METHOD, COMPUTER PROGRAM PRODUCT AND APPARATUS FOR GENERATING INTEGRATED ELECTRONIC HEALTH RECORDS

• US 20080195420A1
• Filed: 02/09/2007
• Published: 08/14/2008
• Est. Priority Date: 02/09/2007
• Status: Abandoned Application

• Current Assignee: Mckesson Financial Holdings Limited (McKesson Corp.)
• Original Assignee: Mckesson Financial Holdings Limited (McKesson Corp.)
• Inventors: Ferriter, Kevin, Ramelson, Harley, Callahan, Megan
• Application Number:
  US11/673,184
• Publication Number:
  US 20080195420A1
• Time in Patent Office: Days
• US Class Current: 705/3
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 70/60 relating to pathologies

Abstract

A method, computer program product, and apparatus for generating an integrated electronic health record. The integrated electronic health record provides an aggregate of health information across multiple data sources, including combining claims data with disease management data into a common electronic health record. By combining these data sources, an integrated electronic health record is generated that includes data that is not currently available at the point of care. As a result, the integrated health record may aid in the avoidance of medical errors, accelerate knowledge diffusion, and allow more patients to receive the latest evidence-based treatment.

Claims

1. A method of generating an integrated electronic health record, said method comprising:

receiving claims data and disease management data, wherein receiving claims data comprises receiving claims data selected from the group consisting of medical claims data and pharmacy claims data;

storing the claims data and the disease management data;

processing the claims data and the disease management data, wherein processing the claims data and the disease management data comprises associating the claims data and the disease management data;

populating a common electronic health record with the claims data and disease management data; and

displaying the common electronic health record in at least one clinical view, wherein displaying the common electronic health record in at least one clinical view comprises presenting at least a portion of the claims data or disease management data in an interactive form.

2. The method of claim 1, wherein at least one detailed view is associated with the clinical view.

3. The method of claim 1, wherein the at least one clinical view is selected from the group consisting of a patient information view, a summary page view, a conditions view, a procedures view, a tests view, an encounters view, an episodes view, a medications view, and a care management view.

4. The method of claim 3, wherein at least one clinical view is a conditions view, and wherein at least one detailed view is associated with the conditions view, the at least one detailed view combining claims data related to a given condition and presenting services associated with that condition, the conditions detailed view also being configured to allow grouping by a rank of diagnoses.

5. The method of claim 3, wherein at least one clinical view is an episodes view, and wherein at least one detailed view is associated with the episodes view, the at least one detailed view providing summary data obtained from claims data for a given episode.

6. The method of claim 5, wherein the summary data is selected from the group consisting of data relating to conditions associated with the given episode, procedures associated with the given episode, tests associated with the given episode, encounters associated with the given episode, medications associated with the given episode, and disease management data associated with the given episode.

7. The method of claim 3, wherein at least one clinical view is a medications view, and wherein at least one detailed view is associated with the medications view, the at least one detailed view configured to allow a user to view prescriptions that were filled for a given medication.

8. The method of claim 7, wherein the medications view comprises at least one therapeutic class categorization for the given medication.

9. The method of claim 7, wherein the medications view is configured to provide a link to a payor'"'"'s formulary.

10. The method of claim 1, wherein the clinical view is configured to select and aggregate diagnoses into a summary.

11. The method of claim 1, wherein the at least one clinical view is configured to detail services for a specific condition, the services selected from the group consisting of encounters, procedures, lab tests, and diagnostic tests.

12. The method of claim 1, wherein the at least one clinical view is configured to separate services into procedures, lab tests, diagnostic tests, and encounters.

13. The method of claim 1, wherein the at least one clinical view is configured to categorize lab tests, diagnostic tests, and encounters.

14. The method of claim 1, wherein the at least one clinical view is configured to aggregate claims data at a medication level.

15. The method of claim 1, wherein displaying the common electronic health record further comprises displaying a customized clinical view including presenting at least a portion of the claims data or disease management data in a customized form.

16. The method of claim 1, wherein displaying the common electronic health record in at least one clinical view comprises applying a series of rules to the claims data and the disease management data to determine which portions of the claims data and the disease management data to display in the clinical view.

17. The method of claim 16, wherein applying the series of rules comprises grouping the claims data and the disease management data into one or more categories.

18. The method of claim 17, wherein grouping the claims data and the disease management data into one or more categories comprises determining if the claims data or the disease management data contains sensitive data, and if so, grouping sensitive claims data, sensitive disease management data, and any other sensitive data into a category containing sensitive data.

