Publication Date: June 20, 1997

Related article: Integrated Health Information Networks: A Prescription for Continuity of Care

Pharmaceutical Sector Putting IT To Work

By Ken Shulman

In a perfect world, no one would ever have to worry about adverse drug interactions or improper dosages. Pharmacists could access a patient’s lifetime medical record with a simple database search. They could observe what medications a patient was taking, and those he had taken in the past. They would know of any drug allergies or potentially lethal interactions. They could determine whether the patient was taking his medicines properly, and alert him when it was time to order a refill.

Unfortunately, as for much of the health care industry, the pharmacist’s perfect world appears to be several years away.

"The health care industry is generally two to five years behind other industries when it comes to information technology," says Roger Allison, service director and vice president of health care strategies at META Group. "The typical hospital has 13 disparate systems, and these are generally proprietary. The standard health care database has 750 field items per person, as compared with only 150 in the financial industry. A comprehensive database would have to include information on hospital registration, insurance, previous conditions, drug information, and all of a patient’s tests and exams. This is bigger than anything that has ever been done in technology. We are talking about light-dimming queries here."

In the throes of an economic and institutional revolution, the U.S. health care industry seems to be lagging in the acquisition and application of information technology. Computer hardware and software have never been high on the priority lists of cost-conscious hospital administrators. And the issue of patient confidentiality -- along with the desire to maintain their client/payer base -- discourages rival health care organizations from sharing vital information, leaving them little incentive to work toward standard IT platforms and protocols.

Still, some sectors of the industry have made substantial progress, including the pharmaceutical sector. There are several services that provide pharmacies and health care companies with comprehensive databases on drug interactions. As a result, computerized drug-interaction screens have become routine at many large health care organizations and at the CVS and Walgreens pharmacy chains. Client modules, which monitor drug dosages and alert pharmacists when a patient is significantly early or late in ordering a refill, are also becoming increasingly common.

"At this point, computer technology is part and parcel of our industry," says Paul O'Connor, director of pharmacies at Harvard Pilgrim Health Care. The largest HMO in New England, with 1.1 million members, Harvard Pilgrim Health Care offers its patients drug-interaction screens and client pharmacy modules. "The major limitation comes when a patient shops at a pharmacy that isn't connected to his primary provider. That is why it is still fundamental that the patient have some sort of discussion with the pharmacist who is filling out his prescription."

For a few health care visionaries, a proper application of IT could provide the industry with better patient care and substantial savings. In May, CVS unveiled a $100 million client/server infrastructure linking all of its 4,000 stores across New England. The system allows pharmacists to share information regarding patient history, current and past medications, and drug interactions. The system is designed to sweep all current transactions into a two-year comprehensive database including every prescription that has been filled at the chain, as well as information on refills, doctors and health plans. Yet for Howard Edels, CVS’ senior vice president for MIS, the system’s greatest benefits will come in the forms of improved workflow, management and customer service.

"The whole idea is to allow the pharmacist to spend more time with his customer," says Edels, who came to the CVS corporation in 1992. "We are only beginning to implement our system here. The drug-interaction feature is a big selling point for us, but I don’t think it's one of our critical issues. In the future, we can use our technology to rationalize our prescription processes, our refill processes, and our patient-monitoring processes. Today, for example, we tend to call doctors somewhat randomly on refills. With our new system, we will be able to sort the refill process by doctor. Instead of calling doctors on each prescription, we can contact them with a single list of 40 or 50 expiring prescriptions, either by phone or electronically. This will ease the workload in our store, and also free up the doctor."

Information and database technologies are also being applied to the research and merchandising sectors of the pharmaceutical industry. Many drug company representatives use databases to analyze sales data and to better identify their marketing targets. And almost all of the largest drug companies are using high-throughput screening to aid researchers in discovering new drug molecules, and in determining the potential use of those compounds. These high-powered searches can execute up to 100,000 screenings per day. "This doesn't mean that every new molecule is a viable drug," says Dan Vogel, senior program director for health care and IT strategies at META Group. "But it is an excellent tool that allows the researcher to select those molecules that require further study."

Ken Shulman writes from Cambridge, Mass.

Related article: Integrated Health Information Networks: A Prescription for Continuity of Care

Roger Allison is a featured speaker at DCI's Data Warehouse World. Please see our online brochure for program and registration information.

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