Patent Application
20170235909
A patient visits a doctor for a medical condition, and the doctor evaluates the patient and makes a diagnosis. The doctor writes up a care plan that includes a medication plan, an exercise plan, a healthy eating plan, and a biometric testing plan. When the patient returns home, he neglects to review his care plan, and he forgets all the items he is supposed to be doing. When he returns to the doctor, he is embarrassed, and does not accurately report how well he has been adhering to the care plan.
Introduced here is technology related to a telemonitoring system, which is a system for remotely monitoring patients who are not at a same location as a health care provider. A daughter takes her elderly father to visit a doctor for a medical condition, and the doctor evaluates the patient (i.e., the father), and makes a diagnosis that he has diabetes. The doctor writes up a care plan that includes a medication plan, an exercise plan, a nutrition plan, an education plan, a medical review plan, and a biometric testing plan, and the care plan is input into a database of a telemonitoring system. When the patient returns home, he neglects to review his care plan, and he forgets all the items he is supposed to be doing. However, the telemonitoring system helps the patient to adhere to his care plan.
The telemonitoring system analyzes the patient's care plan, and determines that the medication plan indicates that it is time for the patent to take a certain medication. The telemonitoring system sends a message to the patient's smartphone, which triggers a care plan application running on the smartphone to display an alert that it is time to take a particular medication. The patient takes his medication and taps an icon on his phone to indicate that he took the medication. At a later time, the patient receives an alert that it is time for him to go for a walk as part of his exercise plan. The patient taps an icon that indicates that he wants to be reminded later. Thirty minutes later, the patient once again receives an alert that it is time for him to go for a walk. The patient goes for the walk, and taps an icon that indicates that he completed his exercise.
At meal time, the care plan application displays a message notifying the patient that he should adhere to the nutrition plan prescribed by his physician or other medical staff. His smartphone displays a recommended meal, and the patient uses the application to swap some food items with other recommended food items. The application displays an alert to notify the patient to adhere to his biometric testing plan by taking a blood sugar reading prior to eating his meal, and the patient does so. The patient uses a glucose meter to take the reading, and the glucose meter wirelessly communicates the blood sugar reading to the care plan application running at the patient's smartphone. The patient eats his meal, and taps an icon on the smartphone to indicate that he consumed the food items recommended by the meal plan. He also notes via the care plan application that he ate some additional food items.
In the morning, the patient is not feeling well, and he ignores the alert to take his morning medication per his medication plan. After a certain period of time, the telemonitoring system, in response to not receiving an indication that the patient took his prescribed medication, sends an alert to a care plan application running at a smartphone of the patient's care giver, who in this example is his daughter. The daughter stops by her father's house on the way home from dropping off the kids at school. She gets her father's medication and brings it to him, and he takes it. The daughter taps on an icon on her smartphone to indicate that her father took his medication in compliance with his medication plan.
At a later time in the day, the care plan application notifies the patient that it is time to take his blood sugar reading and his blood pressure per his biometric testing plan. The patient uses a glucose meter to check his blood sugar, and the glucose meter wirelessly sends his glucose level reading to the care plan application running at his smartphone. He then uses a blood pressure monitor to check his blood pressure, and his blood pressure meter wirelessly sends his blood pressure reading to the application. The application sends the information to a server of the telemonitoring system, and the telemonitoring system determines that the glucose level reading is outside of a safe range, and, in response, the telemonitoring system sends an alert to his physical or other medical staff. A nurse at his doctor's office is notified via the alert, and she initiates a video call with the patient via a care plan application that runs on her smartphone. She notifies the patient that his glucose level is dangerously low, and she urges him to drink some sugary drink, such as orange juice. The patient does so. The nurse sets up an alert to notify the patient to take his blood sugar in ten minutes so she can verify that his blood sugar levels are recovering. Ten minutes later, the patient receives an alert to re-test his blood sugar, which he does. The telemonitoring system sends the blood sugar reading to his nurse, who verifies that his blood sugar readings are recovering.
The physician or other medical staff set up a doctor's appointment to review the patient's progress per the medical review plan, and sets up a diabetes education class per the education plan, which the medical staff conveniently schedules immediately after the doctor's appointment. The care plan application has a reminder that reminds the patient and his daughter of his doctor's appointment and the diabetes education class. The daughter, having been reminded of the appointments by the care plan application running at her smartphone, picks up her father and brings him to his doctor's appointment. When the patient meets with the doctor, the doctor uses his work computer to obtain from the telemonitoring system a compliance score, also sometimes referred to as an adherence score, that indicates the patient's compliance/adherence with the care plan, and how his health is responding to the care plan. The metric indicates that the patient is doing well overall. The doctor uses a care plan application running at his work computer to dig deeper into the telemonitoring data. The doctor reviews the patient's glucose and blood pressure readings, and sees room for improvement. He next reviews the patient's medication plan, which sees no reason to change. He reviews the patient's exercise and nutrition plans, and decides to change the care plan to add additional exercise to the exercise plan. After the doctor's appointment, the patient and his daughter both attend the diabetes education class.
The patient's son learns of his father's medical issue, and asks if he can help out. The father responds that he is having trouble meeting his exercise plan, and he asks his son if he can come by and go on walks with him. Via his care plan application, he grants his son permission to view his care plan. The son uses a care plan application running at this smartphone to determine when his father's next planned walk is, and he arranges his schedule so that he can meet his father at his house to go on a walk together.
The embodiments set forth herein represent the necessary information to enable those skilled in the art to practice the embodiments, and illustrate the best mode of practicing the embodiments. Upon reading the current description in light of the accompanying figures, those skilled in the art will understand the concepts of the disclosure and will recognize applications of these concepts that are not particularly addressed here. It should be understood that these concepts and applications fall within the scope of the disclosure and the accompanying claims.
The purpose of terminology used herein is only for describing embodiments and is not intended to limit the scope of the disclosure. Where context permits, words using the singular or plural form may also include the plural or singular form, respectively.
As used herein, unless specifically stated otherwise, terms such as “processing,” “computing,” “calculating,” “determining,” “displaying,” “generating,” or the like, refer to actions and processes of a computer or similar electronic computing device that manipulates and transforms data represented as physical (electronic) quantities within the computer's memory or registers into other data similarly represented as physical quantities within the computer's memory, registers, or other such storage medium, transmission, or display devices. As used herein, unless specifically stated otherwise, the term “or” encompasses all possible combinations, except where infeasible. For example, if it is stated that a database can include A or B, then, unless specifically stated otherwise or infeasible, the database can include A, or B, or A and B. As a second example, if it is stated that a database can include A, B, or C, then, unless specifically stated otherwise or infeasible, the database can include A, or B, or C, or A and B, or A and C, or B and C, or A and B and C.
As used herein, terms such as “connected,” “coupled,” or the like, refer to any connection or coupling, either direct or indirect, between two or more elements. The coupling or connection between the elements can be physical, logical, or a combination thereof. References in this description to “an embodiment,” “one embodiment,” or the like, mean that the particular feature, function, structure or characteristic being described is included in at least one embodiment of the present disclosure. Occurrences of such phrases in this specification do not necessarily all refer to the same embodiment. On the other hand, the embodiments referred to also are not necessarily mutually exclusive.
