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emids confidential

Agenda

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M1 M2

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Stakeholder

Text Text Tex Text Text

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Qualify Proposer SOW Assessment Plot

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OnLife

FTE – Product Managers | Dev Leads | Architects

Engineering | QA | Support | Architect | Product Management

US

(OnS

hore

) Onsite Program Manager

Business Analyst

Onsite Tech Lead (Ruby) | Onsite Tech Lead (.NET)

Onsite QA Lead

88

IND

IA (O

ffSho

re)

ETL (Data Analytics)

.NET Legacy Application Live On (RoR) Coach On (RoR) OnDemand

(MSFT) MobileLoad

Automation Testing

Services

Shared QA

Architectural Group

88

Inno

vatio

n Ce

ntre

DACl

ient

Uni

vers

ityAc

cele

rato

rs &

En

able

rs

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OnLife

FTE – Product Managers | Dev Leads | Architects

Cont

ract

ors

Engineering | QA | Support | Architect | Product Management

ETL (Data Analytics)

.NET Legacy Application Live On (RoR) Coach On (RoR) OnDemand

(MSFT) MobileLoad

Automation Testing

Services88

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Conceptual Schema Logical Schema ETL Procedures Database/Physical Schema Front End

Functional

Usability

Performance

Stress

Recovery

Security

Regression

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ACTIVITIES RESOURCES DELIVERABLES

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LEVEL

1

LEVEL

2

LEVEL

3

LEVEL

4

LEVEL

5

TEXT TEXT TEXT TEXT TEXT

Text

Text

Text

Text

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Diagrams

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Sample 7En

gage

men

tRe

view

• Monitor overall progress• Change management & communication• Shape ongoing relationship• Resolution of escalated issues

Tran

sitio

nRe

view

• Engagement reviews• Provide overall wave transition progress• Review improvement opportunities• Tollgate reviews (as applicable)• Escalations, if any

Dai

ly S

tatu

sRe

view

• Transition key activity review & sign off• Readiness assessment • Resolve bottlenecks• Transition workshop, team charter• SOP / documentation sign off• Change management • Escalations

Transition Manager Development

Manager Development Leads Architect BAs

Transition Manager Delivery Manager

emids Executive Team

Citra Health Transition Manager

Citra Health Product Managers

Citra Health SME

Citra Health Program Sponsor

Citra Health Transition Manager

Citra Health Product Managers

Citra Health Executive Team

Level 3

Level 2

Level 1

Weekly/

Milestone Driven

Daily

Joint sign off between emids and Citra Health

Bi-weekly

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Paragraphs

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Heading 2

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Timeline and Engagement approach

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• Text

Stage 1 Stage 2 Stage 3 Stage 4

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Transition - Product Management Team for• Claim Manager Suite• Patient Access Suite• IT Support

5

Operations

Value Adds

July-14

ClientUniversity

Operationalized - Product Management Team

Product Engineering Team for• Claim Manager Suite• Patient Access Suite

Product Engineering Team Independent

OperationOngoing execution

Aug-14 Sep-14 Oct-14 Nov-14 Dec-14

Visual Mgmt.Dashboard

7 17 34 34 34

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W1 W3W2 W4 W6W5 W7 W9W8 W10 W12W11 W14W13

Gap Analysis for the additional functionality outside of the original Avantas Project Scope

Use Cases for the additional functionality.

Business and technical requirements additional functionality.

