PERSONALIZED MEDICAL ADHERENCE MANAGEMENT SYSTEM

• US 20080201174A1
• Filed: 04/10/2008
• Published: 08/21/2008
• 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
• Granted Patent: US 8,566,121 B2
• Time in Patent Office: Days
• 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 method comprising:

maintaining a patient database of adherence information of individual medical patients;

wherein the adherence information includes, for individual medical patients, information that records actual patient behavior relating to one or more medically-prescribed actions;

maintaining a phase-state database of specific diseases, regimens and processes, and a plurality of steps on how to address those specific diseases, regimens and processes;

breaking each step of the plurality of steps into separate rules for transitioning between states;

importing patient data from external sources and also directly from the patient and storing within the patient database;

making assumptions about patient data in case such data is not available or provided by the patient, and storing those assumptions in the patient database;

initially mapping the stored patient data to the respective current states for each condition, regimen and process;

coordinating patient data within a personalized patient interface page;

mapping specific stages in each condition to specific interventions &

filtered content in conjunction with that patient'"'"'s personal data and presenting the mapped stages, interventions, and content to a patient through the personalized patient interface page; and

customizing the treatment plan for a specific patient to incorporate the separate rules in coordination with information about that patient from the patient database;

2. The method of claim 1, further comprising:

analyzing the patient database for adherence trends and history for the individual patients, wherein a adherence trend for an individual patient indicates actual changes in behavior of the patient relative to said one or more separate rules;

providing information about the patient'"'"'s adherence trends and history in the form of a graphical dashboard within the personalized patient interface page;

wherein the patient uses the dashboard information to set and track the achievement of individual adherence targets;

3. The method of claim 1, further comprising:

providing information about the trends and history to an organization from the set consisting of insurance companies, payers, managed-care organizations or other authorized parties;

wherein the organization uses a specific patient'"'"'s trend information to trigger high-intensity interventions to that patient;

wherein the organization uses the information to structure incentives to improve adherence performance of the individual patients.

4. The method of claim 1, further comprising:

automatically initiating a scan of the patient database at pre-determined times;

comparing it to published medical guidelines for screening, prevention, diagnosis and treatment for the specific diseases;

identifying the patient'"'"'s relevant conditions and states, and developing a personalized patient intervention plan having specific interventions based on the patient'"'"'s medical conditions and states, along with the applicable channels, response options and the date and time at which each intervention is to be sent.

5. The method of claim 1, further comprising:

wherein each patient has multiple conditions and each condition has multiple phases, wherein the multiple phases comprise a screening phase, a diagnosis phase, a treatment phase, and a follow-up phase;

wherein each patient is also required to follow multiple regimens and processes, and each regimen or process has multiple phases and states;

6. The method of claim 1, further comprising:

maintaining current published medical guidelines within the phase-state database;

dynamically linking to current published medical information by triggering web searches using specific pre-configured search terms;

7. The method of claim 6, further comprising:

directing the triggered information searches to occur only within certified and trusted content.

8. The method of claim 1, further comprising:

presenting a patient with a weekly calendar area for displaying specific actions to be taken on a day to day basis;

wherein clicking on any of the daily action items opens a slide-down display area for displaying more detailed information about the selected action item thereby assisting the patient in learning more about the action item, how to perform it, why it is important, and what to ask the doctor regarding this action item;

wherein each type of information is presented as links in separate tabs;

wherein, clicking on any of the links opens up a different user window and displays the information.

9. The method of claim 6, wherein breaking each step of the plurality of steps into separate rules further comprises:

arranging the calendar area to present a patient with tasks to be completed only within a single specific day.

10. The method of claim 1, further comprising:

presenting a patient with that patient'"'"'s health conditions in a display area thereby providing a snapshot of that patient'"'"'s various conditions and their respective placement within condition-phases obtained from the phase-stage database wherein the condition-phases comprise symptoms, screening/prevention, diagnosis or treatment &

follow-up; and

presenting a consistent intuitive patient interface that allows the patient to see, at a glance, what conditions the patient has, what phase those conditions are in, which stage is each condition is in;

and upon clicking on any of the conditions opens the slide-down display area in which the patient can see what action the patient needs to take immediately.

11. The method of claim 1, wherein adherence further comprises:

wellness adherence including actively participating in healthiness programs comprising diet, exercise, weight management, stress management, and smoking cessation;

screening adherence including getting screened for certain diseases based on age, gender, race and other risk factors as recommended by medical guidelines;

medication adherence processes and regimens including filling/refilling and consuming medications as prescribed;

readings adherence processes and regimens including acquiring devices and taking readings as prescribed, and

treatment adherence processes and regimens including going for specific condition-based treatments and follow-ups as prescribed.

