EP4028851A1 - Traitement de prescriptions pharmaceutiques en temps réel à l'aide d'un fichier de données de message analytique clinique - Google Patents

Traitement de prescriptions pharmaceutiques en temps réel à l'aide d'un fichier de données de message analytique clinique

Info

Publication number
EP4028851A1
EP4028851A1 EP20863094.7A EP20863094A EP4028851A1 EP 4028851 A1 EP4028851 A1 EP 4028851A1 EP 20863094 A EP20863094 A EP 20863094A EP 4028851 A1 EP4028851 A1 EP 4028851A1
Authority
EP
European Patent Office
Prior art keywords
patient
data
prescription
information
pharmaceutical
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Pending
Application number
EP20863094.7A
Other languages
German (de)
English (en)
Other versions
EP4028851A4 (fr
Inventor
Sr. Kenneth A. HILL
Brad T. CROSSLIN
Todd A. Crosslin
III Clinton S. FERGUSON
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Synerio Technologies Inc
Original Assignee
Electronic Health Record Data Inc
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from US16/567,633 external-priority patent/US20200005919A1/en
Application filed by Electronic Health Record Data Inc filed Critical Electronic Health Record Data Inc
Publication of EP4028851A1 publication Critical patent/EP4028851A1/fr
Publication of EP4028851A4 publication Critical patent/EP4028851A4/fr
Pending legal-status Critical Current

Links

Classifications

    • 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
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • 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
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G16H20/10—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to drugs or medications, e.g. for ensuring correct administration to patients
    • 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

