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System-determined indication for facilitating the conversion of medication claims to active medications

System-determined indication for facilitating the conversion of medication claims to active medications description/claims

This application claims the benefit of U.S. Provisional Application No. 60/886,744, filed Jan. 26, 2007. This application is also related by subject matter to the invention disclosed in the commonly assigned application U.S. application Ser. No. (not yet assigned) (Attorney Docket Number CRNI.123640), filed on even date herewith, entitled “CONVERTING MEDICATION CLAIMS TO ACTIVE MEDICATIONS.”

Not applicable.

Prescribing medications to patients is often a complex practice for clinicians, with patients often visiting multiple prescribing clinicians and a continuously increasing number of available medications. The growing complexity of prescribing medications has given rise to an increased risk of medication errors. For example, without proper information, a clinician may prescribe a medication having an adverse interaction with a medication prescribed by another clinician. In addition, a clinician may inadvertently duplicate a medication already prescribed by another clinician.

Accordingly, information detailing what medications a patient is currently taking or has taken in the past may be invaluable to a clinician treating the patient. Such medication information may be available via a patient's medication profile or a medical record, such as a community health record, electronic medical record, or personal health record, for example. Unfortunately, in many circumstances, information detailing a patient's current medications and/or medication history may not be readily available to the clinician treating the patient. For example, in some cases, a medication profile or medical record may not be available for the patient. In other cases in which a medication profile or medical record is available, the profile or record may either provide incomplete medication information or completely fail to provide any medication information at all. In such instances, a clinician may question a patient regarding current and past medications. However, the patient may not know details regarding his/her medications or may provide inaccurate information.

One potential source of medication information for patients may be medical claims data. Payers involved in the business side of healthcare, including insurance companies, claims processing companies, and the like, all have the potential to produce medical claims data as part of their normal business operation. This claims data may be for any of a variety of healthcare-related services, including medications. Typically, a payer may have medication claims data representing years worth of medication utilization information that is tied to each patient. However, there is currently no convenient solution for clinicians to access medication claims information for patients and use the information to populate and/or replenish a medications profile or medical record for each patient.

This summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter.

Embodiments of the present invention relate to facilitating the conversion of medication claims to active medications by determining and providing an indication for medication claims corresponding to medications that a patient may be currently taking. Accordingly, in one aspect, an embodiment of the present invention is directed to a method in a clinical computing environment for facilitating the conversion of medication claims to active medications by determining medication claims that correspond with medications a patient is currently taking. The method includes accessing medication claims data corresponding with one or more medication claims. The method also includes determining, for each medication claim, whether the medication claim corresponds with a medication that the patient is currently taking. The method further includes presenting the one or more medication claims, wherein an indication is provided for each medication claim determined to correspond with a medication that the patient is currently taking.

In another aspect of the invention, embodiments further relate to a system in a clinical computing environment for a system in a clinical computing environment for facilitating the conversion of medication claims to active medications by determining medication claims that correspond with medications a patient is currently taking. The system includes an accessing component, a determining component, and a presentation component. The accessing component is capable of accessing medication claims data corresponding with one or more medication claims. The determining component is capable of determining, for each medication claim, whether the medication claim corresponds with a medication that the patient is currently taking. The presentation component is capable of presenting the one or more medication claims, wherein an indication is provided for each medication claim determined to correspond with a medication that the patient is currently taking.

In a further aspect, an embodiment of the present invention is directed to one or more computer-readable media having computer-useable instructions embodied thereon that provide for the presentation of one or more user interfaces for facilitating the conversion of a medication claim to an active medication by indicating medication claims corresponding with medications a patient is currently taking. The one or more user interfaces include a medication claims area and a current medications area. The medication claims area includes a list of one or more medication claims and provides for a user selection of medication claims for conversion to active medications. An indication is provided for each of the one or more medication claims determined to correspond with a medication that the patient is currently taking. The current medications area comprises a list of one or more current medications, which includes active medications converted from medication claims.

The present invention is described in detail below with reference to the attached drawing figures, wherein:

FIG. 1 is a block diagram of an exemplary computing environment suitable for use in implementing the present invention;

FIG. 2 is a block diagram of an exemplary system for accessing medication claims data and making the medication claims available for conversion to active medications in accordance with an embodiment of the present invention;

FIG. 3 is a flow diagram showing a method for accessing medication claims data and presenting the data, for instance, to a clinician in accordance with an embodiment of the present invention;

• Provisional Patent
• Utility Patent

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