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© 2008 Misys All rights reserved,


Large & Troubled . . .

Our U.S. Healthcare Scorecard

98,000 Deaths from Medical Errors

1.5 Million Injuries

7,000 Deaths from Medication Errors

© 2008 Misys All rights reserved,

Understanding $17B in Physician Incentives
› The $17 Billion in Incentives Require Proof of "Meaningful Use”
− Use of a certified EHR product with ePrescribing capability that meets current HHS
− Connectivity to other providers to improve access to the full view of a patient’s health
− Ability to report on their use of the technology to HHS

› Those That Adopt First Will Benefit The Most (Declining Incentives)
− Physicians can earn between $44,000 to $64,000 over five years from Medicare / Medicaid
if they are utilizing an EHR in 2011
− Late adopters will receive significantly less
− Providers may receive incentives under only one of the programs
− 2015: reductions in Medicare/Medicaid fees for non-EHR users

© 2008 Misys All rights reserved,

The Time is NOW.
Great opportunities are already in place. Take advantage of them now.

› Incentives from Federal Government are Already in Place

− CMS incentive programs = estimated impact of $6,000 to $8,000/MD/year
− 2% financial incentive for physicians to use electronic prescribing
− 2% for Physician Quality Reporting Initiative (PQRI)

› Medicaid: Physicians who see more than 30% of patients paying with Medicaid
(20% for pediatricians) are eligible for payments of up to $64,000 over five years.

› Medicare: Physicians who do not have a large Medicaid volume but do accept
Medicare can receive up to $44,000 over the five years. Additionally, physicians
operating in a "health provider shortage area" will be eligible for an incremental
increase of 10%.

© 2008 Misys All rights reserved,

A Complete Picture
Federal Incentives for EHR Utilization

ePrescribe PQRI
Stimulus + +
Incentive Incentive

$44,000 $3,000-5,000* $3,000-5,000*

per MD
per MD per year per MD per year
over 5 yrs.

Funding over 5 yrs. ranges from $70,000/MD to $90,000/MD

* Estimate – will vary based on Medicare mix and volume of patients

PQRI = Physician Quality Reporting Initiative © 2008 Misys All rights reserved,
Allscripts MyWay
Simple Value Proposition




Intuitive Design

Differentiating Features

Start anywhere, Go anywhere

Speeds learning curve

Quicker Documentation
No Maintenance – No Template Maintenance
Intelligent Navigation

Differentiating Features


Streamline Documentation
Presents clinically relevant terms
Creates Most Frequently used list
Adaptive Learning

Differentiating Features


Shortens learning curve

Learns the practice patterns
Speeds Documentation
“On-the-fly” customization

Differentiating Features


Customize Yourself – No IT staff needed

Customization available immediately
Meet Individual and/or Practice style
Online Character Recognition (OCR) - Scanning

Differentiating Features

Drivers License & Insurance Cards

Minimizes Keystrokes
Minimizes Errors
Improves Cashflow
Fault Tolerant Architecture

Differentiating Features


100% Access to patient charts

No single point of failure
Ensures secure data
Ambulatory Market Opportunity

14 9
The Target Market
› Small provider practices (1-3 physicians) primarily in the
following specialty practices:
− Internal Medicine
− Family Medicine
− Pediatrics
− Urgent Care
− Cardiology
− Urology

› Secondary focus in the following specialty practices:

− General Surgery - Rheumatology
− Plastic Surgery - Neurology
− Gastroenterology - Orthopedic Surgery
− Otolaryngology - Pulmonology
− Endocrinology - Geriatric Medicine
− Neurosurgery

No Fly Zone
 Specialties:
 Ophthalmology - workflow
 Oncology – workflow, billing
 Psychiatry – workflow, content, billing
 Dental – workflow, content, billing

 More Sophisticated Offices

 Billing Services, MSO’s
 Complex billing workflows (DME, split billing)

So what’s keeping Doctors from buying?

Top Barriers to EHR Adoption

1. Fear

2. Ego

3. Money

4. War Stories

5. Change

Dr. Sheffield Success Story

Success Story Example
Critical issue Not maximizing profitability of the Practice
due to billing issues, liability, and

Capabilities (when, who, This solution was able to customize to the

what) nuances of each physician, providing a closer
fit than customizing just to the specialty of the

This solution provided a robust automated

documentation capabilities eliminating the
need for outside transcription services.

