Presenter(s): Ken Banks Database Manager -- Peninsula Community Health Services. Topic Making the Most of Mirth Connect. Level 300

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2 Presenter(s): Ken Banks Database Manager -- Peninsula Community Health Services Topic Making the Most of Mirth Connect Level 300

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 PCHS A little history of our practice

5 Peninsula Community Health Services Founded in 1989, Peninsula Community Health Services (PCHS) is the only Federally-Qualified Health Center (FQHC) with comprehensive healthcare services on the Kitsap Peninsula, of Washington State. We provide medical, dental, behavioral health, pharmacy, and health education/promotion activities for all stages of life and ensure accessible, affordable, compassionate, quality health care services for all people in our communities.

6 Peninsula Community Health Services PCHS currently operates four medical clinics and two dental clinics, serving over 30,000 patients annually We also are developing greater partnerships with other practices in our area including Kitsap Mental Health Services, with which we share patients. PCHS began using NextGen in 2005 as part of the PTSO of Washington In 2007 PCHS began hosting their own copy of NextGen. In 2014 PCHS entered in a partnership with NextGen and Dell hosting to host the hardware for PCHS.

7 PCHS Our Interoperability History Initially in 2007 we began with the NextGen Rosetta Interface Export Lab Orders and Import Lab Results Export Immunizations to the State Immunization Registry In 2010 we replaced the Rosetta Interface for Immunizations with Mirth Connect In 2014 we began the planning for the HIE interfaces using Mirth Connect

8 PCHS How we use Mirth Export Immunizations (HL7 2.5 files) to the Washington State Immunization Registry Export CCD documents to a private hospital network HIE to coordinate information between hospital and primary care providers Import HL7 clinical documents from the private HIE of hospital visits by PCHS patients Export CCD documents to the Washington State HIE (OneHealthPort) that will be passed to our Health Partner Kitsap Mental Health Import CCD documents from Kitsap Mental Health via the Washington State HIE

9 The Future two way interoperability PCHS was recently awarded an ONC interoperability grant that will use Mirth Connect as one of the key components. Consent2Share An open source consent management and patient portal that will be shared by both PCHS and our behavioral health partner, KMH. PCHS will publish documents to Consent2Share using Mirth Connect Consent2Share will publish KMH documents to NextGen using Mirth Connect

10 Mirth The Decision Making Process

11 Advantages Flexibility New Interfaces can be developed in a matter of weeks with no additional costs Low Cost As open source, Mirth can be implemented at a very low cost compared with other technologies Control Mirth allows us to determine the content that is exported and imported according to PCHS policies Adaptable As standards change and improve interfaces can be changed to adhere to those newer standards

12 More Advantages Customizations -- Can work with our template customizations Ease of Use HL7 files can be built with little or no programming experience Support Support for Mirth can be purchased on a flexible basis. Transport Physical files can be created for transport or Mirth can be configured to send directly using the MLLP protocol Modular interfaces can be built in a series of steps that can be dropped in one interface and added to another.

13 Other Considerations SQL Experience to take full advantage of the power of Mirth requires someone with an in-depth knowledge of the NextGen database. Programming Experience For CCD documents, Mirth requires some knowledge of Java Script programming. To offset this there are two programming libraries that are available to aid in the development of these documents. Documentation in depth documentation is only available at certain support levels.

14 Mirth Terminology

15 Terminology Channels this represents each unique interface and is the equivalent of an agent in Rosetta Transformers this is what does the work of taking the information that is stored in one format and transforms it into another format. This allows two way interoperability with NextGen as the source or destination Message Template This is the message format that Mirth will use as a template for the input or as a template for the output.

16 More Terminology Parts of a channel Summary -- outlines the basic information that applies to the whole channel with the data types and the storage settings being the most important Source Transformation this does the work of transforming the input into the formatted output Destination Transformation This can also do the work of transforming the input into the formatted output Destination Where the output is going this can be to another destination or the final destination

17 Mirth Seeing it in practice

18 Current PCHS Channels

19 Monitoring Channel Status Mirth provides details on every processed message

20 One Example Hospital HIE Bi-directional Interface Used to export the Patient population to the hospital The import of the hospital visit data into a Nextgen document The Document goes to the Provider PAQ for sign off Provider Test Action opens following the sign off of the document

21 One Export Channel Notice how the channel can be modular:

22 One Export Channel A Transformation does the work we used java script

23 One Export Channel The final destination is sent directly via MLLP over a secure VPN tunnel

24 Imported Clinical Document How the imported CCD or HL7 document looks to clinicians

25 Demonstration

26 Session Survey Please take a moment to complete a brief survey regarding this session. 1. Open your ONE UGM Mobile App (please note: you must have already logged in and accepted the Terms of Use to access this feature) 2. Click the Navigation Button at the top left of the screen 3. Select Sessions 4. Search for and select this session 5. From the sessions details screen, select Survey at the bottom right of the screen 6. Remember to hit Save at the bottom of the survey once you have answered the questions

27 Any Questions?