SYSTEM AND METHOD FOR MANAGING HEALTH CARE COMPLEXITY VIA AN INTERACTIVE HEALTH MAP INTERFACE

• US 20090089083A1
• Filed: 10/01/2007
• Published: 04/02/2009
• Est. Priority Date: 10/01/2007
• Status: Active Grant

• Current Assignee: Aetna Incorporated (CVS Health Corporation)
• Original Assignee: Aetna Incorporated (CVS Health Corporation)
• Inventors: Shaw, Michael, Paradis, Janet, Cueva, Amy, Barclay, Frederick B. JR.
• Granted Patent: US 8,229,757 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/00 Administration; Management
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records

Abstract

To empower a member to make informed health care decisions, a health care organization (HCO) graphically presents the member with a manageable closed universe of health care information via an online interactive visual interface. The online interactive interface comprises a custom category node display of member health care data based on analyzing the member profile in light of the overall health care data taxonomy built by the HCO. Upon identifying the subset of relevant health care data categories, HCO initiates the display of the identified categories by way of a dynamically linked category node interface. To enhance the member'"'"'s understanding of the relationships between the category nodes, the HCO preferably employs a ring node topology by displaying the online interface as a closed network or map, such as by locating each category node along one or more closed, loop-shaped wireframes, which connect the interrelated categories.

Claims

1. A method for graphically representing a subset of a plurality of health care data categories to a health care plan member via an online health care category node map, the method comprising:

building a health care data taxonomy relating health care terminology to one or more of health care benefits terminology, health care-related financial terminology, health insurance terminology, and dental insurance terminology;

building and dynamically updating a member profile for the health care plan member;

storing the health care data taxonomy and the member profile in a database;

receiving an online member identification token associated with the health care plan member;

identifying the subset of the plurality of health care data categories based on correlating the health care data taxonomy with the member profile corresponding to the online member identification token;

initiating a display of the online health care category node map, the display comprising a ring node topology for graphically indicating a relationship between adjacent health care category nodes within the subset, the online health care category node map capable of responding to member input for selecting a category node by orienting the ring node topology display around the selected category node; and

wherein at least one category node in the online health care category node map comprises one or more subnodes corresponding to one or more health care data subcategories, the at least one category node capable of expanding into the one or more subnodes responsive to member input.

2. The method of claim 1 further comprising displaying text corresponding to content associated with the selected category node.

3. The method of claim 1 further comprising displaying one or more hyperlinks to content associated with the one or more subnodes.

4. The method of claim 1 wherein the member profile comprises at least one of member demographic data, diagnosis data, claims data, health care plan benefits data, health diseases and conditions data, medication data, health event data, allergy data, and vaccination data;

5. The method of claim 4 further comprising collecting at least one of the member demographic data, health diseases and conditions data, medications data, health event data, allergy data, and vaccination data based on information reported by the member.

6. The method of claim 4 wherein building the member profile further comprises analyzing one or more of the member demographic data, claims data, diagnosis data, medication data, health event data, and member-reported health conditions to determine a likelihood of the member having one or more potential health conditions and storing an indicator associated with the one or more potential health conditions in the member profile.

7. The method of claim 5 further comprising interfacing with a personal health record application to obtain the information reported by the member.

8. The method of claim 4 further comprising deriving the medication data from at least one of member-reported medication data and pharmacy claims data.

9. A computer readable medium having stored thereon computer executable instructions for graphically representing a subset of a plurality of health care data categories to a health care plan member via an online health care category node map, the instructions comprising:

building a health care data taxonomy relating health care terminology to one or more of health care benefits terminology, health care-related financial terminology, health insurance terminology, and dental insurance terminology;

building and dynamically updating a member profile for the health care plan member;

storing the health care data taxonomy and the member profile in a database;

receiving an online member identification token associated with the health care plan member;

identifying the subset of the plurality of health care data categories based on correlating the health care data taxonomy with the member profile corresponding to the online member identification token;

initiating a display of the online health care category node map, the display comprising a ring node topology for graphically indicating a relationship between adjacent health care category nodes within the subset, the online health care category node map capable of responding to member input for selecting a category node by orienting the ring node topology display around the selected category node; and

wherein at least one category node in the online health care category node map comprises one or more subnodes corresponding to one or more health care data subcategories, the at least one category node capable of expanding into the one or more subnodes responsive to member input.

10. The computer readable medium of claim 9 further comprising instructions for displaying text corresponding to content associated with the selected category node.

11. The computer readable medium of claim 9 further comprising instructions for displaying one or more hyperlinks to content associated with the one or more subnodes.

12. The computer readable medium of claim 9 wherein the member profile comprises at least one of member demographic data, diagnosis data, claims data, health care plan benefits data, health diseases and conditions data, medication data, health event data, allergy data, and vaccination data;

13. The computer readable medium of claim 12 further comprising instructions for collecting at least one of the member demographic data, health diseases and conditions data, medications data, health event data, allergy data, and vaccination data based on information reported by the member.

14. The computer readable medium of claim 12 wherein the instructions for building the member profile further comprise analyzing one or more of the member demographic data, claims data, diagnosis data, medication data, health event data, and member-reported health conditions to determine a likelihood of the member having one or more potential health conditions and storing an indicator associated with the one or more potential health conditions in the member profile.

15. A system for graphically representing a subset of a plurality of health care data categories to a health care plan member via an online health care category node map, the system comprising:

a database for storing (a) a health care data taxonomy relating health care terminology to one or more of health care benefits terminology, health care-related financial terminology, health insurance terminology, and dental insurance terminology, and (b) a dynamic member profile for the health care plan member;

a server for initiating a display of the online health care category node map, the server comprising memory having stored thereon computer executable instructions for;

receiving an online member identification token associated with the health care plan member;

identifying the subset of the plurality of health care data categories based on correlating the health care data taxonomy with the member profile corresponding to the online member identification token;

initiating the display of the online health care category node map, the display comprising a ring node topology for graphically indicating a relationship between adjacent health care category nodes within the subset, the online health care category node map capable of responding to member input for selecting a category node by orienting the ring node topology display around the selected category node; and

wherein at least one category node in the online health care category node map comprises one or more subnodes corresponding to one or more health care data subcategories, the at least one category node capable of expanding into the one or more subnodes responsive to member input.

16. The system of claim 15 wherein the memory further comprises instructions for displaying text corresponding to content associated with the selected category node.

17. The system of claim 15 wherein the memory further comprises instructions for displaying one or more hyperlinks to content associated with the one or more subnodes.

18. The system of claim 15 wherein the dynamic member profile comprises at least one of member demographic data, diagnosis data, claims data, health care plan benefits data, health diseases and conditions data, medication data, health event data, allergy data, and vaccination data.

19. The system of claim 18 wherein the memory further comprises instructions for collecting at least one of the member demographic data, health diseases and conditions data, medications data, health event data, allergy data, and vaccination data based on information reported by the member.

20. The system of claim 18 wherein the memory further comprises instructions for building the dynamic member profile by analyzing one or more of the member demographic data, claims data, diagnosis data, medication data, health event data, and member-reported health conditions to determine a likelihood of the member having one or more potential health conditions and storing an indicator associated with the one or more potential health conditions in the dynamic member profile.