19. The method of claim 18, wherein displaying a clinical view comprises requiring a predefined security authorization prior to including the sensitive data in the clinical view.

20. The method of claim 1, further comprising accessing the integrated electronic health record through a web browser.

21. A computer program product for generating an integrated electronic health record, wherein the computer program product comprises at least one computer-readable storage medium having computer-readable program code portions stored therein, the computer-readable program code portions comprising:

a first executable portion for receiving claims data, wherein receiving claims data comprises receiving claims data selected from the group consisting of medical claims data and pharmacy claims data;

a second executable portion for receiving disease management data;

a third executable portion for storing the claims data and the disease management data;

a fourth executable portion for processing the claims data and the disease management data, wherein processing the claims data and the disease management data comprises associating the claims data and the diseased management data;

a fifth executable portion for populating a common electronic health record with the claims data and disease management data; and

a sixth executable portion for displaying the common electronic health record in at least one clinical view, wherein displaying the common electronic health record in at least one clinical view comprises presenting at least a portion of the claims data or disease management data in an interactive form.

22. The computer program product of claim 21, wherein at least one detailed view is associated with the clinical view.

23. The computer program product of claim 21, wherein the at least one clinical view is selected from the group consisting of a patient information view, a summary page view, a conditions view, a procedures view, a tests view, an encounters view, an episodes view, a medications view, and a care management view.

24. The computer program product of claim 23, wherein at least one clinical view is a conditions view, and further comprising a seventh executable portion for generating at least one detailed view associated with the conditions view, the at least one detailed view combining claims data related to a given condition and presenting services associated with that condition, the conditions detailed view also being configured to allow grouping by a rank of diagnoses.

25. The computer program product of claim 23, wherein at least one clinical view is an episodes view, and further comprising a seventh executable portion for generating at least one detailed view associated with the episodes view, the at least one detailed view providing summary data obtained from claims data for a given episode.

26. The computer program product of claim 25, wherein the summary data is selected from the group consisting of data relating to conditions associated with the given episode, procedures associated with the given episode, tests associated with the given episode, encounters associated with the given episode, medications associated with the given episode, and disease management data associated with the given episode.

27. The computer program product of claim 23, wherein at least one clinical view is a medications view, and further comprising a seventh executable portion for generating at least one detailed view associated with the medications view, the at least one detailed view configured to allow a user to view prescriptions that were filled for a given medication.

28. The computer program product of claim 27, wherein the medications view comprises at least one therapeutic class categorization for the given medication.

29. The computer program product of claim 27, wherein the medications view is configured to provide a link to a payor'"'"'s formulary.

30. The computer program product of claim 21, wherein the clinical view is configured to select and aggregate diagnoses into a summary.

31. The computer program product of claim 21, wherein the at least one clinical view is configured to detail services for a specific condition, the services selected from the group consisting of encounters, procedures, lab tests, and diagnostic tests.

32. The computer program product of claim 21, wherein the at least one clinical view is configured to separate services into procedures, lab tests, diagnostic tests, and encounters.

33. The computer program product of claim 21, wherein the at least one clinical view is configured to categorize lab tests, diagnostic tests, and encounters.

34. The computer program product of claim 21, wherein the at least one clinical view is configured to aggregate claims data at a medication level.

35. The computer program product of claim 21, wherein said sixth executable portion comprises displaying the common electronic health record in a customized clinical view including presenting at least a portion of the claims data or disease management data in a customized form.

36. The computer program product of claim 21, wherein said sixth executable portion comprises applying a series of rules to the claims data and the disease management data to determine which portions of the claims data and the disease management data to display in the clinical view.

37. The computer program product of claim 36, wherein applying the series of rules comprises grouping the claims data and the disease management data into one or more categories.

38. The computer program product of claim 37, wherein grouping the claims data and the disease management data into one or more categories comprises determining if the claims data or the disease management data contains sensitive data, and grouping sensitive claims data, sensitive disease management data, and any other sensitive data into a category containing sensitive data.

39. The computer program product of claim 38, wherein displaying a clinical view comprises requiring a predefined security authorization prior to including the sensitive data in the clinical view.

40. The computer program product of claim 21, further comprising accessing the integrated electronic health record through a web browser.

