Modifying a Patient Adherence Score

• US 20110010328A1
• Filed: 07/10/2009
• Published: 01/13/2011
• Est. Priority Date: 07/10/2009
• Status: Active Grant

• Current Assignee: Medimpact Healthcare Systems Incorporated
• Original Assignee: Medimpact Healthcare Systems Incorporated
• Inventors: Yamaga, Cynthia Chiyemi, Brunetti, Louis Leo, Patel, Bimal Vinod
• Granted Patent: US 8,417,660 B2
• Time in Patent Office: Days
• US Class Current: 706/52
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 50/50 for simulation or modelling of medical disorders
• CPC Class Codes: G16H 50/70 for mining of medical data, e.g. analysing previous cases of other patients
• CPC Class Codes: G16H 70/40 relating to drugs, e.g. their side effects or intended usage
• CPC Class Codes: G16H 70/60 relating to pathologies

Abstract

Systems, methods and devices for modifying a patient adherence score which include, in one implementation, obtaining a patient profile in a patient population, the patient profile including multiple patient attributes and each patient attribute including a value; obtaining an adherence score for the patient profile for predicting patient adherence based on one or more of the multiple patient attributes wherein the adherence score indicates a likelihood of adherence of the patient to the prescribed treatment; and applying a modifier associated with an application to modify the adherence score obtained for the patient profile into a modified score for the application.

Claims

1. A computer-implemented method for modifying a patient adherence score, comprising:

obtaining from one or more computer-readable storage devices a first patient profile in a patient population, the first patient profile including multiple patient attributes and each patient attribute including a value;

obtaining an adherence score for the first patient profile for predicting patient adherence based on one or more of the multiple patient attributes wherein the adherence score indicates a likelihood of adherence of the first patient to a prescribed treatment; and

applying a first modifier associated with a first application to modify the adherence score obtained for the first patient profile into a modified score for the first application.

2. The computer-implemented method of claim 1,

wherein the multiple patient attributes include a first patient attribute having a first value;

and

further comprising determining the first modifier for the first application by applying to the first value a first weight that corresponds with the first patient attribute.

3. The computer-implemented method of claim 2,

wherein the multiple patient attributes also include a second patient attribute having a second value;

wherein determining the first modifier for the first application further comprises applying a second weight that corresponds to the second patient attribute to the second value.

4. The computer-implemented method of claim 2,

wherein the multiple patient attributes also include a second patient attribute having a second value;

and

wherein the first weight is a function of the second value.

5. The computer-implemented method of claim 1, wherein obtaining an adherence score for the first patient profile for predicting patient adherence based on one or more of the multiple patient attributes wherein the adherence score indicates a likelihood of adherence of the first patient to a prescribed treatment further comprises:

obtaining from one or more computer-readable storage devices a set of model profiles related to patient adherence to a prescribed treatment and adherence scores associated with the model profiles, wherein each model profile includes one or more model attributes, each model attribute in each profile having a model value, and wherein a respective adherence score associated with each model profile indicates a likelihood of adherence of a representative patient having the model values of the respective model attributes to the prescribed treatment; and

assigning an adherence score to the first patient profile by matching the values for the patient attributes in the first patient profile to the values of the model attributes in one of the model profiles in the set of model profiles.

6. The computer-implemented method of claim 1, further comprising applying a second modifier for a second application to further modify the modified score.

7. The computer-implement method of claim 1, wherein the modifier associated with the first application comprises a modifier associated with one or more of:

a specific drug, a specific disease, a specific drug plan, using a specific drug, risk for a particular disease, cost for non-adherence, and response to intervention.

8. The computer-implement method of claim 1, wherein the modifier associated with the first application comprises a modifier associated with clinical research.

9. The computer-implemented method of claim 1, wherein the patient attributes comprise one or more of:

characteristics of a patient'"'"'s insurance plan, including size of payer of a patient'"'"'s insurance plan, a type of payer of a patient'"'"'s insurance plan, the drug benefit afforded by a patient'"'"'s insurance plan, formulary design of a patient'"'"'s drug benefit, prior authorization rules, step therapy rules, cost of co-payment, cost of drug, availability of generics, availability of therapeutic alternatives;

demographics, including gender, ethnicity, geographic location, socioeconomic status, education level;

patient-related information, including drug abuse, patient beliefs, social support, psychosocial factors;

disease information, including disease, disease severity, co-morbidities, time with disease;

drug-related information, including drug category, number of concurrent drugs, complexity of prescription;

pharmacy information, including pharmacy type, pharmacy location, pharmacy geographic proximity to patient, pharmacy service; and

physician information, including physician specialty, physician geographic proximity to patient, physician practice site.

