Providing patient-specific drug information

• US 5,833,599 A
• Filed: 04/09/1996
• Issued: 11/10/1998
• Est. Priority Date: 12/13/1993
• Status: Expired due to Term

• Current Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Original Assignee: Multum Information Services
• Inventors: Austin, Janet L., McNamara, Timothy J., Aweeka, Francesca T., Schrier, Robert W., Gambertoglio, John G., Heiland, Cheryl D., Schrier, Douglas M.
• Primary Examiner(s): Smith, Ruth S.
• Application Number:
  US08/629,763
• Time in Patent Office: 945 Days
• Field of Search: 128/630, 128/920, 128/923, 395/924, 705/2
• US Class Current: 600/300
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/02 Marketing; Price estimation or determination; Fundraising
• CPC Class Codes: G06Q 40/08 Insurance
• 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 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 70/40 relating to drugs, e.g. their side effects or intended usage

Abstract

Systems and methods for processing data relating to use of a drug by a patient that receive patient information and determine a dosage of the drug on the basis of the patient information. The systems and methods may be operated to provide patient-specific information on drug cost and on comparative costs of alternative drugs, on side effects, on allergies, and on pharmacology, as well as information on use in pregnancy, on use in lactation, on drug interactions, on warnings and contraindications, and supporting references. The systems may also be operated to prepare drug orders and prescriptions.

Claims

1. A system for processing data relating to use of an index drug, comprising:

means operable to receive input identifying an index drug;

a drug database, the drug database being a computer-readable collection of information about a set of drugs, the set including the index drug and a drug chemically distinct from the index drug;

means operable to receive a patient profile of information about a patient, the patient profile including information about the patient'"'"'s age, kidney function, and liver function and about a clinical condition for which the index drug would be used;

means operable to use the drug database and the patient profile to calculate a dosage recommendation for the index drug, the recommended dosage including an amount and a frequency of administration; and

means operable to use the drug database to calculate a cost per a unit time of treatment for the recommended dosage of the index drug, said means being operable to calculate a cost per the unit time of treatment for a recommended dosage of the drug chemically distinct from the index drug.

2. The system of claim 1 further comprising:

means operable to use the drug database to produce a report reporting pharmacology or pharmacokinetics of the index drug.

3. The system of claim 1 further comprising:

means operable to use the drug database to identify an alternative drug to the index drug on the basis of the patient profile, the alternative drug being a drug chemically distinct from the index drug that is identified in the drug database as being used for treating the clinical condition.

4. The system of claim 3 further comprising:

means operable to use the drug database and the patient profile to calculate a dosage recommendation, including an amount and a frequency of administration, for the alternative drug.

5. The system of claim 3, wherein the means for identifying is operable to identify substantially all drugs with United States Food and Drug Administration (FDA) approval for treating the patient'"'"'s condition or substantially all drugs commonly used for treating the patient'"'"'s condition.

6. The system of claim 1 further comprising:

means operable to use the drug database and the patient profile to order the index drug for the patient.

7. The system of claim 1 further comprising:

means responsive to the received identity of the index drug for reporting citations to published references relating to the index drug and pertaining to the dosage recommendation calculated by the system.

8. The system of claim 1 further comprising:

means operable to receive input identifying a set of concomitant drugs; and

means operable to use the drug database to produce a report reporting possible drug interactions between the concomitant drugs.

10. The system of claim 1 further comprising:

means operable to receive input identifying a set of administered drugs;

means operable to receive input identifying a set of drug allergies; and

means operable to use the drug database to produce a report reporting possible allergic reactions to drugs in the set of administered drugs based on the set of drug allergies.

11. The system of claim 1 further comprising:

means operable to provide as an output the dosage recommendation and patient-specific information explaining the calculation of the dosage recommendation, including that the dosage has been adjusted to take into account at least one of the patient'"'"'s age, kidney function or liver function.

9. The system of claim 9 further comprising:

means for reporting a mechanism and clinical management of a reported possible drug interaction between concomitant drugs.

