WO2001077986A2 - Automated risk management infrastructure for healthcare - Google Patents
Automated risk management infrastructure for healthcare Download PDFInfo
- Publication number
- WO2001077986A2 WO2001077986A2 PCT/US2001/011129 US0111129W WO0177986A2 WO 2001077986 A2 WO2001077986 A2 WO 2001077986A2 US 0111129 W US0111129 W US 0111129W WO 0177986 A2 WO0177986 A2 WO 0177986A2
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- compliance
- patient
- risk
- patients
- database
- Prior art date
Links
Classifications
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H70/00—ICT specially adapted for the handling or processing of medical references
- G16H70/60—ICT specially adapted for the handling or processing of medical references relating to pathologies
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/20—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for electronic clinical trials or questionnaires
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/20—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
Definitions
- the present invention relates to the process, knowledge and environment for assessing, characterizing and managing disease-specific health care compliance.
- the present invention can help to manage consumption of medical resources by a portion of a patient population most at risk to over consume medical resources as well as facilitating identification of these patients.
- the invention provides a semi-automated environment that enables a process in which health care providers seamlessly interact with a patient to evaluate their compliance with the specified health care protocol, assess their beliefs and behavior regarding compliance management, identify issues in compliance management, and/or design and implement a compliance management plan.
- the environment enables aggregation of system performance that enables knowledge accretion and system improvement. These capabilities are applicable to a broad range of heath care management tasks.
- the software environment is also adaptable to a broad range of behavior modification and self help applications including applications such as monitoring current wellness state.
- the present invention provides protocols and environment for applying knowledge to health care risk management.
- the protocols and environment identify a sequence of actions and knowledge sets based on patient information that may be involved in health care risk management.
- the protocols and environment for identified at risk patients can include assessing compliance risk, establishing compliance goals, identifying and applying required interventions, and collecting and annotating medical information relevant to the compliance management process.
- the environment provides a suite of software tools that seamlessly couple the protocols and knowledge in a health care provider intuitive fashion.
- the present invention includes a computer software environment and systems architecture.
- the computer software includes a computer readable medium and computer program instructions recorded on the computer readable medium and executable by a processor for performing the steps of the method of the present invention.
- the system architecture design enables reconfiguration to many client-server implementations to support different business models.
- the present invention can support a standalone platform, a local area network, and/or world wide web implementations.
- the architecture may be based on Java technology that ensures portability and platform independence.
- the architecture can leverage the Java Enterprise technology, which provides for flexibility and incorporation of enterprise support services such as transaction management and security capabilities.
- the architecture is constructed using object technology that mirrors the problem domain taxonomy.
- Fig. 1 represents a schematic drawing that illustrates aspects of the process according to an embodiment of the present invention
- Fig. 2 represents a schematic drawing that illustrates aspects of an embodiment of the compliance management step in the process according to the present invention
- Fig. 3 represents a schematic drawing that illustrates aspects of compliance management regarding the process of compliance planning, patient interaction for intervention and assessment, results collection, and recording in the patient profile;
- Fig. 4 represents a schematic drawing that illustrates aspects of knowledge accretion and system improvement according to the present invention
- Fig. 5 represents a schematic drawing that illustrates aspects of the architecture in three different embodiments of a health care risk management system
- Fig. 6 represents a schematic drawing of the common modular architecture
- Fig. 7 represents a block diagram that illustrates aspects of an embodiment of a system according to the present invention.
- the present invention provides a protocol and environment, or software, to manage risk in healthcare and to assist in compliance management.
- Patients can enter the process through various mechanisms.
- identification of at risk patients can take place automatically through processing insurance records in electronic form.
- the aspects of the records that are analyzed are claims data, prescription data, referral data, and a review of overall utilization. Patients can also enter through referrals.
- Steps are carried out to reduce the cost of caring for these patients yet maintain an adequate level of care.
- each patient is interviewed for compliance risk assessment.
- Assessing at risk patients can include posing a series of questions to the patients.
- the questions can evaluate a number of aspects of the patient's attitudes, including their beliefs and behaviors regarding their health, attitudes toward their health, managing their health and the healthcare system and/or any other topic. Examples of questions can include questions on the SF-12 health survey. More information on the SF-12 can be found at the following internet site http://qmetric.com/innohome/insfl2.shtml, the entire contents of which and all linked sites are hereby incorporated by reference.
- a nurse, physician or other person may pose the questions to the patients.
- the questions could be posed in person or over the telephone.
- the questioner could pose questions from a printed list of questions.
- the questions may be generated by a computer system and displayed on a graphical user interface (GUI) where the questioner can read them.
- GUI graphical user interface
- the questioner can write down the answers or enter them into the GUI and the answers are stored in a database.
- the internet is utilized to conduct patient compliance risk assessment.
- a patient would access a web site.
- the web site would prompt the patient for a password or some other identifying number that will permit a server to identify the patient and access the patient's profile.
