Personalized medical adherence management system

• US 8,566,121 B2
• Filed: 04/10/2008
• Issued: 10/22/2013
• Est. Priority Date: 08/29/2005
• Status: Active Grant

• Current Assignee: Anand Subra, Narayanan Ramasubramanian
• Original Assignee: Anand Subra, Narayanan Ramasubramanian
• Inventors: Ramasubramanian, Narayanan, Subra, Anand
• Primary Examiner(s): NGUYEN, HIEP VAN
• Application Number:
  US12/101,063
• Publication Number:
  US 20080201174A1
• Time in Patent Office: 2,021 Days
• Field of Search: 705/3
• 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
• CPC Class Codes: G16H 20/30 relating to physical therapies or activities, e.g. physiotherapy, acupressure or exercising
• CPC Class Codes: G16H 20/60 relating to nutrition control, e.g. diets
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

Techniques and systems are described hereafter for reducing medical non-adherence by (1) developing the adherence-profile of a member, (2) using the profile to automatically generate a set of interventions, (3) categorizing, prioritizing and selecting the interventions, (4) incorporating the selected interventions into a personalized member user interface page, (5) serving the selected interventions to the member at the appropriate times via multiple channels, (6) observing and measuring member responses, (7) recording member responses in a database and analyzing the responses, (8) adapting the interventions, based on the analysis, to keep the member actively engaged, (9) escalating the interventions if the member response is inadequate, (10) updating the member'"'"'s adherence profile based on analysis of the database, (11) providing member reports to authorized parties for purposes of paying member incentives, predicting member'"'"'s utilization of high-cost healthcare services, etc., and (12) providing aggregate de-identified reports for purposes of predicting future risk reserve set asides, drug production and supply chain replenishment requirements.

Claims

1. A computer-implemented method comprising:

storing patient information about a particular patient;

storing medical condition information about one or more medical conditions;

wherein the one or more medical conditions includes a particular medical condition;

wherein the medical condition information for the particular medical condition comprises;

phase information about one or more phases of the particular medical condition; and

state information about one or more states of a particular phase of the one or more phases;

each state, of the one or more states, being associated with a stored intervention message, wherein an intervention message comprises a message to be communicated to a patient about a particular action to be taken by the patient;

state transition rules that are associated with a particular state of the particular phase of the particular medical condition;

wherein the state transition rules include a particular state transition rule that specifies that a patient in a first state is to transition to a second state when the patient responds in a particular manner while in the first state;

determining, by one or more computing devices, that the first state is the current state of the particular patient by comparing said patient information with said state information;

in response to determining that the first state of said one or more states is the current state, associating, by the one or more computing devices, the particular patient with the first state;

in response to the particular patient being associated with the first state, selecting a first particular stored intervention message associated with the first state to be sent to the particular patient;

sending the first particular stored intervention message to the particular patient;

receiving a response to the sent first particular stored intervention message from the particular patient;

based, at least in part, on the received response and the particular state transition rule, associating the particular patient with a second state of said one or more states that is different from the first state, and causing the particular patient to no longer be associated with the first state;

in response to the particular patient being associated with the second state, selecting a second particular stored intervention message associated with the second state to be sent to the particular patient, wherein the second particular stored intervention message is different than the first particular stored intervention message;

sending the second particular intervention message to the particular patient.

2. The computer-implemented method of claim 1 further comprising:

determining that no response has been received to the second particular intervention message from the particular patient after waiting a predetermined amount of time; and

in response to determining that no response has been received to the second particular intervention message from the particular patient after waiting the predetermined amount of time, alerting a person that is not the particular patient about the lack of response from the particular patient.

3. The computer-implemented method of claim 1 further comprising:

in response to sending the first particular stored intervention message to the particular patient, retrieving search results related to the first state by executing a search using search strings associated with the first state; and

delivering said search results to the particular patient.

4. The computer-implemented method of claim 1 further comprising:

in response to sending the second particular stored intervention message to the particular patient, selecting a first piece of content related to the second state from a database storing pieces of content related to a plurality of states; and

sending the first piece of content to the particular patient.