Personalized workflow, saving approximately

10 hours per week in physician time.

Result Eliminated $6000-$7200 a year in transcription


These capabilities were delivered by our

Enabling Technology
MyWay Solution.

Practice Buying Drivers & Trends
Legal & Regulatory Regional
• ePrescribing • RHIOs & IPAs
• Stark Law Relaxation • Regional EHR
• P4P • Specialty Association
• DOQ-IT Factors • Hospitals

Financials Socio-Economics
• Practice Size Practice buying • Consumerism
• Business model decision • Continuity of care
• Profitability • Un- & under-insurance
• Quality of care • Baby boomers

• Microsoft technology
Practice • SaaS, SOA, ASP
• Interoperability


What does PM, EMR, & RCM
Practice Electronic Revenue
Managemen Medical Cycle
t Records Management

• Decreasing patient • Decreasing patient • Decreasing patient

satisfaction satisfaction satisfaction
• Increasing costs • Increasing costs • Increasing costs
• Decreasing • Decreasing • Decreasing
Reimbursement Reimbursement Reimbursement
• Staff turnover • Undercoding • Increased A/R days
• Inefficiencies in • Increasing clinical • High cost of
Practice operations errors collections
• Decrease in work/life • Complex payer
balance requirements

It all starts with the proper discovery!

Utilizing a Discovery Document

Utilizing a Discovery Document
› Capturing / Learning P P V V C
− Pain
− Power
− Vision
− Value
− Control

› Answering “Why Now?”

› A good Discovery = Better, Faster, Easier Sale

› Will WIN the deal 10 X over not using Discovery

What is a demo? Why do them?
› Demonstration is defined as:
− “The presentation of the set of Specific Capabilities
needed to solve a customer’s Critical Business Issue.”

› Why do a Demonstration?
− Technical Proof of Capabilities
− Vision Generation

Copyright 2003-2009The Second Derivative 26

Great Demos present the what right
away, and then follow with the how.

Copyright 2003-2009The Second Derivative 27

Demo Guidelines
› “Do the Last Thing First”
› A Great Demo is concise!
− Introduction 1-2 minutes
− Illustration 1-2 minutes
− Do It 1-2 minutes
− Peel Back the Layers 5-10 minutes
− Q&A 5-10 minutes
− Summary 2-4 minutes

› 15 – 30 minutes – A Great Demo!

Copyright 2003-2009The Second Derivative 28

Costs to run a Practice
• Average Physician sees ~ 25 patients per day
Patient • 15% of visits are downcoded (3.75 visits)
Visits • Increase in reimbursement (99213 vs 99214)
= $26/visit
• Total additional revenue =
$31,896 / year / MD
Chart Costs • ~ 15% of Office visits are new patient visits
• Cost to create a new chart is ~ $5/chart
(can be as high as $8/chart)
• Cost ~ $3.55/chart to pull and re-file a chart
• Total cost of new patient charts per month =
Transcriptio • Estimated at $8000/year per MD (= $333 per
n month)
Costs • 50%source:
Reduction in dictation
Allscripts Client Data
Copyright © 2008 AllscriptsMisys Healthcare, Inc.
ROI Tool


Scenario Walk Through

PM/EHR for 2 Docs

2009 2010 2011 2012 2013 2014

ePrescribe $7,013 $7,013

PQRI Incentive $7,013 $7,574 $8,135 $8,696 $9,257 $9,818

PQRI = Physician Quality Reporting Initiative

Stimulus Package $36,000 $24,000 $16,000 $8,000

Total of 6 years = $177,877 + Standard ROI value

Let’s talk about the competition….

Why They Win …
1. Well known brand; growing rapidly
2. Low Price – primary factor in inclusion
3. Good user Interface – strong demo
4. Simplicity/low cost of install
5. Executive Sales involvement – how many Girish’s are there?


