ITCA20130005A1 - DOFAR - PHARMACEUTICAL DOMICILATION - Google Patents

Description

TITLE: Information System

"doFar - Pharmaceutical Domiciliation"

DESCRIPTION: the doFar "Information System", (Fig. 4), the first and only one in Italy and Europe, is an original system that manages, through the integration of five Software Platforms with specific Mobile Devices, a modular procedure aimed at optimizing the Dispensing of Drugs managing even the home delivery, as well as an Alert Service that reminds the chronic patient and not the assumption of therapy in real time.

The latter, created through an application developed for the Apple, Android and WindowsPhone platforms, (called "MiRicordoPerTe"), will allow any user of Mobile Device to have the alert service and, where required, to report via sms to a third party (usually child, relative, friend) that the chronic patient has not taken the therapy.

For doFar subscribers, this Application will allow the patient's record to be automatically implemented, giving evidence to his attending physician of adherence to the therapy, with immediate confirmation of its implications on the patient's state of health.

Analysis of the problem: doFar arises from the analysis of patients' problems, essentially chronic but not limited to, in the hands of general practitioners, hospitals and specialists, as well as free choice pediatricians, who must necessarily remember every month:

• the supply of drugs, often life-saving, essential to keep the disease in a chronic and controlled form;

• go to the doctor to request a repetitive prescription often without the need for a medical examination and being forced to face long lines in medical clinics;

The above analysis highlights how the essentially chronic needs of patients are also reflected in the work of doctors, pharmacists and the National Health System.

In fact, in the case of doctors, the overcrowding of outpatient clinics, especially due to the preparation of repetitive prescriptions, "takes away" precious time for outpatient and home visits for patients who need them.

As far as pharmacists are concerned, it often happens that they do not have immediate availability of the drugs prescribed by the doctor, forcing patients to return for collection; this event is read as a "disservice" of the pharmacy distribution system.

Finally, as regards the National Health System, a huge "waste" of drugs has been observed because the repetitiveness of the prescriptions never checks the stocks that patients accumulate during therapy which, being essentially chronic patients, lasts for a lifetime. when the pathology is diagnosed. This waste was estimated, from analysis of the problem, in the order of € 60 / € 120 per year per chronic patient.

State of the art: at present, as there is no organized system for this "need", patients often, especially if unable by their pathology, turn to family members, friends or caregivers, who do it for them. The procurement of drugs is therefore particularly tiring for the patient or for the people who have responsibility for them, often forced to face long lines in medical clinics.

Problems encountered:

• patients

o uncontrolled drug depletion;

or exhausting files at the doctor;

o need for people available to collect prescriptions / drugs;

• doctors:

o crowded and unmanageable clinics;

o little time to devote to outpatient and / or home visits;

• pharmacists:

o lack of the drug in the pharmacy;

o inefficient service;

• national health service:

o highlighting of the waste of medicines since no person or system controls the inventories that each patient accumulates at home, as a consequence of the different types of packaging and dosage of the therapy drugs;

o worsening of the deficit of the ministry of health, caused by the lack of control of territorial health expenditure;

Proposed solutions: doFar is an original Information System, the first and only one in Italy and Europe, which solves the above problems. Structured in three modules designed according to different needs, doFar supports the patient, the doctor and the pharmacist, in all phases of drug procurement by providing, in module three, the most complete of all, even the home delivery of drugs.

doFar provides primary services and secondary services with a strong socio-health value that make the application complete, giving it a precious added value.

doFar is designed to implement the adoption of the electronic prescription and integrate with the legislation it provides.

These objectives were achieved thanks to the centralized management of data and their flows.

By virtue of this choice, the system has a capacity for continuous expansion and provides for the possibility of introducing and developing new services and functionalities that can be widely used.

doFar is prepared for the adoption of the electronic prescription and to integrate with the legislation that it will provide.

