AUTOMATED HEALTH CARE DELIVERY VERIFICATION

• US 20130226607A1
• Filed: 02/28/2013
• Published: 08/29/2013
• Est. Priority Date: 02/28/2012
• Status: Abandoned Application

• Current Assignee: Assura Technology Group LLC
• Original Assignee: Assura Technology Group LLC
• Inventors: Woody, William F., Holzer, Daryl M., Dunbar, Ronald S., Ogg, Joseph R., Stewart, John C., Monahan, Bradley J., Bledsoe, Benjamin E., Ogg, Mickey K., Kramer, Bruce A., Spoonemore, Tracey E., Rose, Kevin M., Mason, Mark H., Bates, Zachery D., Wetzel, Joel D., Brown, Michael JC, DeMars, Melinda L.
• Application Number:
  US13/779,757
• Publication Number:
  US 20130226607A1
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/063114 Status monitoring or status determination for a person or group
• 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 40/60 for the operation of medical equipment or devices

Abstract

A health service system is described herein that uses commonly available modern mobile computing devices to enhance the delivery and verification of health care services. Information automatically collected from mobile devices can corroborate a timesheet, mileage log, or other information submitted by caregivers. The system provides a comprehensive suite of verification technologies. For example, the system may capture photographic evidence of the visit (e.g., a picture of the patient, caregiver, or both together), GPS location and time information, biometric information (e.g., a fingerprint, retina scan, or other biometric signature from the patient and/or caregiver), and so forth. Thus, the health service system improves the delivery of and payment for health care services by helping each party to collect and provide the information associated with verification in a less obtrusive and more automated manner.

Claims

1. A computer-implemented method to receive care verification information from a mobile device associated with a caregiver, the method comprising:

receiving service information that defines a particular instance of a service to be performed, wherein the service information identifies a particular client to receive the service, a particular caregiver to perform the service, and one or more service actions that comprise successful completion of the service;

identifying the client, caregiver, and service actions received and determining activity of the caregiver to be monitored to verify that the service actions are performed;

collecting activity monitoring information that substantiates service actions performed by the caregiver;

detecting performance of one or more identified service actions based on the collected activity monitoring information; and

storing results of the detection of performance of actions on a storage device associated with the caregiver,

wherein the preceding steps are performed by at least one processor.

2. The method of claim 1 wherein receiving service information comprises at least one of identifying the client by name and address, identifying the caregiver by name and employee number, and identifying the service actions by description.

3. The method of claim 1 wherein receiving service information comprises a mobile device carried by the caregiver that connects to a service from which the mobile device receives the service information.

4. The method of claim 1 wherein receiving service information comprises the caregiver running a particular application on a mobile device that collects the service information automatically.

5. The method of claim 1 wherein receiving service information comprises automatically detecting service actions that the caregiver intends to perform using geo-fencing based on the caregiver'"'"'s location.

6. The method of claim 1 further comprising detecting that the caregiver has arrived at a particular client'"'"'s location, and prompting the caregiver with a list of tasks to be performed for the day.

7. The method of claim 1 wherein determining activity to be monitored comprises taking a pictures of the caregiver and client together upon arrival.

8. The method of claim 1 wherein collecting activity monitoring information comprises automatically collecting information from one or more sensors of the caregiver'"'"'s mobile device.

9. The method of claim 1 wherein collecting activity monitoring information comprises collecting at least one of times, locations, photographic or audiovisual evidence, textual information, and biometric information that can be collected at the client site by a mobile device.

10. The method of claim 1 wherein collecting activity monitoring information comprises collecting information at particular times including upon arrival and departure from the client site.

11. The method of claim 1 wherein collecting activity monitoring information comprises adhering to privacy rules applicable in a particular jurisdiction, and limiting the information collected without explicit authorization based on the privacy rules.

12. The method of claim 1 wherein detecting performance of service actions comprises detecting that a sufficient amount of time was spent in a particular sub-location within a house where a particular service action is performed.

13. The method of claim 1 wherein detecting performance of service actions comprises receiving confirmation from the client that an action was performed.

14. The method of claim 1 wherein storing results of detection comprises uploading stored results of detection to a central service.

15. A computer system for automated verification of delivery of healthcare services, the system comprising:

a mobile device associated with a caregiver and carried with the caregiver to a client location, the mobile device comprising;

a service interface component that communicates between the mobile device and a central service to send monitoring data captured at the mobile device to the service, and to receive information from the service for delivery to the caregiver using the mobile device;

one or more hardware sensors that sample environmental information present around the mobile device during its use, wherein the environmental information provides evidence that a particular healthcare service was performed;

a location detection component that detects a present location of the mobile device at various times based on available hardware sensors for determining location to verify a caregiver'"'"'s location when a particular healthcare service is performed; and

a monitoring component that collects verification information available from the location detection component and the one or more hardware sensors and sends the information using the service interface component to the central service; and

a central service that includes one or more central servers, datacenters, or a cloud-based computing service, the central service comprising;

a device interface component that communicates with the mobile device and receives verification information from the mobile device that substantiates whether one or more healthcare services were performed, by which caregiver the services were performed, and on which client'"'"'s behalf the services were performed;

a verification data store that stores verification information received from the mobile device in one or more storage device;

a rules engine that manages rules that express differences and requirements for service verification from each payer for which the system collects verification information;

a data analysis component that analyzes verification information submitted by the mobile device to identify trends and draw conclusions from the information related to verifying whether healthcare services were performed as requested;

a challenge component that provides dynamic challenges to caregivers at particular times, where a challenge represents a tool for determining whether the caregiver is in possession of a particular mobile device at a specific time; and

a dynamic trust component that dynamically determines a level of verification to request from a particular caregiver based on a historical pattern of trust established with the caregiver.

16. The system of claim 15 wherein the service interface component comprises an offline mode that allows a caregiver to use the mobile device with no real-time connectivity to the central service that to capture information that can later be transferred from the mobile device to the central service upon availability of a connection between the mobile device and central service.

17. The system of claim 15 wherein the central service provides a central location where multiple mobile devices carried by potentially many caregivers can report monitoring data related to services rendered by the caregivers to clients.

18. The system of claim 15 wherein the central service analyzes collected verification data and provides various reports available to at least one of caregivers, payers, clients, and an operator of the service.

19. The system of claim 15 wherein the rules engine includes at least one rule that identifies an entity that pays for a healthcare service and particular verification information requested by the entity as proof that a particular service was performed.

20. A computer-readable storage medium comprising instructions for controlling a computer system to analyze information at a health care service provided by one or more mobile devices associated with caregivers, wherein the instructions, upon execution, cause a processor to perform actions comprising:

receiving information verifying performance of one or more healthcare services from one or more mobile devices carried by caregivers;

analyzing received verification information to detect anomalies in the received verification information and to identify any areas for further investigation and verification;

loading one or more audit rules managed by a rules engine that stores rules related to one or more payers for healthcare services, wherein each rule specifies one or more types of information the receipt of which the payer requests to receive as a condition of payment;

comparing received verification information and analysis results to the one or more loaded audit rules to determine whether a particular healthcare service was performed in accordance with a particular payer'"'"'s rules; and

storing reporting information based on the comparison that will indicate to the payer whether the particular healthcare service was performed in accordance with the particular payer'"'"'s rules.