SYSTEMS AND METHODS FOR MANAGING PATIENT PHARMACEUTICAL CARE

• US 20090076857A1
• Filed: 11/26/2008
• Published: 03/19/2009
• Est. Priority Date: 02/19/1999
• Status: Abandoned Application

• Current Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Original Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Inventors: ELETREBY, Magdy A., ELETREBY, Mohammed N.
• Application Number:
  US12/324,288
• Publication Number:
  US 20090076857A1
• Time in Patent Office: Days
• US Class Current: 705/3
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G06Q 30/00 Commerce
• CPC Class Codes: G06Q 50/00 Information and communication technology [ICT] specially adapted for implementation of business processes of specific business sectors, e.g. utilities or tourism healthcare informatics G16H
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• 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 described for allowing a pharmacist to practice pharmaceutical care in an accurate and efficient manner. The present invention provides the systems for gathering, organizing, and maintaining the necessary clinical and patient data, and providing pharmacists access thereto, through integrated computer software. The clinical data classifies drugs into therapeutic classes, and for each class there is associated therewith known indications, contra-indications, recommended dosages, known adverse reactions, and drug interactions. A clinical database and a patient database are used. In the clinical database, each drug is assigned a unique identification code including a therapeutic cross reference (TXR). The TXR allows access to information associated with the drug'"'"'s adverse reactions, and dosage recommendations, and also to disease indications and contra-indications via a link to the ICD-9s (International Classification of Diseases) associated with the diseases. The patient data includes patient diagnosis profiles and allergy profiles.

Claims

1. One or more computer-readable media having computer-usable instructions embodied thereon for performing a method of clinician disease management, the method comprising:

creating a current drug therapy plan for a patient using a clinical database;

evaluating the current drug therapy plan based on a relationship between the current drug therapy plan and at least one of one or more medical conditions associated with the patient and one or more existing disease states associated with the patient;

assessing the current drug therapy plan based at least in part on the evaluation to determine whether an intervention is necessary to correct the current drug therapy plan; and

constructing an optimization plan to optimize the current drug therapy plan,

wherein the current drug therapy plan is evaluated with one or more clinical queries including at least one of;

(i) a patient-based query configured to, upon receipt of an identification of the patient, present one or more possible drug treatments for a diagnosis of the patient and to provide one or more clinical alerts where the diagnosis of the patient conflicts with one or more co-existing conditions,

(ii) a disease-based query configured to, upon receipt of an identification of a disease, present one or more possible drug treatments for a diagnosis,

(iii) a drug-based query configured to, upon receipt of an identification of a drug, present a set of prescribing information associated with the drug,

(iv) a drug-class-based query configured to, upon receipt of an identification of a drug class, present a set of comparison information associated with one or more drugs in the drug class, and

(v) an adverse-reaction-based query configured to, upon receipt of an identification of an adverse reaction, present a set of reaction information associated with one or more therapeutic classes of drugs.

2. The computer-readable media of claim 1, wherein creating a current drug therapy plan for a patient using a clinical database comprises:

receiving a selection of the patient from a clinician;

presenting a set of historical drug therapy information associated with the patient;

receiving a selection of a drug from the set of historical drug therapy information;

associating a patient diagnosis with the drug;

automatically calculating dispensing information for the drug based on a set of administration instructions, a last fill date, a dispensed data, and a remaining quantity;

automatically calculating patient compliance; and

generating a medication planner associated with the patient.

3. The computer-readable media of claim 1, wherein creating a current drug therapy plan for a patient using a clinical database comprises:

receiving a selection of the patient from a clinician, the patient not already existing in the clinical database;

receiving an identification of a drug in the current drug therapy plan associated with the patient;

retrieving a set of information associated with the drug using the clinical database;

associating a patient diagnosis with the drug;

receiving a set of prescribed dose and frequency information;

receiving a last fill date, a dispensed date, and a remaining quantity;

automatically calculating patient compliance; and

generating a medication planner associated with the patient.

4. The computer-readable media of claim 1, wherein evaluating the current drug therapy plan comprises:

retrieving a set of clinical data associated with a drug in the current drug therapy plan from the clinical database;

checking the drug against one or more allergy conditions associated with the patient and flagging any detected cross-allergies;

checking the drug'"'"'s contra-indications against the patient'"'"'s disease states and flagging any detected contra-indications;

checking the dose specified for the drug against the recommended dose and flagging any dosage outside the recommended range;

comparing the drug against other drugs in the current drug therapy plan to determine whether the drug is a therapeutic duplication;

checking a diagnostic profile for the patient for untreated conditions; and

analyzing the current drug therapy plan to determine if there are any drug interactions between two or more drugs.

5. The computer-readable media of claim 1, wherein assessing the current drug therapy plan comprises:

presenting to a clinician one or more categories of assessment information,

wherein each category includes a problem description, an intervention documentation, a recommendation, a response to documentation, and an action date.

6. The computer-readable media of claim 5, wherein the one or more categories of assessment information include at least one of:

(i) untreated medical condition;

(ii) drugs without medical indication;

(iii) dosage, route, frequency and therapy duration;

(iv) therapeutic duplication;

(v) drug-disease contra-indications;

(vi) drug interactions;

(vii) drug allergies/intolerance;

(viii) adverse drug reactions;

(ix) medication safety efficacy issues;

(x) patient compliance;

(xi) patient knowledge/education needs; and

(xii) social/financial considerations.

7. The computer-readable media of claim 1, wherein constructing an optimization plan to optimize the current drug therapy plan comprises:

receiving a selection of a disease state associated with the patient;

receiving a selection of one or more monitoring parameters;

receiving a statement of the patient'"'"'s health care needs;

receiving a selection setting pharmaceutical goals and recommended optimal therapy for the patient;

monitoring the outcomes of the optimized drug therapy plan; and

presenting the optimized drug therapy plan.

