Insurance Evaluation Engine

• US 20170293722A1
• Filed: 04/07/2017
• Published: 10/12/2017
• Est. Priority Date: 04/11/2016
• Status: Abandoned Application

• Current Assignee: Amgine Technologies (US), Inc.
• Original Assignee: Amgine Technologies (US), Inc.
• Inventors: Valverde, JR., L. James, Miller, Harold Roy, Miller, Jonathan David
• Application Number:
  US15/482,619
• Publication Number:
  US 20170293722A1
• Time in Patent Office: Days
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

A method and a system for evaluating a cost of insurance are provided. The method may commence with parsing a text from medical information sources to obtain statistical data associated with a population of patients. The method may further include structuring the statistical data to form structured medical metadata in an intelligent medical database. Based on the structured medical metadata, a causal network may be created. The method may continue with receiving health data associated with a patient from one or more patient data sources. The health data may be parsed to obtain processed patient health data. The method may further include mapping the processed patient health data against the causal network. Based on the mapping, a future health status associated with the patient may be predicted. The method may continue with evaluating the cost of the insurance associated with the patient based on the future health status.

Claims

1. A system for evaluating a cost of an insurance, the system comprising:

a first parser configured to;

parse a text from one or more medical information sources to obtain statistical data associated with a population of patients;

a second parser configured to;

parse health data associated with a patient to obtain processed patient health data; and

a processor configured to;

structure the statistical data to form structured medical metadata in an intelligent medical database;

based on the structured medical metadata, create a causal network;

receive the health data associated with the patient from one or more patient data sources;

map the processed patient health data against the causal network;

based on the mapping, predict a future health status associated with the patient; and

evaluate, based on the future health status, the cost of the insurance associated with the patient.

2. The system of claim 1, wherein the structured medical metadata comprise elements and relationships between the elements.

3. The system of claim 2, wherein the elements of the structured medical metadata include one or more of the following:

a disease, a state, a cause, a symptom, a treatment, a test, an effect, an outcome, and an outlier.

4. The system of claim 1, wherein the one or more medical information sources include electronic medical records, a Unified Medical Language System, and a Systematized Nomenclature of Medicine.

5. The system of claim 1, wherein each of the first parser and the second parser includes a grammar independent natural language parser configured to retrieve, interpret, and collate medical information from the one or more medical information sources, wherein the text from one or more medical information sources includes the medical information.

6. The system of claim 5, wherein the medical information is obtained from the one or more medical information sources using a metadata dictionary and pattern recognition.

7. The system of claim 6, wherein the metadata dictionary includes an equivalence class of terms and phrases associated with a medical lexicon.

8. The system of claim 1, wherein the statistical data associated with the population of patients include demographical characteristics, personal statistics, medical histories, medications, allergies, immunization statuses, clinical diagnoses, symptoms, diseases, treatments, drug prescriptions, genetic histories, and laboratory test results.

9. The system of claim 1, wherein the health data associated with the patient is processed using an inference model and pattern recognition.

10. The system of claim 1, wherein the health data associated with the patient includes a patient input in a form of one or more of a natural language, a text, and a speech.

11. The system of claim 1, wherein the processor is further configured to generate a patient management plan for the patient.

12. The system of claim 11, wherein the processor is further configured to track a patient response to treatment during and after the treatment according to the patient management plan.

13. The system of claim 1, wherein the processor is further configured to dynamically update the structured medical metadata to reflect additions and modifications associated with the one or more medical information sources.

14. A method for evaluating a cost of an insurance, the method comprising:

parsing, by a first parser, a text from one or more medical information sources to obtain statistical data associated with a population of patients;

structuring, by a processor, the statistical data to form structured medical metadata in an intelligent medical database;

based on the structured medical metadata, creating, by the processor, a causal network;

receiving, by the processor, health data associated with a patient from one or more patient data sources;

parsing, by a second parser, the health data associated with the patient to obtain processed patient health data;

mapping, by the processor, the processed patient health data against the causal network;

based on the mapping, predicting, by the processor, a future health status associated with the patient; and

evaluating, by the processor, based on the future health status, the cost of the insurance associated with the patient.

15. The method of claim 14, further comprising generating a patient management plan for the patient.

16. The method of claim 15, further comprising tracking a patient response to treatment during and after the treatment according to the patient management plan.

17. The method of claim 14, further comprising:

periodically receiving further health data associated with the patient; and

refining the future health status based on the further health data.

18. The method of claim 14, further comprising assigning probabilities to future health issues associated with the future health status.

19. The method of claim 14, further comprising dynamically updating the structured medical metadata to reflect additions and modifications associated with the one or more medical information sources.

20. A system for evaluating a cost of an insurance, the system comprising:

a first parser configured to;

parse a text from one or more medical information sources to obtain statistical data associated with a population of patients;

a second parser configured to;

parse health data associated with a patient to obtain processed patient health data; and

a processor configured to;

structure the statistical data to form structured medical metadata in an intelligent medical database;

based on the structured medical metadata, create a causal network;

receive the health data associated with the patient from one or more patient data sources;

map the processed patient health data against the causal network;

based on the mapping, predict a future health status associated with the patient; and

evaluate, based on the future health status, the cost of the insurance associated with the patient;

generate a patient management plan for the patient;

track a patient response to treatment during and after the treatment according to the patient management plan;

periodically receive further health data associated with the patient;

refine the future health status based on the further health data; and

dynamically update the structured medical metadata to reflect additions and modifications associated with the one or more medical information sources.