EP3058535A1 - Système de groupement déclenché par des données de patient pour le partage de risque de risques de maladie critique chronique de cohortes de personnes âgées et procédé correspondant de ce système - Google Patents

Système de groupement déclenché par des données de patient pour le partage de risque de risques de maladie critique chronique de cohortes de personnes âgées et procédé correspondant de ce système

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Publication number
EP3058535A1
EP3058535A1 EP13821495.2A EP13821495A EP3058535A1 EP 3058535 A1 EP3058535 A1 EP 3058535A1 EP 13821495 A EP13821495 A EP 13821495A EP 3058535 A1 EP3058535 A1 EP 3058535A1
Authority
EP
European Patent Office
Prior art keywords
critical illness
risk
risk exposure
resource
triggering
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
EP13821495.2A
Other languages
German (de)
English (en)
Inventor
Timothy John KNAUST
Louise Elizabeth Anna HAINES
Alison Louisa MCLEAN
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Swiss Re AG
Original Assignee
Swiss Reinsurance Co Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from PCT/EP2013/071755 external-priority patent/WO2015055248A1/fr
Application filed by Swiss Reinsurance Co Ltd filed Critical Swiss Reinsurance Co Ltd
Priority to EP13821495.2A priority Critical patent/EP3058535A1/fr
Publication of EP3058535A1 publication Critical patent/EP3058535A1/fr
Ceased legal-status Critical Current

