WO2006128243A1 - Methods and systems for handling health related information - Google Patents

Abstract

The present invention provides a method for improving the business of a health insurer and/or a pharmacy, the method including obtaining health related information from a pharmacy customer who is also a customer of the health insurer, the information being obtained while the customer is present in the pharmacy, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer. Applicants propose that the sharing of health related information between a pharmacy and a health insurer will lead to significant advantages for the insurer, pharmacy and the customer.

Description

METHODS AND SYSTEMS FOR HANDLING HEALTH RELATED

INFORMATION

TECHNICAL FIELD The present invention relates to methods directed to the improved gathering, distribution and use of health related information. More specifically, the invention provides for methods and systems useful for improving the health of customers of companies involved in the business of health care, as well as improving the business of a health care company.

BACKGROUND TO THE INVENTION

Profits for health insurers are being eroded by many factors. These factors include the increase in the general cost of providing healthcare, increase in the cost of pharmaceuticals, and an increase in the average age of members. A major issue for health insurers today is the prevalence of preventable diseases in the general community such as obesity-related conditions. In the majority of Western countries the availability of low-cost, high fat and high carbohydrate foods has contributed to an epidemic of obesity and associated morbidity and mortality. Obesity can lead to diseases such as diabetes, hypertension, atherosclerosis, cancer and the like that place a significant drain on the resources of a health insurance business.

Another problem facing the health insurance industry is the tight government regulation present in many countries. This regulation is increasing and as result, the opportunities for health funds to exploit their competitive advantage are somewhat restricted.

A further problem is that the health insurance industry is considered to be in a mature market phase. Maturity of any market encourages discounting to protect market share, and all medical benefits insurers are currently evaluating discounting to protect their business. A market model that relies heavily on discounting for growth and profit provides a short-term solution only. Businesses that rely on discounting are constantly eroding profit margins to maintain market share, which simply cannot be sustained over the longer period.

Another strategy to improve health insurance business is toward consolidation to keep costs down and premium increase to a minimum. However, consolidation again is not a long term solution to the problems faced by health insurers.

There has been, and continues to be, a concerted effort to reduce operating expenses through processing and automation improvements. Cost pressure on the industry, which pushed many insurers into debt last financial year are expected to prompt many to seek merger partners.

From the consumer's point of view, health insurers are charging more and providing less. Accordingly, there has been a consistent decrease in consumers prepared to pay premiums, preferring to rely on wholly government

-funded health care. At the end of June 2003, 8.6 million Australians (or 43.5% of the population) were covered by private health insurance (PHIAC 2003).

This compares unfavourably to the situation in 1985, when about 50% of the population had private health insurance cover. This move away from private health insurance has placed a strain on public hospital resources leading to longer waiting times for treatment and a generally lower standard of care.

A further problem is that members of the community have less opportunity to consult a doctor in an effort to improve their health. Considerations such as availability of doctors, cost and convenience can all reduce the number of visits that a person may make to their doctor. For individuals who have chronic degenerative conditions such as type Il diabetes, this is problematic, often leading to a hastened decline in health.

It is an aspect of the present invention to overcome or alleviate a problem of the prior art by providing methods and systems for improving the business of a health insurer. The benefits are not necessarily limited to the insurer and may extend to the customer, the public health system and other participants in the health care industry.

The discussion of documents, acts, materials, devices, articles and the like is included in this specification solely for the purpose of providing a context for the present invention. It is not suggested or represented that any or all of these matters formed part of the prior art base or were common general knowledge in the field relevant to the present invention as it existed in Australia before the priority date of this application.

SUMMARY OF THE INVENTION

In a first aspect the present invention provides a method for improving the business of a health insurer and/or a pharmacy, the method including obtaining health related information from a pharmacy customer who is also a customer of the health insurer, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer. Applicants propose that the sharing of health related information between a pharmacy and a health insurer will lead to significant advantages for the insurer, pharmacy and the customer. The insurer is in a position to assess and potentially control the health and risk profile of individual customers, and therefore their customer pool as a whole. The pharmacy is able to take a more active role in managing the health of their customers and increase sales. The customer is able to receive advice from the pharmacist on maintaining or improving their level of health, and as a result possibly reduce their health insurance premiums, or obtain other rewards from the insurer and/or pharmacy.

Typically, the method is implemented across a computer network such that the health related information is entered into a first database administered by the pharmacy, and transmitted to a second database administered by the health insurer. The health related information can be processed either by the pharmacy or health insurer to provide information useful in the assessment of insurance risk or in formulating strategy to improve the health of the customer. The health related information may be weight, waist circumference, height, body mass index, blood pressure, lipid profile including cholesterol level, bone density, temperature, blood glucose, urine glucose, A1c, pulse rate, urine nitrogen level, or blood oxygen levels or any combination thereof. .

The health related information may be used to provide a treatment plan for improving the current and/or future health of the customer. The treatment plan may include recommendations regarding diet, exercise, medication, diagnostic testing, referrals to a medical or paramedical practitioner, referrals to a health related educational seminar, or a direction to read health a related publication, or any combination thereof. The treatment plan may be transmitted to the customer's usual medical centre for consideration by his doctor.

The method is particularly useful in the management of preventable diseases or conditions such as type Il diabetes, where adherence to the treatment plane can provide significant and long lasting health benefits to the customer. Accordingly, another aspect the present invention provides a method for improving the health of a pharmacy customer who is also a customer of a health insurer, the method including obtaining health related information from the customer while present in the pharmacy, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer.

In a further aspect the present invention provides a health insurance system for improving the business of a health insurer, the method including obtaining health related information from a pharmacy customer who is also a customer of the health insurer, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer.

A further aspect the present invention provides a pharmacy business system for improving the business of a pharmacy, the method including obtaining health related information from a pharmacy customer who is also a customer of a health insurer, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer.

In yet a further aspect the present invention provides a computer program embodied on a computer readable medium for improving the business of a health insurer and/or pharmacy including code for receiving from the pharmacy current health related information on the customer; code for analysing the current health related information on the customer and historical health related information on the customer; code for identifying an improvement or decline in health of the customer, code for determining whether or not a value added product or service or other reward is provided to the customer; and code for determining whether or not a penalty is provided to the customer.

A further aspect of the present invention provides a data communications network including communication devices enabling communication between a pharmacy and a health insurer, a method for improving the business of the health insurer, the method including obtaining health related information from a pharmacy customer who is also a customer of the health insurer, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer.

BRIEF DESCRIPTION OF THE FIGURES Figure 1 illustrates an overview of an exemplary method of the invention.

DETAILED DESCRIPTION OF THE INVENTION

In one aspect, the present invention provides a method for improving the business of a health insurer and/or pharmacy, the method including obtaining health related information from a pharmacy customer who is also a customer of the health insurer, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer. In one embodiment of the method, the health related information is entered into a first database administered by the pharmacy, and transmitted to a second database administered by the health insurer.

