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Boyd Custom Software

Joyce Conner-Boyd

Walden University

Financial Management

Dr. Letsch

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Table of Contents

I. Executive Summary…………………………………………………………………… 5

II. Company Description…………………………………………………………………..5

II.1Company Background…………………………………………………………..5-6

II.2U.S Legislation & Regulations………………………………………………….6-7

I. Incentive Programs…………………………………………………………....6

II. Standards……………………………………………………………………..7

II.3Company Vision………………………………………………………………...7

II.4Company Mission……………………………………………………………….7

II.5Leadership Team……………………………………………………………...…7-8

II.6Board of Directors……………………………………………………………....8-9

II.7Legal Structure………………………………………………………………......10

II.8Human Resources…………………………………………………………...…...10

II.9Organizational Culture…………………………………………………………...10-12

2.10 Risk Factors…………………………………………………………………..…13-14

III. Impact of Global Economy on the Business…………………………………………......13-21

III.1 Opportunity Summary…………………………………………………………….14

III.2 Situational

Summary…………………………………………………………........14-17

I. U.S Legislation & Regulation………………………………………………..…..15

II. Healthcare Market Statistics……………………………………………….........16

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III. Electronic Health Record…………………………………………….……16-17

IV. What is Meaningful Use?...............................................................................17

V. Health I.T Sector………………………………………………………...….17

VI. Mobility………………………………………………………………...….18

VII. Saas………………………………………………………………….……19

III.3 Risk Analysis…………………………………………………………………..19-

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I. Competitive Analysis………………………………………………………..20-21

II. SWOT Analysis…………………………………………………………….21

IV. Global Opportunities for Growth……………………………………………………..21-24

IV.1 Opportunities Summary……………………………………………………….21-22

IV.2 Market Analysis……………………………………………………………….22-24

V. Workforce Management………………………………………………………….…..25-26

V.1Management Summary…………………………………………………….…..25

V.2Organizational Structure………………………………………………….…....25

V.3Management Gap Analysis……………………………………………….…...26

V.4Risk Analysis…………………………………………………………….…....26

VI. Sourcing………………………………………………………………………………26-28

VI.1 Key Solutions………………………………………………………………….27-28

VII. Business Operations……………………………………………………………….….29-30

7.1 Opportunities……………………………………………………………….….29

7.2 Operations Risk……………………………………………………………..…29-30

VIII. Ethics & Legal: Social Responsibility…………………………………………….…30-31

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8.1 Legal……………………………………………………………………….….30

8.2 Ethics…………………………………………………………………..……...30-31

8.3 Social Responsibility…………………………………………………………..31

VIIII. Marketing Plan……………………………………………………………..……..…31-44

9.1 Market Research……………………………………………………….……..…31

9.2 Market Statistics……………………………………………………………....…32-33

9.3 Healthcare Market…………………………………………………….……...….33-34

9.4 Competitive Analysis…………………………………………………………….35

9.5 Target Market…………………………………………………………………….35

9.6 Market Strategy…………………………………………………………………..35

9.7 Marketing Objectives……………………………………………………….……36

9.8 Marketing Database…………………………………………………………..….36

9.9 Marketing Initiatives…………………………………………………….………37

9.10 Marketing Milestones…………………………………………………….……37-43

9.11 Marketing Metrics………………………………………………………….….44

9.12 Marketing Budget………………………………………………………..….…44

X. Innovation and Technology…………………………………………………………44

10.1 Innovation Description…………………………………………………………44-47

10.2 S-Curve Analysis………………………………………………………………47

10.3 Innovation Implementation……………………………………………………47-48

10.4 Innovation Diffusion…………………………………………………………..48-49

10.5 Use of Technology…………………………………………………………….49-51

10.6 Risks & Opportunities for Innovation & Use of Technology………………….53-54

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10.7 Value-Add Proposition………………………………………………………..54-55

10.8 Change Management & Innovation………………………………………..….55

XI. Finance & Accounting………………………………………………………….…..55-59

11.1 Profit & Loss Sheet……………………………………………………………55

11.2 Contribution Graph……………………………………………………………57

11.3 Operating Profit Graph………………………………………………………..57

11.4 Net Cash Flow Graph…………………………………………………………57

11.5 Cumulative Cash Flow Graph…………………………………………………57

XII. Finance Management…………………………………………………………………59-70

12.1 Financial Statement……………………………………………………………60

12.2 Financial Statement……………………………………………………………61-62

12.3 Common Size Financial Statement……………………………………………63

12.4 Written Analysis………………………………………………………………64

12.5 Per Share Analysis……………………………………………………………65

12.6 Ratio Analysis………………………………………………………………..65-66

12.7 Competitive Analysis………………………………………………………...67-68

12.8 Variable Cost to Revenue Ratio……………………………………………...69

12.9 Contribution Margin to Sales Ratio………………………………………….69

12.10 Profit after Interest to Sales………………………………………………...70

12.11 Net Cash Flow to Profit after Interest……………………………………...70

References…………………………………………………………………….…71-73

Appendix………………………………………………………………………. 74-103

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Boyd Custom Software

I. Executive Summary

To be completed last

II. Company Description

2.1 Company Background

The world around us continues to change at an expedited rate. Some of this change is unpredictable and

completely out of our hands, we know that now more than ever. Yet, our response is completely within our

control. This document is meant to provide a clearer understanding of the strategic plan of BCS, including but not

limited to our overall goals and each of our responsibilities as it relates to creating our new business venture of

Boyd Custom Software. BCS is a software development company that primarily collaborates up with independent

software vendors within the healthcare industry to advance and evolve health information technology.

In most sectors of healthcare, progress is measured in decades, but the realm of health information management

(HIT) is unique. Today however, HIT not only in the U.S., but globally has undergone a complete transformation. A

host of innovations has emerged and the field has advanced at a speed previously unimaginable. A global

movement is taking place to establish Health Information Exchanges (HIE) to electronically move health related

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information among organizations in accordance to recognized standards. In an effort to proactively drive the

global crusade for development of a borderless health information exchange and cost control of homeland

healthcare in general, the U.S Federal Government has established initiatives within the Healthcare Industry,

Healthcare Information Management providers and ISVs. These enterprises are focused on making necessary

changes required to move from paper to electronic data exchange amongst other technology driven ingenuities to

take advantage of the government funds available.

On Feb. 17, 2009, Congress passed the American Recovery and Reinvestment Act of 2009 at the urging of President

Obama, who signed it into law four days later. A direct response to the economic crisis, the Recovery Act has three

immediate goals:

Create new jobs and save existing ones

Spur economic activity and invest in long-term growth

Foster unprecedented levels of accountability and transparency in government spending

The Recovery Act intends to achieve those goals by:

Providing $288 billion in tax cuts and benefits for millions of working families and businesses

Increasing federal funds for education and health care as well as entitlement programs (such as extending

unemployment benefits) by $224 billion

Making $275 billion available for federal contracts, grants and loans

US Legislation and Regulations

The Health Information Technology for Economic and Clinical Health (HITECH) Act provides the US

Department of Health and Human Services (HHS) with the authority to establish programs to improve

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health care quality, safety, and efficiency through the promotion of health information technology (HIT),

including electronic health records and private and secure electronic health information exchange.

Under HITECH, eligible health care professionals and hospitals can qualify for Medicare and Medicaid

incentive payments when they adopt certified EHR technology and use it to achieve specified objectives.

Two regulations have been released, one of which defines the “meaningful use” objectives that providers

must meet to qualify for the bonus payments, and the other, which identifies the technical capabilities,

required for certified EHR technology.

I. Incentive Program for Electronic Health Records : Issued by the Centers for Medicare & Medicaid

Services (CMS), this final rule defines the minimum requirements that providers must meet through

their use of certified EHR technology in order to qualify for the payments.

II. Standards and Certification Criteria for Electronic Health Records : Issued by the Office of the National

Coordinator for Health Information Technology, this rule identifies the standards and certification

criteria for the certification of EHR technology, so eligible professionals and hospitals may be assured

that the systems they adopt are capable of performing the required functions.

Boyd Custom Software (BCS) provides customized electronic medical record (EMR) software designed for ISV’s and

clinicians that are proactively participating in the needed requirements to stay compliant with the Health

Information Technology for Economic and Clinical Health (HITECH) Act. BCS not only works with independent

software vendors such as McKesson, G.E, and Allscripts, but in addition, BCS has a software suite that includes an

electronic medical record system, ICD-11 conversion, meaningful use tracking, HIPAA 5010 compliant software as

well as a security and compliance software package. The BCS suite of products was developed in close

collaboration with: clinical experts that perform the day-to-day functions; state HIE chapters, who are testing the

functionality; and the Department of Health and Human Services (HHS), who maintain the authority of compliance.

Because of this collaboration, BCS has a highly intuitive software product that directly mimics the manual

procedures followed by the clinical experts, making it user friendly and giving it a powerful competitive advantage.

This software allows clinicians to dramatically increase the ease, accuracy, and efficiency of their complex, time-

consuming, and error prone reporting processes. BCS has distinguished itself in this market by providing an easy to

use interface, a highly efficient data entry and report generation process, and an outstanding level of

responsiveness to customer design and support needs. BCS’ core competency that creates its competitive

advantage is simply – customer intimacy. BCS understands and meets their customers’ needs better than any of

their competitors. BCS software has been certified by the SEO as a product approved for purchase and use within

the healthcare field, which is a necessity for companies that wish to compete in this market. BCS will be

established in 2012 as a sole proprietorship under the control of founder Tim Aligheri, and with the addition of full-

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time management and a board of advisors to the company, will be restructured as a limited liability company,

effective January 1, 2013. BCS will be a national company with a U.S HQ based in Atlanta, Georgia.

2.2 Company Vision

If your ultimate goal is to attain the highest return on investment, than you need a partner that understands

today’s healthcare challenges and provides the most advanced solutions. Our goal is to become a leading partner

and innovator in evolving the global healthcare industry on its’ quest for a worldwide health information exchange.

2.3 Company Mission

Boyd Custom Software is a software development and consulting partner focused on bringing innovative

healthcare initiatives from concept to reality. Our engineers thrive on every project from the simplest to the most

complex healthcare challenges. We relish the challenge of helping our client’s grow their initiatives and succeed

beyond their highest expectations.

Our healthcare solutions support the entire healthcare ecosystem, with flexible technology and innovative

approaches making information more understandable and easier to access and use for healthcare organizations.

We blend our technical expertise with your insights to create an all-inclusive positive user experience. If your

ultimate goal is to attain the highest return on investment, than you need a partner that understands today’s

healthcare challenges and provides the most advanced solutions, do not trust your project with anyone but Boyd

Custom Software.

2.4 Leadership Team Management Staff Structure

The Boyd Custom Software management team brings significant experience in the software industry and has a

thorough understanding of the issues involved in developing, marketing, and supporting software products.

Resumes of the management team are available upon request. Additionally, advisory boards of leading business

professionals will help ensure the company’s success.

Although our team is relatively small, our focus is to promote a culture that exhibits the good of the whole rather

than the good of the individual. I see myself as a situational leader. Situational leadership allows me to analyze the

needs of a situation I am dealing with, and adopt the most appropriate leadership style. We all lead others at work

and at home. A situational leader allows the ability to adopt different leadership styles depending on the situation,

(Dubrin, 2007). Situational leadership has a four-stage model: participating, telling, delegating, and selling,

(Dessler, 2003).

With each stage, there are times when our executive team will leverage leadership styles in combination of varying

individual instances. Although it is important to have a relationship with your peers or team, it is also important to

remain in that leading role model.

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Joyce Boyd will be the President & CEO of the company. Ms. Boyd has over sixteen years of experience in

operations and senior level management in the healthcare industry. She has been in field operations, executive

management, sales, new business implementation and development, strategic operations as well as mergers and

acquisitions.

Joyce spent thirteen years with Smart Document Solutions where the CEO, COO, chose her; CFO & CIO to initiate

change management cross functionally and restructure operations in preparation for sale. Joyce instituted a national

rating system corporate wide measuring customer, individual and regional performance via Key Performance

Indicators. Concurrently, she implemented new programs and controls resulting in increased productivity of $3MM,

reduced labor rates by 3% and increased customer retention rating to 98%.

In 2007, the Thurston Group purchased SDS forming HealthPort Technologies. Mrs. Boyd was chosen by the Chairman

of the Board to lead the Acquisition and integration of their largest competitor, ChartOne Corporation.

In the fall of 2008, Joyce led the M&A team in the acquisition of ChartOne completing a scheduled 18-month

integration rollout in 6 months while maintaining a 98% customer retention rating.

Joyce is recognized in the field of Healthcare Management as the leading expert in Release of Information, Healthcare

IT and HIM Operations. Over the years, she has worked with a multitude of HIT and HIM departments large and

small, to provide guidance and expertise to maximize efficiencies and marry the drive for operational success via

information technology platforms to deliver HIM compliancy. Ms. Boyd believes in developing true

partnerships among healthcare industry partners throughout the relationship, not just at the point of establishing

vendor contracts. 

Tim Aligheri, founder of RCS, will serve as the Chief Technology Officer. At BCS, Tim will complete all programming

for the BCS solutions, including yearly updates and custom solutions for particular customer demands. He will

continue to build relationships at the international level within the healthcare market in preparation for global

expansion. In addition, Tim may take part in other efforts as time permits, such as sales, implementations,

training, and support.

2.5 Board of Advisors

Jim Day served as the Chief Financial Officer, Treasurer, and Secretary of Enterprise Systems, Inc., a healthcare

information services company, from November 1987 to January 1995, and Senior Vice President Finance and

Treasurer from January 1995 to March 1997, when he retired. Jim graduated from the University of Illinois in 1963

with a Bachelor of Science degree in Accounting, and became a Certified Public Accountant in 1974.

Steve Roberts is an experienced executive with diverse expertise with hospitals, point of care providers, and

pharmaceutical organizations. Steve has a record of significant achievement in measuring and managing the

operations across all departments of the organization with a focus on revenue optimization, client relationship

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management and satisfaction, strategic business planning and selling, project management, and team building.

Steve has worked for large organizations such as; Henry Schein, Healthport, GE Healthcare, Allscripts, McKesson

and System Integration. Steve holds an MBA from Northwestern University, Kellogg Graduate School of

Management.

Joseph Smith is an entrepreneur who founded The Stern Corporation in January 1994. They design, fabricate and

install heating, ventilation, and air conditioning systems for commercial, industrial, and institutional projects. Mr.

Stern’s experience includes 37 years in the industry, managing projects for many notable Chicago high rise

buildings, including the Sears Tower, the world’s tallest building and the 333 South Wacker, the world’s tallest

concrete structure. Since its founding, The Stern Corporation has done approximately 4.5MM in revenues.

