System and method for centralized management and monitoring of healthcare services

• US 20060064320A1
• Filed: 06/02/2005
• Published: 03/23/2006
• Est. Priority Date: 06/02/2004
• Status: Abandoned Application

• Current Assignee: Richard Postrel
• Original Assignee: Richard Postrel
• Inventors: Postrel, Richard
• Application Number:
  US11/144,377
• Publication Number:
  US 20060064320A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G16H 10/65 stored on portable record carriers, e.g. on smartcards, RFID tags or CD
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

A centralized healthcare management and monitoring system and service including a healthcare management server computer interconnected to a computer network, having a first repository of records with patient healthcare information and a second repository with predetermined compliance rules with information regarding an interaction between multiple entities associated with the healthcare management server computer. Multiple healthcare provider computers, associated with a healthcare provider, allow input of patient identification indicia identification indicia presented by a patient and communicating with the healthcare management server computer over the computer network. A query is sent to the healthcare management server computer that includes the patient identification indicia; an identification of the healthcare services performed or proposed to be performed by the associated healthcare provider; and an identification of the healthcare provider performing the healthcare services. The healthcare management server computer then utilizes the query to access the first and second repositories to determine if the parameters of the query are in compliance with one or more of the predetermined compliance rules.

Claims

1. A centralized healthcare management and monitoring system comprising:

a. a healthcare management server computer interconnected to a computer network, the healthcare management server computer comprising;

i. a first repository of patient records, each patient record associated with a patient and accessible via a unique patient identification indicia associated with the patient, each patient record comprising healthcare information associated with the patient; and

ii. a second repository of predetermined compliance rules;

each of the compliance rules comprising information regarding an interaction between multiple entities associated with the healthcare management server computer;

b. a plurality of healthcare provider computers interconnected to the computer network, each of which is associated with a healthcare provider, each of the healthcare provider computers comprising means for inputting a patient identification indicia presented by a patient and communicating with the healthcare management server computer over the computer network using the patient identification presented by the patient;

wherein, when a patient presents, in association with healthcare services performed by the associated healthcare provider, a patient identification indicia associated with the patient, the healthcare provider computer transmits to the healthcare management server computer a query comprising parameters comprising;

the patient identification indicia;

an identification of the healthcare services performed or proposed to be performed by the associated healthcare provider; and

an identification of the healthcare provider performing the healthcare services; and

the healthcare management server computer utilizes the query to access the first and second repositories to determine if the parameters of the query are in compliance with one or more of the predetermined compliance rules.

2. The system of claim 1 wherein the compliance rules comprise rules related to healthcare treatment procedures, and wherein the healthcare management server computer determines if the healthcare services proposed to be performed by the healthcare provider identified in the query are in compliance with the healthcare treatment procedures.

3. The system of claim 2 wherein healthcare information associated with the patient identified in the query is utilized by the healthcare management server computer to determine if the healthcare services proposed to be performed by the healthcare provider identified in the query are in compliance with the healthcare treatment procedures.

4. The system of claim 1 further comprising a healthcare insurer computer associated with a healthcare insurance provider interconnected to the computer network.

5. The system of claim 4 wherein the healthcare management server computer obtains insurance information from the healthcare insurer computer and utilizes the insurance information to determine if the parameters of the query are in compliance with one or more of the predetermined compliance rules.

6. The system of claim 5 wherein the insurance information comprises information related to an insurance payment that the healthcare insurance provider agrees to pay for the proposed healthcare services.

7. The system of claim 6 wherein the insurance payment is made by the healthcare insurance provider to the healthcare provider based on the healthcare services rendered by the healthcare provider to the patient.

8. The system of claim 1 wherein the compliance rules comprise rules promulgated by a governmental agency.

9. The system of claim 1 wherein the compliance rules comprise rules promulgated by a healthcare administrative agency.

10. The system of claim 1 wherein the healthcare provider computer additionally retrieves from the healthcare management server computer healthcare information associated with the patient and presents the healthcare information.

11. The system of claim 1 further comprising a plurality of tokens, each of which is associated with a patient, and each of which is encoded with the unique identification indicia for identifying the associated patient.

12. The system of claim 11 wherein the token is a healthcare card.

13. The system of claim 12 wherein the healthcare card is a card comprising a magnetic stripe encoded with the patient identification indicia.

14. The system of claim 12 wherein the card is a smart card comprising storage means for storing at least the patient identification indicia.

15. The system of claim 11 wherein the token is an RFID device capable of subdermal implantation.

16. The system of claim 1 wherein the healthcare provider computers each comprise means for inputting data, wherein

a. revised healthcare information is entered into the means for inputting data and transmitted to the healthcare management server computer, and

b. the record in the repository associated with the patient is modified to include the revised healthcare information.

17. The system of claim 1 further comprising a third repository of health points account records associated with each of the patients, the health point account records containing a health point account that indicates a number of health points that have been awarded to the patient based on one or more of a plurality of health-related criteria.

18. The system of claim 17 wherein health points are awarded to a patient for participating in a positive health-related activity.

19. The system of claim 17 wherein health points are awarded to a patient for not participating in a negative health-related activity.

