HIMSS Investor Briefing

McKesson Provider Technologies

2005 HIMSS Investor Briefing


Larry KurtzVice President

Investor Relations

Safe Harbor Clause

Some of the information in this presentationmay constitute forward-looking statements

that are subject to various uncertainties and could cause actual results to differ

materially from those projected or implied. These uncertainties are described in the Company’s reports and exhibits filed with

the Securities and Exchange Commission.


Pamela PurePresident


Redefining Success

To make healthcare safer, it takes:• More than software• Broadscale adoption of technology • Joint accountability• Making every dollar count

More Than Software:McKesson Provider Technologies

More Than Software:Medication Safety Solution

Packaging Automation

SoftwareDistribution

More Than Software:Undisputed Leadership in Medication Safety

Inpatient• 44M scanned bedside meds annually• 400,000 warnings issued weekly• 56,000 errors prevented weekly• Considered more often than any other vendor (KLAS)

Ambulatory• 80,000+ e-prescriptions/month and growing• McKesson in top three for MD office e-prescribing• Connectivity to PBMs, retail pharmacies

More Than Software:Innovative Solutions and Technologies

Horizon PatientVision McKesson Telehealth Advisor

Introducing… CarePoint-RNTM

•“All-in-One” tool for nurses–Lightweight and portable–Meds, supplies and clinical systems

travel with the nurse–Two patient medication container

options• Drawers• Envelopes

–Links McKesson clinical software with automation technologies

Broadscale Adoption:More Value, Faster Value

• Drive value for clinicians– HorizonWP Physician Portal – 1.3M logons per month,

15-minute training time– Medical and document imaging – Horizon Expert Orders – 200 beds live in four months

at Duke University Hospital; 96% of orders placed by physicians

• Speed time to value– McKesson QuickStart for medication safety– IASIS - rapid implementation model across 15

hospitals

Broadscale Adoption“Surround” Strategy

DocumentDocumentImagingImaging

MedicalMedicalImagingImaging

Physician Portal

Medication Safety

Medication Safety

CPO

E/CD

SC

POE/C

DS

Existing ITSystems

Broadscale Adoption: Connect the Physicians

HospitalHospital

PortalPortal

PhysicianPhysicianPracticePractice





Joint Accountability

• Senior executive “top down” commitment and involvement

• McKesson Project Management Office • Joint governance

– Project plans with agreed-upon milestones– Weekly / monthly / quarterly assessments of progress

• Monthly executive “dashboard”

Communication, communication, communication

Joint Accountability:Centra Health Program Summary

ExecutiveProgram Sponsors

Program Management Office (PMO)

Clinical Informatics Information Services Financial Informatics

Physician UserGroup

Program Steering Committee

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 282004 2005 Integrated Testing 2006April May June July Aug Sept Oct Nov Dec Jan Feb March April May June July Aug Sept Oct Nov Dec Jan Feb March April May June July Aug

EC 2000 Remittance

Path Fin Mgmt(GL/FA) PFM (GL/FA)

Horizon Care Record

Messaging

Horizon Order Management HED (Rollout to CC and Med Surg)

Rounding

Horizon Expert Orders ..to M36

Clin

ical

Upg

rade

Horizon Meds Manager/Order ScanningAdminRX

Pathways Healthcare Scheduling

STAR Upgrade

HPF HBF Upgrade

Compliance Advisor

STAR - ADT, PA, MR. RWS, Acct ExpressStmts

Horizon Pat Folder/Horizon Bus Folder (MR, BO)

Passport Standalone Passport POS

HAC Lab OutreachHorizon Radiology

Alerts

Horizon Expert Documentation

Denials and AppealsPCON w/NDC

HPM (Financial Decision Support/Budgeting)Horizon Business Insight

DenialsClinical Infrastructure

PCON w/STAR (inc. 1500's)

