Disclosure Statement

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1 Disclosure Statement The electronic health records (EHR) technology offered through IntegraCloud seeks to provide a broad array of clinical and record keeping functions to a variety of users operating in a dynamic and changing health care industry. The nature of the specific data and information that must be collected to achieve those clinical and record keeping functions may change over time and vary by clinical practice or specialty (i.e. Oncology). Therefore, functionality of the certified health IT, including among other things the manner in which data is collected, software coding and processes, interoperability of platforms, and user interfaces, may require updating to address the changing nature of data and information necessarily collected from users. Given the challenges of timely incorporating dynamic market changes into the production environment of the certified health IT, it is possible that updates or changes necessary for some certified functionality may not be effectively implemented in the time or manner necessary for certain users to enjoy the benefit of otherwise expected capabilities. As a result, users may experience reduced functionality related to changes in clinical environment not reflected in the health IT production environment, despite the fact that the health IT received certification by an ONC-ACB. The absence of functionality due to deficiencies in updates in the production environment may adversely affect some users ability to enjoy benefits reasonably expected when using a certified health IT. The current production environment of the EHR offered through IntegraCloud may offer health IT in a version that does not allow users to enjoy reasonably anticipated functionality because the production environment has not been regularly updated to incorporate developments in the health care industry or the clinical environment of certain users or practice specialties. Additional costs and of the Integra Connect EHR are detailed in the following table.

2 EMR DIRECT - Direct Messaging (e)(1) (e)(2) (b)(1) (b)(2) (h)(1) (h)(2) Description of to send and receive Direct-based messages to/from other users of certified health IT systems. Direct messages may include clinical data, notes, and other information. Our Direct offerings support related Meaningful Use and ONC requirements for sending and receiving transitions of care summary documents. We also support a range of other messaging options. Our Direct capabilities include bundled Health Internet Service Provider (HISP) services for facilitating message exchange. However, see and additional types of costs that may apply for these and other third-party HISPs. Monthly fee per provider + onetime setup fee or use of -OR- in the the course of using of a technical or practical or use of -OR- prevent the course of using CHANGE HEALTHCARE SERVICES - Electronic Claim Submission, Patient Payer Eligibility, Receive Clearinghouse Reports, Receive Claim Submission Reports, ERA Services, Claim Status Updates users to the ability to submit primary and secondary claims electronically to most payers who accept electonic claim submission. This functionality also provides users the abilility to receive electronic clearinghouse and payer responses which includes Clearing House reports - denials, electronic claim submission batch reports, Electronic Remittance Advices, Realtime payer verifications, Electonic Claim status reports to update the status of each claim until payment has been received. Monthly fee

3 FAXAGE RELATIENT ELECTRONIC PATIENT STATEMENTS Description of to send and receive secured faxes to/from others via Faxage local and toll free fax. to send automated patient appointment reminders via phone, , text. This functionality also allows patients to confirm, cancel, and/or submit request to reschedule appointments. to batch and send patient statements via PLD Group Volume Based Fee Monthly Fee Volume Based Fee or use of -OR- in the the course of using of a technical or practical or use of -OR- prevent the course of using HEALTH VAULT APP This functionality allows patients to send and receive secured Direct-based messages to/from providers of certified health IT systems. MS SQL SERVER The primary functionality of this software is storing and retreiving data as requested by other software applications-which may run either on the same computer or on another computer across a network (including the Internet).

4 Description of or use of -OR- in the the course of using of a technical or practical or use of -OR- prevent the course of using Newcrop (a)(1) (a)(4) (a)(7) (a)(10) (a)(8) (b)(3) clinicians the ability to send e- prescriptions, the electronic transmission of prescriptions between healthcare organizations and pharmacies. FIRST DATA BANK MEDLINE PLUS clinicians access to pharmaceutical information (medications) that is used within healthcare environment. encyclopedic information on health and drug issues, and provides a directory of medical services. MedlinePlus Connect links patients or providers in electronic health record (EHR) systems to related MedlinePlus information on conditions or medications.

5 Description of or use of -OR- in the the course of using of a technical or practical or use of -OR- prevent the course of using RXNAV MEINBERG NTP This functionality is a browser for several drug information sources, including RxNorm, RxTerms and NDF-RT. RxNav finds drugs in RxNorm from the names and codes in its constituent vocabularies. RxNav displays links from clinical drugs, both branded and generic, to their active ingredients, drug components and related brand names. RxNav also provides lists of NDC codes and links to package inserts in DailyMed. The RxTerms record for a given drug can be accessed through RxNav, as well as clinical information from NDF- RT, including pharmacologic classes, mechanisms of action and physiologic effects. This functionality, Network Time Protocol (NTP), provides time synchronization in a network.