公开(公告)号：US09773094B1

公开(公告)日：2017-09-26

申请号：US14612005

申请日：2015-02-02

Applicant: Express Scripts, Inc.

Inventor： Dhanur S. Balagere ,  David A. Tomala ,  Robert F. Nease ,  Reethi N. Iyengar

IPC: G06F17/00 ,  G06N5/02 ,  G06F19/00 ,  G06F17/50

CPC classification number: G16H50/50 ,  G06F19/00 ,  G06Q50/24 ,  G16H40/20

Abstract: Methods and systems for pharmacy modeling are described. The risk adjusted pharmacy predictive model is created from member data, claims data, and population data. This model can be used to compare the actual pharmacy performance to an expected actual pharmacy performance value, which can be used to identify pharmacies at risk or not performing to an acceptable level. The model can be used for adherence and generic drug utilization ratings of pharmacies. The pharmacy can be judged on a therapy class by therapy class basis with factors that reflect the demographic, socio-economic, location, benefits attributes, etc. that actually affect the performance of the pharmacy and may assist in determining the quality of care by a pharmacy.

公开(公告)号：US09147163B1

公开(公告)日：2015-09-29

申请号：US14196119

申请日：2014-03-04

Applicant: Express Scripts, inc.

Inventor： Robert F. Nease ,  David A. Tomala ,  Seda Follis ,  Tina L. Bauman

IPC: G06F17/00 ,  G06N5/02 ,  G06F19/00

CPC classification number: G06N5/022 ,  G06F19/00 ,  G06F19/3456 ,  G06N5/02

Abstract: A system and method for improving adherence to therapy programs, in particular to adherence to medication therapy and/or to healthcare therapy, that includes medication therapy. Methods of the present invention may also be used to improve compliance with and/or adherence to other wellness and/or health care programs. Methods and systems of the invention may include methods of identifying patients who are at risk of non-adherence, non-compliance, or likelihood of cessation with a therapy program, predicting a basis for such noncompliance, and targeting interventions directed to patients who have been identified as likely to be non-compliant, wherein interventions take into consideration the predicted basis for noncompliance.

Abstract translation: 一种用于改善对治疗程序的依从性的系统和方法，特别是对药物治疗和/或医疗保健治疗的依从性，其包括药物治疗。 本发明的方法也可用于改善对其他健康和/或保健程序的依从性和/或遵守。 本发明的方法和系统可以包括识别患有不遵守，不遵守或有可能停止治疗方案的患者的方法，预测这种不合规的基础，并针对已经被 被确定为可能不合规，其中干预措施考虑到不合规性的预测依据。