The document discusses NextGen Healthcare, a provider of electronic medical records and practice management systems. It provides an overview of NextGen's solutions including their Enterprise Architecture, Community Health Solution (CHS), NextMD patient portal, and Regional Affiliate Marketing Program (RAMP). RAMP allows hospitals to affiliate with independent practices and provide EMR/CHS solutions to enable a community-wide health information exchange.

1. The Connected Healthcare Community:
A New Model for Healthcare in the U.S.

2. NextGen Financial Stability and Scale True Enterprise Architecture (web access to EHR) Single Database Integration Deep Multi-Specialty Support Community Health Solution (CHS) Patient Communication (NextMD) Powerful P4P and disease management reporting capabilities Market Deployment Assistance (RAMP)
Why NextGen for Health Systems:

3. Presentation Content
•NextGen Corporate Overview
•Health System EHR & Stark Strategies
•NextGen Health System Solutions
•Community Health Solution (CHS)
•NextMD
•RAMP

4. A wholly owned subsidiary of Quality Systems, Inc. Manufactures electronic medical records and practice management systems for the ambulatory market space Founded in 1994 as Clinitec International Headquarters in Horsham, PA and Atlanta, GA 600+ Employees 2,000 practices, 30,000 Providers
About NextGen Healthcare

5. NextGen EMR
EPM
ICS
CHS
NextMD
The NextGen Product Suite

6. FY 2007 revenues $157 Million No Debt Publicly traded (NASDAQ: QSII) Cash reserves now over $70 M #4, Forbes Best 200 Small Companies Market cap of $880M
Financial Facts

7. Gartner Magic Quadrant
NextGen in “Leaders” quadrant

8. Innovation Award: Disease Surveillance, MS-HUG Award Partner: Joslin Clinic
Innovation Finalist: Ambulatory EHR, MS-HUG Award Partner: Crystal Run Healthcare
#1 Functionality Rating, AC Group Top ranking in multi-specialty, community health records, FQHC, large, mid-size, and small practices categories
Innovation Finalist: Ambulatory EHR, MS-HUG Award Partner: Crystal Run Healthcare
2007 Awards

9. Innovation Award: Disease Surveillance, MS-HUG Award Partner: Medical College of Wisconsin
2008 Awards

10. Health System EHR and Stark Strategies

11. Improved quality of care and patient safety via information sharing
Enhanced Referral Management Networks
Improved patient and community relations
Clinically integrated virtual staff models
Health System Integration – Driving Forces

12. Offerings must be focused on sharing of patient clinical information Must be able to demonstrate interoperability (w/hospital and other medical systems) Physician participation cannot be determined by volume or value of referrals Recipients must contribute 15% of cost Must have eRx capabilities Subject to written agreement
Safe Harbor to Stark Regulations

13. Integrated Medical Staff Models
owned
independent medical staff
referring community
MSO
PHO or IPA

14. Virtual Clinical Integration
owned
independent medical staff
referring community
MSO
PHO or IPA
Data display
Data retrieval
Workflow
Decision Support
Predictive Models

15. Clinical Integration Strategies
Web-based
EHR/Interoperability
Data Access
Web Portal
Auto-route and print to office
$30-50
Data Retrieval View results Messaging & Alerts Download or Synch Data $50-70
Work Flow
Intelligent Messaging
ePrescribing
Lab Order Entry
$60-100
Decision Support Community Hub EHR Interfaces Charge capture Health Maint. Referral Management $400-500
Integrated EHR Seamless EHR Longitudinal History Disease Management Advanced Analytics $600-1000

16. EHR Endorsement/Negotiated Pricing Hospital/EHR/EPM integration services Health System Sponsored ‘Health Information Exchange’ Managed Service Offering EHR/EPM (financing/ASP) Subsidized EHR funding up to 85%
EHR Distribution Strategies

