CA2917027A1 - Method and system for generating a clinical intervention report - Google Patents
Method and system for generating a clinical intervention report Download PDFInfo
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- CA2917027A1 CA2917027A1 CA2917027A CA2917027A CA2917027A1 CA 2917027 A1 CA2917027 A1 CA 2917027A1 CA 2917027 A CA2917027 A CA 2917027A CA 2917027 A CA2917027 A CA 2917027A CA 2917027 A1 CA2917027 A1 CA 2917027A1
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H70/00—ICT specially adapted for the handling or processing of medical references
- G16H70/40—ICT specially adapted for the handling or processing of medical references relating to drugs, e.g. their side effects or intended usage
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
- G06Q10/00—Administration; Management
- G06Q10/10—Office automation; Time management
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
- G06Q30/00—Commerce
- G06Q30/04—Billing or invoicing
Abstract
A clinical intervention system comprising: a search module for receiving a search query associated with a drug related problem (DRP) from a user and for generating a set of search terms from said search query to identify at least one patient in a pharmacy patient database eligible for a clinical intervention based on predefined rules in DRP rules database; a reporting module for generating a preliminary clinical intervention report and prepopulating particular fields of said preliminary clinical intervention report with one of at least patient data, said DRP, a solution to said DRP, pharmacist data, prescriber data; and compiling a final clinical intervention report comprising preliminary clinical intervention report and user generated content; and a notification module for transmitting said final clinical intervention report to at least one recipient.
Description
METHOD AND SYSTEM FOR GENERATING A CLINICAL INTERVENTION
REPORT
FIELD OF THE INVENTION
[0001] The present invention relates to clinical interventions, more particularly it relates to methods and systems for identifying, resolving drug related problems and generating a clinical intervention report based on pharmacy dispensing records.
DESCRIPTION OF THE RELATED ART
REPORT
FIELD OF THE INVENTION
[0001] The present invention relates to clinical interventions, more particularly it relates to methods and systems for identifying, resolving drug related problems and generating a clinical intervention report based on pharmacy dispensing records.
DESCRIPTION OF THE RELATED ART
[0002] Drug therapy problems are the clinical domain of the pharmaceutical care practitioner, and are central to pharmaceutical care practice. A drug therapy problem is any undesirable event experienced by a patient that involves, or is suspected to involve, drug therapy, and that interferes with achieving the desired goals of therapy and requires professional judgment to resolve. If not resolved, drug therapy problems can have clinical consequences. While it would be desirable to prevent drug related problems, this is often not possible due to the complexity of pharmacotherapy, lack of training or knowledge of health care providers and the behaviour of patients. In some instances, some pharmacotherapy problems are the result of an unexpected reaction to drug therapy by the patient. Accordingly, it is desirable to identify drug therapy problems, thereby helping patients achieve their goals of therapy and realize the best possible outcomes from drug therapy.
[0003] At present there does not exist an end-to-end solution for automatically identifying and resolving drug related problems (DRPs), and sending a clinical intervention report based on a pharmacy dispensing record, to a recipient. The current approach for identifying and resolving DRPs is fragmented and includes a plethora of stand-alone solutions which fall short of adequately addressing this problem.
Inevitably, inter-operability between these stand-alone solutions may be challenging, and generally results in increased set-up and maintenance costs. Moreover, these disparate solutions require an inordinate amount of training and manual input, which makes them prone to human error, and are relatively non-user friendly.
Inevitably, inter-operability between these stand-alone solutions may be challenging, and generally results in increased set-up and maintenance costs. Moreover, these disparate solutions require an inordinate amount of training and manual input, which makes them prone to human error, and are relatively non-user friendly.
[0004] It is an object of the present invention to mitigate or obviate at least one of the above-mentioned disadvantages.
SUMMARY OF THE INVENTION
100051 In one of its aspects, there is provided a system for identifying at least one drug-related problem (DRP), said system comprising:
a search module operating to structure a search query based on a predetermined criteria and apply said search query to a pharmacy patient database and a DRP
rules database to identify at least one patient eligible for a clinical intervention;
a reporting module operating to generate a preliminary clinical intervention report for said at least one patient identified in said search query, and to prepopulate particular fields of said preliminary clinical intervention report with at least one of patient data, pharmacist data, prescriber data, prescription data, said at least one DRP, a proposed solution to said at least one DRP, and to compile a final clinical intervention report comprising said preliminary clinical intervention report and user generated content; and a billing module operating to generate a bill for said final clinical intervention report to a payer 100061 In another of its aspects, there is provided a non-transitory computer readable storage medium storing instructions that when executed by a computer system cause said computer system to perform operations comprising:
structuring a drug related problem (DRP) query;
accessing a patient database and a DRP rules database to identify at least one patient having at least one DRP based on said DRP query, said patient database including prescription dispensing records associated with said at least one patient;
determining whether said at least one patient identified in said DRP query is eligible for a clinical intervention;
generating a solution to said DRP for said at least one patient eligible for said clinical intervention;
generating a clinical intervention report associated with said at least one patient is eligible for said clinical intervention;
transmitting said report to at least one recipient; and generating a bill for settlement by a third party.
100071 In another of its aspects, there is provided a clinical intervention method comprising the steps of:
structuring a drug related problem (DRP) query;
accessing a patient database and said DRP rules database to identify at least one patient having at least one DRP based on said DRP query, said patient database including dispensing records associated with said at least one patient;
determining whether said at least one patient identified in said DRP query is eligible for a clinical intervention;
generating a report associated with said at least one patient, said report comprising at least one of patient data, pharmacist data, said DRY, a proposed solution to said DRP, prescriber data, and user generated content;
transmitting said report to at least one recipient; and generating a bill for settlement by a third party.
10008] In another of its aspects, there is provided a first computing system for generating a clinical intervention report, said first computing system being accessible by a second computing system over a network, said first computing system comprising:
a search module for receiving a search query associated with a drug related problem (DRP) from a user via said second computing system and for generating a set of search terms from said search query to identify at least one patient in a pharmacy patient database eligible for a clinical intervention based on predefined rules in DRP
rules database;
a reporting module for generating a preliminary clinical intervention report and prepopulating particular fields of said preliminary clinical intervention report with one of at least patient data, said DRP, a solution to said DRP, pharmacist data, prescriber data;
and compiling a final clinical intervention report comprising said preliminary clinical intervention report and user generated content;
a collaboration module for providing a user-interface for facilitating communication between a user and a healthcare professional associated with said patient;
a reporting database for storing said final clinical intervention report;
a notification module for transmitting said final clinical intervention report to at least one recipient;
a notification database for storing records of said transmitted reports, timestamps of said transmission and said at least one recipient;
a billing module coupled to said notification module to provide billing statements to a payer; and a billing database for storing said billing statements.
100091 In another of its aspects, there is provided a clinical intervention system comprising:
a search module for receiving a search query associated with a drug related problem (DRP) from a user and for generating a set of search terms from said search query to identify at least one patient in a pharmacy patient database eligible for a clinical intervention based on predefined rules in DRP rules database;
a reporting module for generating a preliminary clinical intervention report and prepopulating particular fields of said preliminary clinical intervention report with one of at least patient data, said DRP, a solution to said DRP, pharmacist data, prescriber data;
and compiling a final clinical intervention report comprising preliminary clinical intervention report and user generated content; and a notification module for transmitting said final clinical intervention report to at least one recipient.
100101 Advantageously, the method and system provides an end-to-end solution for dealing with drug related problems (DRPs) in a pharmacy environment, such as a community pharmacy. The method and system reverses the conventional prior art approaches of identifying drug related problems, in which a patient's drug use is examined in order to identify potential issues. Rather, in one of the aspects of the invention, firstly, a clinical issue is defined and then patients affected by the predefined clinical issue are identified by querying relevant data repositories associated with dispensing records pertaining to the patient. These records comprise patient identity information and patient medication data. Therefore, exhaustive searches may be conducted to discover eligible patients for clinical intervention. In addition, each step in the intervention process is substantially automated, which results in greater efficiency and reduced human errors, more expedient billing, and faster payment and reimbursement by payers, such as patients, insurance providers, government institutions, and so forth.
BRIEF DESCRIPTION OF THE DRAWINGS
[0011] Several exemplary embodiments of the present invention will now be described, by way of example only, with reference to the appended drawings in which:
[0012] Figure 1 shows an exemplary computing system;
[0013] Figure 2 shows an exemplary environment in which a method and system for identifying patients eligible for a clinical intervention, resolving a drug related problem associated with the patients, and transmitting corresponding clinical intervention reports operates;
[0014] Figure 3 shows a high level flow diagram illustrating an exemplary process steps for identifying patients eligible for a clinical intervention, resolving a drug related problems associated therewith, and transmitting corresponding clinical intervention reports, based on pharmacy dispensing records; and [0015] Figure 4 shows an exemplary consultation template form.
DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTS
[0016] Various embodiments of the disclosure are discussed in detail below.
While specific implementations are discussed, it should be understood that this is done for illustration purposes only. A person skilled in the relevant art will recognize that other components and configurations may be used without parting from the spirit and scope of the disclosure.
[0017] As used herein, the term "patient" refers to any person or persons for whom a prescription order is filled for a particular patient condition.
[0018] The term "user" refers to any person or a health professional trained in the art of preparing and dispensing drugs and/or prescribed medical treatments.
[0019] The terms "pharmacist," "Registered Pharmacist," and "RPh" may be used interchangeably throughout this specification, and are used to describe a health professional trained in the art of preparing and dispensing drugs and/or prescribed medical treatments.
[0020] The terms "prescription" and "Rx" may be used interchangeably throughout this specification, and are used to describe an order for the preparation and administration of a medicine or other treatment.
[0021] The terms "drugs", -drug therapy", "medication" and "medical therapy" are used herein interchangeably. A drug is assigned a drug identification number (DIN), by the Health Canada Drug Product Database (DPD) or a national drug code (NDC) by the Food and Drug Administration (FDA).
[0022] The term "clinicians" may include, but are not limited to, a treating physician or physicians, specialists such as surgeons, radiologists, cardiologists, and oncologists, emergency medical technicians, physicians' assistants, nurse practitioners, nurses, nurses' aides, dieticians, microbiologists, laboratory experts, genetic counselors, researchers, veterinarians, students, and the like.
[0023] A detailed discussion of the methods and systems surrounding the concepts of identifying, resolving a drug related problem and transmitting clinical intervention based on a pharmacy dispensing record is provided below. First, a brief introductory description of a basic general purpose system or computing device which can be employed to practice the concepts is illustrated in Figure 1.
[0024] With reference to Figure 1, an exemplary computing system 10 includes a general-purpose computing device 10, including a processing unit (CPU or processor) 12 and a system bus 11 that couples various system components including the system memory 13 such as read only memory (ROM) 14 and random access memory (RAM) 15 to the processor 12. The system 10 can include a cache 16 of high speed memory connected directly with, in close proximity to, or integrated as part of the processor 12.