Pathways Interface MgrSecure Remote Access

Horizon OnePass

ED Tracking BoardPhysician Portal

Making Every Dollar CountTechnology and Service Innovation

• LINUX• Clinical continuity and

disaster recovery solutions

• System optimization• Customer certification• Lean Six SigmaInstallationInstallation

OptimizationOptimizationServicesServices

OperationalOperationalImprovementImprovement

ValueValue

Redefining Success from the Customer’s Perspective

• Duke University Hospital, Durham, N.C.– Mike Russell, M.D., Associate Chief

Information Officer• Presbyterian Health Services,

Albuquerque, N.M.– Mark Reifsteck, Senior Vice President, Chief

Operating Officer

Optimizing Clinical Workflow

Mike Russell, M.D.Associate Chief Information OfficerDuke University Health System and

Medical Center

IT Focus at Duke

• Patient Safety – top priority• Bridging Academic and Community Medicine• Increasing collaborations with technology as an

enabler• Information accessibility and stability• Defining technology with a focus on process,

workflow and ease• Providing technological solutions that are safe,

efficient, and effective

Looking at the complete picture

CPOE Value – Clinical Decision Support System and Workflow Logic

• Incorporating evidence-based best practices and optimized workflow logic into the CPOE product– Development of rules and alerts to prevent errors– Critical rules for all services versus clinical service / clinical

department specific rules - standardization– Integration of rules across various vendors and ancillaries– Proactive decision support, as well as retrospective– Data capture for overrides and tracking– Tracking clinical outcomes – Deployment platforms – desktop, mobile, wall-mounted– Desktop Integration– Zero Data Loss back-end– High Availability back-end

CPOE--A Unique Development Approach

McKesson – Duke RelationshipCPOE DevelopmentCPOE Development

Life Cycle

Analysis

Design

Programming

Testing

Implementation

Evaluation

Implementation

Eval

uatio

n

AnalysisDesign

Programming Eval

uatio

n

AnalysisDesign

Programming Eval

uatio

n

AnalysisDesign

Programming Eval

uatio

n

AnalysisAnalysisDesignDesign

ProgrammingProgramming

Eval

uatio

n

AnalysisDesign

Programming Eval

uatio

n

AnalysisDesign

Programming Eval

uatio

n

AnalysisDesign

Programming Eval

uatio

n

AnalysisAnalysisDesignDesign

ProgrammingProgramming

Traditional Systems Traditional Systems Development Life Development Life

Cycle

Life CycleCycle

Swift Deployment

• CPOE is currently live on 260 beds in Duke North: – 79 Cardiology + CCU – 78 General Medicine + MICU – 33 Pulmonary / Renal + MICU Stepdown– 70 Oncology + BMTU (as of Feb 14 & 15)

Cumulative Orders by Order Category

1-Sep-04 1-Oct-04 1-Nov-04 1-Dec-04 1-Jan-05 1-Feb-05 1-Mar-05

Cum

ulat

ive

Num

ber o

f Ord

ers

Transcribed or Protocol = 1.4%

Verbal or Phone Order = 2.6%

Directly Entered = 96.0%

The initial CPOE Go-Live was on Sept 28, 2004 on N71. The dates demarcate the number and location of beds live on CPOE. The vast majority of orders are entered directly into CPOE. A small percentage are entered as Verbal Orders. A smaller percentage are transcribed from hand-written orders as part of the go-live conversion process or entered by nurses as part of a clinical protocol.

4 beds8 beds 31 beds 43 beds

63 beds79 beds

157 beds

190 bedsN81 - Gen MedN83 - Gen Med

N82 - MICU

N78 - Pulmonary

N72 - CCU

N73 - CardiologyN71 - Cardiology

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

0

0

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000


Cum

ulat

ive

Ord

ers

Nurse Practitioner = 5.5%

Physician Assistant = 6.1%

Attending = 6.1%

Housestaff = 82.3%

Most CPOE orders are entered by Housestaff. However, a significant number are also being entered by Attendings, PAs, and NPs.

