Patent Publication Number: US-2017357774-A1

Title: Automated prescription communication system and method

Description:
CROSS REFERENCE TO RELATED APPLICATION AND CLAIM TO PRIORITY 
     This application is related to Provisional Application No. 62/347,305, filed Jun. 8, 2016 in the United States of America, the disclosure of which is incorporated herein by reference and to which priority is claimed. 
    
    
     TECHNICAL FIELD 
     The invention relates generally to systems and methods of automated communication between pharmacies and patients about the patients&#39; health care, and, more particularly, to an automated system and method for communicating prescription information between a pharmacy and a patient by wired or wireless communication systems, such as by mobile phone, landline phone or email. In particular, the system and method of the invention relate to an automated system that automatically alerts a patient by phone (voice or text) or email when a pharmacy receives a prescription from a prescriber and allows the patient to respond with how the prescription should be handled, i.e., fill immediately, fill later, hold until further notice, etc. 
     BACKGROUND 
     Prescription medications are prescribed to patients by a provider for a wide variety of reasons. Traditionally, prescriptions are written on paper, although electronic prescription systems have become more common. Paper prescriptions require a patient to deliver their prescriptions to a pharmacy. Electronic prescriptions allow a provider to electronically send a prescription to a pharmacy or other entity that fills prescriptions, such as a pharmacy benefits manager. After a prescription is issued by a provider, it may be filled at a pharmacy or other health care facility or service. However, patients often have no way of knowing when their prescriptions have been received by their pharmacy or the status of the prescriptions. Current systems and methods fail to effectively and conveniently help patients fully manage their prescriptions. 
     Alert Solutions, www.alertsolutions.com, alerts a patient when a refill is due based on the date that the last prescription was filled so that the patient does not miss a dose. Some pharmacies have systems that alert patients when a prescription has been filled and is ready for pick up so that the patient will not have to wait at the pharmacy for the prescription to be filled, see www.cubpharmacies.com. Many pharmacies have systems that combine these functionalities, i.e., they alert a patient when a prescription is ready for pick up and a refill is due, see e.g., www.cvs.com, www.schultzpharmacyrx.com, www.telemanager.com, www.walgreens.com. 
     US Publication 2011/0257989 to Kumar discloses systems and methods for managing prescription-related health care data for a patient using a mobile communication device. In one embodiment, a method includes identifying prescription status data for a prescription associated with a patient. The patient is a user of a mobile communication device. The method also includes determining whether the prescription is ready for retrieval from a pharmacy using the prescription status data, and initiating a prescription availability notification on the mobile communication device in response to determining that the prescription is ready for retrieval from the pharmacy. The prescription availability notification notifies the patient that the prescription is ready for retrieval from the pharmacy. The method also includes presenting a set of selectable modules on a graphical user interface of the mobile communication device. At least a portion of the set of selectable modules is related to the prescription. In other words, Kumar communicates with a patient when a prescription is ready for pickup. 
     However, none of these systems or methods alert a patient at the time a prescriber sends a prescription to a pharmacy. This is often a time of confusion for the patient, because the patient doesn&#39;t have control over the prescription and doesn&#39;t know when it will be received by the pharmacy. Accordingly, there remains a need to provide a system and method that alerts a patient earlier in the prescription filling process; that is, at the time when a provider sends a prescription to a pharmacy to be filled. 
     SUMMARY 
     It is a first aspect of the invention to provide a HIPAA (Health Insurance Portability and Accountability Act of 1996) compliant, automated system and method of communication between a pharmacy and a patient, preferably via text messaging, voice messaging or electronic mail. 
     It is a second aspect of the system and method of the invention to notify a patient in real-time when a pharmacy receives a prescription from a prescriber. 
     It is a third aspect of the invention to provide a patient with an opportunity to respond with his/her plans for a prescription once notified that a pharmacy has received the prescription, such as to allow the patient to dictate the desired pickup time for the prescription or alert the pharmacy that the prescription is not to be filled at all. 
     It is a fourth aspect of the invention to provide a method for automated communication of prescription information between a pharmacy and a patient, the method comprising the steps of receiving a prescription for the patient from a prescriber, determining whether the patient has opted into receiving notifications, determining whether the patient has opted into bi-directional notifications, retrieving a notification message and valid responses from storage, determining whether the message has a valid response, notifying the patient that the prescription has been received, and determining whether a valid response was received within an allotted time. 