The system 10 copies data from the memory 13 and/or the storage device 18 to the cache 16 for quick access by the processor 12. In this way, the cache provides a performance boost that avoids processor 12 delays while waiting for data. These and other modules can control or be configured to control the processor 12 to perform various actions. Other system memory 13 may be available for use as well. The memory 13 can include multiple different types of memory with different performance characteristics. It can be appreciated that the methods and system may operate on a computing device 10 with more than one processor 12 or on a group or cluster of computing devices networked together to provide greater processing capability. The processor 12 can include any general purpose processor and a hardware module or software module, such as module 1 20a, module 2 20b, and module 3 20c stored in storage device 18, configured to control the processor 12 as well as a special-purpose processor where software instructions are incorporated into the actual processor design. The processor 12 may essentially be a completely self-contained computing system, containing multiple cores or processors, a bus, memory controller, cache, etc. A multi-core processor may be symmetric or asymmetric.
[0025] The system bus 11 may be any of several types of bus structures including a memory bus or memory controller, a peripheral bus, and a local bus using any of a variety of bus architectures. A basic input/output (BIOS) stored in ROM 14 or the like, may provide the basic routine that helps to transfer information between elements within the computing device 10, such as during start-up. The computing device 10 further includes storage devices 18 such as a hard disk drive, a magnetic disk drive, an optical disk drive, a solid state drive, a tape drive or the like. The storage device 18 can include software modules 20a, 20b, 20n for controlling the processor 12. Other hardware or software modules are contemplated. The storage device 18 is connected to the system bus 11 by a drive interface. The drives and the associated computer readable storage media provide non-volatile storage of computer readable instructions, data structures, program modules and other data for the computing device 10. In one aspect, a hardware module that performs a particular function includes the software component stored in a non-transitory computer-readable medium in connection with the necessary hardware components, such as the processor 12, bus 11, display 22, and so forth, to carry out the function. The basic components are known to those of skill in the art and appropriate variations are contemplated depending on the type of device, such as whether the device is a handheld computing device, a desktop computer, or a computer server.
[0026]
Although the exemplary embodiment described herein employs the hard disk 18, it should be appreciated by those skilled in the art that other types of computer readable media which can store data that are accessible by a computer, such as magnetic cassettes, flash memory cards, digital versatile disks, cartridges, random access memories (RAMs) 15, read only memory (ROM) 14, a cable or wireless signal containing a bit stream and the like, may also be used in the exemplary operating environment.
Non-transitory computer-readable storage media expressly exclude media such as energy, carrier signals, electromagnetic waves, and signals per se.
[0027] To enable user interaction with the computing device 10, an input device 24 represents any number of input mechanisms, such as a microphone for speech, a touch-sensitive screen for gesture or graphical input, keyboard, mouse, motion input, speech and so forth. An output device 22 can also be one or more of a number of output mechanisms known to those of skill in the art. In some instances, multimodal systems enable a user to provide multiple types of input to communicate with the computing device 10. The communications interface 26 generally governs and manages the user input and system output. There is no restriction on operating on any particular hardware arrangement and therefore the basic features here may easily be substituted for improved hardware or firmware arrangements as they are developed.
[0028] For clarity of explanation, the illustrative system embodiment is presented as including individual functional blocks, including functional blocks labeled as a "processor" or processor 12. The functions these blocks represent may be provided through the use of either shared or dedicated hardware, including, but not limited to, hardware capable of executing software and hardware, such as a processor 12, that is purpose-built to operate as an equivalent to software executing on a general purpose processor. For example, the functions of one or more processors, presented in Figure 1, may be provided by a single shared processor or multiple processors. (Use of the term "processor" should not be construed to refer exclusively to hardware capable of executing software.) Illustrative embodiments may include microprocessor and/or digital signal processor (DSP) hardware, read-only memory (ROM) 14 for storing software performing the operations discussed below, and random access memory (RAM) 15 for storing results. Very large scale integration (VLSI) hardware embodiments, as well as custom VLSI circuitry in combination with a general purpose DSP circuit, may also be provided.
[0029] The logical operations of the various embodiments are implemented as: (1) a sequence of computer implemented steps, operations, or procedures running on a programmable circuit within a general use computer, (2) a sequence of computer implemented steps, operations, or procedures running on a specific-use programmable circuit; and/or (3) interconnected machine modules or program engines within the programmable circuits. The system 10, shown in Figure 1, can practice all or part of the recited methods, can be a part of the recited systems, and/or can operate according to instructions in the recited non-transitory computer-readable storage media.
Such logical operations can be implemented as modules configured to control the processor 12 to perform particular functions according to the programming of the module. For example, Figure 1 illustrates three modules 20a, 20b and 20n which are modules configured to control the processor 12. These modules 20a, 20b and 20n may be stored on the storage device 18 and loaded into RAM 15 or memory 13 at runtime or may be stored, as would be known in the art, in other computer-readable memory locations.
[0030] Computer system 10 can be of varying types including a workstation, server, computing cluster, blade server, server farm, or any other data processing system or computing device. Due to the ever-changing nature of computers and networks, the description of computer system 10 depicted in Figure 1 is intended only as a specific example for purposes of illustrating some implementations. Many other configurations of computer system 10 are possible having more or fewer components than the computer system depicted in Figure 1.
[0031] A detailed description of the methods and systems surrounding the concepts of identifying a patient eligible for a clinical intervention, resolving a drug related problem and transmitting a clinical intervention report will now follow.
Several variations shall be discussed herein as the various embodiments are set forth.
Figure 2 shows a top-level component architecture diagram of an exemplary an exemplary environment, generally identified by reference numeral 30, for which the methods and systems for identifying a patient eligible for a clinical intervention, resolving a drug related problem and transmitting a clinical intervention report based on a pharmacy dispensing record operate. As shown, Figure 2 illustrates environment 30, in which a user interacts with computing system 32, such as an application server, through user computer terminal 34 communicatively coupled thereto via communication medium 35, or network, e.g., the Internet, and/or any other suitable network. The computers of environment 30 comprise the features of the general-purpose computing device 10, as described above, and may include, but are not limited to: a mini computer, a handheld communication device, e.g. a tablet, a mobile device, a smart phone, a smartwatch, a wearable device, a personal computer, a server computer, a series of server computers, and a mainframe computer. Coupled to application server 32 is pharmacy patient database 36 which receives queries from user computers 34 via application server 32 to identify patients matching particular criteria which are eligible for a clinical intervention.
[0032] Pharmacy patient database 36 stores patient information, such as, name, social insurance number or social security number, health card number, date of birth, gender, patient identifier, contact information; and prescription information, such as, drug identification, patient's appropriate dosage, and number of refills allowed, including patient insurance information, including dispensing records. Pharmacists receive prescription information or Rx orders from a plurality of sources, for example, patients, guardians, and caregivers, multiple medical entities, hospitals, clinics, and clinicians.
Computers 34 may be located, locally or remotely, in a pharmacy storefront, hospitals, and a distribution center such as for a mail-order pharmacy or other facilities that dispense medication. Computers 34 may be remotely-located at a variety of locations in a medical or research environment, for example, but not limited to, clinical laboratories, hospitals and other inpatient settings, veterinary environments, ambulatory settings, medical billing and financial offices, hospital administration settings, home health care environments, and clinicians' offices.
[0033] In more detail, application server 32 comprises clinical intervention engine 33 for identifying patients that are eligible for clinical interventions, resolving drug related problems and notifying 3rd parties of the outcome of the intervention via clinical intervention reports. DRP rules database 38 is accessed by clinical intervention engine 33, and comprises rules and rule sets related to drug conflicts, such as, incompatible medications (e.g. "drug-to-drug" interactions), drug-genomic conflicts (e.g.
conflicts between a drug a patient's genetic make-up), drug-physiology conflicts (e.g.
conflicts between a drug and a patient's physiology), drug-disease conflicts, drug-lab conflicts, drug-age conflicts, drug-allergy conflicts, etc. DRP rules database 38 also comprises rules and rule sets based on available literature, studies, position papers, industry practice, peer-reviewed studies, feedback from pharmacists, feedback from patients, surveys, medical guidelines, clinical guidelines, operational guidelines, and may include, for example, medication usage criteria and decision trees, weighting factors and systems, and so forth. Generally, a drug therapy problem includes a description of the patient's condition or problem, the drug therapy involved, and the specific association between the drug therapy and the patient's condition. Drug therapy problems may be assessed for their severity, acuteness, and significance to the patient to determine how quickly the resolution of the problem must occur. For example, unambiguous DRPs with standard solutions may be solved expeditiously, such as: identifying patients effected by drug recalls or maximum dose changes, identifying patients for whom specific vaccines are indicated, dealing with maximum duration of therapy issues and finding patients for whom new drug therapies might be preferable. Accordingly, each DRP may be associated with a score which takes into account the severity, acuteness, and significance to the patient, and the score dictates the expediency of the resolution.
[0034] A DRP may be any one of: therapeutic duplication; requires drug; sub-optimal response to a drug; dosage too low; adverse drug reaction; dangerously high dose; non-compliance; non-adherence and continued forgery or falsified prescription. In one example, when the DRP corresponds to a therapeutic duplication, then the drug may not be necessary; while when the DRP corresponds to requires drug, then additional drug therapy is an option; and when the DRP is dangerously high dose, then there exists potential overuse and/or abuse. Each DRP may be assigned a weighting factor based on its severity, acuteness, and significance to the patient, especially when multiple DRPs exist.
[0035] Clinical intervention engine 33 also comprises search module 40 which receives a predetermined drug related problem criteria for a search, translates the drug criteria into a structured database query, and applies the query to pharmacy patient database 36 and DRP rules database 38 to find and generate a record set containing records for patients meeting the drug related problem criteria based on the patient's medical condition and the patient's pharmacotherapy.
[0036] Clinical intervention engine 33 further comprises reporting engine module 44, collaboration module 45, notification module 48 and billing module 52.
Reporting engine module 44 comprises instructions in data storage 18, executable by processor 12 to cause processor 12 to generate a preliminary clinical intervention report based on the search query results. Particular fields of the preliminary clinical intervention report are prepopulated, and may include patient data, the DRP, a solution to the DRP
based on the rules or rule sets from DRP rules database 38 and patient data, prescriber data, prescription data, and so forth. Collaboration module 45 provides a user-interface through which a user can interact with a prescriber, such as the patient's primary care physician, in the event that a consultation with the prescriber is required in order for the pharmacist to make a recommendation regarding the drug therapy issue.
Reporting engine module 44 also compiles a final clinical intervention report comprising the patient data, prescriber data, the DRP, proposed solution to the DRP, prescription data, user generated content such as the pharmacist's recommendations and comments, and the prescriber's review and comments, and so forth. The final clinical intervention report is stored in reporting database 46, and notification module 48 transmits the final clinical intervention report to a third party. Notification database 50 stores records of transmitted reports, date/time of transmission and recipients. Also included with the clinical intervention engine 33 is billing module 52 coupled to notification module 48 which operates to initiate billing and issue a billing statement or claim pertaining to the clinical intervention report to a payer, such as a third party, an insurance provider, a healthcare facility, and a government institution. Financial records of billing statements or claims made, outstanding bills or claims, funds received, accounts receivable are maintained by billing database 54 maintains records for accounting purposes. The funds are transferred electronically or by paper to the user's account or pharmacist account at an appropriate financial institution.
