Horizon Ambulatory Care

2. Horizon Ambulatory Care Andrew Mellin, MD, MBA Product Manager August 14, 2001

3. At Kokomo Family Care, a clinic in Kokomo, Ind., many doctors no longer reach for a pen to write prescriptions or notes. Instead, they use a computer and software from McKessonHBOC, which have started to siphon away the sea of paperwork the small practice has been drowning in. Not only is there less chance of medication foulups or misplaced records, but the clinic has dropped nine employees whose sole job was taking care of paper--instead of patients. Time, APRIL 23, 2001 VOL. 157 NO. 16

4. Clinical Infrastructure Horizon Ambulatory Care A workflow centric, modular approach to clinical process automation and documentation Workflow Orders & Results Reports Prescription Writer Horizon Clinical Documentation

5. Key Differentiators • Full suite of software that can be deployed incrementally • 100% web-based to minimize deployment and management costs • A low cost solution to an expensive problem • Connectivity that allows two-way communication to core services • A set of customizable, embedded rules that follow the “natural” clinical workflow • An integrated component of Horizon Clinicals that leverages existing investments

6. Lab Orders • Enhances regulatory compliance • Real-time medical necessity checking • ABN printing where appropriate • Warnings for duplicate tests • Reduces expense due to correcting incomplete information on lab orders • Ask on order questions • Custom forms for tests • Accurate labels and requisitions • EDI transaction to LIS for order • Decrease costs by providing one system for all ambulatory lab needs • Physician office lab support • Multiple supplier support • Physician or Lab Tech order entry

7. Prescribing • Decrease prescribing errors • Provide real-time warnings for drug-drug, drug-disease, drug-allergy interactions and for exceeding maximum dose • Access to prescribing history • Generate legible scripts • Access to AHFS drug monographs • Decrease cost of renewals • Reduce need for chart pulls • Reduce need to call back pharmacy by faxing and sending prescriptions electronically • Manage risk for drug spend • Provide real-time warnings for formulary compliance • Increase generic substitution

8. Workflow • Provides core infrastructure for clinical messaging • Required component for other Care Manager Ambulatory modules • Not a stand alone module • Assures clinical tasks are routed to appropriate person as soon as available • Eliminates much of the paper-based messaging in office • Enhances administration of office practices through task status, history and audit trail

9. Case Studies Allina Medical System Kokomo Family Care

10. Allina Health System • Purchased 1000 physician licenses for Lab • Deployed in 50 clinics • Generates 1,000,000+ results per month (inpatient and outpatient)—all stored in Lab product • Reduced costs for laboratory • Allina reduced problem requisitions from 34% to <5% within 4 months • $1.25 paper vs. 50 cents electronic • Reduced calls to obtain results

11. Kokomo Family Care: Prescribing Workflow • 20 clinician primary care clinic • 370 calls / day • 206 (56%) related to Rx • Chart retrievals • 50% of Rx calls • adds 9-33 min • Rx messaging FTEs: • Phone nurse: 28 hr/d; MD 6 hr/d

12. Kokomo Family Care • After Horizon Ambulatory Care install: • Over 90% of prescriptions written on-line within 9 months • Saved 1.5 nursing FTEs and 3 medical record FTEs • Calls from pharmacies decreased by 42% • Formulary calls from PBMs decreased by 80% • $4,000 savingsper week in staff reductions • $10,000 savings per week in overall time reduction and efficiency improvements

13. Horizon Clinicals: A Foundation for the Future • Initial Release • Common, shared HL7 interface for ADT and Orders • Common Staff and Patient Information • Common hardware platform (IBM or HP) • Common software infrastructure and database (Unix and Oracle 8i) • Common logon and context sharing • Subsequent iterations in ER 7 • Shared Allergies & Medications • Common order items • Shared results

14. Horizon Ambulatory Care Summary • Proven track record • Benefits for all stakeholders • IDN • Physician • Patient • Demonstrated ROI • Solutions for owned and affiliated physician practices • Modular approach for flexibility and growth • One solution for acute and ambulatory needs

15. Product Demonstration