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SYSTEM AND METHOD USING A PREDICTIVE MODEL FOR NURSE INTERVENTION PROGRAM DECISIONS

  • US 20110137672A1
  • Filed: 12/09/2009
  • Published: 06/09/2011
  • Est. Priority Date: 12/09/2009
  • Status: Active Grant
First Claim
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1. A computer system for facilitating provisioning of nurse intervention program, comprising:

  • a data storage module for receiving, storing, and providing access to data related to historical claim information, including historical injury information and historical claim result information, and to current claim transactions, including current claim transaction injury information;

    a predictive model component, coupled to the data storage module, for determining whether to identify one of said current claim transactions for referral to the nurse intervention program;

    a computer processor for executing programmed instructions and for storing and retrieving said data related to current claim transactions;

    program memory, coupled to the computer processor, for storing program instruction steps for execution by the computer processor;

    a model training component, coupled to the computer processor, for training the predictive model component based on the data related to the historical claim information in accordance with program instructions stored in the program memory and executed by the computer processor, thereby providing a trained predictive model component;

    an output device, coupled to the computer processor, for outputting an output indicative of whether said one of said current claim transactions should be referred to the nurse intervention program, wherein the computer processor generates the output in accordance with program instructions in the program memory and executed by the computer processor, said output generated in response to a notice of injury received in connection with said one of said current claim transaction and being based on an application of data for said one of said current claim transactions to the trained predictive model component; and

    a routing module for directing workflow based on the output from the output device.

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