The Health Network System

The Health Network System is a province-wide computer system that links Ontario pharmacies directly to the ministry. It is used to process claims under the Ontario Drug Benefit (ODB) Program. It also prevents people from misusing the ODB program.

Benefits of the Health Network System

Speeds up processing of ODB claims

If you qualify for the ODB program, your pharmacist will use the Health Network System to process your prescription. As your pharmacist fills your prescription, here is what happens:

  • your pharmacist enters your prescription information and health card number or social assistance drug benefit number into the pharmacy computer
  • the information is communicated online to the ministry's computer system
  • the ministry validates your eligibility and calculates how much of your prescription costs you pay and how much the ODB program pays
  • your pharmacist charges you for your share of your prescription costs and dispensing fees

Supports the proper and safe use of drugs in Ontario

For example, the system identifies:

  • potentially dangerous drug interactions (for people who take two or more drugs)
  • duplicate prescriptions (when people submit more than one prescription for the same drug or class of drugs at different pharmacies)
  • "double doctoring" of narcotics and controlled drugs (when people get prescriptions for the same drug or class of drugs from three different doctors in the last month)
  • improper or fraudulent use of the health care system.

Helps improve communication between pharmacies and the ministry

The ministry uses the Health Network System to immediately inform pharmacists of any program and policy changes. This includes announcing new benefits through an email system called Microsoft Office 365 (O365) email.

Uncovers ways to improve the ODB program

The ministry uses the Health Network System to provide data to health care evaluators, researchers and professionals on drug-use patterns and trends in Ontario. This will help the ministry see which changes to the ODB program are most needed to make the program work better.