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Oracle SecureCARE Records
IMPROVING AVAILABILITY AND QUALITY OF HEALTH INFORMATION




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               The Challenges We’re Hearing

                                                        Duplication of tests, medications, treatments,…
                Fragmented Care &                       Missing/inaccurate/not standard/unorganized/illegible data
                     Quality                            Semantic confusion; medical vs lay; generic vs special
                                                        Structured vs unstructured data


                                                      44,000 to 98,000 patients die in US hospitals yearly due to
                   Risks to Patient                  medical errors. All errors are preventable.
                       Safety                         Need quicker responses for critical decision making
                                                      Information must be available continuously


                                                       Islands of clinical information provide disparate data – not
                Lack of Knowledge                    knowledge
               for Decision Making                     Providers implementing clinical data repositories, but not
                                                     clinical data warehouses


                                                       31% of hospitals surveyed report security breaches
               Protection of Patient                   Privacy of PHI’s at risk
                 Identities & Data                     Cannot de-identify data for Population Health
                                                       Compliance confusion – State policies vs. HIPAA



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Customers in the Pharmaceutical and Biotech industry are telling us
that they want help with three key challenges they are currently facing:

R&D Efficiency

Product Quality and Compliance

Customer Centricity


Customer Centricity
In terms of Customer Centricity, Companies are facing challenges
regarding how to increase the efficiency and effectiveness of their
Sales, Marketing and Service organizations in order to provide greater
value to their Customers such as Physicians, while at the same time
maximizing their revenue growth.

-------------------------

R&D Efficiency
The increased complexity of clinical trials has driven costs to exceed
US$800m and increased time to market. Driving executives to
determine new ways to improve their odds for success by identifying
potential ‘failures’ earlier in the clinical trial process while maximizing
their opportunity for success with other drug candidates. They are
looking for ways to streamline there processes and provide increased                                                  2
confidence in the quality of clinical information.
          US Health IT Direction
                                                                        • HIEs across the
                                                                        country
                                                                        • Network of
                                                                        networks              NHIN

                                              • Seamless exchange across
                                              disparate systems                         Meaningful Use will require HIEs to
                                                                                        exchange:

                                                                          HIE               Public       Private Entities
                                                                                            Providers        Payers
                • Info conforms to National                                                 HIEs        Patients (collaboration)
                Interoperability Standards
                                                                                            …in a secure, private manner
                • Across more than one HC org
                • Systems, People, Policy &
                Processes (workflow)
                                                    EHR                  Meaningful Use will require EHRs to enable:
                                                                            All documentation at Point of Care
 • Within one HC org                                                        Clinical Decision Support
 • Doesn’t scale across orgs                                                Exchange of info across the continuum of care
 • Not standards based                                                      Health and Wellness

                                EMR                                         Personal Health Records
                                                                            HIPAA compliance




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          Meaningful Use Stage 1
          – Health Outcomes / Policy Priorities

          1. Improve quality, safety,
             efficiency, and reduce health
             disparities
          2. Engage patients and families in
             their health care
          3. Improve care coordination
          4. Improve population and public
             health
          5. Ensure adequate privacy and
             security protections for personal
             health information

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          Oracle SecureCARE


                   Collaboration               Analysis                    Records      Exchange

Secure




                           COMPLETE. OPEN. INTEROPERABLE. SECURE.

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          SecureCARE Solution Set


                   Collaboration               Analysis                    Records                    Exchange

                                                                            Oracle Database
Secure                     Oracle Identity Management (IDM)
                                                                          Security


                                                                                  Oracle Data Privacy Shield (ODPS)


                     Oracle Health               Oracle Enterprise           Oracle Healthcare         Oracle Healthcare
                   Management Platform         Health Analytics            Transaction Base          Transaction Base
                   (HMP)                       (EHA)                       (HTB)                     (HTB)
                     Oracle Health 2.0            Oracle Business             Oracle Exadata           Oracle SOA Suite
                                               Intelligence
                     Oracle Siebel CRM         Enterprise Edition            Oracle Database           Oracle Sun Master
                                               (OBIEE)                     11g                       Person Index

                                                 Oracle Enterprise          Oracle Care-Giver         Oracle Sun NHIN-
                                               Performance                 Mobility                  CONNECT
                                               Management (EPM)




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          SecureCARE Records – Maps to Meaningful Use Objectives
          Stage     Year    Meaningful Use Objectives
             1      2011    Use CPOE
             1      2011    Implement drug-drug, drug-allergy, drug-formulary checks
             1      2011    Maintain an up-to-date problem list of current & active diagnoses based on ICD-9-CM or SNOMED CT

             1      2011    Generate & transmit permissible prescriptions electronically (eRx)
             1      2011    Maintain active medication list
             1      2011    Maintain active medication allergy list

             1      2011    Record demographics
             1      2011    Record & chart vital signs
             1      2011    Record smoking status for patients 13 yrs old or older
             1      2011    Incorporate clinical lab-test results into EHR as structured data
             1      2011    Provide summary care record for each transition of care and referral
             1      2011    Assign a unique name and/or number for identifying and tracking user identity and establish controls that permit
                            only authorized users to access electronic health information
             1      2011    Terminate an electronic session after a predetermined time of inactivity
             1      2011    Record action (eg, deletion) related to electronic health information in accordance with the standard specified in
                            Table 2B row 3 (ie, audit log), provide alerts based on user-defined events, and electronically display and print all
                            or a specified set of recorded information upon request or at a set period of time
             2      2013    Use CPOE for all order types
             2      2013    Use evidence-based order sets
             2      2013    Record clinical documentation in EHR
             3      2015    Multimedia support (eg, x-rays)

             3      2015    Access comprehensive patient data from all avilable sources
             3      2015    Use of epidemiologic data