12. A system for processing data relating to use of medications, comprising:

means operable to receive input identifying an index drug;

means operable to receive a patient profile of information about a patient, the patient profile including information about the patient'"'"'s age, kidney function, or liver function, and about a clinical condition for which the index drug would be used;

means for calculating a dosage recommendation for the index drug, the dosage recommendation including an amount and a frequency of administration;

means for calculating a cost per a unit time of treatment for the recommended dosage of the index drug;

means for deriving from a drug database a set of one or more alternative drugs to the index drug on the basis of the patient profile, where the set of alternative drugs includes at least one drug chemically distinct from the index drug that is used for treating the clinical condition;

means for calculating a recommended dosage, including an amount and a frequency of administration, for each alternative drug in the set of alternative drugs; and

means for calculating a cost per the unit time of treatment for the recommended dosage of each of the alternative drugs.

13. The system of claim 12 further comprising:

means for reporting patient-specific information on the pharmacology or pharmacokinetics of the index drug;

means for reporting possible drug interactions between drugs in a designated set of drugs;

means for reporting patient-specific information on side effects of the index drug;

means for reporting patient-specific information on warnings and contraindications as to the use of the index drug; and

means for reporting information concerning use of the index drug during pregnancy or lactation.

14. A computer-implemented method for providing information relating to administration of medication, comprising:

receiving information identifying an index drug;

receiving information about a patient, including information about the patient'"'"'s age, kidney function, or liver function, and about a clinical condition for which the index drug would be administered;

calculating a dosage recommendation for administration of the index drug to the patient, including an amount and a frequency of administration calculated to be suitable in reference to the patient'"'"'s age, kidney function or liver function;

calculating a cost per unit time of treatment for the calculated recommended dosage of the index drug; and

providing as outputs the calculated dosage recommendation and the calculated cost per unit time of treatment for the calculated dosage recommendation.

15. The method of claim 14, further comprising:

using information about the patient to identify a chemically distinct alternative drug to the index drug for treating the patient'"'"'s condition;

using information about the patient to calculate a recommended dosage of the alternative drug for treating the clinical condition;

calculating a cost per unit time of treatment for the recommended dosage of the alternative drug; and

providing as outputs the calculated recommended dosage of the alternative drug and the calculated cost per unit time of treatment for the calculated recommended dosage of the alternative drug.

16. A system for processing data relating to use of an index drug selected from a set of drugs, the system comprising:

a computer;

direct access storage coupled to the computer, on which are stored data files including

a dosage data file for each drug in the set,

a cost data file for each drug in the set, and

one or more drug information files for each drug in the set, each drug information file comprising text relating to the drug;

patient data input instructions residing on a medium readable by the computer programming the computer to receive information about a patient including the patient'"'"'s age, kidney function or liver function;

dosage cost instructions residing on a medium readable by the computer programming the computer to calculate a recommended dosage and to calculate a cost for the recommended dosage per unit time of treatment for the index drug from the dosage data file and the cost data file based on information received about the patient by the patient input instructions and to report the calculated dosage and cost; and

report instructions residing on a medium readable by the computer programming the computer to report text from drug information files pertinent to selected drugs in the set.

17. The system of claim 16 wherein:

the stored data files comprise an expert system knowledge base for each drug in the set;

the report instructions include instructions programming the computer to report an explanation of the calculation of the dosage recommendation, including that the dosage has been adjusted to take into account at least one of the patient'"'"'s age, kidney function or liver function; and

the system further comprises invocation instructions residing on a medium readable by the computer programming the computer to invoke the drug knowledge bases pertinent to selected drugs in the set to produce information for use by the dosage cost instructions.

18. A method for providing information relating to administration of medication, comprising:

receiving into a computer information about a patient, including information about a condition;

identifying at least two alternative drugs used for treating the condition, the alternative drugs including a first drug and a second drug chemically distinct from the first drug;

calculating in the computer a dosage recommendation for administration of each alternative drug to the patient for treatment of the condition, each dosage recommendation including an amount and a frequency of administration calculated to be suitable in reference to information received in the computer about the patient'"'"'s age, kidney function, or liver function;

calculating a cost per a unit time of treatment for each alternative drug'"'"'s dosage recommendation; and

providing as an output from the computer the calculated costs for the alternative drugs.

19. The method of claim 18, wherein the identified alternative drugs include substantially all drugs with United States Food and Drug Administration (FDA) approval for treating the condition or substantially all drugs commonly used for treating the condition.

