“System Method And Network For Evaluating The Progress Of A Managed Care Organization Patient Wellness Goals” in Patent Application Approval Process (USPTO 20230065860): Patent Application

2023 MAR 17 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- A patent application by the inventors Becker, Leslie L. (Mableton, GA, US); Flake, Regenald J. (Mableton, GA, US), filed on August 23, 2022, was made available online on March 2, 2023, according to news reporting originating from Washington, D.C., by NewsRx 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: “Before our invention, it was difficult for managed care organizations to track progress towards meeting their patient population wellness goals through individual patient medical readings. With many types of patient wellness goals, it was difficult and costly for patients to access healthcare facilities and physicians frequently enough to repeat the kinds of medical screen tests that result in the type of data that a managed care organization can use to analyze trends and evaluate the effectiveness of certain medical treatments.

“Another shortcoming is that often managed care organizations’ funding decisions are based on obtaining a certain ‘percentage of goal’, such as for hypertension 70% of patient blood pressure readings should be 140 systolic over 90 diastolic or less. The absence of a way for patients to easily report blood pressure readings in combination with the inability of the managed care organization to perform data analysis on a sufficiently sized patient population of blood pressure readings can lead to funding concerns for the managed care organization and treatment concerns for patients. This same type of gap for hypertension existed in other wellness areas such as weight management, diabetes, cholesterol, and other areas.

“The present invention addresses these and other shortcomings by providing a system, method, and network for evaluating the progress of a managed care organization’s patient wellness goals and other advantages. For these reasons and shortcomings as well as other reasons and shortcomings there is a long-felt need that gives rise to the present invention.”

In addition to the background information obtained for this patent application, NewsRx journalists also obtained the inventors’ summary information for this patent application: “The shortcomings of the prior art are overcome and additional advantages are provided through the provision of a method of evaluating the progress of a managed care organization’s patient wellness goals using a segmented patient population and patient self-reported medical readings. The method comprises the steps of allowing a healthcare evaluator, using a computing device, to data communicate with one or more servers. Defining a predetermined wellness goal. Creating, by the server, a patient record for at least one patient, the patient record comprises a patient identifier. Creating, by the server, a healthcare facility record for one or more of a healthcare facility. The healthcare facility record comprises a healthcare facility identifier, and the patient identifier of each patient who is receiving treatment at the healthcare facility. And, creating, by the server, a managed care organization record that comprises the healthcare facility identifier for each healthcare facility associated with a managed care organization.

“The method continues by distributing a medical monitoring device to each of the more than one patients. Measuring, by way of the patient, for each patient more than one medical reading, repeatedly over a time period by way of the medical monitoring device, the patient identifier, and the medical reading is data communicated to the server. Creating, by the server, a medical reading record for each medical reading received, the medical reading record comprises a medical reading identifier, the patient identifier, the healthcare facility identifier associated with the patient identifier, the medical reading, and a date and a timestamp that indicates when the medical reading was taken.

“The method continues by determining, by the server, a patient population recordset that comprises each of the medical reading identifiers returned in a query of one or more of a patient population segmentation rule from the plurality of the medical reading records that are associated with one or more of the patient identifier that is associated with one or more of the healthcare facility identifier that is associated with the managed care organization record. Calculating, by the server, each the following: for each unique one of the patient identifier in the patient population recordset a percentage of patient goal based on the predetermined wellness goal is determined, for each unique one of the healthcare facility identifier in the patient population recordset a percentage of healthcare facility goal based on the predetermined wellness goal is determined, and for all the records in the patient population recordset a percentage of managed care organization (MCO) goal based on the predetermined wellness goal is determined.

“The method continues by displaying the received plurality of display data from the server on the computing device. The display data is accessible to the healthcare evaluator or other authorized users, the display data is related to at least one of the following: one or more patient record and the percentage of patient goal based on the predetermined wellness goal that the patient record is associated with, one or more healthcare facility record and the percentage of healthcare facility goal based on the predetermined wellness goal that the healthcare facility record is associated with, and the percentage of managed care organization goal based on the predetermined wellness goal.

“Additional shortcomings of the prior art are overcome and additional advantages are provided through the provision of a system for evaluating the progress of a managed care organization’s patient wellness goals using a segmented patient population and patient self-reported medical readings can comprise one or more of a server. The server can comprise a microprocessor and a memory.

“The system comprises at least one computing device that a healthcare evaluator or other authorized users use to data communicate with the server.

