Systems and methods for look-alike sound-alike medication error messaging

• US 20040059600A1
• Filed: 01/09/2003
• Published: 03/25/2004
• Est. Priority Date: 09/25/2002
• Status: Active Grant

• Current Assignee: NDCHealth Corp. (McKesson Corp.)
• Original Assignee: NDCHealth Corp. (McKesson Corp.)
• Inventors: Coffman, Suzanne Agner, Pinsonneault, Roger George, Ball, Sarah Johnston
• Granted Patent: US 7,555,435 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance
• 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

Abstract

Systems and methods are provided for look-alike sound-alike medication error messaging. Prescription data relating to a prescription is parsed to identify a submitted drug product and a submitted daily dosage. An absolute dose screening process may be executed to determine whether the submitted daily dosage meets absolute dosing criteria for the submitted drug product. A typical dose screening process may be executed to determine whether the submitted daily dosage meets statistically derived typical dosing criteria for the submitted drug product and any look-alike sound-alike alternative drug products. In addition, one or more likelihood indicators may be assigned to the submitted drug product in relation to associated look-alike sound-alike drug pairs. If it is determined that the prescription should be rejected based on typical dosing criteria, absolute dosing criteria, or the likelihood indicator(s), a reject message may be built for presentation to the pharmacist.

Claims

1. A method for look-alike sound-alike medication error messaging comprising:

receiving prescription data relating to a prescription and parsing said prescription data to identify a submitted drug product and a submitted daily dosage;

determining that the submitted drug product is associated with at least one look-alike sound-alike drug pair comprising at least one look-alike sound-alike alternative drug name and being associated with at least one look-alike sound-alike alternative drug product;

determining whether the submitted daily dosage meets statistically derived typical dosing criteria for the submitted drug product and, if not, determining a typical dose message for the prescription;

determining whether the submitted daily dosage meets absolute dosing criteria for the submitted drug product and, if not, determining an absolute dose message for the prescription;

determining a likelihood indicator for the look-alike sound-alike drug pair, wherein the likelihood indicator represents a relative probability of whether the submitted drug product is involved in a look-alike sound-alike medication error involving the look-alike sound-alike drug pair; and

and determining a likelihood message based on the likelihood indicator.

2. The method of claim 1, wherein the likelihood indicator is determined based on a degree of similarity between drug names of the look-alike sound-alike drug pair, prescribing frequencies of drug products associated with the drug names of with the look-alike sound-alike drug pair and whether the drug products associated with the drug names of the look-alike sound-alike drug pair are available in same, look-alike or sound-alike strengths.

3. The method of claim 2, wherein the degree of similarity between the drug names of the look-alike sound-alike drug pair comprises the Levenshtein Distance between the drug names.

4. The method of claim 2, wherein the prescribing frequencies of the drug products associated with the drug names of the look-alike sound-alike drug pair are categorized as being either high, medium or low;

and

wherein a low-low, high-low or low-high combination of prescribing frequencies is considered to have the potential for confirmation bias.

5. A computer-readable medium having stored thereon computer-executable instructions for performing the method of claim 1.

6. The method of claim 1, further comprising the steps of:

determining a clinical significance for the look-alike sound-alike drug pair, the clinical significance being a value used to quantify the consequences of a look-alike sound-alike medication error involving the look-alike sound-alike drug pair;

determining a typical dose edit action based on the clinical significance and whether the submitted daily dosage meets the statistically derived typical dosing criteria for the submitted drug product, the typical dose edit action indicating whether the prescription should be rejected;

determining an absolute dose edit action based on whether the prescription relates to a new prescription or a refill and whether the submitted daily dosage meets the absolute dosing criteria for the submitted drug product, the absolute dose edit action indicating whether the prescription should be rejected;

determining a likelihood edit action based on the likelihood indicator, the likelihood edit action indicating whether the prescription should be rejected; and

if at least one of the typical dose edit action, the absolute dose edit action and the likelihood edit action indicates that the prescription should be rejected, building a reject message.

