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. 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 pharmaceutical prescription to the wellness category, and routing a pharmaceutical prescription to a therapeutic pharmacy within the network of therapeutic pharmacies based on the wellness category; and
f. filling and dispensing the pharmaceutical prescription to the patient responsive to said classifying and routing.
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Abstract
A system and method of distributing pharmaceutical prescriptions within a network of pharmacies based on the 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
25 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. 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 pharmaceutical prescription to the wellness category, and routing a pharmaceutical prescription to a therapeutic pharmacy within the network of therapeutic pharmacies based on the wellness category; and f. filling and dispensing the pharmaceutical prescription to the patient responsive to said classifying and routing. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 20, 21, 22, 23)
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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 pharmacy computer systems within a network of therapeutic pharmacies, wherein the individual pharmacies are configured to receive prescriptions electronically for one or more diseases using the pharmacy computer systems, wherein the diseases are selected from the group comprising neurology/psychiatry, pulmonary, cardiovascular, diabetes, gastroenterology, oncology/hematology, rare diseases, pediatrics and combinations thereof b. a plurality of pharmacy station computers located 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 comprising neurology/psychiatry, pulmonary, cardiovascular, diabetes, gastroenterology, oncology/hematology, rare diseases and combinations thereof c. an information warehouse database containing patient prescription claims and medical records; d. a patient stratification/classification system in electronic communication with the information warehouse database, wherein the stratification/classification system electronically retrieves prescription claims and medical records from the information warehouse database, and classifying a patient into a disease state; e. a clinical score system in electronic communication with the information warehouse database and the patient stratification/classification system electronically retrieves information from the information warehouse database and assigning a score to a patient based upon a degree of wellness; f. a patient on-line authoritative record system in electronic communication with the patient stratification/classification system and the clinical score system, wherein the patient on-line authoritative record system electronically receives the stratification and the score information; g. a rules-based system comprising patient health insurance and formulary information, wherein the rules-based system is in electronic communication with and provides insurance coverage information to the patient on-line authoritative record system; h. a prescription receiving system electronically receiving the prescription and refill orders for the prescription, requesting the patient stratification, the clinical score and the 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 system and routing the pharmaceutical prescription, based on the combined prescription stratification, score information and the coverage rules to a at least one of the plurality of individual therapeutic pharmacy computer systems within the network for filling and dispensing prescriptive medication. - View Dependent Claims (18, 19)
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24. 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. 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. correlating the disease category with a plurality of pharmacies established to fill prescriptions for the disease category; f. classifying the pharmaceutical prescription to the wellness category, and routing a pharmaceutical prescription to a therapeutic pharmacy within the network of therapeutic pharmacies based on the wellness category and the disease category; and g. filling and dispensing the pharmaceutical prescription to the patient responsive to said classifying and routing.
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25. 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. 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 disease category; e. correlating the disease category with a plurality of pharmacies established to fill prescriptions for the disease category; f. classifying the pharmaceutical prescription to the disease category, and routing a pharmaceutical prescription to a therapeutic pharmacy within the network of therapeutic pharmacies based on the disease category; and g. filling and dispensing the pharmaceutical prescription to the patient responsive to said classifying and routing.
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Specification