August
2008
03-23-05
Arkansas Medicaid ePrescribing Project Overview
page 1
ePrescribing Project Introductions and Responsibility
• HP - Program management and oversight for the ePrescribing
implementation; Medicaid program data provider
• SureScripts-RxHub - Patient identification and information routing
• Point Of Care Partners - ePrescribing program consultants
• QSource/Buccaneer - Provider outreach and program evaluation
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 2
HP
• Project and Program Management
• System Connectivity to SureScripts-RxHub
• Building transactions to provide program data
– Eligibility
– Medication History
– Drug Coverage Data
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 3
SureScripts-RxHub
The ePrescribing Advantage
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 4
SureScripts-RxHub Formation
• SureScripts: industry owned LLC
formed by the pharmacy
associations representing nation’s
57,000 pharmacies
– Incorporated August 2001
– Mission: improve the prescribing
process through a focus on
Safety, Efficiency and Quality
• RxHub: formed and owned LLC
by the 3 largest PBMs and now
representing more than 200M
covered lives
– Incorporated February 2001
– Mission: improve patient safety
and reduce healthcare delivery
costs
Together, SureScripts-RxHub provide physicians with secure
access to 200 million covered lives and have connected over 95%
of the nation’s pharmacies through proven industry transactional
standards.
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 5
SureScripts-RxHub Benefit
• The merger provides a single, nationwide network that enables more clear,
accurate and efficient communications between prescribers, pharmacists,
and payers.
• The merger makes available critical information that every physician should
have in front of them when they prescribe and, in doing so, accelerate the
country’s transition toward a paperless prescription process that will save
billions of dollars and thousands of lives.
• Streamlining the individual processes of the legacy organizations will save
the industry time and money and give physicians more information needed
to provide quality care to their patients.
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 6
SureScripts-RxHub AR Information
RxHub Certified Technology
Partners offering services
within the State as of first
quarter 2008:
RxHub has a relationship with HP for the Fee-For-Service lives and e-Prescribing can be
enabled. RxHub has access to some Medicaid Managed Care lives covered by PBMs and Payers
connected to the RxHub National Patient Health Information Network.
©
SureScripts-RxHub, 2008
Proprietary and Confidential
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 7
Clinical Decision Support Information
Healthcare
Data Sources
70% of safety and savings advantages
of e-Prescribing result from
Decision Support Information
Physicians utilize RxHub
Patients provide
consent for use of their
data for healthcare
treatment and select
pharmacies to fill
prescriptions.
Payers provide real-time
access to patient
pharmacy eligibility,
benefits & formulary, and
medication history at the
point of care for more
than 200 million patient
records.
Arkansas Medicaid ePrescribing Project Overview
Technology
Applications
Patient Eligibility Data
Name, Address, Date of Birth,
Gender, Cardholder, Group, Health
Plan, Retail Benefit Status, Student
Status
Patient Formulary Data
Formulary Status, Alternatives, Drug
Coverage
Patient Medication History Data
Date Range, Drug Name, Oldest Fill
Date, Most Recent Fill Date, Number
of Fills, Days Supply, Quantity
Dispensed, Pharmacies/Prescribers
August 2008
certified technology
applications to review realtime decision support
information and electronically
transmit prescriptions to the
patient’s choice of pharmacy.
Pharmacists utilize
RxHub certified technology
applications to process
electronic prescriptions and
request refills directly from
physicians offices which
improves patient safety and
processing time.
page 8
Informed ePrescribing Process
Certified Physician Applications
Patient
1
Collects Patient:
 Consent
 Name
 Date of Birth
 Gender
5
 Zip
Electronic
Dr./Patient Information Validation
2
SureScripts-RxHub
provides secure
access to more than
200 million patient
records AND returns
patient clinical
decision support
information in less
than 2 seconds.
6
Patient Uniquely
Identified in
Master Person
Index
3
Patient Selects
Pharmacy
4
Certified Retail Networks
Certified Payers
Provides Patient:
• Eligibility
• Benefit
• Formulary
• Medication History
Arkansas Medicaid ePrescribing Project Overview
August 2008
© SureScripts-RxHub, 2008
Proprietary and Confidential
page 9
SureScripts-RxHub Objectives
• Open to all ePrescribing stakeholders to ensure fastest route to
widespread adoption and cost effective healthcare delivery
• Utilizes and develops industry transactional standards to
securely communicate consenting patient information in realtime between e-Prescribing stakeholders (ASC X12, and NCPDP)
• Provides clinical decision support information - patient eligibility,
benefits, formulary, and medication history - for more than 200
million patients to physicians at the point-of-care
• Delivers real-time, informed electronic prescriptions to
pharmacists in the retail setting
• Does not alter clinician/patient relationships, or business
relationships between payers, pharmacies, and technology
vendors
• Operates as a Cost Recovery Model
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 10
Physician Access to Real Time Information
• Person Index: Access to more than 200M members uniquely identified
using demographic elements.
• Patient Eligibility: Patient eligibility, benefit and coverage, and
formularies for authorized clinicians at the point of care. Patient eligibility
is also available to pharmacists at the point of dispensing.
• Patient Medication History: Drug history for all patient coverages.
Includes original prescription and refills. Data can indicate:

Patient compliance with prescribed regimens

Therapeutic interventions

Drug-drug and drug-allergy interactions

Adverse drug reactions

Duplicate therapy
• Patient Prescriptions: Bi-directional electronic delivery of prescriptions
between physicians and retail pharmacies.
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 11
ePrescribing Readiness
 National infrastructure is secure and
established
 Transaction standards are approved and have
been used for 6+ years
 Technology partners are certified on
transactions and data usage
 Proven ability to improve patient safety and
quality of care
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 12
Point of Care Partners (POCP)
ePrescribing Program Consultants
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 13
Point of Care Partners
Who Are We?
• Health Information Technology (HIT) strategy and management
consulting firm with active practices in:
– ePrescribing
– Chronic Care Management in the context of EHRs
• Focus is on subject matter, not stakeholder segment
• Boutique consulting firm regarded as experts in ePrescribing
What is Our Role?
• Provide overall ePrescribing program advice and counsel
• Advise on PR, media and marketing components of the project
• Offer advice and direction on program parameters
• Provide program management assistance
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 14
POCP Client List
Employers
General Motors, Ford,
Chrysler
Content Companies
Thomson Healthcare
PDR
MICROMEDEX
Wolters Kluwer Health
MediMedia
Government
Natl. Library Of Medicine
Department of Defense
AHRQ
PBMs
Medco
Express Scripts
CVS Caremark
MedImpact
Arkansas Medicaid ePrescribing Project Overview
Providers
Cleveland Clinic
Henry Ford Health System
Health Plans
BCBS Florida – Navigy
Group Health Inc. (GHI)
BCBS Michigan
Cigna
Connectivity Companies
Availity
RMD Networks
eRx Network
Technology Companies
AthenaHealth
Epocrates
August 2008
page 15
Experienced, Successful Team
• Anthony J (Tony) Schueth, MS – CEO and Managing Partner, 17-year
health care veteran, and nationally recognized expert in ePrescribing.
Project manager for SEMI. Project lead for the RAND New Jersey
ePrescribing Action Coalition, one of five MMA pilots. Previously at MerckMedco, IMS MEDACOM, IU Medical Center and Baxter Healthcare.
Project Role: Executive Oversight and Overall Responsibility
• David S. Green – Senior a 20-year healthcare veteran. Most recently with
the ePrescribing companies, Prematics and Zix, he spent 16 years prior to
that with Express Scripts and AdvancePCS (now CVS Caremark) in
ePrescribing-related roles. He has been involved in numerous ePrescribing
initiatives in both business development and operational roles and has
assessed many business opportunities and markets for his employers.
Project Role: Consulting Lead and Key Contact
• Other Executives – POCP has a portfolio of other consultants with whom
we work on a case-by-case basis based on skills. They include: Kurt
Andrews, PhD, epidemiologists and outcomes researcher; Connie
Sinclair, RPh, clinical pharmacist and HIT strategist; Michael Solomon,
HIT Strategist; Lynn Offenhartz, implementation and operations guru
Project Role: As Needed and Where Have Expertise
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 16
Recent Projects
• Project manager for the Southeastern Michigan (SEMI) ePrescribing
Initiative funded by General Motors, Ford, DaimlerChrysler and BCBSM
• ePrescribing planning and feasibility study for the state of Vermont
• Subcontractor to the RAND corporation on:
– the New Jersey ePrescribing Action Coalition, one of the four 2006 MMA eRx pilots
– The eRx Toolset, an AHRQ-funded program to build a toolset for ePrescribing based
on best practices, lessons learned and critical success factors
– A pilot for Structured and Codified Sig, RxNorm
• AHRQ subcontractor leading the business case and standards
development efforts around electronic prior authorization
• Assisted a large regional health plan to determine an ePrescribing
strategy and level of investment using POCP’s proprietary ROI model
• Led initiative to analyze clinical decision support language for the