As used herein, terms such as “cause” and variations thereof refer to either direct causation or indirect causation. For example, a computer system can “cause” an action by sending a message to a second computer system that commands, requests, or prompts the second computer system to perform the action. Any number of intermediary devices may examine and/or relay the message during this process. In this regard, a device can “cause” an action even though it may not be known to the device whether the action will ultimately be executed.
Note that in this description, any references to sending or transmitting a message, signal, etc. to another device (recipient device) means that the message is sent with the intention that its information content ultimately be delivered to the recipient device; hence, such references do not mean that the message must be sent directly to the recipient device. That is, unless stated otherwise, there can be one or more intermediary entities that receive and forward the message/signal, either “as is” or in modified form, prior to its delivery to the recipient device. This clarification also applies to any references herein to receiving a message/signal from another device; i.e., direct point-to-point communication is not required unless stated otherwise herein.
Advantages, components and features of the disclosed technology will be set forth in the description and detailed in the following figures. Some challenges overcome by the current disclosure include efficiently integrating patient clinical data generated by medical devices, data generated during patient engagement with their care providers using a telemonitoring system to collect biometric data under the supervision of a health care provider (HCP), and obtaining payments from health insurance plans (HIPs) for rendered telemonitoring services.
Some embodiments of the technology presented here allow for efficient care coordination methods, patient engagement policies, vital sign analytics, care plan analytics, and medical billing. The health data flow components of the current disclosure are intended to be and generally are in compliance with health regulations and policies.
Some embodiments of the present technology involve a telemonitoring system, which can integrate all the services and functions required to provide the telemonitoring service covered by the health data flow. A telemonitoring system can include some or all of the components described in the current disclosure.
Some embodiments of a telemonitoring system include web application software that supports a user interface for administrating the functions and services of the telemonitoring system. The user interface can be designed to address issues of health or technological literacy.
Some embodiments of a telemonitoring system include an application running at a mobile device that wirelessly communicates with medical devices, such as to collect biometric data obtained by the medical devices. The application running at the mobile device can be a medical care plan application, among others, and the telemonitoring system can include the mobile device and the application running at the mobile device. Some embodiments of a telemonitoring system include hardware components that communicate via a corporate network, and does not include hardware components outside of the corporate network. For example, a telemonitoring system may be comprised of one or more servers and associated storage, where the servers and storage are owned or managed by a single entity and that communicate with each other via a corporate network of the entity. The mobile device can communicate via any of various wireless technologies, such as via cellular technologies (e.g., GPRS, 3G, 4G), WiFi (IEEE 802.11), Bluetooth, Bluetooth Low Energy (BLE), zigbee, Zwave, GPRS, Near Field Communications (NFC), ANT, ANT+, etc. The mobile device can use an abstract communication driver that supports multiple protocols or any other wireless protocols needed to process health or other data.
A telemonitoring system can be coupled with online Electronic Health Record (HER) systems and Electronic Data Interchange (EDI) platforms that provide communication with health insurance providers and pharmacy systems. The telemonitoring system can also be connected with notification suppliers system for sending messages, alerts, audio or video conferencing communication, sending reminders to improve care treatments or reduce communication problems between patients and medical staff, etc.
A telemonitoring system can include handling patient fragmented information through the use of standard protocols and Application Programming Interfaces (APIs) to integrate the following: synchronization of biometric readings between a mobile application and wireless medical devices, clinical data exchange process with any EHR system, billing claims with health insurance systems and e-prescriptions with the pharmacies, etc.
A telemonitoring system can enable a health care provider to enroll patients to provide them with telemonitoring services, to enroll medical staff members to support telemonitoring services, to enroll care givers or other care team members to assist with the a patient's treatment at home or outside of a hospital/clinic, etc. A telemonitoring system can assign a unique identifier to enable consolidation of patient clinical and biometric data with the patient's records. To help ensure secure communications between various components of a telemonitoring system, examples of components including a mobile application, web site, web application, server, etc., the components can obtain a security token to enable secure communication between components of the telemonitoring system. For example, a mobile application can securely obtain biometric data from a wireless medical device, debug the data, and synchronize the data with other components of a telemonitoring system.
In some embodiments, medical staff establish a care plan and biometric parameters for a patient and performs care plan analytics based on data obtained by a telemonitoring system, and the telemonitoring system evaluates compliance with the care plan. The telemonitoring system can analyze the data, and, based on biometric parameters, can generate alerts, reminders, instigate a video or audio conference between a patient and a member of the medical staff, can provide analytics for the medical staff and the patient, etc. The telemonitoring system can further provide an efficient billing process, which includes providing support documents for financial billing, and can generate insurance provider claims for telemonitoring services rendered. A telemonitoring system can further validate patient clinical data or biometric readings, and can analyze patient clinical data or biometric readings in light of the patient's biometric parameters or care plan.
There are many manufacturers of medical devices with wireless communication approved by FDA (Federal Drug Administration of USA), and many of the medical devices use Bluetooth communication to communicate with a medical device or other electronic device. As Bluetooth has become a global standard, however many affiliates have different communication protocols and different implementations of a same standard. Such differences make the integration of various medical devices with a software application a complex job. Some recent technologies, such as smart Bluetooth (e.g., Bluetooth Low Energy), promise better standards, but the implementation still often differs between devices/manufacturers.
Mobile applications that can obtain data from medical devices and that can utilize that data under medical supervision to provide quality medical supervision of a patient are lacking. A need exists for mobile medical applications that include medical supervision, and that provide proper feedback to assist a patient with his or her care plan. Such a mobile medical application should have Federal Drug Administration (FDA) compliance. Because of a lack of proper standardization in the medical device market, it is difficult to construct a mobile medical application that can communicate with the various medical devices from the various medical device manufacturers. Further, there are differences in accuracy and user interface that may affect the usability of a particular device.
A need exists for a telemonitoring system that enables a health care provider to establish and monitor a care plan for a patient. A telemonitoring system that is patient centric, such as a telemonitoring system that only lets a patient establish and change a care plan, is insufficient to provide quality telemonitoring services. When a patient rather than medical staff establishes and monitors a care plan, it lowers the likelihood of achieving desired biometric goals, which increases risk of an emergency room visit for a chronic condition.
Medical providers in United States must adhere to the requirements of the Health Insurance Portability and Accountability Act of 1996 (HIPAA), which places certain requirements on “Protected Health Information.” Under the HIPAA rules, data must be protected, such as by use of encryption, a secure firewall, real time analytics, etc. to prevent unauthorized access to protected information, such as patient records. A health care provider must further establish policies and procedures to ensure that private patient data is kept confidential. In recent years, attacks from hackers to illegally obtain PHI have increased and the cost associated with those security breaches has increased exponentially.
In the healthcare ecosystem, insurance providers, including the Center for Medicaid Services (CMS), are important participants. Health insurance providers have reimbursement policies for provision of telemonitoring services, however, those policies are often not clear and telemonitoring service coverage differs between health insurance providers.
