Abstract:
The invention provides a network computer system and novel pharmacy printers and their methods of use wherein the local CS includes a pharmacy printer for printing pharmacy orders including prescriptions, and the pharmacy printer includes a pharmacy printer database storing drug information and association of a drug identifier with information about a corresponding drug, and additional information, and obtains and uses instructions for printing the additional information in association with printing of a prescription label from characters contained in a prescription label print file for the prescription label.

Description:
CROSS REFERENCE TO RELATED APPLICATIONS 
     This application claims priority to provisional application 60/759,552, filed Jan. 18, 2006, the contents of which are incorporated herein by reference. 
    
    
     FIELD OF THE INVENTION 
     This invention relates generally to computerized systems for printing information about medicines sold in pharmacy stores. 
     BACKGROUND ART 
     Currently, pharmacy printers print information about a medicine on a medicine label for distribution to the consumer along with the corresponding medicine. Often, the label is designed to be fixed to packaging for the medicine. The medicine label is generated after the consumer orders the medicine and prior to when the consumer receives the medicine. Systems for printing a medicine label and related advisory information are described in U.S. Pat. No. 6,304,849 entitled “Method and system for printing a combination pharmaceutical label and directed newsletter”; U.S. Pat. No. 6,240,394 entitled “Method and apparatus for automatically generating advisory information for pharmacy patients”; and U.S. Pat. No. 6,067,524 “Method and system for automatically generating advisory information for pharmacy patients along with normally transmitted data” all of which name Baxter Byerly as an inventor, and the teachings of which are all incorporated herein by reference. 
     U.S. Pat. No. 5,729,666 describes conventional processes for generating, in a computer associated with a printer, print files containing font header data enabling the printer to render fonts, and then the computer transmitting the print file to the printer for printing. 
     A medicine prescription label may include patient name, doctor name, drug expiration date, the name of the drug, the manufacturer of the drug, instructions for taking the drug, the quantity in the bottle, the number of refills, the date of fill, the day the prescription was written, history or medical record number, the prescription number, the name of the pharmacy, the address of the pharmacy, the phone number of the pharmacy, cautions or warnings. 
     Acronyms 
     NDC is an acronym for National Drug Code. 
     DCC is an acronym for Drug Classification Code. 
     CS is used herein as an acronym for “Computer System”. 
     CHR is an acronym for Catalina Health Resources. 
     POS is an acronym for Point of Sale. 
     FDA is an acronym for Food and Drug Administration. 
     CID is an acronym for Consumer IDentification. CID and PID are synonymous in this application. 
     XML is an acronym for Extensible Markup Language. 
     Definitions 
     A CID means any identifier that can be used to identify a consumer that can be scanned, read, or otherwise entered into a computer. 
     A “consumer” means a person or family or group of people that use the same CID when purchasing or filling a medicinal prescription in a store, such as a pharmacy store. 
     A POS is an area where a consumer engages in transactions with a retail store, such as a pharmacy store. 
     NDCs are codes associated with drugs. Preferably, NDCs are the unique 11-digit 3-segment number that identifies the labeler/vendor, product, and trade package size of a medication listed under Section 510 of the U.S. Federal Food, Drug, and Cosmetic Act. 
     DCCs are codes associated with medications based upon the medication&#39;s effects on human beings such that several medications may have the same DCC. 
     Individual transaction data includes but is not limited to data conveying some or all of following information: time of transaction, date of transaction, CID, individual transaction ID, pharmacy ID, product purchased, price of product purchases (list price and/or actual price paid), payment instrument type, payment instrument identifier. 
     Pharmacy, in this application, refers to a retail store in which medicines are provided to consumers. 
     Database, in this application, means data organized in some format in a computer memory that can be read and written by an associated CS. Such a concept is also referred to as a database management system. Examples of databases include commercial database products such as Microsoft Access, SQL server, and any set of files stored in computer memory that can be accessed by an associated CS. 
     Network means communication channels (wired or wireless) and protocols that a set of computers can use to exchange and interpret information. Such channels include dial up telephone data connections, private digital corporate network, and the Internet. Such protocols include real connection modem protocols and virtual connection packet protocols like TCP/IP. 
     A drug monograph is a written description of a drug or medicine associated with an NDC. For example, a monograph can include information such as, introduction, summary, pharmacology, pharmaco-kinetics, FDA approved indications, off-label uses, dosage and administration, adverse effects, overdose, safety data, contraindications, warnings, precautions, drug interactions, efficacy measures, cost comparison, clinical trials, conclusions, recommendations, references, supplied, and research. A drug monogram contains text, which may be stored in a text computer file. 
     A MedGuide is a guideline containing FDA-approved patient information associated with a DCC. For example, a MedGuide can include information such as, important information a patient should know about the drug, what the drug is, who should not take the drug or medicine, information a patient should tell a doctor before starting the drug, how a patient should take the drug, how a patient should store the drug, what a patient should avoid while taking the drug, the side effects of the drug, other information about the ailment of which the patient is taking the drugs for, the ingredients of the drug, and general information about the safe and effective use of the drug. A MedGuide contains text, which may be stored as a text computer file. 
     CHR additional content means drug monograph and MedGuide information associated with a medicine. 
     CHR content means content associated with a patient resulting from applying criteria to the patient&#39;s prescription, the patient&#39;s master record, or the prescription label print file (defined below). 
     CHR content may include (1) patient specific information such as, that patient&#39;s CID, (2) information concerning products related to a drug which the patient has purchased or for which the patient has received a prescription, or a government warning relating to drugs associated in any way with the patient, (3) information relating to patient health (represented in both text and graphic formats), (4) a news item selected for presentation to the patient, (5) incentive offers for printing in the form of bar coded coupons for discounts off purchase of specified products, or instant discounts applicable against the price or a product in a subsequent purchase by the consumer, typically for health related products, and typically products related to a disease associated with the patient based upon pharmacy product purchase data in the patient&#39;s data record. 
     CHR content may in theory also include, although such inclusion may be prohibited by privacy regulations, the patient&#39;s name, address, telephone number, and email address, the patient&#39;s doctors appointments reminders, the patient&#39;s doctor&#39;s name, address, telephone number, and email address, the patient&#39;s billing information such as patient&#39;s insurance policy identifier. 
     A prescription label print file herein means a file transmitted to a printer for printing a prescription label for prescription. 
     A prescription label print job herein means a set of commands to be executed by a printer to print in response to receipt by the printer of a prescription label print file, wherein the prescription label print file does not include CHR content or CHR additional content, but does include a reference to such content, and the prescription label print job include printing of CHR content and CHR additional content referenced by the prescription label print file. 
     SUMMARY OF THE INVENTION 
     Objects of the Invention 
