Safe medicine. linking healthcare providers, patients and health insurance companies
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1 Safe medicine linking healthcare providers, patients and health insurance companies Radomir Veres, CFO & member of the board, Health Insurance Dôvera Marianna Ravallova, Senior consultant AIDC & deputy CEO, GS1 Slovakia 22nd October 2015
2 Top problems with drugs in Slovakia Problem No 1 HIGH COSTS Private and public expenditures on drugs are one of the highest in EU and OECD - as % of total healthcare expenditures and amount per capita Problem No 2 LOW EFFICIENCY duplication in drug prescription and usage Problem No 3 HEALTH RISKS drug interactions or overdosage Problem No 4 - FRAUDS counterfeited prescriptions of expensive drugs 2
3 Reimbursement by the government 3
4 Prescription process Doctor Blank form filled in by a doctor No verification of information about the patient's drugs/diagnoses/healthcare among doctors The only form of protection is a stamp and signature of the doctor - easily falsified 4
5 Prescription process Pharmacy Hands out prescribed drugs partially or fully paid by the insurance company Visually verifies stamp and signature No real-time check of patient's identity - risk of loosing money Once a month manually processes prescriptions for reimbursement 5
6 Prescription process Insurance company Gets information about prescribed drugs after monthend closing (4 6 weeks delay) Pays pharmacies sum of partially/fully paid drugs Manual inspection of prescriptions Does not cover falsified prescription (either loss for pharmacy or insurance company) 6
7 Prescription process Patient Often the only and unreliable source of information for the doctors about drugs, diagnoses, treatments Misses relevant information on how to save money by using so called generic drugs Risks health complications caused by overdosage, drug duplications and interactions General lack of information 7
8 Prescription process Doctor Pharmacy Insurance company 8
9 Reimbursement by Dôvera 9
10 Prescription process by Dôvera Doctor On-line access to the health record and drug list of the patient to eliminate duplications or interactions Receives unique identification number for each prescription in a form of GDTI (Global Document Type Idenfitifier) with serial component from health insurance company Prints GDTI as a bar code GS
11 Prescription process by Dôvera Pharmacy Scans unique prescription ID - GDTI On-line control of patient's identity and his/her creditor status No risk of falsified prescriptions, therefore no risk for pharmacy Hands out prescribed drugs partially or fully paid by the insurance company No need to proccess prescriptions manually - higher efficiency 11
12 Prescription process by Dôvera Insurance company Real time information about prescribed and sold drugs available on-line to the doctors and patients Surveying the real time trends in prescriptions Fraud prevention (No falsified prescription) Pays pharmacies sum of partially/fully paid drugs 12
13 Prescription process by Dôvera Patient mobile app Safer and more efficient treatment, fewer medical risks caused by incomplete health record On-line printable drug list and sms notifications from the insurance company with useful information (prescription validity, possible savings on generic drugs, allerts in case of interaction) One-click claim process, if the drugs were not prescribed or handed out in pharmacy 13
14 Prescription process by Dôvera Doctor Pharmacy 14
15 Safe medicine in numbers MILESTONES Developed in 6 months for 1MIO (complete costs, one-year free license for doctors, hospitals and pharmacies, complete integration with 20 software companies) All relevant pharmacy/ambulance/hospital software companies involved First healthcare provider on-line in Oct % of all healthcare providers of Dôvera on-line in Oct 2015 (3,700 providers, 13,000 users) 3.5 MIO drugs prescribed on-line and 7.5 MIO handed-out on-line 15
16 Safe medicine NEXT LEVEL Doctors sharing real-time information about the patients Patients getting safer and more efficient healthcare Patients becoming more informed about the drugs they are taking, their health and money saving possibilities On-line information about drugs and other medical data available to the rescue system 16
17 Contact Information Radomír Vereš CFO member of the board Dôvera Zdravotná Poisťovňa, a.s. Digital Park II, Einsteinova Bratislava Slovak Republic Marianna Revallová Senior consultant AIDC Deputy CEO GS1 Slovakia Nanterska Žilina Slovak Republic M +421 (0) E Veres.Radomir@dovera.sk E revallova@gs1sk.org
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