5. The computer-implemented method of claim 4 further comprising:

associating one or more pieces of content of said pieces of content with urgency values indicating how likely the corresponding piece of content is to increase seriousness in a patient that would perceive the corresponding piece of content;

determining that no response has been received to the second particular intervention message from the particular patient after waiting a predetermined amount of time; and

in response to determining that no response has been received to the second particular intervention message from the particular patient after waiting the predetermined amount of time, selecting a second piece of content related to the second state from the database storing said pieces of content related to the plurality of states, wherein an urgency value of the second piece of content indicates that the second piece of content is more likely to increase seriousness in a patient that would perceive the second piece of content than the first piece of content.

6. The computer-implemented method of claim 4, wherein sending the first particular stored intervention message to the particular patient comprises sending the first particular stored intervention message through a particular channel of communication, wherein the particular channel of communication is selected from a set of channels of communications through which intervention messages may be sent associated with the first particular stored intervention message.

7. The computer-implemented method of claim 1, further comprising:

determining that no response has been received to the second particular intervention message from the particular patient after waiting a predetermined amount of time; and

in response to determining that no response has been received to the second particular intervention message from the particular patient after waiting the predetermined amount of time, selecting a second particular channel of communication from a set of channels of communications through which intervention messages may be sent associated with a third intervention message, based in part on said stored patient information; and

sending the third intervention message to the particular patient through the selected second particular channel of communication.

8. The computer-implemented method of claim 1, wherein storing patient information about the particular patient further comprises:

importing information about the particular patient from particular databases;

gathering information from the particular patient;

identifying particular types of missing information; and

creating data of said particular types based on said imported information and said gathered information.

9. The computer-implemented method of claim 8, wherein gathering information from the particular patient comprises:

gathering desired intervention frequency information indicating how frequently the particular patient wishes to receive intervention messages;

calculating an intervention frequency value based on the desired intervention frequency information; and

storing said intervention frequency value.

10. The computer-implemented method of claim 9, further comprising:

determining that no response has been received to the second particular intervention message from the particular patient after waiting a predetermined amount of time; and

in response to determining that no response has been received to the second particular intervention message from the particular patient after waiting the predetermined amount of time, modifying said intervention frequency value to indicate that the particular patient is to be sent intervention messages more frequently than before said modification of the intervention frequency value.

11. The computer-implemented method of claim 1, further comprising:

assigning a credibility score to the particular patient;

storing said response to the sent first particular stored intervention message from the particular patient;

based on the assigned credibility score, modifying said response; and

storing said modified response.

12. The computer-implemented method of claim 11, wherein assigning a credibility score to the particular patient comprises:

calculating the credibility score by comparing a number of responses received by the particular patient to a number of times a pre-determined amount of time has passed without a response being received from the particular patient.

13. The computer-implemented method of claim 11, wherein assigning a credibility score to the particular patient further comprises:

accessing medical history data that comprises values indicating how well a particular disease has been controlled by the particular patient; and

determining the credibility score based on said values indicating how well the particular disease has been controlled by the particular patient.

14. A non-transitory computer-readable storage medium storing instructions, wherein the instructions, when executed by one or more processors cause:

storing patient information about a particular patient;

storing medical condition information about one or more medical conditions;

wherein the one or more medical conditions includes a particular medical condition;

wherein the medical condition information for the particular medical condition comprises;

phase information about one or more phases of the particular medical condition; and

state information about one or more states of a particular phase of the one or more phases;

each state, of the one or more states, being associated with a stored intervention message, wherein an intervention message comprises a message to be communicated to a patient about a particular action to be taken by the patient;

state transition rules that are associated with a particular state of the particular phase of the particular medical condition;

wherein the state transition rules include a particular state transition rule that specifies that a patient in a first state is to transition to a second state when the patient responds in a particular manner while in the first state;

determining that the first state is the current state of the particular patient by comparing said patient information with said state information;

in response to determining that the first state of said one or more states is the current state, associating the particular patient with the first state;

in response to the particular patient being associated with the first state, selecting a first particular stored intervention message associated with the first state to be sent to the particular patient;

sending the first particular stored intervention message to the particular patient;

receiving a response to the sent first particular stored intervention message from the particular patient;

based, at least in part, on the received response and the particular state transition rule, associating the particular patient with a second state of said one or more states that is different from the first state, and causing the particular patient to no longer be associated with the first state;

in response to the particular patient being associated with the second state, selecting a second particular stored intervention message associated with the second state to be sent to the particular patient, wherein the second particular stored intervention message is different than the first particular stored intervention message;

sending the second particular intervention message to the particular patient.