“A medical monitoring device can be distributed to each of more than one patient. The medical monitoring device can be used by the patient to effectuate measuring more than one medical reading repeatedly over a time period. A patient identifier and the medical reading can be data communicated to the server by way of the medical monitoring device or by way of a personal computing device that is proximate to the patient that data communicates with the medical monitoring device and the server.

“In operation, the memory is encoded with instructions that when executed by the microprocessor perform the steps of defining a predetermined wellness goal, and creating, by the server, a patient record for at least one patient. The patient record comprises a patient identifier.

“The steps continue by creating, by the server, a healthcare facility record for one or more healthcare facility. The healthcare facility record comprises a healthcare facility identifier and the patient identifier of each patient 102 who is receiving treatment at the healthcare facility. By the server, a managed care organization record is created that comprises the healthcare facility identifier for each healthcare facility associated with a managed care organization. By the server, a medical reading record is created for each medical reading received. The medical reading record comprises a medical reading identifier, the patient identifier, the healthcare facility identifier associated with the patient identifier, the medical reading, and a date and a timestamp that indicates when the medical reading was taken.

“The steps continue by determining, by the server, a patient population recordset that comprises each of the medical reading identifiers returned in a query of one or more of a patient population segmentation rule from a plurality of the medical reading records that are associated with one or more of the patient identifier that is associated with one or more of the healthcare facility identifier that is associated with the managed care organization record.

“The server then calculates each the following: for each unique one of the patient identifier in the patient population recordset a percentage of patient goal based on the predetermined wellness goal is determined, and for each unique one of the healthcare facility identifier in the patient population recordset a percentage of healthcare facility goal based on the predetermined wellness goal is determined, and for all the records in the patient population recordset a percentage of managed care organization goal based on the predetermined wellness goal is determined.

“The received plurality of display data from the server is then displayed on the computing device. The display data are accessible to the healthcare evaluator or other authorized users. The display data is related to at least one of the following: one or more of the patient record and the percentage of patient goal based on the predetermined wellness goal that the patient record is associated with, one or more of the healthcare facility record, and the percentage of healthcare facility goal based on the predetermined wellness goal that the healthcare facility record is associated with, and the percentage of managed care organization goal based on the predetermined wellness goal.

“Additional shortcomings of the prior art are overcome and additional advantages are provided through the provision of a method of evaluating the progress of a managed care organization’s patient wellness goals using a segmented patient population and patient self-reported medical readings. The method comprises the steps of allowing a healthcare evaluator, a healthcare facility user, a physician, or a patient, using a computing device, to data communicate with one or more servers. Defining a predetermined wellness goal. Creating, by the server, a patient record for at least one patient, the patient record comprises a patient identifier. Creating, by the server, a healthcare facility record for one or more of a healthcare facility. The healthcare facility record comprises a healthcare facility identifier, and the patient identifier of each patient who is receiving treatment at the healthcare facility. And, creating, by the server, a managed care organization record that comprises the healthcare facility identifier for each healthcare facility associated with a managed care organization.

“The method continues by distributing a medical monitoring device to each of the more than one patients. Measuring, by way of the patient, for each patient more than one medical reading, repeatedly over a time period by way of the medical monitoring device, the patient identifier, and the medical reading is data communicated to the server. Creating, by the server, a medical reading record for each medical reading received, the medical reading record comprises a medical reading identifier, the patient identifier, the healthcare facility identifier associated with the patient identifier, the medical reading, and a date and a timestamp that indicates when the medical reading was taken.”

There is additional summary information. Please visit full patent to read further.”

The claims supplied by the inventors are:

“1. A method of evaluating progress of a managed care organization’s patient wellness goals using a segmented patient population and patient self-reported medical readings, the method comprising the steps of: allowing a healthcare evaluator or other authorized users, using a computing device, to data communicate with one or more of a server; defining a predetermined wellness goal; creating, by the server, a patient record for at least one of a patient, the patient record comprises a patient identifier; creating, by the server, a healthcare facility record for one or more of a healthcare facility, the healthcare facility record comprises a healthcare facility identifier and the patient identifier of each patient who is receiving treatment at the healthcare facility; creating, by the server, a managed care organization record that comprises the healthcare facility identifier for each healthcare facility associated with a managed care organization; distributing a medical monitoring device to each of more than one of the patient; measuring, by way of the patient, for each of the patient more than one of a medical reading, repeatedly over a time period by way of the medical monitoring device, the patient identifier, and the medical reading is data communicated to the server; creating, by the server, a medical reading record for each of the medical reading received, the medical reading record comprises a medical reading identifier, the patient identifier, the healthcare facility identifier associated with the patient identifier, the medical reading, and a date and a timestamp that indicates when the medical reading was taken; determining, by the server, a patient population recordset that comprises each of the medical reading identifiers returned in a query of one or more of a patient population segmentation rule from plurality of the medical reading record that is associated with one or more of the patient identifier that is associated with one or more of the healthcare facility identifier that is associated with the managed care organization record; calculating, by the server, each of the following: for each unique one of the patient identifier in the patient population recordset a percentage of patient goal based on the predetermined wellness goal is determined; for each unique one of the healthcare facility identifier in the patient population recordset a percentage of healthcare facility goal based on the predetermined wellness goal is determined; and for all the records in the patient population recordset a percentage of managed care organization goal based on the predetermined wellness goal is determined; displaying received plurality of a display data from the server on the computing device, the display data are accessible to the healthcare evaluator or other authorized users, the display data are related to at least one of the following: one or more of the patient record and the percentage of patient goal based on the predetermined wellness goal that the patient record is associated with; one or more of the healthcare facility record and the percentage of healthcare facility goal based on the predetermined wellness goal that the healthcare facility record is associated with; and the percentage of managed care organization goal based on the predetermined wellness goal.

“2. The method in accordance with claim 1, the wellness goal is a hypertension goal, the medical monitoring device is a blood pressure monitoring device, the medical reading is a blood pressure reading.

“3. The method in accordance with claim 2, the hypertension goal is blood pressure readings of less than 140 systolic over 90 diastolic.

“4. The method in accordance with claim 1, further comprising the steps of: communicating each of the medical reading from the medical monitoring device to a personal computing device that is proximate to the patient; and communicating the medical reading from the personal computing device to the server.

“5. The method in accordance with claim 1, further comprising the step of: creating a physician record for one or more of a physician, the physician record comprises a physician identifier, the patient record comprises the physician identifier associated with the physician that is assigned to the patient, the healthcare facility record comprises the physician identifier associated with the physician that is assigned to the healthcare facility.

“6. The method in accordance with claim 5, further comprising the step of: calculating, by the server, for each unique of the physician identifier discoverable from the patient population recordset a percentage of physician goal based on the predetermined wellness goal, the medical reading record comprises the physician identifier associated with the patient identifier; and displaying received plurality of the display data from the server on the computing device, the display data is accessible to the healthcare evaluator or other authorized users, the display data is related to one or more of the physician record, and the percentage of physician goal based on the predetermined wellness goal that the patient record is associated with.

“7. The method in accordance with claim 1, the patient record further comprises a gender, a race, an ethnicity, an age, a zip code, the patient population segmentation rule queries to create the patient population recordset based on at least one of the following patient segmentation criteria the gender, the race, the ethnicity, the age, the healthcare facility, a physician that is assigned to at least one of the patient, or date and timestamp range associated with a date and a timestamp of the medical reading.

“8. The method in accordance with claim 1, the wellness goal is at least one of the following: a diabetes blood sugar goal, the medical monitoring device is a glucose monitoring device, the medical reading is a blood glucose reading; a body weight goal, the medical monitoring device is a scale device, the medical reading is a body weight reading; a body mass index goal, the medical monitoring device is a scale device suitable for measuring body mass index, the medical reading is a body mass index reading; or a cholesterol goal, the medical monitoring device is a device suitable for measuring cholesterol, the medical reading is a cholesterol reading.

“9. The method in accordance with claim 1, further comprising the steps of: allowing at least one of the following the patient, a physician, or the healthcare facility user using the computing device to data communicate with the server; and displaying, accessible to the patient or the physician, received plurality of a display data from the server on the computing device, the display data are related to one or more of the patient record and the percentage of patient goal based on the predetermined wellness goal that the patient record is associated with; and displaying, accessible to the healthcare facility user, received plurality of a display data from the server on the computing device, the display data are related to one or more of the patient record and the percentage of patient goal based on the predetermined wellness goal that the patient record is associated with, and one or more of the healthcare facility record and the percentage of healthcare facility goal based on the predetermined wellness goal that the healthcare facility record is associated with.”

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

URL and more information on this patent application, see: Becker, Leslie L.; Flake, Regenald J. System Method And Network For Evaluating The Progress Of A Managed Care Organization Patient Wellness Goals. U.S. Patent Application Number 20230065860, filed August 23, 2022 and posted March 2, 2023. Patent URL (for desktop use only): https://ppubs.uspto.gov/pubwebapp/external.html?q=(20230065860)&db=US-PGPUB&type=ids

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