4 beds8 beds 31 beds

43 beds63 beds

79 beds

157 beds

190 bedsN81 - Gen MedN83 - Gen MedN82 - MICU

N78 - Pulmonary

N72 - CCU

N73 - Cardiology

N71 - Cardiology

Cumulative Orders by Clinician Category

Number of Clinicians Using CPOE Weekly

0

50

100

150

200

250

300

350


Num

ber o

f Clin

icia

ns

Registered NurseLicensed Practical NurseAttendingPhysician AssistantNurse PractitionerHousestaff

N81 - Gen MedN83 - Gen MedN82 - MICU

N78 - Pulmonary

4 beds

8 beds

31 beds

43 beds

63 beds

79 beds157 beds

190 beds

N72 - CCU

N73 - Cardiology

N71 - Cardiology

This graph shows the number and type of clinicians using CPOE on a daily basis. The number of clinicians of all types remains fairly stable based on the number of beds. Variability is mainly determined by weekends and holidays. The hospital units and cumulative number of beds live on CPOE are also shown.

Cumulative Number of CPOE UsersCumulative Number of CPOE Users

0

100

200

300

400

500

600

700


Num

ber o

f Use

rs

Housestaff = 150

Attending = 48HUC = 27Pharm = 26PA = 14Resp = 13

Diet = 3LPN = 7NP = 7

Cumulative Total = 564This graph shows the cumulative number of clinical personnel who have entered orders via CPOE. These clinicians do not necessarily use CPOE on a daily basis.

Housestaff and Attendings rotate on and off of a service. PAs, RNs, LPNs, Health Unit Coordinators, Respiratory Therapists, Pharmacists, and Dieticians usually stay on a specific service, but have a rotation schedule over time with others.

The hospital units where CPOE has been activated, and the cumulative number of beds, are also shown.

RN = 269

4 beds

8 beds

31 beds

43 beds

63 beds

79 beds

157 beds

190 beds

N78 - Pulmonary

N72 - CCU

N73 - Cardiology

N71 - Cardiology

N81 - Gen MedN83 - Gen MedN82 - MICU

CPOE Order Sets in Clinical Production (as of 02/01/05)

Adm

issio

nDi

seas

e M

anag

emen

t

Wor

kups

Prot

ocol

s &

Care

Map

s

Stud

ies

Proc

edur

esCo

mm

on L

ists

Disc

harg

eLa

bora

tory

Stu

dies

Imag

ing

Stud

ies

Beds

ide

Proc

edur

es

Trea

tmen

tsM

edica

tions

- G

ener

al

Med

icatio

ns -

IDO

ther

Tota

l

Cardiology 4 4 1 3 4 9 1 1 3 30Endocrine 4 4Gastroenterology 2 2 2 6Heme-Coag 3 3Infectious DiseaseGeneral Medicine 3 2Nephrology 1 1 2Neurology 2 1 2 5OncologyPsychiatry 1 1 2Pulmonary 2 1 1 1 1 2 1 9Rheumatology 1Cardiothoracic Surgery 1 1NeurosurgeryGeneral SurgeryOrthopaedicsPlastic SurgeryOHNSOphthalmologyUrologyRadiologyPain Management 1 1 2General 1 2 1 11 2 5 17 3 5 47

Total 9 12 8 4 7 12 5 1 11 2 12 8 18 3 5 117

Red denotes Order Sets completed and put into service within the past month.

Order Entry Benefits

Benefit Manual Clerk Physician End to End

Patient Safety

Timely Processing of orders

Order Context Information

Online Decision Support

Downstream Decision Support

Utilization Management

Targeted Benefits

• Patient Safety & Quality Improvement– Evidence Based Medicine

• Cost Savings– Clinical standardization

• Increased Productivity– Complete clinical adoption

• Improved Communication– Complete orders interfaced to ancillaries

• Compliance with JCAHO and CMS– Process and nomenclature standardization

Partnering with McKesson

Mark ReifsteckSenior Vice President, Chief Operating

OfficerPresbyterian Healthcare Services

Presbyterian Healthcare Services

Presbyterian Healthcare Services

• New Mexico’s largest care provider for 95 years• Two hospitals in Albuquerque, five rural• State’s largest health plan with HMO,

indemnity, Medicaid, Medicare Advantage• State’s fastest-growing employed physician

group with 300+ physicians, 30 practice sites• Modern Healthcare’s Top 10 for integration• State’s highest quality award, Zia• Top 100 “Most Wired”

What are we trying to achieve?