In one form of the method, the health related information is processed by the pharmacy to provide information useful in the assessment of insurance risk or in formulating strategy to improve the health of the customer. In an alternative form of the method the health insurer processes the heath related information to provide information useful in the assessment of insurance risk or formulating a strategy to improve the current or future health of the customer.

Applicants propose that the acquisition, processing, transmission, distribution or use of customer data as described herein overcomes or ameliorates one or more problems of the prior art. Historically, pharmacies and health insurers operated essentially independently. At most, a pharmacy may have advertised the services of a health insurer, or acted as an agent for the insurer for a handling fee. In acting simply as an agent, the pharmacy may convey certain patient information to a health insurer including name, address, age, premium payment information, and claim information. Claim information may include details of a medical treatment performed on the patient, for which the patient is seeking reimbursement. This type of information would be obtained by the insurer in the normal course of business where the pharmacy did not act as an agent and the customer dealt directly with the health insurer. By contrast, the present invention relies on the pharmacy obtaining health related information that would otherwise not be available to a health insurer, the information being obtained when the customer visits the pharmacy. This information, either in raw or processed form can form the basis for intervention by the pharmacist by way of implementation of a treatment plan.

Thus, the sharing of information on customer health between a pharmacy and a health insurer is a significant departure from the state of the art as it stood before the present invention. The interchange of customer data between these two historically distinct businesses allows for a number of advantages including the ability for the health insurer to not only access a whole new pool of potential customers, but also to assess the insurance risk of those customers by information provided by the pharmacy. Of even greater importance, the methods described herein allow the insurer to control and/or intervene in the present and/or future health of their customers.

The present invention requires the pharmacist to obtain health related information from a customer and enter it into a database for subsequent processing and eventual use as a tool for intervention in the health of the customer by the pharmacist and/or health insurer. The customer may be prompted by the pharmacist to enrol in a program embodying the present methods. For example, the pharmacist may prompt an obese customer who is purchasing a blood glucose monitor to enrol, given the benefits proposed for type Il diabetics. Alternatively, the customer's doctor may recommend enrolment if it is in the interests of the customer's health. In another form of the method, the customer is prompted by an advertisement for the program, and presents at his local participating pharmacist for enrolment.

The information held on each customer in the database can be any information that provides the pharmacy or the health insurer information or intelligence that allows improvement of either or both businesses. The health related information may be past, present or future or any combination of all three.

Preferably the health related information is easily obtainable in a pharmacy environment without the need for a medically invasive procedure. Examples of preferred health related information include weight, measurement of body dimensions such as waist circumference and height, body mass index, blood pressure, lipid profile including cholesterol level, bone density, temperature, blood glucose, urine glucose, A1c, pulse rate, urine nitrogen level, blood oxygen levels, and the like. These types of health related information can be obtained with simple tools or test equipment yet provide valuable information on the customer's health. The health related information may also include less easily quantifiable parameters such as mood, libido, skin condition, hair condition, gait, coherence of speech, acuity of hearing, accuracy of vision and the like.

The health related information may also include any information not directly obtained by a pharmacist but is offered by the customer, such as the results of diagnostic tests conducted by a pathology laboratory such as a prostate serum antigen test, full blood examination, tissue biopsy etc. Given the pharmacist's previous interactions with the customer he or she will typically be in a position to ascertain the reliability of any information the customer imparts. For example, if a customer appears confused when detailing the result of a diagnostic test, the pharmacist may choose not to enter that information on the database. Similarly, if a customer insists they have ceased smoking but still have an odour of tobacco about their person, the pharmacist may choose not to enter that information.

In a preferred form of the invention the health related information is obtained in a pharmacy environment. The pharmacy (and the obligatory attending pharmacist) can be considered as a central point for obtaining and transmitting customer health related information. Pharmacists have special expertise in obtaining quantitative health-related information such as blood pressure and bone density, as well as skills in interviewing customers to obtain more qualitative health related information.

In one embodiment of the method the health related information is used to provide a treatment plan for improving the current and/or future health of the customer. The treatment plan may be generated by the pharmacy or health insurer or third party or any combination of the three. The treatment plan is preferably verbally imparted to the customer by the pharmacist (along with a hard copy of the plan for the customer to take home). The treatment plan may include recommendations regarding diet, exercise, medication, diagnostic testing, referral to medical or paramedical practitioners, referral to health related educational seminars, directions to read health related publications, and the like. In the context of the present invention, the pharmacist can be considered as a central point for imparting information to the customer. Registered pharmacists are permitted to provide certain advice to a customer. For example, depending on the specific jurisdiction in which the pharmacist practices, pharmacists are permitted to perform pharmacokinetic monitoring and advise customers on appropriate dosage. In some jurisdictions, a customer purchasing certain over the counter medications must discuss use of the medication with a registered pharmacist. Given the time and effort involved in imparting the treatment plan to the customer, the pharmacist may levy a fee to the health insurer.

An advantage of the present invention is that the business of the health insurer is improved. A further advantage is that the business of the pharmacy is improved. As used herein, reference to "improving" a business is intended to include an increase in one or more of the following business indicators including: customer numbers, sales, profitability, profit margin, return on investment, marketing opportunity, increase in the proportion of low risk clients as customers, increase in the general health of customers, and increase in customer satisfaction. The term "improving" is also intended to include a decrease the proportion of high risk clients as customers, and a decrease in payouts on policies.

A key advantage of the present invention is the ability of the health insurer to control and/or intervene in the current and/or future health of their customers. This would not be possible without the health related information provided by the pharmacy. Since a major drain on the resources of a health insurance business is the increase in hospitalisations due to preventable illness, it is clearly desirable to reduce the number of hospitalisation days payed on average for each customer.

A significant example of a disease that adversely affects the business of a health insurer is diabetes. In 1999-2000, diabetes as a principal or additional diagnosis accounted for 336,976 hospitalisations in Australia (5.7% of all hospital separations), with an average length of stay of 7.0 days compared with 3.6 days for people without diabetes.

Diabetes shortens life and has a significant impact on quality of life. Serious complications including blindness, heart attack, kidney failure, stroke and amputations can be a consequence of the illness. One cause of diabetes is increasing age, a parameter over which customers have no control. However, there are other predisposing factors that are eminently controllable such as obesity, inactivity, high blood pressure, and poor diet. Diabetes is the fastest growing disease in many Western countries. It is the sixth highest cause of death in Australia. People with diabetes are almost three times more likely to have high blood pressure, obesity or elevated blood fats. They are two or three times more likely to have cardiovascular disease. Diabetes is the leading cause of kidney failure, with renal disease accounting for 8%-14% of deaths in people with diabetes. Moreover 5% of people with diabetes will experience foot ulcers. Of the 3000 amputations in people with diabetes, most are preventable.