100371 It should be understood that the clinical intervention engine 33 as depicted is merely provided for illustrative purposes and may have more, or less modules and the modules may vary in their functionality or in how the functionality is implemented. One or more of the components and/or one or more additional components of the example environment of Figure 2 may each include memory for storage of data and software applications, a processor for accessing data and executing applications, and components that facilitate communication over a network. In some implementations, the components may include hardware that shares one or more characteristics with the example computer system that is illustrated in Figure 1.
[0038] It should be noted that although application server 32 has been described as having clinical intervention engine 33 with search module 40, reporting module 44, notification module 48, and billing module 52, and associated databases 36, 38, 46, 50 and 54, user computer 34 may include clinical intervention engine 33 with modules 40, 42, 44, 48, and 52, and having access to associated databases 36, 38, 46, 50 and 54, to operate as a stand-alone solution. Accordingly, clinical intervention engine 33 may be included as an add-on to an existing pharmacy management system to provide the above-noted functionality.
[0039] Advantageously, clinical intervention engine 33 allows for automation of the patient identification and the DRP resolution process, document creation having an audit trail of the actions taken by the user. Combined, these elements substantially enhance patient safety, promote better drug use, substantially enhance regulatory compliance, and substantially increase the revenue for a pharmacy. In addition the user experience is greatly enhanced, while the prevalence of human error is greatly diminished.
[0040] Referring to Figure 3, an exemplary flowchart of an overview of clinical intervention engine 33 for identifying a patient eligible for a clinical intervention, resolving a drug related problem and transmitting a clinical intervention report based on a prescription dispensing record is shown. Other implementations may perform the steps in a different order, omit certain steps, and/or perform different and/or additional steps than those illustrated in Figure 3. For convenience, aspects of Figure 3 will be described with reference to one or more components of Figure 2 that may perform the method, such as the search module 40, reporting module 44, notification module 48, and billing module 52, and associated databases 36, 38, 46, 50 and 54. First, a search event pertaining to a drug related problem (DRP) with predetermined criteria is generated by a user at user computer 34. Search module 40 then translates the search event into a structured query (step 100). The search query is applied to pharmacy patient database 36.
[0041] Next, the structured query is received by the application server 32 which accesses patient database 36 containing patient data, such as identity and dispensing records, and DRP rules database 38, in order to identify patients matching the DRP query (step 102). For example, the DRP query may be structured to find patients that are over a particular age, and have taken a certain anti-inflammatory drug (DIN), at a specific dose within a particular time period. The search query may be initiated automatically, such as by a predefined trigger event, such as a scheduled search, for example, a daily or weekly search; age of the patient; previous search query; or an update to the DRP
rules database.
In step 104, a determination is made as to whether the patient identified following the DRP query is eligible for a clinical intervention, based on a second criterion or guidelines stored in a DRP rules database 38. Accordingly, search module 40 communicates with DRP rules database 38, which contains rules and rule sets associated with different types of clinical decision support events. When the identified patient is eligible for a clinical intervention, search module 40 generates a preliminary clinical intervention report which includes a solution for the DRP (step 106), otherwise the process returns to step 100.
[0042] In step 108, reporting engine module 44 prepopulates particular fields of a preliminary clinical intervention report with data, including patient data, the DRP, solution to the DRP, prescriber data, pharmacist data, prescription data, and so forth.
[0043] A client application at pharmacy computer 34 receives the preliminary clinical intervention report with the prepopulated fields for presentation on the user interface 22 of pharmacy computer 34 (step 110). A determination as to whether a consultation with the prescriber, such as the patient's physician is required is made (step 112). The determination is based on the content of the initial preliminary clinical intervention report. When a consultation with the physician or prescriber is required then a communication session is initiated with the prescriber via collaboration module 45 (step 114), as described below with reference to Figure 4, otherwise the process proceeds to step 116.
[0044] Figure 4 shows an example of a consultation template form 200 concerning a drug prescribed for a patient from a user to the patient's physician or doctor. Consultation template form 200 is generated by collaboration module 45 when a consultation with the doctor is required in order resolve identified problems with the patient's medications and patient condition. Form 200 comprises a plurality of form elements with associated pertinent input fields 201, such as, form element 202 representing the doctor's name and contact information for the doctor, such as address, telephone number, facsimile number or email address. Form element 204 represents the pharmacy's name and contact information for the pharmacy, such as address, telephone number, facsimile number or email address. The patient's name and contact information, such as address, telephone number, facsimile number or email address, date of birth, gender, health card information or identifier are represented by form element 206. The prescribed drug information and the subject of the intervention report are represented in form element 208.
The following information may be included: brand name of the drug and packaging or pill format, drug identification number (DIN), drug strength, route of administration, are included e.g.
"Apo-Diclo SR 75mg TAB, (Diclofenac Sodium), DIN 02162814, Take 1 Tablet Twice Daily When Required". Form element 210 represents the substance of the communication, or informational message, and summarizes the identified drug related problem pertaining to the prescribed drug, the user's concerns and recommendations to resolve the identified problem. Form element 210 may also include a selection of a category associated with the DRP, such as, therapeutic duplication (drug may not be necessary; patient needs additional drug therapy; drug is not working as well as needed (sub-optimal response to a drug); dosage too low; adverse drug reaction due to allergy or conflict with another medication or food; dangerously high dose or patient taking too much medication (either accidentally or deliberately); non-compliance (refusing drug or not taking it properly); non-adherence and confirmed forgery or falsified prescription.
The user's name, signature and identification details, such as a registration number or license number issued by a pharmacist governing body, and date, are represented by form element 212. Certain input fields 201 may be prepopulated with data derived from the clinical intervention report.
[0045] The preliminary clinical intervention report may include free-form fields, radio buttons, dropdown lists, and checkboxes. After the input of user-generated content, such as comments and recommendations, and feedback content from the consultation with the physician, the preliminary clinical intervention report is transmitted to the application server 32 (step 116). Reporting engine module 44 receives the preliminary clinical intervention report and compiles a final clinical intervention report comprising patient data, the DRP, proposed solution to the DRP, pharmacist data, prescriber data, and user generated content (step 118).
[0046] The final clinical intervention report includes the doctor's name and contact information for the doctor, such as address, telephone number, facsimile number or email address. The report also includes the pharmacy's name and contact information for the pharmacy, such as address, telephone number, facsimile number or email address. Also included is the patient's name and contact information, such as address, telephone number, facsimile number or email address, date of birth, gender, health card information or identifier are represented by form element 206. The prescribed drug information and/or prescription details, and the identified drug related problem pertaining to the prescribed drug, the user's concerns and recommendations to resolve the identified problem. The final intervention report also includes a selection of a category associated with the DRP, such as, therapeutic duplication (drug may not be necessary;
patient needs additional drug therapy; drug is not working as well as needed (sub-optimal response to a drug); dosage too low; adverse drug reaction due to allergy or conflict with another medication or food; dangerously high dose or patient taking too much medication (either accidentally or deliberately); non-compliance (refusing drug or not taking it properly);
non-adherence and confirmed forgery or falsified prescription. The user's name, signature and identification details, such as a registration number or license number issued by a pharmacist governing body, and date.
[0047] The final clinical intervention report may indicate a plurality of outcomes pertaining to the DRP, such as one in which the prescription is not filled, one in which the prescription is not filled when there is a determination of at least of confirmed forgery of the prescription and a clinical concern based on consultation with the prescriber, another in which there is no change in a prescription as prescribed following a collaborative communication session with the prescriber; and yet another in which there is a change in a prescription as prescribed following a collaborative communication session with the prescriber.
[0048] The final clinical intervention report may indicate a plurality of outcomes pertaining to the resolution of the DRP, such as one in which the problem is completely solved, another in which the problem is partially solved, and yet another in which the problem is not solved.
[0049] Next, the final clinical intervention report is transmitted to a third party, such as a physician, an insurance provider, a healthcare facility, or a government institution (step 120) to provide notification and details of the clinical intervention.
The report may be transmitted by any one of: fax, electronic fax, electronic mail, SMS, MMS, or printed and sent via snail mail, among others. Alternatively, the report is automatically associated with an electronic health record (EHR) pertaining to the patient. For example, the user interface 22 of pharmacy computer 34 includes a graphical user interface (GUI) icon or button to send the report directly into a patient's EHR electronically in an electronic management record (EMR) system. A copy of the report may also be sent to the patient, the patient's guardian and/or the patient physician or clinician.
[0050] Details of the transmitted reports, such as, user identity, patient identity, date/time transmission, prescriber identity, recipient identity, and historical data pertaining to transmitted reports are stored in notification database 50 (step 122). Lastly, billing module 52 coupled to notification module 48 provides billing statements to third parties, such as, an insurance provider, a healthcare facility, or a government institution (step 124), and the billing statements are stored in billing database 54 coupled to application server 32. Accordingly, application server 32 is capable of determining the number of clinical interventions associated with a specific patient that a particular user has sent. The bill statement and the final clinical intervention report may be sent concurrently to the payer. Copies of the billing statements may also be sent to the patient, the patient's guardian or a physician, for record keeping purposes.
[0051] In another implementation, billing module 52 facilitates third-party (insurance) reimbursement. Possible examples include patient specific, formulary eligibility queries or auto-mated preauthorization process.
[0052] In another implementation, databases 36, 38, 46, 50 and 54 may be included in a single database.
[0053] In another implementation, clinical intervention engine 33 can additionally include an application programming interface (API) or an alternative suitable integration mechanism such as a software development kit (SDK), libraries, and/or other suitable interface tool. The API can function to allow external applications and services to interface and use clinical intervention engine 33 in combination with an internal authentication process. For example, external platform 60 may use an internal account username and password authentication process but make it dependent on successful completion of multi-factor authentication facilitated by the clinical intervention engine 33. External platform 60 can use the API to communicate and integrate with clinical intervention engine 33. Alternatively, the clinical intervention engine 33 can exist as a sub-system of a larger system such as a social network platform or an enterprise platform.
In one example, an API for linking external platform 60, e.g. an insurer system, with application server 32 or pharmacy computer 34 is included.
[0054] In another implementation, integration of the pharmaco-genomic information into environment 30 for the purposes of reimbursement, and treatment decisions could also be facilitated by the aforementioned method and system.
[0055] In another implementation, medical guideline updates are pushed to, or pulled by, user terminals 34 in order to provide timely updates to users, such as pharmacists.
For example, educational content related to a DRP associated with the identified patients is made available.
[0056] In another implementation, enrolled users may exchange ideas and information on a peer-to-peer basis, such as on a peer-to-peer platform.
[0057] In yet another embodiment, the method and system can track the pharmacist's effects on overall patient health outcomes, given the fact that the solution can correlate pharmacist actions (e.g. decision on presented DRP) and changes prescription therapy.