© 2008©
Copyright ©Misys
2008 All rights reserved,
2008 AllscriptsMisys
AllscriptsMisys Company
Healthcare, Inc. Confidential.
Recommended Sales Strategy

1. Kill them with attention – the majority of time eCW is selling over the
phone and through webcasts. Establish and reinforce that relationship!!!
2. Sell against the “drive by” approach by focusing on the strength of our
successful implementations and how that positions them to reap
Stimulus rewards
3. You can’t be all things to all people with one product – eCW is obligated
to focus development, training and support on success of large
customers – Walmart, NY DOH, HCA
4. Focus on the stability, vision, and strength of Allscripts, remember eCW
is approximately 1/10th the size of Allscripts in revenue
5. Sell the strength of the Cardinal/Allscripts relationship


© 2008©
Copyright ©Misys
2008 All rights reserved,
2008 AllscriptsMisys
AllscriptsMisys Company
Healthcare, Inc. Confidential.
Why They Win …

1. Great Client Satisfaction scores with KLAS ?

2. Endorsement of PSS

3. Good references in OBGYN and Primary Care

4. Play up the small company feel – personal service

5. Cost (depending on size)


© 2008©
Copyright ©Misys
2008 All rights reserved,
2008 AllscriptsMisys
AllscriptsMisys Company
Healthcare, Inc. Confidential.
Recommended Sales Strategy
• Wider reference base – larger practices and specialties

• Raise concerns about their interfacing ability compared to ours

• Well known that venture investors are pushing Greenway to either

go public or be acquired – what will that do to company/service

• Show that we are ETDBW … Greenway requires them to buy 5

licenses even if they only need one.


© 2008©
Copyright ©Misys
2008 All rights reserved,
2008 AllscriptsMisys
AllscriptsMisys Company
Healthcare, Inc. Confidential.

Why They Win …

1. Well known brand with AAFP

2. Low Cost

3. Good user Interface – strong demo

4. Simple / Low Cost of implementation

5. “Built for Physicians by Physicians”


© 2008©
Copyright ©Misys
2008 All rights reserved,
2008 AllscriptsMisys
AllscriptsMisys Company
Healthcare, Inc. Confidential.
Recommended Sales Strategy
1. Focus on the stability and strength of a large company.

2. Lack integrated EDI

3. Minimize risk by differentiating Allscripts’ support b/c they have had

challenges with support as customer base grows

4. Lacks adaptive learning and offline synchronization

5. They are template based


© 2008©
Copyright ©Misys
2008 All rights reserved,
2008 AllscriptsMisys
AllscriptsMisys Company
Healthcare, Inc. Confidential.
Comparison Checklist


MyWay Implementation…..
› 100% Remote Implementation
− Role Based Curriculum
− Track and Measurable

› Integrated eLearning
− Learning Management System (Academy)
− Supported by Q&A sessions with Implementation Consultants
− 24/7 Access
− Continuing Education, Employee Turnover, Refresher

MyWay Implementation Overview
› 6-8 Week Rollout
› 5 Phases
› Key Roles
− Project Management
− Implementation Consultant Coordinator
− Liaison throughout process
− Remote Consultation
− Coordinated Q&A sessions with Implementation Consultant
› Academy - Learning Management System

MyWay Standard Implementation
A llscrip ts M y W a y S ta n d a rd Im p le m e n ta- RtioenmMo te
D is c o v e r C o n fig u re T ra in L iv e P

R o le s& R e s p o n s ib ilitie s L iv e Q&A/C o n s u: lt


Im p le m e n ta tio n P ro c e s s C o n fig u re C h e c k lis t Q&A/C o n s u: lt B illin g Q&A C o

I mpplelemmeentntaatio

Im p le m e n ta tio n S c h e d u leIm p.l S p e .cB u ilt F ile s F ro n t D e s k M o n th E


C lin ic a l
D is c o v e r D o c u m e n t C lie n t B u ilt F ile s C lin ic &a l M e d ic a l R e c o rd s P a y e rp a th C o n s u lt F in a n c i
C o n fig u re P re p a ra tio n P P/M a in s tre e t S e tu p A d m in L M S C o u rs e R e v ie w W o rk flo
A c a d e m y R e q u ire m e n t s C o n fig u re&A/C
Q o n s u lt B illin g
P ro v id e r

P M T ra in in : Fg ro n t D e s k
L M S U s e r E n ro llm e n t L M S C o n f ig u re T ra: in in g C lin ic&a Ml e d ic a l R e c o rd s
L M S C o u rs e A s s ig
. n m t B illin g F ile s B illin g M o n th-E