Diabetes (and especially type Il diabetes) is preventable to a large extent yet leads to significant morbidity and hospitalization where left uncontrolled. The present invention will be useful in alleviating the burden of a diabetic or potentially diabetic customer on a health insurer by either increasing premiums for diabetics who do not adequately control their glucose levels and/or encouraging the customer to be better educated on insulin administration. Alternatively, diabetics who do not adequately control their condition may be denied value added products or services or other rewards available to diabetics who are following advice. The pharmacist is instrumental in the methods of the invention since it is he or she who obtains and transmits the health related information on the customer, and may also impart the treatment plan where required. For example, once a customer is identified as at risk for diabetes, an aim of the treatment plan is to improve prevention; earlier diagnosis and management of people with diabetes improve physical activity, diet and achieve more healthy outcomes. The recommendations in the treatment plan provided to the customer could be administered by any other party in addition to, or in place of, that provided by the pharmacist. For example, a diabetic customer could receive the advice or information from an organisation such as Weight Watchers®, or from an alternative health professional such as an osteopath or massage therapist.

It will be understood that the present invention is applicable to customers having any disease or condition that can be prevented or alleviated by education of the customer. While the disease of diabetes is often referred to herein, it will be understood that the present invention would apply to any disease that can be improved or prevented by any means known in medicine.

For example, another disease that is preventable is high blood pressure (hypertension). Hypertension is a major risk factor for coronary heart disease, stroke, peripheral vascular disease and renal failure. The risk of disease increases as the level of blood pressure increases. When high blood pressure is controlled by medication the risk of cardiovascular disease is reduced, but not to the levels of non-affected people. Research has shown that high blood pressure is associated with other cardiovascular risk factors, including high cholesterol levels, obesity and diabetes. For hypertension, the health related information provided by the pharmacist could relate to blood pressure, diet, or compliance with medications. If after the information has been processed according to the inventive methods that blood pressure is not being adequately controlled, the pharmacist could upon instruction from the insurer recommend certain diets, exercise regimes, or the use of a home blood pressure monitor.

Another preventable disease that is relevant to the present invention is high blood cholesterol. Hyperlipidaemia is a major risk factor for coronary heart disease and peripheral vascular disease. High blood cholesterol is the main cause of the process by which the blood vessels that supply the heart and other parts of the body become occluded. The risk of heart disease increases with increasing blood cholesterol levels. An advantage to the customer is that the disease treatment and/or prevention programs (as recommended in the treatment plan) will improve quality of life by providing effective strategies for reducing risk. The disease prevention programs will be exclusively available to customers of the health insurer on a regular basis with future options to provide supervised group exercise and diet modification and the like.

In one form of the invention education forms a significant part of the treatment plan provided by the pharmacy or insurer to the customer. Using diabetes again as a non-limiting example, education will help customers with diabetes, their families and communities achieve a better understanding of the condition. For example, social environmental risk factors (such as poor material circumstances), psychosocial risk factors (such as social isolation and lack of social support), behavioural risk factors (such as physical inactivity and poor nutrition, including high dietary intake of fats and low consumption of fruit and vegetables), and physiological risk factors (such as obesity, impaired glucose tolerance) may all be controlled by adherence to the treatment plan. Exemplary seminars programs and details of trade displays suitable for diabetes education are disclosed at Example 2 herein.

Another education initiative recommended in a treatment plan is the distribution of food diaries to count dietary fat intake, for two days per week. Food diaries may include reasons for reducing fat content, how to identify high fat foods, label reading, and practical strategies for reducing fat intake.

Another education initiative is the provision of a "supermarket tour", whereby under supervision of a dietician customers are lead through their local supermarket. Customers are taught how to make healthy food choices in a simulated shopping situation by consideration of portion size, nutritional content as disclosed on packaging, salt content, and the like. Further general information may be provided such as pointing out the brand names of certain breads that have a low glycaemic index, which cereals are high in fibre, which condiments are low in salt, which margarines are high in omega 3, and the like. The methods of the present invention require at least one database for storing the health related information of the customer for subsequent processing. It will be understood that the database may be embodied in any form capable of holding the health related information. The information may be encoded in electronic form where the method is at least partially implemented on a computer. The data in the database may be stored in any electronic means known to the skilled artisan including use of the following technologies: primary access from the CPU or secondary (indirect) access by the CPU, volatile or non-volatile, read-only memory, WORM, or read-write, random-access or sequential-access, mutable (read-write), immutable (read only). Media categories include, for example, semiconductor storage, optical storage, phase change, magneto-optical storage, and magnetic storage. Suitable storage devices include bubble memory, cache memory, core memory also known as ferrite core memory, core rope memory, delay line memory, holographic memory, magnetic disk:, floppy disk, hard disk, magnetic drum, magnetic tape, magneto-optical disk, memory stick, optical media:, PD, CD-R, CD-ROM, CD- RW, DVD, DVD-RAM, DVD-RW, blu-ray, paper tape, punch card, selectron tube, semiconductor memory:, EPROM, flash memory, NVRAM, RAM, ROM, VRAM, WRAM, and thin film memory.

Of course, it is not strictly necessary for the database to hold information in electronic form, with the invention being executable on paper if absolutely necessary. However, given the large number of records that are likely to be involved, electronic storage and data interchange is preferred.

Where the invention is implemented on a computer platform, the skilled person will be able to select database software suitable for use in the invention. The skilled person would consider aspects such as available hardware, operating system, number of records and so on when selecting an appropriate program.

There are two main types of database contemplated for use in the present invention: flat-file and relational. Which type is preferred for a particular application will depend on factors such as the type and the amount of data to be processed; and how frequently it will be accessed. The flat-file style of database are preferred for small amounts of data that are human readable or edited by hand. This type of database essentially consists of a set of strings in one or more files that can be parsed to get the information they store. This type of database is useful for storing simple lists and data values, but can be less efficient for replicating more complex data structures. The methods used for storing the more complex data types, are also likely to render the file unreadable and un-editable.

One of the main problems with using flat files for even a semi-active database is the fact that it is very prone to corruption. There is no inherent locking mechanism that detects when a file is being used or modified, and so this has to be done on the script level. Even if care is taken to lock and unlock the file on each access, a busy script can cause a "race condition" and it is possible for a file to be wiped clean by two or more processes that are competing for the lock; the timing of file locks becomes more and more important as a database receives increased traffic.

It is possible to implement a Database Management (DBM) layer in relation to a flat-file database, allowing the script programmer to store information as a pair of strings; a key, which is used to find the associated value. Essentially, a DBM adds more functionality and better sortation during storage to the binary flat-files that it uses. There are several versions of DBMs available, but the most popular is the Berkley Database Manager; also known as the Berkley DB.