7. A computer-readable medium having stored thereon computer-executable instructions for performing the method of claim 6.

8. The method of claim 6, wherein the typical dose edit action is further determined based on whether the prescription relates to the new prescription or the refill.

9. The method of claim 6, wherein the likelihood edit action is further determined based on whether the prescription relates to the new prescription or the refill.

10. The method of claim 6, wherein the reject message comprises:

the absolute dose message if the absolute dose edit action indicates that the prescription should be rejected;

the typical dose message if the typical dose edit action indicates that the prescription should be rejected; and

the likelihood message if the likelihood edit action indicates that the prescription should be rejected,

whereby inclusion of more than one of the absolute dose message, the typical dose message and the likelihood message in the reject message is dependent on there being sufficient text space in the reject message, with first preference given to the absolute dose message and second preference given to the typical dose message.

11. The method of claim 1, wherein the submitted daily dosage is determined to not meet the statistically derived typical dosing criteria for the submitted drug product because the submitted daily dosage is equivalent to a common daily dosage for the submitted drug product, but is also equivalent to a most common daily dosage for at least one of the look-alike sound-alike alternative drug products;

and

wherein the typical dose message indicates that the submitted daily dosage is typical for the submitted drug product but that the submitted drug product and the at least one look-alike sound-alike alternative drug product may give rise to a possible look-alike sound-alike medication error.

12. The method of claim 1, wherein the submitted daily dosage is determined to not meet the statistically derived typical dosing criteria for the submitted drug product because the submitted daily dosage is not equivalent to a common daily dosage for the submitted drug product, but is equivalent to a common daily dosage for at least one of the look-alike sound-alike alternative drug products;

and

wherein the typical dose message indicates that the submitted daily dosage is a typical for the submitted drug product and that the submitted drug product and the at least one look-alike sound-alike alternative drug product may give rise to a possible look-alike sound-alike medication error.

13. The method of claim 1, wherein the submitted daily dosage is determined to not meet the statistically derived typical dosing criteria for the submitted drug product because the submitted daily dosage is not equivalent to a common daily dosage for the submitted drug product and is also not equivalent to a common daily dosage for any of the look-alike sound-alike alternative drug products;

and

wherein the typical dose message indicates that the submitted daily dosage is a typical for the submitted drug product.

14. The method of claim 1, wherein the submitted daily dosage is determined to meet the statistically derived typical dosing criteria for the submitted drug product because the submitted daily dosage is equivalent to a most common daily dosage for the submitted drug product.

15. The method of claim 1, wherein the submitted daily dosage is determined to meet the statistically derived typical dosing criteria for the submitted drug product because the submitted daily dosage is equivalent to a common daily dosage for the submitted drug product and is not equivalent to a most common daily dosage for any of the look-alike sound-alike alternative drug products.

16. The method of claim 1, wherein the statistically derived typical dosing criteria are specific to at least one of the group consisting of:

patient demographic group, treatment type, illness type and physician specialty.

17. The method of claim 1, wherein the submitted daily dosage is determined to not meet the absolute dosing criteria for the submitted drug product because the submitted daily dosage is lower than an absolute minimum daily dosage for the submitted drug product;

and

wherein the absolute dose message indicates the absolute minimum daily dosage for the submitted drug product.

18. The method of claim 1, wherein the submitted daily dosage is determined to not meet the absolute dosing criteria for the submitted drug product because the submitted daily dosage exceeds an absolute maximum daily dosage for the submitted drug product;

and

wherein the absolute dose message indicates the absolute maximum daily dosage for the submitted drug product.

19. The method of claim 1, wherein the absolute dosing criteria is specific to at least one of the group consisting of:

patient demographic group, treatment type and illness type.

