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NextGen EHR Cloud NextGen Application Hosting & Support Your One-Stop Shop for EHR Slide 2 ITelagen - Healthcare IT Redefined October 2013Page 2 A Complete NextGen Solution ITelagen is the One-Stop Shop for NextGen for Medical Practices ITelagen is your single point of support contact for all your NextGen EHR needs. Single Point of Contact Certified NextGen Technicians Certified IT Specialists Secure NextGen Hosting Certified Implementation Experts EHR SUPPORT HOSTING IT SUPPORT IMPLEMENTATION OPTIMIZATION UROWORX EHRANYWHERE Slide 3 ITelagen - Healthcare IT Redefined October 2013Page 3 ITelagen: Our Clients ITelagen services over 400 practices / 1,500 physicians nationwide White Plains Hospital Center Muir Medical Group IPA Palisades Medical Associates Caldwell Memorial Hospital El Camino Hospital IPA Asheville Cardiology Manhattans Physician Group Lenox Hill Medical Group Staten Island Physician Practice And over 300 more. OUR CLIENTS Slide 4 ITelagen - Healthcare IT Redefined April 2013Page 4 EHR Hosting (ASP) EHR Cloud Complete NextGen EHR Hosting, Monitoring and Management True ASP Solution - No Hardware Costs Operates with 99.99% Availability On-site 24 x 7 x 365 Network Operations Center HIPAA Certified Network & Infrastructure SOC 1/SSAE 16 Annually Performed Audit Physical, biometric, and electronic data security Software, Updates & Centralized Management Cloud Computing Platform Infrastructure Multi-level Redundancy Unlimited Scalability Power: Always-On UPS with backup generators Connectivity: Multi-vendor Backbone Cooling: Redundant dry coolers EHR Cloud NextGen Hosting & Application Management Slide 5 ITelagen - Healthcare IT Redefined October 2013Page 5 EHRAnywhere NextGen Full Applications EHR, EPM, BBP, etc. Support for iPad Devices Support for Android Devices Voice-to-Text Dictation Leverages Built-in Siri or Google VTT Dictate Real-Time into Any Field Reduce Transcription Costs Other Features/Benefits Single Sign-on High Performance / Low Bandwidth HIPAA Secure: RSA or Password Authentication Easy Navigation: Familiar iPad/Android gestures Complete NextGen Mobile AccessAnywhere Slide 6 ITelagen - Healthcare IT Redefined April 2013Page 6 Traditional Architecture Antiquated Hosting Model: Traditional Hosting Model SQL Server DATAOSCONFIG Terminal Server - 1 OSCONFIG Terminal Server - 2 OSCONFIG Interface Server OSCONFIG Terminal Server - n OSCONFIG Report Server OSCONFIG Single, Physical server dedicated to each role. Fax Servers OSCONFIG Other Servers OSCONFIGDATA Typical Server Rack Slide 7 ITelagen - Healthcare IT Redefined April 2013Page 7 Ideal Architecture: EHR Cloud EHR Cloud: Cloud Based Computing Platform Architecture Multi-server Highly Redundant Highly Scalable Architecture NextGen SQL Server Terminal Server - 1 Terminal Server - 2 Interface Server Terminal Server - n Report Server Other Servers SAN OSsCONFIGsDATA ------------ EHR Cloud ------------ Slide 8 ITelagen - Healthcare IT Redefined April 2013Page 8 Architecture: NextGen Optimized EHR Cloud: Designed & Tuned to Host NextGen EHR Example: SAN Storage for different NextGen Applications NextGen Optimized SAN SATA Drives (FAST) SAS Drives (FASTER) Solid State Drive (RAM) (FASTEST) NextGen SQL Server Terminal Server - 1 Terminal Server - 2 NextGen Root PROD NextGen SQL Server TESTDEVREPORT Slide 9 ADD: Terminal Server - 4 15 Minutes 30 Minutes EXPAND: Terminal Server - 2 ITelagen - Healthcare IT Redefined April 2013Page 9 EHR Cloud Benefits Hosting Challenge: Scalability Overloaded Terminal Servers Terminal Server - 1 Terminal Server - 2 ADD: Terminal Server - 5 EHR Cloud Solution: On-Demand Scalability Add or Expand