The invention relates generally to evaluating medical treatments and providing those evaluations to users (individual healthcare consumers, employers, employees, health plan members, healthcare providers, physicians, nurses, insurance companies, etc.) While extensive evidence about medical treatments exists, users often do not know how reliable various evidence is. In addition, users may have difficulty obtaining evidence about medical treatments, may not have the time to compile evidence about medical treatments, and may further have difficulty in understanding even reliable and accessible evidence.
A method of securing and providing evidence based evaluations of medical treatments according to an embodiment includes steps: (a) providing guidelines for selecting evidence about the treatments; (b) selecting a research expert knowledgeable about evidence relating to the treatments; (c) having the research expert select evidence relating to the treatments; (d) selecting a group of treatment experts knowledgeable about the treatments; (e) having the treatment experts evaluate the treatments based on the evidence relating to the treatments; and (f) placing the evaluations in a database accessible by users.
A method of providing personalized medical plans for consumers according to an embodiment includes steps: (a) providing a database of treatment evaluations based on evidence relating to the treatments; (b) securing personal medical information from the consumers related to medical conditions to be treated by the treatments; (c) securing selection criteria from the consumers, the selection criteria selected from the group consisting of effectiveness, safety, tolerability, and cost; (d) preparing personalized medical plans for the consumers based on the personal medical information, the treatment evaluations, and the selection criteria; and (e) placing the personalized medical plans in a database accessible by at least one of the consumers and a healthcare provider.
A system for securing and providing evidence-based evaluations of medical treatments for various healthcare conditions according to an embodiment includes a computing device having a database; at least one remote input computer in data communication with the database; and at least one remote output computer in data communication with the database. The database includes machine readable instructions for: directing a user to at least one specific portion of the database in accordance with a status associated with the respective user; editing the database to include evidence relating to treatments using at least one respective remote input computer; editing the database to include evaluations of the treatments based on the evidence relating to the treatments in the database using at least one respective remote input computer; and allowing end users to view evaluation information in the database using at least one respective remote output computer.
a through 5d are exemplary screen shots showing visual representations of machine readable instructions contained in a database according to various embodiments.
At step 102 of method 100, guidelines may be provided to ensure that evidence about the treatments is valid, relevant, unbiased, etc. For example, a guideline may disallow evidence appearing in a publication that is not peer-reviewed, a guideline may disallow evidence appearing in a publication that is funded by a biased party, etc. The guidelines may be created by one or more research expert, one or more treatment expert, and/or other appropriate people. Stringent guidelines on the selection of clinical evidence may provide additional value to the method 100.
At step 104 of method 100, the research expert(s) may be selected by an administrator of the method 100 (i.e., a person or a committee overseeing the method 100) and/or other appropriate people. Research experts may be research-oriented physicians, academic-oriented physicians, certified specialists who typically care for the healthcare condition being treated, and/or other appropriate people or systems. A plurality of research experts may be referred to herein as a Medical Advisory Committee (or “MAC”), and research experts selected based on a demonstrated background in evidence-based research along with their knowledge as a thought-leader or medical expert in their respective field may provide additional value to the method 100.
At step 106 of method 100, the research expert(s) may select evidence relating to the treatments from specific randomized clinical trials, published clinical evidence, systematic reviews, meta analysis, publications, and/or other appropriate sources. To select evidence, a research expert may rely on his background and knowledge of the healthcare condition and/or the source of the evidence. The research expert(s) may additionally or alternately rely on the guidelines for selecting evidence about the treatments set forth in step 102. If the guidelines set forth in step 102 are not relied upon when selecting evidence relating to the treatments, the guidelines set forth in step 102 may be used to filter or verify the quality of the selected evidence.
At step 108 of method 100, the treatment expert(s) may be selected by an administrator of the method 100 (i.e., a person or a committee overseeing the method 100) and/or other appropriate people. Treatment experts may be clinically-oriented physicians, certified specialists who typically care for the healthcare condition being treated, and/or other appropriate people or systems. Treatment experts selected based on a demonstrated background in patient treatment and/or prestigious affiliations/recognitions in their respective field may provide additional value to the method 100. For example, treatment experts may be selected based on their affiliation with the top fifty academic medical centers as determined by the annual RTI and University of North Carolina Physician Evaluation. It may be desirable to have some or all treatment experts that are not also research experts to provide a variety of opinions and meaningful review.
At step 110 of method 100, the treatment experts may evaluate the treatments based on the evidence selected by the research expert(s). The treatments may be evaluated for traits such as effectiveness, safety, tolerability, etc., and the treatment experts may further provide an overall ranking (also referred to herein as “overall evaluation”) based upon a combination of the traits. To determine an overall ranking, the treatment experts may consider the traits that are most important to an overall ranking for a specific healthcare condition and those that are less important. For example, effectiveness may be the most important trait to one healthcare condition, while tolerability or safety may be the most important trait to another healthcare condition.
At step 112 of method 100, to validate the evaluations of the treatments provided in step 110, the treatment experts may be required to answer one or more question concerning their judgment used in the evaluation process. These answers may be reviewed by other treatment experts and/or other appropriate people to ensure that the treatment experts used good judgement. Additionally, or alternately, evaluations may be peer-reviewed by MAC members and/or other appropriate people for reasonableness and appropriateness.
