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TMSHOWCASEMAR. 2026MAGAZINE FOR PROVIDERSC O M P L I A N C EQ U A L I T Y C A R EQ U A L I T Y D A T AINSIDEU S E C A S E S Message

Supports high-volume workloadsup to 255,000transactions persecondPerforms cross-database search inunder 1,000millisecondsMaintains 99.99percent annualavailability inproductiondeploymentsIngests andprocesses dataacross payer,provider, and public-sector ecosystemsData is interpretedconsistently acrossteams and programsAutomation behavespredictably instead ofvariablyQualitymeasurementproducesexplainable,defensible resultsCompliance logicexecutes on trusted,aligned dataIntelligence isgenerated from thesame data used forexecutionThe Unified Source of TruthWith a unified, computable data foundation:The OmniVera AdvantageBuilt for Enterprise EnvironmentsComputability removes ambiguity so systems and teams evaluate information the same way across the enterprise.OmniVera is proven in the most demanding healthcare settings.www.smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2026 Smile CDR Inc. (doing business as Smile Digital Health). Trusted in population-scale, statewide, and national interoperability programs.OmniVera is the trusted data foundation of Smile Omni. It provides a unified, standards-based layer thattransforms fragmented healthcare data into aligned, FHIR -native information ready for automation,compliance, quality measurement, and intelligence.Many healthcare organizations ingest large volumes of data, but few succeed in making that data reliable forconsistent execution. Fragmented pipelines, mismatched semantics, and unresolved identities createuncertainty that undermines automation, measurement, and decision-making.OmniVera replaces fragmentation with alignment. It standardizes structure, aligns meaning, resolvesidentity, and produces complete, trustworthy records at enterprise scale, ensuring every downstreamprogram operates from the same source of truth.®What Is OmniVera?Why OmniVera MattersA unified data foundation compounds value over time. As more systems, rules, and programs rely on the samealigned data, organizations reduce rework, improve confidence in results, and accelerate modernization withoutfragmentation.

Who it is forOrganizations modernizing datainfrastructure across clinical,administrative, and regulatory domains.Why it mattersIt establishes the trusted foundationrequired for data quality enforcement,compliance automation, and qualityintelligence.Who it is forTeams responsible for analytics, quality,compliance, and operational reporting.Why it mattersIt reduces downstream errors, rework,and measurement variability caused byincomplete or inconsistent data.Who it is forOrganizations seeking faster access todata without compromising security,privacy, or governance.Why it mattersIt balances flexibility and control,allowing teams to move faster whilemaintaining regulatory alignment.OmniVera solutions are the data-layer solutions organizations license and deploy. Each solution addresses aspecific aspect of data standardization, governance, and access, while operating together on a shared foundation.OmniVera Solutionswww.smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2026 Smile CDR Inc. (doing business as Smile Digital Health). Speak with Our TeamSpeak with our team to see how OmniVera powers yourmodernization strategy.Health Data PlatformThe Core Data FoundationData Quality+Operational Data TrustData Quality+ ensures healthcare data is fit for operational use.It delivers advanced normalization, validation, enrichment, andquality enforcement on top of the Health Data Platform, enablingorganizations to define, monitor, and improve data qualitycontinuously.Data Access+Governed, Self-Service Data UseData Access+ enables teams to discover and consume trusteddata without friction.It provides policy-driven, self-service access to governed data acrossanalytics, quality, compliance, and operational workflows.OmniVera powers every other Smile Omni family. Compliance, quality, intelligence, and expertise solutions all operateon the same trusted data foundation, ensuring consistent outcomes across the enterprise.How OmniVera Fits Within Smile OmniThe Health Data Platform is the FHIR -native foundation thatstructures, secures, and governs healthcare data at scale.It provides a patient-centric clinical data repository that unifies datafrom disparate systems, supports longitudinal records, and enablesprovenance and auditability.®

