Patent Application
20070220086
The present invention relates generally to communication, and, more particularly, to a centrally managed process and system for the production, reception and distribution of electronic information.
The need for production of documents and other information, such as related to medical records, during litigation is well-known. For example, law firms and insurance companies representing defendants in medical-related legal actions need to review various documents, including medical records and reports to properly prepare for and defend a legal case. In a typical prior art scenario, documents are retrieved in paper format, photocopied and then dispatched to requesting parties, e.g., insurance companies and law firms. Photocopies of documents may also be sent to adjusters and expert witnesses.
The volume of paper generated in a document production for a medical-related lawsuit is expensive and time-consuming. The costs in terms of time and money related to accessing, organizing, reproducing, storing and delivering the documents can be very large. Managing the documents, including receiving a single document and providing multiple copies thereof to a plurality of parties is inefficient and increases costs. Also, documents may be inefficiently organized, stored and distributed.
Moreover, a specialist (i.e., paid personnel, such as a paralegal or other legal staff) may be required to manage document production during a lawsuit. In the prior art, a specialist manages requests for documents, retrieving and reproducing the documents, and delivering the documents from/to law firms, insurance companies, physician offices, or the like.
In an effort to overcome problems associated with document production, for example, in a medical-related lawsuit, parties have sought to distribute and receive materials in electronic form. It was believed that electronic distribution of documents would increase efficiency by alleviating delays and costs associated with physical document production. Unfortunately, distributing electronic documents, particularly related to medical healthcare, has not mitigated delays and costs associated with document production and management. This is partly because healthcare information in electronic form is believed to be much less secure than in paper form and, accordingly, laws have been implemented to address policy concerns related to distributing electronic healthcare information and to protect patient privacy and security.
One example of legal standards related to the distribution of electronic healthcare information is the Health Insurance Portability and Accountability Act (“HIPAA” ). In short, HIPAA is a federal law that addresses the availability, portability and efficiency of health coverage and related information. Restrictions and rules defined in HIPAA were designed, in part, to safeguard patient privacy and security. One aspect of HIPAA relates to protected electronic health information generated by health plans, health care clearinghouses, and certain health care providers. The rules in the Act have been developed to improve the effectiveness and efficiency of the health care industry, in general, by establishing a level of patient protection for certain electronic health information.
Unfortunately, HIPAA (and other legal) regulations may adversely impact the amount of time and money that parties who request and provide health-related electronic information incur. Formal requirements, including those related to requesting electronic health information and ensuring that adequate security measures are implemented, have negatively impacted the time and costs associated with electronic health care information distribution. Moreover, the manner of requesting and sharing electronic health information is regulated to the point that many requests for information are denied. Any request for electronic medical information that does not comply with the multitude of requirements related to patient privacy and security can be denied.
In addition to the denial of requests due to non-compliance with regulations, other problems associated with document production exist in the prior art that negatively impact time and costs. In many cases, defendant(s) do not have access to up-to-date or accurate information relating to health care providers, such as names, addresses, telephone numbers or the like. Valuable resources, including time and capital, are often wasted trying to obtain accurate and current information of a party who in some cases is the sole source of information. Thus, another delay in receiving requested health care information is caused by inaccurate contact information.
Moreover, a properly formatted request for healthcare information that is transmitted to and received by the proper party does not ensure timely and cost-effective results. Many requests for electronic healthcare information go unanswered for months. A party managing the document productions in several large lawsuits can easily lose time tracking those requests that go unanswered for periods of time. Thus, another problem in the prior art that negatively impacts costs and time relates to regular and frequent follow-ups to requests.
Thus, even though healthcare information is requested and received in electronic form, problems associated with cost and time are not necessarily alleviated.
The present invention relates to a system and method for facilitating requests for information, such as health information, related to at least one party in a lawsuit. Preferably, the invention comprises providing on an information processor an information request form, such that the form is usable to request information and further wherein the form complies with at least one regulation. Further, a service provider module is provided that is operable to store on the information processor information relating to a service provider, such as a healthcare provider.
