Clinical outcome tracking and analysis

• US 9,646,135 B2
• Filed: 08/10/2016
• Issued: 05/09/2017
• Est. Priority Date: 10/08/2013
• Status: Active Grant

• Current Assignee: COTA, Inc.
• Original Assignee: COTA, Inc.
• Inventors: Pecora, Andrew L.
• Primary Examiner(s): Gilligan, Luke
• Application Number:
  US15/233,577
• Publication Number:
  US 20160350495A1
• Time in Patent Office: 272 Days
• CPC Class Codes: G06Q 10/0637 Strategic management or analysis, e.g. setting a goal or target of an organisation; Planning actions based on goals; Analysis or evaluation of effectiveness of goals
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 10/1095 Meeting or appointment
• CPC Class Codes: G06Q 30/0201 Market modelling; Market analysis; Collecting market data
• 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
• 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 50/70 for mining of medical data, e.g. analysing previous cases of other patients

Abstract

The described invention provides a method, system and non-transitory computer readable medium storing computer program instructions for enabling a patient with a condition to optimize treatment options based on geography, clinical outcome, cost and other patient-set criteria. Computer program instructions when executed on a processor comprising a first clinical outcome tracking and analysis module causes the first clinical outcome and tracking module to account for biological variance up front by grouping patients in the patient population, thereby effectively removing biological variance as a factor in value of care, and leaving treatment variance as a predominant factor in treatment outcome by receiving, sorting, and classifying personal health information the latter by generating and assigning a plurality of nodal addresses, each nodal address representing a discrete punctuated string of digits comprising a prefix, a middle and a suffix that each represent a set of preselected variables that partition the sorted and classified information into a clinically relevant set of information. The described invention provides for communication between the processor comprising the first clinical outcome tracking and analysis module and a client device comprising a second clinical outcome tracking and analysis module that are communicatively linked so that a nodal address is assigned and communicated to the patient along with a geographically organized list of medical professionals treating patients within the assigned nodal address. Once the patient selects a medical professional that meets one or more of geographical, cost and clinical outcome needs of the patient, the first clinical outcome and tracking analysis module is communicatively linked to a computing device at the selected medical professional'"'"'s office to facilitate scheduling of an appointment. The assigned nodal address can be associated with one or more bundles of predetermined patient care services for treatment of the condition, which can provide a predetermined course of treatment, cost certainty, or both.

Claims

1. A method for enabling a patient with a condition to optimize treatment options based on one or more of geography, outcome and cost comprising interactions between a patient, a computer server containing a processor comprising a first clinical outcome tracking and analysis module, a client device comprising a second clinical outcome tracking and analysis module that is communicatively linked to the first clinical outcome tracking and analysis module via a network, and a computing device containing a third clinical outcome tracking and analysis module,

comprising:

(a) executing on the processor comprising the first clinical outcome tracking and analysis module the steps of;

(A) accounting for biological variance up front by grouping patients in a patient population, thereby effectively removing biological variance as a factor in value of care, and leaving treatment variance as a predominant factor in treatment outcome in the patient population by;

(i) receiving, collecting and recording, in a database, personal health information from each patient in the patient population, the personal health information comprising each parameter that characterizes each patient in the patient population;

(ii) sorting the personal health information for each patient in the patient population using a sorting filter to (i) provide a sorted set of personal health information for the patient population, and (ii) identify patients satisfying each parameter in the patient population; and

(iii) classifying like personal health information, and grouping types of patients in the patient population, based on the personal health information associated with the patient population by generating and assigning a plurality of nodal addresses, wherein the generating and assigning the plurality of nodal addresses comprises;

 

(1) representing each nodal address as a discrete punctuated string of digits comprising a prefix, a middle, and a suffix that each represent a set of preselected variables that partition the sorted and classified information into a clinically relevant set of health information;

 

(2) reducing trillions of possible permutations to a reduced number of clinically meaningful permutations based on the discrete punctuated string of digits representing each nodal address that enable analysis of first behavioral and then consequent clinical and cost outcome variance from an ideal value expressed as best clinical outcome at lowest possible cost, in a requisite time needed to alert for necessary care and avoidance of unnecessary care, thereby increasing increase the value of care meaning better clinical outcomes at a lowest possible cost;

 

(3) allowing a user (a′

) to identify certain of the personal health information as a desired set of characteristics, and (b′