20. A system for look-alike sound-alike medication error messaging comprising:

means for receiving prescription data relating to a prescription;

a database comprising one or more database tables for storing a plurality of look-alike sound-alike drug pairs, statistically derived typical dosing criteria and typical dose messages for a plurality of drug products, absolute dosing criteria and absolute dose messages for the plurality of drug products and likelihood indicators and likelihood messages for the plurality of look-alike sound-alike drug pairs; and

a processor functionally coupled to the network interface and the database and configured for executing computer-executable instructions for;

parsing said prescription data to identify a submitted drug product and a submitted daily dosage,

querying the database to determine that the submitted drug product is associated with at least one look-alike sound-alike drug pair, which is further associated with one or more look-alike sound-alike alternative drug products,

querying the database to determine whether the submitted daily dosage meets the statistically derived typical dosing criteria for the submitted drug product and, if not, determining a typical dose message for the prescription,

querying the database to determine whether the submitted daily dosage meets the absolute dosing criteria for the submitted drug product and, if not, determining an absolute dose message for the prescription,

querying the database to determine a likelihood indicator for the look-alike sound-alike drug pair, wherein the likelihood indicator represents a relative probability of whether the submitted drug product is involved in a look-alike sound-alike medication error involving the look-alike sound-alike drug pair, and

querying the database to determine a likelihood message based on the likelihood indicator.

21. The system of claim 20, wherein the likelihood indicator is determined based on a degree of similarity between drug names of the look-alike sound-alike drug pair, prescribing frequencies of drug products associated with the drug names of with the look-alike sound-alike drug pair and whether the drug products associated with the drug names of the look-alike sound-alike drug pair are available in same, look-alike or sound-alike strengths.

22. The system of claim 21, wherein the degree of similarity between the drug names of the look-alike sound-alike drug pair comprises the Levenshtein Distance between the drug names.

23. The system of claim 21, wherein the prescribing frequencies of the drug products associated with the drug names of the look-alike sound-alike drug pair are categorized as being either high, medium or low;

and

wherein a low-low, high-low or low-high combination of prescribing frequencies is considered to have the potential for confirmation bias.

24. The system of claim 20, wherein the one or more database tables further store clinical significance values for each of the plurality of look-alike sound-alike drug pairs, the clinical significance values being used to quantify the consequences of a look-alike sound-alike medication error;

wherein the one or more database tables associate typical dose edit actions and clinical significance values with each of the plurality of typical dose messages, the typical dose edit actions indicating whether prescriptions should be rejected; and

wherein the processor executes further computer-executable instructions for;

querying the database to determine the clinical significance value for the at least one look-alike sound-alike drug pair,

querying the database to determine the typical dose edit action based on the clinical significance value and whether the submitted daily dosage meets the statistically derived typical dosing criteria for the submitted drug product, and

querying the database to determine an absolute dose edit action based on whether the prescription relates to a new prescription or a refill and whether the submitted daily dosage meets the absolute dosing criteria for the submitted drug product, the absolute dose edit action indicating whether the prescription should be rejected;

querying the database to determine a likelihood edit action based on the likelihood indicator, the likelihood edit action indicating whether the prescription should be rejected, and

if at least one of the typical dose edit action, the absolute dose edit action and the likelihood edit action indicates that the prescription should be rejected, building a reject message.

25. The system of claim 24, wherein the typical dose edit action is further determined based on whether the prescription relates to the new prescription or the refill.

26. The system of claim 24, wherein the likelihood edit action is further determined based on whether the prescription relates to the new prescription or the refill.

27. The system of claim 24, wherein the reject message comprises:

the absolute dose message if the absolute dose edit action indicates that the prescription should be rejected;

the typical dose message if the typical dose edit action indicates that the prescription should be rejected; and

the likelihood message if the likelihood edit action indicates that the prescription should be rejected,

whereby inclusion of more than one of the absolute dose message, the typical dose message and the likelihood message in the reject message is dependent on there being sufficient text space in the reject message, with first preference given to the absolute dose message and second preference given to the typical dose message.

