Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
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CUSTOMER-CENTERED PHARMACEUTICAL PRODUCT AND
INFORMATION DISTRIBUTION SYSTEM
BACKGROUND OF THE INVENTION
The present invention relates to methods and systems for providing
information, products, and services to a prescription drug customer, and more
specifically, to methods and systems for increasing the customer's involvement
and
influence in pharmaceutical decisions.
FIG. 1 schematically illustrates the current relationships between parties
associated with distributing prescription drugs from drug manufacturers to
prescription drug customers. The process starts when a patient or customer 30
visits
a physician 32. The physician makes a diagnosis and prescribes a prescription
drug.
The customer then brings the prescription to a pharmacy 34 to obtain the
prescribed
drug.
Staff at the pharmacy 34 enters the customer's personal information into the
pharmacy's computer system (often referred to as a "fill and bill system"). If
the
prescription drug customer has previously used the pharmacy, the information
is
generally already in the pharmacy's computer system and only needs to be
confirmed and/or updated by the pharmacist. The fill and bill system may also
list
any other medications currently being used by and allergies or other medical
conditions of the customer. If this information is not available, the
pharmacist will
solicit such information from the customer prior to filling the prescription.
Often times the physician 32 prescribes a class of drug, or several brands of
drugs, without specifying a particular prescription drug. When this occurs,
the
pharmacist discusses the options with the customer. There may be one or more
brand name drugs and one or more generic equivalents available to the
customer.
The customer and the pharmacist decide which drug the customer will use. This
decision is often based on the pharmacist's recommendation and/or the coverage
the
health insurance of the customer. Many health insurance providers favor the
use of
less expensive generic drugs and often deny coverage for brand name drugs when
a
generic equivalent is available. In addition, insurance providers may have a
lower
customer co-pay amount for generic drugs. In general, the only way the
pharmacist
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can determine the coverage provided by the customer's health insurance is by
calling
the insurance provider at the time of filling a prescription.
When a pharmacist recommends a prescription drug, he confirms that the
newly prescribed drug is safe for use by the customer (i.e., the drug will not
dangerously interact with other medications currently being used by the
customer,
the customer has no allergies to the drug, the customer has no medical
conditions
preventing the use of the drug, etc.). Assuming there are no reasons why the
chosen
drug cannot be used, the pharmacist enters the prescription into the fill and
bill
system. The pharmacist fills the prescription from his bulk supply of the
drug,
which is typically purchased from a distributor that deals directly with the
pharmaceutical manufacturer. The pharmacist packages the prescribed amount of
the drug for the customer and labels the package with a label printed by the
fill and
bill system. The label typically includes the customer's name and physician's
name,
the name of the prescription drug, dosage and use instructions, the number of
refills
available, and the expiration date of those refills.
The pharmacy 34 typically has some method of inventorying the drug supply
to monitor how much of the drug is currently available and when more should be
ordered from the distributor. Some fill and bill systems include an automated
inventory function that is updated when the pharmacist enters prescriptions.
Prior to receiving the filled prescription, the customer either pays for the
drug himself or, more often, provides the pharmacist with his or her insurance
information. When the customer provides the insurance information, the
pharmacist
determines how much, if anything, the customer must pay for the prescription
drug.
Calculation of the customer's co-payment may also be done by the fill and bill
system. The customer tenders any money he may owe for the prescription drug.
An
insurance claim for the prescription is also prepared by the pharmacist or
fill and bill
system.
The pharmacist is required by federal regulations to offer the customer a
consultation prior to delivering the prescription drug. In the consultation,
the
pharmacist explains the manner of using the drug, potential side effects, the
number
of refills available, and asks the customer if he or she has questions or
concerns.
The consultation may involve and exchange of includes information provided by
the
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physician, the pharmacist, and the manufacturer of the drug. The pharmacist
may
also provide a printed information describing the drug and its use. After the
consultation is complete, the pharmacist gives the filled prescription to the
customer.
In most cases, the pharmacy gets paid (with the exception of any co-pay
amount tendered by the customer) by the health insurance provider 36 after the
claim is processed. Typically, the customer will not hear from either the
pharmacy
or the insurance provider once the prescription is filled. If the insurance
provider
denies the claim, the pharmacy or the insurance company bills the customer
directly.
At this point, the customer needs to determine why the claim was denied. To do
so,
the customer must contact a representative of the insurance company. Until the
situation is resolved, the pharmacy or insurance provider will continue to
bill the
customer.
SUMMARY OF THE INVENTION
The inventors) has (have) recognized a need for an improved system of
distributing pharmaceuticals and communicating information between customers,
pharmacists and pharmacies, drug manufacturers, insurance companies, and other
entities involved in the distribution of prescription drugs.
One shortcoming associated with the system shown in FIG. 1 relates to the
limited access customers have to drug manufacturers 38 and the wide variety of
products they offer. Even with the advent of pharmaceutical advertisements and
web sites, patients currently receive most pharmaceutical information from
physicians or pharmacists. Patients rely on these individuals to keep abreast
of the
latest developments in the industry, which is not an easy task. The number of
different types and brands of prescription drugs is already very large and
continues
to grow. Time limitations placed upon the physicians and pharmacists often
lead to
a lack of knowledge of the treatments and drugs available. Often, a
physicians'
recommendation is be based simply on the fact that a drug manufacture
effectively
marketed its drug directly to that physician, even though a more cost
effective or
medically effective drug is available to the patient.
Another problem recognized by the inventors) relates to communication
among and between other parties involved in the prescription drug process. A
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number of government agencies 40 (e.g., the FDA, FTC, HHS, and others)
regulate
the manufacture of drugs, the provision of healthcare benefits by employers
for
employees, and activities of technology support companies 42 that provide
communication links and technical support to the actors in the system.
Communication with these agencies is critical, but less than satisfactory in
the
current drug distribution system because information is often duplicated and
decentralized.
Communication is also deficient when insurance claims for prescriptions are
denied. One cause for denial involves the prescription of non-covered drugs.
