724 Access Overview Designed around two outage scenarios

724 Access Overview Designed around two outage scenarios – Level 1 outage – Data. Center • Application not available but network is available – Level 2 outage – Network • Other components not available (network, san, Citrix farm) Both scenerios can be utilized for planned and unplanned outages Data access to clinician can be made available within minutes Switching clinicians to the downtime solution requires manual intervention

724 Access Standard Configuration Production Level 1 outage – network up Level 2 outage – network down

Level 1 Outage Solution works through a combination of technologies – Replicated Millennium Database – Replicated Cerner Millennium application – Citrix servers pointing to 724 Access domain Clinicians are directed to a second Millennium domain – Access to 724 Access domain is in read only mode – Direct clinicians to Citrix servers pointing to 724 Access domain Complete Millennium application suite available – Same application look and feel as production – Identical user login credentials as production

Level 1: Steps to get clinicians access to solution Production outage is declared – Planned: 5 -10 minute failover – Unplanned: 30 -35 minute failover Enable switchover – Backend server update – Citrix server update Populate application logon message Clinicians can immediately login Outage to clinicians minimal

Level 1: Benefits Millennium Solutions available in read-only mode – Available to all users Complete copy of Millennium database – Full historical data on patients Used for planned and unplanned downtime – Available within 5 -10 minutes for planned downtimes – Available within 30 -35 minutes for unplanned downtimes Easy Access – Same login as production

Level 2 Outage – Downtime Viewer Clinicians use DTViewer to view data stored local to the workstation – – No Access to Millennium domain Subset of Millennium data is stored locally Printing available on local printers Access limited to specific workstations 3 rd party software requirements – Golden. Gate to replicate data to local workstation near real time – < 2 minute data lag

Downtime Viewer Overview Read Only access to data Near real-time data transfer Up to 30 days of historical data Similar look and feel – Downtime Viewer looks more like Enhanced View Power. Chart Better scalable architecture Near zero performance impact against production DB – 1%-2% cpu utilization Continued rollout of new functionality – – Outpatient/clinic support – released Q 3 2010 2 Pharmacy Views – Released Q 4 2011 Lab View – Released Q 4 2011 First. Net Downtime Tracking – scheduled release Q 2 2012

Level 2: Benefits Provides access to Millennium data for network related downtimes Device stores data locally Easy access to the solution Provides critical data (<2 mimutes) – MAR, Orders, Labs, etc Used for planned and unplanned activities

724 Access options vs PCLA DOWNTIME VIEWER COMPARISON Functionality 30 Days of data Data Lag Time Patient Demographics Allergies Problems Diagnosis Original I & O I&O 2 G Mediation Orders Clinical Notes Power. Notes Documents with Embedded Images Lab Results Microbiology Results Vital Signs Scheduled Appointments Pharmacy Fill List Unverified Medications Lab Collections Outpatient Appointment Search Medication Profile Immunization History LDAP Sign on Authentication Uploads Printing Print Chart Print Patient List User Friendly Views Emergency Department 724 Access 30 days Real Time < 2 minute Yes Yes yes - 24 hour totals Yest - Shift Totals (July 2011) Yes Yes Yes - Full Micro Viewer Support Yes Yes Yes - during network availability (July 2011) Yes Yes Yes - Enhanced Capabilities (Dec 2011) 724 Access Lite 7 days Real Time < 2 minutes Yes Yes yes - 24 hour totals Yest - Shift Totals (July 2011) Yes Yes No No Yes Yes PCLA Generally only 48 hours due to system drain 1 -2 hours Yes Yes yes - 24 hour totals Yes Yes No Yes only reports yes No No Yes Yes No No Could be treated as Nurses Unit Most client not using PCLA in ED