SYSTEM AND METHOD FOR CLINICAL STRATEGY FOR THERAPEUTIC PHARMACIES
First Claim
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1. A method comprising:
- receiving a pharmaceutical prescription associated with a patient;
accessing, on a processor, a medical record and a plurality of prescription claims for the patient;
analyzing, on the processor, the medical record and the plurality of prescription claims to stratify the patient into a disease category;
generating, on the processor, a patient clinical score based on the plurality of prescription claims, the medical record, formulary information, and patient health insurance information; and
routing, on the processor, the pharmaceutical prescription to a therapeutic pharmacy among a network of therapeutic pharmacies based on the disease category and the patient clinical score, each therapeutic pharmacy within the network of therapeutic pharmacies being established in accordance with a particular disease category.
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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
20 Claims
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1. A method comprising:
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receiving a pharmaceutical prescription associated with a patient; accessing, on a processor, a medical record and a plurality of prescription claims for the patient; analyzing, on the processor, the medical record and the plurality of prescription claims to stratify the patient into a disease category; generating, on the processor, a patient clinical score based on the plurality of prescription claims, the medical record, formulary information, and patient health insurance information; and routing, on the processor, the pharmaceutical prescription to a therapeutic pharmacy among a network of therapeutic pharmacies based on the disease category and the patient clinical score, each therapeutic pharmacy within the network of therapeutic pharmacies being established in accordance with a particular disease category. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 17, 18, 19)
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- 14. The method of claim 14, wherein the medical record and the plurality of prescription claims are further analyzed to stratify the patient into a wellness category, and wherein the routing of the pharmaceutical prescription is based on the disease category, the wellness category, and the patient clinical score.
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20. A non-transitory machine-readable medium comprising instructions, which when executed by one or more processors, cause the one or more processors to perform the following operations:
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receive a pharmaceutical prescription associated with a patient; access a medical record and a plurality of prescription claims for the patient; analyze the medical record and the plurality of prescription claims to stratify the patient into a disease category; generate a patient clinical score based on the plurality of prescription claims, the medical record, formulary information, and patient health insurance information; and route the pharmaceutical prescription to a therapeutic pharmacy among a network of therapeutic pharmacies based on the disease category and the patient clinical score, each therapeutic pharmacy within the network of therapeutic pharmacies being established in accordance with a particular disease category.
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Specification