Method and system for calculating an alignment date for prescriptions

• US 7,996,243 B1
• Filed: 11/21/2008
• Issued: 08/09/2011
• Est. Priority Date: 11/21/2008
• Status: Active Grant

• Current Assignee: Walgreen Co. (Walgreens Boots Alliance Incorporated)
• Original Assignee: Walgreen Co. (Walgreens Boots Alliance Incorporated)
• Inventors: Marotta, Christina P., Ali, Syed Y., Gounder, Deivasigamani Karichianna, Pankow, Greg, Biesenthal, Amy C., McGonagle, Sean, Khullar, Rishi, Lee, Victor
• Primary Examiner(s): O'Connor; Gerald J.
• Assistant Examiner(s): Winston, III; Edward
• Application Number:
  US12/276,053
• Time in Patent Office: 991 Days
• Field of Search: 705/2, 705/3
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• 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

Abstract

A system and method facilitate alignment of refill dates associated with a plurality of prescriptions, such that each of the plurality of prescriptions requires a refill on the same date, thus limiting the number of occasions on which a customer must visit the pharmacy to retrieve refills of the aligned prescriptions, and increasing the likelihood that the customer will comply with the prescribed medication regimen. The system and method facilitate the alignment of the refill dates while complying with one or more rules governing the adjudication of the prescriptions.

Claims

1. A method for aligning refill dates associated with a plurality of prescriptions for a customer to a single alignment date, each prescription for a medication, the method embodied in a set of machine-readable instructions executed on a processor and stored on a tangible medium, the method comprising:

receiving a selection of a plurality of prescriptions to align;

determining, for each of the plurality of selected prescriptions, a remaining day supply, the remaining day supply indicative of a number of days of the medication the customer has remaining;

calculating a next adjudication date for each of the plurality of selected prescriptions;

selecting as a latest adjudication date, from the plurality of calculated next adjudication dates, the next adjudication date occurring on the latest date;

calculating an alignment adjudication date;

calculating a final alignment date;

wherein the final alignment date is different from at least one of the refill dates associated with one of the plurality of prescriptions for the customer

determining via the processor, for each of the plurality of selected prescriptions, whether a short fill is required so that the customer does not exhaust the remaining day supply of the medication before the final alignment date;

calculating via the processor a short-fill day supply for any prescription requiring a short fill;

determining via the processor a date by which the customer will receive the short fill for any prescription requiring a short fill;

determining via the processor, for any prescription requiring a short fill, whether the customer will exhaust the remaining day supply of the medication before the date by which the customer will receive the short fill for the prescription;

calculating via the processor a short-fill quantity for any prescription for which the customer will receive the required short fill for the prescription prior to exhausting the remaining day supply of the medication;

marking any prescription for which a short fill is required, but for which the short fill is not possible;

performing the following if one or more prescriptions are marked;

(i) recalculating via the processor the next adjudication date for each of the plurality of selected prescriptions;

(ii) selecting via the processor as the latest adjudication date, from the plurality of recalculated next adjudication dates, the next adjudication date occurring on the latest date;

(iii) recalculating via the processor the alignment adjudication date;

(iv) recalculating via the processor the final alignment date;

(v) determining via the processor for each of the plurality of selected prescriptions, using the recalculated dates, whether a short fill is required so that the customer does not exhaust the remaining day supply of the medication before the recalculated final alignment date;

(vi) recalculating via the processor the short-fill day supply for any prescription requiring a short fill;

(vii) adjudicating via the processor each of the selected prescriptions on or after the recalculated alignment adjudication date;

(viii) filling each of the selected prescriptions; and

(ix) providing each of the medications corresponding to the selected prescriptions to the customer by the recalculated final alignment date; and

performing the following for each of the selected prescriptions if none of the prescriptions are marked;

(a) filling and providing to the customer the short-fill quantity for any prescription requiring a short fill;

(b) adjudicating via the processor each of the selected prescriptions on or after the alignment adjudication date;

(c) filling each of the selected prescriptions; and

(d) providing each of the medications corresponding to the selected prescriptions to the customer by the final alignment date.

