ROYL is an integrated and comprehensive web app to help patients and families do Rest of Your Life planning.

1. ROYL
ROYL, LLC
Col. Philip Lisagor, USA (Ret), MD, FACS, CEO and Founder
www.TheROYL.com
Rest of Your Life
Copyright © 2011 Allscripts Healthcare Solutions, Inc. 1 1

2. Solution Overview - 1
 ROYL is an integrated and comprehensive web
app to help patients-families-loved ones achieve
easy and quick Rest of Your Life planning.
 Healthcare/Business problem addressed:
• 10,000 Americans will turn 65 every day for the next 20 years =
78 million boomers
• These baby boomers still have 36 million parents and 80 million
children alive (sandwich generation)
• Health care costs continue to grow particularly in the > 65 year
old group
• Rest of Your Life planning reduces waste currently estimated at
$80-100 billion dollars annually
• ROYL will meet HHS HITECH MU 2 & 3 standards for EHR
reimbursement of EHR purchase
• advanced care planning on the EHR
• patient engagement through patient portal into the EHR
A Connected Community of Health
| Copyright © 2011 Allscripts Healthcare Solutions, Inc. 2 2

3. Solution Overview - 2
 High Level Solution Description:
• Increase the occurrence of advanced care planing
• advanced directives and designation of health agent proxy
• improved availability of advanced directives and health agent proxy
documentation
• increase patient autonomy and engagement
• Increase utilization of home modifications and adaptive architecture
• Increase utilization of cloud based home health monitoring
• weight scales for CHF, glucometers for DM, Wright inspirometers for
COPD/emphysema and ‘mini-Pyxis’ like pharmacy monitors
• reduce hospital admissions and readmissions
• Earlier utilization of home hospice care
 ROYL addresses the following category:
 Home Health Monitoring will reduce hospital admissions and
readmissions for the CMS goals in CHF, DM, COPD
 ROYL will reduce costly treatments that aren’t desired as patients
approach End of Life care and replace with increased
compassionate care and home hospice care.
 ROYL will keep patients at home and preserve financial integrity
of families
A Connected Community of Health 3
| Copyright © 2011 Allscripts Healthcare Solutions, Inc.

4. Usability and Design
 ROYL will morph to a tablet app with increased knowledge and logic
to allow ROYL champions to be present in doctor’s offices and care
delivery organizations
 ROYL will be offered to new patients (office/hospital) in conjunction
with a ROYL champion to achieve advanced care planning
 ROYL champions will coordinate with discharge planners
(office/hospital) to reduce hospital admissions/readmissions
• home evaluations for adaptive architecture and home
modifications
• home health monitoring devices for Congestive Heart Failure,
Diabetes and Emphysema/COPD
• knowledge of availability of earlier home health hospice
• ROYL will be utilized as an add on to the Allscripts
EHR/EMR package in use by the doctor, the group or the
care delivery organization
A Connected Community of Health
| Copyright © 2011 Allscripts Healthcare Solutions, Inc. 4 3

5. Development Stage
 ROYL is an existing web app that has been
through Beta and focus group testing with Code
Complete and awaiting testing and approval by
Allscripts
 Parts of ROYL are provided to interface with the
Allscripts API utilizing the Allscripts SDK
• Advanced care planning documents for the State of NV
will be saved as an Allscripts document after being
completed on the Allscripts/ROY app
• The ROYL Family Conference which will be saved as an
Allscripts document after being completed on the
Allscripts/ROYL app
A Connected Community of Health
| Copyright © 2011 Allscripts Healthcare Solutions, Inc. 5 4

6. Integration Description
 Integration Points
 ROYL Family Conference
 Series of guided points and questions for the patient, their family, and care providers
 Conference results and inputs will be saved to Allscripts per patient/user as a Document
 Nevada Advanced Directive and Durable Power of Attorney Form
 Form inputs and data collection will be saved to Allscripts per patient/user as a Document
 APIs/Web Services
 Enterprise EHR Unity SDK
 SavePatient, SearchPatients, GetPatientFull, GetPatientIDs
 SaveNote, SaveUnstructuredDocument, SaveDocumentImage, GetDocuments,
GetDocumentType, GetDocumentImage
 SaveSimpleEncounter
A Connected Community of Health
| Copyright © 2011 Allscripts Healthcare Solutions, Inc. 6 5