     It is a fifth aspect of the invention to provide an automated prescription communication system for communicating prescription information to a patient, the prescription communication system comprising an electronic prescribing system, the electronic prescribing system comprising prescription information for the patient, a communication unit comprising a table of messages and appropriate responses, the messages and responses associated with the prescription information for the patient, and a prescription communication application executable on an electronic device associated with the patient, the prescription communication application comprising a module to retrieve the prescription information and to provide the prescription information to the patient on the electronic device, wherein the prescription information comprises information on when a new or refill prescription is received from a prescriber. 
     Other aspects of the invention, including processes, systems, and the like that constitute part of the invention, will become more apparent upon reading the following detailed description of the exemplary embodiments. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The accompanying drawings are incorporated in and constitute a part of the specification. The drawings, together with the general description given above and the detailed description of the exemplary embodiments and methods given below, serve to explain the principles of the invention. 
         FIG. 1  is a schematic representation of a system and method for automated communication of prescription information between a pharmacy and a patient according to an exemplary embodiment. 
         FIG. 2  is a block diagram of a system and method for automated communication of prescription information between a pharmacy and a patient according to an exemplary embodiment. 
         FIG. 3  is a block diagram of a system and method for automated communication of prescription information between a pharmacy and a patient according to an exemplary embodiment. 
         FIG. 4  is a block diagram of a system and method for automated communication of prescription information between a pharmacy and a patient according to an exemplary embodiment. 
         FIGS. 5A and 5B  are a flowchart of a system and method for automated communication of prescription information between a pharmacy and a patient according to an exemplary embodiment. 
         FIG. 6  is a table of messages and appropriate responses for the automated communication of prescription information between a pharmacy and a patient according to an exemplary embodiment. 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT(S) 
     Reference will now be made in detail to exemplary embodiments and methods of the invention. It should be noted, however, that the invention in its broader aspects is not necessarily limited to the specific details, representative materials and methods, and illustrative examples shown and described in connection with the exemplary embodiments and methods. Like reference characters refer to like parts throughout the drawings. 
       FIG. 1  is a schematic representation of a system and method  100  for automated communication of prescription information between a pharmacy  101  and a patient according to an exemplary embodiment. According to the exemplary embodiment, a healthcare provider  102  submits, preferably electronically  103 , a prescription to a pharmacy  101  or other entity that fills prescriptions. The prescription is entered into the pharmacy&#39;s pharmacy management system (PMS)  104 . Alternatively, the provider  102  may transmit the prescription to the pharmacy  101  by phone or fax, at which point the pharmacy  101  enters the prescription into the PMS  104 . The PMS  104  is in connection with a communication unit  106  via an interface unit  105 . The interface unit  105  provides a bi-directional interface between the PMS  104  and the communication unit  106 . The communication unit  106  in turn transmits  107  prescription information from the PMS  104  to a patient&#39;s device, such as a mobile phone  109  or computer  110 , preferably via wireless communication  108 , such as by CDMA, GSM, 3G, 4G, Edge, an over-the-air network, Bluetooth, etc. 
       FIG. 2  is an overview of a system and method  100  for automated communication of prescription information between a pharmacy and a patient according to an exemplary embodiment. When a patient is seen by a medical professional, such as a physician, a physician&#39;s assistant, a nurse, etc. at step  200 , the medical professional may prescribe a medication. Prescribers often use electronic prescription systems, i.e., an e-prescription system such as SureScripts®, to electronically transmit prescription information to the patient&#39;s pharmacy&#39;s PMS at step  201 . The system and method of an exemplary embodiment monitors the pharmacy&#39;s PMS for new or refill prescriptions that are received at step  202 . As discussed above, prescriptions may optionally also be received by fax or phone or other method from a prescriber and manually entered into the PMS. 
     For patients that have opted into the automated system  100 , once a new or refill prescription is received from a prescriber and entered into the PMS, the relevant patient is notified in real time of same by Short Message Service (SMS), iMessage, Custom Mobile App, Interactive Voice Response (IVR), or email at step  203 . Preferably, the system notifies the patient by SMS or IVR, such that the patient does not need to download application software and can use any mobile phone or landline phone, as appropriate, to communicate with their pharmacy. 
     In the notification, the patient is given a series of options with which to respond at step  204 . For example, options for a reply can include, 1) on my way; 2) pick up within the hour; 3) pick up tomorrow; or 4) do not fill at this time. The patient&#39;s response is then transmitted to the PMS, alerting them of the proper handling of that prescription at step  205 . 
     If the patient does not respond within an allotted time, such as 30 minutes, 15 minutes, 10 minutes, 5 minutes or the like, the prescription continues through the standard fill process, but is not expedited. If the patient does not respond to the notification at all, the prescription is filled through the standard process. 
