The backstory:
Does anyone out there know what MTMS is? It stands for Medication Therapy Management Service. Still confused? MTMS is almost a mediation service between patients and practitioners to help the patients get the best care possible. There are several positive benefits of the service which can include a reduction in the number of medications being taken, better scrutiny for possible interactions, help with finding less expensive treatments, and more.

In the United States, this service is especially important due to the high costs associated with prescription drugs. If a consulting pharmacist can find a way to reduce the number of medications taken, that’s less out-of-pocket expense for the consumer, and less expense covered by the insurance companies. Insurance premiums are at an all-time high, and part of the reason is the skyrocketing costs associated with pharmaceuticals. Other countries don’t have these concerns as much, but any financial benefit counts, and that’s a place where MTMS can make a huge difference if applied to a large-scale base of patients.

Enter, The PillHelp Company:
So, what does this have to do with me? Well, it’s simple: I wrote the application software and framework to support this service. PillHelp Works was the first software of its kind, and even the knock-offs don’t come close to the functionality of PHW. I wrote this to handle a patient’s complete case history and to be used over the course of years. It has full charting capabilities ranging from vital stats (blood pressure, height, weight, etc.) to laboratory tests (blood, urine, etc.) to illness, disorder, and disease histories. It has more than that, even! It handles letters, consultation documents, FAXing, emailing, scheduling, and has a full billing system. All of this was written from scratch to make sure it was secure and HIPAA compliant.

The code itself is hybridized, PHP, Java, and XML. The site’s front end is in PHP for now, the back-end work is done in Java, and all data is presented and handled in XML. The database is MySQL, running on Linux with the selinux extensions enabled and a Checkpoint firewall in front of it all. It’s hosted in a very high-security facility with no public access allowed to the section of the building in which PillHelp is hosted. Web access is AES-256 encrypted for normal and XML transfers, we’re still working on fully supporting gpg email encryption, but it does work, just not as well as I’d like! The application is fully customizable in how it looks, which features are used, document templates, everything down to the language displayed on the screen. It’s meant to integrate nicely with other software packages a commercial pharmacy may be using, but also to maintain its cross-platform capabilities.

A switch to Java will enable handheld client/server versions of PillHelp Works without major interface or work-flow changes. The idea is to be able to provide consults from anywhere without being dependent on an Internet connection. An example would be a pharmacist doing an in-home patient visit, entering all the data into PillHelp Works Mobile, and then being able to sync it up when a network connection is available. The case would then be merged, the large drug database lookups would become enabled, and the case could then be completed on any Internet-enabled machine.

We went with a ASP model for several reasons. It allowed us to keep the code centralized and secure, ensured tight integration with large drug databases, reduced the overall costs of IT and support to the consumer (usually an independent entrepreneur who is self-funding their venture), and universal access to the data by authorized parties such as physicians, clients, and insurance companies. Different data can be isolated if it is not appropriate for a certain party to view it. Example would be personal notations about a client’s wellbeing should not be viewed by an insurance company because it could be potentially held against the patient.

Most of the protection and security comes from the US HIPAA regulations that are currently still in implementation phases throughout the health care industry. Different sections of HIPAA apply to specific industry segments, and is confusing at best to smaller care providers such as The PillHelp Company. Thank goodness for the web, or I’d probably still be trying to figure out why I can’t email an ODF document, but I can print one out and leave it sealed in an envelope on the counter of my practice.

I will do more about HIPAA at a later date. Got any questions? I know I do…