15. The non-transitory computer-readable storage medium of claim 14, wherein the instructions, when executed by one or more processors, further cause:

determining that no response has been received to the second particular intervention message from the particular patient after waiting a predetermined amount of time; and

in response to determining that no response has been received to the second particular intervention message from the particular patient after waiting the predetermined amount of time, alerting a person that is not the particular patient about the lack of response from the particular patient.

16. The non-transitory computer-readable storage medium of claim 14, wherein the instructions, when executed by one or more processors, further cause:

in response to sending the first particular stored intervention message to the particular patient, retrieving search results related to the first state by executing a search using search strings associated with the first state; and

delivering said search results to the particular patient.

17. The non-transitory computer-readable storage medium of claim 14, wherein the instructions, when executed by one or more processors, further cause:

in response to sending the second particular stored intervention message to the particular patient, selecting a first piece of content related to the second state from a database storing pieces of content related to a plurality of states; and

sending the first piece of content to the particular patient.

18. The non-transitory computer-readable storage medium of claim 17, wherein the instructions, when executed by one or more processors, further cause:

associating one or more pieces of content of said pieces of content with urgency values indicating how likely the corresponding piece of content is to increase seriousness in a patient that would perceive the corresponding piece of content;

determining that no response has been received to the second particular intervention message from the particular patient after waiting a predetermined amount of time; and

in response to determining that no response has been received to the second particular intervention message from the particular patient after waiting the predetermined amount of time, selecting a second piece of content related to the second state from the database storing said pieces of content related to the plurality of states, wherein an urgency value of the second piece of content indicates that the second piece of content is more likely to increase seriousness in a patient that would perceive the second piece of content than the first piece of content.

19. The non-transitory computer-readable storage medium of claim 17, wherein sending the first particular stored intervention message to the particular patient comprises sending the first particular stored intervention message through a particular channel of communication, wherein the particular channel of communication is selected from a set of channels of communications through which intervention messages may be sent associated with the first particular stored intervention message.

20. The non-transitory computer-readable storage medium of claim 14, wherein the instructions, when executed by one or more processors, further cause:

determining that no response has been received to the second particular intervention message from the particular patient after waiting a predetermined amount of time; and

in response to determining that no response has been received to the second particular intervention message from the particular patient after waiting the predetermined amount of time, selecting a second particular channel of communication from a set of channels of communications through which intervention messages may be sent associated with a third intervention message, based in part on said stored patient information; and

sending the third intervention message to the particular patient through the selected second particular channel of communication.

21. The non-transitory computer-readable storage medium of claim 14, wherein the instructions, when executed by one or more processors, further cause:

importing information about the particular patient from particular databases;

gathering information from the particular patient;

identifying particular types of missing information; and

creating data of said particular types based on said imported information and said gathered information.

22. The non-transitory computer-readable storage medium of claim 21, wherein gathering information from the particular patient comprises:

gathering desired intervention frequency information indicating how frequently the particular patient wishes to receive intervention messages;

calculating an intervention frequency value based on the desired intervention frequency information; and

storing said intervention frequency value.

23. The non-transitory computer-readable storage medium of claim 22, wherein the instructions, when executed by one or more processors, further cause:

determining that no response has been received to the second particular intervention message from the particular patient after waiting a predetermined amount of time; and

in response to determining that no response has been received to the second particular intervention message from the particular patient after waiting the predetermined amount of time, modifying said intervention frequency value to indicate that the particular patient is to be sent intervention messages more frequently than before said modification of the intervention frequency value.

24. The non-transitory computer-readable storage medium of claim 14, wherein the instructions, when executed by one or more processors, further cause:

assigning a credibility score to the particular patient;

storing said response to the sent first particular stored intervention message from the particular patient;

based on the assigned credibility score, modifying said response; and

storing said modified response.

25. The non-transitory computer-readable storage medium of claim 24, wherein assigning a credibility score to the particular patient comprises:

calculating the credibility score by comparing a number of responses received by the particular patient to a number of times a pre-determined amount of time has passed without a response being received from the particular patient.

26. The non-transitory computer-readable storage medium of claim 24, wherein assigning a credibility score to the particular patient comprises:

accessing medical history data that comprises values indicating how well a particular disease has been controlled by the particular patient; and

determining the credibility score based on said values indicating how well the particular disease has been controlled by the particular patient.