iconnect ENTERPRISE CLINICAL PLATFORM & MERGE HONEYCOMB : PRODUCT ROADMAPS



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iconnect ENTERPRISE CLINICAL PLATFORM & MERGE HONEYCOMB : PRODUCT ROADMAPS Jon T. Devries, VP Product Solutions, Merge Healthcare Atul Agarwal, SVP R&D, Health IT Solutions, Merge Healthcare Monday, August 27, 2012 2012 Merge Healthcare

This presentation may contains forward looking information including future deliverables which are not yet generally available and are not guaranteed. All dates and features presented are estimates and are subject to change without notice.

agenda 3 iconnect as a Platform for Enterprise Imaging iconnect Roadmaps: iconnect Enterprise Archive iconnect Share iconnect Access Merge Honeycomb Roadmap Voice of the Customer Q&A

iconnect TECHNOLOGY PLATFORM

today isolated departments and image silos 5 Radiology* Cardiology* Orthopedics Dermatology, etc Eye Care * Two largest sources of imaging in a health system.

the move to enterprise imaging strategies 6 1 Archive Images to Eliminate Silos and Centralize Storage Archive Images in Merge s Enterprise Archive Radiology* Cardiology* Orthopedics Eye Care Dermatology, etc * Two largest sources of imaging in a health system.

the move to enterprise imaging strategies 7 1 Archive Images to Eliminate Silos and Centralize Storage 2 Share Images with other hospitals, and imaging centers Share Archive Images in Merge s Enterprise Archive Share Radiology* Cardiology* Orthopedics Eye Care Dermatology, etc * Two largest sources of imaging in a health system.

the move to enterprise imaging strategies 8 1 Archive Images to Eliminate Silos and Centralize Storage 2 Share Images with other hospitals, and imaging centers 3 Access Images through EMR / EHR or Physician Portal Access Share Archive Images in Merge s Enterprise Archive Share Radiology* Cardiology* Orthopedics Eye Care Dermatology, etc * Two largest sources of imaging in a health system.

iconnect ENTERPRISE ARCHIVE ROADMAP iconnect Enterprise Archive was formerly known as iconnect VNA or Emageon s ECM platform

iconnect Enterprise Archive & iconnect Share roadmaps 10 9.0 V9.2 New Features HC Gateway (limited) HC LTA Billing VOC Feedback VMware cluster Non-DICOM Images IRWF WebAdmin UI VM Enterprise Cluster TODAY New Features Prefetcher Update Migration Tool Epic QRY Platform Enhancements Basic Multi-Tenancy Support VOC Feedback 10Gb Support V10 / Futures New Features PACS 7.x support Cardio 10.x support Object Level Storage Support Infrastructure Enhancement Webadmin Enhancement VOC Feedback Improved documentation Q1 2012 Q2 2012 Q3 2012 Q4 2012 Q1 2013 Q2 2012 New Features Honeycomb Launch EMPI Aware XDS & ATNA Support Dell DX Storage iconnect Share New Features Latin-1 Character Set New Features EMC Atmos DIY Morphers Deletion propagation Policy Based Deletion VOC Feedback WebAdmin Update V8.40 v8.80 V9.1: Oct 31, 2012

iconnect Enterprise Archive 9.0 August 10, 2012 11 Honeycomb Gateway Non-DICOM to DICOM Conversion Honeycomb LTA Billing Web-Admin UI Update VNA Enterprise Clustered servers in VMware

August 10, 2012 iconnect Enterprise Archive 9.0: Honeycomb Gateway 12 Merge Honeycomb Gateway The Honeycomb gateway is a device that is the edge server for Honeycomb and communicates with the cloud via SSL Features Proxy for DICOM services Proxy for HL7 services Share for local operations MWL reconciliation Deletion propagation and QC User management Communicate with the Cloud via SSL

9.0: register your VNA with Merge Honeycomb August 10, 2012 13 Your onsite VNA is your on-ramp to Honeycomb Easy solution for image sharing and storing Copy 2 offsite Configure your VNA as a Honeycomb Gateway

