Prescription management system

• US 20020042726A1
• Filed: 08/30/2001
• Published: 04/11/2002
• Est. Priority Date: 10/28/1994
• Status: Active Grant

• Current Assignee: Cybear, LLC (Abbvie Incorporated)
• Original Assignee: Cybear, LLC (Abbvie Incorporated)
• Inventors: Mayaud, Christian
• Granted Patent: US 7,574,370 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 70/40 relating to drugs, e.g. their side effects or intended usage
• CPC Class Codes: Y10S 707/99943 Generating database or data structure, e.g. via user interface

Abstract

An electronic prescription creation system for use by professional prescribers at the point of care has a prescription division subsystem permitting creation of a single prescription to be automatically divided into two components for fulfillment of one portion quickly and locally at higher cost and of another portion by remote mail order taking more time but providing a cost saving for a major part of the prescription. The prescription creation system has an ability to access remote source databases for system presentation to the prescriber of relevant, authorized and current drug, drug formulary and patient history information, with dynamic creation of a transient virtual patient record, the information being presented to the prescriber before completion of the prescription, permitting enhancement of the quality of prescribing decisions.

Claims

1. A computer-implemented prescription management system for use by a prescriber in creating a prescription at a point of patient care, said prescription being usable by a pharmacist to dispense drugs, said prescription management system comprising:

a) electronic posting means to select and capture in said prescription;

i) a patient identifier;

ii) a prescribed drug;

iii) a dosage for said prescribed drug; and

iv) a patient condition intended by said prescriber to be treated by said prescribed drug; and

b) a displayable library of prescribable drugs; and

c) displayable patient drug formulary information to indicate to said prescriber-user selected ones of said prescribable drugs included within a drug formulary associated with said patient to enable compliance with drug formulary guidelines at the point-of-care.

2. A prescription management system according to claim 1 having means to track preferred data usage by a user and to adapt data displays to favor such preferred usage, whereby the system learns and adapts to a user'"'"'s habits.

3. A prescription management system according to claim 2 wherein at least one said preferred usage data display comprises a personal-preference condition-selection list for each system user.

4. A prescription management system according to claim 2 wherein at least one said preferred usage data display comprises a personal-preference drug-selection list for each system user.

5. A prescription management system according to claim 1 further comprising a patient history record displayed online, said patient history record listing electronically available prior prescriptions, said prior prescriptions each including a prescribed drug and a condition treatment objective for each drug prescribed, system-created prescriptions being system-added to said history record.

6. A prescription management system according to claim 5 comprising a patient condition list for selection of a patient condition for posting to said prescription, said patient condition list comprising patient conditions listed in said patient history record.

7. A prescription management system according to claim 1 comprising a source-oriented data-retrieval subsystem, said data retrieval subsystem accessing at least one data-retrieval networks to supply an array of up-to-date prescribing information and patient-related data to the point-of-care from remote source databases.

8. A prescription management system according to claim 7 wherein said data-retrieval subsystem is linked to the prescription management system to provide allergy and interaction alerts, formulary changes, new drug approvals, and to lock out or warn against, the prescribing of inappropriate or recalled drugs.

9. A prescription management system according to claim 1 wherein said patient history record is dynamically assembled online in response to a user request from multiple source record elements retrieved from multiple heterogenous remote databases.

10. A prescription management system according to claim 9 implemented on a user interface device configured for networked digital communication with a host computer facility, wherein said patient history record is retrieved as said record elements from said remote databases by said host computer facility in response to a call from said user device said remote source databases being selected and identified according to said patient'"'"'s prior geographical locations and health-care service providers.

11. A prescription management system according to claim 5 wherein said patient history record is a virtual patient record newly assembled online in response to each user request for said record thereby to be current with regard to possible remote updates of said source record elements.

12. A prescription management system according to claim 11 wherein said host computer facility logs the time, date and user calling for said virtual patient record to provide an audit trail of access to said patient'"'"'s record, or a provider'"'"'s or organization'"'"'s data.

13. A prescription management system according to claim 11 deployed comprehensively throughout a geographical area, demographic, company, plan or community group whereby all drug prescriptions created in said area are products of said system and wherein all said drug prescriptions are posted to source databases accessible to said system whereby a complete patient history record of all drug prescriptions created for said patient in-said geographical area, demographic, company, plan or community group can be listed in said dynamically assembled virtual patient record.

