公开(公告)号：US11521750B1

公开(公告)日：2022-12-06

申请号：US16930822

申请日：2020-07-16

Applicant: Express Scripts Strategic Development, Inc.

Inventor： Mark D. Wong ,  Amit K. Bothra ,  Pritesh J. Shah ,  Karnik D. Patel

IPC: G16H50/30 ,  G16H10/60 ,  G16H20/10

Abstract: A computerized method includes determining a clinical opportunity to improve care for a user according to automated triggering of a gap identification rule, generating a persona of the user based on one or more personalization scores that are specific to the user, and generating a care plan for reducing the gap in care based on the persona. The care plan includes a plurality of methods of increasing compliance of the user with the care plan, selected based on the one or more personalization scores, and include different modes of communicating with the user either directly or through at least one of a physician and a pharmacist depending on the one or more personalization scores. The method includes deploying the care plan to provide automated selection of one or more of the different modes of communicating with the user to increase compliance of the user with the care plan.

公开(公告)号：US11978563B1

公开(公告)日：2024-05-07

申请号：US17126188

申请日：2020-12-18

Applicant: Express Scripts Strategic Development, Inc.

Inventor： Mark D. Wong ,  Heather-Ann Falcon ,  Marian Wilson ,  Jacqueline Luong ,  Jared Schutt ,  Andrew J. Lee ,  Ronald Buesser ,  Rocco Maglio

IPC: G16H80/00 ,  G16H10/60 ,  G16H40/67

CPC classification number: G16H80/00 ,  G16H10/60 ,  G16H40/67

Abstract: Methods and systems for providing a secure healthcare communication exchange platform. The methods and systems perform operations comprising: accessing a collection of data records from a plurality of sources, the collection of data records corresponding to a given entity; generating, based on the collection of data records, an aggregated representation of one or more conditions associated with the given entity; determining, based on the aggregated representation, that a given condition of the one or more conditions satisfies an outreach parameter; in response to determining that the given condition satisfies the outreach parameter, triggering an outreach event to communicate with the given entity; generating status information in the aggregated representation, the status information corresponding to the outreach event; and tracking the status information to establish a relationship between the given condition and the outreach parameter.

公开(公告)号：US20230112191A1

公开(公告)日：2023-04-13

申请号：US18073664

申请日：2022-12-02

Applicant: Express Scripts Strategic Development, Inc.

Inventor： Mark D. Wong ,  Amit K. Bothra ,  Pritesh J. Shah ,  Karnik D. Patel

IPC: G16H50/30 ,  G16H20/10 ,  G16H10/60

Abstract: A computerized method includes receiving, from a predictive model, a personalization score representing a likelihood that a user is receptive to multiple communication protocols. The method includes selecting a set of communication protocols based on the personalization score. The method includes generating a compliance plan, for addressing a non-compliance failure, including a hierarchy of communication protocols and a set of rule-based conditions. The method includes automatically deploying the compliance plan by generating a first compliance message with a first communication protocol that corresponds to a first level of the hierarchy associated with the compliance plan. The method includes, in response to determining that the non-compliance failure persists for a threshold period of time, generating a second compliance message with a second communication protocol that corresponds to a second level of the hierarchy. The second level demands greater communication resources than the first level.