While the present invention contemplates the use of simple flat-file databases, in a preferred form of the invention the customer information is held on a relational database. Relational databases such as MySQL, Microsoft SQL Server and Oracle, have a much more logical structure in the way that data is stored. Tables can be used to represent real world objects, with each field acting as an attribute. For example, a table called "customer body mass index" could have the columns date, weight, waist measurement, and BMI which describe the details of each customer's body mass index measurements. The term "relational" in these types of database comes from the fact that the tables can be linked to each other, for example a record on a given customer could be cross-referenced to entries for other members of the customer's family to provide more information about the customer. For example, while the customer does not smoke, the customer's wife may with this fact being potential useful in assessing risk from passive smoking. These kind of relations can be quite complex in nature, and would be hard to replicate in the standard flat-file format.

One major advantage of the relational model is that, if a database is designed efficiently, there should be no duplication of any data; helping to maintain database integrity. This can also represent a large saving in file size, which is important when dealing with large volumes of data. Joining large tables to each other to obtain the data required for a query can be processor intensive; and so in some cases (particularly when data is read only) it may be beneficial to preserve some duplicate data in a relational database. Relational databases also have in-built functions that help in the retrieval, sorting and editing of data.

Where electronic databases are used in the context of the present invention, it will be understood that the first and second databases may be embodied on computers that are networked. It is not necessary for the computers to be directly connected, it being contemplated that data could be transmitted from the first database to the second database via any number of intermediate computers, routers, or intermediate storage devices. For example, the interchange of information may take place by transmitting from a branch pharmacy administered computer embodying the first database, to a pharmacy head office administered computer, for subsequent transmission to the health insurer administered computer embodying the second database. Alternatively, the data may be transmitted in physical form (such as on a portable hard drive) to the recipient computer.

The exchange of information may take place according to any suitable schedule including immediately upon a new record is entered, hourly, daily, weekly, or monthly. The health insurer can access the health related information and process the information to generate a risk profile of each customer, or a treatment plan for treatment or prevention of disease. For example, body weight measurements could be relayed to the insurer. If the customer reaches a certain critical bodyweight or a certain body mass index, the insurer may decide to increase the premium (or to withdraw value added products or services) until the customer's weight returns closer to normal. In the meantime, the insurer may encourage the customer to speak to the pharmacist about strategies for reducing weight or may refer them to a separate weight loss clinic.

Another example of processing health related information is where the information is blood glucose. This is an important factor in the management of diabetes and can provide valuable information on the insurance risk of a customer. The customer may log their blood glucose readings at home and take them to the pharmacy for entry in the pharmacy administered database. Upon transmission of the data to the database administered by the health insurer and subsequent processing, it may be apparent that the customer's blood sugar is not being correctly managed. This could be decided for example by an algorithm that considers the total length of time that the glucose level is outside normal range for example. Further analysis could discover for example that the customer is administering information at the wrong time of day relative to food intake. In this case, the algorithm could recommend further education of the customer as to the correct timing and dosage of insulin administration.

The health related information may include other parameters useful in the assessment of diabetes, such as the A1c test. The A1c test is used primarily to monitor the glucose control of diabetics over time. As discussed, the goal of those with diabetes is to keep their blood glucose levels as close to normal as possible. This helps to minimize the complications caused by chronically elevated glucose levels, such as progressive damage to body organs like the kidneys, eyes, cardiovascular system, and nerves. The A1c test gives a picture of the average amount of glucose in the blood over the last few months. This test may help the insurer assess if the measures they are recommending to control the customer's diabetes are successful or in need of adjustment. The A1c test is frequently ordered on newly diagnosed diabetics to help determine how elevated their uncontrolled blood glucose levels have been. The test may be ordered several times while control is being achieved, and then several times a year to verify that good control is being maintained.

Multiple data points for blood glucose readings will also be useful in providing information as to how well blood glucose is being regulated by the customer. Many blood glucose monitors are capable of storing a large number of readings, and "dumping" the data into a personal computer. Software capable of retrieving blood glucose readings from a monitor is known in the art, one example being the Accu-check® Compass Diabetes Software provided by Roche. More sophisticated systems are currently in development, including the use of wireless data transmission. It is contemplated that a customer will be able to transmit blood glucose readings to their personal computer by Bluetooth technology, and then transmit the data to the pharmacy computer via the Internet.

While the health related information may be processed automatically by a computer, it is contemplated that there may be human input. For example, an actuary could be involved in assessing a customer's risk profile. In addition, a physician, nurse, dietician, podiatrist, physiotherapist, chiropractor, osteopath, psychologist, counsellor, pharmacist, or fitness trainer could be involved in deciding the correct therapeutic or preventative strategy for a given customer.

It should not be overlooked that the present methods provide significant advantages to the pharmacy business involved in obtaining the health related information. Accordingly, in a preferred form of the method, the pharmacy business improves as well as the health insurance business.

The present invention exploits the existing expertise that a pharmacy has in dealing with and advising customers on issues of health. Once the customers are in the store, the pharmacist can offer their usual range of goods, fills prescriptions etc. Importantly, the pharmacist can offer education and products that will help with prevention of disease. The education and products proposed by the pharmacist may be those identified after processing the health related information. This added value is proposed to overcome the discount pharmacy model of low prices and little or no service.

As discussed supra the pharmacy may levy a fee for time taken to impart the treatment plan to the customer, or for any other educational activity that may improve the customer's health.

The present invention provides a sophisticated approach for the pharmacy business by building and utilising the assets in the business such as the health related information database information of its customers and utilising that information to tailor programs, marketing products, stock, shelving, category management etc. to address specific business needs, and identify business opportunities. Valuable information such as that provided by the present methods have not hitherto been available to pharmacy businesses. Customers will be motivated to provide information over and above that supplied in a normal interaction with a pharmacist, given the prospect of an improvement in their health and other rewards as provided by the present methods.

In addition to data obtained from the customer, the present methods provide the opportunity for transmission of data from the health insurer to the pharmacy. As discussed supra health insurance and pharmacy businesses have previously operated independently, there being no motivation for information exchange. In providing mutually beneficial outcomes for both businesses, the allied pharmacy and health insurer are motivated to provide each other with valuable information. For example, the health insurer may be in possession of general demographic information showing the actual numbers of individuals within a given geographical area served by a pharmacy who are obese. In this scenario, the pharmacy business can identify the possibility of growth in sales of anti-obesity medications, increase orders from wholesalers, and also increase in store marketing. This approach is a significant improvement on the current "trial and error" marketing approaches often utilised by pharmacy businesses. The data generated by implementation of the present methods could be data- mined to the point of putting a value per head on the database. This data could provide valuable actuarial information to the health insurer.

