System and Method for Producing Performance Reporting and Comparative Analytics for Finance, Clinical Operations, Physician Management, Patient Encounter, and Quality of Patient Care

• US 20130054260A1
• Filed: 08/24/2012
• Published: 02/28/2013
• Est. Priority Date: 08/24/2011
• Status: Abandoned Application

• Current Assignee: Paul Evans
• Original Assignee: Paul Evans
• Inventors: Evans, Paul
• Application Number:
  US13/594,413
• Publication Number:
  US 20130054260A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/06 Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof

Abstract

The business performance management platform system and method enables the capture, extraction, data auditing and data validation processes, combined cost accounting and analytical reporting of data required for certain combined financial, clinical operations, physician encounter, patient encounter, electronic health record, and quality of patient care measures; provides close to real-time data access and performance results; provides financial, operational, clinical, physician encounter, patient encounter, electronic health record, and quality performance dashboards and scorecards, summary level reports, Ad hoc reporting, alerting, emailing, and automated reporting and email distribution, alerting, and modeling functions. The results generated from the business performance management platform provide users of the system critical understanding of detailed and summary level data and information, such as: profit/loss characteristics across the longitudinal data elements associated with patient and physician level detail; cost at patient and physician level; expected revenues; payer performance from payer sources and clinical operations performance.

Claims

1. A computer system providing a business performance management platform, comprising:

a) a data extraction, integration, monitoring, auditing, validation, and processing facility for determining data loading readiness by an individual site or a department;

b) a data mapping and normalization system that accepts, transforms, validates, and audits data prior to loading raw data;

c) a cost accounting system that performs at least two of the following;

i) accepts the normalized data to process relevant cost allocations to longitudinal patient level detail;

ii) performs cost accounting at the charge code level and reports on both detailed and consolidated levels;

iii) incorporates weighted Diagnosis Related Groupings (DRG'"'"'s) to allocate costs for non-patient attributable services;

generates reconciliations and audits;

iv) generates a series of pre-designed cost accounting reports that provide detailed general ledger amounts fully allocated down to the patient level;

v) distributes costs to individual activities and services down to the charge description master for inpatient and outpatients;

vi) captures cost components;

vii) integrates reclassification rules and non-standard cost definitions; and

viii) provides automated schedule of allocations to run at user specified times;

d) a logical stored data procedures that holds industry-specific calculations and performs at least 2 of the following;

i) generates a series of pre-designed reports that provide detailed and summary level details at the individual patient, physician, organization, or responsible party level;

ii) performs routine updates to reports based on preferred schedule by individual site or user.

iii) allows users automated report access with ability to customize reports based on security level and job function;

e) a user interface comprising dashboards, scorecards, summary level reports, detailed analytics reports, comparative benchmarking alerting and email distribution that are securely made available by an individual user through HTTPS web protocols;

f) wherein said platform combines the financial data (such as cost, revenues, profitability, etc.), clinical operations (such as operating room, emergency department, radiology department, laboratory department, physician, electronic health records, patient encounter, labor, resource utilization, materials, quality of patient care, etc.), and relative 3^rd party data (such as patient satisfaction, State patient data, etc.) with processed cost accounting data into a multi tenant data warehouse; and

g) wherein said platform enables users to access near real time results of performance metrics associated with financial, clinical operations, physician, patient encounter, and quality of patient care characteristics of a user'"'"'s healthcare facilities from summary of patient or physician level data to analyze results such as statistics, physician and labor utilization, costs, revenues, patient volumes, patient admissions, patient discharges, patient readmissions, patient throughput, scheduling, case mix, payer mix, patient population care, and overall profitability tied to patient care for an individual or a group of healthcare facilities.

2. The system of claim 1, further comprising a central database for storing captured data, the captured data including patient accounting, clinical operations data resource utilization data, electronic health record/electronic medical record data, and/or 3^rd party data.

3. The system of claim 1, further comprising a central database for storing captured data, the captured data including patient accounting, general ledger, clinical operations data such as operating room, emergency department, radiology department, laboratory department, pharmacy department, labor, materials, resource utilization data, electronic health record/electronic medical record data, quality of care data, patient satisfaction data, etc., and/or 3^rd party data, comprising a method for determining data loading readiness by system administrator(s) and customer support personnel, an individual user, site, or department utilizing one of:

a) Multi Tenant Data Warehouse facility that organizes and stores the normalized data;

b) a Client Data Mart;

c) an Audit Facility to determine if all data is accurate and loaded; and

d) a Security Facility to ensure data is only available to end users and that have been assigned by system administrator with secure system login credentials featuring user name and passwords.

