AU2006246444B2 - Dispensing Pharmaceuticals - Google Patents

Description

AUSTRALIA

CPatents Act 0

ORIGINAL

COMPLETE SPECIFICATION STANDARD PATENT

(N

Application Number: 20062 divisional of 2003203618 filed 9-04-03 Lodgement Date: 2 9 th November 2006 Nominated Patentee: ExpressRx Pty Ltd Invention Title: Dispensing Pharmaceuticals The following statement is a full description of this invention, including the best method of performing it known to the applicant.

DISPENSING PHARMACEUTICALS This invention relates to the dispensing of pharmaceuticals particularly those 0 z requiring a prescription from a medical practitioner or authorized prescriber.

Background to the invention Australian retail pharmacists in general sell two types of pharmaceuticals, in addition to a wide range of healthcare and personal care products. These are 'prescription only' products and 'pharmacy only' products. Prescription only products can be supplied only on the prescription of a physician, dentist or the like N registered healthcare practitioner. Dispensing of'prescription only' products may only physically be done by registered pharmacists. 'Pharmacy only' products can be retailed only under the supervision of a licensed pharmacist, but a prescription is not required for their purchase. Supply of such products to 'under age' patients is at the discretion of the medical practitioner in the case of prescription only items, and at the discretion of the pharmacist in the case of pharmacy only products. The sale of pharmceuticals by pharmacists, whether the pharmaceuticals are 'prescription only' or 'pharmacy only', can be time consuming and demanding in terms of the resources required of the pharmacist. Particularly in the case of 'pharmacy only' products, when the pharmacist may need to inquire of the customer for symptoms or signs of a disorder and recommend an appropriate medication. In the case of self diagnosed customers who order a specific medication, it is necessary for the pharmacist to warn the customer about side-effects of medications. In some cases, it will be necessary for the pharmacist to refuse to sell medications to customers who are inebriated or otherwise suffering from substance abuse. In the case of some specific pharmacy only medications such as pseudoephedrine a pharmacist is obliged to refuse to sell the product when there are grounds to suspect that it will be illicitly converted into a prohibited drug. (In the case of pseudoephedrine, converted into methylamphetamine.) There are thus circumstances in which the physical security of the pharmacist becomes an issue. These various requirements however contribute to increasing the expenses of operating a pharmacy.

The Australian Pharmaceutical Benefits Scheme (PBS) is a federal government financed scheme that addresses the costs of supply of pharmaceuticals to patients. The PBS commenced over 50 years ago. At that time, there was concern that many people could not afford expensive but valuable new drugs such as O penicillin. A Pharmaceutical Benefits Advisory Committee (PBAC) was established.

Z It recommended that a limited list of life saving or disease- preventing drugs should be made available on prescription free of charge, the costs to be paid for by the Federal Government.

The PBS has evolved from a scheme that fully subsidised a small number of drugs to one that partially subsidises about 650 drugs. The cost of the PBS has escalated and patient co-payments, brand premiums and other strategies have been used to transfer some of the cost to consumers.

OThe Federal Government has attempted to introduce economies into the PBS by a number of mechanisms. One of these mechanisms is the encouragement of the use of generic or alternative pharmaceuticals. Products in the prescription pharmaceuticals market can generally be considered to be premium brands, alternatives, or generics. Premium brand pharmaceuticals generally first enter the market with patent protection and continue to have the major market share after the patent expires. 'Alternative' and 'generic' pharmaceuticals have the same pharmacologically active ingredients as do the corresponding premium brand, but sell at cheaper prices. The relevant laws were changed to allow the dispensing pharmacist, with the consent of the patient, to dispense a cheaper generic or alternative when the physician has prescribed a premium brand. Physicians are also being encouraged to prescribe alternatives or generics in the first instance, but this assumes that prescribing physicians are already aware of the names of alternative or generic pharmaceuticals. It also assumes that the physician is satisfied that the alternatives or generics are not inferior to the premium brand in quality or efficacy.

The PBS is just one of the schemes under which the Federal Government supplies subsidised or even free pharmaceuticals. These schemes include the 'gold cards' that are issued to war veterans and 'health care' cards that are issued on a 'means tested' basis. Costs of supply of medicines apart, there are situations in which delay in the dispensing of prescriptions is unacceptable. As an example, the patient may have an immediate need, with urgent or emergency implications, to take a pharmaceutical such, for example, as an antibiotic drug prescribed by his or her physician to treat a bacterial infection.

rThere are also situations which contribute to the risk of errors in dispensing in a O traditional pharmacy. The rate at which prescriptions are being written in Australia Z is consistently increasing by about 15% a year, while the supply of qualified pharmacists graduating is relatively static. These trends reinforce the trend towards larger pharmacies that arises from economies of scale. The result is that overall, there tend to be fewer but larger pharmacies, each employing more pharmacists, with the result that the idle time of each pharmacist is decreasing. However, the likelihood that a pharmacist will be interrupted in the course of dispensing a script is correspondingly increasing. This increased rate of interrupted tasks increases the O risk of the pharmacist making an error in the course of dispensing.