Taken in aggregate, this information would be valuable to third-party payers, government agencies, professional organizations and manufacturers. The feature opens the possibility up for predictive analytics of various types. For example, clinical intervention engine 33 may be combined with artificial intelligence or other deep learning approaches to proactively identify health improvement opportunities rather than just respond to them as they arise.
[0058] In another implementation, patient data records are processed in accordance with regulatory requirements, such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) or the Personal Information Protection and Electronic Documents Act (PIPEDA), and may also be stored within data storage structure 36.
[0059] In another embodiment, the patient medical data records that have been processed in accordance with regulatory requirements, such as HIPAA or PIPEDA, may be stored in a separate patient database. It is known that patient medical data that has been disassociated from all patient identification data does not fall within the regulatory requirements of HIPAA.
[0060]
Embodiments within the scope of the present disclosure may also include tangible and/or non-transitory computer-readable storage media for carrying or having computer-executable instructions or data structures stored thereon. Such non-transitory computer-readable storage media can be any available media that can be accessed by a general purpose or special purpose computer, including the functional design of any special purpose processor as discussed above. By way of example, and not limitation, such non-transitory computer-readable media can include RAM, ROM, EEPROM, CD-ROM or other optical disk storage, magnetic disk storage or other magnetic storage devices, solid state drives, or any other medium which can be used to carry or store desired program code means in the form of computer-executable instructions, data structures, or processor chip design. When infounation is transferred or provided over a network or another communications connection (either hardwired, wireless, or combination thereof) to a computer, the computer properly views the connection as a computer-readable medium. Thus, any such connection is properly termed a computer-readable medium. Combinations of the above should also be included within the scope of the computer-readable media.
[0061] Computer-executable instructions include, for example, instructions and data which cause a general purpose computer, special purpose computer, or special purpose processing device to perform a certain function or group of functions.
Computer-executable instructions also include program modules that are executed by computers in stand-alone or network environments. Generally, program modules include routines, programs, components, data structures, objects, and the functions inherent in the design of special-purpose processors, etc. that perform particular tasks or implement particular abstract data types. Computer-executable instructions, associated data structures, and program modules represent examples of the program code means for executing steps of the methods disclosed herein. The particular sequence of such executable instructions or associated data structures represents examples of corresponding acts for implementing the functions described in such steps.
[0062] Certain embodiments described herein may be implemented as logic or a number of modules, engines, components, or mechanisms. A module, engine, logic, component, or mechanism (collectively referred to as a "module") may be a tangible unit capable of performing certain operations and configured or arranged in a certain manner In certain exemplary embodiments, one or more computer systems (e.g., a standalone, user, or server computer system) or one or more components of a computer system (e.g., a processor or a group of processors) may be configured by software (e.g., an application or application portion) or firmware (note that software and firmware can generally be used interchangeably herein as is known by a skilled artisan) as a module that operates to perform certain operations described herein.
[0063] Those of skill in the art will appreciate that other embodiments of the disclosure may be practiced in network computing environments with many types of computer system configurations, including personal computers, hand-held devices, multi-processor systems, microprocessor-based or programmable consumer electronics, network PCs, minicomputers, mainframe computers, and the like. Embodiments may also be practiced in distributed computing environments where tasks are performed by local and remote processing devices that are linked (either by hardwired links, wireless links, or by a combination thereof) through a communications network. In a distributed computing environment, program modules may be located in both local and remote memory storage devices.
[0064] The various embodiments described above are provided by way of illustration only and should not be construed to limit the scope of the disclosure. Those skilled in the art will readily recognize various modifications and changes that may be made to the principles described herein without following the example embodiments and applications illustrated and described herein, and without departing from the spirit and scope of the disclosure.
SUMMARY OF THE INVENTION
100051 In one of its aspects, there is provided a system for identifying at least one drug-related problem (DRP), said system comprising:
a search module operating to structure a search query based on a predetermined criteria and apply said search query to a pharmacy patient database and a DRP
rules database to identify at least one patient eligible for a clinical intervention;
a reporting module operating to generate a preliminary clinical intervention report for said at least one patient identified in said search query, and to prepopulate particular fields of said preliminary clinical intervention report with at least one of patient data, pharmacist data, prescriber data, prescription data, said at least one DRP, a proposed solution to said at least one DRP, and to compile a final clinical intervention report comprising said preliminary clinical intervention report and user generated content; and a billing module operating to generate a bill for said final clinical intervention report to a payer 100061 In another of its aspects, there is provided a non-transitory computer readable storage medium storing instructions that when executed by a computer system cause said computer system to perform operations comprising:
structuring a drug related problem (DRP) query;
accessing a patient database and a DRP rules database to identify at least one patient having at least one DRP based on said DRP query, said patient database including prescription dispensing records associated with said at least one patient;
determining whether said at least one patient identified in said DRP query is eligible for a clinical intervention;
generating a solution to said DRP for said at least one patient eligible for said clinical intervention;
generating a clinical intervention report associated with said at least one patient is eligible for said clinical intervention;
transmitting said report to at least one recipient; and generating a bill for settlement by a third party.
100071 In another of its aspects, there is provided a clinical intervention method comprising the steps of:
structuring a drug related problem (DRP) query;
accessing a patient database and said DRP rules database to identify at least one patient having at least one DRP based on said DRP query, said patient database including dispensing records associated with said at least one patient;
determining whether said at least one patient identified in said DRP query is eligible for a clinical intervention;
generating a report associated with said at least one patient, said report comprising at least one of patient data, pharmacist data, said DRY, a proposed solution to said DRP, prescriber data, and user generated content;
transmitting said report to at least one recipient; and generating a bill for settlement by a third party.
10008] In another of its aspects, there is provided a first computing system for generating a clinical intervention report, said first computing system being accessible by a second computing system over a network, said first computing system comprising:
a search module for receiving a search query associated with a drug related problem (DRP) from a user via said second computing system and for generating a set of search terms from said search query to identify at least one patient in a pharmacy patient database eligible for a clinical intervention based on predefined rules in DRP
rules database;
a reporting module for generating a preliminary clinical intervention report and prepopulating particular fields of said preliminary clinical intervention report with one of at least patient data, said DRP, a solution to said DRP, pharmacist data, prescriber data;
and compiling a final clinical intervention report comprising said preliminary clinical intervention report and user generated content;
a collaboration module for providing a user-interface for facilitating communication between a user and a healthcare professional associated with said patient;
a reporting database for storing said final clinical intervention report;
a notification module for transmitting said final clinical intervention report to at least one recipient;
a notification database for storing records of said transmitted reports, timestamps of said transmission and said at least one recipient;
a billing module coupled to said notification module to provide billing statements to a payer; and a billing database for storing said billing statements.
100091 In another of its aspects, there is provided a clinical intervention system comprising:
a search module for receiving a search query associated with a drug related problem (DRP) from a user and for generating a set of search terms from said search query to identify at least one patient in a pharmacy patient database eligible for a clinical intervention based on predefined rules in DRP rules database;
a reporting module for generating a preliminary clinical intervention report and prepopulating particular fields of said preliminary clinical intervention report with one of at least patient data, said DRP, a solution to said DRP, pharmacist data, prescriber data;
and compiling a final clinical intervention report comprising preliminary clinical intervention report and user generated content; and a notification module for transmitting said final clinical intervention report to at least one recipient.
100101 Advantageously, the method and system provides an end-to-end solution for dealing with drug related problems (DRPs) in a pharmacy environment, such as a community pharmacy. The method and system reverses the conventional prior art approaches of identifying drug related problems, in which a patient's drug use is examined in order to identify potential issues. Rather, in one of the aspects of the invention, firstly, a clinical issue is defined and then patients affected by the predefined clinical issue are identified by querying relevant data repositories associated with dispensing records pertaining to the patient. These records comprise patient identity information and patient medication data. Therefore, exhaustive searches may be conducted to discover eligible patients for clinical intervention. In addition, each step in the intervention process is substantially automated, which results in greater efficiency and reduced human errors, more expedient billing, and faster payment and reimbursement by payers, such as patients, insurance providers, government institutions, and so forth.
BRIEF DESCRIPTION OF THE DRAWINGS
[0011] Several exemplary embodiments of the present invention will now be described, by way of example only, with reference to the appended drawings in which:
[0012] Figure 1 shows an exemplary computing system;
[0013] Figure 2 shows an exemplary environment in which a method and system for identifying patients eligible for a clinical intervention, resolving a drug related problem associated with the patients, and transmitting corresponding clinical intervention reports operates;
[0014] Figure 3 shows a high level flow diagram illustrating an exemplary process steps for identifying patients eligible for a clinical intervention, resolving a drug related problems associated therewith, and transmitting corresponding clinical intervention reports, based on pharmacy dispensing records; and [0015] Figure 4 shows an exemplary consultation template form.
DETAILED DESCRIPTION OF EXEMPLARY EMBODIMENTS
[0016] Various embodiments of the disclosure are discussed in detail below.
While specific implementations are discussed, it should be understood that this is done for illustration purposes only. A person skilled in the relevant art will recognize that other components and configurations may be used without parting from the spirit and scope of the disclosure.
[0017] As used herein, the term "patient" refers to any person or persons for whom a prescription order is filled for a particular patient condition.
[0018] The term "user" refers to any person or a health professional trained in the art of preparing and dispensing drugs and/or prescribed medical treatments.
[0019] The terms "pharmacist," "Registered Pharmacist," and "RPh" may be used interchangeably throughout this specification, and are used to describe a health professional trained in the art of preparing and dispensing drugs and/or prescribed medical treatments.
[0020] The terms "prescription" and "Rx" may be used interchangeably throughout this specification, and are used to describe an order for the preparation and administration of a medicine or other treatment.
[0021] The terms "drugs", -drug therapy", "medication" and "medical therapy" are used herein interchangeably. A drug is assigned a drug identification number (DIN), by the Health Canada Drug Product Database (DPD) or a national drug code (NDC) by the Food and Drug Administration (FDA).
[0022] The term "clinicians" may include, but are not limited to, a treating physician or physicians, specialists such as surgeons, radiologists, cardiologists, and oncologists, emergency medical technicians, physicians' assistants, nurse practitioners, nurses, nurses' aides, dieticians, microbiologists, laboratory experts, genetic counselors, researchers, veterinarians, students, and the like.
[0023] A detailed discussion of the methods and systems surrounding the concepts of identifying, resolving a drug related problem and transmitting clinical intervention based on a pharmacy dispensing record is provided below. First, a brief introductory description of a basic general purpose system or computing device which can be employed to practice the concepts is illustrated in Figure 1.
[0024] With reference to Figure 1, an exemplary computing system 10 includes a general-purpose computing device 10, including a processing unit (CPU or processor) 12 and a system bus 11 that couples various system components including the system memory 13 such as read only memory (ROM) 14 and random access memory (RAM) 15 to the processor 12. The system 10 can include a cache 16 of high speed memory connected directly with, in close proximity to, or integrated as part of the processor 12.
