US20120053960A1 - Centralized pharmacy business method - Google Patents

Centralized pharmacy business method Download PDF

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US20120053960A1
US20120053960A1 US13/270,373 US201113270373A US2012053960A1 US 20120053960 A1 US20120053960 A1 US 20120053960A1 US 201113270373 A US201113270373 A US 201113270373A US 2012053960 A1 US2012053960 A1 US 2012053960A1
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pharmacy
satellite
prescription
prescription orders
orders
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William Gatti
Gary Duty
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Millennium Pharmacy Systems Inc
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Millennium Pharmacy Systems Inc
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Assigned to Millennium Pharmacy Systems, LLC reassignment Millennium Pharmacy Systems, LLC CHANGE OF NAME (SEE DOCUMENT FOR DETAILS). Assignors: MILLENNIUM PHARMACY SYSTEMS, INC.
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    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06QINFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00Administration; Management
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/10ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients

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  • the present invention relates to computer networked centralized pharmacy services for care facilities such as seniors' residences, nursing homes and hospitals.
  • pharmacies Traditional pharmacy services have been rendered by individual pharmacies in localized markets, even for hospitals and nursing homes. In an era prior to computerized networks and reliable, affordable overnight shipping, localized pharmacy services were all that was available to fill institutional, as well as individual, pharmaceutical prescriptions. Recently, certain pharmacies have expanded their services to include mail order shipments throughout the country.
  • the present invention is a trifid business method embracing three essential elements, namely, the central pharmacy, the satellite pharmacy and the shipping service.
  • This trifid business model serves any pharmaceutical consumer including individual patients, but is best designed to serve institutional markets, such as care facilities and hospitals.
  • (1) a central pharmacy service and (2) a shipping service provide daily prescription delivery to the consumer, with acute prescriptions being separately delivered by (3) a satellite pharmacy nearby to the consumer.
  • This protocol is illustrated in FIG. 1 .
  • the economic force which expands the overall trifid business is the incentive pay to which each newly established satellite pharmacy is entitled based upon the consumer volume brought in by each satellite pharmacist/facility director.
  • each satellite pharmacist/facility director participant in the trifid business plan thus becomes a “producer/feeder” for the centralized business (long-term and repeat orders) but remains a direct provider for acute prescriptions the centralized service cannot readily fill.
  • the trifid business method embraces an integrated central pharmacy and shipping service, positioned “end of runway” (i.e., as near as possible to the shipping point of departure).
  • the preponderance of filled prescriptions for each care facility arrives in overnight and/or routine shipments from the central pharmacy, and the satellite pharmacies fill the new and modified prescriptions on an acute need basis.
  • FIG. 1 is a flow diagram illustrating the trifid business method coordinated among the central pharmacy, the satellite pharmacy, and the shipping service.
  • the present invention is a trifid business method embracing three essential elements, namely, the central pharmacy, the satellite pharmacy and the shipping service.
  • This trifid business model serves any pharmaceutical consumer including individual patients, but is best designed to serve institutional markets, such as care facilities and hospitals.
  • (1) a central pharmacy service and (2) a shipping service provide daily prescription delivery to the consumer, with acute prescriptions being separately delivered by (3) the satellite pharmacy nearby to the consumer.
  • This protocol is illustrated in FIG. 1 .
  • the economic force which expands the overall trifid business is the incentive pay to which each newly established satellite pharmacy is entitled based upon the consumer volume brought in by each satellite pharmacist/facility director.
  • each satellite pharmacist/facility director participant in the trifid business plan thus becomes a “producer/feeder” for the centralized business (long-term and repeat orders), but his or her satellite pharmacy remains a direct provider for acute prescriptions the centralized service cannot readily fill.
  • the trifid business method embraces an integrated central pharmacy and shipping service, positioned “end of runway” (i.e., as near as possible to the shipping point of departure).
  • the preponderance of filled prescriptions for each care facility arrives in overnight and/or routine shipments from the central pharmacy, and the satellite pharmacies fill the new and modified prescriptions on an acute need basis.
  • an integrated trifid pharmacy distribution system for a variety of end use customers.
