Healthcare gap management system

• US 9,710,600 B1
• Filed: 10/19/2015
• Issued: 07/18/2017
• Est. Priority Date: 10/17/2014
• Status: Active Grant

• Current Assignee: Inovalon, Inc. (Inovalon Holdings, Inc.)
• Original Assignee: Inovalon, Inc. (Inovalon Holdings, Inc.)
• Inventors: Dunleavy, Keith R., Rizzo, Daniel
• Primary Examiner(s): Kanaan, Maroun
• Application Number:
  US14/886,876
• Time in Patent Office: 638 Days
• 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

Abstract

Methods, systems, and apparatus, including computer programs encoded on non-transitory computer readable storage media, for integrating with an electronic health record system to permit healthcare providers, health insurance companies, and healthcare analytics providers to manage healthcare gaps in real-time.

Claims

1. A non-transitory computer-readable medium storing instructions executable by one or more computers which, upon such execution, cause the one or more computers to perform operations comprising:

receiving, at a data analytics provider server of a healthcare gap management system that includes (a) the data analytics provider server, (b) a healthcare provider server associated with a healthcare provider, (c) a mobile computing device that includes a global positioning system (GPS) sensor and that is associated with the healthcare provider server, (d) medical diagnostic equipment that is associated with the healthcare provider, and (e) an electronic health record server, and from the healthcare provider server over a network, an encounter start notification (i) indicating that an encounter the healthcare provider has begun, (ii) identifying a patient, and (iii) being received in real-time to when GPS sensor data generated by the GPS sensor of the mobile computing device that is associated with the healthcare provider server indicates that a location of the mobile computing device matches a location that is associated with a healthcare provider;

before receiving an encounter end notification indicating that the encounter between the patient and the healthcare provider has ended, determining, at the data analytics provider server of the healthcare gap management system, that one or more healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification are present for the patient, wherein a healthcare gap comprises a difference between a recommended treatment protocol and an actual course of treatment for a diagnosed condition, or a difference between an actual course of treatment and a diagnosis that corresponds to that course of treatment;

before receiving an encounter end notification indicating that the encounter between the patient and the healthcare provider has ended, providing, from the data analytics provider server of the healthcare gap management system to the healthcare provider server of the healthcare gap management system, data indicating that one or more healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification are indicated as present for the patient;

before receiving an encounter end notification indicating that the encounter between the patient and the healthcare provider has ended, receiving, at the data analytics provider server of the healthcare gap management system and from the healthcare provider server of the healthcare gap management system, a request for data identifying one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification and that are indicated as presented for the patient;

before receiving an encounter end notification indicating that the encounter between the patient and the healthcare provider has ended, providing, from the data analytics provider server of the healthcare gap management system to the healthcare provider server of the healthcare gap management system, data identifying one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification and that are indicated as present for the patient, wherein the data identifying the one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification and that are indicated as present for the patient includes at least one entry to be associated with an electronic health record of the patient, wherein the at least one entry to be associated with the electronic health record of the patient enables the healthcare gap management system to indicate whether one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification and that are indicated as present for the patient was at least partially addressed;

receiving, at the data analytics provider server of the healthcare gap management system from the healthcare provider server of the healthcare gap management system, an encounter end notification indicating that the encounter between the patient and the healthcare provider has ended and that the healthcare provider server of the healthcare gap management system at least partially addressed one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification and that are indicated as present for the patient by performing one or more additional tests using the medical diagnostic equipment of the healthcare gap management system; and

updating, by the electronic health record server of the healthcare gap management system, the electronic health record of the patient in real-time based on the received encounter end notification indicating that the healthcare provider server of the healthcare gap management system at least partially addressed one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification and that are indicated as present for the patient by performing the one or more additional tests using the medical diagnostic equipment of the healthcare gap management system.

2. The computer-readable medium of claim 1, wherein the encounter start notification comprises one or more of an electronic health record practice identifier, an electronic health record provider identifier, and a patient identifier.

3. The computer-readable medium of claim 1, wherein the encounter end notification comprises one or more of an electronic health record practice identifier, an electronic health record provider identifier, and a patient identifier.

4. The computer-readable medium of claim 1, wherein determining, at the data analytics provider server of the healthcare gap management system, that one or more healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification are present for the patient comprises querying, by the data analytics provider server of the healthcare gap management system, a healthcare database of the healthcare gap management system to determine that one or more healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification are present for the patient.

