IOM 540: Managing Electronic Commerce Dr. Sulin Ba Dan Cabbell, Nancy Chetron, Jack Hedger, Felix Lin University of Southern California Marshall School of Business December 7, 2000

Agenda The Product Traditional Data Gathering Market Analysis / Industry Competitors Business Model Description Value Propositions and Revenue Model The Process Web Prototype Security / Privacy Issues Conclusion

The Product Our group is an application service provider (ASP) for Medical Groups –Stores patient records –provides a means for retrieval –web based Primary Benefits: Automate BackOffice –billing –insurance –healthcare reimbursement –transfer patient records Revenue –Monthly service fee (Medical group), nominal transaction fee (patient), insurance companies –Primary Customers - Medical Groups

Traditional Data Gathering Example 1Prospective patient enters office and fills out two forms: –Medical/ Personal background information form –Insurance Policy information form 2Smaller offices without a database will file the forms alphabetically with thousands of other files. 3After patient is examined or treated, a doctor will complete a write-up generally handwritten, illegible, and also filed along the other thousand forms. 4Next visit, doctor will need to pull out files from cabinets. 5For billing, insurance forms must be copied onto an insurance claim form and sent to insurance company.

Traditional Data Gathering - cont’d Problems with the Traditional Method –Clarification of question or data item –Unavailable data/unfilled data fields (these will never get updated) –Misfiling –Illegible writing –Inefficiency - lots of copying by hand

Market Analysis Situation Consumer movement Declining financial performance HIPAA regulations Increased Competition “Traditionally the health industry has been a follower rather than a leader in the use of emerging technologies…health organizations are faced with a perennial capital crunch making them cautious, protective of current business practices and slow to adopt new technologies”

Market Analysis - cont’d Issues Who should maintain health records? What types of services to offer: –Emergency medical only –Full personal history maintained by consumer –Electronic medical record (EMR) version of physician maintained record Who pays the price?

Market Analysis - cont’d Reduced admin costs Reduced scheduling time/cost Meets legal requirements of patient access to files No misfiled or misplaced charts Can files to patients/doctors/insurance How to maintain a “lifelong record” Making a profit while keeping fees at level that market will bear Cost and length of time to change software, train staff, etc. Combining physician and patient input Security/privacy Advantages of Electronic RecordsChallenges of Electronic Records

Information Flow Dentist Cardiologist General Practitioner Pediatrician ER Attendant Suppliers Orthopedic Surgeon HMO’s & Insurance Companies Patients Applications Database Doctors pay monthly subscription to gain access to applications Applications and data used to automate information flow with other doctors, insurance companies, suppliers and patients

Value Propositions Medical Group Cost reductions – lower back office cost – Can focus on core competencies – tackles inefficiencies – No added cost of maintaining file servers Lower back office “inventory” – reduced number of paper files – reduced cost associated with maintaining them Patient Reduces information asymmetries disintermediation Convenience records are easily transferred within or external to the medical group All patient information is available Insurance Company Reduced processing time 24 hour access to patient info Economies of scale in processing due to ability to electronically sort info

The Office Process First time Patient registers and is given a Pen Tablet to enter demographic and past medical history information. Vital signs are taken and entered into the “electronic chart” Nursing Assessment completed and entered using a “pen tablet” Physician completes records and examination notes, prescriptions, etc with patient Reduce Data Entry Cycle Time Eliminate Errors Eliminate Redundancies

Patient Data Entry - Pen Tablet Patient enters data via a touch screen tablet –Personal info –Insurance info –Medical history –Allergies,... Patients enter initial data directly –Eliminates non- valued added administrative tasks –Reduces administrative cost –Can also enter data prior to office visit via the web site

Prototype Web Site Demonstration

Use PDA for Data Entry and Downloading Appointments Beam or download appointments to PDA in the office after appointments made, or from home Name Date Dr. Lin 12/14/00 Appointment

Security / Privacy Issues “Need to know” for access Different levels of confidentiality Ability to edit/delete info should be guarded Audit trail of who accesses data Patient access to records on timely basis Patient ability to disclose own medical info Patient ability to revoke disclosing info No reselling of info Current protections in place Some evidence electronic safer than paper

Conclusion There is a need for MedicalRecords.com ! MedicalRecords.com can add value ! The technology exists to make it work ! The business can expand into other arenas within the medical industry Many issues, however, exist –management must monitor and address