Objectives and advantages of the doFar® project

for patients: it improves the quality of life, simplifying all the steps to be taken for the timely and constant supply of their periodic therapy through a system that allows integration between doctors and pharmacists; Furthermore, the service will provide excellent support for all those who generously take care of assisting loved ones who are not self-sufficient, reinforcing that bond of solidarity which is strongly challenged today by territorial dispersion and by the difficulty of coordinating personal commitments, work and family.

for doctors and pharmacists: the adoption of the system improves the organization of work and the control systems of data relating to therapies and patients, freeing up precious time to devote to professional activities with greater added value perceived, as such, by the patient as by the operators of the local health service.

• for the NHS and SSR: the doFar system rationalizes management costs for chronic therapies without increasing management costs (the service is voluntarily subscribed and paid for by the patient!). The service is already set up for integration with the electronic prescription and for the future management in pharmaceutical facilities of additional services of interest to the regional health system (eg CUP, exam booking, ticket collection, management of patients under ADI and OSP 2, diabetic, celiac, TAO aids), as suggested by the recent L69 / 2009.

Structured in three modules designed according to different needs, doFar supports the patient in all phases of the supply of drugs, completely replacing him in module three, the most complete of those proposed.

How it is composed: doFar is composed of five Multimedia Software Platforms, interconnected by a Telematic Network that regulates the flows of data exchanged between pharmacist / doctor / patient courier / helpdesk, and by an Organizational / Logistics Network that coordinates the actions that the subjects involved perform for the purpose of providing the service itself.

Analyzing the Information System in detail, the five platforms are:

Central doFar platform;

DoFar platform for pharmaceutical domiciliation - Pharmacists / Doctors / Patients;

• doFar HelpDesk platform;

• DoFar Couriers Platform / Application;

• "I remember for you" application;

The doFar Information System is built with a layered architecture (fig. 1): the persistence level of the data, the application level, the presentation level.

The data persistence level is achieved through multiple databases managed by a central Database Management System (DBMS), and accessed through a set of procedures exposed by the application layer.

The application level is implemented through the doFar Centrale platform, which is accessed via a web server; the presentation level consists of the remaining platforms and applications described below.

The doFar information system is structured (fig. 2, fig. 3) by an internal network, LAN, consisting of the Application Server, the DBMS, the Report Server and the HelpDesk Platform; and an External Network, INTERNET, consisting of Web Platforms for use by Doctors / Pharmacists / Patients and Couriers; the two networks are put into communication through the Central Web Server.

The doFar platform consists of four parts: a set of timed functionalities in execution (scheduled operations), a set of functions for accessing the database, the library of main features and algorithms, and a set of web services called up by the others. applications of the doFar Information System.

This platform interfaces directly with the database, and constitutes its only access point, used by the other four platforms through the web services exposed.

It is also responsible for data processing and management of data flows, as well as for the management of planned operations.

doFar pharmaceutical domiciliation, is the back-end web platform that allows doctors, pharmacists and patients to interact with the system and save all the necessary information within the doFar system in the database.

It is made using Adobe Flex technology to ensure a high level of security and relies on the web services exposed by the central platform to perform the functions of presenting and manipulating data to service users.

doFar HelpDesk is the web platform that allows operators and supervisors to carry out their own patient support activities, managing the memo lists of commitments, and supporting the activity of couriers, managing the information of recipe and drug logistics planning.

doFar Corrieri is the functional application for carrying out the activity of couriers. Presents logistics planning information and integrates with mobile devices that are part of the doFar Information System, providing features such as geo-localization, barcode scanning, interfacing with the doFar Central platform for updating related data to the courier business.

