Systems and methods for generating user interface data associated with adherence intervention data

1 . A system, comprising:

a processor; and

a memory configured to store computer readable instructions that, when executed by the processor, cause the system to:

obtain claims data, associated with a first patient from a plurality of patients, from one or more data sources;

parse the claims data and extract claims data elements associated with the one or more patients and store the claims data elements in a database of the system;

identify a first medication associated with the first patient using a national drug code (NDC) identifier from the claims data elements;

identify a fill window for the first medication using, at least, a fill date and a days supply from the claims data elements;

identify, a timing component, for timings associated with recommending an intervention associated with the first medication for the first patient, using, at least, the identified fill window for the first medication;

identify, using, at least, a member date of birth and the fill date from the claims data elements, a risk component based on an amount of risk of medication adherence associated with the first medication for the first patient;

identify, using the claims data elements, supplemental information associated with the first patient;

assign a group number, from a set of group numbers, to the first patient based on, at least, the timing component, the risk component, and the supplemental information, wherein the set of group numbers are used to prioritize a listing of patients for recommending intervention;

using at least the group number, determine whether to recommend the intervention associated with the first medication for the first patient; and

generate user interface data associated with a user interface, wherein

the user interface includes a plurality of views, and

at least a first view of the user interface includes:

a first portion having a listing of patients including the first patient, wherein each listing includes an identification of a patient, at least one medication associated with the patient, and an indication related to medication adherence associated with the patient, wherein

upon selection of the first patient, the user interface is configured to switch from the first view to a second view, wherein the second view of the user interface includes:

a first portion having the one or more medications associated with the first patient, wherein

each medication, from the one or more medications, includes an indication associated with the risk of non-adherence to the medication and an indication of outreach type associated with the intervention, and

selection of a medication, from the one or more medications, causes generation of additional display showing a first object having an identification of the medication and a refill date associated with the medication, a second object having a current status indication including at least a days supply associated with the medication, and a third object having a prior status indication associated with fill status for the medication, wherein the additional display further includes a discussion portion indicating whether medication adherence should be discussed with the first patient, and

the user interface is configured to update the second view to display, for each medication, medication detail information, wherein the medication detail information for each medication includes at least:

a first portion having medication overview information that includes, at least, an index date and a next fill date for the medication, and

a second portion having fill detail information that includes, at least, a line item listing of fill details for each medication wherein each item, in the line item listing, includes at least a fill date, identification of the medication and dosage amount, a days supply for the medication, a quantity dispensed for the medication, an identification of a prescriber of the medication, an identification of a pharmacy associated with the medication, and a next due date for the medication.

2 . The system of claim 1 , wherein the system is configured to change group numbers to the patient over time.

3 . The system of claim 1 , wherein the group number is associated with an importance level for carrying out the intervention for the patient.

4 . The system of claim 1 , wherein the system utilizes a learning model to adapt to specific behavior for the patient.

5 . The system of claim 1 , wherein assignment of the group number to each patient includes taking into account patient abrasion from intervention associated with each patient.

6 . The system of claim 1 , wherein determining whether to recommend the intervention includes determining priority of the intervention for each patient based on the group number and/or the stored information.

7 . The system of claim 1 , wherein the timing component includes, at least, a therapy recommendation being early, a therapy intervention is recommended to discuss with a patient because the patient is able to pick up one or more medications at a certain time, and/or a therapy is recommended to discuss with the patient because the patient is currently late to pick up one or more medications.

8 . The system of claim 1 , wherein the risk component is based on a medication fill history, associated with each patient, over a specified period of time.

9 . The system of claim 1 , wherein the risk component includes, at least, a therapy being low risk of non-adherence for a specified period of time, the therapy being moderate risk of non-adherence for the specified period of time, and/or the therapy being high risk of non-adherence for the specified period of time.

10 . The system of claim 1 , wherein the supplemental information includes, at least, information associated with a patient filling at multiple pharmacies and/or a patient being new to a health plan.

11 . The system of claim 1 , wherein the next fill date, in the medication overview information, further includes an indication in number of days until the next fill date or an indication in number of days late from the next fill date.

12 . The system of claim 1 , wherein the fill window includes, at least, a proactive window, a fill eligible window, and an out of drug window.

