System and method of drug disease matching
First Claim
1. A system for establishing a relationship between drugs and diseases, the system comprising:
- a first memory area for storing a quantity of patient medical history billing records identifiable as patient prescription claim records and medical claim records, a second memory area storing a grouping of drug codes and a grouping of diagnosis codes, a processor coupled to said first memory area and said second memory area and configured to perform the following steps;
(a) identify at least one prescription claim for a specific patient from said patient prescription claim records;
(b) identify at least one drug identification code for said at least one prescription claim;
(c) identify at least one disease associated with said at least one drug identification code;
(d) identify patient medical claims for said specific patient associated with said at least one disease, wherein each patient medical claim identified has at least one diagnosis code associated with said at least one disease;
(e) calculate a link weight for each said at least one diagnosis code associated with said at least one disease, wherein said link weight provides a statistical match association value to each said at least one diagnosis code.
2 Assignments
0 Petitions
Accused Products
Abstract
A computer implemented system and method for matching drugs and diseases and generating a weighted relationship between the matched drugs and diseases. The system stores a quantity of patient medical history billing records identifiable as patient prescription claim records and medical claim records, including provider and facility medical claims. The system also stores a grouping of drug codes and groupings of diagnosis codes. The system is configured to match drugs identified in a specific patient'"'"'s prescription claim records with diseases identified in the patient'"'"'s medical claims. The system generates a weighted relationship between the matched drugs and diseases by calculating a link weight in accordance with a preprogrammed formula for each of the diagnosis codes identified in the patient'"'"'s medical claims that is identified as associated with the disease identified and the drug upon which the query is being processed. The link weight provides a statistical match association value to each of the matched diseases identified by way of a diagnosis code in the patient'"'"'s medical claim and the drug identified in the prescription claim. For pharmacy claims with more than one link, the system adds the link weight values to produce an RX-ICD match strength for each unique ICD-9 diagnosis code that constituted a link with that pharmacy claim. The RX-ICD match strength values are sorted in descending order to determine the most likely diseases the drug was prescribed to treat. Matching information is then outputted to two output files.
-
Citations
14 Claims
-
1. A system for establishing a relationship between drugs and diseases, the system comprising:
-
a first memory area for storing a quantity of patient medical history billing records identifiable as patient prescription claim records and medical claim records, a second memory area storing a grouping of drug codes and a grouping of diagnosis codes, a processor coupled to said first memory area and said second memory area and configured to perform the following steps;
(a) identify at least one prescription claim for a specific patient from said patient prescription claim records;
(b) identify at least one drug identification code for said at least one prescription claim;
(c) identify at least one disease associated with said at least one drug identification code;
(d) identify patient medical claims for said specific patient associated with said at least one disease, wherein each patient medical claim identified has at least one diagnosis code associated with said at least one disease;
(e) calculate a link weight for each said at least one diagnosis code associated with said at least one disease, wherein said link weight provides a statistical match association value to each said at least one diagnosis code. - View Dependent Claims (2)
-
-
3. A computer implemented system for matching drugs and diseases, the system comprising:
-
a receiver for receiving a quantity of patient medical history billing records identifiable as patient prescription claim records and medical claim records, a data storage coupled to said receiver and configured to store a grouping of drug codes and a grouping of diagnosis codes, a processor coupled to said data storage arrangement and configured to perform the following steps;
(a) selecting a prescription claim of a specific patient from said patient prescription claim records and identifying at least one drug prescribed to said patient in accordance with said selected prescription claim;
(b) processing said at least one drug identified to determine at least one disease associated with said drug identified in said prescription claim; and
(c) searching said medical claim records of said specific patient and identifying medical claims associated with said at least one disease;
(d) determining a link weight value for each specific disease identified within said medical claims identified as associated with said at least one disease. - View Dependent Claims (4, 5, 6, 7, 8, 9, 10, 11)
-
-
12. A method of establishing a relationship between drugs and diseases comprising the following steps:
-
(a) storing a quantity of patient medical history billing records identifiable as patient prescription claim records and medical claim records in memory;
(b) storing a grouping of drug codes and a grouping of diagnosis codes;
(c) identifying at least one prescription claim for a specific patient from said patient prescription claim records;
(d) identifying at least one drug identification code for said at least one prescription claim;
(f) identifying at least one disease associated with said at least one drug identification code;
(g) identifying patient medical claims for said specific patient associated with said at least one disease identified, wherein each patient medical claim identified has at least one diagnosis code associated with said at least one disease identified; and
(h) calculating a link weight for each said at least one diagnosis code associated with said at least one disease in accordance with a preprogrammed formula, wherein said link weight provides a statistical match association value relationship between said at least one disease identified and each said at least one diagnosis code within each said patient medical claim identified as associated with said at least one disease identified.
-
-
13. A computer storage medium readable by a computing system and encoding a computer program of instructions for executing a computer process for establishing a relationship between drugs and diseases, said computer process comprising the steps of:
-
(a) storing in system data storage a quantity of patient medical history billing records identifiable as patient prescription claim records and medical claim records in memory;
(b) storing in system data storage a grouping of drug codes and a grouping of diagnosis codes;
(c) identifying at least one prescription claim for a specific patient from said patient prescription claim records;
(d) identifying at least one drug identification code for said at least one prescription claim;
(e) identifying at least one disease associated with said at least one drug identification code;
(f) identifying patient medical claims for said specific patient associated with said at least one disease identified, wherein each patient medical claim identified has at least one diagnosis code associated with said at least one disease identified; and
(h) calculating a link weight for each said at least one diagnosis code associated with said at least one disease in accordance with a preprogrammed formula, wherein said link weight provides a statistical match association value relationship between said at least one disease identified and each said at least one diagnosis code within each said patient medical claim identified as associated with said at least one disease identified.
-
-
14. A propagated signal on a carrier detectable by a computing system and encoding a computer program of instructions for executing a computer process for establishing a relationship between drugs and diseases, said computer process comprising the steps of:
-
(a) storing in system data storage a quantity of patient medical history billing records identifiable as patient prescription claim records and medical claim records in memory;
(b) storing in system data storage a grouping of drug codes and a grouping of diagnosis codes;
(c) identifying at least one prescription claim for a specific patient from said patient prescription claim records;
(d) identifying at least one drug identification code for said at least one prescription claim;
(e) identifying at least one disease associated with said at least one drug identification code;
(f) identifying patient medical claims for said specific patient associated with said at least one disease identified, wherein each patient medical claim identified has at least one diagnosis code associated with said at least one disease identified; and
(h) calculating a link weight for each said at least one diagnosis code associated with said at least one disease in accordance with a preprogrammed formula, wherein said link weight provides a statistical match association value relationship between said at least one disease identified and each said at least one diagnosis code within each said patient medical claim identified as associated with said at least one disease identified.
-
Specification