L M S O v e rv ie w C o u rs e C lin ic a l F ile s A d m in F o llo w


T ra in in g

R e q u ire m e n t s L M S A s s e s s m e n ts C lin ic a l T ra in: in

P gro v id e r
C lin ic a l S ta ff
A d m in

MyWay Project Management
› Minimal Project Management Hours
− Included in every Service Package
› Implementation Consultant Coordinator
− Liaison between client/partner and MyWay resources
− Coordinates Implementation Rollout
− Hardware and Software
− Conversion Schedule
− Resource Assignments

› Academy LMS
− Coordinates LMS access
− Tracking and Monitoring progress

Academy for MyWay Details
› Programs are Role-based: › Learning Tracks include:
− Administrative − Implementation Training
− Front office − Core (Comprehensive)
− Back office Curriculum
− Clinical − New Version Training
− Provider
› During an Implementation,
› Courses have three “modes”: courses are interspersed with
− See it: demo live, online Q&A sessions.
− Try it: practice
− Know it: assessment

Allscripts Academy Learning Portal is at:

Is Ongoing Support Important?

› Your customers need the ability to get timely and

knowledgeable assistance when needed
› Our support team serves as an extension of your
business and your customers’ businesses
› We recognize that to grow our business, client support
must be a positive differentiator

Mutually Critical to You and Allscripts

Support Hours
› Normal Support Hours: Monday-Friday 8am-6pm (within your time
zone) excluding Holidays
− Allscripts Support can be reached via telephone at 800-877-5678
− Allscripts Support cases can be logged on the Internet via /Client Login

› After Hours Support/Holiday Support is available

− After Hours Support is Billable by the hour with a 1 hour minimum
at Allscripts current billable rate.

› 24/7 access to Client Support Portal including Solution

(Knowledge Base) articles

Key Expectations for Clients
› Goals
− Respond to 83% of all cases within 2 hours
− Critical cases are prioritized and our goal is to respond to a critical case within 15 min
› Business Impact & Response Times
− Down System: 15 minutes
− 50% or more of the users unable to work or Patient Safety impacted
− Example: Users unable to access MyWay application
− Emergency/High: 2 hours
− Significant Impact/system failure or less than 50% of the users unable to work
− Example: An End user is receiving an error when trying to perform a function OR when performing a task that expected
result does not occur
− Medium: 1 business day
− All other issues/questions
− Example: End user has a question on a specific report or function that is a general question related to an area of the


© 2008 Allscrips. All rights

Allscripts MyWay Stimulus Package Offerings
No Money Down
Full TIME Provider 3 Months No Payments
Description 60 month term

MyWay PM/EHR Stimulus Package Offer $699 per Provider

MyWay EHR ONLY Stimulus Package Offer $459 per Provider
No Money Down
PART TIME Provider 3 Months No Payments
Description 60 month term

(Average of 20
MyWay or less
PM/EHR per
Stimulus week)
Package Offer $449 per Provider
MyWay EHR ONLY Stimulus Package Offer $299 per Provider

No Money Down
OPTIONAL ITEMS 3 Months No Payments
60 month term
Allscripts MyWay Specialty Configuration Package $125 per Practice
Additional day of onsite training (includes $35 per Day
Lab Corp or Quest Interface $105 per Practice
Third Party HL7 LAB Interface $150 per Practice
Third Party HL7 PM Interface $150 per Practice
Demographic Conversion $50 per Practice
Appointment Scheduling Conversion $50 per Practice
Medical Device Interface $20 per Practice

The $699 per provider package
› MyWay PM
› MyWay EHR
› Support
› Maintenance
› Unlimited electronic Claims with claim scrubbing
› Up to 5 Carriers for Insurance Remittance posting
› Online Eligibility Verification for up to 200 patients per doctor per month
› 1st year of the MyWay Academy
› Complete Training and setup of MyWay
› Hosting Fee (no server required)
› 1st year of Patient Portal – Items Include:
− Patient Pre-registration with Standard Health History, Activation (Invitations), Appointment Requests,
Prescription Renewal Request, Unlimited Patient Messaging, Unlimited Secure Patient Messaging,
Ask a Practice Staff, Online Bill Pay