Advanced Healthcare Standards Medcom Information Systems Inc Reengineering

Advanced Healthcare Standards Medcom Information Systems, Inc. Re-engineering the Business of Healthcare Collecting and Processing Information to Maximize the Quality of Patient Health! John Holub, President Ed Golden, VP Business Development

How we came to Springfield n Illinois Lt. Governor Guinn’s interest in the presentations we made to the Ft. Wayne Killer App Conference sponsored by Mayor Graham Richard, a strong supporter of new technologies in healthcare and broadband. Mayor Richard launched a Wired and Inspired campaign for the City of Ft. Wayne

Medcom’s Interest in Ft. Wayne and why we are in Springfield n n n Pursue interests shared by Mayor Graham Richard and Lt. Governor Pat Quinn to use new technologies for healthcare Find a communities each representing a group of patients with a complete medical record to become a demonstration sites Apply quality measures and real time decision support with the aid of a complete intelligent healthcare system - CIMR©

Medcom’s Interest in Ball State n n n Pursue the concept of using multimedia to increase patient involvement and compliance Develop a measurable study model that can demonstrate results and be reliably duplicated Apply quality measures and real time decision support with the use of an interactive knowledge based healthcare system - CIMR©

Healthcare has Broadband Applications but Unknowingly is Expecting a Miracle

Total Commitment and Standards Provides for the Complete Medical Record However, …

Until Standards Arrive Total Commitment Within a Community Drives the Complete Medical Record Note: Compatible technologies operating within the community provide the ability to move forward while waiting for national standards to be universally adopted.

Standards, and more Standards n The healthcare industry is confused and wandering aimlessly through the forest of healthcare issues in search of high quality cost effective healthcare by creating more standards than we can possibly comply with.

Solutions, and more Solutions Not Really!! n We are also creating more rules and guidelines than we can comply with. n And, we are computerizing everything thinking it will solve our problems n But, in so doing, we have not yet plotted a course to cost effective high quality healthcare for everyone

Insanity - doing the same thing over and expecting a different result. Albert Einstein

Healthcare “Groundhog Day” n We are all wrapped up in what amounts to a healthcare groundhog day scenario n The problems are overwhelming but the solution is simple to define for a truly dedicated community of participants.

Create the healthcare tool A Complete Intelligent Medical Record CIMR The quality healthcare platform for Everyone Supported by reliable Broadband connectivity

The real Standard to be pursued n Patients positioned at the center of the healthcare system by: n n Providing the patient with the tools to actively participate with the caregivers. Establishing an environment for patient education that is guided with the physician acting as an advocate for the patient’s well being. Resulting in High Quality Healthcare and Well Informed Patients

Medcom Beliefs Quality healthcare can cost less n Informed patients are more compliant n n A complete intelligent medical record - CIMR© is the foundation for cost effective high quality care

The Ingredients for Success Ready, Willing and Able Participants Institution Pa tie nt The Patient’s Complete Medical Record r e v gi e r Ca

Selecting the Correct Community A Substitute for Standards Selection criteria requires a search for the weakest links Ready Required Infrastructure Equipment and Connectivity Willing Able Commitment To Total Participation Comprehension Continued Training GO/ No Go Caregiver GO/ No Go Patients GO/ No Go Institution (Facility) * With strong support from the community, caregivers and institutions can help to overcome many patient weaknesses.

Medcom Technology Knowledge based analytical engine

Capabilities Afforded the Committed Community Desired quality measures (not minimums) n Increased productivity (with some initial pain) n Complete patient record (patient management) n Analysis of patient data (outcomes) n Patient health record – PHR (the correct way) n Patient oversight (to manage you need to measure) n Tele-health Platform (informed collaboration) n

Thank You for listening to the Medcom story Questions?