• “Three Things”–Malcolm Baldrige Quality Award – continuously improve

processes to produce nationally excellent clinical, service and business results

• Earned New Mexico’s highest quality award, Zia, in 2004

–Top 10% in Patient Safety – create safest possible environment for those who place their trust in us

• Dramatic reduction in medication errors–“AA” Rating – control expenses while growing our

business to sustain positive financial performance and to fund excellence

• Achieved in 2004

What does this mean day-to-day?

• Integrating the patient experience, from physician office to inpatient and back home

• Controlling our costs so that our customers can afford our care

• Creating a “high-reliability” organization with standardized, safe delivery of care

How does McKesson help us do this?

• Automation to drastically reduce medication errors– ROBOT-RxTM

– Horizon Admin-RxTM

– Horizon Meds ManagerTM

– Drove 80% reduction in medication errors


• Helping us control costs– Managing our supply chain with efficiency

• Expenses 15.6% of net revenue — industry benchmark

• Approximately $7M in savings over last five years• In 2004, an additional $1.5M in new savings

– Solving late starts in operating rooms with McKesson consulting

• 55 additional surgical cases/month, $2.4M annually in new revenue

– Capturing and charting all medications• $3.8M annually in new captured revenue


• Helping us integrate our business and clinical functions

Web SolutionsHorizonWP Physician PortalHorizonWP Patient Portal Horizon MobileCare Rounding

Resource Management SolutionsHorizon Surgical ManagerPathways Healthcare SchedulingHorizon Passport (EMPI)Pathways Materials ManagementSupplyScan (inventory management)

Revenue Cycle SolutionsHealthQuest Patient AccountingPathways Contract ManagementStatement AdministratorReal-Time Eligibility

Clinical ProductsROBOT-Rx and Pak-PlusHorizon Admin-RxAcuDose-RxHorizon Order ManagementHorizon Expert OrdersHorizon Clinical DocumentationHorizon Meds ManagerHorizon Ambulatory CareHorizon Care RecordHorizon Emergency CareHorizon Medical ImagingHorizon Radiology ManagerHorizon LabHorizon Homecare

Partnering with McKesson

From the earliest days of our partnership, we have expected McKesson to be “in the room”with us as we care for patients

Breakout Sessions• Ambulatory

–Brian Schatz, Chief Operating Officer Medical Associates, Dubuque, IA

• Medication Safety–Tom Smith, Admin. Director of Oncology/ Pharmacy

FirstHealth / Moore Regional Hospital, Pinehurst, NC• Enterprise Imaging

–Steve Stanic, Chief Information Officer Memorial Health System, Savannah, GA

McKesson Ambulatory Strategy

Michael FillionVice President

Ambulatory Solutions

Medical Group Practice Market Segments

SEGMENT Segment Size Total buying entities (Groups)

Projected Segment IT Spend – 2008

15,57415,574

2,9892,989943943241241

10481048

$804.5M$804.5M

$960.1M$960.1M$813.4M$813.4M

$1,866.9M$1,866.9MMGPs 100+ PhysiciansMGPs 100+ Physicians 66,784 MDs66,784 MDs

$2,449.0M$2,449.0M

MGP*s 3MGP*s 3--10 Physicians10 Physicians 74,108 MDs74,108 MDsMGPs 11MGPs 11--25 Physicians25 Physicians 43,781 MDs43,781 MDsMGPs 26MGPs 26--99 Physicians99 Physicians 41,558 MDs41,558 MDs

