Systems and methods for disease management algorithm integration

A method of formulating a medical order for a patient, the method comprising:

• storing a plurality of medical findings associated with a patient on an electronic storage media;
• storing a set of payer authorization rules associated with a payer on the electronic storage media, the patient associated with the payer;
• transmitting a medical order interface to a healthcare provider interface device, the medical order interface including a plurality of selectable medical order items;
• in response to receiving a selection of a medical order item of the plurality of selectable medical order items, determining an authorization status;
• based on the authorization status, transmitting an authorization request interface to the healthcare provider interface device based at least in part on the set of payer authorization rules associated with the payer, the authorization request interface associated with an electronic authorization request for authorization from the payer, the authorization request interface including a set of selectable indications items, the set of selectable indications items based at least in part on the set of payer authorization rules, at least one of the set of selectable indications items indicating an inconclusive result of a test, the authorization request interface including a send control;
• and
• in response to receiving a selection of a select indications item and receiving selection of the send control, sending the electronic authorization request to request authorization for a medical order associated with the selected medical order item to a payer system associated with the payer, the electronic authorization request including order data associated with the selected medical order item and indications data associated with the select indications item.

A system comprising:

• processor-accessible storage including a set of authorization rules associated with a payer plan, patient information associating a patient with the payer plan, and patient medical findings associated with the patient;
• and
• computer implemented instructions operable by a processor to transmit a medical order interface to a healthcare provider interface device, the medical order interface including a plurality of selectable medical order items;
• computer implemented instructions operable by a processor to transmit an authorization request interface to the healthcare provider interface device based at least in part on the set of payer authorization rules associated with the payer plan in response to receiving a selection of a medical order item of the plurality of selectable medical order items, the authorization request interface associated with an electronic authorization request for authorization from the payer, the authorization request interface including a set of selectable indications items, the set of selectable indications items based at least in part on the set of payer authorization rules, at least one of the set of selectable indications items indicating an inconclusive result of a test, the authorization request interface including a send control;
• and
• computer implemented instructions operable by a processor to send the electronic authorization request to request authorization for a medical order associated with the selected medical order item to the payer in response to receiving a selection of a select findings control and receiving selection of the send control, the electronic authorization request including order data associated with the selected medical order item and including indications data associated with the selected indications item.