United States patent 6,330,491 partially addresses the problem of immediate supply of drugs. This patent discloses a system whereby a prescription issued by a medical practitioner is supplied to a mail-order pharmacy or to a 'cyber' pharmacy.

A 'cyber' pharmacy, in this context, means a pharmacy which is accessible by the patient via the Internet. Once the prescription has been processed by the pharmacy, the automatic release of the pharmaceutical from a dispensing machine occurs when the patient enters a pharmacy-issued prescription identifier (RxlD) into the dispensing machine. That is, the 'dispensing' of the pharmaceutical by the dispensing machine is automatic, conditional only on the entry of a valid RxlD into the machine. This proposal suffers the disadvantage that the patient must go through a two-stage purchase process. First, the patient must, using the Internet, have the prescription electronically 'filled' by a pharmacist. The patient must subsequently attend a dispensing machine for the actual physical supply of the pharmaceutical. The proposal of patent 6,330,491 also suffers the disadvantage that physical step of actual supply of the pharmaceutical is not supervised by a pharmacist who can monitor the physical state of the patient who will be selfadministering the pharmaceutical.

It is an object of this invention to streamline the supply of medicines from authorized prescribers and retain the interaction between pharmacist and customer.

00 Summary of the invention To this end the present invention provides a system for ordering pharmaceuticals at a location remote from the pharmacist which includes ca) a host server for the system b) data bases accessible from the host server for storing customer information, pharmaceutical stock information c) at least one pharmacy terminal with means to indicate that a pharmacist is in attendance and whether the pharmacist is busy or I available S0 d) at least one remote transaction module which includes a call actuator, an audio communication link from the module to the pharmacy, at least one video camera, a printer and a scanner e) a control system which continually monitors the status of the terminals and the modules and responds to a call actuator being activated and searches for a pharmacy terminal with an available pharmacist (ii) commences a session if a pharmacist is available and activates the audio communication video, printer and scanner links between the host server and the remote module 0 (iii) provides prompts for the customer and the pharmacist to proceed stepwise through the transaction including confirmation of what items are required, whether it is available and whether the provision of the items is appropriate (iv) provides for aborting the process if any request is not satisfied or at the instigation of the pharmacist or customer enables the printing of a receipt or repeat script at the remote module on instigation from the pharmacy terminal.

f) the system enabling the pharmacist to prepare the items to be dispensed for mailing or pick up at another location The pharmacist uses the prescription to identify the purchaser, the practitioner who issued the prescription, and the prescribed pharmaceutical.The system allows access to a database which includes data on persons who are entitled to discounts, benefits or the like on the purchase of pharmaceuticals; 00 practitioners who are lawfully entitled to issue prescriptions; and the pharmacological properties of pharmaceuticals.

The module may also include means adapted to electronically read a health card N that is produced to the machine by a person who is entitled to discounts, benefits or the like for the purchase of pharmaceuticals.

Each remote module may also include means adapted to issue, a printed receipt and a printed repeat authorisation which authorises the dispensing of at least one S further supply of the pharmaceutical. A payment transaction system may also be N provided in the module to verify payment for the product.

C 0 The audio link enables the purchaser and the operator to hold a conversation.

The module may include means operable by a user to attract the attention of a remote operator. This may be a telephone handset, call button or a touch screen to allow the user to indicate that they wish to purchase a 'pharmacy only' item.

The present invention allows a centralised staff of pharmacists to efficiently supervise a distributed network of kiosks, which should in turn contribute to economy of operation, particularly to isolated locations and in 'late hours' locations.

Alternatively pharmacies at different locations may be rostered to be the pharmacy on duty for a number of kiosks. These kiosks may be located in a medical clinic so that the patient can immediately interact with the pharmacist and fill the prescription 0 to be delivered or picked up.

The present invention also provides for the physical security of the pharmacists, who are located remote from the dispensing machines.

Detailed description of preferred embodiments of the invention A preferred form of the invention will be described with reference to the drawings Figure 1 outlines schematically the system according to this invention; Figure 2 is a flow diagram showing the qeueing process to start a session with a pharmacist; Figure 3 shows on e embodiment of the steps in the consulting process of this invention; Figure 4 illustrates the process steps in the online payment module of this invention.

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As shown in figure 1 the communication and control system is in three sectors namely a host to support a number of pharmacies, the pharmacies and a number of remote patient kiosks. The host manages the queuing of kiosk calls for a N pharmacist and the queuing of pharmacists as they become available for consultation (see figure The kiosk incorporates arrange of devices and subsystems including a payment system generally indicated as EFTPOS Each pharmacist station incorporates a computer station and keyboard and a modem for connection to host computer and its data centre. Each kiosk also has an internet I modem and also a bank compatible payment system which may be an ATM or an 0 0 internet based secure payment system. The security system shown in figure 1 uses certificates to identify authorized users such as pharmacists. The system also incorporates a video server to record each session with a patient and enables the pharmacist to view the patient while interacting over the audio link.