Currently, there is no quick and easy way prior to filling the prescription to
cross-
reference the available options with the customer's insurance plan to
determine if
there is a drug that could be used to treat the customer that is also covered
by the
customer's insurance. If a claim is denied, the customer is only informed at
the time
the prescription is filled or at a later date when the treatment has already
begun. The
customer is then left to sort out the denial, attempt to find a treatment that
is covered
by insurance, or pay for the drugs out-of pocket.
The communication flaws described above equate to less information
available to the customer and a relatively burdensome system associated with
obtaining and paying for the best available treatment. Ultimately, the current
system
does not achieve the goal of maintaining the health of the customer in an
efficient
and effective manner.
Yet another problem of the current system relates to the influence insurance
companies have over the drugs patients take. Most customers have no choice or
limited choices in picking an insurance provider. Employers 44 determine what
type
of coverage they will provide to their employees. In some cases, larger
employers
act as self insurers. The insurance companies (or employers) then determine
which
prescription drugs and treatments they will cover. Thus, with little or no say
in the
matter, the customer may have no coverage for drugs that may be suitable for
his or
her need. While private insurance or cash payment is possible, most customers
lack
the financial resources to finance these options.
Perhaps the biggest deficiency in the current system is that the customer is a
passive participant in the pharmaceutical decisions affecting his or her
health. The
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customer has little knowledge of all available treatments, and must rely on
their
physician's recommendation of a treatment and prescription drug. As noted, the
physician's recommended treatment may not be the most effective one available.
Additionally, the customer does not usually know what type of insurance
coverage
they have for specific brands of drugs and, therefore, may end up paying for
uncovered brand name drugs that could be replaced with a covered generic
equivalent.
The token involvement and influence of the customer is due in large part to
the lack of interaction between the customer and the other parties in the
system. The
current system isolates the parties from one another. For example, while drug
manufacturers 3 ~ can communicate with the pharmacies 34 via technology
support
companies 42, the manufacturers are not permitted to see which customers are,
or
could be, using their drugs. Only the customer 30, the physician 32, and the
pharmacist are privy to such information. The manufacturer, therefore, relies
on the
physician or pharmacist to present the manufacturer's available and up-and-
coming
treatments to the customer.
While there may be reasons (e.g., privacy) for prohibiting manufacturers
from obtaining customer information, there are disadvantages to prohibiting
interaction between the customer and the manufacturers. If the pharmacist or
physician is not aware of a particular treatment, the customer may not be
fully
informed of the options and may not obtain the best treatment available for a
particular condition. Since the manufacturers have no access to the customer's
medical profile, they cannot aid in presenting all available options to the
customer.
If the drug manufacturer could contact the customer directly, he or she might
learn
of options suitable to his or her circumstances.
Another deficiency of the current system is an inability to track customer
compliance. As used herein, "compliance" refers to a measurement of whether
the
customer takes the prescribed drugs according to the physician's instructions.
Compliance can be monitored by comparing the date the customer obtains a
refill
against the date the refill should have been obtained if the drug was taken as
directed. Compliance is a major issue having an impact on all of the parties
in the
system. A compliant customer has the best chance of becoming healthy in the
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shortest amount of time. Healthy customers are positive indicators of the
efficacy of
the manufacturer's drug and reduce overall health costs, which are, of course,
of
interest to insurance providers, employers, and patients.
The methods and systems of the present invention alleviate these and other
problems. The invention includes a pharmaceutical system having a
communication
and information network that is centered around the customer and that is
accessible
to all of the other parties involved. In one embodiment, the invention
provides a
customer-centered pharmaceutical product and information distribution system.
The
system includes a customer terminal coupled to a network and a pharmacy
terminal
coupled to the network. The pharmacy terminal is coupled to a pharmacy
management system that has a database. A third terminal is also connected to
the
network. The third terminal is selected from the group consisting of an
insurance
provider terminal, a fiscally responsible party terminal, a physician
terminal, a
government agency terminal, a drug manufacturer terminal, and a flexible
benefits
operator terminal.
A server is coupled to the network. The. server has a site accessible by the
customer, the pharmacy, and the third terminal. The server also has a database
that
is synchronized with the database of the pharmacy management system.
Preferably,
the insurance provider terminal is coupled to an insurance store having
information
regarding insurance coverage.
In another embodiment, the invention provides a method of networking a
customer with parties involved in providing information and services that can
increase the customer's involvement and influence in making personalized
pharmaceutical decisions. The method includes providing customer/pharmacy data
on a network, providing customer/insurance company data on the network,
providing customer/pharnaceutical manufacturer data on the network, and
granting
access to the network to a customer, a pharmacist, an insurance company, and a
pharmaceutical manufacturer.
These features as well as other advantages of the invention will become
apparent upon consideration of the following detailed description and
accompanying
drawings of the embodiments of the invention described below.
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BRIEF DESCRIPTION OF THE DRAWINGS
FIG. 1 is a schematic diagram of a prior-art system of providing information
and services to a prescription drug customer.
FIG. 2 is a schematic diagram of an embodiment of the invention.
FIG. 3 is a schematic diagram of a customer-centered pharmaceutical system
according to one embodiment of the invention.
FIG. 4 is another schematic diagram of the pharmaceutical system illustrated
in FIG. 3.
FIG. 5 is a schematic diagram of the pharmacy terminal illustrated in FIG. 3.
FIG. 6 is a schematic diagram of some of the functions a customer can
perform utilizing a web site of one embodiment of the invention.
FIG. 7 is a schematic diagram of how a customer accesses the web site of the
invention.
FIG. 8 is a schematic diagram of how a customer maintains an account.
FIG. 9 is a schematic diagram of how the customer orders refills.
FIG. 10 is a schematic diagram of how a customer checks refill status.
FIG. 11 is a schematic diagram of how a customer requests information and
views responses.
FIG. 12 is a schematic diagram of how a customer views profile information.
FIG. 13 is a schematic diagram of how a customer requests or orders
recommended products.
FIG. 14 is a schematic diagram of some of the functions the pharmacist can
perform utilizing an embodiment of the invention.
FIG. 15 is a schematic diagram of the flow of information between a
database server and a database.
FIG. 16 is a schematic diagram of some of the functions an administrator can
perform utilizing an administration module.
