SYSTEMS AND METHODS FOR OPTIMIZING MANAGEMENT OF PATIENTS WITH MEDICAL DEVICES AND MONITORING COMPLIANCE

• US 20180358114A1
• Filed: 12/02/2016
• Published: 12/13/2018
• Est. Priority Date: 12/02/2015
• Status: Active Grant

• Current Assignee: Icahn School of Medicine at Mount Sinai (The Mount Sinai Health System, Inc.)
• Original Assignee: Icahn School of Medicine at Mount Sinai (The Mount Sinai Health System, Inc.)
• Inventors: Schecter, Stuart Owen
• Granted Patent: US 10,886,011 B2
• Time in Patent Office: Days
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: A61B 5/0031 Implanted circuitry
• CPC Class Codes: A61B 5/7275 Determining trends in physiological measurement data; Predicting development of a medical condition based on physiological measurements, e.g. determining a risk factor
• CPC Class Codes: G06Q 10/06395 Quality analysis or management
• CPC Class Codes: G06Q 30/018 Certifying business or products
• CPC Class Codes: G06Q 50/22 Social work or social welfare, e.g. community support activities or counselling services
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/40 for the management of medical equipment or devices, e.g. scheduling maintenance or upgrades
• CPC Class Codes: G16H 40/67 for remote operation

Abstract

Systems and methods for determining monitoring compliance are provided. Each element in a plurality of data elements is obtained from a medical device connected to a corresponding subject in a first plurality of subjects and interrogated to determine a condition of the device or subject. A medical code and timestamp for evaluation of the device or subject is recorded in the subject'"'"'s medical record. A determination is made for each epoch in a plurality of epochs, for each subject in a second plurality of subjects, whether the medical code is recorded in the subject'"'"'s medical record for the epoch by evaluating the time stamps and codes in the medical records. A compliance counter is advanced when a medical record includes the code for a respective epoch and otherwise a noncompliance counter is advanced. Responsive to a compliance request, compliance information or suggested treatment options are provided based on the counters.

Claims

1. A computer system for determining health care provider monitoring compliance, the computer system comprising one or more processors and a memory, the memory comprising non-transitory instructions which, when executed by the one or more processors, perform a method comprising:

A) performing a first autonomous process wherein, for each respective data element in a plurality of data elements, the first autonomous process comprises;

(i) obtaining the respective data element in the plurality of data elements from a corresponding medical device connected to a corresponding subject in a first plurality of subjects,

(ii) interrogating the respective data element to determine a condition of the medical device or to determine a condition of the corresponding subject, and

(iii) recording, responsive to the interrogating (ii), (a) a first medical code that indicates that the condition of the medical device or the condition of the corresponding subject has been evaluated and (b) an associated timestamp for the interrogating in a medical record associated with the corresponding subject;

B) performing a second autonomous process at each respective epoch in a plurality of epochs, the second autonomous process comprising, for each respective subject in a second plurality of subjects;

(i) determining whether the first medical code has been recorded in the medical record associated with the respective subject during the respective epoch by parsing the medical record for the first medical code and, when found in the medical record, using the associated timestamp to determine if the first medical code is associated with respective epoch,

(ii) advancing a compliance counter when the medical record associated with the respective subject includes the first medical code associated with the respective epoch, and

(iii) advancing a noncompliance counter when the medical record associated with the respective subject does not include the first medical code associated with the respective epoch, wherein,

the first plurality of subjects constitutes all or a portion of the second plurality of subjects and wherein each subject in the second plurality of subjects has the corresponding medical device; and

C) performing a third process, wherein the third process comprises;

(i) receiving a compliance request and, responsive to the compliance request, providing compliance information in accordance with the compliance counter or the noncompliance counter,

(ii) providing one or more suggested treatment options based upon the compliance information, or

(iii) providing a list of subjects, wherein the list of subjects is identified from the second plurality of subjects on the basis that they (a) share one or more characteristics and (b) the medical records of the subjects indicate they lack a specific therapy or a treatment that is standard of care for subjects having the one or more characteristics.

2. The computer system of claim 1, wherein the corresponding medical device is a cardiac implantable electronic device.

3. The computer system of claim 2, wherein the cardiac implantable electronic device is a permanent pacemaker, an implantable cardioverter defibrillator, a cardiac resynchronization therapy device, a monitor of congestive heart failure, or an implantable loop recorder.

4. The computer system of claim 1, wherein the interrogating the data element in the first autonomous process determines the condition of the corresponding subject selected from the group consisting of a pulmonary artery pressure, an intra-thoracic impedance, an atrial arrhythmia, a ventricular arrhythmia, measurement of cardiorespiratory structure/function, an index of congestive heart failure, and a pulmonary vascular congestion.

5. The computer system of claim 1, wherein the interrogating the data element in the first autonomous process determines the condition of the corresponding subject, wherein the condition is an index of cardiorespiratory function.

6. The computer system of claim 5, wherein the condition is hyperlipidemia, thoracic impedance indices of pulmonary vascular congestion, a mean heart rate, or a cardiac inotropic state.

7. The computer system of claim 1, wherein the first medical code is an ICD-9 code, an ICD-10 code, a Current Procedure Terminology (CPT) code, or an equivalent thereof.

8. The computer system of claim 1, wherein the first medical code is extracted from the context of the medical record thereby providing semantic interoperability without specific reliance on a coding standard.

9. The computer system of claim 1, wherein

the interrogating the data element in the first autonomous process determines the condition of the corresponding subject, wherein the condition is an index of cardiorespiratory function, and

each respective epoch in the plurality of epochs is a day.