At step 114 of method 100, cost data may be associated with the treatments. Cost data may be on a daily or average monthly basis, for example, and may be set forth as a standard retail cost and/or as a cost under a health plan.
At step 116 of method 100, the treatments may be evaluated with consideration of the cost data provided at step 114. The evaluation may only compare the costs associated with various treatments, or the evaluation may combine cost with at least one other ranking as set forth in step 110 to determine an overall ranking that includes cost as a component.
At step 118 of method 100, the evaluations may be placed in a database accessible by a user, such as an individual healthcare consumer, an employer, an employee, a health plan member, a healthcare provider, a physician, a nurse, an insurance company, etc. The database may be free of charge or may require an access fee, and the database may be generally accessible or may have a restricted audience. The database may be accessible in various ways, such as through the internet, through a local network, etc.
The database 204 includes machine readable instructions 205a for directing users to specific portions of the database 204 in accordance with a status associated with a respective user, machine readable instructions 205b for editing the database 204 to include evidence relating to treatments, machine readable instructions 205c for editing the database 204 to include evaluations of the treatments based on the evidence relating to the treatments in the database 204, machine readable instructions 205d for allowing end users to view evaluation information in the database 204, and machine readable instructions 205e for allowing administrators to setup the database 204. The machine readable instructions 205a may, for example, direct a research expert to a portion of the database 204 that includes the machine readable instructions 205b, direct a treatment expert to a portion of the database 204 that includes the machine readable instructions 205c, and direct an end user to a portion of the database 204 that includes the machine readable instructions 205d. Even more particularly, the machine readable instructions 205a may direct research and treatment experts to portions of the database 204 that include the machine readable instructions 205b, 205c for specific medical conditions.
The database 204 may include a classification system 300 such as that shown in
Information may be associated with the medical categories 302, the medical conditions 304, and/or the treatments 306 in the database 204 as further shown in
a and 4b show a visual representation of part of the machine readable instructions 205b for editing the database 204 to include evidence relating to treatments. More particularly,
a through 5d show a visual representation of part of the machine readable instructions 205c for editing the database 204 to include evaluations of the treatments 306 based on the evidence relating to the treatments in the database 204. The machine readable instructions 205c provide functionality to carefully control the input of evaluations by treatment experts using various constraints, system variables, and process flow. Upon login through a remote input computer 210, each treatment expert may be presented with a dashboard showing all evaluations (also referred to herein as “rankings”) assigned to him (typically only one evaluation at a time) and any applicable honorarium. Evaluations may be assigned automatically (such as based the expertise of treatment experts) or may be otherwise assigned. Upon selecting (or proceeding to) an evaluation, the treatment expert may be presented with all of the medical conditions 304 that apply based on the setup of the evaluation, how many treatment rankings remain, and the option of proceeding with evaluations or revising evaluations (as shown in exemplary screenshot 501 in
In entering evaluations for a treatment 306, the treatment expert may be provided and required to review all of the evidence in the database 204 selected by the research experts. For each treatment 306, the total number of pieces of evidence in the database 204 may be displayed, as well as whether or not the treatment expert has reviewed each piece of evidence; evidence not yet reviewed may be displayed by the database 204 before evidence already reviewed is displayed. As illustrated in exemplary screenshot 504 in
The machine readable instructions 205d for allowing end users to view evaluation information in the database 204 may allow an administrator, a research expert, a treatment expert, or another appropriate entity to review individual evaluations for oddities and to approve the individual evaluations for publication via the internet, a local network, etc. Before publishing the evaluations, the machine readable instructions 205d may tabulate, normalize, average, and/or perform other operations on the evaluations. Once published, the machine readable instructions 205d may allow end users to access the evaluations in the database 204 on the output computers 220, such as through search routines, an index, graphic links, etc. Login routines may be required to allow only selected end users to access the database 204, and specific interfaces may be provided to various end users. For example, various employers or insurance companies may have specific interfaces for end users. End users may be allowed to input personal medical information, such as a medical condition 304, age, sex, race, prior drug utilization, history of illness, blood test results, urine test results, health status, health history, current drug utilization, results of medical examinations related to the medical condition, priority of effectiveness, priority of safety, priority of tolerability, priority of cost, etc., to access the evaluations in the database 204 and effectively obtain a personalized medical plan.
Those skilled in the art appreciate that variations from the specified embodiments disclosed above are contemplated herein and that the described embodiments are not limiting. The description should not be restricted to the above embodiments, but should be measured by the following claims.
This application claims priority to U.S. Provisional Application No. 60/793,287, filed Apr. 19, 2006, U.S. Provisional Application No. 60/796,225, filed Apr. 28, 2006; and U.S. Patent Application No. 60/912,366, filed Apr. 17, 2007. All of the aforementioned patent applications are incorporated herein by reference.
Number | Date | Country | |
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60793287 | Apr 2006 | US | |
60796225 | Apr 2006 | US | |
60912366 | Apr 2007 | US |