41. An apparatus for generating an integrated electronic health record, said apparatus comprising:

an input element for receiving claims data and disease management data, wherein receiving claims data comprises receiving claims data selected from the group consisting of medical claims data and pharmacy claims data;

a processor in communication with the input element; and

a memory in communication with the processor, said memory storing an application executable by the processor, said application configured, upon execution, to store the claims data and the disease management data, and to process the claims data and the disease management data, wherein processing the claims data and the disease management data comprises associating the claims data and the disease management data, to populate a common electronic health record using the claims data and disease management data, and to display the common electronic health record in at least one clinical view, wherein displaying the common electronic health record in at least one clinical view comprises presenting at least a portion of the claims data or disease management data in an interactive form.

42. The apparatus of claim 41, wherein at least one detailed view is associated with the clinical view.

43. The apparatus of claim 41, wherein the at least one clinical view is selected from the group consisting of a patient information view, a summary page view, a conditions view, a procedures view, a tests view, an encounters view, an episodes view, a medications view, and a care management view.

44. The apparatus of claim 43, wherein at least one clinical view is a conditions view, and wherein at least one detailed view is associated with the conditions view, the at least one detailed view combining claims data related to a given condition and presenting services associated with that condition, the conditions detailed view also being configured to allow grouping by a rank of diagnoses.

45. The apparatus of claim 43, wherein at least one clinical view is an episodes view, and wherein at least one detailed view is associated with the episodes view, the at least one detailed view providing summary data obtained from claims data for a given episode.

46. The apparatus of claim 45, wherein the summary data is selected from the group consisting of data relating to conditions associated with the given episode, procedures associated with the given episode, test associated with the given episode, encounters associated with the given episode, medications associated with the given episode, and disease management data associated with the given episode.

47. The apparatus of claim 43, wherein at least one clinical view is a medications view, and wherein at least one detailed view is associated with the medications view, the at least one detailed view configured to allow a user to view prescriptions that were filled for a given medication.

48. The apparatus of claim 47, wherein the medications view comprises at least one therapeutic class categorization for the given medication.

49. The apparatus of claim 47, wherein the medications view is configured to provide a link to a payor'"'"'s formulary.

50. The apparatus of claim 41, wherein the clinical view is configured to select and aggregate diagnoses into a summary.

51. The apparatus of claim 41, wherein the at least one clinical view is configured to detail services for a specific condition, the services selected from the group consisting of encounters, procedures, lab tests, and diagnostic tests.

52. The apparatus of claim 41, wherein the at least one clinical view is configured to separate services into procedures, lab tests, diagnostic tests, and encounters.

53. The apparatus of claim 51, wherein the at least one clinical view is configured to categorize lab tests, diagnostic tests, and encounters.

54. The apparatus of claim 51, wherein the at least one clinical view is configured to aggregate claims data at a medication level.

55. The apparatus of claim 41, wherein displaying the common electronic health record comprises displaying a customized clinical view including presenting at least a portion of the claims data or disease management data in a customized form.

56. The apparatus of claim 41, wherein said application applies a series of rules to the claims data and the disease management data and determines which portions of the claims data and the disease management data to display in the clinical view.

57. The apparatus of claim 56, wherein applying the series of rules comprises grouping the claims data and the disease management data into categories.

58. The apparatus of claim 57, wherein grouping the claims data and the disease management data into categories comprises determining if the claims data or the disease management data contains sensitive data, and grouping sensitive claims data, sensitive disease management data, and any other sensitive data into a category containing sensitive data.

59. The apparatus of claim 58, wherein displaying a clinical view comprises requiring a predefined security authorization prior to including the sensitive data in the clinical view.

60. The apparatus of claim 41 wherein the integrated electronic health record is accessible through a web browser.

61. A method of providing a collaborative medical management environment among two or more users, comprising:

providing at least one integrated electronic health record, the integrated electronic health record comprising an aggregation of claims data and disease management data;

providing users with access to the integrated electronic health records; and

providing two-way communication among the users, allowing sharing of information among the users.

62. The method of claim 61, wherein the users are selected from the group consisting of provider users, care manager users, and patient users.

63. The method of claim 62, wherein the integrated electronic health record includes at least a care management clinical view comprising a patient care plan that includes a problem list, and wherein the sharing of information comprises one or more provider users reviewing care plan problems.

64. The method of claim 63, wherein reviewing care plan problems is selected from the group consisting of indicating agreement or disagreement with one or more care plan problems, prioritizing one or more of the care plan problems, adding a comment to one or more of the care plan problems, and adding one or more new care plan problems.

65. The method of claim 63, wherein at least one of a message or an alert is sent to one or more care manager users, the message or alert containing information that a change to the care plan has been made by a provider user.