Misys Open Source Solutions (MOSS) – Healthcare

1. Misys Open Source Solutions (MOSS) – Healthcare Redwood MedNet Presentation A Practical Application of Open Source Strategies in a Not-So-Conventional Health Care Company Tim Elwell VP, Misys Open Source Solutions May 20, 2009

2. $1B revenues, 4,500 employees, 1st software company listed on FTSE100 Substantial Expertise 30 years experience in Banking 25 years experience in Healthcare Installed Base 1,200 financial institutions, including every one of the world’s top 50 110,000 Physician users Global Footprint Customers in more than 120 countries, 36 Offices around the World Market Position Award-winning solutions across each business unit, Market leader in banking IT worldwide by customer base Banking Treasury & Capital Markets Health- care experience solutions results Global Services Open Source Misys Integrated Businesses – Before Oct. 2008 2

4. Misys Integrated Businesses – Post Oct. 2008 Banking • Allscripts & Misys Healthcare Solutions • NASDAQ: MDRX • Glen Tullman CEO • Mike Lawrie Chairman Treasury & Capital Markets Health- care experience solutions results MOSS Global Services Open Source Misys plc FTSE: MSY.L CEO: Mike Lawrie 4

5. “The Innovator’s Dilemma” by Clayton M. Christensen • In doing what a company is expected to do (and is rewarded by the market), that company is preparing a way for its own disruption. • BUT, it also is the beginning of the innovator’s solution.

6. 2009 Opportunity • ARRA • 19.2 • 17.2 • 2 • 300 • 100 • CareSpark • 18 • 40

7. Healthcare and Open Source

8. MOSS Purpose • Meaningfuldisruption Causes change to happen Generates Revenue

9. Open Source Solutions –Healthcare • Objective: Committed to improving healthcare delivery using a standards-based, open source approach tobuild interoperability tools between disparate electronic medical records (EMR) systems and healthcare enterprises. • Organization: Independent division inside of Misys plc • Community: The team is collaborating with prominent medical informatics, technology companies, and policy influencers to support and develop Health Information Exchange (HIE). • Goal: Support US-based Nationwide Health Information Network (NHIN) initiatives to provide lower cost, higher quality options that will result in greater EMR adoption and improved healthcare delivery. • Market Opportunity: Estimated that the creation of a NHIN will reduce the cost of healthcare expenditures by $77.8 billion annually. (1) • Business Model: HIE organizational consulting, customer application development, hosting, and support. (1) Walker, Jan, Pan, Eric, Johnson, Douglas, Adler-Milstein, Julia, Bates, David W., Middleton, Blackford. The Value of Health Information Exchange and Interoperability. Marketwatch Health Tracking. Jan. 19, 2005.

10. Uses Case Scenarios • Ambulatory Specialist Referral • Provider to Emergency Department Referral • Unplanned Access to Patient Medical Summary • Ante-Partum Care Delivery

11. Ambulatory Specialist Referral

12. Unplanned Access to Patient Medical Summary

13. SCALE 2008 – MOSS “Coming Out”Updated Plan Based on Customer Needs • IHE library • A basic set of IHE profiles implemented in Java. • This library has been accepted to and successfully completed the Connectathon for the last three years. • Connect application • A basic eMPI application • A viewer to retrieve and view a patient record that encompasses all practices in the community (the longitudinal patient record). • Server – Side Concentration • PIX-PDQ • XDS Registry and Repository X XX X X

14. MOSS - Mission Objectives Create broad-base adoption of the MOSS Platform Develop lower cost Health Information Exchange (HIE) Standard’s based Support Nationwide Health Information Network (NHIN) initiatives Improve healthcare delivery by increasing EHR adoption EHR ‘on-ramp’ through the creation of Clinical Groupware Approaches Provide standard-basedIHE interoperability options Develop open source IHE infrastructural components Leverage core – monetize plug-ins and SaaS; Consulting and Support Open Source Solutions experience, solutions, results 14

