This document discusses secure communication and connectivity in the healthcare industry. It notes that more is spent on internal automation than external connectivity between businesses. There are many inefficiencies in healthcare compared to other industries. The document outlines opportunities to improve data exchange and transactions between payers, providers, employers, consumers and banks by using technologies like EDI, XML, web services and managed file transfer to help securely share information in real-time. Consolidating these exchanges can help simplify and secure business-to-business communication while reducing costs and improving processes.

1. Secure Communication: Delivering Secure Connectivity for Healthcare Presented by: Jonathan Gatrell 11.20.2008

2. Automation Spending Out of Alignment 18X More spent on Internal automation than External B2B Automation $55B Internal Automation $3B External B2B Automation But… “Non-linear revenue growth for companies is not going to come from within but from their extended ecosystem…” Harvard Business Review

3. Unrealized Value in Healthcare Healthcare has huge inefficiencies vs. other industries McKinsey

4. Connections are EVERYWHERE! Who owns data and process governance?

5. How to monitor orphaned processes? Who has what data?

6. Opportunity is beyond the 4 walls.

7. Risk is also beyond the 4 walls.

8. Risk Doesn’t Go Away

9. Gartner Predicts in Healthcare By 2011, 50% of CEOs will demand a 10% reduction in the cost and time to collect payment, because reimbursement will be squeezed by federal deficit reduction imperatives. Through 2015, CDOs [Care Delivery Organizations] characterized as having a "low" probability of success are 80 percent more likely to seriously evaluate full IT operations outsourcing than are CDOs characterized as a "high" probability of CIO success. Outsourcing Real-time Automation

10. Access and Controls The right systems, the right platforms, the people and the right partners

11. Technology Dynamics Inflection Point Complexity Varied Technology Outsourcing Multiple Standards Increasing demand on data exchange More “end points” Need to manage diverse B2B and B2C communities Multiple Models Consumer Driven “ Traditional” Mixed Technology Legacy SOA Changing Content Payments ePrescriptions Rich eligibility/claims Lab Results

12. Data is everywhere New processes and capabilities

13. Some of it just might be PHI Security inside and outside required

14. Technical Realities and Opportunities Production Technology Core transactional model and capabilities are EDI-centric HIPAA compliance Online portal access key Limited Adoption Emerging Technology SOA Investments Digital health records New Transaction models RTA New Opportunities XML Web Services

15. Increased Relevance of Security Source: “2007 Security Budgets Increase: The Transition To Information Risk Management Begins” “ What percentage of your company’s IT spending will go to Security?” 2007 2007 7.5% 6.9%

16. B2B content exchange and transaction management EDI Provider Claims Employee Enrollments Eligibility Requests Batch Adjudication XML Real-Time Adjudication Prescriptions Point-of-Service Payment validation Claims, enrollments and eligibility Payments Providers Employers Banks Understanding Secure Healthcare Transactions

17. Limited Adoption & Automation Key Healthcare Value Chains Payers Consumers Employers Providers Banks Multi-Enterprise processes offer: Expertise Efficiency Scale and reach Cost reduction … but create unique challenges: More complex data Always changing Real-time requirements You don’t own the data

18. Data Exchange Landscape Latency Data capture Batch Real-Time Bulk Transactional Documents Messages >80% of data movement today is by file exchange 80% of the data movement remains unmanaged The primary method of multi-enterprise integration will continue to be file exchange Only about one-seventh of all healthcare transactions are processed electronically today. Meta Group / Gartner

19. Complex Systems and Content MFT/ Batch B2B Messaging Records Mgt Payment Applications HRIS Pharmacy Consumer Applications Patient Care Apps LIS/ HIS

20. Fragmented Healthcare B2B Payments Benefits Banking RTA The Enterprise FTP Client HTTP Solution AS2 SW Translator Firewall Healthcare Revenue Healthcare Supply

21. Simplifying & Securing B2B Exchange in Healthcare VAN P2P – Direct Connect Managed File Transfer BizManager Suppliers Payers Banks Providers Clearing Houses

22. A B2B Gateway: Strategic Consolidation Digital certificates SSH (secure shell) PGP SMTP HTTP/s FTP/s NAESB Event-driven Scheduled Leased line VPN Binary User-defined SSL, TLS/SLL S/MIME IPSEC Proxy Servers (HTTP, FTP) Security Flexible Communication Capabilities AS1, AS2, AS3 ebXML JMS/MQ Web Services EBMX Transport Real-time Store-and-forward mailbox Delivery Internet Frame relay Connectivity EDI XML Text Data Formats

23. Benefits of a Consolidated B2B Gateway Legacy Emerging Single Operational Environment Policy Definition Run-time Enforcement Single Governance Environment Single Repository Rules based notifications Better Audit Capability User access Encryption Better Corporate Security

24. Secure Communication: Delivering Secure Connectivity for Healthcare Presented by: Jonathan Gatrell 11.20.2008