The present invention will enable integration of participating pharmacies which will create a buying group capable of negotiating more beneficial relationships with wholesalers, via a single purchasing entity. The present invention creates a defensive strategy that is able to compete with the discount or "supermarket" model of pharmacy.

The inventive method will also assist in transactions between the pharmacy and pharmaceutical suppliers. If suppliers are able to secure pharmacies that have formed an alliance with a health insurer, this distribution network will be able to secure agreement for the launch of new products for example. Suppliers will understand the sustainability of market share encompassed by pharmacies participating in the inventive method would offer an effective way to market and advertise their products, including to customers of the health insurer. Suppliers will see being part of a pharmacy/health insurance alliance of value. Suppliers will be able to more efficiently manage their issues of manufacturing, forecasting demand to meet supply.

It is also anticipated that a further advantage of the method is that medical centres will be amenable to exchange of, health related information on customers. Linking pharmacies with medical centres and health insurers will provide an appropriate monitoring system for earlier diagnosis, detection, and prevention of diseases of significant public health improtance such as diabetes, obesity, hypertension, and hyperlipidaemia as discussed supra.

Pharmacies will be the source of information that is directed to the medical centre after a consultation, where doctors will be able to file or update the customer's information and then feedback information back to the pharmacist to take appropriate steps. The link between pharmacies and medical centres by providing information to the doctors on a weekly basis will provide customer benefits aimed at improving their quality of life. As well as improving the pharmacy and health insurance businesses, it should not be overlooked that the present invention provides substantial advantages to the client. For example, it is clear that the health of a customer will improve if he regularly attends the pharmacy and implements the plan provided by the health insurer. A further advantage for the customer is that they will be financially advantaged by being offered a lower health insurance premium, value adding for pharmacy items, or other rewards for improving their health.

It should also be recognised that the present invention is applicable not only to customers with an existing medical condition. The invention provides advantages to the customer, pharmacy and health insurer even where the customer is in perfect health. In this scenario, the emphasis is on prevention of disease. For example, the customer may have a strong family history of hypertension, and the customer attends the pharmacy six monthly for a blood pressure reading. Thus, any sign of hypertension will be recognised early, and changes to lifestyle can be implemented to lessen the seriousness of the hypertension that may subsequently develop, or to at least delay the onset of serious hypertension.

In another aspect, the present invention also provides a health insurance system for improving the business of a health insurer, the method including obtaining health related information from a pharmacy customer who is also a customer of the health insurer, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer.

A further aspect the present invention provides a pharmacy business system for improving the business of a pharmacy, the method including obtaining health related information from a pharmacy customer who is also a customer of a health insurer, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer. A further aspect of the present invention is a computer program embodied on a computer readable medium, the program capable of executing a method as described herein.

Another aspect of the present invention provides a computer program embodied on a computer readable medium for improving the business of a health insurer and/or pharmacy including code for receiving from the pharmacy current health related information on the customer; code for analysing the current health related information on the customer and historical health related information on the customer; code for identifying an improvement or decline in health of the customer, code for determining whether or not a value added product, service or other reward is provided to the customer; and code for determining whether or not a penalty is provided to the customer.

A further aspect of the invention provides a computer including a computer program as described herein stored on a computer readable medium.

The skilled person will be enabled to implement the present invention in the form of a data communications network. Accordingly, a further aspect of the present invention provides a data communications network including communication devices enabling communication between a pharmacy and a health insurer, a method for improving the business of the health insurer, the method including obtaining health related information from a pharmacy customer who is also a customer of the health insurer, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer.

The present invention will now be further described by reference to the following non-limiting Examples.

EXAMPLE 1 : Methods for obtaining and transmitting health related information. The invention will be explained by reference to the non-limiting embodiment of illustrated in Fig 1. It can be seen that the method includes an interaction 1 between the customer and the pharmacist. This interaction 1 will generally be a verbal discussion between the pharmacist and customer, however may further include the implementation of one or more diagnostic tests. Upon obtaining the relevant health related information the pharmacist enters the information 2 onto a computer database administered by the pharmacy. The information is then transferred across a computer network 3 to a database hosted by the health insurer. The health insurer then processes the information 4 to identify any indication that the health of the customer may warrant an evaluation or re- evaluation of the insurance risk posed by having that customer as a member. The information may also be processed to identify any therapeutic or preventative strategies that could be implemented to improve the current or future health of the customer. Any relevant strategy is then transmitted directly to the pharmacist 5 and/or to the pharmacy database 6. The pharmacist may obtain the processed information by reading customer records 2 on the pharmacy database. The pharmacist may then relay the processed information 1 back to the customer on their next visit to the pharmacy. For completeness, the treatment plan is forwarded 7 to the medical clinic frequented by the customer, for inclusion in his medical history.

It will be apparent that this method emphasises the role of the pharmacist in health care. This role has diminished in recent years with the advent of discount pharmacies that provide little in the way of service to customers on the understanding that prices will be lower. The discount pharmacy model has lead to an erosion of profits for pharmacies, and a general downturn in the ability of the pharmacist to provide valuable health care information to the customer.

EXAMPLE 2: Management of a compliant diabetic customer who is a customer of an allied pharmacy and health insurer.

This Example is intended to demonstrate one embodiment of the invention described herein as relating to a customer suffering from diabetes. Fundamentally, the Example demonstrates the interaction and interchange of information between the customer and pharmacist, as well as the pharmacist and health insurer.

In this Example, the diabetic customer (diagnosis five years prior) is under medical care but his health is declining. The customer visits his doctor infrequently due to difficulties in gaining an appointment, cost, and the general inconvenience associated with attending the clinic. The customer currently has no loyalty to any pharmacy and for reasons of economy often obtains medication from a local discount outlet. When the customer seeks assistance in the management of his condition from the pharmacist, he complains that he is provided little guidance, preferring to simply fill his prescription. The customer has existing health insurance and complains that he receives little for the high premiums levied.

Upon presentation at the local medical clinic, the doctor recognizes that the customer's health is in decline and recommends enrolment in a "diabetic program" jointly run by a health insurer in alliance with a pharmacy chain. It is explained that enrolment into the program requires the customer to consistently attend the pharmacy chain and to become a member of the health insurer. In the interests of transparency, the doctor explains to the customer that their enrolment in the program may provide economic advantages to the pharmacy and/or health insurer. However, given that an economic advantage is necessary to finance the program, and that the program is designed to improve the customer's health, enrolment is recommended.

In light of his previous experiences and the advice offered by his doctor, the customer transfers his health insurance to a health insurer involved in the program, indicating to the new insurer his desire to become involved in the diabetic program. Upon receipt of the application, and acceptance of the customer, the health insurer updates their diabetic program electronic database to include the customer's details.