Glen Johnson joined Allscripts, Inc. as Chief Executive Officer in August 1997. Allscripts is a privately held company

that provides point-of-care medication management and dispensing solutions. Previously, Tullman was CEO of

Enterprise Systems, Inc., a leading healthcare information services company providing resource management

solutions primarily to large integrated healthcare networks. Enterprise recorded 1996 revenues of $52.3 million.

Tullman led the company’s Initial Public Offering and secondary offerings. Enterprise was recently acquired by

HBO & Company of Atlanta, in a stock transaction valued in excess of $250 million. Prior to joining Enterprise,

Tullman was President and Chief Operating Officer of CCC Information Services, Inc., of Chicago, Illinois. Under his

leadership, the company grew from $17 million to over $100 million and is publicly traded.

will be responsible for the day-to-day operational and strategic direction of the company. She will be actively

engaged in all facets of the business, including sales, implementation, training, finances, operations, and support.

2.6 Legal Structure of the Business and Ownership

BCS is currently structured as a sole proprietorship, with Tim Aligheri as the owner. Plans are in place to change the

BCS legal structure to a limited liability company, effective January 1, 2012. Tim Aligheri and Joyce Conner-Boyd

will each own 50% of the company. The board of advisors will arbitrate any issues that require third party

involvement. Initial plans are that BCS will remain a privately held company. To exit the business, the owners

would most likely exit through the sale of the company to an interested investor (i.e., a larger software company or

the private equity group). Tim and Joyce have a formalized agreement if one should decide to exit the business

prior to the other.

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2.7 Human Resource Requirements

In an increasing economic environment, it has become difficult to assemble a capable well-functioning work force

and even harder to maintain one. Businesses are aware of the value add of human resources. Established well-

have the ability to select and nurture employees to closely fit a company’s culture and performance requirement.

Human Resource Management is taking on a consultative role to management within organizations. Many

established personnel procedures are being abandoned to increase organizational flexibility, and provide greater

agency level responsiveness to both internal and external clientele needs. By embracing a human resource

management department that can assist our line managers to accomplish recruitment, selection, retention,

training, and compensation.

BCS is committed to providing its employees a stable work environment with equal opportunity for learning and

personal growth. Creativity and innovation are encouraged for improving the effectiveness at Boyd Custom

Software. Above all, employees will be provided the same concern, respect, and caring attitude within the

organization that they are expected to share externally with every each of our customers.

Our goal is to recruit top-level developers to enhance and create a value-add experience for our clients. We have

begun the process of collaborating with top-level engineering schools nationwide as well as globally to have

deeper access to the talent pool within our domain of expertise. Once recruited, our technical team will then

participate in an internal university to leverage domain knowledge as it relates to the healthcare industry as well as

any obstacles in the area of language and cultural competence barriers.

Employment agreements have been leveraged in an attempt to retain top talent to mitigate the competitive risk

that is at a premium among the engineering and information technology fields of expertise. As well, our

organization provides the following benefits;

Sign on bonus

Relocation expense

Full medical and dental plans

Life insurance

LT & ST disability insurance

Domestic partner insurance coverage

401K

Vacation pay

To create a true well balanced corporate culture, our employees are immediately set up with career coaches and

are put on a plan to define, recognize an execute on their short term and long term career goals.

2.8 Organizational Culture

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Organizational culture can be defined as a system of shared beliefs and values that develop within and

organization and guides the behavior of its members. It includes routine behaviors, norms, dominant values, and a

feeling or climate conveyed. The purpose and function of a corporate culture is to foster internal integration, bring

staff members from all levels of the organization much closer together, and enhance their performance. Company

culture is not only made up of values but also of philosophy, a particular attitude toward life. BCS' philosophy

consists of eight primary attitudes:

1. Employees are number one. The way you treat your employees is the way they will treat your customers.

2. Think small to grow big.

3. Manage in the good times for the bad times.

4. Learning from mistakes is an aspiration!

5. Be yourself

6. Have fun at work

7. Take the competition seriously, but not yourself.

8. It is difficult to change someone's attitude, so hire for attitude and train for skills

To be successful as a sole contributor within BCS; follow the norms, the patterns of attitude, behavior, and

practice that influence the vigor with which employees work and how far they are willing to go for the company.

There are five company norms that stand out and that should be recognized as adding flavor to the culture.

1. Visionary thinking - Visionary thinking is what gave our company its'start. Big dreams have encouraged

employees of the company to provide legendary service and to give ordinary people extraordinary

opportunities. Visionary thinkers continually provide inspiration for its future success.

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2. Celebrations - The Company throws a party whenever possible to honor and reward people, giving them

the experience of our BCS culture.

3. Hiring the right people - Hire for the culture not the job. We are a company that is fearless; we should

actively be hiring people who are not afraid to express their individuality.

4. Competition - In terms of dealing with competition, BCS has two noticeable practices, to keep a warrior

attitude and to keep multiple scenarios. Be aggressive with our pricing and leverage strategic planning

however, as a company we have learned to forecast and plan by preparing for a variety of possibilities.

5. Simplicity & Freedom - The Company encourages simplicity by avoiding unnecessary paperwork and

elaborate documentation. Do not just type an email or a memo to get the matter addressed. Sit down

with your counterparts, communicate the issues and solve them together. Freedom is encouraged by the

informal work attire. Comfortable and casual clothing is the norm at all company functions, even

meetings, and is thought to provoke a playful and creative spirit within the company.

As our organization grows, it will become critical that we execute on the eight steps needed to successfully

transform a business, (Kotter, 2007). These eight steps are as follows; (1) Establishing a great sense of urgency, (2)

Creating a powerful guiding coalition, (3) Creating a vision, (4) Communicating the vision, (5) Empowering others to

act on the vision, (6) Planning for and creating short-term wins, (7) Consolidating improvements and producing still

more change, and (8) institutionalizing new approaches, (Kotter, 2007, p. 99). It is imperative that the senior team

is steadfast in their mission to create a positive corporate culture, one that is not only defined by the executive

team but one that is believed in by the HR department. Regardless of the title one may hold, HR plays a vital role in

the execution of any business decision.

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2.9 Risk Factors

One source of risk to the future success of BCS is the entrance of a new, superior product. As indicated above, the

barriers to entry in this market are very high, and BCS will be aware of new entrants and respond accordingly. Due

to the level of customer intimacy BCS provides and the level, which is required to service this market, BCS believes

it is offering the best product and best service, and will continue to be the market leader.

Another source of risk remains to be state and federal legislation changes. The Federal Government does not have

the internal resources to develop products that have the full breadth of features and functionality that the

healthcare industry is demanding, nor do they have the bandwidth to support the market during this surge in

health information technology. Therefore, the most likely event is that the Federal Government would grant

exclusivity to one vendor or purchase that vendor. BCS has excellent relations within the healthcare market as

well as the local health information exchanges (HIE) and will continue to maintain these relations in order to gain

exclusivity to be the vendor the Federal Government purchases. Gaining increased dominant market share will

help ensure BCS is the vendor of choice.

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Another possibility is that the Federal Government will force competition and tell BCS they can have no more than

fifty percent (50%) of the market. BCS believes this is very unlikely, however, in the event that unforeseen

situations arise, the structure of BCS is such that most expenses are incurred in direct relation to sales and

customer service can be eliminated in the short or long run as the situation requires.

Various levels of risk are present depending upon which projected financial scenario will take place. The worst-case

scenario will present a situation where the management team will make a loan to the company until such time

when cash flow permits the repayment of principal and interest. During this time the additions of personnel to

BCS will also be scaled back to reflect the lack of new sales.

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III. Impact of Global Economy on the Business

All cultures are driven by their economies, and the ideals of each culture are the basis of how their people do

business. The global healthcare IT market is anticipating growth from $99.6 billion in 2010 to $162.2 billion in 2015,

at a CAGR of 10.2% from 2010 to 2015.

Government support in the form of stimulus packages is the most significant strength for the market.

Implementation of nationwide health records in the U.S., Europe, China, and all the other major markets has a

dependency on these government initiatives. With the changing terms between clients and vendors, the markets

offer huge opportunity for domain specific players. Healthcare IT providers generate more than 60% of their

revenue through license updating and the remaining through new client acquisitions.

The healthcare IT market is witnessing many developments with the introduction of healthcare reforms in

developed nations. IT implementation has already streamlined healthcare and hospital procedures such as billing,

medical imaging, and diagnostic information. However, the market still offers more scope for development,

especially with increasing government incentives in the sector.

III.1 Opportunity Summary

In almost every culture, Healthcare is being viewed as, “broken”. Demand is ubiquitously outpacing supply and to

date, information technology investments in healthcare have been limited. Internationally we are experiencing an

unprecedented participation and collaboration to create health information exchange networks (HIE). However

with this said, there is an inherent lack of infrastructure within and across healthcare organizations. Information

content is very diverse and complex, and is not consistently represented by practitioners. Historically, healthcare

as a market sector has viewed IT as an expense rather than an investment; overall ROI was not recognized.

Creating a culture of continuous innovation and iteration will move the country beyond the 19th century

“mainframe” model to the personal health model of the 21st century. Rather than view the unsustainable

healthcare system as a threat, the U.S needs to generate new opportunities, jobs, and competition in the race to

build a nimble care model that supports the health information exchange movement. Today’s U.S. healthcare

system is being challenged to transform itself in the face of escalating trends influencing costs, quality and access.

Total healthcare spending reached almost $2.5 trillion in 2009 or 17.3% of the U.S. economy with continued

growth in expense forecasted (see Appendix A).

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3.2 Situational Summary/Critical Success Factors

In an effort to proactively drive the global crusade for development of a borderless health information exchange

and cost control of homeland healthcare in general, the U.S Federal Government has established initiatives within

the Healthcare Industry, Healthcare Information Management providers and ISVs. These enterprises are focused

on making necessary changes required to move from paper to electronic data exchange amongst other technology

driven ingenuities to take advantage of the government funds available.

U.S Legislation and Regulations are an apparent critical success factor as it relates to the healthcare information

technology market, as it is the ARRA act that is driving the stimulus money to engage in HIT.

On Feb. 17, 2009, Congress passed the American Recovery and Reinvestment Act of 2009 at the urging of

President Obama, who signed it into law four days later. A direct response to the economic crisis, the Recovery Act

has three immediate goals:

Create new jobs and save existing ones

Spur economic activity and invest in long-term growth

Foster unprecedented levels of accountability and transparency in government spending

The Recovery Act intends to achieve those goals by:

Providing $288 billion in tax cuts and benefits for millions of working families and businesses

Increasing federal funds for education and health care as well as entitlement programs (such as extending

unemployment benefits) by $224 billion

Making $275 billion available for federal contracts, grants and loans

I. US Legislation and Regulations

The Health Information Technology for Economic and Clinical Health (HITECH) Act provides the US

Department of Health and Human Services (HHS) with the authority to establish programs to improve

health care quality, safety, and efficiency through the promotion of health information technology (HIT),

including electronic health records and private and secure electronic health information exchange.

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Under HITECH, eligible health care professionals and hospitals can qualify for Medicare and Medicaid

incentive payments when they adopt certified EHR technology and use it to achieve specified objectives.

Two regulations have been released, one of which defines the “meaningful use” objectives that providers

must meet to qualify for the bonus payments, and the other, which identifies the technical capabilities,

required for certified EHR technology.

I. Incentive Program for Electronic Health Records: Issued by the Centers for Medicare & Medicaid Services (CMS),

this final rule defines the minimum requirements that providers must meet through their use of certified EHR

technology in order to qualify for the payments.

II. Standards and Certification Criteria for Electronic Health Records: Issued by the Office of the National

Coordinator for Health Information Technology, this rule identifies the standards and certification criteria for the

certification of EHR technology, so eligible professionals and hospitals may be assured that the systems they adopt

are capable of performing the required functions.

II. Healthcare Market Statistics

See Appendix B

Practice Fusion’s EHR and Health IT Statistics

Technology advancements are rapidly changing the healthcare sector. Here are a few of the most important US

physician statistics and medical technology figures.

Physicians & Technology

There are over 800,000 physicians in America. (AMA 2009)

7 million people in the US work in healthcare practitioner and technical occupations altogether. (Bureau

of Labor 2008)

Only 10% of physicians reported having a fully functional electronic health records system in use, 20%

report having some basic system. (CDC Report, January 2009)

"Astonishingly, twenty years after the digital revolution, only 1.5% of hospitals have integrated IT systems

today—and half of those are government hospitals." (Washington Monthly - 2009)

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Economic Stimulus

Under the American Recovery and Reinvestment Act of 2009, physicians who adopt "meaningful use" of

an electronic health record system by 2011 will qualify for $44,000 or more in Medicare incentives.

With an estimated 404,000 eligible medical professionals in 2011, CMS predicts that between 10% and

36% will adopt an EHR in 2011, 15% to 44% in 2013, and 21% to 53% in 2015. (Health and Human

Services)

III. What is Electronic Health Record (EHR)?

The Electronic Health Record (EHR) is a longitudinal electronic record of patient health information

generated by one or more encounters in any care delivery setting. Included in this information are patient

demographics, progress notes, problems, medications, vital signs, past medical history, immunizations,

laboratory data and radiology reports. The EHR automates and streamlines the clinician's workflow. The

EHR has the ability to generate a complete record of a clinical patient encounter - as well as supporting

other care-related activities directly or indirectly via interface - including evidence-based decision support,

quality management, and outcomes reporting, (see Appendix C)

"Initial EHR costs averaged $44,000 per full-time-equivalent (FTE) provider, and ongoing costs averaged

$8,500 per provider per year. The average practice paid for its EHR costs in 2.5 years and profited

handsomely after that; however, some practices could not cover costs quickly, most providers spent more

time at work initially, and some practices experienced substantial financial risks." (Health Affairs Journal

2005)

Nearly 62% of surveyed physician group practice administrators consider selecting and implementing a

new electronic health records system as a considerable or extreme challenge. EHR projects ranked high on

the top challenge list for the second straight year in the survey from the Medical Group Management

Association in Englewood, Colo. The top considerable or extreme challenge, cited by 73% of practices, is

dealing with operating costs that are rising quicker than revenue; the second is maintaining physician

compensation levels in an era of declining reimbursements. EHR implementation was cited as the third

most pressing challenge. (MGMA 2009)

Primary care physicians report that use of an electronic health record improves the quality of care

delivered to patients, including reduced medication errors, improved test result follow-up and better

communication with other clinicians. (Journal of General Internal Medicine 2009)

20

21

IV. What is meaningful use?

Meaningful use (MU), in a health information technology (HIT) context, is an as-yet to be determined

critical level for the use of electronic health records (EHR) and related technology within a healthcare

organization. According to the provisions of the Healthcare Information Technology for Economic and

Clinical Health Act (HITECH), healthcare organizations that have achieved meaningful use by 2011 will be

eligible for incentive payments; those who have failed to achieve that standard by 2015 may be penalized.

