The Internet may indeed be the revolution that sparks indelible change in the traditional healthcare delivery system: this is the essence of the meaning behind the phrase, Delivering the Next Healthcare Transformation.There are and will be incredible opportunities to work with and to closely align with medical specialists to meet growing patient literacy concerns by informing patients with specialty specific knowledge and the ability to make informed choices within the sanctuary of their physician's stewardship; to create more efficient relationships between patients and the specialty practice; and to improve the physician's ability to deliver timely, cost effective, and best-in-class medical information services. At the Cardiovascular and Interventional Radiological Society of Europe (CIRCE) conference in Prague in 1999, Barry, JK, and I found ourselves wondering aloud what the role of the medical specialist would be during this profound change known as the next healthcare transformation. Although JK, Barry, and I were unable to precisely articulate that at the time, we knew that the medical specialist must have a direct and meaningful impact in shaping the next healthcare transformation that supports the notion that a thoughtful and well-executed enhancement of the traditional patient/physician relationship, not its replacement, should the medical specialist aspiring to remain in the forefront of this change wish to act as a steward of the care giving process. Responding to new challenges, including managing the life cycle of a patient's interaction with a specialty physician, marketing a medical practice, improving patient satisfaction, improving operational efficiencies, keeping up with medical advances, and deciphering the credibility of Internet-based health information, was at the time becoming, and today is now resolutely a part of, the everyday routine of specialty practice-based patient care. Patients were already becoming more healthcare savvy at the time, and today they are certainly more sophisticated and more demanding than ever, often requiring time and resources beyond the office visit. The need for online practice development services and tools had emerged in the marketplace as early as 1999, as we bore witness to in Prague when we saw the response to an Internet poll sponsored by Boston Scientific through CIRCE. More than 3,500 interventional radiologists were polled on the question of the role and the impact of the Internet on their specific practice of medicine. The overwhelming response and conclusion was that specialty physicians, in this case interventionalists, were facing the daunting task of responding to patients' concerns, questions, and outright challenges of a treatment regimen that they had learned about by "surfing the web," a new, and at that time certainly disruptive technology for the practicing physician. Since that time in Prague, we have learned a great deal from the many customers that we serve, and as the next healthcare transformation continues to evolve, so too, does our company. We are a company that strives to deliver against the promise of the next healthcare transformation in every product that we sell, to every medical specialist that subscribes, and to every patient that a subscribing medical specialty practice serves. Our company's market positioning reflects the gradual movement away from the traditional, transactional-oriented patient care approach, which dictates that more patients equal more revenues, toward the promising approach of the next healthcare transformation, which is rooted in the patient life cycle approach. In straightforward speak, the medical advisory boards, as well as the participating medical specialty physicians that we serve, maintain that market trends that have dictated the crucial importance of inclusive physician-patient relationships in delivering best-in-class healthcare are shifting away from being transaction-oriented, one-time occurrences, toward being life cycle oriented, oftentimes spanning years and, possibly, decades. Today the medical specialists that we serve are striving more than ever before to remain in front of their patients, as well as to provide best-in-class patient services. Our medical advisory boards are admonishing us that in today's practice of medicine, increasing practice revenue is no longer directly correlated to patient volume and throughput, and encouraging our company to recognize and fully appreciate that medical specialists must endeavour to keep a patient for life to treat all of the ailments that a patient may present with that the medical specialty practice treats. As it goes, unless the patient moves to another part of the country or the patient's physician exhibits a particularly poor delivery of bedside manner, a patient should want to stay as close as possible to the medical relationship that has been developed with a specific physician. The transaction is no longer the specific intersection between the physician and the patient and the treatment, as has historically been the case, but rather now represents the complete life cycle of the patient's interaction and management of his or her specific disease state with the same practice and the same physician over the course of the patient's life. A medical specialty practice, and the medical specialists and their team, can no longer expect nor require that a patient physically visit its practice with relative frequency over the course of his or her life. As such, it is incumbent upon medical specialists wanting to provide best-in-class patient services to consider alternative ways to bring their personalized practice of medicine to the patient. The need for an electronic medical practice that responds to the market trends shaped by the next healthcare transformation is taking form, with the patient leading the charge. These are the patient-centric needs that our company meets: Constant interaction between medical specialists, their practice, and their patients, throughout the life cycle of the patients. With patients calling for more of their physicians' time, demanding greater access to practice resources, soliciting consumer-oriented medical information and medical services via the Internet with ever more frequency, and the gradual moving away from the traditional, transactional-oriented patient approach toward the promise of a patient life cycle orientation and approach, the question then arises, how are these multiple, diverse, and persistent patient needs met? The answer