Search engine systems for matching medical providers and patients

• US 9,977,866 B2
• Filed: 09/10/2014
• Issued: 05/22/2018
• Est. Priority Date: 09/10/2013
• Status: Active Grant

• Current Assignee: Accolade, Inc.
• Original Assignee: MD Insider, Inc. (Accolade, Inc.)
• Inventors: Norris, David Lee, Goldstein, Susanne Beth, Calvert, Jay W., Conroy, Brian Patrick, Chatterjee, Kingshuk
• Primary Examiner(s): Kanaan, Maroun P
• Application Number:
  US14/482,921
• Publication Number:
  US 20150073943A1
• Time in Patent Office: 1,350 Days
• CPC Class Codes: G06F 16/24575 using context
• CPC Class Codes: G06Q 10/06393 Score-carding, benchmarking or key performance indicator [KPI] analysis
• CPC Class Codes: G06Q 30/0627 using item specifications
• CPC Class Codes: G06Q 50/22 Social work or social welfare, e.g. community support activities or counselling services
• 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 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• 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

Abstract

In one embodiment, a method comprises receiving a set of parameters for selecting a physician from an administrator of a matching-engine system. The matching-engine system stores the parameters in a data store of the matching-engine system. The matching-engine system receives from a user a search query with a location of the user and a user-specified symptom or treatment. The matching-engine system determines a base-concept of a medical diagnosis or medical procedure based on the search query. The matching-engine system may identify a set of physicians to be recommended to the user based on the parameters, and a performance-score and experience-score associated with the base-concept for each physician. The matching-engine system may send a search-results page to the user listing the recommended physicians.

Claims

1. A method comprising:

receiving, by one or more computing devices of a matching-engine system, from an administrator of the matching-engine system a set of physician-selection parameters comprising;

a performance-score-range for physicians; and

an experience-score-range for physicians;

storing, by one or more of the computing devices, the parameters in a data store of the matching-engine system;

receiving, by one or more of the computing devices, a search query from a client device of a user of the matching-engine system, the search query comprising a geographic location of the user and one or more of a user-specified symptom or a user-specified treatment;

determining, by one or more of the computing devices, at least one base-concept based on the search query, the base-concept comprising a medical diagnosis or a medical procedure;

identifying, by one or more of the computing devices, a set of one or more physicians to be recommended to the user based at least in part on;

a geographic location of each of the one or more physicians;

a performance-score associated with the at least one base-concept for each of the one or more physicians, wherein the performance-score is calculated based on a weighted aggregate of individual performance-scores for one or more sub-concepts of the base-concept, wherein the individual performance-scores are calculated by;

(1) accessing one or more Current Procedural Terminology (CPT) codes from claims data received from the physician, wherein the CPT codes refer to a medical service provided by the physician in connection with the one or more sub-concepts;

(2) determining one or more relative value units (RVUs) corresponding to the one or more CPT codes, wherein the RVUs corresponding to a CPT code represents a location-independent measure of overall resources used for the medical service;

(3) calculating a physician-cost-factor for the physician associated with the one or more sub-concepts, wherein the physician-cost-factor is based on the RVUs corresponding to the medical service provided by the physician for the one or more sub-concepts;

(4) accessing an average cost factor associated with the one or more sub-concepts for a plurality of physicians, wherein the physician and the plurality of physicians share a common specialty and common geographic location; and

(5) comparing the physician-cost-factor with the average cost factor, wherein the individual performance-score for the physician for the one or more sub-concepts is increased if the physician-cost-factor is lower than the average cost factor;

an experience-score associated with the at least one base-concept each of the one or more physicians; and

the set of physician-selection parameters from the administrator; and

sending, by one or more computing devices, a search-results page to a client device of the user, the search-results page comprising references to one or more of the physicians in the set of physicians.

2. The method of claim 1, wherein each physician in the set is associated with:

a performance-score within the performance-score-range; and

an experience-score within the experience-score-range.

3. The method of claim 1 wherein the common geographic location comprises a metropolitan statistical area.

4. The method of claim 1, wherein the common geographic location comprises the geographic location defined by the user.

5. The method of claim 1, wherein the determining the base-concept is based on user input of the user-specified treatment or user-specified symptoms, and a clinical taxonomy for translating the user input to a defined base-concept.

6. The method of claim 1, wherein the experience-score is based at least in part on a volume of cases seen by the physician, a severity associated with each case seen by the physician, and a variety of cases seen by the physician.

7. The method of claim 6, wherein the volume of cases and the variety of cases comprises cases in a condition group common to a condition group associated with the base-concept.

8. The method of claim 1, wherein the set of recommended physicians is ranked for presentation based at least in part on the performance-score and experience-score of each physician.