15. IHE Standards Based Healthcare Network Open Source Solutions experience, solutions, results 15

16. PIX/PDQ Server - OpenPIXPDQ Open Source Solutions 16

17. IHE Standards Based Healthcare Network Open Source Solutions experience, solutions, results 17

18. Open Health Tools Presentation: BOCA Chart IHE Profiles: Server ComponentsApril 2009 • Deleted/Changed: • Full ATNA/CT moved to post 2Q09 (may use Connect Code) • Pressures: • Moving project from Source Forge • Continue harmonization work with the IHE Profiles project • Demonstrate community value, establish precedent for committer status • Tooling harmonization • Dependencies: • JDK 1.5  or 1.6 • JBoss: 4.0.5 or above • Hapi: 0.5.1 • Braid: 1.1 • PostgreSQL 8.3 • Apache: Commons, Log4J, Xerces, Axis2 • OpenEMPI • Beepcore • Jaxb • Plan Content: • Committed: • PIX Manager (PIX Feed, PIX Query & PIX update notification) • PDQ Supplier (PDQ Query) • ATNA transactions specific to PIX/PDQ • Audit Log (Audit Trail Client) • TLS Secure Transaction • Actor Configuration • eMPI & eMPI Adapter • XDS Repository • XDS Registry • Proposed: • PIX v3 Manager (PIX Feed, PIX Query and PIX Update Notification) • PDQ v3 Supplier (PDQ Query) • Added: • IHE Client Libraries harmonization • IHE Profiles roadmap harmonization • XCA • Milestones: • Jan ’09 – go-live for project home • Jan 16 - pre-connectathon MESA testing for openPIXPDQ • March 31 - post connectathon milestone: move openPIXPDQ from Source Forge • April 15 - HIMSS milestone • 2Q09 – XDS Repository/Registry development begins • 3Q09 – IHE Client Library harmonization • Configurations: • JBoss 4.0.5 • PostgreSQL 8.3 • Braid 1.1 • JDK 1.5/1.6

19. MOSS – (OHT) Roadmap ATNA/CT/XCA 2009 IHE Client library harmonization 3Q 2009 Begin XDS Development 2Q 2009 Connect Gateway Code Review 2Q 2009 HIMSS Showcase April ‘09 Connect-a-thon February ‘09 Move OpenPIXPDQ to OHT March ‘09 OHT Charter Project Approval December ‘08 IHE Project harmonization January ‘09 Begin OpenPIXPDQ Development October ‘08

20. Portal Decomposition Clinical Groupware Value-AddComponents & Portal Viewer—Liferay Clinical Data Repository Core Open Source Infrastructure XDS Registry& Repository PIX/PDQeMPI ATNA Misys Connect Server Platform: SaaS IHE CORE Misys SaaS Platform Misys SaaS Lab Orders Mgmt. Encounter Mgmt.Document Mgmt. E-Prescribing Scheduling Reporting Billing CRM experience, solutions, results World Congress 20 20

21. Fundamentally Different EMR StrategyOutside-IN EMR Afterthought EMR EMR EMR

22. Mashable Universe StrategyINSIDE--OUT Meaningful Use as defined By our customer

23. Information and Related Technology Governance Open Source Solutions The CoBIT framework is the property of the Information Systems Audit and Controls Association and has been referenced with permission.

24. Consulting Plan Value Alignment Approach • Multi-stakeholder strategic planning session Identify • Stakeholder value • Milestone development • Governance Framework • Policies and Procedures • Funding resources • Business model analysis • Solution approach • Collect and translate business • As-is  To-be • Map requirements to technical utility • Introduce “best practices” • Create detailed milestone development • Recommend architectural platform • Leverage open source components • Utilize standards-based approach • Include customer resources • Development Approach • Leverage open source center of competence • Iterate with continuous feedback • Leverage customer resources Open Source Solutions

25. Thank you • Questions?