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               Value of SecureCARE Records

                                                           Consolidate all your clinical, administrative, and financial
                  Improved care & safety                 information into one healthcare data infrastructure
                   with complete, quality                  Maintain a single source of truth which can be shared across
                           data                          healthcare entities and regions




                                                          Extreme performance and scalability of all your healthcare
                  Quicker response for                  applications
                 critical decision making                 Your medical decisions faster, with a clinical data repository, a
                                                        clinical data warehouse, or a consolidated mix




                                                          Industry leading performance, security and reliability on your
                       Availability of                  choice of clustered or single servers
                  information to support                  Encrypt/decrypt all your information to NIST Standards and
                       on-going care                    lock it down at no impact to performance and availability




     ORACLE CONFIDENTIAL – RESTRICTED AS PER THE DISCLOSURE STATEMENT TO THIS PRESENTATION




Customers in the Pharmaceutical and Biotech industry are telling us
that they want help with three key challenges they are currently facing:

R&D Efficiency

Product Quality and Compliance

Customer Centricity


Customer Centricity
In terms of Customer Centricity, Companies are facing challenges
regarding how to increase the efficiency and effectiveness of their
Sales, Marketing and Service organizations in order to provide greater
value to their Customers such as Physicians, while at the same time
maximizing their revenue growth.

-------------------------

R&D Efficiency
The increased complexity of clinical trials has driven costs to exceed
US$800m and increased time to market. Driving executives to
determine new ways to improve their odds for success by identifying
potential ‘failures’ earlier in the clinical trial process while maximizing
their opportunity for success with other drug candidates. They are
looking for ways to streamline there processes and provide increased                                                          8
confidence in the quality of clinical information.
             Improved care and safety with
             complete, quality data

         Healthcare
                                                    HTB CAPABILITIES
      Transaction Base
           (HTB)
                                           • Single source of
                                             standardized, normalized
                                             data

                                           • Utilizes HL7 standards

                                           • Inclusive of all healthcare
                                             data: discrete clinical data
                                             and clinical documents

                                           • Accessible via portal,
                                             application, analytic tools,
                                             and Web service


9
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            Quicker response for critical
            decision making

               Exadata                           EXADATA CAPABILITIES


                                           • Extreme performance

                                           • World-class hardware from
                                             Sun

                                           • Intelligent database and
                                             storage software from
                                             Oracle

                                           • Complete optimized
                                             package                                    10X faster, or more
                                                                                        1/6th the cost
                                           • Simple & fast to implement                 1/3rd the power
                                                                                        1/5th the floor space


10
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                                                                                                                10
             Availability of information to support
             on-going care

       Oracle Database                           ORACLE DB 11g
             11g                                 CAPABILITIES


                                           • Protects from server failure
                                             and site failure

                                           • Reduces planned
                                             downtime

                                           • Industry-leading relational
                                             database

                                           • Optimally compresses,
                                             stores and quickly retrieves
                                             unstructured data and
                                             images (DICOM
                                             Standards)


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            Protection of patient identities & data


            Access to                                IDENTITY MANAGEMENT
           Information                               CAPABILITIES



                                           • Ability to provide single sign-
                                             on within your environment

                                           • Ability to utilize multiple
                                             access directories

                                           • Provides attestation and
                                             audit trails of access to
                                             systems and information

                                           • Enables easier access to
                                             information while adhering to
                                             Meaningful Use directives.


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                                                                                        12
            Reduced medical fraud and medical ID theft

          Oracle Data
         Privacy Shield                          ODPS CAPABILITIES
             (ODPS)
                                           • Works with any database /
                                             application

                                           • Transparent encryption

                                           • Stores encryption algorithm
                                             on separate server to
                                             eliminate compromise

                                           • Tokenized data to de-
                                             personalize private
                                             information

                                           • Unique row-level security
                                             with fine-grained auditing


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             SecureCARE Architecture
                                    Information Access & Presentation
                      Access & Presentation
                      Access & Presentation                                                                             Physician


  Family
  Practice                                                Care-
                                                          Care-Giver Mobility
                                                                                                                          Nurse
                      Identity Management
                       Identity Management

 Pharmacy             Application Layer
                      Application Layer                                                                                  Patient

                          Qual
                          EHR
                                         EHR
                                        Modules
                                                        Clinical
                                                         Apps
                                                                                 CRM           ERP           ...
Hospital                                                                                                                  Family
Depts
                      Middleware Layer
                      Middleware Layer
                                               Health 2.0
                                               Health 2.0                             OBIEE
                                                                                      OBIEE     EHA
                                                                                                EHA          EPM
                                                                                                             EPM




                                                                        Portal
                      App Integration
                      App Integration




                                                                       Portal
                                                          Beehive
                                                         Beehive                                      HDM
 CMS                  SOA/BPM
                      SOA/BPM                            WebCenter
                                     eMPI         ECM   WebCenter
                                                                                      BI Foundation
                                                                                      BI Foundation

 Public               Database Layer                      Healthcare              Healthcare
                      Database Layer                    Healthcare
                                                         Transaction
                                                                                 Healthcare
                                                                                     Data
                                                                                                  Exadata
                                                                                                 Exadata
 Health                                       DB        Transaction                Data          Server SW
                                             Vault          Base                  Warehouse     Server SW
                                                           Base                  Warehouse


                      Hardware Layer
                      Hardware Layer
     RHIO

                                                                                                              Exadata


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          Why Oracle SecureCARE?

         • Improve quality, safety and
           efficiency
         • IT Foundation for today & the
           future
         • Implement once
              – Low Total Cost of Provided Care
              – High Return On Investment (ROI)
         • Maximize HITECH incentives
           early
              – Reduce risk of penalties later

                           COMPLETE. OPEN. INTEROPERABLE. SECURE.

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