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The 2014 HL7 Interface Technology Survey Results provide a current view of the HL7 interface marketwithin healthcare. The topics in this survey include technology, organizational priorities, meaningful usepreparedness, and perspectives on interface engine vendors. Survey results are presented from the keyperspectives, CIO/CTOs/CMIOs, IT Managers, and Integration Professionals.These survey results provide a summary of the data collected during a 4 week period in September andOctober 2014 which was open to all participants through our website, corehealthtechnologies.com. Weencouraged participation with email invitations and through various social media outlets.Over 860 individuals participated in this survey. All participants live and work inthe United States and are employed by healthcare organizations, predominantlyproviders, using HL7 interfaces.Published October , 2014

Observations by Core Health Technologies Leadership has experienced an increase in turnover. Over 24% of the CIO/CTO/CMIOcategory reported they have less than 2 years tenure with their current organization. Interface engine usage continues to be diverse, with several engines leveling the market.Infor’s Cloverleaf engine, remained the leader with 39.1% of respondents reporting using.Several other engines continue to make strides with Mirth at 24.2%, Orion’s Rhapsody at 18.6%and iNTERFACEWARE’s Iguana at 18.1% usage. Epic Bridges showed usage by 26.4% ofrespondents and is included in this category at the request of providers even though it is not afull interface engine. Multiple providers reported using more than one interface engine. Organizations plan to stay with their current interface engines. 74% of organizations reportthey plan to stay with their current vendor and either stay on the current version or update asappropriate with the same vendor. Interface engines have more capability beyond their current use. 44.8% of organizationsreport that while they are using their engine to satisfy their initial intent, they know there ismore capability in their interface engine that they have not harnessed. High activity with HIEs while many challenges continue to exist. Over 68% of organizationsreport to be working in some capacity with at least one HIE outside their organization. At thesame time participants report top issues to be integration, technology and the HIE’s businessmodel sustainability. Many IT priorities this year with Meaningful Use topping the list as #1. While 17 differentcategories had enough response to list as priorities this year, the most listed priority for leaderswas Meaningful Use (CIO/CMIO: 23.7%, Managers: 22.2%). FHIR, or Fast Health Interoperable Resources (pronounced ‘fire’) continues in a nascentstage. Only 4.3% of CIO/CTO/CMIOs, 4% of IT Managers and 6.1% of HL7 Professionals report astrong or extensive understanding of FHIR. In contrast, 63.9% of CIO/CTO/CMIOs, 76.3% of ITManagers and 71.8% of HL7 Professionals report their understanding of FHIR as weak or none. Integration activity will increase over the next 12 months. All three categories ofparticipants in this years survey indicate that they expect integration activity to increase(CIO/CMIO: 67%, Managers: 64.3%, Professionals: 62.3%). This is even more impactfulconsidering integration activity has steadily increased in recent years.Core Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

Tenure in 0%7.4%20.0%13.0%30.0%20.3%What is your tenure within your current organization?0.0% 1 year1 - 2 years3 - 5 yearsCIO/CTOs6 - 9 yearsIT Managers10 - 14 years 15 - 19 years20 yearsHL7 ProfessionalsTenure in 6.5%5.2%3.1%0.9%3.7%2.0%10.0%0.0%2.2%20.0%16.3%HL7 Professionals17.0%IT Managers12.6%CIO/CTOs11.1%30.0%21.6%How long have you been in the healthcare sector?0.0% 1 year1 - 2 years3 - 5 years6 - 9 years10 - 14 years 15 - 19 years20 yearsTenure in .0%15.4%28.9%HL7 Professionals7.7%15.6%IT 7.9%60.6%How long have you been in Information Technology (IT)?0.0% 1 year1 - 2 years3 - 5 years6 - 9 years10 - 14 years 15 - 19 years20 yearsCore Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

HL7 TechnologiesSelect all specific HL7 interface technologies which your organization currently f [Lawson (Quovadx)]13.1%Corepoint, NeoTool [Corepoint Health]3.2%3.8%EasyConnect [Iatric Systems]9.5%eLink [Allscripts (Eclipsys)]12.9%Ensemble [Intersystems]26.4%Epic Bridges [Epic]5.4%Fusion Middleware [Oracle]18.1%Iguana [iNTERFACEWARE]iWay [iWay Software]0.3%13.4%JCAPS/ICAN/e*Gate/DataGate 24.2%Mirth Connect [Mirth Corporation]15.2%Open Engine [Cerner]17.2%OPENLink [Siemens]9.0%Pathways [McKesson]24.2%Point-to-Point18.6%Rhapsody [Orion Health]I don’t knowother35.0%9.7%BizTalk [Microsoft ]e-Biz Impact [Sybase]30.0%3.0%16.4%Core Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

Current Interface Engine StatusHow would you best describe your current status of interface engines?3.0%10.0%23.5%8.6%2.4%2.0%We have recently completed a change to anew interface engineWe are actively considering our optionsWe are currently in the process of changingto a different interface engineWe have decided to change to a new interfaceengine but have not selected the engineWe have selected a different interface enginebut have not started the process to changeWe plan to stay with our current vendorand will upgrade as appropriate.We plan to stay with our current vendorand stay on the current version50.5%Interface Engine UtilizationTo what degree is your organization utilizing your interface engine(s)?1.1%2.4%5.6%We are utilizing our interface engineeffectively and to its fullest capability5.7%40.4%We are utilizing our interface engineeffectively for what we initially intended,but know there is more capability that weare not usingWe are still in our initial implementationof this interface engineWe have not achieved our initial utilizationobjectives and have exceeded our timeline44.8%We are using our interface engine, but I amnot aware of the full product capabilityI am not aware of the degree to which weutilize our interface engineCore Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