     It is an object of this invention to improved the speed and reliability of information provided to recipients of medicines in pharmacies. 
     It is another object of the invention to enable centralized control of information to be included by multiple pharmacy stores in medicine labels. 
     Another object of this invention is to reduce the cost and complexity of systems for generating targeted medicine labels. 
     SUMMARY OF THE INVENTION 
     These and other object are generally provided by a network CS that includes a novel printer located in a pharmacy store wherein the novel printer stores a database of one or both of CHR additional content and CHR content, and the printer implements code to enable the printer to selectively incorporate CHR additional content and CHR content in a prescription label print job based upon codes contained in a prescription label print file received by the printer. These and other object are also provided by the network CS that receives prescription order and that determines what CHR content and CHR additional content to include in a prescription label print job for a prescription order and generates and sends to the novel printer a corresponding prescription label print file for the prescription order. Code may exist either on the printer, a central CS, or a local CS that is designed to apply criteria to field values associated with a prescription, such as filed values for fields payor, age/dob, gender, new prescription indicator, refill number, pill count, and NDC to determine what if any CHR content to print in association with the prescription label. The foregoing field values may be incorporated into a prescription label print file received by the printer. 
     These and other objects are provided by a novel network CS and method of its use wherein the network CS includes at least: 
     (1) a central CS; 
     (2) a plurality of local CSs; 
     wherein said central CS and said plurality of local CSs form a network in which said plurality of local CS and said central CS can communicate with one another via network protocols; 
     wherein each local CS of said plurality of local CSs is associated with and proximate to one of a corresponding plurality of pharmacy stores, wherein each local CS of said plurality of local CSs includes a CS terminal for inputting information about pharmacy orders and a pharmacy printer for printing information relating to said pharmacy orders; 
     wherein a first local CS of said plurality of local CSs includes a first pharmacy printer located in a first pharmacy store and a first pharmacy POS located in said first pharmacy store; 
     wherein said first pharmacy printer includes a first pharmacy printer database storing: 
     (1) medicine records including in each medicine record a medicine identifier in association with information about the corresponding medicine; 
     wherein said first pharmacy printer is configured to receive and process print instructions resulting from a pharmacy order containing a specified prescription for a specified medicine having a specified medicine identifier and a specified consumer identifier for a specified consumer, by: 
     (1) searching in said first pharmacy printer database for information about said specified medicine associated with said specified medicine identifier; 
     (2) searching in said first pharmacy printer database for additional information to be conveyed to said specified consumer associated with said specified consumer identifier; 
     (3) printing in association with one another said specified prescription, said information about said specified medicine, and said additional information to be conveyed to said specified consumer. 
     Optionally, the printer database also includes, (2) consumer records including in each consumer record a consumer identifier in association with additional information (referred to herein below as “CHR content”) to be conveyed to the consumer associated with said consumer identifier; wherein said first pharmacy printer is configured to (2) search in said first pharmacy printer database for CHR content to be conveyed to said specified consumer associated with said specified consumer identifier and print that CHR content for the consumer in association with said specified prescription. 
     The association with CHR content or (referred to herein as “CHR content”) to be conveyed to the consumer associated with said consumer identifier may be by storing the actual CHR content in the consumer record. 
     Alternatively, and preferably, the consumer record includes a CHR identifier, and the first pharmacy printer also includes a CHR content or information database containing records having CHR identifiers association with CHR content. In this alternative, the first pharmacy printer includes code to identify, from the CHR identifier in a consumer record, the corresponding CHR content or information for printing for the corresponding pharmacy order. 
     Preferably, said first local CS includes code instructing said first local CS to transmit to said central CS information about pharmacy orders including associated consumer identifiers and an address associated with said first local CS. 
     Preferably, the central CS (which may include by definition the CHR CS) includes code for determining from (1) criteria it stores and (2) information about pharmacy orders associated with said specified consumer identification, CHR information to associate with said specified consumer identification, and said CHR CS includes code for transmitting an identifier of said CHR information to associate with said specified consumer identification to said first local CS. 
     In the preferred embodiment, the central CS and CHR CS are distinct CSs, for example, having different WAN IP addresses, the central CS stores the master patient records and format and transmits prescription label print file to pharmacy printers in response to receipt of prescription order from the local CSs (ASP model), and the CHR CS stores and manages periodic or aperiodic distribution to the local CSs of the CHR content and optionally the CHR additional content (not in response to any particular prescription order). 
     Preferably, said central CS includes code for transmitting to said first local CS medicine records including in each medicine record a medicine identifier in association with information about the corresponding medicine. 
     Preferably, said first local CS includes code for storing in said first pharmacy printer database (1) medicine records including in each medicine record a medicine identifier, such as an NDC, in association with CHR additional information about the corresponding medicine, such as a drug monograph and a MedGuide and (2) CHR content information to associate with said specified CID that said first local CS receives from said central CS, such as targeted health information or company sponsored information from the company making the prescribed medicine. 
     Preferably, said medicine records comprise corresponding drug monograph data and MedGuide data. 
     Said additional information to associate with consumer identifications may include at least one of (1) names of alternative brands of a medicine specified in prescriptions contained in the corresponding pharmacy order, (2) information and advertising promoting the medicine specified in the prescription or the brand or medicine actually distributed by the pharmacy in response to the prescription (3) an incentive offer for a discount or credit on purchase of a product other than said medicine, (4) health related information broadly targeted based upon available data in the file received by the printer and not specifically promoting any particular product. In addition, the additional information may include sufficient information to imply a patient&#39;s disease state, such as a combination of medicines, age, gender, and other information often associated with a specific disease or class of diseases. From that information, an informational message relating to the implied disease state may be triggered and printed for the patient. 
     In one alternative, said central CS includes code for periodically transmitting additional information that it has associated with said specified consumer identification to said first local CS. 
     In one alternative, said central CS includes code for automatically transmitting additional information that it has associated with said specified consumer identification to said first local CS in response to transmission from said local CS to said central CS of said specified consumer identification. That enables said additional information to be printed by said first printer concurrently or sequentially with printing by said first pharmacy printer of said specified prescription and information about said specified medicine. 