Moreover, the invention comprises a lawsuit module that is operable to store on the information processor information relating to the lawsuit. Also, a request module operable to store on the information processor request information that relates to requests for information. An information module is also provided and operable to store electronic information that is received in response to the request for information. Also, a user interface is provided that enables a user to perform at least one of several tasks. For example, the user interface enables a user to request and receive the request form, as well as to enter and view the request information. Also, the user interface enables the entering and viewing status information regarding the information request. Furthermore, the interface enables a user to enter and view the lawsuit information, as well as to enter and view the information.
Furthermore, the various modules of the present invention are operable to receive information as a function of the user interface over a communication network, such that requests for health information can be facilitated.
Other features and advantages of the present invention will become apparent from the following description of the invention, which refers to the accompanying drawings.
For the purpose of illustrating the invention, there is shown in the drawings a form which is presently preferred, it being understood, however, that the invention is not limited to the precise arrangements and instrumentalities shown. The features and advantages of the present invention will become apparent from the following description of the invention that refers to the accompanying drawings, in which:
The present invention includes a system and method that is operable to remove impediments related to obtaining records, such as medical records, quickly and accurately. In a preferred embodiment, the present invention centrally facilitates the processing and fulfillment of requests for information from various providers in a timely and efficient manner. For example, the invention enables parties in a medical-related lawsuit to request medical records, to receive the records and to reproduce the records easily and quickly. The invention provides an integrated interface that enables users to request documents and medical records, and the invention further enables the fulfillment of such requests securely and efficiently.
In a preferred embodiment, the present invention is a centrally managed system that enables a secure, bi-directional communication flow of sensitive information between a plurality of parties. A plurality of parties that are associated with one or more medical-related lawsuits and who either require information related to the lawsuit(s), or, alternatively, provide information related to the lawsuit(s) use the present invention accordingly. For example, a hospital provides medical care to a plaintiff, and maintains medical records regarding the plaintiff. The hospital's records may be requested by a defendant physician, or other defendant who is a party to the lawsuit. In one embodiment, the invention includes receiving paper copies of medical information, and digitizing materials (i.e., by scanning) to ensure timely and reliable distribution, as well as to provide efficient storage thereof.
Using the centrally managed system of the present invention, requests for documents (e.g., records related to medical care provided to a plaintiff) are properly formatted in accordance with various HIPAA and/or other regulations. As noted above, formatting requests to be compliant with HIPAA, particularly requests for electronic information, requires a detailed and proficient knowledge of regulatory rules that are often difficult to understand and follow. Failing to comply with HIPAA rules often results in denials and costly delays, which adversely affects parties seeking to secure information.
In an embodiment, a database is provided that includes forms to be used to request documents and information, for example, related to a person's medical information. Users of the present invention may submit a copy of a preferred form which can be later retrieved from the database and used to request, for example, medical information. In one embodiment, the forms arrive in paper format, and a data entry person reproduces the form by typing it into a word processor. The electronic version of the form is, thereafter, stored in a database and available for future use. In another embodiment, a form is scanned, converted to another format (such as an ADOBE ACROBAT PORTABLE DOCUMENT FORMAT “PDF” file), and then modified such that a user can enter information directly into the form for use in requesting medical healthcare information.
In some cases, a form may need to be executed by a particular patient or authorized representative, and then submitted to the appropriate party via the present invention. One feature of the present invention is that the progress of fulfilling a document request can be tracked in an interactive user interface (described below). Another feature of the invention is that an electronic copy of the document or other record can be viewed via the user interface. Using these features, the progress of a request can be monitored, and, once a document is available, users can view documents electronically without the delays typically associated with copying and shipping physical materials.
By utilizing electronic versions of documents and employing a database via a internet web-based user interface, the invention capitalizes on opportunities directed to improving efficiency and reducing costs. For example, problems associated with interruptions or breakdowns in communication can be prevented.
Once documents have been received and stored in an information processor, users can locate the documents using a plurality of search criteria, such as file number, patient name,.date or other values. When a document is located, users can preferably view the documents electronically, print the document or order a copy of the document on CD/DVD. Users can also order a physical copy of a document. Documents preferably remain available to a user in electronic format until a user elects to archive a case, until expiration of a time period defined by the proprietor or authorized user of the present invention.