13 . A method for generating output data associated with targeted intervention, the method comprising:

at an information processing system having a processor and a memory:

obtaining claims data, associated with a first patient from a plurality of patients, from one or more data sources;

parsing the claims data and extract claims data elements associated with the one or more patients and store the claims data elements in a database of the system;

identifying a first medication associated with the first patient using a national drug code (NDC) identifier from the claims data elements;

identifying a fill window for the first medication using, at least, a fill date and a days supply from the claims data elements;

identifying a timing component, for timings associated with recommending an intervention associated with the first medication for the first patient, using, at least, the identified fill window for the first medication;

identifying, using, at least, a member date of birth and the fill date from the claims data elements, a risk component based on an amount of risk of medication adherence associated with the first medication for the first patient;

assigning a group number, from a set of group numbers, to the first patient based on, at least, the timing component and the risk component, wherein the set of group numbers are used to prioritize a listing of patients for recommending intervention;

using at least the group number, determining whether to recommend the intervention associated with the first medication for the first patient; and

generating user interface data associated with a user interface, wherein the user interface includes a plurality of views, and

at least a first view of the user interface includes:

a first portion having a listing of patients including the first patient, wherein each listing includes an identification of a patient, at least one medication associated with the patient, and an indication related to medication adherence associated with the patient, wherein

upon selection of the first patient, the user interface is configured to switch from the first view to a second view, wherein the second view of the user interface includes:

a first portion having the one or more medications associated with the first patient, wherein

each medication, from the one or more medications, includes an indication associated with the risk of non-adherence to the medication and an indication of outreach type associated with the intervention, and

selection of a medication, from the one or more medications, causes generation of additional display showing a first object having an identification of the medication and a refill date associated with the medication, a second object having a current status indication including at least a days supply associated with the medication, and a third object having a prior status indication associated with fill status for the medication, and

the user interface is configured to update the second view to display, for each medication, medication detail information, wherein the medication detail information for each medication includes at least:

a first portion having medication overview information that includes, at least, an index date and a next fill date for the medication, and

a second portion having fill detail information that includes, at least, a line item listing of fill details for each medication wherein each item, in the line item listing, includes at least a fill date, identification of the medication and dosage amount, a days supply for the medication, a quantity dispensed for the medication, an identification of a prescriber of the medication, an identification of a pharmacy associated with the medication, and a next due date for the medication.

14 . The method of claim 13 , wherein the group number is associated with an importance level for carrying out the intervention for the patient.

15 . The method of claim 13 , wherein assignment of the group number to each patient includes taking into account patient abrasion from intervention associated with each patient.

16 . The method of claim 13 , wherein assignment of the group number to each patient further includes supplemental information associated with each patient.

17 . A non-transitory computer readable storage medium storing computer readable instructions that, when executed by a processor of an information processing system, cause the information processing system to provide execution comprising:

obtaining claims data, associated with a first patient from a plurality of patients, from one or more data sources;

parsing the claims data and extract claims data elements associated with the one or more patients and store the claims data elements in a database of the system;

identifying a first medication associated with the first patient using a national drug code (NDC) identifier from the claims data elements;

identifying a fill window for the first medication using, at least, a fill date and a days supply from the claims data elements;

identifying, a timing component, for timings associated with recommending an intervention associated with the first medication for the first patient, using, at least, the identified fill window medication;

identifying, using, at least, a member date of birth and the fill date from the claims data elements, a risk component based on an amount of risk of medication adherence associated with the first medication for the first patient;

assigning a group number, from a set of group numbers, to each patient from the one or more patients based on, at least, the timing component and the risk component, wherein the set of group numbers are used to prioritize a listing of patients for recommend intervention;

using at least the group number, determining whether to recommend the intervention associated with the first medication for the first patient; and

generating user interface data associated with a user interface, wherein

the user interface includes a plurality of views, and

at least a first view of the user interface includes:

a first portion having a listing of patients including the first patient, wherein each listing includes an identification of a patient, at least one medication associated with the patient, and an indication related to medication adherence associated with the patient, wherein

upon selection of the first patient, the user interface is configured to switch from the first view to a second view, wherein the second view of the user interface includes:

a first portion having the one or more medications associated with the first patient, wherein

each medication, from the one or more medications, includes an indication associated with the risk of non-adherence to the medication and an indication of outreach type associated with the intervention, and

selection of a medication, from the one or more medications, causes generation of additional display showing a first object having an identification of the medication and a refill date associated with the medication, a second object having a current status indication including at least a days supply associated with the medication, and a third object having a prior status indication associated with fill status for the medication, and

the user interface is configured to update the second view to display, for each medication, medication detail information, wherein the medication detail information for each medication includes at least:

a first portion having medication overview information that includes, at least, an index date and a next fill date for the medication, and

a second portion having fill detail information that includes, at least, a line item listing of fill details for each medication wherein each item, in the line item listing, includes at least a fill date, identification of the medication and dosage amount, a days supply for the medication, a quantity dispensed for the medication, an identification of a prescriber of the medication, an identification of a pharmacy associated with the medication, and a next due date for the medication.

18 . The non-transitory computer readable storage medium of claim 17 , wherein the group number is associated with an importance level for carrying out the intervention for the patient.

19 . The non-transitory computer readable storage medium of claim 17 , wherein assignment of the group number to each patient includes taking into account patient abrasion from intervention associated with each patient.

20 . The non-transitory computer readable storage medium of claim 17 , wherein assignment of the group number to each patient further includes supplemental information associated with each patient.