Express Scripts Strategic Development, Inc.

Evernorth Strategic Development, Inc.

Christopher R Markson

Pritesh J Shah

Christopher G Lehmuth

Logan R Meltabarger

Adithya Chowdary Boppana

Amit K Bothra

David Alfredo Tomala

Keith L Widmer

Akash Dwivedi

Bose S Daggubati

Rahul Rajendran

Jiawei Kuang

A computer system includes memory hardware configured to store a transcription database, a call database, and instructions. The transcription database includes multiple call transcription data entries. The call database includes multiple agent call log data entries. The computer system executes instructions including joining the call transcription data entries with the agent call log data entries according to associated timestamps. The instructions include, for at least one of the set of joined call data entries, generating an input vector for an unsupervised machine learning model. The instructions include supplying the input vector to the model to assign an output topic classification of the model to the joined call data entry associated with the input vector, and supplying the input vector to at least one sub-topic model associated with the output topic classification to assign one or more sub-topic output classifications to the joined call data entry associated with the input vector.

Machine learning models for automated processing of transcription database entries

A system includes memory hardware storing processor-executable instructions, a persona, and a data structure associated with the persona. Processor hardware executes the processor-executable instructions. The instructions include generating a graphical user interface and, in response to a first condition, inputting a first set of explanatory variables to a first trained machine learning model to generate a first metric and transforming the graphical user interface according to the persona and the first metric. The instructions include, in response to a second condition, inputting a second set of explanatory variables to a second trained machine learning model to generate a second metric and transforming the graphical user interface according to the persona and the second metric. The first trained machine learning model is different from the second trained machine learning model. The instructions include automatically approving a first prior authorization prescription in response to the first metric reaching a threshold value.

Machine learning model automation of user interface transformation

A computer-implemented method includes defining model attributes including a training iteration value that defines a set of training iterations to be used in machine learning to associate portions of feedback data with a set of topic groups based on similarities in concepts conveyed in the feedback data. The method includes removing at least some of the confidential information from the feedback data. The method includes receiving a topic model number selection that indicates a subset of the set of topic groups. The method includes using machine learning to train a machine model based on the model attributes and the topic model number selection. The method includes generating a display showing at least one of a topic cluster graph or a word cloud based on the machine model.

Iterated training of machine models with deduplication

A method includes storing a parameter related to a user, storing descriptive data for multiple identifiers, and indexing multiple events. Each event corresponds to a physical object supplied to a user on behalf of an entity. The method includes identifying a first set of identifiers based on commonality among the descriptive data. The method includes training a machine learning model for the first set of identifiers based on event data from within a predetermined epoch. The method includes receiving an indication of a selected identifier and determining a first intake metric of the selected identifiers using the machine learning model. The method includes determining a second intake metric of the selected identifier and the parameter and transforming the user interface according to the first and second intake metrics. The first intake metric represents an amount of resources expected to be received during a second epoch subsequent to the predetermined epoch.

Systems and methods for user interface adaptation for per-user metrics

A content analysis system includes a processor executing instructions from memory. The instructions include, in response to receiving a request signal from a user device, obtaining feedback items, each having a source indicator; identifying unique source indicators; and, for each source indicator, aggregating corresponding ones of the feedback items. A set of filtered feedback items is generated according to either first or second access levels associated with a user of the user device. A subset of filtered feedback items is selected according to a date range specified by the request signal, a set of automated rules is applied, and natural language processing is performed based on frequency of presence of salient terms to identify themes. A control signal is transmitted to a user interface of the user device instructing display of a representation that indicates a change in the frequency of the identified themes over the specified date range.

Medical processing systems and methods

A method includes receiving a first set of identifiers selected based on commonality among descriptive data corresponding to the identifiers of the first set. Each identifier corresponds to a user who has been supplied a physical object. The method includes identifying event data for the first set within a specified epoch. The method includes training a machine learning model for the first set using the identified event data. The machine learning model is trained using parallel processing of records from a storage structure storing the event data. The parallel processing includes assigning analysis of the event data of each of a subset of the first set to respective processor threads for parallel execution on processing hardware. The trained machine learning model is configured to receive a selected identifier and generate an output representing an amount of resources expected to be used by the selected identifier for a subsequent epoch.

A computer system includes processor hardware configured to execute instructions that include joining at least a portion of multiple call transcription data entries with at least a portion of multiple agent call log data entries according to timestamps associated with the entries to generate a set of joined call data entries, and validating the joined call data entry by determining whether a transcribed entity name matches with entity identifier information associated with the agent call log data entry. The instructions include preprocessing the joined call data entry according to word confidence score data entries associated with the call transcription data entry to generate preprocessed text, performing natural language processing vectorization on the preprocessed text to generate an input vector, and supplying the input vector to an unsupervised machine learning model to assign an output topic classification of the model to the joined call data entry associated with the input vector.

