Data processing: database and file management or data structures – Database design – Data structure types
Reexamination Certificate
2002-10-31
2004-07-20
Corrielus, Jean M. (Department: 2172)
Data processing: database and file management or data structures
Database design
Data structure types
C707S793000, C707S793000, C704S002000, C704S008000, C704S009000, C704S201000, C704S205000, C704S277000
Reexamination Certificate
active
06766328
ABSTRACT:
TECHNICAL FIELD
Generally, this invention relates to a computer-based system for transcription and related information and other security and data intensive information or the like. Specifically, the invention may focus on applications, methods, software, hardware, services, and even business methods which can provide a variety of functions important in transcribing or handling information, such as medical information, including but not limited to convenient transcription with menu data tailoring as may be of interest to some of the users of the particular information involved. It may involve handling the information through a network such as the global information network or Internet. Specifically, the invention focuses on applications, methods, software, hardware, services, and even business methods which can provide a variety of functions important in the handling of the information, including but not limited to access, research, and other such functions. It can provide a variety of functions important in the dealing with the information, including but not limited to encoding such information with details of interest to some of the users of such information.
BACKGROUND
One of the more inefficient environments in which to capture data is that from verbal information. Because verbal or perhaps dictated information can use a variety of words or phrases for a singular meaning and because verbal information can be highly originator dependent, it can be challenging to capture in a structured data format. But one example is that of the medical environment. This environment can present not only one for which the need can be acute (such as to help the patient with a potentially fatal complication) but also one in which the structures and formats can range from one of insurance billing to one of a need for immediate correlation of information. This is compounded by the professional not having the time to enter the data manually. Moreover, the threat of bioterrorism has become the reality of a bioterrorist attack. Although the technology used to attack was quite simple, the consequences of the ensuing terror have been far reaching and profound. It has become vividly clear that attacks cannot be entirely prevented. Our best weapon then, is in the rapid collection and sharing of critical information and responding to bioterrorist attacks, a process that is entirely dependent on rapid, accurate and comprehensive data capture.
In but one application, it can be understood that healthcare in general and physician practices in particular, have not kept abreast of dramatic improvements in the technology of data capture and management. As a direct result, all stake holders from patient to providers are suffering. Technology solutions have not been adopted by the vast majority of physicians, who for the most part, function as independent small groups focused on patient interaction and patient care, and have little time or patience with high tech solutions. It is, however, quite clear that this is a fragmented market and a giant of a market waiting breathlessly for a palatable solution.
In the medical example, physicians are sometimes quoted as losing money at the rate of up to $60,000 per physician per year because of the complexity of a reimbursement system that literally forces them to choose from millions of possible coding combinations in order to get paid. Driving the revenue loss is the stern gaze of the government and the threat of monetary and even criminal penalties should physicians err on the side of over-charging for their services. Incomplete fragments of patient information are literally hidden in inaccessible paper files in hospital and physician practices around the country and tens of millions of dollars are wasted annually in trying to manage this paper nightmare. The need for a solution is staggering, and yet no one has yet solved this puzzle. Why? The answer lies in a deep understanding of physician practice mechanics and physician culture. Doctors know they have a problem and are indeed in pain. But the pain of the solutions offered have to date been greater than the pain of the existing problem.
The scope of the problem can be understood by realizing that physicians represent merely one type of service provider that is impossibly busy. In many industries, the service provider sees patients or clients non-stop from the time they arrive at their offices until the time they go home. Sixty hour weeks are the norm and their focus during that time is the patient or client; relating to the patient or client, evaluating the patient or client, determining the patient's or client's problems, offering a possible solution, implementing a plan, and explaining this plan with reassurance to the patient or client. In short, the practice of medicine as many other services is very much a relational, interpretive and interpersonal affair. The art of medicine is at least as important as the science which is applied. After each emotionally demanding and intellectually challenging encounter, the physician then must document his thoughts, impression and plan, and justify his reasoning in a legal document. With more patients stacking up to be seen, there is precious little time to accomplish this task, so the vast majority of physicians must dictate the results of the encounter, often very rapidly, with no time left to edit or review before the next patient encounter. Physicians do not, will not, cannot learn new methods of data entry that are less flexible and more time consuming. This is why today, less than 5% use any sort of electronic medical record. Keyboards, pen charts and inaccurate, unedited voice recognition programs cannot serve their needs and so they rely on an existing transcription system and somewhat haphazard coding solution to help them document and justify each encounter. Physicians are willing to pay for this service and pay well to relieve them of the burden of learning a new career, i.e., documentation and coding. They are people oriented, not technology oriented and can and will pay to have someone else manage this aspect of healthcare. Many have mistakenly assumed that if they build a data repository and provide the physicians with a screen and keyboard or a drop list and pen chart, that physicians will flock to them in droves. Many such technologically advanced solutions exist now, and in large part they have been ignored or quickly abandoned. The threshold of entry is simply too great.
The provider will require service as part of the data capture solution. Technology alone is not enough. Furthermore, doctors as well as others often want local service. Someone they or their staff can personally call and hold accountable. Someone who does not hide behind the veil of bureaucracy, but who is available and at risk in the relationship. In the medical application, today, the local medical transcriptionist fills that roll for creating edited paper documents. Mirroring the healthcare industry, medical transcriptionists are also typically small, fragmented, but local accountable shops which serve physician needs. They too, have a need. They realize that eventually technology will replace them, and yet they don't know when. They realize that their clients, the doctors, needs are only partially served by the paper documents that they, the transcriptionist provide. Their very careers are at stake, but because they are small and fragmented, they do not have the individual resources to solve doctor's problems alone. Likewise, coding solutions are many, varied and fragmented and likewise, though they are aware of physician suffering; professional coders don't have the insight or resources to comprehensively address the need.
In the context of sharing information, one of the problems appears to be the fact that healthcare in general and physician practices in particular have not kept abreast of dramatic improvements in the technology of data capture and management. The primary disconnect in our public health surveillance system remains the archaic system
Groves Robert H.
Krueger Christopher S.
Loper Steven W.
Mathe John G.
Scott Robin L.
Ascriptus, Inc.
Corrielus Jean M.
Santangelo Law Offices P.C.
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