Reimbursement models for physicians that provide telemonitoring services are changing and depend highly on regulations and policies dictated by health insurance providers to the network of health care providers. Administrative issues, such as determining which services are reimbursed by insurance providers, who is authorized to provide the care services, what kind of licenses are needed to provide a particular telehealth service, etc., are a significant problem for physicians providing telehealth services via a telemonitoring system. (State Coverage for Telehealth Services, (Updated January 2014) National Conference of State Legislatures. http://www.ncsl.org/research/health/state-coverage-for-telehealth-Services.aspx Accessed Jun. 1, 2015, an archive copy of which is available at http://web.archive.org/web/20151127192025/http://www.ncsl.org/research/health/state-coverage-for-telehealth-services.aspx.)
Other problems associated with patient treatment administered via a telemonitoring system include care coordination problems, such as patient care plan administration and analytics when the patient information is fragmented among different electronic health record systems. Many times patients do not have access to their care plan or health data, so they find it difficult to understand their treatment, current condition, current assessment, the goals established by the Medical Doctor, etc. When all this information is fragmented and not available in an integrated fashion, it creates inefficiencies and difficulties for a physician or other medical staff treating a patient, thereby reducing the probability that the patient has a successful treatment.
Care coordination problems are also related to patient compliance to a medical care plan. When there are poor communication channels between medical staff, the patient, caregivers, or other care team members, additional care coordination problems arise. Such poor communications result in, among others, lack of medical knowledge and information of patients suffering chronic conditions.
Reference to various health data flows practiced by a telemonitoring system will now be made in following embodiments, workflows, data flows and examples, some of which are illustrated in the associated figures. A number of specific details are set forth in order to provide a thorough understanding of the disclosed technology. However, the described health data flow may be practiced without these specific details. Some data flows, methods, procedures, networks or algorithms have been described in general terms so as not unnecessarily confuse aspects of the embodiments.
The disclosed technology describes some embodiments of an “optimized data flow” that integrates wireless medical devices, health care providers, medical staff, patients suffering chronic conditions including metabolic syndrome, care givers, Electronic Data Interchange (EDI) platforms for data interchange with Insurance providers and pharmacies, Electronic Health Record (EHR) systems, third party notification systems with a web/mobile application for providing telemonitoring of biometrics and collecting the required health data of the patient needed to provide a custom care plan, audio and video communication for constant interaction between patient and health care providers, and efficient billing process for the health care provider doing the telemonitoring.
Some embodiments of the disclosed technology involve a telemonitoring system that integrates all the services and functions required to provide the telemonitoring service covered by the health data flow. The patient can apply to be enrolled into a telemonitoring service under the supervision of the health care provider, receive a unique patient identifier, and the telemonitoring system can synchronize the patient clinical information.
Using standard protocols and APIs, the telemonitoring system can integrate efficiently with EHR systems, insurance health plan systems, and pharmacies, to collect patient health data. A telemonitoring system can provide an API for synchronizing biometric data with mobile applications. Some wireless medical devices can synchronize biometric data acquired by the medical devices with a telemonitoring system, such as by communicating with a mobile application running at a patient's mobile device. In some embodiments, the patient's mobile device is part of the telemonitoring system, and in other embodiments, the patient's mobile device sends the biometric data to the telemonitoring system for synchronization.
In some embodiments, medical staff perform all the functions associated with establishing a patient care plan, such as setting patient biometric parameters, and performing analytics of data acquired by the telemonitoring system.
Interaction between the billing health care provider and the health insurance health plan is bidirectional, and can start when a business agreement to provide medical services is established between the parties. Interaction between the health care provider and the medical staff and care givers is bidirectional, as the staff and care givers use the telemonitoring system to establish or monitor a care plan for a patient (see
At block 104, after a patient is enrolled in the telemonitoring system (enrollment 108) and the minimum patient health data is collected (patient health data 110), the telemonitoring system allows setting up a patient care plan 104 (see
At block 106, based on the collection and analysis of biometrics (see
Telemonitoring Server 201 is coupled with EDI Platforms 205 via network environment 210, which provides standards for exchanging data via any of various electronic means. EDI platforms 205 can be used to enable interchange health data including medical records 111 of
Care plan application 209 can access data of telemonitoring system 200, and can set up parameters in wireless medical devices 208. The telemonitoring server 201 can include an online web application to administer the health data flow, process the biometric data, and perform other functions, such as generating care plan related alerts, reminders, notifications, etc. In addition, telemonitoring system 200 is coupled with Notification Supplier System 211, which is a system that supports communication by any of various means, such as by sending email or text (SMS) messages between users, by establishing audio or video communications between user devices, by sending short message (SMS) or push notification to care plan application 209. For example, when a biometric reading is out of range based on the parameters for the patient stored at the telemonitoring system, telemonitoring system 200 notifies the patient and medical staff via notification supplier system 211.
In the example of
Patient care plan 306 integrates the various components of the patient's care plan, which can include, e.g., assessments, goals, prescriptions, treatment details, exercise plans, nutrition plans, biometric testing plans, etc. Patient care plan 306 can be customized in one or more templates, such as in templates for managing any of various chronic diseases, chronic pain conditions, etc. Patient's medical staff component 307 enables assignment of medical staff members to the patient's care and care plan activities. For example, a doctor can be assigned as a primary care giver, a nurse can be assigned as a medical staff care giver, a patient's relative can be assigned as a family care giver, etc., and the various care givers can be given various levels of access to the patient's health data, and can be assigned various tasks related to the patient's care. Biometric parameters component 309 manages communications with wireless medical devices for obtaining biometric data in support of the care plan. Metric data and parameter synchronization 310 includes an API service with JSON format or any other standard or custom format that serves the patient health data, biometrics parameters, and biometrics readings for keeping the information synchronized between various components of a telemonitoring system, such as between a care plan application and a wireless medical device, or a care plan application and a telemonitoring server, etc. Once biometric data and parameters are established, alerts and notification component 311 is able to process and analyze biometric data to determine, based on the patent care plan, if any alert or notification should be generated.
Clinical Review and Health Analytics component 312 includes techniques and processes to process health data in order to generate data that can be used to modify the care plan and biometric parameters for a patient, to improve the patient's care plan and associated health care. Billing of telemonitoring services component 313 includes techniques and processes for generating an insurance claim to send to the patient's insurance health plan in order to obtain payment for medical services provided to the patient in relation with the telemonitoring services. Audio and video conferencing component 314 includes techniques and processes for providing communication capabilities among the various users of the telemonitoring system, such as the health care provider, the patient, the medical staff and care givers, the insurance provider, etc. Secure Social Media Interaction component 315 includes techniques and processes for generating, processing, and sending real-time secure messages between users, and for supporting obtaining usage statistics. Users can include medical staff, care providers, patients, insurance company employees, pharmacy company employees, among others.
When a user decides to decline the terms and conditions, the telemonitoring system ends the process and redirects to the login page (409, 410). When a user accepts the terms and conditions (406), the telemonitoring system verifies that the user has configured security questions (411). If not, the telemonitoring system causes an “adding security questions” page to be displayed at the user's computing device (412). When the telemonitoring system is able to validate that the user's computer or mobile device is secure (413, 414, 420), the telemonitoring system proceeds to identify the user's role and permission (421), otherwise, the telemonitoring system executes security question validation (415, 416). Once the user is validated, the user can select the option “save this device as secure” (417), in which case the telemonitoring system identifies the computing device as secure and saves this information (417, 418, 419). When the telemonitoring system identifies the user's permissions and roles (421), the telemonitoring system redirects to an appropriate landing page (422), such as the user's dashboard in a Web Application or Mobile Application.