Agency for Healthcare Research & Quality (AHRQ)
• Evaluation, analysis and recommendations for leading ePrescribing
solutions for various clients
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 17
QSOURCE
Provider Outreach and Program Evaluation
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 18
Who We Are
Nancy Archer, QSource Executive Director
• QSource of Arkansas is a healthcare consulting firm
• Our parent company is headquartered in Memphis with a satellite
office in Nashville
• QSource created a subsidiary organization in Little Rock called
QSource of Arkansas in March 2008
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 19
Valuable Partnership
• QSource integrates partners into our work to maximize the skills &
services available to our customers
• Buccaneer Computer Systems & Service, Inc. (BCSSI) is partnering
with QSource in delivering superior information systems (IS) and
analytical support. BCSSI is a national leader in IS design and
implementation and is expert in claims analysis, data mining and
reporting. Nena Sanchez will lead BCSSI’s work with QSource.
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 20
QSource Project Role
QSource will provide expertise in the technical aspects of
adoption and use of electronic clinical information; specifically
e-prescribing, such as:
• Facilitating and coordinating intra/inter office workflow
redesign toward maximization of health information
exchange among providers regarding continuity of
treatment
• Quality Improvement and Patient Safety as it relates to eprescribing
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 21
A Hybrid Model
• Existing Medicaid regional and statewide meetings and publications
• Academic detailing: onsite visits to participating physician practices
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 22
Outreach Team
Contact PCP sites and gauge their interest in pursuing assessment,
planning, and implementation of e-prescribing functionality by:
• Examining the technical specifications of any current
product(s)
• Analyzing communication and transmission capabilities
• Identifying the pharmacies they routinely utilize on behalf of
their patients
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 23
Program Evaluation
Evaluation of the Arkansas Medicaid e-prescribing initiative will be
accomplished through 3 recommended methods based on the
principle objective of this initiative:
Facilitate adoption and utilization of e-prescribing among primary care
physicians. Improve the quality, safety, and coordination of care provided
to Arkansas Medicaid beneficiaries.
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 24
Program Evaluation Methods
• Real time feedback from the stakeholder organizations and the
providers
• Monthly reports of number of participants & status of adoption
• A provider survey of satisfaction with the e-prescribing initiative,
including:
– Tools and resources available
– Usage estimates
– Recommendations for future Medicaid technology initiatives
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 25
Communication
Because ePrescribing is a state wide effort and will involve many groups,
associations, stakeholders, physicians, pharmacists, providers and more,
communication is vital to project success. Some forms of communication will
include:
• Information sharing across provider associations
• Quarterly written updates for all stakeholders
• Regional and state wide meetings and publications will be used to
introduce the initiative and offer ePrescribing assistance
• Exhibits and presentations at consumer, stakeholder and medical
community events, such as professional provider organization
conferences and coalition meetings
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 26
Communication
• Arkansas Medicaid Website
• Provider newsletter
• Regional meeting presentations
• Journal articles and ads
• Project status reports, face to face meetings and teleconference
calls between project team and core stakeholders
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 27
THANK YOU
QUESTIONS?
Arkansas Medicaid ePrescribing Project Overview
August 2008
page 28