20. The system of claim 17 wherein health points are awarded to a patient for maintaining a predetermined level of health.

21. The system of claim 17 wherein multiples of health points are accumulated in the health point account.

22. The system of claim 17 wherein a patient may redeem accumulated health points from the associated health point account in exchange for one of a plurality of available benefits.

23. The system of claim 17 wherein the plurality of available benefits comprise reduced insurance premiums.

24. The system of claim 1 further comprising a third party financial services entity interoperable with the healthcare management server computer, said third party financial services entity functioning to make payment to the healthcare provider based on the healthcare services rendered by the healthcare provider to the patient.

25. A method of operating a centralized healthcare management and monitoring system comprising the steps of:

a. providing a healthcare management server computer interconnected to a computer network, the healthcare management server computer comprising;

i. a first repository of patient records, each patient record associated with a patient and accessible via a unique patient identification indicia associated with the patient, each patient record comprising healthcare information associated with the patient; and

ii. a second repository of predetermined compliance rules;

each of the compliance rules comprising information regarding an interaction between multiple entities associated with the healthcare management server computer;

b. providing a plurality of healthcare provider computers interconnected to the computer network, each of which is associated with a healthcare provider, each of the healthcare provider computers comprising means for inputting a patient identification indicia presented by a patient and communicating with the healthcare management server computer over the computer network using the patient identification presented by the patient;

c. a patient presenting to a healthcare provider computer, in association with healthcare services performed by the associated healthcare provider, a patient identification indicia associated with the patient,

d. the healthcare provider computer transmitting to the healthcare management server computer a query comprising parameters comprising;

i. the patient identification indicia;

ii. an identification of the healthcare services performed or proposed to be performed by the associated healthcare provider; and

iii. an identification of the healthcare provider performing the healthcare services; and

e. the healthcare management server computer utilizing the query to access the first and second repositories to determine if the parameters of the query are in compliance with one or more of the predetermined compliance rules.

26. The method of claim 25 wherein the compliance rules comprise rules related to healthcare treatment procedures, and wherein the healthcare management server computer determines if the healthcare services proposed to be performed by the healthcare provider identified in the query are in compliance with the healthcare treatment procedures.

27. The method of claim 26 wherein healthcare information associated with the patient identified in the query is utilized by the healthcare management server computer to determine if the healthcare services proposed to be performed by the healthcare provider identified in the query are in compliance with the healthcare treatment procedures.

28. The method of claim 25 further comprising the steps of

a. the healthcare management server computer obtaining insurance information from a healthcare insurer computer and

b. utilizing the insurance information to determine if the parameters of the query are in compliance with one or more of the predetermined compliance rules.

29. The method of claim 28 wherein the insurance information comprises information related to an insurance payment that the healthcare insurance provider agrees to pay for the proposed healthcare services.

30. The method of claim 29 wherein the insurance payment is made by the healthcare insurance provider to the healthcare provider based on the healthcare services rendered by the healthcare provider to the patient.

31. The method of claim 25 wherein the compliance rules comprise rules promulgated by a governmental agency.

32. The method of claim 25 wherein the compliance rules comprise rules promulgated by a healthcare administrative agency.

33. The method of claim 25 further comprising the steps of:

a. the healthcare provider computer retrieving from the healthcare management server computer healthcare information associated with the patient and

b. presenting the healthcare information.

34. The method of claim 25 further comprising the step of providing a plurality of tokens, each of which is associated with a patient, and each of which is encoded with the unique identification indicia for identifying the associated patient.

35. The method of claim 34 wherein the token is a healthcare card.

36. The method of claim 35 wherein the healthcare card is a card comprising a magnetic stripe encoded with the patient identification indicia.

37. The method of claim 35 wherein the card is a smart card comprising storage means for storing at least the patient identification indicia.

38. The method of claim 34 wherein the token is an RFID device capable of subdermal implantation.

39. The method of claim 25 further comprising the steps of

a. entering revised healthcare information into means for inputting data associated with the healthcare provider computers;

b. transmitting the revised healthcare information to the healthcare management server computer; and

c. modifying the record in the repository associated with the patient to include the revised healthcare information.

40. The method of claim 25 comprising the further step of providing a third repository of health point account records associated with each of the patients, the health point account records containing a health point account that indicates a number of health points that have been awarded to the patient based on one or more of a plurality of health-related criteria.

41. The method of claim 40 wherein health points are awarded to a patient for participating in a positive health-related activity.

42. The method of claim 40 wherein health points are awarded to a patient for not participating in a negative health-related activity.

43. The method of claim 40 wherein health points are awarded to a patient for maintaining a predetermined level of health.

44. The method of claim 40 wherein multiples of health points are accumulated in the health point account.

45. The method of claim 40 wherein a patient may redeem accumulated health points from the associated health point account in exchange for one of a plurality of available benefits.

46. The method of claim 40 wherein the plurality of available benefits comprise reduced insurance premiums.

47. The method of claim 25 further comprising the step of providing a third party financial services entity interoperable with the healthcare management server computer, said third party financial services entity functioning to make payment to the healthcare provider based on the healthcare services rendered by the healthcare provider to the patient.