Adherence monitoring system

1. A system, comprising;

at least one memory operable to store computer-executable instructions; and

at least one processor configured to access the at least one memory and execute the computer-executable instructions to:

receive electronically, from a healthcare provider computer for a prescriber via an electronic health records (EHR) intermediary configured to aggregate healthcare transactions originating from a plurality of healthcare provider computers and a plurality of pharmacy claims processor computers, a prescription benefit check request comprising at least one or more patient data, a service identifier, an identifier for a prescribed medication, and one or more prescriber data;

receive electronically, from a pharmacy claims processor computer, a prescription response comprising at least a patient pay amount for the prescribed medication;

in response to receiving the prescription response, access a routing table stored by a service provider computer embodied by a switch or a router to identify the healthcare provider computer from which the prescription benefit check request originated;

electronically direct the communication of a prescription benefit check response comprising at least the patient pay amount from the prescription response to the healthcare provider computer via the EHR intermediary;

receive electronically, from the healthcare provider device via the EHR intermediary, a prescription fill notification request, wherein the prescription fill notification request is generated by the healthcare provider device in response to the healthcare provider receiving the patient pay amount;

monitor, based at least upon the prescription fill notification request, traffic over a network comprising one or more communication channels associated with the EHR intermediary to determine that a pharmacy billing request corresponding to the prescription benefit check request has been submitted to a pharmacy benefits processor by matching at least one of the one or more prescriber data, the one or more patient data or the service identifier stored on the at least one memory in association with the prescription benefit check request to that of a matching pharmacy billing response communicated over the network;

in response to identifying the matching pharmacy billing response, determine a status of the matching pharmacy billing response indicating that the pharmacy billing request was approved by the pharmacy benefits processor;

access the routing table to identify the healthcare provider computer to be notified of medication adherence information associated with the matching pharmacy billing response;

further in response to identifying the matching pharmacy billing response communicated via the EHR intermediary, generate, by at least the service provider computer, a prescription fill notification response comprising at least a prescription fill date, and a pharmacy identification; and

electronically direct communication of the prescription fill notification response to the healthcare provider computer identified by accessing the routing table and via the EHR intermediary, thereby notifying the healthcare provider of medication adherence.

2. The system of claim 1 , wherein the prescription fill notification request is automatically communicated by the healthcare provider computer based at least upon the communicated patient pay amount.

3. The system of claim 1 , wherein the prescription fill notification request is communicated based upon a physician selection at the healthcare provider computer.

4. The system of claim 1 , wherein the processor is further configured to access the at least one memory and execute the computer-executable instructions to:

identify an EHR vendor corresponding to the EHR intermediary; and

generate, based at least upon the identified EHR vendor, the prescription fill notification request for the prescribed medication included in the prescription benefit check request.

5. The system of claim 1 , wherein the prescription fill notification request is a first fill notification request.

6. The system of claim 1 , wherein the prescription fill notification request is a subsequent fill notification request, and wherein the processor is further configured to access the at least one memory and execute the computer-executable instructions to:

access one or more subsequent fill monitoring criteria comprising at least one of a request to monitor for one or more fills during a specified time period, a request to monitor for a total number of fills, a request to monitor for one or more fills until a refill status for the corresponding medication/product has expired;

monitor the one or more communication channels for the prescribed medication identified in the prescription benefit check request based at least upon the one or more subsequent fill monitoring criteria; and

generate a prescription fill notification response for each subsequent fill of the prescribed medication detected.

7. The system of claim 6 , wherein the processor is further configured to access the at least one memory and execute the computer-executable instructions to:

receive electronically, from the healthcare provider computer via the EHR intermediary, a cancelation notice comprising notification to cancel tracking of one or more subsequent fills for the corresponding prescribed medication identified in the prescription benefit check request.

8. The system of claim 1 , wherein the processor is further configured to access the at least one memory and execute the computer-executable instructions to:

generate, based at least upon the prescription benefit check request or the prescription benefit check response, one or more adherence reports based upon the medication identifier for the prescribed medication, wherein an adherence report comprises at least an adherence fill rate for the prescribed medication; and

electronically direct the communication of the adherence report to the EHR intermediary for distribution to the healthcare provider computer, the pharmacy claims processor computer, or the pharmacy computer.

9. The system of claim 1 , wherein the pharmacy claims processor computer is the same as the pharmacy benefits processor, and wherein the determination that the pharmacy billing request was approved by the pharmacy benefits processor is based at least upon the detection of a pharmacy billing response comprising a field status indicator indicating that the request was approved.

