Apelon Inc. - Press Release

IDX LEADS $9.2 MILLION PROJECT TO DEVELOP ELECTRONIC CLINICAL GUIDELINE INFRASTRUCTURE
Industry/non-profit/academic consortium led by IDX seeks to improve healthcare quality and
reduce medical errors

Burlington, Vt. and Seattle – December 5, 2001 – IDX Systems Corporation (Nasdaq: IDXC), a pioneering provider of healthcare information technology, announced today that it will lead a $9.2 million project awarded by the U.S Commerce Department's National Institute of Standards and Technology (NIST) Advanced Technology Program. The three-year project award will fund the development of software infrastructure aimed to improve healthcare quality and reduce medical errors by enabling the creation, distribution and application of electronic clinical guidelines - best practice benchmarks that provide clinicians with patient-specific recommendations at the point of care. IDX is the lead company in a consortium that includes Apelon, Inc., IHC Health Services Inc. (Intermountain Health Care), Mayo Clinic, Stanford University and University of Nebraska Medical Center.

Electronic clinical guidelines have attracted intense interest in the healthcare industry, both in the U.S. and internationally. In its 2001 report, Crossing the Quality Chasm: A New Health System for the 21st Century, the Institute of Medicine calls for aggressive use of clinical guidelines to improve patient care, and for the use of technology to make scientific evidence more useful and accessible to clinicians.

"IDX is taking a leadership role in what is fast becoming a critical area of clinical information systems functionality," said IDX CEO Richard Tarrant. "Because the technology we envision will be accessible to large and small organizations across the healthcare continuum, we believe it will have a profound impact on raising the quality of care. We are pleased to be joined in this effort by prestigious organizations known for their leadership in using clinical information technology to improve patient care."

The project participants plan to develop a universal framework for electronic clinical guidelines - one that would be compatible with any clinical information system and feasible even for small hospitals and ambulatory care facilities. Currently, full-text guidelines - often many pages in length - are widely available on paper or via the Internet - but neither source is convenient for doctors to consult during patient care.
Lack of technical expertise has limited the creation of electronic guidelines, which involve translating text guidelines into a computer-based form. Guidelines must be tailored to a healthcare organization's particular computer system. The cost and difficulty of doing so often puts such efforts beyond the reach of all but a few well-funded academic medical centers. By delivering a standard electronic format for representing the complex terminology and principles of medical knowledge, the proposed system is aimed to bring the opportunity of higher quality care to hospitals throughout the U.S.

IDX will provide project leadership and sponsorship and will play a key role in software development. Apelon, Inc., a leading supplier of vocabulary tools and services for clinical information systems, will focus on integrating standard medical vocabularies into the framework. Stanford, Mayo Clinic, IHC and the University of Nebraska will provide clinical and academic expertise in the development of guideline models and knowledge representation.

"We expect the benefits of this new technology in both human and financial terms to be significant, " said Nick Beard, M.D., vice president of Healthcare Informatics for IDX. "With accessible, evidence-based guidelines, physicians will be able to better prevent medical errors and provide higher quality care - potentially saving thousands of lives every year."

Recently, the Institute of Medicine has estimated that up to 98,000 deaths annually are caused by medical errors. As many as half of these deaths may be preventable. In addition, total U.S. healthcare spending exceeds $1.2 trillion annually, and that number is projected to more than double by 2010. Yet, numerous studies have reported both substantial overuse of healthcare (one study deemed 30 percent of acute care unnecessary and potentially harmful; another concluded that 53 percent of hospital days were unnecessary) and significant underuse of preventive care (e.g., only two-thirds of children receiving appropriate immunizations).

"There are literally thousands of published guidelines, many of which run 30 or more pages in hard copy," said Stan Huff, M.D., chief medical informatics officer at IHC and chair of the Health Level Seven standards development organization. "It's not feasible for a clinician to review all the relevant guidelines while he or she is with a patient, yet that's exactly when the information is needed most. By participating in this project to marry electronic guidelines with an electronic patient record, we can give IHC physicians better tools for continuous quality improvement. More than that, what we learn here can help support quality improvement efforts at every other healthcare institution as well."

Guidelines do not replace the clinical judgment clinicians develop with years of experience and expertise. Doctors will continue to direct and control patient care, but they will be able to do so with comprehensive medical findings at their fingertips.

"This project is all about bringing knowledge to the point of care. The volume and speed of change in clinical science is a staggering burden for the busy clinician," said James Campbell, M.D., professor of medicine at the University of Nebraska. "We expect to develop a framework capable of organizing massive amounts of medical knowledge, translate it into a sharable electronic format, and deliver it in a context that will be most useful to the practitioner."

A guideline model: a standards-based "language" for representing clinical guidelines in a consistent format;
A guideline "workbench": a software tool to enable standards-based guidelines to be expressed in a uniform electronic format; and
A guideline deployment system: technology to enable the electronic guidelines to be imported into any clinical information system.

" We believe the use of standardized representations for clinical concepts is critical to achieving portability of guidelines and their effective integration with electronic medical record systems," said Apelon CEO Stephen Coady.
Initially, IDX expects to deploy the guidelines in the next generation of its enterprise clinical information system. Subsequent development efforts will enable the guidelines to be imported into other clinical systems.

About the NIST Advanced Technology Program (ATP)
ATP provides cost-shared funding to industry, non-profits and universities to help advance particularly challenging, high-risk research and development projects that have the potential to spark important, broad-based economic or social benefits for the United States. The program supports projects that industry cannot fully fund on its own because of significant technical risks or limited resources. ATP awards are made on the basis of rigorous competitive review considering scientific and technical merit of each proposal and its potential benefits to the U.S. economy. The program funds enabling technology research, but does not support product development work. The program is managed by the National Institute of Standards and Technology.

About IDX Systems Corporation
Founded in 1969, IDX Systems Corporation provides information technology solutions to maximize value in the delivery of healthcare, improve the quality of patient service, enhance medical outcomes, and reduce the costs of care. IDX supports these objectives with a broad range of complementary, functionally rich, and highly integrated products installed at 2,600 client sites. Customers include 120,000 physicians who utilize practice management systems to improve patient care and other workflow processes.

320 Integrated delivery networks (IDNs) representing more than 500 hospitals
260 large group practices
500 small and mid-size group practices

The IDX web strategy includes browser technology, e-commerce and web-based tools -- built using Internet architecture -- that facilitates access for patients, physicians and care providers to vital health information and data managed by the IDX clinical, administrative, financial, and managed care products. EDiX Corporation, an IDX subsidiary, offers medical transcription and clinical documentation services to physicians groups and hospital customers. IDX has approximately 4,450 full-time employees.

IDX and LastWord are trademarks of IDX Systems Corporation.
This press release contains forward-looking statements about IDX Systems Corporation that involve a number of risks and uncertainties. Among the important factors that could cause actual results to differ materially from those indicated by such forward-looking statements are difficulties in developing new systems, including the LastWord system, possible failure of IDX to realize the benefits of developing clinical guidelines, difficulties in implementing systems, possible deferral, delay or cancellation by customers of computer system purchase decisions, possible delay of system installations, development by competitors of new or superior technologies, changing economic, political and regulatory influences on the healthcare and Internet industries, changes in product pricing policies, general economic conditions and regulatory developments in the healthcare industry, and factors detailed from time to time in IDX's periodic reports and registration statements filed with the Securities and Exchange Commission, which important factors are incorporated herein by reference. IDX undertakes no obligation to update forward-looking statements to reflect changed assumptions, the occurrence of unanticipated events, or changes in future operating results, financial condition or business over time.

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