9.0: search onsite and Merge Honeycomb LTAs August 10, 2012 14 An Include LTA Searches check box has been added to the Archive Search screen When selected, the search function will include the Honeycomb LTA New Include LTA Search Feature

iconnect Enterprise Archive 9.1 October 31, 2013 15 Do-It-Yourself ( DIY ) Morphers Policy-Based Deletion Object Storage EMC Isilon Support EMC Atmos API Product Support: EMPI / IPID Support for Cardio PACS and Merge PACS Support for Eye Care PACS storing to VNA

iconnect Enterprise Archive 9.1: DIY morphers October 31, 2013 16 Catalog of morphers The catalog will increase as new morphers are added via Prof. Services or customer create there own and share them Examples IPID Assignment and morphing Study Description Mapping Rules Engine Build from more primitive rules Regular expression manipulation Cascading of rules, priority of the morphers Testing of Morphers Auditing Morphers First Step to DIY DICOM Migrations

October 31, 2013 iconnect Enterprise Archive 9.1: PBD enhancements 17 A number of enhancements were added to the Policy-Based Deletion (PBD) tool: Pt Age & Pt DOB search in WebAdmin Refined Pt Age calculation for use in rules Allow use of a tag with multiple values / re-use within a rule E.g. Modality = CT AND modality = KO Multiple conditions and multiple conditional operators in rules Vetoer editability Early delete option for Mammo CAD SR objects Short run simulations (e.g. 100 items) and scheduled off-line simulation runs Scheduled purge time (time of day and days of week) Study as well as series level test / simulation results Progress indication in WebAdmin Attend tomorrow s session DICOM Image Lifecycle The Journey from Theory to Practice to hear Ascension Health s story regarding policy-based deletion! Session 6: Interoperability

iconnect Enterprise Archive 9.2 1Q 2013 18 Enhanced Prefetcher to Support Teleradiology Workflows DIY Migration Tool Platform Enhancements New Clustering Infrastructure Direct SAN Support 10Gbit Support Clustered File System Basic Multi-tenancy Support

iconnect Enterprise Archive 10.0 2Q 2013 19 Merge Product Support: PACS v7.x Cardio 10.x Object Storage Platforms: Object Level vs. Study Level Support Multi-Tenant Support Merge Honeycomb Reconciliation Web Services Infrastructure RCM auto-failover Support Lossey JPEG 2K Support Reporting Server Improved Packaging / Implementation (aka FIC-on-a-Stic) Encryption Option

iconnect Enterprise Archive 10.0: the future June 2013 20 VNA Helm as in You take the Helm of your VNA Business Intelligence Ad hoc Reporting Notifications / Warnings CrossPlatform Analysis (i.e. RIS to PACS to VNA) IntegratedClinical Imaging Management System (CIMS) Hybrid Onsite / Offsite or Cloud Architectures WebAdmin Enhancements Deletion Management Enhanced Study Browsing Enhanced Help Prefetcher Enhancement Integrate Storage Move& Migration Tools into VNA

iconnect SHARE

iconnect Share 2.1 22 Support for Merge Honeycomb and collect images from anyone who has access to the internet Second Opinions Patient transfers Integrate viewing (iconnect Access) with importing (iconnect Share) to create a comprehensive image distribution and collaboration solution Provides single sign-on experience

iconnect Share 3.0 August 10, 2012 23 CD/ DVD/ USB import Manually edit DICOM header so that it conforms to the requirements of the local PACS and EMR (i.e. local MRN) Non-DICOM wrapping and conversion PDF documents non-dicom still images (JPG baseline lossy, JPEG lossless, BMP, PNG, TIFF) MPEG2 & 4 will be covered in a future release Manually edit the DICOM header In a future release this information will be used to search the DICOM MWL, VNA archive, affiliated archives and the EMPI for similar patients to gather the demographic information for the header

non-dicom header August 10, 2012 24 Associated with an Existing Patient Create a New Patient

