Patent Publication Number: US-2003225627-A1

Title: Method for retail distribution of medical products

Description:
BACKGROUND OF THE INVENTION  
       [0001] 1. Field of the Invention  
       [0002] The invention relates to the distribution of medical products including pharmaceuticals and durable medical equipment (“DME”). The invention is a method for coordination of that distribution using a computer network such as the Internet. A doctor or patient may locate a pharmacy or other supplier. The doctor may manage a prescription for a pharmaceutical or DME electronically after the prescription is written but before the prescription is filled by canceling the prescription, allowing the prescription to remain in effect, or monitoring patient purchase of the pharmaceutical.  
       [0003] 2. Description of the Related Art  
       [0004] The distribution chain for pharmaceuticals and durable medical equipment (“DME”) is generally manual. A physician writes a paper prescription for a drug. A patient delivers the paper prescription to a local (brick-and-mortar) pharmacy. The pharmacy fills the prescription and receives partial payment from the patient. The pharmacy presents a claim to patient&#39;s insurance company for the remainder of the payment due.  
       [0005] Various approaches exist in the prior art to making the manual process more efficient. For example, mail order pharmacies have existed for several years. In the business model used by mail order pharmacies, the patient mails a paper prescription to the pharmacy and the pharmacy mails drugs to the patient. The mail order pharmacies do not provide the doctor involvement in filling and monitoring of the prescription provided by the present invention and do not provide the opportunity for electronic prescriptions and renewal of prescriptions provided by the present invention.  
       [0006] More recently, Internet pharmacies have come into existence. Internet pharmacies receive orders from patients over the internet and deliver drugs by mail. An Internet pharmacy may be a full-line pharmacy handling substantially all governmentally approved prescription medications or may sell only a few medications. Some Internet pharmacies process insurance claims in the same manner as a bricks-and-mortar pharmacy. Other Internet pharmacies do not deal with insurance claims at all.  
       [0007] Some Internet pharmacies employ a staff physician who prescribes medication based on patient entries on a computer-generated electronic form. The physician has no contact with the patient other than by reading words on a form. The physician does not follow up with the patient. Because of the very limited patient care involved, such Internet pharmacies generally stock a limited number of relatively low-risk drugs for non-life threatening conditions, such as sexual dysfunction or hair loss. Some Internet pharmacies commonly provide a referral fee to anyone, such as a doctor, referring business to the internet pharmacy.  
       [0008] The Internet pharmacies do not provide for the choice of suppliers inherent in the present invention. The Internet pharmacies also do not provide for the management of prescriptions under the immediate care of a doctor who actually has examined the patient.  
       [0009] Several prior art patents have addressed the delivery of pharmaceuticals.  
       [0010] U.S. Pat. No. 5,797,515 to Liff issued Aug. 25, 1998 reveals a vending machine for drug containers. The vending machine is controlled by a computer. The machine is placed in a doctor&#39;s office and accessed by the patient. A central service center monitors several vending machines. Liff does not provide for choice of suppliers of the present invention.  
       [0011] U.S. Pat. No. 5,832,497 to Taylor issued Nov. 13, 1998 teaches an online database of jobs and resumes. Taylor provides for searches to match jobs with job seekers. Taylor does not provide for writing or filling of prescriptions for drugs or DME and does not provide for physician management of prescriptions after the prescription is written.  
       [0012] U.S. Pat. No. 5,845,255 to Mayaud dated Dec. 1, 1998 teaches a computerized prescription writing and transmission system using a network. Mayaud provides the physician with information to write the best prescription for the patient, including information on available drugs, patient history and drugs covered by the patient&#39;s insurance. Mayaud does not provide for electronic transmission of a prescription to a pharmacy and does not provide for selection of a pharmacy or DME supplier by a physician or patient. Mayaud also does not provide for management of the prescription by the doctor after the prescription is written.  
       [0013] U.S. Pat. No. 5,963,453 to East issued Oct. 5, 1999 relates to the automated filling of pill bottles at a pharmacy. East does not relate to the process of transmitting the prescription to the pharmacy and does not relate to doctor management of the prescription.  
       [0014] U.S. Pat. No. 5,982,863 to Smiley issued Nov. 9, 1999 teaches a voice appointment system for use by physicians. A caller can set an appointment by speaking to voice recognition software rather than to a live assistant. Smiley does not relate to selecting a pharmacy or filling prescriptions.  
       [0015] U.S. Pat. No. 6,014,631 to Teagarden issued Jan. 11, 2000 teaches a computerized system of determining whether medications are appropriate. An insurance company using the Teagarden invention makes a detailed evaluation of a patient&#39;s medical condition, lifestyle and over the counter drugs. The Teagarden invention does not relate to selecting a pharmacy or electronically transmitting a prescription to a pharmacy.  