5. A non-transitory computer-readable medium storing instructions executable by one or more computers which, upon such execution, cause the one or more computers to perform operations comprising:

determining, at a healthcare provider server that is associated with a healthcare provider and that is of a healthcare gap management system that includes (a) a data analytics provider server, (b) the healthcare provider server, (c) a mobile computing device that includes a global positioning system (GPS) sensor and that is associated with the healthcare provider server, (d) medical diagnostic equipment that is associated with the healthcare provider, and (e) an electronic health record server, and based on GPS sensor data generated the GPS sensor of the mobile computing device of the healthcare gap management system indicating that a location of the mobile computing device matches a location that is associated with a healthcare provider, that a patient has begun an encounter with the healthcare provider;

in response to determining that the patient has begun the encounter with the healthcare provider, providing, from the healthcare provider server of the healthcare gap management system to the data analytics provider server of the healthcare gap management system over a network, an encounter start notification identifying the patient in real-time when the patient begins the encounter with the healthcare provider;

before the encounter between the patient and the healthcare provider has ended, receiving, at the healthcare provider server of the healthcare gap management system from the data analytics provider server of the healthcare gap management system, data indicating that one or more healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began are present for the patient, wherein a healthcare gap comprises a difference between a recommended treatment protocol and an actual course of treatment for a diagnosed condition, or a difference between an actual course of treatment and a diagnosis that corresponds to that course of treatment;

before the encounter between the patient and the healthcare provider has ended, providing, from the healthcare provider server of the healthcare gap management system to the data analytics provider server of the healthcare gap management system, a request for data identifying one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient;

before the encounter between the patient and the healthcare provider has ended, receiving, at the healthcare provider server of the healthcare gap management system from the data analytics provider server of the healthcare gap management system, data identifying one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient;

before the encounter between the patient and the healthcare provider has ended, receiving, at the healthcare provider server of the healthcare gap management system, a selection of a control for initiating one or more additional tests using the medical diagnostic equipment of the healthcare gap management system, to at least partially address one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient;

before the encounter between the patient and the healthcare provider has ended and in response to the selection of the control, performing one or more of the additional tests using the medical diagnostic equipment of the healthcare gap management system to at least partially address one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient;

determining, based on additional sensor data generated by the mobile computing device of the healthcare gap management system, that the encounter between the patient and the healthcare provider has ended or likely ended; and

in response to determining, based on the additional sensor data generated by the mobile computing device of the healthcare gap management system, that the encounter between the patient and the healthcare provider has ended or likely ended, providing, from the healthcare provider server of the healthcare gap management system to the data analytics provider server of the healthcare gap management system, an encounter end notification in real-time to when the patient ends the encounter with the healthcare provider, the encounter end notification indicating that the healthcare provider server of the healthcare gap management system addressed one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient as a result of performing the one or more additional tests using the medical diagnostic equipment of the healthcare gap management system.

6. The computer-readable medium of claim 5, wherein the encounter start notification comprises one or more of an electronic health record practice identifier, an electronic health record provider identifier, and a patient identifier.

7. The computer-readable medium of claim 5, wherein the encounter end notification comprises one or more of an electronic health record practice identifier, an electronic health record provider identifier, and a patient identifier.

8. The computer-readable medium of claim 5, wherein the operations further comprise providing, for display, data representing the one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient.

9. The computer-readable medium of claim 5, wherein the operations further comprise determining that at least one of the one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient has been at least partially addressed based on the performance of the one or more of the additional tests using the medical diagnostic equipment of the healthcare gap management system.

10. The computer-readable medium of claim 5, wherein the one or more healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient include a gap in care.

11. The computer-readable medium of claim 5, wherein the one or more healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient include a gap in documentation.

12. A healthcare gap management system comprising:

a data analytics provider server;

a healthcare provider server associated with a healthcare provider;

a mobile computing device that includes a global positioning system (GPS) sensor and that is associated with the healthcare provider server;

medical diagnostic equipment that is associated with the healthcare provider;

an electronic health record server; and

one or more storage devices storing instructions that are operable, when executed by one or more of the servers, to cause the one or more computers servers to perform operations comprising;

receiving, at the data analytics provider server of the healthcare gap management system from a healthcare provider server of the healthcare gap management system over a network, an encounter start notification (i) indicating that an encounter with a healthcare provider has begun, (ii) identifying a patient, and (iii) being received in real-time to when GPS sensor data generated the GPS sensor of the mobile computing device of the healthcare gap management system indicates that a location of the mobile computing device matches a location that is associated with the healthcare provider;

before receiving an encounter end notification indicating that the encounter between the patient and the healthcare provider has ended, determining, at the data analytics provider server of the healthcare gap management system, that one or more healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification are present for the patient, wherein a healthcare gap comprises a difference between a recommended treatment protocol and an actual course of treatment for a diagnosed condition, or a difference between an actual course of treatment and a diagnosis that corresponds to that course of treatment;

before receiving an encounter end notification indicating that the encounter between the patient and the healthcare provider has ended, providing, from the data analytics provider server of the healthcare gap management system to the healthcare provider server of the healthcare gap management system, data indicating that one or more healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification are indicated as present for the patient;

before receiving an encounter end notification indicating that the encounter between the patient and the healthcare provider has ended, receiving, at the data analytics provider server of the healthcare gap management system from the healthcare provider server of the healthcare gap management system, a request for data identifying one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification and that are indicated as presented for the patient;

