Researchers Submit Patent Application, “Apparatuses, Systems, And Methods For Determining Healthcare Vitality”, for Approval (USPTO 20220093240): Patent Application

2022 APR 12 (NewsRx) -- By a News Reporter-Staff News Editor at Technology Business Daily -- From Washington, D.C., NewsRx journalists report that a patent application by the inventors Alexander, Dale (Montgomery, AL, US); Cunningham, Michael (Littleton, CO, US); Estes, Tim (Castle Rock, CO, US); Gentry, Travis (Highlands Ranch, CO, US); Waldron, Jae (Murfreesboro, TN, US), filed on December 2, 2021, was made available online on March 24, 2022.

No assignee for this patent application has been made.

News editors obtained the following quote from the background information supplied by the inventors: “The healthcare industry experiences problems relating to the visibility of pricing and performance data. Think of a world where commercial retailers like Wal-Mart, Target, or BestBuy have no idea if their wholesale cost of a Samsung TV is competitive because the pricing Samsung offers each retailer is unique and confidential. Think of a world where the consumer has no idea how much a television will cost until they receive a bill weeks or months after the sale. This is currently the world of healthcare! Now think of a world where people invest money into the stock market and attempt to create a diversified portfolio of different stocks, bonds, and mutual funds. Think of a world where there is no competitive information as to the historical or current performance of those investments and no means to evaluate or measure risk, return, or performance. This is the world of healthcare.

“Healthcare is an industry that is deathly afraid of true transparency; however, transparency is healthcare’s single greatest hope for real transformation. The industry operates in a world where providers engage in meaningless “charge” conversations. Reimbursement is hidden under a veil of secrecy by both insurance companies and providers alike. Health insurance companies have all the information while providers are disadvantaged and negotiate without any idea if their reimbursement is competitive. Providers lack access to real-time, unbiased, industry benchmarks and peer comparisons. Providers operate under a false sense of security and really don’t know how well their operations are performing compared to their peers.”

As a supplement to the background information on this patent application, NewsRx correspondents also obtained the inventors’ summary information for this patent application: “Embodiments of the present invention provide apparatuses, systems, and methods for determining healthcare operational and process vitality.

“Hospitals, physicians, patients, and financial institutions desperately need a marketplace where meaningful information is readily available. Hospitals and physicians need to know how well their performance compares to the industry and peers. They need to know if their reimbursement is fair and equitable. Financial institutions need to understand the financial health, strength, and data of the healthcare industry they serve. None of these are possible unless healthcare as an industry is willing to share their information in an anonymous, safe, and secure fashion. Healthcare data needs to be aggregated and benchmarked to empower providers and financial institutions to compare and contrast performance.

“How good are hospital managed care contracts? How do hospitals know how good they are? How does their reimbursement compare to the industry, compare against their competition? Is Aetna paying their competitor better for orthopedic care? Insurance companies dictate their manage care contract reimbursement rates are intentionally confidential and are contractually restricted from industry transparency. Providing national/peer blinded and aggregated percentile reimbursement statistics would be the only way to truly determine for a provider where the reimbursement they receive for the procedures performed compares?

“Apparatuses, systems, and methods consistent with the present disclosure address these and other needs in the art in a novel and nonobvious manner.

“According to aspects of the present disclosure, provided is a system for determining healthcare vitality. The system includes a network, a healthcare provider device configured to transmit a set of provider data via the network, and a server having a storage. The server receives the set of provider data via the network. The server includes a de-identification section which performs a de-identification operation on at least a portion of the received set of provider data, a matching section which performs a matching operation on the at least a portion of the received set of provider data having been de-identified by the de-identification section to create a set of matched de-identified data, a processing section which processes the matched de-identified data to extract at least one set of coded information according to a predetermined data format of the set of provider data, a categorization section which examines at least a portion of the at least one set of coded information and to categorize the at least one set of coded information to one or more categories associated with the healthcare provider, a vitality scoring section which determines at least one vitality composite score based at least in part upon the categorized at least one set of coded information, and a communications unit which selectively transmits at least a set of information relating to the at least one vitality composite score. The storage of the server may store a representation of at least a portion of the set of provider data.

