HIMSS Spring Meeting Nebraska Chapter ____________ May 3, 2012

1. HIMSS Spring Meeting Nebraska Chapter ____________ May 3, 2012

2. Mission ____________ • Prairie Health Ventures exists to help hospitals succeed through collaboration • Hospital owned and directed 2

3. PHV Owners ____________

4. IT Services • Current offerings • IT Leadership and Consulting • Recruiting • Education/Training • Infrastructure Design & Implementation • Virtualization • IT needs evaluation • Helpdesk • Data Center • Data Back-Up • Disaster Recovery • Hosting • Private Network

5. Healthcare Today ____________ • Many initiatives dominate time and resources today

6. Healthcare Data Challenges Exponential Data Growth Tight Healthcare IT Budget • Growing number and size of stored images • EHR adoption fueled by HITECH Act Clinical Data Silos Multiple Changing Regulations • Access to patient health records, test results, labs, medical images, etc. • Heterogeneous HIS and PACS environment managed as islands • Issues managing, protecting, migrating and updating data • Stringent government regulations • HIPAA 5010 • ICD-10 • HITECH Act • Meaningful Use

7. Much of Which Depends on IT ____________ • A robust infrastructure sets the stage for future success 7

8. Hosting – Best thing since.. Minimize/Eliminate Capital cost Minimize/Eliminate Additional IT resources Managed Backups Management of OS, service packs and upgrades Predictable monthly IT Costs

9. Hosting – Embrace the cloud

10. Hosting - continued • Just like Dad always said • It’s too good to be true – What is the oversubscription rate • You get what you pay for – Customer service is nonexistent • Who is actually providing the hosting service. • Regardless of the cost and SLA’s that might be in place you should always know where your data ultimately resides • Many HIS/EMR vendors outsource their hosting offering • “You have plenty of bandwidth” • Speed – How much is the additional bandwidth going to cost • Scalability – You will never retain or move less data than you do today • What does downtime actually cost? • It will happen – understand the cost in dollars and lost time

11. Too Much Emphasis on Their Cloud No SecurityNo ComplianceNo Control “Rebuild your apps & data in their cloud…”

12. ____________ Understand the Marketplace • The buzz around the cloud • All Hosting, Data Replication & Business continuity solutions are NOT created equal • Make sure that you are comparing apples to apples (disk to disk replication or agent/third party replication) • Most offerings do NOT have a complete business continuity component • Very few offerings have the ability to replicate across all architectures e.g.: ISeries AS/400 – RS600 (HMS, CPSI, Healthland) • Equipment decisions that you make today will effect data replication and continuity tomorrow

13. Healthcare Storage Summary HIPAA 5010, IDC-10, HiTech Act & Meaningful usewill expand transaction datasets by at least 400% - More Patients / procedures - More Modalities - More data per modality • Gartner IT Key Metrics Data 2012 • Storage Cost as a Percent of IT Cost • 2011: 6.5% and growing • Storage Cost per Raw Configured : • 2011: $4,876 and growing • Netting it out! Flexibility and efficiency is critical. North America projected Spend ***2011: 1,006,032 TB = $4.9B • 2012: 1,832,976 TB = $8.9B • 2013:2,430,418 TB = $12B • 2014: 3,213,021 TB = $16B2015: 4,248,434 TB = $21B • *** assuming FY11 cost per TB @ $4,876

14. Off Site “Cold” Redundancy • “HOT” Site - • Requires duplicate Hardware, alternate physical site & Secure WAN • Equipment and resources are always running • Requires a huge amount of bandwidth • Duplicate capital and IT resource cost - Cost Prohibitive • “WARM” Site - • Requires dedicated lesser quality Hardware, alternate physical site & Secure WAN • Equipment and resources are NOT running • Incremental replication – RPO can be hours to days old • Requires additional staff intervention – RTO can take hours to days

15. Off Site “Cold” Redundancy – cont. • “COLD” Site – • Does not require dedicated Hardware • Has a higher subscription rate or lower grade hardware • Minimal bandwidth requirements depending on RPO • Typically requires a much more lenient RPO – Days to weeks (not counting lost time) • Typically requires a significantly increased RTO – Days to weeks • Typically is targeted at critical level applications only • Typically has a reduction in cost • Usually unable to run at full production levels

16. What’s Your Plan? ____________ • We really need to talk about this! The Midlands Datacenter (MDC)

17. Prairie Health Ventures Solution ____________ • Harnessing the power of virtualization • VMware as our enabler for Business Continuity (server & desktop) • Eliminates the need for 1:1 hardware duplication • Re-purposes existing hardware or (BYOD) • Simplifies backup, replication, provisioning, copying and cloning of systems • Provides easier testing of Business Continuity plans • Unique solution for CAHs in Nebraska, Iowa, Kansas and Missouri

18. Prairie Health Ventures Solution ____________ • Data Recovery & Business Continuity Service Data Storage & Recovery Services (Premium Tier) • Real-time backup per customer SLA specs • Synchronized connection (varies by bandwidth availability) • Potential for as little as a 4-hour turn-up time • Full production services restored Data only (Basic Tier) • Offsite data storage only • Faster and more reliable storage solution than tape • Delay (72-hour turn-around time)

19. PHV Differentiators ____________ • PHV Advantages • No capital costs to hospitals • Access to a state-of-the-art data center • Health care focused, scalable and affordable • Areas only “full” solution (site, service & options for hosting) • Replication of all outgoing services, not just data or select applications • Solution supports all architectures • High availability=true business continuity for 24/7/365 operations

20. From Concept to Reality ____________ • The Midlands Datacenter (MDC)

21. Thank you! ____________