10. The computer-implemented method of claim 1, further comprising:

determining the first modifier using a modifier algorithm for the first application;

obtaining an adherence score for each of additional patient profiles in the patient population;

applying the modifier algorithm for the first application to determine modifiers for each of the additional patient profiles in the patient population; and

applying each of the modifiers for each of the additional patient profiles to modify each of the respective adherence scores obtained for each of the additional patient profiles in the patient population into modified scores for the first application.

11. The computer-implemented method of claim 10, further comprising:

grouping the first and additional patient profiles; and

comparing the groups based on the modified scores of the first and additional patient profiles.

12. The computer-implemented method of claim 10, further comprising generating a stratification index of the first and additional patient profiles of the patient population based on the modified scores for the first application.

13. The computer-implemented method of claim 12, further comprising

grouping the first and additional patient profiles into two or more groups based on a rank in the stratification index;

obtaining an intervention modifier for each of the first and additional patient profiles in one of the groups;

modifying the modified scores for each of the first and additional patient profiles in the one of the groups into an intervention score using the intervention modifiers for each of the patient profiles in the one of the groups;

sub-grouping the patient profiles in the one of the groups into sub-groups based on the intervention response score; and

implementing a intervention protocol for the sub-groups based on the intervention score.

14. A computer storage medium encoded with a computer program, the program comprising instructions that when executed by a data processing apparatus cause the data processing apparatus to perform operations comprising:

obtaining from one or more computer-readable storage devices a first patient profile in a patient population, the first patient profile including multiple patient attributes and each patient attribute including a value;

obtaining an adherence score for the first patient profile for predicting patient adherence based on one or more of the multiple patient attributes wherein the adherence score indicates a likelihood of adherence of the first patient to a prescribed treatment; and

applying a first modifier associated with a first application to modify the adherence score obtained for the first patient profile into a modified score for the first application.

15. The computer storage medium of claim 14,

wherein the multiple patient attributes include a first patient attribute having a first value;

and

wherein the program further comprises instructions that when executed by the data processing apparatus cause the data processing apparatus to perform operations comprising determining the first modifier for the first application by applying to the first value a first weight that corresponds with the first patient attribute.

16. The computer storage medium of claim 15,

wherein the multiple patient attributes also include a second patient attribute having a second value;

and

wherein determining the first modifier for the first application further comprises applying a second weight that corresponds to the second patient attribute to the second value.

17. The computer storage medium of claim 15,

wherein the multiple patient attributes also include a second patient attribute having a second value;

and

wherein the first weight is a function of the second value.

18. The computer storage medium of claim 14, wherein obtaining an adherence score for the first patient profile from an adherence model for predicting patient adherence based on one or more of the multiple patient attributes wherein the adherence score indicates a likelihood of adherence of the first patient to the prescribed treatment further comprises:

obtaining from one or more computer-readable storage devices a set of model profiles related to patient adherence to a prescribed treatment and adherence scores associated with the model profiles, wherein each model profile includes one or more model attributes, each model attribute in each profile having a model value, and wherein a respective adherence score associated with each model profile indicates a likelihood of adherence of a representative patient having the model values of the respective model attributes to the prescribed treatment; and

assigning an adherence score to the first patient profile by matching the values for the patient attributes in the first patient profile to the values of the model attributes in one of the model profiles in the set of model profiles.

19. The computer storage medium of claim 14, wherein the program further comprises instructions that when executed by the data processing apparatus cause the data processing apparatus to perform operations comprising:

applying a second modifier for a second application to further modify the modified score.

20. The computer storage medium of claim 14, wherein the modifier associated with a first application comprises a modifier associated with one or more of:

a specific drug, a specific disease, a specific drug plan, clinical research using a specific drug, risk for a particular disease, cost for non-adherence, and response to intervention.

21. The computer storage medium of claim 14, wherein the modifier associated with a first application comprises a modifier associated with clinical research.

22. The computer storage medium of claim 14, wherein the patient attributes comprise one or more of

characteristics of the patient'"'"'s insurance plan, including size of payer of a patient'"'"'s insurance plan, a type of payer of a patient'"'"'s insurance plan, the drug benefit afforded by a patient'"'"'s insurance plan, formulary design of a patient'"'"'s drug benefit, prior authorization rules, step therapy rules, cost of co-payment, cost of drug, availability of generics, availability of therapeutic alternatives;

demographics, including gender, ethnicity, geographic location, socioeconomic status, education level;

patient-related information, including drug abuse, patient beliefs, social support, psychosocial factors;

disease information, including disease, disease severity, co-morbidities, time with disease;

drug-related information, including drug category, number of concurrent drugs, complexity of prescription;

pharmacy information, including pharmacy type, pharmacy location, pharmacy geographic proximity to patient, pharmacy service; and

physician information, including physician specialty, physician geographic proximity to patient, physician practice site.

