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

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Sarah O’Connor’
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1 IKA/EOPYY Prescriptions Processing System Results after 20 Months of Productive Operation 15 th December

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

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.

4 IKA/EOPYY Prescription Processing System Highlights Customer: IKA (Social Insurance Institute) Budget: 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.

5 The Problem to be solved in Numbers Number of doctors Different medicines Number of pharmacies Covered citizens and family members Average Number of prescriptions per Month* Average Monthly Expenditure* * Based on 2009 Numbers

System management Clearing Rules Over-all System Doctors Pharmacies

Pharmacy online submission portal Information Portal Doctor

Prescription Clearing Payments Rebates Central B.O.

6 System management Clearing Rules Over-all System Doctors Pharmacies Paper Prescriptions Heavy duty Scanners Pharmacy information Portal Pharmacy online submission portal Information Portal Doctor Information Portal MIS / BI Reporting Basic Key Entities Prescription Clearing Payments Rebates Central B.O. DB Correction & Control sub-systems Doctors Pharmacies Medicines Insured Citizen Central Back-Office System

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 3 rd party systems

8 Operational Model

9 On-Line Information Reporting (Samples) Pharmacy Information Report Doctor Information Report

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

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.

11 Statistics Type of Reductions Start End No. of Months Cost Reduction Monthly Avg. Year 2010 on direct medicine cost May Dec Year 2011 on direct medicine cost Jan Oct Reductions due to error reporting 2010 May Dec Reductions due to error reporting 2011 Jan Oct REBATES 2011 Apr Oct TOTALS

12 Expenditures Statistics ΙΚΑ Pharmaceutical Expenditures w/o System 2010 w/o System 2010 with System 2011 with System JAN FEB MAR APR MAY JUN JUL AUG SEP OCT NOV DEC

13 Final results After 18 months of productive operation the pharmaceutical cost decreased by 693 M in total

14 FUTURE ENHANCEMENTS

15 Doctor Pharmacy Κανόνες Ελέγχου ΦΚΑ API Αςφαλιςμένοι Φάρμακα Φαρμακοποιοί Ιατροί Ψηφιακά ςτοιχεία ςυνταγήσ ΕΟΠΥΥ HDIKA Scan Συνταγών Rebate Φαρμάκων Εκκαθάριση σνταγών Διατείριση Περικοπών Πληρωμές ΔΙΑ / ΣΑΤ MIS / BI Ενημέρωση Web (ΦΚΑ, Ιατροί, Φαρμακοποιοί) ΑΠΟΣΕΛΕΜΑΣΑ ΛΕΙΣΟΤΡΓΙΑ BACKOFFICE

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 3 rd party applications for pharmacies and doctors. 100% Full Functional Prescription Processing Systems

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