Method and system for consolidating and distributing information

• US 6,915,265 B1
• Filed: 10/29/1997
• Issued: 07/05/2005
• Est. Priority Date: 10/29/1997
• Status: Expired due to Term

• Current Assignee: Janice Johnson
• Original Assignee: Janice Johnson
• Inventors: Johnson, Janice
• Primary Examiner(s): Thomas, Joseph
• Assistant Examiner(s): Gilligan, Christopher L
• Application Number:
  US08/960,755
• Time in Patent Office: 2,806 Days
• Field of Search: 600/300, 705 1- 4, 705/40, 705/41, 380 22- 24
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/02 Banking, e.g. interest calculation or account maintenance credit or loans G06Q40/03
• 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 10/65 stored on portable record carriers, e.g. on smartcards, RFID tags or CD
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 70/40 relating to drugs, e.g. their side effects or intended usage
• CPC Class Codes: G16H 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring

Abstract

A method and system are provided for consolidating and distributing information. Implementation of system functionalities for both restricted local and unrestricted system-wide uses are permitted. Open standards for hardware, software and firmware components and standardized medical codes, definitions and formats are supported. The preferred embodiment of the invention provides an integrated health care system. The invention can also be used to allow secure access to Social Security, annuity, retirement account, and benefit information, allowing individuals a unified view of their benefit and payment status. A centralized host maintains, consolidates, and redistributes information generated at all networked locations. Information is electronically transferred among the system components to link an individual'"'"'s local records to those stored remotely. The individual information device, centralized host computer, and any other computers or networks linked to the system can therefore be automatically updated. An individual information device stores a service recipient'"'"'s insurance information, a emergency records and critical health care histories. This information is accessed by the system for use in managing any aspect of the service recipient'"'"'s health care. Portable terminals can be used to access the system. A portable terminal can also be used independently from the system to perform health care functions. Unrestricted system-wide, or restricted local uses are supported. Insurance coverage for services and treatments can be determined and the information transmitted directly from the carrier(s) to the service recipient and service provider(s). Supported features include service authorization, messaging, diagnostic services,coverage determination, billing, and electronic payment.

Claims

1. An integrated health care system for collecting, consolidating, conforming, and distributing health care data concerning at least one individual service recipient, the system comprising:

at least one central host computer for maintaining, consolidating, and distributing information generated by any component of said system;

wherein said centralized host computer is one of a computer, or a network of linked computers having at least one central server;

at least one provider terminal in communication with said central host computer;

wherein said provider terminal is one of a portable computer, personal information device, personal digital assistant, personal computer, or server computer;

at least one portable individual information device for accessing said system;

wherein said portable individual information device is any of an integrated circuit card, a magnetic storage card, or a portable integrated circuit or microchip-based device;

a billing module for calculating billing information for a service provided to the at least one individual service recipient;

an insurance benefits module for calculating available insurance benefits for a service provided to the at least one individual service recipient;

a payment module for electronically transferring funds to pay a bill for services provided to the at least one individual service recipient, said payment module including at least one shared platform service and at least one database managing processes for billing and payment;

an authorization module for authorizing service recipient treatment, said authorization module including at least one shared platform service and at least one database managing processes for authorization;

a messaging module for providing messaging services to a component of said system, said messaging module comprising a communications/file transfer shared platform service that is used for communications between all system participants for all communication features of the system;

wherein a health care record for said at least one service recipients stored on said central host computer, said provider terminal, and said individual information device;

wherein said at least one service recipients health care record comprises a structured database of health care records constructed at points of service, an updatable problem list, and care plans, wherein local records are linked to remotely stored records;

wherein said central host computer, said provider terminal, and said portable individual information device are electronically linked as a network, to permit information distribution to various locations on said network;

wherein said system is implemented using any of a global communications network, the internet, or a local area network;

wherein said individual information device stores any of an individual service recipient'"'"'s insurance information, emergency records, and health care history;

wherein said provider terminal includes;

a medical insurer module;

a health plan sponsor module;

an individual service recipient module;

a health care service provider module;

a health care research module; and

a service support module;

wherein said medical insurer module includes functions for plan definition, open enrollment marketing features, automated authorization of benefits, automated referrals, and service payment accounting and;

wherein said health plan sponsor module includes functions for open enrollment processes, benefit plan information maintenance, and coordination of distribution and activation or deactivation of individual information devices;

wherein said health care service provider module includes functions for maintaining service recipient records, diagnosing and treating service recipient ailments, managing service payments, accounting services, and maintaining service provider records, including licensing information, staffing affiliations, organizational ownership information, tax identification information, curriculum vitae of licensed practitioners, and well as information regarding disciplinary actions;

wherein said health care research module includes functions for collecting data on said system for research and analysis of health care issues;

wherein said service support nodule supports internal maintenance, product billing functions and enablement for module capabilities, said service support module comprising a platform of central host shared processing applications that includes;

database update processing;

applications management;

database management;

a data dictionary;

security management,

a system activity file;

said messaging module; and

central electronic output/archive;

wherein said system provides access to Social Security, annuity, retirement account, and benefit information; and