  • the centralized pharmacy or “hub” provides long-term maintenance prescriptions to a customer base with the aid of a daily shipping service.
  • the hub contracts directly (or indirectly) with satellite pharmacists/facility directors.
  • the respective satellite pharmacies provide acute prescriptions to the customer base through regular delivery means.
  • Customer bases may include long-term care facilities, hospitals, institutions, and/or private residences. Communication between the hub and the satellites is accomplished through a coordinated computer network, preferably enabled by Internet connectivity.
  • the centralized “hub” pharmacy is the keystone of the operation. It can house an enormous quantity of maintenance and “fast mover” medications because of the high volume of orders filled daily. The enormous quantity of medications is proportionate to enormous savings in drug costs. Many pharmaceutical companies provide discounts on wholesale medication costs that may increase with the quantity of medication purchased. Equally important are the similar economic benefits that accrue from formulary-driven increases in manufacturer's market share.
  • the centralized pharmacy and the shipping service are located “end of runway,” which term means that the shipping service is co-located with or in close proximity to the centralized pharmacy. Close proximity means that the centralized pharmacy and the shipping service are within about a one-hour surface traveling time from each other.
  • This arrangement decreases costs because prescriptions only need to be shipped one way, i.e., from the end of runway directly to the customer base.
  • the arrangement also decreases prescription delivery time because the filled prescription orders can be easily and quickly loaded onto carriers by the shipping service.
  • Satellite pharmacists receive many benefits for participating in the system. Potentially, they accrue incentives for recruiting other satellite pharmacists and/or customer bases.
  • the hub pharmacy distributes a percentage of profits to the producer based on total sale volume generated from the producer's recruited customer base. Also, when applicable, the first producer receives a percentage of profits based on total sale volume generated from the customer base of a second producer recruited by the first producer, and so on. The incentives thus multiply, generating more profit incentives as more customer bases and/or additional producers are recruited. Second, by not having to fill maintenance and long-term orders for a large customer base, a satellite pharmacist/facility director can drastically reduce his or her cumbersome and expensive inventory.
  • the decrease in inventory of maintenance medications allows a satellite pharmacist/facility director to stock less frequently used, but still requested, medications.
  • the technician and pharmacy staff needs of the satellite pharmacist/facility director decrease because the workload related to providing maintenance medications to a customer base decreases. This allows for decreased pharmacy man hours with an increase in both profitability and pharmaceutical care quality, because satellite pharmacist/facility directors have more time to evaluate and to manage acute prescription filling while steady revenues can be counted on from hub sales.
  • the customer base also receives many benefits from this system.
  • the centralized “hub” pharmacy, the satellite pharmacists/facility directors and the shipping service work in concert to provide accurate, efficient, and cost-effective pharmaceutical care to customer bases.
  • the satellite pharmacists/facility directors enter the system on an incentive basis.
  • the producers receive a percentage of the total profits from the total volume of sales generated by each customer base they recruit.
  • the satellite pharmacies are mostly responsible for providing acute medications to the customer base.
  • Acute prescriptions may include new, short-term medication orders such as orders for a one-week cycle of an antibiotic or a few days' worth of pain medication.
  • An acute prescription may also be an adjusted therapeutic strategy such as an increased or decreased dose and/or strength of a maintenance drug or an altered medication route of administration.
  • a fully operating system involving one institutional care customer base, one satellite pharmacist/facility director, the hub pharmacy and the shipping system is orchestrated as follows.
  • a physician or authorized person at the customer base scans or enters prescriptions for their patients into the pharmacy system's coordinated computer network using an optional hand-held prescribing device. Additionally, orders may be automatically renewed via the computer on a scheduled basis.
  • a pharmacist at the hub receives the prescriptions and verifies them for accuracy, proper indication, etc.
  • prescription labels are generated with numeric bar code indicators at the hub.
  • the order is filled with the use of filling trays and checked by a pharmacist. Checked orders are placed in a customer base specific tote and are scanned for customer base specific completeness and accuracy. If complete and accurate, the tote is delivered by the shipping service to the designated customer base. Upon arrival to the base, the tote is scanned again for accuracy and completeness. After scanning, the medications are delivered to the appropriate patients at the customer base.