How the doFar System is implemented:

ο How it is done: Registration process: Registration takes place at the Pharmacy: the pharmacist will accompany the patient in choosing the module that best suits his needs; having chosen the form, the patient will sign the "contract" with the Pharmacist for the acquisition of the service, thus determining the choice of the Pharmacy. In addition to the Personal Data Authorization Form, the Pharmacist will also deliver the Personal Data and Therapy Data Collection Form to the patient, which must be completed with his / her Doctor. The data collection form has several sections:

• a section with the patient's personal data and contact details; • a section with the physician's personal data and his address; • a section with details of medicines and dosage.

The Data Collection form and the Authorization Form for the Processing of Personal Data, completed in all their parts, will then be delivered to the Pharmacy chosen by the patient or by his / her delegate. The registration to the doFar service is completed.

How to do it: Data entry phase: the Pharmacist will enter the patient's data in the doFar Pharmacists / Doctors / Patients platform.

How it is done: Individual patient data processing phase: once the patient's pharmacological data has been entered, the system will process:

1. on the patient side: the calculation of the frequency with which to prescribe the prescriptions for the drugs, tracing the pharmacological needs of the patient to a single day of the month; calculates the frequency with which to prescribe the prescriptions for the drugs, tracing the patient's pharmacological needs to a single day of the month; aligns the therapy by monitoring the actual consumption of drugs by the Patient based on the packaging, doses and times of administration of each prescribed drug; avoid waste by evaluating the presence of remnants of medicines in patients; guarantees the coverage of the Drug requirements established by the doctor on the basis of the regulations in force; reduces the number of recipes issued based on the legal provisions in force for the compilation of recipes.

The result of these complex operations is the Monthly Planning of Recipes that must be prescribed to ensure coverage of the annual pharmaceutical needs of the individual Patient;

How it is carried out: Data processing phase for all patients: subsequently the Central Application will carry out a second complex processing by collecting the data of all the Monthly Recipe Schedules, (enrolled in the Service at different pharmacies but headed by the same Doctor), and generating on the medical side the Memorandum Recipes, on the Pharmacist side the Dispensation Agenda:

2. Memorandum Recipes: contains the unification of all the Recipe Plans of the individual Patients in a single electronic form, so that the doctor can proceed with their "overall printing" once or only twice a month). For the printing of the recipes, you will have 7 days prior to the date of collection of the same; the doctor can consult the document at any time.

It is essential to underline that the Memorandum is elaborated by the system on the basis of the therapeutic plan drawn up by the Doctor at the time of registration of the Patients. Any modification must therefore be authorized by the doctor.

Specifically, the Memorandum Recipes will contain the following data:

· List of patients to prepare prescriptions for;

· List of drugs with details of the number of packs to be prescribed;

detection and highlighting of any drug residues that the patient has accumulated over time by virtue of the different posologies and / or packaging.

When the set of residues constitutes an entire package of the drug, the doctor can prescribe a smaller number of packages adequate to cover the dispensing period: this "service" offered by the doFar system is strategic for the purposes of controlling and limiting expenditure. Sanitary.

The prescriptions that the Doctor will prescribe using the Memorandum Recipes will be delivered to the pharmacist so that he can provide for the dispensing of drugs.

If the Doctor makes changes to the patient's therapy, with respect to the data "remembered" in the Memorandum, the Pharmacist will notify the system of such changes.

In the absence of changes, the system automatically updates the residues of each patient and therefore the subsequent memoranda. 3. the Dispensation Agenda is the fundamental document in which the drugs to be dispensed to patients registered at their pharmacy are displayed on a daily basis for the entire duration of the contract. From the Dispensation Agenda derives the Supplies Calendar which will allow the pharmacist to optimize the purchases of drugs according to the prescriptions arriving and to be sure of the immediate availability of drugs for his Patients.