Definitions

  • a system for performing a review process of patient clinical data upon a submitted prescription from a healthcare provider in real time before it is received by a pharmacy for fulfillment comprising a consolidated database that receives and stores patient clinical data from a plurality of sources in a patient clinical data record; a clinical analytical message data file (“CAM data file”) containing patient clinical data associated with the patient identified on the submitted prescription and the one or more pharmaceuticals identified on the submitted prescription; and a review processor operative on the CAM data file contents and with the database, the review processor including a suite of editing mechanisms for accessing the patient clinical data in the CAM data file, analyzing the patient clinical data in the context of the submitted prescription and information about the prescribed pharmaceuticals, and completing the review process.
  • CAM data file clinical analytical message data file
  • the invention in another embodiment, in a system operating in a network including an electronic transaction hub (“switch”) and having a first database containing electronic patient outcome data (“EPO data”) coupled with a review processor that utilizes a clinical analytical message (“CAM”) data file, the invention embodies a process for performing a submission review of a pharmaceutical prescription submitted to a pharmacy (“a submitted prescription”), comprising the steps of logging into, by a healthcare practitioner, a healthcare website connected to the review processor in the network and adapted for entering the submitted prescription containing patient and medication information for the submission review; receiving via the healthcare website the submitted prescription into the review processor coupled to the healthcare website and to the first database containing patient clinical and pharmaceutical data from a plurality of sources; generating Docket No. 28860.049-PC
  • a further key component of the system to be described is an innovative data file that travels with and is involved in the transactions processed by the system.
  • a data file is a component of a data record comprised of a sequence of fields for the entry of data.
  • a database is a storage repository for data records.
  • This “Clinical Analytical Message” or “CAM” data file is an integral part of the system that enables accurate and complete, real time processing of the submission and fulfillment transactions involving specialty prescription drugs.
  • the pharmacy Upon receipt of the specialty drug, the pharmacy arranges for delivery of the required clinical and educational services information to the patient, and for delivery of the specialty drug to the patient or to the person or entity authorized to administer the drug. Subsequently the pharmacy submits separate requests for payment to the patient’s insurance carrier of the claim for delivery of the clinical and educational information and the claim for dispensing the specialty drug to the patient.
  • the payment portion of these transactions is preferably handled by a Pharmacy Benefit Coalition (“PBC”), also called a Pharmacy Benefit System or Office herein, that will be described with Figure 3. Docket No. 28860.049-PC
  • PBC Pharmacy Benefit Coalition
  • FIG. 2 depicts, from top to bottom, two of the key components of the present embodiment - the CAM data file 220 and the clinical services platform 202, which together form a novel combination with the EPO data 140 not heretofore available.
  • a patient safety portal which provides for safe and secure patient access to that patient’s electronic patient outcomes record (EPOR) and provides the enabling authorization for clinical practitioners, is provided by the website portal 104 into the system 100 that facilitates much of the functionality of the present embodiment.
  • EOR electronic patient outcomes record
  • clouds may reduce the capital expense of maintaining one’s own computing infrastructure to an operating expense.
  • Another important advantage of clouds is the ease of providing redundant and secure resources for critical systems such as healthcare data systems that have substantial data backup and security requirements. Clouds may be public or private. Public clouds may have multiple users who share the available resources. Private clouds are maintained by individual entities that limit access for their own purposes.
  • the clinical analytical message data file 220 contains (A) information resident in the patient data fields for completing drug utilization review (“DUR”), including at least (1) a plurality of patient clinical data retrieved from addressable locations in the database associated with the patient and the submitted prescription; (2) statements reporting results of analysis of the submitted prescription against patient clinical data retrieved from the database and analyzed by the software mechanism; and (3) information regarding required clinical education and services to be delivered to the patient with the dispensed prescription.
  • DUR drug utilization review
  • the fulfillment processing begins when a prescription 88 (originated by a healthcare provider 204) sent from the review processor 202 with the CAM data file 220 is received via path 212 and transmitted by the switch 208 over path 242 to the pharmacy 210.
  • the pharmacy 210 performs several functions. If the prescription 88 is for a specialty drug the pharmacy 210 reviews and prepares the prescription 88 for delivery of clinical and educational services at step 260 along paths 330 and 334 and dispensing or administering the prescription drug to the patient in step 302 through the step 250.
  • the clinical and educational services information is contained in the CAM data file 220 that travels with a specialty drug prescription. Upon delivery of these services via step 260, the CAM data file 220 confirms delivery of the services 260 along path 262.
  • the pharmacy 210 When the pharmacy 210 has delivered the clinical and educational services (for specialty drugs) and dispensed the specialty of non-specialty prescription drugs, and established acknowledgement of those services, the pharmacy 210 prepares and files claims 90 for payment with the PBC 310.
  • the claims 90 include first claims 91 for delivery of the clinical and educational services via path 312 and second claims 92 for dispensing the drugs.
  • the PBC then forwards the claims 91 , 92 to a payer of record 320, which may adjudicate Docket No. 28860.049-PC
  • step 530 the pharmacy prepares and submits claims for payment to the payer 320 in the system by submitting via the electronic transaction hub or “switch” 208 and the pharmacy benefit coalition or “PBC” 310 to a payer 320 a first claim for the clinical and educational services it delivered and a second claim for the prescription drug it dispensed to the patient 302.
  • the payer may Docket No. 28860.049-PC
  • Electronic storage may include one or more of optically readable storage media (e.g., optical disks, etc.), magnetically readable storage media (e.g., magnetic tape, magnetic hard drive, floppy drive, etc.), electrical charge-based storage media (e.g., EEPROM, RAM, etc.), solid-state storage media (e.g., flash drive, etc.), and/or other electronically readable storage media.
  • Electronic storage may include one or more virtual storage resources (e.g., cloud storage, a virtual private network, and/or other virtual storage resources).
  • Electronic storage may store software algorithms, information determined by processor(s), information received from server(s), information received from computing platform(s), and/or other information that enables server(s) to function as described herein.
  • the CAM engine server 702 can include a machine learning module 704.
  • the machine learning module 704 can be implemented on one or more servers, having one or more processors, with access to memory.
  • the machine learning module 704 can be a single networked node, or a machine learning cluster, which can include a distributed architecture of a plurality of networked nodes.
  • the machine learning module 704 can include control logic for implementing various functionality, as described in more detail below.
  • the machine learning module 704 may, based at least partly on a patient’s information, conduct a patient analysis to establish a profile for the patient.
  • the patient profile can correspond to health concerns based at least in part on the identified patient’s pharmaceutical, clinical, genomic, laboratory, disease, or standardized drug information.
  • the reconciled entry for the identified patient can include updated information (based on time stamp comparison) for populated fields, additional information (for unpopulated fields), or deletions (for previously populated fields). In this way, the reconciled entry will have the most accurate, up-to-date information regarding the identified patient.
  • the record generation control logic 800 can include a feedback loop such that the thresholds can be modified using other information. For example, the record generation control logic 800 can calculate the differences, standard deviation, average, interpolation, or other data analysis, on the information to set or modify the thresholds. The control logic then proceeds to step 812.
  • the prescription modification control logic 1000 determines, responsive to the server, whether one or more of the prescription parameters satisfy one or more parameters of the health concern definitions.
  • the health concern definitions can be satisfied by determining whether differences meet, exceed, or fall below the thresholds or health concern definitions, based on the particular application.
  • the prescription modification control logic 1000 can correlate one or more of the prescription parameters with one or more parameters of the health concern definitions for the identified patient to determine any differences and whether those differences fall below the predetermined thresholds, match the predetermined thresholds, or exceed the predetermined thresholds, among other suitable definitions.
  • the health concern definitions relate to health concerns or potential issues for the identified patient related to health related information. If the prescription parameters satisfy one or more parameters of the health concern definitions, the control logic proceeds to step 1010. If the Docket No. 28860.049-PC
  • the consolidated healthcare database is populated with pharmaceutical and standardized healthcare data at every prescription transaction, including translation of the native data format of the source data into a common, readily accessible data format.
  • the clinical services platform through its interactions with the active components of the system, using the suite of mechanisms both structural and algorithmic directs the processing for both constructing and maintaining the single healthcare database and for processing the submission and fulfillment of prescriptions submitted by the patient’s healthcare providers.
  • the data transactions and processes carried out by the clinical services platform with its review processor, operating in conjunction with the single healthcare database are enabled and facilitated in real time by a unique clinical analytical message data file that conveys both data and process commands within the system and with external entities such as a transaction hub (the “switch”), claim processing entities, payers, and drug manufacturers.
  • a transaction hub the “switch”

