Method and system for generating personal/individual health records

• US 20070027720A1
• Filed: 07/28/2006
• Published: 02/01/2007
• Est. Priority Date: 10/11/2000
• Status: Active Grant

• Current Assignee: Healthtrio LLC (Spok Holdings, Inc.)
• Original Assignee: Healthtrio LLC (Spok Holdings, Inc.)
• Inventors: Peterson, John, Hasan, Malik, Wallen, J.
• Granted Patent: US 7,428,494 B2
• Time in Patent Office: Days
• US Class Current: 705/3
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records

Abstract

A system and method for generating and/or updating a personal/individual health record. Inputs of data to the system may come from diverse sources including, but not limited to, patient questionnaires, insurance company (or other payor) claims data, hospitals, clinics and other institutional providers, and individual physicians and physicians'"'"' offices.

Claims

1. A method for generating a personal/individual health record, said method comprising:

receiving payor claims data associated with a patient;

deriving encounter data indicative of an encounter between said patient and a health care provider from said payor claims data; and

inserting a new entry in a personal/individual health record associated with said patient based on said encounter data.

2. The method of claim 1, wherein said deriving step includes deriving a primary care physician encounter history, an outpatient encounter history and a hospital admissions history from said payor claims data.

3. The method of claim 1, wherein said deriving step includes deriving encounter data selected from the group consisting of medication prescribed to said patient, referrals of said patient to specialists, tests ordered for said patient, and changes in medication prescribed to said patient.

4. The method of claim 1, wherein said receiving step includes accessing a computer-usable medium that includes payor claims data associated with an insurance company.

5. The method of claim 4, wherein said payor claims data are downloaded from a computer system associated with an insurance company at least once a week.

6. The method of claim 4, wherein said payor claims data are downloaded from a computer system associated with an insurance company at least once per day.

7. The method of claim 4, wherein said payor claims data are downloaded from a computer system associated with an insurance company on a substantially real time basis.

8. The method of claim 1, further comprising accessing a computer-usable medium that includes medication data associated with a pharmacy benefits manager, wherein said medication data is indicative of a medication prescribed to said patient, and further comprising supplementing said new entry based on said medication data.

9. The method of claim 1, further comprising accessing a computer-usable medium that includes diagnosis data associated with said health care provider, wherein said diagnosis data is indicative of a diagnosis by said health care provider during said encounter and updating said new entry with said diagnosis data.

10. The method of claim 1, further comprising accessing a computer-usable medium that includes procedure data associated with said health care provider, wherein said procedure data is indicative of a procedure conducted by said health care provider during said encounter and updating said new entry with said procedure data.

11. The method of claim 1, further comprising accessing a computer-usable medium that includes laboratory data associated with a laboratory, wherein said laboratory data is indicative of a test conducted by said laboratory and updating said new entry with said laboratory data.

12. The method of claim 1, further comprising accessing a computer-usable medium that includes imaging data associated with said health care provider, wherein said imaging data is indicative of an image created during said encounter and updating said new entry with said imaging data.

13. The method of claim 1, further comprising accessing a computer-usable medium that includes manually entered health-related data associated with said health care provider and updating said new entry with said health related-data.