       [0016] U.S. Pat. No. 6,202,923 to Boyer issued Mar. 20, 2001 is a system for use in a pharmacy to avoid error. Boyer does not relate to selection of a pharmacy by a doctor or patient and does not relate to electronic transmission of a prescription to a pharmacy by a doctor or to management of the prescription by the doctor.  
       SUMMARY OF THE INVENTION  
       [0017] The present invention is a method for coordinating the retail distribution of medical products, including pharmaceuticals or durable medical equipment (“DME”), from a pharmacy or DME supplier using the Internet. A doctor or other health care provider authorized by law to write prescriptions utilizes a computer network such as the Internet to write a prescription for pharmaceuticals or DME and uses the computer network to manage the prescription after issuance, including submitting the prescription to a pharmacy or DME supplier, canceling the prescription, and monitoring patient compliance, as appropriate.  
       [0018] For purposes of this application, the term “pharmaceutical” means any material intended for treatment of a health-related condition of a human being or animal and which by law may be dispensed only by prescription. The term ‘durable medical equipment’ means equipment to treat a human or animal health condition, but excluding pharmaceuticals. Examples of DME include a wheelchair or a crutch.  
       [0019] In the method of the present invention, a patient queries a computer database through an internet web site to locate a suitable health care provider, such as a doctor or dentist. The doctor examines the patient and determines medications or DME appropriate to the patient&#39;s medical condition. The doctor or the patient queries the Internet web site and searches a database to locate a pharmacy or durable medical equipment dealer offering appropriate services and in a convenient physical location. The doctor electronically transmits the prescription to the selected pharmacy or DME supplier. The doctor may manage the prescription electronically, including canceling the prescription or monitoring patient compliance, as appropriate. The pharmacy or DME supplier may submit requests to refill the prescription electronically to the doctor, who will either grant or deny the request.  
       [0020] Insurance information may be submitted to the pharmacy or DME supplier electronically either by the doctor or by the patient. Insurance information may reside in computer memory to render unneccessary reentry of that information. If some or all of the cost of the prescribed drug or DME is not covered by insurance, as by a patient co-pay, the patient may provide for payment of the co-pay amount by credit card though the Internet web site. A commission on a sale may be paid to the operator of the Internet web site for providing transaction facilitation services. A commission on a sale may be provided to a doctor or other referring person. Payment of such a commission should be in compliance with any laws and ethical standards which apply to the recipient. 
     
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
     [0021]FIG. 1 is an overview diagram of the present invention.  
     [0022]FIG. 2 is a diagram of communication flow of the present invention.  
     [0023]FIG. 3 is a flow diagram of the initial choices offered to a user of the Internet embodiment of the invention.  
     [0024]FIG. 4 is a flow diagram of the choices offered to a patient.  
     [0025]FIG. 5 is a flow diagram for choices offered to a health care provider.  
     [0026]FIG. 6 is a flow diagram of the choices offered to the health care location manager.  
     [0027]FIG. 7 is a flow diagram of the process of managing prescription refills by the doctor.  
     [0028]FIG. 8 is a flow diagram showing doctor or patient selection of durable medical equipment.  
     [0029]FIG. 9 is a flow diagram showing choices offered to the pharmacy.  
     [0030]FIG. 10 is a flow diagram showing choices offered to the Pharmacy location manager.  
     [0031]FIG. 11 is a flow diagram showing the process of obtaining prescription refill approval by the pharmacy.  
     [0032]FIG. 12 is a flow diagram of the choices offered to the durable medical equipment supplier.  
     [0033]FIG. 13 is a flow diagram of the choices offered the DME location manager.  
     [0034]FIG. 14 is flow diagram of choices available to the store manager.  
    
    
     DESCRIPTION OF AN EMBODIMENT  
     [0035]FIG. 1 is an overview diagram of the present invention. A patient  2  utilizes a client computer  4  to communicate with a server computer  6  over a computer network, which may be the Internet  8 . The patient  2 , through a client computer  4 , queries the server computer  6  to locate a healthcare provider  10  providing a specified service in a specified location. The server computer  6  conducts an appropriate search of a database resident in the memory of the server computer  6  and provides the patient  2  with a list of suitable healthcare providers  10 , who may be physicians.  
     [0036] The patient  2  visits the health care provider  10 , who determines that pharmaceuticals or durable medical equipment (“DME”) are appropriate to the care of the patient  2 . The patient  2  or health care provider  10  selects a pharmacy  12  and medical equipment supplier  14  to supply the pharmaceuticals and DME to the patient  2 . The health care provider  10 , patient  2 , DME supplier  14  and pharmacy  12  each communicates by transmitting data from a client computer  4  through the Internet  6  to a server computer  6  programmed to display to client computers  4  an Internet web site specific to the purpose. The web site provides a secure avenue for the exchange of sensitive medical information.  