     Preferably, the elements of the local CS including the CS terminal and the pharmacy printer in each pharmacy store are inside a local area network (LAN). 
     Preferably, the central CS is networked to each one of the local CSs over a wide area network, such as a private WAN, the Internet, or a set of dial up Plain Old Telephones (POTs) lines. Preferably, the data transmission speed in said LAN is greater than the data transmission speed in said WAN. 
     The inventors recognize that, while drug monographs and MedGuides can be stored as relatively small text files, the graphical information for CHR content that the inventors want to associate with CIDs may require a relatively large amount of memory for storage, often occupying more than one megabyte and typically occupying on the order of 10 megabytes. The inventors envision the size of data storing this information to increase with time, for example, possibly to 100 megabytes in the next few years. The inventors envision storing much or all of this CHR content data locally in the pharmacy printer, thereby avoiding redundant data transfer to the pharmacy printer of large volumes of CHR content. 
     The printer may also store local rules that the printer implements in addition to the rules instructing it what to print based upon identifications of medicines and CIDs. The additional local rules may instruct the printer with (1) additional content local rules, to print additional text or graphics, upon receipt of instructions to print specified CHR content and/or additional CHR content and the other print file information, and with (2) layout local rules, to lay out all of the material for printing defined by the print file information and the specified CHR content and/or additional CHR content, depending upon all of the material for printing, the type of the local printer, and local printer&#39;s print specifications, such as paper width and margins. Preferably, one or both of the central CS and the CHR CS store a master set of rules based upon printer type, material for printing, and print specifications, and includes code specifying that the central CS or CHR CS distribute corresponding rules to printers having the printer type, material for printing, or print specifications stored by the central or CHR CS, or both. 
     The first pharmacy printer may receive in response to a single pharmacy order print instructions from a first local CS controller CPU in the first local CS and also from the central CS. For example, the first local CS controller CPU may process the pharmacy order payment aspects to specify costs of the transaction, to itemize product items included in the pharmacy order, to request and receive payment or credit from a third party insurer or credit card company. The central CS may receive at least the prescription information in the pharmacy order and respond during the transaction involving a consumer in the first pharmacy by transmitting CHR additional content identifiers in association with the prescription and an order ID, or in association with the CID, back to the first pharmacy printer. The central CS may associate the customer master record with the prescription order and transmit back to the local CS a prescription record supplemented by information from the customer master record, and that transmission may include or contain the prescription label print file for the prescription. The first pharmacy printer may include code to prioritize print instructions received from both the first local CS controller CPU and the central CS regarding a single pharmacy order, and print transaction information, prescription label, and all other related information accordingly. 
     The pharmacy printer may be configured to print partially on an adhesive backed portion of printer paper and partially on a non-adhesive backed portion of paper. For example, the pharmacy printer may be designed to format printing so that prescription information is printed on an adhesive backed portion so that it can be readily attached to a prescription drug container, and the pharmacy printer may be designed to format printing so that CHR additional content (drug monograph, MedGuide), and CHR content is printed on a portion of material having a perforation separating it from the prescription information so that it can be separated at a perforation line from the prescription label portion of the pharmacy label. 
     The central CS may store transaction data it receives from each one of the plurality of local CSs. The central CS may run criteria against all transaction data associated with a CID, regardless at which pharmacy stores the transaction data originated. 
     Preferably, the CHR CS maintains an up to date list of drug monograph and MedGuide data for a large number of drugs, and updates each of the pharmacy printers with that information via transmissions over the network. Alternatively, or in addition, the central CS, may also CS maintain an up to date list of drug monograph and MedGuide data. 
     In some embodiments, the local CSs only transmit, outside of its LAN, de-identified pharmacy order information and encrypted versions of the associated CIDs to protect privacy. De-identified, means that information that could be used to identify the corresponding person, is removed. That information includes for example, name, residence address, telephone number, email address, and demographic information particular to a small group of individuals. Either the CHR CS or the central CS may run criteria on the de-identified information and transmit back to the local CS encrypted CIDs in association with identifiers for CHR information, and the pharmacy printer includes code to associate those from the encrypted CID, the non-encrypted CID. Preferably, the CHR CS runs the foregoing criteria. 
     The local CS may be implemented in various network architectures. For example, the local CS may be a POS CS that includes a store controller CPU having a LAN address, a pharmacy printer including a CPU and memory and also having a LAN address, and a router logically separating the LAN from the WAN. Alternatively, the store controller CPU may act as a router logically separating the LAN from the WAN. Alternatively, the pharmacy printer may include a CPU and memory but have no separate LAN address, and instead it may communicate with the store controller CPU via always on connections as opposed to packet switched virtual connections. 
     Examples of criteria that can be used to determine CHR content to associate with a CID or encrypted CID include: NDC, age; gender; number of allowed refills; refill number; payor; whether the prescription is a new prescription; implied patient disease state; no criteria (associating certain CHR content with every CID, such as public announcements); sequential (distribute certain additional CHR content to every second, third, fourth, etc. CID identifier from a POS, as they appear at a POS, or as they appear in a local CS having multiple POSs); random (randomly distribute certain CHR content to CIDs); to specified frequent shoppers based upon shopping or specific product purchase frequency or existence of a prior purchase, specified demographic data, specified frequency of purchases, specified frequency of visits to a location, specified frequency that a consumer exercises incentives, specified purchase history of the consumer, specified particular circumstances in the consumer&#39;s life, specified indicated tastes of the consumer, other characteristics of the consumer associated data that indicates a consumer possesses certain traits, specified purchase of specified items in specified time periods, specified transaction dollar volume, specified transaction frequency, specified associated pharmacy, region, address, retail chain, and/or postal code. 
     Preferably, a patient master record table exists, either stored locally in local CS database  30 A or centrally in central CS database  20 A or CHR CS database  50 A, or stored at any combinations of the foregoing. Preferably, the patient master record table includes for each record fields storing for example: CID or encrypted CID, date of birth or age, gender, insurance plan ID, payor, and insurance company name. The patent master record may be used to associate date of birth or age, gender, insurance plan ID, payor, and insurance company name with a patient&#39;s prescription record, and to determine CHR non-CID additional content mentioned below. 
     Example of CHR content triggered by those criteria include (1) additional information provided by the company producing that medicine about a prescribed medicine, and information about a disease which can be associated with the patient based upon data in the customer master record table, or, associated with the patient by the printer based upon the data it receives in the prescription label print file. 
    
