System and method of stratifying intervention groups and comparison groups based on disease severity index scores and ranges

• US 20050159985A1
• Filed: 11/22/2004
• Published: 07/21/2005
• Est. Priority Date: 11/21/2003
• Status: Abandoned Application

• Current Assignee: Walgreen Co. (Walgreens Boots Alliance Incorporated)
• Original Assignee: Walgreen Co. (Walgreens Boots Alliance Incorporated)
• Inventors: Bertram, Carl T.
• Application Number:
  US10/994,560
• Publication Number:
  US 20050159985A1
• Time in Patent Office: Days
• US Class Current: 705/3
• 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 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 70/60 relating to pathologies

Abstract

A method of intervention by retail pharmacies prevents adverse health outcomes resulting from drug-drug and/or drug-disease interactions, in turn, reducing medical payouts for healthcare insurers. Methods of intervention and for measuring the impact of such intervention are provided herein. The methods of measuring the impact of intervention comprise comparing intervention groups against control groups using comparison methodology. The comparison methodology described herein includes categorizing patients using the disease severity index.

Claims

1. A method of medical intervention comprising:

receiving data relating to one or more prescriptions for a person;

evaluating the prescription data for an adverse health outcome; and

intervening in a medical treatment of the person in response to a detected adverse health outcome based on the prescription data.

2. The method of claim 1, further comprising:

receiving data relating to medical insurance for the person;

evaluating the medical insurance data and the prescription data for an adverse health outcome; and

intervening in the medical treatment of the person in response to a detected adverse health outcome based on the prescription data and the medical insurance data.

3. The method of claim 1, wherein the adverse health outcome comprises a potential adverse health outcome based on the prescription data.

4. The method of claim 1, wherein the adverse health outcome comprises an identified adverse health outcome based on the prescription data.

5. The method of claim 1, wherein the adverse health outcome comprises one or more of the following:

a toxicity outcome or a decreased efficacy outcome.

6. The method of claim 1, wherein intervening in the medical treatment of the person comprises preventing a drug interaction, wherein the drug interaction potentially causes the detected adverse health outcome.

7. The method of claim 6, wherein the drug interaction comprises one or more of the following:

an interaction between two or more prescriptions for the person or an interaction between one or more prescription for the person and a disease of the person.

8. The method of claim 1, wherein intervening in the medical treatment of the person comprises one or more of the following:

communicating the detected adverse health outcome to the person, communicating the detected adverse health outcome to a physician for the person, communicating one or more of the prescriptions for the person, providing an alternative medical treatment, providing an additional medical treatment, or providing medical instructions.

9. The method of claim 1, wherein the person comprises one of a plurality of persons, the method further comprising:

receiving medical data for each of the plurality of persons;

creating a disease severity index for each of the plurality of persons based on the medical data, wherein the disease severity index represents a degree of sickness of the person;

creating a first group of persons from the plurality of persons based on the disease severity indexes;

creating a second group of persons from the plurality of persons based on the disease severity indexes;

evaluating the medical data for an adverse health outcome for each of the persons in the first group;

intervening in a medical treatment of a person in the first group in response to a detected adverse health outcome based on the medical data;

receiving post-intervention medical data for each of the plurality of persons in the first and second groups; and

evaluating the post-intervention medical data.

10. The method of claim 9, wherein the first group and the second group comprise an equal number of persons.

11. The method of claim 9, wherein the disease severity index of persons in the first group and the second group are equivalent.

12. The method of claim 9, wherein the range of disease severity indexes of persons in the first group and the second group are equivalent.

13. The method of claim 9, wherein a ratio of disease severity indexes in the first group is equivalent to a ratio of disease severity indexes in the second group.

14. The method of claim 9, wherein the disease severity index is based on one or more of the following:

a prescription, a medical insurance claim, a quantity of medications, a medication classification, a quantity of pharmacies, a quantity of doctors, an inferred disease, an actual disease, age, gender or laboratory results.

15. The method of claim 9, wherein the post-intervention medical data comprises one or more of the following:

prescription data or medical insurance data.

16. The method of claim 9, wherein evaluating the post-intervention medical data comprises measuring an impact of the intervention on the medical treatment of the person.

