METHODS FOR OPTIMIZING MANAGED HEALTHCARE ADMINISTRATION AND ACHIEVING OBJECTIVE QUALITY STANDARDS

• US 20200135312A1
• Filed: 12/30/2019
• Published: 04/30/2020
• Est. Priority Date: 12/12/2012
• Status: Active Grant

• Current Assignee: Quality Standards, LLC
• Original Assignee: Quality Standards, LLC
• Inventors: Thesman, Debra
• Granted Patent: US 11,429,930 B2
• Time in Patent Office: Days
• CPC Class Codes: G06F 3/0482 Interaction with lists of selectable items, e.g. menus
• CPC Class Codes: G06F 3/04842 Selection of displayed objects or displayed text elements G06F3/0482 takes precedence
• 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 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

Healthcare is administered to members/enrollees of a healthcare plan according to objective quality standards. A patient population of eligible members/enrollees is identified and for each member/enrollee, medical information is aggregated via a web-based compilation of medical data from multiple sources that is continuously updated so as to provide an accurate, up-to-date and readily accessible compilation of a member/enrollee past diagnoses, healthcare history, medical procedures, medications and the like. Such member/enrollees are continuously tracked, on an individual basis, and monitored to ensure healthcare is delivered for a variety of specific medical conditions pursuant to objective health program quality criteria.

Claims

1. (canceled)

2. A system for correcting deficiencies in medical records, the system comprising:

a central database storing medical records for each of a plurality of patients; and

a server for providing a remote computer with access to the central database via a web-based application, the web-based application performing operations comprising;

generating a screen for displaying diagnostic information for a specific patient from among the plurality of patients, the diagnostic information including one or more diagnostic codes and a diagnosis description corresponding to each of the one or more diagnostic codes;

displaying, on the screen, one or more data entry fields by which an additional diagnostic code may be added to the medical records stored for the specific patient in the central database;

applying a plurality of code edits to prevent the addition of inappropriate diagnostic codes using the web-based application; and

,

for each additional diagnostic code added using the web-based application, tracking a page number of the medical records stored for the specific patient in the central database.

3. The system of claim 2, wherein the diagnostic information further includes a hierarchical condition category (HCC) corresponding to each of the one or more diagnostic codes.

4. The system of claim 2, wherein the operations further comprise displaying, on the screen, a comment input tool by which a user of the web-based application may add comments to the medical records stored for the specific patient in the central database.

5. The system of claim 4, wherein the comment input tool includes a plurality of selectable prewritten comments.

6. The system of claim 5, wherein the comment input tool further includes a text field for adding a comment other than the selectable prewritten comments.

7. A method for correcting deficiencies in medical records, the method comprising:

storing medical records for each of a plurality of patients in a central database;

generating, by a web-based application, a screen for displaying diagnostic information for a specific patient from among the plurality of patients, the diagnostic information including one or more diagnostic codes and a diagnosis description corresponding to each of the one or more diagnostic codes;

displaying, on the screen, one or more data entry fields by which an additional diagnostic code may be added to the medical records stored for the specific patient in the central database;

applying a plurality of code edits to prevent the addition of inappropriate diagnostic codes using the web-based application; and

,

for each additional diagnostic code added using the web-based application, tracking a page number of the medical records stored for the specific patient in the central database.

8. The method of claim 7, wherein the diagnostic information further includes a hierarchical condition category (HCC) corresponding to each of the one or more diagnostic codes.

9. The method of claim 7, further comprising displaying, on the screen, a comment input tool by which a user of the web-based application may add comments to the medical records stored for the specific patient in the central database.

10. The method of claim 9, wherein the comment input tool includes a plurality of selectable prewritten comments.

11. The system of claim 10, wherein the comment input tool further includes a text field for adding a comment other than the selectable prewritten comments.

12. A non-transitory computer-readable medium storing instructions executable by a computer to perform operations comprising:

serving a web-based application including a screen for displaying diagnostic information for a specific patient from among a plurality of patients, the diagnostic information including one or more diagnostic codes and a diagnosis description corresponding to each of the one or more diagnostic codes;

displaying, on the screen, one or more data entry fields by which an additional diagnostic code may be added to medical records stored for the specific patient in a central database in communication with the computer;

applying a plurality of code edits to prevent the addition of inappropriate diagnostic codes using the web-based application; and

,

for each additional diagnostic code added using the web-based application, tracking a page number of the medical records stored for the specific patient in the central database.

13. The non-transitory computer-readable medium of claim 12, wherein the diagnostic information further includes a hierarchical condition category (HCC) corresponding to each of the one or more diagnostic codes.

14. The non-transitory computer-readable medium of claim 12, wherein the operations further comprise displaying, on the screen, a comment input tool by which a user of the web-based application may add comments to the medical records stored for the specific patient in the central database.

15. The non-transitory computer-readable medium of claim 14, wherein the comment input tool includes a plurality of selectable prewritten comments.

16. The non-transitory computer-readable medium of claim 15, wherein the comment input tool further includes a text field for adding a comment other than the selectable prewritten comments.