1. Solution Overview for NIPDEC- CDAP July 15, 2005

2. Agenda Background Solution Overview Solution Details Review of Implementation Phases

3. Background

4. Health Care in Trinidad & Tobago Multiple levels, regions, and stakeholders Patients Pharmacists RHAs Doctors NIPDECMinistry of Health Primary Health Care National Health Care Administration

5. Chronic Disease Assistance A complex balance of risk and responsibility Patient Pharmacist NIPDEC Doctor

6. Patient records management Claim settlement Approved drug lists & drug profiles Patient history Inventory management Patient history Prescription details Compliance with Pharmacy Laws Claim submission Drug lists and profiles Prescriptions Personal medical history Access to information and benefits Rapid service Convenient locations Needs & Challenges

7. Different users have different needs: not all users are “technical”! For patients solution must be virtually foolproof must be durable enough to stand up to normal use must not introduce risk of losing data or use components that cannot withstand every-day handling Meeting Needs For pharmacists equipment must be easy to use must not require specialized technical skills to install, maintain, and use on a day-to-day basis must be reliable and available at all business hours

8. Meeting Needs For NIPDEC administrators the central database must securely store information from all parties (in case of loss, theft or failure at any other point) must be easy to produce regular reports for a range of different uses must be able extract information with little or no specialized training must meet future needs with little additional expense For future system must be expandable to include doctors, suppliers, etc. must be able to grow to include other national health administration bodies

9. The Solution

10. Solution Vision E-Prescription Smart Cards Tracking software Point of Sale Terminals

11. Solution Overview Augment existing inventory system Link into existing accounting system and automate payment process

12. Solution Details Creates new connections between: Primary health care level and national health administration Primary health care level and national health administration Patients, pharmacies and NIPDEC Patients, pharmacies and NIPDEC Inventory and accounting systems Inventory and accounting systems Payments and dispensing activities Payments and dispensing activities

13. Solution Details: Patients Patients will be issued a smart cardPatients will be issued a smart card Prescriptions will be obtained as usual from doctorsPrescriptions will be obtained as usual from doctors Prescriptions will be entered on smart cardsPrescriptions will be entered on smart cards Patients Health Card

14. Solution Details: Pharmacies When smart card is read on POS terminal: Patient information is updated at NIPDEC for more complete view of patient Patient information is updated at NIPDEC for more complete view of patient NIPDEC can confirm medications were dispensed by the pharmacy NIPDEC can confirm medications were dispensed by the pharmacy Amounts dispensed are recorded at NIPDEC for settlement of payments Amounts dispensed are recorded at NIPDEC for settlement of payments Health Card Patient records

15. Solution Details: NIPDEC Daily updates into inventory management system allows NIPDEC to: --easily predict reorder points Keep track of pharmacy stock for automatic reordering --plan deliveries before stock is depleted at pharmacies --confirm delivery acceptance at pharmacies

16. Solution Details: NIPDEC As dispensed prescriptions are reported by pharmacies via the terminals, NIPDEC can: --automate payments to pharmacies --begin to build national patient database --begin analysing cost patterns and drug use patterns to predict cash flow and ordering needs for the future Completing, verifying and coordinating payments

17. Implementation

18. Envisioning Planning Development Deployment Maintenance & Support Software & network preparation Communications & Information Governance & Change management Develop governance structure Define roles and responsibilities Identify key metrics and performance measures Plan internal and external communications and prepare materials Roll out communications campaign Monitor user take-up and usage levels Collect feedback at all levels Develop training priorities and plans Develop processes for managing and troubleshooting Monitor key metrics and performance measures and refine as needed Customize and test software Develop deployment plans Train staff as needed Work with users at all levels to develop specifications Work with users at all levels to identify top priorities for software Install hardware and software Provide ongoing backups, troubleshooting, and maintenance services Interview patients and potential system users to identify key information needs

19. Envisioning Communications & Information Governance & Change management Develop governance structure Define roles and responsibilities Work with users at all levels to identify top priorities for software Software & network preparation Who is involved? Technical team will consult with NIPDEC IT staff to: Confirm software and hardware needs and establish contact points and regular communications schedule Ensure all understand how solution is to integrate with existing systems Management consultants will work with NIPDEC business analysts, accounts staff, administrators to: Ensure everyone involved understands the objectives and knows their role identify communication needs, strategies, and processes to keep all informed

20. Planning Communications & Information Governance & Change management Identify key metrics and performance measures Work with users at all levels to develop specifications Interview patients and potential system users to identify key information needs Software & network preparation Who is involved? Technical team will work with NIPDEC IT staff and system users to: Define functional requirements for the software and overall solution Develop a prototype for initial user testing Management consultants will work with NIPDEC business analysts, accounts staff, administrators to: Identify processes which may need to change Select performance measures and targets to be able to track how system meets needs

21. Development Communications & Information Governance & Change management Plan internal and external communications and prepare materials Develop training priorities and plans Develop processes for managing and troubleshooting Customize and test software Develop deployment plans Software & network preparation Who is involved? Technical team will: develop software to create patient cards; process prescriptions; route and summarize claims and inventory movements develop software to allow data to be searched and to create reports for accounting and other administrative uses Management consultants will work with NIPDEC staff and pharmacy board to: develop enrolment documentation and processes for the public develop how-to information for pharmacists develop communication materials to educate patients

22. Deployment Communications & Information Governance & Change management Roll out communications campaign Train staff as needed Install hardware and software Software & network preparation Who is involved? Technical teams will work with NIPDEC IT staff to: test applications in the NIPDEC environment and ensure stability resolve any defects and deploy terminals to pharmacies train system administrators and operations staff to manage and run the new components Management consultants will work with NIPDEC staff and pharmacy board to: Ensure the public and pharmacy users understand the services and benefits enroll patients and train pharmacists on using terminals

23. Maintenance & Support Monitor user take-up and usage levels Collect feedback at all levels Monitor key metrics and performance measures and refine as needed Provide ongoing backups, troubleshooting, and maintenance services Communications & Information Governance & Change management Software & network preparation Who is involved? Technical team will conduct phased handover to NIPDEC operations and administrative staff Management consultants will perform follow-up review to ensure reporting and information generated by the system is meeting needs Planning for next phase can begin based on experience from first phase