IOM 540: Managing Electronic CommerceDr. Sulin Ba

Dan Cabbell, Nancy Chetron, Jack Hedger, Felix Lin

University of Southern CaliforniaMarshall School of Business

December 7, 2000

Agenda

• The Product• Traditional Data Gathering• Market Analysis / Industry Competitors• Business Model Description• Value Propositions and Revenue Model• The Process• Web Prototype• Security / Privacy Issues• Conclusion

The Product

• Our group is an application service provider (ASP) for Medical Groups– Stores patient records– provides a means for retrieval– web based

• Primary Benefits: Automate BackOffice– billing– insurance– healthcare reimbursement– transfer patient records

• Revenue– Monthly service fee (Medical group), nominal transaction fee

(patient), insurance companies– Primary Customers - Medical Groups

Traditional Data Gathering Example

1 Prospective patient enters office and fills out two forms:

– Medical/ Personal background information form– Insurance Policy information form

2 Smaller offices without a database will file the forms alphabetically with thousands of other files.

3 After patient is examined or treated, a doctor will complete a write-up generally handwritten, illegible, and also filed along the other thousand forms.

4 Next visit, doctor will need to pull out files from cabinets.

5 For billing, insurance forms must be copied onto an insurance claim form and sent to insurance company.

Traditional Data Gathering - cont’d

• Problems with the Traditional Method– Clarification of question or data item– Unavailable data/unfilled data fields (these will

never get updated)– Misfiling– Illegible writing– Inefficiency - lots of copying by hand

Market Analysis

Situation• Consumer movement• Declining financial performance• HIPAA regulations• Increased Competition

“Traditionally the health industry has been a follower rather than a leader in the use of emerging technologies…health organizations are faced with a perennial capital crunch making them cautious, protective of current business practices and slow to adopt new technologies”

Market Analysis - cont’d

Issues• Who should maintain health records?• What types of services to offer:

– Emergency medical only– Full personal history maintained by consumer– Electronic medical record (EMR) version of physician

maintained record

• Who pays the price?

Market Analysis - cont’d

• Reduced admin costs

• Reduced scheduling time/cost

• Meets legal requirements of patient access to files

• No misfiled or misplaced charts

• Can email files to patients/doctors/insurance

• How to maintain a “lifelong record”

• Making a profit while keeping fees at level that market will bear

• Cost and length of time to change software, train staff, etc.

• Combining physician and patient input

• Security/privacy

Advantages of Electronic Records Challenges of Electronic Records

Information Flow

Dentist

Cardiologist

General Practitioner

Pediatrician

ERAttendant

Suppliers

Orthopedic Surgeon

HMO’s & Insurance

Companies

Patients

Applications

Database

• Doctors pay monthly subscription to gain access to applications

• Applications and data used to automate information flow with other doctors, insurance companies, suppliers and patients

Value PropositionsMedical Group

• Cost reductions– lower back office cost– Can focus on core competencies– tackles inefficiencies– No added cost of maintaining file

servers

• Lower back office “inventory”– reduced number of paper files – reduced cost associated with

maintaining them

Patient• Reduces information asymmetries• disintermediation• Convenience• records are easily transferred within or

external to the medical group• All patient information is available

Insurance Company• Reduced processing time• 24 hour access to patient info• Economies of scale in

processing due to ability to electronically sort info

The Office Process

First time Patient registers and is given a Pen Tablet to enter demographic and past medical history information.

Vital signs are taken and entered into the “electronic chart”

Nursing Assessment completed and entered using a “pen tablet”

Physician completes records andexamination notes, prescriptions, etcwith patient

• Reduce Data Entry Cycle Time

• Eliminate Errors

• Eliminate Redundancies

Patient Data Entry - Pen Tablet

• Patient enters data via a touch screen tablet

– Personal info– Insurance info– Medical history– Allergies, ...

• Patients enter initial data directly

– Eliminates non-valued added administrative tasks

– Reduces administrative cost

– Can also enter data prior to office visit via the web site

Prototype Web Site Demonstration

Use PDA for Data Entry and Downloading Appointments

Beam or download appointments to PDA in the office after appointments made, or from home

Name DateDr. Lin 12/14/00

Appointment

Security / Privacy Issues

• “Need to know” for access• Different levels of confidentiality• Ability to edit/delete info should be guarded• Audit trail of who accesses data• Patient access to records on timely basis• Patient ability to disclose own medical info• Patient ability to revoke disclosing info• No reselling of info• Current protections in place• Some evidence electronic safer than paper

Conclusion

• There is a need for MedicalRecords.com !• MedicalRecords.com can add value !• The technology exists to make it work !• The business can expand into other arenas within the

medical industry• Many issues, however, exist

– management must monitor and address