Method and system for generating personal/individual health records

DC CAFC

US 7,428,494 B2
Filed: 07/28/2006
Issued: 09/23/2008
Est. Priority Date: 10/11/2000
Status: Expired due to Term

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1. A method for generating a personal/individual health record, said method comprising a personal health record system server performing the steps:

(a) enrolling a patient in a health plan of a payor, wherein the patient undergoes encounters with a plurality of health care providers regarding a health related issue of the patient, wherein the health care providers request payment for at least a portion of the cost for the encounters from the payor, wherein the health care providers submit health related information of the patient to the payor to support the cost of encounters with the patient;

(b) initially establishing a communication link between a personal health record (“

PHR) system and the payor, wherein there is no communication between the PHR system and the health care providers and between the PHR system and the patient;

(c) receiving payor claims data by the personal health record system server regarding the patient from the payor via the communication link;

(d) analyzing at the PHR system server said payor claims data to determine which portion of said payor claims data is encounter data comprising at least one of a diagnosis, a treatment, a medication, a procedure of said patient, a history of office visits with one or more of the health care providers, and duration of office visits;

(e) translating at the PHR system server said encounter data into at least one universal health care concept code;

(f) creating at the PHR system server a personal/individual health record of the patient by storing one or more entries into the personal/individual health record based on the encounter data and associating the universal health care concept code with each entry;

(g) organizing at the PHR system server the personal/individual health record by grouping together entries in the personal/individual health record as related based on the universal health care concept code associated with the entries;

(h) subsequent to steps (a), (b), (c), (d), (e), and (f), establishing a communication link between the personal health record system and the patient, wherein said personal/individual health record is viewable by said patient via the communication link; and

(i) subsequent to steps (a), (b), (c), (d), (e), and (0, supplementing the personal/individual health record with health-related data regarding the patient from one or more of the health care providers.

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Abstract

A system and method for generating and/or updating a personal/individual health record. Inputs of data to the system may come from diverse sources including, but not limited to, patient questionnaires, insurance company (or other payor) claims data, hospitals, clinics and other institutional providers, and individual physicians and physicians'"'"' offices.

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24 Claims

1. A method for generating a personal/individual health record, said method comprising a personal health record system server performing the steps:
- (a) enrolling a patient in a health plan of a payor, wherein the patient undergoes encounters with a plurality of health care providers regarding a health related issue of the patient, wherein the health care providers request payment for at least a portion of the cost for the encounters from the payor, wherein the health care providers submit health related information of the patient to the payor to support the cost of encounters with the patient;
  
  (b) initially establishing a communication link between a personal health record (“
  
  PHR) system and the payor, wherein there is no communication between the PHR system and the health care providers and between the PHR system and the patient;
  
  (c) receiving payor claims data by the personal health record system server regarding the patient from the payor via the communication link;
  
  (d) analyzing at the PHR system server said payor claims data to determine which portion of said payor claims data is encounter data comprising at least one of a diagnosis, a treatment, a medication, a procedure of said patient, a history of office visits with one or more of the health care providers, and duration of office visits;
  
  (e) translating at the PHR system server said encounter data into at least one universal health care concept code;
  
  (f) creating at the PHR system server a personal/individual health record of the patient by storing one or more entries into the personal/individual health record based on the encounter data and associating the universal health care concept code with each entry;
  
  (g) organizing at the PHR system server the personal/individual health record by grouping together entries in the personal/individual health record as related based on the universal health care concept code associated with the entries;
  
  (h) subsequent to steps (a), (b), (c), (d), (e), and (f), establishing a communication link between the personal health record system and the patient, wherein said personal/individual health record is viewable by said patient via the communication link; and
  