The present invention further regularly follows up requests for electronic information to ensure that the information is received and delivered. In case of a denial to a request, reasons for the denial are quickly pursued and, when possible, remedied. This is accomplished by a tracking system, referred to herein as a tickler, that monitors dates to ensure that requests are not forgotten or ignored. Thus, requesting parties, such as law firms representing defendants and who are authorized by the proprietor of the present invention, are provided the materials in a timely and cost effective manner. The present invention dramatically improves upon prior art methods to ensure that requests for electronic information are met.
The present invention preferably facilitates properly formatted requests for materials, such as documents directed to discovery in a medical-related lawsuit, to ensure compliance with various regulations, such as in HIPAA. Preferably, an archive of pre-formatted documents can be accessed from a secured internet web site and used for requesting materials. Various embodiments are provided herein. For example (as noted above), the pre-formatted documents may be ADOBE PDF files that are formatted to accept alphanumeric information in one or more data entry fields. In another embodiment, users print the pre-formatted documents and add information on a hard copy (i.e., printed copy) of the document. In yet another alternative, users independently recreate the pre-formatted documents, such as by using word processor software, and effectively use a pre-formatted document as a template.
As note above, failure to comply with technical regulations, including relating to the formatting of requests for electronic health information, can result in costly delays. The present invention reduces the chances that requests for information, including information related to medical healthcare are not denied for failing to comply with proper formatting requirements.
Also in a preferred embodiment, the present invention comprises a secure, on-line computer software application that supports the retrieval and distribution of information, for example, typically sought in medical-related lawsuits. The application is easy to learn and use, is robust, secure and customizable for each of a plurality of entities and users. The present invention includes data management and data retrieval, and utilizes executable computer code for performing the functions described herein. For example, user-interfaces are presented that enable user-queries to be executed quickly. The invention further provides a robust security infrastructure without degrading operation performance. Moreover, the application is preferably adaptable to support changes in the future, as needed.
Although many of the descriptions and examples used herein refer to defendants and/or medical-related lawsuits, the present invention is not so limited. The present invention may be used in any context in which information, such as documents and/or records, are requested and delivered to parties with various needs.
The present invention preferably maintains comprehensive lists of service providers, medical healthcare providers or other parties that provide information for defendants in medical-related lawsuits. Preferably, the lists are regularly and/or frequently maintained and/or updated in order to ensure that current and accurate information regarding service providers, medical caregivers or the like is available. For example, service providers, medical healthcare providers or other parties are regularly reviewed and/or contacted and, if necessary, change of address information, telephone number listings or the like are updated. Further, information regarding such parties are preferably annotated so users can provide additional information corresponding to an entry in the list.
Thus, the present invention accommodates a plurality of parties that interact with a proprietor of the present invention in a variety of contexts. A feature of the invention is that the integrity of information, particularly with respect to the many contexts in which users interact, is maintained. For example, each respective law firm preferably receives data regarding its respective client(s). Also, a plurality of defendants in a medical-related lawsuit may have a single insurer and a plurality of attorneys. Proper and specific authorization is provided for each party in accordance with the teachings herein. In a preferred embodiment, a plurality of parties, for example requesting information and/or documentation related to one or more medical-related lawsuits, each receive respective information that is requested. Moreover, access to electronic information is preferably limited to particular parties. In case, for example, two related medical-related lawsuits are pending, a substantial amount of data (typically in the form of medical records and reports) is received by the present invention and the data are managed such that information is correctly provided to each authorized requestor for each respective lawsuit.
The present invention is preferably implemented via an internet web site. For example, insurance companies, law firms, expert witnesses and various parties functioning in an administrative capacity may interact with the present invention, preferably via computer workstations equipped with standard web browsing software applications. In accordance with the teachings herein, various parties use the present invention to perform actions, typically related to obtaining or disbursing information, such as medical documents and records. A plurality of users establish communication sessions with a central provider, such as a computer server, to identify requests and/or actions that are pending related, for example, to a medical-related lawsuit. In this way, various requests and/or actions that are performed in can be monitored and managed, for example, during the course of a lawsuit.
