Solution Overview for NIPDEC-CDAP July 15, 2005

1. Solution Overview for NIPDEC-CDAPJuly 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 National Health Care Administration RHAs NIPDEC Ministry of Health Primary Health Care Doctors Pharmacists Patients

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

6. Needs & Challenges 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 Patient records management Claim settlement Approved drug lists & drug profiles Patient history Inventory management

7. Meeting Needs • 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 • 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 Smart Cards E-Prescription Point of Sale Terminals Tracking software

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

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

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

14. Health Card Solution Details: Pharmacies • When smart card is read on POS terminal: • Patient information is updated at NIPDEC for more complete view of patient • NIPDEC can confirm medications were dispensed by the pharmacy • Amounts dispensed are recorded at NIPDEC for settlement of payments 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. Software & network preparation Communications & Information Governance & Change management Develop governance structure Define roles and responsibilities Envisioning Work with users at all levels to identify top priorities for software Planning Work with users at all levels to develop specifications Interview patients and potential system users to identify key information needs Identify key metrics and performance measures Develop training priorities and plansDevelop processes for managing and troubleshooting Development Plan internal and external communications and prepare materials Customize and test software Develop deployment plans Deployment Install hardware and software Train staff as needed Roll out communications campaign Monitor user take-up and usage levels Collect feedback at all levels Maintenance & Support Provide ongoing backups, troubleshooting, and maintenance services Monitor key metrics and performance measures and refine as needed

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