Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Health care management
Reexamination Certificate
1998-08-25
2001-05-08
Stamber, Eric W. (Department: 2146)
Data processing: financial, business practice, management, or co
Automated electrical financial or business practice or...
Health care management
C705S002000, C707S793000
Reexamination Certificate
active
06230142
ABSTRACT:
BACKGROUND OF THE INVENTION
I. Field of the Invention
The present invention provides data manipulation and analysis systems and methods associated therewith. In particular, the present invention is directed to systems useful for analyzing medical data related to clinical pathways and performing actions based upon the analyses.
II. Background of the Invention
Escalation of medical costs has led to attempts in the past to streamline systems for providing medical care. Attempts to control such costs have heretofore been thwarted by inexact methods of gathering statistical information relevant to the medical care of interest. Certainly, rudimentary systems for tracking patient information have been developed. Moreover, patient treatment information has also been tracked and stored for further analysis. However, to date, there have not been systems for continuously tracking patient information and patient treatment information, such as clinical pathways for the patient, incorporating these into a useful form, and reacting in an automated fashion according to the recorded information. Therefore, consistent with the goal of providing cost-effective medical care, there remains a need for integrated systems capable of tracking and analyzing medical treatment information.
As an example, home health care is expected to account for an ever-increasing amount of medical care to be provided over the coming years. Therefore, cost reduction systems applicable to the home care setting are similarly highly desirable and yet are, heretofore, virtually unknown.
Similarly, there exists a need for effective data tracking and manipulation vital to providing “stable acute” care, as that term is defined and used herein. Historically, patients who had surgery would have to come to the hospital anywhere from one to three days early. After surgery, they would then spend significant time in the hospital and, in years past, these patients would actually be kept in the hospital and on bed rest for a lengthy stay. The operative patient's stay can be broken down to three phases: pre-operative, operative and post-operative. Each of these phases has changed drastically over the years.
During the pre-operative time period, patients historically came to the hospital anywhere from one to three days prior to surgery. Early arrival at the hospital usually was required for patients undergoing abdominal procedures because of the necessary to perform a bowel prep believed to be necessarily done in the hospital. This has changed because patients now can receive an equivalent bowel prep in their own home before coming to the hospital. However, although the bowel prep may be equally effective in cleaning out the intestine, the home prepared patients often become dehydrated. Yet pressures from managed care to save money have forced the medical community to ignore the fact that these patients are often dehydrated.
Additionally, even those patients not needing a bowel prep used to come in one day prior to surgery. A history and physical would be done the night before surgery and then the pre-op, including anesthesia visit and various x-rays and blood tests, would be done prior to the operation. This, too, has changed in that the history and physical is now done in the doctor's office and the pre-op, including the anesthesia visit, laboratories and x-rays, are now done a number of days prior to the operation. Again, the pressures of managed care have reduced the prior one to three day in-hospital pre-operative period to the current practice of admission to the hospital early in the morning of surgery.
Economic pressures have recently forced movement toward minimizing any pre-operative stay. For similar reasons, it would be desirable to minimize post-operative in-hospital stays. One example of the result of this desire is the so-called “drive through mastectomy,” which permits discharge from the hospital within 24-36 hours after abdominal hysterectomy or laparoscopic procedures. Unfortunately, in major abdominal procedures, there are great limitations to sending patients home early. These limitations are present for any major procedure requiring an abdominal incision (such as in gynecological oncology, radical hysterectomy, lymph node sampling or debulking, urology, radical prostatectomy, nephrectomy through abdominal approach, general surgical procedures including colectomy, small bowel resection with abdominal approach, or gastrectomy). Once there has been significant manipulation of the intestines after an abdominal incision, there are tremendous limitations to sending the patients home prior to demonstration of gastrointestinal (“GI”) function, an event which can easily take four to seven days to occur.
In the operative period, there are many changes that have occurred in the past few years. For instance, the suture materials used today cause much fewer adverse reactions and are much more secure. Staple devices have increased the speed of the operative procedures as well as providing more security resulting in less problems post-operatively. For example, colectomies are now done with staple anastomoses thereby minimizing the likelihood of a leak of stool through the anastomosis is minimal. This, of course, effects the post-operative time period because fewer complications are expected and observed compared to the past. Finally, operative procedures have been significantly refined and improved, which also aids in shorter operating room (“OR”) time and less post-op complications.
The post-operative period has seen many changes and improvements over the years, including quicker ambulation of the patient, decreased bed rest, knowledge that faster discharge probably decreases likelihood of venous thrombosis and hospital acquired infections, and understanding that many post-operative situations do not necessitate long hospital stays. For example, patients who had mastectomies used to stay in the hospital for four to five days until the drain stopped yielding fluid. Presently, patients with mastectomies can go home within the first 24 hours of surgery and are taught how to take care of the drains at home. However, there are patients who have had mastectomies who have no care giver at home, yet are expected to take care of the drains, pain, any questions and any emotional discomfort without any assistance. Other improvements include decreased use of nasogastric tube after gastrointestinal procedures including small bowel resection or large bowel resection, use of patient controlled analgesia as opposed to injections which allows the patient to manage his or her pain more easily at home, development of intravenous computerized monitors which prevent against possible IV errors, use of sequential hose which are stockings which blow up on the legs in a sequential manner and significantly decrease the likelihood of thrombosis, use of H2 blockers (Histamine-2 blockers) such as PEPCID®, TAGAMET®, and ZANTAC® in the post-operative setting to significantly decrease the chance of gastric bleeding or other upper GI complications, use of home care for either the chronically ill post-operative patients or the generally chronically ill patient, and the use of improved IV antibiotics to decrease post-operative infections.
Over the past ten to fifteen years, home care has also become a viable option. However, although home care has been quite successful in the past with patients, home care has only been known for handling patients classified as chronically ill or, very recently, for handling patients who would usually come to the emergency room. For a chronically ill patient, the patient remains in the hospital for a long period of time. While it may take 24-48 hours to send the patient home, the stay at home may vary from as much as two weeks to a few months.
Hospital length of stay and other clinical pathways are ultimately the purview of the physician. However, certain guidelines exist, such as those published under the title
Milliman & Robertson Healthcare Management Guidelines
by Milliman & Robertson, Inc., Actuaries & Consultant
Benigno Benedict B.
Burrell Matthew O.
Feuer Gerald A.
Sadler William E.
Withers Leland A.
Harle Jennifer I.
Homeopt, LLC
Needle & Rosenberg P.C.
Stamber Eric W.
LandOfFree
Health care data manipulation and analysis system does not yet have a rating. At this time, there are no reviews or comments for this patent.
If you have personal experience with Health care data manipulation and analysis system, we encourage you to share that experience with our LandOfFree.com community. Your opinion is very important and Health care data manipulation and analysis system will most certainly appreciate the feedback.
Profile ID: LFUS-PAI-O-2452584