Preferably, the present invention provides substantial reductions in costs associated with document and information distribution. By distributing electronic documents to various parties, for example, to one or more medical-related lawsuits, information is rapidly disseminated and costs are reduced for the recipients. For example, multiple defendants may be involved in a single lawsuit, each of which require copies of the same documents. Thus, in one embodiment of the present invention, various business methods are envisioned. For example, a reduced rate may be charged to parties who request information that has already been produced for that party, or another party. After initial fees have been received for receiving, digitizing documents and disseminating documents to an authorized requestor, the fees associated with disseminating the documents to another authorized requestor (or the same requestor) may be considerably less.
In addition to reducing rates associated with document and information production, the present invention provides substantial revenue opportunities particularly for the proprietor thereof. Preferably, the proprietor of the present invention charges a fee to parties for services provided, as described herein. Further, the paying parties receive a substantial savings over prior art document production methods. For example, third party administrators (e.g., insurance companies) and law firms pay the proprietor of the present invention a fee, and receive information faster and more securely than in the prior art. The proprietor realizes profit from the fees, particularly as the number of parties that interact with the proprietor increase.
In a preferred embodiment of the present invention, the present invention notifies parties that are identifying actions to be taken or assigned that all activity (or, alternatively specific activity) related to the matter is halted. For example, in the event that a lawsuit settles, the present invention prevents users from expending time and resources by notifying parties of the settlement. In a preferred embodiment, a user who attempts to perform or assign an activity related to a settled lawsuit is automatically prevented from doing so. For example, graphic screen controls in a user interface may become disabled, or a user may be automatically logged off of a data entry session. Preferably, some form of notification, such as a pop-up window display screen, is provided that indicates to the user that a lawsuit has settled or some other event has occurred, and that no further actions should be taken. In this way, users are informed of the current status of a lawsuit, and unnecessary activity that would otherwise result in wasted resources is prevented.
In a preferred embodiment, the present invention allows parties to upload electronic documents to a central location, thereby precluding the need to physically produce paper documents. During medical-related lawsuit document production, it is envisioned herein that security and safety standards, such as those related to HIPAA regulations, will be carefully and consistently enforced. Therefore, parties desiring to transmit electronic documents that contain sensitive information, such as medical records, comply with regulations before sending the electronic documents.
Referring to the drawings, in which like reference numerals refer to like elements,
Information processors 2 and user terminals 4 are any devices that are capable of sending and receiving data across communication network 6, e.g., mainframe computers, mini computers, personal computers, laptop computers, a personal digital assistants (PDA) and internet access devices such as Web TV. In addition, information processors 2 and user terminals 4 are preferably equipped with a web browser, such as MICROSOFT INTERNET EXPLORER, NETSCAPE NAVIGATOR, MOZILLA FIRREFOX or the like. Thus, as envisioned herein, information processor 2 and/or user terminals 4 are devices that can communicate over a network and can be operated anywhere, including, for example, moving vehicles.
The nature of the present invention is such that one skilled in the art of writing computer executable code (i.e., software) can implement the described functions using one or more of a combination of popular computer programming languages and developing environments including, but not limited to C, C++, Visual Basic, JAVA, PHP, HTML, XML, ACTIVE SERVER PAGES, JAVA server pages, servlets, MICROSOFT .NET, and a plurality of various web site development applications.
For example, data may be configured in a MICROSOFT EXCEL spreadsheet file, as a comma delimited ASCII text file, as a MICROSOFT SQL SERVER compatible table file (e.g., MS-ACCESS table), or the like. In another embodiment, data may be formatted as an image file (e.g., TIFF, JPG, BMP, GIF, or the like). In yet another embodiment, data may be stored in an ADOBE ACROBAT PDF file. Preferably, one or more data formatting and/or normalization routines are provided that manage data received from one or a plurality of sources. In another example, data are received that are provided in a particular format (e.g., MICROSOFT EXCEL), and programming routines are executed that convert the data to another formatted (e.g., ASCII comma-delimited text).