) to add one or more attribute(s) to the personal health information to identify the personal health information of each patient as being on an equal level of importance to other health information in the database;

 

(4) reducing processing requirements and time for processing to make real-time monitoring of medical provider performance efficient, based on the discrete punctuated string of digits representing each nodal address and based on the reduction in the possible permutations; and

 

(5) enabling a prediction of key points in time at which behavioral variance is likely to occur and interrupting treatment flow to avoid over-/under-utilization of care to prevent the behavioral variance;

(B) measuring a clinical outcome for each nodal address by analyzing the clinically relevant set of health information for a subset of the patient population; and

(C) measuring behavioral variance for each medical care provider of each patient in the patient population assigned to each nodal address by comparing differences between one medical care provider and another medical care provider(s) in treating, testing, following-up, complying with prescribed medicines, and cost for each patient in the patient population assigned to the each nodal address;

(b) the patient sending via a client device a first communication reporting a health concern to the first clinical outcome tracking and analysis module;

(c) the first clinical outcome tracking and analysis module, upon receiving the first communication in (b), sending to the client device comprising the second clinical outcome tracking and analysis module in reply a second communication containing list of tests needed to diagnose the health concern as a medical condition;

(d) the patient sending via the client device containing the second clinical outcome tracking and analysis module to the first clinical outcome tracking and analysis module a third communication containing results of the tests needed to diagnose the health concern in (c);

(e) the first clinical outcome tracking and analysis module upon receiving the third communication in (d) sending to the client device comprising the second clinical outcome and analysis module in reply a fourth communication containing a diagnosis of the medical condition and a list of additional tests needed for further classifying the medical condition;

(f) the patient upon receiving the fourth communication in (e) sending via the client device containing the second clinical outcome tracking and analysis module to the first clinical outcome tracking and analysis module a fifth communication containing the results of the additional tests in (e);

(g) based on the results of the tests in (d), the tests in (f), and the diagnosis in (e), the first clinical outcome tracking and analysis module

(i) assigning, a nodal address to the patient from the plurality of nodal addresses available in (a)A(iii), the assigned nodal address containing the clinically relevant set of health information for the patient; and

(ii) transmitting to the client device comprising the second clinical outcome tracking module a sixth communication comprising;

1. the assigned nodal address; and

2. a geographically organized list of medical professionals treating patients within the assigned nodal address, wherein the list of medical professionals is classified by one or more of geography, clinical outcome or cost;

(h) the patient sending to the first clinical outcome tracking and analysis module via the client device comprising the second clinical outcome tracking module, a seventh communication selecting a medical professional that meets one or more of the geographical, cost, and outcome needs of the patient; and

(i) communicatively linking the first clinical outcome and tracking analysis module to the computing device comprising a third clinical outcome tracking and analysis module at the selected medical professional'"'"'s office to facilitate the patient'"'"'s scheduling of an appointment with the selected medical professional.

2. The method as recited in claim 1, wherein the assigned nodal address in (g)(i) is associated with one or more bundles of predetermined patient care services for treatment of the condition.

3. The method as recited in claim 2, wherein at least one of the one or more bundles of predetermined patient care services provides a predetermined course of treatment.

4. The method as recited in claim 2, wherein the one or more bundles of predetermined patient care services provide cost certainty for treatment of the condition.

5. The method as recited in claim 1, wherein the clinical outcome in (g(ii)(2) comprises one or more of:

therapeutic agent received, delivered dose intensity, dose interval, dose duration, quality of life metrics, toxicity to therapy, progression free survival, overall survival, response metrics, and death.

6. The method as recited in claim 1, wherein the list of medical professionals in (g)(ii)(2) is visually classified by clinical outcome, such that:

(a) green signifies a better than average clinical outcome;

(b) yellow signifies an average clinical outcome; and

(c) red indicates a poorer than average clinical outcome.

7. The method as recited in claim 1, further comprising, with permission from the patient and the medical professional selected in h:

transmitting, from the first clinical outcome tracking and analysis module, the personal health information of the patient to a computing device comprising a third clinical outcome tracking and analysis module at the selected medical professional'"'"'s office.

8. The method as recited in claim 1, wherein the receiving of the first communication from the client device in (c) is via a human user or a technical process.

9. The method according to claim 1, wherein the set of preselected variables in (a)(A)(iii)(1) includes a disease-specific clinical molecular phenotype, wherein the string of digits representing the phenotype is determined based on a directed graph.

