PokitDok Launches Pharmacy APIs To Power Insight Into Formulary & Benefit Data


Tackling data problems and creating tech applications that streamline patient services has been a major goal within the medical field. While hospitals have had increasing access to tools that allow for an easier view of relevant data, prescriptions and pharmacy services have historically been stuck in locked-up antiquated systems. Enter Silicon Valley and Silicon Harbor-based PokitDok, a company that is bringing pharmacy and prescription processes into the future with a new suite of valuable Application Programming Interfaces (API). At the recent American Telemedicine Association Annual Conference,  PokitDok unveiled its new services in an ongoing mission to power the business of healthcare.

Existing technology for electronic prescribing is more than a decade old, and uses antiquated methods such as batch file transfers of volumes of data. Without real-time data, the process of prescribing is disorganized, and in many cases eligibility, coverage, and costs are not considered before writing a prescription. For the first time in history, PokitDok makes a library of drug information, formularies, Medicare Part D pharmacy network and pricing information available through an API that draws data from the Centers for Medicare & Medicaid Services (CMS) and First DataBank.

The three new APIs announced at the conference give physicians, EMRs, and digital healthcare innovators better aggregated access to a patient’s prescription plans, qualified formularies, in-network pharmacies, and related financial information. This real-time digital access to the medications that are covered by a patient’s insurance plan before prescribing ensures that the right drugs are available for pickup and payment can be processed quickly and accurately. The APIs can improve a medical visit by empowering more informed treatment plans, whether it takes place from the comfort of home or a hospital.

“Today, much of the critical financial and administrative components of picking up a prescription are addressed after the fact,” said Lisa Maki, co-founder and CEO, PokitDok. “Like most ways we make a purchase, it should start with knowledge of what you’re buying, potential risks and price implications. How much is this prescription going to cost me? Is it covered by my insurance? Are there equally effective but cheaper options? Where do I pick it up or does it have to be shipped to my house? The technology is finally here to reverse that problematic workflow and inspire more intelligent medication decisions.”

Let’s take a look at the new APIs available through PokitDok, which has had over 4,000 applications already built on its development platform. These three APIs are immediately available and can be integrated into existing health IT systems:

The Pharmacy Plan API provide a member’s pharmacy plan name, premium, deductible, initial coverage limit, and copays for each tier—from lower cost generic drugs to patented medications.

The Pharmacy Formulary API which provides a deep dive into the member’s pharmacy benefit, including what medications a patient is qualified for and how much they can get at any one time. This API covers the financial mechanisms, including a projected charge and cost break down of who is paying what. It returns details about a medication’s out of pocket cost, total cost, and payment that insurance provides.

The In-Network Pharmacy API which geolocates retail pharmacies, identifies available mail order institutions, and authenticates the dispensing pharmacy as being covered by insurance, giving patient an informed choice for prescription fulfillment.

“Right now, there are too many draconian steps in the pharmacy management process, which layers in costs and mistakes that often contribute to a less than ideal experience-of-care for patients and members,” said John Moore, founder and managing partner, Chilmark Research. “PokitDok is introducing a modern way to make critical data available in a format that’s simple to read and based on the business need, rather than building rigid enterprise software that forces a generic process on the customer.”

Learn more about PokitDok development platform HERE

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