Method, apparatus and computer readable medium for identifying health care options

• US 20050149359A1
• Filed: 11/24/2004
• Published: 07/07/2005
• Est. Priority Date: 12/12/2003
• Status: Abandoned Application

• Current Assignee: Resolution Health, Inc. (Elevance Health, Inc.)
• Original Assignee: Resolution Health, Inc. (Elevance Health, Inc.)
• Inventors: Frankfort, James D., Steinberg, Earl P., Soza, Harry
• Application Number:
  US10/995,090
• Publication Number:
  US 20050149359A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 30/02 Marketing; Price estimation or determination; Fundraising
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

The present invention is directed to methods, apparatuses and computer readable media for identifying health care options that benefit patients and reduce costs associated with providing health care for those patients.

Claims

1. A method of identifying health care options having at least one act implemented in a computer, the method comprising the acts of:

receiving patient information for a first patient,

evaluating said patient information for the first patient to identify a low cost alternative health care option from among a plurality of health care options, and

conveying at least a first recommendation of a group of recommendations relating to said patient information for the first patient, said first recommendation including a recommendation to select the low cost alternative health care option.

2. The method of claim 1, wherein said plurality of health care options includes at least one health care option previously selected by said first patient.

3. The method of claim 1, wherein said plurality of health care options includes at least one health care option previously selected by a doctor of said first patient.

4. The method of claim 1, wherein said group of recommendations is stored in a database.

5. The method of claim 4, wherein the act of conveying comprises the act of:

conveying one or more of said recommendations stored in said database, said one or more of said recommendations including said first recommendation.

6. The method of claim 4, wherein the act of receiving further comprises receiving patient information for a plurality of patients, wherein the act of evaluating further comprises evaluating said patient information for said plurality of patients to identify a low cost alternative health care option for each of said plurality of patients, said low cost alternative health care option being identified from among a plurality of health care options, and wherein the act of conveying further comprises conveying to each of the plurality of patients at least a first recommendation of a group of recommendations relating to said patient information for each of said plurality of patients, said first recommendation including a recommendation to select the low cost alternative health care option.

7. The method of claim 1, wherein the act of conveying comprises creating a report containing said first recommendation, and conveying said report.

8. The method of claim 7, wherein the report is printed on paper.

9. The method of claim 7, wherein the report is electronically generated.

10. The method of claim 1, further comprising the act of:

ranking said group of recommendations according to a predetermined ranking scheme,

11. The method of claim 10, further comprising the acts of:

selecting a subgroup of said group of recommendations according to the result of said act of ranking, said subgroup including the first recommendation.

12. The method of claim 7 wherein said report is conveyed to said first patient.

13. The method of claim 7 wherein said first recommendation contained in said report is intended for said first patient.

14. The method of claim 13 wherein said report further comprises at least a second recommendation intended for a doctor of said first patient.

15. The method of claim 7 wherein said first recommendation contained in said report is intended for a doctor of said first patient.

16. The method of claim 13, further comprising the acts of:

creating a second report containing at least a second recommendation, said second recommendations being intended for a doctor of said first patient, and

conveying said second report.

17. The method of claim 7, wherein the step of conveying comprises the act of:

retaining said report on a web server to enable said report to be accessed by a web browser and to be displayed via said web browser.

18. The method of claim 12 wherein said report is conveyed via email.

19. The method of claim 12 wherein the act of conveying comprises the act of:

retaining said report on a web server to enable said report to be accessed by a web browser and to be displayed via said web browser.

20. The method of claim 16 wherein said first report and said second report are conveyed together via first class mail.

21. The method of claim 16, wherein said first report and said second report are conveyed to said first patient.

22. The method of claim 1, further comprising the act of:

receiving feedback from a doctor of said first patient regarding said first recommendation relating to said patient information for the first patient.

23. The method of claim 1, wherein the step of receiving patient information comprises the acts of:

receiving raw individual patient information from at least one source, and

reformatting said raw individual patient information to conform to a predefined format.

24. The method of claim 1, further comprising the act of:

requesting patient information from at least one source.

25. An apparatus for identifying health care options, the apparatus comprising:

one or more computer processors that receive patient information for a first patient, evaluate said patient information for the first patient to identify a low cost alternative health care option from among a plurality of health care options, and initiate conveyance of at least a first recommendation of a group of recommendations relating to said patient information for the first patient, said first recommendation including a recommendation to select the low cost alternative health care option.

26. A computer readable medium for identifying health care options, the computer readable medium having one or more computer modules executable on one or more computer processors, the computer modules carrying out the following acts:

receiving patient information for a first patient,

evaluating said patient information for the first patient to identify a low cost alternative health care option from among a plurality of health care options, and

initiating conveyance of at least a first recommendation of a group of recommendations relating to said patient information for the first patient, said first recommendation including a recommendation to select the low cost alternative health care option.