2. The method of claim 1, wherein calculating a final alignment date further comprises adding one or more days to the alignment adjudication date for processing the prescriptions and providing the medications to the customer.

3. The method of claim 1, wherein calculating a next adjudication date further comprises determining via the processor a number of days corresponding to a percentage of a prescribed day supply for the medication.

4. The method of claim 1, wherein determining a date by which the customer will receive the short fill for any prescription requiring a short fill further comprises adding one or more days to the next adjudication date for the prescription for processing the prescription and providing the medication to the customer.

5. The method of claim 1, wherein the prescription is provided to the customer by a shipping service or a postal service and further comprising:

performing the following for any prescription for which the customer will not receive the short fill for the prescription prior to exhausting the remaining day supply of the medication;

(a) requesting the customer to pick up the short fill of the prescription from a retail location;

(b) indicating retail pickup of the short fill of the prescription if the customer agrees to retail pickup; and

(c) recalculating the short-fill day supply if the customer does not agree to retail pickup.

6. The method of claim 1, wherein providing each of the medications to the customer comprises providing the medications to the customer by a shipping service or a postal service.

7. The method of claim 1, wherein providing to the customer the short fill quantity for any prescription requiring a short fill further comprises:

providing the short fill to the customer by a preferred delivery method when, using the preferred delivery method, the customer will receive the short fill before exhausting the remaining day supply of the medication; and

evaluating an alternate delivery method when using the preferred delivery method would result in the customer exhausting the remaining day supply of the medication before receiving the short fill.

8. The method of claim 1, wherein short fills are not adjudicated.

9. The method of claim 1, wherein the customer comprises two or more people.

10. The method of claim 9, wherein the two or more people comprising the customer are members of the same family or are members of the same household.

11. A method for aligning refill dates associated with a plurality of prescriptions for a customer to a single alignment date, each prescription for a medication, the method embodied in a set of machine-readable instructions executed on a processor and stored on a tangible medium, the method comprising:

receiving a selection of a plurality of prescriptions to align;

determining, for each of the plurality of selected prescriptions, a remaining day supply, the remaining day supply indicative of how many days of the medication the customer has remaining;

calculating a final alignment date, wherein the final alignment date is different from at least one of the refill dates associated with one of the plurality of prescriptions for the customer;

determining via the processor, for each of the plurality of selected prescriptions, whether a short fill is required so that the customer does not exhaust the remaining day supply of the medication before the final alignment date;

calculating via the processor one or both of a short-fill day supply and a short-fill quantity for any prescription requiring a short fill;

filling and providing to the customer any required short fill, based on either the short-fill quantity or the short-fill day supply for the prescription; and

filling each of the selected prescriptions.

12. The method of claim 11, further comprising providing to the customer by the final alignment date each of the medications corresponding to the selected prescriptions.

13. The method of claim 11, wherein calculating a final alignment date further comprises complying with at least one adjudication rule set by a third-party payor.

14. The method of claim 13, wherein complying with at least one rule set by the third-party payor further comprises:

calculating via the processor, for each of the plurality of selected prescriptions, a next adjudication date;

selecting via the processor as a latest adjudication date, from the plurality of next adjudication dates, the next adjudication date occurring on the latest date;

calculating an alignment adjudication date; and

selecting the final alignment date using the alignment adjudication date.

15. The method of claim 14, wherein selecting the final alignment date using the alignment adjudication date further comprises adding via the processor one or more days to the alignment adjudication date for processing the prescriptions and providing the medications to the customer.

16. The method of claim 14, wherein selecting the final alignment date using the alignment adjudication date further comprises adding via the processor one or more days to the alignment adjudication date as a patient start buffer.