The attached chart outlines the proposed criteria for Stage 1 of demonstrating meaningful use. To receive

the maximum reimbursement, physicians and hospitals must achieve Stage 1 of meaningful use of EHR for

at least a 90-day period within the 2011 fiscal year and for the entire year thereafter. These are some of

the pain points that SoftServe can help solve for the healthcare market.

V. Health IT Sector

I. The health information technology industry is booming due to the economic stimulus boost. The

Health IT sector grew 30%, compared to 2% S&P 500 growth, in Q2 2009. It remained about

30%for 2010 as well. (Healthcare Growth Partners 2009)

3.3 Key Services

I. Information Technology

The healthcare information technology market alone is estimated to reach $53.8 billion by 2014 and to

grow at a CAGR of around 24% during 2012-2014.

The market is expected to grow because of the tremendous demand for general applications, which

includes electronic medical records, electronic health records, computerized physician order entry system

and non-clinical systems.

The main driving element for global healthcare information technology market is the changing

government regulations and government initiatives to bring down the healthcare costs.

21

22

Based upon the above-mentioned data and having a HIMS flagship customer (Allscripts), SoftServe’s research

suggests targeting, (see Appendix D):

Healthcare Information Management Independent Software Vendors

Healthcare Information Management Enterprise Providers

Healthcare Information Management Consultant

VI. Mobility (see Appendix E)

Kalorama research finds:

The US is the key economy driving growth within the global Healthcare IT market. It contributed 37%

towards the global Healthcare IT market in 2008. The contribution is expected to increase to 48% by 2015.

The US Healthcare IT market is forecast to grow in double-digit rates for the next seven years to exceed

$18 billion by 2015.

Smartphone and other mobile applications or “apps” are being utilized in many areas of healthcare:

education, health management, data management, health information, and other workflow processes.

The Market for Electronic Medical Record Systems was valued at $15.7 billion in 2010.

Not only is the medical community using smartphones and their applications for basic work at a higher

rate than the general population, but also they are reporting using smartphones in replacement for some

of the work that would have previously been done on a desktop or laptop computer.

Worldwide enterprise electronic medical record (EMR) software markets will grow substantially as

vendors are able to leverage the EMR expertise to provide competitive advantage from automation of

process using IT infrastructure.

VII. Software-as-a-Service (SaaS)(see Appandix F)

In-Stat has forecasted:

Public cloud computing model SaaS (software-as-a-service) spending by US businesses will increase by

112% between 2010 and 2014.

Spending is expected to grow significantly across all service options of cloud computing, including IaaS and

PaaS.

Within SaaS, the professional services and healthcare verticals will see the largest growth in spending,

each growing over 30% during the forecast period.

22

23

Additional research data on cloud computing market includes:

SaaS (software-as-a-service) spending will increase 112% between 2010 and 2014.

IaaS (infrastructure-as-a-service) spending will approach $4 billion in 2014.

PaaS (platform-as-a-service) spending will increase 113% to roughly $460 million in 2014.

3.3 Risk Analysis

In evaluations by analysts (and feedback from prospects and others in industry), BCS currently is viewed as being

behind others in the industry primarily due to lack of infrastructure, concentrated market expertise, and limited

reference site accessibility both within the domestic and international market.

BCS is prepared to address many of these concerns, but may still be viewed as at par vs. significantly ahead of the

market. Referencable accounts may be seen as a true differentiator, but it remains to be seen as to whether

customers will collaborate with BCS over other software development companies because of this feature. With

that said, this will still be seen by many as significant progress and an improvement in BCS’s position in the baseline

healthcare vertical market share.

Highly skilled engineers and software developers and highly sought out within the national and international

market place. With this said, the need to be able to recruit and retain top level talent will remain to be a significant

risk factor as we progress within this industry space.

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24

I. Competitive Landscape

Competition can be segmented by who is only playing in the healthcare ISV market vs. who is extending there as a

vertical market segment strategy/client base.

Independent Software Vendors

Globallogic Accenture Ziliant

Healthcare Vertical Market Vendors

EPIC1

McKesson Eclipsys Misys Cerner Allscripts

One of the most important strategic challenges continues to be who to align with (in some case indirect

competitors) in the healthcare or independent software vendor marketplaces. The basic BCS approach should be

to have a cross-functional relationship with multiple industry leaders and to play more of a stealth role in regards

to software development, as we are not creating a product for distribution to sell. The overall strategy has been

informally discussed but not formally communicated.

II. SWOT Analysis

See Appendix G

A high level SWOT analysis has been provided to outline the Market Opportunities and Threats.

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25

IV: Global Opportunities for Growth

4.1 Opportunity Summary

Will e-health be a necessity for future consumers to utilize? Research supports this hypothesis. Given the information

and research put into the advantages and disadvantages, pros and cons, and barriers and benefits of e-healthcare, it

is quite evident that e-healthcare and essentially, e-commerce will be the primary medium of healthcare exchange

in the future. Patients will be able to talk to doctors, doctors to providers, employers to providers, etc. and a network

of information will be formed known as the health information exchange (HIE). We are in and still advancing towards

a world dominated by the internet and high –tech devices and systems. There is no stopping this movement. The only

way for businesses to please consumers and to satisfy their own needs, is to turn towards e-healthcare.

BCS has a the industry knowledge and technological framework to gain enough of the market share to engage in a

profitable and successful organization within the health information industry be it as a supporter of ISV’s or as a

software application developer that brings a product to market.

4.2 Market Analysis

The health information technology industry is booming due to the economic stimulus boost. The Health IT sector

grew 30%, compared to 2% S&P 500 growth, in Q2 2009. It remained about 30%for 2010 as well. (Healthcare Growth

Partners 2009)

"Initial EHR costs averaged $44,000 per full-time-equivalent (FTE) provider, and ongoing costs averaged $8,500 per provider per year. The average practice paid for its EHR costs in 2.5 years and profited handsomely after that; however, some practices could not cover costs quickly, most providers spent more time at work initially, and some practices experienced substantial financial risks." (Health Affairs Journal 2005)

Nearly 62% of surveyed physician group practice administrators consider selecting and implementing a new electronic health records system as a considerable or extreme challenge. EHR projects ranked high on the top challenge list for the second straight year in the survey from the Medical Group Management Association in Englewood, Colo. The top considerable or extreme challenge, cited by 73% of practices, is dealing with operating costs that are rising quicker than revenue; the second is maintaining physician compensation levels in an era of declining reimbursements. EHR implementation was cited as the third most pressing challenge. (MGMA 2009)

Primary care physicians report that use of an electronic health record improves the quality of care delivered to patients, including reduced medication errors, improved test result follow-up and better communication with other clinicians. (Journal of General Internal Medicine 2009)

25

26

Market and Research predicts:

The healthcare information technology market is estimated to reach $53.8 billion by 2014 and to grow at a CAGR of around 24% during 2012-2014.

The market is expected to grow because of the tremendous demand for general applications, which includes electronic medical records, electronic health records, computerized physician order entry system and non-clinical systems.

The main driving element for global healthcare information technology market is the changing government regulations and government initiatives to bring down the healthcare costs.

Kalorama research finds:

The US is the key economy driving growth within the global Healthcare IT market. It contributed 37% towards the global Healthcare IT market in 2008. The contribution is expected to increase to 48% by 2015. The US Healthcare IT market is forecast to grow in double-digit rates for the next seven years to exceed $18 billion by 2015.

Smartphone and other mobile applications or “apps” are being utilized in many areas of healthcare: education, health management, data management, health information, and other workflow processes.

The Market for Electronic Medical Record Systems was valued at $15.7 billion in 2010.

Not only is the medical community using smartphones and their applications for basic work at a higher rate than the general population, but also they are reporting using smartphones in replacement for some of the work that would have previously been done on a desktop or laptop computer.

Worldwide enterprise electronic medical record (EMR) software markets will grow substantially as vendors are able to leverage the EMR expertise to provide competitive advantage from automation of process using IT infrastructure.

In-Stat has forecasted:

Public cloud computing model SaaS (software-as-a-service) spending by US businesses will increase by 112% between 2010 and 2014.

Spending is expected to grow significantly across all service options of cloud computing, including IaaS and PaaS.

Within SaaS, the professional services and healthcare verticals will see the largest growth in spending, each growing over 30% during the forecast period.

Additional research data on cloud computing market includes:

SaaS (software-as-a-service) spending will increase 112% between 2010 and 2014. IaaS (infrastructure-as-a-service) spending will approach $4 billion in 2014. PaaS (platform-as-a-service) spending will increase 113% to roughly $460 million in 2014.

BCS five year projection (See Appendix H):26

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V. Workforce Management

In order to be an effective manager in the work force today, one must have a very good understanding of the various

ways in which people interact and communicate with one another. It is critical that our leaders display the ability to

effectively communicate with their associates and subordinates as well as train and encourage others to demonstrate

those same communication skills. By doing so, we will promote a healthy and efficient work environment that

everyone will enjoy. With this, there are a few critical success factors to take into account;

Diversity

Varying Ethnicity

Effective Communication techniques

Cultural Competence

5.1 Management Summary

The Boyd Custom Software senior team has over thirty years of healthcare and information technology experience

collectively. Although we draw a significant amount of our experience from our senior executives, we are a

progressive organization that is driven by the awareness and advancement of market trends by our junior executives

that have completed their MBA’s within the culture of the latest technology trends.

Our executive team has been thoroughly involved in cross-cultural training in preparation for a long-term global

strategy plan.

5.2 Organizational Structure

See Appendix I

5.3 Management Gap Analysis

Currently we have a significant gap as it relates to the overall structure of our organization. As we continue to grow

and solidify market share, our core team will grow concurrently with the revenue.

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5.4 Risk Analysis

Due to the need to slim down overhead expense and the strategic emphasis on gaining market share, a scope risk

exists in today’s current setting. As a start-up company, we are lacking in bench, and therefore may experience a

delay in starting projects until the appropriate domain knowledge experts are hired.

There is a tremendous learning curve as it relates to cross-cultural competence and communication with in the

software industry. Although the initial start-up will take place within the United States, in order to control costs,

we will need to leverage an on-shore/off-shore model to gain the highest profit models.

Due to the utilization of foreign development centers and developers, a significant gap is apparent as it relates to

human resource areas of expertise such as;

Pay scale

Benefits

Insurance

401-K

A significant amount of pre-planning will need to be strategically defined and executed to not only stay in

compliance with international rules and regulations but to also create a sustainable workforce cross-culturally.

VI. Sourcing

BCS will not be utilizing vendors in this new venture due to the nature of our domain

knowledge.

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6.1 Key Solutions

BCS has three main solution modules designed to automate the reporting requirements of the healthcare industry.

The first solution module concentrates on the health information technology industry.

The second module is SaaS and Cloud Solutions, which provide accelerated software deployment with less risk,

lower upfront costs, and greater reliability, security and privacy.29

30

The third module is Mobility, the need for assessment of current situations, data access requirements, user

mobility profiling, and security.

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StrategyApplications to mobilizeShort, mid and long-term goalsIndustry requirementsMapping of

mobilized business

processes into back officeMobile application roadmap

SolutionsMobile applications requirementsMobile platforms

& devicesBack-office designImplementation strategy

DevelopmentScopingProject planningRequirements definitionDesign/DevelopmentPorting from Legacy systemsIntegration and testingAcceptance

Running head: BOYD CUSTOM SOFTWARE 29

VII. Business Operation

7.1 Opportunities:

Seventy-nine percent of respondents indicated their software development budgets would increase in 2011; with

nearly half-indicating their budget is likely to grow greater than 10% as compared to last year. Only 5.25 believed

their 2011 budget would decrease by 10% or more as compared to 2010. This is an even more bullish outlook for

budget growth than reported in 2010.

Almost 86% of respondents surveyed identified their organization’s top priority being new product and application

development. That is up from 70% of respondents surveyed last year. This demonstrates continued commitment to

the core mission of developing new applications.

Survey data indicates growing interest and early-market activity in Saas/Cloud and mobile applications in the

healthcare market. The majority of respondents indicated business case planning, solution architecture and

implementation as their greatest challenges and need for assistance.

7.2 Operations Risk:

There are some key risks to the success of our venture within the healthcare industry.

National and International Laws and Regulations – BCS has joined key industry conferences and societies to

stay abreast of any changing legislation as it relates to our market.

Global Economy – technology, although it is a necessity can be highly influenced by the financial health of a

country. Well-developed nations are engaging in health information technology but that limits the

functionality of a global health information exchange.

Cross-Cultural Competence and Talent Pool – we are embarking in a highly competitive arena, it will be

critical that we engage in a short and long term strategic plan to recruit the best of the best within the

technology industry. Human Resource Management will become a critical aspect to our long-term growth

and sustainability plans.

Ethics and Legalities- As we begin to engage in multi-cultural and global employment we will need to be

cognizant of the countries that we are engaging in business with and make every effort to refrain from

unethical practices from both an employment standpoint and a legal standpoint.

VIII. Ethics and Legal: Social Responsibilities

8.1 Legal

U.S Healthcare Industry is historically surrounded with regulations legalities. Although the anticipated percentage of liability is extremely low for a third party vendor, the proactive steps will be taken to ensure the security and compliance of these regulations and the sustainability and reputation of SoftServe in the Healthcare industry.

HIPAA Compliance – A major Critical Success Factor for SoftServe is to maintain compliance with current U.S regulations such as the HIPAA 5010 requirements. Business Associate Agreements will be executed with all clients to stay in compliance with 3rd party vendor regulations.

Confidentiality Compliance – Internal policies and procedures will be defined and implemented such as confidentiality agreements with internal staff to ensure HIPAA compliance.

Internal Training – Additional courses within in SSU specifically designed and focused on U.S Healthcare regulations and compliance requirements.

Liability Insurance – Minimal organizational expenditure to ensure the protection of the organization when engaging in global healthcare initiatives.

8.2 EthicsAs a growing organization, the need for a clear set of business ethics is mandatory in order to sustain consistent growth within the healthcare environment. We will continue to foster a sense of ethical advancement as we are closely regulated by the legislation per HIPAA requirements.