17. EMR licenses and maintenance HW & Network Infrastructure Interoperability standards enforcement (EMPI, Lab coding, etc…) Data exchange agreements Interface/Integration & PMS support Physician office physical environment Deployment/Training responsibility On-going Help-Desk support
EHR Strategy Considerations

18. • Patient-centric design
• Disparate IT systems unified
through a shared
architecture
• Collaborative Care Model
• All providers have access to
complete, up-to-date
information
Physicians
& Staff
Hospitals
Diagnostic
Labs
Patients
Managed
Care
Community Health Information Exchange
Pharmacies

19. COST CATEGORIES
Pass Thru Model
Financed Model
Subsidy Model
Year 1
Year 2
Year 3
Year 1
Year 2
Year 3
Year 1
Year 2
Year 3
Physician One Time Costs
$ 38,000
$ -
$ -
$ 8,000
$ -
$ -
$ 8,000
$ -
$ -
Physician Monthly Costs
ASP Hosting
$ 350
$ 350
$ 350
$ 350
$ 350
$ 350
$ 100
$ 100
$ 100
Software
$ 250
$ 250
$ 250
$ 250
$ 250
$ 250
$ 85
$ 85
$ 85
Front-end Cost Recap
$ -
$ -
$ -
$ 470
$ 470
$ 470
$ 70
$ 70
$ 70
Clearinghouse Fees
$ 100
$ 100
$ 100
$ 100
$ 100
$ 100
$ 100
$ 100
$ 100
Sub w/o Connectivity
$ 700
$ 700
$ 700
$ 1,170
$ 1,170
$ 1,170
$ 355
$ 355
$ 355
Connectivity
$ 550
$ 550
$ 550
$ 550
$ 550
$ 550
$ 110
$ 110
$ 110
Per Physician Monthly Cost
$ 1,250
$ 1,250
$ 1,250
$ 1,720
$ 1,720
$ 1,720
$ 465
$ 465
$ 465
Total Cost Per Year
Hosptial Up Front Cost
$ -
$ -
$ -
$ 29,000
$ -
$ -
$ 29,000
$ -
$ -
Hospital Subsidy
$ -
$ -
$ -
$ -
$ -
$ -
$ 12,043
$ 12,043
$ 12,043
Physician Subsidy Models

20. NextGen Health System Solutions

21. True Enterprise Architecture (web access to EHR) Single Database Integration Multi-Specialty Support Community Health Solution (CHS) Patient Communication (NextMD) Powerful P4P and disease management reporting capabilities Market Deployment Assistance (RAMP)
Why NextGen for Health Systems:

22. Single NextGen Database
Fully Integrated Solutions

23. Enterprise Architecture

24. Single Database Multiple Entities Associations Enterprise Location Roles Users Sharing information Demographics, Meds, Allergies, Diagnosis, Procedures Maintaining Privacy
Enterprise Architecture

25. Cardiology
Ophthalmology
Orthopedics
OB/GYN
Primary Care/Family Practice
Community Health Centers
Rheumatology
Pediatrics
Otolaryngology
Dermatology
Urology
Multi-Specialty Clinics
Specialty Content

26. The goals of CCHIT product certification are to:
• Reduce the risk of HIT investment
• Ensure interoperability (compatibility) of HIT products “Software will be deemed to be interoperable if a certifying body recognized by the Secretary (CCHIT) has certified the software within no more than twelve (12) months prior to the date it is provided to the recipient.“
CCHIT is the recognized certification authority for EHRs

27. Community Health Solution

28. •Holy Grail of EHRs
–continuous flow of structured data
–full data integration
•Shared Medical Record for an Entire Community
Community Health Solution

29. Longitudinal access to clinical data Security Infrastructure and Model Master Person Resolution Data Integration Codification Libraries Workflow Engine Reporting Infrastructure Web Application Delivery
CHS Interoperability Platform

