Method and system for generating personal/individual health records
DC CAFC
First Claim
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1. A method for generating a personal/individual health record of a patient enrolled in a health plan of a payor, said method comprising a computer performing the steps:
- (a) enrolling a patient in a health care 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 the encounters with the patient;
(b) initially establishing a communication link with 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 to the PHR system server a payor data element indicative of a health related parameter for the patient from the payor via the communication link, wherein said payor data element includes payor claims data;
(d) extracting at the PHR system server encounter data comprising at least one of outpatient encounter history, hospital outpatient encounter history, and hospital admissions data from said payor data element;
(e) determining at the PHR system server at least one universal health care concept code corresponding to the encounter data;
(f) creating at the PHR system server a personal/individual health record of said patient by storing one or more entries into said personal/individual health record based on said encounter data that was extracted from said payor data element and associating the universal health care concept code with each entry;
(g) establishing from the PHR system server a communication link with at least one of the health care providers and the patient;
(h) supplementing to the PHR system server said personal/individual health record with supplemental data received from the health care providers and the patient;
(i) associating at the PHR system server an access list with each user capable of accessing the personal/individual health record, wherein said access list categorizes said personal/individual health record into a restricted set of entries and an accessible set of entries based on the universal health care concept code associated with each entry in the personal/individual health record;
(j) denying at the PHR system server access to a user requesting an entry in the personal/individual health record if the requested entry is in the restricted set of entries;
(k) allowing at the PHR system server access to a user requesting an entry in the personal/individual health record if the requested entry is in the accessible set of entries; and
wherein steps (b), (c), (d), (e) and (f) occur prior to steps (g) and (h).
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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.
116 Citations
21 Claims
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1. A method for generating a personal/individual health record of a patient enrolled in a health plan of a payor, said method comprising a computer performing the steps:
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(a) enrolling a patient in a health care 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 the encounters with the patient; (b) initially establishing a communication link with 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 to the PHR system server a payor data element indicative of a health related parameter for the patient from the payor via the communication link, wherein said payor data element includes payor claims data; (d) extracting at the PHR system server encounter data comprising at least one of outpatient encounter history, hospital outpatient encounter history, and hospital admissions data from said payor data element; (e) determining at the PHR system server at least one universal health care concept code corresponding to the encounter data; (f) creating at the PHR system server a personal/individual health record of said patient by storing one or more entries into said personal/individual health record based on said encounter data that was extracted from said payor data element and associating the universal health care concept code with each entry; (g) establishing from the PHR system server a communication link with at least one of the health care providers and the patient; (h) supplementing to the PHR system server said personal/individual health record with supplemental data received from the health care providers and the patient; (i) associating at the PHR system server an access list with each user capable of accessing the personal/individual health record, wherein said access list categorizes said personal/individual health record into a restricted set of entries and an accessible set of entries based on the universal health care concept code associated with each entry in the personal/individual health record; (j) denying at the PHR system server access to a user requesting an entry in the personal/individual health record if the requested entry is in the restricted set of entries; (k) allowing at the PHR system server access to a user requesting an entry in the personal/individual health record if the requested entry is in the accessible set of entries; and wherein steps (b), (c), (d), (e) and (f) occur prior to steps (g) and (h). - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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Specification
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Litigation Data
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Current AssigneeHealthtrio LLC (Spok Holdings, Inc.)
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Original AssigneeMalik M. Hanson
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InventorsWallen, J. Dominic, Peterson, John C., Hasan, Malik M.
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Primary Examiner(s)Gilligan; C Luke
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Assistant Examiner(s)SEREBOFF, NEAL
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Application NumberUS11/495,093Publication NumberTime in Patent Office816 DaysField of Search705 2- 4US Class Current705/3CPC Class CodesG06Q 10/00 Administration; ManagementG06Q 10/10 Office automation; Time man...G06Q 40/08 InsuranceG16H 10/20 for electronic clinical tri...G16H 10/40 for data related to laborat...G16H 10/60 for patient-specific data, ...G16H 50/20 for computer-aided diagnosi...G16H 70/60 relating to pathologiesG16H 80/00 ICT specially adapted for f...