At block 507, the telemonitoring system determines whether the medical doctor or the care provider is providing services under more than one innovative CMS program, and determines what restrictions, if any, may result from participation in the more than one innovative CMS program. Some restrictions are set by CMS. If the provider is already participating in a CMS innovative Program, the telemonitoring system determines if the provider can apply to participate in an additional CMS innovative program, taking into account the programs' restrictions. If the provider is able to participate in the additional CMS innovative program(s), at block 508, the telemonitoring system provides the “Practice Enrollment” documents needed (e.g., Business Association Agreement and services Agreement), to ensure that patient's Protected Health Information is safe according to CMS laws and HIPAA compliance.
To meet the needs of the provider, the telemonitoring system assesses the practice (509), and generates/provides/obtains corresponding documentation. Once the practice is assessed, at block 510, the telemonitoring system proceeds to collect information required to the provide service(s). When a provider decides that the telemonitoring system will provide billing support (block 516), the telemonitoring system generates an Electronic Data Interchange Enrollment form (block 511), which may include claims and claims attachments, remittances, eligibility/benefits, claim status or any other electronic information that the provider may need to provide to CMS to become an authorized participant. At block 511, the telemonitoring system also generates/provides/obtains an ACH enrollment form, which is used for payment processing via the Automated Clearing House (ACH) payment system. At block 512, setup or installation of equipment or software at the provider's location is done under the provider's supervision and approval. Once the on-site setup is completed, the telemonitoring system verifies the provider's credentials (513), and creates the provider at the telemonitoring system (514).
At block 602, a person or the telemonitoring system explains services provided by the telemonitoring system to a patient. For example, the telemonitoring system can cause a video to be displayed, at a computing device of a patient, that helps to explain the services provided by the telemonitoring system, and can display a service agreement, which the patient can read and electronically sign. Alternately, a health care professional, such as a physician, nurse, medical assistance, etc. can explain the services provided by the telemarketing system to the patient (602). At block 603, when the patient agrees to accept services of the telemonitoring system, the telemonitoring system will implement a unique patient's identification system (604) to assign a registry within the telemonitoring service. In case the patient is already enrolled (605), a warning message will be sent to a medical staff person and the telemonitoring system will apply a conflict solution process (606) to avoid creating a duplicate patient in the telemonitoring system's data base. If the patient does not exist, the telemonitoring system will cause a user interface to be displayed, such as at the medical staff member's computing device, where the medical staff member or the patient can input various enrollment or medical related information regarding the patient (607).
At block 608, the telemonitoring system determines whether the patient is covered by any public or private insurance provider. If so, the telemonitoring system saves information related to the insurance provider (609) and determines whether the insurance provider covers telemonitoring services (612). When a patient does not have the economic ability to pay for the telemonitoring service (610), the patient is not eligible (611). When blocks 610 and 612 evaluate positively, at block 614, the telemonitoring system proceeds to register the health provider information (614) and assign an account to the patient and establish the patient's profile at the telemonitoring system (615). An advantage of the telemonitoring system of this example is that it is oriented for multilingual users, including Spanish-speaking demographics like Hispanic/Latino communities. Accordingly, the telemonitoring system can be set in Spanish/English according to the user's language proficiency (616-618).
At block 619, the telemonitoring system establishes the time zone where the end user will be using the service, such as by receiving input from a patient via a computing device that indicates a time zone. At block 620, the telemonitoring system is customized according to the patient's sexual gender preferences, and at block 621, the telemonitoring system does further customization based on the patient's gender. At block 622, the telemonitoring system provides information regarding the benefits of telemonitoring, and at block 623, the user provides any needed legal consents.
In the example of
Due to the nature of the interoperability engines in the health care industry, the telemonitoring system includes techniques and processes to ensure a successfully communication process between various systems. At block 704, the telemonitoring system collects patient identification information needed by the EHR system to match the patient records in the various systems. The telemonitoring system further identifies, based on protocols supported, what specific information can be synchronized, such as: patient demographics, allergies, vital signs, or other health information as identified by the telemonitoring system (705). When the telemonitoring system confirms which information can be synchronized, the communication is done using any of various techniques, such as via a file transfer server (706), an API service (707), etc. When a connection is not successful, the telemonitoring system applies a retry process (721, 723) to help ensure a successfully connection with the EHR system (708, 709). When communication is via file transfer, the telemonitoring system sends a file that is compliant with the receiving system, where the file includes patient matching information and specific information to synchronize with the EHR system (710).
At block 711, the telemonitoring system receives a response file generated by the EHR system. When communication is via an API service, such as a restful API service, the telemonitoring system sends an API request that includes patient matching information and specific information to synchronize with the EHR system (712). At block 713, analysis of the EHR system data is according to one or more of the following standards: HL7, DAM, CDA, CMET, D-MIM, or is via a custom API of the EHR system. At block 714, the telemonitoring system validates the data returned by the EHR system, and determines if there is any issue or conflict with the patient information (725). For data that doesn't meet requirements, the telemonitoring system may apply an automatic conflict/issue resolution process (715), or may allow a user to check and solve a conflict/issue manually (715). Once the response meets the requirements, the patient's records in the telemonitoring system are updated (716) and a notification about the operation result is sent either to the “EHR system” and the user of the telemonitoring system (717). Finally the connection between the interoperable systems is closed and all the changes saved (718).
At block 801, the medical staff member determines if the patient will be granted an appointment. The medical staff member, sometimes with the assistance of the telemonitoring system, determines whether the patient meets the requirements to be granted a medical appointment. The medical staff member searches for physician profiles to determine an appropriate physician to see the patient, such as via a computing device that is part of or is in communication with the telemonitoring system, and the medical staff member selects the physician for the appointment (802). The medical staff member checks the physician's availability, and selects a date and time for the appointment. The medical staff member, with assistance from the telemonitoring system, assigns the appointment and provides appointment information (803).
The appointment information can include, for example, the reason for the consultation, referring providers, time/date, or the associated Telemonitoring event, such as: a notification, an alert, triage, task, or reminders (804). The telemonitoring system notifies the physician with the status of the appointment, such as whether it is a first time or follow up appointment (805). When the appointment is a first time appointment, the medical staff enrolls the patient in the telemonitoring service, and sets the appointment (806). When the appointment is a follow up appointment, the medical staff sets the appointment (806). At various times, the telemonitoring system sends a notification to remind the patient of the upcoming appointment (807). A patient may modify an appointment (808), in which case the telemonitoring system determines whether the appointment can be changed (809), and whether any penalty may apply (810). The patient may decide to cancel the appointment (812), in which case the telemonitoring system determines whether the appointment can be canceled (813), and whether any penalties apply (810).
At block 905, the medical provider creates a SOAP (subjective, objective, assessment, and plan) form (905), such as by inputting the SOAP form by use of a computing device that is in communication with the telemonitoring system.
