DrugBuyers.Com: Does Walgreens have the most erratic procedures?

Walgreens is unique to most chains in one very important respect, the architechture and implementation of their pharmacy management system.

In terms of processing individual prescriptions, it doesn't do a whole of things substantially different from others; it checks for interactions, performs NDC integrity validation, validates dispensing history, and retains patient-specific disease state information and so forth. Even so, it tends to do these much better, and in a means much more attuned to their operating structure than most other chains, as all development, maintenance, and enhancements are performed in-house, and with a greater allocation of capital resources than virtually any other. (For example, CVS' and Eckerd's system uses a customized version of a canned application for which they purchased the source code to modify to their own needs.

Anyway, Walgreens' architecture provides the most substantial difference, which is its mix of centrally-maintained and local information. It grew from a mainframe-based system that originally kept all information at its central data center in Deerfield, Illinois. This was in the old days of IBM Mainframes, TSO, and 3270 terminals. It was archaic and inflexible for a long period of time, but it has since allowed them to leapfrog virtually everyone else because of their huge database structure from the get-go that most chains can't cost-effectively recreate.

While certain information about each prescription resides at each store, the patient profile, and references to each prescription filled under that profile reside centrally. That is why providing your name, phone number, or social security number to any Walgreens is enough for them to have instant access to all of your information. Other chains may have similar capabilities, but they usually require identifying a specific store from which their computer can obtain the profile, and even so, the prescription data does not transfer with it as it does not pertain to the specific store. With Walgreens, it all originates with the central patient profile, which is why that link inherently exists.

Of course, links fail, and contingencies exist that give them limited views to say a profile of personal information, but not prescription history if a link is down or table is undergoing locked maintenance. If all communication is down, a store can create a new patient record which will eventually roll up into their master database.

Given that this is how their system is designed and works, it is entirely possible that at any step along the way, the pharmacy may have created an independent patient record that was later reconciled into the master, or pharmacy B decided to honor an early fill due to certain circumstances to which it may have not had visibility at a given moment in time. Nevertheless, this is by far the exception instead of the rule, as their communication infrasturcture is one of the most inerhently reliable and redundant (by design and need) in the industry. While it may have resulted in denying an early fill, its goal is to provide universal access to information across all of its stores and facilitate the seamless transfer and processing of prescriptions while maintaining FULL interaction checking and utilization review, which is something that Walgreens does exceptionally well, and is an asset to health care. They are excellent at what they do, and in my opinion, as a company they provide the gold standard of care. It also means that, with rare exception, every Walgreens prescription will be dispensed in full awareness of every other Walgreens prescription.

I'm not debating whether this particular incident was confusing, inconvenient, or frustrating; but in the larger sense of the practice of pharmacy, their technology leads the industry by a huge margin. But I do think that the ability to obtain refills at will, or the fact that receiving exception refills requires additional time and involvement is a criteria for determining whether they have problems or not. Having said that, an individual whose needs are best served when each prescription is treated in isolation to all others (except earlier refills of the same prescription), will likely find Walgreens the least accommodating and are going to be best served by having each prescription processed at a separate and unrelated pharmacy.