    
     
       BRIEF DESCRIPTION OF DRAWINGS 
         FIG. 1  is a schematic of a novel network CS; 
         FIG. 2  is a schematic of a data structure of central CS database  20 A of  FIG. 1 ; 
         FIG. 3  is a schematic of a data structure of local CS database  30 A of  FIG. 1 ; 
         FIG. 4  is a schematic of a data structure of pharmacy store printer database  40 A of  FIG. 1 ; 
         FIG. 5  is a schematic of a data structure of CHR CS database  50 A of  FIG. 1 ; 
         FIG. 6  shows data elements of a prescription record  600  received from terminal  30 C of local CS  30 ; 
         FIG. 7  shows data elements that may be in a data transmission of a prescription label print file to pharmacy printer  40  in response to a pharmacy order received from terminal  30 C of local CS  30 ; 
         FIG. 8  shows data elements in a drug monograph record  210 ; 
         FIG. 9  shows data elements in MedGuide table  220  of  FIG. 2 ; 
         FIG. 10  shows data elements in CHR content table  240  of  FIG. 2 ; 
         FIG. 11  is a schematic showing inter relationships between elements of the drug monograph, MedGuide, and CHR content records and process flow for printing prescription labels with drug monograph, MedGuide, and CHR information; 
         FIG. 12  is a flow chart showing at a high level novel process steps for using the network CS; 
         FIG. 13  is the first page of a drug monograph for the drug brand name Zoloft; and 
         FIG. 14  is the first page of a MedGuide for the drug corresponding to brand name Zoloft. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
       FIG. 1  shows novel network CS  1  including: 
     WAN network  10 ; 
     associated with a pharmacy central office: central CS  20 ; and a central CS database  20 A; 
     associated with pharmacy store A, 30 : local CS  30 ; local CS database  30 A; local CS terminal  30 C; pharmacy printer  40 ; pharmacy printer database  40 A; pharmacy store switch  60 ; 
     pharmacy stores B, C, . . . indicating equivalent network computer structure to that illustrated for pharmacy store A; 
     CHR CS  50  and CHR CS database  50 A; and line  70 ,  71 ,  72 . 
     Network  10  may be the Internet, a private packet switching network, or a telephone dial up communication system. Lines  70  represent local area network (LAN) connections between network addressable computerized components. Lines  71  between a CS and a database represent that the connected CS controls read and write access to the connected database. Lines  72  between computer components and WAN  10  represent a relatively slow speed network connection to WAN  10 . 
     Each one of central CS  20 , local CS  30 , and CHR CS  50  includes a digital central processing unit, human user input and output devices, and associated high speed memory. Each one of these CSs stores network protocols and code for converting and transmitting data in those network protocols, such as TCP/IP. 
     One or both of local CS  30  and central CS  20  are configured to receive and store in their respective databases pharmacy transaction data for transactions in pharmacy store A. 
     Pharmacy store switch  60  in a preferred embodiment is a router designed to route packet switched signals from computers inside a LAN, such as a LAN including local CS  30  and printer  40 , to WAN IP addresses, such as an address for central CS  20 , and to route packets from the WAN to the associated LAN computers specified by IP address information in incoming packets. 
     In one less preferred alternative embodiment, store switch  60  is replaced by a dial up modem telephone connection. 
     In another less preferred embodiment, no pharmacy store switch  60  exists and network addressing services to both printer  40  and local CS  30  are provided local CS  30 . In this alternative, all signals addressed to printer  40  first pass through local CS  30 . 
     Printer  40  includes conventional structure or code for printing based upon print instructions, and also conventional structure or code for receiving and interpreting information in at least one network protocols, such as TCP/IP. 
     In preferred embodiments, printer  40  also includes in printer database  40 A drug monograph, MedGuide, and CHR additional content, along with a list of pointers to data elements therein. In these preferred embodiments, printer  40  includes structure or code for acting on instructions including pointers and/or names data, for including in a pharmacy label printout, monograph, MedGuide, and CHR additional content identified by the pointers and names. 
     CHR CS  50  and its database  50 A store addresses of CSs to update with drug monograph, MedGuide, and CHR content, addresses and/or names for each drug and content&#39;s data record, criteria for selecting drug monograph, MedGuide, and CHR content, code to distribute updated content, address, and name information to CSs. 
     Central CS  20  and database  20 A optionally includes therein all data and function ascribe to GM CS  50 . 
     Central CS  20  runs code implementing criteria on pharmacy transaction data associated with CIDs to determine specified content to associate with the CIDs. Central CS  20  distributes identifiers of specified content associated with an associated CID, in association with that CID, back to the pharmacy printer or printers from which the transaction data originated. The transmission may be to an address for each such printer. Alternatively the transmission may be to an address for a local CS containing that printer in which case the local CS is programmed to forward the transmission or at least the identifiers and associated CIDs to the pharmacy printer. 
     For example, criteria may depend upon patient age, gender, prescription history, or product purchase history. Specific content associated via criteria with a CID may include informational messages, incentive offers to purchase or sample a product, and instant discounts. 
     Tables herein means both tables as defined for relational database structures and other data associations such as those enabled by XML and XML tagging. 
       FIG. 2  shows central CS database  20 A of  FIG. 1  as including patient master records table  205 , drug monograph table  210 , MedGuide table  220 , NDC/DCC association table  235 , link  230  from NDC field of drug monograph table  230  to NDC/DCC association table  235 , link  231  from DCC field of NDC/DCC table  235  to DCC field of MedGuide table  220 , CHR content table  240 , pharmacy store addresses table  250 , transaction logs and accounting data structure  260 , targeting criteria data structure  270 , and code  280 . As mentioned above, central CS database  20 A may also include the CHR content table  240  shown in  FIG. 5 . Links  230 ,  231  denote that data fields in records for drug monographs and MedGuide information store corresponding data to field in the NDC/DCC table. Links  230 ,  231  enable code to determine which drug monographs correspond to MedGuides for that drug. 
     Central CS  20  uses pharmacy store address table  250  to store network addresses data for local CSs and pharmacy store printers. A CHR CS may store an analogous table. Central CS  20  uses data structure  260  to store transaction logs and accounting logs based upon data received from the plurality of local CSs. In some cases, transaction logs data contain encrypted CIDs and de-identified transaction data. 
     Preferably, central CS  20  received complete data transaction records and any CHR CS received de-identified records. 
     Code  280  includes for example operating system code, and applications code, including the code to transmit content, identifiers in association with CIDs, to determine network addresses for transmissions, and to determine associations of content identifiers with CIDs. 
