Method and system for generating personal/individual health records

• US 8,131,563 B2
• Filed: 04/19/2010
• Issued: 03/06/2012
• 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: Hasan, Malik M., Peterson, John C., Wallen, J. Dominic
• Primary Examiner(s): Sereboff, Neal
• Application Number:
  US12/762,673
• Publication Number:
  US 20100198623A1
• Time in Patent Office: 687 Days
• Field of Search: 705/2, 705/3
• 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 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 10/40 for data related to laboratory analysis, e.g. patient specimen analysis
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 70/60 relating to pathologies
• 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

A system and method for generating and/or updating a personal/individual health record. Inputs of data to the system may come from diverse sources including, but not limited to, patient questionnaires, insurance company (or other payor) claims data, hospitals, clinics and other institutional providers, and individual physicians and physicians'"'"' offices.

Claims

1. A computerized method for generating a personal/individual health record, said method comprising a personal health record system server performing the steps:

(a) enrolling a patient in a health plan of a payor, wherein the health plan covers at least a portion of the cost of the patient when a patient undergoes encounters with a plurality of health care providers regarding a health related issue of the patient, wherein under the plan the health care providers request payment for at least a portion of the cost for the encounters from the payor, wherein the plan requires the health care providers to submit health related information of the patient to the payor to support the cost of encounters with the patient;

(b) transferring payor claims data regarding the patient to a personal health record (“

PHR”

) system server;

(c) analyzing, at the PHR system server, said payor claims data concerning the patient to determine which portion of said payor claims data is encounter data comprising one or more of a diagnosis of the patient, a treatment of the patient, a medication of the patient, a procedure of said patient, a history of office visits of the patient with one or more of the health care providers, or duration of office visits of the patient;

(d) populating, at the PHR system server, a personal/individual health record of the patient by storing one or more entries into the personal/individual health record of the patient based on the encounter data, wherein initial population of the personal/individual health record of the patient is based solely on encounter data extracted from the payor claims data;

(e) organizing, at the PHR system server, the personal/individual health record by associating together one or more entries in the personal/individual health record of the patient that are related; and

(f) providing a web-based portal accessible by the patient to view the personal/individual health record of the patient.

6. The method of claim 1, further comprising the step of providing a messaging facility accessible by one or more health care providers of the patient to supplement the personal/individual health record of the patient.

11. The method of claim 1, wherein the web-based portal is configured to allow the patient to supplement the personal/individual health record of the patient.

14. The method of claim 1, further comprising the step of providing a messaging facility for supplementing the personal/individual health record of the patient with health related data comprising one or more of laboratory data, imaging data, medication data, or ancillary test data.

2. A computerized method for analyzing an electronic health record, said method comprising the steps of:

(a) transferring payor claims data regarding a plurality of patients of a payor to an electronic health record system server, wherein a plurality of patients enrolled in a health plan of the payor undergo encounters with a plurality of health care providers regarding a health related issue of the patients, wherein under the health plan the health care providers request payment for at least a portion of the cost for the encounters from the payor, wherein the health plan requires health care providers to submit health related information of the patients to the payor to support the cost of encounters with the patient;

(b) analyzing at the electronic health record system server said payor claims data concerning a respective patient of the plurality of patients to determine which portion of said payor claims data is encounter data comprising one or more of a diagnosis of the respective patient, a treatment of the respective patient, a medication of the respective patient, a procedure of the respective patient, a history of office visits of the respective patient with one or more of the health care providers, or duration of office visits of the respective patient;

(c) creating at the electronic health record system server electronic health records concerning the plurality of patients by storing one or more entries into the respective patient'"'"'s electronic health record based on the encounter data, wherein initial population of the electronic health records of the patients is based solely on the encounter data extracted from the payor claims data;

(d) organizing, at the electronic health record system server, the health records by associating together one or more entries in the respective patient'"'"'s electronic health record that are related; and

(e) analyzing the electronic health care records by measuring the outcomes of specific treatments of diseases under investigation and providing a direct comparison of outcomes measured of a specific treatment with various other treatments to allow setting up or modification of clinical protocols.

7. The method of claim 2, further comprising the step of providing a messaging facility accessible by one or more health care providers of the patients to supplement the electronic health records of the patients.