The system 10 copies data from the memory 13 and/or the storage device 18 to the cache 16 for quick access by the processor 12. In this way, the cache provides a performance boost that avoids processor 12 delays while waiting for data. These and other modules can control or be configured to control the processor 12 to perform various actions. Other system memory 13 may be available for use as well. The memory 13 can include multiple different types of memory with different performance characteristics. It can be appreciated that the methods and system may operate on a computing device 10 with more than one processor 12 or on a group or cluster of computing devices networked together to provide greater processing capability. The processor 12 can include any general purpose processor and a hardware module or software module, such as module 1 20a, module 2 20b, and module 3 20c stored in storage device 18, configured to control the processor 12 as well as a special-purpose processor where software instructions are incorporated into the actual processor design. The processor 12 may essentially be a completely self-contained computing system, containing multiple cores or processors, a bus, memory controller, cache, etc. A multi-core processor may be symmetric or asymmetric.
[0025] The system bus 11 may be any of several types of bus structures including a memory bus or memory controller, a peripheral bus, and a local bus using any of a variety of bus architectures. A basic input/output (BIOS) stored in ROM 14 or the like, may provide the basic routine that helps to transfer information between elements within the computing device 10, such as during start-up. The computing device 10 further includes storage devices 18 such as a hard disk drive, a magnetic disk drive, an optical disk drive, a solid state drive, a tape drive or the like. The storage device 18 can include software modules 20a, 20b, 20n for controlling the processor 12. Other hardware or software modules are contemplated. The storage device 18 is connected to the system bus 11 by a drive interface. The drives and the associated computer readable storage media provide non-volatile storage of computer readable instructions, data structures, program modules and other data for the computing device 10. In one aspect, a hardware module that performs a particular function includes the software component stored in a non-transitory computer-readable medium in connection with the necessary hardware components, such as the processor 12, bus 11, display 22, and so forth, to carry out the function. The basic components are known to those of skill in the art and appropriate variations are contemplated depending on the type of device, such as whether the device is a handheld computing device, a desktop computer, or a computer server.
[0026]
Although the exemplary embodiment described herein employs the hard disk 18, it should be appreciated by those skilled in the art that other types of computer readable media which can store data that are accessible by a computer, such as magnetic cassettes, flash memory cards, digital versatile disks, cartridges, random access memories (RAMs) 15, read only memory (ROM) 14, a cable or wireless signal containing a bit stream and the like, may also be used in the exemplary operating environment.
Non-transitory computer-readable storage media expressly exclude media such as energy, carrier signals, electromagnetic waves, and signals per se.
[0027] To enable user interaction with the computing device 10, an input device 24 represents any number of input mechanisms, such as a microphone for speech, a touch-sensitive screen for gesture or graphical input, keyboard, mouse, motion input, speech and so forth. An output device 22 can also be one or more of a number of output mechanisms known to those of skill in the art. In some instances, multimodal systems enable a user to provide multiple types of input to communicate with the computing device 10. The communications interface 26 generally governs and manages the user input and system output. There is no restriction on operating on any particular hardware arrangement and therefore the basic features here may easily be substituted for improved hardware or firmware arrangements as they are developed.
[0028] For clarity of explanation, the illustrative system embodiment is presented as including individual functional blocks, including functional blocks labeled as a "processor" or processor 12. The functions these blocks represent may be provided through the use of either shared or dedicated hardware, including, but not limited to, hardware capable of executing software and hardware, such as a processor 12, that is purpose-built to operate as an equivalent to software executing on a general purpose processor. For example, the functions of one or more processors, presented in Figure 1, may be provided by a single shared processor or multiple processors. (Use of the term "processor" should not be construed to refer exclusively to hardware capable of executing software.) Illustrative embodiments may include microprocessor and/or digital signal processor (DSP) hardware, read-only memory (ROM) 14 for storing software performing the operations discussed below, and random access memory (RAM) 15 for storing results. Very large scale integration (VLSI) hardware embodiments, as well as custom VLSI circuitry in combination with a general purpose DSP circuit, may also be provided.
[0029] The logical operations of the various embodiments are implemented as: (1) a sequence of computer implemented steps, operations, or procedures running on a programmable circuit within a general use computer, (2) a sequence of computer implemented steps, operations, or procedures running on a specific-use programmable circuit; and/or (3) interconnected machine modules or program engines within the programmable circuits. The system 10, shown in Figure 1, can practice all or part of the recited methods, can be a part of the recited systems, and/or can operate according to instructions in the recited non-transitory computer-readable storage media.
Such logical operations can be implemented as modules configured to control the processor 12 to perform particular functions according to the programming of the module. For example, Figure 1 illustrates three modules 20a, 20b and 20n which are modules configured to control the processor 12. These modules 20a, 20b and 20n may be stored on the storage device 18 and loaded into RAM 15 or memory 13 at runtime or may be stored, as would be known in the art, in other computer-readable memory locations.
[0030] Computer system 10 can be of varying types including a workstation, server, computing cluster, blade server, server farm, or any other data processing system or computing device. Due to the ever-changing nature of computers and networks, the description of computer system 10 depicted in Figure 1 is intended only as a specific example for purposes of illustrating some implementations. Many other configurations of computer system 10 are possible having more or fewer components than the computer system depicted in Figure 1.
[0031] A detailed description of the methods and systems surrounding the concepts of identifying a patient eligible for a clinical intervention, resolving a drug related problem and transmitting a clinical intervention report will now follow.
Several variations shall be discussed herein as the various embodiments are set forth.
Figure 2 shows a top-level component architecture diagram of an exemplary an exemplary environment, generally identified by reference numeral 30, for which the methods and systems for identifying a patient eligible for a clinical intervention, resolving a drug related problem and transmitting a clinical intervention report based on a pharmacy dispensing record operate. As shown, Figure 2 illustrates environment 30, in which a user interacts with computing system 32, such as an application server, through user computer terminal 34 communicatively coupled thereto via communication medium 35, or network, e.g., the Internet, and/or any other suitable network. The computers of environment 30 comprise the features of the general-purpose computing device 10, as described above, and may include, but are not limited to: a mini computer, a handheld communication device, e.g. a tablet, a mobile device, a smart phone, a smartwatch, a wearable device, a personal computer, a server computer, a series of server computers, and a mainframe computer. Coupled to application server 32 is pharmacy patient database 36 which receives queries from user computers 34 via application server 32 to identify patients matching particular criteria which are eligible for a clinical intervention.
[0032] Pharmacy patient database 36 stores patient information, such as, name, social insurance number or social security number, health card number, date of birth, gender, patient identifier, contact information; and prescription information, such as, drug identification, patient's appropriate dosage, and number of refills allowed, including patient insurance information, including dispensing records. Pharmacists receive prescription information or Rx orders from a plurality of sources, for example, patients, guardians, and caregivers, multiple medical entities, hospitals, clinics, and clinicians.
Computers 34 may be located, locally or remotely, in a pharmacy storefront, hospitals, and a distribution center such as for a mail-order pharmacy or other facilities that dispense medication. Computers 34 may be remotely-located at a variety of locations in a medical or research environment, for example, but not limited to, clinical laboratories, hospitals and other inpatient settings, veterinary environments, ambulatory settings, medical billing and financial offices, hospital administration settings, home health care environments, and clinicians' offices.
[0033] In more detail, application server 32 comprises clinical intervention engine 33 for identifying patients that are eligible for clinical interventions, resolving drug related problems and notifying 3rd parties of the outcome of the intervention via clinical intervention reports. DRP rules database 38 is accessed by clinical intervention engine 33, and comprises rules and rule sets related to drug conflicts, such as, incompatible medications (e.g. "drug-to-drug" interactions), drug-genomic conflicts (e.g.
conflicts between a drug a patient's genetic make-up), drug-physiology conflicts (e.g.
conflicts between a drug and a patient's physiology), drug-disease conflicts, drug-lab conflicts, drug-age conflicts, drug-allergy conflicts, etc. DRP rules database 38 also comprises rules and rule sets based on available literature, studies, position papers, industry practice, peer-reviewed studies, feedback from pharmacists, feedback from patients, surveys, medical guidelines, clinical guidelines, operational guidelines, and may include, for example, medication usage criteria and decision trees, weighting factors and systems, and so forth. Generally, a drug therapy problem includes a description of the patient's condition or problem, the drug therapy involved, and the specific association between the drug therapy and the patient's condition. Drug therapy problems may be assessed for their severity, acuteness, and significance to the patient to determine how quickly the resolution of the problem must occur. For example, unambiguous DRPs with standard solutions may be solved expeditiously, such as: identifying patients effected by drug recalls or maximum dose changes, identifying patients for whom specific vaccines are indicated, dealing with maximum duration of therapy issues and finding patients for whom new drug therapies might be preferable. Accordingly, each DRP may be associated with a score which takes into account the severity, acuteness, and significance to the patient, and the score dictates the expediency of the resolution.
[0034] A DRP may be any one of: therapeutic duplication; requires drug; sub-optimal response to a drug; dosage too low; adverse drug reaction; dangerously high dose; non-compliance; non-adherence and continued forgery or falsified prescription. In one example, when the DRP corresponds to a therapeutic duplication, then the drug may not be necessary; while when the DRP corresponds to requires drug, then additional drug therapy is an option; and when the DRP is dangerously high dose, then there exists potential overuse and/or abuse. Each DRP may be assigned a weighting factor based on its severity, acuteness, and significance to the patient, especially when multiple DRPs exist.
[0035] Clinical intervention engine 33 also comprises search module 40 which receives a predetermined drug related problem criteria for a search, translates the drug criteria into a structured database query, and applies the query to pharmacy patient database 36 and DRP rules database 38 to find and generate a record set containing records for patients meeting the drug related problem criteria based on the patient's medical condition and the patient's pharmacotherapy.
[0036] Clinical intervention engine 33 further comprises reporting engine module 44, collaboration module 45, notification module 48 and billing module 52.
Reporting engine module 44 comprises instructions in data storage 18, executable by processor 12 to cause processor 12 to generate a preliminary clinical intervention report based on the search query results. Particular fields of the preliminary clinical intervention report are prepopulated, and may include patient data, the DRP, a solution to the DRP
based on the rules or rule sets from DRP rules database 38 and patient data, prescriber data, prescription data, and so forth. Collaboration module 45 provides a user-interface through which a user can interact with a prescriber, such as the patient's primary care physician, in the event that a consultation with the prescriber is required in order for the pharmacist to make a recommendation regarding the drug therapy issue.
Reporting engine module 44 also compiles a final clinical intervention report comprising the patient data, prescriber data, the DRP, proposed solution to the DRP, prescription data, user generated content such as the pharmacist's recommendations and comments, and the prescriber's review and comments, and so forth. The final clinical intervention report is stored in reporting database 46, and notification module 48 transmits the final clinical intervention report to a third party. Notification database 50 stores records of transmitted reports, date/time of transmission and recipients. Also included with the clinical intervention engine 33 is billing module 52 coupled to notification module 48 which operates to initiate billing and issue a billing statement or claim pertaining to the clinical intervention report to a payer, such as a third party, an insurance provider, a healthcare facility, and a government institution. Financial records of billing statements or claims made, outstanding bills or claims, funds received, accounts receivable are maintained by billing database 54 maintains records for accounting purposes. The funds are transferred electronically or by paper to the user's account or pharmacist account at an appropriate financial institution.