At block 908, the medical provider creates or updates the patient care plan, which is central to the telemonitoring system. The care plan can include, for example, a nutrition plan, an exercise plan, a medication plan, a biometric reading plan, etc.
The treatment plan is used to generate treatment orders (909), which can consist of physical activities, nutrition, life style, actions, task information, etc. that will assist in the management of the patient's health condition. In addition to orders or recommendations to follow, the telemonitoring system includes a module for tracking or managing medications, where prescribed medications are stored in a data base at the telemonitoring system that a patient or medical staff can check for currently prescribed medicines. Consequently, information that the telemonitoring system can generate, based on the care plan or orders, includes Dx images, patient education, and support (911). Such information can help physicians understand the patient's behaviors and how those behaviors affect his chronic disease.
After the care plan and orders are input, confirmed, and saved at the data base, the telemonitoring system or a medical provider can determine if a referral is needed (912), and can refer the patient to a specialist (926). The telemonitoring system can generate a referral form that can be sent directly to the specialist if needed. Upon completion of all the actions of the patient's appointment are completed, the telemonitoring system creates progress notes (913) which include data associated with the chronic condition of the patient, and which include feedback from the specialist referral (925). The telemonitoring system, such as via interaction with the medical provider, determines whether to update the patient's progress notes (914). If the notes are to be updated, the telemonitoring system can proceed with the update. After the care plan is created, the telemonitoring system notifies the patient of upcoming or completed events/tasks/etc., such as when the patient is due to take a medication, to take a biometric reading, to do a physical activity, etc. The notification can be via any of various mechanisms, such as via a text message to a mobile device of the patient, via an email to the patient, etc. The notification can also be via a checklist or any other appropriate mechanism. For example,
Patient care often involves more than just a medical staff member or any single person, so the telemonitoring system supports the concept of a care team, which enables patient care to be spread amongst a set of people. At block 1005, the telemonitoring system allows identification of other people who may assist with patient care, such as a physician's assistant, a physical therapist, a nurse, a care giver, a relative or friend of the patent, etc. A medical staff member, such as a physician or a nurse, or some other person, such as the patient, inputs identification of assistants by use of a computing device that communicates with the telemonitoring system, and also inputs the person's role (1006). At block 1007, a medical staff member or the telemonitoring system assigns tasks to any member of the care team, such as by inputting the tasks via the computing device.
At block 1011, the telemonitoring system determines whether the care team wants to receive patient notifications. When notifications are the be sent, at block 1008, in some cases, a medical staff member sets up a same notification scheme for all members of the care team. In others, the medical staff member sets up custom notifications for each member of the care team. In yet others, each member of the care team sets up his or her own custom notifications. In some cases, the notification scheme(s) is automatically created by the telemonitoring system. At block 1009, the telemonitoring system sets up the patient's notification preferences, either automatically or based on input from the patient provided by a computing device of the patient.
At block 1106, the patient chooses a caregiver, such as by inputting his choice at his computing device, which communicates the choice to the telemonitoring system, or by communicating with a medical staff member or other person, who inputs the choice via a computing device that communicates the choice with the telemonitoring system. To facilitate the choice, the telemonitoring system provides to the patient a caregiver list, which the telemonitoring system received from the HHA, and the patient has the availability to filter the list according to the patient's preferences. At block 1107, the telemonitoring system creates a profile for the caregiver (e.g., e-mail, password and security questions to access to the telemonitoring system, etc.), such as based on information input by a medical staff member working for the PCP. At block 1108, the telemonitoring system assigns the care giver to the patient, based on the patient choice of block 1106.
At block 1109, the telemonitoring system assigns tasks to the caregiver, such as based on guidelines accessible to the telemonitoring system, or based on input from a medical staff member, etc. The tasks can include, e.g., assisting the patient with meal preparation and tracking food consumed by the patent, taking daily biometric readings, tracking prescription drugs, checking safety of the patient at home, teaching the patient on how follow recommendations and guidelines assigned by the physician, etc. An advantage of the telemonitoring system is that it allows physicians or other medical staff members or other care givers to track a patient's care at home (e.g., biometric readings, diet, daily habits, prescription drugs) through real-time communication between patient's caregiver and patient. At block 1110, the telemonitoring system provides electronic communication means between the parties, such as real-time video or audio, electronic messaging, etc.
At block 1204, the telemonitoring system determines whether default settings are assigned to enable automatically setting biometric targets. When the default settings are assigned, at block 1222, the telemonitoring system executes an algorithm that assigns default values for the patient's biometric settings, such as an algorithm that takes into account the patient's diagnosis, medical care plan, guidelines for the diagnosis, etc. When the default settings of block 1204 are not assigned, the telemonitoring system at block 1205 accepts manual input of patient target values for biometric readings, such as input of a medical staff member via a computing device that communicates with the telemonitoring system.
When the biometric values are input manually, the telemonitoring system divides settings for the biometric readings into four categories, target/alert tolerances, biometric reading schedule, daily biometric reading times, and biometric devices. The first category is biometric tolerances, in which a physician or other qualified medical staff assigns or reviews biometric tolerance values according to the patient's condition, where the tolerances can be set in automatically or manually, as can notifications based on those tolerances. The second category is the biometric reading schedule (1209) where a physician or other qualified medical staff can assign the times in which biometric readings of a patient are to be taken, such as blood pressure, weight, glucose, temperature, oxygen level readings or any condition that can be monitored with a wireless medical device. The third category called daily times (1212) in which a physician or other qualified medical staff can save and configure the patient's daily time data (1214). The last category is called medical devices (1215) in which a physician or other qualified medical staff can assign one or more medical devices for the patient's treatment.
At block 1206, the telemonitoring system establishes a frequency at which biometric readings will be taken. At block 1207, the telemonitoring system determines whether a medical staff member wants to assign default values for biometric reading tolerances. When the medical staff member wants to assign the default values for the tolerances, at block 1226, the medical staff member inputs the tolerances for each biometric reading. When the medical staff member does not want to assign the default values for the tolerances, at block 1227, the telemonitoring system sets the default biometric values. At block 1208, the medical staff member determines if he wants to assign default values for alert settings. When he does, at block 1230 he inputs the default values for alert settings. When he does not, at block 1228, the telemonitoring system sets the alert settings. At block 1209, which can be the same as block 1206, the telemonitoring system establishes a reading schedule. At block 1210, the medical staff member determines if he wants to assign default time(s) for the various biometric readings. When he does, at block 1229, he sets the reading schedule manually. When he does not, at block 1231, the telemonitoring system sets the reading schedule automatically. At block 1211, the telemonitoring system sets the schedule for biometric readings.
At block 1212, the medical staff member or the telemonitoring system sets the daily times. At block 1213, the medical staff member determines if he wants to assign default daily times. When he does, at block 1232, he sets the default daily times. When he does not, at block 1233, the telemonitoring system sets the default daily times. At block 1214, daily times, such as times for meals, when the patient wakes up, when the patient goes to sleep, etc., are established. At block 1215, a medical staff member assigns one or more medical devices to the patient, such as a wireless blood pressure meter, a wireless glucose meter, a wireless thermometer, a wireless scale, etc. When a medical device to be assigned does not exist in the database of the telemonitoring system, an entry is created (1217) which can include the model of the device, the manufacturer, the custom name of the medical device, its serial number, etc. At block 1218, the medical device has been added to the database. The medical device is configured (1219), assigned to the patient (1220), and the assignment is completed (1224). In some embodiments, the medical device is synchronized via the Internet of things (IoT).