14. A prescription management system according to claim 1 wherein said drugs in said drug list are classified according to a patient condition for which said drugs have efficacy and said prescription management system further comprises a patient-condition specification procedure for selecting said condition from groups of possible conditions and an onscreen drug selection procedure for selecting said prescribed drug from said library, listing multiple drugs for treating each said patient problem.

15. A prescription management system according to claim 1 wherein said patient drug formulary display means comprises a condition-driven formulary drug list, and a condition-driven nonformulary drug list, said drug lists being changeable according to the patient selected.

16. A prescription management system according to claim 15 wherein said system provides drug efficacy guidelines based on patient information and formulary information.

17. A prescription management system according to claim 3 wherein said prescriber-user'"'"'s personal-preference list of drugs displayed with formulary drugs indicated.

18. A prescription management system according to claim 1 including relative cost information for displayed formulary drugs.

19. A prescription management system according to claim 1 wherein said drug formulary is generated by a prescription benefits management company by providing computer access to remote databases containing said drug formulary information whereby appropriate formulary drugs are presented to said user on screen on a user interface device deployable at said point-of-care, to facilitate compliance with drug formulary guidelines at said point-of-care.

20. A prescription management system according to claim 1 wherein prescribability of a drug pursuant to formulary guidelines is formulary-qualified according to said patient condition.

21. A prescription management system according to claim 1 comprising built-in logic for accessing drug formulary information from multiple drug formulary providers wherein said drug formulary list is selected from said multiple available drug formularies according to said patient identification, said patient having a prior arrangement with said drug formulary provider to provide prescription-related benefits to that patient, said drug formulary list information being dynamically presented to said prescriber-user in the form of at least one selection of patient-specific formularies from which a formulary status indication relevant to a patient therapy-related choice made by said prescriber-user is made.

22. A prescription management system according to claim 21 comprising network data communication means to update and maintain said multiple available formularies from remote source databases of formulary information.

23. A prescription management system according to claim 1 wherein comprising means to categorize and display said patient conditions categorized into multiple lists, said lists being selected from the group consisting of a personal condition list of conditions encountered by the prescriber, a historical condition list of conditions exhibited by the patient, one or more prescriber-customized condition lists, a body system condition list, conditions organized according to disease pathology, therapy, personal knowledge and others.

24. A prescription management system according to claim 23 wherein drug selection is condition driven and said prescriber selects a patient condition to be treated via at least one of said condition lists.

25. A prescription management system according to claim 24 wherein a prescriber-user can intelligently to access a large body of drug data selections via multiple condition-driven routes to provide multiple mapping so that the user can find a suitable drug or selection of drugs via different pathways according to their preferred work methods.

26. A prescription management system according to claim 1 wherein said electronic posting means can select and capture dosage and route of administration information, and optionally, length-of-treatment and generic substitution authorization information, for a selected drug, said information being system-available for all listed drugs.

27. A prescription management system according to claim 26 comprising network data communication means to update and maintain said dosage information said dosage information being dynamically supplied from a remote source database when called by the system.

28. A prescription management system according to claim 1 comprising a prescription expiration routine including dosing, amount and expiration drug quantifiers and system calculation of a relationship between said drug quantifiers where said system provides default values for unspecified ones of said drug quantifiers in response to user selection of one or more of said drug quantifiers and optionally patient history information, formulary information indicating preferred drug lists for treatment.

29. A prescription management system according to claim 2 comprising a patient data access control subsystem including data access control specification means enabling a patient to authorize a user to access said patient'"'"'s history data and comprising data access control means whereby only an authorized user can access said patient'"'"'s data.

30. A prescription management system according to claim 29 comprising a patient data access auditor, said patient data access auditor generating an access record logging information as to the time date and identity of entities accessing said patient history data, to provide a patient data access audit trail and optionally further comprising similar access audit means for generating an access record logging similar information regarding access to a prescriber'"'"' or organization'"'"'s data.

31. A prescription management system according to claim 1 comprising a patient data access subsystem providing patient-directed control of the flow of their own data.

32. A prescription management system according to claim 31 wherein said patient-directed data-access control is achieved by centrally inputting to said patient data access subsystem at a host computer facility, patient-generated record-access specifications determining which parties can access what data during what period of time.

33. A prescription management system according to claim 32 wherein said patient-generated record-access specifications provide a patient security profile in a pre-authorization file said pre-authorization file being used to control access to said patient'"'"'s data.

34. A prescription management system according to claim 1 comprising user-related historical records generated by operation of said system by a prescriber-user, a user data-access control subsystem including data-access control specification means enabling a user to authorize selective third party access to said user'"'"'s history data and comprising data access control means whereby only an authorized third party can access said user'"'"'s data and what data type may be accessed by what organization or provider.