IDNIDN--owned practices & owned practices & AMCsAMCs 98,950 MDs98,950 MDs

* MGP = Medical Group Practice* MGP = Medical Group Practice

Sources: POMIS Report 2004; DatamonitorSources: POMIS Report 2004; Datamonitor

Ambulatory Market Dynamics: Our View

Advancing MedicalAdvancing MedicalTechnologyTechnology

Changing MDChanging MD--Hospital relationsHospital relations

Economic issues Economic issues for MDsfor MDs

““Patient migrationPatient migration””

Focus on chronic Focus on chronic disease managementdisease management

UnprecedentedUnprecedentedFederal ImpactFederal Impact

Shift

ing

Dyn

amic

s in

Am

bula

tory

Car

e

More incentives, standards for EMR & More incentives, standards for EMR & eRx adoptioneRx adoption

Continued growth of ASCs, Diagnostic Continued growth of ASCs, Diagnostic Centers, Centers, ““PHOsPHOs””

Fewer 1Fewer 1--2 MD practices; Fewer major 2 MD practices; Fewer major standalone groups standalone groups

Focus on total patient experience as Focus on total patient experience as competitive differentiatorcompetitive differentiator

PayPay--forfor--performance linked to quality performance linked to quality measuresmeasures

Resulting Market Trends

McKesson’s Solution Portfolio for Ambulatory Care

– Disease management– Patient Web Portal– Patient Education solutions – Electronic Health Record

– Financial & Administrative

– E-Prescribing– EDI Connectivity– PACS– Inventory Management

– Retail pharmacy automation– E-Prescribing connectivity

Pharmacy Services– Medical-Surgical supplies– Capital equipment– McKesson Brand

solutions

Supply Solutions

Patient-centered Solutions

Information Technology

– Distribution services– Specialty pharmacy

services– Reimbursement services– Clinical support programs

Specialty Pharmaceuticals

Strategic Initiatives: MD-Hospital Relationships

Via PortalVia Portal••OutreachOutreach

••Complete EMRComplete EMR

••EE--prescribingprescribing

••Practice ManagementPractice Management

••Other servicesOther servicesHospitalHospital(McKesson IT (McKesson IT

Solutions)Solutions)

Physician Practice

Physician Practice

Physician Practice

Physician Practice

Physician Practice

E-PrescribingPhysician writes Physician writes

electronic scriptelectronic script

E-Prescribing

PBMPBMConnectivityConnectivity

Return:Return:Patient eligibility informationPatient eligibility informationPatientPatient--specific formularyspecific formularyMedication HistoryMedication History

E-Prescribing

Send:Send:Electronic Electronic

PrescriptionPrescription

Retail Retail PharmacyPharmacy

ConnectivityConnectivity

Receive:Receive:RenewalRenewal

requestrequest

E-Prescribing

PBMPBMConnectivityConnectivity

Retail Retail PharmacyPharmacy

ConnectivityConnectivity

McKesson’s Leadership Position

Breadth of SolutionsService Excellence• Supply solutions

• Information technology

• Consulting and clinical support

• Solutions for physician practices, ambulatory centers, & patients

• 99% customer satisfaction in specialty pharmaceuticals*

• 98% customer satisfaction in physician practice I.T.*

• Highest customer satisfaction in primary care medical-medical-surgical supply*

Scale & ResourcesExperience & Knowledge• Hospitals / IDN’s

• Over 500 account managers focused on ambulatory surgery & primary care

• 12 Distribution Centers Nationwide serving ambulatory customers

• 50 years’ experience serving the ambulatory market

• Over 40,000 ambulatory customers nationwide

• Savvy clinical, administrative, process management, and financial experts

* Based on independent customer surveys

Physician Adoption of EHR

An Update on Status of McKesson Horizon Ambulatory Care Roll-out,

Physician Adoption and Early Results at Medical Associates Clinic, P.C.