before receiving an encounter end notification indicating that the encounter between the patient and the healthcare provider has ended, providing, from the data analytics provider server of the healthcare gap management system to the healthcare provider server of the healthcare gap management system, data identifying one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification and that are indicated as present for the patient, wherein the data identifying the one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification and that are indicated as present for the patient includes at least one entry to be associated with an electronic health record of the patient, wherein the at least one entry to be associated with the electronic health record of the patient enables the healthcare gap management system to indicate whether one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification and that are indicated as present for the patient was at least partially addressed;

receiving, at the data analytics provider server of the healthcare gap management system from the healthcare provider server of the healthcare gap management system, an encounter end notification indicating that the encounter between the patient and the healthcare provider has ended and that the healthcare provider server of the healthcare gap management system at least partially addressed one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification and that are indicated as present for the patient by performing one or more additional tests using the medical diagnostic equipment of the healthcare gap management system; and

updating, by the electronic health record server of the healthcare gap management system, the electronic health record of the patient in real-time based on the received encounter end notification indicating that the healthcare provider server of the healthcare gap management system at least partially addressed one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before receiving the encounter start notification and that are indicated as present for the patient by performing the one or more additional tests using the medical diagnostic equipment of the healthcare gap management system.

13. The system of claim 12, wherein the encounter start notification comprises one or more of an electronic health record practice identifier, an electronic health record provider identifier, and a patient identifier.

14. The system of claim 12, wherein the encounter end notification comprises one or more of an electronic health record practice identifier, an electronic health record provider identifier, and a patient identifier.

15. A healthcare gap management system comprising:

a data analytics provider server;

a healthcare provider server associated with a healthcare provider;

a mobile computing device that includes a global positioning system (GPS) sensor and that is associated with the healthcare provider server;

medical diagnostic equipment that is associated with the healthcare provider;

an electronic health record server; and

one or more storage devices storing instructions that are operable, when executed by one or more of the servers, to cause the one or more servers to perform operations comprising;

determining, at the healthcare provider server and based on GPS sensor data generated the GPS sensor of the mobile computing device of the healthcare gap management system indicating that a location of the mobile computing device matches a location that is associated with a healthcare provider, that a patient has begun an encounter with the healthcare provider;

in response to determining that the patient has begun the encounter with the healthcare provider, providing, from the healthcare provider server of the healthcare gap management system to the data analytics provider server of the healthcare gap management system over a network, an encounter start notification identifying the patient in real-time when the patient begins the encounter with the healthcare provider;

before the encounter between the patient and the healthcare provider has ended, receiving, at the healthcare provider server of the healthcare gap management system from the data analytics provider server of the healthcare gap management system, data indicating that one or more healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began are present for the patient, wherein a healthcare gap comprises a difference between a recommended treatment protocol and an actual course of treatment for a diagnosed condition, or a difference between an actual course of treatment and a diagnosis that corresponds to that course of treatment;

before the encounter between the patient and the healthcare provider has ended, providing, from the healthcare provider server of the healthcare gap management system to the data analytics provider server of the healthcare gap management system, a request for data identifying one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient;

before the encounter between the patient and the healthcare provider has ended, receiving, at the healthcare provider server of the healthcare gap management system from the data analytics provider server of the healthcare gap management system, data identifying one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient;

before the encounter between the patient and the healthcare provider has ended, receiving, at the healthcare provider server of the healthcare gap management system, a selection of a control for initiating one or more additional tests using the medical diagnostic equipment of the healthcare gap management system, to at least partially address one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient;

before the encounter between the patient and the healthcare provider has ended and in response to the selection of the control, performing one or more of the additional tests using the medical diagnostic equipment of the healthcare gap management system to at least partially address one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient;

determining, based on additional sensor data generated by the mobile computing device of the healthcare gap management system, that the encounter between the patient and the healthcare provider has ended or likely ended; and

in response to determining, based on the additional sensor data generated by the mobile computing device of the healthcare gap management system, that the encounter between the patient and the healthcare provider has ended or likely ended, providing, from the healthcare provider server of the healthcare gap management system to the data analytics provider server of the healthcare gap management system, an encounter end notification in real-time to when the patient ends the encounter with the healthcare provider, the encounter end notification indicating that the healthcare provider server of the healthcare gap management system addressed one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient as a result of performing the one or more additional tests using the medical diagnostic equipment of the healthcare gap management system.

16. The system of claim 15, wherein the encounter start notification comprises one or more of an electronic health record practice identifier, an electronic health record provider identifier, and a patient identifier.

17. The system of claim 15, wherein the encounter end notification comprises one or more of an electronic health record practice identifier, an electronic health record provider identifier, and a patient identifier.

18. The system of claim 15, wherein the operations further comprise providing, for display, data representing the one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient.

19. The system of claim 15, wherein the operations further comprise determining that at least one of the one or more of the healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient has been at least partially addressed based on the performance of the one or more of the additional tests using the medical diagnostic equipment of the healthcare gap management system.

20. The system of claim 15, wherein the one or more healthcare gaps that were identified by the data analytics provider server of the healthcare gap management system before the encounter between the patient and the healthcare provider began and that are indicated as present for the patient include a gap in care.