3. A personal health record (“

PHR”

) system server for use with a patient enrolled in a health plan of a payor, wherein the health plan covers at least a portion of the cost of the patient when a patient undergoes encounters with a plurality of health care providers regarding a health related issue of the patient, wherein under the plan the health care providers request payment for at least a portion of the cost for the encounters from the payor, wherein the plan requires the health care providers to submit health related information of the patient to the payor to support the cost of encounters with the patient, the PHR system server comprising;

a memory for storing instructions and data associated with a personal/individual health record of a patient; and

a processor configured to execute the instructions, wherein the instructions cause the processor to perform the steps comprising;

(a) transferring payor claims data of the patient to the (“

PHR”

) system server;

(b) analyzing said payor claims data concerning the patient to determine which portion of said payor claims data is encounter data comprising one or more of a diagnosis of the patient, a treatment of the patient, a medication of the patient, a procedure of said patient, a history of office visits of the patient with one or more of the health care providers, or duration of office visits of the patient;

(c) populating the personal/individual health record of the patient by storing one or more entries into the personal/individual health record of the patient based on the encounter data, wherein initial population of the personal/individual health record of the patient is based solely on encounter data extracted from the payor claims data;

(d) organizing the personal/individual health record by associating together one or more entries in the personal/individual health record of the patient that are related; and

(e) providing a web-based portal accessible by the patient to view the personal/individual health record of the patient.

8. The method of claim 3, further comprising an instruction for providing a messaging facility accessible by one or more health care providers of the patient to supplement the personal/individual health record of the patient.

12. The method of claim 3, wherein the web-based portal is configured to allow the patient to supplement the personal/individual health record of the patient.

15. The method of claim 3, further comprising an instruction for providing a messaging facility for supplementing the personal/individual health record of the patient with health related data comprising one or more of laboratory data, imaging data, medication data, or ancillary test data.

4. An electronic health record system server for use with analyzing electronic health records of a plurality of patients enrolled in a health plan of the payor, wherein the patients undergo encounters with a plurality of health care providers regarding a health related issue of the patients, wherein under the health plan the health care providers request payment for at least a portion of the cost for the encounters from the payor, wherein the health plan requires health care providers to submit health related information of the patients to the payor to support the cost of encounters with the patient, the electronic health record system server comprising:

a memory for storing instructions and data associated with electronic health records of a plurality of patients; and

a processor configured to execute the instructions, wherein the instructions cause the processor to perform the steps comprising;

(a) transferring payor claims data regarding the plurality of patients to an electronic health record system server;

(b) analyzing at the electronic health record system server said payor claims data concerning a respective patient of the plurality of patients to determine which portion of said payor claims data is encounter data comprising one or more of a diagnosis of the respective patient, a treatment of the respective patient, a medication of the respective patient, a procedure of the respective patient, a history of office visits of the respective patient with one or more of the health care providers, or duration of office visits of the respective patient;

(c) creating at the electronic health record system server electronic health records concerning the plurality of patients by storing one or more entries into the respective patient'"'"'s electronic health record based on the encounter data, wherein initial population of the electronic health records of the patients is based solely on the encounter data extracted from the payor claims data;

(d) organizing, at the electronic health record system server, the health records by associating together one or more entries in the respective patient'"'"'s electronic health record that are related; and

(e) analyzing the electronic health care records by measuring the outcomes of specific treatments of diseases under investigation and providing a direct comparison of outcomes measured of a specific treatment with various other treatments to allow setting up or modification of clinical protocols.

9. The method of claim 4, further comprising an instruction for providing a messaging facility accessible by one or more health care providers of the patients to supplement the electronic health records of the patients.

5. A personal health record (“

PHR”

) system server for use with a patient enrolled in a health plan of a payor, wherein the health plan covers at least a portion of the cost of the patient when a patient undergoes encounters with a plurality of health care providers regarding a health related issue of the patient, wherein under the plan the health care providers request payment for at least a portion of the cost for the encounters from the payor, wherein the plan requires the health care providers to submit health related information of the patient to the payor to support the cost of encounters with the patient, the PHR system server comprising;

a memory for storing instructions and data associated with a personal/individual health record of the patient; and

a processor configured to execute the instructions, wherein the instructions cause the processor to perform the steps comprising;

(a) transferring payor claims data of the patient to the (“

PHR”

) system server;

(b) analyzing said payor claims data to determine which portion of said payor claims data concerning the patient is encounter data comprising one or more of a diagnosis of the patient, a treatment of the patient, a medication of the patient, a procedure of said patient, a history of office visits of the patient with one or more of the health care providers, or duration of office visits of the patient;

(c) populating the personal/individual health record of the patient by storing one or more entries into the personal/individual health record of the patient based on the encounter data, wherein population of at least a portion of the entries in the personal/individual health record of the patient is encounter data extracted from the payor claims data;

(d) organizing the personal/individual health record by associating together one or more entries in the personal/individual health record of the patient that are related; and

(e) providing a web-based portal accessible by the patient to view the personal/individual health record of the patient.

10. The method of claim 5, further comprising an instruction for providing a messaging facility accessible by one or more health care providers of the patient to supplement the personal/individual health record of the patient.

13. The method of claim 5, wherein the web-based portal is configured to allow the patient to supplement the personal/individual health record of the patient.

16. The method of claim 5, further comprising an instruction for providing a messaging facility for supplementing the personal/individual health record of the patient with health related data comprising one or more of laboratory data, imaging data, medication data, or ancillary test data.