The mobile application determines whether it is waiting for data from a medical device (1306). When it is (1307), the mobile application periodically checks whether any data has been received (1308), and determines if the data is valid. When valid data is received (1309), the mobile application checks if the medical device was previously assigned (1310). If the mobile application cannot find the medical device in a data base of medical devices that are assigned, the mobile application resumes at block 1302. When the mobile application matches the medical device with a previously assigned medical device from the database, before storing any data, the mobile application verifies that the data is not a duplicate of data already in the database (1311, 1324). When data already exists, the duplicate data is ignored. The mobile device verifies whether the medical device is still connected (1313), and, if it is, the process resumes at block 1307. Otherwise, the process is ended. When the data is not duplicate data (1324), the data is stored in the database (1312), and the process continues at block 1313. If communication is in Master Mode, the master synchronization process mode ends.
When it is not waiting for data, the mobile sends commands to the medical device (1314), such as to determine if the medical device has particular needed data (1315). When the mobile device has the needed data (1322), the mobile application requests this data (1316) and verifies that the medical device is assigned (1317). When the medical device matches with an assigned medical device in the database (1320), the mobile application validates that the data is not duplicate (1318, 1321), and, when non-duplicate data is verified, the mobile application saves the data in the database (1319). The database can be local to the mobile device, or can be remote, such as at a telemonitoring system or at cloud storage.
At block 1613, when data is queued to be stored, a background task is initiated to store the data (1613). This approach optimizes computational resources, since the mobile application does not need to wait for the actual store to occur. Once the task is scheduled (1613), the telemonitoring system sends a message to the mobile application indicating that the data was successfully saved (1614), and the connection is closed (1615). The mobile application continues in the background. As previously mentioned, the storing or other processing of data is added as a task in a queue (1613), and the actual work of storing or doing other processing of the data is done as a background task (1625), which frees up resources of both the mobile device and the telemonitoring system. When the background task starts, the data is verified to not be a duplicate (1616). When it is a duplicate, the task stops and the results are saved (1622). Then the data is not a duplicate, the telemonitoring system processes the data (1617), such as to determine if any alerts or notifications need to be sent, or to determine if any future events needs to be scheduled. At block 1618, the telemonitoring system saves the data (1618), and any alerts/notifications/future events are added to a queue for future processing (1619). Upon successful processing of the data and any associated events (1617, 1619), the telemonitoring system sends a notification to the patient or the care team (1620). If an error is detected, the telemonitoring system or the mobile application raise an exception error and ends the process with an error, and stores the result of the task in a log file (1622).
When the user is fully authorized (1707), the telemonitoring system proceeds to provide the information requested (1709) and to prepare data for transmission (1710). When the data requested is considered sensitive (1711), the telemonitoring system encrypts the data prior to sending (1712). The telemonitoring system determines if the data was successfully prepared for transmission (1713), and, if it was, it sends the requested data (1715) and closes the secure connection (1716). If the data was not successfully prepared for sending (1713), the telemonitoring system reports an error (1714).
When the patient does not have targets (1802), the telemonitoring system determines whether a qualified medical staff person, such as an appropriately licensed medical professional, appropriately trained medical staff person, etc., wants to input targets (1803), and take actions previously discussed to input those targets. When the qualified medical staff person does not input targets, the telemonitoring system determines if default targets exist for the patient, the patient's condition (e.g., disease, age, ethnicity, etc.), etc. (1804). When no targets exist, the telemonitoring system sends a warning notification to the patient or the medical staff (1821). When target values are established for a patient (1802, 1803, 1804), the telemonitoring system evaluates the data in light of the target values (1820), and in light of the alert settings (1805).
When the alert settings are active (1805), such that alerts are sent, and the biometric readings are outside of the target range (1806), the biometric readings are evaluated in light of the tolerances (1807). For example, an alert may be sent when a glucose reading exceeds a target range by more than 10% for 3 days, by more than 20% for 2 days, by 50% for one day, etc. When the tolerances have been fulfilled (1808), the telemonitoring system creates a new alert (1809), and logs the alert (1810). The telemonitoring system further performs some or all of blocks 1811 (send a secure email to the patient and the care team regarding the alert), 1812 (send a secure SMS to the patient and care team), 1816 (establishes an audio or video conference between the patient and care team), 1817 (generates allowable social media interaction using secure messages), and 1813 (sends a real-time notification to the patient and the care team). The user has the flexibility to enable or disable any of the notifications methods and only use preferred ones. The telemonitoring system determines whether there was any error while notifying the patient or care team (1814), and, when there is an error, raises an exception error (1814), and, in either case, saves the result (1815). The user has the flexibility to enable or disable any of the notifications methods and only use preferred ones.
When the patient does take his readings (1905), the telemonitoring system verifies if the readings are in compliance with the requirements of the readings (1911). Examples of some requirements include that the readings were taken within a required time frame (e.g., between 8 am and 8 pm on Tuesday), that three readings were taken in a 24 hour period, that the readings were taking by a certain type of medical device, etc. When the readings do not meet the requirements, such as the reading was not taken within the required time frame, the telemonitoring system generates an alert (1906) notifying the patient or his care givers that the readings have in compliance with the patient's care plan have not been taken. The telemonitoring system saves the alert (1907), logs the alert (1908), and sends the alert 1909). An advantage of this process is to increase patient engagement with his treatment and to facilitate his compliance with the care plan to help the patient achieve the care plan goals in a timely manner.
In an example, at block 2001, the telemonitoring system checks the patient's eligibility 2001. When the patient is eligible, the telemonitoring system checks to see if a medical care plan has been assigned to the patient (2002). When a care plan has not been assigned, the telemonitoring system notifies the care team to create a care plan for the patient (2050). When a care plan is assigned (2002), the telemonitoring system proceeds to verify whether there are progress notes/data in the database (2003). When the database includes progress notes/data, the telemonitoring system verifies the notes of the patient (2004) (diagnosis, symptoms, conditions, clinical data and demographics) to provide health care providers, care team members, etc. with information regarding the present condition of the patient. The telemonitoring system allows the review of the patient's triage and call records (2005), mood reports (2006), and the patient's daily tasks (2007), such as daily biometric readings, daily nutrition log, daily exercise log, etc. This information will help physicians, health care providers, or care team members to generate an outcome report for clinical review.
