Good morning everybody . My name is Mike new show on the health care I.T. analyst here at J.P. Morgan and it's my pleasure to introduce our next presenting company all scripts with us today presented for the company it is C.E.O. Paul black and C.F.O. and President Rick Pullman . They'll be available for Q. and A in the Olympic room following the presentation and with that I'll hand it over to Paul thank you very much thank you . Greetings everybody . Paul black C.E.O. of all scripts would like to take you a little bit through the story this morning . Appreciate everybody coming and taking the time to spend it with us today from a from a corporate corporate overview . We're filing a case this morning on the some of the announcers would that we made and some of the information that's in the packet in our company so all scripts . Rick and I've been here for a little over three years there's been a lot of work that's gone on to really position the company for success and we have a lot of updates to bring you today and you think about what we do as a company . There's really four main things that we do four main things we supply to the marketplace on a global basis . First of all we have electronic medical records systems we have record systems for inpatient outpatient amatory electronic integrated delivery networks we have four large multi-group specialty practices and we also have . Electronic Medical Records for a small community physician practices have a platform for Population Health which we've leaned into the two thousand and thirteen timeframe a lot of work has gone on in that regard from a connectivity standpoint but also from a cost basis so we are one of the few people that actually provide the cost accounting system when you think about quality care these days people talk about all comes in quality divided by cost . So having a costing system if you're in being the value of a scarcity environment are very important . Third platform that we have as a consumer platform and I distinguish consumer from patient engagement . We'll talk about that throughout the course of the platform throughout the course of the day today and in the last platform that we are talking about in one or investing in is a precision medicine platform . If the the organization that we have is manifest by a lot of people that work very hard each and every day over seven thousand associates we also have a very large vast installed base on a global basis that it's all based it has forty five thousand physician office practices in the United States and when you think about what it means to be an Accountable Care Organization one of the main components to being and having an effective accountable care is having primary care physicians being able to assess patients and be able to manage them through a continuum of care . We also have over four hundred thousand connections that people that are connected to caregivers connected to consumers will talk about five point seven million people in our portal today that are in a single instance in the cloud that are actively interfacing with their record on a day to day basis . We also have over two hundred two thousand five hundred hospitals A hundred eighty thousand physicians seventeen thousand post acute facilities and we manage over twelve million referrals each and every year . So the installed base is a acute care in the ample Torrie opposed to Q. and A consumer oriented suite of solutions that are out there in production today not from a from from a directional standpoint but from an operational day to day management of . And that's what we do from an industry standpoint this is a very complex industry most of you have been in this room have been students of this for a very long period of time . But it is two thousand and sixteen and we all just got a year older and we will hopefully I'll get a year older this year . The aging population is it is a dynamic that's been going on throughout the course of history and in this case from an economics and macro economics and what's going on specifically United States and other parts of the world a very important component when you think about governments you think about other agencies employers payers who are accountable for the financial side of the equation with regard to health . Over five trillion dollars have been projected to be spent in the United States on health care alone up from the three billion or three trillion today clearly unsustainable number in a number that continues to grow as we expect folks to . Hit that can consume health care over the course of the next fifteen to ten to fifteen years and we are also in an environment in the United States and also around the world where you can be guaranteed one thing and that is you can get paid less for next year and this year for doing more work and so it's an extraordinarily complex environment that people that are running health care systems have to navigate through each and every day . The switch on top of that reimbursement challenge and cost challenge is a it is a reimbursement component with regard to where the market's gone and going from a volume based organization and a reimbursement model to being a value . So you get paid for quality you get paid for outcomes as compared to getting paid for seeing as many patients each and every day . In certain regions of the country that uptake has not been as as advanced in other regions of the country like where we sit in California today they're doing full cavitation for over thirty years . Those represent big challenges for our clients and the movement from A to B. from volume to value has been a big topic it's been talked about for a long time which drives a lot of the the market requirements that we're seen in in the environment that we operate in today . If you look at that what that means from a strategic imperative for our clients if you look at what the what they're faced with each and every day that five percent of the population actually consumes over far forty five percent of the cost and end of the care that's an incredibly important statistic when you think about if you're managing that if you're at risk clinically and financially for that population how are you going to manage and how you identify those people how you manage them through a care protocol and how do you take care of them to manage those