Presenter(s): Ted McCain Bob Koman. Topic Rosetta Interfaces. Level 200

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2 Presenter(s): Ted McCain Bob Koman Topic Rosetta Interfaces Level 200

3 Safe Harbor Provisions/Legal Disclaimer This presentation may contain forward-looking statements within the meaning of the federal securities laws, including statements concerning future prospects, events, developments, the Company s future performance, management s expectations, intentions, estimates, beliefs, projections and plans, business outlook and product availability. These forward-looking statements do not represent a commitment, promise or legal obligation to deliver any material, code or functionality. The development, release and timing of any features or functionality described for our products remains at our sole discretion. Future products developed beyond what is contemplated by existing maintenance agreements, will be priced separately. This roadmap does not constitute an offer to sell any product or technology. We believe that these forward-looking statements are reasonable and are based on reasonable assumptions and forecasts, however, undue reliance should not be placed on such statements that speak only as of the date hereof. Moreover, these forward-looking statements are subject to a number of risks and uncertainties, some of which are outlined below. As a result, actual results may vary materially from those anticipated by the forward-looking statements. Among the important factors that could cause actual results to differ materially from those indicated by such forward-looking statements are: the volume and timing of systems sales and installations; the possibility that products will not achieve or sustain market acceptance; the impact of incentive payments under The American Recovery and Reinvestment Act on sales and the ability of the Company to meet continued certification requirements; the development by competitors of new or superior technologies; the timing, cost and success or failure of new product and service introductions, development and product upgrade releases; undetected errors or bugs in software; changing economic, political or regulatory influences in the health-care industry or applicable to our business; changes in product-pricing policies; availability of third-party products and components; competitive pressures including product offerings, pricing and promotional activities; the Company's ability or inability to attract and retain qualified personnel; uncertainties concerning threatened, pending and new litigation against the Company; general economic conditions; and the risk factors detailed from time to time in the Company s periodic reports and registration statements filed with the Securities and Exchange Commission.

4 What is Rosetta? Rosetta is NextGen s proprietary interface service used to send and receive HL7 messages to and from the NextGen application suite Rosetta supports the following HL7 message types: Demographics ADT [A04,A08,A18,A28,A31] Patient Case ADT [Z01] Scheduling SIU [S12,S13,S14,S15,S17,S26] Charges DFT [P03] Lab/RIS/PACS Orders ORM [O01], Lab Results ORU [R01] Documents/RIS/PACS Results MDM [T02] & ORU [R01] Immunizations VXU [V04] Pharmacy RDE [O11] Master File Notification MFN Syndromic Surveillance ADT [A08] Rosetta manages the HIE Gateway - Used for EHR Connect (integration with 3 rd party HIEs)

5 What Rosetta Is Not Rosetta is not an interface (mapping) engine like CloverLeaf, egate, OpenLink, or Mirth (now a QSI-owned company) Rosetta expects data in their standard HL7 fields Rosetta cannot manipulate, move, or reformat data Any HL7 data changes must be made before/after the message is processed by Rosetta NextGen Implementation will use Mirth to manipulate messages where critical Rosetta is not generally used for Equipment Interfaces

6 Rosetta Year in Review

7 Updated Windows Server Support Customer Central - Search for: Rosetta Server Requirements 5.8: Windows Server 2008, 32-bit or 64-bit 5.8 UD1: Windows Server 2008, 32-bit or 64-bit Windows Server 2008 R2 SP1, 32-bit or 64-bit 5.8 UD2: Windows Server 2008, 32-bit or 64-bit Windows Server 2008 R2, 32-bit or 64-bit Windows Server 2012 R2, 32-bit or 64-bit

8 Year in Review What s New to 5.8 Background Business Processor Integration Ability to query an HIE prior to patient appointment Can query up to 3 times (including day of appointment)

