Disease management system and health assessment method

• US 8,630,875 B2
• Filed: 10/31/2007
• Issued: 01/14/2014
• Est. Priority Date: 03/13/1997
• Status: Expired due to Fees

• Current Assignee: Healthways SC, LLC (Warner Bros. Discovery, Inc.)
• Original Assignee: Clinical Decision Support, LLC (Tivity Health, Inc.)
• Inventors: Iliff, Edwin C.
• Primary Examiner(s): RANGREJ, SHEETAL
• Application Number:
  US11/930,778
• Publication Number:
  US 20080052120A1
• Time in Patent Office: 2,267 Days
• Field of Search: 705 2- 3
• US Class Current: 705/3
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• 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
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• 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 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 70/20 relating to practices or guidelines
• 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
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation
• CPC Class Codes: Y10S 128/92 Computer assisted medical diagnostics
• CPC Class Codes: Y10S 128/925 Neural network

Abstract

A system and method for allowing a patient to access an automated process for managing a specified health problem called a disease. The system performs disease management in a fully automated manner, using periodic interactive dialogs with the patient to obtain health state measurements from the patient, to evaluate and assess the progress of the patient'"'"'s disease, to review and adjust therapy to optimal levels, and to give the patient medical advice for administering treatment and handling symptom flare-ups and acute episodes of the disease. The medical records are updated, the progression of the disease is stored and tracked, and the patient'"'"'s preferences for treatment are stored and then used to offer medical advice based on the current state of the disease. A prestored general disease trend curve is compared against a patient specific disease trend curve, and the system makes an automated response such as adjusting therapy.

Claims

1. A computerized method for assessing health for a patient having a disease being managed via a computing device, the method comprising:

receiving, by the computing device, information input by a patient, via direct interactive dialogue between the patient and the computing device, the information input including at least one of;

an objective measurement, a subjective input, and a side effect input, the information input including whether the patient presently has a symptom;

receiving, by the computing device, data associated with a disease;

storing, by the computing device, the data associated with the disease;

determining, by the computing device, whether the information input is related to the disease being managed for the patient based on the stored data associated with the disease;

receiving, by the computing device, health assessment information based at least on the determining and based on the information input of whether the patient is a new patient or a returning patient;

determining, by the computing device, a current health state of the patient via

     1) a current health assessment module, the current health assessment module including a correlation assessment including a subjective objective-correlation factor (SOCF),

     2) a correlation assessment function, the correlation assessment function compares subjective measurements to objective measurements from the patient to determine a reliability of the patient'"'"'s subjective measurements, and

     3) an analysis of a SOCF time plot, the SOCF time plot based on a ratio of subjective to objective measurements over time, the current health state based on the objective measurement, the side effect input as adjusted by the SOCF, the current health assessment module, the correlation assessment function, and the analysis of the SOCF time plot and the subjective input as adjusted by the SOCF; and

outputting, by the computing device, the current health state of the patient;

wherein the current health assessment module comprises an assessment function, the assessment function analyzes disease-specific changes with regard to health measurements of the patient tracked over time to identify and predict changes in the current health state of the patient.

2. The method of claim 1, wherein the symptom determination comprises determining a severity level of the symptom based on the stored data.

3. The method of claim 2, further comprising automatically informing, via the computing device, a healthcare provider if the severity level of the symptom reaches a particular severity threshold.

4. The method of claim 1, wherein the received health assessment information comprises new patient parameters related to the disease being managed.

5. The method of claim 4, wherein the new patient parameters comprise patient instructions, choice of therapy, and permissions relating to permission to access data.

6. The method of claim 1, wherein the patient is a returning patient, and wherein the health assessment comprises data indicative of the health of the patient, wherein the data is obtained from a critical curve.

7. The method of claim 6, wherein the critical curve comprises a curve with health measurement points plotted over time, wherein the measurement points form a slope indicative of improving health or declining health.

17. The computer readable medium of claim 1, wherein the decline in health is identified by matching predetermined criteria.

18. The method of claim 1, wherein the information input by the patient indicates whether the symptom is a significant symptom.

8. A computerized disease management system for assessing the health of a patient with a disease being managed, the system comprising:

a registration module configured to identify whether the patient has previously registered with the system;

a specifications module configured to reference health assessment specifications, from a data storage, for the disease being managed if the patient has not previously registered with the system;

a symptom filter module configured to determine a severity level of a symptom of the patient based on stored reference data indicative of the severity of the symptom and contact a medical health professional when a severity level of the symptom reaches a severity threshold;

an initial health assessment module configured to retrieve side effects and health data of the patient based at least in part on direct interactive dialogue between the patient and the module and the referenced health assessment specifications, the health data including at least one of;

a subjective input, an objective measurement, and a side effect ;

a current health assessment module configured to obtain, via direct interactive dialogue between a patient and the module, current health data and determine a current health state of the patient, the current health data including at least one of;

the subjective input, the objective measurement, and the side effect, wherein the modules are executable in a computing environment;

a correlation assessment function, the correlation assessment function compares subjective measurements to objective measurements from the patient to determine a reliability of the patient'"'"'s subjective measurements, wherein the correlation assessment function comprises a comparison of the subjective input to the objective measurements to determine a subjective objective correlation factor (SOCF), the SOCF applied to the patient'"'"'s subjective inputs,

wherein the current health assessment module comprises an assessment function, wherein the assessment function analyzes at least one of;

the objective measurements, the subjective inputs as adjusted by the SOCF, the side effect as adjusted by the SOCF, and disease-specific changes with regard to health data of the patient tracked over time to identify and predict changes in the current health state of the patient.