A method includes defining model attributes of a machine model that organizes feedback data into topic groups based on similarities in concepts in the feedback data. The model attributes include a topic model number that defines how many topic groups are to be created, a hyperparameter optimization alpha value, and/or a hyperparameter optimization beta value. The method also includes generating the machine model using the model attributes that are defined and the feedback data, and applying the machine model to the feedback data to divide different portions of the feedback data into the different topic groups based on contents of the feedback data, the topic model number, the hyperparameter optimization alpha value, and/or the hyperparameter optimization beta value.

Machine model generation systems and methods

A computerized method for transforming an interactive graphical user interface according to machine learning includes selecting a persona, loading a data structure associated with the selected persona, and generating the interactive graphical user interface. The method includes, in response to a user selecting a first selectable element, inputting a first set of explanatory variables to a first trained machine learning model to generate a first metric, and transforming the user interface according to the selected persona and the first metric. The method includes, in response to the user selecting a second selectable element, inputting a second set of explanatory variables to a second trained machine learning model to generate a second metric, and transforming the user interface according to the selected persona and the second metric. In various implementations, first metric is a first probability of the persona being approved for a first prior authorization prescription.

Systems and methods for transforming an interactive graphical user interface according to machine learning models

A computer system for transforming a user interface according to data store mining includes a data store configured to store a parameter related to a user and index event data of a set of events. A data processing circuit is configured to identify a first set of identifiers and train a machine learning model based on event data by the data store. An interface circuit is configured to receive an indication of a selected identifier of the plurality of identifiers, determine a first intake metric of the selected identifier using the machine learning model, and a second intake metric of the selected identifier and the parameter using the machine learning model. The interface circuit is configured to transform the user interface according to the first intake metric and the second intake metric.

A computer system for dynamic adaptation of a user interface according to data store mining includes a data store configured to index event data of a plurality of events. A data analyst device is configured to render the user interface to a data analyst and transmit a message that identifies a selected identifier of the plurality of identifiers. A data processing circuit is configured to train a machine learning model based on event data stored by the data store for a first set of identifiers from within a predetermined epoch. An interface circuit determines an interface metric for the selected identifier based on the determined output of the selected identifier and transmits the interface metric to the data analyst device. The data analyst device is configured to, in response to the interface metric from the interface circuit, selectively perform a modification or removal of a second user interface element.

A computer system includes an input configured to receive a first image of medication located in a receptacle, memory, and a processor configured to execute instructions including creating a second image based on the first image, dividing pixels of the second image into first and second subsets, and scanning the second image along a first axis to count, for each point along the first axis, a number of pixels in the first subset along a line perpendicular to the first axis that intersects the first axis at the point. The instructions also include estimating positions of first and second edges of the receptacle along the first axis based on the counts of the pixels, defining an opening of the receptacle based on the estimated positions of the first and second edges, and outputting a processed image that indicates areas of the image that are outside of the defined opening.

Computer imaging pre-processing for automated medication dispensing analysis

A system includes a processor and memory. The memory stores a model database including models and a classification database including classification scores corresponding to an input. The memory stores instructions for execution by the processor. The instructions include, in response to receiving a first input from a user device of a user, determining, for the first input, classification scores for classifications by applying the models to the first input. Each model determines one of the classification scores. The instructions include storing the classification scores as associated with the first input in the classification database and identifying the first input as within a first classification in response to a first classification score corresponding to the first classification exceeding a first threshold. The instructions include transmitting, for display on an analyst device, the first input based on the first classification to a first analyst queue associated with the first classification.

Systems and methods for machine-automated classification of website interactions

A method includes maintaining a question repository in which each question corresponds to a set of decision trees. A distance matrix encodes a distance between each pair of questions. In response to a request for a new question, the method converts the new question into a set of tokens. For each question of the existing questions, the method determines a minimum distance between each token of the new question and the tokens of the question and sums the minimum distances to calculate a distance between the question and the new question. The method includes performing cluster analysis on the distance matrix. Performing cluster analysis includes normalizing the distance matrix and applying a hierarchical clustering process to the normalized distance matrix. Based on the cluster analysis, the method transmits an alternative question proposal or adds the new question to the question repository.

Computer-implemented automated authorization system using natural language processing

A method includes defining model attributes of an organizational machine model that organizes feedback data from one or more sources of the feedback data into plural different topic groups based on similarities in concepts expressed in the feedback data. The model attributes represent criteria for establishment of the organizational machine model and include a topic model number that defines how many of the different topic groups are to be created by the organizational machine model and used to organize the feedback data into, a hyperparameter optimization alpha value that defines how likely a feedback datum in the feedback data is to be included in a single topic group of the different topic groupings or multiple topic groups of the different topic groupings, and a hyperparameter optimization beta value that defines how broadly each of the different topic groups are defined relative to the feedback data.

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Hawthorne, NJ, United States of America

Christopher R Markson