It is contemplated herein that any suitable operating system can be used on user terminals 4 and information processor 2, for example, DOS, WINDOWS 3.x, WINDOWS 95, WINDOWS 98, WINDOWS NT, WINDOWS 2000, WINDOWS ME, WINDOWS CE, WINDOWS POCKET PC, WINDOWS XP, MAC OS, UNIX, LINUX, PALM OS, POCKET PC or any other suitable operating system. Of course, one skilled in the art will recognize that other software applications are available in accordance with the teachings herein, including, for example, via JAVA, JAVA Script, Action Script, Swish, or the like.
Moreover, a plurality of data file types is envisioned herein. For example, the present invention preferably supports various suitable multi-media file types, including (but not limited to) JPEG, BMP, GIF, TIFF, MPEG, AVI, SWF, RAW or the like (as known to those skilled in the art).
The various components of information processor 2 and/or user terminal 4 need not be physically contained within the same chassis or even located in a single location. For example, storage device 20 may be located at a site which is remote from the remaining elements of information processor 2 or user terminal 4, and may even be connected to CPU 12 across communication network 6 via network interface 18. Information processor 2 preferably includes a memory equipped with sufficient storage to provide the necessary databases, forums, and other community services as well as acting as a web server for communicating hypertext markup language (HTML), FLASH, Action Script, Java, Active Server Pages, Active-X control programs on user terminals 4. Information processors 2 are arranged with components, for example, those shown in
As used herein, the term, “module” refers, generally, to one or more discrete components that contribute to the effectiveness of the present invention. Modules can operate or, alternatively, depend upon one or more other modules in order to function.
Continuing with reference to
Third-party administrator 304 preferably provides claims administration, for example, related to health benefits for companies and/or individuals. In accordance with the present invention, third-party administrator 304, typically, is an insurance company representing a defendant in a medical-related lawsuit. For example, an individual may slip and fall on stairs under the control of a large retail establishment. The individual, injured by the slip and fall, sues the retailer for his injuries. Continuing with this example, the third-party administrator 304 represents the retailer and solicits the services of proprietor 302, among other things, to gain access to health-care records and information related to the plaintiff.
As shown in
In addition to attorneys, insurers and associated various parties interfacing with proprietor 302, it is envisioned herein that one or more health care providers 316 interface with proprietor 302 in various contexts. Example of health care providers 316 include hospitals, physicians, physician assistants, nurses, physical therapists, or the like. Preferably, various parties seeking access to health information (e.g., third-party administrators 304, law firms 308, expert witnesses 310, or the like) interface with proprietor 302 in order to request and receive such information.
Proprietor 302 provides various services associated with requesting and distributing electronic health information. For example, proprietor 302 ensures proper formatting of requests for health information in order to avoid such requests being denied on technical and/or legal grounds. Proprietor 302 receives requests for health information from submissions in web-based data entry form(s), and properly formats such requests in accordance with HIPAA standards. The properly formatted requests are preferably transmitted by proprietor 302 to healthcare provider(s) 316.
Another example of services provided by proprietor 302 is an assurance that requests for health information will be sent to correct parties and correct addresses. As noted above, lists of health care providers 316 are regularly and/or frequently updated to maintain current and accurate information. For example, a request for health information from a Dr. Smith at 100 Broadway is received by proprietor 302, and modified to be sent to the same Dr. Smith at 200 State Street. The modification of the request in this example represents Dr. Smith's change of address information, which was unknown to the requestor. Proprietor 302 reduces costly delays by properly formatting requests for information (e.g., to comply with HIPAA standards), and by maintaining current and accurate information.
In practice, parties to system 10, such as those illustrated in
Each of the selections in Options 400 are available for users have respective authorization. For example, a user that is authorized to determine whether a particular document request has been satisfied may not have the authority to open a new case. Therefore, it is to be understood that the examples and features described herein relate to particular users, and that levels of access preferably correspond to a user's predefined authorization.
After a user has submitted a valid user name and password, Options 400 are preferably presented that allow the authorized user to execute functions and use features associated with the present invention. For example and as illustrated in
In addition to the Reports 416, 418 and 420 provided via Reports 404, the present invention preferably provides selected access to records in which various conditions have occurred that delay or prevent a request from being fulfilled. More particularly, Action Required Reports 406, when selected, provides a list of reports that are preferably available to a user and that effectively filter records to allow a user to access only those records that correspond with the action required. A discussion relating to choices available in accordance with Action Required 406 is provided below.
