A Brief for IT Managers and Pharmacy Architects

ePostRx Making ePharmacy a Reality

Prepared by AdvanceNet Health Solutions, Inc. November 2002 1 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc Table of Contents ELECTRONIC PRESCRIBING BACKGROUND...... 3

WHAT IS EPHARMACY?...... 3 WHAT IS ELECTRONIC PRESCRIBING?...... 3 WHY ELECTRONIC PRESCRIBING?...... 4 EPOSTRX – MAKING EPHARMACY A REALITY...... 5

WHAT IS EPOSTRX?...... 5 WHY WAS EPOSTRX CREATED?...... 6 WHO WOULD USE EPOSTRX?...... 6 WHY WOULD I USE EPOSTRX?...... 7 EPOSTRX PRODUCT SUITE...... 8

BUSINESS-TO-BUSINESS (B2B) TRANSACTION ENGINE...... 8 MANAGEMENT CONSOLE...... 9 CLIENT TOOLKIT...... 9 RELATIONAL DATABASE MANAGEMENT SYSTEM...... 10 WEBCONNECT...... 10 EPOSTRX IN ACTION; SOME REAL WORLD SCENARIOS...... 11

SCENARIO 1 - CLINIC OR HOSPITAL...... 12 SCENARIO 2 – FULFILLMENT WORKFLOW...... 13 CONCLUSION...... 14

Prepared by AdvanceNet Health Solutions, Inc. November 2002 2 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc Electronic Prescribing Background

What is ePharmacy?

Similar to a Business-to-Business or B2B model where partners trade information electronically to satisfy their business needs, electronic or ePharmacy will allow pharmacy business to communicate and manage the electronic transfer of prescription data among trading partners, store locations, workflow queues and customers. ePharmacy means point-to-point (P2P) digital transfer of electronic prescription or eRx data. No more fax! No more email! The workflow possibilities are endless creating new business opportunities with inherit dynamics for customer choice and convenience. ePharmacy will foster new, non-traditional pharmacy applications and processes that maximize efficiency, boost productivity, reduce costs, all while addressing the industry concerns over the shortage of qualified Pharmacists and high fatality rate due to prescription errors. Additionally, similar to the introduction of consumer products and technologies like the microwave, bank ATMs, VHS and DVD, ePharmacy will breed customer convenience. No longer will customers go to their pharmacy of choice, but rather to their pharmacy of convenience!

What is Electronic Prescribing?

At the core of ePharmacy is the concept of electronic prescribing. Electronic Prescribing is the process by which prescription information is transferred electronically between physicians and dispensing pharmacies. While it may initially seem that Electronic Prescribing involves only new prescriptions requiring data transfer from physicians to pharmacies, this is not the case. In fact, electronic prescribing involves several functions, including:

 New prescriptions: A physician writes a new prescription. Data flows from physician to pharmacies  Refill/Renew prescriptions: A prescription has expired (no refills left); the pharmacy sends a refill request to the physician. Data flows from pharmacies to physician.  Approvals/Denials: In response to a Refill/Renew prescription request, a physician sends a response. Data flows from physician to pharmacies.

Prepared by AdvanceNet Health Solutions, Inc. November 2002 3 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc Why Electronic Prescribing?

Traditional approaches to controlling prescription benefit costs and improving quality have peaked in terms of effectiveness. Unfortunately, the peak is not high enough: Drug spending has been rising at a blistering rate and prescribing errors according to the 1999 Institute of Medicine Report, remain rampant attributing to over 7,000 deaths each year with an annual cost of over $77 billion. The cornerstone of the solution to these problems is computerized prescribing or ePrescribing. By delivering knowledge-based patient-specific information during the Physician Order Entry (POE) process to an electronic device such as a Personal Digital Assistant (PDA), physicians can reduce prescribing errors. Consequently, pharmacy efficiency also benefits from ePrescribing because the delivered prescriptions are legible and formulary compliant, even if the prescription is faxed to the pharmacy. Additional savings and efficiencies could be realized if the prescription information could be passed electronically, Point- to-Point (P2P) among all business entities in the provider and dispensing chain.

