Facilitating transactions for health applications designed for mobile devices

• US 10,152,761 B2
• Filed: 10/04/2013
• Issued: 12/11/2018
• Est. Priority Date: 10/04/2013
• Status: Active Grant

• Current Assignee: IQVIA, Inc. (IQVIA Holdings, Inc.)
• Original Assignee: IQVIA, Inc. (IQVIA Holdings, Inc.)
• Inventors: Kress, Andrew, Tindall, Matthew, MacCarthy, John, Sadek, Hossam
• Primary Examiner(s): Nguyen, Hiep V
• Application Number:
  US14/046,603
• Publication Number:
  US 20150100328A1
• Time in Patent Office: 1,894 Days
• Field of Search: 705 2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/0631 Item recommendations

Abstract

Methods, systems, and apparatus, including computer programs encoded on computer storage media, for facilitating transactions for health-related computing products (e.g., mobile health applications or health-related devices). One method includes storing a plurality of lists, each list including health-related computing products approved for compensation by a payer entity. A claim for a health-related computing product is received from a user. The list with which the user is associated is determined. A determination is made whether the health-related computing product included in the claim is listed in the list with which the user is determined to be associated. When the health-related computing product is determined to be listed in the list with which the user is determined to be associated, compensation by the payer is authorized. However, when the health-related computing product is not determined to be listed in the list with which the user is determined to be associated, compensation by the payer is declined.

Claims

1. A computer-implemented method comprising:

receiving, by a computer system and from a prescriber system, data indicating (i) an electronic profile for a particular patient that identifies one or more payer entities, and (ii) a mobile application related to a prescription for the particular patient;

obtaining, by the computer system and from database systems of the one or more payer entities, healthcare data indicating (i) a list of mobile applications that are authorized for use by each of the one or more payer entities, and (ii) available benefits for the electronic profile for the particular patient;

verifying, by the computer system, that (i) the mobile application related to the prescription for the particular patient is included in the list of mobile applications that are authorized for use by each of the one or more payer entities and (ii) the available benefits for the electronic profile for the particular patient included compensation for a cost associated with the mobile application;

determining, by the computer system, to install the mobile application on a device of the particular patient based on verifying that the mobile application is included in the list of mobile applications that are authorized for use by each of the one or more payer entities and that the available benefits for the electronic profile for the particular patient include compensation for the cost associated with the mobile application;

in response to determining to install the mobile application to the mobile device based on verifying that the mobile application is included in the list of mobile applications that are authorized for use by each of the one or more payer entities and that the available benefits for the electronic profile for the particular patient include compensation for the cost associated with the mobile application, transmitting, by the computer system and to the device, an electronic instruction for installing the mobile application on the device, wherein the electronic instruction, when received by the device, causes the device to automatically perform operations specified by the electronic instruction, the operations comprising;

identifying a device type of the device;

determining a third-party mobile application store to obtain a mobile application based on a device type of the device, the third-party mobile application store providing access to mobile applications for execution on the mobile device;

determining an installation protocol for installing the mobile application on the device based on the device type of the device;

obtaining the mobile application from the third-party mobile application store, and

installing the mobile application on the device according to the installation protocol;

receiving, by the computer system and from the device, data indicating the installation of the mobile application on the device; and

in response to receiving the data indicating the installation of the mobile application on the device, establishing, by the computer system, an electronic communication network between the device and a data collection system operatively configured to the computer system,

the communication network configured to enable the data collection system to;

provide a hosted environment for executing the mobile application on the device,

obtain sensor data collected by one or more medical devices configured to exchange communications with the device through the mobile application, and

store electronic transaction data submitted on the mobile application relating to the electronic profile for the particular patient.

2. The method of claim 1, wherein determining to install the mobile application on the device of the particular patient comprises:

receiving, by the computer system and from the device of the particular patient, data indicating an electronic reimbursement claim relating to the mobile application; and

validating, by the computer system, the electronic reimbursement claim relating to the mobile application based at least on the obtained healthcare data, wherein validating the electronic reimbursement claim relating to the mobile application comprises;

accessing, from a database of the computer system, a plurality of formulary data structures that are each (i) associated with a healthcare plan, and (ii) include a list of mobile applications approved for compensation by the particular healthcare plan; and

determining that at least one of the plurality of formulary data structures is associated with a particular healthcare plan for the electronic profile for the particular patient; and

determining that the mobile application related to the prescription for the patient is included within the list of mobile applications for the at least one of the plurality of formulary data structures.

