Patent Application Titled “System And Method For Healthcare Security And Interoperability” Published Online (USPTO 20230138488): Patent Application - Insurance News | InsuranceNewsNet

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May 19, 2023 Newswires
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Patent Application Titled “System And Method For Healthcare Security And Interoperability” Published Online (USPTO 20230138488): Patent Application

Insurance Daily News

2023 MAY 19 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- According to news reporting originating from Washington, D.C., by NewsRx journalists, a patent application by the inventors Lee, Jessica (Edison, NJ, US); Morimura, Jun (Tokyo, JP); Moschetti, Michael (Montville, NJ, US); Quesada, Marvin (Princeton, NJ, US); Thomson, Andrew (Robbinsville, NJ, US); Vig, John (Irvine, CA, US), filed on December 15, 2022, was made available online on May 4, 2023.

No assignee for this patent application has been made.

Reporters obtained the following quote from the background information supplied by the inventors: “Healthcare information systems face compliance challenges that limit interoperability. For example, stored information may be subject to various privacy regulations such as Health Insurance Portability and Accountability Act (HIPAA). Privacy rules under HIPAA establish national standards to protect individual medical records and other personal health information when health care transactions are conducted electronically. These regulations may cover privacy (e.g. which entities have access to information), content (what information an authorized entity may access), security (how the information is protected from unauthorized access when stored and during electronic communication) and integrity (the accuracy and authenticity of information). In addition, commercially valuable information may be protected under an organizational policy that may limit sharing of the information with third parties (e.g. as trade secrets, and/or for business or commercial reasons). Regulations such as the European Union (EU) General Data Protection Regulation (GDPR) and state regulations may also impact information collection, storage, sharing, and communication. These regulations have affected the information available to healthcare marketplace participants and led to the creation of organizational “data silos,” where information available to an entity is isolated, even when it could be useful systemically (e.g. to another non-competitive entity). Such compartmentalization of information has led to increased systemic costs (e.g. by a patient or medical provider considering the costs of treatment alternatives, treatment locations, etc.), raised patient risk (e.g. from drug interactions, prescription abuse etc.), and limited the efficacy of outcome based approaches to medical treatment or remediation (e g making it more difficult and expensive to determine when a desired outcome has been achieved or compare metrics in approaches that achieve similar outcomes). Systems and techniques to address one or more of the above issues that would help facilitate healthcare information security while promoting interoperability between marketplace participants are therefore desirable.”

In addition to obtaining background information on this patent application, NewsRx editors also obtained the inventors’ summary information for this patent application: “In some embodiments, a processor-implemented method may comprise: receiving at least one encrypted first Electronic Health Record (EHR) sub-block decryptable by the first entity, wherein the at least one EHR sub-block comprises patient medical coverage information for a patient and one or more first treatments; transmitting, in response to the first EHR sub-block, at least one encrypted first Drug/Device Information (DIR) sub-block decryptable by at least one corresponding second entity, wherein the at least one first DIR sub-block comprises, for each of the one or more first treatments, a corresponding first treatment class, one or more corresponding first treatment class members associated with each corresponding first treatment class, and for each first treatment class member, corresponding first treatment class member cost information; receiving, in response to the first DIR sub-block, an encrypted second EHR sub-block decryptable by the first entity, wherein the second EHR sub-block comprises one or more second treatments, wherein each of the one or more second treatments is associated with a corresponding first treatment and each second treatment is selected from the corresponding first treatment class members associated with the corresponding first treatment; and augmenting, in response to a transaction confirmation, a multi-dimensional blockchain, wherein the multi-dimensional blockchain is augmented with a multi-dimensional block formed by linking: a DIR block comprising information associated with the one or more second treatments, an EHR block comprising information associated with the second EHR sub-block, and a transaction block.

