1. Misys Open Source Solutions (MOSS) HealthcareRedwood 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. Misys Integrated Businesses Before Oct. 2008

$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 worlds 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

experience solutions results Treasury& Capital Markets Global Services Banking Health- care Open Source 3. 4. Misys Integrated Businesses Post Oct. 2008 experience solutions results Treasury& Capital Markets Global Services Banking Open Source

Allscripts &

Misys Healthcare

Solutions

NASDAQ: MDRX

Glen Tullman

CEO

Mike Lawrie

Chairman

Health- care MOSS Misys plc FTSE: MSY.L CEO: Mike Lawrie 5. The Innovators Dilemmaby 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 theinnovators solution .

6. 2009 Opportunity

ARRA

• 19.2

• 17.2

• 2

• 300

• 100

CareSpark

• 18

• 40

7. Healthcare and Open Source 8. MOSS Purpose

Meaningful disruption

Generates Revenue Causes change to happen 9. Open Source Solutions Healthcare

Objective:Committed to improving healthcare delivery using a standards-based, open source approach to build 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. TheValue 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 toPatient 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 X X X X 14. MOSS - Mission

Objectives

Create broad-base adoption of the MOSS Platform

• D eveloplower costHealth Information Exchange (HIE)

• Standards based

S upport Nationwide Health Information Network (NHIN) initiatives

Improve healthcare delivery by increasing EHR adoption

• EHR on-ramp through the creation of Clinical Groupware

Approaches

P rovidestandard-based IHEinteroperability options

Develop open source IHE infrastructural components

Leverage core monetize plug-ins and SaaS; Consulting and Support

experience, solutions, results Open Source Solutions 15. IHE Standards Based Healthcare Network experience, solutions, results Open Source Solutions 16. PIX/PDQServer - OpenPIXPDQ Open Source Solutions 17. IHE Standards Based Healthcare Network experience, solutions, results Open Source Solutions 18. IHE Profiles:Server Components April 2009 Open Health Tools Presentation: BOCA Chart

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

PostgreSQL8.3

Apache: Commons, Log4J, Xerces, Axis2

OpenEMPI

Beepcore

Jaxb

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

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)

Deleted/Changed:

Full ATNA/CT moved to post 2Q09 (may use Connect Code)

Configurations:

JBoss 4.0.5

PostgreSQL 8.3

Braid 1.1

JDK 1.5/1.6

Added:

IHE Client Libraries harmonization

IHE Profiles roadmap harmonization

XCA

19. MOSS (OHT) Roadmap OHT Charter Project Approval December 08 Connect-a-thon February 09 IHE Project harmonization January 09 Move OpenPIXPDQ to OHT March 09 IHE Client library harmonization3Q 2009 HIMSS Showcase April 09 Begin OpenPIXPDQ Development October08 Begin XDS Development2Q 2009 ATNA/CT/XCA2009 Connect Gateway Code Review 2Q 2009 20. Portal Decomposition experience, solutions, resultsWorld CongressViewerLiferay Misys SaaS MisysSaaS Platform Value-Add Components & Portal E-Prescribing Encounter Mgmt. Document Mgmt. Lab Orders Mgmt. Scheduling Billing CRM Reporting Clinical Data Repository PIX/PDQ eMPI XDS Registry & Repository ATNA IHE CORE Misys Connect Server Platform: SaaS Core Open Source Infrastructure Clinical Groupware 21. Fundamentally Different EMR Strategy Outside-IN EMR EMR EMR EMR Afterthought 22. Mashable Universe Strategy INSIDE--OUT Meaningful Use as defined By our customer 23. Information and Related Technology GovernanceOpen Source Solutions The CoBIT framework is the property of the Information Systems Auditand Controls Association and has been referenced with permission. 24. Open Source Solutions Consulting Plan

Solution approach

Collect and translate business

As-isTo-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

Value Alignment Approach Multi-stakeholder strategic planning session Identify Stakeholder value Milestone development Governance Framework Policies and Procedures Funding resources Business model analysis 25. Thank you

Questions?