       FIG. 3  shows local CS database  30 A preferably including store transaction logs and accounting data structure  310  for storing transaction logs and accounting data for the corresponding pharmacy store, network address and data table  320  for storing for example LAN and WAN network addresses, and code  330 . 
     Code  330  could include for example aspects of conventional local POS CS processing for accounting for inventory and transactions. 
       FIG. 4  shows pharmacy store printer database  40 A including drug monograph table  410 , MedGuide table  420 , CHR/CID content table  430 , CID/CHR identifier table  440 , CHR/Non CID content table  430 A, identifier table  440  code  450 , NDC/CDD table  460 , and logical association line  470 . Tables  410  and  420  are segmented to illustrate the NDC or DCC identifiers for corresponding data describing a specified drug or class of drugs. CHR content table  430  is likewise segmented to show that it contains a CHR identifier field. Table  440  is likewise segmented to show that it contains both CID and CHR identifier fields. The lines  460 ,  470  define fields containing the information. Table  460  indicate that drug monograph and MedGuide information for the same medicine can be matched, and that CHR content may be associated with a CID via the matching of CHR identifiers. The existence of the NDC field, the MedGuide field, and the CID field enable the printer to receive drug name data and CID data and to determine from that data drug monograph and MedGuide information to print, and to determine CHR content to print, in association with a prescription label for a prescription for a patient having that CID. 
     CHR/non CID additional content table  430 A includes field for NDC, whether prescription is new, number of refills remaining, number of refills used, payor, pill count or quantity, gender, age and or date of birth, and associated informational content. CHR/non CID additional content table  430 A does not include a CID field. Printer  40  uses this data to determine from data in a prescription label print file whether to include in the prescription label print job associated informational content. It does so by implementing code matching values and ranges of these fields to records in table  430 A. For example, printer  40  may run code determining whether a prescription label print file table  430 A is for a male over age 50 having an insurance payor and, if so, printing, along with the patient&#39;s prescription label, information about Viagra, which is a male oriented drug suitable for older men, and if not, not printing out the information about Viagra. The matching is not dependent upon CID. 
     The code and determination whether to print based upon the fields whether prescription is new, number of refills remaining, number of refills used, payor, pill count or quantity, gender, age and or date of birth may occur at the central CS or the CHR CS, be associated with a CID, and then be transmitted as a CHR/CID content record to the pharmacy printer database CHR/CID content table  430 , to await the pharmacy printer&#39;s identification of that CID in a prescription label print file or when the patient&#39;s CID is identified in a transaction in the pharmacy. Thus, the non-CID targeting determinations for CHR content may either occur remote from the local CS at any time or locally in the local CS and preferably in the pharmacy printer using the pharmacy printer database in response to and as part of processing of receipt of a prescription label print file into a prescription label print job for printing by the pharmacy printer. 
       FIG. 5  shows database  50 A of optional additional CHR CS as including substantially the same data structures as central CS database  20 A, and also including update status table  510  to indicate the status of monograph, MedGuide, and CHR content of each one of the local CSs and/or pharmacy printers. Central CS  20  may use the update information to determine when to send new data sets of information to the various local CS and pharmacy printer databases. 
       FIG. 6  shows data elements of a prescription record  600  received from terminal  30 C of local CS  30  including fields for name of drug, patient name, doctor ID, date of prescription, quantity, number of refills. In this regard, the terminal may be one at which a clerk manually keys in the prescription information, or it may be an automated system to receive and process prescriptions transmitted remotely from outside the pharmacy store to the pharmacy store&#39;s local CS, such as via web access, email, or automated telephone service. Either the local CS or the central CS may associate with that information a CID, associate with a de-identified subset of that information an encrypted CID, and determine from the CID or encrypted CID, additional information relating to the prescription and the customer as noted in the prescription record  700  in  FIG. 7 . The local computer system may transmit in de-identified form the prescription information and/or product purchase transactions, to the CHR CS. 
       FIG. 7  shows a data record for a prescription of the type to be transmitted (either from central CS  20  or local CS  30 ) to pharmacy printer  40  in response to a pharmacy order received from terminal  30 C. The field or tag names may include name of drug  701  field; patient name  705  field; doctor name  710  field; drug expiration date  715  field; manufacturer of drug  720  field; instructions for taking drug  725  field; quantity in the package  730  field; number of refills  735  field; date of fill  740  field; date prescription was written  745  field; history/medical record number field  750 ; prescription number field  755 ; name of pharmacy field  760 ; address of pharmacy  765  field; phone number of pharmacy  770  field; cautions or warnings  775  field; and CID  780  field; Age/DOB  781  field; gender  782  field; whether a new prescription  783 ; refill number  784  field; pill count  785  field; payor name  786  field; and NDC  787  field. 
     Name of drug  700  field stores the name of the drug for which the prescription was written. 
     A complete list of the currently contemplated fields in the data record for a prescription of the type to be transmitted) to pharmacy printer  40  include, in XML tagged data format: message version number; state code for store location; geographic region; division ID to aid in triggering division specific programs; store ID to aid in triggering store specific programs; national council for prescription provider ID; English or Spanish language preference; pharmacy system&#39;s unique patient identifier; customer name; name mask flag field indicating printing “Valued Customer” instead of patient name; date of birth; gender; opt out flag indicating patient does not want information based upon patient&#39;s record; transaction sequence number generated by local CS for Q/A purposes; script status indicating whether prescription is a new unfilled prescription or a refill; NDC; medication name; prescription number printed on newsletter; dispensed quantity of medication (pill count); daily supply quantity; number of days supply; original fill date; expiration of prescription date; prescription refills remaining; alpha numeric associated with a drug monograph; patient directions; doctor&#39;s ID; pharmacists directions; boolean indicating whether printing of prescription and newsletter are simplex or integrated; boolean indicating whether to print HIPAA notice; payor (third party payor name or “CASH” if paid by customer); payor code (third party payor code or “CASH” if paid by customer); payor&#39;s processor control number; bank identification number; legal relationship between agent and principal for the prescription; insurance policy group ID; and insurance policy plan ID. Based upon any of the foregoing data fields having data possibly transmitted to the printer, the following data fields and combination of fields are contemplated with boolean combinations of rules for triggering to provide different information to different patients: 
     