Until now, ePrescribing players have placed more emphasis on the POE process and NOT prescription delivery and its overall impact on pharmacy workflow. Traditional methods of so-called electronic delivery include fax and email from the POE system to the patient’s pharmacy of choice. Unfortunately, these methods are unpredictable, unreliable and insecure. In fact, HIPPA is still undecided if faxing patient information to a third party is an acceptable method that guarantees patient privacy!

In this age of electronic commerce, the solution is quite obvious. A cost-effective Point-to-Point (P2P) solution based product is required that provides seamless connectivity over the Internet, LAN/WAN or private network. This solution would have to efficiently manage eRx transactions between healthcare business partners, and provide security that meets and exceeds HIPPA compliance, as well as the DEAs newly defined standard for Electronic Prescriptions for Controlled Substances (EPCS). Does this product exist? Yes! It’s called ePostRx!

Prepared by AdvanceNet Health Solutions, Inc. November 2002 4 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc ePostRx – Making ePharmacy a Reality

What is ePostRx?

To better define ePostRx, let’s first define what ePostRx is not:

What ePostRx is NOT

 Pharmacy Software  Physician Ordering System  Internet Connectivity Hub such as RxHub or SureScripts.  On-line Prescription Exhange.  Prescription Writing tool.

What ePostRx IS ePostRx is the only ePharmacy business solution currently available that allows YOUR business to connect, manage and intelligently route electronic NCPDP SCRIPT transactions between you and your healthcare partners, store locations and workflow queues.

With ePostRx, companies (such as Physician, Clinic, Point Of Care (POC) vendor, Hospital, Chain Pharmacies and Independent Retail) who need to transfer prescription data electronically can now implement a cost effective, enterprise solution that can be configured to meet any pharmacy scenario. Because ePostRx provides the tools required to connect, manage and monitor electronic

Prepared by AdvanceNet Health Solutions, Inc. November 2002 5 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc prescription transactions between business partners, companies can now extend into any segment of digital pharmacy to effectively meet the growing demand for prescriptions. Best of all, because ePostRx acts as an enterprise plug-in, your current infrastructure investment is preserved!

Why was ePostRx created?

The primary mission in developing ePostRx was to accelerate the adoption of electronic prescribing by providing B2B tools and services which:  Enable the pharmacy/healthcare market to connect, manage and intelligently transfer electronic prescription or NCPDP SCRIPT data among business partners.

 Address the operational impact of this new electronic medium by providing cost effective, open, secure and configurable solution(s).

Who would use ePostRx? ePostRx was designed with Business-to-Business (B2B) in mind. Just as in a B2B model where partners trade information electronically to satisfy their business needs, ePostRx allows businesses to transfer prescription information among their trading partners or business entities who prescribe or dispense prescriptions. A business entity can be a:

1. Provider 2. Prescriber Service 3. Mail-Order 4. Retail Pharmacy 5. Chain Pharmacy 6. Central Fill 7. Clinic 8. Hospital 9. Internet Connectivity Hub 10.On-line Prescription Exchange

The ePostRx business solution can enhance any pharmacy business model that has the need to electronically transfer prescription information among these business entities. Users can manage the data exchange via a web based management console which provides centralized, secure P2P digital connectivity for all entities involved.

Prepared by AdvanceNet Health Solutions, Inc. November 2002 6 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc Why would I use ePostRx?

The reasons to use ePostRx are many, but here are a few:

 Cost Effective - because ePostRx is an Enterprise middle-ware solution that acts as a plug-in preserving your current infrastructure investment.

 Compliant - full support for NCPDP, RxHub and SureScript SCRIPT Implementations, which includes data element validation and real-time translation between various SCRIPT implementations

 Configurable - Business Rules Engine allows partners to configure their environment to meet everyday business needs and create new workflow possibilities.