25

iconnect Share 3.1 October 31, 2012 26 URL Launch Share from EMR / RIS / Portal in context, including Attach other ology images to Encounter / Visit / Note at the point of care Demographic Information Identification Number e.g. Encounter # + Date + Time Imported images can be viewed with Access or any DICOM viewer Group Management (i.e. each hospital in an IDN is a Group) Attend today s session The Future of Non-DICOM Images to hear Cincinnati Children s story! Session 3: Interoperability Selecting the destination from a picklist triggers a routing / morphing rule DMWL and/or Archive query lookup

iconnect Share 4.0 October 31, 2012 27 Proxied DICOM Query Proxied Access Query Patient Demographic Query (QRY) Web Service Interface MPEG 2 & 4 Support

iconnect ACCESS Zero-client Viewer

iconnect Access roadmap 29 V3.01 New Features Quick 1 on 1 compare VOC Feedback Auto global stack ipad Physician query ipad My Search V3.2 New Features Ortho Tools Joint, Plumb, and Continuous line tools PDF report with Key images VOC Feedback Linked scrolling or prior and current View non-diocm and PDF images TODAY Merge Live WIP Demo Speed Scrolling W / L Zoom Pan RSNA WIP Demo Speed Cine Editable annotations Highly responsive Q1 2012 Q2 2012 Q3 2012 Q4 2012 4.0 New Features HTML5 FDA approved for diagnosis on ipad SPEED SPEED SPEED Q1 2013 New Features New UI New ipad UI Ortho support VOC Feedback LDAP Report improvements New Features Briefcase w/ PACS Ortho tools Passing User Preferences between Applications VOC Feedback GUI Enhancement Open multiple pts Edge Enhancement Pixel Value tool GSPS Support for Radsuite Maintenance Release Multiple Authentication (Ortho) Storage Time (Allina) Access in HTML5 Ready for Beta Testing All of current features Improved performance WIP 3 : Pre-Release V3.0 V3.1 V3. 2. 1

iconnect Access 3.0 February 8, 2012 30 Revamped User Interface New study list Search, sort, scroll,group New viewer controls and layout Better use of screen real-estate Dual / triple study layout capability study splitting like PACS / Halo Fly out Patient History New toolbars and icons to better match PACS and Ortho New ipad UI Closer to desktop version more tools and up to 4 up display ipad Specific gesture support Improved play (stack scroll) performance Active Directory / LDAP Support SSO Process and User Provisioning Interfaces

iconnect Access 3.1 May 31, 2012 31 Orthopedic Workflow Enhancements Inherit Access User Preferences when launching from the RTWL vs. a generic set of user preferences Launch multiple simultaneous patients in Access from the RTWL to support a high volume clinic workflow Briefcase Express in Access (view only) Viewer Improvements Free Draw tool Calibration feature in iconnect Access Pixel and Edge Enhancement Tool as well as GSPS support for RadSuite Search results are cached on the ipad to allow a physician to return to a prior search

iconnect Access 3.1 May 31, 2012 32 Viewer Enhancements Default Modality Toolbars Hide Toolbars Enhanced ipad Search Add Physician to query field on ipad This is the first phase of the work in iconnect Access to support the orthopedic market and transition existing OfficePACS customers to Merge OrthoPACS

iconnect Access 3.2: viewer functions August 12, 2012 33 Linked Scrolling of Current and Prior Exams Plumb Lines, Vertical and Horizontal Plumb Lines (Vertical and Horizontal) Joint Line Continuous Line (Option) New Behavior: Click Drag Release Old Behavior: Click Click

iconnect Access v3.2: viewer enhancements August 12, 2012 34 View non-dicom Image and PDFs Non-DICOM images are saved as secondary capture OT PDFs are saved as Encapsulated PDF Print Preview and PDF Report with Key Images Improved formatting and insertion of header / logo for the practice Based on Vericis report format Reports can be printed or downloaded (as PDF) to local client or local drive Local download is important for import into referring physician's local EMR NOTE: This is a critical feature in attracting referring physicians because most physician EMRs will NOT have an HL7 connection to the iconnect Access host site due to implementation costs and need for VPN.