Integration ApproachHow would you best describe your organization's approach to integration?(Select all that apply)0.0%10.0% 20.0% 30.0% 40.0% 50.0% 60.0% 70.0% 80.0% 90.0% 100.0%74.8%35.2%9.3%Training1.4%3.7%Internal StaffEngine Vendor Professional Service3rd Party Consulting FirmsStaffing intenance2.0%4.0%81.1%17.0%20.0%Short Suspense Projects3.0%6.0%Core Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

Meaningful Use PreparednessHow well is your organization prepared to achieve Meaningful Use Stage 2 criteria?CIOs/CTOsIT 16.5%38.5%15.4%12.8%17.6%HL7 Professionals3.8%12.0%We have achieved Stage 26.6%We are currently in the ONCcertification process for Stage 226.3%We are currently on track forStage 2 certification in 2014We are currently on track forStage 2 certification in 2015We do not have a current milestoneset but it is a priority19.1%We do not have a current milestoneset and it is not a current priority10.0%22.1%I do not knowCore Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

HIE Involvement & StatusPlease select the statement that best describes your organization's current HIE status.CIOs/CTOs8.8%IT %40.7%35.2%20.9%We are actively integrating with anHIE outside our organization.HL7 Professionals7.8%4.5%We are actively integrating with morethan one HIE outside our organization7.0%7.2%We are actively integrating with our ownorganization's HIE, but no HIE outside20.8%21.9%We are currently working towardsintegrating with an HIE outside our orgWe are currently researching and makingplans to start working towards integratingwith an HIE outside our organization.We are currently not engaged in any activityor planning regarding integrating with an HIE.I do not know30.9%Core Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

HIE ChallengesWhat are your organization's biggest current challenges regarding ATEGY/VISION0.0%13.6%15.5%BUSINESS GRATION26.1%4.8%SECURITY7.4%2.5%3.6%ORGANIZATIONAL PRIORITIES0.0%0.5%Core Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

IT PrioritiesWhat are the top three priorities/objectives for your internal IT organization this year?0.0%Staff Resources5.0%1.0%1.2%3.4%AnalyticsHosting/ Cloud1.2%1.0%1.0%0.4%1.2%Financial %2.5%Integration/InterfacesPatient s & Expansion25.0%5.9%Meaningful Use/EMRHardware20.0%16.5%18.3%4.4%Core Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

FHIR Understanding and InvolvementWhat is your current understanding, involvement and future outlook of FHIR (Fast Health Interoperable Resources - .9%36.2%27.5%28.0%27.7%20.0%10.0%7.7%1.1% 2.2%Understanding30.0%20.9%10.8%1.1% 3.2%1.1%InvolvementIT Managers0.0%Future 0%22.8%19.8%22.2%10.9%0.0%40.0%4.0%10.0%9.1%0.0% 2.0%Understanding20.0%18.2%0.0%0.0%InvolvementHL7 ProfessionalsFuture .0%0.0%Future OutlookWeak20.0%NoneCore Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

Healthcare Integration Impact to PrioritiesHow does “healthcare integration” affect your priorities/objectives?CIOs/CTOsIT Managers7.5%11.7%6.9%12.9%13.9%13.8%62.8%66.3%HL7 Professionals3.5%24.0%2.9%Integration is our top priorityIntegration is integral to at least oneof our priorities7.0%12.5%Integration is integral to all of ourpriorities and cannot be separatedIntegration has some effect on usachieving our top prioritiesIntegration has little effect on usachieving our top prioritiesIntegration has no effect on usachieving our top priorities50.1%Core Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

Integration Activity Outlook - Next 12 MonthsLooking forward to the next 12 months, how will your HL7 integrationactivities compare with the past 12 months?CIOs/CTOsIT 5.1%HL7 Professionals3.7%4.3%Our integration activities/effortswill decrease significantly29.0%29.8%Our integration activities/efforts willdecrease slightly/moderatelyOur integration activities/efforts willstay the about the sameOur integration activities/efforts willincrease slightly/moderatelyOur integration activities/efforts willincrease significantly33.3%Core Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

Information Security Impact to PrioritiesHow does “information security” affect your priorities/objectives?CIOs/CTOs3.2%21.3%IT Managers1.0%3.2%3.2%1.0%5.0%6.0%34.0%69.2%53.0%HL7 Professionals1.0%25.3%2.7%3.7%8.1%Information Security is our top priorityInformation Security is integral to atleast one of our prioritiesInformation Security is integral to allof our priorities and cannot be separatedInformation Security has some effect onus achieving our top prioritiesInformation Security has little effect onus achieving our top prioritiesInformation Security has no effect on usachieving our top priorities59.2%Core Health Technologies - www.corehealthtechnologies.com 919-780-4HL7

What Keeps You Awake at Night?In regard to your work responsibilities, goals, and priorities: What keeps you up at night?CIOs/CTOs5.9%7.8%7.8%19.6%17.6%Requirements & Strategic VisionWork Pace, Complexity, D109.8%Integration VariablesMeaningful UseIT Managers9.8%1.6%Vendor/Product AbilityPatient-Focused Services9.8%Staff/Resources4.9%Privacy & Security13.1%27.9%Stability & UptimePersonal Career4.9%4.9%3.3%14.8%Core Health Technologies - www.corehealthtechnologies.com 919-780-4HL7