17. The method of claim 9, wherein evaluating the post-intervention medical data comprises:

determining the occurrences of adverse health outcomes in the first and second groups;

determining a cost associated with the adverse health outcomes in the first and second groups;

comparing the occurrences of adverse health outcomes for the first group with the occurrences of the adverse health outcomes for the second group; and

comparing the cost associated with the adverse health outcome of the first group with the cost associated with the adverse health outcomes of the second group.

18. The method of claim 9, further comprising receiving a subscription request based on the evaluation of the post-intervention medical data.

19. A method of stratifying intervention groups and comparison groups comprising:

receiving medical data for each of a plurality of persons;

creating a disease severity index for each of the plurality of persons based on the medical data, wherein the disease severity index represents a degree of sickness of the person;

creating a first group of persons from the plurality of persons based on the disease severity indexes;

creating a second group of persons from the plurality of persons based on the disease severity indexes;

evaluating the medical data for an adverse health outcome for each of the persons in the first group;

intervening in a medical treatment of a person in the first group in response to a detected adverse health outcome based on the medical data;

receiving post-intervention medical data for each of the plurality of persons in the first and second groups; and

comparing the post-intervention medical data of the first group with the post-intervention data of the second group.

20. The method of claim 19, wherein receiving medical data comprises receiving medical insurance data from a medical insurer, the medical insurance data relating to medical insurance claims by a person.

21. The method of claim 19, wherein receiving medical data comprises receiving prescription data from a pharmacy, the prescription data relating to a prescription for the person.

22. The method of claim 19, wherein receiving medical data comprises receiving medical data from the person.

23. The method of claim 19, wherein the first group and the second group comprise an equal number of persons.

24. The method of claim 19, wherein the disease severity index of persons in the first group and the second group are equivalent.

25. The method of claim 19, wherein the range of disease severity indexes of persons in the first group and the second group are equivalent.

26. The method of claim 19, wherein a ratio of disease severity indexes in the first group is equivalent to a ratio of disease severity indexes in the second group.

27. The method of claim 19, wherein the disease severity index is based on one or more of the following:

a prescription, a medical insurance claim, a quantity of medications, a medication classification, a quantity of pharmacies, a quantity of doctors, an inferred disease, an actual disease, age, gender or laboratory results.

28. The method of claim 19, wherein the post-intervention medical data comprises one or more of the following:

prescription data or medical insurance data.

29. The method of claim 19, further comprising measuring an impact of the intervention on the medical treatment of the person based on the post-intervention medical data.

30. The method of claim 19, wherein'"'"'the post intervention medical data comprises one or more occurrences of adverse health outcomes and a cost associated with each adverse health outcome, wherein comparing the post-intervention medical data of the first group with the post-intervention data of the second group comprises:

comparing the occurrences of adverse health outcomes for the first group with the occurrences of the adverse health outcomes for the second group; and

comparing the cost associated with the adverse health outcome of the first group with the cost associated with the adverse health outcomes of the second group.

31. The method of claim 19, further comprising receiving a subscription request based on the comparison of the post-intervention medical data.

32. A method of intervening in a medical treatment comprising:

receiving prescription data relating to one or more prescriptions for a person;

receiving medical insurance data relating one or more medical insurance claims for the person;

evaluating the prescription data and the medical insurance data for an adverse health outcome; and

intervening in a medical treatment of the person in response to a detected adverse health outcome based on the prescription data and the medical insurance data.

33. The method of claim 32, wherein receiving the medical insurance data comprises receiving the medical insurance data from one or more of the following:

a medical insurance provider, a physician of the person, or the person.

34. The method of claim 32, wherein receiving the prescription data comprises receiving the prescription data from one or more of the following:

a pharmacy, a medical insurance provider, a physician of the person, or the person.

35. The method of claim 32, wherein intervening in the medical treatment of the person comprises preventing a drug interaction, wherein the drug interaction potentially causes the detected adverse health outcome.

36. The method of claim 32, wherein intervening in the medical treatment of the person comprises one or more of the following:

communicating the detected adverse health outcome to the person, communicating the detected adverse health outcome to a physician for the person, communicating one or more of the prescriptions for the person, providing an alternative medical treatment, providing an additional medical treatment, or providing medical instructions.

