“System and Method for Health Care Data Integration and Management” in Patent Application Approval Process (USPTO 20170270257)

By a News Reporter-Staff News Editor at Politics & Government Week -- A patent application by the inventors St. Clair, David (Narberth, PA); Schimmoller, Kristel L. (Media, PA); Nair-Hartman, Anita (Media, PA); DePhillips, Henry A. (Wilmington, DE), filed on June 7, 2017, was made available online on September 28, 2017, according to news reporting originating from Washington, D.C., by VerticalNews correspondents.

This patent application has not been assigned to a company or institution.

The following quote was obtained by the news editors from the background information supplied by the inventors: "The invention relates generally to the field of electronic health records, and in exemplary embodiments relates to improved methods for maintaining and delivering health record information.

"The Electronic Health Record (EHR) is a key element in efforts to manage health care delivery. In general, the EHR is most valuable today for the sickest members of our society--the 10% of the population that consumes 80% of the cost. With multiple conditions requiring multiple specialists, many powerful medications, numerous ancillary care providers and careful care coordination from case and disease managers, these individuals are also likely to be the least able personally to communicate the complexity of their histories and health status to their next treating physician. Yet it is exactly that complexity that confounds the medical community's attempts to reduce errors of omission and commission and to minimize the cost of duplicative and otherwise unnecessary care.

"Broadly speaking, there are three sources of health care information about patients: the patients themselves (or their care givers); the patients' physicians, hospitals and other providers; and the patients' health plan or other payer.

"Most patients have only limited information about their own care and even less ability to obtain, retain and store such data. Worse, a patient's ability to personally maintain their own health record decreases with illness, infirmity and, often, with age. Even the most user-friendly personal health record (PHR) systems available today are seldom used and even less frequently updated on a timely basis by their owners.

"Physicians, hospitals and other providers are required by law and professional ethics to maintain significant records pertaining to the care they provide. These providers do not either generally or comprehensively obtain patient data from the spectrum of other providers. Thus, hospitals might have a deep reservoir of information regarding the services and tests provided to patients within the facility and, perhaps, by the admitting physician, but little, if any, information from other facilities or physicians who have treated those same patients. A single physician knows and has records of everything the patient has told him and the treatment he has provided, but that provider knows neither what the patient has been told by other physicians nor what treatment other physicians have provided. Complicating the distributed nature of the information is that it remains overwhelmingly paper-based and hand-written, rendering it exceedingly difficult to integrate, analyze and/or transmit effectively.

"Therefore, there is a need for improved systems and methods for integrating patient data and providing it in a useful form to those who need it."

In addition to the background information obtained for this patent application, VerticalNews journalists also obtained the inventors' summary information for this patent application: "It is to be understood that both the following summary and the detailed description are exemplary and explanatory and are intended to provide further explanation of the invention as claimed. Neither the summary nor the description that follows is intended to define or limit the scope of the invention to the particular features mentioned in the summary or in the description.

"In an exemplary embodiment, a method creates an electronic health record (EHR), and analyzes that record to present treatment opportunities, strategies, and plans for the physician and patient in a Patient Clinical Summary report also referred to as a PCS report.

"An electronic health record (EHR) may provide clinical information about an individual patient and may include data from various primary stakeholders in the healthcare system: Payers (insurance companies and other entities at financial risk for care), providers (physicians, pharmacists, nurses and other medical professionals in acute, ambulatory, nursing home, and home care settings), and the patients themselves.

"Data residing at payers will be referred to as a payer-based health record (PBHR). The PBHR may include claims, care management, pharmacy, self-surveys and other data. Provider (hospitals and physician offices) data will be referred to as an electronic medical record (EMR). These records may include clinical findings, laboratory results, radiology images, or other data.

"Finally, data that patients maintain on themselves are referred to as a personal health record (PHR). This data may include family medical history, patient medical history, over-the-counter medications, allergies, acute or chronic diseases, and other health and wellness information.