Leading the Way to Leading the Way to Better HealthBetter Health……

Location

Medical Associates Clinic

• Oldest multi-specialty group in Iowa - c.1924• Privately owned, for-profit; 83 shareholder physicians• 140+/- revenue producing providers

– (MD, PA, NP, DPM, PT, Audiology)• 30 Specialties, including ancillary services• 40,000+ member health plan; ambulatory surgery and

occupational medicine joint ventures • 210,000 population service area - 60 mile radius• Total patient visits: 540,000 - CY 2004

MA Core Values

• Above all else, provide high-quality care• Always exceed service expectations• Be the recognized leader in healthcare for the Tri-State

area• Treat everyone with compassion and respect• Teamwork among physicians, staff, patients and

customers• Achieve financial success through motivated, innovative

and hardworking people

Why EMR?

• A strategic opportunity, not a financial crisis– “Be the recognized leader in healthcare…”

• Improve quality of care through evidenced-based practice and better processes

• EMR will become the standard – “when, not if”• Improve coordination and communication throughout the

medical group• Administrative efficiency and cost savings• Make the strategic financial investment while we are able

Financial Return on Investment Approach

• Stop using the paper record– “Age” paper chart (not start “paperless”)– Eliminating chart pulls and transportation– Default to electronic clinical information for

patient care• Reduce transcription expense (dictate less)• Grow encounter revenue (code better)

eMac Project High-level Goals

• High physician adoption (ideal goal: 100%)• Minimal reduction in physician productivity while

implementing; no reduction long-term• EMR integration with legacy systems, including practice

management and lab• Group-wide implementation over 2-3 year period• Achieve a 6-year return on financial investment

Full Implementation – Incremental Annual Operational Income Impact

Software MaintenancePC Replacement

IT/User Support StaffDepreciation / Big Box

Additional RevenueAnnual Savings

Net Income Impact

($200,000)($100,000)($200,000)($100,000)$500,000

$1,888,946$1,788,946

Early Results

Ambulatory EMR Progress-to-Date*

* As of February 11, 2004

• Implementation began July 1, 2003 with one physician • Using a phased approach:

– 96 providers in 25 specialties live on E-prescribing module

• 25,000 e-prescriptions monthly– 53 providers in 12 specialties live on Orders

and Results module• 4,200 diagnostic e-orders monthly

– 21 providers in 4 specialties live on Documentation/Charting

eMac Specialties & Clinics

• Acute Care (emergent / urgent medicine) (4)

• Adolescent Medicine (1)• Allergy (2)• Audiology (1)• Cardiology (5)• Cardiovascular & Thoracic

Surgery (2)• Dermatology (3)

• Family Practice (26)• Gastroenterology (2)• Infectious Disease (1)• Internal Medicine (16)• Neurology (3)• Obstetrics & Gynecology (7)• Occupational Medicine (2)• Occupational Therapy (2)• Oncology (4)• Ophthalmology, Optometry (7)

eMac Specialties & Clinics

• Orthopaedic Surgery (5)• Otolaryngology (2)• Pediatrics (10)• Physical Medicine &

Rehabilitation (2)• Physical Therapy (7)• Podiatry (2)• Pulmonary Medicine (1)

• Psychiatry & Behavioral Medicine (9)

• Rheumatology (2)• Sports Medicine (2)• Surgery, General (5)• Urology (2)• Women’s Health (1)

Electronic Prescription Volume

eMac Prescription Volume Trend

0

5,000

10,000

15,000

20,000

25,000

30,000

Jul-0

3

Aug

-03

Sep

-03

Oct

-03

Nov

-03

Dec

-03

Jan-

04

Feb-

04

Mar

-04

Apr

-04

May

-04

Jun-

04

Jul-0

4

Aug

-04

Sep

-04

Oct

-04

Nov

-04

Dec

-04

Jan-

05

Month

# of

Rx Fax

PrinterTotal

Nursing Productivity

Preliminary Transcription $ Savings

• 21 physicians and providers on Documentation / Charting (as of 2/11/05)

• 40%-80% dictation reduction in first 2 weeks– Several individuals > 90%– Long-term reduction target of >75%

achievable– Voice recognition pilot / March

“Stop Moving the Chart” Savings

• Approximately 10% year-over-year savings in Medical Records staffing expense as of 1/2005

• Scheduled 43% Medical Records staffing hours and expense reduction by end of 3rd Qtr 2005. $580,000 annually.– Initial savings from not maintaining paper

chart “redundancy.”– Additional savings will accrue as patients are

seen “chartless”.