23. The computer storage medium of claim 14, wherein the program further comprises instructions that when executed by the data processing apparatus cause the data processing apparatus to perform operations comprising:

determining the first modifier using a modifier algorithm for the first application;

obtaining an adherence score for each of additional patient profiles in the patient population;

applying the modifier algorithm for the first application to determine modifiers for each of the additional patient profiles in the patient population; and

applying each of the modifiers for each of the additional patient profiles to modify each of the respective adherence scores obtained for each of the additional patient profiles in the patient population into modified scores for the first application.

24. The computer storage medium of claim 23, wherein the program further comprises instructions that when executed by the data processing apparatus cause the data processing apparatus to perform operations comprising:

grouping the first and additional patient profiles; and

comparing the groups based on the modified scores of the first and additional patient profiles.

25. The computer storage medium of claim 23, wherein the program further comprises instructions that when executed by the data processing apparatus cause the data processing apparatus to perform operations further comprising

generating a stratification index of the first and additional patient profiles of the patient population based on the modified scores for the first application.

26. The computer storage medium of claim 25, wherein the program further comprises instructions that when executed by the data processing apparatus cause the data processing apparatus to perform operations further comprising:

grouping the first and additional patient profiles into two or more groups based on a rank in the stratification index;

obtaining an intervention modifier for each of the patient profiles in one of the groups;

modifying the modified scores for each of the patient profiles in the one of the groups into an intervention score using the intervention modifiers for each of the patient profiles in the one of the groups; and

sub-grouping the patient profiles in the one of the groups into sub-groups based on the intervention response score; and

implementing a intervention protocol for the sub-groups based on the intervention score.

27. A system for generating information related to patient adherence to a prescription comprising:

one or more computer-readable storage devices;

a processing module in communication with the one or more computer-readable storage devices configured to obtain from the one or more computer-readable storage devices a first patient profile in a patient population, the first patient profile including multiple patient attributes and each patient attribute including a value;

the processing module including a mechanism to obtain an adherence score for the first patient profile for predicting patient adherence based on one or more of the multiple patient attributes wherein the adherence score indicates a likelihood of adherence of the first patient to a prescribed treatment; and

the processing module including a to apply a first modifier associated with a first application to modify the adherence score obtained for the first patient profile into a modified score for the first application; and

an user-interfacing module configured to interface with an user and to display results from the processing module.

28. The system of claim 27,

wherein the one or more computer-readable storage devices stores one or more modifier algorithms;

wherein the user-interfacing module is configured to receive a selection of a first modifier algorithm from the one or more modifier algorithms; and

wherein the processing module includes a mechanism to obtain the selected first modifier algorithm from the one or more computer-readable storage devices and to determine the first modifier using the first modifier algorithm.

29. The system of claim 27,

wherein the multiple patient attributes include a first patient attribute having a first value;

and

wherein the processing module is further configured to determine the first modifier for the first application by applying to the first value a first weight that corresponds with the first patient attribute.

30. The system of claim 27,

wherein the multiple patient attributes also include a second patient attribute having a second value;

and

wherein to determine the first modifier for the first application further comprises a mechanism to apply a second weight that corresponds to the second patient attribute to the second value.

31. The system of claim 27,

wherein the multiple patient attributes also include a second patient attribute having a second value;

and

wherein the first weight is a function of the second value.

32. The system of claim 27, wherein the processing module in communication with the one or more computer-readable storage devices to obtain from the one or more computer-readable storage devices a first patient profile in a patient population, the first patient profile including multiple patient attributes and each patient attribute including a value is further configured to:

obtain from the one or more computer-readable storage devices a set of model profiles related to patient adherence to a prescribed treatment and adherence scores associated with the model profiles, wherein each model profile includes one or more model attributes, each model attribute in each profile having a model value, and wherein a respective adherence score associated with each model profile indicates a likelihood of adherence of a representative patient having the model values of the respective model attributes to the prescribed treatment; and

assign an adherence score to the first patient profile by matching the values for the patient attributes in the first patient profile to the values of the model attributes in one of the model profiles in the set of model profiles.

