Group+Health+Experts

Team Contact Info Santiago Paz sp11j@my.fsu.edu 954 918 4652 Jeremy Singleton jcs10j@my.fsu.edu  954 816 1261 Andrius Sevcovas as12n@my.fsu.edu  561 313 7611 Mirza Gurda mg12f@my.fsu.edu 850 228 5230 Erich Marlowe eam10f@my.fsu.edu 954 778 9308 Matt Sarmiento ms12v@my.fsu.edu 407 947 3555

1. Problem

 * Main problem: prescriptions are largely paper-based and it drives up the costs in the health industry.
 * Other problem: using paper-based prescriptions is a hassle for both physicians and patients. Physicians have to write-out countless prescriptions for countless patients. Patients have to pick-up medicines using the paper-based prescription. If they lose it or misplace it, the process of getting it back can be problematic. Also, medical errors on the prescriptions could lead to more severe issues. Paper does not allow for electronic queries that will allow companies and doctors to do a recall on any potentially harmful medicines.

2. Evidence

 * Medical Group Management Association’s Group Practice Research Network study:
 * Key findings:
 * Paper-based prescription costs a practice approximately $15,700/year
 * There is an estimated 563,000 office-based physicians that currently prescribe medicines in the U.S.
 * $8.8 billion total worth of physician and staff time spent on the phone clarifying prescription information
 * The researchers found an astonishing 37 errors for every 100 paper prescriptions, versus around 7 per 100 for those who used e-prescribing software.


 * Surescripts research:
 * Key findings:
 * Estimated $50,000/year per practice spend on refills management
 * Practices on average, spend 4.78 to 4.92 hours a day managing refills
 * Prescribers on average, spend 1.84-1.88 hours a dayt


 * Medication Errors
 * 1.5 million Americans are injured annually by medication errors
 * Most errors are a result of miscommunication due to illegible handwriting, unclear abbreviations, unclear telephone/verbal orders, and fax-related problems.
 * From 1998-2005, serious adverse drug events and deaths more than doubled

3. Potential solutions
1) Solution 1: App that creates a system of paperless-prescriptions, convenient for both the physician and patients. 2) Solution 2: Prescriptions sent through email and printed at home at the patient's own expense. 3) Solution 3: Flash drives with patient information and their prescriptions to allow easy exchange between doctor, patient, and pharmacy.

4. Research on existing/alternate solutions tried by others

 * Surecripts E-Prescribing Services
 * "Allow physicians to ellectronically send prescriptions from their office to more than 64,000 retail pharmacies and six of the largest mail order pharmacies"
 * Electronic access to prescriptions and medication history for physicians
 * Allscripts ePrescribe Deluxe
 * Electronic prescription-sending system
 * Web-based access
 * Capability to be used on mobile devices
 * Access to drug reference library
 * One-click prescription printing, print up to four prescriptions
 * Ability for patient to upload data
 * Rcopia
 * Electronic prescribing system
 * Intended to increase physician productivity
 * Allows access to clinical decision support tools and patient medication history
 * Easy to read medication list for patients
 * Doctor has access to patient's formulary

5. Feasibility of each solution

 * 1) Solution 1: A prescription app could be useful and could save the industry a large amount of money. However, there are some concerns associated with this solution. First and foremost, there is always a sense of distrust and insecurity with users of such a system. Some users might be afraid their medical information is being shared with corporations for marketing purposes, or with the government. Secondly, the learning curve of an app is a big issue. Even though the developers will attempt to make the app as user-friendly and as easy-to-use as possible, some users, especially the older crowd, will still have trouble using it. For such a concern, the app needs some sort of user support system, which will obviously drive up the costs of this. Accessibility could be a potential issue because not everyone has a smartphone that supports app. But this could be solved by creating a web version of the application, as our group also suggested. If such is the case, the only accessibility issue would be users without computers and/or internet access. However, there are many benefits of the app as well. As mentioned, the app will make the lives of both doctors and patients easier and will save valuable time. The fact that paper will no longer be used for prescriptions will leave to reduced costs at all levels of the industry.
 * 2) Solution 2: An e-mailed prescription system would be attractive to most patients, since most people use e-mail anyway. Some problems that could arise from this system include hacking, theft or misuse of personal information, and user concerns such as privacy and security. In order for such a system to work as securely as possible, data would have to be encrypted during transmission and user validation and authentication would have to be strong and free of errors. Accessibility would mostly be an issue to users without computers or internet access. As far as usability goes, people who are not computer-savvy might have problems with this system, many might struggle with downloading attachments from e-mails or some people might have filters that automatically send the message to their junk/spam folder. Printing prescriptions would also be an issue for not only those people who don't know how to use technology well, but also those people who do not have a printer. This solution might also be counter-productive since it could increase the sales of paper and ink for printing.
 * 3) Solution 3: Flash drives are not only cheap, but they are easy to use and easy to carry around. Some users might love this option because it will allow them to keep a record of the medicines they take. Data from the USBs could also be used for medical research or for data analysis. This also solves the need for paper since all users (patients, doctors, pharmacists) would be editing or accessing the flash drive through the computer. The fact that flash drives are portable are a benefit, but it could also be a detriment. Many people may argue that they're easy to lose and losing it could be potentially dangerous since they will contain personal information. As with the other options, some users might find this method to be insecure and a violation of their privacy. Some might feel uncomfortable with having their information on a drive without any sort of encryption or password protection.

