Method and apparatus for managing physician profile and healthcare appointment services

• US 10,185,929 B2
• Filed: 03/12/2010
• Issued: 01/22/2019
• Est. Priority Date: 09/15/2008
• Status: Active Grant

• Current Assignee: ZocDoc, Inc.
• Original Assignee: ZocDoc, Inc.
• Inventors: Kharraz Tavakol, Oliver D., Massoumi, Cyrus E.
• Primary Examiner(s): Sorey, Robert A
• Application Number:
  US12/722,728
• Publication Number:
  US 20100228564A1
• Time in Patent Office: 3,238 Days
• Field of Search: 705 2- 4
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/018 Certifying business or products
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Method and apparatus for the collection and management of healthcare practitioner profile information prior to inclusion in a hospital directory of affiliated practitioners or insurance provider directory of participating practitioners. Healthcare practitioners (e.g., physicians) enter and communicate changes to their profile data to a central database to increase their compliance and decrease the frequency of providing updated or incomplete information in a hospital or insurance provider directory. The profile data can be credentialed according to rules specific to each hospital or insurance provider, prior to inclusion in the directory. The directory may further provide online booking of available appointment times for affiliated physicians from multiple practice groups. The online booking process can simultaneously be available on multiple websites of a hospital, insurance provider, physician practice group and/or centralized provider (aggregator).

Claims

1. A method of managing a physician profile data aggregator server comprising:

maintaining a central managed database of profile information for physicians having affiliations with multiple hospitals and insurance providers, wherein the multiple hospitals and insurance providers have multiple respective online directories of profile information and have different sets of credentialing rules, each set of credentialing rules for a given hospital or insurance provider specifying a subset of the profile information that is compliant for inclusion in the respective online directories of physicians affiliated with the given hospital or insurance provider;

the aggregator'"'"'s server providing a web page to a client computer, the web page serving as a template for entry of physician profile data and having a plurality of data fields for entering items of profile information according to a data entry mask, said data fields being standardized so that data can be used across multiple hospitals/insurance providers;

receiving input adding an affiliation of the physician with an additional hospital and/or insurance provider;

searching for an additional set of credentialing rules required for the additional hospital and/or insurance provider and adding dynamically updating the data fields of the data entry mask to generate an updated data entry mask for the additional hospital and/or insurance provider comprising an intersection of the set of the plurality of data fields and the subset of profile information determined by the additional set of credentialing rules to be compliant for inclusion in a respective online directory of the additional hospital/insurance provider;

receiving physician profile data at the web page and storing a record of physician profile information in the central database;

providing the physician profile information from the central database for inclusion in various online physician profile directories of the hospitals/insurance providers with which the physician is affiliated; and

applying the set of credentialing rules specific to the hospital or insurance provider in order to determine compliance with the rules of some or all of the profile information, wherein said rules comprise criteria for determining whether individual ones of said data fields are automatically excluded from an online directory of the respective hospital or insurance provider, automatically included in the online directory, and require approval prior to being included in the online directory;

including the profile information for which compliance is found in the online directory of the respective hospital or insurance provider; and

mapping physician availability between an availability aggregator system and a practice management system to provide a view of physician availability, where mapping comprises installing a program on the practice management system that captures a screenshot showing at least one of physician availability and unavailability times and transmits the screenshot to the availability aggregator system that determines at least one of physician availability and unavailability times by evaluating color and position of one or more pixels in the screenshot.

2. The method of claim 1, further comprising:

comparing the provided profile information to the hospital'"'"'s or insurance provider'"'"'s existing physician profile information and applying a merge process to create a merged profile.

3. The method of claim 1, further comprising:

allowing shared access to the profile information as a web-based service.

4. The method of claim 1, further comprising:

the aggregator managing a central database of available appointments with the physicians and providing online booking of available appointments with the physicians.

5. The method of claim 4, further comprising:

simultaneously providing the available appointments for online booking on a plurality of websites hosted by two or more of the aggregator, hospital, insurance provider, and/or physician practice group.

6. The method of claim 4, further comprising:

providing a link in the hospital or insurance provider directory to the online booking process.