The customer also informs a local pharmacy allied to the health insurer of his enrolment in the diabetic program. This is achieved by handing a completed form including customer details to the pharmacist. The pharmacist updates his diabetic program electronic database to include the client's details.

The diabetic program electronic databases administered by the health insurer and the pharmacist are capable of exchanging information on the customer by way of Internet connection using a secure sockets layer (SSL) protocol for data security.

In the first week of enrolment, the customer attends the pharmacy and has a consultation with the pharmacist. During this consultation, the pharmacist obtains health related information including weight, hemoglobin A1c, blood glucose, blood pressure, and lipid levels. The pharmacist also obtains basic lifestyle and dietary information. This baseline information is entered into the pharmacist's database, the information being subsequently transferred to the health insurer's database at close of business.

The baseline health related information is evaluated by the health insurer and an assessment made as to whether any improvement can be made, based on the single data point. In this Example, the diabetic customer is a male 50 years of age, weighing 120 kg, and having an A1c of 9% (corresponding to an average glucose of 240 mg/dL, or 13.5 mmol/L). Data from the customer's blood glucose monitor (Accu-Check®, Roche) is downloaded to the pharmacy computer using Accu-Check® Compass Diabetes Software (Roche), with the last 20 readings being noted. In this Example, glucose levels are often outside normal range, indicating that the customer does not control diet and/or insulin administration in a manner sufficient to maintain normal blood glucose levels. The customer's lipid (LDL) is found to be 4.0 mmol/L, which is well in excess of the recommended upper level of 2.59 mmol/L for diabetics. The customer's blood pressure is 200/110, which is significantly elevated.

The customer's diet is found to consist mainly of take away foods having high a glycaemic index, as well as sugary drinks. The customer has a sedentary job, with little or no exercise as part of his normal routine. After the close of business, the pharmacist transfers the customer's health related information to the health insurer's diabetic program database. Upon consideration of the baseline information as present in the health insurer's database, the health insurer notes immediately that the customer is in poor health and is likely to be a significant liability for the company over the coming years. In order to lessen the likely negative financial impact of this client on the insurer's business, the insurer formulates a treatment plan for the customer designed to improve his health.

One aspect of the treatment plan is for the customer to attend a general diabetes education seminar. The seminar is funded by the health insurer, although the pharmacist is present at the function providing information as required. Features of the seminar program are described in Appendix 1 to this Example.

The seminar also includes a trade exhibit area where businesses can market diabetes-related products and services. Features of the trade exhibit area are described in Appendix 2 to this Example.

After the initial consultation with the pharmacist and exposure to the diabetes education program, the customer is scheduled to return to the pharmacy at monthly intervals. At each visit, updated health related information is obtained from the customer, and is transmitted to the health insurer's database as described supra. In this Example, the customer's health related information at the second consultation showed weight of 118 kg, A1c of 8%, glucose levels still sometimes outside normal range but generally improved, lipid (LDL) is 3.2 mmol/L, and blood pressure of 180/90. While the customer still has occasional take away meals, foods having a lower glycaemic index (including "diet" soda) now predominate in his diet. The customer now walks for 4 km, twice per week.

After transmission of the updated data to the health insurer's database, a further assessment is made by the insurer. The insurer is please to note the improvements, and is confident that the data is accurate since it has been collected and transmitted by the pharmacist (as distinct from self-reported data). However, further improvement is desired and so the insurer recommends that the customer increase his level of exercise, take blood glucose readings more often, and completely remove take away food from his diet. These further recommendations are transmitted to the pharmacist, who imparts the treatment plan to the customer on his next monthly visit. To reward the customer, and to motivate him toward further health improvements, the pharmacist offers value adding of blood glucose measurement consumables. The customer takes up the offer, and now more regularly monitors his blood glucose. The pharmacist is advantaged because he has the loyalty of the customer (including monthly visits), and sales in diabetes-related products are improved. A further advantage to the pharmacist is that the customer is also a new father, and so purchases products such as infant formula and diapers while on his monthly visits to the pharmacy.

After 12 months consistent improvement in the customer's health related information, the insurer now considers that he poses a lessened risk for payout due to hospitalization for complications of diabetes. As a reward, the insurer decides to value add to goods or services. However, the value added goods or services will only apply so long as the customer's health related information (as collected and transmitted by the pharmacist) remains within acceptable limits. Relevant to the pharmacist's interests, the customer is therefore still required to attend the pharmacy regularly, albeit at extended intervals. Relevant to the customer's interests, any decline in the customer's health will be detected early, and a further treatment plan recommended by the health insurer to halt or reverse the decline.

For the duration of the customer's enrolment in the program, the health related information is forwarded to the customer's doctor for inclusion in his medical history. Even though the customer visits his doctor only sporadically, the doctor is pleased to note the customer's improvement.

Appendix 1: Diabetes Information Seminar Program Aims:

1. To provide a quality diabetes education session for clients 2. To enhance client understanding and management of diabetes

Methods:

Timing • Pre-session refreshments/trade display: 1.5 hours

• Session duration: 1.5 hours o 10 mins introduction o 20 mins presentation from each speaker + 5 mins question time after each speaker o 5 mins close

• Post-session refreshments: 1 hour Content

Living With Diabetes (presented by diabetes educator)

• What is diabetes? • What are the consequences of diabetes?

• Who is at risk?

• How can the risk be reduced?

• How can diabetes be managed? o Blood Glucose Monitoring o Glycaemic Levels, Haemoglobin A1 c o Weight o Cardiovascular o Complications Screening (retinal examination, kidney, podiatric assessment) • Diabetes Empowerment Model

Lifestyle Management of Type 2 Diabetes (presented by dietician)

• General Healthy Eating Principles o Glycaemic Index (Gl) o Fat recommendations o Dietary information panels

• Weight loss

• Physical activity o Health benefits of physical activity Wound management in diabetes (presented by wound care expert) • Wound management issues in diabetes

• Smoking

Key points • Monitor blood glucose regularly

• Routine health check-ups

• Eat healthy

• Increase physical activity

Evaluation:

• Evaluation form/survey to be completed by customers

Appendix 2: Diabetes Care Management Program Exhibitors:

• An adequate evidence based range of solutions/products • Samples/trial sizes available at seminar nights and for each pharmacy where demonstration may be required. Attendees must be able to try products

• Items as giveaways for information packs (pens, notepads and other merchandise such as fridge magnets, videos, CDs or DVDs) • Information leaflets and material

• Items that can be used as "door prizes" or "program rewards"

• Corporate posters and signage

• Ensure the product display at the seminar is supported by stock in pharmacy. • Collaboration of printed materials re nutritional information, healthy recipe ideas and complimentary samples to be included in the post- seminar information packs planned

Exhibits/ Display:

1. Foot care/Skin care (presented by foot care product manufacturer).

Aim: • to introduce customers to the different products available for foot care to minimise corns, calluses, blisters and cracked heals

• to demonstrate proper skin care

2. Wound Management (presented by wound care product manufacturer).

Aim:

• to introduce customers to the different products available for wound management and to maximise wound healing 3. Blood Glucose Monitors (presented by monitor manufacturer).