6. Chosen approach
Prescription App Basic App Information
 * Name: Meds 2 Go
 * Cost: Two versions, free and paid ($ 1.99). The free version has a limited number of prescriptions, while the paid version has unlimited prescriptions. The free version will have relevant advertisements (hospitals, medicines, etc). The paid version will be free of ads.
 * Audience: Available to any interested parties.
 * Concept: Web and Mobile App that allows user to enter his/her prescription information and have it sent to the pharmacy of their choice. Will then notify user when it is ready for pick-up.
 * Purpose: To make picking up prescriptions easy and convenient. Will reduce the need for paperwork.
 * Meds 2 Go works with a code-system. Every particular medicine is given a code by the pharmacy, which then sends a list of codes and medicine names to all physicians. When physicians prescribe the medicine, the patient is given the option of being given the code so that they can enter it in the app. Each user has his/her own username and password to sign in/out of the app. Once the user sends the code, it is sent to the pharmacy with the patient's information. The pharmacy notifies the patient via the app when the prescription is ready.
 * Potential issues of app:
 * Security- thousands, if not millions, of prescriptions will be processed through the app. Could create security concerns for users and doctors.
 * Privacy- some people do not like having personal information on an app
 * Learning curve- not all users are familiar with using applications. Some do not even have the resources to use them. It could take a significant amount of time before the app is widely used, especially among senior citizens who are not as efficient with technology.

8. Team workload and roles

 * Santiago Paz- designed the prototype; researched existing/alternative solutions; feasibility of each solution
 * Mirza Gurda- project completion timeline, researched evidence backing solutions, meeting minutes
 * Andrius Sevcovas- Meeting minutes, researched HIT system features.
 * Erich Marlowe- feasibility of each solution, initial evidence research
 * Matt Sarmiento- Final Solution, research on solutions
 * Jeremy Singleton- Next steps, researched existing solutions

10. Solution prototype


Meds 2 GO prototype: []

11. Final Solution
Group Health Experts has came up with with a mobile app called "Meds 2 Go" for an easier more efficient way to order prescriptions. With the rise of smart phone use around the world, Meds 2 Go can provide patients an alternative to paper prescriptions.

This app will be available on iOS, Android, and Blackberry devices. The cost is free for single prescriptions, but can upgrade for unlimited prescriptions for $1.99.

After a doctor visit, if a patient has the option to receive a paper prescription or receive a code for that prescription and enter it in the app. Once the code is on the app the patient can send that prescription to their local pharmacy. If one doesn't have set pharmacy, one can search for nearby pharmacy's. Once the prescription is sent to the pharmacy, the patient will choose a desired pick up time, then later be able to see the status on it to know when the prescription is ready to be picked up.

The Next Steps in completing this project will include the following:
> === ===
 * Determining the platform the Meds2Go Application
 * Conducting further research into the prescription process currently in place to better improve the app
 * Build a beta version of the mobile app and have it tested with the local hospital Tallahasee Memorial HealthCare.

13. Citations
Sources consulted:

[|__http://www.surescripts.com/media/536872/theproblemwithpaper.pdf__]

[|__http://healthitsecurity.com/2013/05/22/mobile-healthcare-application-development-security-implications/__]

[|__http://www.nytimes.com/2012/04/29/business/e-prescriptions-reduce-errors-but-their-adoption-is-slow.html?_r=0__]

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