30. Web Users
Seamless Integration to Repository Data
Inter/Cross Enterprise Referrals
Automated Data Notifications
Automated Upload of Core Data
Filter Capability on Data Imports
HL7 Data (Documents and Demographics)
HL7 Feeds
NextGen EMR Users – Enterprise DB 1
Hospitals
NextGen EMR Users – Enterprise DB 2
Demographics and Documents
Routed via CHS to
Multiple NextGen EMR’s
Pass Through Lab Orders from Multiple EMR Enterprises
Results Only Interface to distribute Lab Data
Standard User Emergency Room/Provider View Access to Patient Centric Chart for Medications Allergies Diagnosis Documents Referral View Labs Images
Full Web User Data Entry Capability for Add/Modify/Delete Patient Problems (ICD9,DSM4) Immunizations Allergies Lab Result Receipt and Signoff Referral Entry / Management
CCR/CCD Payload
3rd Party EMR’s
XDS Query, Retrieval Mechanisms
XDS Submission Mechanism
CHS Release 7

31. Health System Configuration

32. CHS Release 7

33. NextGen CHS markets
Live site
Implementation
Planning
Ann Arbor, MI
Doylestown, PA

34. Shares data & messaging between multiple NextGen and 3rd Party EMR users Community-wide Portal Applications: Patient Demographic Search & Clinical History Prescription Management Referral Tracking Lab/Radiology Ordering & Results Analytics Reporting & Dashboard
CHS Functionality

35. Benefit
Why?
Closer affiliation with hospital
Physicians know who is brokering the exchange
Quality
Reduced Errors
More complete record
Break the glass
The record is more easily shared and more complete doctors have the info they need for a more informed, higher-quality visit
Increased utilization
Admissions, Ancillary Services
Technology makes it faster and easier to refer to the hospital so utilization goes up
Reduced Costs
A more complete chart eliminates unnecessary re-orders of tests
Patient Satisfaction
Shared patient data eliminates re-work by the patient
Reduced IT Expense
IT can eliminate the need for multiple interfaces
Lock-in
Once involved, walking away from referrals, results & patients is hard
Physician Relations Value Proposition
CHS gives their Relations staff a new reason to visit

36. Pharmacy/eRx Labs Radiology
•Payors Clearinghouse
•PBM / RxHub
Kittitas Valley Hospital
• Emergency Room
• Remote Consultants
• Practices with no EMR
NextGen EPM/EMR
• Valley Clinic
• Ellensburg Fam. Pr
• Hospital Practices
McKesson Paragon
NextGen CHS NextGen Enterprise
•SureScripts
•Fletcher Flora
•PAML
NextGen RTS
• ViaTrak
• RxHub
NextMD patient portal
Kittitas Valley, Washington Tomorrow’s CCHIT Architecture Today
Orion Rhapsody

37. NextMD

39. Features: Patient Messaging Prescription Renewals Appointment Scheduling Attachments and Interactive Medical Forms Patient Education Patient Statements Seamless Integration to EHR/EPM

41. CHS Referral Network
Payers
Primary Care
Hospital, Specialists

42. Regional Affiliate Marketing Program

43. • Co-marketing plan customized for hospitals to affiliates
 Branding, seminars, PR, messaging, etc.
• Offers EMR/EPM/CHS to non-owned practices
 Special pricing and packages
• Creates a community data exchange infrastructure
 Complete patient records and workflow automation
• Excellent Stark opportunity
Regional Affiliate Marketing Program

44. • Improved ambulatory physician affinity
• Rapid and efficient deployment of EMRs
• Outsourced management of connectivity, interfaces
• Access to ambulatory patient data for:
 Emergent care or care continuity
 Patient safety, medication reconciliation
 Clinical trials, outcomes reporting, P4P, etc…
 Administration savings
Benefits
Regional Affiliate Marketing Program

45. Why It Works
• Connectivity through NextGen CHS
• Leading ambulatory EMR, with:
 Clinical content for 26 specialties
 Discrete data captured for exchange and mining
 Data exchange industry standards incorporated
 2007 CCHIT certification, critical for Stark
• Full “community” suite of integrated products
• Hospital endorsement and contacts
Regional Affiliate Marketing Program