The Welford Medical Engine Natural language based n Integration oriented n Individually user defined (have it your way) n Secure architecture n Scaleable (follows user skills) n Context sensitive help (1000+ manual, ask) n Rules & algorithms (for compliance analysis) n

Patient: BOOP, BETTY Age: 56 Date: April 5, 2007 User: Dr. Jerry Brown ALLERGIES: sulfa causes Unspecified. MEDICATIONS: aspirin; Vasotec 5 g bid; Zoloft 150 mg i gd; Coumadin 1 mg po bid; amoxicillin 200 mg po bid; ketoconazole 200 mg PO q day dispense one; codeine 30 mg po prn; Elavil 25 mg po QHS; Valium; indomethacin 50 mg po tid with food; Kaopectate 30 ml po qid prn diarrhea; naproxen 250 mg po bid with food; Effexor XR 75 mg, i po daily; Synthroid 0. 125 mg po daily; Prevacid 15 mg, po qhs; Feosol; Nystatin; Zocor 20 mg qd; HEPARIN; Percocet 1 po every six; Claritin; Prednisone 40 mg po qam with; Kaopectate 30 ml po qid prn diarrhea; Magnesium; Phenobarbital; Glucotrol 10 mg po daily; Advair. HPI: ° Home glucose readings: ° Hypoglycemic symptoms: °no Infections: ° Eyes: °no visual disturbances Feet: °mild Last eye exam: ° Dietary compliance: °Very Good Medication side effects: °Pain Home BP readings: ° Chest pain: °absent Dyspnea: °short of breath with chest pain Edema: °stable Palpitations: °absent Dizziness: °occasional Headache: °steady

A perfection of means, and confusion of aims, seems to be our main problem. Albert Einstein Therefore, …

*Existing Resources are not Capable of Producing the Desired Results Typically Observed Ready Willing Able Result/ Structure Desire Comprehension Weakest Link Patients Low to Medium Low Caregiver Low High Low (content only) Institution Medium Low to Medium Low Low Low (Facility) Result/ Weakest Link *Without standards and high commitments from institutions, caregivers and patients, a complete medical record will be very hard to maintain and not very useful.

The Confusing Search for Standards By specialty group n Government agencies n Insurance groups n Standards groups n Local/Regional n

Overview of Medcom’s Unique “Killer App” Approach

MARY B. CHIEF COMPLAINT: Nausea and vomiting. HISTORY OF PRESENT ILLNESS: Pt. is a 20 y/o white female who is c/o nausea and vomiting since 3/20/07. She states her last menstrual period was 3/28/07. She describes it as somewhat irregular and that it started a couple of days late and she described it as a different period. She was very nonspecific at to whether she felt that it was more bleeding or less bleeding, just different. She does take Ortho Tri-Cyclen and states that she had missed a few pills last month and is concerned about pregnancy at this time. Denies any other complaints. She did gain five pounds in the last month. She also states that she had a recent exposure to someone with mono. PAST MEDICAL HISTORY: ALLERGIES: NKDA. MEDICATIONS: 1. Ortho Tri-Cyclen. FAMILY HISTORY: Positive for depression, arthritis, stroke and ischemic heart disease, epilepsy, seizures and diabetes. SOCIAL HISTORY: She is married. Denies alcohol or tobacco use. Occasionally exercises. REVIEW OF SYSTEMS: Denies any complaints except as outlined above. PHYSICAL EXAM: Temp 97. 2, BP 120/74, pulse 76, resp 16, height 5' 2 1/2", weight 140 1/2. Pleasant female. HEENT - EOMI. Mucous membranes moist. Posterior pharynx clear. Neck supple. Cardiac - RRR, no rubs, gallops or murmurs. Pulmonary CTA bilat. GI - positive bowel sounds, soft, nontender. Extremities - no C, C, or E. Neuro - alert and oriented x 3. ASSESSMENT: 1. NAUSEA AND VOMITING. 2. FATIGUE. PLAN: 1. Pt. had a negative pregnancy test in the office. Check CBC, chem 7, mono spot. She was given an Rx for Compazine Spansules, 15 mg, 1 po q 12 h prn nausea and vomiting, #15 with one refill. She was also started on Prenatal Vitamins with 1 mg of folic acid as she states she would like to begin getting pregnant in the near future. Return in 7 days if no improvement. Otherwise, will see her back when she decides she is ready to get pregnant. Call with any other problems.