FIG. 17 is a schematic diagram of creation of an educational page for an
educational module.
FIG. 18 is a diagram of a data flow model for an embodiment of the
invention.
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DETAILED DESCRIPTION
Before embodiments of the invention are explained in detail, it is to be
understood that the invention is not limited in its application to the details
of
construction and the arrangements of the components set forth in the following
description or illustrated in the drawings. The invention is capable of other
embodiments and of being practiced or being carried out in various ways. Also,
it is
understood that the phraseology and terminology used herein is for the purpose
of
description and should not be regarded as limiting. The use of "including" and
"comprising" and variations thereof herein is meant to encompass the items
listed
thereafter and equivalents thereof as well as additional items.
FIG. 2 schematically illustrates an embodiment 50 of the invention. It
should be noted that FIG. 2 is only representative of one embodiment of the
invention. As such, other embodiments that include fewer or more parties are
also
encompassed by the invention. In the embodiment 50, a prescription drug
customer
52 is positioned at the center of a group of parties participating in the
distribution of
pharmaceuticals and the exchange of pharmaceutical and other information. The
two-way arrows represent the two-way communication and information transfer
between the customer and the remaining parties: a physician 54, retail
pharmacy 56,
an operator 58 of a benefits account, a drug manufacturer 60, and an insurance
provider 62. Each party can exchange data with the others, but what provides
significant benefit is that the customer has two-way data exchange with the
physician 54, pharmacy 56, benefits account operator 58, and drug manufacturer
60.
As used herein, the term "data" can include any communication, data, contact,
or
other transfer of knowledge or information pertaining to the relationship of
the two
or more parties specified.
The data available to the customer 52 can be selectively shared and used by
all of the parties as desired. This selective sharing of data between parties
is
represented by the circular arrow configuration around the customer. The
networking systems and methods of the invention ultimately provide the
customer
with access to each of the parties, and in turn, provide each of the parties
with at
least limited access to the customer and the customer's information. As such,
the
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network becomes personalized and extremely useful to the customer for making
pharmaceutical decisions.
For example, educational data and data regarding rebates or incentives on
various prescriptions, brand-to-brand comparisons, available alternative
treatments,
S and the scope of insurance coverage can be used by the customer. The other
parties
involved also benefit from the exchange of information. For example,
pharmacists
and physicians get valuable input from the manufacturers on available
treatments
that might be suitable for a specific customer. Additionally, the pharmacist
can
minimize the number of denied claims by quickly checking whether the
customer's
insurance provider covers the prescribed treatment before filling the
prescription.
The pharmacy, the insurance provider, the manufacturer, and the physician can
all
monitor prescription drug customer compliance and take steps to help the
prescription drug customer comply. ,
In one embodiment, the invention is a network-based system, such as the
1 S system 70 shown in FIG. 3. A site 72 (such as an Internet site) is created
on a server
74 as the prescription drug customer's gateway to obtaining information from
pharmacists, drug manufacturers, government agencies, fiscally responsible
parties
(e.g., employer who pays insurance premiums or fund private insurance),
physicians,
and any other parties that may have access to a network 76. In the example
shown,
the physician S4, pharmacy S6, benefits account operator S8, drug manufacture
60,
and insurance company 62 are shown coupled to the network 76. Also connected
to
the network 76 are a government agency 80 and a fiscally responsible party 82.
It should be understood that while the description discusses parties being
"connected" to the network 76, the parties are not part of the physical layer
of the
2S system. Rather, the parties operate computers, terminals, or other hardware
devices
that are connected to the network 76. The terminals may include standard input
and
output devices such as a mouse, keyboard, printer, and display. Of course, the
terminals could include a host of advanced and/or yet to be developed input
and
output devices such as voice recognition devices. The terminals or hardware
devices
may include an operating system, a browser, and communication software for
communicating with the server 74 and each of the other terminals via the
network
76. Preferably, the browser is a web based browser, such as a Microsoft
Explorer
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browser or a Netscape Communicator browser, capable of displaying information
formatted with a fixed set of tags, such as HTML or XML documents. In a
preferred embodiment, the network 76 is the Internet, thereby providing global
communication and scale to the invention. However, the network may be other
types of networks, whether packet switching or not or based on Internet
protocols or
not. Further, although not shown, the system 70 can be scaled to include
numerous
customer's, physicians, pharmacies, insurance providers, and other parties,
and, of
course, associated terminals.
In one embodiment, the site 72 can include web pages for each participating
pharmacy 56, with each drug customer 52 having his own secure account for
interaction with the web site and a pharmacy specific web page. The customer
is
provided with a login name and password. Once logged onto the site, the
customer
can input his personal information, including his medical profile.
Alternatively, this
information can be loaded automatically by the fill and bill system or
pharmacy
management system of the pharmacy when the prescription drug customer's
account
is set up. Preferably, the pharmacy management system communicates with the
server 74 such that the customer's personal account may be kept up to date.
Once the customer's personal account is operational, any of the other parties
can be granted access to the account. This may require the customer 52 to
waive
certain privacy rights. As the system evolves, other parties that are not
mentioned or
described herein can also be added to the network. Other pages and links can
be
provided to organize the personal and customized information available to the
customer.
The customer can access personalized information relating to any of the
networked parties. This includes, for example, information provided by the
drug
manufacturer 60 about prescription drugs the customer is currently using or
drugs
that might be suitable for the customer. The information can be tailored
specifically
for the customer based on the medical profile in the customer's personalized
account. Dangerous interactions, drug allergies, and other risks can be
communicated to the customer. Since the physician 54 and the pharmacist can
also
access the customer's account, they can consider the manufacturer's
recommendations and decide whether the treatment recommended by the
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manufacturer is a viable option for the customer. While the manufacturer does
not
make any final decisions about the customer's treatment, the physician and
pharmacist may be provided with more options from which to choose.
The system 70 also provides the customer access to information from his
fiscally responsible party regarding claim status for filled prescriptions,
available
coverage, and price information for various drugs and treatments, and any
other
beneficial information. This information allows the customer to make an
informed
decision as to which treatment options are affordable and which are not. It
also
makes communication easier and reduces the number of misunderstandings leading
to coverage disputes.
