E-Prescribing Implementation: Achievements and Future Steps for a 200-Bed Suburban Hospital

1. E-Prescribe: Adopting Health Care Information TechnologyADG associates presenting:Barbara AntunaJessica CarpenterPatrick EsparzaBrian Frazior

2. E-Prescribe Project Recap Summary so far…. ADG has been asked to consult for a suburban 200 bed hospital to help them implement E-Prescribing

3. So far we have examined… • Stakeholders • Business Case • Common workflow scenarios • Use of Standards • Information system requirements

4. Presentation Overview NOW we will look at: • Information Architecture • Origin of data elements • Flow of data sets between systems

5. Information Architecture • Fundamental system properties • Databases • Applications • Standards • Procedures • Information use and confidentiality policies • Hardware • Software • Networks

6. System Architecture – Pharmacy Information Exchange • Need to be able to integrate various data systems, such as medication distribution, billing, and inventory • Pharmacy Information Exchange certifies software to connect to pharmacies • Provides behind the scenes network that makes the exchange of new prescriptions and prescription renewals between prescriber and pharmacy possible. • Works to improve the prescribing process through a focus on safety, efficiency, and quality

7. System Architecture: Overview • Patient Demographics • Medical History Data • 2. Eligibility Data • 3. Formulary and Benefits • 4. Medication Data • 5. Fill Status Data • 6. Billing Data

8. System Architecture: Origins of Data • Patient Demographics • Medical History Data • 2. Eligibility Data • 3. Formulary and Benefits • 4. Medication Data • 5. Fill Status Data • 6. Billing Data

9. System Architecture: Origins of Data • Patient Demographics • Medical History Data • 2. Eligibility Data • 3. Formulary and Benefits • 4. Medication Data • 5. Fill Status Data • 6. Billing Data

10. System Architecture: Origins of Data • Patient Demographics • Medical History Data • 2. Eligibility Data • 3. Formulary and Benefits • 4. Medication Data • 5. Fill Status Data • 6. Billing Data

11. System Architecture: Origins of Data • Patient Demographics • Medical History Data • 2. Eligibility Data • 3. Formulary and Benefits • 4. Medication Data • 5. Fill Status Data • 6. Billing Data

12. System Architecture: Origins of Data • Patient Demographics • Medical History Data • 2. Eligibility Data • 3. Formulary and Benefits • 4. Medication Data • 5. Fill Status Data • 6. Billing Data

13. System Architecture: Origins of Data • Patient Demographics • Medical History Data • 2. Eligibility Data • 3. Formulary and Benefits • 4. Medication Data • 5. Fill Status Data • 6. Billing Data

14. System Architecture: Origins of Data • Patient Demographics • Medical History Data • 2. Eligibility Data • 3. Formulary and Benefits • 4. Medication Data • 5. Fill Status Data • 6. Billing Data

15. Data Flow: Patient Eligibility Eligibility Request and Respsonse

16. Data Flow: Medication Formulary and Benefits Information Formulary & Benefit Request and Response

17. Data Flow: Medication Request Prescription Request and Response

18. Data Flow: Medication History Medication History Request and Response

19. System Architecture Concerns Usability and Availability EMR upgrade in order to connect to Pharmacy Information Exchange Current EMR system creates limited need for additional workstations Security System functions will depend on prescriber level System will require HIPAA compliant secure login to access database Cost Cost of system upgrades will be agreed upon in vendor contract in advance of implementation Reliability System will have frequent upgrades to keep it operational System will be functional for at least 95% of the time Data Integrity System will back-up data frequently System will have data entry checks in place to prevent data error

20. System Architecture - Timeline