating HCOs to each other’s progress toward High Performance The study included HCOs that indicated they were 50% or greater implemented and, Included 20 HCOs representing 175 hospitals with annual net patient revenues between $500M and $4.0B and a total of 3M admissions (6% of US volume) and 35M ambulatory visits (8% of US volume) Used a detailed advance data collection tool and on-site or telephone data validation Was conducted over an 8-month period ending in October 2009 2

3. Copyright © 2010 Accenture All Rights Reserved. HCOs were scored using the Accenture EMR Maturity Framework across five dimensions and placed in one of three maturity levels for each dimension and overall 3 Foundational capabilities in at least one IP and Ambulatory site Percentage of sites implemented (IP AND Ambulatory) Percentage of key users using the EMR capabilities Sharing of information with consumers and community physicians Progress towards paperless health care Foundational Capabilities Assessed :  Clinical Documentation- IP & Ambulatory for Non-physicians and physicians  CPOE – IP and Ambulatory for Non-physicians and physicians

4. Copyright © 2010 Accenture All Rights Reserved. The scoring criteria identifies what is required to attain each level of EMR maturity for each of the five dimensions 4

5. Copyright © 2010 Accenture All Rights Reserved. When compared on overall maturity, only15% ranked as high performers. Most HCOs were much less mature than they estimated prior to the study *The bubbles represent the relative size of the HCOs 5

6. Copyright © 2010 Accenture All Rights Reserved. Study findings indicate dramatically different levels of results in EMR maturity achieved EMR Overall  High Performers had an enterprise strategy and focused simultaneously on all measured dimensions of maturity.  Clinical documentation is not widely deployed for non-physicians or physicians  Only 15% of HCOs demonstrated broadly available CPOE capabilities with high adoption across the continuum of care in their patient care enterprise  There is limited physician adoption of critical foundational capabilities  The size of an organization has little to no impact on the organization’s ability to achieve a high performing level of EMR maturity  Having an enterprise core vendor strategy isn’t necessary to achieve high levels of overall EMR maturity but it does appear to help EMR Spend and Timeline  Organization spending on EMR implementations does not positively correlate with results achieved.  Some organizations in the study have demonstrated the ability to implement EMR solutions at an accelerated pace and achieve greater levels of overall maturity and derive greater value  A number of lagging and progressing organizations in the study may have under-funded EMR programs and this may be contributing to longer timelines, greater spend, and lower levels of maturity 6

7. Copyright © 2009 Accenture All Rights Reserved. Conclusions  Tremendous levels of variability exist in the availability of foundational EMR capabilities, how widely deployed they are and the levels of adoption that has occurred to date  In general, EMR ambulatory progress lags inpatient on most maturity dimensions  In general, CPOE implementation progress is lagging clinical documentation implementation progress  Physicians are lagging other clinicians in adoption of foundational capabilities even where the capabilities are available and widely deployed  Leadership mandates, funding and organization support for accelerated implementations are key to success  Very few organizations are able to claim the ability to conduct population health management on their own population of patients  For national health care reform to succeed, the majority of provider organizations will need to significantly progress beyond their current EMR baseline performance For many HCOs participating in the EMR study, a new approach to their EMR programs may be necessary to achieve a high performance level of EMR maturity between now and 2012 7

8. Copyright © 2010 Accenture All Rights Reserved. For questions or additional information, please contact: Deniese M. Chaney, MPH Partner Suite 800 900 West Trade Street Charlotte, NC 28202 Tel: (919) 304-5571 Fax: (704) 348-4746 Mobile: (919) 593-2820 Deniese.m.chaney@ accenture.com 8 Kathleen A. Loeb Partner 180 Fountain Parkway Second Floor St. Petersburg, FL 33716 Tel: 72-897-4247 Mobile: 615-828-8767 Kathleen.a.loeb@ accenture.com