Continuing with reference to
Steps and features associated with entering a new case are now provided with reference to
An authorized user of the present invention enters information regarding a new case into a database managed by information processor 2. For example, after a defendant receives a summons, for example, related to a charge of medical malpractice, an authorized user enters the case in information processor 2. The user preferably accesses a user interface that includes selections corresponding with Options 400, and selects Create New Case With Requests 408 to access a data entry form and submit information regarding the case.
Continuing with reference to
In case the user is not satisfied with the entries, the user selects either clear work order control 512, which erases all previous entries, but does not close the form 500, or cancel work order control 514, which erases the data entry and closes the form 500.
Thus, a user enters new case information via data entry form 500, and the data is preferably stored in database 8 for future use. As will become apparent to one skilled in the art, the ability to enter new case information in information processor 2 requires a relatively high degree of access by the user. Accordingly, many other users, such as those seeking to review whether a particular document has been distributed to a party, are not afforded the degree of access to the secured web site provided via information processor 2. The present invention is flexible to provide a range between minimum security allowing authorized users to access to virtually any respective area, and maximum security which severely restricts a user's access. A discussion regarding security and authorized access to features of the present invention is described in greater detail below.
Once a case has been submitted into database 8, various requests related to the case are managed and performed in accordance with Options 400.
Continuing with reference to
Continuing with reference to
In a preferred embodiment, control section 705 includes action control 706, communicate control 708, view control 710, notes control 712, history control 714, order control 716, go to case control 718 and bookmark control 720. Some of these controls appear in various other display screens provided by information processor 2, and, enable convenient navigation to various display screens. Action control 706 preferably enables the user to instruct information processor 2 to fulfill various requests with regard to the case, and/or parties associated with the selected record in completed requests section 602. For example, action control 706, when selected, allows the user to cancel a request, place a request on hold (e.g., temporarily suspending the request), or alert information processor 2 that the request must be rushed. Alternatively, action control 706 enables the user to remove a cancellation, remove a hold, or remove a rush.
Continuing with reference to control section 705, communicate control 708, when selected, preferably causes a data entry form to be displayed that enables the user to compose and send an e-mail message to a party. View control 710, when selected, allows the user to view information regarding the request. For example, view control 710 enables the user to select an original HIPAA compliant authorization request (referred to herein as “AZ”) that was transmitted to a healthcare provider 316. In another example, view control 710 enables a user to view a health care provider fee invoice. Notes control 712, when selected, preferably provides a data entry form that allows the user to compose and save a note. The note is preferably saved in database 8 and is available for future review. History control 714, when selected, displays a history of user access with respect to the current record. Preferably, the present invention tracks users, and proprietor 302 can, accordingly, monitor users and corresponding access dates and times for any record. By monitoring users and corresponding activity, the proprietor 302 has an opportunity to define various fee schedules to be charged to parties that interact with the present invention. For example, various business models can be fashioned by proprietor 302 that relate to a party's activity and/or use in accordance with system 10.
Order control 716, when selected, enables a user to order a copy of the record that is being viewed via request overview display screen 702. Preferably, users can order a printed copy of a record, or, alternatively, can request an electronic copy that is stored, for example, on CD-ROM. Go to Case control 718, when selected, preferably displays a display screen that lists all requests, completed or otherwise, that are associated with the case identified in request overview display screen 702. Bookmark control 720 allows the user to add a bookmark, as known to those skilled in the art, in order to simplify accessing the record in the future.
In addition to provider information section 704 and control section 705, request overview display screen 702 preferably includes document available icon 722 that, when selected, displays a requested document for the user. In a preferred embodiment, the documents are provided in a particular file format (e.g., ADOBE PORTABLE DOCUMENT FORMAT, “PDF”) and, when the user selects document available icon 702, the software application associated with the file format is automatically launched in the user's web browser software application. In the case of a PDF file, for example, when a user selects document available icon 722, ADOBE ACROBAT READER is automatically launched and the PDF file is displayed.