       
         
               
               
             
           
               
                   
                   
               
             
             
               
                   
                 ndc 
               
               
                   
                 ndc/age/gender 
               
               
                   
                 ndc/refill 
               
               
                   
                 ndc/new 
               
               
                   
                 ndc/PillCount 
               
               
                   
                 ndc/refill# 
               
               
                   
                 ndc/refills remaining 
               
               
                   
                 age/gender 
               
               
                   
                 payor 
               
               
                   
                 payor/ndc 
               
               
                   
                 payor/age/gender 
               
               
                   
                 payor/ndc/age/gender 
               
               
                   
                 payor/ndc/refill 
               
               
                   
                 payor/ndc/new 
               
               
                   
                 patient ID or CID 
               
               
                   
                 Ndc/patient 
               
               
                   
                 Ndc/new/patient 
               
               
                   
                 Ndc/refill/patient 
               
               
                   
                 Ndc/refill#/patient 
               
               
                   
                 Ndc/age/gender/refill/new 
               
               
                   
                 Ndc/bin no 
               
               
                   
                 Refill/new /patient ID 
               
               
                   
                   
               
             
          
         
       
     
     In one preferred embodiment, the printer receives the prescription label print file as an XML data stream, and data for the foregoing currently contemplated fields exists and the beginning of the data stream between XML tags indicating to in the PCL printer language to ignore the tagged contents, such as between “1Bh&amp;foX” and “27d&amp;flX” tags. 
     An example of a sample prescription label and CHR content file layout is as follows. 
     
       
         
               
               
             
           
               
                   
                   
               
             
             
               
                   
                 Sample Label Stream Layout 
               
               
                   
                 Printer PCL* 
               
               
                   
                 [esc]E[esc]&amp;l2S[esc]&amp;l1H[esc]&amp;l1o 
               
               
                   
                 CHR tagged info 
               
               
                   
                 [esc]&amp;f0X[All CHR non-print data elements here][esc]&amp;f1X 
               
               
                   
                 Pharmacy back side data 
               
               
                   
                 [monograph] 
               
               
                   
                 CHR back side marker 
               
               
                   
                 [esc]&amp;f0X[esc]&amp;f1X 
               
               
                   
                 Pharmacy front side data1 
               
               
                   
                 [label information] 
               
               
                   
                 CHR front side marker 
               
               
                   
                 [esc]&amp;f0X[esc]&amp;f1X 
               
               
                   
                 Printer reset 
               
               
                   
                 [esc]E 
               
               
                   
                   
               
             
          
         
       
     
     An example of an XML string passing CHR information is as follows: 
     
       
         
               
               
             
           
               
                   
                   
               
             
             
               
                   
                 esc&amp;f0X 
               
               
                   
                 &lt;newsletter&gt; 
               
               
                   
                 &lt;BinNumber&gt;12&lt;/BinNumber&gt; 
               
               
                   
                 &lt;ControlNumber&gt;12313&lt;/ControlNumber&gt; 
               
               
                   
                 &lt;DailySupply&gt;2&lt;/DailySupply&gt; 
               
               
                   
                 &lt;DaysSupply&gt;30&lt;/DaysSupply&gt; 
               
               
                   
                 &lt;DateOfBirth&gt;02/01/1952&lt;/DateOfBirth&gt; 
               
               
                   
                 &lt;DispQty&gt;100&lt;/DispQty&gt; 
               
               
                   
                 &lt;DrDEA&gt;12323&lt;/DrDEA&gt; 
               
               
                   
                 &lt;Gender&gt;M&lt;/Gender&gt; 
               
               
                   
                 &lt;HIPAA&gt;Y&lt;/HIPAA&gt; 
               
               
                   
                 &lt;Language&gt;E&lt;/Language&gt; 
               
