SYSTEM AND METHOD FOR GENERATING REAL-TIME HEALTH CARE ALERTS
First Claim
1. A method of providing a customized real-time medical alert to an individual patient via an electronic patient interface, the method comprising:
- establishing a set of clinical rules from available evidence-based medical standards, at least one such rule defining an expected mode of care given a particular set of clinical data;
interfacing with at least one network service for receiving medical care information relating to the patient, the at least one network service having real-time access to at least one source of data, including claims data reflecting clinical information relating to the patient obtained from at least one health care provider and submitted in connection with a claim under a health plan;
organizing the collected medical care information into a medical data file for the patient and storing the medical data file, the medical data file comprising patient clinical data, the patient clinical data indicating an actual mode of care provided to the patient;
in response to receiving the medical care information relating to the patient, applying the set of clinical rules to the contents of the medical data file in real-time to identify at least one alert based on the patient clinical data, and storing an indicator of the at least one alert in the medical data file;
interfacing with the at least one network service for sending the at least one alert to the electronic patient interface in real-time, the at least one alert automatically generated based on the presence of the alert indicator in the medical data file and comprising an explanation of circumstances underlying the at least one alert and a suggestion for patient follow up; and
displaying the at least one alert for the patient via the electronic patient interface.
1 Assignment
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Accused Products
Abstract
An automated system is described for presenting a patient with an online interactive personal health record (PHR) capable of delivering individualized alerts based on comparison of evidence-based standards of care to information related to the patient'"'"'s actual medical care. A health care organization collects and processes medical care information, including clinical data relating to a patient in order to generate and deliver customized clinical alerts and personalized wellness alerts directly to the patient via the PHR. The PHR also solicits the patient'"'"'s input for tracking of alert follow-up actions and allows the health care organization to track alert outcomes. Further embodiments include implementing a plurality of modules for providing real-time processing and delivery of clinical alerts and personalized wellness alerts to the patient via the PHR and to a health care provider via one or more health care provider applications, including disease management applications.
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Citations
25 Claims
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1. A method of providing a customized real-time medical alert to an individual patient via an electronic patient interface, the method comprising:
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establishing a set of clinical rules from available evidence-based medical standards, at least one such rule defining an expected mode of care given a particular set of clinical data; interfacing with at least one network service for receiving medical care information relating to the patient, the at least one network service having real-time access to at least one source of data, including claims data reflecting clinical information relating to the patient obtained from at least one health care provider and submitted in connection with a claim under a health plan; organizing the collected medical care information into a medical data file for the patient and storing the medical data file, the medical data file comprising patient clinical data, the patient clinical data indicating an actual mode of care provided to the patient; in response to receiving the medical care information relating to the patient, applying the set of clinical rules to the contents of the medical data file in real-time to identify at least one alert based on the patient clinical data, and storing an indicator of the at least one alert in the medical data file; interfacing with the at least one network service for sending the at least one alert to the electronic patient interface in real-time, the at least one alert automatically generated based on the presence of the alert indicator in the medical data file and comprising an explanation of circumstances underlying the at least one alert and a suggestion for patient follow up; and displaying the at least one alert for the patient via the electronic patient interface. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19)
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20. A system for providing a customized medical alert to an individual patient via an electronic patient interface, the system comprising:
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a database for maintaining medical care information relating to the patient through a real-time application messaging module comprising at least one network service, the at least one network service having real-time access to at least one source of data, including claims data reflecting clinical information relating to the patient obtained from at least one health care provider and submitted in connection with a claim under a health plan; a rules engine for applying a set of clinical rules to the contents of the database in real-time and identifying an instance where the patient'"'"'s actual care as indicated by the patient clinical data is inconsistent with an expected mode of care defined by at least one of the clinical rules, and storing an indicator of the instance in the database, wherein the set of clinical rules is established from available medical standards; and an electronic patient interface for receiving an alert from the at least one network service in real-time and displaying the alert to the patient, the alert automatically-generated based on the presence of the indicator in the database and comprising an explanation of circumstances underlying the identified instance and a suggestion for patient follow up. - View Dependent Claims (21, 22, 23, 24)
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25. A computer readable medium having stored thereon computer executable instructions for providing a customized real-time medical alert to an individual patient via an electronic patient interface, the instructions comprising:
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establishing a set of clinical rules from available medical standards, at least one such rule defining an expected mode of care given a particular set of clinical data; interfacing with at least one network service for receiving medical care information relating to the patient, the at least one network service having real-time access to at least one source of data, including claims data reflecting clinical information relating to the patient obtained from at least one health care provider and submitted in connection with a claim under a health plan; organizing the collected medical care information into a medical data file for the patient and storing the medical data file, the medical data file comprising patient clinical data, the patient clinical data indicating an actual mode of care provided to the patient; in response to receiving the medical care information relating to the patient, applying the set of clinical rules to the contents of the medical data file in real-time to identify at least one alert based on the patient clinical data, and storing an indicator of the at least one alert in the medical data file; interfacing with the at least one network service for sending the at least one alert to the electronic patient interface in real-time, the at least one alert automatically-generated based on the presence of the alert indicator in the medical data file and providing an explanation of circumstances underlying the at least one alert and a suggestion for patient follow up; and displaying the at least one alert for the patient via the electronic patient interface.
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Specification