lies in the delivery of information services in tandem with clinical therapy along the continuum of care, all as they intersect at the point of care. Consider: A patient presents with a certain disease and is treated surgically. It is of little use to the patient to learn that a non-surgical, minimally invasive treatment approach is available while he or she is recovering in post-op. Medical Information Services are physician-centric by design, advocate that medical information is best prescribed at the point of care, and are only prescribed by medical specialists to meet the specific and evolving medical information needs of their patients. We have never maintained that our company would drive patients to participating practices sites and thereby supplant the physician-patient relationship. What we can say is that the visibility of participating physician's electronic medical practice and the public's and patient's usage is directly correlated to how well specialty practices promote and position their electronic practice to their internal staff, their patients, and the healthcare consumers in their respective communities. For those participating specialty practices that have been able to embrace fully the power of what it is we do and to integrate fully our products into their daily routine and daily practice of medicine, we can say that our original vision is working, and many participating specialty practices and their patients have benefited in ways that were never before possible. Practices such as UNC Cardiology, the Urologic Institute of New Orleans, and Jefferson X-Ray are truly Delivering the Next Healthcare Transformation to their patients, their communities, and their staffs and medical teams through innovative NorthPoint Domain products such as Secure Messaging CenterTM, Practice Marketing Center, Accelerator Resource Center, and Patient Literacy Center to name a few. That truly is nothing short of profound. With all of this activity, and the addition of several new medical advisors, we consistently remind ourselves that as a healthcare company, first and foremost, our obligation is to those countless sick patients that suffer from myriad diseases - many of whom have and will benefit from the innovation, ingenuity, resourcefulness, and productivity of our company, NorthPoint Domain. We urge those of you who have taken the time to learn about our Company not to forget that since JK, Barry, and I opened our doors almost five years ago, our company has had a profound impact on the quality of life and welfare of thousands and thousands of patients that our products serve through hundreds of participating specialty practices. As we look ahead, we will rededicate ourselves to living up to our principles and guide ourselves by our business instincts. They define who we are, what we do, and where we are headed. They motivate us as a team, inspire our work, and arouse our dedication. Yours Sincerely, Peter M. Nicholas, Jr Barry T. Katzen, MD J.K. Nicholas Co-Founder, Chairman & C.E.O. Co-Founder, C.M.O. Co-Founder The circle with the N at the top of our company's logo represents a compass with the N symbolically pointing True North. True North is the actual direction to the North Pole while Magnetic North refers to the location of the Earth's Magnetic North Pole. What is less known is that the position of Magnetic North is constantly changing in various cycles over centuries, years, and days. True North, on the other hand, refers to the earth's celestial pole, and this position does not vary. It is important to note in this story that the locations of these two poles do not coincide. Thus, a relationship is required between these two values for users to relate compass bearings in order to arrive at the right destination. In recent years the advent of the Internet has ushered in an era of unprecedented information flow and consumerism. If one visits Google and types in a search query, regardless of the subject, one will almost certainly be provided with a litany of responses and choices to learn about a subject matter. The same principle applies to individuals seeking health information. Today there are more "consumers" of healthcare information than ever before. Consider all of the choices, such as Google, the National Institute of Health, WebMD - the list is endless. But how do consumers of healthcare information determine what search results are germane to their specific conditions? Ask an individual at Starbucks Coffee the difference between stable and unstable angina and you will most likely get a sideways glance and a quick dismissal. In fact, it is more than likely that the same individual will not even know what angina is, never mind understanding the difference. But that same person is logging on the web at home, searching for that very information when he or she learns that his or her mother or father has been recently diagnosed. Consumer healthcare information is defined as that healthcare information that an individual possesses without the direction of a physician. Consumer healthcare information is not altogether that different from Magnetic North: It is constantly changing in various cycles over years, months, weeks, and oftentimes days. At the medical specialty level, it is not difficult to conceive that individuals who receive healthcare information without the guidance of their medical specialist could easily find themselves lost, misunderstanding the information, if one were to take a charitable view. A less than charitable view could dictate that perhaps some consumer-oriented healthcare information could be not only plain wrong, but also perhaps dangerous or life altering if acted upon improperly. Patient healthcare information is defined as that healthcare information that is prescribed to the patient by the physician. Patient healthcare information is not altogether that different from True North: This position is always the same and does not vary. It is dependable, peer reviewed, sourced, and presented in a regime beginning with conditions, then tests, and finally treatment options. It affords the patient the opportunity to learn and to make choices in concert with family members and under the governance of his or her physician. Like the story that the company's logo tells, the location of these two poles - the consumer pole and the patient pole - do not coincide. Often the magnetic North, information that healthcare consumers glean from Google, varies from True North, healthcare information that is provided