SYSTEM AND METHOD TO ASSIST HEALTH ADVOCATE PROFESSIONALS AND EMPLOYERS

• US 20110288876A1
• Filed: 05/19/2010
• Published: 11/24/2011
• Est. Priority Date: 05/19/2010
• Status: Abandoned Application

• Current Assignee: Health Advocate
• Original Assignee: Health Advocate
• Inventors: Messina, Daniel, Johnston, Kelly, Cardillo, Michael
• Application Number:
  US12/783,241
• Publication Number:
  US 20110288876A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance
• 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

Abstract

A computer-assisted method for assisting a health advocate professional in counseling employees of a plan sponsor comprising receiving health records of employees of a plan sponsor, analyzing data in the records, displaying the analyzed data for any selected employee in dashboard format, calculating any health improvement options for the selected employee, and displaying the health improvement options in the form of questions to be asked by a health advocate professional viewing the displayed dashboard, preferably arranged in categories under spotlight buttons, and a computer system adapted to carry out the method. The method and system can also provide in some embodiments summary medical benefits usage information to plan sponsors, including costs, health improvement options, return on investment.

Claims

1. A method for assisting a health advocate professional in counseling employees of a plan sponsor comprising

receiving health records of employees of a plan sponsor;

analyzing data in the records;

displaying the analyzed data for any selected employee in dashboard format;

calculating any health improvement options for the selected employee; and

displaying the health improvement options in the form of questions to be asked by a health advocate professional viewing the displayed dashboard.

2. The method of claim 1 further comprising displaying a set of categories in spotlight format and a customized question to be asked relating to one of the categories when the corresponding spotlight is selected.

3. The method of claim 1 further comprising analyzing the health history and profile of a selected employee and displaying a set of categories in spotlight format and a customized question relating to one of the categories when the corresponding spotlight is selected, wherein the categories displayed fit the selected health history and profile of the selected employee based on a set of preprogrammed criteria.

4. The method of claim 1 further comprising displaying at least one spotlight button within the dashboard for a category selected from the group consisting of disease management, lifestyle coaching, prescription compliance, and medical test which, when clicked on or selected by the health advocate professional, automatically displays a question and a field for the health advocate professional to enter an answer, and record any answers in the record of the employee.

5. The method of claim 1 further comprising

receiving data from a human resource management system of the plan sponsor;

receiving data from a health care provider for employees of the plan sponsor;

receiving data from a health benefit vendor; and

updating the records as the data is received.

6. The method of claim 1 further comprising generating a plan sponsor interface which displays in dashboard format summaries of medical benefit usage by employees, risk factors, health insurance eligibility and usage, and contacts with a benefits provider.

7. The method of claim 1 wherein the health advocate professional dashboard displays data comprising an employee'"'"'s name and one or more of the employee'"'"'s medical plan, medical plan deductibles, amount of medical plan deductible met, medical plan co-pays, pharmacy plan, pharmacy plan deductibles, amount of pharmacy plan deductible met, pharmacy co-pays, smoking, weight, blood pressure, cholesterol, diabetes, asthma, high stress, sedentary behavior, heart disease risks, and program participation.

8. A computer system for assisting a health advocate professional in counseling employees of a plan sponsor comprising

a module adapted to receive a plurality of data feeds relating to records of employees of a plan sponsor from sources comprising the plan sponsor'"'"'s human resources management system, and one or more health benefit vendors and store the records;

a module adapted to display a selected record in dashboard format; and

a module adapted to calculate any health improvement options in the form of questions to be asked by the health advocate professional viewing the displayed dashboard for the selected employee.

9. The computer system of claim 8 further comprising

a module adapted to generate a plan sponsor interface for presenting aggregated statistics calculated from the data feeds relating to employee benefits, medical benefit usage by employees, risk factors, health insurance eligibility and usage, and contacts with a benefits provider;

and

the system adapted to display the plan sponsor interface to a plan sponsor representative and to display the personal health advocate interface to the personal health advocate in dashboard format and to receive data from a personal health advocate interacting with the dashboard display.

10. The computer system of claim 8 further comprising

a module adapted to analyze the data and to calculate appropriate risk area information and recommended intervention program information and display the risk area information and intervention program information in the employee interface;

and

a module adapted to generate the summary risk area information and the summary recommended intervention program information in the plan sponsor interface.

11. The computer system of claim 8 further comprising

a module adapted to plan sponsor to calculate return on investment based on improvements in one or more of absenteeism, pharmacy benefit usage, wellness, and disease management.

12. The computer system of claim 8 further including:

a health care provider user interface for receiving information about an employee of the plan sponsor pertinent to a prevention plan for the employee.

13. The computer system of claim 8 wherein the plan sponsor display includes current and historical plan sponsor insurance cost information calculated from the data.

14. The computer system of claim 8 wherein a set of categories customized to fit the health profile of an individual employee is displayed in spotlight format, questions customized to fit the profile are displayed when any of the spotlights is selected, and a field for answers to the questions to be entered by the health advocate professional is displayed.

15. A computer-assisted method for tracking employee health care-related costs and employee health care effectiveness of a plan sponsor having a population of employees comprising:

receiving a plurality of data feeds from sources comprising a plan sponsor human resources management system, one or more health care providers, and an employee self-reporting computer system;

calculating statistical information from the data; and

generating a plan sponsor dashboard interface for presenting the statistical information relating to employee benefits, medical benefits usage by employees, risk factors, health insurance eligibility and usage, and contacts with a benefits provider.

16. The computer-assisted method of claim 15 comprising

generating a personal health advocate dashboard interface for presenting individual-specific statistics calculated from the data relating to employee benefits, medical coverage, and risk factors;

displaying the plan sponsor dashboard interface to a plan sponsor representative and displaying the personal health advocate dashboard interface to the personal health advocate;

receiving data from a personal health advocate interacting with the dashboard display;

calculating levels of risk and need for intervention from the data; and

generating a prevention plan based on the levels of risk and need for intervention for display on the health care advocate dashboard interface or plan sponsor dashboard interface.

17. The method of claim 15 wherein the plan sponsor dashboard interface comprises one or more of employee statistics, return on investment factors, long term disability participant information, preventative care statistics, disease management statistics, wellness statistics, prescription statistics, medical benefits statistics, employee demographics, and productivity benchmarks.

18. The method of claim 15 wherein the health care advocate dashboard interface comprises employee-specific data comprising one or more of general information, medical coverage, prescription coverage and usage, dental plan, and risk areas.

19. The method of claim 15 further including generating a health care provider dashboard interface for receiving information about an employee of the plan sponsor pertinent to a prevention plan for the employee.

20. The method of claim 15 further including calculating current and historical plan sponsor insurance cost information from the data.

21. The method of claim 15 wherein the health benefits vendors are selected from employee assistance programs, disease management vendors, long term disability vendors, wellness vendors and the health care insurers are insurance companies.