As we move into the global market, it is critical that we are cognizant of the following obstacles; Labor laws Moral codes of conduct Management styles Accounting practices Cultural Dimensions

8.3 Social ResponsibilityBCS is continuing to engage in advancements as it relates to social and environmental responsibility. A critical part of our external social responsibility is to enable healthcare. The number of citizens over. The age of 60 is likely to double in developed countries over the next three decades. At BCS are goal is to play a vital role to enhance the quality and reduce the cost of healthcare by leveraging applications such as electronic health records and health services. By utilizing health information technology, we are enabling sustainability worldwide. The reduction of paper products could result in a 15 percent reduction of global CO2 emissions by 2020.

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VIIII. Marketing Plan

9.1 Marketing Mix

Our marketing team is poised to deliver a strategical plan as it relates to the 4 P’s that are reflective of the conponents within the marketing mix. These components, (product, price, promotion, place and an additional people) will be leveraged throughout the course of our plan to strengthen our market presence and overall market share to deliver a steady stream of wealth to our investors.

I. (Product/Service) BCS offers a software development service. Focusing primarily in a vertical healthcare market space.

II. (Place) We support Independent Software Vendors (ISV’s) that provide products and services to the Healthcare Industry

III. (Price) BCS pricing is competitive for the marketplace. We do not generally offer bulk discounts as our specialty is a service not a product however, we do have “discounted” pricing for multi-year strategic partnerships.

IV. (Promotion) Our organization will leverage multiple forms of mass media to gain the footprint needed within the market space to leverage our services. Ad campaigns, websites, white papers, and social networking just to name a few.

V. (People) Currently we are leveraging existing customers within the healthcare industry to execute on testimonials as to our superior capabilities within the software development sector.

9.2 Market ResearchMarket Analysis and Research

• U.S Healthcare spending is estimated to reach $3,000,000,000.00 by 2013.• The Healthcare Information Management Systems (HIMS) market is estimated to reach $53.8 billion by

2014 and to grow at a CAGR of around 24% during 2012-2014.

• World healthcare IT market is estimated to grow from $99.6 billion in 2010 to $162.2 billion in 2015 at a CAGR of 10.2% during 2010-1015.

• Electronic Medical Records (EMR) is expected to be the highest growing market with a CAGR of 16.7% from 2010-2015.

• Computerized Physician Order Entry Systems (CPOE) is expected to be the second largest growing market with a CAGR of 16.5% from 2010-1015.

• Point Of Care Information Systems (Cardiovascular Information Systems, Oncology Information Systems, Surgical Information Systems) is expected to grow with a CAGR of 15.1% from 2010-1015.

Market Drivers

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• The growth is due to the demand for applications such as:

– Electronic medical records, electronic health records, computerized physician order entry system and non-clinical systems.

• The main driver is the changing government regulations and government initiatives to bring down the healthcare costs.

• Global Health Information Exchanges

Marketing Mix 7 P’s, (see Appendix J)

Research Conclusions

• Based upon the initial research findings and the government funding initiatives through 2015, the optimum market for BCS to target:

– Healthcare Information Management Independent Software Vendors

– Healthcare Information Management Enterprises / Providers

– Healthcare Information Management Consultants

Healthcare markets

• Pharmaceutical Market

• Diagnostics Market

• Medical Device Market

• Healthcare IT Market

• Healthcare Information Management Systems

9.3 Healthcare Market Statistics

Practice Fusion’s EHR and Health IT Statistics

Technology advancements are rapidly changing the healthcare sector. Here are a few of the most important US physician statistics and medical technology figures.

Physicians & Technology

34

There are over 800,000 physicians in America. (AMA 2009)

7 million people in the US work in healthcare practitioner and technical occupations altogether. (Bureau of Labor 2008)

Only 10% of physicians reported having a fully functional electronic health records system in use, 20% report having some basic system. (CDC Report, January 2009)

"Astonishingly, twenty years after the digital revolution, only 1.5% of hospitals have integrated IT systems today—and half of those are government hospitals." (Washington Monthly - 2009)

Health IT Sector

The health information technology industry is booming due to the economic stimulus boost. The Health IT sector grew 30%, compared to 2% S&P 500 growth, in Q2 2009. It remained about 30%for 2010 as well. (Healthcare Growth Partners 2009)

Market and Research predicts:

The healthcare information technology market is expected to grow because of the tremendous demand for general applications which includes electronic medical records, electronic health records, computerized physician order entry system and non-clinical systems.

The main driving element for global healthcare information technology market is the changing government regulations and government initiatives to bring down the healthcare costs.

Kalorama research finds:

The US is the key economy driving growth within the global Healthcare IT market. It contributed 37% towards the global Healthcare IT market in 2008. The contribution is expected to increase to 48% by 2015. The US Healthcare IT market is forecast to grow in double digit rates for the next seven years to exceed $18 billion by 2015.

Smartphone and other mobile applications or “apps” are being utilized in many areas of healthcare: education, health management, data management, health information, and other workflow processes.

The Market for Electronic Medical Record Systems was valued at $15.7 billion in 2010.

Not only is the medical community using smartphones and their applications for basic work at a higher rate than the general population, but they are reporting using smartphones in replacement for some of the work that would have previously been done on a desktop or laptop computer.

Worldwide enterprise electronic medical record (EMR) software markets will grow substantially as vendors are able to leverage the EMR expertise to provide competitive advantage from automation of process using IT infrastructure.

35

In-Stat has forecasted:

Public cloud computing model SaaS (software-as-a-service) spending by US businesses will increase by 112% between 2010 and 2014.

Spending is expected to grow significantly across all service options of cloud computing, including IaaS and PaaS.

Within SaaS, the professional services and healthcare verticals will see the largest growth in spending, each growing over 30% during the forecast period.

Additional research data on cloud computing market includes:

– SaaS (software-as-a-service) spending will increase 112% between 2010 and 2014.

– IaaS (infrastructure-as-a-service) spending will approach $4 billion in 2014.

– PaaS (platform-as-a-service) spending will increase 113% to roughly $460 million in 2014.

9.4 Boyd Custom Software/Healthcare Market

I. Health Information TechnologyII. Saas/Iaas/Paas

III. Mobility

HIMS Pain Points and Challenges

Streamlining of processes

Increasing speed of information flow

Distributed access to medical information

Healthcare data, warehousing and analytics

Regulatory compliance fulfillment

Scientific information management

Reducing medical errors

Boyd Custom Software Focus within HIMS

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Electronic health record (EHR): part of an automated order-entry/patient-tracking system providing real-time access to patient data and a continuous record of their care.

Electronic medical record (EMR) is a stand-alone computerized medical record that allows storage, retrieval and modification of records.

Computerized provider order entry (CPOE): CPOE is a medication ordering and fulfillment system.

Clinical decision support system (CDSS): CDSS provides physicians and nurses with real-time diagnostic and treatment recommendations.

Electronic materials management (EMM): Is used to track and manage inventory of medical supplies, pharmaceuticals, and other materials.

Interoperability: This concept refers to an electronic communication among organizations so that the data in one IT system can be incorporated into another.

9.5 Competitive Analysis See Appendix L “LIST OF TOP HEALTHCARE SOFTWARE COMPANIES”

9.6 Healthcare Initial Target Market See Appendix M “TOP 100 COMPANIES TO TARGET”

9.7 Healthcare Marketing Strategy

• Focus on one segment of the healthcare industry (HIMS)

• Research the best opportunities within the market (By revenue, product type, location, etc.)

• Research associations to join, certifications to acquire and tradeshows and conferences to attend or speak

• Add healthcare prospects to Eloqua Marketing Automation System through a series of initiatives

• Create healthcare marketing collateral for field effectiveness

• Create new Healthcare Banner and Solutions page for our website

• Create white papers written by 3rd parties

• Publish case studies - Allscripts, Clarient, PDT, InSight Health, Henry Schein and Consult-a-Doctor

• Execute marketing programs: email, direct mail, workshops, industry events, public relations, etc.

• Measure results and alter programs based upon results

9.8 Healthcare Marketing Objectives

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• Lead Generation

• Brand Awareness

• Field Effectiveness

• Healthcare Sales Accepted Leads (SALs)

• Face-to-Face Meetings

• Closed Sales

• Conduct market research in the healthcare software industry for services needed

• Create a strong brand strategy and messaging

• Develop aggressive sales, marketing and PR programs for increasing creditability, visibility, and revenue

• Develop lead generation programs that provide face-to-face meetings

• Deliver a total of 60 marketing qualified sales leads quarterly. This number would now include healthcare with all other industries

• Develop business partnerships with companies that offer complimentary services with a focus in healthcare

9.9 Marketing Database• Eloqua Healthcare ISV’s & Enterprises to date

– 700 Total Healthcare Companies

• 630 ISVs

• 70 Enterprises

– 2,300 contacts with titles: CEO, CIO, CTO, CIO, CTO, EVP / SVP / VP / Director of IT/Software Development / Product Development/Product Management, etc.

9.10 Marketing Initiatives

• Messaging

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• Nurturing programs

• Face-to-face meetings

• Strategy and initiatives to reach influencers

Messaging

• Differentiators– Highly intelligent engineers and developers with a successful track record in healthcare industry

– Software Development Lifecycle Services that use best practices and processes creating an industry first customized SDLC Playbook

– Consulting services that include strategy, solutions, development and support

– Existing satisfied and reference healthcare clients

• Focus on Healthcare’s largest pain points that include: – Streamlining processes– Increasing speed of information flow – Distributed access to medical information– Healthcare data - warehousing and analytics– Regulatory compliance fulfillment– Reducing medical errors– Fast return on investment

Develop messages that anticipate prospective healthcare buyers/payers thoughts, needs and questions. Tailor message to different audiences.

– Healthcare ISVs

– Healthcare Enterprises

– Healthcare Consultants

– Decisions Makers CEO, CFO, CIO, CTO VP IT, etc.

Focus key messages on how Boyd Custom Software Services can save or make healthcare ISV’s and Enterprises money and the business value to develop software to streamline processes from paper to electronics.

Develop a healthcare section under “Solutions” on our website illustrating the benefits, differentiators and revenue generating or revenue savings opportunities.

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Strengthen our position as thought leaders in the healthcare software development industry by writing and publishing white papers, briefing analysts/venture firms and securing appropriate speaking opportunities.

Communications Strategy

Consistently communicate Boyd Custom Software healthcare news and information in a simple format for brand awareness, educational purposes and general knowledge to employees, partners, customers and prospects. This will include newsletters, emails, letters, meetings, website, etc.

Create specific healthcare value propositions for different audiences:

o Enterprises

o Healthcare ISVs

o Healthcare consultants

Target vertical markets through print and web advertising, PR, case studies, articles, white papers, tradeshows/conferences, speaking opportunities, seminars, and direct marketing

Marketing Collateral

Created Healthcare sales presentation and brochure for Sales Team

Advertising

• Researching magazines and websites to advertise Boyd Custom Software Healthcare Solutions

– LinkedIn

– Healthcare IT News

– Healthcare Finance

– HDM Revenue cycle management watch

– HITSP Healthcare information tech standards panel

Nurturing Programs

Healthcare Specific Email and Direct Mail Campaigns:

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1. Introduction of PDT partnership (August/September)

• Sent press release announcing the partnership 8/15/11

• Place article in BCS Digest and PDT’s newsletter from Juan/Mark announcing the partnership 8/25/11

• Send promotional Flyer with SmartStart consulting offer to HIMSS and Continua Alliance Membership database scheduled for September

2. Mobility Campaign (November)

• Send new white paper on E-medicine from Tim Aligheri via email

• Send new case study via direct mail

• Make outbound calls to follow up on the direct mail

3. SaaS Campaign (January 2012)

• Send new white paper written by Fred Pennic on Healthcare and the Cloud via email

• Send the Allscripts case study as a follow up direct mail

• Make outbound calls to prospects to follow up direct mail

4. Business Analysis/SmartStart Campaign (February 2012)

• Send Outsourcing 2.0 white paper from Kris Kosyk via email

• Send Healthcare outsourcing article via direct mail

• Make outbound calls to follow up direct mail

5. BCs Healthcare Software Development (March 2012)

• Create new survey with healthcare related questions

• Send from BCS and from ExecutiveBrief to healthcare enterprises and ISV

• Send appropriate follow up based upon the survey answers

Corporate Website Enhancements

• TBD

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Corporate Website Continued

• Search Engine Optimization (SEO):

– Create a list of healthcare keywords and use SEO techniques to improve organic search results within the major search engines. Began work on healthcare SEO 8-22-11 with completion on first audit scheduled for 10/1/11.

– Create healthcare technology blog/tech tips

Public Relations

• Published ABC and BCS Partnership Press Release on August 15th and will continue to write releases with healthcare newsworthy stories

• Publish 3rd party healthcare technology articles and whitepapers on ExecutiveBrief’s website and newsletter and use them for BCS purposes in campaigns, social media, etc.

• List BCs profile in Healthcare technology directories

• Publish White Papers e-medicine and Healthcare in the Cloud

Healthcare Customer Case Studies

• Allscripts (completed)

• InSight Health

• PDT

• Henry Schein

• Consult-a-Doctor

• Clarient

Healthcare White Papers

• Tim Aligheri from Jackson Healthcare completed white paper on e-medicine

• Fred Pennic (colleague of Joyce) in process of writing paper on Healthcare and the Cloud

Speaking OpportunitiesIn an effort to increase our thought leadership in the healthcare industry we will secure speaking opportunities in

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software development emerging areas including Software Development and Methodologies: Some possible speakers include:

Gene Guertin Frank Murphy Terry Cameron Bill Fricke

Bonny Cassidy Jerry Baker John Connors

Industry Analysts

Marketing will schedule meetings with Industry Analysts that focus on healthcare such as:

Gartner Forrester IDC

Social Networking

• Develop Healthcare technology thought leadership through social media

• Publish links to SS healthcare materials and pages

• Promote healthcare solutions and services

• Become an active member of healthcare community in social networks.

Healthcare Associations

Researching the following associations for membership benefits:

HIMSS AMMI SIIMAHIOS AMIA WHCCKLAS AHIMAPAHCOM ARMAADVAMED MGMAAHDI NBCH

Strategic Partnerships

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• Our goal is to form a close partnership with key strategic partners to help introduce us to our target markets indirectly.

• Work to identify a number of strategic consultants with expertise in areas where BCS may have gaps and creating the partnership programs for 2012.

Healthcare Events

Marketing will research and identify the top healthcare industry events to attend, exhibit and speak at to increase brand awareness and enhance our thought leadership.

