Techniques for providing referrals for opioid use disorder treatment
Examples described herein generally relate to referring a patient to a provider for a drug use disorder. A computer system accesses a plurality of provider data records. The system determines a geographical location of the patient. The system searches, within a geographical distance of the geographical location for a provider that satisfies patient requirements based on a patient data record. The system determines one or more certified providers that are certified to treat a condition of the patient. The system determines that one or more of the certified providers has an available opening for the patient. The system determines an outcome rating for the patient and each certified provider based on the patient data record. The system matches the patient to a certified provider with a best outcome rating that accepts payment from a payer for the patient. The system refers the patient to the matched provider.
1. A method of treating a patient for a substance use disorder, comprising:
accessing, by a central computer device of a referral system including a central processing unit (CPU) and a memory, a plurality of provider data records by periodically accessing corresponding data sources and rectifying records based on an accuracy rating of each data source, wherein accessing a plurality of provider data records by periodically accessing corresponding data sources and rectifying records based on an accuracy rating of each data source comprises:
generating a time limited payload including the plurality of data records from the corresponding data sources, the time limited payload having a set expiration time when records in the plurality of data records are expected to be updated;
generating a forensics fingerprint of the time limited payload including auditable data keys describing the corresponding data source and timing of the plurality of provider data records; and
consolidating the plurality of data records for the patient into a single virtual data record with conflicting elements represented by a union of the conflicting elements or a conflicting element from a data record with a highest accuracy rating;
determining a geographical location of the patient;
searching, within a geographical distance of the geographical location for a provider of treatment that satisfies patient requirements based on the single virtual patient data record, wherein the searching includes:
determining one or more certified providers that are certified to treat a condition of the patient;
determining that one or more of the certified providers has a currently available opening for the patient according to the rectified provider records;
determining an outcome rating for the patient and each certified provider based on the patient data record; and
matching the patient to a certified provider with the currently available opening and a best outcome rating that accepts payment from a payer for the patient; and
referring the patient to the matched provider, wherein referring the patient to the matched provider comprises transferring the patient record to the matched provider and electronically reserving the currently available opening.
2. The method of claim 1 , wherein referring the patient to the matched provider comprises using a patient portable virtual network that tracks a consent of the patient and the patient record in a blockchain.
3. The method of claim 2 , wherein the patient portable virtual network further includes a record of referrals and treatment experiences within the blockchain.
4. The method of claim 1 , wherein determining the outcome rating for the patient and each certified provider based on the patient data record comprises:
determining a provider success rate by patient profile; and
determining a provider success rate with referral provider by patient profile.
5. The method of claim 1 , wherein determining the outcome rating for the patient and each certified provider based on the patient data record comprises:
determining a similarity between a patient demographic matrix of the provider based on an age, sex, and ethnicity and the patient based on the patient data record.
6. A system for treating a patient for a substance use disorder, comprising:
a memory storing computer-executable instructions; and
a processor configured to execute the computer-executable instructions to:
access a plurality of provider data records by periodically accessing corresponding data sources and rectifying records based on an accuracy rating of each data source, wherein to access the plurality of provider data records and rectify records based on an accuracy rating of each data source, the processor is configured to:
generate a time limited payload including the plurality of data records from the corresponding data sources, the time limited payload having a set expiration time when records in the plurality of data records are expected to be updated;
generate a forensics fingerprint of the time limited payload including auditable data keys describing the corresponding data source and timing of the plurality of provider data records; and
consolidate the plurality of data records for the patient into a single virtual data record with conflicting elements represented by a union of the conflicting elements or a conflicting element from a data record with a highest accuracy rating;
determine a geographical location of the patient;
search, within a geographical distance of the geographical location for a provider of treatment that satisfies patient requirements based on the single virtual patient data record;
determine one or more certified providers that are certified to treat a condition of the patient;
determine that one or more of the certified providers has a currently available opening for the patient according to the rectified provider records;
determine an outcome rating for the patient and each certified provider based on the patient data record;
match the patient to a certified provider with the currently available opening and a best outcome rating that accepts payment from a payer for the patient; and
refer the patient to the matched provider by transferring the patient record to the matched provider and electronically reserving the currently available opening.
7. The system of claim 6 , wherein the processor is configured to execute the instructions to transfer the patient record to the matched provider using a patient portable virtual network that tracks a consent of the patient and the single virtual patient record in a blockchain.
8. The system of claim 7 , wherein the patient portable virtual network further includes a record of referrals and treatment experiences within the blockchain.
9. The system of claim 6 , wherein the processor is configured to execute the instructions to:
determine a provider success rate by patient profile; and
determine a provider success rate with referral provider by patient profile.
10. The system of claim 6 , wherein the processor is configured to execute the instructions to determine a similarity between a patient demographic matrix of the provider based on an age, sex, and ethnicity and the patient based on the patient data record.
11. A non-transitory computer readable medium storing computer-executable instructions that when executed by a processor cause the processor to:
access a plurality of provider data records by periodically accessing corresponding data sources and rectifying records based on an accuracy rating of each data source, wherein the instructions to access the plurality of provider data records and rectify records based on an accuracy rating of each data source, include instructions to:
generate a time limited payload including the plurality of data records from the corresponding data sources, the time limited payload having a set expiration time when records in the plurality of data records are expected to be updated;
generate a forensics fingerprint of the time limited payload including auditable data keys describing the corresponding data source and timing of the plurality of provider data records; and
consolidate the plurality of data records for a patient into a single virtual data record with conflicting elements represented by a union of conflicting elements or a conflicting element from a data record with a highest accuracy rating;
determine a geographical location of a patient;
search, within a geographical distance of the geographical location for a provider of treatment that satisfies patient requirements based on the single virtual patient data record;
determine one or more certified providers that are certified to treat a condition of the patient;
determine that one or more of the certified providers has a currently available opening for the patient according to the rectified provider records;
determine an outcome rating for the patient and each certified provider based on the patient data record;
match the patient to a certified provider with the currently available opening and a best outcome rating that accepts payment from a payer for the patient; and
refer the patient to the matched provider by transferring the patient record to the matched provider and electronically reserving the currently available opening.