PHYSICIAN ACCREDITATION SYSTEM WITH MECHANISM FOR AUTOMATED RECORDS EXTRACTION

• US 20110125522A1
• Filed: 02/08/2011
• Published: 05/26/2011
• Est. Priority Date: 10/30/2006
• Status: Abandoned Application

• Current Assignee: National Committee for Quality Assurance
• Original Assignee: National Committee for Quality Assurance
• Inventors: KAPLAN, Robert E., MCGURRIN, James
• Application Number:
  US12/961,128
• Publication Number:
  US 20110125522A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

A system for accrediting physicians based on pre-determined best practices by examining the records for a subset of the physician'"'"'s patients as measured against a set of criteria for the desired accreditation. The system provides a mechanism for automatically extracting patient records from a physician'"'"'s electronic health records (EHR) system, thus minimizing the risks of data entry error and minimizing the risk of physician falsification of data. The system also provides security and privacy in order to avoid the malicious theft or accidental disclosure of patient records. The system further allows physicians to review and approve a submission before it is finally copied into the review system, allowing for correction of a submission where, for example, the wrong patient was included. The system also isolates patient data so that no user of the system has access to confidential information, apart from the physician.

Claims

1. A distributed computer system for accrediting a health care provider comprising:

a first database comprising health records associated with said health care provider;

a records extraction system connected to the first database, the records extraction system comprising;

an extraction module configured to copy selected health records, translate the selected health records into a pre-specified XML format, store the translated health records in a single XML file, encrypt the XML file using a pre-specified encryption scheme, and transmit the encrypted XML file across a network,

a data collection server, wherein the data collection server receives the encrypted XML file, decrypts the encrypted XML file using the pre-specified encryption scheme, translates the XML file into an internal data storage format comprising health care review data records, and computes a preliminary accreditation score for the health care review data records, and

an extraction database for temporarily storing the health care review data records; and

a physician review system connected to the records extraction system for receiving and scoring the stored health care review data records from the extraction database.

2. The distributed computer system of claim 1 further comprising a review database connected to the physician review system to store the received health care review data records.

3. The distributed computer system of claim 1, wherein the records extraction system forwards the preliminary accreditation score to the health care provider.

4. The distributed computer system of claim 3, wherein the records extraction system is adapted to receive an approval signal from the health care provider, and the records extraction system does not forward stored health care review data records to the physician review system until the records extraction system receives the approval signal from the health care provider.

5. The distributed computer system of claim 1, wherein the extraction module is further configured to certify the selected health records.

6. The distributed computer system of claim 5, wherein the certifying of the selected health records by the extraction module comprises verifying that the health records conform with a desired format.

7. The distributed computer system of claim 5, wherein the certifying of the selected health records by the extraction module comprises searching the health records for pre-specified data, and rejecting health records containing said pre-specified data.

8. The distributed computer system of claim 1, wherein the extraction module operates in batch mode to collect the health records periodically.

9. The distributed computer system of claim 1, wherein the extraction module operates in real time to collect the health records when updated.

10. The distributed computer system of claim 1, wherein the healthcare provider is a first healthcare provider, and wherein the distributed computer system further comprises a second database comprising health records associated with a second health care provider, wherein the records extraction system is connected to both the first and the second databases, and wherein the physician review system receives and scores the stored health care review data records for both the first and the second health care providers.

11. A health care provider accreditation method comprising:

providing a first database comprising health records;

extracting said health records, said extracting step comprising copying selected health records, translating the selected health records into a pre-specified XML format, storing the translated health records in a single XML file, encrypting the XML file using a pre-specified encryption scheme, and transmitting the encrypted XML file across a network to a data collection server;

said data collection server decrypting the encrypted XML file using the pre-specified encryption scheme, translating the XML file into an internal data storage format comprising health care review data records, and computing a preliminary accreditation score for the health care review data records;

temporarily storing the health care review data records; and

transmitting the health care review data records to a physician review system for scoring the stored health care review data records.

12. The health care provider accreditation method of claim 11 further comprising the physician review system storing the received health care review data records.

13. The health care provider accreditation method of claim 11 further comprising the step of forwarding the preliminary accreditation score to the health care provider.

14. The health care provider accreditation method of claim 13 further comprising receiving an approval signal from the health care provider, wherein stored health care review data records are not forwarded to the physician review system until the approval signal from the health care provider is received.

15. The health care provider accreditation method of claim 11 further comprising the step of certifying the selected health records.

16. The health care provider accreditation method of claim 15, wherein the certifying of the selected health records comprises verifying that the health records conform with a desired format.

17. The health care provider accreditation method of claim 15, wherein the certifying of the selected health records comprises searching the health records for pre-specified data, and rejecting health records containing said pre-specified data.

18. The health care provider accreditation method of claim 11, wherein the health records are collected periodically.

19. The health care provider accreditation method of claim 11, wherein the health records are collected automatically when updated.

20. An automated health care provider accreditation system for acquiring and scoring stored health records associated with a health care provider;

the system comprising a records extraction system connected to the first database, the records extraction system configured to copy selected health records, translate the selected health records into a pre-specified XML format, store the translated health records in a single XML file, encrypt the XML file using a pre-specified encryption scheme, and transmit the encrypted XML file across a network;

a data collection server configured to receive the encrypted XML file, wherein a data collection server decrypts the encrypted XML file using the pre-specified encryption scheme and translates the XML file into an internal data storage format comprising health care review data records; and

a physician review system configured to receive and score the stored health care review data records.