BCS Hosted Healthcare Events

• 3 Partner Workshops:

– February, CA/Utah Outsourcing 2.0 and SaaS/SDK

– March, Austin Mobility

– April, Boston SaaS/SDK

BCS Innovations User Conference

• Invite 2-3 customers (Henry Schein and Jackson Healthcare)

• Invite 2-3 prospects from other healthcare ISV’s or enterprises

Healthcare Industry Events

BCS plans to attend events, conference and tradeshows in 2011 to prepare for exhibiting as well as speaking at events in 2012 and beyond.

• Allscripts ACE.12, 8-29-12 to 8-31-12

• Health 2.0, 9-25-12 to 9-27-12

• AHIMA, 10-1-12 to 10-6-12

• MGMA, 10-23-12 to 10-26-12

• Global PharmaCloud, 11-2012

• WHIT v.7.0, 11-7-12 to 11-8-12

• HIMSS 2012, 2-20-12 to 2-24-12

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• eCloud Conference & Expo, 4-2012

• hCloud Conference & Expo, 4-2012

Education/Certification

Marketing will research and join healthcare associations and organizations to increase brand awareness and to keep abreast of new and emerging technologies, development techniques and methodologies.

• Harvard Business School of public health – Leadership for productivity and health management issues innovation and solutions ($1,200)

• Leadership strategies for information technologies in healthcare – Boston January and May

• Health Level Seven (HL7) Certification– A global authority on standards for interoperability of health information technology.

– By joining HL7, we will gain access to their standards, and help to create the best and most

– widely used standards in healthcare.

9.11 Marketing Milestones (See Appendix L)

• Identity/Brand • Industry Events • Speaking Opps• White Papers• Editorial Coverage• Marketing Collateral

• Case Studies• Customer Referrals• Associations• Certifications• Qualified SALs• Closed Sales

9.12 Marketing Metrics

• New Healthcare Suspects • New Healthcare Inquires • Healthcare Marketing Qualified Leads

• Healthcare Sales Accepted Leads • Healthcare Leads in Sales Pipeline • Healthcare Closed Sales

9.13 Marketing Budget Q1’ 2012

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$150,000

o Lead list database purchase $10,000o Association membership $20,000o Events $30,000o Workshop $15,000o Advertising/Sponsorships $30,000

o Certifications $10,000o White Papers $20,000o Articles $20,000

Market Threats

See Appendix O See Appendix P

X. Innovation and Technology

10.1 Innovation Description

High traffic internet/web applications come in multiple flavors. Such as large consumer sites managing high volumes of simultaneous consumer visitors and ecommerce transactions and the popular multi-tenant business applications, such as SalesForce.com and Success Factors. In some organizations, the process of building and running these applications, sites, and systems on horizontally scaling server farms has driven a tighter collaboration between the software development and IT operations disciplines. Dev Ops refers to methods and processes for driving a holistic, continuous build and release process for medium and large scale software services running on IT infrastructure. Holistic and continuous here means a repeatable process where developers, testers, and system admin configuration managers frequently, confidently, and deliberately collaborate to release new builds to the stage and production instances of their high traffic web based systems. These processes are rooted in the intersection of Agile development and IT operational standards like ITIL.

An effective Dev Ops release process can resemble a complex military drill full of critical sequential and dependent tasks. Especially when the upgrade is a major upstream release to the production instances of new application code, or a new version upgrade of the underlying data management platforms or web application servers.

At the same time, effective build and release process is also a hierarchy flattening team effort. No single technical department or discipline is prioritized. The management of the release lifecycle typically involves tight collaboration between four engineering related roles:

o Operations Team (OPS) - all activities related to support the service in operational stateo Development Team (DEV) - features development and code-base optimizationo Quality Control and Assurance (QA) - features validation and quality controlo Client service and support (CS) - provide customer support

Development Ops: A High Priority

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Recent explosive growth within the healthcare industry in cloud computing and SaaS application consumption has increased the number of tenant organizations depending upon the smooth operation of centralized infrastructure and software services. This concentration of risk has combined with the successful positioning of SaaS and Cloud Computing as an alternative to on premise to create a fishbowl effect. Both small and large providers of Infrastructure as a Service and Software as a Service live in a highly transparent world when it comes to service availability. The concentration of risk for multiple tenants places high stakes on continuously executing successful operations plans.

Mainstream SaaS ISV Community

There are thousands of Healthcare ISVs around the world offering SaaS solutions. The infrastructure approach chosen by the ISV can include managed services, unmanaged colocation, data center ownership, public services like AWS, or combinations. Depending upon the nature of an application and the user base served, limited or zero tolerance for outages can be absolute requirements. Examples of SaaS applications which may exhibit such high availability and ‘survival requirements’ include SaaS based billing systems, critical patient healthcare systems, and ecommerce sites. Transparency, Rising Standards, and PublicityWhen the majority of business applications were deployed inside private enterprise networks, public visibility into application downtime was non-existent. As SaaS providers deploy more and more critical enterprise applications, downtime is an increasingly public event, impacting large numbers of tenants running on various types of centralized data center facilities. The result is increasing expectations for highly available Infrastructure as a Service, rising standards for application uptime, and increasing transparency for application uptime performance.Since individual IaaS providers do not provide instant or plug and play solutions for high availability and data durability requirements, SaaS ISVs feel increasing pressure to develop applications, processes, and automated operations to meet these requirements. In many cases ISVs should be considering new tools and methods to deliver on improved Dev Ops practices.

Following the Money: Impact of SaaS DevOps on Metrics

Aside from the risk of public embarrassment, another factor motivating SaaS ISVs to optimize service and infrastructure operations is financial. The overall financial impact of SaaS operations is felt in several aspects of topline revenue performance and operating costs.The offering of month to month rental style contracts is considered one of the key advantages SaaS providers offer over on premise enterprise software products. Upfront ownership cost is thus lowered. This is also a major vulnerability: customers of SaaS providers can try solutions within small user populations, and if perceived problems outweigh the sold benefits, readily de-commission the solution, or delay broader rollout. More mature SaaS ISVs watch the customer churn rate carefully. It is common for Dev Ops difficulties to cause the loss of both relatively new and more established customers. Here is a short list of some of the most common Dev Ops difficulties that can increase customer churn rate (and thus reduce Monthly Recurring Revenue) or delay broad customer rollout:

o Upstream code base releases which break prior customizationso Upstream code base releases which change prior recurring systems behavioro Maintenance windows expanding beyond SLA, prohibiting critical customer usage activity o System response time degradation (performance and capacity issues)o Inability to migrate customizations and meta data configuration from stage instances to production

Customer Acquisition Cost (CAC) is another metric used by many SaaS ISVs to measure the financial performance of the business. A major component of CAC can be customer onboarding, and this process can be significantly helped or hindered by Dev Ops practices.

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Here is a short list of some of the common Dev Ops related onboarding problems that can drive up CAC:

o Manual process to spin up a new tenant and/or application instanceso Manual process to move a tenant from stage to productiono Manual processes to configure standard new tenant meta datao Manual processes to configure new tenant support in OS, web application servers, and data management

layerso Migrating and cleansing historical data required to bring a new tenant into production

Operations Roadmap for SaaS ISVs

The typical early stage SaaS ISV is often facing immediate strategic and tactical challenges in adjusting to the growing importance of operations. This can be a ‘CXO level’ problem: perhaps critical customer churn has resulted in defection, or rollout delay, by large and intolerant name brand customers, and several million dollars is needed to invest in and properly deploy more Infrastructure as a Service (IaaS) to consistently achieve the in place Service Level Agreement (SLA). Or the challenges can be organizational: traditionally skilled software engineering teams are in the early stages of adjusting to the requirements the SaaS offering has placed on integrating development and operations.

Operations Assessment

A good starting point is a thorough assessment of the current Dev Ops state relative to best practices. Ideally the assessment is conducted by a third party with a legitimate track record of substantial experience in the intersection of SaaS operations and software development. An effective assessment uncovers current practices for the following:

o Capacity planning o Performance monitoring o Configuration management o Release processes o Application and Data Maintenance o Tenant Management o Backup/restore/disaster recovery o Availability o SLA implementation and measurement o Operational tools, methods, and automation state

About Boyd Custom Software

BCS is a fast growing software engineering services firm headquartered in FortMyers, Florida, USA. The BCS SaaS practice is frameworks, consulting, design, development,and operations services for helping healthcare ISVs deliver next generation Software as a Service. The increasing velocity of projects completed by BCS in the past corresponds to accelerating adoptionof SaaS in the Healthcare ISV community. Recent milestones in the BCS SaaS practice include:

o cloud computing Infrastructure as a Service (IaaS)o Configuration and operations automation for thousands of instances using the SoftServe SaaSo Operations Framework (SSOF)o Design of highly available SaaS solutions incorporating Content Delivery Networks and separate, redundant IaaS from multiple 3rd party providerso Compression of definition/development/production delivery cycle time for complex SaaS applications to less than 180 days

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o Automated provisioning of new load balanced application server instances to clusters in minuteso Multiple SaaS operations assessments for a variety of early stage and established SaaS ISVs

BCS SaaS Operations Practice: Examples and Artifacts

The first example is an executive summary of a point in time SaaS operational state of an ISV discovered from a comprehensive operations assessment:

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The second example is an overview architecture diagram of the BCS SaaS Operations Framework, an integrated BCS

toolset for automating SaaS operations in production with several existing clients:

See Appendix Q

10.2 S-Curve Analysis

BCS utilizes the S-Curve Metric to illustrate our business growth phases throughout the enterprise life cycle. Our entrepreneurial start-up with some initial resources has experienced a wave ofgrowth as the market responds to our new offering. Currently BCS is in a Category 1 of the innovation category, we have a new solution to an old problem, the software development life cycle. Currently we are beginning to trend into a growth stage however it will be critical for us to continually invest in R&D to move through the chasm in order to achieve sustainable growth.

Ultimately our goal will be the utilization of progress metrics to provide a comparison between the Target S- Curve and the Actual S-Curve. The actual S-Curve is a measure of the actual man-hours and expenditures of a project on a specific completion stage date.Historically the Actual S-Curve is anticipated to run below the lines of the Target S-Curve, since the results of constant monitoring entails compliance and observance of the targeted time and costs. Consequently, the two curved lines are expected to meet or converge towards the end of the project completion.

See Appendix R

10.3 Innovation Implementation

The BCS SaaS practice is a set of consulting and development services to help Healthcare ISVs and Enterprises design,

build, deliver, and manage next generation Software as a Service solutions. The increased velocity of successful

projects completed by BCS in the past corresponds to the accelerating adoption of SaaS in major healthcare

information technology markets. Some key recent achievements in the BCS SaaS practice include:

o The complete incorporation of BCS Platinum extended Agile methodology into all projects, including all aspects of project framework (gap analysis, concept phase, definition phase, design phase, development phase and application phase.

o The delivery of complex social network SaaS solutions featuring large amounts of unstructured data and geographically distributed cloud computing Infrastructure as a Service (IaaS)

o The design of highly available SaaS solutions incorporating Content Delivery Networks and separate yet redundant IaaS from multiple third party providers

o The compression of definition/development/delivery cycle time for complex SaaS applications to less than 180 days

o The automated provisioning of new load balanced application server instances to server farm clusters in minutes.

As a result of these intense immersions in client SaaS projects, BCS delivery teams have developed reusable software development tools and frameworks for future SaaS project efforts. The tools cover both open source Java

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and Microsoft .Net development stacks. Because of the unique new requirements placed on ISVs and Enterprises to operate IaaS as part of service delivery, BCS also provides an integrated set of Operations Framework tools as well.

Agile Development: See Appendix S

10.4 Innovation Diffusion

Diffusion of Innovation, Everett Rogers defines diffusion as the process by which an innovation is communicated

through certain channels over time among the members of a social system (Everett Rogers 1995). BCS believes that

creating an open environment only enhances the ability to leverage our belief in Agile methodology and promotes

creativity and innovation with our team.

The four elements that are present in the diffusion of innovation process remain the strategy that BCS leverages to

this day. These four main elements are:

1. Innovation - an idea, practices, or objects that is perceived as knew by an individual or other unit of adoption.

2. Communication channels - the means by which messages get from one individual to another.

3. Time - the three time factors are: innovation-decision process; relative time with which an innovation is adopted by

an individual or group; and innovation's rate of adoption.

4. Social system - a set of interrelated units that are engaged in joint problem solving to accomplish a common goal.

BCS has to consistantly adopt new technological innovations one way or the other in order to improve or keep their

efficiency or competitive advantages in business. Our belief is that our greatest asset is our people and the innovation

that is depicted in the successful projects that they complete and their proven success rate.

Our IP framework such as SDLK is in the beginning stages of the innovation stage however, we are successfully

heading to a successful crossing of the chasm. See Appendix T

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10.5 Use of Technology

The BCS SaaS Operations Framework (SSOF) is an integrated set of tools, components, and

automation services for achieving excellence in SaaS operations. SSOF drives efficient and repeatable

practices for provisioning, release management, monitoring, centralized security, data management,

and inventory control. See Appendix Q

Key Features

Provisioning

Add application instances to load balanced clusters in minutes, starting from ‘bare metal’. Automate

provisioning from a central control point using web user interface, command line, or API. Centralized Security

Authentication and authorization for all collected application, system, and device consoles is managed within a single

LDAP compatible security service. Implement and Control Tenant Segmentation IaaS, application, and database

requirements for operating varied multi-tenancy configurations all configured, managed, monitored, and controlled

from a single central point.

Achieve Scalability and High Availability Goals

o Automate responses to additional capacity requirements. Automate geographical and multi-data center

replication to create hot copies of data across zones.

o Create Central Logging and Backup System. A single control point is provided for all log files of IaaS,

database, and application services. A single control point is provided for initiating, managing, and monitoring

all data and configuration backups.

o Leverage Best of Breed Open Source Operations Technology The SSOF integrates best of breed open source

tools to automate operations.

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Drive Application Lifecycle Management

SSOF functions as the collaboration hub for development and operations to manage application

lifecycle. Supports the successful management of two or more codebases. Successfully manages the

release process for patch and version changes to the application instances.

SSOF Benefits

Reduce Risk

The SSOF helps startup and established ISVs integrate SaaS development and operations to ensure

satisfactory tenant experience. SSOF drives collaboration between software developers, sys admins,

and quality assurance testers. Increase Monthly Recurring Revenue, SSOF drives successful continuous release cycles

for Agile application development process, ensuring that new and existing SaaS tenants all have stable access to

the latest feature and enhancement releases on a regular basis. Helps get more new features and enhancements

running with stability on production instances faster.

