PROOF OF CONCEPT PROJECT NAME PREPARED BY DATE Reviewed NAME TITLE ORGANIZATION DATE REVIEWED DATE PROJECT TYPE DEPARTMENT(S) © 2015 NantWorks, LLC. Proprietary and Confidential information for the exclusive use of employees, customers and authorized recipients of NantWorks, LLC. 1. TERMS AND ABBREVIATIONS (List any abbreviations or jargon terms that are used in the document. It should be borne in mind that the document has a primarily non-technical audience) TERM/ABBREVIATION MEANING 2. PROOF OF CONCEPT SCOPE (Define the scope of the POC by clearly stating which functions, services and features will be included and which will not) (Be sure to describe how you expect to proceed after the POC is complete. If you plan to keep some functions in place and remove others for the full production rollout, identify the features that will be removed.) (Include the POC evaluation stage and rollback stage if applicable or if this is not applicable) (Review Clinical Requirements) 3. PROOF OF CONCEPT OBJECTIVES (Explicitly state the objectives of the POC. Use the objectives to identify criteria for measuring the success of your POC) © 2015 NantWorks, LLC. Proprietary and Confidential information for the exclusive use of employees, customers and authorized recipients of NantWorks, LLC. 4. POC RESOURCES (List all key resources, including their role) POC PARTICIPANTS RESOURCE ROLE RESPONSIBILITIES: POC TEAM (INCLUDE TECHNICAL RESOURCES AS WELL AS SUPPORT RESOURCES) RESOURCE ROLE RESPONSIBILITIES: © 2015 NantWorks, LLC. Proprietary and Confidential information for the exclusive use of employees, customers and authorized recipients of NantWorks, LLC. 5. PROOF OF CONCEPT SCHEDULE KEY POC ACTIVITIES ACTIVITIES EXPECTED COMPLETION DATE RESPONSIBLE © 2015 NantWorks, LLC. Proprietary and Confidential information for the exclusive use of employees, customers and authorized recipients of NantWorks, LLC. 6. SUCCESS CRITERIA AND METRICS (The Success Criteria and Metrics section defines the POC’s success criteria and the specific measurements that will be taken to determine the level of success) 7. PROOF OF CONCEPT EVALUATION (The POC Evaluation section describes how the results of the POC will be evaluated. It includes the process by which lessons learnt will be incorporated into the final solution) © 2015 NantWorks, LLC. Proprietary and Confidential information for the exclusive use of employees, customers and authorized recipients of NantWorks, LLC. 8. PROOF OF CONCEPT RISKS (Provide details of all risks relevant to the proposed project that have been identified to date) RISK LIKELIHOOD CONSEQUENCE RISK RATING CONTROL Despite these risks the project would appear to be viable at this stage, and it would appear that each of these risks would be able to be effectively mitigated © 2015 NantWorks, LLC. Proprietary and Confidential information for the exclusive use of employees, customers and authorized recipients of NantWorks, LLC. PROOF OF CONCEPT ACCEPTANCE Nant Executive Sponsor Print Name: Signature: Title: Date: Nant Security and Compliance Officer Print Name: Signature: Title: Date: Nant Legal Officer Print Name: Signature: Title: Date: Nant Production Support Manager Print Name: Signature: Title: Date: Nant Program Manager Print Name: Signature: Title: Date: Nant Project/Client Manager Print Name: Signature: Title: Date: © 2015 NantWorks, LLC. Proprietary and Confidential information for the exclusive use of employees, customers and authorized recipients of NantWorks, LLC. Client Project Sponsor Print Name: Signature: Title: Date: © 2015 NantWorks, LLC. Proprietary and Confidential information for the exclusive use of employees, customers and authorized recipients of NantWorks, LLC. APPENDIX A – REQUIREMENTS DEFINITION ID REQUIREMENT BUSINESS PROCESS PRIORITY BUSINESS REQUIREMENTS CLINICAL REQUIREMENTS REPORTING REQUIREMENTS USER ACCESS/SECURITY REQUIREMENTS SERVICE LEVEL/PERFORMANCE REQUIREMENTS SUPPORT & MAINTENANCE REQUIREMENTS DATA MIGRATION RECORDS MANAGEMENT INTERFACES © 2015 NantWorks, LLC. Proprietary and Confidential information for the exclusive use of employees, customers and authorized recipients of NantWorks, LLC. APPENDIX B – TRAINING PLAN (This section is included for appendices as required. Replicate the section if more appendices are needed. Remember to update the Table of Contents for the document to pick up the change.) TRAINER (S) TRAINING DESCRIPTION TRAINING SESSION DATES TRAINING PARTICIPANTS TRAINING MATERIALS (INCLUDING RESPONSIBLE) -I.E.: MANUALS, FAQ TRAINING ROOMS TRAINING EQUIPMENT REQUIREMENTS (IDENTIFY RESPONSIBLE FOR PROVIDING EQUIPMENT) © 2015 NantWorks, LLC. Proprietary and Confidential information for the exclusive use of employees, customers and authorized recipients of NantWorks, LLC. APPENDIX C – SUPPORT MATRIX (This section is included for appendices as required. Replicate the section if more appendices are needed. Remember to update the Table of Contents for the document to pick up the change) NAME CONTACT DETAILS ROLE RESPONSIBILITY (I.E.: FIRST POINT OF CONTACT WHEN RAISING ISSUES) © 2015 NantWorks, LLC. Proprietary and Confidential information for the exclusive use of employees, customers and authorized recipients of NantWorks, LLC.