               
                   
                 &lt;MaskName&gt;N&lt;/MaskName&gt; 
               
               
                   
                 &lt;MedicationName&gt;DuraVent D/A&lt;/MedicationName&gt; 
               
               
                   
                 &lt;NCPDP&gt;123&lt;/NCPDP&gt; 
               
               
                   
                 &lt;NDC&gt;12345678901&lt;/NDC&gt; 
               
               
                   
                 &lt;OptOut&gt;N&lt;/OptOut&gt; 
               
               
                   
                 &lt;PatientID&gt;123456&lt;/PatientID&gt; 
               
               
                   
                 &lt;PatientName&gt;Joe Public&lt;/PatientName&gt; 
               
               
                   
                 &lt;Payor&gt;CASH&lt;/Payor&gt; 
               
               
                   
                 &lt;RefillsRemaining&gt;2&lt;/RefillsRemaining&gt; 
               
               
                   
                 &lt;ScriptStatus&gt;N&lt;ScriptStatus&gt; 
               
               
                   
                 &lt;/newsletter&gt; 
               
               
                   
                 esc&amp;f1X 
               
               
                   
                   
               
               
                   
                 Note: 
               
               
                   
                 The above information is intended as an example and not all fields are included. 
               
             
          
         
       
     
     Patient name  705  field stores the name of the patient for which the prescription was written. Optionally, this data field may be added to record  700  in printer  40  in response to receipt of a CID or encrypted CID. 
     Doctor name  710  field stores the name of the doctor who wrote the prescription for the patient. 
     Drug expiration date  715  field stores the date in which the drugs will expire. 
     Manufacturer of drug  720  field stores the name of the manufacturer of the drug. 
     Instructions for taking drug  725  field stores instructions for taking the drug. Such instructions can include: take only at night, take 3 pills a day, take with a full glass of water, or the like. 
     Quantity in the package  730  field stores how much of the drug was given the to the patient. For example, this field could store that 32 pills were given to the patient, or 12 oz., etc. 
     Number of refills  735  field includes how many times the patient may refill the prescription without needing a new prescription from the doctor. For example, this field could store the number 6, indicating that the prescription may be refilled 6 times. 
     Date of fill  740  field stores the date in which the prescription was filled. 
     Date prescription was written  745  field stores the date that the prescription was written. 
     History/medical record number  750  field stores a medical number unique to the patient. 
     Prescription number  755  field stores a unique number designated by the pharmacy that filled the prescription. 
     Name of pharmacy  760  field stores the name of the pharmacy which filled the prescription. 
     Address of pharmacy  765  field stores the address of the pharmacy which filled the prescription. Such address can include a website address or a street address, including street, city, state, and zip code. 
     Phone number of pharmacy  770  field stores the phone number of the pharmacy. 
     Cautions/warnings  775  field stores any cautions or warnings issued by the government, pharmacy, or doctor in taking the drug. For example, the label could read: Caution: Federal law prohibits transfer of this drug to any other person than patient for whom prescribed. 
     CID  780  field stores a CID. Optionally, the field may be added by printer  40  in response to receipt of and decryption of an encrypted CID. 
     Age/DOB field  781  stores age in year or date of birth of the patient. 
     Gender field  782  store gender, either male or female, or status unknown. 
     New prescription field  783  store a boolean value indicating whether the prescription is for an unfilled new or a refill request. 
     Refill number field  784  indicates the number of fills the patient has obtained on the prescription. 
     Pill count field  785  indicated the number of pills or quantity of non-pill medicine specified in the prescription. 
     Payor name field  786  indicated the name of the health insurance company payor if one exists, or “cash” if no the customer does not have or use a health insurance policy. 
     NDC field  787  stores the NDC number for the medicine provided. 
       FIG. 8  shows a representation of a monograph record in which monograph record preferably includes name of drug field  800 ; introduction/summary  805 ; pharmacology/pharmacokinetics field  810 ; FDA approved indications field  815 ; off label uses field  820 ; dosage and administration field  825 ; adverse effects field  830 ; overdose field  835 ; safety data field  840 ; contraindications field  845 ; warnings field  850 ; precautions field  855 ; drug interactions field  860 ; efficacy measures field  865 ; cost comparison field  870 ; clinical trials field  875 ; conclusions field  880 ; recommendations field  885 ; references field  890 ; research field  895 ; and NDC field  896 . 
     Name of drug  800  field stores the name of the drug. 
     Introduction/summary  805  field stores a summary of the information provided in the monograph. 
     Pharmacology/pharmacokinetics  810  field stores the composition of the drug, its uses, effects, the characteristics or properties of the drug that make it medically effective, the process by which the drug is absorbed, distributed, metabolized, and eliminated by the body. 
     FDA approved indications  815  field stores symptoms or particular circumstances that indicates the advisability or necessity of a specific medical treatment or procedure. 
     Off label uses  820  field stores uses relating to the drug to treat a condition which has not been approved by the FDA. 
     Dosage and administration  825  field stores the amount of the drug that should be taken and when it should be taken. This field may store different dosage amounts depending on an individuals situation, such as age, or what they are taking the medicine for. 
     Adverse effects  830  field stores the adverse effects of the drug. For example, adverse effects can include one or more of: headache, nervousness, insomnia, drowsiness, fatigue or asthenia, anxiety, tremor, dizziness, lightheadedness, nausea, diarrhea, and excessive sweating. 
     Overdose  835  field stores information about how much of the drug is considered overdose, if and how a person has died from overdose, symptoms of overdose and treatment. 
     Safety data  840  field stores safety data on the drug, such as data regarding safety in humans, in animals, and in vitro studies. 
     Contraindications  845  field stores factors that render the administration of the drug inadvisable. 
     Warnings  850  field stores information such as allergic reactions, who should not take the drug, what may happen to people who take the drug that should not be, and what may happen to a person if they overdose. 
     Precautions  855  field stores information with advice of what to do in advance to protect against possible danger, failure, or injury related to the drug. 
     Drug interactions  860  field stores information about reactions with other drugs or food interaction with the prescribed drug. 