27. A method of identifying health care options having at least one act implemented on a computer, the method comprising the acts of:

receiving patient information for a first patient,

evaluating said patient information to determine whether one or more health care options may be recommended for the first patient, the one or more health care options having a tendency to lower future health care costs for the first patient, and

recommending said one or more health care options if it is determined that the one or more health care options may be recommended for the first patient.

28. The method of claim 27 wherein said act of evaluating said patient information comprises determining whether the first patient has a health condition necessitating health care for which future health care costs cannot be reduced and determining whether the one or more health care options may be recommended for the first patient only if it is determined that the first patient does not have said health condition.

29. The method of claim 27, wherein said act of evaluating is performed by applying a predefined set of rules.

30. The method of claim 27, wherein the act of receiving further comprises receiving patient information for a plurality of patients including said first patient, and wherein the method further comprises the acts of selecting a subgroup of said plurality of patients having a predetermined characteristic and selecting at least one patient from said subgroup of said plurality of patients for evaluation, said at least one patient being said first patient.

31. The method of claim 27, wherein said patient information includes historical insurance claim information.

32. The method of claim 27, wherein said recommending comprises the acts of:

creating a report containing at least one of said one or more health care options, and

conveying said report.

33. A method of identifying health care options having at least one act implemented on a computer, the method comprising the acts of:

receiving patient information for a first patient,

evaluating said patient information to determine whether one or more health care options may be recommended for the first patient, the one or more health care options having a tendency to improve the quality of health care for the first patient, and

recommending said one or more health care options if it is determined that the one or more health care options may be recommended for the first patient.

34. The method of claim 33, wherein said act of evaluating said patient information comprises determining whether the first patient has a health condition necessitating health care for which future health care costs cannot be reduced and determining whether the one or more health care options may be recommended for the first patient only if it is determined that the first patient does not have said health condition.

35. An apparatus for identifying health care options, the apparatus comprising:

one or more computer processors that receive patient information for a first patient, evaluate said patient information to determine whether one or more health care options may be recommended for the first patient, the one or more health care options having a tendency to lower future health care costs for the first patient, and generate a recommendation to select said one or more health care options if it is determined that the one or more health care options may be recommended for the first patient.

36. The apparatus of claim 35, wherein the one or more computer processors, as part of the evaluation of the patient information, determine whether the first patient has a health condition necessitating health care for which future health care costs cannot be reduced and determine whether the one or more health care options may be recommended for the first patient only if it is determined that the first patient does not have said health condition.

37. An apparatus for identifying health care options, the apparatus comprising:

one or more computer processors that receive patient information for a first patient, evaluate said patient information to determine whether one or more health care options may be recommended for the first patient, the one or more health care options having a tendency to improve the quality of health care for the first patient, and generate a recommendation to select said one or more health care options if it is determined that the one or more health care options may be recommended for the first patient.

38. The apparatus of claim 37, wherein the one or more computer processors, as part of the evaluation of the patient information, determine whether the first patient has a health condition necessitating health care for which future health care costs cannot be reduced and determine whether the one or more health care options may be recommended for the first patient only if it is determined that the first patient does not have said health condition.

39. A computer readable medium for identifying health care options, the computer readable medium having one or more computer modules executable on one or more computer processors, the computer modules carrying out the following acts:

receiving patient information for a first patient,

evaluating said patient information to determine whether one or more health care options may be recommended for the first patient, the one or more health care options having a tendency to lower fuiture health care costs for the first patient, and

generating a recommendation to select said one or more health care options if it is determined that the one or more health care options may be recommended for the first patient.

40. The computer readable medium of claim 39, wherein said act of evaluating said patient information comprises determining whether the first patient has a health condition necessitating health care for which future health care costs cannot be reduced and determining whether the one or more health care options may be recommended for the first patient only if it is determined that the first patient does not have said health condition.

41. A computer readable medium for identifying health care options, the computer readable medium having one or more computer modules executable on one or more computer processors, the computer modules carrying out the following acts:

receiving patient information for a first patient,

evaluating said patient information to determine whether one or more health care options may be recommended for the first patient, the one or more health care options having a tendency to improve the quality of health care for the first patient, and

generating a recommendation to select said one or more health care options if it is determined that the one or more health care options may be recommended for the first patient.

42. The computer readable medium of claim 41, wherein said act of evaluating said patient information comprises determining whether the first patient has a health condition necessitating health care for which future health care costs cannot be reduced and determining whether the one or more health care options may be recommended for the first patient only if it is determined that the first patient does not have said health condition.