“In another aspect, a computing device for a first entity may comprise: a memory, a communications interface, and a processor coupled to the memory and the communications interface. In some embodiments, the processor may be configured to: receive at least one encrypted first Electronic Health Record (EHR) sub-block decryptable by the first entity, wherein the at least one EHR sub-block comprises patient medical coverage information for a patient and one or more first treatments; transmit, in response to the first EHR sub-block, at least one encrypted first Drug/Device Information (DIR) sub-block decryptable by at least one corresponding second entity, wherein the at least one first DIR sub-block comprises, for each of the one or more first treatments, a corresponding first treatment class, one or more corresponding first treatment class members associated with each corresponding first treatment class, and for each first treatment class member, corresponding first treatment class member cost information; receive, in response to the first DIR sub-block, an encrypted second EHR sub-block decryptable by the first entity, wherein the second EHR sub-block comprises one or more second treatments, wherein each of the one or more second treatments is associated with a corresponding first treatment and each second treatment is selected from the corresponding first treatment class members associated with the corresponding first treatment; and augment, in response to a transaction confirmation, a multi-dimensional blockchain, wherein the multi-dimensional blockchain is augmented with a multi-dimensional block formed by linking: a DIR block comprising information associated with the one or more second treatments, an EHR block comprising information associated with the second EHR sub-block, and a transaction block.

“In a further aspect, an apparatus may comprise: means for receiving at least one encrypted first Electronic Health Record (EHR) sub-block decryptable by a first entity, wherein the at least one EHR sub-block comprises patient medical coverage information for a patient and one or more first treatments; means for transmitting, in response to the first EHR sub-block, at least one encrypted first Drug/Device Information (DIR) sub-block decryptable by at least one corresponding second entity, wherein the at least one first DIR sub-block comprises, for each of the one or more first treatments, a corresponding first treatment class, one or more corresponding first treatment class members associated with each corresponding first treatment class, and for each first treatment class member, corresponding first treatment class member cost information; means for receiving, in response to the first DIR sub-block, an encrypted second EHR sub-block decryptable by the first entity, wherein the second EHR sub-block comprises one or more second treatments, wherein each of the one or more second treatments is associated with a corresponding first treatment and each second treatment is selected from the corresponding first treatment class members associated with the corresponding first treatment; and means for augmenting, in response to a transaction confirmation, a multi-dimensional blockchain, wherein the multi-dimensional blockchain is augmented with a multi-dimensional block formed by linking: a DIR block comprising information associated with the one or more second treatments, an EHR block comprising information associated with the second EHR sub-block, and a transaction block.

“In some embodiments, a non-transitory computer-readable medium may comprise executable instructions to configure a processor to: receive at least one encrypted first Electronic Health Record (EHR) sub-block decryptable by the first entity, wherein the at least one EHR sub-block comprises patient medical coverage information for a patient and one or more first treatments; transmit, in response to the first EHR sub-block, at least one encrypted first Drug/Device Information (DIR) sub-block decryptable by at least one corresponding second entity, wherein the at least one first DIR sub-block comprises, for each of the one or more first treatments, a corresponding first treatment class, one or more corresponding first treatment class members associated with each corresponding first treatment class, and for each first treatment class member, corresponding first treatment class member cost information; receive, in response to the first DIR sub-block, an encrypted second EHR sub-block decryptable by the first entity, wherein the second EHR sub-block comprises one or more second treatments, wherein each of the one or more second treatments is associated with a corresponding first treatment and each second treatment is selected from the corresponding first treatment class members associated with the corresponding first treatment; and augment, in response to a transaction confirmation, a multi-dimensional blockchain, wherein the multi-dimensional blockchain is augmented with a multi-dimensional block formed by linking: a DIR block comprising information associated with the one or more second treatments, an EHR block comprising information associated with the second EHR sub-block, and a transaction block.

“Further, in another aspect, a processor-implemented method may comprise: obtaining, from at least one encrypted first Health Transaction Record (HTR) sub-block decryptable by the first entity, a first set of first treatments for the patient over a time period, wherein each first treatment comprises a first diagnosis code and a first treatment code; obtaining, based on the first set: (a) one or more second sets of second treatments, wherein each corresponding second treatment is associated with: a distinct first treatment in the first set, and (b) a corresponding number of recurrences for each second treatment; obtaining a set of available insurance plans available to the patient and corresponding coverage related information for each available insurance plan; obtaining, based on the set of second treatments and corresponding coverage related information for each insurance plan, corresponding estimated plan-specific cost metrics for the patient; and transmitting, a first encrypted Drug/Device Information Record (DIR) sub-block decryptable by at least one second entity, wherein the DIR sub-block comprises the plan-specific cost metrics for the patient.

