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Who Is DSS, Inc. ? • Privately held • Founded in 1990 • Principle Who Is DSS, Inc. ? • Privately held • Founded in 1990 • Principle office Juno Beach, FL: satellite offices Atlanta, Minneapolis, & Tampa • 128 Employees • Supports 1200+ VA implementations • 6 VA National Contracts • Major provider of external software to the VA • Created vx. Vist. A, based on FOIA Vist. A, 2005 2

Vist. A developed by the VA is… • • Complete Electronic Health Information System Vist. A developed by the VA is… • • Complete Electronic Health Information System DHCP released I 984 Vist. A released 1996 CPRS released 1999, current version is 27 Built to improve the quality of healthcare Design based on clinician requirements Used by over 180, 000 healthcare professionals Used in 170 medical centers, 135 nursing homes & 850 community based outpatient clinics • Over several hundred million dollars spent annually on support and development of Vist. A 3

VISTA SOFTWARE PACKAGES VOLUNTARY SERVICE COMPUTERIZED PATIENT RECORD SYSTEM (CPRS) REHAB MEDICINE MEDICAL RECORDS VISTA SOFTWARE PACKAGES VOLUNTARY SERVICE COMPUTERIZED PATIENT RECORD SYSTEM (CPRS) REHAB MEDICINE MEDICAL RECORDS TRACKING ACCOUNTS RECEIVABLE Kernel ADMISSION DISCHARGE TRANSFER NURSING PATIENT FUNDS MAILMAN TASK MANAGER INTEGRATED DATABASE LAB RESULTS BAR CODE MEDICATION ADMINISTRATION MENU MANAGER RADIOLOGY IMAGES DRUGS SURGERY RPC BROKER PERSONS PATIENTS LABORATORY DENTAL LIBRARY BLOOD BANK WARDS DEVICE MANAGER SOCIAL WORK MENTAL HEALTH INVENTORY PRESCRIPTIONS MEDICINE USER SECURITY ENGINEERING ONCOLOGY VA FILEMAN DIETETICS WOMEN’S HEALTH INPATIENT PHARMACY SCHEDULING MEDICAL CARE COST RECOVERY INTEGRATED FUNDS CONTROL ACCOUNTING & PROCUREMENT OUTPATIENT PHARMACY 4

Vist. A • Makes medical records of VA patients instantly available across the country Vist. A • Makes medical records of VA patients instantly available across the country to healthcare professionals treating the patient at any VA facility • While much of the Do. D’s health records are currently available within Vist. A, the VA and Do. D are working to achieve complete interoperability 5

DSS vx. Vist. A • Based on FOIA released Vist. A • Maintains the DSS vx. Vist. A • Based on FOIA released Vist. A • Maintains the integrity of FOIA Enhancement and Patch Process • Develop enhancement products to promote best practices, performance measures, and workflow efficiencies providing a great return on investment • Certification Commission for Healthcare Information Technology (CCHIT) 2006 Certified 6

vx. Vist. A - A Complete EHR 7 vx. Vist. A - A Complete EHR 7

Open Choice vx. Vist. A • Allows users to implement the software themselves, hire Open Choice vx. Vist. A • Allows users to implement the software themselves, hire a third party to do so, or have DSS implement, customize, and support • Remains as close as possible to the FOIA Vist. A • Allows additional functionality provided by DSS and vendor partners software 8

vx. Vist. A Integrated Medical Decision Support, Computer Order Entry, and Electronic Health Record vx. Vist. A Integrated Medical Decision Support, Computer Order Entry, and Electronic Health Record : ADT : Pharmacy : Allergies : Problems : Consults : Progress Notes : Interfaced Products : Radiology : Integrated Products : Reminders : Labs : Scheduling : Notifications : Surgery Anesthesia 9

DSS Integrates Commercial Software into Vist. A • CAS – Automated patient vitals • DSS Integrates Commercial Software into Vist. A • CAS – Automated patient vitals • Complete Medical Solutions – Fee basis claim system • Dräger Medical - Innovian with DSS SAVLink™ An electronic anesthesia documentation system • DSHI Systems, Inc. - VHG with DSS TRM™ Access treatment protocols for triage algorithms and case disposition • Eclipsys - Anesthesiology and ICU • GE Medical – Anesthesiology and ICU 10

DSS Integrates… • Philips Electronics -Anesthesiology and ICU • Picis - Anesthesiology and ICU DSS Integrates… • Philips Electronics -Anesthesiology and ICU • Picis - Anesthesiology and ICU • Pocket. MD - The power of CPRS in the palm of your hand • Pro. Vation Medical - Procedural notes for Imaging Procedures. Modules for GI and GI Nursing • Quadra. Med – Encoder Product Suite, VIP Compliance Suite, Chart Complete: integrated software solutions improving compliance, coding, workflow efficiencies and revenue enhancement 11

DSS Integrates. . . • Theradoc Inc. – Medical Decision Support, infectious disease, & DSS Integrates. . . • Theradoc Inc. – Medical Decision Support, infectious disease, & biosurveillance • Vist. A Chemotherapy Manager – Based on Intellidose® Oncology decision support tool. Contains a broad array of safety features to ensure the accuracy of the dose and the treatment decision for the life time of the patient • Welch Allyn – Automated Patient Vitals 12

Integrated DSS Products • Clinical Note Templates (CNT) 290 templates which include programs for Integrated DSS Products • Clinical Note Templates (CNT) 290 templates which include programs for Real Time Vitals, Patient Input Touch Screen, Bar Code Labels, and patient documentation • Dental Record Manager Plus (DRM Plus) a GUI front end for total documentation of dental treatment and plans, including dental billing codes • Doc. Manager document imaging & insurance card system, providing scanning and data retrieval at the patient’s chart level • Encoder Product Suite Inpatient & Outpatient coding compliance and claim scrubbing modules 13

Integrated DSS Products • Mental Health Suite (MHS) providing Mental Health Treatment Planner and Integrated DSS Products • Mental Health Suite (MHS) providing Mental Health Treatment Planner and Reporter • Provider Assistive Templates (PAT) E & M Coding Templates that allow ancillary staff to collaborate with physicians and other providers in completing a patient’s history and physical • Release of Information (ROI) maintaining HIPAA compliance while facilitating the release of patient information • Tele. Care Record Manager (TRM) Triage patients’ phone calls, provide decision protocols and track actions taken 14

DSS & Open Source • • Non-Viral License DSS support for Open vx. Vist. DSS & Open Source • • Non-Viral License DSS support for Open vx. Vist. A Community support for vx. Vist. A Enhancements to vx. Vist. A in areas not scheduled for VA development near-term 15