Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Health care management
Reexamination Certificate
1997-03-14
2001-07-03
Stamber, Eric W. (Department: 2765)
Data processing: financial, business practice, management, or co
Automated electrical financial or business practice or...
Health care management
C705S003000
Reexamination Certificate
active
06256613
ABSTRACT:
FIELD OF THE INVENTION
This invention relates to health care management systems and more particularly to a system for facilitating and managing consultation between primary care physicians and specialists.
BACKGROUND OF THE INVENTION
A need exists for new approaches to medical consultation, physician referral and continuing medical education. In the United States, health care costs have increased since 1960 at the average annual rate of 11.3%, over three times the rate of inflation, resulting in intense scrutiny of both the costs and quality of health care from private, public and governmental institutions.
One solution has been managed care, a concept that has slowed the rate of growth and, in some instances, actually cut costs through the formation of closed panels of providers who deliver care at a pre-negotiated price utilizing managed and controlled approaches. Under managed care, primary care physicians treat the majority of the patients and serve as gatekeepers to triage to specialists.
As medical and technological knowledge increases, primary care physicians must keep abreast of rapidly changing developments. Unfortunately, much of this new knowledge resides with expensive specialists. Consumers are concerned that their primary care physician is limited in his or her access to such information because of the expense of using the specialist, and the physician gatekeeper is viewed frequently by the public as the one who avoids incurring expenses to the system rather than helping the patient.
Primary care physicians frequently need access to leading specialists in a matter of hours when difficult problems arise. Although consultations with specialists in the HMO's provider network suffice in most instances, the necessary expertise may not always be available “in panel,” thus requiring timely access to an expert outside of the panel.
There is consequently a need for managed, direct access to outside medical consultants. Such access helps avoid inaccurate, incomplete, or uncertain diagnoses which can result in inappropriate or excessive care, as well as the liability and operating costs which result when physicians do not receive the necessary help at an early stage in treatment.
HMOs also have an increasing need to better document the performance of each doctor in order to better understand and influence physician behaviors, to modify treatments to coincide with established patient outcomes, to better disseminate improve methods as they arise. Physicians desire ways of obtaining necessary or useful knowledge in an educational format consistent with how they have been trained during their professional life. By better documentation of the knowledge gained through experience, HMOs can improve patient outcomes and decrease the risk of costly malpractice claims. There is accordingly a need for better procedures for encouraging and documenting the continuing medical education which is gained when primary care physicians consult with specialists having particular expertise.
The varying skill levels and the variety of training and backgrounds of providers further complicates the delivery of quality, lowest, cost care. As provider groups enlarge and become less homogeneous, the physician population in organizations is growing both in size and in diversity of knowledge and experience. As a result, educating physicians and other medical staff so as to ensure standards and “best practice” protocols has become a critical factor to effective delivery of health care services. Moreover, health care administrators also want these “best practice” standards to be followed in order to eliminate unnecessary medical procedures without increasing legal liability or stifling a physician's flexibility to practice medicine. There is accordingly a need to integrate the communication of proven practices and protocols which should be applied to special situations with the process of seeking consultation on those special situations.
SUMMARY OF THE INVENTION
In a principal aspect, the present invention takes the form of a medical consultation support system in which a client computer, such as a personal computer or a terminal of an existing medical support system, is provided with means for accepting a structured request for consultation from a primary care physician. The client computer also preferably includes means for including additional information related to the request, such as existing data files containing patient history information, medical image data, laboratory results, pathologies, etc., forming a transmittable, machine-readable collection of information relating to the consultation request.
In accordance with the invention, this structured consultation request is received and processed by a supervisory host computer which includes means for visually displaying at least a portion of the request for consultation for preliminary review by a receiving staff physician. The supervisory computer accepts the designation of a specialist from the staff physician, and additionally provides means for retrieving and assembling selected tutorial and background information, including related published articles, tutorial background lessons, practice and protocol documentation, and records of prior consultations which are related to the current consultation request, all of which are stored in one or more databases of medical information accessible to the supervisory host computer. The supervisory computer then transmits the request for consultation, together with at least the identification of the assembled supporting documentation, to the selected specialist for review.
The supervisory computer thereafter receives the responsive comment from the selected specialist, and transmits this response, along with the selected tutorial and/or background information, to the requesting primary care physician. The supervisory computer further stores the request for consultation, including the specialist's responsive comment and an identification of the cited supporting material, as a structured case history item in the database of medical information where it may be accessed for future reference.
Each consultation is further stored as a recorded learning event associated with the requesting primary we physician, and used to generate a report of continuing legal education credits earned by the requesting physician while participating in the managed consultation sessions.
The invention may be advantageously implemented by forming both the request for consultation and the specialist's responsive comments into one or more hypertext documents linked to the supporting materials, forming highly accessible case history documentation which may be readily manipulated using standard hypertext processing facilities.
These and other features of the invention may be more clearly understood by considering the following detailed description of a preferred embodiment of the invention. During the course of this description, frequent reference will be made to the attached drawings.
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Medical Information Services, “Saving Rural Medical Services”, San Jose Mercury News, Morning Final, Section: Science & Medicine, p. 2E, Dec. 1993.*
Jonathan Rabinovitz, New York Times, “You Have Questions? Profnet Has Answers”, San Jose Mercury News, Morning Final Section: Computing Page: 1E, Dec. 1994.*
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Falchuk Kenneth H.
Halperin José A.
Health Resources and Technology Inc.
Kazimi Hani M.
Nelson Gordon E.
Stamber Eric W.
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