METHOD FOR MEASURING HEALTH CARE QUALITY

• US 20120179487A1
• Filed: 03/22/2012
• Published: 07/12/2012
• Est. Priority Date: 04/20/2006
• Status: Active Grant

• Current Assignee: Jack Joseph Tawil
• Original Assignee: Jack Joseph Tawil
• Inventors: Tawil, Jack Joseph
• Granted Patent: US 8,392,215 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/02 Banking, e.g. interest calculation or account maintenance credit or loans G06Q40/03
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• 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

A method is presented for measuring the recovery of a medical treatment provider'"'"'s patients from a given medical condition. During treatment and recovery, a patient periodically takes a survey to report the current intensity of the signs and symptoms caused by his/her medical condition. The patient also assigns a weight to each sign/symptom, indicating the relative intensity of his/her desire to eliminate it. The product of the intensity of a sign or symptom and its corresponding weight measures the diminishment of quality of life. An outcomes measure, measurable in quality-adjusted life-years, compares a patient'"'"'s predicted recovery, which is rendered by an independent source at the time the patient'"'"'s diagnosis is determined, with the patient'"'"'s actual recovery. Outcomes measures for a provider'"'"'s patients with a given medical condition and with similar predicted recoveries are combined to produce an unbiased, risk-adjusted outcomes index that can be compared with that of other providers.

Claims

1. A method for measuring the performance of a medical treatment provider, comprising the steps of:

a) producing a set of reference recovery functions (RRFs) for each of a plurality of illnesses or injuries from historical patient data;

b) generating a predicted recovery score for a patient of said medical treatment provider by combining said set of RRFs and the prognosis rating of said patient for an episode of illness or injury, and where said prognosis rating is produced independently of said medical treatment provider;

c) administering a survey of the signs and symptoms of said patient, wherein;

each said sign or symptom is caused by said episode of illness or injury;

each said sign or symptom is assigned a score corresponding to said patient'"'"'s perception of the intensity of said sign or symptom; and

each said sign or symptom is assigned a weight corresponding to the relative intensity with which said patient desires to eliminate said sign or symptom;

d) calculating a survey score, comprising the normalized sum of the products of said sign-or-symptom scores and their corresponding said weights;

e) generating a personal recovery function by combining with said set of RRFs a plurality of said patient'"'"'s survey scores obtained at different times;

f) calculating an actual recovery score from said personal recovery function; and

g) calculating an outcomes measure by combining said predicted recovery score with said actual recovery score.

2. The method as claimed in claim 1, calculating for a medical treatment provider an outcomes index with respect to each prognosis rating group for a given illness or injury, comprising combining the outcomes measures of a plurality of said medical treatment provider'"'"'s patients within each said prognosis rating group for said illness or injury, whereby each said outcomes index is a measure of the performance of said medical treatment provider with respect to said prognosis rating group and said illness or injury.

3. The method as claimed in claim 2, providing a comparative report wherein the outcomes indices with respect to the same prognosis-rating group for a given illness are compared for a plurality of treatment providers.

4. The method as claimed in claim 3, further including a comparative report comprising a value chart depicting for said medical treatment providers the relationship between said outcomes index and the treatment cost, whereby the value of treatments administered by said medical treatment providers can be compared.

5. The method as claimed in claim 1, providing the self-administering of said survey by said patient.

6. The method as claimed in claim 1, providing said RRFs and said scores assigned to each said sign or symptom are expressed in units compatible with quality-adjusted life-years.

7. The method as claimed in claim 1, providing generating a set of RRFs for a given illness or injury, comprising the steps of ordering said survey scores, dividing said survey scores into n subsets and statistically fitting at least one mathematical function through said survey scores within each of said n subsets, whereby said statistically fitted functions for each said subset comprise an RRF;

each RRF is labeled RRF.sub.1 through RRF.sub.n;

RRF.sub.0 is a horizontal line below RRF.sub.1 that corresponds to the state of death; and

RRF.sub.n+1 is a horizontal line above RRF.sub.n that corresponds to the bliss state.

8. The method as claimed in claim 7, providing said method of ordering of said survey scores is selected from the methods ordering by survey scores and ordering by prognosis ratings, wherein the method of ordering by survey scores comprises the following steps:

a) computing the arithmetic mean of each of a plurality of survey score sets associated with a given illness or injury;

b) ranking said arithmetic means in descending order; and

c) dividing said rank ordered arithmetic means into n subsets, where each n corresponds to a prognosis rating group, and n is greater than 2;

and wherein the method of ordering by prognosis ratings comprises the following steps;

a) ranking in descending order said survey score sets with respect to their corresponding prognosis ratings; and

b) dividing said rank ordered prognosis ratings and their corresponding survey score sets into n subsets, where each n corresponds to a prognosis rating group, and n is greater than 2.