Decrease Customer Acquisition Costs

SSOF automates the migration of tenants and configurations from stage to production instances. It also automates

configuration and provisioning of technology stacks required to deploy new tenants. You achieve a reduction

in the time and effort from the operations and customer success teams to get tenants running live.

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10.6 Risks and Opportunities for Innovation and Use of Technology

The growth of technology globalization is influencing economic relationships that affect each individuals’ quality of

life. Cities currently are striving to separate and define their identity to appeal to the seemingly smaller world

community. This in turn places more pressure on smaller countries to draw more monetary resources to compete

with some of the worlds more affluent nations. One could argue that the stages of globalization are an inevitable

aspect of human kinds evolution. By placing more importance on worldly reciprocal relationship, it is probable that

globalization is the mechanism in which the future of human kind will be measured.

Globalization is an inevitable force of human evolution that is partly driven by objectives in cutting costs in our free

market economy. With this need to stimulate global economy it is understood that each country could benefit from

the expansive mechanism. It is my opinion that globalization will continue to reshape the world and the relationships,

and peoples that are effected. With this said, BCS will continue to follow the moral standards that take into account

the highest degree of social, economic, environmental and human rights concerns.

10.7 Value Add Proposition

BCS, with its track record of successful software development projects, is recognized as a trusted, strategic partner. Market demands among healthcare solutions require business models to improve processes, reduce costs and become more customer-centric. High quality solutions need to become synonymous with cost control measures. The bottom line is that your success depends on whether you can eliminate inefficiency, streamline processes and stay in compliance. That is where BCS can help.

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BCS, through the pioneering use of cutting-edge technologies, along with the unmatched skills of our software engineers, consistently develops breakthrough solutions that meet and exceed complex healthcare management requirements. Our healthcare solutions support the entire healthcare ecosystem, with flexible technology and innovative approaches making information more understandable and easier to access and use for healthcare organizations. We blend our technical expertise with your insights to create an all-inclusive positive user experience.

We understand the many challenges facing the healthcare market:

Streamlining processes

Increasing speed of information flow

Distributed access to medical information

Healthcare data - warehousing and analytics

Regulatory compliance fulfillment (HIPAA 50-10, ICD-10, Meaningful Use, HITECH, etc.)

Reducing medical errors

Fast return on investment

To offset these challenges, we offer these healthcare solutions:

Integration solutions

Cloud development

Security and authentication

Patient Portals

EMR systems

Mobility

Healthcare Management systems Electronic Medical Records Software

BCS is a software development and consulting partner focused on bringing innovative healthcare initiatives from concept to reality. Our engineers thrive on every project from the simplest to the most complex healthcare challenges. We relish the challenge of helping our client’s grow their initiatives and succeed beyond their highest expectations.

10.8 Change Management & Innovation - TBD

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XI. Finance and Accounting

BCS is a start-up company that will not require any outside financing. The initial investment will be funded by the owner in its’ entity. Offshore outsourcing is recognized as a value enhancer that enables organizations to streamline their core operations at a significant cost advantage, (Cunningham, 2006). These value enhancers enable BCS to develop software by managing labor costs while deploying world renowned quality software development.

11.1 Background Data

The below graphs supplied by JP Morgan provide significant analysis on the rise of healthcare development and technology deployment over the next several years comparing the relative strength to the S&P 500, (JP Morgan, 2011). With this said and in conjunction with the owners expertise within the industry, due diligence has been proven on a number of factors therefore the need for substantial R&D is postponed during the first year.

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11.2 Financial Projections:

The following financial projections are based on sales forecasts quarter over quarter for FY’2012. We will continue to sell value-add software solutions to independent software vendors, (ISV’s) throughout FY’ 2012 at which time we expect to have Intellectual Property (IP) ready for deployment and sales in the area of business intelligence and analytics for enterprise software solutions.

Projected revenues are based on relationships and verbal agreements with large tier 1 and tier 2 CEO’s and Executives. These relationships will allow for the launching of BCS with the need to raise limited capital resources and the basis for aggressive financial sales projections.

Average price of development is based on industry standards as it relates to off-shore development. Average hourly rate is approximately $10.00 US per hour. Each software development project requires a Senior and Junior developer as well as a BA, and PM. The average hourly rate for the team is $50 US dollars and an average software deployment is around 100 hours of work depending on the complexities of the project.Variable costs will be extensive primarily due to travel abroad to engage in development agreements and the need for Business Analyst and Project Managers to travel to the client for extended periods of time throughout the smart-start period.

Fixed costs are minimal due to the off-shore model. There is limited space needed to write the code and provide Q&A for the customer. As well, there is limited recognition of depreciation values as equipment is limited and mobility devices are typically supplied by the customer.

Salaries and wages are low in comparison due to the value of the dollar in the countries to which development will be deployed such as Romania and the Ukraine. The average annual salary is $12,000 US dollars which allows for our margins to be significantly higher due to competitive US development rates and very low labor costs in comparison.

Quarter by quarter analysis shows that a moderate profit will be recognized in Q1-Q2 with a substantial increase in profit in Q3 due to the fact that the average development life cycle is 6-9 months. Q4 will recognize a period of continued capital expenditure and need for strong sales efforts to sustain profit margins. Due to the payment cycle Q4 will not recognize revenues similar to Q2-Q3.

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11.1 Profit and Loss Sheet

The income statement also known as the P&L shows the revenue, expenses and net income (loss). BCS shows an increase in our revenue during Q2 and Q3 which is reflective of the lifecycle of software development. Historically Q1 consists of consulting services which generates partial payment with more of a robust recognition of revenue in Q2 and Q3. Q4 our revenue projections are quite conservative compared to Q1-Q3. The price of development and L&M fees are reflective of our revenue projections.

Fixed Cost are consistent from Q1-Q4. The management team has taken a rather liberal approach to our cost projections for the first year.

What else should I put in here to talk about the P&L?

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Boyd Custome Software P&LQtr 1 Qtr 2 Qtr 3 Qtr 4 Total

Budget Revenue 50,000 60,000 75,000 42,500 227,500 Avg Price of Development 5000 5000 5000 310 15310 Variable costs (License & Maintanance Fees) 2500 2500 2200 2000 9200

Budget Sales and development 250,000 300,000 375,000 13,175 938,175 Variable costs 125,000 150,000 165,000 85,000 525,000 Contribution 125,000 150,000 210,000 (71,825) 413,175

Fixed Costs: Salaries and wages 75,000 75,000 75,000 75,000 300,000 Maintenance 2,200 2,200 2,200 2,200 8,800 Insurance 250 250 250 250 1,000 Electricity 1,200 1,200 1,200 1,200 4,800 Depreciation 400 400 400 400 1,600 Other costs(Income Tax) 5,500 5,500 5,500 5,500 22,000 Total Fixed Costs 84,550 84,550 84,550 84,550 338,200

Operating Profit 40,450 65,450 125,450 (156,375) 74,975 Interest Expense 600 600 600 600 2,400 Profit after Interest 39,850 64,850 124,850 (156,975) 72,575

BudgetCash Flow Profit after Interest 39,850 64,850 124,850 (156,975) 72,575 Add back depreciation 400 400 400 400 1,600

40,250 65,250 125,250 (156,575) 74,175

Less capital expenditure 6500 2000 1000 9000 18,500 Less dividend - Less debt repayments 1000 5000 4000 3000 13,000

7500 7000 5000 12000 31500Net cash flow 32,750 58,250 120,250 (168,575) 42,675

Cumulative cash flow 32,750 91,000 211,250 42,675 377,675

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XII. Finance Management

Financial statements are bases for understanding the financial position of the firm, not only currently but also

historically. They can also be used in predicting possible future financial condition of a company.

On the current financial position, the balance sheet shows where a company is, in terms of size, level of liabilities, and

ownerships. The income statement shows marketability of the company’s products, pricing, direct and indirect

expenditures, payments of interests, taxes, owners’ dividends, level of profitability, and others.

Historically, the said financial statements show patterns and trends in the company’s financial condition. By looking

into year-to-year financial statements, one would see whether the company is continuously improving, deteriorating, or

fluctuating in terms of results of operations.

Various entries in the financial statements can also predict or provide signs of future financial direction of a company.

The past trends may be interpolated and carried over to the future, assuming certain conditions, to show future financial

health.

The balance sheet and income statement show a picture of a business organization. This picture has several parts; in the

same manner, the financial statements have various parts too. Furthermore, they are used by several stakeholders. Not

every stakeholder will look into all parts of the picture. Each stakeholder, though interested in the organization as a

whole, focuses on a part or specific parts of the picture, depending on various factors such as his role in the company,

his objectives, his priorities, and other related factors.

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12.1 Financial Statement (Budget 1)

Boyd Custome Software P&LQtr 1 Qtr 2 Qtr 3 Qtr 4 Total

Budget Revenue 50,000 60,000 75,000 42,500 227,500 Avg Price of Development 5000 5000 5000 310 15310 Variable costs (License & Maintanance Fees) 2500 2500 2200 2000 9200

Budget Sales and development 250,000 300,000 375,000 13,175 938,175 Variable costs 125,000 150,000 165,000 85,000 525,000 Contribution 125,000 150,000 210,000 (71,825) 413,175

Fixed Costs: Salaries and wages 75,000 75,000 75,000 75,000 300,000 Maintenance 2,200 2,200 2,200 2,200 8,800 Insurance 250 250 250 250 1,000 Electricity 1,200 1,200 1,200 1,200 4,800 Depreciation 400 400 400 400 1,600 Other costs(Income Tax) 5,500 5,500 5,500 5,500 22,000 Total Fixed Costs 84,550 84,550 84,550 84,550 338,200

Operating Profit 40,450 65,450 125,450 (156,375) 74,975 Interest Expense 600 600 600 600 2,400 Profit after Interest 39,850 64,850 124,850 (156,975) 72,575

BudgetCash Flow Profit after Interest 39,850 64,850 124,850 (156,975) 72,575 Add back depreciation 400 400 400 400 1,600

40,250 65,250 125,250 (156,575) 74,175

Less capital expenditure 6500 2000 1000 9000 18,500 Less dividend - Less debt repayments 1000 5000 4000 3000 13,000

7500 7000 5000 12000 31500Net cash flow 32,750 58,250 120,250 (168,575) 42,675

Cumulative cash flow 32,750 91,000 211,250 42,675 377,675

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12.2 Financial Statement (Budget 2)

The trends in previous analysis are even more glaringly apparent here. We can see the increase in the level of revenue

in the first three quarters followed by its sharp decline in the fourth quarter. This is apparent in both the first and

second budgets. In the second budget the contribution margin and the income increase in quarters 1 to 3, then decline

sharply in quarter 4 as a result of the increased costs. Fixed Costs remain constant for each quarter, following its

expected pattern. In the third budget the net cashflow follows the pattern of the contribution margin and the profits in

the second budget, increasing from quarters 1 - 3 then declining in quarter 4.

Financial Statement on Page 62

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Boyd Custmer Software P&L Financial Statements

Qtr 1 Qtr 2 Qtr 3 Qtr 4 TotalBudgetRevenue 50,000 60,000 75000 42500 227,500Average Price of development 5000 5000 5000 310 15310Variable Costs (License & Maintenance Fees) 2500 2500 2200 2000 9200

BudgetSales and Development 250000 300000 375000 13175 938175Variable Costs 125000 150000 165000 85000 525000Contributin 125000 150000 210000 -71825 413175

Fixed CostsSalaries and wages 75000 75000 75000 75000 300000Maintenance 2200 2200 2200 2200 8800Insurance 250 250 250 250 1000Electricity 1200 1200 1200 1200 4800Depreciation 400 400 400 400 1600Other Costs (Income Tax) 5500 5500 5500 5500 22000Total Fixed Costs 84550 84550 84550 84550 338200

Operating Profit 40450 65450 125450 -156375 74975Interest Expense 600 600 600 600 2400Profit after Interest 39850 64850 124850 -156975 72575

BudgetCash FlowProfit after Interest 39850 64850 124850 -156975 72575Add Back Depreciation 400 400 400 400 1000

40250 65250 125250 -156575 74175Less Capital Expenditure 6500 2000 1000 9000 18500Less DividendLess Debt repayments 1000 5000 4000 3000 13000

7500 7000 5000 12000 31500Net Cash Flow 32750 58250 120250 -168575 42675

Cumulative Cash Flow 32750 91000 211250 42675 377675

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12.3 Common Size Financial Statement

Boy d Custmer Software P&L Boy d Customer Software P&L Financial Statements Common Size Financial Statement

Qtr 1 Qtr 2 Qtr 3 Qtr 4 Total Qtr 1 Qtr 2 Qtr 3 Qtr 4 TotalBudget Budget 1Revenue 50,000 60,000 75000 42500 227,500 Revenue 100% 100% 100% 100% 100%Average Price of development 5000 5000 5000 310 15310 Average Price of development 10% 8.33% 6.67% 0.73% 6.73%Variable Costs (License & Maintenance Fees)2500 2500 2200 2000 9200 Variable Costs (License & Maintenance Fees) 5% 4.17% 2.93% 4.71% 4.04%

Budget Budget 2Sales and Development 250000 300000 375000 13175 938175 Sales and Development 100% 100% 100% 100% 100%Variable Costs 125000 150000 165000 85000 525000 Variable Costs 50% 50.00% 44.00% 645.16% 55.96%Contributin 125000 150000 210000 -71825 413175 Contribution 50% 50.00% 56.00% -545.16% 44.04%

Fixed Costs Fixed CostsSalaries and wages 75000 75000 75000 75000 300000 Salaries and wages 30% 25.00% 20.00% 569.26% 31.98%Maintenance 2200 2200 2200 2200 8800 Maintenance 0.88% 0.73% 0.59% 16.70% 94.00%Insurance 250 250 250 250 1000 Insurance 0.10% 0.08% 0.07% 1.90% 11.00%Electricity 1200 1200 1200 1200 4800 Electricity 0.48% 0.40% 0.32% 9.11% 51.00%Depreciation 400 400 400 400 1600 Depreciation 0.16% 0.13% 0.11% 3.04% 17.00%Other Costs (Income Tax) 5500 5500 5500 5500 22000 Other Costs (Income Tax) 2.20% 1.83% 1.47% 41.75% 2.34%Total Fixed Costs 84550 84550 84550 84550 338200 Total Fixed Costs 33.82% 28.18% 22.55% 641.75% 36.05%

Operating Profit 40450 65450 125450 -156375 74975 Operating Profit 16.18% 21.82% 33.45% -1186.91% 7.99%Interest Expense 600 600 600 600 2400 Interest Expense 0.24% 0.20% 0.16% 4.55% 0.26%Profit after Interest 39850 64850 124850 -156975 72575 Profit after Interest 15.94% 21.62% 33.29% -1191.46% 7.74%

Budget Budget 3Cash Flow Cash FlowProfit after Interest 39850 64850 124850 -156975 72575 Profit after Interest 121.68% 71.26% 59.10% -367.84% 19.22%Add Back Depreciation 400 400 400 400 1000 Add Back Depreciation 1.22% 0.44% 0.19% 0.94% 0.26%

40250 65250 125250 -156575 74175 122.90% 71.70% 59.29% -366.90% 19.64%Less Capital Expenditure 6500 2000 1000 9000 18500 Less Capital Expenditure 19.85% 2.20% 0.47% 21.09% 4.90%Less Dividend Less DividendLess Debt repayments 1000 5000 4000 3000 13000 Less Debt repayments 3.05% 5.49% 1.89% 7.03% 3.44%

7500 7000 5000 12000 31500 22.90% 7.69% 2.37% 28.12% 8.34%Net Cash Flow 32750 58250 120250 -168575 42675 Net Cash Flow 100.00% 64.01% 56.92% -395.02% 11.30%

Cumulative Cash Flow 32750 91000 211250 42675 377675 Cumulative Cash Flow 100.00% 100.00% 100.00% 100.00% 100.00%

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12.4 WRITTEN ANALYSIS

Budget 1:

The Variable cost to revenue ratio has remained relatively stable throughout the quarters. It should be noted

that in the third quarter when revenues were at their highest, the variable costs were at their lowest. This is

unusual for a cost that is generally expected to move in the same direction as revenue.