Gap Analysis for Scheduling functionality

Final Interface Specs documented to utilize for future LPNT hospital implementations

Quality Assurance testing of all data feeds for the project

QA for Data Feeds for scheduling application

QA of all the new functionality developed by Avantas

Milestone

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W1 W3W2 W4 W6W5 W7 W9W8 W10 W12W11 W14W13

WH

ENAC

TIVI

TIES

WH

O

GA ReportPrioritize

requirementsUse Case + Fn + T[S1]

Interface Spec

Analysis Validation Elaboration

[S2] + test Plan

Proj Manager

Tech Cons

BA

QA Analyst

Proj Manager

Tech Cons

BA

QA Analyst

Proj Manager

Tech Cons

BA

QA Analyst

15 Dec 22 Dec 29 Dec 5 Jan 12 Jan 19 Jan 26 Jan 2 Feb 9 Feb 16 Feb 23 Feb 2 Mar 9 Mar 16 Mar 23 Mar

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Signoff

Week 1 Week 2 Week 3 Week 4 Week 5 Week 6 Week 7 Week 8 Week 9 Week 10 Week 11

Text

Text

Text

Text

Text

Text

Text

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Text

Text Text

Text

Text

Text

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Dep

ende

ncie

s Text

• Text

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Sample 6

Inception Elaboration Construction

Text

Text

Text

Text

Text

Text

Text

Text

Text

Sprint 1 Sprint 2 Sprint 3 Sprint 4

Text Text Text

Text Text Text

Text Text Text

TEXT TEXT TEXT TEXT TEXT TEXT

Weeks 1-2 Weeks 3-4 Weeks 5-13

Text

Text

Text

UAT Support

Text

Text

Text

Text

TEXT

Weeks 14-15

Text Text Text Text TextText Text

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Sample 7 Signoff

Week0

Week2

Week3

Week4

Week5

Week6

Week7

Week8

Week9

Week10

Week1

Sprint 1 and Sprint 2Sprint 0

Week11

3 Weeks

1 week

4Weeks

Integration and Testing UAT Support

2 Weeks

• text

Inception and Elaboration

Integration and Testing

Final UAT Support

• text

• text

• text

Sprint 2- Construction

Sprint 1- Construction

• text

4 Weeks

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Sample 8

44Onsite

Contractors7

Onsite Resources

43Offshore

Resources

In Scope Baseline Cost

2016 Project Cost

$6.01mn

$300K $3.60mn

* Costs incurred during transition

7Onsite

Resources

48Offshore

Resources

$5.06mn

$-218 K*

$278K

2015 Project CostJan 2015 Dec 2016

Savings

29.81%

Additional20.03%

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Sample 9

Savings

44Onsite

Contractors

7Onsite

Resources

44Offshore

Resources

In Scope Baseline Cost Jan Feb March April May Through June

to December2015 Project

Cost

$6.01mn $-218 K*

$25K$30K $146K $218K $278K $5.06mn

* Costs incurred during transition

29.81%

Savings

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Sample 10

Inception Engineering Validation Release

ARC – Tracking and Reporting

Management Review Dashboard

DA Architect

Functional SME

QA SME

Practice SME DA Architect

Functional SME

Practice SME

DA Architect

Functional SME

QA SME

Practice SME

Checklists / Questionnaires

• Technical Solution o Design Review Checklisto SAD Review Checklist

• Test Automation script review • Performance Testing script review • Risk Identification• QA review & Process Compliance QA• Handover to Delivery

Templates

• Project Initiation • Project Planning & Monitoring • Change Management • Requirement Management repository• Manual Testing management

repository • Test Automation plan • Performance Test plan &

Requirements• Transition Management• Risk Management

Procedure

• Project Initiation, Planning & Monitoring

• Change Management • Configuration Management • Testing • Transition Management • Portfolio Management

•Disaster Recovery •Customer Satisfaction•Risk Management •Delivery Assurance •Project Closure •Process compliance

DA Architect

Functional SME

QA SME

Practice SME

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Inception Engineering Validation Release

Plan

Requirement

Arch. Design

Regression

Performance

Upgrade testing

EV Patch

Construction & Unit Testing

Integration Testing

Config. Mgmt. & release

ARC – Tracking and Reporting

Management Review Dashboard

DA Architect

Functional SME

QA SME

Practice SME

DA Architect

Functional SME

QA SME

Practice SME

DA Architect

Functional SME

Practice SME

• Requirement & Plan • Functional workflow • UX strategy • Architectural & Design

• Coding standards• Test scenarios & scripts • Test automation • Continuous Integration• UI Screens & code • User stories mapping

