Data processing: database and file management or data structures – Database design – Data structure types
Reexamination Certificate
2000-11-01
2003-11-18
Choules, Jack M. (Department: 2177)
Data processing: database and file management or data structures
Database design
Data structure types
C707S793000
Reexamination Certificate
active
06651060
ABSTRACT:
BACKGROUND OF THE INVENTION
1. The Field of the Invention
The present invention relates to methods and systems for assisting a requester (e.g., an insurer) in rapidly obtaining medical records from a medical provider (e.g., a doctor). More particularly, the invention relates to methods and systems that employ a computer network which automatically processes and transmits a request and authorization for a medical record from a requestor to a provider and which subsequently receives, matches up, and forwards the medical record in electronic form to the requester.
2. The Prior State of the Art
There are various businesses and other entities that rely heavily on medical records to make business and other critical decisions. These include life insurance companies, property and casualty companies, personal injury attorneys, and patients, which may collectively be referred to as “medical record requesters.” Medical records are typically generated by “providers,” such as, doctors, hospitals, and independent diagnostic laboratories. There is, however, quite a disconnect between medical record providers and the aforementioned requestors such that actually filling a request for a medical record may take weeks or even months.
In a typical scenario for obtaining a medical record a requestor first determines which medical record from which provider is needed. Second, the person to whom the medical records pertain must fill out and send to the requestor a signed authorization form authorizing the provider to release the person's medical records to the requestor or representative. Third, the requestor sends the medical record request and signed authorization form to the provider. Fourth, the requester either relies on the provider to copy the medical record or sends someone to arrange to copy the requested medical records on the premises of the provider. Fifth, the provider must locate the requested medical record, the vast majority of which are in paper form and filed away in large filing rooms. Sixth, the medical record is photocopied. Seventh, the medical record is sent or otherwise delivered to the requestor. The foregoing process is cumbersome even when the requestor and provider are in close geographic proximity, sometimes even having an ongoing relationship. The process becomes exponentially more difficult when the requestor and provider are separated by large distances, particularly when the two parties do not have an ongoing relationship.
In many cases, doctors and other providers are slow to release medical records and often charge high rates in an attempt to recover what are, at best, the hassle costs of tracking down and providing medical records. This is particularly the case where the provider and requestor do not have an ongoing relationship and/or are separated geographically. In short, doctors and other providers are in the business of providing medical services and are not equipped and motivated to retrieve and provide medical records in a timely and efficient manner.
Likewise, the requestor is typically in the business of writing insurance policies, providing insurance coverage, or performing legal services. At best, obtaining medical records is a significant irritant. Worse, delays in obtaining medical records may mean lost sales to an insurance salesman, delay in processing loss claims, or inadequate or inefficient legal representation by a personal injury or defense attorney. Property and casualty insurers estimate that it costs about $25.00 per open claim per day. Life insurers often lose customers due to delays in being able to close deals and collect premiums. Notwithstanding the tremendous need to rapidly obtain copies of medical records, most requestors of medical records are typically not equipped to efficiently track down and retrieve medical records from the large number of potential providers, many of which have no ongoing relationship with the requester.
Because providers and requesters typically view medical record retrieval and copying to be, at best, an irritating facet of their respective businesses, third party copy services are often employed. Such copy services, in essence, bridge the communication and cultural gaps that separate disparate and essentially unrelated industries that would rather have nothing to do with each other but for the fact that one industry (the provider) produces a commodity (the medical record) that another industry (the requestor) needs but generally cannot generate on its own. While copy services may be better equipped and more willing to be the go-between and courier between requesters and providers, and whereas such services may actually be able to speed up the medical record retrieval and copying processes due to inherent economies of scale and expertise, such increases in efficiency are mostly marginal and do not address the more difficult systemic problems that work together to make the retrieval and copying of medical records an inherently time consuming and inefficient problem.
Aside from the foregoing problems and inefficiencies that presently plague requestors and providers in locating and sharing medical records, the rise of computers, more sophisticated telecommunications devices, facsimile machines, and the global computer network (i.e., the “Internet”) show great promise and provide hope in generally increasing the efficiency of how businesses are run and how common and routine activities are carried out. The challenge, however, is implementation. Theoretical and predicted increases in efficiency in the business and manufacturing industries have not been realized and have often lagged behind the expectations of commentators and experts. This is due, of course, to the lack of workable systems that are able to efficiently and realistically implement an automation process. Different types of businesses commonly have very distinct cultures and methods of carrying out their day-to-day operations. More often than not, such differences do not easily lend themselves to quick and obvious automation procedures. For example, it would greatly increase the speed and efficiency of medical record retrieval if such records were electronically created and stored. Unfortunately, about 95% of all medical records are still in paper form and hand written.
In the industry of locating, copying, and providing medical records, there are a number of issues that must be addressed for a document retrieval system to be workable. These include, for example, maintaining the confidentiality of information in a person's records, ensuring that the copying of a particular record has been legally authorized, preventing the record from being available to or intercepted by unauthorized parties, correctly matching up a particular medical record with a particular request, and preventing unauthorized copying, alteration, or obliteration of data in the medical record. Simply requesting information via e-mail or other unsecured means over the Internet would not adequately address the foregoing concerns.
In short, it would be an advancement in the art of medical record retrieval to provide methods and systems which could greatly accelerate the retrieval process, while maintaining the confidentiality and security of the medical record.
SUMMARY OF THE INVENTION
The present invention encompasses medical record retrieval processes and systems, and software for implementing these processes, that greatly streamline the process of obtaining a medical record from a provider on behalf of a requestor. Typical requesters of medical records include life insurers, property and casualty insurers, and personal injury and defense attorneys. In many cases, obtaining a medical record is a condition precedent to entering into a contract, paying out a claim, or having sufficient evidence to prepare a legal case. The present invention greatly reduces the time in which a medical record may be obtained, thus reducing, e.g., monetary costs and lost business.
The processes and systems according to the present invention are advantageously implemented using a plurality of co
Colemere Michael Glen
Cottrell Matthew Doxey
Harper Travis Kelly
Schade, Jr. Fred Bergstedt
Stout Benjamin Clark
Choules Jack M.
Mediconnect.net, Inc.
Workman Nydegger
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