7. The method of claim 1, wherein the aggregator manages and provides multiple such directories, each for a different hospital.

8. The method of claim 7, wherein the aggregator manages credentialing of the physician profile information prior to inclusion of the profile information in the directory.

9. The method of claim 7, wherein each directory provides online booking of appointments with the hospital'"'"'s respective affiliated physicians.

10. The method of claim 1, wherein the aggregator manages a central database of available appointments for physicians affiliated with multiple hospitals.

11. The method of claim 1, further comprising:

providing a hospital directory of the physician profile information for physicians affiliated with the hospital.

12. The method of claim 1, wherein the physicians:

have affiliations with multiple hospitals;

practice in multiple practice groups; and

/or

participate with multiple insurance providers;

and the profile information undergoes a credentialing process specific to each

affiliated hospital, practice group or insurance provider prior to inclusion in a directory of the respective hospital, group or provider.

13. The method of claim 1, wherein the physicians:

have affiliations with multiple hospitals;

practice in multiple practice groups; and

/or

participate with multiple insurance providers;

and the online booking process is available on multiple websites of the hospital(s), group(s) and provider(s).

14. A physician profile management apparatus comprising:

a computer apparatus including a processor and memory storing one or more programs for execution by the processor;

a storage module for storing in an aggregator'"'"'s central managed database physician profiles for physicians having affiliations with multiple hospitals and/or insurance providers, wherein the multiple hospitals and insurance providers have multiple respective online directories of profile information and have different sets of credentialing rules, each set of credentialing rules for a given hospital or insurance provider specifying a subset of the profile information that is compliant for inclusion in the respective online directories of physicians affiliated with the given hospital or insurance provider;

a template module executed by the processor for delivering a web page to a client computer over a public network, the web page serving as a template for physicians to submit the profile information to the database; and

a selection filter executed by the processor for retrieving from the database different select categories of the profile information for a specified physician, based on the affiliated hospital/insurance providers for each physician, whereby the web page has a plurality of data fields according to a data entry mask, said data fields being standardized so that data can be used across multiple hospitals/insurance providers;

the apparatus configured so that when input is received from a physician adding an affiliation with an additional hospital and/or insurance provider, an additional set of credentialing rules for the additional hospital and/or insurance provider is retrieved and the data fields of the data entry mask are dynamically updated to generate an updated data entry mask for the additional hospital and/or insurance provider, the updated data entry mask comprising an intersection of the set of the plurality of data fields and the subset of profile information determined by the additional set of credentialing rules as compliant for inclusion in a respective online directory of the additional hospital/insurance provider, the apparatus being configured to receive physician profile data at the web page, store a record of physician profile information in the aggregator'"'"'s database and provide the physician profile information from the central database for inclusion in various online physician profile directories of the hospitals/insurance providers with which the physician is affiliated, and a credentialing module executed by the processor for applying credentialing rules specific to a hospital or insurance provider for application to the profile information prior to inclusion of the profile information in an on-line physician profile directory of the respective hospital or insurance provider, wherein said rules comprise criteria for determining whether individual ones of said data fields are automatically excluded from an online directory of the respective hospital or insurance provider, automatically included in the online directory, and require approval prior to being included in the online directory; and

a physician availability mapping module for mapping between an availability aggregator system and a practice management system to provide a view of physician availability, where the mapping module comprises a program module installed on the practice management system that captures a screenshot showing at least one of physician availability and unavailability times and transmits the screenshot to the availability aggregator system that determines at least one of physician availability and unavailability times by evaluating color and position of one or more pixels in the screenshot.

15. The apparatus of claim 14, wherein the fields comprise one or more of:

physician name;

phone number;

practice location;

office hours;

title;

department;

professional suffixes;

board membership;

gender;

specialties;

procedures performed;

insurances;

awards;

publications;

practice location; and

a geographic indicator of the practice location.

16. The apparatus of claim 14, further comprising:

a central managed database of available appointments with the physicians.

17. The apparatus of claim 16, further comprising:

a web portal accessible by computer to patients over a public network for booking one of the available appointments.

18. The apparatus of claim 17, wherein the hospital or insurance provider directory includes a link to the web portal providing online booking of appointments with physicians.