10. A computer-implemented method for adherence monitoring, comprising:

receiving electronically, by the service provider computer associated with a service provider and comprising one or more computer processors from a healthcare provider computer for a prescriber via an electronic health records (EHR) intermediary, an electronic health records (EHR) intermediary configured to aggregate healthcare transactions originating from a plurality of healthcare provider computers and a plurality of pharmacy claims processor computers, a prescription benefit check request comprising at least one or more patient data, a service identifier, an identifier for a prescribed medication, and one or more prescriber data;

receiving electronically, by the service provider computer from a pharmacy claims processor computer, a prescription response comprising at least a patient pay amount for the prescribed medication;

in response to receiving the prescription response, accessing a routing table stored by a service provider computer embodied by a switch or a router to identify the healthcare provider computer from which the prescription benefit check request originated;

transmitting electronically, by the service provider computer, a prescription benefit check response comprising at least the patient pay amount from the prescription response to the healthcare provider computer via the EHR intermediary;

receiving electronically, by the service provider computer from the healthcare provider device via the EHR intermediary, the prescription fill notification request, wherein the prescription fill notification request is generated by the healthcare provider device in response to the healthcare provider receiving the patient pay amount;

monitoring, by the service provider computer and based at least upon the prescription fill notification request, traffic over a network comprising one or more communication channels associated with the EHR intermediary to determine that a pharmacy billing request corresponding to the prescription benefit check request has been submitted to a pharmacy benefits processor by matching at least one of the one or more prescriber data, the one or more patient data or the service identifier stored on the at least one memory in association with the prescription benefit check request to that of a matching pharmacy billing response communicated over the network;

in response to identifying the matching pharmacy billing response, determining, by the service provider computer, a status of the matching pharmacy billing response indicating that the pharmacy billing request was approved by the pharmacy benefits processor;

accessing the routing table to identify the healthcare provider computer to be notified of medication adherence information associated with the matching pharmacy billing response;

further in response to identifying the matching pharmacy billing response communicated via the EHR intermediary, generating, by at least the service provider computer, a prescription fill notification response comprising at least a prescription fill date, and a pharmacy identification; and

transmitting electronically, by service provider computer, the prescription fill notification response to the healthcare provider computer identified by accessing the routing table and via the EHR intermediary, thereby notifying the healthcare provider of medication adherence.

11. The computer-implemented method of claim 10 , wherein the prescription fill notification request is automatically communicated by the healthcare provider computer based at least upon the communicated patient pay amount.

12. The computer-implemented method of claim 10 , wherein the prescription fill notification request is communicated based upon a physician selection at the healthcare provider computer.

13. The computer-implemented method of claim 10 further comprising:

identifying, by the service provider computer, an EHR vendor corresponding to the EHR intermediary; and

generating, by the service provider computer and based at least upon the identified EHR vendor, the prescription fill notification request for the prescribed medication included in the prescription benefit check request.

14. The computer-implemented method of claim 10 , wherein the prescription fill notification request is a first fill notification request.

15. The computer-implemented method of claim 10 , wherein the prescription fill notification request is a subsequent fill notification request, and further comprises:

accessing, by the service provider computer, one or more subsequent fill monitoring criteria comprising at least one of a request to monitor for one or more fills during a specified time period, a request to monitor for a total number of fills, a request to monitor for one or more fills until a refill status for the corresponding medication/product has been exhausted;

monitoring, by the service provider computer, the one or more communication channels for the prescribed medication identified in the prescription benefit check request based at least upon the one or more subsequent fill monitoring criteria; and

generating, by the service provider computer, a prescription fill notification response for each subsequent fill of the prescribed medication detected.

16. The computer-implemented method of claim 10 further comprising:

receiving electronically, by the service provider computer from the healthcare provider computer via the EHR intermediary, a cancellation notice comprising notification to cancel tracking of one or more subsequent fills for the corresponding prescribed medication identified in the prescription benefit check request.

17. The computer-implemented method of claim 10 further comprising:

generating, by the service provider computer based at least upon the prescription benefit check request or the prescription benefit check response, one or more adherence reports for a prescriber based upon the medication identifier for the prescribed medication, wherein an adherence report comprises at least an adherence fill rate for the prescribed medication; and

transmitting electronically, by the service provider computer, to the EHR intermediary for distribution to the healthcare provider computer, the pharmacy claims processor computer, or the pharmacy computer.

18. The computer-implemented method of claim 10 , wherein the pharmacy claims processor computer is the same as the pharmacy benefits processor, and wherein the determination that the pharmacy billing request was approved by the pharmacy benefits processor is based at least upon the detection of a pharmacy billing response comprising a field status indicator indicating that the request was approved.

19. The system of claim 1 , wherein monitoring a network comprising one or more communication channels associated with the EHR intermediary is further based on a monitoring window associated with the prescription fill notification request.