HIUG Membership Survey

The Healthcare Industry User Group (HIUG) actively works to help our member institutions find and work with members from around the world with similar profiles. This survey will be used to populate and update the HIUG membership database, so please complete it to the best of your knowledge*. When complete, please email this document to: [email protected] *Institution Information and Contact Information are required information and necessary to assign initial login. You are strongly urged to fill out as much information as possible and keep profile information up-to-date. Institution Information Institution Name Address Line 1 (Company headquarters) Address Line 2 City State/Province (Abbr.) Country (Abbr.) Postal Code Timezone Select a value Main Company Homepage (i.e. www.abc.edu or www.xyz.edu) Public or Private Select a Value Geographic Region Select a Value Company Type Select a Value

Number of Hospitals (Providers Only ) Hospital Bed Size (Providers Only) Number of Members (Payers Only) Products Offered (Payers Only) (ie. Life, Dental, Vision) Number of Employees Number of Core Users Number of Self-Service Users Number of IT Support Individuals (Only those who directly support your Oracle applications) First Oracle Purchase Select a Value First Year live on Oracle Select a Value Contact Information Key Contact – This is the primary person to contact in regards to your Oracle implementation at your company. Key Contact Name Key Contact Title Key Contact Phone Key Contact Email Updates Contact – This is the person who the HIUG should contact to keep your membership profile current. This may be the same person as your key contact, or a staff member with detailed knowledge of your company’s implementation assigned this task. Updates Contact Name Updates Contact Title Updates Contact Phone Updates Contact Email

Vendor Contact - The Vendor contact may be you, a purchasing department person, or a special person setup to handle vendor inquiries. This person will be the only person our online vendor partners will be able to see from your company, giving you control of where you want that single point of contact to be. Sponsorship from vendors helps support the HIUG cause, so please provide some form of contact. Vendor Contact Name Vendor Contact Title Vendor Contact Phone Vendor Contact Email Product Information The following section asks you to let us know what products you have implemented and what your current projects are.  For any ‘Date’ row, please select the date when you went live on the version selected.  If there are products missing, or additional information you would like to provide, please enter it into the ‘NOTES/OTHER’ box at the bottom of the product information section.  In the ‘Development’ row, please enter product information for what your organization currently has in development (i.e. your next upgrade or implementation).

Oracle Version Database Platform Date PeopleSoft HCM Implemented Select a Value Select a Value Select a Value Select a Value Development Select a Value Select a Value Select a Value Select a Value MODULES LIVE (check all modules that you have installed or are installing): Benefits Admin ePay Global Payroll Payroll Interface Directory Interface ePerformance HelpDesk for HR Pension Admin eBenefits eProfile HRMS Portal Pack Personal Portfolio eCompensation eProfile Mgr Dsktp HRMS Warehouse Resource Management eComp Mgr Dsktp eRecruit Human Resources Resume Processing eDevelopment eRecruit Mgr Dsktp Learning Mgmt Time & Labor Enterprise Warehouse FSA Administration Payroll for N.America Workforce Planning Other Modules In Use None None None

Oracle Version Database Platform Date PeopleSoft FM Implemented Select a Value Select a Value Select a Value Select a Value Development Select a Value Select a Value Select a Value Select a Value MODULES LIVE (check all modules that you have installed or are installing): Asset Liability Mgmt Contracts Expenses Payables Asset Management Enterprise Scorecard Financials Portal Pack Project Portfolio Mgmt Billing Enterprise Wrhouse Financials Warehouse Purchasing CFO Portal eProcurement General Ledger Receivables Other Modules In Use None None None

Oracle Version Database Platform Date PeopleSoft SCM Implemented Select a Value Select a Value Select a Value Select a Value Development Select a Value Select a Value Select a Value Select a Value MODULES LIVE (check all modules that you have installed or are installing): Billing eProcurement Purchasing Supply Chain Portal Cost Management eSupplier Connection Strategic Sourcing Supply Chain Wrhouse Enterprise Planning Inventory Other Modules In Use None None None

Oracle Version Database Platform Date PeopleSoft EPM Implemented Select a Value Select a Value Select a Value Select a Value Development Select a Value Select a Value Select a Value Select a Value MODULES LIVE (check all modules that you have installed or are installing): Bus. Plng & Bdgt Solution EPM Portal HRMS Wrhouse Workforce Planning CFO Portal Financials Wrhouse Supplier Rating System Workforce Rewards Enterprise Scorecard Financials Portal Supply Chain Wrhouse Workforce Scorecard Enterprise Wrhouse Other Modules In Use None None None Oracle PeopleSoft CRM Version Select a Value - Please enter the version in use or currently under implementation if not live. Primary Modules None None None

Oracle PeopleSoft ESA Version Select a Value - Please enter the version in use or currently under implementation if not live. Primary Modules None None None

Oracle PeopleSoft SRM Version Select a Value - Please enter the version in use or currently under implementation if not live. Primary Modules None None None

Oracle PeopleSoft ES-IA Version Select a Value - Please enter the version in use or currently under implementation if not live. MODULES LIVE (check all modules that you have installed or are installing): Enterprise Portal Enterprise Warehouse Integration Broker

3rd Party Products or Other Product Notes

NOTES / OTHER Primary Product Contacts

On this page please list you primary functional and technical contacts for each of the major product areas. Ideally this should be the project manager or lead for these product areas. While we know that you may have additional contacts, please only list the primary contact.

NOTE: If you add someone to this list, please make sure that they also appear on your initial user list (on the next page).

Functional Contact Technical Contact Oracle PeopleSoft HCM Oracle PeopleSoft EPM Oracle PeopleSoft FM Oracle PeopleSoft SCM Oracle PeopleSoft CRM Oracle PeopleSoft ESA Oracle PeopleSoft SRM Oracle PeopleSoft ES-IA

Vendor Information

The HIUG is interested in vendors you have worked with in the past, present or are scheduled to do work with in the future. Please list below any vendors you have worked with. The vendors will not be informed that your agency listed them on this survey – this information will be used in aggregate with other agencies only.

Vendor Name Purpose Positive? Contact Email / Phone

Initial Members

Please list any employees who you think would benefit from being a HIUG member. This should include anyone who participates on your Oracle projects, your key contacts for each area, and anyone else who you think may be interested in getting involved with the HIUG. There is no cost associated with being a member of the HIUG so you can list as many employees as you would like. Members can always be added later by your company or by individuals through HIUG email support.

In addition, you can help your employees get involved by selecting any initial subscriptions they should have. You can select from our four interest group areas, and members may be subscribed to multiple groups. As we add them to the system, we will automatically subscribe them to that group so they can begin participating in discussions immediately. The user can easily remove an initial subscription at any time by logging in and updating their profile.

Human Name Email Address Financials Materials Technology Insurers Resources