“The categorization section may associate one or more processed categories with a plurality of healthcare providers or payers. The one or more processed categories may relate to a vitality score for a healthcare provider associated with the at least one vitality composite score. The system may include a user device having a communications unit and a display unit. The user device may be coupleable to the network. The user device may communicate with the server via the network to obtain information relating to the vitality score. The user device may provide a representation of the information relating to the vitality score to a user of the user device via the display unit.

“The server may include a normalization section which performs a normalization operation on the at least one set of coded information in association with the vitality score to form a set of normalized provider data. The user device may display the normalized provider data via the display unit. The user device may display the normalized provider data for a plurality of healthcare providers via the display unit. The categorization section may categorize the at least a portion of the matched de-identified data to at least one category which is non-coded with respect to a data format of the set of provider data.

“The server may include a normalization section which performs a normalization operation on the at least one set of coded information. The normalization operation may be a localized cost adjustment.

“According to additional aspects of the present disclosure, provided is a method for determining healthcare vitality. The method includes receiving a set of provider data from a healthcare provider, performing a de-identification operation on at least a portion of the received set of provider data, creating a set of matched de-identified data by performing a matching operation on the at least a portion of the received set of provider data, processing the matched de-identified data to extract at least one set of coded information according to a predetermined data format of the set of provider data, examining at least a portion of the matched de-identified data and categorizing the at least a portion of the coded information to one or more categories associated with the healthcare provider, determining at least one vitality composite score based at least in part upon the categorized at least one set of coded information, and selectively transmitting or storing at least a set of information relating to the at least one vitality composite score.

“The method may include associating one or more processed categories with a plurality of healthcare providers or payers, wherein the one or more processed categories relate to a vitality score for the plurality of healthcare providers.

“The method may further include obtaining information relating to the vitality score at a user device, and visually displaying the information relating to the vitality score to a user of the user device.

“The method may further include normalizing the at least one set of coded information in association with the vitality score to form a set of normalized provider data.

“The method may further include transmitting at least a portion of the set of normalized provider data to a user device, and visually displaying the at least a set of normalized provider data by the user device.

“According to yet other aspects of the present disclosure provided is an apparatus for determining healthcare vitality. The apparatus includes a storage, a communications section coupleable to a network, the communications section configured to receive a set of provider data, a de-identification section configured to perform a de-identification operation on at least a portion of the received set of provider data, a matching section configured to perform a matching operation on the at least a portion of the received set of provider data having been de-identified by the de-identification section to create a set of matched de-identified data, a processing section configured to process the matched de-identified data to extract at least one set of coded information according to a predetermined data format of the set of provider data, a categorization section configured to examine at least a portion of the at least one set of coded information and to categorize the at least one set of coded information to one or more categories associated with the healthcare provider, and a vitality scoring section configured to determine at least one vitality composite score based at least in part upon the categorized at least one set of coded information. The storage may store a representation of at least a portion of the set of provider data.

“The categorization section may associate one or more processed categories with a plurality of healthcare providers or payers. The one or more processed categories may relate to a vitality score for a healthcare provider associated with the at least one vitality composite score. The apparatus may include a normalization section, the normalization section configured to perform a normalization operation on the at least one set of coded information in association with the vitality score to form a set of normalized provider data.

“Numerous other objects, features, and advantages of the present invention will be readily apparent to those skilled in the art upon a reading of the following disclosure when taken in conjunction with the accompanying drawings.”

The claims supplied by the inventors are:

“1. A system for determining healthcare vitality, comprising: a network; a healthcare provider device configured to transmit a set of provider data via the network; a server having a storage, the server configured to receive the set of provider data via the network, the server including: a de-identification section configured to perform a de-identification operation on at least a portion of the received set of provider data; a matching section configured to perform a matching operation on the at least a portion of the received set of provider data having been de-identified by the de-identification section to create a set of matched de-identified data; a processing section configured to process the matched de-identified data to extract at least one set of coded information according to a predetermined data format of the set of provider data; a categorization section configured to examine at least a portion of the at least one set of coded information and to categorize the at least one set of coded information to one or more categories associated with the healthcare provider; a vitality scoring section configured to determine at least one vitality composite score based at least in part upon the categorized at least one set of coded information; and a communications unit configured to selectively transmit at least a set of information relating to the at least one vitality composite score, wherein the storage is configured to store a representation of at least a portion of the set of provider data.