  • an order from the customer base is for an acute prescription
  • the pharmacist at the hub sends the order through the computer network to a producer's satellite pharmacy closest to the customer base.
  • the acute prescription order may be sent directly from the customer base to the satellite pharmacy.
  • Proper prescription dispensing procedures are followed as well as the additional bar code scanning step for “customer base” completeness and accuracy.
  • the order is immediately delivered to the base through regular delivery means.
  • the order is scanned again for accuracy and completeness. After scanning, the medication(s) are delivered to the appropriate patient at the base.
  • the producer is the satellite pharmacist/facility director as an individual who bears the individual contractual rights and obligations. For this reason, the distinction has been carefully made, above, between the satellite pharmacist/facility director and the satellite pharmacy itself.

Abstract

A centralized pharmacy business method which comprises forming a business alliance between a centralized pharmacy, one or more satellite pharmacists/facility directors, and a shipping service. Optionally, the centralized pharmacy and the shipping service are located “end of runway,” which means that the shipping service is co-located with or in close proximity to the centralized pharmacy. The satellite pharmacists/facility directors preferably accrue incentives based on recruiting one or more customer bases. Maintenance prescription orders are received and filled by the centralized pharmacy and delivered to the respective customer base. Acute prescription orders are received and filled by the satellite pharmacy of the pharmacists/facility directors near the customer base and delivered to the respective customer base.

Description

    CROSS REFERENCE TO RELATED APPLICATIONS
  • This patent application claims priority as a continuation of U.S. patent application Ser. No. 10/134,293, filed on Apr. 29, 2002, which is a continuation of and claims priority to U.S. patent application Ser. No. 10/062,170, filed Jan. 31, 2002, and which also claims priority to U.S. Provisional Patent Application Ser. No. 60/265,508, filed Jan. 31, 2001; all of which are incorporated herein by reference.
  • FIELD OF THE INVENTION
  • The present invention relates to computer networked centralized pharmacy services for care facilities such as seniors' residences, nursing homes and hospitals.
  • BACKGROUND OF THE INVENTION
  • Traditional pharmacy services have been rendered by individual pharmacies in localized markets, even for hospitals and nursing homes. In an era prior to computerized networks and reliable, affordable overnight shipping, localized pharmacy services were all that was available to fill institutional, as well as individual, pharmaceutical prescriptions. Recently, certain pharmacies have expanded their services to include mail order shipments throughout the country.
  • A pervasive limitation of traditional localized pharmacy services has always related to sales volume. Inventory stocks of pharmaceuticals are enormously expensive, yet the localized nature of the traditional pharmacy business makes it nearly impossible to achieve the economies of scale necessary to high profitability. Even now that overnight shipping and sophisticated computer networks are readily available, the constant last-minute ordering and changing of prescriptions in care facilities such as nursing homes and hospitals has heretofore made regionally or nationally centralized pharmacy services an impractical dream. Even the best overnight delivery cannot accommodate a physician's prescription for a dosage form to be administered one hour hence.
  • Accordingly, a need remains for a centralized pharmacy business method which accommodates the practical realities of the practice of medicine and the administration of drugs.
  • SUMMARY OF THE INVENTION
  • In order to meet this need, the present invention is a trifid business method embracing three essential elements, namely, the central pharmacy, the satellite pharmacy and the shipping service. This trifid business model serves any pharmaceutical consumer including individual patients, but is best designed to serve institutional markets, such as care facilities and hospitals. Within a protocol coordinated by a computer network and the appropriate software, (1) a central pharmacy service and (2) a shipping service provide daily prescription delivery to the consumer, with acute prescriptions being separately delivered by (3) a satellite pharmacy nearby to the consumer. This protocol is illustrated in FIG. 1. Preferably, the economic force which expands the overall trifid business is the incentive pay to which each newly established satellite pharmacy is entitled based upon the consumer volume brought in by each satellite pharmacist/facility director. Each satellite pharmacist/facility director participant in the trifid business plan thus becomes a “producer/feeder” for the centralized business (long-term and repeat orders) but remains a direct provider for acute prescriptions the centralized service cannot readily fill. In its preferred configuration, the trifid business method embraces an integrated central pharmacy and shipping service, positioned “end of runway” (i.e., as near as possible to the shipping point of departure). The preponderance of filled prescriptions for each care facility arrives in overnight and/or routine shipments from the central pharmacy, and the satellite pharmacies fill the new and modified prescriptions on an acute need basis.