     [0037] The health care provider  10  electronically transmits a prescription  16  for a pharmaceutical or DME to a pharmacy  12  or DME supplier  14  and may manage the prescription  16  after the prescription  16  is transmitted through selection of the pharmacy  12  or DME supplier  14 , through canceling of the prescription  16  and through monitoring of patient  2  compliance, as appropriate. Because the patient  2  is under the immediate care of the health care provider  10 , the web site is a suitable medium for distributing drugs for all purposes, including treatment of life threatening conditions. The web site further provides a structured means for the health care provider  10  to receive electronic (rather than telephonic) requests for prescription  16  refills.  
     [0038] The web site also may host a store  18  from which any user may search for or browse items for sale and may purchase such items.  
     [0039]FIG. 2 presents a diagram of the major communication flow of the present invention. The health care provider communicates prescriptions  16  and prescription  16  refills to the pharmacy  12 . The health care provider  10  also orders DME through the DME supplier  14 . Also from FIG. 2, the pharmacy  12  provides filled prescriptions  16  to the patient  2 . The pharmacy  12  submits prescription  16  refill requests to the health care provider  10 . The pharmacy  12  receives prescriptions  16  from the health care provider  10  or the patient  2 . The pharmacy  12  may receive the patient&#39;s  2  insurance information from the web site and may receive patient&#39;s  2  credit card information from the web site to secure any co-payment that may be due.  
     [0040] From FIG. 2, the patient  2  transmits prescriptions  16  to the pharmacy  12  or DME supplier  14  and received the filled prescriptions  16  from the pharmacy  12  or DME supplier  14 . The patient  2  may transmit insurance information to the pharmacy  12 , DME supplier  14  or health care provider  10 .  
     [0041] Also from FIG. 2, the DME supplier  14  receives an order for medical equipment from the health care provider  10  or patient  2  and provides the DME to the patient. The DME supplier  14  may receive patient&#39;s insurance information from the web site to facilitate payment and may receive credit card information from the web site to pay for portions of the cost not paid by patient&#39;s  2  insurance.  
     [0042]FIG. 3 illustrates the choices presented to a person accessing the web site over the Internet  8 . The person must log on  20  and identify him or herself as a patient  2 , health care provider  10 , pharmacy  12 , DME supplier  14  or store  18 . The store  18  is an internet store selling non-prescription health-related items. Once the person identifies him or herself as belonging to one of the above categories, the user is presented with additional choices.  
     [0043]FIG. 4 shows the choices presented to a user who identifies him or herself as a patient  2 . The patient  2  may elect to find a DME supplier  14 , find a pharmacy  12 , find a health care provider  10 , fill a prescription  16 , change his or her profile or review his or her transaction history. If the patient  2  elects to find a DME supplier  14 , the patient  2  may search a database for DME suppliers  14  based on distance, zip code and DME needed. A list of DME suppliers  14  meeting the patient&#39;s  2  criteria is presented to the patient  2 , who may then search the DME supplier&#39;s  14  inventory and, if desired, place an order with DME supplier  14 .  
     [0044] If the patient  2  elects to find a health care provider  10 , the patient  2  is allowed to search a database of doctors and other health care providers  2  by zip code, distance and discipline. Any other search criteria also may be used, such as gender, name, hospital or affiliation. The patient  2  is presented with a list of health care providers  10  meeting patient&#39;s  2  criteria. Patient  2  then may select a health care provider  10 .  
     [0045] Similarly, if the patient  2  elects to find a pharmacy  12 , the patient  2  searches a database of pharmacies  12  based on zip code, distance and pharmaceuticals required. Patient  2  may be allowed to search for a pharmacy  2  based on any criteria, including price for the required drug or acceptance of insurance. Once the patient  2  has selected a pharmacy  12 , the patient  2  may fill a prescription  16 . If the patient  2  is in possession of a paper prescription  16 , the patient  2  may transmit the prescription  16  to the pharmacy  12  by any means, including by facsimile transmission or by transmitting a scanned image.  
     [0046] If patient  2  elects to change his or her profile  22 , the patient  2  is allowed to modify the patient&#39;s  2  identification and background information resident in the computer memory of the server computer  6  maintaining the web site. If patient  2  selects to review his or her transaction history  24 , the patient  2  is presented with the patients transaction history  24  on the web site, a record of prescriptions  16  submitted or renewed.  