9 Year in Review What s New to 5.8 Batch CCD Export Ability to export CCDs (with filtering) from the Holding Tank

10 Year in Review What s New to 5.8 Ability to disable log encryption in Rosetta/HIE Gateway Use with caution!

11 Year in Review What s New to 5.8 Filtering for export, based on Provider

12 Year in Review What s New to 5.8 Filtering for export, based on Payer

13 Year in Review What s New to 5.8 DirectSecure (XDR) Holding Tank routing updated Previously would only allow you route to default provider Now will allow selection of/routing to correct provider

14 Year in Review What s New to 5.8 DirectSecure adding HPD directory query Reduces dependency on static directories Only pertinent in you are on a private or 3 rd party HISP Not pertinent to SureScripts HISP

15 Year in Review What s New to 5.8 Added ability to do a PIX EMPI query before CCDA export Important for HIE integrations where patient identifier could change Eliminates requirement of A31 backfeed from HIE

16 Enterprise Master Patient Index Integrations Models and Workflows

17 Enterprise Master Patient Indexes Two major scenarios where EMPI is employed: Integration with Hospital/Large Healthcare systems Integration with HIE/RHIO

18 EMPI Integration Types Bi-directional registration (A28/A31) PIX only Requires sharing of identifiers Best practice is to have ALL demographics in sync across both databases Query to EMPI, with identifier returned PIX/PDQ EAD Most common with HIEs Will take Patient Consent into account in next version Query to EPMI, with demographics exchange Siemens-only. Equivalent functionality to PIX/PDQ.

19 Bi-Directional Registration NextGen Patient Lookup Does Patient Exist? Yes Change to Demographics? Yes A31 Sent to 3 rd Party System Demographics Changes Stored in 3 rd Party System (based on External ID) No NextGen No Register Patient Stop A28 Sent to 3 rd Party System Patient and NG ID Stored in 3 rd Party System, External ID Created A31 Sent Back to NextGen with External ID External ID Stored in NextGen 3 rd Party System Patient Lookup Does Patient Exist? Yes Change to Demographics? Yes A31 Sent to NextGen Demographics Changes Stored in NextGen (based on NG ID) No No Stop 3 rd Party System Register Patient A28 Sent to NextGen Patient and External ID Stored in NG, NG ID Created A31 Sent Back to 3 rd Party System with NG ID NG ID Stored in 3 rd Party System

20 PIX-Only Integration

21 PIX/PDQ Integration (4 Scenarios) New patient, not found in either the local NextGen database or the EMPI New patient added to NextGen and EMPI New patient, not found in the local NextGen database but was found in the EMPI Patient information copied from EMPI and stored in NextGen along with EMPI identifier Person found in NextGen database but not found in EMPI Patient added to EPMI and indetifier returned to NextGen Person found in NextGen and in EPMI Association created between NextGen and EMPI, Identifier stored in NextGen

22 EMPI Things to Consider Two Configuration Modes for Demographics: EMPI is the Source of Truth in TRUSTED mode In UNTRUSTED mode, NextGen remains the Source of Truth Workflow and policy are key inaccurate data is propagated Downstream effects of poor data integrity are magnified Patient lookups can take longer If EMPI is down, the end user will see an error message

23 What you can look forward to in the next release

24 New Features Performance enhanced for CCDA generation Formerly gathered EVERYTHING, then filtered and generated the CCDA Now will be content-specific query and CCDA generation Details available in David Venier s Presentation on Wednesday at 9:15am

25 New Features Adding support for HL7 v3 Import for ADT V3 already supported for ADT export Adding full support for bi-directional Immunizations Query and post with Immunization registries

26 New Features Adding support for document import to Lab (Results) interfaces Customer Request (for Document Import) Supports Application Data or Image Data as well as URL DOC, PDF, RTF, HED BMP, GIF, JPG, TIF Does not support plain ASCII text document Cannot determine if ASCII is discreet data or an attachment but we can convert to PDF on import

27 New Features Rosetta notifications updated Previously was global to single address Now will allow for notifications to be sent to unique addresses PER AGENT

28 New Features Additional options for automatic CCDA export Now allows automated export without requirement of encounter being locked

29 New Features Adding Mirth Probabilistic matching feature to Holding Tank Will increase accuracy of matching Should decrease reliance on specific patient searches

30 Technical Q&A

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32 Any Questions?