Expose OnceExpose a single authenticatedinterface through a FHIRGateway, enabling applicationsto access a consistent APIwithout migrating underlyingsystemsTrust AlwaysValidate at ingestion, maintainauditability and lineage, andsupport subscriptions sosystems respond automaticallyas data changesIngest AnythingIngest HL7v2, C-CDA, CSV, JSON,XML, and FHIR, and normalize toFHIR while preservingprovenanceFHIR -native, Computable, Semantically Aligned Healthcare Data®OmniVera Health Data Platformwww.smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2026 Smile CDR Inc. (doing business as Smile Digital Health). Healthcare organizations do not struggle because they lack data. They struggle becausedata is fragmented across systems and formats, and legacy workflows andterminologies produce datasets that are non-standardized, semantically misaligned,duplicated, and incomplete. This drives manual effort to maintain disconnectedarchitectures and slows decisions. OmniVera Health Data Platform unifies data into agoverned FHIR-native foundation, supports longitudinal records with provenance, anddelivers a single, computable source of truth that downstream interoperability,analytics, and operational workflows can depend on.A computable foundation standardizes data to FHIR, enforces conformance, and preservesprovenance. Interoperability, analytics, and operational workflows can then operate on the samegoverned dataset with traceable results.Why Health Data PlatformPoint solutions solve isolated problems but create disconnected architectures over time. Legacysystems with proprietary workflows, formats, and terminologies produce data that is duplicated,incomplete, and interpreted differently across teams. The result is manual rework, slower decisions,and reporting that becomes difficult to defend.What Changes With a Computable FoundationCore outcomes

Scale and performanceReduce storage footprint by 60–80%Execute complex multi-resource queries in under 2 secondsProcess 2B+ FHIR resources in approximately 26 hoursSecurity, privacy, anddeployment controlCertifications: HITRUST v9.4, ISO 13485:2016, ISO/IEC 27001, SOC 2 Type I and IIControls: AES-256 encryption, RBAC, MFA, consent enforcement, audit loggingDeployable on Azure, AWS, GCP, and on-premises environments with portableconfigurationsProof at scale255,000+ transactions per secondAbout 1,000 ms cross-database search time99.99% annual availability190+ global FHIR implementations2B+ records transformed to FHIR in under 26 hoursSpeak with Our TeamTo see how OmniVera Health Data Platform supportsinteroperability, analytics, and operational workflowson governed, computable data.www.smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2026 Smile CDR Inc. (doing business as Smile Digital Health). Built for enterprise environmentsOmniCompli and OmniQ operate directly on the OmniVera foundation, eliminating duplication andreprocessing across compliance and quality programs. Advanced enrichment and governed accessare delivered through OmniVera Data Quality+ and OmniVera Data Access+.Where it fits in Smile OmniOmniVera Health Data Platform

Processes billions ofdata points acrossmillions of membersSupports digital qualityprograms acrossHEDIS , MIPS, Stars,Medicare, Medicaid,and state initiatives®Demonstrated accuracywith less than onepercent variancethrough NCQA digitalHEDIS validationQuality measuresexecuteconsistently acrossprograms andpopulationsMeasurementresults areaccurate,explainable, andaudit-readyPayers andproviders see thesame gaps usingshared data andlogicInsights surfacecloser to the pointof action, notmonths laterUpdates tomeasures and logicare applied onceand propagateconsistentlyDesigned to support enterprise-wide quality measurement and intelligence at scale.Delivers near-real-timescoring andcontinuous populationmonitoringThe Unified Source of Quality With a unified, computable quality foundation:The OmniQ AdvantageBuilt for Enterprise EnvironmentsComputability ensures quality intelligence remains predictable, reproducible, and trusted across the enterprise.OmniQ is proven in large-scale quality and population health programs.OmniQ is the quality measurement and intelligence layer of Smile Omni. It transforms aligned,computable data into accurate, explainable insight that supports quality programs, population health, andoperational decision-making.Many organizations generate quality reports and analytics, but those insights often arrive too late, live indisconnected systems, or cannot be trusted across workflows. Fragmented data, inconsistent logic, andretrospective reporting limit the ability to act when it matters most.OmniQ replaces fragmented quality processes with a unified, standards-based approach. By executingmeasurement and intelligence logic directly on computable data, OmniQ delivers consistent, explainableinsight that both payers and providers can rely on to understand performance and drive improvement.www.smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2026 Smile CDR Inc. (doing business as Smile Digital Health). What Is OmniQ?Why OmniQ MattersA unified quality layer enables organizations to move from retrospective reporting to proactive improvement. By aligningdata, logic, and insight, OmniQ reduces operational friction and creates a reliable foundation for continuous qualityperformance.

