Researchers Submit Patent Application, “Medical Insurance Method”, for Approval (USPTO 20230125734): Patent Application

2023 MAY 12 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- From Washington, D.C., NewsRx journalists report that a patent application by the inventors Ebihara, Yohei (Tokyo, Jp); Hirai, Takayoshi (Tokyo, Jp); Nakamura, Naoto (Tokyo, Jp); Suzuki, Hironori (Tokyo, Jp), filed on March 12, 2021, was made available online on April 27, 2023.

No assignee for this patent application has been made.

News editors obtained the following quote from the background information supplied by the inventors: “In recent years, utilizing an artificial intelligence (AI) system including machine learning, as an auxiliary tool for doctors or a diagnostic tool instead of doctors has been proposed. For example, utilizing pathological diagnosis by AI as a second opinion for pathologists has been considered. Furthermore, it has been also proposed that patients utilize diagnosis by AI as preliminary diagnosis. For example, a home medical support system that calculates an insurance premium is provided (see Japanese Patent Application Laid-Open No. 2019-53789).”

As a supplement to the background information on this patent application, NewsRx correspondents also obtained the inventors’ summary information for this patent application: “SUMMARY:

“Problems to be Solved by the Invention

“According to a conventional technique, an insurance premium is calculated on the basis of medical treatment provided in home, such as drip infusion or medication, and contents of an in-home management guidance, such as meal support or nursing care support.

“However, not only diagnosis by human but also by AI can be wrong. In such cases, each county has different discussion on whether users (for examples, doctors or patients) or companies that developed the AI should be responsible for wrong diagnosis by AI. Under the circumstances, users may cease active use of AI due to fear of effects of wrong diagnosis by AI.

“Furthermore, in a case where companies are responsible for wrong diagnosis by AI, motivation of companies that have been engaged on AI decreases. Thus, preparations for wrong diagnosis by AI are demanded to promote active use of AI in a medical field. In view of the circumstances as described above, systems and the like for promoting utilization of AI has been desired.

“Therefore, the present disclosure proposes a medical insurance method that can promote use of AI in a medical field.

“Solutions to Problems

“In order to solve the above issue, one aspect of a medical insurance method according to the present disclosure includes a step of acquiring, as a first patient condition, a type of a condition of a patient estimated through input of first patient data of the patient to a predetermined machine learning model, a step of acquiring, as a second patient condition, a type of a condition of the patient estimated by a method different from the predetermined machine learning model on the basis of data including the first patient data, a step of acquiring a third patient condition estimated on the basis of second patient data measured after measurement time of the first patient data, and a step of determining whether or not insurance coverage is available on the basis of the first patient condition, the second patient condition, and the third patient condition.”

The claims supplied by the inventors are:

“1. A medical insurance method comprising: a step of acquiring, as a first patient condition, a type of a condition of a patient estimated through input of first patient data of the patient to a predetermined machine learning model; a step of acquiring, as a second patient condition, a type of a condition of the patient estimated by a method different from the predetermined machine learning model on a basis of data including the first patient data; a step of acquiring a third patient condition estimated on a basis of second patient data measured after measurement time of the first patient data; and a step of determining whether or not insurance coverage is available on a basis of the first patient condition, the second patient condition, and the third patient condition.

“2. The medical insurance method according to claim 1, wherein whether or not insurance coverage is available is determined on a basis of a relationship between the first patient condition, the second patient condition, and the third patient condition.

“3. The medical insurance method according to claim 2, wherein the relationship is determined by using information about a lookup table stored in advance.

“4. The medical insurance method according to claim 1, wherein whether or not insurance coverage is available is determined on a basis of whether or not the first patient condition matches the third patient condition in a case where the first patient condition differs from the second patient condition.

“5. The medical insurance method according to claim 1, wherein whether each of the first patient condition, the second patient condition, and the third patient condition is a benign disease or a malignant disease is determined by using table information, and insurance coverage is determined available in a case where the first patient condition differs from the second patient condition, and the third patient condition and the first patient condition are malignant.

“6. The medical insurance method according to claim 1, wherein whether or not insurance coverage is available is determined by using diagnosis environment information.

“7. The medical insurance method according to claim 6, wherein the diagnosis environment information includes information about environment where a doctor diagnoses or patient data is acquired.

“8. The medical insurance method according to claim 6, wherein the diagnosis environment information includes at least one of a time period taken for decision by a doctor himself/herself, a time period taken from time when a result by AI is output till time when confirmation is pressed, line-of-sight information, mouse movement information, a fatigue level of a doctor, brightness of lighting, or a type of a camera.

“9. The medical insurance method according to claim 6, wherein the diagnosis environment information includes at least one of a behavioral pattern, the number of times a doctor blinks, or a type of a portable terminal of a doctor.

“10. The medical insurance method according to claim 1, wherein whether or not insurance coverage is available is determined by using information about a likelihood.”

For additional information on this patent application, see: Ebihara, Yohei; Hirai, Takayoshi; Nakamura, Naoto; Suzuki, Hironori. Medical Insurance Method. U.S. Patent Application Number 20230125734, filed March 12, 2021 and posted April 27, 2023. Patent URL (for desktop use only): https://ppubs.uspto.gov/pubwebapp/external.html?q=(20230125734)&db=US-PGPUB&type=ids

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