12. The method of claim 11, further comprising:

wherein the adherence information for individual medical patients includes information about at least one of the following;

whether the individual medical patient actually obtained eligible health condition screenings within a recommended timeframe;

whether the individual medical patient actually obtained vaccinations or immunizations within a recommended timeframe;

whether the individual medical patient actually participated in recommended health improvement activities over a period of time at the recommended level of participation;

whether the individual medical patient actually obtained prescribed medical treatments within the timeframe recommended by a physician;

whether the individual medical patient actually obtained prescribed medication;

whether the individual medical patient actually took prescribed medication according to a prescribed schedule;

whether the individual medical patient actually took prescribed medication at a prescribed dosage level;

whether the individual medical patient actually obtained prescribed self-reading devices; and

whether the individual medical patient actually took prescribed self-readings according to a prescribed schedule

13. The method of claim 1, comprising:

maintaining an intervention database comprising a repository of all the interventions that can be sent by the present system;

wherein the intervention database comprises links to third-party interventions as well and their respective e-commerce interactions.

14. The method of claim 1, comprising:

maintaining a single point of reference for all interventions to be sent to a particular patient, whether the interventions are within the present system or within external parties;

wherein interventions are structured into the intervention model below before storage in the database;

thereby facilitating the identification of appropriate interventions from the intervention database for a particular member.

15. The method of claim 14 further comprising, for each member, incorporating the selected interventions into a personalized member user interface page.

16. The method of claim 15 wherein the interventions on the personalized page are also sent via at least one of the channels of email, SMS messaging and Voice Response Unit messaging;

wherein means are provided for the patient to respond to the intervention via any of the same channels;

wherein means are provided for analysis of the patient'"'"'s response or non-response within a set time period, and taking appropriate escalation, alerting or exception management actions;

wherein means are provided for the patient to respond via any channel to the intervention (not necessarily the same channel through which the patient received the intervention)

17. The method of claim 1 wherein the adherence information also includes information on differences between when prescribed medication is actually obtained and when prescribed medication was supposed to have been obtained.

18. The method of claim 1 wherein the adherence information also includes information on differences between the actual dosage taken by the patient and the prescribed dosage for a patient.

19. The method of claim 1 wherein the adherence information includes, for individual medical patients, information about whether the individual medical patient actually obtained eligible health condition screenings within a recommended timeframe.

20. The method of claim 1 wherein the adherence information includes, for individual medical patients, information about whether the individual medical patient actually obtained prescribed medical treatments and tests within a recommended timeframe.

21. The method of claim 17 wherein the information about the degree to which said individual medical patient performed the medically-prescribed action includes information about frequency, within a given period, that the individual performed the medically prescribed action.

22. A method for increasing medical adherence of a patient, comprising:

providing a means for registering and profiling individual patients;

using the profile to automatically generate and personalize a set of interventions;

categorizing, prioritizing, and selecting specific interventions;

incorporating the selected interventions into a member user interface page personalized for each of those patients;

serving the selected interventions to the patient at the appropriate time via a plurality of channels;

observing and measuring member responses and recording member responses in a database and analyzing the responses;

adapting the interventions, based on the analysis, to keep the member actively engaged;

updating the member'"'"'s adherence profile based on analysis of the database; and

providing member reports to authorized parties for purposes of paying member incentives, predicting and reducing utilization of high-cost healthcare services.

23. The method of claim 22, further comprising:

escalating the interventions if the member response is inadequate and getting other authorized parties involved to persuade the member to respond;

24. The method of claim 22, further comprising:

providing aggregate de-identified reports for purposes of predicting future risk, reserving set asides, stabilizing production of prescription medications and supply chain replenishment requirements.

25. A method, comprising:

breaking down medical conditions, regimens, processes and clinical trials into phases &

stages;

associating each stage with intervention and content links relevant to questions a patient may have at each stage;

importing patient data from external sources and also directly from the patient;

coordinating patient data within a personalized patient interface page;

mapping specific stages in each condition to specific interventions &

filtered content and presenting that information to a patient in conjunction with that patient'"'"'s personal data;

retrieving content from the web in real time using a combination of predetermined search words, specialized search engines, and consolidation of links;

dynamically presenting filtered portions of the retrieved content to a patient within the personalized patient interface page in separate tabs;

prioritizing &

categorizing patient interventions;

generating action plans within specified calendar time windows;

sending patient interventions to a patient thru multiple communication channels according to rules-based timing and frequency;

receiving and interpreting patient responses through the multiple communication channels;

incorporating a rules-based handling of patient responses including progression to following stages and invocation of multiple dependent and independent processes;

moderating the patient-reported measurements including correcting the measurements for bias;

incorporating a rules-based handling of non-responses including escalations, alerts and exceptions;

performing analytics on individual patient adherence score utilizing patient response patterns, web behavior; and

obtaining corroboration from clinical results/data from authorized 3^rd parties or direct observation methods.

26. The method of claim 25, further comprising:

wherein the analytics comprise individual, descriptive, predictive, slope, and trend; and

wherein the analytics comprise group, descriptive, predictive, slope and trend.