Method and apparatus for protecting relationships with referring providers within a system that identifies patients overdue for an appointment

• US 8,650,040 B2
• Filed: 05/14/2010
• Issued: 02/11/2014
• Est. Priority Date: 05/14/2010
• Status: Active Grant

• Current Assignee: Brevium Incorporated
• Original Assignee: Brevium Incorporated
• Inventors: Gerlach, Brett Cornell, Perrin, William Brian
• Primary Examiner(s): O'Connor, Gerald J.
• Assistant Examiner(s): WINSTON III, EDWARD B
• Application Number:
  US12/780,843
• Publication Number:
  US 20110282681A1
• Time in Patent Office: 1,369 Days
• Field of Search: 705/2, 705/3
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/107 Computer-aided management of electronic mailing [e-mailing]
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

A method and apparatus for protecting relationships with referring providers, so that when a patient reactivation system is used, patients referred by protected providers will be contacted and invited to make an appointment only when appropriate.

Claims

1. A computer-implemented system for improving health care provider practices by considering referral information in the generation of a contact list, the computer-implemented system comprising:

one or more computers executing computer instructions for automatically performing the steps of;

examining a patient reactivation database of a first health care provider;

identifying patients in the patient reactivation database who require health care within a specified period of time but who do not have an appointment scheduled with the first health care provider;

generating a contact list, the contact list comprising a list of the patients who require health care within a specified period of time but who do not have an appointment scheduled with the first health care provider;

comparing patients in contact list with a list of referring providers, each referring provider comprising a second health care provider that previously referred one or more patients to the first health care provider, at least some of the referring providers being protected referring providers; and

removing from the contact list those patients who were referred to the first health care provider by a protected referring provider or indicating in the contact list those patients who were referred to the first health care provider by protected referring providers.

2. The computer-implemented system of claim 1 further comprising, subsequent to the removing or indicating step, contacting the patients on the contact list who were not referred by a protected referring provider to schedule health care appointments.

3. The computer-implemented system of claim 2 in which contacting patients on the contact list includes contacting the patients by telephone or email.

4. The computer-implemented system of claim 1 in which providing an indication in the contact list includes providing to a caller an explicit notice or warning that a patient in the contact list has a protected referring provider.

5. The computer-implemented system of claim 1 in which a patient that was set up for a recall notice in the practice management system or electronic medical record system will not be excluded from or indicated in the contact list, regardless of whether the referring provider is a protected referring provider.

6. The computer-implemented system of claim 1 further comprising:

one or more computers executing computer instructions for automatically performing the steps of;

searching by a computer executing computer instructions a health care practice database to identify referring providers; and

generating by a computer executing computer instructions a list of the referring providers.

7. The computer-implemented system of claim 6 in which searching by a computer executing computer instructions a health care practice database to identify referring providers includes searching one or more of patient demographic data, appointment data, billing data, and electronic medical records data.

8. The computer-implemented system of claim 6 further comprising analyzing multiple sources of referring provider information, and excluding from or indicating in the contact list, patients having one or more protected referring providers, thereby protecting referring providers by using the multiple sources of information.

9. The computer-implemented system of claim 6 further comprising analyzing multiple sources of referring provider information, and displaying the names of one or more protected providers, displaying a warning, or displaying both the name of the one or more protected providers and a warning, when prompting a user to contact patients with one or more referring providers to protect referring providers across these sources.

10. The computer-implemented system of claim 6 further comprising indicating on a list of reasons for contact whether the existence of a protected referring provider will prevent the contact.

11. The computer-implemented system of claim 10 in which excluding from the patients to be called those that were referred by referring providers having protected status includes failing to exclude at least one patient having a contact reason that is indicated in the computer memory as requiring a contact regardless of whether the referring provider is a protected referring provider.

12. The computer-implemented system of claim 10 in which if a patient has multiple reasons for contact and at least one reason indicates that the patient should be contacted even if the referring provider is indicated as a protected referring provider, then the patient is placed on the contact list and not indicated.

13. The computer-implemented system of claim 10 in which a patient has multiple referring providers and in which if any of the multiple referring providers is protected, the patient is not contacted unless at least one reason indicates that the patient should be called even if the referring provider is indicated as a protected referring provider.

14. The computer-implemented system of claim 10 in which excluding from or indicating the contact list patients that were referred by protected referring providers includes verifying that the reason for the contact does not provide an exception from protected status that allows a contact before eliminating patients from the contact list.

15. A computer programmed to execute the steps of:

examining a patient reactivation database of a first health care provider;

identifying patients in the patient reactivation database who require health care within a specified period of time but who do not have an appointment scheduled with the first health care provider;

generating a contact list, the contact list comprising a list of the patients who require health care within a specified period of time but who do not have an appointment scheduled with the first health care provider;

comparing patients in the contact list with a list of referring providers, each referring provider comprising a second health care provider that previously referred one or more patients to the first health care provider, at least some of the referring providers being protected referring providers; and

removing from the contact list those patients who were referred to the first health care provider by a protected referring provider or indicating in the contact list those patients who were referred to the first health care provider by protected referring providers.

16. A nontransitory computer readable media encoded with computer instructions for executing the steps of:

examining a patient reactivation database of a first health care provider;

identifying patients in the patient reactivation database who require health care within a specified period of time but who do not have an appointment scheduled with the first health care provider;

generating by a computer executing the computer instructions a contact list, the contact list comprising a list of the patients who require health care within a specified period of time but who do not have an appointment scheduled with the first health care provider;

comparing by a computer executing the computer instructions patients in the contact list with a list of referring providers, each referring provider comprising a second health care provider that previously referred one or more patients to the first health care provider, at least some of the referring providers being protected referring providers; and

removing from the contact list those patients that were referred to the first health care provider by protected referring providers or indicating in the contact list those patients who were referred to the first health care provider by protected referring providers.

17. A computer-implemented method for improving health care provider practices by considering referral information in the generation of contact list, comprising:

examining a patient reactivation database of a first health care provider;

identifying patients in the patient reactivation database who require health care within a specified period of time but who do not have an appointment scheduled with the first health care provider;

generating by a computer executing computer instructions a contact list, the contact list comprising a list of the patients who require health care within a specified period of time but who do not have an appointment scheduled with the first health care provider;

comparing by a computer executing computer instructions patients in the contact list with a list of referring providers, each referring provider comprising a second health care provider that previously referred one or more patients to the first health care provider, at least some of the referring providers having an indication of protected status; and

removing from the contact list those patients who were referred to the first health care provider by a protected referring provider or indicating in the contact list those patients who were referred to the first health care provider by protected referring providers.

18. The computer implemented method of claim 17 in which determining based on referring provider information in one or more electronic databases whether the patient should be contacted by the practice to schedule an appointment includes determining based on referring provider information and on the reason for the appointment whether the patient should be contacted by the practice to schedule an appointment.

19. The computer implemented method of claim 17 further comprising compiling by the computer a list of referring providers, the referring providers designated in the list as protected or not protected.

20. The computer implemented method of claim 17 in which reviewing practice records in one or more electronic databases to determine whether a patient requires an appointment includes determining a reason a patient requires the appointment and further comprising determining from the computer memory whether a protected provider is a disqualifying condition for the determined reason.