  • DESCRIPTION OF THE DRAWING
  • FIG. 1 is a flow diagram illustrating the trifid business method coordinated among the central pharmacy, the satellite pharmacy, and the shipping service.
  • DETAILED DESCRIPTION OF THE INVENTION
  • The present invention is a trifid business method embracing three essential elements, namely, the central pharmacy, the satellite pharmacy and the shipping service. This trifid business model serves any pharmaceutical consumer including individual patients, but is best designed to serve institutional markets, such as care facilities and hospitals. Within a protocol coordinated by a computer network and the appropriate software, (1) a central pharmacy service and (2) a shipping service provide daily prescription delivery to the consumer, with acute prescriptions being separately delivered by (3) the satellite pharmacy nearby to the consumer. This protocol is illustrated in FIG. 1. Preferably, the economic force which expands the overall trifid business is the incentive pay to which each newly established satellite pharmacy is entitled based upon the consumer volume brought in by each satellite pharmacist/facility director. Each satellite pharmacist/facility director participant in the trifid business plan thus becomes a “producer/feeder” for the centralized business (long-term and repeat orders), but his or her satellite pharmacy remains a direct provider for acute prescriptions the centralized service cannot readily fill. In its preferred configuration, the trifid business method embraces an integrated central pharmacy and shipping service, positioned “end of runway” (i.e., as near as possible to the shipping point of departure). The preponderance of filled prescriptions for each care facility arrives in overnight and/or routine shipments from the central pharmacy, and the satellite pharmacies fill the new and modified prescriptions on an acute need basis.
  • According to the invention, stated a little differently, there is provided an integrated trifid pharmacy distribution system for a variety of end use customers. The centralized pharmacy or “hub” provides long-term maintenance prescriptions to a customer base with the aid of a daily shipping service. The hub contracts directly (or indirectly) with satellite pharmacists/facility directors. The respective satellite pharmacies provide acute prescriptions to the customer base through regular delivery means. Customer bases may include long-term care facilities, hospitals, institutions, and/or private residences. Communication between the hub and the satellites is accomplished through a coordinated computer network, preferably enabled by Internet connectivity.
  • The centralized “hub” pharmacy is the keystone of the operation. It can house an enormous quantity of maintenance and “fast mover” medications because of the high volume of orders filled daily. The enormous quantity of medications is proportionate to enormous savings in drug costs. Many pharmaceutical companies provide discounts on wholesale medication costs that may increase with the quantity of medication purchased. Equally important are the similar economic benefits that accrue from formulary-driven increases in manufacturer's market share.
  • Preferably, the centralized pharmacy and the shipping service are located “end of runway,” which term means that the shipping service is co-located with or in close proximity to the centralized pharmacy. Close proximity means that the centralized pharmacy and the shipping service are within about a one-hour surface traveling time from each other. This arrangement decreases costs because prescriptions only need to be shipped one way, i.e., from the end of runway directly to the customer base. The arrangement also decreases prescription delivery time because the filled prescription orders can be easily and quickly loaded onto carriers by the shipping service.
