GE Healthcare

1. GE Healthcare Building Connected Communities: Interoperability for Integrated Care HIMSS 2013 Interoperability Show Case

2. Agenda: Building connected communities • Digitization & Connectivity of Data: Accessing and integrating information from multiple sources – We need interoperability standards! • Connecting your data is not enough: You need to connecting your process and culture – Building your value based delivery environment • Building Connected Communities : Where GE is heading

3. GE Capital GE today Healthcare GE Energy Transportation Oil and Gas Energy Management Aviation Home and Business Solutions Power and Water

4. GE Healthcare IT & Performance Solutions • A leading provider of IT solutions for hospitals, specialty departments, and physician practices • Headquartered in Barrington, IL with over 4500 employees operating in 57 offices world-wide • A part of GE Healthcare a $17B unit of GE (NYSE: GE), a diversified infrastructure and finance company taking on the world’s toughest challenges

5. Healthcare Challenges

6. The Clinical Knowledge-Processing Burden “Current medical practice relies heavily on the unaided mind to recall a great amount of detailed knowledge – a process which, to the detriment of all stakeholders, has repeatedly been shown unreliable” Crane and Raymond The Permanente Journal Winter 2003 Volume 7 No.1 Kaiser Permanente Institute for Health Policy Knowledge processing requirement This gap injures patients Knowledge processing capacity Today Many years ago

7. Healthcare is facing a perfect storm Big Data Workflow High levels of legacy and proprietary technology Product rather than care specific orchestrations Cloud Vocabularies Rise of disruptive and acceleration technology represents threat or opportunity Current state fosters low productivity with high cost of customer ownership Mobile Inability to address Enterprise/Regional and CXO/RHA needs Complexity/TCO from overlapping products and technology Future demands a different game plan … from business models to product boundaries and technology Collaboration HTML5 Virtualization Learning & NLP

8. Agenda: Building connected communities • Digitization & Connectivity of Data: Accessing and integrating information from multiple sources – We need interoperability standards! • Connecting your data is not enough: You need to connecting your process and culture – Building your value based delivery environment • Building Connected Communities : Where GE is heading

9. Why Participate in Standards? • The Health IT market is not dominated by any one vendor. Any where we go, our products need to interoperate with other: • Modalities • RIS and PACS • EHR and Departmental Systems • Analytics • Clinical Decision Support

10. Emerging Trends in Standards • Patient Engagement • e.g., View/Download/Transmit • Mobile Health • Largely driven by Patient Engagement • But also telemedicine and remote monitoring • Analytics • Quality Measurement • Critical for Accountable Care

11. INTEGRATED CARE: Far beyond an inpatient-centric model … Ambulatory Payer Hospital Consumer “Practical” market problems Integrated Care “Promise” Evidence-basedcare Patientengagement Qualitymeasurement& improvement Future needs? Fiscalmanagement Populationhealth Carecoordination workflows … new healthcare delivery ecosystems required

12. Holistic approach to Data Knowledge Workers Knowledge Repository Maps Models Codes Rules Constraints Queries Forms HL7 XDS ATNA Interface Manager PIX Interface (e.g. HL7) to Model Transforms Terminology Translation, Decision Support & Business Rules Unified Data Repository of Models &Terminology Based Data Applications Assembled from User Generated Alerts, Queries and Forms PDQ CDA 4 3 5 1 2 Standard Models & Terminology Coded, Computable Clinical Data Configured by Knowledge Workers Shareable & Reusable Assets

13. OPEN SOA Architecture Overview SOA with embedded Enterprise Service Bus (ESB) Our approach is anchored by an OPENServices Oriented Architecture which allows applications and internal components to be loosely coupled while interacting with Infrastructure, Business, and Interoperability Services Interoperability Services Business Services Infrastructure Services Terminology Decision Support Patient Registry Security & Auditing Analytics & Reporting HL7 Messaging ProviderRegistry Workflow Patient Admin Session Management Document Services Clinical Data Services Location Registry Content Management Diagnostics & Monitoring Radiology Information System LabInformation System Pharmacy System Hospital / Physician Office EMR Patient Review & Visualization Future Content-Driven Apps Lab Clinician Physician / Provider Radiologist Pharmacist Physician / Provider Physician / Provider Point of Service Qualibria Component ESB Access Point External Application ESB Access Point Qualibria Component Qualibria Application External Application

14. Transforming data into insight: Advanced processing & Information fusion Clinical Data Fusion - Terminology Services: • The Terminology Foundation contains services and rich management tools for code mapping, browsing and querying: • Load external code systems, including: SNOMED-CT, LOINC, ICD-9, ICD-10, CPT, RxNorm, HL7 Vocabularies, HCPCS, Genomics Ontologies, NCI Metathesaurus, Open Biomedical Ontologies, etc. • Many entry forms for one concept • myocardial infarction • MI • S/P MI 1987 • hx of heart attacks • 4500 Elemental terms available today

15. Centricity Practice Solution (EMR) Research: MQIC is a unique, de-identified patients – aimed at helping identify and inform industry best practices MQIC Database 30million patient records 173 million office visits 1.3 billion documents • Benchmark a case, or your practice, against nearly 30 million unique patients • Identify financial inefficiencies and opportunities to help reduce costs • helping identify and inform industry best practices • Designed with physicians for optimal efficiency

16. Imaging IT and HIE: GE with our CARADIGM partnership Reporting Tools Metrics Patient Consent Data Analysis Government Agencies eHealth Community Desktop (HIE & DICOM Viewer) Patient eHealth Registry 2.0 (XDS Registry) CentricityTM Enterprise Archive 4.0 (DICOM Archive & XDS Repository) Prior Studies General Practitioners Radiologists Images & Reports Images & Reports Hospitals Master Patient Index Specialists Imaging Centers

17. CENTRICITY CLINICAL ARCHIVE

18. Agenda: Building connected communities • Digitization & Connectivity of Data: Accessing and integrating information from multiple sources – We need interoperability standards! • Connecting your data is not enough: You need to connecting your process and culture – Building your value based delivery environment • Building Connected Communities : Where GE is heading

19. Connecting your data is not enough: You need to connecting your process and culture • Capacity • Reducing variation • Balancing supply and demand • Improving workflow • Safety • Reducing adverse events • Increasing transparency and accountability • Performance • Managing costs • Developing leaders • Creating a culture of continuous improvement • Asset Management • Improving utilization • Increasing staff productivity • Reducing operating costs • Care Delivery • Moving from care silos to systems • Continuous population management • Integrating clinical decision support and informatics

20. GEPS: Connecting your data is not enough: You need to connecting your process and culture GE HealthcarePerformanceSolutions

21. GE Interoperability: IHE Radiology PACS, Mammography and RIS Computed Tomography (CT) Bone Health Nuclear Medicine & PET IHE Surgical & Clinical Information Systems Nuclear Medicine & PET IHE X-ray & Mammo Acquisition Systems IHE Ultrasound

22. Agenda: Building connected communities • Digitization & Connectivity of Data: Accessing and integrating information from multiple sources – We need interoperability standards! • Connecting your data is not enough: You need to connecting your process and culture – Building your value based delivery environment • Building Connected Communities : Where GE is heading

24. Building Connected Communities: The Continuum of Care>>> Questions? Quality of Life Shift Left Highest Quality of Life Lowest Cost of Care Health &Wellness HomeCare ResidentialCare Acute Care Cost of Care