Compuware Covisint provides an innovative, on-demand technology framework that transforms healthcare information and access for members of United Physicians (UP). At 2,200 doctors, UP is Michigans largest physician group. In February alone, Covisint helped 5,000 physicians securely, efficiently and electronically process 1 million transactions for UP and its partners. 

Together, Covisint and UP offer a dramatic and transformational benefit to healthcare, changing the way physicians and other caregivers interact and transact business -- saving money while saving lives. Specifically, Covisint is helping UP achieve its goal of eliminating paper -- which is unsecure, inefficient, error-prone and expensive 

Healthcare expenditures, according to the National Coalition on Health Care, are expected to have risen 6.9 percent in 2008 and to grow to $4.3 trillion--or 20 percent of GDP--by 2017. Yet the industry remains more than 70 percent paper-based. The task of reducing and eliminating paper is massive at best, Herculean at worst. Healthcares only viable answer to this problem involves the widespread adoption of health information technology.

This effort is changing lives, most notably in the reduction in errors like adverse drug events (ADEs) that cause tens of thousands of avoidable deaths every year. Other critical savings include reductions in unnecessary inpatient hospitalizations due to missing patient information, in duplicative lab and radiology tests, in third-party data-sharing and in fraud. Through Covisints innovative and on-demand healthcare technologies, including those for ePrescribing, UP is achieving these benefits for its physicians and the patients they serve.

The cost savings to the industry are eye-popping. With widespread adoption of health information technology use, potential savings are estimated at one-third of the $2.2 trillion spent on healthcare annually. These savings will come from improvements in appropriate medication use and diminished adverse drug effects (ADEs).

Finally, on a societal level, Covisints chief security officer has actually testified to the U.S. Senate on ePrescribing, arguing that ePrescribing of controlled substances (currently illegal) is not only a good thing to do, but the only thing to do. As a result, a letter was signed by then-Senator Barack Obama and 18 other U.S. Senators, including Ted Kennedy, supporting Covisints position and encouraging the DEA to begin the process of changing the law, which is beginning to happen.

Covisint offers physicians a powerful concept: all the information they need at their fingertips -- conveniently and securely. With Covisint, the patient context and identity is shared across the doctors entire healthcare ecosystem. No longer do physicians need to learn all new systems with all new (and unique) passwords in a Rube-Goldberg complexity. Physicians may choose their own best-of-breed approach where everyone benefits, including doctors, patients, health plans and even society.

Covisint employs a technology-agnostic approach, enabling UP member doctors of varying technical sophistication to leverage the power of health information technology. Now, UP physicians can augment and keep their current practice management (and other) systems and simply connect to Covisint. With Covisint, physicians only need to sign-in once, with one user-name and one password from any web browser.  

The key for physician adoption is to focus on the workflow, where, ideally, different applications interact and behave as one. Once the identity has been validated, physicians are then freed to ePrescribe as well as share information, labs, consults, radiology reports and even interact among their own communities.  

Physicians also have traditionally been technology-averse, as evidenced by the fact that some 70 percent of healthcare is still paper-based. Many physicians cling to paper systems because of security concerns and because they simply dont have the time to learn several new technologies. 

Technology, for its part, never came up with a unified way to deal with all of that complexity. Rather, most solutions offered siloed approaches that solved isolated instances of the overall problem.  

Together, Covisint and United Physicians have improved public health and care delivery by being a simple, secure and relevant part of physicians lives -- shaping the future of healthcare with technology that serves the greater public good.  

Yes

Yes

Covisint provides benefits to the organization, to the individual and to society. By offering a more efficient, secure means for doctors to access and share the information they need to do their jobs, Covisint and UP provide better quality of care more cheaply.

From an organizational perspective, Covisint enables four key value propositions for operations, including 1) an agnostic approach leveraging the technology already in use; 2) identity management, meaning physicians need only log into their systems one time; 3) tight integration across applications and information; and 4) an existing software-as-a-service (SaaS) infrastructure. Covisints SaaS approach means that organizations dont need to purchase different and incompatible software solutions from different vendors, worry about HIPAA regulations and combat the other inconveniences of a do-it-yourself approach.

Individual advantages aggregated from information at the point of care include the: availability and portability of lab results; legibility of prescriptions; reduction in translation errors; protection against prescription alteration; ability to track appropriate usage of the medication; ability to create current medication lists and generate reports; prevention of medicine duplication; ability to employ software tools such as clinical decision support (CDS), providing alerts and reminders to the prescribing clinician; ability to capture the transaction digitally for sharing with other providers in standardized methods; providing of generic alternatives; speeding up the ability to renew medications; and the providing of electronic communication between the physician, pharmacy and patient.

Society benefits through the knowledge from aggregated data, while still protecting individual health information. This allows, for example, spotting of certain types of cancer in specific geographies since different types of medication trends can then be ascertained. Such information in turn, can be used by the Center for Disease Control (CDC) or other public/ governmental agencies to monitor and predict outbreaks, trends and other diagnostic and predictive data that benefits society.

United Physicians (UP) is the largest independent physicians association in Michigan with nearly 2,200 physicians and a very strong presence in Metropolitan Detroit. Group physicians practice at multiple hospitals and participate in numerous health plans. Early in its history, UP leadership decided that healthcare information technology (HIT) would be a necessary and strategic component its business. An attempted electronic medical record (EMR) roll-out to all UP physicians hit a roadblock, however, when physicians resisted and were very slow to adopt technology. This was due to the same reasons that other EMR rollouts have failed: cost of the product, decreased patient volume for 6-12 months, and the disruptive nature of the technology.  