3. The method of claim 2, wherein:

the received electronic reimbursement claim relating to the mobile application comprises a payment request to purchase the mobile application from the third-party mobile application store, and

the transmitted communication enabling the device to obtain the mobile application from the third-party mobile application store comprises a payment authorization from the one or more payer entities to purchase the mobile application from the third-party mobile application store.

4. The method of claim 2, wherein validating the electronic reimbursement claim for the mobile application comprises determining, by the computer system and based at least on the obtained healthcare data, that the available benefits for the electronic profile for the patient includes sufficient compensation for the purchase of the mobile application from the third-party mobile application store.

5. The method of claim 2, wherein:

validating the electronic reimbursement claim for the mobile application comprises determining, by the computer system and based at least on the obtained healthcare data, that the available benefits for the electronic profile for the patient does not include sufficient compensation for the purchase of the mobile application from the third-party mobile application store, and

the transmitted electronic communication enabling the device to obtain the mobile application from the third-party mobile application store comprises a user confirmation for partial or total payment for the purchase of the mobile application from the third-party mobile application store.

6. The method of claim 2, validating the electronic reimbursement claim for the mobile application is further based on determining that a prescriber associated with the received data from the prescriber system is authorized to provide the prescription for the particular patient.

7. The method of claim 2, further comprising automatically generating, by the computer system, a repository of mobile applications approved by a plurality of payer entities, comprising:

identifying, by the computer system, a list of mobile applications available on the third-party mobile application store that are related to healthcare;

categorizing, by the computer system, each mobile application within the list of mobile applications based at least on one or more application functions; and

storing, by the computer system and within an electronic database of the computer system, information related to each mobile application within the list of mobile applications, wherein the information comprises an initial cost for the purchase of a particular mobile application, one or more maintenance for a continued use of the particular mobile application.

8. The method of claim 1, wherein the transmitted electronic communication enabling the device to obtain the mobile application from a third-party mobile application store includes a hyperlink that, when activated by the particular patient, causes the installation of the mobile application on the device.

9. The method of claim 1, further comprising:

in response to receiving the data indicating the installation of the mobile application on the device, determining one or more application services offered by an organization associated with the one or more payer entities, the one or more application services being offered through the mobile application to devices that have installed the mobile device using the electronic instruction.

10. A system comprising:

one or more processing devices; and

a non-transitory computer-readable medium coupled to the one or more processing devices having instructions stored thereon which, when executed by the one or more processing devices, cause the one or more processing devices to perform operations comprising;

receiving, by a computer system and from a prescriber system, data indicating (i) electronic profile for a particular patient that identifies one or more payer entities, and (ii) a mobile application related to a prescription for the particular patient;

obtaining, by the computer system and from database systems of the one or more payer entities, healthcare data indicating (i) a list of mobile applications that are authorized for use by each of the one or more payer entities, and GO available benefits for the electronic profile for the particular patient;

verifying, by the computer system, that (i) the mobile application related to the prescription for the particular patient is included in the list of mobile applications that are authorized for use by each of the one or more payer entities and (ii) the available benefits for the electronic profile for the particular patient included compensation for a cost associated with the mobile application;

determining, by the computer system, to install the mobile application on a device of the particular patient based on verifying that the mobile application is included in the list of mobile applications that are authorized for use by each of the one or more payer entities and that the available benefits for the electronic profile for the particular patient include compensation for the cost associated with the mobile application;

in response to determining to install the mobile application on the mobile device based on verifying that the mobile application is included in the list of mobile applications that are authorized for use by each of the one or more payer entities and that the available benefits for the electronic profile for the particular patient include compensation for the cost associated with the mobile application, transmitting, by the computer system and to the device, an electronic instruction for installing the mobile application on the device, wherein the electronic instruction, when received b, the device, causes the device to automatically perform operations specified by the electronic;