20. The method of claim 18 wherein, in the step of calculating dosage recommendations, calculating each dosage recommendation comprises running a knowledge base specific to the corresponding alternative drug in an expert system shell.

21. The method of claim 18 wherein the unit time of treatment is one day.

22. Apparatus for processing data relating to the use of medications, comprising:

a computer system having a memory section and operating a computational process coupled to the memory section;

the computational process being operable to provide an interface for receiving an identity of an index drug and a patient profile of information about a patient, including information about the patient'"'"'s age, kidney function and liver function and including a clinical condition representing a medical diagnosis for which the index drug may be used in treatment, and to store received information in the memory section for use by the computational process;

the memory section including a drug database of information about a set of drugs that includes at least the index drug and an alternative drug for the clinical condition that is chemically distinct from the index drug;

the computational process being operable to use the drug database and the patient profile to calculate an index-drug dosage recommendation including an amount and a frequency of administration of the index drug for the patient taking into account in the calculation at least one of the patient'"'"'s age, kidney function or liver function, and to produce a patient-specific explanation of the index-drug dosage recommendation that makes specific reference to the effect of at least one of the patient'"'"'s age, kidney function or liver function on the calculation of the index-drug dosage recommendation;

the computational process being operable to process the drug database and the patient profile and the database information to calculate an alternative dosage recommendation for the alternative drug including an amount and a frequency of administration; and

the computational process being operable to calculate a cost per a unit time of treatment for the index-drug dosage recommendation and to calculate a cost per the unit time of treatment for the alternative dosage recommendation.

23. The apparatus of claim 22, wherein the computational process is operable to use the drug database to identify additional drugs suitable for the clinical condition, to calculate an additional dosage recommendation including an amount and a frequency of administration according to the patient profile for each of the additional drugs, to produce an explanation of each of the additional dosage recommendations, and to calculate a cost per the unit time of treatment for each of the additional dosage recommendations.

24. The apparatus of claim 22, wherein the computational process is operable to use the drug database to identify additional drugs suitable for the clinical condition, to calculate an additional dosage recommendation including an amount and a frequency of administration according to the patient profile for each of the additional drugs, and to produce a patient-specific explanation of each of the additional dosage recommendations.

25. The apparatus of claim 22, wherein the computational process is operable to use the patient profile to order the index drug for the patient.

26. The apparatus of claim 22, wherein the computational process is operable to use the drug database to produce as output citations identifying published reference sources supporting the correctness of the calculation of the index-drug dosage recommendation.

27. The apparatus of claim 22, wherein the computational process is operable to receive a designation of a set of concomitant drugs and to use the drug database to produce as output information about possible drug interactions between or among the concomitant drugs.

28. The apparatus of claim 27, wherein the computational process is operable to use the drug database to report a mechanism and clinical management of possible drug interactions between or among the concomitant drugs.

29. The apparatus of claim 22, wherein the computational process is operable to receive a designation of a set of administered drugs and a designation of a set of drug allergies comprising drugs or drug categories, and to use the drug database to produce as output information about possible allergic reactions to drugs in the set of administered drugs based on the set of drug allergies.

30. The apparatus of claim 22, wherein the memory section and the computational process of the computer system are distributed across a plurality of computers.

31. The apparatus of claim 22, wherein the interface for receiving the patient profile is operable to interact with a hospital information system to receive information about the patient.

32. The apparatus of claim 23, wherein:

the computational process is operable to produce as output information about pharmacology or pharmacokinetics of the index drug;

the computational process is operable to receive a designation of a set of concomitant drugs and to use the drug database to produce as output information about possible drug interactions between or among the concomitant drugs;

the computational process is operable to receive a designation of a set of administered drugs and a designation of a set of drug allergies comprising drugs or drug categories, and to use the drug database to produce as output information about possible allergic reactions to drugs in the set of administered drugs based on the set of drug allergies;

the computational process is operable to produce as output information about side effects of the index drug;

the computational process is operable to produce as output information about warnings and contraindications as to the use of the index drug; and

the computational process is operable to produce as output information about use of the index drug during pregnancy or lactation.