Why McKesson?

• Ambulatory EMR product best compared to available• Collaboration with McKesson on further product

development – value in this relationship• Single vendor IT strategy: Clinical, Administrative, Imaging

What’s Next?

• Full EMR deployment– Ensure administrative gains– Pursue enhanced quality management

• Full PACs deployment with EMR/PACs integration

Enterprise Imaging

Jay DeadyVice President


McKesson’s Imaging Solution Overview

• Enterprise document imaging

• Enterprise medical imaging

• Common enterprise image access

• Common enterprise storage

• EHR framework

Enterprise Document Imaging

Horizon Patient FolderHorizon Business Folder

(Document Repository)



• Focused on:– Medical Records / HIM– Patient Accounting– Registration – Human Resources

• Market leader with 57% share• 30,000+ physician logons daily• 4B document images• 120-150 day implementation

Enterprise Medical Imaging

Horizon Medical ImagingHorizon Radiology Manager

(Medical Image Repository)



• Focused on– Radiology– Cardiology– Ultrasound

• Contract volume doubled, vs. last year

• 700 facility installations• 15M radiology exams/year• 2B medical images• 90-120 day implementation

Common Enterprise Image Access

HorizonWP Physician Portal(Enterprise Access)


• More than 1.3 million HorizonWP Physician Portal logons per month

• Physician training in under 15 minutes• Over 430 facilities are using the portal today• 90-120 day implementation

Common Enterprise Image AccessHorizonWP Physician Portal

(Enterprise Access)HorizonWP Physician Portal

(Enterprise Access)

Documents• History & Physical• Discharge Summary

• Discrete Data• Lab• Vitals—I & Os

Medical Images

An EHR Framework











Advanced Clinical SolutionsAdvanced Clinical SolutionsAdvanced Clinical Solutions

Enterprise Hardware and StorageEnterprise Hardware and StorageEnterprise Hardware and Storage

Steve Stanic

VP of Information Systems/ CIOMEMORIAL HEALTH

UNIVERSITY MEDICAL CENTER

Memorial Health Profile

• Three hospitals600 bed medical Center – Savannah, GeorgiaTwo small, rural hospitalsServicing 50% of Savannah and 50% of rural Georgia & South Carolina

• Largest integrated delivery system in Southeast Georgia• Teaching program• 4,000 employees• Various awards as “Best Hospital” for clinical operations

J. D. Power Award for Excellent Patient Experience“100 Most Wired” Health Systems four years in a rowFortune “100 Best Places to Work” winner

• Financial operations$550 M of net revenue

The Memorial processto gain adoption

• Step One: Understand the technology potential• Step Two: Know your user community and where the

quick wins lie• Step Three: Keep the look and feel of the technology

simple• Step Four: Institute a strong technology governance

structure– Heavy senior leadership involvement– They are driving most of the change that technology

enables

Quality Results…

• Through adoption of electronic medical record, clinical data repository and picture archiving communication system (PACS), clinicians now have:– Access to 98% of all available clinical information– Alerts that check allergies and adverse medication

reactions– Access to this information anytime anywhere

• 75% reduction in sentinel events• $10M in savings from technology implementation coupled

with our Error Prevention Program• Streamlined order entry process for nurses and physicians

Cost Reduction and Revenue Improvement

• PACS – Savings of $850K per year due to eliminated film in

radiology• PACS and Electronic Medical Record

– Annual salary savings of $805K• Physician Portal

– 35% increase in physician referrals• Increase in team member satisfaction from 3.85 to 4.25

Next Steps

• Foundation is in place• Continue building the base• Introduce CPOE and clinical decision support

McKesson Medication Safety Advantage

Billie Waldo, MS, RN, BCVice President and General Manager

Medication Safety Solutions

McKesson Differentiator

McKesson is the ONLYsingle-source provider of integrated software, automation, packaging, distribution and consulting services that help organizations prevent medication errors and improve efficiency across both the supply chain and clinical process.

