Methods for Improving the Clinical Outcome of Patient Care and for Reducing Overall Health Care Costs

• US 20080262866A1
• Filed: 05/06/2005
• Published: 10/23/2008
• Est. Priority Date: 05/06/2004
• Status: Abandoned Application

• Current Assignee: Medencentive LLC
• Original Assignee: Medencentive LLC
• Inventors: Greene, Jeffrey C.
• Application Number:
  US11/596,305
• Publication Number:
  US 20080262866A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/087 Inventory or stock management, e.g. order filling, procurement or balancing against orders
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• 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 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

The current invention is directed to improve methods for providing health care and for reducing the cost of health care. Additionally, the methods of the current invention are designed to improve the clinical outcome for the patient. The methods of the current invention provide financial incentives to both the patient and the medical service provider in an integrated manner that create appropriate checks and balances which encourages patient empowerment as well as patient and medical practitioner accountability. The method of the current invention incorporates evidence-based medicine treatment guidelines and content, and dispenses information therapy and other similar types of content through an Internet application or by other means to improve the standard of health care treatment which leads to better clinical outcomes, healthier behavior, and a reduction in the overall cost of health care.

Claims

1. A method for delivering health care services comprising the steps of:

receiving a claim for compensation for medical services from a medical practitioner for medical treatment of a patient, said claim including at least one diagnosis code corresponding to at least one medical treatment received by said patient;

determining if at least one diagnosis code corresponds to a medical diagnosis found in a data base of medical diagnoses;

sending a notice to the medical practitioner when at least one diagnosis code submitted by said medical practitioner corresponds to a medical diagnosis found in said data base;

providing the medical practitioner access to a website, said website provides the medical practitioner with access to EBM treatment guidelines for said medical diagnosis;

said medical practitioner prescribes information therapy for said patient;

said medical practitioner provides said patient with instructions relating the medical diagnosis and a healthy lifestyle; and

,

said practitioner rating patient compliance with the prescribed information therapy and instructions relating to a healthy lifestyle.

2. A method for delivering health care services comprising the steps of:

receiving a claim for compensation for medical services from a medical practitioner for medical treatment of a patient, said claim including at least one diagnosis code corresponding to at least one medical treatment received by said patient;

determining if at least one diagnosis code corresponds to a medical diagnosis found in a data base of medical diagnoses;

sending a notice to the medical practitioner when at least one diagnosis code submitted by said medical practitioner corresponds to a medical diagnosis found in said data base;

providing the medical practitioner access to a website, said website provides the medical practitioner with access to EBM treatment guidelines for said medical diagnosis;

said medical practitioner prescribes information therapy for said patient, said information therapy includes guidelines for healthy behavior related to said medical treatment;

said practitioner rating patient compliance with the prescribed information therapy;

following prescription of information therapy, said website automatically generates a notice for transmission to said patient directing said patient to access said website; and

,

following the entry of a compliance rating by said medical practitioner, said website notifies said patient and provides said patient with the option of forwarding the compliance rating to the patient'"'"'s Health Plan and/or employer.

3. A method for delivering health care services comprising the steps of:

receiving a claim for compensation for medical services from a medical practitioner for medical treatment of a patient, said claim including at least one diagnosis code corresponding to at least one medical treatment received by said patient;

determining if at least one diagnosis code corresponds to a medical diagnosis found in a data base of medical diagnoses;

sending a notice to the medical practitioner when at least one diagnosis code submitted by said medical practitioner corresponds to a medical diagnosis found in said data base;

providing the medical practitioner access to a website, said website provides the medical practitioner with access to EBM treatment guidelines for said medical diagnosis;

said medical practitioner prescribes information therapy for said patient, said information therapy includes guidelines for healthy behavior related to said medical treatment;

said practitioner rating patient compliance with the prescribed information therapy;

following prescription of information therapy, said website automatically generates a notice for transmission to said patient directing said patient to access said website;

said website providing said patient with the means to access medical information relating to said medical diagnosis;

monitoring the access of said medical information by said patient;

providing said patient with a knowledge exam to determine said patient'"'"'s understanding of the medical diagnosis;

automatically scoring said knowledge exam;

providing said patient with the option of forwarding the knowledge exam results to patient'"'"'s Health Plan; and

,

providing said patient with the option of forwarding the compliance rating to the patient'"'"'s Health Plan and/or employer.

4. A system for delivering health care services comprising:

a website having a medical practitioner portion and a patient portion;

said medical practitioner'"'"'s portion being programmed to receive a coded claim for medical services rendered by said medical practitioner, comparing said coded claim to a database of medical diagnoses, if said coded claim matches a medical diagnosis in said database, then said website sends a notice to said medical practitioner directing the medical practitioner to access said website;

said medical practitioner portion of said website includes a database of EBM guidelines, patient names, dates of services provided and medical diagnoses;

said website provides for input of medical practitioner compliance with EBM guidelines;

said website provides for input by said medical practitioner of a patient'"'"'s compliance with prescribed treatment;

said website provides for tracking of medical practitioner during access of said website;

said patient portion of said website includes a database accessible by said patient;

said patient portion of said website provides said patient with a knowledge exam;

said patient portion of said website provides the means for forwarding patient results of said knowledge exam to a third party;

said patient portion of said website provides the means for forwarding the input provided by said medical practitioner of patient'"'"'s compliance with prescribed treatment to a third party.