The customer 52 can also view his records on the site 72 (as provided or
updated from the pharmacy management system), including usage instructions for
the prescriptions, refill status, and any other beneficial information. The
customer
can communicate with the pharmacist to request refills and ask questions
regarding
dosage, usage, and side effects. Responses can be posted on the site or e-
mailed
directly to the customer. This portion of the web site can also include refill
renewal
forms that can be faxed, e-mailed, or sent over the network to the physician
54.
Drug manufacturers send information to the server 74. The information may
include data about drugs and treatments the manufactures produce, conditions
and/or
allergies the drugs and treatments can be prescribed for, side effects the
drugs and
treatments may cause, interactions that may occur when the drugs and
treatments are
used with other drugs and treatments, educational content for the drugs and
treatments, pricing, and discounts or special deals that are currently
available. After
receiving the information, the server 74 updates other computer and sofl;ware
components (discussed below) to ensure that updated information is used by the
parties participating in the system 70. An advantage of the invention is that
the
pharmaceutical system 70 may be configured to allow drug manufacturers to
provide
information about specific drugs to a particular segment of customers. For
example,
if the drug manufacture has just released a new drug that effectively treats
high
blood pressure, it would be advantageous for the drug manufacture to target
all
customers that have high blood pressure listed as a condition in their
profile. In an
alternative embodiment, the drug manufacturer can offer a discounted rate to a
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customer that previously used one of their drugs, but has since switched to a
substitute drug. If the drug manufacturers have access to more information
about
the customers they will be better able to assist in the recommendation of
drugs and
treatments that the physician or pharmacist may not be aware of. The drug
manufacturer can inform the customer of such alternatives and the physician
and
pharmacist can directly view the customer's profile to evaluate the
suggestions, or
the customer can interact communicate with the physician or pharmacist
regarding
the suggestions.
The fiscally responsible party (e.g., an employer, etc.) also provides
information to the system 70. This information may include drugs and
treatments
covered and any co-payments required by the customer. Interaction between the
fiscally responsible party and the drug manufacturers may change the coverage
provided to the customer if a more expensive drug is demonstrated to be more
effective in treating a condition or allergy in a shorter amount of time.
Fiscally
responsible parties do cost benefit analyses of the drugs and treatments they
cover
and determine from that what type of coverage to extend to the customer. The
information about coverage is communicated from the server 74 to the pharmacy.
The information allows the pharmacist to determine what drug or treatment is
most
cost effective for the customer. The fiscally responsible party may also
interact with
the government agency regarding what types of coverage they are required or
not
required to offer to the customer. If a dispute arises regarding coverage for
a
particular drug, the pharmaceutical system 70 provides a quick and efficient
avenue
for communication and resolution of the problem.
Government agencies provide information on rules and regulations they have
established with respect to distributing pharmaceutical drugs and providing
coverage
to the customer. An agency may also utilize the pharmaceutical system 70 as a
forum for discussion of possible changes in the rules and regulation. The
government agency may also receive complaints from customers about parties
that
are participating in the pharmaceutical system 70 that are not abiding by the
established rules and regulations.
Physicians use the system 70 to respond to requests for prescription
renewals, answer questions regarding proposed drugs and treatments for a
customer,
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and view information provided by the drug manufacturers about new and existing
drugs and treatments. The physician can view the customer's profile to
determine
the compliance of the customer with respect to a particular drug. If the
customer is
not following the established regimen, the physician can use this information
when
discussing conditions and treatments with the customer.
Having described the general architecture and operation of the system 70, its
various components will now be described in greater detail.
FIG. 4 illustrates components of the system 70 in more detail. For purposes
of discussion, the system 70 is illustrated with customers and pharmacies
only. As
shown in FIG. 4, the system 70, includes a router 90, a firewall 92, an
encryption
module 94, an educational content server 96, a synchronization server 98, a
SQL
server 100, a data transformation service 102, a database server 104, a
database 106,
and a pharmaceutical system software server 108.
The router 90 is capable of interconnecting the terminals and the servers 108,
90, and 98. In one embodiment, the router 90 interconnects two or more
computer
networks that use a single network layer procedure, but that may use different
data
link layer and physical layer procedures. The firewall 92 can be any of a
number of
hardware/software components that prevent unauthorized users from gaining
access
to the servers, or that monitor transfers of information to and from the
network 76.
In one embodiment, the firewall 92 is a software module such as the Check
Point
Firewall-1 that further requires a dedicated computer system. In another
embodiment, the firewall 92 is a hardware module such as the Cisco PIX 515.
The
encryption module 94 is capable of encrypting information passed between the
terminals and the servers via the network 76. An appropriate security solution
is
necessary in order to protect personal information of the customer that is
transferred
over the network 76. In one embodiment, the encryption module 94 is an Intel
SSL
Encrypter.
The educational content server 96 includes educational modules that the
customer can access. The educational modules may include information on how to
properly administer prescribed drugs or treatments, or alternatives to the
prescribed
drugs or treatments. The pharmacist can recommend to the customer that he view
media clips, listen to audio clips, or read text in the educational modules
that may
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help him to better understand how to use the drugs and treatments that he is
being
provided. The actual educational content or information can be built as web
pages
that include links to pages within the educational modules. The educational
modules
may also include quizzes that test the customer's understanding of the
educational
content. In one embodiment, the educational content server 96 uses Windows NT
Enterprise Server 4.0 software.
The synchronization server 98 is responsible for ensuring that the database
106 of the server 104 includes up-to-date data, (i.e., the same data that is
provided
by the parties at each terminal connected to the system). Each terminal can
contact
the synchronization server 98 and download and/or upload any changes to the
information stored in the database server 104. In one embodiment, the
synchronization server 98 uses Windows NT Enterprise Server 4.0 software.
The SQL (Structured Query Language) server 100 handles queries and loads
of the database 106. In one embodiment, the SQL server 100 includes SQL Server
7.0 Enterprise Internet Connector software. The data transformation service
102
modifies the data being transferred to the database 106 when the physical
representation of the data used in the source hardware or software environment
is
not compatible with the hardware or software environment of the database 106.
