Unleashing Big Data in Oncology: Making Real World Cancer Data Useful

June 18, 2015 Unleashing Big Data in Oncology: Making Real World Cancer Data Useful Bobby Green, MD MSCE Vice President, Clinical Strategy Senior Medical Director bobby@flatiron.com www.flatiron.com

Funding Disclosures Corporate Leadership Flatiron Health (VP and Sen. Med Dir) 2015 Flatiron Health, Inc. Proprietary and confidential. 2

2015 Fla*ron Health, Inc. Proprietary and confiden*al. 3

3% of cancer patients enrolled in clinical trials! 97% are not represented 2015 Fla*ron Health, Inc. Proprietary and confiden*al. 4

License # of Patients Treated Treated, no surveillance RCTs Observational Studies Time 2015 Fla*ron Health, Inc. Proprietary and confiden*al. 5

Solving This Problem Is Complex 2015 Flatiron Health, Inc. Proprietary and confidential. 6

2015 Fla*ron Health, Inc. Proprietary and confiden*al. 7

2015 Fla*ron Health, Inc. Proprietary and confiden*al. 8

The Major Challenges Fragmentation of real world data across providers Extracting and harmonizing data from different systems is complex Meaningful patient insights require solving problems of Structured data Unstructured data 2015 Flatiron Health, Inc. Proprietary and confidential. 9

Partnership with Providers 10

Flatiron Software Platforms for Providers OncoAnalytics TM OncoEMR EHR-agnostic analytics portal that allows administrators and physicians to explore and analyze practice data Cloud-based oncology-specific Electronic Health Record (EHR) developed for community clinics 2015 Flatiron Health, Inc. Proprietary and confidential. 11

Flatiron Network of Cancer Clinics 220 Cancer Clinics 1,700 Clinicians 750,000+ Active Cancer Patients Represents largest real-world oncology data source, with ~17% of incident cases Unprecedented 24% growth of oncologist footprint in the past ~11 months Diverse across geographies, EHRs, payers, GPOs, clinical pathways, etc. Will represent the only database with integrated clinical data at a patient level from academic hospitals in 2015 2015 Flatiron Health, Inc. Proprietary and confidential. 12

Strategic Partnership with Varian Medical Systems Scope of Partnership The Flatiron Varian partnership was announced earlier this week Partnership will position Flatiron to aggressively grow the Flatiron Provider Network of U.S. community oncology practices on OncoEMR and create a compelling EHR offering for the hospital market Expectation is that Flatiron will add 1,700 new clinicians to its network through this partnership by 2018 2015 Flatiron Health, Inc. Proprietary and confidential. 13

Flatiron Software Platforms for Providers OncoAnalytics TM OncoEMR EHR-agnostic analytics portal that allows administrators and physicians to explore and analyze practice data Cloud-based oncology-specific Electronic Health Record (EHR) developed for community clinics 2015 Flatiron Health, Inc. Proprietary and confidential. 14

OncoAnalytics 2015 Flatiron Health, Inc. Proprietary and confidential. 15

OncoAnalytics 2015 Flatiron Health, Inc. Proprietary and confidential. 16

OncoAnalytics 2015 Flatiron Health, Inc. Proprietary and confidential. 17

Integration: Structured Data Provider A EMR Provider B EMR PM Provider C HIE Unstructured data pipeline Structured data pipeline Flatiron data model 2015 Flatiron Health, Inc. Proprietary and confidential. 18

Integration: Unstructured Data Provider A EMR Provider B Unstructured data pipeline EMR PM Structured data pipeline Flatiron data model Provider C HIE 2015 Flatiron Health, Inc. Proprietary and confidential. 19

QA is Essential to the Process now the data are ready 2015 Flatiron Health, Inc. Proprietary and confidential. 20

2015 Flatiron Health, Inc. Proprietary and confidential. 21

Longitudinal View of a Single Patient 2015 Flatiron Health, Inc. Proprietary and confidential. 22

Quality Measurement 2015 Flatiron Health, Inc. Proprietary and confidential. 23

Strategic Partnership with NCCN Scope of Partnership Flatiron won a multi-step RFP process in 2014 to power the next generation version of the NCCN Outcomes Database The Flatiron-NCCN partnership was announced in early January 2015 Expectation is that between 15-20 NCCN institutions will choose to participate in the re-launched database over time We expect to see data from NCCN sites in our database beginning in Q3/ Q4 2015 2015 Flatiron Health, Inc. Proprietary and confidential. 24

Complete Data is Crucial Metric From structured data Flatiron data completeness (N=248 patients) Metastatic diagnosis 35% 100% Date of met diagnosis 35% 98% BRAF testing status (of those tested) Date of BRAF testing (of those tested) BRAF value (of those tested) 13% 100% 13% 100% 2% 100% 2015 Flatiron Health, Inc. Proprietary and confidential. 25

Identify The Right Patients To Study 2015 Flatiron Health, Inc. Proprietary and confidential. 26

Metastatic Melanoma Cohort Selection 2015 Flatiron Health, Inc. Proprietary and confidential. 27

Biomarker Data: BRAF 2015 Flatiron Health, Inc. Proprietary and confidential. 28

Timing of EGFR Testing in Non-Squamous Lung Ca 2015 Flatiron Health, Inc. Proprietary and confidential. 29

Derived Data: Line of Therapy pemetrexed albumin- paclitaxel carbopla*n bevacizumab pemetrexed carbo/pem carbo/alb- paclitax bevacizumab carbo/pem > pem carbo/pem/bev > bev/pem carbo/alb- paclit/bev à bev 30

Met Melanoma: BRAF Mut 1st Line Therapy 6. Improving clinical decisions 2015 Flatiron Health, Inc. Proprietary and confidential. 31

Decision Support within EHR 2015 Flatiron Health, Inc. Proprietary and confidential. 32

Partnering with Content Providers Agnostic integration of relevant clinical content into clincal workflow 2015 Flatiron Health, Inc. Proprietary and confidential. 33

Thank you/q&a 2015 Flatiron Health, Inc. Proprietary and confidential. 34