System and method for automatically and iteratively producing and updating patient summary encounter reports based on recognized patterns of occurrences

• US 7,983,935 B1
• Filed: 03/22/2010
• Issued: 07/19/2011
• Est. Priority Date: 03/22/2010
• Status: Expired due to Fees

• Current Assignee: Intermedix Office Based LLC (R1 RCM, Inc.)
• Original Assignee: IOS Health Systems, Inc.
• Inventors: Sanchez, Jose M., Carricarte, Andrew L.
• Primary Examiner(s): Gilligan; Luke
• Assistant Examiner(s): NGUYEN, TRAN N
• Application Number:
  US12/728,850
• Time in Patent Office: 484 Days
• Field of Search: 705/2
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof

Abstract

A method for automatically and iteratively updating patient encounter reports based on recognized patterns of occurrences. A patient'"'"'s information is obtained prior to a visit to a healthcare facility. This information is compared to a set of guidelines. The result is a preliminary patient encounter report that may be presented to a physician as well as act as a preset trigger to generate financial transactions. The physician can edit the report due to his own preferences and the updated report automatically sent to a rules engine that examines the edits, on a physician, healthcare facility, and patient level and determines if changes to the existing guidelines need to be made. The new guidelines are sent to a predictor module so that upon subsequent visits by patients, new guidelines will appear on the preliminary patient encounter summary report along with other learned administrative and financial transactions within the system.

Claims

1. A method for automatically and iteratively updating patient encounter reports, the method comprising:

storing one or more rules in a tangible, storage medium;

a predictor module applying patient characteristics to the stored rules to produce a preliminary patient encounter report, the preliminary patient encounter report including predicted activity for a patient medical encounter;

presenting the preliminary patient encounter report for editing;

receiving edits to the preliminary patient encounter report;

producing an edited patient encounter report containing updated predicted activity in response to the editing;

a processor determining if the edits to the patient encounter report meet a threshold level; and

a rules engine replacing the stored rules with updated rules based on a result of determining if the edits to the preliminary patient encounter report meet a threshold level

the predictor module applying a subsequent set of patient characteristics to the updated rules to produce a subsequent patient encounter report, the subsequent patient encounter report including predicted activity for a subsequent patient medical encounter.

2. The method of claim 1, further comprising automatically generating at least one action upon submission of the edited patient encounter report.

3. The method of claim 2, wherein the at least one action includes one or more of generating a referral letter, issuing a medication prescription, generating financial transactions, and ordering tests.

4. The method of claim 1, wherein determining if the edits to the patient encounter report meet a threshold level includes determining if a threshold level has been met at a physician level.

5. The method of claim 1, wherein determining if the edits to the patient encounter report meet a threshold level includes determining if a threshold level has been met at a healthcare facility level.

6. The method of claim 1, wherein determining if the edits to the patient encounter report meet a threshold level includes determining if a threshold level has been met at a patient level.

7. The method of claim 1, wherein determining if the edits to the patient encounter report meet a threshold level occurs automatically when the editing of the patient encounter report occurs.

8. A system for automatically and iteratively updating patient encounter reports comprising:

a tangible storage medium for storing patient characteristics and one or more stored rules;

a predictor module comprising a central processing unit (CPU), a computer-readable memory, and a computer-readable, tangible data storage device for applying the patient characteristics to the one or more stored rules to produce a patient preliminary encounter report, the patient preliminary encounter report containing predicted activity for a patient medical encounter, the patient preliminary encounter report adapted to receive annotations by a user, the predictor module producing an edited patient preliminary encounter report containing updated predicted activity in response to receiving the annotations; and

a rules engine having a processor for determining if the annotations to the patient preliminary encounter report meet a threshold level, the rules engine replacing the one or more stored rules with updated rules based on a result of determining if the annotations to the patient preliminary encounter report meet a threshold level,

the predictor module applying a subsequent set of patient characteristics to the updated rules to produce a subsequent patient encounter report, the subsequent patient encounter report including predicted activity for a subsequent patient medical encounter.

9. The system of claim 8, further comprising an event generating module for automatically generating at least one action upon submission of the annotations by the user.

10. The system of claim 9, wherein the at least one action includes one or more of generating a referral letter, issuing a medication prescription, generating financial transactions, ordering tests and sending information to a Health Information Exchange.

11. The system of claim 8, wherein the processor determines if the annotations to the patient preliminary encounter report meet a threshold level, at a physician level.

12. The system of claim 8, wherein the processor determines if the annotations to the patient preliminary encounter report meet a threshold level, at a healthcare facility level.

13. The system of claim 8, wherein the processor determines if the annotations to the patient preliminary encounter report meet a threshold level, at a patient level.

14. A computer program product tangibly embodied in a computer storage medium, for executing instructions on a processor, the computer program product being operable to cause a machine to:

apply patient characteristics to a stored set of rules to produce a preliminary patient encounter report, the preliminary patient encounter report including predicted activity for a patient medical encounter;

present the preliminary patient encounter report for editing

receive edits to the preliminary patient encounter report;

produce an edited patient encounter report containing updated predicted activity in response to the editing;

determine if the edits to the preliminary patient encounter report meet a threshold level;

replace the stored set of rules with updated rules based on a result of determining if the edits to the preliminary patient encounter report meet a threshold level; and

apply a subsequent set of patient characteristics to the updated rules to produce a subsequent patient encounter report, the subsequent patient encounter report including predicted activity for a subsequent patient medical encounter.

15. The computer program product of claim 14, wherein the computer program product automatically generates at least one action upon submission of the edited patient encounter report.

16. The computer program product of claim 15, wherein the at least one action includes one or more of generating a referral letter, issuing a medication prescription, generating financial transactions, ordering tests and sending information to a Health Information Exchange.

17. The computer program product of claim 14, wherein the computer program product determines if the edits to the preliminary patient encounter report meet a threshold level at a physician level.

18. The computer program product of claim 14, wherein the computer program product determines if the edits to the preliminary patient encounter report meet a threshold level at a healthcare facility level.

19. The computer program product of claim 14, wherein the computer program product determines if the edits to the preliminary patient encounter report meet a threshold level at a patient level.

20. The computer program product of claim 14, wherein the computer program product automatically determines if the edits to the preliminary patient encounter report meet a threshold level when the editing of the preliminary patient encounter report occurs.