instruction, the operations comprising;

identifying a device type of the device;

determining a third-party mobile application store to obtain a mobile application based on a device type of the device, the third-party mobile application store providing access to mobile applications for execution on the mobile device;

determining an installation protocol for installing the mobile application on the device based on the device type of the device;

obtaining the mobile application from the third-party mobile application store, and

installing the mobile application on the device according to the installation protocol;

receiving, by the computer system and from the device, data indicating the installation of the mobile application on the device; and

in response to receiving the data indicating the installation of the mobile application on the device, establishing, by the computer system, an electronic communication network between the device and a data collection system operatively configured to the computer system,

the communication network configured to enable the data collection system to;

provide a hosted environment for executing the mobile application on the device,

obtain sensor data collected by one or more medical devices configured to exchange communications with the device through the mobile application, and

store electronic transaction data submitted on the mobile application relating to the electronic profile for the particular patient.

11. The system of claim 10, wherein determining to install the mobile application on the device of the particular patient comprises:

receiving, by the computer system and from the device of the particular patient, data indicating an electronic reimbursement claim relating to the mobile application; and

validating, by the computer system, the electronic reimbursement claim relating to the mobile application based at least on the obtained healthcare data, wherein validating the electronic reimbursement claim relating to the mobile application comprises;

accessing, from a database of the computer system, a plurality of formulary data structures that are each (i) associated with a healthcare plan, and (ii) include a list of mobile applications approved for compensation by the particular healthcare plan; and

determining that at least one of the plurality of formulary data structures is associated with a particular healthcare plan for the electronic profile for the particular patient; and

determining that the mobile application related to the prescription for the patient is included within the list of mobile applications for the at least one of the plurality of formulary data structures.

12. The system of claim 11, wherein:

the received electronic reimbursement claim relating to the mobile application comprises a payment request to purchase the mobile application from the third-party mobile application store, and

the transmitted communication enabling the device to obtain the mobile application from the third-party mobile application store comprises a payment authorization from the one or more payer entities to purchase the mobile application from the third-party mobile application store.

13. The system of claim 11, wherein validating the electronic reimbursement claim for the mobile application comprises determining, by the computer system and based at least on the obtained healthcare data, that the available benefits for the electronic profile for the patient includes sufficient compensation for the purchase of the mobile application from the third-party mobile application store.

14. The system of claim 11, wherein:

validating the electronic reimbursement claim for the mobile application comprises determining, by the computer system and based at least on the obtained healthcare data, that the available benefits for the electronic profile for the patient does not include sufficient compensation for the purchase of the mobile application from the third-party mobile application store, and

the transmitted electronic communication enabling the device to obtain the mobile application from the third-party mobile application store comprises a user confirmation for partial or total payment for the purchase of the mobile application from the third-party mobile application store.

15. The system of claim 11, wherein the transmitted electronic communication enabling the device to obtain the mobile application from a third-party mobile application store includes a hyperlink that, when activated by the particular patient, causes the installation of the mobile application on the device.

16. The system of claim 11, validating the electronic reimbursement claim for the mobile application is further based on determining that a prescriber associated with the received data from the prescriber system is authorized to provide the prescription for the particular patient.

17. The system of claim 11, further comprising automatically generating, by the computer system, a repository of mobile applications approved by a plurality of payer entities, comprising:

identifying, by the computer system, a list of mobile applications available on the third-party mobile application store that are related to healthcare;

categorizing, by the computer system, each mobile application within the list of mobile applications based at least on one or more application functions; and

storing, by the computer system and within an electronic database of the computer system, information related to each mobile application within the list of mobile applications, wherein the information comprises an initial cost for the purchase of a particular mobile application, one or more maintenance for a continued use of the particular mobile application.

