Erickson Communities

1. Erickson Communities • Developer of large scale retirement communities • 1500 independent apartments • Service rich environment • Home care (nursing and rehab) • Outpatient rehab • Extended care • Skilled inpatient nursing and rehab • Long term care • Assisted Living • Physician Practice on site (one doctor/400 residents) • Sublease to Specialists • Only CCRC with its own Medicare Advantage Plan

2. Strategy Optimize the Resident Provider Encounter

3. Interdisciplinary Care Delivery Model

4. Automating the Clinical Model • Erickson committed to automating all clinical transactions in 2003. • Strong interdisciplinary team due to clinical model • Emphasis on customer service due to “Erickson Living” • Excellence in Geriatrics is defined by whole person care on their terms • Less testing, less medications, lower hospitalization rates • More use of rehabilitative and restorative services

5. Erickson Health IT Home Health Out Patient Rehab Resident Portal Hospital Care Coordination Renaissance Gardens Labs Functional Health Record Institutional Pharmacy Retail Pharmacy Specialists Medical Center

6. Solutions • Ambulatory Practice EMR (GE Centricity) • Custom content for all types of service and levels of care • Compliance support • E and M • Risk Adjustment • Workflow tools • Meds to be avoided in elderly, meds contributing to falls • Advance Care • PQRI Preventive Measures

7. Ambulatory EMR • Reporting • Quarterly provider dashboard on Quality • Registry to CMS for PQRI • Resident Portal (launched 2005) • Integrations with Care MEDX (The Erickson Functional Health Record) • Health Risk Assessments

8. ER Chart Summary

9. Ambulatory EMR • Reporting • Quarterly provider dashboard on Quality • Registry to CMS for PQRI • ER Chart Summary (2004) • Resident Portal (launched 2005) • Integrations with Care MEDX (The Erickson Functional Health Record) • Health Information Exchange with hub Hospital (with Health Unity) 2007

10. Care MEDX “Vision” • Long Term Care • Assisted Living • Inpatient and Outpatient Rehab • Home Health (to be completed with occasionally connected solution)

11. Intel Health Guide • Resident apartment • High risk patient in skilled care • Complex patients in Erickson Advantage • 30 devices, Peripherals, Care Management • Very high compliance with care plans • Improved review of critical issues • Weight gain • Blood Pressure • Medication Compliance • High patient and care manager satisfaction • Improved patient knowledge of disease

12. The Functional Health Record • Integrations across all clinical platforms • Lab Corp electronic order entry • Electronic Prescribing (2009) • Document imaging • Point of care reporting • Physicians use physicians system at all levels of care • Nursing and Allied health use their systems • View reporting allows chart review, data mining and decision support • Advance Directive Project • Interdisciplinary Workflow Alignment Application

13. Quality Measures

14. Advance Directives on File National Average < 10%

15. Long Term Plan • Close gap on Medication Reconciliation • Single Source for all aspects of medication use, administration and compliance • Transitions of Care • Improve patient involvement in HRA • Planned transitions • Better integration with Specialists through HIE • Unplanned Transitions • Reduce admission rate from Ere • Reduce transition rate

16. Beyond the Gates • How can community health systems achieve care alignment and quality • Incentives • HIT adoption and Functionality • Patient Expectations • Training