Building an online pharmacy in six months
Together with 123Apotek, a new independent online pharmacy, we made a digital service that enables people to order prescription medication and health care online, and have it directly delivered to their doorstep.
Health tech in the age of a pandemic
In the early phase of the Covid-19 pandemic, it became apparent that medicine and health care needed to become more accessible.
Physical pharmacies, often small in size and with limited opening hours, seemed less convenient and secure when physical and social distancing became our primary concerns. To create a digital solution, we teamed up with 123Apotek.no, a newcomer in a market predominantly run by bigger pharmacy chains.
Digital remedies
When working on the project, we acquired first-hand knowledge of how the intricate e-prescription system works and how health tech can benefit patients, doctors, medical suppliers, and pharmacies.
The Norwegian Health Care system, although criticized for being digitally underdeveloped in some areas, is at the forefront in Europe when it comes to electronic prescriptions.
In the early phases of the process, we had the opportunity to explore all details relating to e-prescriptions and how they connect general practicians, patients, medical manufacturers, wholesalers, and pharmacies in a seamless network.
Before going further into details, let us shortly describe how e-prescriptions work: It makes prescribing, using and dispensing medications safer, more efficient, practical and accessible for everyone involved. People can easily and safely pick up their prescription and medicine at a pharmacy, or have it sent to their homes.
The complex system also provides security and ease on another level. Since it updates in real-time, the whole supply chain immediately receives a notice when medicine is unavailable or sold out, enabling suppliers to import a secure replacement, so doctors can prescribe them shortly after.
Programming prescriptions
With a vast number of public parties involved, and updates provided in real-time, it is needless to say that the technological foundation behind the Norwegian e-prescription model has a high level of complexity. With its many different users, each with large amounts of highly personal and confidential data, it requires the highest level of security and encryption.
One of our biggest challenges when building and designing 123Apotek from scratch, was to create the entire platform on top of a heavy, governmental system thats is based on communication standards going back two decades. To make everything run smoothly and work with with the rest of our technology stack, we undertook the entire implementation of the prescriptions in Python.
Although ostensibly based on the W3C/IETF open standards for encrypted web services, interoperability was not as frictionless as we had hoped. In order to make it work, we had to reverse engineer the C# libraries used by the example code, and reimplement parts of the WS-Security stack in Python.
Participation in the e-prescription system relies on several different service from different government agencies. The system uses the Norwegian BankID system for federated login, social security information from NAV (Norwegian Labour and Welfare Administration), drug information from FEST and the actual prescription information from ReseptFormidleren.
The workflow is rather complicated, with different rules for all types of medication. There are blue prescriptions and white prescriptions, for instance. These colors indicate a sum for the patient to pay, and refer to different codes doctors use to prescribe the medication, which again is connected to a public reimbursement system. Combining all in one product was a challenge indeed.
Opening e-health to a cloud-based world
All professional participants in the e-prescription system must go through an audit process before being allowed access to the real systems. This was an interesting experience for us, since the procedure is the same whether you spend five years creating a new back-office system for all medical offices in Norway, or six months creating software for an independent online pharmacy.
We took a more cloud-based approach than most players. Government IT services are only slowly moving into semi-private cloud services, but we pulled our online pharmacy together with existing cloud services for online payments and shipping services. This way, we contributed to making the e-health department a bit more open to a more modern cloud-based IT world.
It was also challenging to make sure the very sensitive medical and personal information remained under our control, only being accessible to the pharmacists when they process orders. In the end we learned a lot about a larger, more privacy sensitive, and heavyweight IT systems.
Accessible and affordable
In addition to building 123Apotek from the ground up in six months, our designers and copywriters made the user experience easy to understand, by creating logical pharmaceutical categories for a wide range of health merchandise, including bandages, face masks, pregnancy tests and everything in between.
Less than two months after its launch, 123Apotek.no came out as the most affordable pharmacy in a national survey by TV2, which goes to show that small, independent businesses can compete — and win — against the ones dominating the field.
Illustrations by Oliver O’Callaghan.