• Diabetes Educator or Nurse to demonstrate correct technique for BGL measurements

Aim:

• to demonstrate the different models of monitors available • diabetes educator to demonstrate the correct technique for using glucose monitors and lancing devices

4. Blood Pressure/Pedometer (presented by device manufacturer).

Aim: • to demonstrate the at home blood pressure monitoring kits

• to demonstrate the use of pedometers

5. Natural Supplements (presented by nutritional manufacturer).

Aim: • to advise customers on the products available for management of diabetes and health

• A Naturopath will be present to offer advice

6. Foot Care (presented by podiatrist). Aim:

• to advise on the importance of regular podiatrist visits and proper foot care

Services available, appointment cards, make appointments, discount if appointment made that night 7. Pharmacy Products and Services (presented by pharmacist).

Aim:

• to inform customers of products and services available in pharmacy (Dosettes, diabetes consumables, customer information, medication information)

8. Diabetic Friendly Foods (presented by pharmacist).

Aim: • to offer healthy food alternatives for diabetics

• display diabetic friendly foods for sale in store on display

9. Diabetic Unfriendly Foods (presented by pharmacist)

Aim: • to alert customers to the foods that are best avoided or consumed at a minimum by diabetics

• display of non- diabetic friendly foods

EXAMPLE 3: Management of a non-compliant diabetic customer who is a customer of an allied pharmacy and health insurer.

The methods of Example 2 generally apply herein, except that the customer does not fully comply with the recommendations of the health insurer. A further difference is that the customer maintains regular contact with his doctor.

The customer arrives very late to the diabetes education seminar and misses key information on blood glucose monitoring and diet. Furthermore, he fails to modify his diet and lifestyle such that there is little improvement in his health related information over a 6 month period. Accordingly, his general health declines. For example, he notices an ulcer on his lower leg that fails to heal. He also briefly loses consciousness while driving due to abnormal insulin levels.

As stated, the customer visits his doctor monthly; however this is proposed to make little difference to his overall health. While this customer would like to improve his health, he requires some material motivation that his doctor simply cannot provide. As will be understood, the doctor gains no financial advantage in improving the health of his customer (indeed, it could be argued that the doctor suffers a financial disadvantage), and therefore cannot pass on a financial reward to the customer.

EXAMPLE 4: Management of a chronic asthmatic who is a customer of an allied pharmacy and health insurer.

The methods of Example 2 generally apply herein, except that the customer is a chronic asthmatic. As will be understood, poorly managed asthma can result in hospitalization of a customer, thereby diminishing the profitability of a health insurer.

In this example, the health related information obtained and transmitted by the pharmacist include peak flow and forced vital capacity readings (both historic readings recorded by the customer in a diary, as well as a reading taken the pharmacist as a "validity check" of the customer reported readings). If a poorly managed customer does not follow the advice of the insurance company (for example gentle exercise, regular use of preventive medications such as Pulmocort®, then value adding and other motivations will not be provided. Regular visits by the asthmatic customer to the pharmacy will facilitate sales of medication such as Ventolin®, as well as ancillary items such as anti-dust mite bedding, dust mite spray, nebulisers, allergen air filters, and humidifiers.

EXAMPLE 5: Management of a chronic alcoholic who is a customer of an allied pharmacy and health insurer.

The methods of Example 2 generally apply herein, except that the customer is a chronic alcoholic. As will be understood, chronic alcoholism can result in hospitalization of a customer, thereby diminishing the profitability of a health insurer. In this example, the health related information obtained and transmitted by the pharmacist includes blood alcohol readings (e.g. by breathalyser) as well as interview with the pharmacist. By virtue of their general experience with a broad cross section of the community, experienced pharmacists are typically skilled in assessing the veracity of statements or claims made by customers. For example, pharmacists are often required to quickly assess the bona fides of a customer wanting a small supply of a certain medication because they have allegedly lost their prescription. In this Example, there is no definitive test to determine whether a person has been drinking excessively in the past month. The interpersonal skills of the pharmacist therefore assume some importance in assessing a customer's compliance or non-compliance of a treatment program.

If a poorly managed customer does not follow the advice of the insurance company (for example cutting down on drinking, use of appropriate medication, attendance at counselling sessions etc), then value adding and other motivations will not be provided.

In this example the counselling is not provided by the pharmacist. However, the pharmacist sights a letter from the counsellor confirming the customer's attendance, this fact being transmitted to the health insurer.

Regular visits by the alcoholic customer to the pharmacy will facilitate sales of medication such as Antabuse®, ReVia®, and Campral®, as well as complementary therapies such as homeopathic compositions.

It will be apparent to the skilled person that many routine variations may be applied to the various methods and described herein. It is intended that these variations are included with the scope of the present application.

Claims

CLAIMS:

1. A method for improving the business of a health insurer and/or a pharmacy, the method including obtaining health related information from a pharmacy customer who is also a customer of the health insurer, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer.

2. A method according to claim 1 wherein the health related information is entered into a first database administered by the pharmacy, and transmitted to a second database administered by the health insurer.

3. A method according to claim 1 or claim 2 wherein the health related information is processed by the pharmacy to provide information useful in the assessment of insurance risk or in formulating strategy to improve the health of the customer.

4. A method according to any one of claims 1 to 3 wherein the health insurer processes the heath related information to provide information useful in the assessment of insurance risk or formulating a strategy to improve the current or future health of the customer.

5. A method according to any one of claims 1 to 4 wherein the health related information excludes information that is ordinarily available to a health insurer.

6. A method according to any one of claims 1 to 5 wherein the health related information excludes information relating to an insurance claim.

7. A method according to any one of claims 1 to 6 wherein the health related information allows the health insurer to assess the insurance risk of the customer.

8. A method according to any one of claims 1 to 7 wherein the health related information allows the insurer to control and/or intervene in the present and/or future health of the customer.

9. A method according to any one of claims 1 to 8 wherein the health related information is obtained in a pharmacy environment.

10. A method according to any one of claims 1 to 9 wherein the health related information is selected from the group consisting of weight, waist circumference, height, body mass index, blood pressure, lipid profile including cholesterol level, bone density, temperature, blood glucose, urine glucose, A1c, pulse rate, urine nitrogen level, and blood oxygen levels.

11. A method according to any one of claims 1 to 9 wherein the health related information is selected from the group consisting of mood, libido, skin condition, hair condition, gait, coherence of speech, acuity of hearing, and accuracy of vision.