How to do it: Commitment Memo Phase: The Commitment Memo phase, provided for all modules, consists of a telephone call that will be made the day before the expiry of a commitment by a Help desk operator. With the phone call, depending on the type of recipe and the module chosen, the operator will remind the patient to:

• go to the doctor to collect the prescription and to the Pharmacy to collect the drugs, (form l)

• go to the Pharmacy to collect the Drugs, (form 2)

• be available at home for the delivery of medicines, (form 3);

How is it done? Recipe Collection Phase: the next phase consists in the collection of prescriptions from doctors by patients (form 1) or couriers (form 2 - 3). The collection of the prescriptions and the subsequent delivery to the pharmacy (mod. 2, 3) will be carried out by a single courier company for each region, This choice was made to minimize costs and delivery times, and to reduce the passage to doctors or pharmacies (mod. 2 - 3)

How is it done? Drug Delivery Phase: the last phase is the delivery of drugs to patients. The delivery will take place 2 to 3 days before the expected date for the patient's medicines to run out. Deliveries can be made to different domiciles depending on the information provided by the patient. The delivery service will start the month following the enrollment month. Courier operations are managed through the doFar Corrieri Software Application Platform for time planning and logistical optimization of Recipe Collection and Drug Delivery and for calculating routes on the road graph. Based on the geographic positioning of the stakeholders (patients, pharmacists, doctors) and the dates on which patients run out of drug coverage, the platform collects the deliveries to be made and calculates the optimal routes in order to carry out the least number of passes by doctors and pharmacists.

How is it done? Security: the doFar application uses the HTTPS protocol for secure data management via the Internet. HTTPS is HTTP encapsulated in an SSL / TSL stream. SSL is the Secure Socket Layer protocol, which allows the exchange of data streams in a manner designed to avoid interception, modification or falsification of the same. TSL stands for Transport Layer Security, or transport layer security. HTTPS currently represents the highest level of security for the protection of information transmitted over the Internet.

HTTPS therefore guarantees:

data confidentiality

• data encryption

• exclusive channel to and from the doFar® centralized system. How is it done? Privacy and Sensitive Data: the doFar system processes Sensitive Data: for this reason it provides, as an absolute condition, the adoption of effective technological protections as established by law 675/96 "Protection of persons and other subjects regarding the processing of personal data ". The need to use the Public Network for the functioning of the doFar System has forced the adoption of rigorous design criteria to guarantee the system the following safety features:

• confidentiality of information;

• data protection during transport;

• protection of the system from unauthorized access attempts; • protection of the central archive against any attempts of unauthorized physical or telematic access.

What requirements? Pharmacies: to access the application and provide the service, the pharmacy must be equipped with a personal computer and internet connection. No specification is required on the platform and operating system, in fact the application "runs" on any Internet browser.

What requirements? General Practitioners: under the Paper Recipe regime, the doctor is not required to have any computer equipment; the documents necessary to use the service, in fact, will be delivered through the company's couriers; communications between the Help Desk and doctors will take place by telephone or via text message. Under the Electronic Prescription regime, the doctor will use the telematic equipment to view the documents. Communications between doctors and the Help Desk can therefore take place via computer, telephone or text message.

What requirements? Patients: the patient is not required to use any technological equipment to use the service because communications between the Help Desk and patients will take place by telephone or via text message. Similarly, if the patient is equipped with a personal computer and internet connection, communications with the Help Desk will also make use of the electronic channel.

Who involves the doFar Information System:

at a regional level at a national level ± 500,000 chronic patients ± 22,000,000 chronic patients

± 1,450 general practitioners ± 45,000 medical practitioners generate

± 580 pharmacy owners ± 17800 pharmacy owners

Claims (13)

