Health care information system

• US 9,406,097 B1
• Filed: 01/17/2006
• Issued: 08/02/2016
• Est. Priority Date: 01/17/2006
• Status: Expired due to Fees

• Current Assignee: Transition Automation Incorporated
• Original Assignee: Transition Automation Incorporated
• Inventors: Piety, Kenneth R.
• Primary Examiner(s): Nguyen, Hiep V
• Application Number:
  US11/333,420
• Time in Patent Office: 3,850 Days
• Field of Search: 705/3
• US Class Current: 1/1
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records

Abstract

In a method for creating and managing personal medical records a request for health care information is sent to a third-party payer, and health care information is received from the third-party payer and used to create received health care information. A patient profile identifies the types of health care information the patient wishes to obtain and save, and the received health care information is processed based on the patient profile to produce a result that includes one or more of (a) health care information that the patient wishes to save and was directly obtained from the received health care information, (b) the identity of health care information that was suggested to exist by the received health care information and that the patient wishes to save, but that was not contained within the received health care information. Based on the result, a web based computer or a patient'"'"'s computer creates and manages personal medical records. The computer may create and transmit a request for additional health care information that was suggested to exist.

Claims

1. A method for updating a patient-controlled and patient-centered electronic personal medical record database comprising:

providing a database of medical records for one or more patients including a patient identifier, a patient profile indicating the type of medical records desired by the patient, and information relating to the healthcare of the one or more patients;

using a computer and computer software to request and receive the patient'"'"'s explanation-of-benefits information from a third party payer using the computer software to identify and interpret the received explanation-of-benefits information to produce an interpretation;

using the interpretation to selectively generate a trigger for requesting medical records from a healthcare entity, the trigger being generated if a medical record is suggested to exist by the interpretation step and if the patient profile in the database indicates that the medical record is the type of medical record desired by the patient;

requesting the identified medical record when the trigger is generated;

receiving the identified medical record; and

updating the database using at least a portion of the received medical record.

2. The method of claim 1 further comprising providing the database with a plurality of data fields and using the software to translate and extract data from at least a portion of the medical record and parse the data into data fields.

3. The method of claim 2 wherein the translating uses a standardized vocabulary.

4. The method of claim 1 further comprising anticipating and reporting possible need for future health care actions based on receiving explanation-of-benefits information.

5. The method of claim 1 further comprising logging activities performed by the method to produce:

an information log listing the received explanation-of-benefits information and received medical records and at least the computer location of the received explanation-of-benefits information and received medical records;

a request log listing information requested by the method including the party to whom the request was made and the identity of the information requested;

a tickler identifying additional information that was requested and indicating whether each item of the additional information was or was not received.

6. A method for updating a patient-controlled and patient-centered electronic personal medical record database comprising:

providing a database of medical records for one or more patients including a patient identifier, a patient profile indicating the type of medical records desired by the patient, and information relating to the healthcare of the one or more patients;

using a computer for receiving and automatically interpreting the patient'"'"'s explanation-of-benefits information or request-for-payment information to produce an interpretation;

using the interpretation to selectively generate a trigger for requesting medical records from a healthcare entity, the trigger being generated if a medical record is suggested to exist by the interpretation step and if the patient profile in the database indicated that the medical record is the type of medical record desired by the patient as defined in the patient'"'"'s profile;

requesting the identified medical record when the trigger is generated;

receiving the identified medical record;

updating the database using at least a portion of the received medical record.

7. The method of claim 6 further comprising:

logging the requests for medical records to produce an information log listing requests for medical records that were produced;

identifying information that was requested but not received;

making additional attempts to obtain information that was requested but not received; and

informing the patient of unsuccessful requests for information; and

identifying the health care provider who did not provide information after being requested to do so.

8. A method for automatically creating and managing personal medical records comprising:

identifying in a patient profile types of the patient'"'"'s medical record information that the patient wants to obtain and save wherein the identified types comprise a selected subset from the larger set of the patient'"'"'s medical record information;

receiving one or more of;

(a) explanation-of-benefits information regarding a patient, and

(b) request-for-payment information regarding the patient'"'"'s health care;

computer processing the one or more of the received explanation-of-benefits information and request-for-payment information to interpret data contained thereon and produce an interpretation that suggests the existence of types of medicals records;

comparing the interpretation with the patient profile to determine a medical record of the type the patient wants to obtain and save and of a type that was suggested to exist by the interpretation;

using results of the comparison to selectively generate a trigger;

using the trigger to automatically request an identified medical record that is a type that the patient wants to obtain and save.