dQMMeasures for HEDISdQM Measures for HEDIS delivers standards-based digital qualitymeasurement using FHIR and CQL.It executes regulated quality measures directly on aligned,computable data to produce accurate, explainable results thatsupport payer and provider programs.Organizations participating inregulated digital quality programs.Who it is forIt enables trusted digitalmeasurement with results alignedto regulatory expectations.Why it matters®OmniQ solutions are the quality and intelligence solutions organizations license and deploy. Each solutionoperates on the same shared, computable foundation to ensure consistent results across programs.OmniQ SolutionsSpeak with Our TeamLearn how OmniQ can modernize quality measurementand intelligence with clarity, consistency, and confidence.www.smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2026 Smile CDR Inc. (doing business as Smile Digital Health). OmniQ operates on the trusted data foundation provided by OmniVera and works alongside OmniCompli andOmniConcierge to ensure quality measurement and intelligence are consistent, explainable, and operational acrossthe enterprise.How OmniQ Fits Within Smile OmnidQMCustom MeasuresdQM Custom Measures enables organizations to author andexecute custom digital measures using the same standards-basedapproach.It supports internal initiatives, state-specific measures, and emergingprograms using aligned data and reusable logic.Organizations extending digitalmeasurement beyond fixedregulatory programs.Who it is forIt provides flexibility withoutsacrificing consistency, traceability,or trust.Why it mattersIntelligence HubOperational Quality IntelligenceIntelligence Hub transforms quality data into near-real-timeinsight that supports operational and clinical action.It surfaces care gaps, population trends, attribution signals, andperformance indicators using standards-based logic executed directlyon computable data.Teams responsible for qualityimprovement, population health,and operational decision-making.Who it is forIt makes quality intelligenceactionable by embedding insightinto everyday workflows.Why it matters

Built for enterprise environmentsVisualize diagnoses, medications, lab trends,and risk factors across time. Detect datafidelity issues, understand why a patient isflagged at risk, and convertrecommendations into structured actionsLongitudinal, context-awareintelligenceClosed-loop intelligenceexecutionMove beyond dashboards by embeddingintelligence directly into operationalworkflows so teams can act on insightswith greater speed and confidenceExecute standards-basedclinical logic using CQL onFHIR so intelligence isgenerated directly fromgoverned data ratherthan separate reportinglayersMake intelligenceoperationalSurface care gaps, populationtrends, attributions, risk signals,and quality indicators in aunified interface with sharedsemantics across payer andprovider teamsSupport context-awaredecisionsTurn insight intoactionUse recommendations totrigger care managementworkflows, generatestructured clinical orders,initiate electronic priorauthorization, and update thelongitudinal patient record asnew evidence is received Operationalize Clinical Intelligence Clinical intelligence often lives across disconnected dashboards, proprietary systems, andretrospective reports built on siloed data. Clinical logic is separated from governed data, insightsarrive after decisions are made, and teams spend time reconciling outputs instead of improvingperformance. This creates duplicated cohort definitions, inconsistent risk thresholds, limited visibilityinto data fidelity, and significant manual effort. Why Intelligence HubCore outcomeswww.smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2026 Smile CDR Inc. (doing business as Smile Digital Health). OmniQ Intelligence HubOmniQ Intelligence Hub turns aligned, computable data into actionable clinicalintelligence that supports operational action when and where decisions occur. Itexecutes reusable clinical logic directly against governed FHIR data so insights canmove into action within payer and provider workflows. ®