9. The method as claimed in claim 7, calculating a predicted score, PS, for said patient whose prognosis rating is x, according to the steps:

calculating the two areas A.sub.k′

+1 and A.sub.k′

, under the two RRF curves RRF.sub.k′

+1 and RRF.sub.k′

, where k′

+1 is the number of the RRF immediately greater than x and k′

is the number of the RRF immediately smaller than x; and

calculating said predicted recovery score as;

PS=(A.sub.k′

+[x−

int(x)](A.sub.k′

+1−

A.sub.k′

))/n,

where n is the highest possible survey score.

10. The method as claimed in claim 7, providing that said survey scores comprising a survey score set is further subdivided into a plurality of recovery phases;

then statistically fitting a mathematical function through the data points of the survey scores for each said recovery phase for each of said n subsets, whereby said RRF is comprised of a plurality of fitted functions, each fitted function corresponding to a recovery phase.

11. The method as claimed in claim 7, generating said personal recovery function for said patient, comprising the steps:

a) for each pair of consecutive survey scores, dividing the line segment connecting said survey scores into sub-segments, as necessary, such that each sub-segment lies wholly between two successive RRFs; and

b) interpolating the path of said personal recovery function between said survey scores such that said recovery function passes through both survey scores, the curvature of said recovery function is based on the curvatures of the RRFs immediately above and immediately below said line segment, and the curvature characteristics of said personal recovery function are a weighted average of the curvature characteristics of said RRFs, where the weights are inversely proportional to the vertical distances of said line segment from said RRFs.

12. The method as claimed in claim 11, calculating an actual recovery score from said recovery function comprising the following steps:

computing the area under each said sub-segment, totaling the areas under all said sub-segments and dividing the total area by the highest possible survey score.

13. The method as claimed in claim 1, updating said outcomes index of a provider to include outcomes measures of more recent patients of said provider and, optionally, dropping the outcomes measures of less recent patients with the same illness or injury.

14. The method as claimed in claim 1, providing the administrator of a health plan with a fully automated process for generating outcomes indices of medical treatment providers serving members of said health plan, whereby all of the data inputs required to produce outcomes indices are provided in digital form by patients and providers.

15. The method as claimed in claim 1, calculating an outcomes measure as

M.sub.dp*=(.SIGMA..sub.i RS.sub.idp/.SIGMA..sub.i years.sub.i)/I,

where RS is the actual recovery score, .SIGMA..sub.i years.sub.i is the total number of actual years over which the recovery scores are measured for the i-th patient, and I is the total number of patients.

16. The method as claimed in claim 1, calculating an outcomes measure as

M.sub.dp.sup.+=(.SIGMA..sub.i (RS.sub.idp/PS.sub.idp))/I,

where RS is the actual recovery score, PS is the predicted recovery score and I is the total number of patients.

17. The method as claimed in claim 1, calculating an outcomes measure as

M.sub.dp.sup.#=.SIGMA..sub.i RS.sub.idp/.SIGMA..sub.i PS.sub.idp, where RS is the actual recovery score and PS is the predicted recovery score

18. The method as claimed in claim 1, statistically estimating an outcomes measure as

Y.sub.idp=b.sub.0+b.sub.1 M.sub.idp*+b.sub.2 M.sub.idp.sup.# +b.sub.3 PR.sub.idp+b.sub.4 ln Q.sub.idp+u,

where M.sub.dp*=(.SIGMA..sub.i RS.sub.idp/.SIGMA..sub.i years.sub.i)/I;

M.sub.dp.sup.#=.SIGMA..sub.i RS.sub.idp/.SIGMA..sub.i PS.sub.idp;

PR is the prognosis rating;

ln Q is the natural logarithm of the number of times the provider has performed the treatment; and

u is a random error term.

19. The method as claimed in claim 1, statistically estimating for patients with co-morbidities the relationship:

Y=a.sub.0+a.sub.1 A+b.sub.1 D.sub.1+ . . . +b.sub.n D.sub.n+c.sub.1 P.sub.1+ . . . +c.sub.n P.sub.n+d.sub.1 D.sub.1 D.sub.2+d.sub.2 D.sub.1 D.sub.3+ . . . +u,

where A is the age of said patient, D.sub.d (d=1, . . . , n) is a dummy variable with a value of 1 if the illness d is present, 0 if it is not present, D.sub.d D.sub.d′

is a term for the interaction between illness d and illness d′

, P.sub.d is the prognosis rating for illness d, where P.sub.d=0 if illness d is not present, Y is the time between the patient'"'"'s original diagnosis and the time of death, a.sub.0, a.sub.1, b.sub.1, . . . , b.sub.n, c.sub.1, . . . , c.sub.n, d.sub.1, . . . , d.sub.n, are parameters to be estimated, and u is a randomly distributed error term;

20. The method as claimed in claim 1, determining any expected loss of life attributable to a diagnosed illness and its treatment, comprising, for a patient with given risk factors prior to said diagnosis, comparing the pre-diagnosis probability distribution of the life expectancy of a population with said risk factors with the probability distribution of the life expectancy for a preferably deceased population with said patient'"'"'s risk factors, diagnosed illness and its treatment, whereby any expected loss of life can be determined by a person skilled in the art.