100371 It should be understood that the clinical intervention engine 33 as depicted is merely provided for illustrative purposes and may have more, or less modules and the modules may vary in their functionality or in how the functionality is implemented. One or more of the components and/or one or more additional components of the example environment of Figure 2 may each include memory for storage of data and software applications, a processor for accessing data and executing applications, and components that facilitate communication over a network. In some implementations, the components may include hardware that shares one or more characteristics with the example computer system that is illustrated in Figure 1.
[0038] It should be noted that although application server 32 has been described as having clinical intervention engine 33 with search module 40, reporting module 44, notification module 48, and billing module 52, and associated databases 36, 38, 46, 50 and 54, user computer 34 may include clinical intervention engine 33 with modules 40, 42, 44, 48, and 52, and having access to associated databases 36, 38, 46, 50 and 54, to operate as a stand-alone solution. Accordingly, clinical intervention engine 33 may be included as an add-on to an existing pharmacy management system to provide the above-noted functionality.
[0039] Advantageously, clinical intervention engine 33 allows for automation of the patient identification and the DRP resolution process, document creation having an audit trail of the actions taken by the user. Combined, these elements substantially enhance patient safety, promote better drug use, substantially enhance regulatory compliance, and substantially increase the revenue for a pharmacy. In addition the user experience is greatly enhanced, while the prevalence of human error is greatly diminished.
[0040] Referring to Figure 3, an exemplary flowchart of an overview of clinical intervention engine 33 for identifying a patient eligible for a clinical intervention, resolving a drug related problem and transmitting a clinical intervention report based on a prescription dispensing record is shown. Other implementations may perform the steps in a different order, omit certain steps, and/or perform different and/or additional steps than those illustrated in Figure 3. For convenience, aspects of Figure 3 will be described with reference to one or more components of Figure 2 that may perform the method, such as the search module 40, reporting module 44, notification module 48, and billing module 52, and associated databases 36, 38, 46, 50 and 54. First, a search event pertaining to a drug related problem (DRP) with predetermined criteria is generated by a user at user computer 34. Search module 40 then translates the search event into a structured query (step 100). The search query is applied to pharmacy patient database 36.
[0041] Next, the structured query is received by the application server 32 which accesses patient database 36 containing patient data, such as identity and dispensing records, and DRP rules database 38, in order to identify patients matching the DRP query (step 102). For example, the DRP query may be structured to find patients that are over a particular age, and have taken a certain anti-inflammatory drug (DIN), at a specific dose within a particular time period. The search query may be initiated automatically, such as by a predefined trigger event, such as a scheduled search, for example, a daily or weekly search; age of the patient; previous search query; or an update to the DRP
rules database.
In step 104, a determination is made as to whether the patient identified following the DRP query is eligible for a clinical intervention, based on a second criterion or guidelines stored in a DRP rules database 38. Accordingly, search module 40 communicates with DRP rules database 38, which contains rules and rule sets associated with different types of clinical decision support events. When the identified patient is eligible for a clinical intervention, search module 40 generates a preliminary clinical intervention report which includes a solution for the DRP (step 106), otherwise the process returns to step 100.
[0042] In step 108, reporting engine module 44 prepopulates particular fields of a preliminary clinical intervention report with data, including patient data, the DRP, solution to the DRP, prescriber data, pharmacist data, prescription data, and so forth.
[0043] A client application at pharmacy computer 34 receives the preliminary clinical intervention report with the prepopulated fields for presentation on the user interface 22 of pharmacy computer 34 (step 110). A determination as to whether a consultation with the prescriber, such as the patient's physician is required is made (step 112). The determination is based on the content of the initial preliminary clinical intervention report. When a consultation with the physician or prescriber is required then a communication session is initiated with the prescriber via collaboration module 45 (step 114), as described below with reference to Figure 4, otherwise the process proceeds to step 116.
[0044] Figure 4 shows an example of a consultation template form 200 concerning a drug prescribed for a patient from a user to the patient's physician or doctor. Consultation template form 200 is generated by collaboration module 45 when a consultation with the doctor is required in order resolve identified problems with the patient's medications and patient condition. Form 200 comprises a plurality of form elements with associated pertinent input fields 201, such as, form element 202 representing the doctor's name and contact information for the doctor, such as address, telephone number, facsimile number or email address. Form element 204 represents the pharmacy's name and contact information for the pharmacy, such as address, telephone number, facsimile number or email address. The patient's name and contact information, such as address, telephone number, facsimile number or email address, date of birth, gender, health card information or identifier are represented by form element 206. The prescribed drug information and the subject of the intervention report are represented in form element 208.
The following information may be included: brand name of the drug and packaging or pill format, drug identification number (DIN), drug strength, route of administration, are included e.g.
"Apo-Diclo SR 75mg TAB, (Diclofenac Sodium), DIN 02162814, Take 1 Tablet Twice Daily When Required". Form element 210 represents the substance of the communication, or informational message, and summarizes the identified drug related problem pertaining to the prescribed drug, the user's concerns and recommendations to resolve the identified problem. Form element 210 may also include a selection of a category associated with the DRP, such as, therapeutic duplication (drug may not be necessary; patient needs additional drug therapy; drug is not working as well as needed (sub-optimal response to a drug); dosage too low; adverse drug reaction due to allergy or conflict with another medication or food; dangerously high dose or patient taking too much medication (either accidentally or deliberately); non-compliance (refusing drug or not taking it properly); non-adherence and confirmed forgery or falsified prescription.
The user's name, signature and identification details, such as a registration number or license number issued by a pharmacist governing body, and date, are represented by form element 212. Certain input fields 201 may be prepopulated with data derived from the clinical intervention report.
[0045] The preliminary clinical intervention report may include free-form fields, radio buttons, dropdown lists, and checkboxes. After the input of user-generated content, such as comments and recommendations, and feedback content from the consultation with the physician, the preliminary clinical intervention report is transmitted to the application server 32 (step 116). Reporting engine module 44 receives the preliminary clinical intervention report and compiles a final clinical intervention report comprising patient data, the DRP, proposed solution to the DRP, pharmacist data, prescriber data, and user generated content (step 118).
[0046] The final clinical intervention report includes the doctor's name and contact information for the doctor, such as address, telephone number, facsimile number or email address. The report also includes the pharmacy's name and contact information for the pharmacy, such as address, telephone number, facsimile number or email address. Also included is the patient's name and contact information, such as address, telephone number, facsimile number or email address, date of birth, gender, health card information or identifier are represented by form element 206. The prescribed drug information and/or prescription details, and the identified drug related problem pertaining to the prescribed drug, the user's concerns and recommendations to resolve the identified problem. The final intervention report also includes a selection of a category associated with the DRP, such as, therapeutic duplication (drug may not be necessary;
patient needs additional drug therapy; drug is not working as well as needed (sub-optimal response to a drug); dosage too low; adverse drug reaction due to allergy or conflict with another medication or food; dangerously high dose or patient taking too much medication (either accidentally or deliberately); non-compliance (refusing drug or not taking it properly);
non-adherence and confirmed forgery or falsified prescription. The user's name, signature and identification details, such as a registration number or license number issued by a pharmacist governing body, and date.
[0047] The final clinical intervention report may indicate a plurality of outcomes pertaining to the DRP, such as one in which the prescription is not filled, one in which the prescription is not filled when there is a determination of at least of confirmed forgery of the prescription and a clinical concern based on consultation with the prescriber, another in which there is no change in a prescription as prescribed following a collaborative communication session with the prescriber; and yet another in which there is a change in a prescription as prescribed following a collaborative communication session with the prescriber.
[0048] The final clinical intervention report may indicate a plurality of outcomes pertaining to the resolution of the DRP, such as one in which the problem is completely solved, another in which the problem is partially solved, and yet another in which the problem is not solved.
[0049] Next, the final clinical intervention report is transmitted to a third party, such as a physician, an insurance provider, a healthcare facility, or a government institution (step 120) to provide notification and details of the clinical intervention.
The report may be transmitted by any one of: fax, electronic fax, electronic mail, SMS, MMS, or printed and sent via snail mail, among others. Alternatively, the report is automatically associated with an electronic health record (EHR) pertaining to the patient. For example, the user interface 22 of pharmacy computer 34 includes a graphical user interface (GUI) icon or button to send the report directly into a patient's EHR electronically in an electronic management record (EMR) system. A copy of the report may also be sent to the patient, the patient's guardian and/or the patient physician or clinician.
[0050] Details of the transmitted reports, such as, user identity, patient identity, date/time transmission, prescriber identity, recipient identity, and historical data pertaining to transmitted reports are stored in notification database 50 (step 122). Lastly, billing module 52 coupled to notification module 48 provides billing statements to third parties, such as, an insurance provider, a healthcare facility, or a government institution (step 124), and the billing statements are stored in billing database 54 coupled to application server 32. Accordingly, application server 32 is capable of determining the number of clinical interventions associated with a specific patient that a particular user has sent. The bill statement and the final clinical intervention report may be sent concurrently to the payer. Copies of the billing statements may also be sent to the patient, the patient's guardian or a physician, for record keeping purposes.
[0051] In another implementation, billing module 52 facilitates third-party (insurance) reimbursement. Possible examples include patient specific, formulary eligibility queries or auto-mated preauthorization process.
[0052] In another implementation, databases 36, 38, 46, 50 and 54 may be included in a single database.
[0053] In another implementation, clinical intervention engine 33 can additionally include an application programming interface (API) or an alternative suitable integration mechanism such as a software development kit (SDK), libraries, and/or other suitable interface tool. The API can function to allow external applications and services to interface and use clinical intervention engine 33 in combination with an internal authentication process. For example, external platform 60 may use an internal account username and password authentication process but make it dependent on successful completion of multi-factor authentication facilitated by the clinical intervention engine 33. External platform 60 can use the API to communicate and integrate with clinical intervention engine 33. Alternatively, the clinical intervention engine 33 can exist as a sub-system of a larger system such as a social network platform or an enterprise platform.
In one example, an API for linking external platform 60, e.g. an insurer system, with application server 32 or pharmacy computer 34 is included.
[0054] In another implementation, integration of the pharmaco-genomic information into environment 30 for the purposes of reimbursement, and treatment decisions could also be facilitated by the aforementioned method and system.
[0055] In another implementation, medical guideline updates are pushed to, or pulled by, user terminals 34 in order to provide timely updates to users, such as pharmacists.
For example, educational content related to a DRP associated with the identified patients is made available.
[0056] In another implementation, enrolled users may exchange ideas and information on a peer-to-peer basis, such as on a peer-to-peer platform.
[0057] In yet another embodiment, the method and system can track the pharmacist's effects on overall patient health outcomes, given the fact that the solution can correlate pharmacist actions (e.g. decision on presented DRP) and changes prescription therapy.
