Healthcare management system

• US 20070150308A1
• Filed: 12/23/2005
• Published: 06/28/2007
• Est. Priority Date: 12/23/2005
• Status: Abandoned Application

• Current Assignee: Caterpillar Incorporated
• Original Assignee: Caterpillar Incorporated
• Inventors: Srinivasan, Syamala
• Application Number:
  US11/315,284
• Publication Number:
  US 20070150308A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/04 Forecasting or optimisation specially adapted for administrative or management purposes, e.g. linear programming or "cutting stock problem" market predictions or forecasting for commercial activities G06Q30/0202
• CPC Class Codes: G06Q 10/06 Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 20/00 ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

A healthcare management system is provided. The system may include a memory configured to store health-related information about individual members of a population and a processor operatively coupled to the memory. The processor may be configured to select a first treatment intervention for addressing predetermined symptoms of an individual member of the population from two or more potential treatment interventions. The processor may be configured to select the first treatment intervention based on information stored in the memory, such as a determined risk that the symptoms are caused by one or more predetermined health conditions. In addition, the processor may be configured to select the first treatment intervention based on at least one of the following factors: a success rate of each potential treatment intervention at treating the one or more predetermined health conditions; and a cost of each potential treatment intervention. The system may also include an output module configured to provide information regarding the first treatment intervention to at least one of a healthcare provider and an insurer of the individual member.

Claims

1. A healthcare management system, comprising:

a memory configured to store health-related information about individual members of a population; and

a processor operatively coupled to the memory and configured to;

select a first treatment intervention for addressing predetermined symptoms of an individual member of the population from two or more potential treatment interventions, based on the following information stored in the memory;

a determined risk that the symptoms are caused by one or more predetermined health conditions; and

at least one of the following factors;

a success rate of each potential treatment intervention at treating the one or more predetermined health conditions; and

a cost of each potential treatment intervention; and

an output module configured to provide information regarding the first treatment intervention to at least one of a healthcare provider and an insurer of the individual member.

2. The system of claim 1, wherein the processor is further configured to select the first treatment intervention based on both the success rate and the cost.

3. The system of claim 2, wherein the processor is further configured to prioritize the cost of each potential treatment intervention over the success rate.

4. The system of claim 2, wherein the processor is further configured to prioritize the success rate of each potential treatment intervention over the cost.

5. The system of claim 2, wherein the processor is further configured to prioritize the cost and the success rate relative to one another for selection of the first treatment intervention, and select a second treatment intervention from the two or more potential treatment interventions based on the determined risk, the cost, and the success rate, wherein the cost and the success rate of each potential treatment intervention are prioritized differently than for selection of the first treatment intervention.

6. The system of claim 1, wherein the information stored in the memory includes at least one of the following:

demographics;

medical records; and

pharmacy information.

7. The system of claim 1, wherein the processor is further configured to select a preventative intervention from two or more potential preventative interventions to address one or more health conditions prior to detection of any symptoms of the one or more health conditions in the individual member.

8. The system of claim 7, wherein the processor is further configured to select the preventative intervention based on the following information stored in the memory:

a determined risk that the individual member may experience at least one of the one or more health conditions and at least one of the following factors;

a success rate of each potential preventative intervention at treating the one or more health conditions; and

a cost of each potential preventative intervention.

9. The system of claim 8, wherein the output module is further configured to provide information regarding the selected preventative intervention to at least one of a healthcare provider and an insurer of the individual member.

10. A method of healthcare management, comprising:

selecting a first treatment intervention for addressing predetermined symptoms of an individual member of the population from two or more potential treatment interventions, based on the following information stored in a memory;

a determined risk that the symptoms are caused by one or more predetermined health conditions; and

at least one of the following factors;

a success rate of each potential treatment intervention at treating the one or more predetermined health conditions; and

a cost of each potential treatment intervention; and

providing information regarding the first treatment intervention to at least one of a healthcare provider and an insurer of the individual member.

11. The method of claim 10, further including selecting the first treatment intervention based on both the success rate and the cost.

12. The method of claim 11, further including prioritizing the cost of each potential treatment intervention over the success rate.

13. The method of claim 11, further including prioritizing the success rate of each potential treatment intervention over the cost.

14. The method of claim 11, further including prioritizing the cost and the success rate relative to one another for selection of the first treatment intervention;

and

selecting a second treatment intervention from the two or more potential treatment interventions based on the determined risk, the cost, and the success rate, wherein the cost and the success rate of each potential treatment intervention are prioritized differently than for selection of the first treatment intervention.

15. The method of claim 10, wherein the information stored in the memory includes at least one of the following:

demographics;

medical records; and

pharmacy information.

16. The method of claim 10, further including selecting a preventative intervention from two or more potential preventative interventions to address one or more health conditions prior to detection of any symptoms of the one or more health conditions in the individual member.

17. The method of claim 16, further including selecting the preventative intervention based on the following information stored in the memory:

a determined risk that the individual member may experience at least one of the one or more health conditions and at least one of the following factors;

a success rate of each potential preventative intervention at treating the one or more health conditions; and

a cost of each potential preventative intervention.

18. The method of claim 17, further including providing information regarding the selected preventative intervention to at least one of a healthcare provider and an insurer of the individual member.

19. A computer-readable medium having stored thereon machine executable instructions for healthcare management, the instructions comprising the steps of:

selecting a first treatment intervention for addressing predetermined symptoms of an individual member of the population from two or more potential treatment interventions, based on the following information stored in a memory;

a determined risk that the symptoms are caused by one or more predetermined health conditions; and

at least one of the following factors;

a success rate of each potential treatment intervention at treating the one or more predetermined health conditions; and

a cost of each potential treatment intervention; and

providing information regarding the first treatment intervention to at least one of a healthcare provider and an insurer of the individual member.

20. The computer-readable medium of claim 19, further including instructions for selecting the first treatment intervention based on both the success rate and the cost.

21. The computer-readable medium of claim 20, further including instructions for prioritizing the cost of each potential treatment intervention and the success rate of each potential treatment intervention relative to one another.

22. The computer-readable medium of claim 20, further including instructions for prioritizing the cost and the success rate relative to one another for selection of the first treatment intervention;

and

selecting a second treatment intervention from the two or more potential treatment interventions based on the determined risk, the cost, and the success rate, wherein the cost and the success rate of each potential treatment intervention are prioritized differently than for selection of the first treatment intervention.

23. The computer-readable medium of claim 19, wherein the information stored in the memory includes at least one of the following:

demographics;

medical records; and

pharmacy information.

24. The computer-readable medium of claim 19, further including instructions for selecting a preventative intervention from two or more potential preventative interventions to address one or more health conditions prior to detection of any symptoms of the one or more health conditions in the individual member based on the following information stored in the memory:

a determined risk that the individual member may experience at least one of the one or more health conditions and at least one of the following factors;

a success rate of each potential preventative intervention at treating the one or more health conditions; and

a cost of each potential preventative intervention.

25. The computer-readable medium of claim 24, further including instructions for providing information regarding the selected preventative intervention to at least one of a healthcare provider and an insurer of the individual member.