33. Apparatus for processing data relating to use of medication, the apparatus comprising:

a computer system coupled to a computer-readable data store storing drug data for each drug in a set of drugs, the computer system operating a computational process coupled to the data store to obtain and process drug data from the data store, the drug data for each drug including at least dosage data drug cost data, and drug information data;

the computational process being operable to provide an interface for receiving a patient profile of information about a patient including the patient'"'"'s age, kidney function or liver function, and to provide an interface for receiving information identifying an index drug in the set of drugs;

the computational process being operable to process the patient profile and drug data about the index drug obtained from the data store to calculate an index-dosage recommendation including an amount and a frequency of administration of the index drug for the patient and

to calculate a cost of therapy for treatment of the patient with the index drug according to the index-drug dosage recommendation.

34. The apparatus of claim 33, wherein:

the drug data on the data store includes information about an alternative drug that is chemically distinct from the index drug; and

the computational process is operable to calculate an alternative dosage recommendation for the alternative drug including an amount and a frequency of administration and to calculate a cost of therapy for treatment of the patient with the alternative drug according to the alternative dosage recommendation, the cost of therapy for the index drug and the alternative drug being calculated as a cost per a unit time of treatment for the each dosage recommendation.

35. The apparatus of claim 33, wherein:

the patient information identifies a clinical condition representing a medical diagnosis; and

the computational process is operable to use drug information data obtained from the data store to identify additional drugs suitable for the clinical condition, to use dosage data from the data store for each additional drug to calculate a patient-specific additional dosage recommendation including an amount and a frequency of administration for the patient for each of the additional drugs, to produce a patient-specific explanation of each of the additional dosage recommendations.

36. The apparatus of claim 33, wherein:

the computational process is operable to use drug information data obtained from the data store to produce as output information about the pharmacology or pharmacokinetics of the index drug.

37. The apparatus of claim 33, wherein:

the computational process is operable to order a prescription for the index drug for the patient.

38. The apparatus of claim 33, wherein:

the computational process is operable to produce as output citations identifying published literature references supporting the correctness of the calculation of the index-drug dosage recommendation.

39. The apparatus of claim 33, wherein:

the computational process is operable to provide an interface for receiving a designation of a set of drugs and to use drug information data obtained from the data store about the drugs in the designated set to produce as output information about possible drug interactions between the drugs in the designated set.

40. The apparatus of claim 39, wherein:

the computational process is operable to produce as output a description of a mechanism and a clinical management of possible drug interactions between drugs in the designated set of drugs.

41. The apparatus of claim 33, further comprising:

the computational process is operable to provide an interface for receiving a designation of a set of administered drugs and a designation of a set of drug allergies comprising drugs or drug categories and to use drug information data obtained from the data store to produce as output information about possible allergic reactions to drugs in the set of administered drugs based on the set of drug allergies.

42. The apparatus of claim 33, wherein:

the computational process is operable to provide an interface for interacting with a human user through a graphical user interface.

43. The apparatus of claim 33, wherein:

the computational process is operable to provide an interface for interacting with a hospital information system to receive information about the patient.

44. The apparatus of claim 33, wherein:

the computational process is operable to provide as an output patient-specific information explaining the calculation of the index-drug dosage recommendation.

45. A method for using a computer system to process data relating to the use of medications, comprising:

providing computer-readable drug information for a set of drugs on a computer-readable storage medium, the drug information including dosage data for each drug in the set of drugs, cost data for each drug in the set of drugs, and descriptive information describing each drug in the set of drugs;

providing input instructions on a computer-readable medium, the input instructions being operable to program a computer system to receive an identity of an index drug and to receive clinical information about a patient;

providing dosage cost instructions on a computer-readable medium, the dosage cost instructions being operable to program the computer system to use the computer-readable drug information to calculate a recommended dosage and to calculate a cost for the recommended dosage per a unit time of treatment for the index drug based on the clinical information and to report the calculated dosage and cost; and

providing report instructions on a computer-readable medium, the cost instructions being operable to program the computer system to produce as output descriptive information from the computer-readable drug information for the index drug.