“In some embodiments, a computing device for a first entity may comprise: a memory, a communications interface, and a processor coupled to the memory and the communications interface. In some embodiments, the processor may be configured to: obtain, from at least one encrypted first Health Transaction Record (HTR) sub-block decryptable by the first entity, a first set of first treatments for the patient over a time period, wherein each first treatment comprises a first diagnosis code and a first treatment code; obtain, based on the first set: (a) one or more second sets of second treatments, wherein each corresponding second treatment is associated with: a distinct first treatment in the first set, and (b) a corresponding number of recurrences for each second treatment; obtain a set of available insurance plans available to the patient and corresponding coverage related information for each available insurance plan; obtain, based on the set of second treatments and corresponding coverage related information for each insurance plan, corresponding estimated plan-specific cost metrics for the patient; and transmit, a first encrypted Drug/Device Information Record (DIR) sub-block decryptable by at least one second entity, wherein the DIR sub-block comprises the plan-specific cost metrics for the patient.”

There is additional summary information. Please visit full patent to read further.”

The claims supplied by the inventors are:

“1. A processor-implemented method at a first entity comprising: obtaining, from at least one encrypted first Health Transaction Record (HTR) sub-block decryptable by the first entity, a first set of first treatments for a patient over a time period, wherein each of the first treatments comprises a corresponding first diagnosis code and a corresponding first treatment code; obtaining, based on the first set, one or more second sets of second treatments, wherein each of the second treatments is associated with: a distinct corresponding first treatment in the first set and a corresponding number of recurrences of the second treatment; obtaining a set of available insurance plans available to the patient and a corresponding coverage related information for each of the available insurance plans; obtaining, for each of the available insurance plans, based on the corresponding coverage related information, corresponding estimated insurance plan-specific cost metrics for the patient based on the first treatments and the second treatments; and transmitting, a first encrypted Drug/Device Information Record (DIR) sub-block decryptable by at least one second entity, wherein the DIR sub-block comprises one or more of the estimated insurance plan-specific cost metrics for the patient.

“2. The processor-implemented method of claim 1, further comprising: receiving a second encrypted HTR sub-block decryptable by the first entity, wherein the second HTR sub-block comprises at least one selected insurance plan selected from the set of available insurance plans; and augmenting, in response to a received transaction block with a transaction confirmation comprising the at least one selected insurance plan, a multi-dimensional blockchain, wherein the multi-dimensional blockchain is augmented with a multi-dimensional block formed by linking: an HTR block comprising information associated with the second HTR sub-block, a DIR block comprising the corresponding estimated insurance plan-specific cost metrics in the first DIR sub-block for the at least one selected insurance plan, and the transaction block.

“3. The processor-implemented method of claim 1, wherein, obtaining the one or more second sets of second treatments comprises: determining, for each of the first treatments in the first set, one or more corresponding first treatment classes; and determining, for each of the one or more first treatment classes, the corresponding second set comprising the one or more second treatments.

“4. The processor-implemented method of claim 3, wherein obtaining, for each of the available insurance plans, the corresponding estimated insurance plan-specific cost metrics comprises: determining one or more treatment plans, wherein each treatment plan corresponds therapeutically to the first set, wherein each treatment plan is associated with a corresponding third set of third treatments, wherein the third treatments are selected from at least one of: the first treatments, or the second treatments, or a combination thereof; and determining, for each of the available insurance plans, the corresponding estimated insurance plan-specific cost information based on each of the corresponding third sets associated with the one or more treatment plans.

“5. The processor-implemented method of claim 4, wherein determining the corresponding estimated plan-specific cost metrics further comprises: determining, for each of the available insurance plans, and for each of the one or more treatment plans, corresponding aggregate cost metrics.

“6. The processor-implemented method of claim 5, wherein the corresponding aggregate cost metrics account for at least one of: co-payment assistance, discounts, or a combination thereof.

“7. The processor-implemented method of claim 1, wherein the corresponding estimated plan-specific cost metrics for each available insurance plan account for co-payment assistance, discounts, or a combination thereof.

“8. The processor-implemented method of claim 1, wherein set of available insurance plans and the corresponding coverage related information for each available insurance plan is obtained from a health exchange.