costs and get a better outcome for them for a long extended extended period of time . The the the piece on that last chart that is important is not only do you have a very large dollar being consumed by a very small number of people but you also have a component of that very complex set of diagnostics in very complex set of conditions that a poll a chronic patient has . So it's not one pill it's not one protocol it's a multi variant and that's another reason why we think in we are confident that our emphasis on precision medicine to help can not only control that top five percent of the consumption but that's going to be a very important way that we manage and help our clients manage through that . Our value proposition is it's pretty simple and that we believe that we have to combine all patient data not just patient data . I don't want to electronic medical records but patient data from the entire community in order for it . People to make better decisions we can plan it in one single place and we poll put it in an organization what we call the single source of truth we do that through our connectivity platform . D.B. Motion we then provide insights to people that are in the care management area of the organizations in order to be able to determine bifurcate that prior chart what people have what conditions and what care protocols should they be on what care protocols are they on and then tracking the results of the care protocol that they are on . Coordinate that care across the community not just across an inpatient setting not just cross and post acute setting but across the entire community and providing tools and solutions that allow people to actually core need to care . We also engage patients in managing their care in their health by giving them access not only to the electronic medical record that we have but our patient portal allows access to all ear Mars . We are not only wired to our own it's called a on tethered patient portal in is one of very few in the marketplace that allow that to occur . We also enable change the point of care so a lot of people talk about population health a lot of people talk about analytics in what we have learned over a long period of time in working with physicians and caregivers . If you don't incorporate that information if you don't incorporate that insight into the bedside into the clinic into the workflow without a lot of disruption to the way people are operating the way people are thinking I have to log in a log out to multiple systems . The workflow component of this has been highly glossed over and it's one of the reasons why we think our population L. solutions are the uptake that we have in that regard are surely effective at the biggest most important thing I learned when I first got here when I want to enlarge clients is that when people are making decisions clinicians they don't want to log in log out they don't have to click on another tab they want information to be brought to them in a delta view in other words since the last time I saw the patient what has changed is there's if there's information that I trust from other sources source systems I want to know about what my other colleagues have told me about this patient across the community . When I see that information based on my specialty type I will make a different decision and one of our largest clients sixty percent of the time that they click on the community view . Of that patient they make a different clinical decision which is a phenomenally large statistic when you think about . So why is population health management important you can't manage a population unless you have the entirety of their medical record in front of you as you're trying to take care and make decisions about their health care . But as we execute across the platforms the breadth and depth of the solutions that we have cover amatory acute post acute which is extraordinary large piece of work health care is going community as well as consumer is I've talked in the past when we have tools for many different issues . These areas obviously the impatient patient not only the electronic medical records but solutions that where we do the remote hosting of those solutions for our clients and in many cases will totally outsource the entirety of that of their solutions so that's a big piece of the revenue growth driver that Rick will talk about in a minute . We're getting a lot of we give you we received and we have achieved a lot of momentum as a result of not only business travelers but a lot of our clients have had success . So we're pleased with the success that our clients have demonstrated through their achievement of his level seven the National Institute of Health which is a very little known Jemma from our standpoint with wit with regard to rest of the world's understanding of what we do . The National Institute of Health is one the largest research organizations in the world . They have over seventy one thousand seven hundred different clinical trials going on at any point in time they do bench to bedside back to the bench that is an all scrip sunrise client . The National Cancer Institute also is running on that platform . They were achieved EMS level seven certification which is the highest level of certification you can receive for total automation . Got another client receive the Davies award which is an X. extraordinarily prestigious award that on their behalf because of their accomplishments with clinically and financially through the use electronic medical records system they were able to achieve that . We have over five hundred sixty new clients through the Q three of last year that we previously announced we had over eight hundred different source systems that are attached and operational for D.B. Motion for interoperability layer . So again we're not talking about being open we can demonstrate it . We have entire countries that operate inpatient outpatient Ambuhl Torie the military as well the payment system all attached to the D.B. Motion platform and that's an extraordinarily important component . When we think about an open connected community of health . A big piece of the openness is a demonstration of that . We celebrated on December twenty fourth of this year . Bless you . After three years of counting our billionths transaction that has gone through an A.P.I. layer . So where