     According to another exemplary embodiment, the system and method also alerts patients when they have prescriptions that have not been picked up within a certain period of time, i.e., a certain number of days, preferably 2-7 days, preferably 3-5 days, more preferably 3 days. The system and method may also optionally alert a patient when it is time to refill a prescription or take their medication, with or without the ability for bi-directional communication. 
     As seen in FIG,  3 , in the system and method of an exemplary embodiment, the PMS  104  communicates prescription information to the communication unit  106  via the interface unit  105 . The communication unit  106 , in turn communicates the prescription information to a patient device, such as a mobile phone  109 . In other words, the communication unit  106  handles the bidirectional communication and messaging with a patient&#39;s device, such as a patient&#39;s mobile phone  109 . 
     The communication unit  106  includes a server  400 , a communication processor  401  and a message database  402  as seen in  FIG. 4 . The message database  402  includes the communication messaging definitions. The communication processor  401  sends and receives communications from the patient&#39;s device. 
     Turning now to  FIGS. 5A and 5B , when the electronic prescription is received by the PMS at  500 , the automated system  100  determines whether the patient has opted into notifications at  501 . By default, a patient is not enrolled in the notification system. According to an exemplary embodiment, a patient must affirmatively opt into the notification system at  501  by requesting enrollment with the pharmacy, either verbally or in writing. The pharmacy then marks the patient&#39;s profile for notification in the PMS. A patient can opt out of the system at any time by notifying the pharmacy directly, verbally or in writing, or through the automated system  100 . 
     If the patient has not opted into notification, the automated system  100  terminates at  502 . If the patient has opted into notification, the automated system  100  determines if the patient has specifically opted into bi-directional communication at  503 . If the patient has opted into notifications, but not bi-directional communication  503 , the automated system  100  terminates at  504 . The notifications and alerts are written to storage each time a message is sent at  505  or received at  517  by the automated system  100 . 
     The automated system  100  then retrieves the appropriate messages and valid responses from storage at  506 . As best seen in  FIG. 6 , the automated system  100  includes a table of messages and appropriate responses in a database for retrieval, which includes at least the following fields: 1) message to send, 2) appropriate responses, and 3) indicate next message to send or to terminate. 
     The automated system  100  then determines if a message has a valid response in the database at  507 . If there is no valid response in the database, a notification is sent to the patient, but the patient is not given the opportunity to respond at  508  and the automated system  100  at terminates  509 . If the automated system  100  determines that the message has a valid response in the database, a notification is sent to the patient with response options at  510 . The automated system  100  then waits for a response for a defined time, x, at  511 . According to an exemplary embodiment, the defined or response time, x, is about 2-7 minutes, preferably about 3-5 minutes, more preferably about 3 minutes. If no response is received within the allotted response time, x, at  512 , the automated system  100  determines how many times k the message has been sent at  513 . If the message has been sent fewer than k times, the message is resent at  513 . If the message has been sent at least k times, the automated system  100  terminates at  514 . According to an exemplary embodiment, k is preferably 2 or 3, preferably 2 times. In other words, system  100  will send the message 2-3 times seeking a response, and will terminate messaging if no response is timely received after the predetermined number of messages have been sent without response. 
     If a response is received, the automated system  100  then determines whether the response was received after y time at  515 . According to an exemplary embodiment, y time is about 5-15 minutes, preferably about 7-12 minutes, more preferably about 10 minutes. If the response was received after y time, the automated system  100  terminates at  514 . If the response is received before y time, the automated system  100  determines if the response is valid at  516 . If the response is not valid, the automated system resends the message at  510  and the automated system  100  repeats the process of sending a notification. If the response is valid, the automated system  100  determines if the response terminates the conversation at  518 . If the response terminates the conversation, the pharmacy is so notified via the PMS at  519  and the automated system  100  terminates at  514 . If the response does not terminate the conversation, the automated system retrieves the next message and response at  520 , determines whether the message has a valid response at  507 , and the automated system  100  repeats the process. 
     Exemplary automated messages may include, for example: 
     Pharmacy received a Prescription. Please text/respond pickup option: 
     A=On my way 
     B=After hh:mm (wherein hh:mm is the time about 15-180 minutes, preferably about 20-120 minutes, preferably about 20-60 minutes, preferably about 25-45 minutes, more preferably about 30 minutes, from the time the message was sent) 
     C=Tomorrow 
     D=Fill later 
     According to another exemplary embodiment, the system and method may also include additional notifications, i.e., insufficient inventory to fill at this time; alternative response options, i.e., fill on (future date); authorize 3 rd  party pick up; or follow-up notifications, i.e., original prescription required, insurance card required at pickup, etc. Table 1 lists additional messages that are optionally included in the system and method. 
     
