Abstract: In some embodiments, quality assurance systems for verifying branding of at least one medication container associated with at least one of a prescription and medication order are provided.

Abstract: A computer-implemented method de-identifies data collected for patients. In at least one embodiment, the method comprises the sequential, non-sequential and/or sequence independent steps of providing information representative of at least one patient, at least one medical characteristic associated with at least one patient thereto, and a geographic area of the at least one patient, and providing at least one organizational structure for organizing medical characteristics. The method also includes associating the at least one organizational structure with at least one geographical area and at least one medical characteristic, and aggregating, in the at least one organizational structure, said information by medical characteristic and the at least one geographic area therein. Various alternative embodiments are additionally disclosed.

Abstract: A computer system architecture and process transforms the organizing principles of business data management seen in traditional or common place settings across disparate data stores into an object-semantic model. The transformation is implemented in a transitory, managed risk implementation approach for data access migration. This approach will enable data agility and will move data storage closer to information storage, while supporting the rapid development of business capabilities. This approach will bridge the gaps between relational database/file based storage (less expressive) and object-semantic representation (more expressive). This process/method will connect information residing in legacy data structures such as relational database/file based storage on disk drives to instances populating an expressive object-semantic model in persistent grid based memory.

Abstract: In some embodiments, quality assurance systems for verifying branding of at least one medication container associated with at least one of a prescription and medication order are provided.

Abstract: A healthcare risk index is generated using a patient or individual's pharmacy claims. The index may be used to explain and predict variation in pharmacy-related costs and variation in total healthcare costs or utilization. In particular, the index is generated by first examining the individual's pharmacy claims to identify any chronic conditions possessed by the individual. Similarly, the individual's pharmacy claims are examined to identify any compliance medications prescribed to the individual. The chronic condition information is used to generate a chronic condition score by summing regression coefficients for each chronic condition possessed by the individual. Likewise, the compliance medication information is used to generate a compliance medication score by summing products of regression coefficients for each compliance medication prescribed to the individual with associated medication supply weights.

Abstract: A coded sealing device for a medicine bottle includes a substantially solid structure comprising a first sidewall, a first top surface, and a first concavity. A label is located on at least one of the first sidewall and first top surface, and the first concavity is for receiving a medicine bottle. In at least one embodiment, at least one of the first sidewall, first top surface, and label may include a color coding and/or other indicia. The label containing information relevant to the patient may be located on at least one of the first sidewall and first top surface. The coded sealing device also includes various alternative embodiments.

Abstract: A healthcare risk index is generated using a patient or individual's medical claims. The index may be used to explain and predict variation in pharmacy-related costs and variation in total healthcare costs or utilization. In particular, one example of such a method involves first generating a medical condition score using the individual's medical information for each medical condition possessed by the individual. From there, each medical condition score is modified according to a regression coefficient, to result in one or more modified medical condition scores. Finally, the risk index may be generated by summing the medical condition scores. This risk index is indicative of at least one of the individual's medical costs, chronic medical conditions, and variation in medical costs.

Abstract: An imaging and workflow method, system, computer readable medium and user interface for processing information efficiently for the processing of medical prescription orders. The system includes support for document scanning, automated rules-based order processing, statistical reporting, document generation and document storage and retrieval. The present invention takes advantage of imaging technology to assist the user in scanning information into the system and software modules to improve the processing of orders. The present invention also includes database tables that identify to application processing logic the types and sequences of actions to be implemented for orders.

Abstract: An automated system and method for emptying the contents of pharmaceutical containers. In an embodiment, a gripper unit receives and holds a pharmaceutical container. A cutter cuts the pharmaceutical container, and a rotating unit, operable with the gripper, rotates at least a portion of the gripper unit to empty the contents of the pharmaceutical container.

Abstract: A computer-implemented method de-identifies data collected for patients. In at least one embodiment, the method comprises the sequential, non-sequential and/or sequence independent steps of providing information representative of at least one patient, at least one medical characteristic associated with at least one patient thereto, and a geographic area of the at least one patient, and providing at least one organizational structure for organizing medical characteristics. The method also includes associating the at least one organizational structure with at least one geographical area and at least one medical characteristic, and aggregating, in the at least one organizational structure, said information by medical characteristic and the at least one geographic area therein. Various alternative embodiments are additionally disclosed.

Abstract: Systems and methods for allowing a user (e.g., a benefits administrator) to maintain and modify a contract or a group for a prescription drug plan may be provided. In response to receiving a request to modify a contract or a group, a prescription benefits management application may retrieve data relating to the contract or group and allow the user to input information relating to the contract or group, input broker information, input billing information, select a pharmacy network, select pricing options for the prescription plan, create a customized prescription plan, input brand/generic difference overrides, etc. In some embodiments, the modifications and/or additions made to a contract or group may be transmitted to a pharmacist, thereby allowing the pharmacist to fill one or more prescriptions in real-time or upon updating the system (e.g., within 48 to 72 hours).

