HEALTH PLAN RATING SYSTEM IMPROVEMENT PROGRAM

• US 20140214444A1
• Filed: 03/27/2014
• Published: 07/31/2014
• Est. Priority Date: 11/11/2011
• Status: Active Grant

• Current Assignee: Star Measures Investments, LLC
• Original Assignee: Star Measures Investments, LLC
• Inventors: THESMAN, DEBRA
• Granted Patent: US 11,010,716 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• 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 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

Methods and training programs for improving the level of quality of care within a healthcare plan. The methods include obtaining medical data from a population of patients within the plan, storing such data in electronic medical records embodied on a computer readable medium, evaluating at least one metric within the data via a computer capable of interpreting said electronic medical records, and presenting a notification if the metric is found to be below a standard for the metric. The training includes evaluating the healthcare plan'"'"'s current practices, training the healthcare provider in improved practices, providing a system for recording medical documents, and training the healthcare provider in use of the system.

Claims

1. A method of improving the level of quality of care within a healthcare plan comprising:

(a) obtaining medical data from a population of patients within the plan;

(b) storing such data obtained in step (a) in electronic medical records embodied on a computer readable medium;

(c) evaluating at least one metric within said data stored in step (b) via a computer capable of interpreting said electronic medical records; and

(d) presenting a notification if the at least one metric evaluated in step (c) is found to be below a standard for said metric.

2. The method of claim 1, wherein the at least one metric includes providing a disease screening.

3. The method of claim 1, wherein the at least one metric includes providing a vaccination.

4. The method of claim 1, wherein the at least one metric includes managing a chronic condition.

5. A method of training healthcare plans to improve the level of quality of care within the plan, said method comprising the steps:

(a) evaluating the healthcare plan'"'"'s current practices;

(b) training the healthcare provider in improved practices;

(c) providing a system for recording medical documents, wherein the system comprises;

(i) a computer readable medium capable of storing medical data obtained from a population of patients;

(ii) a computer with software capable of evaluating at least one metric of the data stored on the computer readable medium in comparison with a standard for the at least one metric; and

(iii) a notification system capable of presenting to the user of the system a warning if the at least one metric is found to be below the standard for such metric; and

(d) training the healthcare provider in use of said system.

6. The method of claim 5, wherein the training provided in step (b) comprises instructing the healthcare plan to preemptively contact potential at-risk patients.

7. A system for recording medical documents comprising:

(a) a computer readable medium capable of storing medical data obtained from a population of patients;

(b) a computer with software capable of evaluating at least one metric of the data stored on the computer readable medium in comparison with a standard for the at least one metric; and

(c) a notification system capable of presenting to the user of the system a warning if the at least one metric is found to be below the standard for such metric.

8. The system of claim 7, wherein the notification system presents a warning if the metric is the percentage of patients within a population receiving a disease screening and the percentage is below a standard assigned for screening said disease.

9. The system of claim 7, wherein the notification system presents a warning if patients within a population are determined to be at-risk for medical complications based upon the patients'"'"' medical data.