       
         
           
               
             
               
                 TABLE 1 
               
             
            
               
                   
               
               
                 Additional Notifications/messages 
               
            
           
           
               
               
               
            
               
                 Notifications 
                 Description 
                 Responses 
               
               
                   
               
               
                 Pickup alerts 
                 Sends a notification to a 
                 A = Pickup today 
               
               
                 &amp; reminders 
                 patient that they have a 
                 B = Pickup this week or 
               
               
                   
                 prescription ready for 
                 Pickup on [Date] 
               
               
                   
                 pickup 
                 C = Deliver 
               
               
                   
                   
                 D = Don&#39;t need 
               
               
                 Refill 
                 Sends a notification to a 
                 A = Fill 
               
               
                 reminders 
                 patient to remind them of 
                 B = Fill tomorrow 
               
               
                   
                 an upcoming prescription 
                 C = Don&#39;t fill yet 
               
               
                   
                 refill that has remaining 
                 Optional additional response 
               
               
                   
                 refills 
                 D = Fill on [Date] 
               
               
                 Rx renewal 
                 Sends a notification to a 
                 A = Request refill from 
               
               
                 alert 
                 patient that a prescription is 
                 prescriber 
               
               
                   
                 due for a refill in a certain 
                 B = Appointment with 
               
               
                   
                 number of days, i.e., 5 
                 prescriber before date refill is 
               
               
                   
                 days, 7 days, 14 days, or 21 
                 due 
               
               
                   
                 days, but that there are no 
                 C = Do nothing at this time 
               
               
                   
                 remaining refills 
               
               
                 Return to 
                 Sends a notification to a 
                 A = Pickup today 
               
               
                 stock alert 
                 patient that they have had a 
                 B = Pickup this week or 
               
               
                   
                 prescription ready for pick- 
                 Pickup on [Date] 
               
               
                   
                 up for a certain number of 
                 C = Deliver 
               
               
                   
                 days, i.e., 5 days, 7 days, 
                 D = Don&#39;t need 
               
               
                   
                 14 days, or 21 days and re- 
               
               
                   
                 quests a response or pre- 
               
               
                   
                 scription will be returned 
               
               
                   
                 to stock 
               
               
                 Rx on file 
                 Sends a notification to a 
                 A = Please fill 
               
               
                 not filled 
                 patient that they have a 
                 B = Keep on file 
               
               
                   
                 prescription that has been 
                 C = Discontinue prescription 
               
               
                   
                 on file for more than a 
               
               
                   
                 certain amount of time, i.e., 
               
               
                   
                 a month, that has never 
               
               
                   
                 been filled 
               
               
                 Medication 
                 Sends a notification to a 
                 Initial response 
               
               
                 synchroni- 
                 patient enrolled in a 
                 A = Today 
               
               
                 zation 
                 medication synchronization 
                 B = Tomorrow 
               
               
                 update alert 
                 program that their 
                 C = In 2 days 
               
               
                   
                 prescription is due to be 
                 Optionally, D = On [date] 
               
               
                   
                 filled in certain number of 
                 Follow-up response 
               
               
                   
                 days, i.e., 3 days, 5 days or 
                 Indicate time (hh:mm) for the 
               
               
                   
                 7 days, and allows them to 
                 date selected 
               
               
                   
                 respond with a day and 
               
               
                   
                 time to schedule a call to 
               
               
                   
                 discuss the details 
               
               
                   
               
            
           
         
       
     
     A medication synchronization program allows a pharmacy to coordinate refills of various prescriptions so that they can be picked up on a single day each month. Patients are given the option to enroll verbally, in writing or through the automated system  100 . Once enrolled, the pharmacy will review the various prescriptions and develop a plan to synchronize them so they can be picked up on a single day each month that is convenient for the patient. About a week before the prescriptions are due to be refilled each month, the automated system sends a notification to the patient to confirm the pickup date and identify any changes that need to be made before the prescriptions are refilled. After reviewing the changes to the prescriptions, the pharmacy prepares the prescriptions and creates one package for easy pick up on the scheduled pickup date. On the scheduled day, the patient picks up all of the prescriptions at the pharmacy. At that time, they patient can ask the pharmacist any questions that he/she may have about the prescriptions. The process repeats itself each month so that the patient can pick up all of the prescriptions at once, and the pharmacy can identify potential issues to help the patient take the prescriptions as prescribed. 
     Optionally, the system and method provide prescription workflow status notifications. This feature sends a notification to a patient asking if the patient wants to subscribe to workflow status. If a patient elects not to subscribe to the notifications, no prescription workflow status notifications are sent. If a patient elects to subscribe to the notifications, the system and method send notifications each time the prescription moves through the fill process, i.e., Entry, Fill, Quality Control, Completion, or Clinical delay, wherein Clinical delay means that something needs to be verified with the prescriber. 
     The system and method of the invention is HIPPA compliant because there is no personal health information (PHI), such as patient name, date of birth, social security number, prescription information, etc. in the messages. 
     The foregoing detailed description of the certain exemplary embodiments has been provided for the purpose of explaining the principles of the invention and its practical application, thereby enabling others skilled in the art to understand the invention for various embodiments and with various modifications as are suited to the particular use contemplated. This description is not necessarily intended to be exhaustive or to limit the invention to the precise embodiments disclosed. The specification describes exemplary embodiments to accomplish a more general goal that may be accomplished in another way.