HEALTHCARE MANAGEMENT SYSTEM AND METHOD

• US 20070162295A1
• Filed: 08/22/2006
• Published: 07/12/2007
• Est. Priority Date: 08/22/2005
• Status: Abandoned Application

• Current Assignee: Adil Akhtar, Jayakumar Ravindran, Rupesh Srivastava
• Original Assignee: Adil Akhtar, Jayakumar Ravindran, Rupesh Srivastava
• Inventors: Akhtar, Adil, Srivastava, Rupesh, Ravindran, Jayakumar
• Application Number:
  US11/466,438
• Publication Number:
  US 20070162295A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

A system and method for managing healthcare in which payers, providers, pharmacists, and/or patients can interact with appropriate aspects of a particular treatment or surveillance plan. Treatment and/or surveillance plans can be designed, created, selected, implemented, tracked, evaluated, modified, improved, expanded, and/or otherwise managed. Outcomes data can be used to update efficacy data, which in turn can influence future treatment and/or surveillance plans. A wide variety of different types of data can influence the functionality of the system. A wide range of technical architectures can be used to achieve the functionality of the system.

Claims

1. A method of managing a treatment plan on a computer network, comprising:

making a database of efficacy data accessible to a provider interface;

receiving a work-up from the provider interface;

creating a treatment plan on the database from the work-up received from the provider interface;

assigning an approval status to the treatment plan;

sending an approval notice relating to the treatment plan to said provider interface and to a pharmacy interface, wherein the approval notice relates to the treatment plan;

invoking a surveillance plan to track and capture outcome information generated from the implementation of the treatment plan;

storing a plurality outcome information received from at least one of;

(a) a payer interface;

(b) the pharmacy interface;

(c) the provider interface; and

(d) a patient interface; and

automatically updating the efficacy data using the outcome information.

2. The method of claim 1, further comprising:

automatically changing the status of the treatment plan in response to the stored outcome information.

3. The method of claim 1, wherein the creation of the treatment plan is automatically influenced by an efficacy datum and a patient datum.

4. The method of claim 3, wherein the creation of the treatment plan is automatically influenced by a plurality of patient data, including business information, medical information, and surveillance information.

5. The method of claim 1, wherein the creation of the treatment plan is automatically influenced by a payer rule, a provider rule, a patient rule, and a pharmacy rule.

6. The method of claim 1, wherein the treatment plan relates to a condition of cancer, wherein the treatment plan includes a chemotherapy as a treatment component, and wherein the treatment plan is automatically modified before the completion of the treatment plan.

7. The method of claim 1, wherein the surveillance plan relates to a cancer condition, wherein the surveillance plan includes a pharmaceutical product, and wherein the surveillance plan is automatically modified before the completion of the surveillance plan.

8. The method of claim 1, wherein the work-up is selected from a pre-approved regimen selection.

9. The method of claim 1, further comprising an automatic sending of a notice to at least one of:

(a) the payer interface;

(b) the provider interface;

(c) the patient interface; and

(d) the pharmacy interface in response to a failure to comply with at least one of;

(i) the treatment plan; and

(ii) the surveillance plan.

10. The method of claim 1, wherein a surveillance plan is automatically created without human intervention after the approval of the treatment plan.

11. A healthcare management system, comprising:

an application and database residing on a server;

said database including a plurality of regimen data, a plurality efficacy data, a plurality of interaction data, a plurality of patient data, a treatment plan, and a surveillance plan;

said application providing for a patient interface, a provider interface, a payer interface, and a pharmacist interface;

wherein said treatment plan is selected from said provider interface and is selectively and automatically influenced by said patient data, and said efficacy data.

12. The system of claim 11, wherein said treatment plan selected from said provider interface is a pre-approved treatment plan.

13. The system of claim 11, wherein said surveillance plan is approved separate from the approval of said treatment plan.

14. The system of claim 11, wherein said efficacy data and said regimen data are updated before the completion of said surveillance plan.

15. The system of claim 11, wherein a status associated with said treatment plan is modified before the completion of said treatment plan.

16. The system of claim 11, said database further including a payer rule received thru said payer interface, wherein said payer rule influences said application to reject a work-up.

17. The system of claim 11, said application further providing for the capture of a plurality of outcome data, wherein receipt of said outcome data triggers a modification to said surveillance plan.

18. The system of claim 11, wherein the treatment plan relates to a condition of cancer, wherein the treatment plan includes a chemotherapy as a treatment component, and wherein the treatment plan is pre-approved from a regimen selection made with said provider interface.

19. The system of claim 11, wherein said efficacy data is automatically updated by said application.

20. A health care management system, comprising:

a provider subsystem, said provider subsystem providing for the scheduling of an examination with a patient, the creation of a work-up using a regimen selected using a provider interface, and the submission of the work-up for approval as a treatment plan, wherein the schedule of the examination, the work-up are stored on a database accessible by a payer subsystem;

said payer subsystem providing for populating a database with a plurality of regimen data and a plurality of efficacy data, wherein said payer subsystem further provided for approving a work-up as a treatment plan and transmitting an order corresponding to the treatment plan to a pharmacy subsystem;

said pharmacy subsystem providing for initiating at least one shipment and at least one notification;

wherein said treatment plan is associated with a surveillance plan, and wherein said system automatically collects a plurality of outcome data in accordance with said surveillance plan.