Unified intelligence interfaceSurface reports on care gaps, population trends,attributions, risk signals, and quality performanceindicatorsLongitudinal patient timelinePresent historical case data alongside forward-lookingclinical plans in one viewData fidelity and risk detectionIdentify conflicting diagnoses, missing lab values, andexplain why a patient is flagged at riskFHIR and CQL-based intelligence executionRun reusable clinical and quality logic directly ongoverned FHIR dataWorkflow-triggered actionsTrigger care workflows, structured orders, priorauthorization, and longitudinal record updates fromrecommendationsReuses version-controlled logicacross population health, caremanagement, provider workflows,and prior authorization Executes standards-based clinicallogic using CQL on FHIR Uses unified, computable FHIR-native data Supports measurable operationaland clinical action, notretrospective reporting Surfaces risk, attribution, care gap,and quality insights in a unifiedinterface Speak with Our TeamSee how OmniQ Intelligence Hub turns computable data into operational intelligence thatsupports faster, more confident action across payer and provider workflows.www.smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2026 Smile CDR Inc. (doing business as Smile Digital Health). Intelligence Hub works alongside dQM - Custom Measures and dQM - Measures for HEDIS to extend digitalquality into operational intelligence and workflow action. Where it fits in OmniQOmniQ Intelligence HubIntelligenceHubcapabilitiesOperational impact

Rules execute consistentlyacross programs instead ofvarying by system or reviewerManual review is reducedthrough deterministic, standards-based automationCompliance, utilizationmanagement, quality, andoperations align on oneinterpretation of policyDecisions are transparent,explainable, and audit-readyRegulatory updates are appliedonce and propagated consistentlyExecutes rule evaluationsin under 1,000millisecondsMaintains 99.99 percentannual availability inproduction deploymentsProven in large payer,provider, and public-sectorcompliance programsOmniCompli is engineered for high-volume, high-scrutiny compliance programs.Supports throughput upto 255,000 transactionsper secondDesigned to keep compliance operations responsive, reliable, and scalable.The Unified Source of ComplianceThe OmniCompli AdvantageBuilt for Enterprise EnvironmentsComputability removes ambiguity so compliance decisions are evaluated the same way across the enterprise.With a unified, computable compliance foundation:OmniCompli is the unified compliance layer of Smile Omni. It provides a standards-based rules framework thattransforms fragmented regulatory interpretation into consistent, transparent, and auditable execution acrosshealthcare programs.Many organizations manage compliance through disconnected systems, manual review, and inconsistentinterpretation of regulatory text, clinical guidelines, and organizational policies. These fragmented approachesintroduce variability, increase operational burden, and create audit risk.OmniCompli replaces fragmented compliance workflows with a single, shared rules foundation. Regulatoryand policy requirements are translated into computable, deterministic logic that executes consistently at enterprisescale, ensuring decisions are applied the same way across programs, systems, and partner ecosystems.www.smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2026 Smile CDR Inc. (doing business as Smile Digital Health). What Is OmniCompli?Why OmniCompli MattersA unified compliance framework reduces risk while increasing speed. By centralizing interpretation and execution,organizations eliminate conflicting logic, reduce operational burden, and establish a future-ready complianceinfrastructure that adapts as mandates evolve.