  (i) subsequent to steps (a), (b), (c), (d), (e), and (0, supplementing the personal/individual health record with health-related data regarding the patient from one or more of the health care providers.
- View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22)
- - 2. The method of claim 1, wherein said receiving step includes downloading said payor claims data from said payor via the Internet.
  - 3. The method of claim 2, wherein said payor claims data are downloaded from said payor at least once a week.
  - 4. The method of claim 2, wherein said payor claims data are downloaded from said payor at least once per day.
  - 5. The method of claim 2, wherein said payor claims data are downloaded from said payor on a substantially real time basis.
  - 6. The method of claim 2, wherein said payor is an insurance company.
  - 7. The method of claim 2, wherein said payor is a governmental entity that pays health-related expenses.
  - 8. The method of claim 2, wherein said payor is a pharmacy benefits manager (“
    - PBM”
      
      ).
  - 9. The method of claim 1, further comprising the following steps subsequent to steps (a), (b), (c), (d), (e), and (f):
    - (j) receiving by the personal health record system diagnosis data from a health care provider via the Internet, wherein said diagnosis data indicate one or more medical diagnoses regarding said patient;
      
      (k) translating said diagnosis data into one or more universal health care concept codes; and
      
      (l) updating said personal/individual health record with at least a portion of said diagnosis data and said universal health care concept codes.
  - 10. The method of claim 1, further comprising the following steps subsequent to steps (a), (b), (c), (d), (e), and (f):
    - (j) receiving by the personal health record system procedure data from a health care provider via the Internet, wherein said procedure data indicate one or more medical procedures performed on said patient;
      
      (k) translating said procedure data into one or more universal health care concept codes; and
      
      (l) updating said personal/individual health record with at least a portion of said procedure data and said universal health care concept codes.
  - 11. The method of claim 1, further comprising the following steps subsequent to steps (a), (b), (c), (d), (e), and (f):
    - (j) receiving by the personal health record system laboratory data from a health care provider via the Internet, wherein said laboratory data indicate one or more laboratory test results regarding said patient;
      
      (k) translating said laboratory data into one or more universal health care concept codes; and
      
      (l) updating said personal/individual health record with at least a portion of said laboratory data and said universal health care concept codes.
  - 12. The method of claim 1, further comprising the following steps subsequent to steps (a), (b), (c), (d), (e), and (f):
    - (j) receiving by the personal health record system manual entries into said personal/individual health record from a health care provider via the Internet;
      
      (k) translating said manual entries into one or more universal health care concept codes; and
      
      (l) updating said personal/individual health record with at least a portion of said manual entries and said universal health care concept codes.
  - 13. The method of claim 1, further comprising the following steps subsequent to steps (a), (b), (c), (d), (e), and (f):
    - (j) receiving by the personal health record system health-related data from said patient via the Internet;
      
      (k) translating said health-related data into one or more universal health care concept codes; and
      
      (l) updating said personal/individual health record with at least a portion of said health-related data and said universal health care concept codes.
  - 14. The method of claim 13, wherein step (j) is responsive to said patient being presented with a health-related questionnaire via the Internet.
  - 15. The method of claim 1, wherein said analyzing step includes extracting encounter data comprising a primary care physician encounter history, an outpatient encounter history, and a hospital admissions history from said payor claims data.
  - 16. The method of claim 1, wherein said analyzing step includes extracting encounter data comprising medication prescribed to said patient, referrals of said patient to specialists, tests ordered for said patient, and changes in medication prescribed to said patient from said payor claims data.
  - 17. The method of claim 1, wherein said analyzing step includes extracting any International Classification of Diseases (“
    - ICD”
      
      ) codes, Current Procedural Terminology (“
      
      CPT”
      
      ) codes, and National Drug Code (“
      
      NDC”
      