TITLE: Information System "doFar - Pharmaceutical Domiciliation" CLAIM: 1. The first and only original procedure in Italy and in Europe, of data acquisition, optimization of consumption based on therapeutic needs, and scheduling of the activity of withdrawal of prescriptions and delivery of the same in the pharmacy, withdrawal of drugs and delivery of themselves at the patients' homes, with the aim of: a. facilitate the use of therapy for the patient; b. simplify the activities that are usually carried out by the doctor and pharmacist; c. reduce drug waste and health service costs. 2. The first and only original information system in Italy and Europe, for the management of a pharmaceutical domiciliation service, characterized by: to. A central software platform (called doFar) for data processing and which exhibits support web services for all other platforms; b. A web platform (called doFar - pharmaceutical domiciliation) to allow users to access the service and interact with it; c. An internal web platform (called doFar -HelpDesk) for carrying out support activities for users, especially for patients for the commitment memo service, and for couriers for assistance in the logistics of collection and delivery; d. An application software, (called doFar - Couriers) to be distributed on hardware devices dedicated to the activity of couriers to support their activity; And. An application software, (called doFar MiRicordoPerTe) distributed on dedicated devices, having the alert function for patient therapy. 3. The central platform of claim 2. a (called original doFar first and only in Italy and in Europe), which has the task of performing the following processing on the data: to. Processing of data concerning the distribution on the territory of patients, doctors and pharmacists involved, with the aim of determining macro-areas of activity; b. Data processing for each macro-area in order to determine the days of withdrawal of prescriptions from medical clinics, and the relative delivery routes to pharmacies. c. Processing, for each patient, of the data concerning the therapy, in order to determine the periodic consumption and needs, with the aim of guaranteeing a monthly coverage of 35 days, throughout the period of delivery of the service; d. Processing of aggregate data of all users by macro-area, in order to determine the drug / product delivery routes. 4. The central platform of claim 2. a (called doFar, original first and only in Italy and in Europe), which operates as a server in order to offer web services used by other platforms for interfacing with the database for manipulation operations (insertion, modification and cancellation) and data processing. 5. The web platform of claim 2.b (called: doFar-pharmaceutical domiciliation, the first and only original in Italy and Europe), composed, for the medical user, of the following tools: to. Patient Cards for viewing all the summary data of patients enrolled in doFar; b. Patient Card for viewing and editing information relating to the personal data, exemptions, prescriptions, therapy of each patient; c. Memorandum Recipes for consultation, preparation, printing and electronic sending of recipes; d. Recipe collection calendar for consulting the calendar of recipe collection days indicating the names of the patients for whom the recipes must be collected and the name of the courier delegate; calendars are subject to personalized queries with unlimited time intervals. And. Consumption Calendar, to consult the progress of the consumption of drugs prescribed in the therapy of each patient; calendars are subject to personalized queries with unlimited time intervals. f. Patient dossier containing all the historical information of the activity carried out by the doFar service for patients; g. Communications service for the exchange of e-mails between doctor-pharmacist-patient, internal e-mails; h. Visit planning module for scheduling follow-up visits for patients with commitment memo service provided by the HelpDesk; the. Statistics module for the generation of preloaded statistics and section for the generation of customized statistics. 6. The web platform of claim 2.b (called: doFar-pharmaceutical domiciliation, original first and only in Italy and in Europe), composed, for the pharmacist user, of the following tools: to. Patient Cards for viewing all the summary data of patients enrolled in doFar; b. Patient Card for viewing and editing information relating to personal data, doctor data, exemption data, prescription data, therapy data, pharmaceutical product data of each patient; c. Dispensation Agenda for consulting the drugs to be dispensed to patients with a calendar subject to personalized queries with unlimited time intervals; d. Supply calendar for consulting the drug warehouse to be dispensed to patients organized by customizable time intervals, this calendar is very important so that the drugs to be dispensed are present in drugs on the day of delivery; And. Collection / delivery calendar for consulting the calendar of prescription delivery / drug collection days; delivery of recipes couriers recipes; withdrawal of drugs drug / patient couriers; the calendars are with personalized queries with customizable time intervals. f. Consumption Calendar, to consult the progress of the consumption of drugs prescribed in the therapy of each patient; g. Patient dossier containing all the historical information of the activity carried out by the doFar service for patients; h. Communications service for the exchange of e-mails between doctor-pharmacist-patient, internal e-mails; the. Visits planning module for scheduling commitments; j. Statistics module for the generation of preloaded statistics and section for the generation of customized statistics. 