Abstract

La présente invention concerne un système et des procédés de traitement automatique de données de soins de santé associées à la soumission et à l'exécution de prescriptions pharmaceutiques par des fournisseurs en temps réel, y compris un traitement des requêtes, qui sont activés par une plate-forme de services cliniques configurée avec un processeur d'examen et utilisables avec un fichier de données de message analytique clinique (CAM). Le système comprend l'utilisation d'une première et d'une seconde base de données contenant respectivement des données pharmaceutiques et des données de soins de santé normalisées. Ces données sont extraites pendant le traitement par le système et traduites en un format commun pour un stockage dans un troisième enregistrement des résultats électroniques de patients (EPOR) qui est accessible aux fournisseurs et patients autorisés, en toute sécurité et en garantissant la sécurité du patient. La présente invention concerne des plateformes informatiques améliorées conçues pour générer un dossier médical et pharmaceutique de patient qui est interopérable et portable, pour déterminer la compatibilité d'une prescription pour un patient, et pour déterminer les exigences de modification de prescription pour un patient.
EP20863094.7A 2019-09-11 2020-09-11 Traitement de prescriptions pharmaceutiques en temps réel à l'aide d'un fichier de données de message analytique clinique Pending EP4028851A4 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US16/567,633 US20200005919A1 (en) 2016-09-12 2019-09-11 Processing Pharmaceutical Prescriptions in Real Time Using a Clinical Analytical Message Data File
PCT/US2020/050465 WO2021050922A1 (fr) 2019-09-11 2020-09-11 Traitement de prescriptions pharmaceutiques en temps réel à l'aide d'un fichier de données de message analytique clinique

Publications (2)

Publication Number Publication Date
EP4028851A1 true EP4028851A1 (fr) 2022-07-20
EP4028851A4 EP4028851A4 (fr) 2023-09-13

Family

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Family Applications (1)

Application Number Title Priority Date Filing Date
EP20863094.7A Pending EP4028851A4 (fr) 2019-09-11 2020-09-11 Traitement de prescriptions pharmaceutiques en temps réel à l'aide d'un fichier de données de message analytique clinique

Country Status (3)

Country Link
EP (1) EP4028851A4 (fr)
AU (1) AU2020346899A1 (fr)
WO (1) WO2021050922A1 (fr)

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR3132634A1 (fr) 2022-02-15 2023-08-18 Nanomedsyn Composés bifonctionnels ciblant le récepteur du mannose 6-phosphate cation-indépendant

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10453157B2 (en) * 2010-01-22 2019-10-22 Deka Products Limited Partnership System, method, and apparatus for electronic patient care
US10262112B2 (en) * 2013-02-04 2019-04-16 Precera Bioscience, Inc. Prescription decision support system and method using comprehensive multiplex drug monitoring
US20180121606A1 (en) * 2016-11-01 2018-05-03 International Business Machines Corporation Cognitive Medication Reconciliation
US20190147992A1 (en) * 2017-11-01 2019-05-16 National Health Coalition, Inc. Electronic Healthcare Treatment Discharge System

Also Published As

Publication number Publication date
EP4028851A4 (fr) 2023-09-13
WO2021050922A8 (fr) 2021-10-21
AU2020346899A1 (en) 2022-04-28
WO2021050922A1 (fr) 2021-03-18

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