 Extensible - WebConnect component can easily be integrated into any business portal to provide technician access to pharmacy-to-physician SCRIPT transactions

 Secure - meets HIPPA and DEAs Electronic Prescription for Controlled Substance (EPCS) standards for security and encryption of electronic prescription data.

 Open - utilizes latest open source technologies to avoid vendor lock and provide increased affordability!

Prepared by AdvanceNet Health Solutions, Inc. November 2002 7 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc ePostRx Product Suite

The ePostRx Product Suite was developed using the latest open technologies such as J2EE, JCE, XML and XSL. ePostRx runs on any platform that supports the JVM (Java Virtual Machine) such as Windows, Solaris, Linux etc. The ePostRx™ product suite is comprised of the following major components:

 Business-to-Business (B2B) Transaction Engine  Management Console  Client Toolkit  Relational Database Management System

Together, these Java, XML and RDMS components provide the management and communication tools necessary for companies to participate in any segment of electronic prescribing.

Business-to-Business (B2B) Transaction Engine

The ePostRx B2B Transaction engine is a set of J2EE Enterprise Java Beans (EJB) that provide the following:

 Full support for NCPDP, RxHub and SureScript SCRIPT Implementations that include data element validation and real-time translation between various SCRIPT implementations.

Prepared by AdvanceNet Health Solutions, Inc. November 2002 8 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc  Support for the new NCPDP Provider Broadcast and Query (PBR) transaction and RxHub Patient Medication History, Formulary Status and Point-to-Point Transactions.  Support for Direct Connect (P2P) and Mailbox communication modes.  Support for both EDI and XML message formats.  Rules based routing of prescription data for more efficient pharmacy workflow among business entities.  Security Management through Public Key Infrastructure (PKI) and X509 version 3 Digital Certificates.  Auto-contact Management of received events.

The ePostRx B2B Transaction engine runs on any J2EE compliant server such as JBoss or Weblogic.

Management Console

The ePostRx Management Console is a web portal that allows users to effectively manage and monitor their business transactions. Users can:

 Provide centralized management of all accounts, entities and external users.  Control and limit access to user defined areas.  Act as Certificate Authority Administrator to manage PKI and X509 Digital Certificate information for all associated business entities.  Track and monitor NCPDP Script message transactions between those business entities.  Apply rules to NCPDP message transactions to intelligently re-route prescription data between business entities.  Create custom reports that can be added to the ePostRx Management Console using the ePostRx Management Console Report framework.

The ePostRx Management Console communicates with the ePostRx B2B Transaction engine and runs on any web server environment that supports Java Server Pages (JSP) and the Java Servlet API 2.3.

Client Toolkit

The ePostRx client toolkit provides the tools necessary to securely communicate with the ePostRx B2B Transaction engine. It provides:

Prepared by AdvanceNet Health Solutions, Inc. November 2002 9 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc  Common Java and XML based API that can be used to build and send NCPDP formatted SCRIPT standard messages to the ePostRx server for processing.  Security Tools necessary to generate a Public/Private Key Pair and a X.509 Version 3 Digital Certificate to communicate with the ePostRx B2B Transaction engine. These keys are used to authenticate and sign all transactions between you and ePostRx.

The ePostRx client toolkit also provides an ePostRxBridge, which allows a user who doesn’t support Java, to natively bridge heterogeneous systems such as Pharmacy Management Systems desktops and allow seamless transfer of ePostRx client/server messages. The bridge supports two methods to transfer the ePostRx Bridge XML API document:

a) Native Bridge which uses JNI to Native C b) IP Bridge, which uses a local IP listener to communicate between the Java API and native platform.

Relational Database Management System

The ePostRx RDMS provides the data repository to which transactions are logged and configurations are maintained. Currently ANS supports Microsoft SQL Server 7.0 and Microsoft SQL Server 2000. Plans are currently underway to add support for Oracle and Sybase.

