Systems and methods for providing supplemental materials to increase patient adherence to prescribed medication

1. A method implemented on a computing device having at least one processor, storage, and a communication platform for providing supplemental programs, the method comprising:

generating program cohort group data for a program cohort group, the program cohort group including a plurality of cohorts, each cohort including health care provider identifiers, a prescribed substance or a diagnostic code, a maximum prescription counter, a current prescription counter, and a supplemental program permutation, wherein generating the program cohort group data includes:

receiving, by the processor, electronic prescription data for a prescribed substance for a patient when the health care provider prescribes the prescribed substance for the patient;

determining whether the electronic prescription data qualifies for a cohort of the plurality of cohorts, the electronic prescription data qualifying for a cohort responsive to:

determining that the health care provider of the electronic prescription data exists in the health care provider identifiers for the cohort,

determining that the prescribed substance for the electronic prescription data matches the prescribed substance for the cohort or the diagnostic code for the electronic prescription data matches the diagnostic code for the cohort, and

determining that the current prescription counter for the cohort is less than the maximum prescription counter for the cohort;

responsive to determining that the electronic prescription data qualifies for the cohort:

generating a notification to the patient that includes the supplemental programs included in the supplemental program permutation,

incrementing the current prescription counter for the cohort, and

tagging the electronic prescription data as activated in connection with the cohort; and

receiving, responsive to tagging the electronic prescription data as activated in connection with the cohort, medical history data for the patient and the prescribed substance;

analyzing, responsive to determining the current prescription counter for each cohort is not less than the maximum prescription counter for the cohort, the medical history data for tagged prescriptions in each cohort in the program cohort group data to determine a chosen cohort of the plurality of cohorts for the program cohort group, the chosen cohort having highest patient adherence based on the medical history data; and

generating, responsive to receiving a new electronic prescription for the prescribed substance for another patient, a notification to the other patient including the supplemental programs associated with the chosen cohort.

2. The method of claim 1 , wherein the supplemental programs are provided in a single data file via at least one of email, SMS, WAP, and mobile application.

3. The method of claim 1 , further comprising:

determining a decile level for each of a plurality of providers, the decile level being an indicator of a frequency with which the provider prescribes the substance; and

assigning the plurality of providers to cohorts so that cohorts have a similar average decile level.

4. The method of claim 1 , wherein said electronic prescription data qualifies for a cohort responsive to further receiving a selection of the supplemental programs for the cohort from the health care provider.

5. The method of claim 1 , wherein the supplemental programs includes educational data that relates to one or more specific diseases for which the substance can be prescribed, including signs, symptoms, abnormal findings, complaints, social circumstances, and/or external causes of injury or disease for which the substance can be prescribed to the patient.

6. The method of claim 1 , wherein each cohort further includes a cohort rule and the electronic prescription data qualifies for a cohort responsive to further determining that the cohort rule is satisfied.

7. The method of claim 6 , wherein the cohort rule specifies a range for a percentage that represents how often a patient filled a prescription compared to how often the prescription could optimally have been filled.

8. A non-transitory computer-readable storage medium encoded with instructions which, when executed on a processor, perform a method comprising:

generating program cohort group data for a program cohort group, the program cohort group including a plurality of cohorts, each cohort including health care provider identifiers, a prescribed substance or a diagnostic code, a maximum prescription counter, a current prescription counter, and a supplemental program permutation, wherein generating the program cohort group data includes:

receiving electronic prescription data for a prescribed substance for a patient from a health care provider when the health care provider prescribes a prescribed substance for the patient;

determining whether the electronic prescription data qualifies for a cohort of the plurality of cohorts, the electronic prescription data qualifying for a cohort responsive to:

determining that the health care provider of the electronic prescription data exists in the health care provider identifiers for the cohort,

determining that the prescribed substance for the electronic prescription data matches the prescribed substance for the cohort or the diagnostic code for the electronic prescription data matches the diagnostic code for the cohort, and

determining that the current prescription counter for the cohort is less than the maximum prescription counter for the cohort;

responsive to determining that the electronic prescription data qualifies for the cohort:

generating a notification to the patient that includes supplemental programs included in the supplemental program permutation,

incrementing the current prescription counter for the cohort, and

tagging the electronic prescription data as activated in connection with the cohort; and

receiving, responsive to tagging the electronic prescription data as activated in connection with the cohort, medical history data for the patient and the prescribed sub stance;

analyzing, responsive to determining the current prescription counter for each cohort is not less than the maximum prescription counter for the cohort, the medical history data for tagged prescriptions in each cohort in the program cohort group data to determine a chosen cohort of the plurality of cohorts for the program cohort group, the chosen cohort having highest patient adherence based on the medical history data; and

generating, responsive to receiving a new electronic prescription for the prescribed substance for another patient, a notification to the other patient including the supplemental programs associated with the chosen cohort.