In accordance with the teachings herein, a user preferably operates the data entry display screens to request health information from a particular health provider, and the present invention ensures that proper formatting of the request occurs. As noted above, requests for health information, particularly with respect to HIPAA compliance, have technical formatting requirements which, if not adhered to, results in denials. Denials of health information can be extremely costly in terms of capital, time and resources. By centrally managing requests and ensuring proper compliance with formatting requirements, the present invention provides a substantial improvement over prior art methods of requesting, receiving and managing health information.
Thus, using various graphical screen controls, for example as illustrated in
Continuing with reference to
In a preferred embodiment, the present invention provides several reports that assist users in managing document request workloads. Some reports preferably display information for a particular period of time that is selected by the user. Once the user runs such a report, the user preferably selects a row, as described above, to so-called “drill down” a respective line item to view additional information regarding a particular request. In addition to reports that contain selectable rows enabling a user to drill down to view additional information, some reports are preferably displayed that are static. These static reports, for example, Referral Report 418 and Accounting Report 420, display information for the user may contain selectable rows for limited use, such as for enabling access to request overview display screen 702. These reports can preferably be saved or printed by the user for future review.
Referring back to
As shown in
In a preferred embodiment, user type 1110 represents a category of user, such as an expert witness. Further, security level 1112 represent a respective degree of authorization and corresponding privilege defined for a user. For example, a security level 1112 of one (“1”) may enable the newly added user to review case summary display screen 800, but not to select any screen controls in section 802. Alternatively, a security level 1112 of nine (“9”) may allow the newly added user to access each and every control and option provided by the present invention. Of course, one skilled in the art will recognize that various levels of security can be defined and/or modified. Enable date 1118 and disable date 1120 are preferably used to maintain a user's authorization to access various features of the present invention and defined herein.
In addition to adding new users, the present invention preferably enables a user to add or select an expert witness for a respective case.
An expert witnesses may also be assigned a control number that must be used when logging in to review requests for an individual case. This is an additional security feature provided to diminish the possibility of sharing a user name and password with an outside party who would then have access to all the cases to which the expert witness has been granted access.
As shown in
As noted above, an important feature of the present invention relates to security and access to the information provided by the present invention. When a new third party administrator 304, for example, solicits and contracts with proprietor 302, proprietor 302 ensures that only authorized users and respective parties can access data and information described herein. One of the security checks provided by the present invention relates to checking each user's IP address. As known to those skilled in the art, the user IP is a unique number that is assigned by the user's internet service provider. Proprietor 302 has the option to limit a user's access to the internet web site provided by information processor 2 from computers that are located on-site at the third party administrator's 304 office. Information processor 2 preferably captures the user's IP address, and then compares it to a stored value in database 8. If there is a match with the IP address, then the user is allowed access.
In a preferred embodiment the present invention allows for up to six different on-site IP addresses, or three different IP address ranges. Most third party administrators use a single IP address, even if there are multiple computers on a network. Typically, there is one shared router and this router has the IP address that is stored in database 8. Alternatively, a third party administrator may have a connection to the internet that uses dynamic IP addresses, or a company may have multiple sites or use multiple routers. The present invention is preferably designed to handle such cases. For example, in case a single router is shared on a network, the router's outside IP address is stored in database 8. If multiple routers use the same subnet, then the starting IP address and ending IP address for client computing devices is preferably stored in database 8. Preferably, the present invention supports up to three different subnet pairs. In case of multiple routers on different subnets or different locations, individual IP addresses (e.g., up to six) are preferably stored in database 8. Further, in case a dynamic IP connection is used, then a starting IP address and ending IP address, representing a range of IP addresses is preferably stored.
Other security options that are preferably configurable by proprietor 302 include setting a default time-out value, and defining security level privileges. Other features, such as described above with reference to
Other security features known in the art are envisioned herein. For example, the present invention preferably provides secured communication sessions with users that employ one or more encryption protocols.
In addition to maintaining security, the present invention preferably includes data utilities, such as to transform data from one format to another. Preferably, the present invention utilizes file transfer protocol (“FTP”) and various data extraction routines in order to efficiently transmit and store data. Data archival mechanisms are further employed in order to efficiently store data, for example, during and after a law suit.