Core Regulatory Compliance AutomationOrganizations required tomeet CMS interoperabilityand compliance mandates.Who it is forIt delivers predictable,auditable complianceoutcomes aligned toregulatory expectations.Why it mattersCMS SuiteCMS Suite translates CMS interoperability and compliancerequirements into deterministic, executable logic.It operationalizes regulatory mandates using standards-basedinputs and transparent rule execution, reducing variabilitycaused by manual interpretation.OmniCompli SolutionsSpeak with Our TeamLearn how OmniCompli and CMS Concierge can modernizecompliance execution with clarity, consistency, and confidence.OmniCompli operates on the trusted data foundation provided by OmniVera and works in concert withOmniConcierge to deliver compliance outcomes that are consistent, explainable, and scalable across the enterprise.OmniCompli solutions are the compliance-layer solutions organizations license and deploy. Each solutionoperationalizes regulatory and policy requirements using the same shared rules foundation, ensuring consistent executionacross programs.www.smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2026 Smile CDR Inc. (doing business as Smile Digital Health). How OmniCompli Fits Within Smile OmniCMS Suite+Enterprise-Scale Compliance ExecutionCMS Suite+ extends CMS Suite for organizations managinglarge-scale, high-throughput compliance programs.It supports consolidated rule governance across compliance,utilization management, quality, and reporting teams,reducing duplication and maintenance overhead.Enterprises operatingmultiple, complexregulatory and operationalcompliance programs.Who it is forIt enables faster adaptationto evolving mandates withoutarchitectural redesign.Why it mattersCMS ConciergeManaged CMS Compliance OutcomesCMS Concierge combines OmniCompli technology withOmniConcierge expertise to deliver an operationallyready CMS compliance outcome.It pairs the CMS Suite rules foundation with expertimplementation, hosting, maintenance, and regulatorychange management to help organizations move fromtechnical compliance to real-world execution.Organizations that needspeed, predictability, andoperational confidence inmeeting CMS mandates.Who it is for It reduces time tocompliance, lowersoperational burden, andprovides a clear path frommanaged execution to self-managed capability asinternal maturity grows.Why it matters

Support real-time priorauthorization automation for in-network and out-of-networkproviders using Da Vinci IGs for CRD,DTR, and PAS, executed on a FHIRand CQL foundationAutomate prior authorizationnetwork-wideAuthor and execute priorauthorization policies using FHIR andCQL to support real-timedeterministic adjudication that isexplainable, traceable, anddefensibleOperationalize priorauthorization with computablepolicy logicUse the same FHIR and CQLfoundation to extend beyondCMS-0057-F into automatedreal-time PriorAuth, evolving CMSrequirements, and new payerprovider workflows withoutre-platforming or duplicating effortMove beyond mandates withoutrebuilding your stackEnterprise-Scale Prior Authorization Automation and Rule GovernanceWhy CMS Suite+ Core outcomesApproaching CMS-0057-F as a discrete IT projectseparate from operations often propagatesfragmented implementations. Governance,compliance data quality, and workflows remaindisconnected across internal departments. Theseefforts often fail to serve the full providernetwork, including out-of-network providers,introduce additional point solutions, andundermine payer-provider collaboration. Aunified FHIR platform and implementationstrategy turns CMS investment into durableinfrastructure for workflow automation,governance, and operational intelligence. www.smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2026 Smile CDR Inc. (doing business as Smile Digital Health). OmniCompli CMS Suite+What Changes with CMS Suite+Where CMS Suite ensures standards-conformant execution of CMS-0057-F interoperability APIs,CMS Suite+ adds deterministic prior authorization adjudication, centralized policy management,and high-throughput automation aligned with Da Vinci Implementation Guides. It builds on thesame unified rules engine foundation so compliance capabilities become reusable building blocks,not isolated implementations. OmniCompli CMS Suite+ extends CMSSuite with enterprise-scale priorauthorization automation and centralizedrule governance. It enables payers tooperationalize computable policy logicacross compliance, utilizationmanagement, and delegated partnerecosystems using a unified FHIR andClinical Quality Language (CQL) foundation. Smile Digital Health is DrummondGroup certified for CMS-0057-F. ®

