SYSTEMS AND METHODS FOR PROCESSING ELECTRONICALLY TRANSMITTED HEALTHCARE RELATED TRANSACTIONS

• US 20090327363A1
• Filed: 04/06/2009
• Published: 12/31/2009
• Est. Priority Date: 06/30/2008
• Status: Abandoned Application

• Current Assignee: McKesson Corp.
• Original Assignee: McKesson Corp.
• Inventors: Cullen, Peter, Kaye, Elizabeth S.
• Application Number:
  US12/418,829
• Publication Number:
  US 20090327363A1
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients

Abstract

Systems and methods for the processing, modifying, and/or performance of a clinical, administrative and/or financial “value-add” service to an electronic healthcare related transaction from a healthcare provider to a third party such as a pharmacy. A prescription switch provider receives an incoming transaction from a healthcare provider system. The switch provider may then parse the transaction to review or modify data contained in the transaction and/or perform a value-add service or function based on the data contained in the transaction. Alternatively, the switch provider may copy the transaction for parallel processing. The transaction may be forwarded to a third party system, and a response message from the switch provider or the third party may be transmitted to the healthcare provider system pertaining to the modified transaction data and/or value-add service performed.

Claims

1. A computer implemented method comprising:

receiving, from a healthcare provider system, an electronic prescription transaction;

performing, by a switch provider processor, a value-add service to the electronic prescription transaction, wherein the value-add service creates a modified electronic prescription transaction; and

forwarding the modified electronic prescription transaction to a pharmacy system specified in the electronic prescription transaction.

2. The method of claim 1, further comprising:

prior to creating the modified electronic prescription transaction, creating a copy of the electronic prescription transaction; and

storing the copy of the electronic prescription transaction.

3. The method of claim 1, further comprising:

transmitting a response message to the healthcare provider system, wherein the response message is associated with the modified healthcare related transaction.

4. The method of claim 3, further comprising:

prior to forwarding the modified electronic prescription transaction to the pharmacy system, receiving an approval message from the healthcare provider system.

5. The method of claim 1, further comprising storing the modified electronic prescription transaction prior to forwarding the modified electronic prescription transaction to the pharmacy system.

6. The method of claim 1, wherein creating a modified electronic prescription transaction includes correcting an error detected in the electronic prescription transaction.

7. The method of claim 1, wherein creating a modified electronic prescription transaction includes amending the data contained in the electronic prescription transaction with routing information associated with the pharmacy system, wherein the pharmacy system is a preferred pharmacy system.

8. The method of claim 1, wherein creating a modified electronic prescription transaction includes amending the data contained in the electronic prescription transaction to include additional information pertaining to a prescribed drug identified in the electronic prescription transaction.

9. A system comprising:

a memory device; and

a processor in communication with the memory device, wherein the processor is configured to execute computer executable instructions to;

receive, from a healthcare provider system, an electronic prescription transaction;

perform a value-add service to the electronic prescription transaction, wherein the value-add service creates a modified electronic prescription transaction; and

forward the modified electronic prescription transaction to a pharmacy system specified in the electronic prescription transaction.

10. The system of claim 9, wherein the processor is further configured to execute instructions to:

create a copy of the electronic prescription transaction prior to processing; and

store the copy of the electronic prescription transaction in the memory device.

11. The system of claim 9, wherein the processor is further configured to execute instructions to:

transmit a response message to the healthcare provider system, wherein the response message is associated with the modified healthcare related transaction.

12. The system of claim 11, wherein the processor is further configured to execute instructions to:

receive an approval message from the healthcare provider system prior to forwarding the modified electronic prescription transaction to the pharmacy system.

13. The system of claim 9, wherein the processor is further configured to execute instructions to:

store the modified electronic prescription transaction prior to forwarding the modified electronic prescription transaction to the pharmacy system.

14. The system of claim 9, wherein the computer executable instructions to create a modified electronic prescription transaction include correcting an error detected in the electronic prescription transaction.

15. The system of claim 9, wherein the computer executable instructions to create a modified electronic prescription transaction include amending the data contained in the electronic prescription transaction with routing information associated with the pharmacy system, wherein the pharmacy system is a preferred pharmacy system.

16. The system of claim 9, wherein the computer executable instructions to create a modified electronic prescription transaction include amending the data contained in the electronic prescription transaction to include additional information pertaining to a prescribed drug identified in the electronic prescription transaction.

17. A system for comprising:

a memory device; and

a processor in communication with the memory device, wherein the processor is configured to execute computer executable instructions to;

receive, from a pharmacy system, a response to an electronic prescription transaction previously submitted by a healthcare provider system;

perform a value-add service to the response to the electronic prescription transaction, wherein the value-add service creates a modified response; and

forward the modified response to the healthcare provider system specified in the electronic prescription transaction.

18. The system of claim 17, wherein the processor is further configured to execute instructions to:

store the response in the memory device prior to creating a modified response.

19. The system of claim 17, wherein the computer executable instructions to create a modified response include amending the response to include additional information.

20. The system of claim 19, wherein the additional information is a disease management enrollment message.