The processing of a purchase is shown in figures 2 to 4.

As shown in figure 2 queuing programs connect an available pharmacist to the next in queue kiosk. The host computer communicates with a pharmacy support software system that is used in each pharmacy. This is done through a host administration system that includes modules for billing, data storage, certification management, and auditing. The host computer also communicates with the kiosk ,0 and each pharmacy and provides the data and video links between the pharmacy and the kiosk.

The voice link is preferably direct between pharmacy and the kiosk but an alternative is to have the voice link communicate via the host computer.

The pharmacist logs into system when available in the dispensary. The system switches the kiosk terminal to available mode, activating the terminal call button and changing information screens to advise that a pharmacist is available. The system then waits for the customer to activate the call button. The kiosk may have other screen driven functions that are available when the kiosk is not being used for processing prescriptions. The other functions may include a health information inquiry system.

The pharmacist can log out when leaving the dispensary. The system switches the kiosk terminal to unavailable mode, deactivating the terminal call button and 00 changing the information screens to notify customers at the terminal that a pharmacist is not available.

The detail of the script handling is shown in figure 3 where the prescription is inserted in a secure script tray after which the script is scanned and the image viewed by the pharmacist.

The customer presses call button, the system notifies the pharmacist in the dispensary and the pharmacist accepts the call request. The customer is provided a call receipt which provides a transaction number and relevant pharmacist contact N support information.

S0 Pharmacist welcomes customer and consults with customer as to the nature of the service. At the request of the pharmacist, the script scan lid is unlocked, customer then inserts scripts which are scanned and viewed by pharmacist in dispensary.

The pharmacist can also view and/or store images of identification cards such as Medicare, Drivers Licence and health Insurance cards.

In the case of an electronic prescription the customer inserts script coupon (eScript), and the system scans the coupon, reads unique ID number or bar code and notifies the eScript provider of the request. The eScript is sent to the pharmacy location by the medical service provider or the coupon number is matched to the relevant eScript that has been provided to the dispenser by the prescriber on D request of customer.

If the pharmacist is able to fill the request without prescription or with a prescription, the transaction proceeds and the script may be held in a script tray during the transaction.

The pharmacist switches to the dispensing application system to complete a patient history review, clinical checks, and asks the customer questions as required and then prepares dispensing information label, CMI's and prescription repeats. If the script cannot be filled by supply from the dispensary, the session is aborted and the script is returned to the customer. The return of the script may be achieved by opening the script tray so that the purchaser can remove the script.

Dispensing information is then completed by the terminal control system while the pharmacist monitors the printing of documents, authorises label printing, views printed label and authorises product to be placed in a secure area for later 00 collection or delivery. During this process the system display indicates the stage in the process.

When the pharmacist is satisfied all items have been processed correctly, payment N may be completed by the customer via debit or credit or on pharmacy account as illustrated in figure 4. Then the receipt and repeat documents are printed and issued. The pharmacist may check off supplied items with customer and complete counselling with the customer. The pharmacist closes the transaction, the system S status is checked and then the system goes back into wait mode for next customer.

N The pharmacist need not be involved in all aspects of the process as an assistant 0 O 0 or pharmacy technician can carry out many of the steps until the final sign off for authorization by pharmacist which may occur online or at the dispensary when the medicines are collected.

As can be seen in figures 2 to 4 there are check points at each step in the sequence which, if negative, result in the session being aborted.

The system provides for the customer to contact the pharmacist. The pharmacist can then hold or park the transaction until there is time to complete the transaction or necessary checks are completed. The pharmacist may complete other stages of the transaction and then again put the transaction on hold until the purchaser contacts them preferably from the kiosk, identifies themselves correctly and then 3 the transaction is recommenced and processed through to completion.

During the holding period the purchaser may leave the terminal location and then return after a period of time to contact a pharmacist and complete the transaction stages.

The need to hold or delay completion of the transaction, may be necessary due to transaction demand on the available pharmacist, lack of qualified users to complete necessary checks, enable pharmacist to refer to technical information databases or similar to check whether the patient is authorised to receive the product or to contact the prescriber of the product to confirm details relating to the purchaser.

From the above description it can be seen that this invention provides a unique and safe means of remote filling of prescriptions for pharmaceuticals.

Those skilled in the art will realize that this invention can be implemented in a variety of embodiments without departing from the core teachings of this invention.

Claims (1)

1. 2. A system as claimed in claim one which also includes a payment transaction system in the remote module to enable payment for the product to be transacted