35. A prescription management system according to claim 20 comprising a user data access auditor, said user data access auditor generating an access record logging information as to the time date and identity of third parties accessing said user history data, to provide a user data access audit trail.

36. A prescription management system according to claim 1 comprising organization-generated source data retrievable for display in said prescription-management system from at least one remote database an organization-directed data-access control subsystem including data-access control specification means enabling an organization to authorize selective third party access to said organization-generated source data and comprising data access control means whereby only an authorized third party can access said organization-generated source data.

37. A prescription management system according to claim 36 comprising an organization data access auditor, said organization data access auditor generating an access record logging information as to the time date and identity of third parties accessing said organization-generated source data to provide an organization data access audit trail.

38. A prescription management system according to claim 2 comprising newly created prescription evaluation means to evaluate a newly prescribed drug for system-known patient allergies or drug-to-drug interactions, or drug-to-multiple drug interactions and absolute contraindications with currently prescribed drugs, as known to the system.

39. A prescription management system according to claim 2 comprising a drug alert subsystem for communicating alerts relating to unfavorable or cautionary characteristics of particular drugs wherein said alerts are associated with system information on the drug so that when a user calls up the drug in question, they receive the warning or alert, or other special message.

40. A prescription management system according to claim 39 wherein said drug alert subsystem is operative to communicate drug withdrawal information to system users electronically in real time or when said withdrawn drug is selected for prescribing or a warning is posted directly to the prescription.

41. A prescription management system according to claim 40 whereby a drug can be withdrawn from the market the same day by making a system entry preventing completion of a prescription for the withdrawn drug.

42. A prescription management system according to claim 40 wherein current users of a drug or medication can be identified from prescription history records, referencing not only drugs prescribed, but also prescription expiry dates and both the patient and their doctor are notified of said drug withdrawal optionally for the physician via direct point-to-point electronic mail.

43. A prescription management system according to claim 1 comprising onscreen electronic mail access to other users of said system, said electronic mail capability additionally being linked with said prescription creation function and enabling a prescriber-user to append an electronic record to a prescription or prescription-related record.

44. A prescription management system according to claim 43 wherein said electronic mail provides a platform for accessing other artificial intelligence and expert systems and optionally providing linkage for transaction services such as the ordering and reviewing of scheduling and similar administrative functions.

45. A prescription management system according to claim 1 comprising a patient-selection subsystem whereby preliminary selection of groups of patients can be made by providing multiple patient lists selected from the group consisting of “

Today'"'"'s Patients”

, “

In-Patients”

, “

Out-Patients”

, “

Private Patients” and

others.

46. A prescription management system according to claim 45 wherein said patient lists are system-maintained, on an ongoing basis, using the latest data available to the system and include intelligent patient selection means enabling the user to select a convenient group of patients that has a high probability of including the next patient or patients to be encountered, thereby speeding access and retrieval of a desired patient record.

47. A prescription management system according to claim 1 comprising onscreen access to drug detail information as to indications, interactions, side effects and precautions.

48. A prescription management system according to claim 1 comprising a drug literature-retrieval subsystem to retrieve drug -related information a cross a network from a remote heterogenous database for display to said user in real time.

49. A prescription management system according to claim 48 wherein said drug literature-retrieval subsystem provides the user with an access point to full disclosure and prescribing information on a selected drug and wherein available said drug information is selected from the group consisting of drug-treatment guidelines, one or more literature references supporting said guidelines, details of the particular conditions for which a system-suggested alternative drug has been found effective, adverse conditions, preferred dosages and administration routes, literature sources and other relevant drug-prescribing information.

50. A prescription management system according to claim 49 wherein said drug literature-retrieval subsystem is operative to enable a physician, to have a hard or printed copy, or other media form of relevant studies or literature sent to them by onscreen selection, said onscreen selection being system-communicated to a source for said study or literature information.

51. A prescription management system according to claim 49 wherein said drug literature-retrieval subsystem is operative to provide a simple nonintrusive technique for bringing new drug information to physicians at a point of care when creating a prescription.

52. A prescription management system according to claim 49 comprising an outcome study subsystem for selecting outcome study participants by centrally maintaining patient-directed patient-record-access specifications whereby the system can include records of patients agreeable to becoming study participants in such outcome studies pursuant to indications in their patient-record-access specifications optionally with output of said study data being controlled to comply with access specifications of prescribers and organizations having proprietary rights thereto.

