Methods and systems for member messaging

Abstract

Methods and systems for improving therapy adherence are described. In an embodiment, a disease state associated with a member is identified. A member classification of the member is determined. The member classification may be based on past therapy the member received to treat a condition associated with the disease state. A diagnostic loop is selected based on the disease state associated with the member and the member classification. The diagnostic loop may include a plurality of operations. At least one of the plurality of operations of the diagnostic loop is performed. Other methods and systems are described.

What is claimed is: 
     
         1 - 24 . (canceled) 
     
     
         25 . A method comprising:
 identifying, on a computer processor, a disease state associated with a patient;   classifying, on the computer processor, the patient based on past therapy the patient received to treat a condition and whether the patient is as a new-to-therapy patient classification or an experienced-therapy patient classification;   selecting, on the computer processor, a diagnostic loop based on the disease state associated with the member and patient classification, wherein the diagnostic loop includes a plurality of operations that include a drug therapy operation related to a drug; and   transmitting, on the computer processor, a patient intervention based on selection of the diagnostic loop.   
     
     
         26 . The method of  claim 25 , wherein performing the at least one of the plurality of operations further comprises:
 identifying the prescription drug associated with the patient, the prescription drug prescribed to treat a condition associated with the disease state;   determining whether the patient is taking the prescription drug as prescribed; and   determining a pharmaceutical delivery channel associated with the prescription drug,   wherein transmission of the patient intervention is in response to a determination of whether the member is taking the prescription drug as prescribed and a determination of the pharmaceutical delivery channel.   
     
     
         27 . The method of  claim 25 , further comprising:
 determining a likelihood of the patient to continue the drug therapy program for the prescription drug and a likelihood of the patient to comply with the drug therapy program for the prescription drug; and   calculating a likelihood of patient adherence of the patient with the prescription drug based on the likelihood of the patient to continue the drug therapy program and the likelihood of the patient to comply with the drug therapy program,   wherein selection of the diagnostic loop is based on the disease state associated with the member, the patient classification, and the likelihood of patient adherence.   
     
     
         28 . The method of  claim 25 , further comprising:
 calculating the medication possession ratio (MPR) and a refill gap delay for a plurality of patients; and   selecting the patient among a plurality of patients based on calculation of the MPR and the refill gap delay.   
     
     
         29 . The method of  claim 25 , wherein the patient intervention is transmitted through text messaging. 
     
     
         30 . A method comprising:
 identifying, on a computer processor, a disease state associated with a patient;   classifying, on the computer processor, the patient based on past therapy the patient received to treat a condition and whether the patient is as a new-to-therapy patient classification or an experienced-therapy patient classification;   selecting, on the computer processor, the patient for a therapy adherence program based on the disease state associated with the member and patient classification; and   transmitting, on the computer processor, patient outreach information based on selection of the patient.   
     
     
         31 . The method of  claim 30 , further comprising:
 determining a likelihood of the patient to continue the drug therapy program for the prescription drug and a likelihood of the patient to comply with the drug therapy program for the prescription drug; and   calculating a likelihood of patient adherence of the patient with the prescription drug based on the likelihood of the patient to continue the drug therapy program and the likelihood of the patient to comply with the drug therapy program,   wherein selection of the patient for the therapy adherence program is based on the disease state associated with the member, patient classification, and the likelihood of patient adherence.   
     
     
         32 . The method of  claim 30 , further comprising:
 identifying a prescription drug associated with the patient, the prescription drug prescribed to treat a condition associated with the disease state; and   determining that the patient is not taking the prescription drug as prescribed,   wherein selection of the patient for the therapy adherence program is based on the disease state associated with the member, patient classification, and a determination that the patient is not taking the prescription drug as prescribed.   
     
     
         33 . The method of  claim 30 , further comprising:
 selecting, on the computer processor, a diagnostic loop that includes a plurality of operations that include a drug therapy operation related to a drug,   wherein transmission of the patient outreach information is based on selection of the patient for the therapy adherence program and selection of the diagnostic loop.   
     
     
         34 . The method of  claim 30 , further comprising:
 determining a primary non-adherence cause associated with the patient,   wherein selection of the patient of the therapy adherence program is based on the disease state associated with the member, the patient classification, and the primary non-adherence cause associated with the patient.   
     
     
         35 . The method of  claim 30 , wherein the patient outreach information is transmitted to a patient device associated with the patient. 
     
     
         36 . A method comprising:
 identifying, on a computer processor, a disease state associated with a patient;   classifying, on the computer processor, the patient based on past therapy the patient received to treat a condition and whether the patient is as a new-to-therapy patient classification or an experienced-therapy patient classification;   determining, on the computer processor, a probability of adherence to a prescription drug based on the disease state associated with the member and patient classification; and   transmitting, on the computer processor, patient outreach information based on a determination of the probability of adherence being within a range.   
     
     
         37 . The method of  claim 36 , wherein determining the probability of adherence comprises:
 determining a probability of therapy cessation based on demographic data of the patient and the disease state associated with the patient;   determining a probability of therapy compliance based on demographic data of the patient and the disease state associated with the patient; and   calculating the probability of adherence of the identified member to the prescription drug based on the probability of therapy cessation and the probability of therapy compliance.   
     
     
         38 . The method of  claim 36 , further comprising:
 identifying the patient among a plurality of patients based on a known or predicted health condition associated with the patient.