PROGRAM OPTIMIZATION SYSTEM

• US 20140222451A1
• Filed: 02/04/2014
• Published: 08/07/2014
• Est. Priority Date: 02/04/2013
• Status: Active Grant

• Current Assignee: C-HCA, Inc.
• Original Assignee: HCA Holdings Incorporated (HCA Healthcare, Inc.)
• Inventors: Hall, Charles J., Marks, Michael A., Manoukian, Steven V., Perez, Elio, Perez Rodriguez, Gabriel O.
• Granted Patent: US 9,734,298 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

Program optimization systems are provided herein. The program optimization system can include a plurality of data sources that can be mined for information relating to one or several patients. The format and content of the information from the data sources can be evaluated and can be conformed to formats and content types used by the program optimization system. The information retrieved from the data sources can be evaluated for one or several trigger events. If a trigger event is identified in the retrieved data, a treatment protocol can be selected.

Claims

1. A method of identifying a member of a healthcare organization for potential treatment, the method comprising:

retrieving patient data, wherein the patient data identifies a plurality of patients;

identifying a patient from the patient data;

retrieving data source information, wherein the data source information identifies a plurality of data sources, and wherein the data sources originate clinical results relating to aspects of patient health;

identifying a first data source from the data source information as having originated a first clinical result;

retrieving the first clinical result from the first data source;

identifying a categorization of the first clinical result, wherein the categorization of the first clinical result is associated with a trigger, wherein the trigger identifies a threshold;

generating a trigger result from the comparison of the first clinical result and the trigger;

storing the trigger result in the patient data;

identifying a navigator based on the patient data and the trigger result;

identifying a treatment protocol relevant to the patient and based on the trigger result, wherein the treatment protocol comprises a workflow identifying a plurality of actions;

receiving an input indicating the completion of one of the plurality of actions in the workflow; and

updating the patient data with information relating to the completion of one of the plurality of actions in the workflow.

2. The method of claim 1, wherein the patient data identifies aspects of the patient'"'"'s medical history.

3. The method of claim 1, wherein retrieving the first clinical result from the first data source comprises determining the units of the first clinical results.

4. The method of claim 3, wherein the categorization is associated with a plurality of triggers having different units.

5. The method of claim 4, further comprising selecting the trigger having units matching the units of the first clinical result.

6. The method of claim 1, wherein the trigger result indicates if the threshold has been exceeded.

7. The method of claim 1, further comprising, providing the clinical result, the trigger result, and the patient data for the identified patient to the navigator.

8. The method of claim 7, further comprising:

providing the clinical result, the trigger result, and the patient data for the identified patient to a physician;

providing the treatment protocol to the physician; and

receiving an input from the physician selecting the treatment protocol.

9. A system for identifying a member of a healthcare organization for potential treatment, the system comprising:

a data source configured to originate clinical results relating to aspects of patient health;

memory comprising;

patient data, wherein the patient data identifies a plurality of patients and contains aspects of patients medical history; and

data source information, wherein the data source information identifies a plurality of data sources;

a processor configured to;

retrieve patient data;

identify a patient from the patient data;

retrieve data source information;

identify a first data source from the data source information as having originated a first clinical result;

retrieve the first clinical result from the first data source;

identify a categorization of the first clinical result, wherein the categorization of the first clinical result is associated with a trigger, wherein the trigger identifies a threshold;

generate a trigger result from the comparison of the first clinical result and the trigger;

send the trigger result to the memory for storage in the patient data;

identify a navigator based on the patient data and the trigger result;

identify a treatment protocol relevant to the patient and based on the trigger result, wherein the treatment protocol comprises a workflow identifying a plurality of actions;

receive an input indicating the completion of one of the plurality of actions in the workflow; and

update the patient data with information relating to the completion of one of the plurality of actions in the workflow.

10. The system of claim 9, wherein retrieving the first clinical result from the first data source comprises determining the units of the first clinical results.

11. The system of claim 10, wherein the categorization is associated with a plurality of triggers having different units.

12. The system of claim 11, wherein the processor is further configured to select the trigger having units matching the units of the first clinical result.

13. The system of claim 9, wherein the trigger result indicates if the threshold has been exceeded.

14. The system of claim 9, wherein the processor is further configured to provide the clinical result, the trigger result, and the patient data for the identified patient to the navigator.

15. The system of claim 14, wherein the processor is further configured to:

provide the clinical result, the trigger result, and the patient data for the identified patient to a physician;

provide the treatment protocol to the physician; and

receive an input from the physician selecting the treatment protocol.

16. A method for admitting a member of a healthcare organization into a program, the method comprising:

receiving data identifying a first data source, wherein the data source originates clinical results relating to aspects of patient health;

updating data source information with information identifying the first data source, wherein the data source information identifies a plurality of data sources, and wherein the data sources originate clinical results relating to aspects of patient health;

identifying patient data associated with a member of a healthcare organization;

retrieving a first clinical result from the first data source, wherein the first clinical result relates to the health of the member of a healthcare organization;

querying a database of trigger data for a first trigger value demarking a threshold for determining whether to provide a first treatment;

determining whether the first clinical result is relevant to the first trigger value, wherein determining if the first clinical result is relevant to the first trigger value includes determining whether the format and units of the first clinical result corresponds to the first trigger value;

generating a first trigger result by comparing the first clinical result to the first trigger value, wherein the first trigger result can comprise a first value associated with a first potential treatment or a second value that is not associated with the first potential treatment;

updating the patient data with an indicator identifying the member of a healthcare organization as a candidate for the first potential treatment.

17. The method of claim 16, wherein the data identifying the first data source comprises a request for use of clinical results from the first data source in admitting a member of a healthcare organization into the treatment program.

18. The method of claim 17, further comprising identifying the type of clinical result generated by the first data source and the format and units of the first clinical result.

19. The method of claim 18, further comprising determining if the type, format, and units of the clinical results generated by the first data source meet a first criteria, wherein the data source information is updated if the type, format, and units of the clinical results generated by the first data source meet the first criteria.

20. The method of claim 16, further comprising:

retrieving a second clinical result from a second data source, wherein the second clinical result relates to the health of the member of the healthcare organization;

generating a second trigger result by comparing the second clinical result to the second trigger value, wherein the second trigger result can comprise a first value associated with a second potential treatment or a second value that is not associated with the second potential treatment; and

updating the patient data with an indicator identifying the member of a healthcare organization as a candidate for the second potential treatment.