17. The method of claim 14, wherein calculating, for each of the plurality of selected prescriptions, a next adjudication date, further comprises determining via the processor a number of days corresponding to a percentage of a prescribed day supply for the medication.

18. The method of claim 11, further comprising:

determining, for any prescription requiring a short fill, a date by which the customer will receive the short fill; and

wherein the date by which the customer will receive a short fill for a particular prescription is used to calculate one or both of the short-fill quantity and the short-fill day supply of medication corresponding to the particular prescription if the customer will receive the short fill for the particular prescription before exhausting the remaining day supply of the medication.

19. The method of claim 18, wherein medications are provided to the customer by a method involving lead time, and further wherein filling and providing to the customer any prescription requiring a short fill, based on the short-fill quantity or the short-fill day supply for the prescription, further comprises:

determining, for any prescription requiring a short fill, whether the customer will receive the short fill for the prescription before the customer exhausts the remaining day supply of the medication corresponding to the prescription;

performing the following for any prescription for which the customer will not receive the short fill for the prescription before the customer exhausts the remaining day supply of the medication corresponding to the prescription;

(a) requesting the customer to pick up the short fill of the prescription from a retail location;

(b) marking the short fill of the prescription for retail pickup if the customer agrees to retail pickup; and

(c) recalculating one or both of the short-fill quantity and the short-fill day supply if the customer does not agree to retail pickup;

determining whether any prescriptions are marked; and

performing the following if one or more prescriptions are marked and the retail location cannot provide a short fill for each of the one or more marked prescriptions;

(i) updating the next adjudication date for each of the selected prescriptions;

(ii) recalculating the final alignment date;

(iii) determining for each of the plurality of selected prescriptions, using the recalculated dates, whether a short fill is required so that the customer does not exhaust the remaining day supply of the medication before the recalculated final alignment date; and

(iv) recalculating one or both of the short-fill day supply and the short-fill quantity for any prescription requiring a short fill.

20. The method of claim 18, wherein medications are provided to the customer by a first method involving lead time, and further wherein filling and providing to the customer any prescription requiring a short fill, based on the short-fill quantity or the short-fill day supply for the prescription, further comprises:

determining, for any prescription requiring a short fill, whether the customer will receive the short fill for the prescription before the customer exhausts the remaining day supply of the medication corresponding to the prescription; and

evaluating an alternate method for providing the medications to the customer if using the first method involving lead time will result in the customer exhausting the remaining day supply of the medication corresponding to the prescription before receiving the short fill for the prescription.

21. The method of claim 18, wherein determining, for any prescription requiring a short fill, a date by which the customer will receive the short fill, further comprises adding one or more days to the next adjudication date for the prescription for processing the prescription and providing the medication to the customer.

22. The method of claim 18, further comprising:

marking any prescription for which a short fill is required, but for which the customer cannot receive the required short fill before exhausting the remaining day supply of the medication;

performing the following if one or more prescriptions are marked;

(i) updating the next adjudication date for each of the selected prescriptions;

(ii) recalculating the final alignment date;

(iii) determining for each of the plurality of selected prescriptions, using the recalculated dates, whether a short fill is required so that the customer does not exhaust the remaining day supply of the medication before the recalculated final alignment date; and

(iv) recalculating the short-fill day supply or the short-fill quantity for any prescription requiring a short fill.

23. The method of claim 18, wherein prescriptions are provided to the customer by a method involving lead time, and further wherein filling and providing to the customer any required short fill, based on either the short-fill quantity or the short-fill day supply for the prescription, further comprises:

determining, for any prescription requiring a short fill, whether the customer will receive the short fill for the prescription before the customer exhausts the remaining day supply of the medication;

performing the following for any prescription for which the customer will not receive the short fill for the prescription before the customer exhausts the remaining day supply of the medication;

(a) requesting the customer to pick up the short fill of the prescription from a retail location;

(b) marking the short fill of the prescription for retail pickup if the customer agrees to retail pickup; and

(c) recalculating one or both of the short-fill day supply and the short-fill quantity if the customer does not agree to retail pickup; and

determining whether any prescriptions are marked; and

wherein filling and providing to the customer any required short fill, based on the short-fill quantity or the short-fill day supply for the prescription, comprises delivering to the customer at a retail location the medications corresponding to any prescriptions marked for retail pickup.

