System and method for clinical strategy for therapeutic pharmacies
First Claim
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1. A method for routing a pharmaceutical prescription to a therapeutic pharmacy within a network of therapeutic pharmacies, wherein the method is suitable for selecting a therapeutic pharmacy for filling the prescription based upon patient medical records and prescription claims, comprising the steps of:
- a. means for receiving a pharmaceutical prescription for a patient at a pharmacy intake center;
b. retrieving medical records and prescription claims for the patient from an information warehouse;
c. analyzing the medical records and prescription claims to stratify the patient into a disease category;
d. establishing a network of therapeutic pharmacies, wherein each therapeutic pharmacy within the network is established in accordance with a wellness category;
e. classifying the patient prescription to the patient wellness category, and routing a pharmaceutical prescription to a therapeutic pharmacy within a network; and
f. filling and dispensing the prescription to the patient.
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Abstract
A system and method of distributing pharmaceutical prescriptions within a network of pharmacies based review of prescription claim data and patient medical state to enable stratification of patients, wherein each pharmacy within the network has been established to handle one or more particular patient medical states.
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Citations
18 Claims
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1. A method for routing a pharmaceutical prescription to a therapeutic pharmacy within a network of therapeutic pharmacies, wherein the method is suitable for selecting a therapeutic pharmacy for filling the prescription based upon patient medical records and prescription claims, comprising the steps of:
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a. means for receiving a pharmaceutical prescription for a patient at a pharmacy intake center;
b. retrieving medical records and prescription claims for the patient from an information warehouse;
c. analyzing the medical records and prescription claims to stratify the patient into a disease category;
d. establishing a network of therapeutic pharmacies, wherein each therapeutic pharmacy within the network is established in accordance with a wellness category;
e. classifying the patient prescription to the patient wellness category, and routing a pharmaceutical prescription to a therapeutic pharmacy within a network; and
f. filling and dispensing the prescription to the patient. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A system for routing a pharmaceutical prescription to a therapeutic pharmacy within a network of therapeutic pharmacies, wherein the system is suitable for selecting a therapeutic pharmacy for filling the prescription based upon patient medical records and prescription claims, comprising:
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a. a plurality of individual therapeutic pharmacies within a network of therapeutic pharmacies, wherein the individual pharmacies are established to receive prescriptions for one or more diseases, wherein the diseases are selected from the group consisting of neurology/psychiatry, pulmonary, cardiovascular, diabetes, gastroenterology, oncology/hematology, rare diseases, pediatrics and combinations thereof;
b. a plurality of pharmacist in the individual pharmacies able to resolve protocol, perform drug utilization review, and fill and dispense prescriptions for one or more diseases, wherein the diseases are selected from the group consisting of neurology/psychiatry, pulmonary, cardiovascular, diabetes, gastroenterology, oncology/hematology, rare diseases and combinations thereof;
c. an information warehouse containing patient prescription claims and medical records;
d. a patient stratification/classification unit in communication with the information warehouse, wherein the stratification/classification system is suitable for retrieving prescription claims and medical records from the information warehouse, and classifying a patient into a disease state;
e. a clinical score unit in communication with the information warehouse a patient stratification/classification unit suitable for retrieving information from the information warehouse and assigning a score to a patient based upon a degree of wellness;
f. a patient on-line authoritative record unit in communication with the patient stratification/classification and clinical score units, wherein patient on-line authoritative record unit receives stratification and score information;
g. a rules-based unit comprising patient health insurance and formulary information, wherein the rules-based unit is in communication with and provides insurance coverage information to the patient on-line authoritative record unit;
h. a prescription receiving unit suitable for receiving prescription and refill orders for the system, requesting patient stratification, clinical score and coverage rules from patient on-line authoritative record unit; and
i. an optimal workflow and load-balancing unit capable of receiving combined prescription-stratification-score information from the prescription receiving unit and assigning the combined prescription-stratification-score information to a suitable pharmacy within the network for filling and dispensing prescriptive medication. - View Dependent Claims (18)
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Specification