10. The computer system of claim 1, wherein each respective epoch in the plurality of epochs is the same length of time, and wherein the length of time is an hour or less, a day or less, two days or less, a week or less, a month or less, or a quarter of a year or less.

11. The computer system of claim 1, wherein the corresponding medical device connected to the corresponding subject wirelessly transmits the respective data element.

12. The computer system of claim 1, wherein

the interrogating the data element in the first autonomous process determines the condition of the corresponding subject,

the first autonomous process further comprises generating an alert for the corresponding subject when determination of the condition in the corresponding subject triggers an alert rule, and

a nature of the alert is specified by the alert rule.

13. The computer system of claim 12, wherein the condition is one or more index of cardiorespiratory function.

14. The computer system of claim 1, wherein the medical record is an electronic medical record.

15. The computer system of claim 1, wherein the first autonomous process and the second autonomous process occur concurrently.

16. The computer system of claim 1, wherein the first autonomous process, the second autonomous process, and the third process occur concurrently.

17. The computer system of claim 1, wherein the second plurality of subjects is associated with a physician, a provider group, a hospital, a hospital network, a health insurance

company, a pharmacy, a governmental body, or a prescribing clinician.

18. The computer system of claim 1, wherein

the second plurality of subjects is associated with a physician, a provider group, a hospital, a hospital network, a health insurance company, a pharmacy, a governmental body or a prescribing clinician,

each subject in the second plurality of subjects has a pathologic condition,

the interrogating the data element in the first autonomous process determines a condition of the medical device, and

the corresponding medical device connected to the corresponding subject wirelessly transmits the respective data element.

19-65. -65. (canceled)

66. A method for determining health care provider monitoring compliance, the method comprising:

A) performing a first autonomous process wherein, for each respective data element in a plurality of data elements, the first autonomous process comprises;

(i) obtaining the respective data element in the plurality of data elements from a corresponding medical device connected to a corresponding subject in a first plurality of subjects,

(ii) interrogating the respective data element to determine a condition of the medical device or to determine a condition of the corresponding subject, and

(iii) recording, responsive to the interrogating (ii), (a) a first medical code that indicates that the condition of the medical device or the condition of the corresponding subject has been evaluated and (b) an associated timestamp for the interrogating in a medical record associated with the corresponding subject;

B) performing a second autonomous process at each respective epoch in a plurality of epochs, the second autonomous process comprising, for each respective subject in a second plurality of subjects;

(i) determining whether the first medical code has been recorded in the medical record associated with the respective subject during the respective epoch by parsing the medical record for the first medical code and, when found in the medical record, using the associated timestamp to determine if the first medical code is associated with respective epoch,

(ii) advancing a compliance counter when the medical record associated with the respective subject includes the first medical code associated with the respective epoch, and

(iii) advancing a noncompliance counter when the medical record associated with the respective subject does not include the first medical code associated with the respective epoch, wherein,

the first plurality of subjects constitutes all or a portion of the second plurality of subjects and wherein each subject in the second plurality of subjects has a corresponding medical device; and

C) performing a third process, wherein the third process comprises;

(i) receiving a compliance request and, responsive to the compliance request, providing compliance information in accordance with the compliance counter or the noncompliance counter,

(ii) providing one or more suggested treatment options based upon the compliance information, or

(iii) providing a list of subjects, wherein the list of subjects is identified from the second plurality of subjects on the basis that they (a) share one or more characteristics and (b) the medical records of the subjects indicate they lack a specific therapy or a treatment that is standard of care for subjects having the one or more characteristics.

67. A non-transitory computer readable storage medium, wherein the non-transitory computer readable storage medium stores instructions, which when executed by a computer system, cause the computer system to perform a method for determining health care provider monitoring compliance, the method comprising:

A) performing a first autonomous process wherein, for each respective data element in a plurality of data elements, the first autonomous process comprises;

(i) obtaining the respective data element in the plurality of data elements from a corresponding medical device connected to a corresponding subject in a first plurality of subjects,

(ii) interrogating the respective data element to determine a condition of the medical device or to determine a condition of the corresponding subject, and

(iii) recording, responsive to the interrogating (ii), (a) a first medical code that indicates that the condition of the medical device or the condition of the corresponding subject has been evaluated and (b) an associated timestamp for the interrogating in a medical record associated with the corresponding subject;

B) performing a second autonomous process at each respective epoch in a plurality of epochs, the second autonomous process comprising, for each respective subject in a second plurality of subjects;

(i) determining whether the first medical code has been recorded in the medical record associated with the respective subject during the respective epoch by parsing the medical record for the first medical code and, when found in the medical record, using the associated timestamp to determine if the first medical code is associated with respective epoch,

(ii) advancing a compliance counter when the medical record associated with the respective subject includes the first medical code associated with the respective epoch, and

(iii) advancing a noncompliance counter when the medical record associated with the respective subject does not include the first medical code associated with the respective epoch, wherein,

the first plurality of subjects constitutes all or a portion of the second plurality of subjects and wherein each subject in the second plurality of subjects has a corresponding medical device; and

C) performing a third process, wherein the third process comprises;

(i) receiving a compliance request and, responsive to the compliance request, providing compliance information in accordance with the compliance counter or the noncompliance counter,

(ii) providing one or more suggested treatment options based upon the compliance information, or

(iii) providing a list of subjects, wherein the list of subjects is identified from the second plurality of subjects on the basis that they (a) share one or more characteristics and (b) the medical records of the subjects indicate they lack a specific therapy or a treatment that is standard of care for subjects having the one or more characteristics.