  • Satellite pharmacists (producers) receive many benefits for participating in the system. Potentially, they accrue incentives for recruiting other satellite pharmacists and/or customer bases. In any case, the hub pharmacy distributes a percentage of profits to the producer based on total sale volume generated from the producer's recruited customer base. Also, when applicable, the first producer receives a percentage of profits based on total sale volume generated from the customer base of a second producer recruited by the first producer, and so on. The incentives thus multiply, generating more profit incentives as more customer bases and/or additional producers are recruited. Second, by not having to fill maintenance and long-term orders for a large customer base, a satellite pharmacist/facility director can drastically reduce his or her cumbersome and expensive inventory. Third, the decrease in inventory of maintenance medications allows a satellite pharmacist/facility director to stock less frequently used, but still requested, medications. Fourth, the technician and pharmacy staff needs of the satellite pharmacist/facility director decrease because the workload related to providing maintenance medications to a customer base decreases. This allows for decreased pharmacy man hours with an increase in both profitability and pharmaceutical care quality, because satellite pharmacist/facility directors have more time to evaluate and to manage acute prescription filling while steady revenues can be counted on from hub sales.
  • The customer base also receives many benefits from this system. First, because the satellite pharmacies will generally have more room to stock infrequent medications, it is less likely that an acute need medication would be unavailable. Second, the institutionalized customer base can depend on regularly scheduled drug delivery for its patients from the hub pharmacy. Staff time management is greatly improved because staff can plan for the majority of drug shipments to arrive only once a day. Third, the private residence base can also benefit from the above-described prescription delivery system. Many people on maintenance medication are elderly, incapacitated, without transportation, etc. Because it can be difficult for them to travel to the local pharmacy, residential medication delivery is a helpful way to improve prescription compliance.
  • The aforementioned benefits of this system are not limited. The embodiment of this invention that follows illuminates the many advantages of a centralized pharmacy business system.
  • In essence, the centralized “hub” pharmacy, the satellite pharmacists/facility directors and the shipping service work in concert to provide accurate, efficient, and cost-effective pharmaceutical care to customer bases. Preferably, the satellite pharmacists/facility directors (producers) enter the system on an incentive basis. The producers receive a percentage of the total profits from the total volume of sales generated by each customer base they recruit. Thus, although the producers take no direct part in providing maintenance medications to their customer base, they still receive a profit from the maintenance business thus generated. The satellite pharmacies are mostly responsible for providing acute medications to the customer base. Acute prescriptions may include new, short-term medication orders such as orders for a one-week cycle of an antibiotic or a few days' worth of pain medication. An acute prescription may also be an adjusted therapeutic strategy such as an increased or decreased dose and/or strength of a maintenance drug or an altered medication route of administration.
  • A fully operating system involving one institutional care customer base, one satellite pharmacist/facility director, the hub pharmacy and the shipping system is orchestrated as follows. A physician or authorized person at the customer base scans or enters prescriptions for their patients into the pharmacy system's coordinated computer network using an optional hand-held prescribing device. Additionally, orders may be automatically renewed via the computer on a scheduled basis. A pharmacist at the hub receives the prescriptions and verifies them for accuracy, proper indication, etc. For maintenance medications, prescription labels are generated with numeric bar code indicators at the hub. The order is filled with the use of filling trays and checked by a pharmacist. Checked orders are placed in a customer base specific tote and are scanned for customer base specific completeness and accuracy. If complete and accurate, the tote is delivered by the shipping service to the designated customer base. Upon arrival to the base, the tote is scanned again for accuracy and completeness. After scanning, the medications are delivered to the appropriate patients at the customer base.
  • If an order from the customer base is for an acute prescription, the pharmacist at the hub sends the order through the computer network to a producer's satellite pharmacy closest to the customer base. Alternatively, the acute prescription order may be sent directly from the customer base to the satellite pharmacy. Proper prescription dispensing procedures are followed as well as the additional bar code scanning step for “customer base” completeness and accuracy. Once completed, the order is immediately delivered to the base through regular delivery means. Upon arrival, the order is scanned again for accuracy and completeness. After scanning, the medication(s) are delivered to the appropriate patient at the base.
  • As one can imagine, the possibilities for this coordinated system are endless. Because of the numerous advantages and incentives, an ever-growing network of pharmacies and customer bases can be grown. The larger the network, the more efficient and cost-effective the system will become, thus creating improved and expedient customer care at a reduced price and greater overall profitability.
  • Generally, if not always, the producer is the satellite pharmacist/facility director as an individual who bears the individual contractual rights and obligations. For this reason, the distinction has been carefully made, above, between the satellite pharmacist/facility director and the satellite pharmacy itself.