12. A method according to any one of claims 1 to 11 wherein the health related information is not directly obtained by the pharmacist but is communicated to the pharmacist by the patient.

13. A method according to claim 12 wherein the health related information is the results of a diagnostic test conducted by a pathology laboratory.

14. A method according to any one of claims 1 to 13 wherein the health related information is used to provide a treatment plan for improving the current and/or future health of the customer.

15. A method according to claim 14 wherein the treatment plan is generated by the pharmacy and/or health insurer and/or a third party.

16. A method according to claim 14 or claim 15 wherein the treatment plan includes information selected from the group consisting of a recommendation regarding diet, exercise, medication, diagnostic testing, a referral to a medical or paramedical practitioner, a referral to a health related educational seminar, and a direction to read health a related publication.

17. A method according to any one of claims 1 to 16 wherein the customer suffers from, or is likely to suffer from a preventable disease or condition.

18. A method according to any one of claims 1 to 17 wherein the customer suffers from a disease selected from the group consisting of diabetes, hypertension, coronary heart disease, stroke, peripheral vascular disease, renal failure, obesity, and hyperlipidaemia

19. A method according to claim 18 wherein the disease is type Il diabetes.

20. A method according to any one of claims 1 to 19 wherein the health related information is first entered into a first electronic database administered by the pharmacy and is subsequently transmitted to second electronic database administered by the health insurer.

21. A method according to claim 20 wherein the method is at least partially implemented on a computer.

22. A method according to claim 20 or claim 21 wherein the database is a relational database.

23. A method according to any one of claims 20 to 22 wherein the first database is embodied on a first computer, the second database is embodied on a second computer, and the first and second computers are networked

24. A method according to any one of claims 1 to 23 wherein the health related information and/or treatment plan is transmitted to the customer's doctor or other health professional attended by the customer.

25. A method according to any one of claims 1 to 24 wherein where the customer's health related information improves over time the customer is provided with a reward selected from the group consisting of a lower health insurance premium and/or a value added pharmacy items.

26. A method for improving the health of a pharmacy customer who is also a customer of a health insurer, the method including obtaining health related information from the customer while present in the pharmacy, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer.

27. A method according to claim 26 wherein the health related information is entered into a first database administered by the pharmacy, and transmitted to a second database administered by the health insurer.

28. A method according to claim 26 or claim 27 wherein the health related information is processed by the pharmacy to provide information useful in the assessment of insurance risk or in formulating strategy to improve the health of the customer.

29. A method according to any one of claims 26 to 28 wherein the health insurer processes the heath related information to provide information useful in the assessment of insurance risk or formulating a strategy to improve the current or future health of the customer.

30. A method according to any one of claims 26 to 29 wherein the health related information excludes information that is ordinarily available to a health insurer.

31. A method according to any one of claims 26 to 30 wherein the health related information excludes information relating to an insurance claim.

32. A method according to any one of claims 26 to 31 wherein the health related information allows the health insurer to assess the insurance risk of the customer.

33. A method according to any one of claims 26 to 32 wherein the health related information allows the insurer to control and/or intervene in the present and/or future health of the customer.

34. A method according to any one of claims 26 to 33 wherein the health related information is obtained in a pharmacy environment.

35. A method according to any one of claims 26 to 34 wherein the health related information is selected from the group consisting of weight, waist circumference, height, body mass index, blood pressure, lipid profile including cholesterol level, bone density, temperature, blood glucose, urine glucose, A1c, pulse rate, urine nitrogen level, and blood oxygen levels.

36. A method according to any one of claims 26 to 33 wherein the health related information is selected from the group consisting of mood, libido, skin condition, hair condition, gait, coherence of speech, acuity of hearing, and accuracy of vision.

37. A method according to any one of claims 26 to 36 wherein the health related information is not directly obtained by the pharmacist but is communicated to the pharmacist by the patient.

38. A method according to claim 37 wherein the health related information is the results of a diagnostic test conducted by a pathology laboratory.

39. A method according to any one of claims 26 to 38 wherein the health related information is used to provide a treatment plan for improving the current and/or future health of the customer.

40. A method according to claim 39 wherein the treatment plan is generated by the pharmacy and/or health insurer and/or a third party.

41. A method according to claim 39 or claim 40 wherein the treatment plan includes information selected from the group consisting of a recommendation regarding diet, exercise, medication, diagnostic testing, a referral to a medical or paramedical practitioner, a referral to a health related educational seminar, and a direction to read health a related publication.

42. A method according to any one of claims 26 to 41 wherein the customer suffers from, or is likely to suffer from a preventable disease or condition.

43. A method according to any one of claims 26 to 42 wherein the customer suffers from a disease selected from the group consisting of diabetes, hypertension, coronary heart disease, stroke, peripheral vascular disease, renal failure, obesity, and hyperlipidaemia

44. A method according to claim 43 wherein the disease is type Il diabetes.

45. A method according to any one of claims 26 to 44 wherein the health related information is first entered into a first electronic database administered by the pharmacy and is subsequently transmitted to second electronic database administered by the health insurer.

46. A method according to claim 45 wherein the method is at least partially implemented on a computer.

47. A method according to claim 45 or claim 46 wherein the database is a relational database.

48. A method according to any one of claims 45 to 47 wherein the first database is embodied on a first computer, the second database is embodied on a second computer, and the first and second computers are networked

49. A method according to any one of claims 26 to 48 wherein the health related information and/or treatment plan is transmitted to the customer's doctor or other health professional attended by the customer.

50. A method according to any one of claims 26 to 49 wherein where the customer's health related information improves over time the customer is provided with a reward selected from the group consisting of a lower health insurance premium and/or a value added on pharmacy item.

51. A health insurance system for improving the business of a health insurer, the method including obtaining health related information from a pharmacy customer who is also a customer of the health insurer, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer.

52. A pharmacy business system for improving the business of a pharmacy, the method including obtaining health related information from a pharmacy customer who is also a customer of a health insurer, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer.

53. A computer program embodied on a computer readable medium, the program capable of executing a method according to any one of claims 1 to 50.

54. A computer program embodied on a computer readable medium for improving the business of a health insurer and/or pharmacy including code for receiving from the pharmacy current health related information on the customer; code for analysing the current health related information on the customer and historical health related information on the customer; code for identifying an improvement or decline in health of the customer, code for determining whether or not a value added product or service or other reward is provided to the customer; and code for determining whether or not a penalty is provided to the customer.

55. A computer including a computer program according to claim 53 stored on a computer readable medium.

56. In a data communications network including communication devices enabling communication between a pharmacy and a health insurer, a method for improving the business of the health insurer, the method including obtaining health related information from a pharmacy customer who is also a customer of the health insurer, and transmitting the information to the health insurer, wherein the information is useful in the assessment of insurance risk or in formulating strategy to improve the current or future health of the customer.