24. The method of claim 18, further comprising:

determining, for each required short fill, whether the short fill is possible using a preferred delivery method;

determining, for each required short fill that is possible by the preferred delivery method, whether the customer will receive the short fill before exhausting the remaining day supply of the medication;

determining, for each required short fill that is not possible using the preferred delivery method and for each required short fill that is possible using the preferred delivery method but for which the customer will not receive the short fill before exhausting the remaining day supply of the medication, whether the short fill is possible using an alternate delivery method;

marking the short fill as not possible if the short fill is not possible using the alternate delivery method or if the customer does not want to use the alternate delivery method; and

determining, for each required short fill that is possible by the alternate delivery method and for which the customer wants to use the alternate delivery method, whether the customer will receive the short fill before exhausting the remaining day supply of the medication.

25. The method of claim 11, wherein filling and providing to the customer any required short fill comprises selecting one or more of the required short fills and providing the selected one or more short fills to the customer without adjudicating the selected short fills.

26. The method of claim 25, wherein the one or more selected short fills are selected because adjudicating the one or more selected short fills would delay the final alignment date.

27. The method of claim 11, wherein short fills are not adjudicated.

28. The method of claim 11, wherein the customer comprises two or more people.

29. The method of claim 28, wherein the two or more people comprising the customer are members of the same family or are members of the same household.

30. A system for aligning refill dates associated with a plurality of prescriptions for a customer to a single alignment date, each prescription for a medication, the system comprising:

a network;

a computer coupled to the network;

a database coupled to the computer; and

an alignment engine configured to run on the computer to determine parameters associated with the alignment of the plurality of prescriptions, the alignment engine configured to;

receive a selection of a plurality of prescriptions to align;

calculate a final alignment date, wherein the final alignment date is different from at least one refill date associated with one of the plurality of prescriptions for the customer; and

calculate a short-fill parameter.

31. The system of claim 30, wherein the alignment engine is further configured to determine a latest adjudication date, from a plurality of calculated next adjudication dates, in compliance with a rule determined by a third-party payor or a regulatory agency.

32. The system of claim 30, wherein the alignment engine is further configured to:

retrieve information from the database; and

calculate a parameter required to determine compliance with the rule determined by the third-party payor or the regulatory agency.

33. The system of claim 32, wherein the rule comprises an adjudication rule and wherein calculating a parameter required to determine compliance with the rule comprises calculating a percent-consumption period.

34. The system of claim 32, wherein calculating a short-fill parameter comprises one of the group consisting of:

calculating a short-fill day supply;

calculating a short-fill quantity; and

calculating a short-fill delivery date.

35. A method for aligning refill dates associated with a plurality of prescriptions for a customer to a single alignment date, each prescription for a medication, the method embodied in a set of machine-readable instructions executed on a processor and stored on a tangible medium, the method comprising:

receiving a selection of a plurality of prescriptions to align;

determining via the processor, for each of the plurality of selected prescriptions, a remaining day supply, the remaining day supply indicative of how many days of the medication the customer has remaining;

calculating via the processor a final alignment date, wherein the final alignment date is different from at least one of the refill dates associated with one of the plurality of prescriptions for the customer;

determining via the processor, for each of the plurality of selected prescriptions, whether the customer will exhaust the remaining day supply of the medication before the final alignment date;

filling and providing one intermediate fill of the medication for each of the selected prescriptions for which the customer will exhaust the remaining day supply of the medication before the alignment date; and

filling each of the selected prescriptions.

36. The method of claim 35, wherein, for each medication for which one intermediate fill is provided, the one intermediate fill may be a short fill, a full fill, or an overfill.