Methods and system for evaluating medication regimen using risk assessment and reconciliation

摘要

Computer-based and network-based methods and system that provide for evaluating medication regimen using medication-related risk assessment in an automated medication reconciliation process can comprise, without limitation, collecting comprehensive information with respect to a patient that can fill in gaps typical of claims, EHR, or HIE-based data sets, based on curated clinician review and annotation or tagging of data. Various embodiments introduce flexible use of a variety of accurate and efficient methods for capturing and characterizing medications in point-of-care settings, including structured interviews, bar code scanning, and image recognition. Embodiments of the invention can further provide for harmonizing and reconciling data from disparate sources, calculating risk based on a more comprehensive assessment and annotation of the data sets and comparing risk to create a risk offset or differential, with a subsequent tailoring of interventions based on the risk offset or differential.

主权项

1. A computer-implemented method for assessing medication risk and improving treatment regimen for a patient having an existing treatment regimen, comprising the steps of:
automatically receiving via a computer network or via HTTPs protocol over the internet one or more distinct sets of data elements indicating a current state of a patient's treatment or therapeutic regimen via one or more external sources of clinical or claims information; calculating, by a computing device, one or more first risk values for the patient associated with each concurrent distinct source of the automatically received first data elements, each one of the first risk values being based on a subset of the automatically received first data elements, wherein the first risk values indicate a likelihood of the patient developing sub-optimal outcome per the existing treatment regimen; receiving into the data processing system, by a computing device, one or more second data elements in the form of patient-related information, wherein the second data elements are captured directly from a patient, a clinician or a professional conducting a patient assessment; by a computing device, at least one of annotating and augmenting values for the one or more first data elements from information received via the second data elements; calculating, by a computing device, one or more second risk values for the patient associated with a combination of (i) the automatically received first data elements as annotated or augmented and (ii) the second data elements, each one of the second risk values being based at least in part on data unique to the step of annotating or augmenting values for the one or more first data elements, wherein the second risk values indicate a likelihood of the patient developing sub-optimal outcome per the existing treatment regimen; determining, by a computing device, a risk value differential between the first and second risk values; displaying the risk value differential via a computer or electronic display; and associating the risk value differential with interventions in an Action Plan that updates the existing treatment regimen to an improved treatment regimen.