Similarly, the data transformation service 102 also modifies data transferred
from
the database 106 if it does not have the correct physical presentation for
destination
hardware or software.
The database server 104 and associated database 106 store information
including information about the customers. This information may be accessed by
the terminals if appropriate authorization is given to the requesting terminal
to
upload and/or download such information. In one embodiment, the database
server
104 is an HP Unix database server and the database 106 is built using Oracle
8i
Enterprise Edition server software.
The pharmaceutical system software server 108 contains software that is
accessed by customers. In a preferred embodiment, the pharmaceutical system
software server 108 includes web pages that are accessed by the customer. The
pharmaceutical system software server 108 may also include content and
software
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that is accessed by the other terminals in the system. In one embodiment, the
pharmaceutical system software server 108 is a cluster of Windows NT web
servers
Preferably, the server 74 has the capability to handle tens of thousands of
pharmacy terminals sending updates to the server at regular intervals. (An
average
pharmacy handles approximately 200 transactions per day and updated
information
regarding each transaction needs to be sent to the server.) Additionally, it
is
preferable that the server 74 handle over 200 simultaneous connections and
have a
constant uptime for operation (i.e., 24 hours a day, 7 days a week). It is
also
preferable that web pages provided by the pharmaceutical system software
server
108 load quickly when interfaced by the customer (i.e., within 5 -10 seconds
for
content pages and 10 -15 seconds for dynamic pages over a standard dial-up
connection). The database server 104 needs to have a memory storage capacity
to
store information from each of the terminals, conservatively estimated to be
between
45 gigabytes and 195 gigabytes.
The server 74 is administered by a system administrator using an
administration module 110 having an administration interface 62. As will be
discussed in greater detail below, the administrator performs setup and
ongoing
maintenance of the server 74. As should be apparent the discussion herein, the
server 74 plays an important role in the system 70. However, computer systems
at
each of the participating parties are also important. FIG. 5 illustrates a
computer
system 113 at an exemplary pharmacy 56. The computer system 113 includes a
pharmacy management system 114. The pharmacy management system 114 is
coupled to a data base 116 that stores information including customer address,
phone
number, physician, insurance provider information as well as a list of any
medications currently being used by the customer and any known allergies or
other
medical conditions that the customer has. The pharmacy management system 114
is
a type of a fill and bill system and has the ability to interface all new and
changed
customer accounts, customer prescriptions, responses to customer requests,
profile
information, changes to the pharmacists, changes to web site content, etc. In
a
preferred embodiment, the pharmacy management system 114 is designed to
effectively interact with the server 74 and the other components of the system
70.
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Alternatively, upgrades may be provided to allow existing pharmacy management
software to interact with the system 70.
In operation, the pharmacy at which the customer is a patron registers with
the server 74. The pharmacy contacts the administrator and an account is
established. The pharmacy assists the administrator in developing a pharmacy
specific web page that is accessible by customers. The web page may also be
accessible from the pharmacy's own standalone web site. The pharmacy specific
web page includes contact and operating information about the pharmacy and
other
pharmaceutical content. The pharmacy is equipped with the pharmacy management
system 114 or an upgrade to its existing management software to provide
functionality equivalent to that provided by the computer system 113.
After the pharmacy is setup for participation in the pharmaceutical system
70, customers of the pharmacy register for participation in the system. As
noted,
each customer receives a username and a password for logging onto the web site
and
establishes a profile. FIG. 6 schematically illustrates some of the functions
the
customer can perform utilizing the web site 72. The customer can maintain
their
account, request/order recommended products, order refills, check refill
status, view
profile information, and request information and view responses. FIG. 7
illustrates
these processes in more detail. As shown at step 120, Customer Opens Web Site,
the customer opens the web site by connecting to the network 76 using a
browser.
Next, as shown at step 124, Show Login Page, the login page of the web site is
displayed. The customer can then choose to enter user specific content of the
web
site or to view general non-user content of the web site.
The customer is presented an option 126 to view content 128 regarding the
benefits of using the system 70. The customer is also presented an option 130
to
view the security/privacy policy 135 for the system 70. The general content of
the
web site can include as much or as little information about prescription drugs
and
treatments and the pharmaceutical system 70 as the administrator desires to
provide
the general public.
If the customer has registered with the system 70, he or she may enter his or
her username and password, as shown at step 140. The username and password
information is then validated at step 150. If the login is not valid, a web
page is
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loaded that informs the customer that the data fields are invalid, as shown at
step
160. The customer is then redirected to re-enter username and password
information, as shown by path 162.
If the username and password is valid then a hit counter is incremented at
step 170. After the counter is incremented, the customer's main page is
loaded, as
shown at step 180. Based on the customer's age and medical conditions that are
stored in the profile, an appropriate interface is established (e.g., older
customers are
provided with larger lettering that is easier for them to read). This may
include
viewing a pharmacy specific web page that has an age appropriate font and
background depending on what demographic the customer falls into (i.e.,
geriatric,
adult, or child/young adult). Step 180 may also include providing a customer
interface in different languages, such as French, English, Spanish, etc.,
depending on
the language spoken by the customer.
FIG. 8 schematically illustrates how the customer maintains their account
using the web site 72 of the pharmaceutical system 70. As shown at step 200,
Show
My Account Page, the customer can view various content and select several
options.
A page is loaded that shows the account information and, as shown at step 210,
Modify Account?, the customer is asked if they would like to modify any of the
information currently listed in the account profile. If the customer does not
wish to
modify their account, the customer may move to another page, as shown at step
215,
Customer Moves to Another Page. In a preferred embodiment, the web site
reloads
the main page. If the customer does wish to modify their account, they may
make
various changes, as shown at step 220. Examples of information that the
customer
can change include the email address they use to receive information from the
pharmaceutical system 70 and the password used to access the web site.
If the customer enters a proposed change to their account, as shown at step
230, Submit Change?, they are asked if they would like to submit the change.