At block 2008, the telemonitoring system verifies the active problems list of the patient (e.g., the patient's chronic conditions) and their associated classifications within the database (2009). The telemonitoring system checks biometrics records and their associated reading schedules during a specific period of time (2010). The telemonitoring system verifies whether the patient has biometric targets assigned (2011) that correspond to the patient's chronic condition(s). When the patient does, the telemonitoring system checks issues notifications and alerts (2012). When the patient's care plan includes goals for any health indicators (2013), the telemonitoring system reviews progress on the various health indicators, such as actual versus target reading goals, actual nutrition versus nutrition goals, actual exercise versus exercise goals, actual medications versus medication goals, etc. The telemonitoring system generates a health status report (2014), such as a report on the outcome of the care plan, and saves the report. The telemonitoring system, such as under the supervision of, or based on input of, a doctor or other appropriately licensed or qualified medical professional, updates the patient's care plan (2015), such as by updating the patient's target indicators (e.g., target biometric readings), the patent's biometric reading schedule, or the patient's exercise, nutrition, or medication plans, to improve the health care of the patient.
At block 2016, the telemonitoring system checks the patient's medical orders to determine whether the medical orders properly address the patient's current active health issues (2017). When the patient does not have medical orders, or they do not address the patient's issues, the telemonitoring system generates a status report for the patient that so indicates (2029). When the patient has medical orders that address the patient's current active health issues, the telemonitoring system determines if they properly address the issues (2018). The telemonitoring system determines whether any changes in the nutrition, medication, exercise, biometric reading, etc. medical orders are needed. At block 2019, the telemonitoring system checks if there are any needed changes in the nutrition medical orders (2019). When there are, the telemonitoring system generates a nutrition report, such as a report that includes the calories and nutrients consumed each day, the calories burned each day, etc. The telemonitoring system updates the nutrition-related medical orders in the care plan (2022).
At block 2023, the telemonitoring system verifies the prescribed medicines of the patient (2023) while under the supervision of or based on input from a physician or other appropriately licensed or qualified medical care practitioner. The telemonitoring system checks the list of the current medicines for the patient and determines whether the patient is in compliance with the medication plan (2024). If not, during medication reconciliation/notes (2025), the telemonitoring system reconciles medication data/notes in the database with the medical orders. The telemonitoring system updates the medical plans/orders as needed (2026, 2027), and verifies the plan, such as by checking for drug interactions, patient allergies, proper doses, etc. When the patient is taking current medications as prescribed (2024), the telemonitoring system determines whether the patient has any adverse drug effects (2028), and, when he does, the process proceeds to block 2025. When the patient has no adverse drug effects, the telemonitoring system generates a status report for the patient that reports the patient's progress towards the medical care plan (2029).
At block 2030, the telemonitoring system established a patient's education goals, such as how to properly obtain daily, weekly and monthly readings, how to properly perform various health-related tasks or activities from the patient's care plan, etc. At block 2031, the telemonitoring system generates and checks referrals, such as a referral to a particular type doctor (e.g., endocrinologist), to a medical lab for testing, to a nutritionist, etc. The checking can entail checking the patient's insurance, PHI, Labs, DX images, referral justification, diagnosis codes, etc. When the patient has referral reports (2032), the telemonitoring system can check the clinical specialist feedback from the referral report (2033), and can determine if the patient needs special attention (2034). When there are no referral reports (2032), or when the patient does not need special attention (2034), the telemonitoring system checks and updates the care plan goals (2035). When the patient needs special attention (2034), the telemonitoring systems allows physicians to share the information with the medical staff for peer review analysis (2051) in order to update the information in the patient's care plan (2090).
At block 2036, the telemonitoring system generates a clinical record summary, which includes summaries of the patient's various health-related data, to allow physicians determine the partial/final outcomes for the patient. The summary report can include, for example, current diagnosis ICD-10, assessment notes, medications, targets, current care plan, etc. Based on this summary, the telemonitoring system, under the supervision of or based on input of an appropriately licensed or other qualified medical professional, generates the CPT/HCPCS codes (2037) and updates the patient's progress notes (2038). If the CPT/HCPCS codes are already generated, the health care provider can plan the next follow-up appointment for the patient's treatment via the telemonitoring system (2039). At block 2040, the medical staff member (e.g., nurse, doctor) can establish an audio or video conference with the patient to discuss the Care Plan Review, where the medical staff member and the patient can exchange information regarding the care plan in real-time. The medical staff member can further generate allowable social media interaction using secure messages in order to communicate key changes in the Care Plan (2041).
If the telemonitoring system detects any conflict or warning with the requirements (2106), the telemonitoring system either automatically, or with input from a medical staff member, resolves any conflict with CPT or HCPCS codes (2107). Once the conflicts are resolved, the telemonitoring system determines fees that correspond to each CPT/HCPCS code (2108). In determining the proper fee, the telemonitoring system uses 1) the contract between the insurance provider and the medical practice, 2) the patient health plan, 3) and the medical treatment provided. With this fee information, the telemonitoring system prepares the insurance claim, which further includes the units and the service date (2109). In order to provide support for the insurance claim, and to increase the successful rate of reimbursement once the claim is sent to the insurance systems, the telemonitoring system generates a medical summary of the patient's chart (2110), and it stores information associated with the generated claim in a “document support system.”
The telemonitoring system also keeps track of payments made by the patient during the billing period, and keeps statistics of the accumulated deductible (2111). In addition, the telemonitoring system provides in the billing form information regarding the various medical services provided during the billing period (2112). Before the telemonitoring system submits the claim, it re-verifies the patient's eligibility status with the health insurance providers registered in the telemonitoring system (2113) to ensure that the patient has at least one insurance plan active (2114). When the patient has no active insurance (2114), the telemonitoring system is not able to bill an insurance provider, and rather generates a report regarding the patient's lack of insurance (2115), which is sent to the appropriate medical staff and to the patient. When the patient has one or more active insurance plans, the telemonitoring system chooses the insurance plan to bill for the medical services (2116). The telemonitoring system further checks whether the health care provider is inside the insurance network (2117) to determine whether additional authorizations are needed from the insurance provider (2119), and checks to see who the insured person is (2118).
Based on the collected information, the telemonitoring system generates the insurance claim based on the CMS and/or health insurance provider rules (2120) and activates a notification system (2121) to track and update the current status of the claim process for designated users. The process to send the claim could be done either manually (2122) or electronically (2123). When feedback is received from the health insurance provider is received, the telemonitoring system processes the health insurance provider feedback regarding the claim 2124). Some examples of insurance plan responses include claim accepted, claim rejected, or claim denied. When the claim is accepted by the insurance company (2192), the telemonitoring system obtains the payment details and the EOB (Explanation of Benefits) information (2129) and verifies the payment by doing a reconciliation electronically or manually with the bank balance (2130). When the claim is rejected by the insurance company (2191), the telemonitoring system will suggest corrections to the claim, or an appeal process (2128), and put the claim in a pending review status. When the claim is denied by the insurance company (2190), the telemonitoring system obtains the EOB (Explanation of Benefits) information (2125), but no payment information. The telemonitoring system changes the balance due to the patient (2126) to account for the lack of an insurance payment, and generates a payment request to send to the patient (2127). The platform closes the claim and updates the balance, to provide financial information to other systems (2131).
At block 2204, the telemonitoring system identifies a weight for each category. In the example of
In addition to a weight, a correction factor is identified for each category. A correction factor is a factor used to adjust the weights of the categories, and the sum of weights plus correction factors equals 100% (2206). Stated another way, the sum of the correction factors for a given patient equals zero (2208). In some cases, a goal of the correction factor is to normalize patient compliance scores so that patients that have similar compliance to a similar care plan have similar compliance scores (2209). Blocks 2250 and 2251 include additional detail on one method for calculating a correction factor.