     [0047]FIG. 6 shows the choices presented to the person identifying him or herself as a health care provider  10  from FIG. 3. Three levels of health care provider  10  are allowed. The health care superuser  26  is the top level administrator in charge of the account for a health care provider  10 . The health care superuser  26  may change the profile  22  of the account, may designate health care location managers  28  and may manage locations  30 . Each health care location  30  is a separate physical location or practice group under common management. The health care superuser  26  may create subaccounts for separate locations and may appoint health care location managers  28  for those locations  30 .  
     [0048] As shown by FIG. 6, health care location managers  28  have such power as is designated by the health care superuser  26 . The health care superuser  26  and health care manager  28  may be the same person. The health care manager  28 , as designated by the superuser  26 , has the authority to manage users  32 , to find DME suppliers  14 , to find a pharmacy  12 , to work with prescriptions  16  and to register a patient  2 . Users  32  are members of the health care provider  10  staff and have so much of the power of the health care location manager  28  as is designated by the manager  28 . A health care superuser  26 , manager  28  or user  32  may be a doctor.  
     [0049] The health care location manager  28 , or, if designated, the health care user  32 , may work with prescriptions  16 , including transmitting a prescription  16  to a pharmacy  12 , canceling the prescription  16 , and monitoring patient  2  compliance as appropriate.  
     [0050]FIG. 7 is a flow chart illustrating the function of the health care manager  28  or user  32  in authorizing that a prescription  16  be refilled on request of the pharmacy  12 . FIG. 8 is a flow chart illustrating the functions of the health care location manager  28  or user  32  in finding and ordering DME from a DME supplier  14 .  
     [0051]FIG. 9 shows the choices provided to a person identifying him or herself as a pharmacy  12  in the step illustrated by FIG. 3. The person is a pharmacy superuser  34 , pharmacy location manager  36  or pharmacy user  38 . The pharmacy superuser  34  may change the pharmacy identification and contact information in the profile  22  and manage pharmacy locations  40 , which may be separate physical locations or may be other separately administered business units, as designated by the pharmacy superuser  34 . The pharmacy superuser  34  also may designate pharmacy location managers  36  for the pharmacy locations  40 . The pharmacy location managers  36  have such powers as are designated by the pharmacy superuser  34 , including viewing product orders, managing prescriptions  16 , managing products and managing pharmacy users  38 . Pharmacy users  38  are pharmacy  12  staff delegated authority by the pharmacy location manager  36  to perform any or all of the actions of the pharmacy location manager  36 .  
     [0052] The pharmacy location manager  36  manages prescriptions  16  by viewing prescription  16  orders received, modifying or deleting the prescription  16  or adding comments. The orders received by the pharmacy  12  may be integrated automatically into the pharmacy&#39;s  12  prescription  16  control system or may be entered manually by the pharmacy location manager  36  or pharmacy user  38 . The pharmacy location manager  36  manages products by posting an inventory of goods or services to the web site. The patient  2  or health care provider  10  may browse through the inventory or search for particular items. The health care provider  10  or patient  2  may purchase goods or services in the inventory from the pharmacy  12  through the web site.  
     [0053]FIG. 11 provides a flow chart of the steps followed by the pharmacy location manager  36  or pharmacy user  38  in submitting a prescription  16  refill request to a health care provider  10 .  
     [0054]FIG. 12 is a flow chart of options available to a person who identifies him or herself as a DME supplier  14  in response to the query of FIG. 3. The person is a DME superuser  42 , DME location manager  44  or DME user  46 . The DME superuser  42  is the top level DME administrator and has the power to change the DME supplier&#39;s profile  22 , including contact and identifying information. The DME superuser  42  also may manage DME supplier locations  48 , which may be separate physical locations or may be business units of the DME supplier  14 . The DME superuser  42  has the further power to designate DME location managers  44  with operational control over the DME supplier locations  48 .  
     [0055] The DME location manager  44  has the power to designate DME users  46  who have some or all of the DME location manager&#39;s  44  powers, as designated by the DME location manager  44 . The DME location manager  44  or designated DME user  46  may view orders for medical equipment. Each order may be entered automatically in the DME location&#39;s  48  inventory control system, or may be entered manually by the DME location manager  44  or designated DME user  46 . The DME location manager  44  or designated DME user  46  may maintain the DME location&#39;s  48  product line by entering an inventory of available products so that a patient  2  or health care provider  10  may browse or search the inventory.  
     [0056] The DME supplier  14  or pharmacy  12  may compensate the web site operator for orders placed over the web site.  
     [0057] The goods and services offered by a pharmacy  12 , DME supplier  14  and store  18  may overlap, and each may provide the goods of the other.  
     [0058] Many different embodiments of the above invention are possible. This application is intended to address all possible embodiments and is limited only as described in the following claims.