Point-of-service computer system and drug-use evaluation: implications for pharmacy practice in ambulatory care.
The point-of-service (POS) computer system and its possible effects on ambulatory-care pharmacy practice are described. The POS system, a key component of the Medicare Catastrophic Coverage Act, is an electronic claims-transmittal device to be installed in community pharmacies. The system transmits information about the patient and the prescribed drug to a claims processor, which verifies the eligibility of the patient for Medicare drug benefits, determines the amount of payment allowed, and sends information back to the POS terminal in less than 30 seconds. Because prescription information can be consolidated into a central data pool, drug-use patterns can be reviewed. The system will also permit automated screening of drug-drug interactions. Problems posed by the POS system relate to (1) the lack of a claims-transmittal device that can communicate with all claims processors, (2) the lack of a direct interface between the POS system and all pharmacy computer systems, (3) the expense of training personnel to operate the POS system, (4) the cost incurred by pharmacies in installing the POS system, and (5) the conflict between protecting the privacy of a patient's drug profile and permitting the monitoring of drug interactions. The catastrophic coverage act proposes that POS data be used to assess the appropriateness of drug use with a focus on outcome and quality-of-care issues; for the full intent of the act to be achieved, the components of an effective drug-use-evaluation program must be employed. Drug-use evaluation should eventually decrease health-care costs and improve quality of care.(ABSTRACT TRUNCATED AT 250 WORDS)
Sturek
J K
JK
The Prudential, Roseland, NJ 07068.
D000555:Ambulatory Care Information Systems; D002388:Catastrophic Illness; D003201:Computers; D004363:Drug Utilization; D006801:Humans; D007256:Information Systems; D007356:Insurance, Pharmaceutical Services / Q000458:organization & administration*; D006278:Medicare; D010595:Pharmacists; D010607:Pharmacy Service, Hospital / Q000458:organization & administration*; D014481:United States