4. The system of claim 2, wherein a retrieval component is employed to retrieve captured data from the central database.

5. A method for providing a business performance management platform, comprising:

a) enabling end user access through a Reporting Facility that provides access to normalized data that is combined with stored query logic (SQL) to produce results to end users;

b) providing end user access through a User Interface Facility;

i) written in HTML, Java, Opensource or similar web development code;

ii) including user experience of selecting standard reports and analytics for dynamic or drill down;

iii) including dashboards, charts, reports displayed to enable users with visual representation of data for trending, alerting users of performance by department, service line, individual, group of individuals, or other Color coding of data or groups of data within charts, graphs or reports that can be customized by end user or system administrator(s) in order to signify status of performance

iv) including an Ad hoc reporting facility for manipulating data, creating and retrieving reports;

v) converting or exporting to other reporting or data manipulation tools and applications;

vi) distributing manually on demand through email, SMS, or other services; and

vii) distributing automatically through Web Services Facility functions over email, SMS, or other services;

c) managing data retrieval logic through a Web Services Facility securely through a Firewall Facility; and

d) accessible over HTTPS through a Web Browser Facility, an RSS facility, an SMS facility, an SMTP Facility.

6. A method for providing a business performance management platform, comprising:

assessing one of a Data Source File'"'"'s origin or source using a data validation facility that includes information relating to a site'"'"'s location or the time it was received;

if the Data Source File'"'"'s origin or source is from a known system, then;

a) transferring the Data Source File into a staging area within the computer system and performing a data audit to determine whether a Data Source File is either incomplete or failed;

b) generating an automated report if the data source file is either incomplete or complete;

c) identifying a user name and facility name for the incomplete or complete Data Source File;

d) sending the automated report to a system administrator responsible for the Data Source File, said automated report indicating whether the data Source File is within a standard deviation selected by the system administrator or whether it is outside the standard deviation; and

e) alerting the system administrator that a Data Source File was not complete or not received in time to update the business performance management platform.

7. A method for data extraction from within a host source computer system comprising:

a) determining if a host Data Source File comprises a list of data elements expected from host computer system

b) generating a Data Source File using SQL, NPR, HL7, CSV, or similar data extract processes

c) creating a completed Data Source File within the host computer system

d) transferring the Data Source File to a spool group file server within the host computer system

e) readying the Data Source File to be transferred from the host computer system

f) transferring the Data Source File to one of a network server drive or a location where the data source file can be either processed or compressed by the host computer system using a secure data encryption process;

detecting a presence of an encrypted. Data Source File;

i) Logging each of a date, time, type, and size of the encrypted Data Source File;

ii) Transferring the encrypted Data Source File using either a SFTP or WinSCP process;

iii) Retrieving Data Source File by employing a secure login process;

iv) Unzipping the Data Source File

v) Transferring the Data Source File to a Data Validation Facility;

g) determining data readiness of the data source file by employing the Data Validation Facility;

h) verifying whether an SFTP process performed on the Data Source File is complete;

i) notifying a system administrator automatically through email or via a SMS of the readiness of the Data Source File;

j) determining if the Data Source File should be automatically transferred to a Data Audit Facility by;

i) assessing the data accuracy of the Data Source File as compared to a customized standard deviation that is stored in the Data Audit Facility, whereby if it is determined that the Data Source File are inaccurate or outside the custom standard deviation, an auto-generated message is sent to the Data Source File system administrator(s) to trouble shoot and restart the SFTP process;

or determined that the SFTP process is successful, the host of the Data Source File is sent to a data server using SFTP and an email notification is sent;

k) Transferring the Data Source File that is accurate to a Data Mapping and Loading facility;

l) processing the accurate Data Source File from the Data Audit Facility to the Data Mapping and Loading Facility;

m) loading the data source files into the Raw Data Store facility;

n) normalizing the data source data;

o) transferring the data source data to either to a Cost Accounting facility or the central database; and

p) readying the normalized data for end user access.