     Efficacy measures  865  field stores the ability of the drug to control or cure an illness. 
     Cost comparison  870  field stores a table which compares similar drugs and dosages and their associated costs. 
     Clinical trials  875  field stores data on the clinical trials, such as the method, the criteria, results, conclusions, and critiques. 
     Conclusions  880  field stores the conclusions of the monograph. 
     Recommendations  885  field stores how the drug will be available, such as an open access basis or whether the drug should be made available. 
     References  890  field stores a list of references cited to in the monograph. 
     Research  895  field stores the research data that was analyzed to arrive at the present monograph. 
     NDC field  896  stores the NDC for the named drug. 
       FIG. 9  is a representation of one alternative for a MedGuide record which may include name of drug  900  field, important information about the drug field  905 ; who should not take the drug field  910 ; information a patient should tell a doctor before starting the drug field  915 ; how a patient should take the drug field  920 ; how a patient should store the drug field  925 ; what a patient should avoid while taking the drug field  930 ; the side effects of the drug field  935 ; other information about the ailment for which the patient is taking the drugs for field  990 ; ingredients of the drug field  995 ; general information about the safe and effective use of the drug field  950 ; and DCC for the drug field  951 . 
     Name of drug  900  field stores the name of a drug. 
     Important information about the drug  905  field stores a summary of what the drug is used to treat, severe side affects, and other important information. 
     Who should not take the drug  910  field stores information regarding who should not take the drug; such as, a person allergic to an ingredient in the drug should not take the drug. 
     Information a patient should tell a doctor before starting the drug  915  field stores information regarding what a doctor should know before prescribing the drug. Such information can include, whether the patient is pregnant, medical history, other drugs the patient is taking, allergies, and the like. 
     How a patient should take the drug  920  field stores information on how the drug should be taken. For example, the field can store the information that the drug should be taken in tablet form orally every 4 hours. 
     How a patient should store the drug  925  field stores information about storing the drug. This field can contain information such as, store at room temperature in a closed container, away from heat, moisture, direct light, or keep away from children. 
     What a patient should avoid while taking the drug  930  field stores information about what a patient should avoid while taking the drug, such as, alcohol or other medications. 
     The side effects of the drug  935  field stores information on side effects of the drug; such as, drowsiness, headaches, nausea, dizziness, etc. 
     Other information about the ailment of which the patient is taking the drugs for  940  field stores other information about the ailment such as what else is used to treat it, the history of the ailment, and characteristics of patients who have the ailment. 
     Ingredients of the drug  945  field stores the ingredients of the drug. 
     General information about the safe and effective use of the drug  950  field stores general information about the safe and effective use of the drug. 
     Alternatively, all information for each MedGuide may be stored in a single text or image field in association with a DCC for the named drug. 
       FIG. 10  shows a representation of a CHR content record which may include for example a CID  1000  field, a greeting  1005  field, a doctor&#39;s appointment reminder  1010  field, billing information  1015  field, promotion material  1020  field, information concerning a related product  1025  field, discount  1030  field, coupon  1035  field, government warning  1040  field, and news item  1045  field. 
     CID  1000  field stores a CID. Optionally, this field may be generated in printer  40  upon receipt of an encrypted CID. 
     Greeting  1005  field stores a greeting for the consumer. 
     Doctor&#39;s appointment reminder  1010  field stores a reminder for a consumers doctor&#39;s appointment. This field may not be present in implementations employing encrypted CIDs and de-identified information. 
     Billing information  1015  field stores information regarding billing, such as who was billed, how much the bill was, who paid for the bill, and the like. 
     Promotion material  1020  field stores information promotion drugs consumer is on, related drugs, new drugs, etc. 
     Information concerning a related product  1025  field stores information concerning a related product. 
     Discount  1030  field stores discounts for drugs consumer is taking, related drugs, new drugs, etc. 
     Coupon  1035  field stores coupons for drugs consumer is taking, related drugs, new drugs, etc. 
     Government warning  1040  field stores warnings issued by the government with respect to the drug or ailment. 
     News item  1045  field stores news information about the drug, a related drug, or any medical news. 
       FIG. 11  shows exemplary relationships between table or corresponding data elements in the various data record types including prescription record  700 , drug monograph table  210 , MedGuide record NDC/DCC table  235 , CHR/CID additional content  240 , and CHR non-CID additional content table  430 A leading to printing. 
       FIG. 11  shows prescription record table  700  logically linked to drug monograph table  210  via NDC code.  FIG. 11  shows Drug Monograph table  210  logically linked to MedGuide record  220  via correspondence of NDC to DCC in NDC/DCC lookup table  235 .  FIG. 11  shows identification of pre-existing stored CHR/CID additional content record  240  for CID in prescription record  700  via identification in prescription record  700  of a corresponding CID. 
       FIG. 11  shows CHR non-CID additional content table or filter  430 A and corresponding fields in prescription drug record  700  for new/refill, refills remaining, pill count, gender, and age/DOB. Printer code determines which if any records in table  430 A have values matching the corresponding field values in prescription record  700 , as indicated by operator  1110 .  FIG. 11  schematically shows data flows  1120 ,  1130 ,  1140 ,  1145  of data for CHR/CID content, CHR non-CID content, CHR additional content (drug monograph and MedGuide), and prescription label content for formatting  1150  as a prescription label print job. 
       FIG. 12  shows method  1200  including in sequence, entering a pharmacy order in step  1210 , transmitting prescription information to a pharmacy printer in step  1220 , in the pharmacy printer, identifying drug and CHR content for printing in association with the prescription in step  1230 , and then formatting and printing a prescription label and related drug and CHR content information. Either prior to step  1220 , additional information relating to the prescription may be added to the prescription data, including information stored in the local CS database  30 A, the central CS database  20 A, or the printer database  30 A, by the corresponding CPU. This information may include additional information about patient or the doctor, such as contact information or payment information.