“2. The system of claim 1, wherein the categorization section is configured to associate one or more processed categories with a plurality of healthcare providers or payers.

“3. The system of claim 2, wherein the one or more processed categories relate to a vitality score for a healthcare provider associated with the at least one vitality composite score.

“4. The system of claim 3, wherein the system further includes: a user device having a communications unit and a display unit, the user device coupleable to the network, the user device configured to communicate with the server via the network to obtain information relating to the vitality score, the user device further configured to provide a representation of the information relating to the vitality score to a user of the user device via the display unit.

“5. The system of claim 4, wherein the server further includes: a normalization section, the normalization section configured to perform a normalization operation on the at least one set of coded information in association with the vitality score to form a set of normalized provider data, wherein the user device is configured to display the normalized provider data via the display unit.

“6. The system of claim 5, wherein the user device is further configured to display the normalized provider data for a plurality of healthcare providers via the display unit.

“7. The system of claim 1, wherein the categorization section is configured to categorize the at least a portion of the matched de-identified data to at least one category which is non-coded with respect to a data format of the set of provider data.

“8. The system of claim 1, wherein the server further includes: A normalization section, the normalization section configured to perform a normalization operation on the at least one set of coded information.

“9. The system of claim 8, wherein the normalization operation comprises a localized cost adjustment.

“10. A method for determining healthcare vitality, comprising: receiving a set of provider data from a healthcare provider; performing a de-identification operation on at least a portion of the received set of provider data; creating a set of matched de-identified data by performing a matching operation on the at least a portion of the received set of provider data; processing the matched de-identified data to extract at least one set of coded information according to a predetermined data format of the set of provider data; examining at least a portion of the matched de-identified data and categorizing the at least a portion of the coded information to one or more categories associated with the healthcare provider; determining at least one vitality composite score based at least in part upon the categorized at least one set of coded information; and selectively transmitting or storing at least a set of information relating to the at least one vitality composite score.

“11. The method of claim 10, further comprising: associating one or more processed categories with a plurality of healthcare providers or payers, wherein the one or more processed categories relate to a vitality score for the plurality of healthcare providers.

“12. The method of claim 10, further comprising: obtaining information relating to the vitality score at a user device; and visually displaying the information relating to the vitality score to a user of the user device.

“13. The method of claim 10, further comprising: normalizing the at least one set of coded information in association with the vitality score to form a set of normalized provider data.

“14. The method of claim 13, further comprising: transmitting at least a portion of the set of normalized provider data to a user device; and visually displaying the at least a set of normalized provider data by the user device.

“15. An apparatus for determining healthcare vitality, comprising: a storage; a communications section coupleable to a network, the communications section configured to receive a set of provider data; a de-identification section configured to perform a de-identification operation on at least a portion of the received set of provider data; a matching section configured to perform a matching operation on the at least a portion of the received set of provider data having been de-identified by the de-identification section to create a set of matched de-identified data; a processing section configured to process the matched de-identified data to extract at least one set of coded information according to a predetermined data format of the set of provider data; a categorization section configured to examine at least a portion of the at least one set of coded information and to categorize the at least one set of coded information to one or more categories associated with the healthcare provider; and a vitality scoring section configured to determine at least one vitality composite score based at least in part upon the categorized at least one set of coded information, wherein the storage is configured to store a representation of at least a portion of the set of provider data.

“16. The apparatus of claim 15, wherein the categorization section is configured to associate one or more processed categories with a plurality of healthcare providers or payers.

“17. The apparatus of claim 16, wherein the one or more processed categories relate to a vitality score for a healthcare provider associated with the at least one vitality composite score.

“18. The apparatus of claim 15, further comprising: a normalization section, the normalization section configured to perform a normalization operation on the at least one set of coded information in association with the vitality score to form a set of normalized provider data.”

For additional information on this patent application, see: Alexander, Dale; Cunningham, Michael; Estes, Tim; Gentry, Travis; Waldron, Jae. Apparatuses, Systems, And Methods For Determining Healthcare Vitality. Filed December 2, 2021 and posted March 24, 2022. Patent URL: https://appft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PG01&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.html&r=1&f=G&l=50&s1=%2220220093240%22.PGNR.&OS=DN/20220093240&RS=DN/20220093240

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