WebConnect

If you own a small to medium-sized pharmacy business then ePostRx WebConnect is for you! ePostRx WebConnect is a secure, web extension of our flagship product. ePostRx WebConnect can easily be integrated into your business web portal to provide bi-directional NCPDP SCRIPT support for pharmacy-to-physician transactions.

Prepared by AdvanceNet Health Solutions, Inc. November 2002 10 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc ePostRx In Action; Some Real World Scenarios

ePostRx can be applied to any pharmacy model to complement or enhance your business to meet the demands of ePharmacy. Whether you are a Provider, Clinic, Retail Chain, Mail-Order or a Connectivity Hub (just to name a few), the ePostRx product suite can help your business create, connect, manage and control your electronic prescription transactions with your pharmacy business partners, store locations and workflow queues.

ePostRx does not replace your current Pharmacy Management System or Point of Care System investment. It is an enterprise plug-in that lets you manage your electronic prescription transactions, all while preserving your current infrastructure. The following pages detail some real world scenarios.

Prepared by AdvanceNet Health Solutions, Inc. November 2002 11 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc Scenario 1 - Clinic or Hospital

Problem: In today's Clinic or Hospital, once a prescription is completed by the Clinic physician, the prescription is either faxed or e-mailed to the Clinic pharmacy to be dispensed. Not only are these delivery methods insecure, it is NOT real-time Point-to-Point (P2P) communication. Provided the pharmacist receives the fax or email, he or she still has to key the information into their Pharmacy Management System. This re-keying allows a window of opportunity for additional prescribing errors. Furthermore, these 'pseudo' electronic delivery methods are lacking industry format standards, as well as the ability to perform real-time two-way communication. Fax and email still force the pharmacist to call the Clinic physician for any dispensing concerns.

Solution: ePostRx can provide a Clinic or Hospital, two-way Point-to-Point (P2P) connectivity to/from a Providers office directly into the Pharmacy's Management System. By simply installing the ePostRxBridge for both the Clinic Provider and the Clinic Pharmacy systems, these systems can securely communicate via the ePostRx B2B Transaction/Rule Server using the NCPDP Script standard. The communication channel can be a private LAN/WAN, or the Internet.

Prepared by AdvanceNet Health Solutions, Inc. November 2002 12 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc Scenario 2 – Fulfillment Workflow

Problem: Company Z needs to transfer all prescriptions for heart disease medications to Company's Y's mail-order for fulfillment and dispense the remaining products in their Clinic's pharmacy. How can Company Z provide a prescription fulfillment workflow solution that is cost-efficient, electronic and real- time?

Solution: ePostRx contains a Rules Engine that can electronically re-route prescriptions based on user defined rules. The rules are applied to the NCPDP Script message elements that can trigger the re-rerouting of prescriptions to various business entities other than the originally intended recipient. This is a powerful and exciting feature of ePostRx that can be applied to any pharmacy business model to increase overall productivity and reduce cost.

Prepared by AdvanceNet Health Solutions, Inc. November 2002 13 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc Conclusion

In today’s digital healthcare marketplace, it is imperative that companies “think globally” by extending their services electronically to meet the current demand for prescriptions. With an estimated 4 billion prescriptions to be filled annually by 2004 and ever-shrinking profit margins, healthcare is looking for proven solutions to enhance efficiency and increase revenues. Agility and responsiveness directly affect a company’s ability to compete, add and retain business and customer relationships.

ePostRx which is based on proven industry technology and industry support standards, provides the tools and framework for your company to participate in the ePharmacy marketplace to meet these business challenges. The future of ePharmacy is now. The future of ePharmacy is ePostRx.

Contact ANSHealth today for free information about how ePostRx can help boost productivity, reduce dispensing errors and increase profit margins for all organizations involved in your healthcare business model.

Prepared by AdvanceNet Health Solutions, Inc. November 2002 14 ANSHealth™,ePostRx™, ePostRx Enterprise™, ePostRx WebConnect™ and ePostRxBridge™ are trademarks of AdvanceNet Health Solutions, Inc. Java™ and Java™ related products are trademarks of Sun Microsystems, Inc