If the
customer does not wish to submit the change, the customer may move to other
portions of the site, as shown at 215. If the customer does submit the change,
the
validity of the change is checked, as shown at step 240, Validate Change. If
the
proposed change is invalid, an error message is generated, as shown at step
255,
Show Error Message. After the error message is displayed, the customer may be
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redirected to step 200. If the proposed change is valid, the proposed change
is saved
at step 260, Save Changes, and the customer is informed that the change was
successful at step 270, Show Thank You Page. Once the customer has completed
viewing the confirmation page, the customer is redirected to step 200.
FIG. 9 schematically illustrates how the customer orders refills using the
pharmaceutical system 70. As shown at step 300, Show Refill Request Page, the
customer can select a refill request page. In one embodiment, only the
prescriptions
that are less than one year old are shown on the refill request page. The
customer
may be able to load the prescriptions that are older than one year old, but
ideally the
customer should have checkups with his or her physician where older
prescriptions
are evaluated and adjusted according to the progress of the prescribed
regimen. As
shown at step 310, Request Refills, the customer is allowed to select any of
the
prescriptions that axe currently stored in the pharmaceutical system 70, and
request a
refill. The customer enters a proposed date to pickup the refill from the
pharmacy.
If a prescription has expired (either by date or by number of refills) and the
customer
would like to continue receiving the prescription drug, the customer's
physician is
contacted for authorization. The physician can be contacted using fax, phone,
or by
contacting the representative computer system at the physician's office. If
the
customer would like an expired prescription renewed, this fact is indicated on
the
refill request. Once the customer has selected the prescriptions they would
like
refilled and entered information in all of the required fields, a
determination is made
whether or not the request is valid, as shown at step 340. If the request is
not valid,
an error message is displayed, as shown at step 345. An example of an invalid
request is a pickup date that is past a future expiration date of the selected
prescription. After the error message is displayed, the customer is redirected
to step
300.
If the request is valid, the request is saved in the database server 104 at
step
350, Save Refills. At step 360, Contact Physician For Authorization of Chosen
Refills, the customer's physician is contacted for authorization to continue
the
expired prescription. At step 370, Show Refill Request Confirmation Page, a
web
page is loaded that shows the customer what refills are refillable and on what
date
they will be ready for pickup, and what refills are waiting for approval from
the
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physician. Once the customer has finished reviewing the show refill request
confirmation page, the customer can return to the main page for further action
by the
customer. All information regarding refills requested is sent to the
respective
pharmacy management system 113 so the pharmacist can prepare the refill
according to the customer's request.
FIG. 10 schematically illustrates how the customer checks refill status using
the pharmaceutical system 70. As shown at step 400, Show Refill Status Page,
the
customer can select a status page that displays refills ordered as described
with
respect to FIG. 9. In one embodiment, only the refill requests that are less
than one
month old are shown. The customer may be able to load the refills that are
older
than one month old, but ideally the customer should pickup refills in a timely
manner after requesting such refills. The information displayed on the status
page is
similar to the information provided at step 370 as described with respect to
FIG. 9.
The information displayed allows the customer to check whether or not their
physician authorized refills that required physician approval. If the
physician
authorizes the refill, the customer can pickup the refill on the date
indicated on the
refill status page. If the physician does not authorize the refill the
customer is
informed of the denial through the status page and may contact the physician
regarding the denial. The pharmaceutical system 70 can automatically, or upon
request by the customer, send reminders to the physician if no response is
received
within a set amount of time. Once the customer has finished reviewing the
refill
status page, the customer can return to the main page. All information
regarding
refills requested and later verified is sent to the respective pharmacy
management
system 114 so the pharmacist can prepare the refill according to the
customer's
request.
FIG. 11 schematically illustrates how the customer requests information and
views responses using the pharmaceutical system 70. The embodiment of the
invention illustrated in FIG. 11 primarily relates to communication of
customer/pharmacy data. Generally, the customer interacts with the pharmacist
at
the retail pharmacy to a greater extent than he or she interacts with the
other parties.
However, the pharmaceutical system 70 can be configured to allow the customer
to
request information and view the responses with respect to other types of
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communication (i.e., customer/physician, customer/drug manufacturer,
customer/fiscally responsible party, customer/governmental agency, etc.). As
shown
at step 500, Show Communicate with Pharmacist Page, the customer can request
information and view responses from their pharmacist. A web page is loaded
that
allows the customer to request new information, view a response to past
information
requests, or delete old responses that are no longer needed.
As shown at step 510 and 515, the customer can delete responses. In one
embodiment, the Communicate With Pharmacist Page is similar to an email system
that includes a listing of all old, new, and outgoing messages. The customer
may
organize the responses stored in their account by eliminating old responses.
Once
the deletion and organization is completed, the customer may return to the
Communicate With Pharmacist Page.
As shown at step 520, Choose a Specific Response to View, the customer
can select a response from the pharmacist to view. The response may be a new
1 S response that has not yet been viewed or an old response that has already
been
viewed. After the response is selected, as shown at step 525, Show Response
Detail
Page, the chosen response is displayed. Once the selected response is viewed,
the
customer can return to the Communicate With Pharmacist Page.
As shown at step 530, Choose to Request New Information, the customer can
request information from the pharmacist. This information may include
information
about a particular drug the customer discovered to be an alternative to his
current
prescription, information about a side effect the customer is experiencing, or
other
information. A web page is displayed at step 540, Show Request Information
Page,
that allows the customer to input the information they would like to request
from the
pharmacist. At step 550, Enter Subject, Choose Pharmacist, and Message, the
customer enters a subject of the information requested, chooses the pharmacist
they
would like to answer their question (if a particular pharmacist is desired),
and writes
the message requesting information. At step 560, Submit Request?, the customer
determines whether to submit the request. If the customer does not submit the
request, the customer moves to another page, as shown at step 565, Customer
Moves
to Another Page. In a preferred embodiment, the web site reloads the main page
of
the site. If the customer submits the request, the request is validated, as
shown in
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steps 570 and 580. If the request is invalid, an error message is generated,
as shown
at step 585. If the request is valid, the request is saved in the database
server 104 at
step 590, Save Request. At step 600, Show Thank You Page, the customer is
informed that the request was successfully saved. Once the customer has
completed
viewing the confirmation page, the customer is redirected to step 500 and the
account page is redisplayed. All requests for information are sent to the
respective
pharmacy so the pharmacist can prepare a response to the request fox
information.