“9. The processor-implemented method of claim 8, wherein obtaining corresponding estimated insurance plan-specific cost metrics comprises receiving, at the first entity, for each available insurance plan, the corresponding estimated insurance plan-specific cost metrics from at least one third entity, wherein the at least one third entity comprises a Pharmacy Benefit Manager (PBM), or an insurer, or an employer, or a combination thereof.

“10. The method of claim 1, wherein the first entity is a Pharmaceutical Provider and/or Medical Device Provider (PMDP), and the at least one second entity is a Health Care Provider (HCP), or the patient, or the Health Exchange (HEX), or a combination thereof.

“11. A computing device for a first entity comprising: a memory, a communications interface, and a processor coupled to the memory and the communications interface, wherein the processor is configured to: obtain, from at least one encrypted first Health Transaction Record (HTR) sub-block decryptable by the first entity, a first set of first treatments for a patient over a time period, wherein each of the first treatments comprises a corresponding first diagnosis code and a corresponding first treatment code; obtain, based on the first set, one or more second sets of second treatments, wherein each of the second treatments is associated with: a distinct corresponding first treatment in the first set and a corresponding number of recurrences of the second treatment; obtain a set of available insurance plans available to the patient and a corresponding coverage related information for each of the available insurance plans; obtain, for each of the available insurance plans, based on the corresponding coverage related information, corresponding estimated insurance plan-specific cost metrics for the patient based on the first treatments and the second treatments; and transmit, a first encrypted Drug/Device Information Record (DIR) sub-block decryptable by at least one second entity, wherein the DIR sub-block comprises one or more of the estimated insurance plan-specific cost metrics for the patient.

“12. The computing device of claim 11, wherein the processor is further configured to: receive a second encrypted HTR sub-block decryptable by the first entity, wherein the second HTR sub-block comprises at least one selected insurance plan selected from the set of available insurance plans; and augment, in response to a received transaction block with a transaction confirmation comprising the at least one selected insurance plan, a multi-dimensional blockchain, wherein the multi-dimensional blockchain is augmented with a multi-dimensional block formed by linking: an HTR block comprising information associated with the second HTR sub-block, a DIR block comprising the corresponding estimated insurance plan-specific cost metrics in the first DIR sub-block for the at least one selected insurance plan, and the transaction block.

“13. The computing device of claim 11, wherein, to obtain the one or more second sets of second treatments, the processor is configured to: determine, for each of the first treatments in the first set, one or more corresponding first treatment classes; and determine, for each of the one or more first treatment classes, the corresponding second set comprising the one or more second treatments.

“14. The computing device of claim 13, wherein to obtain, for each of the available insurance plans, the corresponding estimated insurance plan-specific cost metrics, the processor is configured to: determine one or more treatment plans, wherein each treatment plan corresponds therapeutically to the first set, wherein each treatment plan is associated with a corresponding third set of third treatments, wherein the third treatments are selected from at least one of: the first treatments, or the second treatments, or a combination thereof; and determine, for each of the available insurance plans, the corresponding estimated insurance plan-specific cost information based on each of the corresponding third sets associated with the one or more treatment plans.

“15. The computing device of claim 14, wherein to determine the corresponding estimated plan-specific cost metrics, the processor is further configured to: determine, for each of the available insurance plans, and for each of the one or more treatment plans, corresponding aggregate cost metrics.

“16. The computing device of claim 15, wherein the corresponding aggregate cost metrics account for at least one of: co-payment assistance, discounts, or a combination thereof.

“17. The computing device of claim 11, wherein the corresponding estimated plan-specific cost metrics for each available insurance plan account for co-payment assistance, discounts, or a combination thereof.

“18. The computing device of claim 11, wherein set of available insurance plans and the corresponding coverage related information for each available insurance plan is obtained from a health exchange.”

There are additional claims. Please visit full patent to read further.

For more information, see this patent application: Lee, Jessica; Morimura, Jun; Moschetti, Michael; Quesada, Marvin; Thomson, Andrew; Vig, John. System And Method For Healthcare Security And Interoperability. U.S. Patent Application Number 20230138488, filed December 15, 2022 and posted May 4, 2023. Patent URL (for desktop use only): https://ppubs.uspto.gov/pubwebapp/external.html?q=(20230138488)&db=US-PGPUB&type=ids

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