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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
First Claim
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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.

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