Evan Schuman's StorefrontBacktalk

Within a few days of each other, two of the nation’s largest pharmacy chains–Walgreens and Rite-Aid–this month rolled out programs in which their customers can use Internet chat to talk with pharmacists about medical advice 24×7. But each chain opted for a very different approach, with $63 billion Walgreens giving its pharmacist chatters full access to the medical databases on patients across the country while $26 billion Rite-Aid took the more conservative route of limiting chatters to generic advice based on nothing more than what consumers choose to share.

The moves–and different strategies–are especially interesting given how pharmacies today find themselves in arguably the most data-sensitive retail segment. This space has all of the usual retail privacy concerns and regulations, in addition to medical requirements such as the U.S. Health Insurance Portability and Accountability Act (HIPAA).

Rite-Aid, which announced its plan first, on August 3, chose to limit its chatters to drug interactions and general recommendations based on generic knowledge plus whatever personal details the consumer opts to share during the chat. That’s the safer and more conservative route, compared to what Walgreens announced three days later, on August 6. (Given how many months programs like this need to win legal and regulatory approval, the fact that the two chains launched and announced within 72 hours of each other shows how closely these rivals are shadow-boxing.)

Walgreens’ more daring approach has some huge potential benefits. For example, what if a consumer asks about a particular drug interaction with an over-the-counter (OTC) sleep aid but forgets to mention a long-term prescription? With the ability to see that consumer’s full list of medications, the pharmacist could spot a problem and potentially prevent a life-threatening combination. How much consumer loyalty is earned by a chat that proactively saves a patient’s life?

The ability to add in OTC drug questions and information to consumers’ databases is also medically valuable. It would allow their personal pharmacist in their local branch to flag OTC interactions, which those pharmacists otherwise would have little way of knowing (unless an eagle-eyed cashier happened to notice).

Of course, this type of access has huge potential problems, too. What if the consumer’s computer uses a program that captures chat sessions, such as Google Desktop, and that consumer shares her machine with others? That very personal information exchange would wind up with someone else who has access to the computer.

Even worse, how much of a temptation is it to have employees with access to the medical history of every Walgreens customer nationally?

It’s unclear what restrictions have been put in place at Walgreens. For example, the pharmacist chatters may be restricted to accessing the data of only the customer who is currently logged in and chatting. Even so, that is still a huge amount of very valuable information. Perhaps a divorce lawyer–or a potential employer–wants to know about a history of anti-psychotic medications or, for that matter, birth control prescriptions?

Unlike E-mail, which is not exactly a monument to secure communications, instant messages leave relatively unprotected footprints at various points on the Internet. Using these chats to discuss patient medical history is indeed daring.