,

wherein said medical insurer module;

said health plan sponsor module, said individual service recipient module, said health care service provider module, said health care research module; and

said service support module each include databases for storing information; and

,

wherein said information is linked and organized by at least one indexing key;

said data dictionary ensuring standardization of all system database elements, wherein said data dictionary includes;

field definitions;

acceptable codes or values organized in acceptable values tables to provide a uniform healthcare vocabulary;

wherein said codes ensure data integrity throughout a data value chain and ensure the data'"'"'s universal consistency;

edit rules;

format rules;

identification of a field'"'"'s data owner, wherein the owner has ultimate authority for issuing updates and revisions to the field; and

references to diagnostic, procedural, pharmaceutical and personal information codes for use in processing changes to databases and in construction of research requests to identify potential incompatibilities and problems;

wherein a database accesses data dictionary codes when responding to a query so that information retrieved in response to a query is limited to those cases containing no potential incompatibilities or problems.

2. The system of claim 1, wherein open standards are used for hardware, software, and firmware components of said system.

3. The system of claim 1, wherein said health care research module converts said health care data on said system into one common format for use by said central host computer.

4. The system of claim 3, wherein said health care research module further strips the health care data of any personal information that might compromise the anonymity of the individual service recipient from whom the health care data was collected before distributing the information to any other component of the module.

5. The system of claim 3, further including a statistical analysis module for providing statistical analysis of said common-format health care data stored in said system.

6. The system of claim 5, further comprising a card reader linked to said provider terminal, for accessing information stored on said portable individual information device, and for transmitting information among said portable individual information device and any of said components of said system.

7. The system of claim 6, wherein said provider terminal is operable to communicate with said entire system or any portion of said system, or is operable independently from said system.

8. An integrated health care system, implemented using any of a global communications network, the Internet or a local area network, the system comprising:

at least one central host computer for collecting, conforming, maintaining, consolidating, and distributing information generated by any component of said system;

at least one provider terminal in communication with said central host computer;

wherein said provider terminal is one of a portable computer, personal information device, personal digital assistant, personal computer, or server computer; and

,

wherein said provider terminal communicates with said entire system or any portion of said system, or independently from said system;

at least one portable individual information device for accessing said system, wherein said portable individual information device stores an individual service recipients insurance information, emergency records, and health care history;

a card reader, linked to said provider terminal, for accessing information stored on said portable individual information device, and for transmitting information among said portable individual information device and said components of said system;

a messaging module for providing messaging services to said components of said system, said messaging module comprising a communications/file transfer shared platform service that is used for communications between all system participants for all communication features of the system;

wherein a health care record for said service recipient is stored on said central host computer, said provider terminal, and said individual information device;

wherein said at least one service recipient'"'"'s health care record comprises a structured database of health care records constructed at points of service, an updatable problem list, and care plans, wherein local records are linked to remotely stored records;

wherein said central host computer, said provider terminal, and said portable individual information device are electronically linked as a network, to permit information distribution to various locations on said network;

wherein open standards are used for hardware, software, and firmware components of said system;

wherein said provider terminal includes;

a medical insurer module including functions for plan definition, open enrollment marketing features, automated authorization of benefits, automated referrals, and service payment accounting;

a health plan sponsor module including functions for open enrollment processes, maintenance of benefit plan information, and coordination, distribution, and deactivation of said portable individual information devices;

a health care service provider module including functions for maintaining service recipient records, diagnosing and treating service recipient ailments, service payment management, and accounting services;

a health care research module including functions for the collection of data on said system for research and analysis of health care issues; and

,

a service support module that supports internal maintenance, product billing functions and enablement for module capabilities, said service support module comprising a platform of central host shared processing applications that includes;

database update processing;

applications management;

database management;

a data dictionary;

security management;

a system activity file;

said messaging module; and

central electronic output/archive;

said data dictionary for ensuring standardization of all system database elements, wherein said data dictionary includes;

field definitions;

acceptable codes or values organized in acceptable values tables to provide a uniform healthcare vocabulary;

wherein said codes ensure data integrity throughout a data value chain and ensure the data'"'"'s universal consistency;

edit rules;

format rules;

identification of a field'"'"'s data owner, wherein the owner has ultimate authority for issuing updates and revisions to the field;

references to diagnostic, procedural, pharmaceutical and personal information codes for use in processing changes to databases and in construction of research requests to identity potential incompatibilities and problems;

wherein a database accesses data dictionary codes when responding to a query so that information retrieved in response to a query is limited to those cases containing no potential incompatibilities or problems.