Servers. CPU RAM CPU RAM CPU RAM Terminal Server - 3 CPU RAM 1 2 ---- EHR Cloud ----- Benefits Servers can be expanded easily Servers can be added easily Eases and speeds scalability Delivers true On Demand scalability Slide 10 EXPAND: NextGen SQL Server ITelagen - Healthcare IT Redefined April 2013Page 10 EHR Cloud Benefits Hosting Challenge: Overloaded SQL Server EHR Cloud Solution: On-Demand Scalability Expand SQL Server Limitlessly. ------------ EHR Cloud ------------ CPU RAM CPU RAM CPU 5 Minutes Benefits Servers can be expanded easily Not limited to a physical box Speeds scalability True On Demand scalability NextGen SQL Server CPU RAM Slide 11 NextGen SQL Server Instantly No Human Intervention ITelagen - Healthcare IT Redefined April 2013Page 11 EHR Cloud Benefits Hosting Challenge: High Risk Aging Hardware Failure(s) EHR Cloud Solution: Images move *automatically* to other portion of Cloud ------------ EHR Cloud ------------ X OK NextGen SQL Server Benefits No downtime Reduces hardware failure risk Eliminates risk of aging hardware Speeds recovery from failed hardware Slide 12 ITelagen - Healthcare IT Redefined April 2013Page 12 ITelagen: Partnership ITelagen + NetAccess = Industry Leading Healthcare Hosting Expertise IT Experts + Healthcare EHR Experts IT Expertise NCP Certified NextGen Expertise NCP Certified Partner SQL Expertise Network Expertise Server Management Expertise *True* Proactive Server Management Leader in Datacenter Management Staff: Staffed (Onsite) 24 x 7 x 365 Backbone: multiple carriers, multi-route, multi-homed with no single point of failure Cooling: Redundant dry coolers and hot aisle / cold aisle configuration Power: Always-On UPS with backup generators known as 1+1, A and B power. HIPAA: True SAS-70 Type II Audit Green Facility: Facility operated with Green features + Slide 13 Internet 1 Internet 2 Internet 3 Internet 4 Internet 5 ITelagen - Healthcare IT Redefined April 2013Page 13 EHR Cloud Architecture Our High-Level EHR Cloud Architecture Outside of Cloud ----------- EHR Cloud ----------- DATACENTER FORTIGATE 1 FORTIGATE 2 NAC Access Concentrators POWER A POWER B NAC Power Distribution A POWER B POWER Generator B Generator A Internet 6 NAC Power Distribution NAC Access Concentrators Slide 14 ITelagen - Healthcare IT Redefined April 2013Page 14 EHR Cloud Architecture Our High-Level EHR Cloud Architecture Inside of Cloud ------------ EHR Cloud ------------ ROUTER 1 ROUTER 2 NextGen SQL Server Terminal Server - 1 Terminal Server - 2 Interface Server Terminal Server - n Report Server Other Servers NextGen Servers Private Network Bridge Virtual Firewall PRIVATE Client Location A FORTIGATE Client Location B FORTIGATE Home Office DSL INTERNET VPN Slide 15 ITelagen - Healthcare IT Redefined April 2013Page 15 ITelagen Live Datacenter Tour Scheduling Cedar Knolls, NJ Slide 16 ITelagen - Healthcare IT Redefined April 2013Page 16 Our NextGen Specialists Complete IT Certifications Microsoft Certified Professionals Cisco Trained & Certified Apple Certified Engineers NextGen Certified Professionals (NCP) EPM, EHR, & ICS SCT - NextGen System Administration HIPAA Compliant Staff & Support Methodologies HIPAA Tested & Certified Physician Environment Sensitive Our Techies have diverse IT + NextGen Healthcare Knowledge. "Techie" is a term, derivative of the word technology, for a person that displays a great, quite possibly even obsessive, interest in technology, as well as high-tech devices, particularly computers. Tech ie also tekkie (tk) Slide 17 ITelagen - Technology Empowered April 2013Page 17 Proactive Server Management Unlimited Technical Support Telephone & Remote Server Control (Primary) On-Site (Secondary) Proactive