we EK open in express our A.P.I. is to third party developers as well as our client clients . When a client developed or a third party developed application it puts it makes a call to an electron or one of our electronic medical records we count that we had a billionth transaction so when we talk about and we distinguish our company in the marketplace from others and we talk about open we can demonstrate it in multiple different ways . And lastly on my point the future of precision medicine the patient specificity around having additional diagnostic capabilities that are available in the marketplace today are profound . The work that you've seen us work do with not only the National Institute of Health the National Cancer Center but also with large organizations like C.T. CA Memorial Sloan Kettering and others where they are doing and have been working on genomic sequencing for a long period of time bringing that information back into the workflow with the phenotypic information that resides in electronic medical record as a result of tissue and blood but blood sampling allow us to provide an extraordinarily detailed level of specificity around protocol adherence as well as protocol selection . And on a going forward basis this newfound medical insight is being developed each and every day is I think a very important in profound on set of capabilities that we will have . And as the F.D.A. talks about not only do we want to compress the amount of time frame to get the clinical trials are completed they also want to get that information in those new protocols out into the community much more quickly not to be locked into large academic medical centers to MIT but to make that much more compelling and make that much more available . And when you think about our capabilities by having forty five thousand physician office practices spread throughout the United States spread throughout main streets right throughout the rural areas of the country we're quite excited about our capability to bring that information to that primary care caregiver . Thank you very much . That will turn put him over to Mr Rick Bolton our President and C.F.O. . OK Good morning everyone thanks Paul . I just want to pivot now the conversation talk a little bit about our financial model and what we see as our financial opportunity ahead . We have talked for some time now to those who have followed us about four planks of growth that we see as the opportunity for their company to pursue as we go forward . And those are as I list on the slide here so first it starts with H.R. replacements the market for E.H.R.'s today is largely a mature market . We have a very unnatural industry structure meaning way too many vendors out there and what we're seeing is some vendors slowing down their investment in their solutions and built on old technology in particular and that gives the opportunity to have some consolidation . So there will be a market share winners market share losers as we come as we evolve to a more natural industry structure . We expect to be a market share winner . We've invested heavily in our solutions we amped up our investment significantly three years ago . We continue to invest at those levels . They are industry leading levels in terms of a percentage of our revenues . And though that investment gives us the opportunity to be a share shift when our second opportunity is initial adoption of new digital tools . So population health management is an area that most providers are focused on today as they're forced to manage risk for the first time . And that amount of risk they have to manage is growing significantly as they look ahead . They need tools to be able to accommodate that and that's really what the population health umbrella stands for . The third area of opportunity for us is improving and increasing our share of wallet with clients by providing more recurring services to them . So today are today our mix of business with our clients is about two thirds of our business it comes from our software about a third of our business comes from various services that we provide . We see an opportunity to bring that ratio closer in line with what we see from some other competitors in our in our universe . So a good opportunity for us to expand our services . And then finally bringing our solution stack outside the U.S. So we see in general the out there outside the U.S. is behind us in terms of adoption of clinical tools and we have some very strong bulkheads of strength out mostly in English speaking countries where we have the opportunity to grow from those points of presence . We've had a lot of momentum in these areas . So this isn't just theory . We've on the replacements we've seen twenty new sunrise sunrises are acute in-patient solution twenty ninth's facilities added since two thousand and thirteen . We've seen some nice steady revenue growth in population health solutions very strong growth in recurring services solutions and then also our increased presence outside the U.S. So both in the third quarter as well as the fourth quarter we announced significant new wins in the U.K. . So the best measure of momentum is probably really our sales activity and in our industry parlance we call that bookings . This is a chart over the last two years of what our quarterly bookings performance has been . There is a little seasonality in the buying patterns so you do see a dip when you go from Q four to Q one . But you can see on the right side of this graph how we've had a nice steady increase throughout the year . Each of our first three quarters of the year were records for the company and we announced this morning that our fourth quarter is also expect is a record as well . So as when we draw this graph for you next time you'll see this trend line continue in terms of revenue our revenue results have have been if you looked at us just casually you'd see that for the last couple of years top line is kind of stalled . There's really two stories going on there though there's recurring revenue growth and then there's also are nonrecurring and so our recurring revenue has grown pretty nicely throughout the year it's around six percent these are nine month numbers . But that was offset almost entirely with a reduction in non recurring revenue we've spoken in the past about the reasons for that but we had a lot of