      ) codes from said payor claims data.
  - 18. The method of claim 17, wherein said translating step includes translating any ICD codes, CPT codes, and NDC codes extracted from said payor claims data into universal health care concept codes.
  - 19. The method of claim 18, wherein said inserting step includes inserting at least a portion of the ICD codes, CPT codes, and NDC codes extracted from said payor claims data and said universal health care concept codes into said personal/individual health care record.
  - 20. The method of claim 1, further comprising establishing an access list for a user capable of accessing said personal/individual health record and adjusting said access list based on selections received by the personal health record system from said patient via the Internet, wherein said access list categorizes said personal/individual health record into a restricted set of data elements and an accessible set of data elements based on the universal health care concept code associated with entries in the personal/individual health record, wherein the personal health record system denies access to the user requesting an entry in the personal/individual health record if the requested entry is in the restricted set of entries, and wherein said personal health record system allows access to the user requesting an entry in the personal/individual health record if the requested entry is in the accessible set of entries.
  - 21. The method of claim 20, further comprising providing limited access to said personal/individual health record based on a positive identification of a user as a health care provider and preparing an audit record indicative of each data element in the personal/individual health record that said user accesses.
  - 22. The method of claim 20, wherein said access list is modified responsive to said patient selecting from a predetermined list of possible restricted areas via the Internet.

23. A method for generating a personal/individual health record, said method comprising a personal health record system server performing the steps:
- (a) enrolling a patient in a health plan of a payor, wherein the patient undergoes encounters with a plurality of health care providers regarding a health related issue of the patient, wherein the health care providers request payment for at least a portion of the cost for the encounters from the payor, wherein the health care providers submit health related information of the patient to the payor to support the cost of encounters with the patient;
  
  (b) initially establishing a communication link between a personal health record (“
  
  PHR) system and the payor, wherein there is no communication between PHR system and the health care providers and between the PHR system and the patient;
  
  (c) receiving at the PHR system server by the personal health record system server payor claims data regarding the patient from the payor via the communication link;
  
  (d) analyzing at the PHR system server said payor claims data to determine which portion of said payor claims data is encounter data comprising at least one of a diagnosis, a treatment, a medication, and a procedure of said patient;
  
  (e) translating at the PHR system server said encounter data into at least one universal health care concept code;
  
  (f) creating at the PHR system server a personal/individual health record of the patient by storing one or more entries into the personal/individual health record based on the encounter data and associating the universal health care concept code with each entry;
  
  (g) subsequent to steps (a), (b), (c), (d), (e), and (f), receiving by the personal health record system provider data comprising at least one of diagnosis data, procedure data and laboratory data from one or more of the health care providers via the Internet, wherein said diagnosis data indicate one or more medical diagnoses regarding said patient, said procedure data indicate one or more medical procedures performed on said patient, and said laboratory data indicate one or more laboratory test results regarding said patient;
  
  (h) translating at the PHR system server said provider data into one or more universal health care concept codes;
  
  (i) updating s at the PHR system server aid personal/individual health record with at least a portion of said provider data and said universal health care concept codes translated from said provider data; and
  
  wherein said personal/individual health record is viewable by said patient via the Internet.
- View Dependent Claims (24)
- - 24. The method of claim 23, further comprising the following steps subsequent to steps (a), (b), (c), (d), (e), and (f):
    - (j) receiving health-related data from said patient via the Internet;
      
      (k) translating said health-related data into one or more universal health care concept codes; and
      
      (l) updating said personal/individual health record with at least a portion of said health-related data and said universal health care concept codes.

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Litigation Data

Current Assignee
Healthtrio LLC (Spok Holdings, Inc.)
Original Assignee
Malik M. Hasan
Inventors
Wallen, J. Dominic, Peterson, John C., Hasan, Malik M.
Primary Examiner(s)
Gilligan; C Luke
Assistant Examiner(s)
SEREBOFF, NEAL

Application Number

US11/494,940
Publication Number

US 20070027720A1
Time in Patent Office

788 Days
Field of Search

705 2- 4
US Class Current

705/3
CPC Class Codes

G06Q 40/08 Insurance

G16H 10/60 for patient-specific data, ...

Method and system for generating personal/individual health records

First Claim

6 Assignments

Litigations

0 Petitions

Accused Products

Abstract

167 Citations

24 Claims

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Method and system for generating personal/individual health records

First Claim

6 Assignments

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Accused Products

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Abstract

167 Citations

24 Claims

Specification

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Solutions

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