McKesson Differentiator

Innovation Track Record

Bar-code scanning with computer-generated MAR

Robotic drug dispensing

Clinical data repository with rules-driven monitoring alerts

Smart/mobile medication cart, Connect-RN

BPOC/Smart IV pump integration

1989 20001992 2004 2005

Market Drivers

• Mandates from:– Government– Regulators– Consumers

• Proof of Spending:– Cap Gemini 2005 HIT Spending– HIMSS 2004 Leadership Survey– Health Data Management 2004 CIO Survey

Market Opportunity

• Computerized Provider Order Entry– Clinical decision support– Only 4-12% of large hospitals claim some usage

• Bar-coded medication administration– Only 5% of hospitals scan bar codes at bedside– McKesson market share leader (est. 32%)

• Robotics– 80% of hospitals have centralized distribution– Only 8% use robotic dispensing– McKesson dominant player (est. 97%)

Results

University of Wisconsin Hospital & Clinics87% fewer medication errors

Methodist Medical Center50% fewer medication errors

Regional West Medical CenterMore time for nurses to focus on care

Concord Hospital80% fewer medication errors

ResultsDupont HospitalBar-code scanning of all inpatient medications

Presbyterian Healthcare Services80% fewer medication errors

Peninsula Regional Medical Center95% of medications robot dispensed

St. Vincent’s HospitalLegible, accurate MAR’s

Bottom Line

Issue 403,995 warnings and Prevent 55,776 medication errors

44 million medications are safely scannedat the bedside every year

Each week, McKesson customers

FirstHealth of the Carolinas: Medication Safety Strategies

Tom Smith, R.Ph., M.S Administrative Director Oncology/Pharmacy

Moore Regional Hospital Pinehurst, NC

First Health Moore Regional Hospital

Three-hospital systemSeven clinicsPrimary facility

400-bed community hospital26 nursing unitsSpecialties

CardiologyOrthopedicsComprehensive Cancer Center

FirstHealth Goals

• Protect our patients– Provide a comprehensive med safety

strategy across three hospitals

– Automate our system

– Optimize processes

– Measure outcomes

Choosing a Partner: Why McKesson?

• Comprehensive suite of products

– Integrated approach to medication safety

• Proven track record in the industry

• Leader in medication safety

FirstHealth’s Decisions

• Start with the patient

• Use hybrid approach

– Best of the best

• Integrate vs. Interface

FirstHealth’s Product Integration

• ROBOT-Rx• AcuDose-Rx cabinets• PakPlus-Rx packaging service• MedCarousel / FulFill-Rx (vertical shelving)• Horizon Admin-Rx• Horizon Clinical Documentation• STAR Pharmacy / Horizon Meds Manager• MedDirect (physician pharmacy order fax

management)

Outcomes

• Improved medication safety– Reduced missing doses

90%– Provided a bar-code

solution• Streamlined our medication

delivery system– Reduced time to fill meds

from 16 staff hours to 3– Decreased medication

order turnaround time by 85%

– Reduced pharmacy staff by 7 FTEs

Outcomes

• Dispensed 9 million+ doses error free

• Redeployed pharmacists– Saved $40K/RPh/yr

• 97% RPh retention• $500,000 anesthesia charges

recouped with cabinets in surgery suite

• Provided outcome data

Pearls of Wisdom

• It takes more than software • Integration is key • This technology pays for itself

HIMSS Investor Briefing

Economy & Finance

Transcript of HIMSS Investor Briefing