10. The method according to claim 1, wherein the parameters of sorting in (a)(A)(ii) comprise one or more of:

sex, age, ethnicity, comorbidities, tobacco use, source of insurance, medical record number, primary care physician, referring physician, hospital, approved service vendors, disease-specific clinical molecular phenotype, therapy intent, stage of therapy, biomarkers, and cost of care.

11. A system that enables a patient with a condition to optimize treatment options based on one or more of geography, outcome and cost, the system comprising:

(a) a processor of a computer server comprising;

a database comprising personal health information data for a population of human subjects;

a first clinical outcome tracking and analysis module communicatively linked to the database and a network; and

a memory to store computer program instructions, and

(b) a client device comprising;

a processing unit;

a memory; and

a second clinical outcome tracking and analysis module communicatively linked to the first clinical outcome tracking and analysis module and the network, and

computer program instructions when executed on the processor causing the first clinical outcome tracking and analysis module to perform operations comprising;

(A) accounting for biological variance up front by grouping patients in a patient population, thereby effectively removing biological variance as a factor in value of care, and leaving treatment variance as a predominant factor in treatment outcome in the patient population by;

(i) receiving, collecting and recording, in the database, the personal health information from each patient in the patient population, the personal health information comprising each parameter that characterizes each patient in the patient population;

(ii) sorting the personal health information for each patient in the patient population using a sorting filter to (i) provide a sorted set of personal health information for the patient population, and (ii) identify patients satisfying each parameter in the patient population; and

(iii) classifying like personal health information, and grouping types of patients in the patient population, based on the personal health information associated with the patient population by generating and assigning a plurality of nodal addresses, wherein the generating and assigning the plurality of nodal addresses comprises;

(1) representing each nodal address as a discrete punctuated string of digits comprising a prefix, a middle, and a suffix that each represent a set of preselected variables that partition the sorted and classified information into a clinically relevant set of health information;

(2) reducing trillions of possible permutations to a reduced number of clinically meaningful permutations based on the discrete punctuated string of digits representing each nodal address that enable analysis of first behavioral and then consequent clinical and cost outcome variance from an ideal value expressed as best clinical outcome at lowest possible cost, in a requisite time needed to alert for necessary care and avoidance of unnecessary care, thereby increasing increase the value of care meaning better clinical outcomes at a lowest possible cost;

(3) allowing a user (a′

) to identify certain of the personal health information as a desired set of characteristics, and (b′

) to add one or more attribute(s) to the personal health information to identify the personal health information of each patient as being on an equal level of importance to other health information in the database;

(4) reducing processing requirements and time for processing to make real-time monitoring of medical provider performance efficient, based on the discrete punctuated string of digits representing each nodal address and based on the reduction in the possible permutations; and

(5) enabling a prediction of key points in time at which behavioral variance is likely to occur and interrupting treatment flow to avoid over-/under-utilization of care to prevent the behavioral variance;

(B) measuring a clinical outcome for each nodal address by analyzing the clinically relevant set of health information for a subset of the patient population; and

(C) measuring behavioral variance for each medical care provider of each patient in the patient population assigned to each nodal address by comparing differences between one medical care provider and another medical care provider(s) in treating, testing, following-up, complying with prescribed medicines, and cost for each patient in the patient population assigned to the each nodal address;

(c) the computer server comprising the first clinical outcome tracking and analysis module,

(1), upon receiving from the patient a first communication sent via the client device reporting a health concern, sending to the client device comprising the second clinical tracking and analysis module in reply a second communication containing a list of tests needed to diagnose the health concern as a medical condition;

(2) upon receiving from the patient a third communication sent via the client device containing results of the tests in (1);

sending to the client device comprising the first clinical outcome and analysis module in reply a fourth communication containing a diagnosis of the medical condition and a list of additional tests needed for further classifying the medical condition;

(3) upon receiving from the patient a fifth communication sent via the client device containing the results of the additional tests in (2), and based on the results of the tests in (1) in the third communication, the results in the fifth communication and the diagnosis in (2),

(i) assigning, a nodal address to the patient from the plurality of nodal addresses available in A(iii), the assigned nodal address containing the clinically relevant set of health information for the patient; and

(ii) transmitting to the client device comprising the second clinical outcome tracking module a sixth communication comprising;

1. the assigned nodal address; and

2. a geographically organized list of medical professionals treating patients within the assigned nodal address, wherein the list of medical professionals is classified by one or more of geography, clinical outcome and cost;

(4) upon receiving a seventh communication from the patient selecting a medical professional that meets one or more of the geographical, cost and outcome needs of the patient, communicatively linking the first clinical outcome and tracking analysis module to a computing device comprising a third clinical outcome and tracking analysis module at the selected medical professional'"'"'s office to facilitate the patient'"'"'s scheduling of an appointment with the selected medical professional.

