System, method, and computer program product for processing diagnostic, treatment, costs, and outcomes information for effective analysis and health care guidance

• US 20020087358A1
• Filed: 10/09/2001
• Published: 07/04/2002
• Est. Priority Date: 12/16/1998
• Status: Abandoned Application

• Current Assignee: Edward H. Gilbert
• Original Assignee: Edward H. Gilbert
• Inventors: Gilbert, Edward H.
• Application Number:
  US09/973,216
• Publication Number:
  US 20020087358A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• 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: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 70/60 relating to pathologies

Abstract

A computer-assisted system and method that guides health-care providers through a diagnostic decision-making process, including giving the providers guidance as to a treatment program which conforms to medically-accepted practice and health industry insurance practices. The preferred embodiment guides the health care provider in entering protocol, diagnostic, and treatment choices in a natural manner that corresponds to a mental diagnostic and treatment process, and also checks diagnoses and treatments against appropriateness rules according to protocol choices and test results entered for each patient. The data entered is processed to process and audit clinical procedures and costs.

Claims

1. A method, comprising the steps of:

receiving a test result variable code;

receiving a protocol choice corresponding to the test result variable code;

receiving a treatment code;

determining whether the treatment code corresponds to the protocol choice; and

storing the test result variable code, protocol choice and treatment code.

2. The method of claim 1, further comprising the step of displaying a set of protocol choices corresponding to the test result variable code, from which the protocol choice may be selected.

3. The method of claim 1, further comprising the step of displaying a set of treatment codes corresponding to the protocol choice, from which the treatment code may be selected.

4. The method of claim 1, further comprising the step of displaying a warning if the treatment code does not correspond to the protocol choice.

5. The method of claim 1, further comprising the step of receiving a justification for at least one of the protocol choice and the treatment code.

6. The method of claim 1, wherein the test result variable code, protocol choice, and treatment code are stored in a data structure comprising:

a first code uniquely identifying a protocol grouping assigning priorities to one or more protocol choices based on a range of one or more disease variable values;

a second code identifying a protocol choice selected from the protocol grouping and a justification for selecting the protocol choice;

a third code identifying each procedure, diagnostic test, or treatment performed pursuant to the protocol choice and a justification for selecting each respective procedure, diagnostic test, or treatment; and

a fourth code defining a charge code for all procedures, diagnostic tests, and treatments performed..

7. The method of claim 1, wherein the test result variable code, protocol choice and treatment code are analyzed for cost accounting and to determine clinical appropriateness.

8. A data processing system having at least a processor and an accessible memory, comprising:

circuitry for receiving a test result variable code;

circuitry for receiving a protocol choice corresponding to the test result variable code;

circuitry for receiving a treatment code;

circuitry for determining whether the treatment code corresponds to the protocol choice; and

circuitry for storing the test result variable code, protocol choice and treatment code.

9. The data processing system of claim 8, further comprising circuitry for displaying a set of protocol choices corresponding to the test result variable code, from which the protocol choice may be selected.

10. The data processing system of claim 8, further comprising circuitry for displaying a set of treatment codes corresponding to the protocol choice, from which the treatment code may be selected.

11. The data processing system of claim 8, further comprising circuitry for displaying a warning if the treatment code does not correspond to the protocol choice.

12. The data processing system of claim 8, further comprising circuitry for receiving a justification for at least one of the protocol choice and the treatment code.

13. The data processing system of claim 8, wherein the test result variable code, protocol choice, and treatment code are stored in a data structure comprising:

a first code uniquely identifying a protocol grouping assigning priorities to one or more protocol choices based on a range of one or more disease variable values;

a second code identifying a protocol choice selected from the protocol grouping and a justification for selecting the protocol choice;

a third code identifying each procedure, diagnostic test, or treatment performed pursuant to the protocol choice and a justification for selecting each respective procedure, diagnostic test, or treatment; and

a fourth code defining a charge code for all procedures, diagnostic tests, and treatments performed..

14. The data processing system of claim 8, wherein the test result variable code, protocol choice and treatment code are analyzed for cost accounting and to determine clinical appropriateness.

16. The computer program product of claim 15, further comprising instructions for displaying a set of protocol choices corresponding to the test result variable code, from which the protocol choice may be selected.

17. The computer program product of claim 15, further comprising instructions for displaying a set of treatment codes corresponding to the protocol choice, from which the treatment code may be selected.

18. The computer program product of claim 15, further comprising instructions for displaying a warning if the treatment code does not correspond to the protocol choice.

19. The computer program product of claim 15, further comprising instructions for receiving a justification for at least one of the protocol choice and the treatment code.

20. The computer program product of claim 15, wherein the test result variable code, protocol choice, and treatment code are stored in a data structure comprising:

a first code uniquely identifying a protocol grouping assigning priorities to one or more protocol choices based on a range of one or more disease variable values;

a second code identifying a protocol choice selected from the protocol grouping and a justification for selecting the protocol choice;

a third code identifying each procedure, diagnostic test, or treatment performed pursuant to the protocol choice and a justification for selecting each respective procedure, diagnostic test, or treatment; and

a fourth code defining a charge code for all procedures, diagnostic tests, and treatments performed..

15. A computer program product having computer-readable code in a computer-readable medium, comprising:

instructions for receiving a test result variable code;

instructions for receiving a protocol choice corresponding to the test result variable code;

instructions for receiving a treatment code;

instructions for determining whether the treatment code corresponds to the protocol choice; and

instructions for storing the test result variable code, protocol choice and treatment code.