Meaningful Use: Driving Physicians to eprescribing/emr and Pharma Marketing Opportunities

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1 Meaningful Use: Driving Physicians to eprescribing/emr and Pharma Marketing Opportunities Devin Paullin EVP, New Business Development Physicians Interactive Dan Pucci Director, Informatics Solutions Allscripts

2 Today s Discussion: eprescribe and Electronic Health Record (EHR) Adoption today Environmental Drivers of Healthcare Technology Adoption at the Point of Care HITECH Tools available today to meet the needs of the Pharmaceutical Marketer

3 eprescribe and Electronic Health Record (EHR) Adoption today

4 Physicians are adopting EMR systems 33% are not currently engaged 67% use an EMR or plan to within the year In February 2009 the American Recovery and Reinvestment Act (ARRA) was passed. 69% of these physicians had a system in place before ARRA was passed. Source: Taking the Pulse v10.0

5 eprescriptions nearly Tripled in 2009 The number of eprescriptions nearly tripled last year to 191 million from the previous year's 68 million This increase is 12% of the 1.63 billion original prescriptions, excluding refills Millions of scripts Allscripts forecasts: 125 million scripts will be processed over the next 12 months May- 08 Jun- 08 Jul- 08 Aug- 08 Sep- 08 Oct- 08 Nov- 08 Dec- 08 Jan- 09 Feb- 09 Mar- 09 Apr- 09 May- 09 Jun- 09 Jul- 09 Aug- 09 Sep- 09 More Doctors Are Prescribing Medicines Online, WSJ, April 20, 2010 Allscripts, April 2010

6 eprescribing Channel: Many Brands Impacted Today! Drug Name # Scripts # Doctors # Patients Lisinopril 35,045 5,447 32,611 Simvastatin 32,837 4,968 30,741 Amoxicillin 21,201 3,249 20,415 Metformin HCl 20,605 4,105 19,245 Lipitor 20,479 4,548 19,054 Hydrochlorothiazide 17,950 4,610 16,837 Levothyroxine Sodium 17,812 3,964 16,514 Synthroid 17,786 3,824 16,144 Amlodipine Besylate 16,035 4,185 14,973 Prednisone 15,944 3,641 14,873 TOTAL 215,694 42, ,407 Source: Allscripts Data, Last 30 days, March, 2010: 7 MM erxs /month Over 1.0 MM erxs via eprescribe App 87,000 prescribers

7 Environmental Drivers of Healthcare Technology Adoption at the Point of Care

8 Health Care Reform: $30B for Providers $30 Billion Physician Incentives Incentive Bonuses from Medicare/Medicaid eprescribe Incentives: HR 6331: The Medicare Improvements for Patients and Providers Act of 2008 eprescribing Provides benefits to those who electronically prescribe 2009 and 2010: 2.0% 2011 and 2012: 1.0% 2013: 0.5% Provides penalties to those who don t after : 1.0% payment cut 2012: 2.0% payment cut

9 Health Care Reform: $30B for Providers $30 Billion Physician Incentives Incentive Bonuses from Medicare/Medicaid HITECH INCENTIVES : The Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the American Recovery and Reinvestment Act of 2009 HITECH ACT Stimulus Package As much as $44K to $64K per physician

10 Health Care Reform: $30B for Providers $30 Billion Physician Incentives Incentive Bonuses from Medicare/Medicaid MEANINGFUL USE: The Centers for Medicare & Medicaid Services (CMS) released its final rule for Stage 1 of the meaningful use of electronic health record (EHR) technology on July 13th. As stated in the HITECH Act. eprescribe Incentives - demonstrate meaningful use by 2015 to avoid financial penalties in the form of reduced Medicare reimbursements. HITECH incentives - demonstrate meaningful use before 2015 to be eligible for financial incentives, which top out at $44,000 for individual providers and millions of dollars for hospitals

11 The Basics The greatest opportunity in our industry s history Physicians have to choose one program Medicare up to $44,000; Medicaid up to $63,750 There are penalties for not participating Meaningful Use is required Allscripts is assisting EHR clients in achieving Meaningful Use

12 Final Requirements Interoperable The EHR must have ability to be connected to other systems Standards The EHR must be ARRA certified and include eprescribing Meaningful Use The provider must submit reports on use and clinical quality measures Allscripts EHR will do the required Meaningful Use reporting for the providers

13 Final Rules Synopsis Greater flexibility to meet and report certain objectives for meaningful use No longer all or nothing Lowered metrics for EHR operational use in most instances Reduced the number of clinical quality measures CAHs (Critical Access Hospitals) now eligible for Medicaid incentives 13

14 Where s the money? The eligible [provider] demonstrates... that during such period the [provider] is using certified EHR technology in a meaningful manner. Certified EHR Technology + Meaningful Use = Incentive $

15 Meaningful Use Stage 1 Complete 15 Core measures Complete 5 of 10 Menu measures May attest to irrelevant items Minimal performance standards First year: 90 days of meaningful use Second year: full year

16 Operational Measures (samples) CPOE (medication orders only) was 80% 30% eprescribing was 75% 40% Drug screening Functionality enabled Active medication list 80% Active medication allergy list 80% Medication reconciliation 50% Problem list in ICD 9 CM or SNOMED CT 80% Lab results (numeric) stored as structured data 40% Clinical decision support was 5 One alert in use

17 Meaningful Use: The Staged Approach Stage 3 Stage 2 Stage Capture & Share Data Advanced Care Processes & Decision Support Improved Outcomes 17

18 HITECH Tools available today to meet the needs of the Pharmaceutical Marketer

19 Brand Engagement at Point of Care Infoscripts delivers contextually relevant messages to HCPs at the point of prescribing Sponsor a medically relevant message embedded within erx application Place a four line text message with hyperlink to external sponsored site Deliver prescription discounts and coupons to pharmacies electronically Include links to mobile and desktop edetails, sample and rep requests and other calls to action

20 Example: eprescribing Related Messaging Enter medication name to be searched Click check box to select medication InfoScript appears after a medication is is selected

21 Integrated Coupon and Co pay Benefit Programs: Empower HCPs to help patients at the point of prescribing Brand X 30 day free trial View Offer Details Prescribing Information Apply Voucher/Co-Pay Compliance Offer(s)

22 Integrated Coupon and Co pay Benefit Programs: Empower HCPs to help patients at the point of prescribing Sent electronically to the pharmacy with the erx Brand X 30 day free trial View Offer Details Prescribing Information Apply Voucher/Co-Pay Compliance Offer(s)

23 Closing Cliff Notes Allscripts is the largest connected EHR and erx network is the United States HITECH is happening now with over 156,000 providers eprescribing in 2009 and 67% of all providers using an EHR today or planning on adopting EHR within a year MIPPA and HITECH are the incentives. Meaningful Use is driving compliance (operational and clinical) eprescribing and Mobile provider messaging and guidance tools are available from Allscripts today Clinical Decision Support Pilots within EHR are happening now

24 Questions?

25 Thank you!

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