33. The computer-implemented method of claim 27, wherein the processing module is further configured to apply a second modifier for a second application to further modify the modified score

34. The system of claim 27, wherein the processing module is further configured to:

determine the first modifier using a modifier algorithm for the first application;

obtain an adherence score for each of additional patient profiles in the patient population;

apply the modifier algorithm for the first application to determine modifiers for each of the additional patient profiles in the patient population; and

apply each of the additional modifiers to modify each of the respective adherence scores obtained for each of the additional patient profiles in the patient population into modified scores for the first application.

35. The system of claim 34, wherein the processing module is further configured to:

group the patient the first and additional patient profiles; and

compare the groups based on the modified scores of the first and additional patient profiles.

36. The system of claim 34, wherein the processing module is further configured to generate a stratification index of the first and additional patient profiles of the patient population based on the modified scores for the first application.

37. The system of claim 35, wherein the processing module is further configured to

group the first and additional patient profiles into two or more groups based on a rank in the stratification index;

obtain an intervention modifier for each of the patient profiles in one of the groups;

modify the modified scores for each of the patient profiles in the one of the groups into an intervention score using the intervention modifiers for each of the patient profiles in the one of the groups; and

sub-group the patient profiles in the one of the groups into sub-groups based on the intervention response score; and

implement a intervention protocol for the sub-groups based on the intervention score.

38. A computer-implemented method for determining patient adherence to a prescribed treatment, comprising:

obtaining from one or more computer-readable storage devices a set of model profiles related to patient adherence to a prescribed treatment and adherence scores associated with each of the model profiles, wherein each model profile includes one or more model attributes, each attribute in each profile having a model value, and wherein the adherence score associated with each model profile indicates a likelihood of adherence of a representative patient having the model values of the respective model profile to a prescribed treatment;

determining a modifier for a first application for each of the model profiles using an additional attribute different from the attributes in the model profile, the additional attribute having a value; and

modifying the adherence scores associated with each of the model profiles into a modified scores by applying a modifier associated with the first application to determine the adherence score for each of the model profiles based on the value of each of the one or more additional attributes.

39. The computer-implemented method of claim 38, further comprising indexing the model profiles according to the modified scores.

40. The computer-implemented method of claim 38, wherein modifying the adherence score associated with each of the model profiles further comprises applying a second modifier associated with a second application to modify the modified score into a combination score for the first and second application.

41. A computer storage medium encoded with a computer program, the program comprising instructions that when executed by data processing apparatus cause the data processing apparatus to perform operations comprising:

obtaining from one or more computer-readable storage devices a set of model profiles related to patient adherence to a prescribed treatment and adherence scores associated with each of the model profiles, wherein each model profile includes one or more model attributes, each attribute in each profile having a model value, and wherein the adherence score associated with each model profile indicates a likelihood of adherence of a representative patient having the model values of the respective model profile to a prescribed treatment;

determining a modifier for a first application for each of the model profiles using an additional attribute different from the attributes in the model profile, the additional attribute having a value; and

modifying the adherence scores associated with each of the model profiles into a modified scores by applying a modifier associated with the first application to determine the adherence score for each of the model profiles based on the value of each of the one or more additional attributes.

42. The computer storage medium of claim 41, the program comprising instructions that when executed by data processing apparatus cause the data processing apparatus to perform operations comprising indexing the model profiles according to the modified scores

43. The computer storage medium of claim 41, wherein modifying the adherence score associated with each of the model profiles further comprises applying a second modifier associated with a second application to modify the modified score into a combination score for the first and second application.

44. A system comprising:

one or more computer-readable storage devices;

a processing module configured to

obtain from one or more computer-readable storage devices a set of model profiles related to patient adherence to a prescribed treatment and adherence scores associated with each of the model profiles, wherein each model profile includes one or more model attributes, each attribute in each profile having a model value, and wherein the adherence score associated with each model profile indicates a likelihood of adherence of a representative patient having the model values of the respective model profile to a prescribed treatment;

determine a modifier for a first application for each of the model profiles using an additional attribute different from the attributes in the model profile, the additional attribute having a value; and

modify the adherence scores associated with each of the model profiles into a modified scores by applying a modifier associated with the first application to determine the adherence score for each of the model profiles based on the value of each of the one or more additional attributes; and

an user-interfacing module configured to interface with an user and to display results from the analysis module.

45. The system of claim 44, wherein the processing module is further configured to index the model profiles according to the modified scores

46. The system of claim 44, wherein the processing module configured to modify the adherence score associated with each of the model profiles is further configured to apply a second modifier associated with a second application to modify the modified score into a combination score for the first and second application.