HIMSS10

3. HIMSS10 Brad Savage SVP & CIOGolden Living

4. At Golden Living, we are redefining how senior care is provided in this country… • Better Outcomes • Improved Efficiencies • Integration across the Spectrum of Care • Managing/Affecting Regulation and Policy • Mitigating Risk Technology is a key enabler.

5. TodayA Fragmented Golden Living Ecosystem Medical Director Nurse Referring Hospital, Discharge Planner Family of Golden Living Resident Clinical Pharmacist Therapist Resident at Golden Living Physician, Facility outside of Golden Living

6. Post Microsoft® Amalga Unified Intelligence SystemTM (UIS) and HealthVaultTMA Connected Ecosystem Medical Director Nurse Web Referring Hospital, Discharge Planner Physician, Facility outside of Golden Living Clinical Pharmacist Therapist Family of Golden Living Resident Resident at Golden Living

7. Amalga UIS greatly improves clinical oversight by liberating and unifying data within our own organization, and between us and outside providers, payers, and patient families. BENEFITS More effective management of chronic disease Referring Hospital Improved outcomes Early intervention Payer Family Prevention Patient MD

8. Support Caregivers Today Golden Living’s Data Shadow IT Organization Rx Billing Data Mart Care Quality Analysis Compliance Monitoring Staff Reporting 1M Enterprise Unknown Data Mart Finance Data Mart Rx Utilization Unknown Data Mart Unknown Data Mart 1M Enterprise Charge & Payment Analysis SNF Therapy Home Health Hospice Telehealth Pharmacy General Ledger Dietary Human Resources SNF ADLs Document Imaging Data Warehouse Residence Accounting Learning Management Homegrown Application(s Future Applications

9. Support Caregivers Post Amalga UIS Data Liquidity, Data Reuse Rx Billing Finance Reporting Staff Reporting Compliance Monitoring PHRConnectivity TeleHealth Initiative RUG & Level of Service Monitoring Discharge Outreach Active Diagnostics Monitoring Hospital Outreach Care Quality Analysis Physician Outreach Charge & Payment Analysis Active Therapy Monitoring Adverse Drug Event Surveillance Rx Utilization Appropriate Pharmaceutical Utilization Active Quality Monitoring Pharmacy Billing Auditing SNF Therapy Home Health Hospice Telehealth Pharmacy General Ledger Dietary Human Resources SNF ADLs Document Imaging Data Warehouse Residence Accounting Learning Management Homegrown Application(s Future Applications

10. Support Caregivers Today’s Golden Living Environment Sub-optimal decision-making, redundant labor, adverse events, unnecessary hospitalizations, lost business… I don’t have insight… I need to take action… I’m overwhelmed with queries… It will take two weeks to pull the data together… EPO drug usage… what’s going on? Corporate Manager, Administrator Clinicians, Managers, Staff Business and Database Analysts Rx Billing Data Mart Care Quality Analysis Compliance Monitoring Staff Reporting 1M Enterprise Unknown Data Mart Charge & Payment Analysis Finance Data Mart Rx Utilization Unknown Data Mart Unknown Data Mart 1M Enterprise Shadow IT Organization

11. Support Caregivers Post Amalga UIS: Your People Empowered New workflows, New Interactions, Ease and Speed to Impact, Increased Quality and Volume of Work… I have real-time insight… I can take action and monitor… I can help people to understand their data… I can spend time on analysis… EPO drug usage… what’s going on? Corporate Manager, Administrator Clinicians, Managers, Staff Business and Database Analysts Care Quality Analysis Finance Reporting Rx Billing RUG & Level of Service Monitoring

12. Support Caregivers Empowering People Patients and Families as Consumers—experiencing more control, more convenience, better service, and better value for what they spend. Healthcare Professionals as Knowledge Workers— getting the right data in the right format at the right time to provide the best treatment & preventative care.

13. Support Caregivers Leveraging Clinical Experts What is the cause of potentially avoidable hospitalizations? Has this patient been re-hospitalized three times in the last three months? What is the root cause behind the missing INR/PT orders? Which patients on Coumadin do not have an INR/PT ordered? Which patients are on 2 or more psychotropic medications? What are the root causes behind these medication orders? Real time Over time

14. Support Caregivers Leveraging Clinical Experts Is Nursing staff rating her as showing fewer disruptive behaviors on her MDS? Patient is cooperating so much more in therapy as her cognitive skills have increased Are treatments gains resulting in decreased pain medications? Patient is showing much better range of motion in his shoulder Looks like we're starting to see more falls at this facility What percentage of our staff has taken the E-Learning on Balance Management? Real time Over time

15. Connecting the enterprisewith physician communities Connecting the enterprisewith patient-controlled data Connecting to acute and other healthcare organizations Connect Care Connect Care

16. Connect Care Connecting the Health Ecosystem Skilled Nursing Facility Physicians Assisted Living Health & Fitness Device Manufacturers Physicians Health & Fitness Device Manufacturers Health Plans Laboratories Employers Hospitals Laboratories HealthcareAssociations Pharmacies and PBMs Application Provider Hospitals Application Provider Pharmacies and PBMs

17. Connect Care Amalga UIS/HealthVault Integration On admission to a Golden Living facility or to a hospital, a Golden Living Resident may decide to share certain data elements from their HealthVault account. Medications, allergies, and discrete results from home devices (blood pressure, blood glucose) While receiving routine care at Golden Living or when being discharged from a hospital, the institution can share information with the Golden Living Resident’s HealthVault account Discrete data if available, discharge summaries, medication data, etc

18. Connect Care Connecting With Physicians Amalga Light – anytime, anywhere physician access

19. Amalga Web Connect Care Solutions to Connect Care Across the Ecosystem Community Health System • Medications • Discharge instructions • Lab test results • EKG Report • Operative Report Record

20. Connect Care Enabling real-time access to data and greater impact of data…when moments count Residents and Families Physician in the home, office & hospital Consultant Pharmacists

21. Q&A