1Q 2013 iconnect Access 4.0 Mission Speed,Speed, Speed Leverages HTML5 to move some functionality to the client to improve performance Release is scheduled for March 2013 3 WIPs Merge Live: Scrolling, W/L, Zoom, Pan RSNA: Majority of Tools, improve consistency of behaviors Pre-Release: Near complete and ready for beta customer evaluation FDA approval to use iconnect Access on ipad for diagnoses 35

MERGE HONEYCOMB ROADMAP

Merge Honeycomb roadmap 37 V1.2 New Features HC Gateway Non-DICOM VOC Feedback Group Support Advanced reporting & Auditing Improved Gateway Performance Integrations Portal Customization Mobile Apps SDK TODAY V 3.0 New Features Performance EHR integrations Process Notifications Q1 2012 Q2 2012 Q3 2012 Q4 2012 Q1 2013 New Features Go Live Image Sharing Upload/Download/ View/ Share End User VOC Feedback Limited Launch System hardening V1.0 New Features Group Support Performance & UI SDK Reporting & Auditing Gateway enhancement V2.0

Merge Honeycomb 1.0 June 2012 38 Applications Leverage iconnect solutions to run Honeycomb services Upload iconnect Share View iconnect Access Archive iconnect VNA Share Honeycomb user interface to call on the iconnect services Hosting 3 rd party to host and manage in multiple geographically separate data centers Implement redundant cloud based solutions Contract for management services Support Services Online self-service and support portal for knowledge base and user questions 3 rd party monitoring and security services

Merge Honeycomb 1.0 June 2012 39 Image Sharing Users upload and share DICOM studies with existing contacts Archive Accounts contract for long term storage and disaster recovery services

Merge Honeycomb 1.2 July 2012 40 Honeycomb Gateway The Merge edge device for SSL communication to Honeycomb (No VPN) Proxy for DICOM services Proxy for HL7 services MWL Reconciliation Deletion propagation and QC Option for CD import functionality Non-DICOM Honeycomb Gateway or Honeycomb for accepting non-dicom information Options to associate DICOM header with other DICOM files Gateway options to associate via MWLQ Supported Images: TIFF, BMP, PNG, JPEG, PDF Billing and Reporting tools Ability to report on ingested studies Ability to produce internal reports for billing reconciliation

Merge Honeycomb 2.0 October 2012 41 Group Support Users have the ability to create groups and sub-groups with permissions Allow for group and sub-group based notifications Performance and User Interface Speed of processes and functions UI improvements and synchronization with the addition of group functionality Software Development Kit (SDK) for edge devices Merge PACS, Merge OrthoPACS, efilm, PACS Gear, Sorna, etc. Reporting and Auditing additions Better tracking of study ingestion and archive size Ability to download Activity lists for customized audit processing Gateway enhancements Ease of deployment, support, maintenance, upgrades and cost to produce

Merge Honeycomb 3.0 Q1, 2013 42 Performance and User Interface Speed of processes and functions Enhanced group and user functionality based on customer feedback EHR integrations Ability to link viewing from Honeycomb to Electronic Health Records or third party systems Process notifications Communications from Honeycomb and Gateway on executed processes Integration between systems for active communication of status

Merge Honeycomb futures 43 Enhanced monitoring User level dashboards Real-time usage Local database back-up Onsite database back-up Patient workflows Ability to notify and store for patients Lock studies Lock individual studies from 90 day delete Credit card processing Portal customizations Java improvements To upload tool Mobile application

WHAT DO YOU NEED?

USER INTERFACE 1

iconnect Access: patient search iconnect Access: patient search

iconnect Access: patient search, advanced

USER INTERFACE 2

iconnect Access: study list iconnect Access: study list

iconnect Access: view study

iconnect Access: full screen view iconnect Access: full screen

iconnect Share: create group iconnect Share: create group

iconnect Share: worklist iconnect Share: worklist

iconnect Enterprise Archive: configure devices

iconnect Enterprise Archive: Reports

56 What do you think?

QUESTIONS? Jon T. Devries, VP Product Solutions, Merge Healthcare jon.devries@merge.com Atul Agarwal, SVP R&D, Health IT Solutions, Merge Healthcare atul.agarwal@merge.com