Built for enterprise environments255,087+Transactionsprocessed persecond3 monthsCMSimplementation fora large payviderorganization (200k+staff)30+Payers usingSmileCompli70%Reduction in priorauthorizationburden throughauto-adjudication100M+American livesimpacted acrossBCBS networkimplementationsElectronic PriorAuthorization (ePA) APIAutomated ePAadjudication automationaligned with Da Vinci CRD,DTR, and PASImplementation Guides toprocess requests anddetermine decisionsProvider Access APISecure sharing ofmember data within-network providersincluding identityverification,authorization, andconsent managementPatient Access APIPublicly availableprior authorizationmetrics, details, anddecisions withembedded reporting andaudit capabilitiesPayer-to-Payer APIContinuity of careworkflows with safeguards,consent modules, IDmatching, and securehigh-volume exchangeProvider Directory APIPublicly available,searchable providerdirectory usingFHIR-based APIsUnified foundationwithout addedtechnical complexityOrganizations operating multipleregulatory and operationalprograms across large networksbenefit from a unified foundationthat does not introduce additionaltechnical complexityHigh-throughputautomation aligned toenterprise workflowsStandards-based automationsupports faster, more predictabledecisions and reducesadministrative burden and delaysbetween payer-providerworkflowsSpeak with Our TeamTo see how OmniCompli CMS Suite+ supports CMS-0057-F compliance and network-wideprior authorization automation on a unified FHIR and CQL foundation. CMS Suite+ builds on the compliance foundation of CMS Suite and complements Smile-managed CMS compliancedelivery through CMS Concierge. CMS Suite+ delivers pre-built, FHIR-compliant APIs for CMS-0057-F and supports broader compliance modernization.With real-time prior authorization adjudication enabled, payers can also meet the June 2025 Prior Authorization Pledge. www.smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2026 Smile CDR Inc. (doing business as Smile Digital Health). Where it fits in OmniCompliOmniCompli CMS Suite+Proof at scaleCMS Suite capabilities

Executive SummaryClient: A large US payer and healthcare delivery organization Summary: Smile Digital Health (Smile) authored Clinical Practice Guidelines (CPGs) and contributed to Clinical Decision Support (CDS) and Clinical Reasoning (CR) services for the client. Healthcare analytics and data-driven care delivery and quality metrics are a core competency of the organization. The rst implemented set of solutions contributed an operational benet of $10M within a single surgical unit. In continued eorts, these clinical guideline driven, real-time CDS recommendation solutions were expanded for chronic condition management and are still being used at the point-of-the-care today.Objectives:• Standardizing data inputs and outputs on FHIR® across all divisions with real-time connections to EHRs• To produce better, more ecient clinical recommendations and cognitive support, seamlessly integrated with the clinical workow• To reduce ineciencies, errors, delays, cost and time burdens in their manual and disjointed CDS processes• To adopt emerging best-practice clinical guidance early and enhance patient outcomes• To create a sustainable market share and new revenue streams in the CDS market. The ChallengeClinical data comes in a variety of formats and has a complex structure (structured, unstructured and semi-structured) depending on which proprietary EHR format it has been collected and stored in. When it comes to data exchange and interoperability, standardization of data has been a major road-block for the entire industry. Disparate data sources in a variety of unstandardized formats make it dicult (in terms of time, cost and manual burden) to achieve high quality data that can be used to provide high quality care across all points of care. Through the years 2018 and 2019, the client acquired a number of primary and specialist clinics across the US, all of which utilized dierent proprietary EHR systems. As such, they inherited fragmented and inconsistent CDS solutions—specications had dierent clinical denitions, elds, values and contexts making them unstandardized and not interoperable. The process of researching a variety of specications, processing them and then making a clinical decision was entirely manual. This created both a clinical and business need to provide consistent, reliable, high delity CDS across the points of care delivery and breadth of care. As a leading and innovative healthcare organization, the client saw the need to ensure consistent application of high quality care—applying a standards-based approach with evidence-based CPGs to patient care, across all points-of-care. In order to achieve better patient outcomes and enhance operational eciency, the client needed to elevate their Clinical Reasoning (CR) and CDS smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2024 Smile CDR Inc. (doing business as Smile Digital Health).How Smile’s Clinical Reasoning Expertise And Capabilities Contributed to a $10M Operational Benet

