Patent Issued for Systems, methods, and media for laboratory benefit services (USPTO 11056229)

2021 JUL 27 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- According to news reporting originating from Alexandria, Virginia, by NewsRx journalists, a patent by the inventors Conlin, Paul (Burlington, NC, US), Engel, Louis (Burlington, NC, US), Verrengia, Roberto (Burlington, NC, US), filed on March 13, 2013, was published online on July 6, 2021.

The assignee for this patent, patent number 11056229, is Beacon Laboratory Benefit Solutions Inc. (Montvale, New Jersey, United States).

Reporters obtained the following quote from the background information supplied by the inventors: “Health care providers desire to provide the best care to their patients and, in doing so, often need to select laboratory tests. It is advantageous for health care providers to select the optimal test, or tests, for their patient, to know the proper timing of selected tests, and to be able to differentiate the labs that have the expertise to perform the selected tests. It is also advantageous for health care providers and patients to be able to understand insurance coverage relating to laboratory tests.

“Health plans and self-funded employer groups are seeking better and easier ways to improve patient care and physician support while managing laboratory utilization and costs. As the number of laboratories, laboratory tests, health plans, and medical codes have increased, the complexity of managing the ordering, delivery, and fulfillment of laboratory tests has also increased. Systems and methods that reduce the complexity of ordering laboratory tests, and support health care providers in the ordering of the laboratory tests would be advantageous. Systems and methods that increase the efficiency of the delivery of health care services to a patient, would be also advantageous. Furthermore, systems and methods that increase the efficiency of the delivery of health care services to a patient, by providing health care providers with better and more efficient means for interacting with health plans and laboratories, including the ability to interact on mobile devices, such as mobile computing devices, including, for example, mobile phones, mobile tablets, and the like, would be advantageous.”

In addition to obtaining background information on this patent, NewsRx editors also obtained the inventors’ summary information for this patent: “Embodiments of the present invention provide systems, methods, and media that may advantageously enhance the quality of health care related services to a patient, thereby enhancing patient care. Embodiments of the present invention also provide the advantages referenced above.

“In an embodiment, the present invention provides systems, methods and media that present a health care provider with information to support a decision, for example, a decision relating to a test, or tests, for a patient. In addition, or in additional embodiment, the present invention provides systems, methods and media that present information relating to a patient’s health plan to advantageously facilitate a health care provider’s knowledge and use of a patient’s health plan information. Further, or in an additional, or further, embodiment, the present invention provides systems, methods and media that present information relating to a laboratory to advantageously facilitate a health care provider’s knowledge and use of laboratory information, including laboratory expertise. Still further, or in an additional, or still further, embodiment, the present invention provides systems, methods and media that advantageously allow interaction between and/or among a health care provider, a laboratory and/or a health plan.

“In an embodiment, the present invention provides a system, a method or media that facilitates interaction among a health care provider and (i) a patient’s information; (ii) a patient’s health plan/health insurance information; and/or (iii) laboratory information. In an embodiment a system, a method or media of the present invention may present a health care provider with (i) a patient’s medical information; (ii) a patient’s health plan/health insurance information; and/or (iii) laboratory information to support a decision to be made by the health care provider.

“As used herein health care provider refers to an individual or an institution that provides preventive, curative, promotional, or rehabilitative health care services to individuals, families or communities. An example of a health care provider includes, but is not limited to, a physicians, a physician’s assistant, a nurse, a nurse’s aide, a pharmacist, a pharmacist’s assistant, a dentist, a dentist’s assistant, a dental hygienist, a laboratory technician, a physical therapist, an occupational therapist and the like. As used in the present application, health care provider also includes administrative and other staff who may work with a health care provider.

“As used herein, patient information may comprise medical information and refer to information relating to a patient’s individual and/or family medical history, including but not limited to, physical characteristics such as height, weight, eye color, hair color, tattoo’s, birthmarks; test information such as temperature, blood pressure, resting pulse, clinical test results; disease states past or present; pregnancy information; and similar information generally found in a health care record maintained by a health care provider and/or an insurer, and/or an electronic medical record.”

The claims supplied by the inventors are:

“1. A method, comprising: generating, by a pass through server, a web portal in a number of portal pages presented by use of portlets, the web portal provideable to an electronic device of a health care provider and useable for receiving user input via the electronic device; receiving, by the pass through server and from the electronic device of the health care provider, an order request for a first laboratory test for a patient corresponding to the health care provider via the web portal; verifying, by the pass through server and in response to receiving the order request and prior to completing an order corresponding to the order request for the first laboratory test, an authenticity of the health care provider by authenticating a username and password or a digital certificate associated with the health care provider, wherein verifying the authenticity of the health care provider comprises: accessing, by the pass through server, an authenticity data store to determine whether the username and password or the digital certificate received from the electronic device of the health care provider authenticates the health care provider; in response to verifying the authenticity of the health care provider and after receiving the order request for the first laboratory test and prior to completing the order corresponding to the order request for the first laboratory test: dynamically determining, by an application server in a clustered server environment, a recommended laboratory test for the patient based at least in part on the first laboratory test for the patient and by querying a data store in communication with the application server for medical information corresponding to the patient stored in the data store; wherein the medical information stored in the data store used in dynamically determining the recommended laboratory test for the patient comprises a medical classification code corresponding to the patient, a health plan corresponding to the patient, and historical medical information corresponding to the patient; wherein the recommended laboratory test comprises at least one of an additional laboratory test for the patient or an alternate laboratory test for the patient; determining an availability of a previous sample from the patient for the recommended laboratory test, wherein the availability includes an existence of and a duration of the existence of the previous sample; sending, by the pass through server and via the web portal, the recommended laboratory test for the patient and an alert based on the availability of the previous sample for the recommended laboratory test to the electronic device of the health care provider asking whether the recommended laboratory test for the patient should be ordered; receiving, by the pass through server and via the web portal, a response from the electronic device of the health care provider to order the recommended laboratory test for the patient; completing the order from the health care provider based at least in part on the determining of the availability, wherein the order comprises the recommended laboratory test for the patient; receiving, by the pass through server and via the web portal, a plurality of selections made on the electronic device of the health care provider to define a presentation customization, the plurality of selections including a selection for displaying raw data, a selection for displaying historical medical information, and a selection for displaying graphical indications; dynamically generating a test result report in accordance with the presentation customization; and electronically sending the test result report to at least one of the patient or the health care provider.

“2. The method of claim 1, wherein the order further comprises the first laboratory test.

“3. The method of claim 2, wherein the order request further comprises a first laboratory facility to perform the first laboratory test, and wherein the method further comprises: after receiving the order request and prior to completing the order corresponding to the order request for the first laboratory test: dynamically determining, by the application server, an alternate laboratory facility to perform the first laboratory test and the recommended laboratory test, wherein the alternate laboratory facility is determined based at least in part on the first laboratory test, the recommended laboratory test, and the health plan for the patient; and wherein the order comprises the alternative laboratory facility to perform both the first laboratory test and the recommended laboratory test.

“4. The method of claim 1, wherein the medical classification code comprises at least one of an International Statistical Classification of Diseases and Related Health Problems (ICD) code or an American Medical Association (AMA) CPT code.

“5. The method of claim 1, wherein the recommended laboratory test comprises the alternate laboratory test to the first laboratory test, and wherein the order does not comprise the first laboratory test.

“6. The method of claim 5, wherein the alternate laboratory test is determined based at least in part on a potential illness corresponding to a current symptom of the patient, and wherein the alternate laboratory test is configured to diagnose the potential illness.

“7. The method of claim 6, wherein the alternate laboratory test is further determined based at least in part on an evidence-based guideline.

“8. The method of claim 7, wherein the evidence-based guideline is based on a medical journal article, a medical case study, or a clinical trial.

“9. The method of claim 5, wherein the alternate laboratory test is determined based at least in part on a determination that the alternate laboratory test is a prerequisite to the first laboratory test and that the patient has not received the first laboratory test.

“10. The method of claim 5, wherein the alternate laboratory test is determined based at least in part on a first determination that a predetermined time period required before the patient is eligible for the first laboratory test has not passed and a second determination that the patient is eligible for the alternate laboratory test.

“11. The method of claim 5, wherein the alternate laboratory test is determined based at least in part on a maximum reimbursement amount corresponding to the alternate laboratory test.

“12. The method of claim 5, further comprising: dynamically determining a laboratory facility to perform the alternate laboratory test.

“13. The method of claim 12, wherein the order request comprises a first laboratory facility to perform the first laboratory test, and wherein the determined laboratory facility is a same laboratory as the first laboratory facility.

“14. The method of claim 12, wherein the laboratory facility is determined based at least in part on a maximum reimbursement amount for the alternate laboratory test when performed at the laboratory facility.

“15. The method of claim 12, wherein the medical information comprises the health plan for the patient and wherein the laboratory facility is determined based at least in part on the health plan for the patient, an expertise of the laboratory facility in performing the alternate laboratory test, a cost of performing the alternate laboratory test at the laboratory facility, and a capacity of the laboratory facility to perform the alternate laboratory test within a predetermined turnaround time.

“16. The method of claim 1, wherein the test result report is formatted based at least in part on a predefined preference of the patient.

“17. The method of claim 1, wherein the test result report is sent to the health care provider based on a predetermined delivery preference of the health care provider.

“18. The method of claim 1, further comprising: determining a recommendation for the patient to have a follow-up laboratory test, wherein the recommendation is determined based at least in part on a test result, wherein the test result report comprises the recommendation.

“19. The method of claim 18, wherein the recommendation is further determined based at least in part on the historical medical information and an evidence-based guideline corresponding to the test result and the follow-up laboratory test.

“20. The method of claim 1, wherein the test result report comprises a chart corresponding to test results of a population of patients that previously received the recommended laboratory test.

“21. The method of claim 1, wherein the test result report comprises a chart of a historical medical indicator of the patient, the historical medical indicator corresponding to the recommended laboratory test.”

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

For more information, see this patent: Conlin, Paul. Systems, methods, and media for laboratory benefit services. U.S. Patent Number 11056229, filed March 13, 2013, and published online on July 6, 2021. Patent URL: http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PALL&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.htm&r=1&f=G&l=50&s1=11056229.PN.&OS=PN/11056229RS=PN/11056229

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