METHOD OF GROUPING AND ANALYZING CLINICAL RISKS
First Claim
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1. A method of creating a classification system for rating the nature and severity of health care requirements, including:
- (a) obtaining a set of medical disease codes;
(b) categorizing the medical disease codes into major disease categories;
(c) categorizing the medical disease codes in each major disease category into episode disease categories based on severity;
(d) sub-dividing at least some of the episode disease categories by severity of illness level by using severity of illness rules to take into account other episode disease categories or other information not related to a particular episode disease category being subdivided; and
(e) defining criteria for assigning an overall clinical risk group to an individual patient, where the criteria takes into account the episode disease categories and severity of illness levels, where the criteria adjusts for the effect of interacting conditions in different episode disease categories.
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Abstract
A method of creating a classification system for rating the nature and severity of health care requirements, including obtaining a set of medical disease codes, categorizing the medical disease codes into major disease categories, and categorizing the medical disease codes in each major disease category into episode disease categories based on severity.
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Citations
21 Claims
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1. A method of creating a classification system for rating the nature and severity of health care requirements, including:
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(a) obtaining a set of medical disease codes;
(b) categorizing the medical disease codes into major disease categories;
(c) categorizing the medical disease codes in each major disease category into episode disease categories based on severity;
(d) sub-dividing at least some of the episode disease categories by severity of illness level by using severity of illness rules to take into account other episode disease categories or other information not related to a particular episode disease category being subdivided; and
(e) defining criteria for assigning an overall clinical risk group to an individual patient, where the criteria takes into account the episode disease categories and severity of illness levels, where the criteria adjusts for the effect of interacting conditions in different episode disease categories. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15)
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16. A method of creating a classification system for rating the nature and severity of health care requirements, including:
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(a) obtaining a set of medical disease codes;
(b) categorizing the medical disease codes into major disease categories;
(c) categorizing the medical disease codes into episode disease categories in each major disease category based on severity;
(d) obtaining a set of medical procedure codes;
(e) categorizing the medical procedure codes into episode procedure categories;
(f) sub-dividing at least some of the episode disease categories by severity of illness level by using severity of illness rules, wherein the severity of illness rules take into account temporal information including order of occurrence of the episode disease categories and episode procedure categories. - View Dependent Claims (17, 18, 19)
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20. A method of creating a classification system for rating the nature and severity of health care requirements, including:
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(a) first, obtaining a set of medical disease codes;
(b) second, categorizing the medical disease codes into major disease categories, wherein each major disease category corresponds to a single organ system, a malignancy or a multiple trauma;
(c) third, categorizing the medical disease codes in each major disease category into episode disease categories based on severity; and
(d) fourth, sub-dividing at least some of the episode disease categories by severity of illness level by using severity of illness rules, thereby defining a set of severity of illness levels for each episode disease category. - View Dependent Claims (21)
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Specification