12. The system as recited in claim 11, wherein the assigned nodal address in (c)(3)(i) is associated with one or more bundles of predetermined patient care services for treatment of the condition.

13. The system as recited in claim 12, wherein at least one of the one or more bundles of predetermined patient care services provides a predetermined course of treatment.

14. The system as recited in claim 12, wherein one or more bundles of predetermined patient care services provides cost certainty for treatment of the condition.

15. The system as recited in claim 11, wherein the clinical outcome in (c)(3)(ii)(2) comprises one or more of:

therapeutic agent received, delivered dose intensity, dose interval, dose duration, quality of life metrics, toxicity to therapy, progression free survival, overall survival, response metrics, and death.

16. The system as recited in claim 11, wherein the list of medical professionals in (c)(3)(ii)(2) is visually classified by clinical outcome, such that:

(a) green signifies a better than average clinical outcome;

(b) yellow signifies an average clinical outcome; and

(c) red indicates a poorer than average clinical outcome.

17. The system as recited in claim 11, further comprising, with permission from the patient and the medical professional selected in (c)(4):

transmitting, from the first clinical outcome tracking and analysis module, the personal health information of the patient to a computing device comprising a third clinical outcome tracking and analysis module at the selected medical professional'"'"'s office.

18. The system as recited in claim 11, wherein the receiving the communication from the client device in (c) is via a human user or a technical process.

19. The system according to claim 11, wherein the set of preselected variables in (a)(1)(A)(iii)(1) includes a disease-specific clinical molecular phenotype, wherein the string of digits representing the phenotype is determined based on a directed graph.

20. The system according to claim 11, wherein the parameters of sorting in (A)(iii)(i) comprise one or more of:

sex, age, ethnicity, comorbidities, tobacco use, source of insurance, medical record number, primary care physician, referring physician, hospital, approved service vendors, disease-specific clinical molecular phenotype, therapy intent, stage of therapy, biomarkers, and cost of care.

21. A non-transitory computer readable medium storing computer program instructions for enabling a patient with a condition to optimize treatment options based on one or more of geography, outcome and cost, which, when executed on a processor comprising a first clinical outcome tracking and analysis module, causes the first clinical outcome and tracking module to perform operations comprising:

(A) accounting for biological variance up front by grouping patients in a patient population, thereby effectively removing biological variance as a factor in value of care, and leaving treatment variance as a predominant factor in treatment outcome in the patient population by;

(i) receiving, collecting and recording, in a database, the personal health information from each patient in the patient population, the personal health information comprising each parameter that characterizes each patient in the patient population;

(ii) sorting the personal health information for each patient in the patient population using a sorting filter to (i) provide a sorted set of personal health information for the patient population, and (ii) identify patients satisfying each parameter in the patient population; and

(iii) classifying like personal health information, and grouping types of patients in the patient population, based on the personal health information associated with the patient population by generating and assigning a plurality of nodal addresses, wherein the generating and assigning the plurality of nodal addresses comprises;

(1) representing each nodal address as a discrete punctuated string of digits comprising a prefix, a middle, and a suffix that each represent a set of preselected variables that partition the sorted and classified information into a clinically relevant set of health information;

(2) reducing trillions of possible permutations to a reduced number of clinically meaningful permutations based on the discrete punctuated string of digits representing each nodal address that enable analysis of first behavioral and then consequent clinical and cost outcome variance from an ideal value expressed as best clinical outcome at lowest possible cost, in a requisite time needed to alert for necessary care and avoidance of unnecessary care, thereby increasing increase the value of care meaning better clinical outcomes at a lowest possible cost;

(3) allowing a user (a′

) to identify certain of the personal health information as a desired set of characteristics, and (b′

) to add one or more attribute(s) to the personal health information to identify the personal health information of each patient as being on an equal level of importance to other health information in the database;

(4) reducing processing requirements and time for processing to make real-time monitoring of medical provider performance efficient, based on the discrete punctuated string of digits representing each nodal address and based on the reduction in the possible permutations; and

