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System and method for clinical strategy for therapeutic pharmacies

  • US 10,192,034 B2
  • Filed: 07/01/2013
  • Issued: 01/29/2019
  • Est. Priority Date: 10/05/2005
  • Status: Active Grant
First Claim
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1. A method for integrated management of stratification and clinical scoring of patients with a three tiered architecture to route a prescription for a tangible prescription drug to an appropriate pharmacy, comprising:

  • receiving, at a first processor of an analytic engine, a pharmaceutical prescription associated with a patient remote from a prescriber device and a pharmacy device;

    converting the received pharmaceutical prescription to a warehouse server request using an intermediate server;

    downloading, on a second processor remote from the pharmacy device using the warehouse server request, a first set of rules, a second set of rules, a medical record and a plurality of prescription claims for the patient, wherein downloading includes accessing a central fact table that links to a plurality of physical claim tables, the central fact table storing having a reduced data set related to plurality of prescription claims for the patient and reference pointers, the plurality of physical claim tables including a client subject table storing client reference data, a drug table storing drug reference data, a patient table storing patient reference data, and a provider table storing practitioner reference data, wherein the reference pointers point to the client subject table, the drug table, the patient table, and the provider table;

    analyzing with the first set of rules, on the second processor remote from the pharmacy device, the medical record and the plurality of prescription claims accessed through the central fact table from at least the drug table and the patient table to stratify the patient into a disease category, wherein the first set of rules to have the central fact table to access at least one of the reference pointers point to the client subject table, the drug table, the patient table, the provider table or combinations thereof to display dynamically at least one of a plurality of service type selections and routing a prescription;

    dynamically scoring, on the second processor using the second set of rules, a patient clinical score based on the plurality of prescription claims, the medical record, formulary information, and patient health insurance information from the drug table and the patient table, along with an indication of risk for the patient taking a medication associated with the pharmaceutical prescription;

    storing the patient clinical score remote from the pharmacy device in a warehouse server;

    routing, from a third processor using a third set of rules, the pharmaceutical prescription to a therapeutic pharmacy among a network of therapeutic pharmacies based on the disease category and the patient clinical score, each therapeutic pharmacy within the network of therapeutic pharmacies being established in accordance with a particular disease category for the therapeutic pharmacy that received the routed, pharmaceutical prescription to fill and dispense a drug for the pharmaceutical prescription, wherein routing includes;

    dynamically monitoring a workload of each therapeutic pharmacy in the network of therapeutic pharmacies and each worker in the therapeutic pharmacy,computing a utility score of the therapeutic pharmacy based on the dynamically monitored workload, wherein the utility score represents a current work load, time to complete a candidate schedule, and value of filling prescription at the therapeutic pharmacy, wherein the value of filling prescription represents a productivity rate to perform operations of filling pharmaceutical prescription under the current work load, and the candidate schedule, anddynamically optimizing a prescription fulfillment using the utility score and the clinical score to assign the pharmaceutical prescription to the therapeutic pharmacy; and

    filling and dispensing a tangible drug for the pharmaceutical prescription at the therapeutic pharmacy that received the routed, pharmaceutical prescription using a protocol for the particular disease category and a prescribed drug in which the therapeutic pharmacy has established the protocol.

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