technologies. They had to decide whether to build it completely in-house or buy the solution. They decided on a model, where Smile’s team would author CPGs and augment their codebase with fully integrated clinical capabilities. They chose this model because they had limited expertise and technical resources to build high-quality computable CPGs. Smile’s task was highly nuanced and complex: to author re-usable CPGs into a standardized format, that would make relevant and ecient recommendations to clinicians; thereby supporting consistently available CDS to all points-of-care. The recommendations would then have to be implemented in a way that integrated with any EMR to reduce clinical burden and achieve ecient high quality treatment for patients with an overall lowered cost of care.Expertise and SolutionSmile Digital Health is an award-winning company and a subject matter expert in FHIR, CQL and CR. Smile is the maintainer of HAPI FHIR—the world’s prevailing open source reference implementation—and custodian of CQF (Clinical Quality Framework) Ruler—a decision support service that runs quality measures on clinical reasoning. Smile directs and contributes to several IGs (Implementation Guides). These include, but are not limited to US Core CPG, CDS Hooks, CPG and QM. Smile is also the primary contributor to establishing the CDS standardization process into FHIR. Smile has over 160 real-world data transformation and modernization implementations around the globe.The client was aware of the limited technical expertise in the eld of health standards, in terms of both understanding, and applying them into clinical practice guidelines. In order to build the foundation, and grow their library of reusable and scalable CPGs, they needed Smile’s knowledge authoring expertise to augment their CDS process.To this end, Smile Digital Health authored a set of CPGs as computable code to run and use along with CDS services. These reusable CPGs continue to work with the client’s common computable enterprise-level platform that tightly integrates the unied open standard data framework (FHIR) with a clinical logic standard, CQL. In contrast with other CPG recommendation solutions, Smile takes specications created by expert agencies—like ADA (American Diabetes Association), AHA (American Health Association) and NCI (National Cancer Institute)—and faithfully represents those established treatment guidelines using CPG logic. The resulting CPGs were then made available in near real-time at all points-of-care in the client’s network. Since CPGs are not locked into proprietary authorship, the client can scale them across clinics, regardless of which EHR system is being used. The client analyzed the benets of Smile’s expertise in authoring CPGs, and compared that with using their own in-house teams to build them from scratch. Given the depth of expertise and requirement of high-quality consistent CDS across clinics, they chose Smile knowledge authoring expertise to augment their CDS processes.Technical Components of the SolutionSmile’s solution is integrates two key technical components:• FHIR® is the dominant interoperability standard for health data exchange. It is a widely adopted open standard that provides unied smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2024 Smile CDR Inc. (doing business as Smile Digital Health).How Smile’s Clinical Reasoning Expertise And Capabilities Contributed to a $10M Operational Benet

specications for how to describe health data. In the context of the quality improvement landscape and lifecycle, a FHIR-based solution enables the interoperability, availability and seamless exchange of clinical data. • CQL (Clinical Quality Language) is a standardized authoring language that enhances the expressiveness and human readability of CDS and quality measures content. It is executable by a machine and enables consistent interoperability of clinical logic. Together FHIR and CQL, eliminate systemic inconsistencies by providing semantic accuracy, reusability and system interoperability. FHIR resources are the foundational data elements for quality measurement, providing a standardized representation of clinical data. CQL, in turn, enables the expression of complex logic and criteria using these FHIR resources. This integration is the engine that powers the ingestion and normalization of data in an easily searchable language that runs fast, time-saving queries and analytics for CDS. Computable CPG can seamlessly integrate with any EMR at all points-of-care and then recommends best practices to support CDS. Results of Implementing Smile’s SolutionSmile’s authored CPGs—built from established industry best practices for colorectal cancer post-surgical care—were consistently applied to a patient group of 3,000 patients under a team of 8 surgeons. A combination of multiple CPGs were used together in this setting. The care team had access to real-time CDS and could compare it to a patient’s current state of recovery. This resulted in:• An average 33% (1 day) reduction in length of patient stay. This reduction enabled the care team to complete more patient visits, better manage the clinic’s workow and increase revenue.• A 50% drop in post-operative risk complications. This improved patient satisfaction and reduced costs in the clinic as fewer additional procedures and corrective surgeries had to be performed—services that were often not reimbursable. Prior to utilizing Smile’s authored CPGs, clinician sta started their shifts ~1 hour earlier in order to forage necessary data from paper and electronic records. At times, extra funding was required to hire additional administrative sta. Once the CPGs were implemented, there was a 95% reduction in time (and cost) spent doing administrative tasks like navigating records for information.Combined, this resulted in a $10M operational benet.Additional mid and long term benets the client is enjoying, as an early adopter of Smile’s cutting edge technology are:• Rich CPG libraries—which combine healthcare specic language and established expert treatment plans with clinical logic, vocabulary and content—that form the basis for high-value AI generated analytics.• De-risking the health ecosystem, as quality measures can be run on the same data as the CPG specication. smiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2024 Smile CDR Inc. (doing business as Smile Digital Health).How Smile’s Clinical Reasoning Expertise And Capabilities Contributed to a $10M Operational Benet