In an example, care plans of patients with a same medical diagnosis (e.g., diabetes) share some common categories amongst different health care providers. The different health care providers have a similar weighting of a first category, e.g., weighting of glucose readings. Because the weights are similar, the contribution to the overall compliance score for patients with similar glucose readings will be similar, so the correction factor in this example for glucose readings will be small. However, the different health care providers have a dissimilar weighting of a second category, e.g., exercise. Because the weights are dissimilar, without a correction factor, the contribution to the overall compliance score for patients with similar exercise performance will be dissimilar. As a result, the correction factors for exercise performance will be larger. The correction factor will be negative for patients with exercise performance weights higher than the average amongst medical providers, and will be positive for patients with exercise performance weights lower than average amongst the medical providers (2207). For categories 2301, the correction factor for Biometric is 5%, and for Physical Activity is −5%.
In a second example, the telemonitoring system supports ten health care providers, and nine of the providers have a similar weighting of a first shared category, and one health care provider has a substantially higher weighting of the first shared category. In this example, the correction factor for the nine providers for this first shared category will be small, and the correction factor for the one health care provider will be substantially larger and will be negative.
At block 2210, the telemonitoring system establishes elements for each category. Examples of categories and associated elements include: Physical Activities (category)—walk 3 km, run 30 minutes (elements); Medication—take omeprazole 30 mg by mouth every 8 hours (2211).
At block 2212, the telemonitoring system defines the weight of each element score in each category.
At block 2215, the telemonitoring system defines the type of variable assigned to each element. The type of variable can be binomial, or not binomial. Examples of variable types include (2216): run 30 minutes (element)—binomial (type of variable); glucose reading—not binomial. At block 2217, the telemonitoring system gathers target goals established in the care plan for elements which are not binomials, and for each element determines the maximum high score (2218). At block 2219, the telemonitoring system calculates a score for each element. The telemonitoring system obtains various care plan related data, such as tracking reports of various elements.
For every element within a category that is a binomial variable, the telemonitoring system adds the value of the “n” binomial variables reported to a total for the category element, and divides by the high score assigned previously to that category element (2222). For some binomial variable elements, the telemonitoring system needs to determine the binomial value for the element. For example, when the element is glucose measurement between a lower range and an upper range (e.g., between 60 and 150), the binomial variable is 1, else the binomial variable is 0 (2223).
At block 2224, the telemonitoring system computes a patient compliance score over a period of time. In the example of
At block 2228, the telemonitoring system calculates the partial compliance scores for each category, and an overall partial compliance score. An overall partial compliance score is a compliance score over a portion of a care plan time period, where the portion is less than 100%. When the patient has exceeded his care plan goals (2232), the telemonitoring system generates awards for the patient (2233). For example, the telemonitoring system may provide a discount on a next doctor's visit, may provide a discount on a medication refill, may provide an electronic message that enables the patient to obtain a free coffee at a local coffee house, etc. When the patient falls short of his care plan goals (2231), the telemonitoring system generates a notification (2231), such as a notification that includes a motivational message. For example, the notification can be a text message sent to the patient's smartphone that includes the message “Keep up the good work, you exercised 3 out of 7 days this past week, and have almost achieved your goal of 4 days out of 7 !”, or “great job on keeping your blood sugar under control, you met your goal 6 days this past week, only 1 day short of your goal !”
At block 2230, the telemonitoring system generates a task for a member of the medical staff to follow up with the patient to determine why the patient is not in compliance with the care plan. At block 2234, the telemonitoring system determines whether a modification to the care plan is required. When the patient is achieving his care plan goals, the modification to the care plan may be to raise the target goals. When the patient is not achieving his care plan goals, the modification may be to lower the target goals. When the care plan has ended (2235), the telemonitoring system generates a final compliance score (2236).
In the illustrated embodiment, the processing system 3100 includes one or more processors 3110, memory 3111, a communication device 3112, and one or more input/output (I/O) devices 3113, all coupled to each other through an interconnect 3114. The interconnect 3114 may be or include one or more conductive traces, buses, point-to-point connections, controllers, adapters and/or other conventional connection devices. The processor(s) 3110 may be or include, for example, one or more general-purpose programmable microprocessors, microcontrollers, application specific integrated circuits (ASICs), programmable gate arrays, or the like, or any combination of such devices. The processor(s) 3110 control the overall operation of the processing device 3100. Memory 3111 may be or include one or more physical storage devices, which may be in the form of random access memory (RAM), read-only memory (ROM) (which may be erasable and programmable), flash memory, miniature hard disk drive, or other suitable type of storage device, or any combination of such devices. Memory 3111 may store data and instructions that configure the processor(s) 3110 to execute operations in accordance with the techniques described above. The communication device 3112 may be or include, for example, an Ethernet adapter, cable modem, Wi-Fi adapter, cellular transceiver, Zigbee transceiver, Bluetooth transceiver, or the like, or any combination thereof. Depending on the specific nature and purpose of the processing device 3100, the I/O devices 3113 can include various devices, e.g., a display (which may be a touch screen display), audio speaker, keyboard, mouse or other pointing device, microphone, camera, etc.
Unless contrary to physical possibility, it is envisioned that (i) the methods/steps described above may be performed in any sequence and/or in any combination, and that (ii) the components of respective embodiments may be combined in any manner.
The techniques introduced above can be implemented by programmable circuitry programmed/configured by software and/or firmware, or entirely by special-purpose circuitry, or by any combination of such forms. Such special-purpose circuitry (if any) can be in the form of, for example, one or more application-specific integrated circuits (ASICs), programmable logic devices (PLDs), field-programmable gate arrays (FPGAs), etc.
Software or firmware to implement the techniques introduced here may be stored on a machine-readable storage medium and may be executed by one or more general-purpose or special-purpose programmable microprocessors. A “machine-readable medium”, as the term is used herein, includes any mechanism that can store information in a form accessible by a machine (a machine may be, for example, a computer, network device, cellular phone, personal digital assistant (PDA), manufacturing tool, any device with one or more processors, etc.). For example, a machine-accessible medium includes recordable/non-recordable media (e.g., read-only memory (ROM); random access memory (RAM); magnetic disk storage media; optical storage media; flash memory devices; etc.), etc.
Note that any and all of the embodiments described above can be combined with each other, except to the extent that it may be stated otherwise above or to the extent that any such embodiments might be mutually exclusive in function and/or structure.
Although the present invention has been described with reference to specific exemplary embodiments, it will be recognized that the invention is not limited to the embodiments described, but can be practiced with modification and alteration within the spirit and scope of the appended claims. Accordingly, the specification and drawings are to be regarded in an illustrative sense rather than a restrictive sense.
This application claims the benefit of U.S. Provisional Patent Application No. 62/294,254, filed Feb. 11, 2016, and U.S. Provisional Patent Application No. 62/455,570, filed Feb. 6, 2017, both of which are incorporated by reference herein in their entirety.
| Number | Date | Country | |
|---|---|---|---|
| 62294254 | Feb 2016 | US | |
| 62455570 | Feb 2017 | US |