The average price of development took a considerable dip in the fourth quarter.

Budget 2

The proportion of variable cost to sales appear stable in the first three quarters. However, in the third quarter the

variable cost increased exponentially. While variable cost was increasing in the third quarter the sales level was

moving in the opposite direction. The opposite movements of variable cost and sales led to a huge decrease in the

contribution margin in the fourth quarter. The ratio of fixed cost to sales also increased in the fourth quarter.

The increase in fixed and variable cost in the fourth quarter led to a tremendous decline in profits for the firm.

POINTS TO NOTE:

1. The movement of the variable and fixed cost in the fourth quarter is reflective of the strategic plan to expand in this

quarter, thereby, expecting high expansion costs.

2. Interest expense remained fixed in each quarter indicating that even if the firm is planning expansion, it does not

expect to increase its debt financing in order to expand.

Budget 3

As far as cash flow goes, the firm appears to be expecting to collect over 80% of its net profit amount for the first three

quarters and nearly 60% for the year.

65

12.5 Per Share Analysis

BCS is a well-funded private equity start-up company. At this point in time, there is insufficient data to supply a robust

analysis on EPS, DPS, BVPS or CVPS nor a need. As the organization continues to gain market share and revenue

growth the executive team will decipher the options; preferably to either acquire organizations with complimentary

products/services to capitalize on synergistic value at which time additional investors may be necessary or the more

strategic short term goal to maximize revenue in preparation for sale.

12.6 Ratio Analysis

Currently BCS is a start-up, proper trending analysis will be executed at the end of FY’1. At this point in time, the

financial team will begin to trend historical calculations via ratio analysis and trend analysis year over year.

Ratio Analysis Graph on Page 66

66

RATIO ANALYSIS

Total Budget 1 Qtr 1 Qtr 2 Qtr 3 Qtr 4 TotalRatios

227,500 Variable Cost to Revenue 5% 4% 3% 5% 4%15310 Average Price of Development to Revenue 10% 8% 7% 1% 7%

9200Budget 2Ratios

938175525000 Variable Cost to Sales 50% 50% 44% 645% 56%413175 Contribution Margin to Sales 50% 50% 56% -545% 44%

3000008800100048001600

22000 Variable cost to Fixed Cost 147.00% 177.41% 195.15% 100.53% 155.23%338200 Fixed Cost to Sales 33.82% 28.18% 22.55% 641.75% 36.05%

74975 Operating Profit to Sales 16.18% 21.82% 33.45% -1186.91% 7.99%2400 Profit after Interest to Sales 15.94% 21.62% 33.29% -1191.46% 7.74%

72575

Budget 3

725751000

7417518500 Capital Expenditure to Profit after Interest 16.31% 3.08% 0.80% -5.73% 25.49%

13000 Debt Repayment to Profit after Interest 2.51% 7.71% 3.20% -1.91% 17.91%3150042675 Net Cash Flow to Profit after Interest 82.18% 89.82% 96.32% 107.39% 58.80%

377675

67

12.7 Competitive Analysis:

Boyd Custom Software quarterly revenue growth has been negative, which is not reflective of the industry standard, which is positive. BCS is obviously a start- up company that is currently much smaller than most of its competitors, this is evident by the differences in revenue and income levels. Even though its actual earnings before interest and taxes is lower than that of the industry,Boyd Custom Software is experiencing a very good level of operating margin, 7.99% in comparison with the industry's 6.62%.

Direct Competitor Comparison EPAM CTSH PVT1 INFY Industry Boyd

Market Cap: 855.47M 23.01B N/A 32.44B 390.31MEmployees: 8,125 137,700 N/A 145,000 1.50KQtrly Rev Growth (yoy): 34.40% 26.90% N/A 13.90% 8.60% -17.16%Revenue (ttm): 334.53M 6.12B 3.46B1 6.82B 618.06M 1.17MGross Margin (ttm): 38.62% 42.19% N/A 40.21% 27.09%EBITDA (ttm): 64.24M 1.26B N/A 2.14B 30.55M 0.07498MOperating Margin (ttm): 16.95% 18.57% N/A 28.56% 6.62% 7.99%Net Income (ttm): 11.77M 883.62M 362.60M1 1.66B N/A 0.073MEPS (ttm): 0.63 2.85 N/A 2.89 0.35P/E (ttm): 31.88 26.61 N/A 19.64 11.26PEG (5 yr expected): 0.65 1.19 N/A 1.22 0.98P/S (ttm): 2.66 3.83 N/A 4.8 0.67

68

Boy d Custmer Software P&L Financial Statements

Qtr 1 Qtr 2 Qtr 3 Qtr 4 TotalBudgetRevenue 50,000 60,000 75000 42500 227,500Average Price of development 5000 5000 5000 310 15310Variable Costs (License & Maintenance Fees) 2500 2500 2200 2000 9200

Qtrly Growth Average QtrlyBudget GrowthSales and Development 250000 300000 375000 13175 938175 0.2 0.25 -0.96487 -0.17162Variable Costs 125000 150000 165000 85000 525000Contributin 125000 150000 210000 -71825 413175

Fixed CostsSalaries and wages 75000 75000 75000 75000 300000Maintenance 2200 2200 2200 2200 8800Insurance 250 250 250 250 1000Electricity 1200 1200 1200 1200 4800Depreciation 400 400 400 400 1600Other Costs (Income Tax) 5500 5500 5500 5500 22000Total Fixed Costs 84550 84550 84550 84550 338200

Operating Profit 40450 65450 125450 -156375 74975 operating margin 0.079916Interest Expense 600 600 600 600 2400Profit after Interest 39850 64850 124850 -156975 72575

BudgetCash FlowProfit after Interest 39850 64850 124850 -156975 72575Add Back Depreciation 400 400 400 400 1000

40250 65250 125250 -156575 74175Less Capital Expenditure 6500 2000 1000 9000 18500Less DividendLess Debt repayments 1000 5000 4000 3000 13000

7500 7000 5000 12000 31500Net Cash Flow 32750 58250 120250 -168575 42675

Cumulative Cash Flow 32750 91000 211250 42675 377675

69

12.8 Variable Cost to Revenue Ratio:

12.9 Contribution Margin to Sales Ratio:

70

12.10 Profit after Interest to Sales:

12.11 Net Cash Flow to Profit after Interest

71

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Appendix A

75

Appendix B

76

Appendix C

77

Appendix D

78

Appendix E

79

Appendix F

80

Appendix G (SWOT Analysis)

Strengths Mobile application

development/deployment SDLC Mobility SaaS/Cloud IT agility Interoperability Agile Framework

Weaknesses Market Recognition Resources Executive Commitment Changing Technology Bench strength

Opportunities Become leading software

developer and leverage this as competitive differentiator

Strong referencable sites are – this will continue to create opportunities

Targeting application specific opportunities

Potential positive changes in regulatory environment

New Technologies (mobility, PDA’s etc)

Threats More focus/movement into

this market by acute players Current client base alienation HIPAA Security Un-defined security rules

81

Appendix H (Financials)

82

Appendix I(Organizational Chart)

83

Appendix J(7’P’s)

HealthcareTarget Market

PRODUCTSaaSMobilityInteroperabilty

PRICEStrategies:SkimmingPenetrationPsychologicalCost-PlusLoss leader, etc.

PLACERetailWholesaleMail orderInternetDirect SalesPeer to PeerMulti-Channel

PROMOTIONSpecial OffersAdvertisingEndorsementsUser trialsDirect mailingLeaflets/postersFree giftsCompetitionsJoint ventures

PhysicalEnvironmentISVHospitalClinics

ProcessSoftWare ServiceAgile Framework

PeopleEmployeesManagementCultureCustomer Service

84

Appendix K(Ansoff Matrix)Ex

isti

ngN

ew

Existing New

MarketPenetration

ProductDevelopment

MarketDevelopment Diversification

Products

Mar

kets

85

Appendix L(Gantt Chart)

Task Name Duration Start Finish Predecessors Resource Names

Create healthcare marketing brochure 10 days? Mon 5/23/11 Thu 6/2/11Create new Healthcare Banner and Solutions page for our website 5 days? Mon 5/30/11 Fri 6/3/11

Healthcare Specific Email and Direct Mail Campaigns: 98 days Tue 7/26/11 Fri 12/2/11

Introduction of PDT partnership 6 days Tue 7/26/11 Tue 8/2/11 Send formal press release over the newswires 1 day Tue 7/26/11 Tue 7/26/11 Send informal article in BCS Digest and PDT’s newsletter 1 day Thu 7/28/11 Thu 7/28/11

Send promotional Flyer with SmartStart 1 day Tue 8/2/11 Tue 8/2/11 SaaS Campaign 14 days Tue 8/16/11 Fri 9/2/11 Send new white paper written by Fred Pennic on Healthcare and the Cloud via email 6 days Tue 8/16/11 Tue 8/23/11

Send the Allscripts case study as a follow up direct mail 1 day Thu 8/25/11 Thu 8/25/11

Make outbound calls to prospects to follow up direct mail 1 day Fri 9/2/11 Fri 9/2/11

Mobility Campaign 15 days Thu 9/8/11 Tue 9/27/11 Send new white paper on E-medicine from Tim Aligheri via email 1 day Thu 9/8/11 Thu 9/8/11

Send new case study via direct mail 1 day Thu 9/15/11 Thu 9/15/11 Make outbound calls to follow up on the direct mail 7 days Tue 9/20/11 Tue 9/27/11 Business Analysis/SmartStart Campaign 15 days Tue 10/18/11 Fri 11/4/11 Send Outsourcing 2.0 white paper from Kris Kosyk via email 6 days Tue 10/18/11 Mon 10/24/11

Send Healthcare outsourcing article via direct mail 1 day Tue 10/25/11 Tue 10/25/11 Make outbound calls to follow up direct mail 5 days Mon 10/31/11 Fri 11/4/11 SDLC Playbook 12 days Thu 11/17/11 Fri 12/2/11 Send case study from RenewData via email 2 days Thu 11/17/11 Fri 11/18/11 Send an article on software development and healthcare via direct mail 1 day Tue 11/22/11 Tue 11/22/11

Make outbound calls to follow up direct mail 5 days Mon 11/28/11 Fri 12/2/11 SoftSer Healthcare Software Development Trends Survey 27 days Mon 9/12/11 Fri 10/14/11

Create new survey with healthcare related questions 6 days Mon 9/12/11 Mon 9/19/11

Send from Bfrom ExecutiveBrief to healthcare enterprises and ISV 6 days Tue 9/20/11 Mon 9/26/11

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Appendix M

LIST OF TOP HEALTHCARE SOFTWARE COMPANIES This is an extensive list of companies developing software solutions for the healthcare industry. They all have healthcare software development as their key expertise and provide solutions for practice management, electronic medical records, diagnosis and treatment support, medication management, medical billing and a whole lot more. The companies are listed in alphabetical order. There is a link to each of them with a short description about their profile and services. Abraxas Medical Solutions Offers medical office workflow automation software solution www.abraxasmedical.com

Accumedic Computer Systems Solutions for practice management, behavioral health and electronic medical records www.accumedic.com Accurate health systems Provide software solutions to administrative problems ranging from nurse rounding to patient satisfaction to revenue cycle solutions www.accuratehealth.com Akhil Systems Healthcare software solutions for HIS, EMR, LIS, RIS, PACS and PIS for hospitals, nursing homes, diagnostic centers and pharmacy shops www.akhilsystems.com American Health Care Software Continuum of care information system, clinical care system, human resources management system and financial management solutions www.ahconline.com American Healthnet Provides a variety of healthcare management software solutions for the healthcare and hospital industry www.americanhealthnet.com Antek Healthware Medical technology solutions provider that delivers advanced clinical laboratory and medical billing software solutions www.antekhealthware.com

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API Healthcare Solutions for time and attendance, scheduling/staffing, human resources, payroll, education tracking and access control softwarewww.apihealthcare.com BioAnalytical Technologies Provides software products, services and solutions in the domains of Health care, Life Sciences and Biotechnology www.bioanalytical.net Bowlink Technologies Software solutions to send, receive, and exchange patient healthcare information using an electronic document management system www.health-e-link.net Carestream Health Practice management software designed to manage financial information and maintain accurate clinical records for dental or specialty practice www.kodakdental.com Casenet Healthcare case management software to automate clinical, administrative, and technical components of medical management programs www.casenetinc.com CBORD Group Provider of hospital room service, nutritional analysis software, menu planning, dietary software, food kiosks, and other healthcare technology www.cbord.com Cielo MedSolutions Provides software solutions for clinical quality management (CQM), patient registry and population management www.cielomedsolutions.com Claricode Creates medical software for healthcare providers, physicians and nurses www.claricode.com Clinical Solutions Supplier of decision support and clinical software solutions for use in both call centre environments and face to face encounters with patients. www.csdss.com

