IKA Prescriptions System

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IKA Prescriptions System

  1. 1. IKA/EOPYY Prescriptions Processing System Results after 20 Months of Productive Operation 15th December 2011 www.unisystems.com Uni Systems Copyright © 2011
  2. 2. Key Project / System mission• To design, develop and commission an integrated system to digitize, control, clear and pay 2,5 M paper prescription per month for IKA (Social Insurance Institute)*• To fully operate the system based on a very strict SLA. * IKA contributes around 45% of the total pharmaceutical expenditures of the country Uni Systems Copyright © 2011
  3. 3. Previous Situation before system implementation (Till mid 2010)• Manual processing of 2,5 M paper prescriptions.• Detailed manual control only on small statistical samples.• No Rebate collection, no control, no detailed statistics.• Increase of pharmaceutical expenditures by 10-20% per year. Uni Systems Copyright © 2011
  4. 4. IKA/EOPYY Prescription Processing System HighlightsCustomer: IKA (Social Insurance Institute)Budget: € 5.857.000Project Conception: 2005, RFP: Sep 2007, Contract Signature: Jul 2009 (In total 2-4 Years)Project Duration (24 Months): •Implementation: 09/2009 till 04/2010 (8 months) •Operation: 05/2010 till 08/2011 (16 Months)Project Deliverables :•Redesign of the IKA prescription paper Form (improve digital processing)•Design & creation of IKA prescriptions processing Data Center•Provision & Installation of IT Infrastructure•Development of appropriate software applications•Commissioning of the overall system•Provision of human resources required for the clearance of 2,5 M prescriptions/month for 14 Months.•SLA for the timely and correct clearance of 2,5 M prescriptions/month.•Support of the applications & infrastructure.Current Status: Initial Project Completed – Two new contracts extensions signed Uni Systems Copyright © 2011
  5. 5. The Problem to be solved in Numbers Number of doctors 12.000 Different medicines 22.000 Number of pharmacies 10.000Covered citizens and family 5.500.000 members Average Number of 2.500.000prescriptions per Month* Average Monthly 180.000.000 € Expenditure* * Based on 2009 Numbers Uni Systems Copyright © 2011
  6. 6. Over-all System Pharmacies Paper PrescriptionsDoctors Heavy duty Scanners Pharmacy Pharmacy on- Doctor information line submission Information Portal portal Portal Information Portal System management Clearing Rules Prescription Clearing MIS / BI Reporting Payments Rebates Correction & Control sub-systems Basic Key Entities Central B.O. DB •Doctors •Pharmacies •Medicines Central Back-Office System •Insured Citizen Uni Systems Copyright © 2011
  7. 7. Functional Sub-Systems of the Integrated Back-Office• Management of key system files (medicines, doctors, pharmacies, insured citizens)• Fully parameterized prescription control sub-system• Processing & Clearing sub-system• Payment sub-system, I/F with Inter-banking system (DIAS)• Rebate management sub-system• MIS/BI/Reporting sub-system• On-Line Information portal. – Doctor Information portal – Pharmacy Information portal – On-Line submission portal for pharmacies• Application management & Access Rights sub-system• I/F with external 3rd party systems Uni Systems Copyright © 2011
  8. 8. Operational Model Uni Systems Copyright © 2011
  9. 9. On-Line Information Reporting (Samples) …• Pharmacy Information Report• Doctor Information Report
  10. 10. MIS – Standard Reporting (Samples) …• Number of prescribing doctors and specialty• Doctors with over 70% on a specific pharmacy• 20 first pharmacies with largest claimed amounts• 50 first medicines with largest total volumes in prescriptions• Amount and volume of prescription per doctor specialty and diagnosis type• 200 first doctors based on volume & amount of prescriptions• 30 first pharmaceutical companies based on volume & amounts• First pharmacies in amount reduction after control• Detailed Doctor Prescription Report (in english / for Troica) + hundreds of ad-hoc reports and analysis
  11. 11. Statistics No. of Type of Reductions Start End Cost Reduction Monthly Avg. Months Year 2010 on direct medicine cost May Dec 8 -374.347.593 € -46.793.449 € Year 2011 on direct medicine cost Jan Oct 10 -292.282.568 € -29.228.257 €Reductions due to error reporting 2010 May Dec 8 -3.600.700 € -450.087 €Reductions due to error reporting 2011 Jan Oct 10 -4.571.584 € -457.158 € REBATES 2011 Apr Oct 7 -18.150.624 € -2.592.946 € TOTALS -692.953.069 € Uni Systems Copyright © 2011
  12. 12. Statistics ΙΚΑ Pharmaceutical Expenditures 250.000.000 € 200.000.000 €Expenditures 150.000.000 € 2009 w/o System 2010 w/o System 2010 with System 100.000.000 € 2011 with System 50.000.000 € 0€ JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC Uni Systems Copyright © 2011
  13. 13. Final resultsAfter 18 months of productive operation the pharmaceutical cost decreased by 693 M € in total Uni Systems Copyright © 2011
  14. 14. FUTURE ENHANCEMENTS Uni Systems Copyright © 2011
  15. 15. Doctor Pharmacy Αςφαλιςμένοι Κανόνες Ελέγχου ΦΚΑ API Φάρμακα Ψηφιακά ςτοιχεία HDIKA Φαρμακοποιοί ςυνταγήσ ΕΟΠΥΥ Ιατροί Scan Συνταγών Εκκαθάριση Ενημέρωση ΢σνταγών Web Rebate Διατείριση Πληρωμές (ΦΚΑ, Ιατροί, MIS / BIΦαρμάκων Περικοπών ΔΙΑ΢ / Σ΢ΑΤ Φαρμακοποιοί) ΑΠΟΣΕΛΕ΢ΜΑΣΑ ΛΕΙΣΟΤΡΓΙΑ΢ BACKOFFICE
  16. 16. Full System Exploitation and on-line extensions• The Back-Office is already there (90% ready).• Full & Real Integration with the on-line prescription system (HDIKA)• Development of state-of-the art I/F (API) for 3rd party applications for pharmacies and doctors.• 100% Full Functional Prescription Processing Systems Uni Systems Copyright © 2011

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