  • It will be understood by those skilled in the art that while the foregoing description sets for in detail preferred embodiments of the present invention, modifications, additions, and changes might be made thereto without departing from the spirit and scope of the invention.
  • Having thus described our invention with the detail and particularity required by the Patent Laws, what is desired to be protected by Letters Patent is set forth in the following claims.

Claims (13)

1. A computerized method for fulfilling pharmacy prescription orders, the method comprising:
receiving, via a computer network, one or more maintenance prescription orders on a first computer at a central pharmacy from a first customer base, wherein a maintenance prescription order is one that is prescribed on a scheduled and routine basis;
receiving, via the computer network, one or more acute prescription orders on the first computer at the central pharmacy from the first customer base;
accessing the one or more acute prescription orders via the computer network with a second computer associated with a first satellite pharmacy, wherein the first satellite pharmacy is one of a plurality of satellite pharmacies, wherein each of the plurality of satellite pharmacies has a customer base;
filling, the one or more maintenance prescription orders at the central pharmacy; and
delivering the one or more filled maintenance prescription orders from the central pharmacy to the first customer base via a first shipment,
wherein the one or more acute prescription orders are filled at the first satellite pharmacy and delivered from the first satellite pharmacy to the first customer base via a second shipment.
2. The computerized method of claim 1 for fulfilling pharmacy prescription orders, wherein an acute prescription order is one that is identified as needed immediately, within a time period inconsistent with an overnight delivery, said acute prescription needed for a limited and defined duration,
3. The computerized method of claim 1 for fulfilling pharmacy prescription orders, wherein acute prescription orders are new, short-term medication orders.
4. The computerized method of claim 1 for fulfilling pharmacy prescription orders, wherein acute prescription orders are adjusted medication orders.
5. The computerized method of claim 1 for fulfilling pharmacy prescription orders, wherein maintenance prescription orders are long-term medication orders.
6. The computerized method. of claim 1 for fulfilling pharmacy prescription orders, further comprising recruiting one or more customer bases by a producer, wherein said producer accrues incentives based on said recruiting.
7. The computerized method of claim 6 for fulfilling pharmacy prescription orders, wherein said incentives derive from the centralized pharmacy's distributing a percentage of profits to said producer based on total sales volume generated from said one or more customer bases.
8. The computerized method of claim 1 for fulfilling pharmacy prescription orders, wherein said customer base is selected from a group consisting of long-term care facilities, hospitals, institutions and private residences.
9. The computerized method of claim 1 for fulfilling pharmacy prescription orders, wherein the centralized pharmacy is located within about a one-hour surface traveling time from a shipping service.
10. The computerized method of claim 1 for fulfilling pharmacy prescription orders, wherein the shipping service is equipped to provide daily overnight prescription deliveries.
11. A computerized system for fulfilling; pharmacy prescription orders, the system comprising:
a computer network;
at least one first computer in a central pharmacy connected to the computer network; and
at least one second computer associated with at least one satellite pharmacy, wherein the at least one satellite pharmacy is one of a plurality of satellite pharmacies, wherein each of the plurality of satellite pharmacies has a customer base,
wherein one or more maintenance prescription orders are received via the computer network on the first computer at the central pharmacy from a first customer base, wherein a maintenance prescription order is one that is prescribed on a scheduled and routine basis, for filling the one or more maintenance prescription orders at the central pharmacy and for delivering the one or more filled maintenance prescription orders from the central pharmacy to the first customer base via a first shipment, and
wherein one or more acute prescription orders are received via the computer network on the first computer at the central pharmacy from the first customer base and wherein the one or more acute prescription orders are accessed via the computer network with the second computer associated with the first satellite pharmacy, wherein the one or more acute prescription orders are filled at the first satellite pharmacy and delivered from the first satellite pharmacy to the first customer base via a second shipment.
12. The system of claim 11, wherein the first satellite pharmacy is located closest to the customer base.
13. The system of claim 11, wherein an acute prescription order is one that is identified as needed immediately, within a time period inconsistent with an overnight delivery, said acute prescription needed for a limited and defined duration.
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