System for communication of health care data

• US 7,664,660 B2
• Filed: 10/26/2007
• Issued: 02/16/2010
• Est. Priority Date: 10/11/2000
• Status: Expired due to Term

• Current Assignee: Healthtrio LLC (Spok Holdings, Inc.)
• Original Assignee: Healthtrio LLC (Spok Holdings, Inc.)
• Inventors: Wallen, J. Dominic, Post, Cindy A., Korpman, Ralph A., Peterson, John C., Hasan, Malik M.
• Primary Examiner(s): Morgan; Robert W
• Application Number:
  US11/925,072
• Publication Number:
  US 20080103819A1
• Time in Patent Office: 844 Days
• Field of Search: 705/2, 705/3, 705/4, 600/300
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• 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 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 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring

Abstract

An apparatus for communicating health care data from a sender to a receiver is provided. The apparatus has a first computer system, a second computer system, and a rules engine. The first computer system has health care data stored therein. The second computer system is in operable communication with, and is configured to extract the health care data from, the first computer system. The rules engine normalizes the extracted health care data to a predefined format.

Claims

1. A system to communicate health care data between a health care payor and a participant, the computer system comprising:

an intermediary computer system configured to communicate with one or more legacy databases that store records of health care data and operated by one or more payor computer systems;

wherein the intermediary computer system is configured to receive less than all of the health care data associated with a health care record from the one or more legacy databases, as a plurality of selected health care data;

wherein the plurality of selected health care data the intermediary computer system is configured to receive is of a type that each of the plurality of selected health care data is displayed in a separate field and all collectively stored in the one or more legacy databases;

wherein any of the plurality of selected health care data associated with the health care record having the same meanings is expressed in different formats;

wherein the plurality of selected health care data the intermediary computer system is configured to receive is of a type that is organized for use by the payor but has not previously been subject to a normalized format; and

wherein the normalized format is of a type that displays health care data from one or more sources such that any health care data associated with a health care record having the same meaning will be expressed in the same format despite any prior formatting;

a staging database that is part of the intermediary computer system and that is configured to receive the plurality of selected health care data from the one or more of the payor computer systems;

wherein receipt of the plurality of selected health care data by the intermediary computer from the one or more health care payor computer systems allows initiation of processing of the plurality of selected health care data to the normalized format;

a normalization system that interacts with the staging database and is configured to remodel the plurality of selected health care data into the normalized format, the normalization system comprising;

a rules engine that establishes the predefined format and predetermines how each of the plurality of selected health care data is to appear in its respective field for the participant;

wherein fields in the normalized format that correspond to the fields containing the selected health care data from the one or more legacy databases are identified;

wherein any of the plurality of selected health care data that is not expressed as predetermined by the normalized format is remodeled so all the plurality of selected health care data of the health care record is expressed as predetermined by the normalized format becoming normalized data such that all normalized data expressing information having the same meaning now expresses that meaning in the same format; and

wherein the the plurality of selected health care data on the intermediary system is replaced with normalized data;

an audit database that is configured to track remodeling of the selected health care data into normalized data; and

wherein the intermediary system is configured to transfer the normalized data over a data network to a participant computer system and back to the health care payor.

2. The system of claim 1, wherein the intermediary computer system is configured to receive a request by the participant computer system that initiates extracting the health care data from the payor computer system.

3. The system of claim 2, wherein the rules engine applies the normalized data to respond to the request of the participant computer system.

4. The system of claim 2, wherein the rules engine determines whether the participant computer system is authorized to receive the normalized data.

5. The system of claim 2, wherein the normalized data is applied to respond to the request of a patient computer system.

6. The system of claim 2, wherein the rules engine applies the normalized data to respond to the request of a provider computer system.

7. The system of claim 1, wherein the participant computer system is configured to transmit a request that is sent to the intermediary computer system that determines which health care data is to be extracted and normalized in order to respond to the request.

8. The system of claim 7, wherein the participant computer system transmits the request and the intermediary system transmits the normalized data to the participant computer system over the internet.

9. The computer system of claim 1, wherein the intermediary computer system is configured to determine whether any of the plurality of health care data is invalid and configured to transfer the invalid health care data to an invalid data database to be corrected.

10. The system of claim 9, wherein any invalid health care data is evaluated to make the invalid health care data useable.

11. The system of claim 1, wherein the rules engine determines how the normalized data can be used.

12. The system of claim 1, further comprising a medical administration system including a process of executing a medical test referral that includes transmitting a determination of the referral to the participant computer system which is a health care provider, patient, employer, or payor.

13. The system of claim 12, wherein a result of a medical test is transmitted to at least one receiver selected from the group consisting of the one or more payors, the health care provider, another health care provider, a patient, and an employer.

14. The system of claim 1, wherein the rules engine defines relationships among the selected health care data normalized to the predefined format pursuant to predetermined instructions to determine a response to a request.

15. The system of claim 1, wherein the normalized data is used to respond to a request by a payor computer system.

16. The system of claim 1, further comprising a provider computer system that makes a request tat initiates extracting the plurality of the selected health care data from the payor computer system.

17. The system of claim 1, wherein a payor computer system makes a request that initiates extraction of the selected health care data from the one or more payor computer systems.

18. The system of claim 1, further comprising a medical administration system wherein the rules engine refers a specialist, and is configured to transmit a referral to the participant computer system which is a health care provider, patient, employer, or the one or more payors.

19. The system of claim 1, further comprising a medical administration system including a process of executing a medical procedure referral that includes transmitting a determination of the referral to the participant computer system which is a health care provider, patient, employer, or payor.

20. The system of claim 1, wherein a medical health record can he generated from the normalized data.