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AN INTRODUCTION TO EPIC’S NATIVE VIDEO CLIENT 16 April 2020 Due to the current pandemic, many of you have asked us to offer a video-conferencing service directly. Well, we are… …but this is a new venture for us. We will learn a lot as we go. And today, we can’t say yes to everyone who might want to use it. And so, in the spirit of transparency, this webinar is to explain what we do know and what we don’t yet know. 1 WHAT IS IT?

2 MANAGING EXPECTATIONS

3 THE ROAD AHEAD

CONTEXT-AWARE LINKING lets Epic connect, in a plug-and-play way, with a number of different video technology providers

Example from InTouch

Hyperspace Haiku/Canto EpicCare Link MyChart

Native Applications AN OPTION FROM EPIC

Hyperspace Microsoft Azure Video Programming Haiku/Canto web application APIS + Stun/Turn EpicCare Link hosted at Epic. WebRTC backend MyChart

Video Visit Scalable Video Native Applications Client Infrastructure A BRIEF “DEMO” “Our patient Doug has a video visit scheduled at 5 pm. He logs into the website or mobile app, where he sees the reminder and taps it to get details.”

PATIENT VIEW Available on web or mobile Patient taps the notification to get started “He selects “Begin Visit’ to get started.”

PATIENT VIEW “Begin visit” launches the video “When he taps that button, that launches him out to the local browser that’s already available on his mobile device. He’s in the virtual waiting room right now, where he can see his own video feed. He’ll wait here for the provider.”

PATIENT VIEW Video client opens up in the local browser Patient waits in the virtual waiting room PROVIDER VIEW Patient’s visit shows on the schedule

“As a provider, I can see that my Icon shows that patient has patient has connected to the connected video visit from this icon. I can choose to open the patient’s Provider can open the chart first or chart first and review their begin the visit right from the information, or I can launch his chart and the video at the same schedule time by double clicking the icon.” “Now that I’ve connected with my patient, I can continue my documentation as normal. I also have the option to mute my audio if needed, disable my camera momentarily, or switch my audio or visual devices.”

PROVIDER VIEW Patient’s video opens in a local browser or on Canto Documentation can be done simultaneously Mute audio, disable camera, or switch devices “The patient also has the same options. They can mute, disable their camera, or choose to have their camera switch to front facing. When the visit is over, our patient just leaves the visit or closes the .”

PATIENT VIEW Mute audio, disable camera, or switch cameras Leave when visit is complete “I’ll also leave the conference.”

PROVIDER VIEW Provider can leave visit or close camera Documentation is finished up in Hyperspace like normal “And at this point, I’ll finish my documentation and then sign the visit.”

PROVIDER VIEW Provider can leave visit or close camera Documentation is finished up in Hyperspace like normal A QUICK TECHNICAL INTERLUDE Your site (if on premises) Epic’s hosting space for you “Here’s a quick HOW IT WORKS schematic of your system, whether it’s hosted on Chronicles prem or by Epic.”

Hyperspace Interconnect (Citrix)

FIREWALL HTTPS (TLS 1.2)

Audio/Video over UDP

ECF Protocol Your site (if on premises) Epic’s hosting space for you “The video client is HOW IT WORKS an Epic-offered SAAS solution, hosted on Azure Chronicles U.S region servers.”

Epic’s Native Video Client A distributed cloud application Hyperspace Interconnect (Citrix) Twilio FIREWALL HTTPS (TLS 1.2)

Audio/Video over UDP U.S. West & U.S. East ECF Protocol Your site (if on premises) Epic’s hosting space for you “The provider’s local HOW IT WORKS web browser (opened via content redirection) connects to the video Chronicles client.”

Web Browser (Local Computer)

Epic’s Native Video Client A distributed cloud application Hyperspace Interconnect (Citrix) Twilio FIREWALL HTTPS (TLS 1.2)

Audio/Video over UDP U.S. West & U.S. East ECF Protocol Your site (if on premises) Epic’s hosting space for you “The video client communicates with your HOW IT WORKS organization using web services. It retrieves a Chronicles token to open the A/V stream with Twilio.”

Web Browser (Local Computer)

Epic’s Native Video Client A distributed cloud application Hyperspace Interconnect (Citrix) Twilio FIREWALL HTTPS (TLS 1.2)

Audio/Video over UDP U.S. West & U.S. East ECF Protocol Your site (if on premises) Epic’s hosting space for you HOW IT WORKS “When the patient joins the conference, it Chronicles works the same way!”