7. The web platform of claim 2.b (called: doFar-pharmaceutical domiciliation, the first and only original in Italy and Europe), composed, for the patient user, of the following tools: to. Patient Card for viewing and editing information relating to their personal data, delivery addresses, modification of delegates and others; b. Doctor Card for viewing and editing information relating to personal data, addresses for collecting prescriptions of your doctor, surgery hours; c. Pharmacy tab for viewing and editing information relating to the registry of the chosen pharmacy, addresses, hours, holiday shifts; d. Delivery calendar for the consultation of drug collection / delivery days, in the second case the name of the courier who will carry out the service is indicated; And. Patient dossier containing all the historical information of the activity carried out by the doFar service for patients, important is the presence of a section in which all the receipts issued during the service by the pharmacy will be stored. The filing of the receipts is useful for the unloading of pharmaceutical expenses during the redemption declaration phase; f. Communications service for the exchange of e-mails between doctor-pharmacist-patient, internal e-mails; 8. The web platform of claim 2.c (called: doFar HelpDesk, the first and only original in Italy and Europe), which provides HelpDesk operators: to. On the patient side, the telematic tools for the memo-commitment service activities, that is the system of regularly scheduled telephone calls according to the frequency of drug procurement planned by the central platform, in addition to the general support service for patients; this platform also offers the functions to manage user data for common operations, such as registration, modification, cancellation, as well as the functions to manage the internal activity of the Help Desk operators (supervision, assignment of tasks, etc.) b. On the courier side, the monitoring of the management of the stages of a 'recipe collection / delivery' - 'drug collection / delivery' path with relative management of the problems that may involve 1) the rescheduling of the stage that encountered anomalies, 2) the convocation of wildcard couriers when the control system of the HelpDesk platform shows that a courier is unable to guarantee collections / deliveries, 3) the telephone call to the patient absent on the day of delivery, 4) the telephone call to the patient who has not collected the drugs; 5) the telephone call to delegates when it is not possible to contact patients; 6) reporting problems with the functioning of the Information System platforms highlighted by users; 7) check solution of anomalies. 9. the application software of claim 2.d (called doFar Corrieri, original first and only in Italy and in Europe), which has the function of supporting couriers by providing detailed information on the daily route to be carried out, downloaded from the central server and updated constantly with each new activity relating to a stage, and on each stage (prescription / drug collection / delivery activity, which and how many professionals / patients / goods are involved). 10. the application software of claim 2. e (called doFar MiRicordoPerTe original first and only in Italy and in Europe), developed for the Apple, Android and WindowsPhone platforms, which will allow any user of Mobile Device to have an alert service that reminds the chronic and non-chronic patient, the assumption of therapy in real time, the method of intake and, where required, to report via text message to a third party (usually a child, relative, friend) that the chronic patient has not taken therapy. The application is equipped with modules for the accessibility of users with hearing and visual impairments: in the first case the alert for taking the drug is signaled by a very persistent light signal; in the case of patients with visual impairment and reading skills, the alert for taking the drug is 'communicated' through a synthetic voice. 11. the application software of claim 2. and (called doFar MiRicordoPerTe, original first and only in Italy and in Europe), for doFar subscribers this Application will allow to automatically implement the patient's file by giving evidence to his doctor of the adherence to therapy, with immediate confirmation of its implications on the patient's state of health. In the event of a change in therapy or in the method of intake, the data entered in the central platform will be updated in real time in the patient's MiRicordoPerTe software. 12. The applicability of the doFar system for all the "products / resources" that are handled within the National Public Health System for which an optimized consumption planning is foreseen and / or necessary with eventual logistic management. 13. The applicability of the doFar system for all the "products / resources" that are handled within the industrial and commercial sectors, for which an optimized consumption planning is foreseen and / or necessary with eventual logistic management.