9. The method of claim 1, wherein the parameters are sent by an administrator of a health-care plan associated with the user.

10. The method of claim 1, wherein the experience-score is determined by an experience-engine of the matching-engine system based at least in part on one or more International Classification of Diseases (ICD) codes received from a physician or health-care provider, wherein each ICD code corresponds to a medical diagnosis associated with a patient.

11. The method of claim 1, wherein the user accesses the matching-engine system through a website interface of a health insurance provider of the user.

12. The method of claim 1, wherein the performance-scores and experience-scores are updated automatically at predetermined periods of time by the matching-engine system.

13. One or more non-transitory, computer-readable storage media embodying software that is operable when executed to:

receive from an administrator of a matching-engine system a set of physician-selection parameters comprising;

a performance-score-range for physicians; and

an experience-score-range for physicians;

store the parameters in a data store of the matching-engine system;

receive a search query from a client device of a user of the matching-engine system, the search query comprising a geographic location of the user and one or more of a user-specified symptom or a user-specified treatment;

determine at least one base-concept based on the search query, the base-concept comprising a medical diagnosis or a medical procedure;

identify a set of one or more physicians to be recommended to the user based at least in part on;

a geographic location of each of the one or more physicians;

a performance-score associated with the at least one base-concept for each of the one or more physicians, wherein the performance-score is calculated based on a weighted aggregate of individual performance-scores for one or more sub-concepts of the base-concept, wherein the individual performance-scores are calculated by;

(1) accessing one or more Current Procedural Terminology (CPT) codes from claims data received from the physician, wherein the CPT codes refer to a medical service provided by the physician in connection with the one or more sub-concepts;

(2) determining one or more relative value units (RVUs) corresponding to the one or more CPT codes, wherein the RVUs corresponding to a CPT code represents a location-independent measure of overall resources used for the medical service;

(3) calculating a physician-cost-factor for the physician associated with the one or more sub-concepts, wherein the physician-cost-factor is based on the RVUs corresponding to the medical service provided by the physician for the one or more sub-concepts;

(4) accessing an average cost factor associated with the one or more sub-concepts for a plurality of physicians, wherein the physician and the plurality of physicians share a common specialty and common geographic location; and

(5) comparing the physician-cost-factor with the average cost factor, wherein the individual performance-score for the physician for the one or more sub-concepts is increased if the physician-cost-factor is lower than the average cost factor;

an experience-score associated with each of the one or more physicians; and

the set of physician-selection parameters from the administrator; and

send a search-results page to a client device of the user, the search-results page comprising references to one or more of the physicians in the set of physicians.

14. A system comprising:

one or more processors; and

a memory coupled to the processors comprising instructions executable by the processors, the processors being operable when executing the instructions to;

receive from an administrator of a matching-engine system a set of physician-selection parameters comprising;

a performance-score-range for physicians; and

an experience-score-range for physicians;

store the parameters in a data store of the matching-engine system;

receive a search query from a client device of a user of the matching-engine system, the search query comprising a geographic location of the user and one or more of a user-specified symptom or a user-specified treatment;

determine at least one base-concept based on the search query, the base-concept comprising a medical diagnosis or a medical procedure;

identify a set of one or more physicians to be recommended to the user based at least in part on;

a geographic location of each of the one or more physicians;

a performance-score associated with the at least one base-concept for each of the one or more physicians, wherein the performance-score is calculated based on a weighted aggregate of individual performance-scores for one or more sub-concepts of the base-concept, wherein the individual performance-scores are calculated by;

(1) accessing one or more Current Procedural Terminology (CPT) codes from claims data received from the physician, wherein the CPT codes refer to a medical service provided by the physician in connection with the one or more sub-concepts;

(2) determining one or more relative value units (RVUs) corresponding to the one or more CPT codes, wherein the RVUs corresponding to a CPT code represents a location-independent measure of overall resources used for the medical service;

(3) calculating a physician-cost-factor for the physician associated with the one or more sub-concepts, wherein the physician-cost-factor is based on the RVUs corresponding to the medical service provided by the physician for the one or more sub-concepts;

(4) accessing an average cost factor associated with the one or more sub-concepts for a plurality of physicians, wherein the physician and the plurality of physicians share a common specialty and common geographic location; and

(5) comparing the physician-cost-factor with the average cost factor, wherein the individual performance-score for the physician for the one or more sub-concepts is increased if the physician-cost-factor is lower than the average cost factor;

an experience-score associated with each of the one or more physicians; and

the set of physician-selection parameters from the administrator; and

send a search-results page to a client device of the user, the search-results page comprising references to one or more of the physicians in the set of physicians.