Mediscor assists pharmacists to provide immediate adjudication on prescriptions

Imagine standing in your local pharmacy. You feel sick and have just come from the doctor who has given you a prescription. All you want to do is collect your medicine and go home to rest.

But you`ve already been waiting for 10 minutes. The pharmacist cannot get authorisation from your medical insurer to supply your medicines because the "computer is down". There is nothing the pharmacist can do. You have three options: pay cash, come back later or wait.

Mediscor, a South African company, had this challenge when it decided to improve operations five years ago. It wanted to offer pharmacists a solution that would provide uninterrupted access to their database systems, while at the same time provide instant response to their requests.

A difficult and demanding task. Mediscor is a pharmaceutical benefit management company (PBM). Mediscor`s mission is to be a "centre of excellence" in the healthcare industry in SA. The company has around 100 employees and a record over the past five years of providing excellent reliability to its customers, primarily pharmacists and medical insurers.

Mediscor acts as a link between pharmacists and medical insurers by managing medicine benefits. This includes services such as protecting patients against possible allergies, side-effects and interactions.

Mediscor processes in the region of 80 000 transactions per day through a network of more than 3 000 pharmacies and doctors and 20 medical insurers.

Once a prescription has been approved by Mediscor`s electronic checking mechanism, payment to the pharmacy is guaranteed by the medical insurer. Unless Mediscor checks the prescription, payment is not guaranteed. The system therefore must be available at all times. If a pharmacist has to wait because response times are slow or the system is down, customers have to wait to receive medicines. It goes without saying that an ill customer has little patience. Without the assurance of having Mediscor online when needed, a visit to the pharmacy could result in a poor customer satisfaction and future lost revenues from once-loyal customers.

From the outset, management needed a solution to meet the high-availability requirements of this demanding environment. "The risks associated with downtime and the importance of ensuring that the patient gets their medicine effortlessly, made it critical that we chose correctly," says Francois Venter, IT director of Mediscor.

Mediscor selected a solution comprising two separate systems, a production system fully synchronised with a backup system, leaving no room for data error, data loss, data corruption or communications downtime.

MIMIX, developed by Lakeview Technology, was proposed and chosen as the managed availability solution by TCM, the authorised MIMIX solution provider in SA and one of the largest IBM business partners worldwide.

Mediscor`s core systems run on IBM eServer iSeries systems, with support systems based on Sun`s Solaris and Progress database. Mediscor also runs Windows XP, 2000, NT and Windows 98 with about 100 desktops supported by nine IT staff.

"In five years," says Mediscor IT manager Bryan Douglas-Henry: "We have not had a single unscheduled outage on the iSeries, neither a hardware nor software failure. However, we did experience numerous power and telecommunications outages during that time. In fact, we had no less than six telecommunications failures in one year alone," explains Douglas-Henry.

A decision was made to move the secondary IBM eServer iSeries to Mediscor`s supplier`s premises TCM, about 50km away. This has provided an infrastructure which ensures that the backup and production servers are less susceptible to the same power and telecommunication outages as well as any other unplanned disasters that may occur, such as fire or flood.

The production system comprises two IBM eServers and two links between the production and backup machines. A switch redirects traffic between the production and backup machines.

Pharmacists and medical schemes enter the network via the switch to the Mediscor systems using X.25 radiopads, dialup modems, ISDN or direct IP connections.

MIMIX replicates the applications, data and objects from the production iSeries system to the secondary backup iSeries server. In the event of an unplanned outage, such as a telecommunications failure, the backup iSeries can be used as a production server until the primary telecommunications path is restored.

The MIMIX solution is also crucial to providing continuous operations in the case of planned events, which can tie up system capacity for activities like batch jobs, system and application upgrades, database reorganisations, daily/weekly backups and ongoing system maintenance.

All critical data on the production server, such as claim transactions, membership information and transaction logs, are replicated to the backup server. All development information, such as databases and test systems, are replicated to the production iSeries machine.

"In terms of a competitive advantage, although MIMIX does not directly influence our clients` decision to contract our clinical services. The running of the entire service for pharmacists and medical insurers would not be viable without MIMIX providing 100% availability. It is a must," says Venter.

Both Mediscor and TCM agree that planning is a crucial factor in ensuring the success of MIMIX. Says TCM marketing executive Jorge de Campos: "When implementing a managed availability solution, there is a need for an in-depth evaluation to determine what must be replicated. If the incorrect information is replicated, the data may not be there when it is needed. But if too much information is replicated, there will be an unnecessary workload and overhead on the telecommunications and hardware capacity requirements."

"Our advice to anyone looking at high availability," says Douglas-Henry, "is to plan properly, and choose a competent solution provider that is able to craft an all-encompassing solution to cover all your needs today as well as in the future. In our case that was TCM. They supplied the MIMIX managed availability solution expertise, the IBM eServer iSeries installation support, knowledge of our operating environment, and networking LAN/WAN support."

Concludes Venter: "MIMIX forms the core of the 100% level of reliability we are able to offer our customers and therefore the efficiency of our service levels."