8. The computer-readable media of claim 7, wherein the one or more monitoring parameters include at least one of a symptom, a disease issue, a measurement, and an adherence rating.

9. The computer-readable media of claim 8, wherein construction of the optimization plan is facilitated using at least one of a care plan template, a care plan protocol, a communications library, and an online knowledge database.

10. One or more computer-readable media having computer-usable instructions embodied thereon for performing a method of clinician disease management, the method comprising:

creating a current drug therapy plan for a patient using a clinical database;

evaluating the current drug therapy plan based on a relationship between the current drug therapy plan and at least one of one or more medical conditions associated with the patient and one or more existing disease states associated with the patient using one or more clinical queries;

assessing the current drug therapy plan based at least in part on the evaluation and determining that an intervention is necessary to correct the current drug therapy plan; and

constructing a optimization plan to optimize the current drug therapy plan,

wherein the intervention is documented in the clinical database, and

wherein the intervention includes at least one of;

(i) a patient educational intervention for educating the patient about the patient'"'"'s medical condition and the current drug therapy plan, and

(ii) a patient compliance intervention for assessing the patient'"'"'s compliance with the current drug therapy plan and recommending actions to cure noncompliance.

11. The computer-readable media of claim 10, wherein creating a current drug therapy plan for a patient using a clinical database comprises:

receiving a selection of the patient from a clinician;

presenting a set of historical drug therapy information associated with the patient;

receiving a selection of a drug from the set of historical drug therapy information;

associating a patient diagnosis with a drug;

automatically calculating dispensing information for the drug based on a set of administration instructions, a last fill date, a dispensed data, and a remaining quantity;

automatically calculating patient compliance based on the remaining quantity; and

generating a medication planner associated with the patient.

12. The computer-readable media of claim 10, wherein creating a current drug therapy plan for a patient using a clinical database comprises:

receiving a selection of the patient from a clinician, the patient not already existing in the clinical database;

receiving an identification of a drug in the current drug therapy plan associated with the patient;

retrieving a set of information associated with the drug using the clinical database;

associating a patient diagnosis with the drug;

receiving a set of prescribed dose and frequency information;

receiving a last fill date, a dispensed date, and a remaining quantity;

automatically calculating patient compliance; and

generating a medication planner associated with the patient.

13. The computer-readable media of claim 11, wherein evaluating the current drug therapy plan comprises:

retrieving a set of clinical data associated with a drug in the current drug therapy plan from the clinical database;

checking the drug against one or more allergy conditions associated with the patient and flagging any detected cross-allergies;

checking the drug'"'"'s contra-indications against the patient'"'"'s disease states and flagging any detected contra-indications;

checking the dose specified for the drug against the recommended dose and flagging any dosage outside the recommended range;

comparing the drug against other drugs in the current drug therapy plan to determine whether the drug is a therapeutic duplication;

checking a diagnostic profile for the patient for untreated conditions; and

analyzing the current drug therapy plan to determine if there are any drug interactions between two or more drugs.

14. The computer-readable media of claim 13, wherein assessing the current drug therapy plan comprises:

presenting to a clinician one or more categories of assessment information,

wherein each category includes a problem description, an intervention documentation, a recommendation, a response to documentation, and an action date.

15. The computer-readable media of claim 14, wherein the one or more categories of assessment information include at least one of:

(i) untreated medical condition;

(ii) drugs without medical indication;

(iii) dosage, route, frequency and therapy duration;

(iv) therapeutic duplication;

(v) drug-disease contra-indications;

(vi) drug interactions;

(vii) drug allergies/intolerance;

(viii) adverse drug reactions;

(ix) medication safety efficacy issues;

(x) patient compliance;

(xi) patient knowledge/education needs; and

(xii) social/financial considerations.

16. The computer-readable media of claim 15, wherein constructing an optimization plan to optimize the current drug therapy plan comprises:

receiving a selection of a disease state associated with the patient;

receiving a selection of one or more monitoring parameters;

receiving a statement of the patient'"'"'s health care needs;

receiving a selection setting pharmaceutical goals and recommended optimal therapy for the patient;

monitoring the outcomes of the optimized drug therapy plan; and

presenting the optimized drug therapy plan.

17. The computer-readable media of claim 16, wherein the one or more monitoring parameters include at least one of a symptom, a disease issue, a measurement, and an adherence rating.

18. The computer-readable media of claim 17, wherein construction of the optimization plan is facilitated using at least one of a care plan template, a care plan protocol, a communications library, and an online knowledge database.

19. One or more computer-readable media having computer-usable instructions embodied thereon for performing a method of managing patient compliance and intervention, the method comprising:

receiving an indication from a clinician that a patient may not be complying with a current drug therapy plan;

presenting the clinician with one or more major problem areas, each problem area outlining one or more possibilities for non-compliance;

receiving a selection from the clinician of at least one of the one or more possibilities for non-compliance that best describes the reasons for the patient'"'"'s non-compliance;

presenting the clinician with one or more major action areas, each action area outlining one or more possible actions;

receiving a selection from the clinician of at least one of the one or more possible actions that represent at least one intervention likely to enhance the patient'"'"'s compliance; and

storing a set of compliance information and a set of intervention information on a clinical database in association with the patient and the patient'"'"'s current drug therapy plan.

20. The computer-readable media of claim 19, wherein the set of compliance information and the set of intervention information is stored by prompting the clinician with one or more forms and storing the forms with information added by the clinician.