Patent Application
20070214006
The invention relates to the field of remote monitoring. More particularly, the invention relates to the field of performance measurement in remote monitoring.
For a variety of reasons, monitoring of chronically ill patients in a remote, non-hospital environment will become more common in the near future. The clinical data collected, for example, blood pressure, weight, self-assessments, etc., is transmitted back to a caseworker or clinician who can provide early intervention to prevent re-hospitalizations. By monitoring patients remotely, costly re-hospitalization events can be avoided and the overall cost of managing the disease can be reduced.
One of the barriers to implementing home monitoring systems is measuring their benefit. The benefit of these systems can be measured in several ways. The first way is measured in terms of clinical outcomes, where payors may set benchmarks or target goals for re-hospitalization rates, mortality rates, or other outcome-type metrics. The second way is measured in terms of compliance, where payors may demand that chronic disease management programs are being implemented uniformly and in accordance with clinically proven guidelines. Metrics related to frequency of contact, types of interventions, medications prescribed, etc. might be used to measure a program's success.
Payors including the Centers for Medicare & Medicaid Services (CMS), may institute “Pay for Performance” requirements, thereby requiring providers to provide evidence of performance. This may include clinical outcomes and compliance to published guidelines. Current chronic disease monitoring systems do not provide this type of performance evidence.
The method and system includes producing performance reports for payors that require performance evidence. The method and system collects a set of clinical data from the patient, combines the set of remote patient data with a set of EMR data, de-identifies this data, and produces a set of reports including compliance reports and outcomes reports, which can be tailored to a payor's needs, and further delivered to the payor. The method may be implemented as software to be executed on the system.
In one aspect of the present invention, a method of producing a set of performance reports for a payor comprises collecting a set of remote patient data from a patient, combining the set of remote patient data with a set of electronic medical record data to produce a set of combined data, de-identifying the set of combined data to produce a set of de-identified data and compiling the set of de-identified data in a performance database to produce the set of performance reports. The set of remote patient data may also be directly collected in the set of electronic medical record data. The method further includes storing the set of de-identified data in the performance database before the compiling step. This method further comprises formatting the set of performance reports to comply with a set of payor specifications, delivering the set of performance reports to the payor, and the de-identifying step includes redacting all patient references and personal information from the set of combined data. This set of performance reports may also include a compliance report that identifies a compliance level with a set of established treatment protocols, or that tracks a level of compliance over time, and a clinical outcomes report that may be a comparative clinical outcome report or a tracking clinical outcome report.
In yet another aspect of the present invention, a system for producing a set of performance reports for a payor comprises a remote sensing system configured to collect a set of remote patient data from a patient, a storage media for storing a computer application and a processing unit coupled to the remote sensing system and the storage media, the processing unit configured to execute the computer application, and further configured to receive the set of patient data from the remote sensing system, wherein when the computer application is executed, the set of remote patient data is combined with a set of electronic medical record data from an electronic medical record database to produce a set of combined data, the set of combined data is de-identified to produce a set of de-identified data, and the set of de-identified data is compiled in a performance database to produce a set of performance reports. In this system the set of remote data may be directly collected in the set of electronic medical record data, and the set of de-identified data is stored in the performance database before the set of de-identified data is compiled. The set of performance reports are formatted to comply with a set of payor specifications and the set of performance reports are delivered to the payor and the set of combined data is de-identified by redacting all patient references and personal information from the set of combined data. This set of performance reports may include a compliance report that identifies a compliance level with a set of established treatment protocols or a compliance report that tracks a level of compliance over time, and the set of performance reports may include a clinical outcomes report which may be a comparative clinical outcome report or a tracking clinical outcome report.
The method and system combines remotely acquired patient data with available electronic medical records data and de-identifies this combined data before storing the de-identified data in a performance database. The method and system compiles the stored de-identified database to produce a set of performance reports for a particular payor. Payors may include government agencies, such as the Centers for Medicare and Medicaid Systems (CMS), private insurance companies or self-insured firms, or third party such as auditing firms. The set of performance reports are formatted to comply with the particular payor's specifications, and delivered to the payors.
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It should be understood that the method may be implemented as software and run on an appropriate reporting system 50 including a storage medium 58, a processor 56, an electronic device 62 such as a computer, laptop, PDA, or other similar device, and be compatible with the remote sensing system 54 as well as appropriate databases 60, 61.
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This method and system provides the advantages of having automatic generation of pay for performance reports, which will save time and money. Rather than compiling this type of information manually, the reports will be automatically generated and sent to the payors in the proper format at the correct time, which will result in cost saving for care providers of chronic disease care.
The present invention has been described in terms specific embodiments incorporating details to facilitate the understanding the principles of construction and operation of the invention. Such reference herein to specific embodiments and details thereof is not intended to limit the scope of the claims appended hereto. It will be apparent to those skilled in the art that modifications may be made in the embodiment chosen for illustration without departing from the spirited scope of the invention.
