Method and system for outcome based medical referrals

• US 7,873,525 B1
• Filed: 09/22/2005
• Issued: 01/18/2011
• Est. Priority Date: 09/22/2005
• Status: Active Grant

• Current Assignee: David Ray Kraus
• Original Assignee: David Ray Kraus
• Inventors: Kraus, David Ray
• Primary Examiner(s): O'Connor; Gerald J.
• Assistant Examiner(s): Pauls; John A
• Application Number:
  US11/232,779
• Time in Patent Office: 1,944 Days
• Field of Search: 705/2, 705/3, 705/4, 705/37, 702/182, 600/300, 514/252.18
• US Class Current: 705/2
• CPC Class Codes: G06Q 30/02 Marketing; Price estimation or determination; Fundraising
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires

Abstract

A method and system is described to provide outcome data to the healthcare industry allowing for fair and accurate quality based purchasing decisions. The system deploys methods to facilitate the accurate and unbiased collection of patient outcome data. From this data warehouse of outcome data, purchasers can access aggregate outcome data identifying those providers or health plans that have achieved the best outcomes for specific criteria. Similarly, individual patient referrals can be made to providers with the best track record of helping comparable patients. Based upon outcome assessment data these searches can automatically be made based on specific patient characteristics and needs.

Claims

1. A method of patient referral, comprising:

for each of a plurality of patients each treated by a respective provider, administering questionnaires to each said patient over time,

wherein each time a questionnaire is administered, a time-based outcome for each said patient and said respective provider is produced; and

wherein each time-based outcome comprises a measure of said patient'"'"'s change in a medical condition over time; and

wherein each time-based outcome further comprises a measure of said respective provider'"'"'s level of success in treating said medical condition;

storing said plurality of time-based outcomes in a computer-implemented database correlated by at least said respective provider; and

on a programmed computer, automatically;

determining the medical condition for at least one of said plurality of patients based at least on said time-based outcome produced by the questionnaire most recently administered to said one of said plurality of patients;

determining the medical specialty of a provider to treat the determined medical condition based at least on said time-based outcome produced by the questionnaire most recently administered to said one of said plurality of patients;

querying said computer-implemented database for specific providers having said medical specialty and having a plurality of said time-based outcomes for said medical condition, said querying resulting in a summary table of said specific providers;

ranking each of said specific providers in said summary table based on each of said specific providers'"'"' plurality of time-based outcomes for said medical condition to form a ranked summary table of specific providers, wherein each of said specific providers'"'"' ranking is based on the average of the plurality of said measures of said respective provider'"'"'s level of success in treating said medical condition; and

presenting said ranked summary table of specific providers to the at least one of said plurality of patients.

2. The method of claim 1, wherein said questionnaires comprise general health and functioning and disease-specific questions.

3. The method of claim 1, wherein said computer-implemented database is linked to a schedule of at least one of said specific providers to facilitate scheduling of said referral.

4. The method of claim 1, wherein, prior to said automatically determining, the plurality of time-based outcomes for said plurality of patients is risk adjusted.

5. The method of claim 1, wherein said automatically determining further comprises identifying at least one abnormal medical condition, wherein said abnormal medical condition is the specific medical condition for each patient that is the most out of the norm.

6. The method of claim 5, wherein said automatically determining further comprises using a weighting of a severity of said at least one abnormal medical condition.

7. The method of claim 1, wherein said querying further comprises filtering on non-outcome-based criteria.

8. The method of claim 7, wherein said non-outcome-based criteria are selected from a list consisting of distance to travel, gender, race, religion, and insurance coverage.