• Test Cases• Critical Workflows Spec• Automate Functional Test Suite• Performance Test suite• Installation manual• Install package • Platform configuration document • Configuration Checklist

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Week 1 Week 2

Emids Specific Intermediate Healthcare

Certification Advanced Healthcare certification

Navinet's Architecture & APIs Navinet's Development & Testing

processClient Specific Process Trainings Health Care - Claims Submission Navinet's Framework Robot Framework ( For QA only)

PRE-BOARDING

ONBOARDING & RAMP-UP

ASSIGNED TO PROJECT

Week 0

• adsf

Week 3 Onwards

• adsf

Role

s

OPM

Business Analyst

Project Manager

Business Analyst

Architect

Developer 1

Tech Lead

Developer 3

Developer 2

QA Lead

Developer 4

Performance Tester

QA 1

QA (Auto. Test Engineer)

Onshore

Hired

Existing

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Sample 13

Business Vision Statement

Prioritized Business Goals

Business Requirements Document

DISCOVERY REQUIREMENTS PROOF OF CONCEPT REPORT SUBMISSION

ACTI

VITI

ESD

ELIV

ERAB

LES

BUILD + TEST

FLU

ENCE

Interface

Interface

Interface

Interface

Interface

Interface

Interface

Fluence Integration Guide and Data Model

Data flow, exchange formats and data format conversions

Analyze the structure and content of all source clinical systems

Identify natively available extraction interfaces

Define the Conversion architecture

Determine interface strategy

Data mapping strategy

Detailed design specifications

Document the POC results

Integration recommendations

Risks, mitigations and challenges

Detailed design specifications Sample Scripts

Integration strategy

Key constraints, risks / mitigation strategies

Customization required of EHR vendor

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W-0 W-1 W-2 W-3 W-4 W-5 W-6 W-7 W-8 W-9 W-10 W-11 W-12

• Vision for the clinical integration

• Business goals • Key performance indicators • Business requirements

• Detailed interface and conversion requirements• Building, configuring, and unit testing all interface and data conversion initiatives• Unit, data communications, and integration and user acceptance tests

• Prepare draft TO-BE integration Strategy

• Present draft strategy to UPMC Stakeholders , refine & finalize per feedback

Discovery Requirements Definition (Functional/Technical) Assessment Conclusion & Report Submission

• Discussion with UPMC’s TDC & Business stakeholders

• Discussion with Fluence platform team

• Info gathering workshops

• Analysis • Consultation with Fluence platform team & SMEs

• Stakeholder presentation and report

• Discussion & Finalization• Demonstration of POC

Tech. project Manager

Clinical Data Architect

Business Analyst

Interface Engine Dev.

Tech. Product Integration Specialist

1

1

2

2

7

Interface Engine Dev.Tech. Product Integration

Specialist

Tech. project Manager 1 Clinical Data Architect 1 Business Analyst 2

2 7

Tech. project Manager

Clinical Data Architect

Business Analyst

Interface Engine Dev.

Tech. Product Integration Specialist

1

1

2

2

7

F2F F2F F2F

• TDC & Business stakeholders

• Fluence SMEs• Fluence platform team

• Fluence SMEs• Fluence platform team• Fluence interface analysts • Data Architect

• TDC & Business stakeholders

• Fluence SMEs & Management

Kick off meeting Signed off business requirements POC – Interim demo complete Finalized integrationstrategy & presentation

Phase

What

Who

Method

Mode

Client Involvement

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Stakeholders’ Requirements

BUSINESS OBJECTIVE ALIGNMENT PRODUCT EVALUATION SCORING & RECOMMENDATION

Pain Points

Plus + Parallon (Scheduling)

Smart Square

Scheduling

Productivity

Product comparison for evaluation criteria

Scoring based on priority & weightage of each SH requirement

& its category

Recommendation report & presentation feedback

implementation

Acceptance

Workflow

Data

Cost

Support

Prioritize

0 21 3 54 6 7 8WEEK WEEK WEEK WEEK WEEK WEEK WEEK WEEK WEEK

nWEEK

FEATURE ELABORATION

Product comparison

for evaluation

criteria

Technical

Functional

Business

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Org Chart and Team structures