28. The system of claim 20, wherein the submitted daily dosage is determined to not meet the statistically derived typical dosing criteria for the submitted drug product because the submitted daily dosage is equivalent to a common daily dosage for the submitted drug product, but is also equivalent to a most common daily dosage for at least one of the look-alike sound-alike alternative drug products;

and

wherein the typical dose message indicates that the submitted daily dosage is typical for the submitted drug product but that the submitted drug product and the at least one look-alike sound-alike alternative drug product may give rise to a possible look-alike sound-alike medication error.

29. The system of claim 20, wherein the submitted daily dosage is determined to not meet the statistically derived typical dosing criteria for the submitted drug product because the submitted daily dosage is not equivalent to a common daily dosage for the submitted drug product, but is equivalent to a common daily dosage for at least one of the look-alike sound-alike alternative drug products;

and

wherein the typical dose message indicates that the submitted daily dosage is a typical for the submitted drug product and that the submitted drug product and the at least one look-alike sound-alike alternative drug product may give rise to a possible look-alike sound-alike medication error.

30. The system of claim 20, wherein the submitted daily dosage is determined to not meet the statistically derived typical dosing criteria for the submitted drug product because the submitted daily dosage is not equivalent to a common daily dosage for the submitted drug product and is also not equivalent to a common daily dosage for any of the look-alike sound-alike alternative drug products;

and

wherein the typical dose message indicates that the submitted daily dosage is a typical for the submitted drug product.

31. The system of claim 20, wherein the submitted daily dosage is determined to meet the statistically derived typical dosing criteria for the submitted drug product because the submitted daily dosage is equivalent to a most common daily dosage for the submitted drug product.

32. The system of claim 20, wherein the submitted daily dosage is determined to meet the statistically derived typical dosing criteria for the submitted drug product because the submitted daily dosage is equivalent to a common daily dosage for the submitted drug product and is not equivalent to a most common daily dosage for any of the look-alike sound-alike alternative drug products.

33. The system of claim 20, wherein the statistically derived typical dosing criteria are specific to at least one of the group consisting of:

patient demographic group, treatment type, illness type and physician specialty.

34. The system of claim 20, wherein the submitted daily dosage is determined to not meet the absolute dosing criteria for the submitted drug product because the submitted daily dosage is lower than an absolute minimum daily dosage for the submitted drug product;

and

wherein the absolute dose message indicates the absolute minimum daily dosage for the submitted drug product.

35. The system of claim 20, wherein the submitted daily dosage is determined to not meet the absolute dosing criteria for the submitted drug product because the submitted daily dosage exceeds an absolute maximum daily dosage for the submitted drug product;

and

wherein the absolute dose message indicates the absolute maximum daily dosage for the submitted drug product.

36. The system of claim 20, wherein the absolute dosing criteria is specific to at least one of the group consisting of:

patient demographic group, treatment type and illness type.

37. In or for a system for look-alike sound-alike medication error messaging in relation to prescription claim transactions indicating a submitted drug product and a submitted daily dosage, a propagated data signal representing a reject message comprising at least one of a typical dose message and a likelihood message;

wherein the reject message is built in response to screening a prescription claim transaction and determining that the submitted drug product is a member of at least one look-alike sound-alike drug pair comprising at least one look-alike sound-alike alternative drug product and that the prescription claim should be rejected due to at least one possible cause of a look-alike sound-alike medication error;

wherein the typical dose message is included in the reject message if the submitted daily dosage is determined to not meet statistically derived typical dosing criteria for the submitted drug product and a clinical significance for the look-alike sound-alike drug pair indicates that a look-alike sound-alike medication error could have more than a mild effect on a patient; and

wherein the likelihood message is included in the reject message if the look-alike sound-alike medication error is determined to be likely based on a degree of similarity between drug names of the submitted drug product and the look-alike sound-alike alternative drug product, prescribing frequencies of the submitted drug product and the look-alike sound-alike alternative drug product and whether the look-alike sound-alike alternative drug product is available in a same or look-alike strength as the submitted drug product,

whereby inclusion of more than one of the typical dose message and the likelihood message in the reject message is dependent on there being sufficient text space in the reject message, with first preference given to the typical dose message.