- the questions would be transmitted to the patient via the internet.
- the patient's answers would be transmitted over the internet to a compliance risk assessment system.
- Patient responses are stored in a patient profile data set. Each patient has a patient profile, which contains a dynamic representation of the patient's current state. Patient responses may invite a new series of questions - the questions adapt to the responses. The adaptation process may be continued throughout the questioning.
- a decision tree may be utilized to guide the questioning. The questioning may be stopped by the questioner or may be automatically terminated by a computer system. Termination of the questioning may take place upon reaching a certain point or may be terminated by the questioner, the patient or the system at an arbitrary point.
- numerical values may be attached to answers to any or all of the questions. Assigning values to the answers can permit a more objective representation of the patient's compliance risk status to be developed. Also, quantifying patient responses can lead to more standardized care at least in part by replacing judgement calls by questioners with more standardized operations. If the assessment process leads to identifying a patient as at risk, a provider, whether a nurse, physician, nurse practitioner, physician's assistant or other person, may be assigned to a patient to develop, implement, and/or ensure compliance with a course of action. The adaptive decision tree can be employed to guide the caregiver to an appropriate course of action. In fact, the course of action may be continuously modified as patient attitudes and behavior changes, as reflected by continued interaction with the system. Figure 3 illustrates this process.
- the results of the patient interviews performed in Risk Assessment provide the initial data used to form the plan to manage patient compliance.
- Patient interactions are recorded. These interactions can include facts and judgements as well as the patient's health status. The interaction and record thereof can go into developing the patient profile. Furthermore, the patient profile is used by the plan to adapt the compliance management process.
- Fig. 2 illustrates aspects of this portion of the present invention.
- assessment may continue of patient beliefs and behavior, particularly behavior with respect to carrying out the course of action, or care plan, developed for the patient.
- questions may be posed to the patient regarding particular issues that exist in their care plan.
- the care plan may be altered through time to help ensure patient compliance and/or to adapt to changing circumstances, such as changing health status. Also if necessary, a health care worker may intervene to help ensure compliance.
- Fig. 4 illustrates the process of knowledge base mining.
- the contents of the patient profile database are the resource used in knowledge mining techniques.
- the techniques extract additional risk assessment and compliance management knowledge that can be subsequently used in the process.
- Fig. 5 illustrates various embodiments of a system according to the present invention.
- Fig. 6 illustrates in greater detail one, two, and three tier business models.
- software according to the present invention may be built using functional building blocks, including user interface classes, business logic classes, data set classes, data provider classes, data resolver classes, class stubs, and the database. This functional decomposition allows for an architecture that can replicate and distribute the building blocks as necessary to seamlessly support one-, two-, and three tier business models as shown in Fig. 6.
- Fig. 7 illustrates an exemplary block diagram of a system according to the present invention.
- System 100 is typically a programmed general-purpose computer system, such as a personal computer, workstation, server system, and minicomputer or mainframe computer.
- Risk management system 100 includes processor (CPU) 102, input/output circuitry 104, network adapter 106, and memory 108.
- CPU 102 executes program instructions in order to carry out the functions of the present invention.
- CPU 102 is a microprocessor, such as an INTEL PENTIUM® processor, but may also be a minicomputer or mainframe computer processor.
- Input/output circuitry 104 provides the capability to input data to, or output data from, computer system 100.
- input/output circuitry may include input devices, such as keyboards, mice, touchpads, trackballs, scanners, etc., output devices, such as video adapters, monitors, printers, etc., and input/output devices, such as, modems, among other elements.
- Network adapter 106 interfaces risk management system 100 with network 110.
- Network 110 may be any standard local area network (LAN) or wide area network (WAN), such as Ethernet, Token Ring, the Internet, or a private or proprietary LAN/WAN.
- Memory 108 stores program instructions that are executed by, and data that are used and processed by, CPU 102 to perform the functions of the present invention.
- Memory 108 may include electronic memory devices, such as random-access memory (RAM), read-only memory (ROM), programmable read-only memory (PROM), electrically erasable programmable read-only memory (EEPROM), flash memory, etc., and electro-mechanical memory, such as magnetic disk drives, tape drives, optical disk drives, etc., which may use an integrated drive electronics (IDE) interface, or a variation or enhancement thereof, such as enhanced IDE (EIDE) or ultra direct memory access (UDMA), or a small computer system interface (SCSI) based interface, or a variation or enhancement thereof, such as fast-SCSI, wide-SCSI, fast and wide-SCSI, etc, or a fiber channel-arbitrated loop (FC-AL) interface.
- IDE integrated drive electronics
- EIDE enhanced IDE
- UDMA ultra direct memory access
- SCSI small computer system interface
- FC-AL fiber channel-ar
- Memory 108 includes a plurality of blocks of data, such as graphical user interface classes block 109, business logic classes block 112, data set classes block 114, and data resolvers and data providers block 116, and a plurality of blocks of program instructions, such as processing routines 118 and operating system 120.