9. The system of claim 8, wherein the current health assessment module comprises a critical curve assessment function, wherein the critical curve assessment function is configured to analyze health measurements of the patient plotted over time to identify and predict changes in the current health state of the patient.

10. The system of claim 8, wherein the symptom filter module comprises a first filter, wherein the first filter determines whether the patient has reported experiencing any significant symptoms.

11. The system of claim 10, wherein the symptom filter module comprises a second filter, wherein the second filter determines whether the symptom is related to the disease being managed for the patient.

12. The system of claim 11, wherein the symptom filter module comprises a third filter, wherein the third filter assesses whether the severity level of the symptom reaches the severity threshold.

19. The system of claim 8, wherein the symptom filter module is configured to determine a significance level of the symptom.

13. A method of assessing a patient'"'"'s health in a disease management system, the method comprising:

receiving, via direct interactive dialogue between the patient and a computing device, patient symptom input of at least one of objective measurements, subjective input or side effects, the patient input including whether the patient presently has a symptom;

assessing a reliability of the subjective input and side effects based on a subjective objective correlation factor (SOCF);

determining, by the computing device, that the symptom input of the patient is a side effect of a current therapy of the patient;

determining, by the computing device, if the computing device should communicate with a medical health professional based on a severity level of the symptom, the severity level of the symptom being determined based on stored reference data indicative of the severity level of the symptom and the reliability of the patient subjective input;

communicating, via the computing device, with the medical health professional;

determining, by the computing device, if the patient should communicate with a medical health professional based on a severity level of the symptom, the severity level of the symptom being determined based on stored reference data indicative of the severity level of the symptom and based on the patient symptom input factored by the SOCF;

determining, by the computing device, a prediction of a current health state of the patient;

communicating, via the computing device, with the patient;

obtaining, by the computing device, an initial or current health assessment based at least on whether it was determined that the patient should communicate with a medical health professional; and

storing, by the computing device, the initial or current health assessment in a data storage, wherein the initial or current health assessment comprises obtaining objective measurements, subjective measurements or side effects, the subjective measurements and the side effects factored by the SOCF.

14. The method of claim 13, wherein the initial health assessment comprises providing one or more initial health assessment questions to a new patient, wherein the initial health assessment questions comprise a subjective assessment of current health, an inquiry about any available objective health measurements, and an inquiry of any pre-existing side effects.

15. The method of claim 13, wherein the current health assessment of a patient comprises comparing the obtained objective measurements, subjective measurements or side effects to one or more health parameter tables.

21. The method of claim 13, wherein determining if the patient should communicate with a medical health professional is based at least in part on the determined side effect.

22. The method of claim 13, comprising determining that the patient should communicate with a medical health professional when the severity level of the symptom reaches a severity threshold.

16. A computerized health assessment method, comprising:

obtaining and storing, by a computing device, via direct interactive dialogue between a patient and the computing device, initial health measurements from the patient, and any pre-existing therapy or side effects, if the patient has not been previously assessed;

obtaining and storing, by the computing device, subsequent health measurements from the patient if the patient has been previously assessed;

comparing, by the computing device, the patient'"'"'s initial health measurements, subsequent health measurements, and pre-existing therapy or side effects to stored data associated with management of a particular disease;

determining, by the computing device, a reliability of a subjective input of the subsequent health measurements based on a comparison of the subjective input to objective measurements;

determining, by the computing device, a prediction of a current health state of the patient;

factoring, by a subjective-objective correlation factor (SOCF) and the reliability, a subjective input of one of the subsequent health measurements and the side effects; and

outputting, by the computing device, a health assessment and the prediction of the current health state of the patient.

20. The method of claim 16, further comprising determining the significance level for the health measurements.

23. A computerized method for assessing health for a patient having a disease being managed via a computing device, the method comprising:

receiving, by the computing device, information input by a patient in response to a question, the information indicating whether the patient presently has a symptom;

providing, by the computing device, at least one additional question to the patient based upon the information input by the patient in response to said question;

receiving, by the computing device, data associated with a disease;

storing, by the computing device, the data associated with the disease;

determining, by the computing device, whether the symptom is related to the disease being managed for the patient based on the stored data associated with the disease;

determining, by the computing device, a reliability of a subjective portion of the information input based on a comparison of subjective input to objective measurements;

factoring, by a subjective-objective correlation factor (SOCF) and the reliability, a subjective portion of the information input by the patient;

receiving, by the computing device, health assessment information based at least on the determining and based on the information input of whether the patient is a new patient or a returning patient;

determining, by the computing device, a current health state of the patient via a current health assessment module; and

outputting, by the computing device, a health assessment of the patient,

wherein the current health assessment module comprises an assessment function, wherein the assessment function analyzes at least one of;

the subjective portion of the information, the information, and disease-specific changes with regard to health measurements of the patient tracked over time to identify and predict changes in the current health state of the patient.