7. Go to Market Plans
 Marketing Models
• ROYL will be an optional add on for physicians, groups and care delivery organizations
• ROYL will be available either as an “all you can eat” purchase for large groups of
patients or as a pay as you go for each patient
• ROYL is currently working with Wal-Mart/Dossia.org to bring ROYL to Wal-Mart associates
(1.4 million) through the Dossia.org livli.com web site
• ROYL is available in a B to C model through the internet
• ROYL will be marketed subsidiary to Allscripts distributors including Henry Schein etc.
• Allscripts customers will include individual practices, group practices and care delivery
organizations.
• The current charge for ROYL type planning by boutique medical practices is $1500 per
individual, ROYL will provide this service for $15 per individual. For larger groups ROYL will
negotiate the price
A Connected Community of Health
| Copyright © 2011 Allscripts Healthcare Solutions, Inc. 7 6

8. Video Demonstration/Web Links
 Video: Philip Lisagor, MD, FACS discusses ROYL
• https://vimeo.com/58795623
 right click for live link to ROYL
 right click for live link to www.TheROYL.com
A Connected Community of Health
| Copyright © 2011 Allscripts Healthcare Solutions, Inc. 8 7

9. Why this solution should be
selected - 1
• How and Why ROYL was developed: I am a retired cardiothoracic surgeon
and have served as a Chief of Surgery, Assistant Medial School Dean and
Chief of Quality Management for the US Army. During my career I came to
realize that no one was really talking to patients about the meaning of their
situations. I learned about doing this and is was a positive experience for me
and for my patients. When I retired, I wanted to provide a computer
companion for doctors and their patients to help people have ‘The
Conversation.”
• How and Why ROYL has evolved: I developed ROYL as a web app geared
to doctors and end of life care. In this process, I came to understand that
there were many stakeholders involved in addition to doctors- nurses,
lawyers, financial planners and insurance agents, social service workers,
health and retirement specialists and death industry workers. I also realized
that this is about living and about the Rest of Your Life and that end of life
issues are important but need to be addressed earlier on and as part of Rest
of Your Life planning. ROYL is dedicated to the many patients and families
and loved ones I have worked with the past forty years and for their patience
with me.
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10. Why this solution should be
selected - 2
Improving quality of health care, minimizing variation from benchmark
standards of care, is the way to reduce the cost of health care. ROYL improves
quality of care by increasing patient engagement and education regarding
options for health care through advanced care planning. If patients will do
advanced care planning, they can be involved in all the home issues; home
modification to keep them at home, home health monitoring to keep them out of
the hospital and home hospice to keep them at home. Promoting ROYL to
physicians and their patients is the right thing to do and will increase quality of
care, increase patient-family-loved one satisfaction with care and will reduce
the cost of care. The Allscripts EHR is the perfect medium to bring ROYL to
Americans and their care providers.
A Connected Community of Health
| Copyright © 2011 Allscripts Healthcare Solutions, Inc. 9 8

11. Why this solution should be
selected - 3
• ROYL begins with the goal of increasing advanced care planning. This may utilize a
new work force member to be a ROYL Champion in clinical settings. If a patient
chooses to do advanced care planning, they are on the road to fulfilling their goals of
remaining at home and preserving the family financial integrity. The ROYL Champion
will follow up with help for home modifications, for home health monitoring and for
earlier home hospice in appropriate situations.
• ROYL also facilitates patient/family/loved one interactions with doctors, nurses,
lawyers, financial planners and insurance agents, social service workers, health and
aging specialists and death industry workers.
• ROYL helps patients/families/loved ones and health care providers have ‘The
Conversation’
• ROYL also meets some HITECH MU-2 criteria for advanced care planning and helps
care providers meet their goals for HITECH reimbursement
• ROYL also meets some HITECH MU-3 criteria for patient health portals to increase
patient engagement with the EMR/EHR
• ROYL improves the quality of care, increases patient/family/loved ones
satisfaction and reduces the cost of health care.
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