Patent Issued for Outcomes and performance monitoring (USPTO 11494724): Lightbeam Health Solutions LLC

2022 NOV 29 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A patent by the inventors Cline, Patrick (Irving, TX, US), Hoxter, Jr., James Michael (Irving, TX, US), Nary, Robert (Irving, TX, US), Shultz, Jerry (Irving, TX, US), filed on July 15, 2016, was published online on November 8, 2022, according to news reporting originating from Alexandria, Virginia, by NewsRx correspondents.

Patent number 11494724 is assigned to Lightbeam Health Solutions LLC (Iriving, Texas, United States).

The following quote was obtained by the news editors from the background information supplied by the inventors: “Field

“This application relates generally to health care service provider selection and performance and outcome monitoring.

“Description of Related Art Including Information Disclosed Under 37 CFR 1.97 and 1.98

“In response to ever-increasing healthcare costs and poor quality healthcare service delivery, the largest purchaser, the Federal Government, has begun tying income to payer and provider quality measures and outcomes. The government and a number of quality improvement organizations have created performance measurements and effective methods for measuring value, compliance with care guidelines, and quality measures. Yet, the very same payer and provider organizations whose income will increasingly be tied to their performance against these measures, lack an effective and automated solution that measures, tracks, and graphically presents performance. What payers, providers and care managers need, is a way to quantify, measure and compare quality scores, quality score trends, workload, tasks assigned, tasks completed or the overall efficiency and productivity of each provider, care managers and providers care teams. They also need a way to effectively measure and trend performance against quality scores over time.”

In addition to the background information obtained for this patent, NewsRx journalists also obtained the inventors’ summary information for this patent: “A system is provided for selecting a health care provider from a group of health care providers, and then monitoring and reporting the selected provider’s performance. The system may include a database and a processor connected to the database and to the internet. The processor may be programmed to retrieve from the internet and store in the database historical performance data on each provider in the group and healthcare data relating to the health care providers’ historical performance. The processor may also be programmed to determine whether the provider should be selected to perform a task, by assessing the providers’ historical performances against each other; selecting from the group of providers a provider to perform a task, monitoring post-selection healthcare data relating to the provider’s performance of the task, and generating a reporting metric comprising a display of a trend in the selected provider’s historical or current performance of the task.”

The claims supplied by the inventors are:

“1. A system for selecting a health care provider from a group of health care providers, and then monitoring and reporting the selected provider’s performance, wherein the system is electronically accessible by a member portal over the internet; the system including: an electronic database; a processor connected to the electronic database and to the internet, wherein the system is configured to allow registration of one or more external systems for integration with the system, wherein, as a result of an electronic registration process of at least one external system of the one or more external systems, the system provides at least one application programming interface (API) that is used to link the system to the at least one external system, wherein an external system profile for the at least one external system is maintained by the system and used for communications and/or interoperability between the system and the at least one external system, and wherein the external system profile is configured in part based on the electronic registration process; and wherein the system is configured to communicate with the at least one external system through use of the API and based on the external system profile; and wherein the processor is programmed to: retrieve discrete data from one or more internet-accessible discrete data sources via an electronic data connection that uses transmission control protocol (TCP) and store at least a portion of the discrete data in the electronic database as historical performance data for each provider in a group of health care providers, and as healthcare data relating to each health care provider’s historical performance, wherein the discrete data includes clinical data relating to the health of patients in a population of patients, wherein the discrete data is from at least three of the following systems or components: an ambulatory system, an inpatient system, a health insurance exchange, payers, a care management system, a hospital system, a claims data system, a pharmacy, a pharmacy aggregator, a pharmacy benefit manager, a lab, patient biometric monitoring devices, a credit score agency, a genomic database, and a search engine, and wherein at least one of the one or more internet-accessible discrete data sources is a part of the at least one external system and is accessed by the system through use of the external system profile for the at least one external system; normalize and transform the discrete data into a normalized data set by mapping the discrete data to a healthcare data model using various terminology, codes, and abbreviations; assess the providers’ historical performances against each other based on the historical performance data of the normalized data set; select a provider among the group of providers based on the assessment of the providers’ historical performances against each other, to perform a plurality of tasks; monitor post-selection healthcare data relating to the selected provider’s performance of the plurality of tasks; and generate a reporting metric to be displayed on the member portal, wherein the reporting metric comprises a graphical display of an overall task workload score for the selected provider and overall task workload scores for a plurality of other providers of the group of providers, wherein the overall task workload score for the selected provider is based on a plurality of task workload ratings, wherein a single one of the plurality of task workload ratings corresponds to a single one of the plurality of tasks, and wherein each of the plurality of task workload ratings is calculated based on: the post-selection healthcare data relating to the corresponding task, wherein the post-selection healthcare data relating to the corresponding task is determined based on compliance of performance of the corresponding task with target values of a measure that is set by a third party for the corresponding task; and a weighting for the corresponding task, wherein the weighting for the corresponding task is based on an importance of the corresponding task to the health of a patient and an acuity of the corresponding task.