37. A medical intervention system comprising:

a network;

a server operatively coupled to the network, the server including a database to store medical information;

a controller operatively coupled to the network, the controller including a processor and a memory operatively coupled to the processor,

the controller being programmed to receive the medical information from the server;

the controller being programmed to evaluate the medical information for an adverse health outcome;

the controller being programmed to intervene in a medical treatment of a person in response to a detected adverse health outcome based on the medical information.

38. The system of claim 37, wherein the medical information comprises one or more of the following:

prescription information or medical insurance information.

39. The system of claim 37, further comprising a pharmacy server operatively coupled to the network, the pharmacy server comprising the controller.

40. The system of claim 37, further comprising:

wherein the server comprises a medical insurance server including a database to store information related to one or more medical insurance claims;

wherein the controller is programmed to receive the medical insurance information from the medical insurance server;

wherein the controller is programmed to evaluate the medical insurance information for an adverse health outcome;

wherein the controller is programmed to intervene in the medical treatment of the person in response to a detected adverse health outcome based on the medical insurance information.

41. The system of claim 37,

wherein the server comprises a pharmacy server including a database to store information related to one or more prescriptions;

wherein the controller is programmed to receive the prescription information from the pharmacy server;

wherein the controller is programmed to evaluate the prescription information from the pharmacy server for an adverse health outcome;

wherein the controller is programmed to intervene in the medical treatment of the person in response to a detected adverse health outcome based on the prescription information.

42. The system of claim 37, further comprising:

a data input device operatively coupled to the network;

wherein the controller is programmed to receive medical information from the data input device;

wherein the controller is programmed to evaluate the medical information from the data input device for an adverse health outcome;

wherein the controller is programmed to intervene in the medical treatment of the person in response to a detected adverse health outcome based on the prescription information from the pharmacy server and the medical information from the input device.

43. The system of claim 37,

wherein the medical information comprises medical information relating to a plurality of persons;

wherein the controller is programmed to create a disease severity index for each of the plurality of persons based on the medical information, wherein the disease severity index represents a degree of sickness of the person;

wherein the controller is programmed to create a first group of persons from the plurality of persons based on the disease severity indexes, wherein the person comprises one of the plurality of persons in the first group;

wherein the controller is programmed to create a second group of persons from the plurality of persons based on the disease severity indexes;

wherein the controller is programmed to evaluate the medical data for an adverse health outcome for each of the persons in the first group;

wherein the controller is programmed to receive post-intervention medical data for each of the plurality of persons in the first and second groups; and

wherein the controller is programmed to compare the post-intervention medical data of the first group with the post-intervention medical data of the second group.

44. The system of claim 43,

wherein the controller is programmed to provide results of the comparison to a medical insurer;

wherein the controller is programmed to receive a subscription request from the medical insurer based on the results.

45. An article comprising a machine-accessible medium having stored thereon instructions that, when executed by a machine, cause the machine to:

receive medical information;

evaluate the medical information for an adverse health outcome; and

intervene in a medical treatment of a person in response to a detected adverse health outcome based on the medical information.

46. The article of claim 45, wherein the medical information comprises one or more of the following:

prescription information or medical insurance information.

47. The article of claim 45 wherein the medical information comprises medical information relating to a plurality of persons, the article having further instructions that, when executed by the machine, cause the machine to:

create a disease severity index for each of the plurality of persons based on the medical information, wherein the disease severity index represents a degree of sickness of the person;

create a first group of persons from the plurality of persons based on the disease severity indexes, wherein the person comprises one of the plurality of persons in the first group;

create a second group of persons from the plurality of persons based on the disease severity indexes;

evaluate the medical data for an adverse health outcome for each of the persons in the first group;

receive post-intervention medical data for each of the plurality of persons in the first and second groups; and

compare the post-intervention medical data of the first group with the post-intervention medical data of the second group.

48. The article of claim 47 having further instructions that, when executed by the machine, cause the machine to:

provide results of the comparison to a medical insurer; and

receive a subscription request from the medical insurer based on the results.