© 2005 Medixine Oy Piloting a Multimodal Medication Management System Tapio Jokinen, M.D., CEO Medixine Ltd

© 2006 Medixine Oy Medixine Medixine is a software company Our product is a multimodal communication software suite Our customers are healthcare providers, insurance companies, pharmacies, pharmaceutical companies Over users in 16 countries

© 2006 Medixine Oy Health care provider Patients/caregivers/customers Communication platform eBookingMeasurementsCounsellingMessagingQueries

© 2006 Medixine Oy The Strategy Vertical - Horizontal Diabetes Hypertension Call Center E-Booking Safe messaging MEDI X INE Generic communication solution Counselling Queries

© 2006 Medixine Oy Medixine Functional Modules Medixine Application Server Software Additional Medixine/ third-party Web modules Patient management systems Medixine Solutions XML Bluetooth

© 2006 Medixine Oy Patient Portal Family Friends Home care Professionals Social services PharmacyNutrition Medication Patient

© 2006 Medixine Oy Sample Solutions Medication management RFID logging RFID Communication board Automatic Treatment Follow-up Chronic Disease Support Network Chronic Disease Clinic Mobile data collection Occupational Health Card Citizen’s Interface Laboratory e-booking Hypertension, diabetes, warfarin treatment...

© 2006 Medixine Oy Pilot in Helsinki City Homecare Piloting a full logistic solution including pharmacies 400 patients planned, ca. 100 enrolled, pilot now extended and area expanded Co-operation between public and private sector Pilot evaluated by STAKES National Research and Development Centre for Welfare and Health

© 2006 Medixine Oy Background to Pilot Medication related tasks take up to 20% of nurses’ active work time ”33% of the medication is taken as prescribed, 33% is taken some times and 33% not at all” Elderly patients forget, take incorrect doses Medication related problems substantial reason for hospitalisation Invest saved nursing time and better quality of care into activating patients -> postpone hospitalisation ?

© 2006 Medixine Oy Drug Dispenser Ensures correct medication management Gives out only the correct dose –beeps reminders if dose not taken in time –transmits a remote alarm if dose remains not taken Skips possible not taken doses that remain safely inside the dispenser User definable 1, 2, 3 or 4 daily dose times –14 compartment cassette for big 1 or 2 daily doses –28 compartment cassette for small doses –21 compartment cassette for 3 doses a day use

© 2006 Medixine Oy Reminders, alerts dddd d Medixine Server Mobile alert Reminder Alarm Patient Family Nurse

© 2006 Medixine Oy Patient Portal For patients, their families, nurses, doctors, pharmacies Records compliance, alerts, reminders Uses web, SMS, IVR, unlimited number of recipients Shows reports Allows for additional e-services to be used (next: patient monitoring, mobile nurse) Generic substitution Information about medication, integration to pharmaca

© 2006 Medixine Oy Medication Logistics Pharmacy managed medicine logistics Cassettes packed at pharmacy, marked with sticker Dispensed mediciation documented to patient portal Supplied to nurses’ offices Nurses bring patient’s cassette when visiting patient Nurses change cassettes at patient’s home Empty cassette back to nurses’ office Pharmacy picks up empty cassettes

© 2006 Medixine Oy A usability survey with two purposes Surveying the conventional medicine delivery service process currently in use. Identifying the benefits and disadvantages of the new medicine delivery service process compared with the conventional one, with an emphasis on the client’s perspective, as well as on medicinal and information technology considerations. National Research and Development Centre for Welfare and Health

© 2006 Medixine Oy Evaluation Surveying the conventional medicine delivery service process currently in use, 10 delivery models found Surveying the new medicine delivery service process Identifying the benefits and disadvantages of the new medicine delivery service process compared with the conventional one, with an emphasis on the client’s perspective, as well as on medicinal and information technology considerations. Results to be published Q1/2007

© 2006 Medixine Oy Questions to Answer (1)How functional is the current action model from the perspective of the client, staff time use and related costs, and medicine dispensing (accuracy/wastage)? (2) What are the benefits and disadvantages of the current action model? (3)How will the new process of medicine delivery service change the operations from the perspective of the client, staff time use and medicine dispensing? (4)How well does the new process of medicine delivery service function from the perspective of the usability of information technology? (5)How will the change affect the clients’ and family members’ experiences? (6)How will the introduction of the new service model affect the staff’s experiences of professionality, co-operation with pharmacies and the interaction between home-care clients and staff? (7)How will the new action model and information technology change the work duties of the home-care staff?