How Smile is Leading the WayThe adoption and application of standards—common methods, guides and measures—in an industry creates the foundation for how large-scale problems are solved in the real world. For example, when ISO (International Standards Organization) came into existence in 1947, several nations adopted common standards in an eort to rebuild infrastructure after the war. The standardization of processes, materials and components, along with management and quality guidelines, enabled specialization of skill, ecient utilization of resources (time, funds and labor) and provided the ability to drive progress across industries, including healthcare. Today organizations such as HL7 (Health Level Seven International) create open interoperable standards—like HAPI FHIR—to create new foundations for global health IT infrastructure. Smile’s solution suite is a commercially viable, enterprise-level solution that integrates these foundations with clinical logic (CQL) into a robust architecture, which no other vendor in the marketplace currently oers. The solution architecture allows for more advanced capabilities like Multi-threaded Processing—the ability to have multiple concurrent users of a program without duplicating it. This is an essential requirement to ensure organizations have high-performance solutions that are robust, secure, scalable and supported by technology experts. Even with well-established CPGs, the lack of standardization and interoperability results in inconsistent application. Adherence to CPGs for colorectal surgery can be as low as 29%, which creates gaps in care. Smile’s solution suite can be leveraged for predictive assessment of care gaps and clinical recommendations to close the gaps before they ever occur. By choosing Smile as a vendor for digital transformation and innovation for any one part of the CQI lifecycle, the technology implementation will solutionize the entire cycle—be it CPG, CDS, CQM or dQM.Historically, CDS and Clinical Quality Measures (CQM) were developed in silos and were not interoperable; even though they are both a part of the Quality Improvement cycle. A meaningful and continuously evolving CQI (Clinical Quality Improvement) cycle requires harmony and exchange between these two specications, so that improvements can be assessed, implemented and measured. Integrating FHIR and CQL brings needed technological revolution to harmonize the entire lifecycle of CQI, including but not limited to CDS, CQMs and dQMs (digital quality measures).The work to unify the quality lifecycle solution has taken almost a decade. The standards and cutting edge technology—FHIR, CPG and CQL based solutions—now exist. The next steps are to capitalize on this work and invest in the innovative Clinical Quality solution suite within the Smile Health Data Platform (HDP) to generate sustainable improvements in revenue, operations, patient care and care quality.How Smile’s Clinical Reasoning Expertise And Capabilities Contributed to a $10M Operational Benetsmiledigitalhealth.com | sales@smiledigitalhealth.com | 877-537-3343Copyright © 2024 Smile CDR Inc. (doing business as Smile Digital Health).Learn how you can elevate your market advantage with Smile’s clinical reasoning tools. The form below is the rst step to booking a discovery call with us.

Smile Digital Health622 College Street, Suite 401Toronto, Ontario M6G 1B4, Canada info@smiledigitalhealth.com1 (877) 537-3343www.SmileDigitalHealth.comCopyright © 2024 Smile CDR Inc. (doing business as Smile Digital Health).All product names, logos, and brands are the property of their respective owners. All company, product and service names used are for identication purposes only. The use of these names, logos, and brands does not imply endorsement.TM