FIG. 12 schematically illustrates how the customer views his or her profile
information using the pharmaceutical system 70. As shown at step 600, Show
Profile Information Page, the customer can view their profile information. A
web
page is loaded that allows the customer to view current medical diagnoses and
choose various information about their profile.
As shown at steps 610 and 612, the customer can view all conditions and
allergies currently listed in their profile. In an alternative embodiment, the
system
may display all conditions and allergies currently listed in the system. This
allows
the customer to research conditions and allergies that they may have (based on
symptoms they are experiencing), but have not yet been diagnosed. The customer
then selects a specific diagnosis or allergy at step 614, Choose a Specific
Diagnosis
or Allergy. Once the specific diagnosis or allergy is selected, available
treatments
are displayed, as shown at step 616, Show Prescription Profile Page for Chosen
Diagnosis or Allergy. The customer then selects a specific prescription at
step 630,
Choose a Specific Prescription, and once the customer has selected a specific
prescription, a web page is loaded at step 635, Show Prescription Detail Page,
that
displays information including directions, warnings, and common uses for the
chosen prescription. The customer may also arrive at steps 630 and 635 by
other
routes shown in FIG. 12.
As shown at steps 620 and 625, the customer can view all prescription
listings currently in their profile. In one embodiment, only the prescriptions
issued
in the past one year are displayed. In an alternative embodiment, the system
may
, display all current prescription listings in the system for the customer.
This allows
the customer to research prescriptions they learn about through various
communication avenues, and thus determine if they would be effective in
treating
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conditions and/or allergies they currently are experiencing. The customer is
then
directed to steps 630 and 635.
As shown at steps 640 and 645, the customer can view education materials
recommended by the pharmacist. The pharmacist may utilize the educational
materials as a method of teaching the customer how to efficiently and
effectively use
the drugs or treatments prescribed to them. In one embodiment, the educational
modules may be utilized to satisfy the explanation requirements placed on the
pharmacist by government agencies. The customer then selects a specific
educational module at step 650, Choose an Educational Module, and a category
page
for the chosen module is displayed at step 655, Show Category Page for Chosen
Module. At step 660, Choose a Category, the customer selects a category of the
chosen educational module. Once a category is chosen, a question for the
category
is asked of the customer at step 665. The question quizzes the customer and
determines whether or not the customer understands the information without
viewing the educational content of the module. The customer may have already
reviewed the educational content of the category at an early date, or
discussed it in
person with the pharmacist. At step 670, Correct Answer?, a determination is
made
whether or not the customer answered the question correctly. If answered
correctly,
the customer is directed to step 660 and another category is chosen. If
answered
incorrectly, the customer is informed of the incorrect response, as shown in
step 675.
Once the customer has completed viewing the incorrect answer page, the
customer
can proceed to step 6~0, View Educational Material. The customer then views
the
displayed information about the chosen category. The customer is questioned
about
the category again, as shown at step 665. If the customer continues to answer
the
question incorrectly, the customer is directed back to the educational
material.
As shown at step 690, Choose Pharmacist Recommendations, the customer
can view recommendations made by the pharmacist. If selected, a web page is
loaded that displays the products recommended by the pharmacist for the
customer,
as shown at step 692. At step 694, Choose a Specific Product, the customer
selects a
product from the list of recommended products and product detail page is
displayed,
as shown at step 696 includes a description of the chosen product and benefits
of
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using the chosen product. The customer may then request or order the selected
products as described with respect to FIG. 13.
FIG. 13 schematically illustrates how the customer requests or orders
recommended products using the system 70. As shown at step 702, Show Request
or Order Recommended Products Page, the customer can request or order products
recommended to them by the pharmacist or one of the other parties involved in
the
pharmaceutical system. The customer can elect to buy the product on-line or
elect to
buy the product at a retail location, such as a pharmacy.
If the customer elects to purchase the product on-line, the customer is
directed to step 702, Choose to Buy On-line. The customer can then select the
product for purchase at step 705, Show Shopping Cart for Chosen Product, by
placing the product in their shopping cart in accordance with commonly known e-
commerce product purchasing techniques. At step 710, Submit On-line Order for
Product, the customer checks out and purchases all the products they have
placed in
their on-line shopping cart. If the customer purchases an item on-line, the
representative information will be transferred to an appropriate facility for
shipment
of the product to the customer.
If the customer wants to pickup the product at the pharmacy, the customer is
directed to step 715, Choose to Pickup Product at Pharmacy. At step 720, Show
Request Information Page with Request to Buy Filled In, a web page is
displayed
that includes a request to purchase by the customer. The customer can then
submit
the request, as shown at step 725. If the customer determines not to submit
the
request, the customer is directed to another page, as shown at step 727. If a
request
is submitted, the request is validated at steps 730 and 735. If the request is
not valid,
an error message is generated, as shown at step 737. If the request is valid,
the
request is saved at step 740, Save Request, and the customer is informed that
the
request was successfully submitted at step 745, Show Thank You Page. Once the
customer has completed viewing the confirmation page, the customer is
redirected to
step 600, as shown in FIG. 12. If the customer purchases an item for pickup at
the
pharmacy, that information is transferred to the pharmacy.
FIG. 14 schematically illustrates some of the functions the pharmacist
performs utilizing the pharmacy management system 70. The pharmacist views and
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responds to customer questions, reviews quiz results, views refill requests,
maintains
customer accounts, maintains customer profiles, and receives updated
recommended
product defaults.
When a customer submits a question to the pharmacist, the pharmacist
reviews the information requested and prepares an appropriate response. If the
pharmacist believes the customer is experiencing some undesirable side effects
or
some other adverse reaction that requires immediate attention, they may
contact the
customer directly and request that they visit their physician. The pharmacist
may
determine that some questions that are repeatedly asked are better dealt with
by
providing all customers the opportunity to review answers to frequently asked
questions using the web site.
The pharmacist reviews quiz results to determine if the educational content is
effective in educating the customer. If numerous customers reviewing a
particular
educational module are getting the content questions incorrect, the pharmacist
may
wish to update the educational content or use other avenues of educating the
customer with respect to the particular drug or treatment. The pharmacist may
also
review quiz results to determine if the customer has actually reviewed the
material
that was recommended to them.
