Weitere ähnliche Inhalte Ähnlich wie IKA Prescriptions System (20) Mehr von Uni Systems S.M.S.A. (20) Kürzlich hochgeladen (20) IKA Prescriptions System2. 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
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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.
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4. 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
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5. 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
5.500.000
members
Average Number of
2.500.000
prescriptions per Month*
Average Monthly
180.000.000 €
Expenditure*
* Based on 2009 Numbers
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6. Over-all System
Pharmacies Paper Prescriptions
Doctors
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
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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
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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. 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 €
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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
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13. Final results
After 18 months of productive operation the
pharmaceutical cost decreased by
693 M € in total
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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 / BI
Φαρμάκων Περικοπών ΔΙΑ / ΣΑΤ 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 3rd party applications
for pharmacies and doctors.
• 100% Full Functional Prescription Processing Systems
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