"In an exemplary embodiment, a plurality of data processing steps are used to create the electronic health record and the summary. For example, these steps may include aggregation, integration, internal validation, inspection, prediction, and communication. In an embodiment, these patient-centric data processes correctly identify the patient and all the data from all sources that belong to that patient.

"Aggregation is a process that collects data from one or more disparate sources that could belong to the patient in question. Preferably, aggregation takes all available data from all the components of the PBHR, EMR and PHR described above, and 'weaves' them into an aggregate patient record that is utilized by subsequent data processes.

"In an exemplary embodiment, an integration process examines the aggregate record for duplicate and overlapping data (e.g. identical laboratory results from both the lab and the doctor's office), identifies that data, eliminates the duplicate data, and assembles a revised single, consolidated record.

"In an embodiment, internal validation processes are performed using various techniques, which may include probability assessment, referential edits, algorithms and/or other techniques to determine that certain key data elements in the consolidated record are, in fact, correct. For example, for some medical conditions such as heart attack, the 'rule out' and 'present' codes may be the same. Therefore, in exemplary embodiments, a mechanism to resolve ambiguity is desirable. In exemplary embodiments, an internal validation process is applied to drug data, laboratory results, physicians' assessments, and other data elements to conclude that a condition is or is not present. If, for example, there is one healthcare claim that indicates a condition, this may be insufficient information to conclude with certainty that the condition really exists. If, however, this claims data are corroborated by two or three physician encounter records or other healthcare data diagnosing the condition, then it is far more likely that the condition exists.

"A similar validation process is used in exemplary embodiments to confirm that the patient in question is, indeed, the correct patient.

"At the conclusion of these processes, in an exemplary embodiment, a single, integrated, woven, complete, and consolidated clinical history is provided for the correct patient. This record can then be used as a common, central electronic health record or EHR.

"Inspection of the aggregated, integrated, and validated patient data in the consolidated record may then be accomplished as desired. In exemplary embodiments, this process compares the consolidated patient record to evidence-based guidelines and best practices to probe for gaps in care and reveal treatment opportunities. Some embodiments of the inspection process may identify care being delivered that is not appropriate as well as recommended care. In example embodiments, this process includes a hierarchy of prompts (alerts, warnings, and potential errors) that supports the physician's decision-making process.

"In other exemplary embodiments, a prediction process may use various predictive modeling techniques (neural networks, artificial intelligence, etc.) to identify patients who are at higher risk than others for various conditions. In such cases, analytical techniques search for those patients who could require extensive medical services and identify the approximate cost of those services. The prediction process then identifies appropriate treatment strategies, plans and actions for the patient.

"In exemplary embodiments, at the conclusion of the inspection and prediction processes, a summary (for example, a Patient Clinical Summary) of the analyzed consolidated patient record may be created for use by authorized individuals within the healthcare system.

"In an embodiment, the summary is also forwarded to authorized individuals. Communication can be via the internet, smart card, fax, or in person with the display medium being a PC monitor screen, PDA device, or paper, for example.

"The method disclosed is useful in creating a consolidated and validated electronic health record for a patient using data from one or more possibly inconsistent databases, and which may be summarized and communicated to any authorized health care provider, or the patient, as desired.

"Additional features and advantages will be set forth in the description which follows, and in part will be apparent from the description, or may be learned by practice of the invention. These advantages will be realized and attained by the structure particularly pointed out in the written description and claims hereof as well as the appended drawings."

URL and more information on this patent application, see: St. Clair, David; Schimmoller, Kristel L.; Nair-Hartman, Anita; DePhillips, Henry A. System and Method for Health Care Data Integration and Management. Filed June 7, 2017 and posted September 28, 2017. Patent URL: http://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=%2220170270257%22.PGNR.&OS=DN/20170270257&RS=DN/20170270257

Keywords for this news article include: Patents, Hospital, Information Technology, Electronic Medical Records.

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