9. The system of claim 8, wherein said health care service provider module further includes

a function for maintenance of service provider records, including licensing information, staffing affiliations, organizational ownership information, tax identification information, curriculum vitae of licensed practitioners, and information regarding disciplinary actions against the health care service provider.

10. The system of claim 9, further comprising an integrated statistical analysis software module for providing statistical analysis of said health care data stored in said system.

11. The system of claim 10, further comprising a billing module for calculating billing information for a service provided to the individual service recipient.

12. The system of claim 11, further comprising an insurance benefits module for calculating available insurance benefits for a service provided to the individual service recipient.

13. The system of claim 9, wherein said centralized host computer is one of a computer, or a network of linked computers having at least one central server.

14. The system of claim 10, further comprising a payment module for electronically transferring funds to pay a bill for services provided to said service recipient, said payment module including at least one shared platform service and at least one database managing processes for billing and payment.

15. The system of claim 10, further comprising an authorization module for authorizing service recipient treatment, said authorization module including at least one shared platform service and at least one database managing processes for authorization.

16. The system of claim 10, wherein said system provides access to any of Social Security, annuity, retirement account, and benefit information, and said statistical analysis module provides comparative statistical analysis of Social Security, retirement account and benefit information.

17. A method for collecting, conforming and consolidating information in an integrated health care system implemented using any of a global communications network, the Internet or a local area network, the method comprising steps of:

maintaining, consolidating, and distributing information generated by a component of said system with at least one central host computer;

providing at least one provider terminal in communication with the central host computer;

wherein said provider terminal is one of a portable computer, personal information device, personal digital assistant, personal computer, or server computer;

wherein the provider terminal is operable to communicate with the entire system or any portion of the system, or is operable independently from the system;

providing at least one portable individual information device for accessing the system, wherein the portable individual information device stores an individual service recipient'"'"'s insurance information, emergency records, and health care history;

linking a card reader to the provider terminal, for accessing information stored on the portable individual information device, and for transmitting information among the portable individual information device and the components of the system;

providing messaging services to a component of the system;

wherein a health care record for the service recipient is stored on said central host computer, said provider terminal, and said individual information device;

wherein said at least one service recipient'"'"'s health care record comprises a structured database of health care records constructed at points of service, an updatable problem list, and care plans, wherein local records are linked to remotely stored records;

wherein the central host computer, the provider terminal, and the portable individual information device are electronically linked as a network, to permit information distribution to various locations on said network;

wherein open standards are used for hardware, software, and firmware components of said system; and

providing a data dictionary for ensuring standardization of all system database elements, wherein said data dictionary includes;

field definitions;

acceptable codes or values organized in acceptable values tables to provide a uniform healthcare vocabulary;

wherein said codes ensure data integrity throughout a data value chain and ensure the data'"'"'s universal consistency;

edit rules;

format rules;

identification of a field'"'"'s data owner, wherein the owner has ultimate authority for issuing updates and revisions to the field; and

references to diagnostic, procedural, pharmaceutical and personal information codes for use in processing changes to databases and in construction of research requests to identify potential incompatibilities and problems;

wherein a database accesses data dictionary codes when responding to a query so that information retrieved in response to a query is limited to those cases containing no potential incompatibilities or problems.

18. The method of claim 17, further comprising steps of:

converting information in the system into a common format for processing by the central host computer;

analyzing the information in the system;

creating resulting analytical data;

converting the resulting analytical data into a format readable by a component of the system; and

,

distributing the resulting analytical data to a component of the system.

19. The method of claim 18 wherein said analyzing step further includes the step of performing statistical analysis of the information such that resulting analytical data is suitable for use in a clinical research facility;

wherein the clinical research facility is a component of the system; and

wherein the clinical research facility further distributes the analytical data to at least one government agency.

20. The method of claim 18 further including a step of stripping the information of any data that might compromise anonymity of the individual from whom the information was collected.

21. The method of claim 17, further comprising steps of:

analyzing information collected by a component of the system;

transmitting resulting analytical data to the central host computer;

converting the resulting analytical data into a common format;

storing the common format analytical data on the central host computer;

converting the common format analytical data into a format usable by any component of the system; and

distributing the converted analytical data to any component of the system.

22. The method of claim 21 wherein said analyzing step is performed by a statistical module and wherein the statistical module uses analytical algorithms specific to the component of the system.