46. What It Entails
• Product brochure and pricing guide
• Large or small-scale symposia
• PR, telemarketing, direct mail, e-mail, ads
• Custom website
• Educational resources and tools
Regional Affiliate Marketing Program

47. How It Works
• Leverages NextGen marketing resources and experience
• Materials, messages already developed
• Replicates successful programs
Regional Affiliate Marketing Program

48. NextGen Financial Stability and Scale True Enterprise Architecture (web access to EHR) Single Database Integration Deep Multi-Specialty Support Community Health Solution (CHS) Patient Communication (NextMD) Powerful P4P and disease management reporting capabilities Market Deployment Assistance (RAMP)
Why NextGen for Health Systems:

49. Additional Slides

50. Regional Affiliate Marketing Program (Before)

51. Regional Affiliate Marketing Program (After)

52. Standards Within NextGen
Messaging
Exchange Protocols
Technology/Coding Systems
HL7
https
CPT
ANSI ASC X12
IHE XDM
First Databank
CCR
IHE XDS
ICD-9
CCD
MLLP
LOINC
CCOW
SOAP 1.1
SNOMED CT
CDA
UDP
ELINCS
Web services
MAPI
NCPDP Script 8.1
TWAIN
XML

53. Vendor CCHIT Compliance
85+ EMR vendors
18 EMR vendors (as of 2/20/08)
2008
?
NextGen Healthcare is committed to annual CCHIT certification status

54. •Adventist Health System
•Banner Health Systems
•Bozeman Deaconess Health
•Catholic Healthcare West
•CentraState Medical Center
•Centegra Primary Care/Horizon
•Centura Health
•Children's Hospital of Orange County
•Doylestown Hospital
•Elmhurst Memorial Healthcare
•Hackley Primary Care
•Hoag Practice Management, Inc.
•HMA - Health Management Assoc.
•Hunterdon Healthcare System
•Kittitas Valley Community Hospital
•Mercy Health Partners, Toledo, OH
•Mercy Health Partners, Lorain, OH
•Meridian Health System
•Mount Carmel Health
•Munson Healthcare
•Piedmont Medical Foundation
•Santa Clara Valley Health
•St. Croix Regional Medical (USVI)
•St. Francis Health System
•St. Michael’s Hospital
•Scottsdale Healthcare
•Stormont-Vail Healthcare
•United Health Services
•W.A. Foote Health System
Health Systems/Clinics (partial list)

55. 8/30/2014
55
•Referrals – % completed, in network, on time with right data (one group saw average referral turnaround go from 2 weeks to 24 hours)
•Data availability at time of encounter (notifications with every encounter – reduction of chart prep FTEs, encounter time focused on care not data gathering)
•Cost reduction – chart prep, reentry, duplicate test reduction (one practice had a policy of repeating all tests)
•Length of patient stay in hospital (Cardiology group projecting many one day early discharges as a result of HIE)
• Emergency room utilization – patient safety (St Joseph’s / Trinity, getting close to critical mass – current estimate that over 50% of patients coming to ER have records in A3HIE)
•Medication reconciliation (when data first consolidated one child came in with 25 medications)
•Membership expansion (double the number of lives from one year ago, 5th “founding” member under consideration)
Ann Arbor CHS Profile

56. Speaker
•25+ Years in Revenue Cycle Management & Billing Service Administration
•BA, Brigham Young University
•Author, 2 books, hundreds of articles including articles for the MGMA Connexion and Advance For Health Information Executives
•Educator for many organizations including various MGMA chapters and Metro managers groups.
•Certifications from IBM, 3Com, Miller-Heiman, Franklin Covey and JES.
•Longstanding active participant with MGMA & HFMA
James M Muir VP Sales NextGen Healthcare – Southwest Region NextGen Healthcare Speaker, Author, Educator www.linkedin.com/in/puremuir/ jmuir@RCMguy.com