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Sample 1

Vice President, Delivery

49

Sunquest Management

Sunquest Project Owner

Sunquest Project Team

Delivery Manager

Project Manager

UXP Lead

Architect

Tech Lead

Account Manager

COE Head

BA Practice QA Practice

Business Analysts

QA Manager

Performance Lead

Automation Lead

QA Lead

Performance Engineer

Automation Engineer

QA Analysts

Quarterly Reviews

Escalation Path

Bi-Weekly Reviews

Weekly Reviews

Delivery Assurance

Healthcare Practice

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ONSITE

Developer

nH Stake holders

emids Onsite Program Manager

Delivery Head

Delivery Manager

nH Project TeamProject Manager

BA QA

Onsite Tech Lead

OFFSHORE

Unbilled Resource-Offshore 100% Billed Resource-OnsiteUnbilled Resource-Onsite 100% Billed Resource-Offshore 50% Billed Resource-Offshore

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Flows

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Sample 1

• Manage New/ Refill Medication Orders, Medication Inventory Tracking

• Discontinue Active Orders• Maintain Non- Medication Orders

• Manage Patient Administration• View Care Grid/ Full Patient MAR• Recommend tapering & sliding orders• Postpone order administration

• View Medication Administration Reports• Receive alerts on overdue orders

Nurse

Nurse Supervisor

EMR

Order Management

Medication Administration

Reports and Alerts System admin

System Admin

phMS

• Define Med Pass• Manage Nurse Assignments

• View Nurse Efficiency Report• Receive missed order alerts

• Send Patient Administration Data• Send missed order alerts

• Receive Tapering & Sliding Order • Recommendations Approval/ Denial

• Send Vital Signs, Pain Assessments and medication Follow-Up results

• Send Tapering & Sliding Order Recommendations Send/ Receive

Medication Orders

Send New/ Refill medication Orders

Configure System Parameters

CLINICAL SOFCARE2

EMR

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Predictive Analytics & Scoring

MED

SEEK

Pre

dict

Ideal Target Selection (Recipe)

Target List Builder

Measuring Results (BI & Reporting)

Communication Mailers

Hospital Data

Experian Data

Marketing Data

Predict Data+

+

+

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Sample 3Ac

ute

Care

Pr

ovid

ers

Send Pre-Auth & assessment request

Wor

kben

chCM

Life

Sav

e

Start

Receive & Process RequestAuto

Assignment

Review req. & process it

Send the Auth response

Review req. & process it

Send the LS assessment med report

Receive response & send it to

provider

Receive the response , process it & review itEnd

Yes

No

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Pre-Engagement Activity- Query log: assessing the customer technical and business environment

• Engagement process begins with pre-kickoff meetings and initial conversations with the customer

• Document High level objective

• Resource identification• High level plan

• Define CTQ for customer• Acceptance criteria

• Execution• Assessment of current BI systems• Stakeholders interviews(business and

technical)• Documentation

• Logical Data Architecture and Master Data Management plan

• Logical Information Delivery Architecture

• Logical Security Architecture• Logical BI Semantics Architecture• Conceptual Data model

• Create BI strategy and roadmap

• Final findings are presented to the customer along with clear roadmap for implementing BI strategy

0 1 2

34

5

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Case Studies

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Scenario: The incumbent testing team was almost entire onsite based with a large number of contractors who had spent extended stints on the applications. With no documentation available (for most applications), the challenge was to replace the incumbent team without affecting overall service delivery within a span of 90 days. Additionally, the QA Ops were to move from KANBAN to Agile methodology along with ramping up a team of 100 + QA resources.