9. A computer system for electronically providing supplemental programs, the computer system comprising:

a processor;

a cohort database that stores a plurality of cohorts for a program cohort group, each cohort including:

health care provider identifiers,

a prescribed substance or a diagnostic code,

a maximum prescription counter,

a current prescription counter, and

a supplemental program permutation;

a network interface;

instructions residing on a storage unit, which when executed by the processor, causes the processor to generate program cohort data by:

receiving electronic prescription data for a prescribed substance for a patient from a health care provider when the health care provider prescribes a prescribed substance for the patient;

determining whether the electronic prescription data qualifies for a cohort of the plurality of cohorts, the electronic prescription data qualifying for a cohort responsive to:

determining that the health care provider of the electronic prescription data exists in the health care provider identifiers for the cohort,

determining that the prescribed substance for the electronic prescription data matches the prescribed substance for the cohort or the diagnostic code for the electronic prescription data matches the diagnostic code for the cohort, and

determining that the current prescription counter for the cohort is less than the maximum prescription counter for the cohort;

responsive to determining that the electronic prescription data qualifies for the cohort:

generating a notification to the patient that includes the supplemental programs included in the supplemental program permutation,

incrementing the current prescription counter for the cohort, and

tagging the electronic prescription data as activated in connection with the cohort; and

receiving, responsive to tagging the electronic prescription data as activated in connection with the cohort, medical history data for the patient and the prescribed substance; and

instructions residing on the storage unit, which when executed by the processor, causes the processor to generate, responsive to receiving a new electronic prescription for the prescribed substance for another patient, a notification to the other patient that includes the supplemental programs associated with a chosen cohort in the cohort database by:

analyzing the medical history data for tagged prescriptions in each cohort in the program cohort group to determine the chosen cohort of the plurality of cohorts, the chosen cohort having highest patient adherence based on the medical history data.

10. The method of claim 7 wherein the method further comprises:

determining a qualification rate for the cohort; and

adjusting the range to increase the number of prescriptions determined to qualify for the cohort.

11. The method of claim 1 , wherein the supplemental programs in the chosen cohort includes a plurality of coupon programs, and the method further includes: determining one or more coupon programs that relate to the prescribed substance for which the patient is eligible, which further includes:

obtaining data that relates to the patient, the prescribed substance, the health care provider, and the patient's payer; and

determining whether the patient is eligible based on the obtained data.

12. The method of claim 11 , wherein determining whether the patient is eligible based on the obtained data includes applying rules of the coupon programs to the obtained data.

13. The method of claim 1 , wherein the supplemental program permutations are generated from coupon data, educational material, a combined coupon educational document, a loyalty card, a prescription reminder service, an appointment reminder service, and a health care coaching service.

14. The system of claim 9 , further comprising instructions residing on the storage unit, which when executed by the processor, causes the processor to:

determine a respective decile level for each of the providers; and

assign, in the cohort database, the providers to cohorts so that the average decile level of providers in the cohorts are similar.

15. The system of claim 9 , wherein the medical history data includes data from which to determine: number of refills, prescription start date, prescription stop date, information relating to whether the patient picked up the prescription, number of refills of the prescription that the patient filled, and a time frame between refills in comparison to the duration of each prescription.

16. The system of claim 9 , wherein the cohort database further includes a cohort rule and the electronic prescription data qualifies for a cohort responsive to further determining that the cohort rule is satisfied.

17. The system of claim 16 , wherein the cohort rule specifies a range for a percentage that represents how often a patient filled a prescription compared to how often the prescription could optimally have been filled.

18. The system of claim 16 , wherein the supplemental programs in the chosen cohort includes a plurality of coupon programs, and generating the notification that includes the supplemental programs associated with the chosen cohort further includes:

obtaining data that relates to the patient, the prescribed substance, the health care provider, and the patient's payer; and

determining, from among the plurality of coupon programs, at least one coupon program from which the patient is eligible based on the obtained data.

19. The system of claim 9 , wherein analyzing the medical history data for tagged prescriptions in each cohort in the program cohort group to determine the chosen cohort of the plurality of cohorts includes:

calculating, from the medical history data, a percentage that represents how often each patient filled the prescription compared to how often the prescription could optimally have been filled;

calculating an average percentage for the cohort; and

selecting, the cohort of the plurality of cohorts with a highest average percentage as the chosen cohort.

20. The system of claim 9 , wherein the electronic prescription data qualifies for a cohort responsive to further receiving a selection of the supplemental programs for the cohort from the health care provider.

21. The system of claim 9 , further comprising instructions residing on the storage unit, which when executed by the processor, causes the processor to:

determine prescribing factors for each of the plurality of providers for the prescribed substance or the diagnostic code; and

assign the plurality of providers to cohorts so that cohorts have a commonality of prescribing factors for the prescribed substance or the diagnostic code.

22. The system of claim 9 , further comprising instructions residing on the storage unit, which when executed by the processor, causes the processor to:

receive rules by which the plurality of providers will be assigned to each cohort; and

assign the plurality of providers to cohorts according to the rules.