System and method for optimizing medical diagnosis, procedures and claims using a structured search space

• US 20030050798A1
• Filed: 03/08/2002
• Published: 03/13/2003
• Est. Priority Date: 12/23/1998
• Status: Abandoned Application

• Current Assignee: Dynamedix Incorporated
• Original Assignee: Dynamedix Incorporated
• Inventors: Waters, A. Bryan, Rae, Gerald J.C.
• Application Number:
  US10/092,981
• Publication Number:
  US 20030050798A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/06 Buying, selling or leasing transactions
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 40/63 for local operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

A system and method for optimizing medical diagnosis, procedures and reimbursement claims using a structured search space is described. The system may comprise: a master procedure list of alphanumeric codes that represent each of a plurality of medical procedures, wherein the master procedure list includes simple procedures and compound procedures which consist of at least two simple procedures; a value associated with each of the plurality of medical procedures; a list of ordered procedures listing medical procedures for a specific medical encounter; a search tree of all possible combinations of the simple procedures and the compound procedures in the list of ordered procedures; and a minimum total of the values associated with the medical procedures in the list of ordered procedures.

Claims

1. A method of optimizing medical diagnosis, procedures and reimbursement claims using a structured search space, the method comprising:

listing alphanumeric codes that represent each of a plurality of medical procedures to produce a master procedure list, wherein the master procedure list includes simple procedures and compound procedures which consist of at least two simple procedures;

associating a value to each of the plurality of medical procedures;

listing medical procedures for a specific medical encounter to produce a list of ordered procedures;

building a search tree of all possible combinations of the simple procedures and the compound procedures in the list of ordered procedures; and

searching the search tree for the lowest total of values associated with the medical procedures in the list of ordered procedures.

2. The method of claim 1, wherein the master procedure list also includes a short description of the represented medical procedure;

a long description of the represented medical procedure, and a list of all simple procedure that make up all compound procedures.

3. The method of claim 1, wherein the value associated with each of the plurality of medical procedures includes regional costs and fluctuations.

4. The method of claim 1, wherein building a search tree includes:

matching compound procedures in the master procedure list to a plurality of simple procedures in the list of ordered procedure to produce a matched compound procedure;

eliminating the plurality of simple procedures from the ordered procedure list; and

adding the matched compound procedure to the ordered procedure list.

5. The method of claim 1, wherein the method further includes eliminating duplicates of simple procedures in the list of ordered procedures.

6. The method of claim 1, wherein the method is implemented on a palm sized computer.

7. The method of claim 1, wherein the method is implemented on a general purpose computer.

8. The method of claim 1, wherein the listing of the medical procedures is implemented by a medical professional at the medical encounter.

9. A computer program for optimizing medical diagnosis, procedures and reimbursement claims using a structured search space, the computer program comprising:

instructions for listing alphanumeric codes that represent each of a plurality of medical procedures to produce a master procedure list, wherein the master procedure list includes simple procedures and compound procedures which consist of at least two simple procedures;

instructions for associating a value to each of the plurality of medical procedures;

instructions for listing medical procedures for a specific medical encounter to produce a list of ordered procedures;

instructions for building a search tree of all possible combinations of the simple procedures and the compound procedures in the list of ordered procedures; and

instructions for searching the search tree for the optimal total of values associated with the medical procedures in the list of ordered procedures.

10. The computer program of claim 9, wherein the master procedure list also includes a short description of the represented medical procedure;

a long description of the represented medical procedure, and a list of all simple procedure that make up all compound procedures.

11. The computer program of claim 9, wherein the value associated with each of the plurality of medical procedures includes regional costs and fluctuations.

12. The computer program of claim 9, wherein building a search tree includes:

instructions for matching compound procedures in the master procedure list to a plurality of simple procedures in the list of ordered procedure to produce a matched compound procedure;

instructions for eliminating the plurality of simple procedures from the ordered procedure list; and

instructions for adding the matched compound procedure to the ordered procedure list.

13. The computer program of claim 12, wherein the computer program further includes instructions for eliminating duplicates of simple procedures in the list of ordered procedures.

14. The computer program of claim 9, wherein the computer program is implemented on a palm sized computer.

15. The computer program of claim 9, wherein the computer program is implemented on a general purpose computer.

16. The computer program of claim 9, wherein the instructions for listing of the medical procedures is implemented by a medical professional at the medical encounter.

17. A system for optimizing medical diagnosis, procedures and reimbursement claims using a structured search space, the system comprising:

a master procedure list of alphanumeric codes that represent each of a plurality of medical procedures, wherein the master procedure list includes simple procedures and compound procedures which consist of at least two simple procedures;

a value associated with each of the plurality of medical procedures;

a list of ordered procedures listing medical procedures for a specific medical encounter;

a search tree of all possible combinations of the simple procedures and the compound procedures in the list of ordered procedures; and

a minimum total of the values associated with the medical procedures in the list of ordered procedures.

18. The system of claim 17, wherein the master procedure list also includes a short description of the represented medical procedure;

a long description of the represented medical procedure, and a list of all simple procedure that make up all compound procedures.

19. The system of claim 17, wherein the value associated with each of the plurality of medical procedures includes regional costs and fluctuations.

20. The system of claim 17, wherein the system is implemented on a palm sized computer.

21. The system of claim 17, wherein the system is implemented on a general purpose computer.