“2. The system of claim 1 in which the processor is further programmed to determine whether the provider should continue a current task, based on the post-selection healthcare data relating to the provider’s performance of the plurality of tasks.

“3. The system of claim 1 in which the processor, in selecting a provider, is further programmed to: determine whether the provider should continue a current task based on the weighting for each of the plurality of tasks.

“4. The system of claim 1 in which the processor is further programmed to determine whether the provider should be assigned another task, based on the post-selection healthcare data relating to the provider’s performance of the plurality of tasks.

“5. The system of claim 1 in which the processor, in selecting a provider, is further programmed to: determine whether the provider should be assigned one or more additional tasks based on the weighting for each of the plurality of tasks.

“6. The system of claim 1 in which the processor, in generating a reporting metric, is further programmed to monitor and report on the status of an assigned task.

“7. The system of claim 1 in which the processor, in generating a reporting metric, is further programmed to generate reports that indicate whether the provider is meeting performance standards.

“8. The system of claim 1, wherein at least part of the discrete data originated from an electronic home monitor.

“9. A system for selecting a health care provider from a group of health care providers, and then monitoring and reporting the selected provider’s performance, wherein the system is electronically accessible by a member portal over the internet; the system including: an electronic database; and a processor connected to the electronic database and to the internet, wherein the system is configured to allow an electronic registration process of one or more external systems for integration with the system, wherein, as a result of registration of at least one external system of the one or more external systems, the system specifies at least one application programming interface (API) that is used to link the system to the at least one external system, and wherein an external system profile for the at least one external system is maintained by the system and used for communications and/or interoperability between the system and the at least one external system, and wherein the external system profile is configured in part based on the electronic registration process; wherein the system is configured to communicate with the at least one external system through use of the API and based on the external system profile; and wherein the processor is programmed to: retrieve discrete data from two or more internet-accessible discrete data sources via an electronic data connection that uses transmission control protocol (TCP) and store at least a portion of the discrete data in the electronic database as historical performance data for each provider in a group of healthcare providers and as healthcare data relating to each health care provider’s historical performance, wherein the discrete data includes clinical data relating to the health of patients in a population of patients, wherein the discrete data is from at least three of the following systems or components: an ambulatory system, an inpatient system, a health insurance exchange, payers, a care management system, a hospital system, a claims data system, a pharmacy, a pharmacy aggregator, a pharmacy benefit manager, a lab, patient biometric monitoring devices, a credit score agency, a genomic database, and a search engine, and wherein at least one of the two or more internet-accessible discrete data sources is a part of the at least one external system and is accessed by the system through use of the external system profile for the at least one external system; normalize and transform the discrete data into a normalized data set by mapping the discrete data to a healthcare data model using various terminology, codes, and abbreviations; determine which provider should be selected to perform a task, by assessing the providers’ historical performances against each other based on the historical performance data of the normalized data set; select a provider from the group of providers, to perform a plurality of tasks; monitor post-selection healthcare data relating to the selected provider’s performance of the plurality of tasks; and generate a reporting metric to be displayed on the member portal, wherein the reporting metric comprises a display of an overall task workload score for the provider and overall task workload scores for a plurality of other providers of the group of providers, wherein the overall task workload score for the provider is based on a plurality of task workload ratings, wherein a single one of the plurality of task workload ratings corresponds to a single one of the plurality of tasks, wherein each of the plurality of task workload ratings is calculated based on: the post-selection healthcare data relating to the corresponding task, wherein the post-selection healthcare data relating to the corresponding task is determined based on compliance of performance of the corresponding task with target values of a measure that is set by a third party for the corresponding task, wherein each of the measures is selected from one or more of the following: an accountable care organization (ACO), a healthcare effectiveness data and information set (HEDIS), a situation task/target action result (STAR), and a pay for performance (P4P) payment model; and a weighting for the corresponding task, wherein the weighting for the corresponding task is based on an importance of the corresponding task to the health of a patient and an acuity of the corresponding task.”

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

URL and more information on this patent, see: Cline, Patrick. Outcomes and performance monitoring. U.S. Patent Number 11494724, filed July 15, 2016, and published online on November 8, 2022.

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