ika prescriptions system

15th December 2011

IKA/EOPYY Prescriptions Processing System Results after 20 Months of Productive Operation

www.unisystems.com

Uni Systems Copyright © 2011

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

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.


IKA/EOPYY Prescription Processing System Highlights


Customer: IKA (Social Insurance Institute) Budget: € 5.857.000 Project 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

The Problem to be solved in Numbers


Number of doctors 12.000

Different medicines 22.000

Number of pharmacies 10.000

Covered citizens and family members

5.500.000

Average Number of prescriptions per Month*

2.500.000

Average Monthly Expenditure*

180.000.000 €

* Based on 2009 Numbers

Basic Key Entities

•Doctors •Pharmacies •Medicines

•Insured Citizen

Central B.O. DB

Prescription Clearing

Payments Rebates

Information Portal

Pharmacy information

Portal

Doctor Information

Portal

Pharmacy on-line submission

portal

Cle

arin

g R

ule

s

MIS / BI Reporting

Syst

em

man

age

me

nt

Over-all System

Heavy duty Scanners

Correction & Control sub-systems

Pharmacies

Doctors

Paper Prescriptions

Central Back-Office System


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


Operational Model


On-Line Information Reporting (Samples) …

• Pharmacy Information Report

• Doctor Information Report

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

Statistics

Type of Reductions Start End No. of

Months Cost Reduction Monthly Avg.

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 €


Statistics

0 €

50.000.000 €

100.000.000 €

150.000.000 €

200.000.000 €

250.000.000 €

JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

Exp

en

dit

ure

s

ΙΚΑ Pharmaceutical Expenditures

2009 w/o System

2010 w/o System

2010 with System

2011 with System


Final results

After 18 months of productive operation the

pharmaceutical cost decreased by

693 M € in total


FUTURE ENHANCEMENTS


Φαρμακοποιοί

Φάρμακα

Ιατροί

Αςφαλιςμένοι Κανόνες

Ελέγχου ΦΚΑ

Scan Συνταγών

Rebate

Φαρμάκων

Πληρωμές

ΔΙΑ / ΣΑΤ MIS / BI

Εκκαθάριση

σνταγών

Διατείριση

Περικοπών

Ενημέρωση

Web

(ΦΚΑ, Ιατροί,

Φαρμακοποιοί)

ΑΠΟΣΕΛΕΜΑΣΑ ΛΕΙΣΟΤΡΓΙΑ BACKOFFICE

Ψηφιακά ςτοιχεία ςυνταγήσ

ΕΟΠΥΥ

API

HDIKA

Doctor Pharmacy

http://www.banctec.de/fileadmin/images/products/intelliscan_xds_large.jpg

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


ika prescriptions system

Technology

total uni systems copyright

numbersuni systems copyright

country uni systems

subsystem payment subsystem

system implementation

system exploitation

key project system mission

volume of prescription