53. A prescription management system according to claim 1 comprising a new drug surveillance subsystem to conduct post introduction market surveillance of new drugs for adverse outcomes to the treatment of a specified condition or conditions with the newly introduced drug.

54. A prescription management system according to claim 53 wherein said new drug surveillance subsystem is operative to monitor patients reporting new problems after having been prescribed the new drug in question, refer such new problems to the physician user to qualify them for medical relevance and then statistically compare a collection of similar reports with data on a pool of similarly treated patients for significance.

55. A prescription management system according to claim 1 wherein said condition list comprises at least five conditions, and said drug list comprises at least five drugs.

56. A prescription management system according to claim 1 wherein said drug information comprises associated condition information and dosage information for at least about fifty percent of all prescribable FDA-approved drugs.

57. A prescription management system according to claim 1 comprising means to output a newly created electronic prescription in any desired form such as to print, to local or remote storage or to remote file transfer as an electronic prescription.

58. A prescription management system according to claim 1 comprising means for transmitting said electronic prescription across a network for fulfillment by a specified pharmacy.

59. A prescription management system according to claim 57 comprising a printed dosage schedule output for said patient.

60. A prescription management system according to claim 1 wherein multiple physicians accessed by a patient utilize the system described herein, with common online access to, and assembly of, a patient'"'"'s prescription history record whereby that record provides a current record of new prescriptions, then a common abuse can be controlled wherein a patient presents a problem or condition to more than one physician to obtain multiple prescriptions with a view to indulging in abusive ingestion or illicit resale.

61. A prescription management system according to claim 1 wherein the system also provides, for example in the patient'"'"'s history record, notification from a pharmacy, or from a drug benefit plan linked to the pharmacy, of fulfillment of a prescription, and that information is available to the prescriber, for example from the patients'"'"' history record, another common abuse wherein a patient pleads loss of a prescription to obtain a duplicate, can also be prevented.

62. A prescription management system according to claim 1 wherein the system also provides, for example in the patient'"'"'s history record, notification from a pharmacy, or from a drug benefit plan linked to the pharmacy, of fulfillment of a prescription, and that information is available to the prescriber, for example from the patients'"'"' history record, wherein a patient'"'"'s failure to have a prescription fulfilled indicating discontinuance of the prescribed therapy can be monitored and possibly corrected.

63. A prescription produced by the system of claim 1 output in a form selected from the group consisting of electronic, paper, digitized voice and fax.

64. A prescription management system for electronic prescription creation by a Prescriber at a point of patient care, said prescription being usable by a pharmacist to dispense drugs, said prescription management system comprising electronic posting means to select and capture in said prescription:

i) a patient identifier;

ii) a prescribed drug;

iii) a dosage for said prescribed drug; and

iv) a patient condition intended by said prescriber to be mitigated by said prescribed drug.

65. A prescription management system according to claim 64 further comprising an onscreen drug selection procedure having a patient condition list specifying multiple possible patient conditions, having a drug list specifying multiple possible prescribable drugs and having drug specification means to select and post a desired drug to said prescription;

wherein drugs in said drug list are classified according to a patient condition for which said drugs have efficacy and said onscreen drug selection procedure lists multiple drugs for treating each said patient problem.

66. A prescription management system according to claim 64 comprising drug formulary information being a selected list of drugs being preferred for prescribing by a drug benefit provider to said patient.

67. In combination, a host computer facility and a prescription management system according to claim 64 implemented on said host computer facility said host computer facility supporting network delivery of user-relevant components of said prescription management system to multiple remote user interface devices and providing data and communications resources for users to draw upon employing said interface devices.

68. A combination according to claim 67 wherein said host computer facility can communicate with multiple heterogenous remote databases to retrieve complementary data elements from said databases and comprises:

i) a dynamic record assembly procedure for online assembly of a data record from said complementary data elements; and

ii) a user-device communication procedure to deliver said dynamically assembled record to a calling user-interface device as an integral data component of said prescription management system.

69. A professional product specification system for electronically creating a technical specification usable by a professional to specify technical products said product specification system comprising:

a) electronic posting means to select and capture in said prescription;

i) a customer identifier;

ii) a specified product; and

iii) product specification; and

b) an onscreen product selection procedure having a product benefit list specifying multiple possible customer benefits having a product list specifying multiple possible specifiable products and having product specification means to select and post a desired product to said specification;

wherein products in said product list are classified according to a customer-useful technical purpose attainable with said products and said onscreen product selection procedure lists multiple products for providing each said customer benefit.