System for communication of health care data
DC CAFCFirst Claim
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1. A computer 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 payor 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 a request from a participant computer system and wherein the request initiates extracting the health care data from the payor computer systemwherein the intermediary computer system determines which health care data the participant computer system is authorized to receive which is less than all of the health care data;
wherein the intermediary computer system is configured to receive the less than all of the health care data associated with a health care record extracted from the one or more legacy payor 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 payor 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 payor 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 plurality of selected health care data on the intermediary system is replaced with normalized data; and
wherein the intermediary system is configured to transfer the normalized data over a data network to the participant computer system.
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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.
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Citations
18 Claims
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1. A computer system to communicate health care data between a health care payor and a participant, the computer system comprising:
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an intermediary computer system configured to communicate with one or more legacy payor 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 a request from a participant computer system and wherein the request initiates extracting the health care data from the payor computer system wherein the intermediary computer system determines which health care data the participant computer system is authorized to receive which is less than all of the health care data; wherein the intermediary computer system is configured to receive the less than all of the health care data associated with a health care record extracted from the one or more legacy payor 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 payor 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 payor 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 plurality of selected health care data on the intermediary system is replaced with normalized data; and wherein the intermediary system is configured to transfer the normalized data over a data network to the participant computer system. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16)
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17. A computer system to communicate health care data between a health care payor and a participant, the computer system comprising:
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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 a request from a participant computer system and wherein the request initiates extracting the health care data from the payor computer system; wherein the intermediary computer system determines which health care data the participant computer system is authorized to receive which is less than all of the health care data; wherein the intermediary computer system is configured to receive less than all of the health care data associated with a health care record extracted 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; and
wherein the intermediary system is configured to transfer the selected health care data over a data network to the participant computer system.
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18. A computer system to communicate health care data between a health care payor and a participant, the computer system comprising:
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an intermediary computer system configured to communicate with two 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 a plurality of health care; wherein the intermediary computer system determines which health care data the participant computer system is authorized to receive which is less than all of the health care data; wherein the intermediary computer system is configured to receive less than all of the health care data associated with a health care record extracted from the plurality of health care data is displayed in a separate field and all collectively stored in the two 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 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 health care data from the one or more payor computer systems;
wherein receipt of the plurality of 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 health care data to the normalized format;
a normalization system that interacts with the staging database and is configured to remodel the plurality of 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 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 plurality of selected health care data on the intermediary system is replaced with 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.
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Specification