Test Engagement Highlights

Transitioned 110+ QA resources within one quarter

Successful transformation from KANBAN to Agile testing methodology

Global delivery model for QA cost optimization

Dedicated Testing Center of Excellence (TCoE) for continuous improvements

Implemented uniform QA governance Model

Test Categories covered

Functional Testing

System Testing

Integration testing

Regression testing

Test automation

Performance testing

Security Testing

Database validation

Business Outcome

Contained spiraling QA cost within 2 quarters

Standardized QA process across product suite

Reduced Application Release cycle time by 20% fp

Successful transition in a multi-vendor env

Continuous improvement thru TCoE

Test tools & Technology

Quality Center

HP Quick Test Professional

HP LoadRunner

Selenium

Rally

App tracks under test

Population health management applications including: Member portals, Total Member View Application for Providers, Web based applications for nurses and Data analytics reporting tool

Data Sources: EMR, Lab, Claims, HRA

Data Ingest: ETL, HIE, Adapters

Technical components tested includes:

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Challenges Engagement Highlights

Reduced the claim analysis

cycle time by 25%

Resulted in 30% increase

in data loads, year on year

through automation

Multiple data sources and files in different formats made it very difficult for the client’s data analysts to process the claims information

Turn around time and the error rates were very high due to the manual processes

• Used emids’ ETL QA analyzer tool to ensure data quality during pre and post ETL processes

• Worked with the client’s data analysts and BI experts in providing DBA and query maintenance services for trend analysis and overpayment analysis of claims

Tech

com

pone

nts

& v

alue

add

s

• Improved claims analysis processes and lower turnaround time

• Improved data quality, leveraging emids ETL Quality Analyzer tool

• Cost contained delivery Dom

ain

valu

e ad

ds

• Leveraged emids’ data management framework to implement an end to end solution for claims data management• The framework enabled data aggregation, validation and reporting • Created automated scripts for data validation and data extraction from multiple source files and loaded it to a staging database• Converted multiple data formats from different source systems into a single CSV format, and loaded data onto the client’s claims

analysis application

Engagement Specifics

Technology Stack

• ETL QA analyzer tool • SQL Server• C# .net• Sql server• Load Automation tool

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HEALTHCARE TECHNOLOGY VENDORS HEALTHCARE PAYERS

HEALTHCARE PROVIDERS

HEALTHCARE TECHNOLOGY VENDORS

• INTEROPERABILITY AND INTEGRATION

• IMPLEMENTATION AND MIGRATION• DATA MANAGEMENT, BI/DW

SERVICES• MOBILE HEALTH SOLUTIONS• ICD 10 SOLUTION• MEANINGFUL USE SOLUTION

• EMR/EHR VENDORS

• HEALTH INFORMATION EXCHANGES

• PACS AND MEDICAL IMAGING

• RCM AND INTERMEDIARIES

• WELLNESS MANAGEMENT

HEALTHCARE PAYERS

• COMMERCIAL HEALTH PLANS

• BLUE PLANS

• DENTAL AND VISION PLANS

• MEDICARE, AND MEDICAID

• MEDICARE ADVANTAGE

• ACOS AND PCMH

• PAYER- PROVIDER INTEGRATION SERVICES

• ENHANCEMENT OF CORE APPLICATIONS

• BI/DW SERVICES• APPEALS AND GRIEVANCES SOLUTION• METRICS THAT MATTER

• ARCHITECTURE AND DEVELOPMENT SERVICES

• DATA MANAGEMENT/BI

• APPLICATION ENHANCEMENT

• MAINTENANCE SERVICES

• TESTING & QA AUTOMATION SOLUTIONS

MARKETSMARKETS SOLUTIONS & SERVICES

• ACUTE CARE HOSPITALS

• LONG TERM CARE

• AMBULATORY AND MEDICAL GROUPS

• SPECIALTY PROVIDERS

• ACOS AND PHO

HEALTHCARE PROVIDERS

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To Learn More:Visit our website at www.emids.com or send an email to [email protected] Headquarters: 520 Royal Parkway, Nashville TN 37214 | Phone: (615)332-7701 | Fax: (615)523-2825

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