to patients through the stewardship of their medical specialist. As the story goes on to differentiate, a relationship is required between these two values for users to relate bearings in order to arrive at the right destination. So, too, is a relationship required between the physician and the patient to guide the patient to the right choices. That relationship is NorthPoint Domain, our company. Since our inception, we have sought to distinguish our specialty specific products, media, and content in the marketplace by adhering to a strict code of medical stewardship, governance, and ethics. We are proud to say that each and every article in our media and content, to which a practice's patients are exposed, has been thoroughly reviewed, updated and approved by our Medical Advisory Boards. In an effort to further distinguish our offerings, we have developed a medical governance system at the medical specialty level: That is to say that cardiology specific materials are only reviewed by cardiologists, urology specific materials are only reviewed by urologists, and so on. Finally, each of our medical advisors possesses a shared sense of mission, vision, and personal commitment to electronic patient care and the next healthcare transformation. We believe that each of our advisors' thoughtful consideration of the Company's Cardiology, Vascular, Urology, and NeuroScience Domain business mission will support well not only the welfare of our Company, but also our customers, the patients that we serve, and the employees and their families that comprise our team. The function of the Company's medical advisory board(s) is to provide information and recommendations to the Company's board of directors and Executive and Operating Committee members on matters relating to the development and advancement of the company's core products, media and content, and business mission; to give informal assistance to the company's managers about strategic market positioning and direction, products, strategic and key physician practices, operations, and any other matter deemed appropriate by the Executive Officers of the Company; and, in general, to promote better communication with the Company's medical advisory boards, current customers, and management teams. We are honored and privileged to work with some of the nation's and the world's finest medical specialists in this endeavour. Our Media and Content department is responsible for creating, managing, and maintaining all the content that appears in Cardiology, Vascular, Urology, and NeuroScience Domains. Our Media and Content includes articles and art, including medical illustrations, graphics, charts, photographs, and test images for each medical specialty market that we serve. None of our medical specialty specific media and content is store bought or "stock" or "form." All of our medical specialty specific media and content is created exclusively by our team. The company's library of articles is original and reviewed by our specialty based medical advisory teams. Each article is evidence based, and in the absence of evidence based materials it is consensus based, either by an endorsement of a medical society such as the American College of Cardiology, the Society for Interventional Radiology, the Society for Vascular Surgery, or the Urologic Society of America, or by an endorsement of our medical advisory board. The mission of our media and content team, as well as that of the medical advisors who govern all of our media and content activities, is to inform and to inspire patients and physicians with customized information about disease and its treatment by means of a powerful multi-media online experience. Our media and content team intends to set the standard for editorial excellence on the Internet, with content that is accurate, informative, comprehensive, relevant, and timely. Each piece of clinical content is regularly reviewed by the Medical Advisors to ensure that it is up to date and reflects the latest trends and developments in medicine. Our team uses only the most respected sources for medical information, and sourcing for every article is detailed on the site. All articles are dated to disclose the latest review date. The Medical Advisory Boards are invaluable for their advice and direction in creating this content and for ensuring the medical accuracy, ethics, and integrity of all of the company's domains. NorthPoint Domain maintains complete editorial independence. The company's goal is to create the most trustworthy site for medical information on the Internet. NorthPoint Domain's Mission is to improve the quality of patient care and the productivity of healthcare delivery through the development and advocacy of the Internet and related technologies. This is accomplished by the investigation and development of new Informed Care Technologies that will reduce risk, concern, cost, and the need for aftercare, all serving to expand the effectiveness and the scope of the healthcare relationship between the physician and the patient. Our values are straightforward: to improve the quality of life of patients; to maintain the highest standards of medical accuracy, ethics and objectivity; to be an advocate for the physician as the primary provider of care; to maintain integrity, both professionally and personally; to create and deliver long term value to our stakeholders; to maintain entrepreneurial spirit; to hold mutual respect for our customers and for ourselves; and finally, to give back to our community. NorthPoint Domain, Inc is a closely held private corporation founded by Peter M. Nicholas, Jr, John "JK" Nicholas and Barry T. Katzen, MD, FACR, FACC in 1999. The company is committed to selling internet based products and offering consultative services that support the exchange of information between leading medical specialists, their peers, and their patients at the point of care. Our products are designed specifically for medical specialty practices that unite patient literacy concerns and medical information services to clinical therapy at the point of care. As a strategic advisor, NorthPoint Domain strives to identify opportunities for short term and long term value creation. As a custom developer of Internet based health literacy products, NorthPoint strives to meet the specific and evolving needs of the medical specialty practice. Since our inception, JK, Barry, and I have always maintained that medical decisions are best made by physicians in partnership with patients and their families.