- Graphical user interface classes block 109 stores elements of the graphical user interface included in the present invention.
- Business logic classes block 112 stores a plurality of business logic classes that may be employed in the system.
- Data set classes block 114 stores data set classes.
- Data resolvers and data providers block 116 stores data resolvers and data providers that may interface with the database.
- Processing routines 118 are software routines that implement the processing performed by the present invention.
- Operating system 120 provides overall system functionality.
Abstract
Description
Claims
Priority Applications (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
AU2001249897A AU2001249897A1 (en) | 2000-04-05 | 2001-04-05 | Automated risk management infrastructure for healthcare |
US10/240,480 US20040030577A1 (en) | 2001-04-05 | 2001-04-05 | Automated risk management infrastructure for healthcare |
CA002400483A CA2400483A1 (en) | 2000-04-05 | 2001-04-05 | Automated risk management infrastructure for healthcare |
EP01923179A EP1297479A2 (en) | 2000-04-05 | 2001-04-05 | Automated risk management infrastructure for healthcare |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US19460100P | 2000-04-05 | 2000-04-05 | |
US60/194,601 | 2000-04-05 |
Publications (2)
Publication Number | Publication Date |
---|---|
WO2001077986A2 true WO2001077986A2 (en) | 2001-10-18 |
WO2001077986A3 WO2001077986A3 (en) | 2003-01-23 |
Family
ID=22718206
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/US2001/011129 WO2001077986A2 (en) | 2000-04-05 | 2001-04-05 | Automated risk management infrastructure for healthcare |
Country Status (5)
Country | Link |
---|---|
EP (1) | EP1297479A2 (en) |
AU (1) | AU2001249897A1 (en) |
CA (1) | CA2400483A1 (en) |
WO (1) | WO2001077986A2 (en) |
ZA (1) | ZA200205782B (en) |
Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5572421A (en) * | 1987-12-09 | 1996-11-05 | Altman; Louis | Portable medical questionnaire presentation device |
EP0887759A1 (en) * | 1997-06-23 | 1998-12-30 | Smithkline Beecham Corporation | Method and system for identifying at risk patients diagnosed with congestive heart failure |
US5897493A (en) * | 1997-03-28 | 1999-04-27 | Health Hero Network, Inc. | Monitoring system for remotely querying individuals |
EP0917078A1 (en) * | 1996-09-30 | 1999-05-19 | Smithkline Beecham Corporation | Disease management method and system |
US6047259A (en) * | 1997-12-30 | 2000-04-04 | Medical Management International, Inc. | Interactive method and system for managing physical exams, diagnosis and treatment protocols in a health care practice |
-
2001
- 2001-04-05 EP EP01923179A patent/EP1297479A2/en not_active Withdrawn
- 2001-04-05 AU AU2001249897A patent/AU2001249897A1/en not_active Abandoned
- 2001-04-05 WO PCT/US2001/011129 patent/WO2001077986A2/en not_active Application Discontinuation
- 2001-04-05 CA CA002400483A patent/CA2400483A1/en not_active Abandoned
-
2002
- 2002-07-19 ZA ZA200205782A patent/ZA200205782B/en unknown
Patent Citations (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US5572421A (en) * | 1987-12-09 | 1996-11-05 | Altman; Louis | Portable medical questionnaire presentation device |
EP0917078A1 (en) * | 1996-09-30 | 1999-05-19 | Smithkline Beecham Corporation | Disease management method and system |
US5897493A (en) * | 1997-03-28 | 1999-04-27 | Health Hero Network, Inc. | Monitoring system for remotely querying individuals |
EP0887759A1 (en) * | 1997-06-23 | 1998-12-30 | Smithkline Beecham Corporation | Method and system for identifying at risk patients diagnosed with congestive heart failure |
US6047259A (en) * | 1997-12-30 | 2000-04-04 | Medical Management International, Inc. | Interactive method and system for managing physical exams, diagnosis and treatment protocols in a health care practice |
Non-Patent Citations (1)
Title |
---|
CLARKE M ET AL: "Integrated Selective Heart Disease Screening" ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY, 1990., PROCEEDINGS OF THE TWELFTH ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE PHILADELPHIA, PA, USA 1-4 NOV. 1990, NEW YORK, NY, USA,IEEE, US, 1 November 1990 (1990-11-01), pages 1212-1213, XP010035344 ISBN: 0-87942-559-8 * |
Also Published As
Publication number | Publication date |
---|---|
CA2400483A1 (en) | 2001-10-18 |
WO2001077986A3 (en) | 2003-01-23 |
ZA200205782B (en) | 2004-01-26 |
EP1297479A2 (en) | 2003-04-02 |
AU2001249897A1 (en) | 2001-10-23 |
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