Abstract: Systems and methods for analyzing spend and/or trend for a prescription drug plan may be provided. In response to receiving a request to analyze spend and/or trend, a prescription drug spend and/or trend application may retrieve data related to the prescription drug plan from a database. The data may include drug claims data related to the prescription drug plan. The results of the analysis may be provided to a user computing device for display. In connection with the spend and/or trend analysis, a profile may be created for a prescription drug plan using data from at least one data source. The creation of a profile for a prescription drug plan may include the selection of a performance metric for a parameter of the prescription drug plan. If the performance metric deviates from plan data, a performance alert may be provided to the user computing device indicating this deviation.

Abstract: A computer implemented method and/or computer system determines a Generic Opportunity Score (GOS) and/or a generic drug's performance demonstrating how a generic utilization can be better identified and improved relative to the total overall generic opportunity, which can provide savings information relative to a clinically appropriate generic alternative. In some embodiments, the process and/or system determines the GOS as the proportion of generic prescriptions dispensed relative to the maximum number of prescriptions that have a generic equivalent or a clinically-appropriate generic alternative. In some embodiments, the process determines the GOS as the number of generic claims dispensed over the total number of generic claims plus the brand claims that have a generic equivalent or generic alternative.

Abstract: Systems and methods for determining options for reducing spend and/or trend for a prescription drug plan are provided. Based on an analysis of spend and/or trend for the prescription drug plan, a prescription drug spend and/or trend application may determine that an option is available to reduce spend and/or trend. For example, an option may be provided that addresses a primary component of spend and/or trend as determined by the spend and trend application. In another example, an option may be provided that addresses a deviation by the prescription drug plan from a selected performance metric. In yet another example, an option may be provided that addresses a status change for a drug in a marketplace. The spend and/or trend application may optionally project an impact of an option on the prescription drug plan (e.g., financial impact, member impact) using a related model.

Abstract: An apparatus and method are disclosed for processing phone-in prescription requests. The apparatus is in the form of a prescription processing network that includes a prescription processing system and a communication device remotely located from the prescription processing system. The communication device is used to establish a communication channel with the prescription processing system and submit a prescription request over the communication channel. A pharmacist, associated with the prescription processing system, prepares a completed prescription form based, at least in part, on the submitted prescription request. The prescription processing network also includes a pharmacy for receiving the completed prescription form, and filling the prescription request based on the completed prescription form.

Abstract: A system is provided that integrates of records of clinical laboratory services into the assessment and optimization of patient health care and, in particular, regulation of the use of pharmaceuticals. Laboratory test result records are used in conjunction with other health care benefits records to monitor regulation of use of pharmaceuticals by patients. The incorporation of laboratory tests and results into such a utilization system allows improvement in the management of a patient's therapy based on a more precise picture of the patient's level of illness as revealed by the laboratory test results.

Abstract: A healthcare risk index is generated using a patient or individual's pharmacy claims. The index may be used to explain and predict variation in pharmacy-related costs and variation in total healthcare costs or utilization. In particular, the index is generated by first examining the individual's pharmacy claims to identify any chronic conditions possessed by the individual. Similarly, the individual's pharmacy claims are examined to identify any compliance medications prescribed to the individual. The chronic condition information is used to generate a chronic condition score by summing regression coefficients for each chronic condition possessed by the individual. Likewise, the compliance medication information is used to generate a compliance medication score by summing products of regression coefficients for each compliance medication prescribed to the individual with associated medication supply weights.

Abstract: The method of labeling of a container including a medication includes, in at least one embodiment, reducing a size of the label using a label apparatus and reducing the label size using the label apparatus, applying a surface securing adhesive to at least one surface securing section of the label using an adhesive application apparatus, and attaching the at least one surface securing section of the label to the container with the securing adhesive. The method also includes applying a label securing adhesive to the label to maintain the label in the reduced orientation.

Abstract: A system and method of distributing pharmaceutical prescriptions within a network of pharmacies based on the review of prescription claim data and patient medical state to enable stratification of patients, wherein each pharmacy within the network has been established to handle one or more particular patient medical states.

Abstract: A healthcare risk index is generated using a patient or individual's medical claims. The index may be used to explain and predict variation in pharmacy-related costs and variation in total healthcare costs or utilization. In particular, one example of such a method involves first generating a medical condition score using the individual's medical information for each medical condition possessed by the individual. From there, each medical condition score is modified according to a regression coefficient, to result in one or more modified medical condition scores. Finally, the risk index may be generated by summing the medical condition scores. This risk index is indicative of at least one of the individual's medical costs, chronic medical conditions, and variation in medical costs.