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CureTrac Web-based software solutions for bariatric surgery outcomes reporting, cancer research, diagnosis and treatment supportwww.curetrac.com Diabco Offers medical billing software solutions and management tools for Home Medical Equipment Providers, Physicians and Billing Service Companies www.ar-express.net e-MDs, Inc Manage Electronic Medical Records (EMR) and Electronic Health Records (EHR) systems with medical management and practice management software www.e-mds.com edgeMED Healthcare Solutions Specializes in medical billing software patient billing software, medical office software, electronic medical records www.edgemed.com EMRPEOPLE Provides medical software to healthcare practices including Electronic Medical Record Software (EMR), EHR and Medical Billing Software www.emrpeople.com

HCS Healthcare Systems Delivers integrated clinical software solutions for healthcare facilities specializing in pharmacy, radiology and physician applications www.hcsinc.net

Health Care Software Inc Interactant is a healthcare information system featuring integrated clinical and financial applications including billing and clinical tools www.hcsinteractant.com Healthcare Software Software solutions that improves medication management and communication processes www.healthcaresoftware.com.au HealthFusion Software service for practice management, claims clearinghouse, e-Prescribing, and electronic medical solutions www.healthfusion.com

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Healthland Provides Electronic Medical Record (EMR), clinical and financial software systems to small community and critical access hospitals www.healthland.com HealthLine Systems Provides credentialing, contact center and quality management software and support to the healthcare industry www.healthlinesystems.com Helix Health Provides software solutions for practice management, pharmacy management, point-of-sale, centralised electronic health records and transaction processing www.helixhealth.com Heron Technology Software solutions for integrated disease surveillance, patient administration system and diagnostic imaging software www.herontech.com ICPA Provides infection control software, employee health software and syndromic surveillance www.icpa.net Indura Systems Provides integrated software information management system for the home health care industry www.indurasystems.com IntelliSoft Provider of healthcare credentialing, credentialing application completion and contract management software solutions www.intellisoftgroup.com iSOFT Supplier of healthcare software solutions used for managing patient information and driving improvements in healthcare services www.isoftplc.com MedAppz MedAppz iSuite can be used to schedule appointments, chart patient information, write prescriptions, bill your patients and file claims www.medappz.com Medical Republic

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Hosted software solutions for health care practice management and billing companies www.medicalrepublic.com MediPro Provider of electronic medical records software, Lytec medical billing software, electronic health records and practice management software solutions www.medipro.com Meditab Software Medical Software for medical office, Pharmacy software, Dental Software, Radiology management software, EMR, electronic health records www.meditab.com MediTract Provides contract management software solutions for healthcare organizations www.meditract.com MedStar Solutions Provides software solutions for Medical Practice Management software, Medical Billing System, radiology software, Electronic Medical Records, EMR and EHR www.medstarsystems.com MedWorxs Provides software solutions for electronic health record and practice management www.medworxs.com Momentum Healthware Solutions for electronic health records, dietary management and decision support systems with historical and predictive analytics to effectively manage operations www.momentumhealthware.com MRecord Digital dictation, transcription and enterprise voice recognition platform for the healthcare industry www.mrecord.com

Navicure Provider of web-based account receivables management solutionswww.navicure.com

Nightingale Informatix Provider (ASP) of Electronic Medical Record (EMR) and Practice Management software www.nightingale.md

91

One45 Software Healthcare education software provider for multi-point competency based evaluations, patient/procedure logs, LCME/ACGME tracking, and performance reporting www.one45.com Opus Healthcare Solutions Develops web-based clinical software & mobile / smartphone applications for healthcare organizations, physician group practices and reference laboratories www.opushealthcare.com www.plexisweb.com Premier Computer Systems Develops medical staffing software solution for healthcare staffing agencies www.premier1st.com RiverSoft Software for Home Healthcare Agencies to automate your scheduling, billing, etc. riversoft.net SoftTech Health Provides solutions for document control for hospitals, accreditation/audit Management, solutions for lab, nursing, risk management and pharmacy www.softtechhealth.com StatCom Provides solutions for patient flow logistics, tracking, bed management, patient-stay management, discharge planning and hospital support services www.statcom.com Syntermed Advanced imaging technologies to assist radiologist, nuclear medicine physicians and other healthcare professionals www.syntermed.com Technosoft Experience in developing and maintaining custom made healthcare software solutions www.techno-soft.com VisionTree Provides web-based, patient-centric data collection and health management solutions for patient management and clinical trial administration www.visiontree.com Wellogic

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Web-based clinical application that provides solutions for clinician, patient, and payor Portals, Health Information Exchanges (HIEs), Electronic Health Records (EHRs)www.wellogic.com

Origin Healthcare Solutions Provides practice management and EMR Solutions that apply to registration, billing, appointment scheduling, patient charting, document imaging and routing www.originhs.com OSSCube Web based custom healthcare software solutions like CCHIT, EMR, EHR, HIS, HL7, 21 CFR 11 osscube.com Patient Placement Systems Web based health care software that automates discharge planning and accelerates continuing care admissions www.patientplacement.com PCG Software Develops cost containment, financial recovery and fraud & abuse software for healthcare industry www.pcgsoftware.com Plexis Healthcare Systems Solutions for medical claim processing‚ dental and vision claim processing, EDI and healthcare web portal software

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Appendix N

Top Companies to Target

McKesson Technology Solutions | Alpharetta, GA | http://www.mckesson.comHIT Revenue: $3,064,000,000 (09) $2,984,000,000(08) $2,239,000,000 (07) Major Revenue: 19% Software; 5% Hardware; 76% ServicesEmployees: 13,300 Type Company: Public Founded: 1974Information technology and connectivity business, providing IT solutions--------------------------------------------------------------------------------Dell | Round Rock, TX | 800-274-1550 | http://www.dell.comHIT Revenue: $2,500,000,000 (09) Major Revenue: 50% Hardware; 50%ServicesM&A 2009: Acquired Perot SystemsEmployees: 10,000+ Type Company: Public Founded: 1985Delivers technology solutions that connect hospitals, physicians and payers. Solutions include electronic medical record (EMR), mobile clinical computing, infrastructure services, virtual hosting,consulting, applications and revenue cycle solutions. Firm now includesPerot Systems.

--------------------------------------------------------------------------------CareFusion | San Diego, CA | 858-617-2000 | http://www.carefusion.comHIT Revenue: $2,400,000,000 (09)M&A 2009: Divested Mediqual,11/09Type Company: Public Founded: 2009A global medical device manufacturer that helps customers measurably improve patient care by focusing on two of the biggest issues affecting healthcare - medication errors and healthcare-associated infections.--------------------------------------------------------------------------------GE Healthcare* | Chalfont St. Giles, U.K. | http://www.gehealthcare.com

HIT Revenue: $1,900,000,000* (09)GE Healthcare's broad range of products and services enable healthcare providers to better diagnose and treat cancer, heart disease,neurological diseases, and other conditions earlier.--------------------------------------------------------------------------------Cerner Corp. | Kansas City, MO | 816-201-1024 | http://www.cerner.comHIT Revenue: $1,670,000,000 (09) $1,680,000,000(08) $1,520,000,000 (07)Major Revenue: 22% Software; 9% Hardware; 69% Services

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Employees: 7,775 Type Company: Public Founded: 1979Cerner solutions optimize processes for consumers and healthcare organizations ranging in size from single-doctor practices, to health systems, to entire countries, for the pharmaceutical and medical device industries, and for the healthcare commerce system.CSC | Falls Church, VA | 703-876-1000 | http://www.csc.comHIT Revenue: $1,566,000,000 (09) $1,640,000,000(08) $1,366,000,000 (07)Major Revenue: 5% Software; 95% ServicesEmployees: 6,000 Type Company: Public Founded: 1959Serves all segments of the healthcare industry, providing strategic planning, operations improvement, systems integration and outsourcing services.

--------------------------------------------------------------------------------Siemens Healthcare* | Malvern, PA | 610-249-0003 | http://www.medical.siemens.comHIT Revenue: $1,400,000,000* (09)One of the first companies to bring together medical imaging and therapy, laboratory diagnostics, and healthcare IT solutions across thecontinuum of care - from prevention and early detection, to diagnosis,therapy and ongoing care.

--------------------------------------------------------------------------------Emdeon | Nashville, TN | 615-932-3000 | http://www.emdeon.comHIT Revenue: $918,448,000 (09) $853,599,000 (08) $808,537,000(07) Major Revenue: 97% Software; 3% ServicesM&A 2009: Acquired The Sentinel Group, 6/09; Divested Control-O-Fax, 9/09Employees: 2,350 Type Company: Public Founded: 1998Provides revenue and payment cycle solutions that connect payers, providers and patients to integrate and automate key business and administrative functions throughout the patient encounter.--------------------------------------------------------------------------------Cognizant | Teaneck, NJ | 201-801-0223 | http://www.cognizant.comHIT Revenue: $860,427,276 (09) $688,233,756 (08) $507,896,394(07)Major Revenue: 100% Services Employees: 17,000+ Type Company: Public Founded: 1994Provides global business process outsourcing, IT and consulting services and serves as a strategic partner to leading payers, providers and intermediaries, delivering industry-specific solutions that drivesustainable value and operational improvements.--------------------------------------------------------------------------------Philips Healthcare | Andover, MA | 978-659-3000 | http://www.philips.com/healthcareHIT Revenue: $787,000,000 (09) $732,000,000 (08) $356,000,000(07) Philips' clinical informatics and patient care solutions are designed to complement electronic health records (EHRs) by providing actionable

95

patient data to support advanced clinical decision making, simplify clinician workflow, improve financial outcomes, and help improve and save lives.--------------------------------------------------------------------------------Epic | Verona, WI | 608-271-9000 | http://www.epic.comCore product is a central database that links clinics, hospitals, and remote Web-based settings with clinical, scheduling, and billing information.--------------------------------------------------------------------------------Allscripts-Misys Healthcare Solutions, Inc. | Chicago, IL | 800-654-0889 | http://www.allscripts.com Provides connectivity solutions to physicians, hospitals and post-acute and home care organizations.--------------------------------------------------------------------------------Eclipsys | Atlanta, GA | 404-847-5000 | http://www.eclipsys.comProvides advanced integrated clinical, revenue cycle and performance management software, clinical content and professional services that help healthcare organizations improve clinical, financial andoperational outcomes.--------------------------------------------------------------------------------The Trizetto Group, Inc. | Newport Beach, CA | 949-719-2200 | http://www.trizetto.comServes the healthcare payer industry, providing enterprise and component software, hosting, outsourcing services and consulting that optimize payers' operations.

--------------------------------------------------------------------------------Wipro Technologies | East Brunswick, NJ | 732-509-1500 | http://www.wipro.comServes payers, providers and life sciences with IT services in the areas of consulting, application development, implementation, maintenance and IT infrastructure and provide outsourcing services for business processes.--------------------------------------------------------------------------------Ingenix | Eden Prairie, MN | 888-445-8745 | http://www.ingenix.comOffers health information, technology, services and consulting to help physicians, hospitals and health systems resolve challenges facing their organizations, implement and use health IT systems more effectively, and improve clinical and financial performance.--------------------------------------------------------------------------------3M Health Information Systems | Salt Lake City, UT | 800-367-2447 | http://www.3mhis.comHelps h unications technology and consulting services that optimize caregiver efficiency, drive better decisions, foster prevention and empower patients.--------------------------------------------------------------------------------MedAssets, Inc. | Alpharetta, GA | 678-248-8194 | http://www.medassets.comOffers data-driven software and services to help increase revenue capture, decrease supply costs, and improve cash flow and profit margins for hospitals and other non-acute healthcare providers.--------------------------------------------------------------------------------Vangent, Inc. | Arlington, VA | 703-284-5600 | http://www.vangent.comLeads development of NHIN Connect architecture and provides technology to improve care and reduce costs.--------------------------------------------------------------------------------MedQuist, Inc. | Mount Laurel, NJ | 866-542-7253 | http://www.medquist.com

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MedQuist's technology-enabled clinical documentation workflow solutions including mobile voice capture devices, speech recognition, coding, web-based workflow platforms, and global outsourced transcription options help healthcare facilities lower operational costs. --------------------------------------------------------------------------------NextGen Healthcare | Horsham, PA | 215-657-7010 | http://www.nextgen.comProvides integrated clinical, financial and connectivity solutions to physician practices, hospitals, health systems and other care centers nationwide.--------------------------------------------------------------------------------HealthPort Technologies, LLC | Alpharetta, GA | 800-737-2585 | http://www.healthport.comA major provider of release of information services and health information solutions and technology to healthcare facilities, physicians and requestors nationwide.

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Appendix O (Balanced Scorecard)

Vision

Growth

Learning & Growth PerspectiveTo achieve our vision, how will we sustain our ability

to change and improve?

Strategic goals

Actions MeasuresCertifications

HIPAA ComplianceSaas 70

Business Process PerspectiveTo satisfy our customers and stakeholders, at what

business processes must we excel?

Strategic goals

Actions MeasuresSaas

MobilityAgile Framework

SDLC

Customer PerspectiveTo achieve our vision, how should we appear to our

customers?

Strategic goals

Actions MeasuresIndustry LeadersStrategic Partner

Financial PerspectiveTo achieve our goals, how should we appear to our

shareholders?

Strategic goals

Actions Measures45% Profit Margin$65MM In Revenue

Adapted from the Balanced Scorecard by Robert S. Kaplan and Dave P. Norton. Harvard Business School Press. 1996.

98

Appendix P(PEST)

POLITICAL

ecological/environmentalissuescurrent legislation homemarketfuture legislationinternational legislationregulatory bodies andprocessesgovernment policiesgovernment term andchangetrading policiesfunding, grants andinitiativeshome marketlobbying/pressure groupsinternational pressuregroupswars and conflicts

ECONOMIC

home economy situationhome economy trendsoverseas economies andtrendsgeneral taxation issuestaxation specific toproduct/servicesseasonality/weatherissuesmarket and trade cyclesspecific industry factorsmarket routes anddistribution trendscustomer/end-user driversinterest and exchangeratesinternationaltrade/monetary issues

SOCIAL

lifestyle trendsdemographicsconsumer attitudes andopinionsmedia viewslaw changes affecting socialfactorsbrand, company,technology imageconsumer buying patternsfashion and role modelsmajor events andinfluencesbuying access and trendsethnic/religious factorsadvertising and publicityethical issues

TECHNOLOGICAL

technologicalcompeting technologydevelopmentresearch fundingassociated/dependenttechnologiesreplacementtechnology/solutionsmaturity of technologymanufacturing maturityand capacityinformation andcommunicationsconsumer buyingmechanisms/technologytechnology legislationinnovation potentialtechnology access,licensing, patentsintellectual propertyissuesglobal communications

99

Appendix Q

100

Appendix R

101

Appendix S

102

Appendix T

103

Appendix U

104

Appendix V

105

Appendix W

106

Appendix X

107