18. A non-transitory computer-readable storage medium encoded with a computer program, the program comprising instructions that when executed by data processing apparatus cause the data processing apparatus to perform operations comprising:

receiving, by a computer system and from a prescriber system, data indicating (i) an electronic profile for a particular patient that identifies one or more payer entities, and (ii) a mobile application related to a prescription for the particular patient;

obtaining, by the computer system and from database systems of the one or more payer entities, healthcare data indicating (i) a list of mobile applications that are authorized for use by each of the one or more payer entities, and (ii) available benefits for the electronic profile for the particular patient;

verifying, by the computer system, that (i) the mobile application related to the prescription for the particular patient is included in the list of mobile applications that are authorized for use by each of the one or more payer entities and (ii) the available benefits for the electronic profile for the particular patient included compensation for a cost associated with the mobile application;

determining, by the computer system, to install the mobile application on a device of the particular patient based on verifying that the mobile application is included in the list of mobile applications that are authorized for use by each of the one or more payer entities and that the available benefits for the electronic profile for the particular patient include compensation for the cost associated with the mobile application;

in response to determining to install the mobile application on the mobile device based on verifying that the mobile application is included in the list of mobile applications that are authorized for use by each of the one or more payer entities and that the available benefits for the electronic profile for the particular patient include compensation for the cost associated with the mobile application, transmitting, by the computer system and to the device, an electronic instruction for installing the mobile application on the device, wherein the electronic instruction, when received b, the device, causes the device to automatically perform operations specified by the electronic;

instruction, the operations comprising;

identifying a device type of the device;

determining a third-party mobile application store to obtain a mobile application based on a device type of the device, the third-party mobile application store providing access to mobile applications for execution on the mobile device;

determining an installation protocol for installing the mobile application on the device based on the device type of the device;

obtaining the mobile application from the third-party mobile application store, and

installing the mobile application on the device according to the installation protocol;

receiving, by the computer system and from the device, data indicating the installation of the mobile application on the device; and

in response to receiving the data indicating the installation of the mobile application on the device, establishing, by the computer system, an electronic communication network between the device and a data collection system operatively configured to the computer system,

the communication network configured to enable the data collection system to;

provide a hosted environment for executing the mobile application on the device,

obtain sensor data collected by one or more medical devices configured to exchange communications with the device through the mobile application, and

store electronic transaction data submitted on the mobile application relating to the electronic profile for the particular patient.

19. The non-transitory computer-readable storage medium of claim 18, wherein determining to install the mobile application on the device of the particular patient comprises:

receiving, by the computer system and from the device of the particular patient, data indicating an electronic reimbursement claim relating to the mobile application; and

validating, by the computer system, the electronic reimbursement claim relating to the mobile application based at least on the obtained healthcare data, wherein validating the electronic reimbursement claim relating to the mobile application comprises;

accessing, from a database of the computer system, a plurality of formulary data structures that are each (i) associated with a healthcare plan, and (ii) include a list of mobile applications approved for compensation by the particular healthcare plan; and

determining that at least one of the plurality of formulary data structures is associated with a particular healthcare plan for the electronic profile for the particular patient; and

determining that the mobile application related to the prescription for the patient is included within the list of mobile applications for the at least one of the plurality of formulary data structures.

20. The device of claim 19, wherein:

the received electronic reimbursement claim relating to the mobile application comprises a payment request to purchase the mobile application from the third-party mobile application. store, and

the transmitted communication enabling the device to obtain the mobile application from the third-party mobile application store comprises a payment authorization from the one or more payer entities to purchase the mobile application from the third-party mobile application store.

21. The device of claim 19, wherein validating the electronic reimbursement claim for the mobile application comprises determining, by the computer system and based at least on the obtained healthcare data, that the available benefits for the electronic profile for the patient includes sufficient compensation for the purchase of the mobile application from the third-party mobile application store.

22. The device of claim 19, wherein:

validating the electronic reimbursement claim for the mobile application comprises determining, by the computer system and based at least on the obtained healthcare data, that the available benefits for the electronic profile for the patient does not include sufficient compensation for the purchase of the mobile application from the third-party mobile application store, and

the transmitted electronic communication enabling the device to obtain the mobile application from the third-party mobile application store comprises a user confirmation for partial or total payment for the purchase of the mobile application from the third-party mobile application store.