Systems and methods for providing patient medication history

• US 8,538,777 B1
• Filed: 06/30/2008
• Issued: 09/17/2013
• Est. Priority Date: 06/30/2008
• Status: Active Grant

• Current Assignee: McKesson Corp.
• Original Assignee: Mckesson Financial Holdings Limited (McKesson Corp.)
• Inventors: Kaye, Elizabeth S., Williams, Jessica Landisman, Liggin, Reed, Dennis, John Taylor, Reisz, Sean Daniel, Sauers, Jeffrey Scott, Smith, Charles David
• Primary Examiner(s): Holcomb, Mark
• Application Number:
  US12/165,031
• Time in Patent Office: 1,905 Days
• Field of Search: 705/2/3, 705 2- 4
• US Class Current: 705/3
• 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

Systems and methods may be provided for obtaining and providing patient medication history. The systems and methods may include receiving a request for medication history information of a patient, the request including identification information for the patient. At least one memory may be accessed utilizing at least a portion of the identification information, the at least one memory including information associated with pharmacy claims transactions stored in the at least one memory in near real time as the pharmacy claims transactions are processed. Information associated with the medication history of the patient is obtained from the at least one memory and communicated in response to the received request.

Claims

1. A method for providing medication history information of a patient, the method comprising the following steps implemented by one or more computers:

receiving, from a plurality of pharmacies by a switch provider system comprising the one or more computers, a plurality of respective pharmacy claim transactions for a patient;

processing, by the switch system, the plurality of claim transactions to facilitate routing of the claim transactions to a plurality of claims adjudicators and routing of responses to the claim transactions from the plurality of claims adjudicators to the plurality of pharmacies;

storing, by the switch system as the claims are processed by the switch system, information associated with at least one of (i) the claim transactions or (ii) the responses to the claims transactions as medication history information for the patient;

receiving, by a switch provider system from a healthcare service provider or from a healthcare service provider aggregator associated with the healthcare service provider, a request for medication history of the patient, the request comprising identification information for the patient;

accessing, by the switch provider system utilizing at least a portion of the patient identification information, at least a portion of the stored medication history information; and

aggregating, by the switch provider system, at least a portion of the accessed medication history information with patient medication history information received from one or more third party data sources corresponding to respective queries to the one or more third party data sources,

communicating, by the switch provider system, the aggregated information in response to the received request.

2. The method of claim 1, wherein the identification information for the patient comprises one or more of a name of the patient, a zip code of the patient, a gender of the patient, a date of birth for the patient, or insurance information associated with the patient.

3. The method of claim 1, wherein the request is received from the healthcare service provider and the aggregated information is communicated to the healthcare service provider in response to the received request.

4. The method of claim 1, wherein the request is received from the healthcare service provider aggregator associated with the healthcare service provider, and the aggregated information is communicated to the healthcare service provider aggregator.

5. The method of claim 1, further comprising:

communicating, by the switch provider system, one or more respective queries for medication history information associated with the patient to the one or more third party data sources; and

receiving, by the switch provider system, the patient medication history information from the one or more third party data sources.

6. The method of claim 1, wherein receiving a request for the medication history of the patient comprises receiving a request via a world wide web based application.

7. A switch provider system comprising:

at least one network interface configured (i) to receive, from a plurality of pharmacies, a plurality of respective pharmacy claim transactions for a patient, (ii) to communicate the claim transactions to a plurality of claims adjudicators, (iii) to receive, from the plurality of claims adjudicators, respective responses to the claim transactions, (iv) to communicate the responses to the plurality of pharmacies, (v) to receive, a request from a healthcare service provider for the medication history of the patient, the request comprising identification information for the patient, and (vi) to communicate aggregated medication history information for the patient to the healthcare service provider;

at least one memory comprising a medication history database, the medication history database comprising stored medication history information associated with at least one of (i) the claim transactions or (ii) the responses to the claim transactions; and

at least one computer processor configured (i) to process the claim transactions and the responses, (ii) to direct communication of the claim transactions and the responses, (iii) to direct, during the processing, storage of the medication history information in the medication history database, (iv) to access, utilizing at least a portion of the patient identification information, the medication history information from the medication history database, (v) aggregate at least a portion of the information accessed from the medication history database with patient medication history information received from one or more third party data sources corresponding to respective queries to the one or more third party data sources, and (vi) to direct communication of the aggregated information to the healthcare service provider in response to the received request.

8. The system of claim 7, wherein the identification information for the patient comprises one or more of a name of the patient, a zip code of the patient, a gender of the patient, a date of birth for the patient, or insurance information associated with the patient.

9. The system of claim 7, wherein the at least one computer processor is further configured to direct communication of the respective queries for medication history information associated with the patient to the one or more third party data sources and to receive the patient medication history information from the one or more third party data sources.

10. The system of claim 9, wherein each of the one or more third party data sources is associated with a prescription benefit manager, a pharmacy switch provider, a pharmacy benefit manager, an insurance company, or a healthcare coverage company.

11. The system of claim 7, wherein the at least one computer processor receives the request for medication history information via a world wide web based application.

12. The system of claim 9, wherein the at least one computer processor is configured to access the medication history database in parallel with directing communication of the queries for patient medication history information to one or more third party data sources.

13. A method for providing patient medication history information, the method comprising the following steps implemented by one or more computers:

switching, by a switch provider system comprising one or more computers, a plurality of pharmacy claim transactions and associated adjudicated responses for a patient between a plurality of pharmacies and at least one claims adjudicator, wherein the switching comprises;

receiving, from a plurality of pharmacies by the switch provider system, a plurality of respective pharmacy claim transactions for a patient; and

processing, by the switch provider system, the plurality of pharmacy claim transactions to facilitate routing of the pharmacy claim transactions to a plurality of claims adjudicators and routing of responses to the pharmacy claim transactions from the plurality of claims adjudicators to the plurality of pharmacies;

storing, by the switch provider system, information associated with at least one of (i) the pharmacy claim transactions or (ii) the responses to the claims transactions as medication history information for the patient;

receiving, by the switch provider system from a healthcare service provider or from a healthcare service provider aggregator associated with the healthcare service provider, a request for medication history of the patient, the request comprising identification information for the patient;

utilizing, by the switch provider system, at least a portion of the identification information to access the stored information associated with the plurality of switched pharmacy claim transactions;

obtaining, by the switch provider system, at least a portion of the stored medication history information; and

aggregating, by the switch provider system, at least a portion of the obtained medication history information with patient medication history information received from one or more third party data sources corresponding to queries to the third party data sources; and

communicating, by the switch provider system, the aggregated information in response to the received request.

14. The method of claim 13, wherein the stored information for each of the plurality of switched pharmacy claim transactions comprises at least one of a name of a patient associated with the pharmacy claim transaction, a zip code of the patient, a gender of the patient, a date of birth for the patient, or insurance information associated with the patient.

15. The method of claim 13, wherein the received identification information for the patient comprises one or more of a name of the patient, a zip code of the patient, a gender of the patient, a date of birth for the patient, or insurance information associated with the patient.

16. The method of claim 13, wherein the request is received from a healthcare service provider and the at least a portion of the stored information is communicated to the healthcare service provider or the healthcare service provider aggregator in response to the received request.

17. The method of claim 13, further comprising:

communicating, by the switch provider system, the respective queries for medication history information associated with the patient to the one or more third party data sources; and

receiving, by the switch provider system, the patient medication history information from the one or more third party data sources.