Web Browser Patient (Local Computer) (Mobile Phone)

Epic’s Native Video Client A distributed cloud application Hyperspace Interconnect (Citrix) Twilio FIREWALL HTTPS (TLS 1.2)

Audio/Video over UDP U.S. West & U.S. East ECF Protocol Your site (if on premises) Epic’s hosting space for you HOW IT WORKS

Chronicles

Web Browser Patient (Local Computer) (Mobile Phone)

Epic’s Native Video Client A distributed cloud application Hyperspace Interconnect (Citrix) Twilio FIREWALL HTTPS (TLS 1.2)

Audio/Video over UDP U.S. West & U.S. East ECF Protocol

WHAT IT DOESN’T (CURRENTLY) DO

Multi-Party Hardware Check Image Capture  In the first release, only  Full pre-visit hardware testing  Support for a doctor connections between a single will be implemented at a later capturing images which save patient and provider will be date. back to the patient’s chart will supported. come in a future release. Patients will see a video That means no family or preview from their camera Screen sharing is also not group visits. Nurse rooming within the virtual waiting supported. support is bare-bones. room. WebRTC

Standard for supporting video conferencing in a web browser.

No app needed! That’s a good thing.

Launches out into a web Visit launches in new web browser view on device browser. That’s …an okay thing.

WebRTC: YES WebRTC: NO If Apple adds support, Edge Embedded iOS we’ll make it work in the Chrome iOS embedded browser. Android “Begin Visit” prompt in MyChart Mobile IF YOU’RE COMING FROM DEEP INTEGRATION TO CONTEXT-AWARE LINKING (regardless of vendor)

WORKS WELL BARE BONES (IF THAT) Direct-to-patient video visits Rover* On-demand or scheduled video visits Telestroke in Canto MyChart on iOS, Android, and web Epic Monitor Clinic-to-clinic visits in Hyperspace No image capture Affiliate support in EpicCare Link* Mobile support with Haiku** and Canto

*New with context-aware linking! **Includes Android! (RN 728030) *Wasn’t supported in deep integration either IMPLEMENTATION “WAVES” aka, flattening the support curve

EPIC’S CAPACITY FOR SUPPORT

Everyone who expresses interest gets to go first VOLUME

Measured rollouts with breaks for lessons learned

TIME “NEED” IS A SPECTRUM

UNHAPPY WITH NO VENDOR VENDOR OUTSIDE THE U.S.

EXPIRING OKAY WITH CONTRACT VENDOR

EPIC MISSES EPIC’S OFFERING IS EXPECTATIONS WILDY SUCCESSFUL

Delay in getting telehealth You may save money operational (maybe)

Possible failure in production No extra contracting work

Extra contracting work Great solution without MAKING THE CHOOSEEPIC needed flailing DECISION You’ll be as successful as Could be stuck in a long anyone else using that third contract you don’t want party Might spend money you Quick solution without don’t have to

flailing CHOOSE 3RD PARTY 3RD CHOOSE CONTEXT-AWARE LINKING SET-UP DONE

Determine if you’ll plan to expand Set up any extra use cases

DEEP INTEGRATION SET-UP DONE WHEN THE Determine if you’ll plan to expand Set up any extra use cases (EpicCare Link, Haiku Android) Reference transitioning article on Galaxy (link) TIME COMES

NO TELEHEALTH SET-UP DONE

Set up context-aware linking Determine your use cases Standard telehealth implementation MYCHART IS REQUIRED – PLAN FOR THAT NOW

link Improve the native video client EPIC’S

Image capture PRIORITIES Hardware testing etc. Improve Epic’s general telehealth offerings More workflows More platforms More use cases © 2020 Epic Systems Corporation. All rights reserved. PROPRIETARY INFORMATION - This item and its contents may not be accessed, used, modified, reproduced, performed, displayed, distributed or disclosed unless and only to the extent expressly authorized by an agreement with Epic. This item is a Commercial Item, as that term is defined at 48 C.F.R. Sec. 2.101. It contains trade secrets and commercial information that are confidential, privileged and exempt from disclosure under the Freedom of Information Act and prohibited from disclosure under the Trade Secrets Act. After Visit Summary, Analyst, App Orchard, ASAP, , BedTime, Break-the-Glass, Cadence, Canto, Care Everywhere, Charge Router, Chronicles, Clarity, Cogito ergo sum, Cohort, Colleague, Comfort, Community Connect, Cosmos, Country Connect, Cupid, Epic, EpicCare, EpicCare Link, Epicenter, Epic Earth, EpicLink, EpicOnHand, EpicWeb, Good Better Best, Grand Central, Haiku, Healthy People, Healthy Planet, Hyperspace, Identity, IntraConnect, Kaleidoscope, Light Mode, Lucy, MyChart, OpTime, OutReach, Patients Like Mine, Phoenix, Powered by Epic, Prelude, Radar, RedAlert, Region Connect, Resolute, Revenue Guardian, Rover, SmartForms, Sonnet, Stork, Tapestry, Trove, Trusted Partners, Welcome, Willow, Wisdom, With the Patient at Heart and World Connect are registered trademarks, trademarks or service marks of Epic Systems Corporation in the United States of America and/or other countries. Other company, product and service names referenced herein may be trademarks or service marks of their respective owners. U.S. and international patents issued and pending.