Moreover, proprietor 302 preferably trains third party administrators 304 or other users to ensure accurate and fluent use of the present invention. By properly training various personnel, proprietor 302 can rely on the security and usefulness of the sensitive information that is transmitted and received by various parties.
Thus, as described herein, the present invention comprises a centrally managed system that processes, formats and transmits requests for information, including documents and records related to medical care provided to a patient. The invention ensures properly formatted requests in accordance with various HIPAA or other requirements. Furthermore, the present invention assures a process of regular follow-up to such requests to ensure that electronic information is received. In case of a denial, reasons for the denial are quickly pursued and, when possible, remedied. Parties requesting the documents, such as law firms representing defendants, who are authorized to access such materials are provided the materials in a timely and cost effective manner. Thus, the present invention dramatically improves upon prior art methods of requesting and providing electronic information.
The present invention is now further described by way of an example.
A physician is served a summons in civil litigation. The physician is being sued for malpractice related to medical care that was provided to a plaintiff four years earlier, however the plaintiff's symptoms have only recently appeared. The physician treated the patient at a hospital, and, following treatment, referred the patient to a physical therapist for follow up therapy. The physician has malpractice insurance with a well-known provider, and contacts his provider immediately upon being served. The physician also contacts his personal attorney.
The insurance provider is a contracting member with proprietor 302 of the present invention. An authorized user of the insurance provider logs into information processor 2 and selects create new case 408. The user submits information regarding case law firm data 502, patient data 504, and the plaintiff 506, and saves the record. Thereafter, the user selects enter new request 411 and requests all medical records maintained at the hospital relating to the patient from one year prior the treatment to the present. The user enters a request for medical records maintained by the physical therapist. The physical therapist relocated his office three times over the past four years. Using the annotated and notes feature of the present invention, the user is informed of each respective relocation, typically during a later time during the process, and has the correct demographic information for processing the request. Thereafter, the user logs out of information processor 2.
Using the automated functions of the present invention, all of the requests submitted by the user are properly formatted in accordance with HIPAA, and the requests are transmitted to the hospital and the physical therapist. The hospital and the physical therapist receive the requests, and proceed to retrieve the relevant documents. The documents are sent via courier to the proprietor of the present invention, and are scanned and converted to ADOBE PDF files. The user of the present invention receives an e-mail message indicating that the documents are available. The user logs into information processor 2, selects Recently Completed Requests 402, and navigates to the electronic documents.
From the time that the request for the documents was made, the physician's attorney hired an expert witness who asked to review the medical records. Another authorized user of the present invention, an administrator at the attorney's law firm, selects the add/edit/users 410 and selects the expert witness to have access to the medical records via information processor 2. The administrative user selects a termination date, in which the expert witness will no longer have access to information processor 2. Thereafter, the expert witness logs into the system, and reviews the medical records. The expert witness determines by the medical records that the physician did not cause the plaintiff's injury. Accordingly, at trial, the expert testifies and the physician is held to be not liable.
Thus, as described with reference to the above example, the present invention enables parties to have access to electronic materials quickly and conveniently. The present invention provided a substantial cost savings resulting from the timely and secure transmission of sensitive information.
Although many of the examples and descriptions used herein refer to a single medical lawsuit and a single defendant, the invention is not so limited. For example, the present invention supports complex arrangements regarding, for example, a plurality of defendants, a plurality of patients and a plurality of lawsuits. For example, a single third party administrator may require documents for a plurality of pending lawsuits for respective defendants. Each defendant may have a plurality of law firms working on a respective case. Furthermore, each respective plaintiffs in a plurality of lawsuits may have a plurality of healthcare providers 316. In accordance with the security standards implemented by the present invention, for example, as described above, information is properly channeled to correct parties. Thus, extremely complex arrangements of parties, including plaintiffs, defendants, healthcare providers, law firms, expert witnesses, or the like all interact with proprietor 302 in an organized and efficient way.
Other uses and products provided by the present invention will be apparent to those skilled in the art. Although the present invention has been described in relation to particular embodiments thereof, many other variations and modifications and other uses will become apparent to those skilled in the art. It is preferred, therefore, that the present invention not be limited by the specific disclosure herein.
