Medication Selection Portal for Insurance-Aware Prescription Fulfillment
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Solution Overview
Problem
Existing systems lack efficient communication between patients, doctors, and pharmacists, leading to inefficiencies in medication selection and fulfillment due to lack of insurance coverage and cost awareness, resulting in additional time and expense for patients, doctors, and pharmacists.
Innovation Solution
A personalized patient portal (SelectMed) that integrates medical diagnosis and treatment options, allowing doctors to rank and select medications based on insurance coverage and budget, facilitating seamless communication among patients, doctors, and pharmacists.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of time
If the doctor writes a prescription on paper and the patient drops it off at the pharmacy, then the patient can obtain medication, but the process takes additional time and results in insurance coverage issues or cost problems
Solution Approach 1:
The patent combines the doctor's office and pharmacy operations into an integrated electronic system. The doctor's portal and pharmacy management system communicate electronically, allowing prescription writing, insurance verification, and medication dispensing to occur as a coordinated process rather than separate physical visits.
Solution Approach 2:
The system performs preliminary actions by having the pharmacy verify insurance coverage and medication availability before the patient arrives. The doctor can electronically transmit the prescription immediately upon writing it, and the pharmacy can pre-check coverage, preventing delays that occur when issues are discovered only after the patient drops off the physical prescription.
2Adaptability or versatility
If the doctor does not know which insurance companies cover which medications or the cost of those medications, then the doctor can prescribe any medication, but the patient incurs additional expense and time for calls and appointments
Solution Approach 1:
The system implements feedback loops where insurance coverage information and cost data are automatically provided to the doctor's portal. When the doctor enters a diagnosis and selects medications, the system retrieves and displays relevant insurance coverage information, allowing the doctor to make informed prescribing decisions without needing to manually research each insurance policy.
Solution Approach 2:
The electronic portal system acts as an intermediary between the doctor, pharmacy, and insurance companies. It automatically exchanges information between these parties, providing the doctor with insurance coverage data without requiring direct communication with insurance companies, thus maintaining prescribing flexibility while eliminating information gaps.
3Reliability
If the pharmacist cannot disperse medication based on insurance coverage and budget, then the pharmacy can stock all medications, but the patient cannot obtain covered medications quickly
Solution Approach 1:
The pharmacy performs preliminary verification of insurance coverage and medication availability before the patient arrives or before dispensing. The electronic system allows the pharmacist to check coverage status in advance, so when the prescription is ready, only covered medications are prepared for dispensing, eliminating delays caused by discovering coverage issues at the counter.
Data Source
AI summary
SelectMed will streamline communication between patients, doctors, and pharmacists. SelectMed provides patients with a secure, personalized portal, where their diagnosis and treatment options are integrated. Doctors, patients and pharmacists can communicate, upload results and provide follow up. Once a doctor enters the patient's diagnosis, SelectMed generates approved medications for that condition. Doctors then select and rank multiple medications. There is also an option for doctors to add medications not on the list.The patient and pharmacist then choose the medication covered by insurance and within their budget. Currently doctors write prescriptions without knowing the patient's insurance coverage or costs. Patients then face delays due to insurance issues, unavailability, or cost. This leads to additional doctor visits/phone calls, delaying treatment.SelectMed enables doctors to pre-approve a range of medications, giving pharmacists the flexibility to dispense the best option based on coverage and affordability, saving time, reducing costs, and improving health faster.