46. The method of claim 45, wherein:

the report instructions include instructions operable to program the computer system to produce as output an explanation of the calculation of the dosage recommendation in reference to clinical information about the patient received by operation of the input instructions; and

the method further comprises providing invocation instructions on a computer-readable medium, the invocation instructions being operable to program the computer system to invoke a drug knowledge base pertinent to the index drug to produce information for use by the dosage cost instructions.

47. The method of claim 45, wherein the computer system comprises computers in a network configuration.

48. A computer program product, residing on a computer-readable medium, comprising:

instructions operable to program a computer system to read computer-readable drug information for a set of drugs from a computer-readable data store, the drug information including dosage data, cost data, and descriptive information;

input instructions operable to program the computer system to receive an identity of an index drug and to receive a clinical profile for a patient;

dosage cost instructions operable to program the computer system to use the computer-readable drug information to calculate a recommended dosage and to calculate a cost for the recommended dosage per a unit time of treatment for the index drug based on the clinical profile and to report the calculated dosage and cost; and

report instructions operable to program the computer system to produce as output descriptive information from the computer-readable drug information for the index drug.

49. The computer program product of claim 48, further comprising:

instructions operable to program the computer system to produce as output an explanation of the calculation of the dosage recommendation in reference to clinical information about the patient received by operation of the input instructions; and

instructions operable to program the computer system to invoke a drug knowledge base pertinent to the index drug to produce information for use by the dosage cost instructions.

50. The computer program product of claim 48, wherein:

the computer-readable drug information includes information about an alternative drug that is chemically distinct from the index drug; and

the computer program product further comprises drug instructions operable to program the computer system to calculate an alternative dosage recommendation for the alternative drug including an amount and a frequency of administration and to calculate a cost per the unit time of treatment for the alternative dosage recommendation.

51. The computer program product of claim 48, further comprising:

instructions operable to program the computer system to identify additional drugs suitable for a clinical condition and to calculate an additional dosage recommendation including an amount and a frequency of administration for the patient for each of the additional drugs, to produce an explanation of each of the additional dosage recommendations, and to calculate a cost per the unit time of treatment for each of the additional dosage recommendations.

52. The computer program product of claim 48, further comprising:

instructions operable to program the computer system to produce as output information about the pharmacology or pharmacokinetics of the index drug.

53. The computer program product of claim 48, further comprising:

instructions operable to program the computer system to receive a request from a user to order a prescription for the index drug for the patient.

54. The computer program product of claim 48, further comprising:

instructions operable to program the computer system to produce as output citations identifying published reference sources supporting the correctness of the calculation of the index-drug dosage recommendation.

55. The computer program product of claim 48, further comprising:

instructions operable to program the computer system to receive a designation of a set of drugs and to produce as output information about possible drug interactions between the drugs in the designated set of drugs.

56. The computer program product of claim 55, further comprising:

instructions operable to program the computer system to report the mechanism and clinical management of the possible drug interactions between drugs in the designated set of drugs.

57. The computer program product of claim 48, further comprising:

instructions operable to program the computer system to receive a designation of a set of administered drugs and a designation of a set of drug allergies comprising drugs or drug categories and to produce as output information about possible allergic reactions to drugs in the set of administered drugs based on the set of drug allergies.

58. The computer program product of claim 48, wherein:

the input instructions comprise instructions operable to program the computer system to interact with a human user through a graphical user interface.

59. The computer program product of claim 48, further comprising:

instructions operable to program the computer system to interact with a hospital information system to receive information about the patient.

60. The computer program product of claim 48, further comprising:

instructions operable to program the computer system to produce as output information about the pharmacology or pharmacokinetics of the index drug;

instructions operable to program the computer system to receive a designation of a set of drugs and to produce as output information about possible drug interactions between the drugs in the designated set of drugs;

instructions operable to program the computer system to receive a designation of a set of administered drugs and a designation of a set of drug allergies comprising drugs or drug categories and to produce as output information about possible allergic reactions to drugs in the set of administered drugs based on the set of drug allergies;

instructions operable to program the computer system to produce as output information about side effects of the index drug;

instructions operable to program the computer system to produce as output information about warnings and contraindications as to the use of the index drug; and

instructions operable to program the computer system to produce as output information about use of the index drug during pregnancy or lactation.

61. The computer program product of claim 48, wherein the computer system comprises computers in a network configuration.