Health Management Automated Proactive Maintenance Automated Proactive Server Updates Microsoft Security Patch Management System Monitoring - Proactive Disk Space Terminal Server Availability Monitoring SQL Server Performance Monitoring ITelagens management of the EHR servers is Proactive (Not Reactive). Slide 18 ITelagen - Healthcare IT Redefined April 2013Page 18 Offsite Backup Solution ITelagens leverages Seagate eVault for offsite data protection NJ-1 QUESTION 8 ITelagen SAN 2 NJ-2 Parsippany, NJ ITelagen SAN 1 NJ-1 Cedar Knolls, NJ Industry Leading Powered by eVault Redundant Data Mirrored Offsite Fast Restore Same-day delivery of Data Delivered via External Drives Regularly Schedule Testing Mutually Agreed to Test Plan Verifies Integrity of Data Cedar Knolls, NJ Slide 19 ITelagen - Technology Empowered April 2013Page 19 NextGen Performance Monitoring Identify Root Cause of Performance Issues Historical CPU Utilization Reports Historical Memory Utilization Reports SQL Tracing Template Issue Debugging Shadowing Providers Measure Functionality Timing Identify Problem SQL Statements ITelagen provides NextGen performance analytics Slide 20 ITelagen - Healthcare IT Redefined April 2013Page 20 ITelagen: Support Technologies What Do We Monitor? Hardware: Disk space, CPU, Memory, etc. Services: SQL, NextGen Load Balancing: SQL, Terminal Servers Network: Device Availability (Ping or SNMP) Others: Custom Scripts (ex. DB Tables) ITAgent Remote Agent Patent-Pending - Artificial Intelligence Proactive Alerting/Monitoring Software Deployment / Patch Management System Health Monitoring 128-bit SSL Encryption SAS-70 Type II Compliant Data Center ITAgent Leverages Technologies from Solarwinds Kaseya Fortigate Salesforce.com Patent-Pending Management Technologies Enable Superior Service Slide 21 ITelagen - Healthcare IT Redefined April 2013Page 21 ITelagen: Network Monitoring Unlimited Technical Support Telephone & Remote Control (Primary) On-Site (Secondary) (Part of Desktop Support Service) Network & Device Uptime Monitoring/Alerting Internet Connection Applications: Email & Web (HTTP & HTTPS) Instant Alerting for Issues ISP/Internet Connection Management Interface with your ISP & Support Department Internet Infrastructure Management Router/Modem Management VPN & Firewall Management (Optional) Email & Web Application Hosting (Optional) Monitoring & Management of your ISP, Routers, Firewall and Network. Slide 22 ITelagen - Healthcare IT Redefined April 2013Page 22 ITelagen: Ticketing System ITelagen leverages Salesforce.com Service Cloud 2 Support Ticketing Complete Trouble Ticketing Automated tickets with alerts Complete issue documentation ITIL process management Change Request Management Client Accessible Reporting Custom Reporting / Dashboards Custom Metrics Client Accessible Documentation Management Escalations/Process Infrastructure documentation Client Accessible Slide 23 ITelagen - Healthcare IT Redefined April 2013Page 23 ITelagen: Differentiator What is Needed to be Successful with NextGen Hosting? Large NCP Certified Engineering Staff Ability to Ramp-up NCP Certified Staff (Staff will be added small or large) Experience in managing, fixing & supporting NextGen ITelagen is better positioned to provide hosting than large" companies. What About the Other Vendors? Small NCP Staff (1 NCP Engineer at best) Others are NOT NCP Certified Reactive / Limited Monitoring No Implementation/Template Expertise Not Managing NextGen What does ITelagen Offer? Additional Staff Required Over 12+ NCP Engineers 100% of Support Staff In-house NCP training Ability to ramp quickly Implementation/Template Expertise Workarounds/Fixes for NextGen Employee Owned Business Slide 24 24