Taken in aggregate, this information would be valuable to third-party payers, government agencies, professional organizations and manufacturers. The feature opens the possibility up for predictive analytics of various types. For example, clinical intervention engine 33 may be combined with artificial intelligence or other deep learning approaches to proactively identify health improvement opportunities rather than just respond to them as they arise.
[0058] In another implementation, patient data records are processed in accordance with regulatory requirements, such as the Health Insurance Portability and Accountability Act of 1996 (HIPAA) or the Personal Information Protection and Electronic Documents Act (PIPEDA), and may also be stored within data storage structure 36.
[0059] In another embodiment, the patient medical data records that have been processed in accordance with regulatory requirements, such as HIPAA or PIPEDA, may be stored in a separate patient database. It is known that patient medical data that has been disassociated from all patient identification data does not fall within the regulatory requirements of HIPAA.
[0060]
Embodiments within the scope of the present disclosure may also include tangible and/or non-transitory computer-readable storage media for carrying or having computer-executable instructions or data structures stored thereon. Such non-transitory computer-readable storage media can be any available media that can be accessed by a general purpose or special purpose computer, including the functional design of any special purpose processor as discussed above. By way of example, and not limitation, such non-transitory computer-readable media can include RAM, ROM, EEPROM, CD-ROM or other optical disk storage, magnetic disk storage or other magnetic storage devices, solid state drives, or any other medium which can be used to carry or store desired program code means in the form of computer-executable instructions, data structures, or processor chip design. When infounation is transferred or provided over a network or another communications connection (either hardwired, wireless, or combination thereof) to a computer, the computer properly views the connection as a computer-readable medium. Thus, any such connection is properly termed a computer-readable medium. Combinations of the above should also be included within the scope of the computer-readable media.
[0061] Computer-executable instructions include, for example, instructions and data which cause a general purpose computer, special purpose computer, or special purpose processing device to perform a certain function or group of functions.
Computer-executable instructions also include program modules that are executed by computers in stand-alone or network environments. Generally, program modules include routines, programs, components, data structures, objects, and the functions inherent in the design of special-purpose processors, etc. that perform particular tasks or implement particular abstract data types. Computer-executable instructions, associated data structures, and program modules represent examples of the program code means for executing steps of the methods disclosed herein. The particular sequence of such executable instructions or associated data structures represents examples of corresponding acts for implementing the functions described in such steps.
[0062] Certain embodiments described herein may be implemented as logic or a number of modules, engines, components, or mechanisms. A module, engine, logic, component, or mechanism (collectively referred to as a "module") may be a tangible unit capable of performing certain operations and configured or arranged in a certain manner In certain exemplary embodiments, one or more computer systems (e.g., a standalone, user, or server computer system) or one or more components of a computer system (e.g., a processor or a group of processors) may be configured by software (e.g., an application or application portion) or firmware (note that software and firmware can generally be used interchangeably herein as is known by a skilled artisan) as a module that operates to perform certain operations described herein.
[0063] Those of skill in the art will appreciate that other embodiments of the disclosure may be practiced in network computing environments with many types of computer system configurations, including personal computers, hand-held devices, multi-processor systems, microprocessor-based or programmable consumer electronics, network PCs, minicomputers, mainframe computers, and the like. Embodiments may also be practiced in distributed computing environments where tasks are performed by local and remote processing devices that are linked (either by hardwired links, wireless links, or by a combination thereof) through a communications network. In a distributed computing environment, program modules may be located in both local and remote memory storage devices.
[0064] The various embodiments described above are provided by way of illustration only and should not be construed to limit the scope of the disclosure. Those skilled in the art will readily recognize various modifications and changes that may be made to the principles described herein without following the example embodiments and applications illustrated and described herein, and without departing from the spirit and scope of the disclosure.
Claims (82)
1. A system for identifying at least one drug-related problem (DRP), said system comprising:
a search module operating to structure a search query based on a predetermined criteria and apply said search query to a pharmacy patient database and a DRP
rules database to identify at least one patient eligible for a clinical intervention;
a reporting module operating to generate a preliminary clinical intervention report for said at least one patient identified in said search query, and to prepopulate particular fields of said preliminary clinical intervention report with at least one of patient data, pharmacist data, prescriber data, prescription data, said at least one DRP, a proposed solution to said at least one DRP, and to compile a final clinical intervention report comprising said preliminary clinical intervention report and user generated content; and a billing module operating to generate a bill for said final clinical intervention report to a payer.
a search module operating to structure a search query based on a predetermined criteria and apply said search query to a pharmacy patient database and a DRP
rules database to identify at least one patient eligible for a clinical intervention;
a reporting module operating to generate a preliminary clinical intervention report for said at least one patient identified in said search query, and to prepopulate particular fields of said preliminary clinical intervention report with at least one of patient data, pharmacist data, prescriber data, prescription data, said at least one DRP, a proposed solution to said at least one DRP, and to compile a final clinical intervention report comprising said preliminary clinical intervention report and user generated content; and a billing module operating to generate a bill for said final clinical intervention report to a payer.
2. The system of claim of 1, further comprising a collaboration module operating to provide a user-interface through which a user can interact with a healthcare professional associated with said patient eligible for said clinical intervention.
3. The system of claim of 2, wherein said DRP rules database comprises rules and rule sets pertaining to drug conflicts and clinical support events.
4. The system of claim of 3, wherein said drug conflicts comprise at least one of incompatible medications, drug-genomic conflicts, drug-physiology conflicts, drug-disease conflicts, drug-lab conflicts, drug-age conflicts, drug-allergy conflicts.
5. The system of claim of 4, further comprising a reporting database for storing said final clinical intervention report.
6. The system of claim 5, further comprising a notification module for transmitting said final clinical intervention report to at least one recipient.
7. The system of claim 6, further comprising a notification database for storing records of said transmitted reports.
8. The system of claim 7, further comprising a billing database for storing said billing statements.
9. The system of any of claims 3 to 8, wherein said search query is applied via at least one of automatically based on a predefined trigger event, periodically, a user, and a change in said rules and rule sets.
10. A non-transitory computer readable storage medium storing instructions that when executed by a computer system cause said computer system to perform operations comprising:
structuring a drug related problem (DRP) query;
accessing a patient database and a DRP rules database to identify at least one patient having at least one DRP based on said DRP query, said patient database including prescription dispensing records associated with said at least one patient;
determining whether said at least one patient identified in said DRP query is eligible for a clinical intervention;
generating a solution to said DRP for said at least one patient eligible for said clinical intervention;
generating a clinical intervention report associated with said at least one patient is eligible for said clinical intervention;
transmitting said report to at least one recipient; and generating a bill for settlement by a third party.
structuring a drug related problem (DRP) query;
accessing a patient database and a DRP rules database to identify at least one patient having at least one DRP based on said DRP query, said patient database including prescription dispensing records associated with said at least one patient;
determining whether said at least one patient identified in said DRP query is eligible for a clinical intervention;
generating a solution to said DRP for said at least one patient eligible for said clinical intervention;
generating a clinical intervention report associated with said at least one patient is eligible for said clinical intervention;
transmitting said report to at least one recipient; and generating a bill for settlement by a third party.
11. The non-transitory computer readable storage medium of claim 10, wherein said DRP query is based on a predetermined search criteria.
12. The non-transitory computer readable storage medium of claim 11, wherein said predetermined search criteria is defined by at least one of a user, automatically based on a predefined trigger event, periodically and a change in said rules and rule sets.
13. The non-transitory computer readable storage medium of claim 12, wherein said DRP rules database having rules and rule sets pertaining to drug conflicts.
14. The non-transitory computer readable storage medium of claim 13, wherein said drug conflicts comprise at least one of incompatible medications, drug-genomic conflicts, drug-physiology conflicts, drug-disease conflicts, drug-lab conflicts, drug-age conflicts, drug-allergy conflicts.
15. The non-transitory computer readable storage medium of claim 14, wherein said step of accessing said patient database and said DRP rules database is initiated by said user.
16. The non-transitory computer readable storage medium of claim 14, wherein said step of accessing said patient database and said DRP rules database is initiated automatically.
17. The non-transitory computer readable storage medium of claim 14, wherein said step of accessing said patient database and said DRP rules database is initiated periodically.
18. The non-transitory computer readable storage medium of claim 14, wherein said step of accessing said patient database and said DRP rules database is initiated automatically based on said rule or rule set.
19. The non-transitory computer readable storage medium of claim 14, wherein said step of accessing said patient database and said DRP rules database is initiated automatically based on a change in said rule or rule set.
20. The non-transitory computer readable storage medium of any of claims 10 to 19, wherein said DRP is assigned a weighting factor.
21. The non-transitory computer readable storage medium of any of claims 10 to 20, wherein said report comprises at least one of patient data, pharmacist data, said DRP, proposed solution to said DRP, prescriber data, and user generated content.
22. The non-transitory computer readable storage medium of any of claims 12 to 21, wherein said user is a professional trained to prepare and dispense drugs and/or prescribed medical treatments.
23. The non-transitory computer readable storage medium of claim 21, wherein said report comprises an outcome of said intervention pertaining to said DRP.
24. The non-transitory computer readable storage medium of claim 21, wherein said report comprises an outcome of said intervention pertaining to said DRP
following a consultation with at least one of said patient's physician and a prescriber of said prescription.
following a consultation with at least one of said patient's physician and a prescriber of said prescription.
25. The non-transitory computer readable storage medium of claims 23 or 24, wherein said outcome includes one of no change in said prescription and a change in said prescription.
26. The non-transitory computer readable storage medium of any of claims 23 to 24, wherein said outcome includes plurality of outcomes pertaining to said resolution of said DRP, such as one in which said problem is completely solved, another in which said problem is partially solved, and yet another in which said problem is not solved.
27. The non-transitory computer readable storage medium of any of claims 16, 18 and 19, wherein said step of accessing said patient database and said DRP rules database to identify said at least one patient having at least one DRP based on said DRP
query is triggered by an age of said at least one patient.
query is triggered by an age of said at least one patient.
28. The non-transitory computer readable storage medium of any of claims 10 to 27, wherein said clinical intervention report is transmitted to at least one of a physician, an insurance provider, a healthcare facility, and a government institution.
29. The non-transitory computer readable storage medium of any of claims 10 to 28, wherein said at least one recipient is one of a patient, a guardian, a physician, an insurance provider, a healthcare facility, or a government institution.
30. The non-transitory computer readable storage medium of any of claims 10 to 29, wherein said report is sent to said at least one recipient by any one of a fax, electronic fax, electronic mail, simple message service (SMS), multi-media message service (MMS), and snail mail.
31. The non-transitory computer readable storage medium of any of claims 10 to 29, wherein said report is automatically associated with an electronic health record (EHR) of said patient, such that said HER is automatically updated.
32. The non-transitory computer readable storage medium of any of claims 28 to 31, wherein said bill is sent to said third party following transmittal of said report to at least one recipient.