UPs next foray into health information technology (HIT) was to utilize an IPA-wide secure portal framework for member physicians to facilitate the exchange of information and to assist physician transition into HIT. At the same time, UP agreed with a local health plan to roll out ePrescribing program aimed at decreasing the use of non-formulary medications and promoting use of generic medications. A portion of the funding from the health plan was provided up front, which helped to offset the costs of the ePrescribing solution and the portal.

Although the disruptive nature of ePrescribing is generally much less than full-featured electronic medical records (EMRs), it became very apparent that adoption was going to be slow. This may have in part been due to the previous EMR attempt, as well as the general barriers to adoption. However, as the ePrescribing product was being deployed, it became acutely evident that a major hurdle was the enormous amount of time necessary to enter patient demographic and medication history before it could be used for the first time for any given patient. It often takes practices six months or more to attain a critical mass of patients who have been entered before many of the potential efficiencies are achieved. As a result, physicians were very hesitant to sign up. This is reflected in the number of users brought on in the first year of rollout; of the nearly 2,000 member physicians of UP, as of May 2007, only 87 physicians had signed up.

In July of 2007, United Physicians tried an innovative approach to increase provider adoption; incorporate the ePrescribing tool into their portal and integrating it with the practice management system. Now, the physician was able to look up a patient in the portal, and from the patient dashboard launch into the ePrescribing software without having to provide a login and password. This was achieved while maintaining the patient context, and having the patient demographic information uploaded into the ePrescribing software, thus minimizing disruption. As a result, provider adoption increased significantly. Overall Generic Prescribing Rate (GPR) has increased from an already very good 62% to 69%, enabled by Covisint technology.

United Physicians now benefits from a more efficient workflow without many of the previous barriers to ePrescribing adoption. Physician buy-in has the potential to be greatly enhanced, but perhaps more importantly the resulting efficiencies in workflow actually make it quicker to write prescriptions. This promotes higher utilization of the application which is necessary to achieve many of the benefits of e-prescribing as a whole.

Never before have United Physicians, physician associations elsewhere and doctors across the entire nation had so much potential to eliminate a major problem so exhaustively in such a short amount of time. In addition to saving lives, there are also significant cost savings and efficiencies for UP physicians and their patients.  

With any form of health information technology, the argument always circles back to adoption. And, to improve adoption, there is a simple solution to a seemingly complex problem: follow the money.

When segmented out into the key players, the challenge with funding this change comes into focus. To doctors, free isnt cheap enough. Patients obviously dont want to pay for the privilege of funding the change since taking a piece of paper from the doc was free before.  

Using the conservative assumption that a physician writes 6,000 medications per year, a 10 percent increase in generic prescribing at a cost-differential of $80 per change from brand to generic medication, can save employers and health plans $48, 000 per year per doctor. ePrescribing is a stimulus package in and of itself.

For individual patients with no prescription coverage, the difference between brand and generic prescriptions would save them $948 annually. And, for a person on four medications (which is very common), the annual savings would run between $480 to $1,440. Finally, with the ability to do mail order for three-month supplies, the savings are even greater.

Physician adoption of technology has been the traditional barrier. New applications and systems can be disruptive technology to physicians, physician assistants, nurse practitioners and pharmacists because they are rarely fully integrated with the rest of the physicians application suite. Additionally, since physicians are so busy, they require an easy-to-use method involving little to no training and a speedy time-to-benefit ratio -- all of which Covisint provides. 

In a stand-alone mode, workflows change to accommodate duplicate patient data entry applications (patient demographics, formulary, and eligibility). As a result users who try stand-alone applications become less efficient, and choose to revert to the environment where they are most comfortable  what they have used before.

Physicians have been slow to adopt, specifically, because of basic barriers that include the cost of buying and installing a system; time/workflow impact; the need to login to a stand-alone system with patient search; loading demographic, medication and allergy information for each new patient; the updating of demographics and insurance information when any changes occur; the lack of reimbursement for costs and resources and the fact that new technology is not an expected standard of care as well as unknown obstacles and barriers.

Exceeded

Since announcing its partnership with United Physicians, other healthcare organizations in Michigan and across the country were prompted to consider the benefits of on-demand, secure collaboration. Covisint has secured partnerships with Initiate Systems, CIGNA Healthcare, Georgia Department of Community Health, Olympia Medical systems, State of Minnesota, State of Tennessee, Michigan State Medical Society, Michigans Thumb Health Information System, Blue Cross of North East Pennsylvania, and the California-based VIP Health Initiative.  

Covisint also has acquired Hilgraeve for the quick, easy and remote onlining of physicians into the system, and also inked a deal with Microsoft and AT&T to form a national health information exchange. Microsoft also leverages Covisint to validate the identities of physicians logging into its Healthvault application.

Covisints technology is very sticky, meaning that once people become part of the system, they find it so valuable that going back to the old way of doing things just does not make sense. And, the American Medical Association is considering leveraging Covisint for its hundreds of thousands of doctors nationwide. 

Covisints origins are automotive, but its future is healthcare. The healthcare division of Covisint is growing at triple-digit rates -- faster than any other slice of the company --and healthcare will overtake automotive in this calendar year.

Covisint also has grown its customer base in healthcare significantly. Since 2004, the number of Covisint healthcare seats or users has grown from zero to 45,000, and the annual savings per physician is $40,000 - $50,000. Additionally, in the years 2006-2009, the number of Covisint member physicians has grown, respectively, as follows: 39, 318, 560 and 1500. The number of prescriptions has grown, respectively, from 24,000, to 284,400, to 702,550 to more than 1 million.