System and method of drug disease matching

A computer implemented system for matching drugs and diseases, the system comprising:

• a receiver for receiving a quantity of patient medical history billing records identifiable as patient prescription claim records and medical claim records,
• a data storage coupled to said receiver and configured to store a grouping of drug codes and a grouping of diagnosis codes,
• a processor coupled to said data storage and configured to perform the following steps:
• (a) selecting a prescription claim record of a specific patient from said patient prescription claim records and identifying at least one drug prescribed to said patient in accordance with said selected prescription claim record;
• (b) processing said at least one drug identified to determine at least one disease associated with said drug identified;
• and
• (c) searching said medical claim records of said specific patient and identifying medical claims associated with said at least one disease;
• and
• (d) determining a link weight value for each specific disease identified within each of said medical claims identified as associated with said at least one disease wherein determining a link weight value is performed by:
• determining the number of days between said prescription claim selected and each of said medical claims identified as associated with said at least one disease;
• and
• generating a link weight value based on said number of days in accordance with a preprogrammed formula.

A computer-implemented method of establishing a relationship between drugs and diseases comprising one or more computers performing the following steps:

• (a) storing a quantity of patient medical history billing records identifiable as patient prescription claim records and medical claim records in memory;
• (b) storing a grouping of drug codes and a grouping of diagnosis codes;
• (c) identifying at least one prescription claim for a specific patient from said patient prescription claim records;
• (d) identifying at least one drug identification code for said at least one prescription claim;
• (f) identifying at least one disease associated with said at least one drug identification code;
• (g) identifying patient medical claims for said specific patient associated with said at least one disease identified, wherein each patient medical claim identified has at least one diagnosis code associated with said at least one disease identified;
• and
• (h) calculating a link weight for each said at least one diagnosis code associated with said at least one disease in accordance with a preprogrammed formula, wherein said link weight provides a statistical match association value relationship between said at least one disease identified and each said at least one diagnosis code within each said patent medical claim identified as associated with said at least one disease identified wherein calculating a link weight includes:
• determining the number of days between said at least one prescription claim identified and each said patient medical claim identified as associated with said at least on disease;
• and
• generating a link weight value based on said number of days in accordance with a preprogrammed formula.

A computer storage medium readable by a computing system and encoding a computer program of instructions for executing a computer process for establishing a relationship between drugs and diseases, said computer process comprising the steps of:

• (a) storing in system data storage a quantity of patient medical history billing records identifiable as patient prescription claim records and medical claim records in memory;
• (b) storing in system data storage a grouping of drug codes and a grouping of diagnosis codes;
• (c) identifying at least one prescription claim for a specific patient from said patient prescription claim records;
• (d) identifying at least one drug identification code for said at least one prescription claim;
• (e) identifying at least one disease associated with said at least one drug identification code;
• (f) identifying patient medical claims for said specific patient associated with said at least one disease identified, wherein each patient medical claim identified has at least one diagnosis code associated with said at least one disease identified;
• and
• (h) calculating a link weight for each said at least one diagnosis code associated with said at least one disease in accordance with a preprogrammed formula, wherein said link weight provides a statistical match association value relationship between said at least one disease identified and each said at least one diagnosis code within each said patient medical claim identified as associated with said at least one disease identified wherein calculating a link weight includes:
• determining the number of days between said at least one prescription claim identified and each said patient medical claim identified as associated with said at least one disease;
• and
• generating a link weight value based on said number of days in accordance with a preprogrammed formula.