33. The non-transitory computer readable storage medium of any of claims 28 to 31, wherein said bill is sent to said third party following notification of said report to at least one recipient.
34. The non-transitory computer readable storage medium of claim 31, wherein said bill is sent to said third party following association of said report with said EHR.
35. The non-transitory computer readable storage medium of any of claims 10 to 31, wherein said bill and said report are sent concurrently.
36. The non-transitory computer readable storage medium of claim 35, wherein said settlement is received by said billing module.
37. The non-transitory computer readable storage medium of any of claims 32 to 35, wherein said settlement is sent to said user electronically.
38. A clinical intervention method comprising the steps of:
structuring a drug related problem (DRP) query;
accessing a patient database and said DRP rules database to identify at least one patient having at least one DRP based on said DRP query, said patient database including dispensing records associated with said at least one patient;
determining whether said at least one patient identified in said DRP query is eligible for a clinical intervention;
generating a report associated with said at least one patient, said report comprising at least one of patient data, pharmacist data, said DRP, a proposed solution to said DRP, prescriber data, and user generated content;
transmitting said report to at least one recipient; and generating a bill for settlement by a third party.
structuring a drug related problem (DRP) query;
accessing a patient database and said DRP rules database to identify at least one patient having at least one DRP based on said DRP query, said patient database including dispensing records associated with said at least one patient;
determining whether said at least one patient identified in said DRP query is eligible for a clinical intervention;
generating a report associated with said at least one patient, said report comprising at least one of patient data, pharmacist data, said DRP, a proposed solution to said DRP, prescriber data, and user generated content;
transmitting said report to at least one recipient; and generating a bill for settlement by a third party.
39. The clinical intervention method medium of claim 38, wherein DRP is at least one of a therapeutic duplication, requires drug, sub-optimal response to a drug, and dosage too low.
40. The clinical intervention method of claim 38, wherein when said DRP is said therapeutic duplication, then said drug may not be necessary.
41. The clinical intervention method of claim 38, wherein when said DRP is said requires drug, then additional drug therapy is an option.
42. The clinical intervention method of claim 38, wherein when said DRP is said dangerously high dose, then there exists potential overuse and/or abuse.
43. A first computing system for generating a clinical intervention report, said first computing system being accessible by a second computing system over a network, said first computing system comprising:
a search module for receiving a search query associated with a drug related problem (DRP) from a user via said second computing system and for generating a set of search terms from said search query to identify at least one patient in a pharmacy patient database eligible for a clinical intervention based on predefined rules in DRP
rules database;
a reporting module for generating a preliminary clinical intervention report and prepopulating particular fields of said preliminary clinical intervention report with one of at least patient data, said DRP, a solution to said DRP, pharmacist data, prescriber data;
and compiling a final clinical intervention report comprising said preliminary clinical intervention report and user generated content;
a collaboration module for providing a user-interface for facilitating communication between a user and a healthcare professional associated with said patient;
a reporting database for storing said final clinical intervention report;
a notification module for transmitting said final clinical intervention report to at least one recipient;
a notification database for storing records of said transmitted reports, timestamps of said transmission and said at least one recipient;
a billing module coupled to said notification module to provide billing statements to a payer; and a billing database for storing said billing statements.
a search module for receiving a search query associated with a drug related problem (DRP) from a user via said second computing system and for generating a set of search terms from said search query to identify at least one patient in a pharmacy patient database eligible for a clinical intervention based on predefined rules in DRP
rules database;
a reporting module for generating a preliminary clinical intervention report and prepopulating particular fields of said preliminary clinical intervention report with one of at least patient data, said DRP, a solution to said DRP, pharmacist data, prescriber data;
and compiling a final clinical intervention report comprising said preliminary clinical intervention report and user generated content;
a collaboration module for providing a user-interface for facilitating communication between a user and a healthcare professional associated with said patient;
a reporting database for storing said final clinical intervention report;
a notification module for transmitting said final clinical intervention report to at least one recipient;
a notification database for storing records of said transmitted reports, timestamps of said transmission and said at least one recipient;
a billing module coupled to said notification module to provide billing statements to a payer; and a billing database for storing said billing statements.
44. The first computing system of claim 43, wherein said user generated content includes at least one of feedback from said healthcare professional and recommendations by said user.
45. The first computing system of claim 43, wherein said report comprises an outcome of said intervention pertaining to said DRP.
46. The first computing system of claim 43, wherein said pharmacy patient database comprises patient information having at least one of a name, social insurance number, health card number, date of birth, gender, patient identifier, contact information;
prescription information.
prescription information.
47. The first computing system of claim 43, wherein said DRP rules database comprises rules related to drug conflicts.
48. The first computing system of claim 47, wherein said drug conflicts comprise at least one of incompatible medications, drug-genomic conflicts, drug-physiology conflicts, drug-disease conflicts, drug-lab conflicts, drug-age conflicts, and drug-allergy conflicts.
49. The first computing system of claim 48, wherein said rules are based on at least one of available literature, studies, position papers, industry practice, peer-reviewed studies, feedback from pharmacists, feedback from patients, surveys, medical guidelines, clinical guidelines, operational guidelines.
50. The first computing system of claim 49, wherein said predefined rules comprise at least one of medication usage criteria, decision trees, weighting factors.
51. The first computing system of claim 50, wherein said reporting module assesses each DRP for at least one of severity, acuteness, and significance to said at least one patient, and associates each of said DRP with a score.
52. The first computing system of claim 51, wherein said score determines the expediency of a resolution of said DRP.
53. The first computing system of claim 52, wherein said DRP is associated with a category selected from one of a therapeutic duplication; requires drug; sub-optimal response to a drug; dosage too low; adverse drug reaction; dangerously high dose; non-compliance; non-adherence and confirmed forgery or falsified prescription.
54. A clinical intervention system comprising:
a search module for receiving a search query associated with a drug related problem (DRP) from a user and for generating a set of search terms from said search query to identify at least one patient in a pharmacy patient database eligible for a clinical intervention based on predefined rules in DRP rules database;
a reporting module for generating a preliminary clinical intervention report and prepopulating particular fields of said preliminary clinical intervention report with one of at least patient data, said DRP, a solution to said DRP, pharmacist data, prescriber data;
and compiling a final clinical intervention report comprising preliminary clinical intervention report and user generated content; and a notification module for transmitting said final clinical intervention report to at least one recipient.
a search module for receiving a search query associated with a drug related problem (DRP) from a user and for generating a set of search terms from said search query to identify at least one patient in a pharmacy patient database eligible for a clinical intervention based on predefined rules in DRP rules database;
a reporting module for generating a preliminary clinical intervention report and prepopulating particular fields of said preliminary clinical intervention report with one of at least patient data, said DRP, a solution to said DRP, pharmacist data, prescriber data;
and compiling a final clinical intervention report comprising preliminary clinical intervention report and user generated content; and a notification module for transmitting said final clinical intervention report to at least one recipient.
55. The clinical intervention system of claim 54, further comprising a collaboration module for providing a user-interface for facilitating communication between a user and a healthcare professional associated with said patient.
56. The clinical intervention system of claim 55, further comprising a reporting database for storing said final clinical intervention report.
57. The clinical intervention system of claim 55, wherein said user generated content includes at least one of feedback from said healthcare professional and recommendations by said user.
58. The clinical intervention system of claim 57, further comprising a notification database for storing records of said transmitted reports, date/time of transmission and said at least one recipient.
59. The clinical intervention system of claim 58, further comprising a billing module coupled to said notification module to provide billing statements to a payer.
60. The clinical intervention system of claim 59, further comprising a billing database for storing said billing statements.
61. The clinical intervention system of claim 60, wherein said billing statement and said report are sent concurrently to said payer.
62. The clinical intervention system of claim 54, wherein a DRP rules database comprises rules related to drug conflicts.
63. The clinical intervention system of claim 62, wherein said drug conflicts comprise at least one of incompatible medications, drug-genomic conflicts, drug-physiology conflicts, drug-disease conflicts, drug-lab conflicts, drug-age conflicts, and drug-allergy conflicts.
64. The clinical intervention system of claim 63, wherein rules are based on at least one of available literature, studies, position papers, industry practice, peer-reviewed studies, feedback from pharmacists, feedback from patients, surveys, medical guidelines, clinical guidelines, operational guidelines.
65. The clinical intervention system of claim 64, wherein said rules comprise at least one of medication usage criteria, decision trees, weighting factors.
66. The clinical intervention system of claim 60, wherein said reporting module assesses each DRP for severity, acuteness, and significance to said patient, and wherein said DRP's severity, acuteness, and significance to said patient determines the expediency of a resolution of said DRP.
67. The clinical intervention system of claim 54, wherein said search query is initiated by said user.
68. The clinical intervention system of claim 54, wherein said search query is initiated automatically.
69. The clinical intervention system of claim 54, wherein said search query is initiated automatically based on said rules.
70. The clinical intervention system of claim 54, wherein said search query is initiated by said user initiated automatically based on a change in said rules.
71. The clinical intervention system of claim 54, wherein said search query is initiated by said user is initiated periodically.
72. The clinical intervention system of claim 54, wherein said search query is initiated by said user is initiated periodically based on predetermined criteria.
73. The clinical intervention system of any of claims 68 to 72, wherein said search query is triggered by an age of said at least one patient.
74. The clinical intervention system of any of claims 54 to 73, wherein said DRP is assigned a weighting factor.
75. The clinical intervention system of any of claims 54 to 74, wherein said report comprises an outcome of said intervention pertaining to said DRP.
76. The clinical intervention system of any of claims 54 to 73, wherein said report comprises an outcome of said intervention pertaining to said DRP following a consultation with said at least one of said patient's physician.
77. The clinical intervention system of any of claims 75 or 76, wherein said outcome includes one of no change in prescription and a change in said prescription.
78. The clinical intervention system of any of claims 75 to 77, wherein said outcome includes a plurality of outcomes pertaining to said resolution of said DRP, such as one in which said problem is completely solved, another in which said problem is partially solved, and yet another in which said problem is not solved.
79. The clinical intervention system of any of claims 54 to 78, wherein said at least one recipient is one of a patient, a guardian, a physician, an insurance provider, a healthcare facility, or a government institution.
80. The clinical intervention system of claim 79, wherein said report is sent to said at least one recipient by any one of a fax, electronic fax, electronic mail, simple message service (SMS), multi-media message service (MMS), and snail mail.
81. The clinical intervention system of claim 79, wherein said wherein said report is automatically associated with an electronic health record (EHR) of said patient for automatic update to said HER.
82. The clinical intervention system of claim 60, wherein said wherein said billing statement is sent to said payer following transmittal of said report.
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA2917027A CA2917027C (en) | 2016-01-08 | 2016-01-08 | Method and system for generating a clinical intervention report |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA2917027A CA2917027C (en) | 2016-01-08 | 2016-01-08 | Method and system for generating a clinical intervention report |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2917027A1 true CA2917027A1 (en) | 2016-02-09 |
| CA2917027C CA2917027C (en) | 2019-01-08 |
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