(5) enabling a prediction of key points in time at which behavioral variance is likely to occur and interrupting treatment flow to avoid over-/under-utilization of care to prevent the behavioral variance;

(B) measuring a clinical outcome for each nodal address by analyzing the clinically relevant set of health information for a subset of the patient population; and

(C) measuring behavioral variance for each medical care provider of each patient in the patient population assigned to each nodal address by comparing differences between one medical care provider and another medical care provider(s) in treating, testing, following-up, complying with prescribed medicines, and cost for each patient in the patient population assigned to the each nodal address;

the first clinical outcome tracking and analysis module,

(1) upon receiving from the patient a first communication reporting a health concern sent via a client device comprising a second clinical outcome tracking and analysis module communicatively linked to the first clinical outcome tracking and analysis module and a network, sending to the client device comprising the second clinical outcome tracking and analysis module in reply a second communication containing list of tests needed to diagnose the health concern as a medical condition;

(2) upon receiving from the patient a third communication sent via the client device comprising the first clinical outcome and analysis module containing results of the tests in (b);

sending to the client device comprising the first clinical outcome and analysis module in reply a fourth communication containing a diagnosis of the medical condition and a list of additional tests needed for further classifying the medical condition;

(3) upon receiving from the patient a fifth communication sent via the client device comprising the first clinical outcome and analysis module containing the results of the additional tests in (2), and based on the results in the third communication, the results in the fifth communication and the diagnosis in (2),

(i) assigning, a nodal address to the patient from the plurality of nodal addresses available in A(iii), the assigned nodal address containing the clinically relevant set of health information for the patient; and

(ii) transmitting to the client device comprising the second clinical outcome tracking module a sixth communication comprising;

1. the assigned nodal address; and

2. a geographically organized list of medical professionals treating patients within the assigned nodal address, wherein the list of medical professionals is classified by geography, clinical outcome and cost;

(4) upon receiving a seventh communication from the patient selecting a medical professional that meets one or more of geographical, cost and outcome needs of the patient, communicatively linking the first clinical outcome and tracking analysis module to a computing device comprising a third clinical outcome and tracking analysis module at the selected medical professional'"'"'s office to facilitate the patient'"'"'s scheduling of an appointment with the selected medical professional.

22. The non-transitory computer readable medium as recited in claim 21 wherein the assigned nodal address in 3(i) is associated with one or more bundles of predetermined patient care services for treatment of the condition.

23. The non-transitory computer readable medium as recited in claim 21, wherein at least one of the one or more bundles of predetermined patient care services provides a predetermined course of treatment.

24. The non-transitory computer readable medium as recited in claim 21, wherein at least one of the one or more bundles of predetermined patient care services provides cost certainty for treatment of the condition.

25. The non-transitory computer readable medium as recited in claim 21, wherein the clinical outcome in (3)(ii)(2) comprises one or more of:

therapeutic agent received, delivered dose intensity, dose interval, dose duration, quality of life metrics, toxicity to therapy, progression free survival, overall survival, response metrics, and death.

26. The non-transitory computer readable medium as recited in claim 21, wherein the list of medical professionals in (3)(ii)(2) is visually classified by clinical outcome, such that:

(a) green signifies a better than average clinical outcome;

(b) yellow signifies an average clinical outcome; and

(c) red indicates a poorer than average clinical outcome.

27. The non-transitory computer readable medium as recited in claim 21, further comprising, with permission from the patient and the medical professional selected in (4):

transmitting, from the computer server comprising the first clinical outcome tracking and analysis module, the personal health information of the patient to a computing device comprising a third clinical outcome tracking and analysis module at the selected medical professional'"'"'s office.

28. The non-transitory computer readable medium as recited in claim 21, wherein the receiving the communication from the client device contacting in steps (1) through (4) is via a human user or a technical process.

29. The non-transitory computer readable medium as recited in claim 21, wherein the set of preselected variables in (A)(iii)(1) includes a disease-specific clinical molecular phenotype, wherein the string of digits representing the phenotype is determined based on a directed graph.

30. The non-transitory computer readable medium as recited in claim 21, wherein the parameters of sorting in (A)(ii) comprise one or more of:

sex, age, ethnicity, comorbidities, tobacco use, source of insurance, medical record number, primary care physician, referring physician, hospital, approved service vendors, disease-specific clinical molecular phenotype, therapy intent, stage of therapy, biomarkers, and cost of care.