The pharmacist views refill requests and prepare the refills for pickup
according to the date entered by the customer. The pharmacy management system
114 can include a scheduler that informs the pharmacist when a particular
refill
request needs to be filled so the refills are always ready for pickup as
indicated. If
authorization by the customer's physician is required before further action is
taken,
the pharmacist can note that and wait for the appropriate authorization. If
the
authorization is not received as the time nears for pickup, the pharmacist can
use the
pharmaceutical system 70 to inform the physician of such required response.
The pharmacist maintains customer accounts and profiles adding new
customers to the system, deleting old customers from the system, and updating
any
information that has changed for current customers. The pharmacist verifies
all
information when the customer comes to the pharmacy to pick up a refill to
make
sure that the customer still has the same insurance provider, physician,
address,
phone number, etc. The customer can update this information using the web
site,
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but the pharmacist double checks the information before delivering the
prescribed
drugs or treatments. If other information changes for the customer, such as a
new
allergy, an adverse reaction, or a change in medical status (e.g., new
disability
detected), that information is input into the system.
The pharmacist receives updated recommended product defaults.
Recommended products may be based on discounts the drug manufacturer is
offering or may be based on other factors such as coverage of the product by
the
insurance provided. The pharmacist may also recommend products to customers
that other customers with similar conditions or allergies used successfully.
The
pharmacist updates the recommended products the customer can view using the
web
site so the list is as up-to-date as possible.
When the pharmacist utilizes the pharmaceutical system 70, the pharmacist is
relieved of some managerial duties that occupy a large amount of time, thereby
freeing the pharmacist to practice more pharmacological science. The
pharmacist
has more time to study new and existing drugs and treatments, and the
pharmaceutical system 70 increases the speed at which the pharmacist can
review
such information. In the end, the customer experiences better service from the
pharmacist and, thereby, maintains a healthier lifestyle.
As noted, the pharmacy management system 113 communicates with the
server 74 via the network 76. FIG. 15 schematically illustrates the flow of
information from the pharmacy management database 116 to the database 106 and
the flow of information from the database 106 to the pharmacy management
database 116. As shown, the flow of information between the database 116 to
the
database 106 includes collecting updated data from the pharmacy management
database 116 including changes to the customer's profile, account information,
prescriptions, responses, pharmacy, and physician and loading the updated
information into the database 106. The flow of information from the database
106 to
the pharmacy management database 116 includes collected updated data from the
database 106 including refills, quiz results, e-mail address, password,
requests, and
loading the updated information into the pharmacy management database 116. In
one embodiment, the flow of information between the database 106 and the
pharmacy management database 116 utilizes an XML file layout.
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FIG. 16 schematically illustrates some of the functions the administrator can
perform utilizing the administration module 110. The administrator can access
the
administration module 110, report on pharmacy usage, report on on-line orders,
maintain educational modules, maintain pharmacy accounts, and maintain request
types. As noted above, the administrator accesses the administration module
110
using the administration interface 112. Once the administrator has logged onto
the
administration module 110, he can interface the server and perform the
representative functions illustrated in FIG. 16. The administrator can report
on
pharmacy usage based on number of hits on the site. The administrator can use
this
information in conjunction with the pharmacy in making appropriate changes to
the
site to increase the number of hits. The administrator may also use the
counter to
establish future pricing for the pharmacy.
The administrator can report on on-line orders when the customer orders a
recommended product on-line. The information is transferred to an appropriate
facility for processing of the order. The product is then sent to the customer
at the
address listed in their profile using the payment information also listed in
their
profile. If the product is covered by the customer's insurance, the
administrator
informs the customer accordingly.
FIG. 17 schematically illustrates how an educational page for an educational
module is created. The educational page is typically created outside of the
administration module 110 by the drug manufacturer or the pharmacist, and then
incorporated into an educational module maintained by the administrator. As
shown
at step 800, Create Content Page, a content page is created in HTML with
appropriate links to other pages. A corresponding question page is then
created at
step 810, Create Question Page. The question page is directly linked from the
content page. As described with respect to FIG. 12, if the customer gets the
question
incorrect they are informed of their incorrect response by an incorrect answer
page,
created at step 820, Create Incorrect Answer Page. As shown at step 830,
Create
Education Pages, the education pages are created in HTML (or a similar
language)
with links to each other. These pages are then copied to the appropriate
directory in
the educational content server 96 at step 840, Copy Pages to Appropriate
Directory.
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The administrator then creates the new educational module at step 850, Create
the
New Educational Module, using the administration module 110.
The administrator maintains pharmacy accounts by updating any information
that has changed. Similarly, the administrator makes any changes to the
pharmacy
specific web page if the customers are having difficulty with the web page.
Changes
to account information may include pricing, billing, location, contact
information,
pharmacists at the location, affiliation with other pharmacies, etc. The
administrator
also, establishes what types of request the customer can and cannot make. The
requests may be limited to a list of topics that have been approved by the
paxties
involved in the pharmaceutical system. If a particular drug manufacturer does
not
want to receive requests for a certain type of information, the administrator
can
invalidate such a request and thereby not allow the request to be processed.
FIG. 18 schematically illustrates a data model diagram upon which one
embodiment of the invention is based. The data model diagram represents the
interaction between entities of the pharmaceutical system 70. Cardinality is
indicated by the presence or absence of a crow's foot at the end of a
relationship
branch. If the terminating end of a relationship branch has a crow's foot, an
instance
of the originating entity can be related to one or more instances of the
terminating
entity. If the terminating end is a single line, an instance of the
originating entity
can be related to only one instance of the terminating entity. For example,
the
relationship between a patient and an account is drawn as a straight line
indicating
only one account per patient is allowed. In the case of a physician-
prescription
relationship, a single line at the physician's box and crow's foot at the
prescription
box indicates that a single physician can dispense multiple prescriptions.
As can be seen from the above, the invention provides a patient centric
method and system of distributing pharmaceutical products and information.
Various features of the invention are set forth in the following claims.
