DETECTION AND NOTIFICATION OF PRESCRIPTION NON-ADHERENCE

• US 20170076059A1
• Filed: 03/25/2016
• Published: 03/16/2017
• Est. Priority Date: 09/11/2015
• Status: Abandoned Application

• Current Assignee: Experian Health, Inc. (Experian plc)
• Original Assignee: Experian Health, Inc. (Experian plc)
• Inventors: Morefield, Hans P.
• Application Number:
  US15/081,494
• Publication Number:
  US 20170076059A1
• Time in Patent Office: Days
• US Class Current: 1/1
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 70/20 relating to practices or guidelines
• CPC Class Codes: G16H 70/40 relating to drugs, e.g. their side effects or intended usage

Abstract

Improving prescription adherence for discharged patients is of growing importance for healthcare providers, accountable care organizations, and insurance providers. Patients have several reasons for deviating from a course of treatment or falsifying data to indicate that they are following a course of treatment. By removing the patient from the reporting chain, the risk of falsified data is reduced, and healthcare providers can intervene and adapt treatments to account for non-adherence to a course of treatment. Existing electronic medical record systems and methods, however, are cumbersome and do not allow for adherence information to be reliably collected and presented to healthcare providers to use in the ongoing or future treatment of a patient.

Claims

1. A method for the improved identification of non-adherence to a prescribed course of medication, comprising:

providing an adherence engine to a healthcare provider for installation on a computer device including a processor and memory storage device including instructions, which when execute by the processor enable the adherence engine to;

receive a continuity of care document (CCD) related to a patient sent from an Electronic Medical Records (EMR) database;

extract prescription information from the CCD;

receive filling information for the patient related to the prescription information from a pharmacy database;

compare the filling information to the prescription information to determine whether the filling information and the prescription information match;

when the filling information and the prescription information do not match;

calculating deviation information to generate a healthcare provider alert from the deviation information;

storing the healthcare provider alert; and

transmitting a message via a communication manager to a device associated with the healthcare provider, wherein the message includes a hyperlink to the healthcare provider alert stored by the adherence engine.

2. The method of claim 1, wherein if the filling information and the prescription information to not initially match based on not naming identical medications:

querying an equivalency database for equivalent compounds to medications indicated in the filling information and the prescription information to determine whether the filling information and the prescription information match but indicate different names for a given medication; and

when it is determined that the filling information and the prescription information indicate different names for the given medication, determining that the filling information matches the prescription information.

3. The method of claim 1, wherein if the filling information and the prescription information to not initially match based on not indicating identical dosages for a medication:

querying a metabolism rate database to determine whether a filled dosage is metabolically equivalent to a prescribed dosage; and

when it is determined that the filled dosage is metabolically equivalent to the prescribed dosage, determining that the filling information matches the prescription information.

4. The method of claim 1, wherein the CCD is received in response to a CCD pull request sent by the adherence engine to the EMR database.

5. The method of claim 4, wherein the CCD pull request is generated in response to receiving the fill information from the pharmacy database as a push from the pharmacy database.

6. The method of claim 1, wherein the filling information is received in response to a filling pull request sent by the adherence engine to the pharmacy database.

7. The method of claim 6, wherein the filling pull request is generated in response to receiving the CCD from the EMR database as a push from the EMR database.

8. The method of claim 1, wherein the filling information is null, indicating that the patient has not filled the prescription.

9. The method of claim 1, wherein prescription information includes a fill-by date and wherein comparing the filling information to the prescription information to determine whether the filling information and the prescription information match includes comparing a date that the filling information was generated to the fill-by date.

10. The method of claim 9, wherein the fill-by date is for a loosely scheduled medication, based on a date of a previous fill for the loosely scheduled medication for the patient, the amount of the loosely scheduled medication previously provided by the pharmacy to the patient, and a historic consumption rate of the loosely scheduled medication.

11. A system for the improved identification of non-adherence to a prescribed course of medication, comprising:

an adherence engine, operable to compare prescription information, indicating the prescribed course of medication, against filling information, indicating medications received by a patient, to determine whether the medications received match the prescribed course of medication, and to generate a healthcare provider alert when it is determined that the medications received do not match the prescribed course of medication, the adherence engine including;

an equivalency database, including listings of equivalent compounds for the medications received by the patient, wherein the listings are used by the adherence engine to compare against the prescription information in addition to the medications indicated by the filling information;

a metabolism rate database, including metabolism rate information for medications received by the patient, wherein the metabolism rates are used by the adherence engine to compare against the prescription information in addition to the medications indicated by the filling information;

a communications manager, operable to transmit a message to an operator to indicate that the healthcare provider alert has been generated; and

a portal server, operable to provide a user interface by which the operator accesses the healthcare provider alert.

12. The system of claim 11, wherein the adherence engine pulls the prescription information from an Electronic Medical Records database in response to receiving the filling information from a pharmacy database.

13. The system of claim 11, wherein the adherence engine pulls the filling information from a pharmacy database in response to receiving the prescription information from an Electronic Medical Records database.

14. The system of claim 11, wherein the prescription information includes a fill-by date after which it is determined that the medications received do not match the prescribed course of medication.

15. The system of claim 11, wherein the user interface enables the operator to browse healthcare provider alerts based on patient, medication, and healthcare professional.

16. A method for the improved identification of non-adherence to a prescribed course of medication, comprising:

generating a continuity of care document (CCD) associated with a patient at the discharge of the patient from a healthcare provider, wherein the continuity of care document includes a human readable component and a coded component, wherein the coded component is automatically generated from content entered into the human readable component;

analyzing the continuity of care document to determine whether the patient was discharged with an ongoing condition;

when it is determined that the patient was discharged with an ongoing condition;

extracting prescription information from the continuity of care document, the prescription information including a date of issue, a medication name, a medication dosage, a medication frequency, and a refill policy for a prescription;

analyzing the prescription information to determine a fill-by date;

querying a pharmacy database for filling information associated with the prescription;

comparing the prescription information with the filling information to determine whether the patient has filled the prescription by the fill-by date; and

when it is determined that the patient has not filled the prescription by the fill-by date, generating a healthcare provider alert, including deviation information, and updating the content of the human readable component of the continuity of care document to include the deviation information.

17. The method of claim 16, wherein updating the content of the human readable component bypasses the automatic generation of content in the coded component.

18. The method of claim 16, wherein the fill-by date is for a loosely scheduled medication and is based on historic fill rates for the loosely scheduled medication.

19. The method of claim 16, wherein the determination of whether the patient has filled the prescription by the fill-by date is used to update a risk assessment score for the patient.

20. The method of claim 16, wherein the healthcare provider alert is transmitted to an entity other than the healthcare provider from which the patient was discharged, wherein the entity is one of:

an insurance provider;

a medication monitor;

or

a second healthcare provider.