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Classifications

    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08—Insurance

Definitions

  • the present invention relates to critical illness insurance systems for providing risk sharing of critical illness risks associated with elderly persons by providing a dynamic self-sufficient risk protection for the risk exposure components by means of resource pooling system.
  • the invention relates to automated event-driven systems triggering on the patient dataflow pathway.
  • the pooling entity directly intercepts the loss or damage caused by the event by transferring resources from the pooled resources to the affected unit.
  • Pooling of resources can be achieved by exchanging predefined amounts of resources with the resource-pooling system; e.g. payments or premiums to be paid, for the transfer of the risk. This means that predefined amounts of resources are exchanged for the other unit assuming the risk of loss.
  • resource-pooling systems were developed that cover such "critical illnesses", where the resource-pooling unit operated by the insurer provides a lump sum cash payment if the risk-exposed unit, which is, seen from the perspective of the insurer the policyholder, is diagnosed with one of the critical illnesses listed in a defined table of transferred risk.
  • the operation of the resource-pooling system may also be structured to pay out regular income, and the payouts may also benefit the policyholder undergoing a surgical procedure, for example, having a heart bypass operation.
  • such systems require the risk-exposed unit to survive a minimum number of days (the so- called survival period) from when the illness was first diagnosed.
  • the survival period can vary; however, 14 days is the most commonly used survival period used.
  • critical illnesses are typically covered by critical illness risk transfer; these are heart attack, cancer, stroke and coronary artery by-pass surgery.
  • Examples of other conditions that might be covered include: Alzheimer's disease, blindness, deafness, kidney failure, major organ transplant, multiple sclerosis, HIV/ AIDS contracted by blood transfusion or during an operation, Parkinson's disease, paralysis of limb, terminal illness.
  • One of the problems of the risk transfer system as provided by the prior art lies in the fact that the incidence of a condition may vary (i.e. in- or decrease) over time, and that diagnosis and treatment may improve over time, that the financial need to cover some illnesses deemed critical a decade ago is no longer considered necessary today.
  • Another limiting feature of traditional critical illness insurance systems is related to mandatory boundary conditions for these systems given by age restrictions for critical illness risk transfer.
  • Traditional systems normally provide a child procedure associated to risk transfer of individuals for example in the age of 30 days to 17 years, and for example a adult procedure associated to risk transfer of individuals between 18 years to 50 years. Above the upper limit (here 50 years), the system does not allow a new individual to pool resources in exchange for risk transfer of critical illness. In some systems, the actual risk cover is longer, e.g. up to the age of 65 year. However, the individual also in those cases must have applied to the system before the first upper limit (here 50 years). For example for UK, individuals can usually apply for cover up to the age of 65 with cover expiring at 75.
  • Distressing symptoms are common, resource utilization and costs are enormous, return to the community is rare, and 6-mon ⁇ h mortality rates exceed those for most malignancies.
  • An other class of problematic chronic critical illness is related to dementia.
  • Dementia is defined as a serious loss of global cognitive ability in a previously unimpaired person, beyond what might be expected from normal aging. It may be static, the result of a unique global brain injury, or progressive, resulting in long-term decline due to damage or disease in the body. Although dementia is far more common in the geriatric population (about 5% of those over 65 are said to be involved), it can occur before the age of 65, in which case it is called "early onset dementia”. Dementia is not a classical disease, but is indicated typically by set of non- specific symptoms. Affected cognitive areas can be memory, attention, language, and problem solving. Normally, symptoms must be present for at least six months to support a diagnosis. Cognitive dysfunction of shorter duration is called delirium.
  • dementia In advanced stages of dementia, subjects can be disoriented in time (not knowing the day, week, or even year), in place (not knowing where they are), and in person (not knowing who they and/or others around them are). Dementia is classified as either reversible or irreversible, depending upon the etiology of the disease. It is important to note that dementia is not reversible in the sense that the system (human) undergoing the process can be returned to its original state, i.e. can be cured to a state without dementia. In the present state of neurological research, dementia is not curable as such. However, there can be specific conditions where the clinical symptoms mimic or closely mimic those suffered by those with dementia. Reversible used in connection with dementia means that these conditions are reversible.
  • Alzheimer's disease vascular dementia
  • frontotemporal dementia semantic dementia
  • dementia with Lewy bodies A patient can exhibit two or more dementing processes at the same time, as none of the known types of dementia protects against the others.
  • mixed dementia which may be a combination of Alzheimer's disease and multi-infarct dementia.
  • other critical illnesses like malignant cancer, also in the case of dementia, especially in advanced stages of dementia, the patient is exposed to the same problems as above mentioned for critical illnesses. The patient will be ⁇
  • Cost estimations of treating the chronically critically ill in the United States already exceed $20 billion and are increasing. Therefore, it is a need, especially for older people, to provide the possibility for risk transfer related to chronic critical illnesses without an age restriction, excluding the age group, which need risk transfer most for chronic critical illnesses.
  • the risk at 75 was more than double that of the 66 to 69 year olds. And this rose to more than five times the risk for those age 85 and older. Women had a marginally higher risk than men and, as other studies have shown, race was also important to risk. Length of stay in ICU was not a factor nor was the need for mechanical ventilation, (cf. fig. 5/6, C. Guerra et al., Critical Care 2012 16:R233) Three factors could be identified related to the critical illness as being independently associated with an increased risk of a diagnosis of dementia (cf. fig. 7, C.
  • the system should be designable to be based on a single occurrence scheme following the diagnosis of specific condition having multiple triggers following each diagnosis. As an option, the system should also be able to capture for multiple occurrence of critical illness, including dementia followed by the occurrence of a critical illness.
  • Traditional critical illness risk transfer systems are not able to capture this group of persons affected by critical chronic illnesses and provide an efficient method for risk transfer, thereby providing mechanism to unburden public social wellness services and duties and to alleviate social hardship.
  • the critical illness insurance system realized as a automated resource-pooling system shall be completely automated and self-adaptable/self-maintaining by its technical means and shall provide the technical risk transfer basis, which can be used by service providers in the risk transfer or insurance technology for risk transfer related to critical illness risks (CI).
  • CI critical illness risks
  • a further object of the invention provides for a way to technically capture, handle and automate complex related operations of the insurance industry related to critical illness risk transfer. Another object is to synchronize and adjust such operations based on technical means.
  • the resource-pooling system shall create a reproducible operation with the desired, technically based, repetitious accuracy based on technical means, process flow and process control/operation. It is also an object of the invention to provide a risk and resource-pooling system able to cope with difficult chronic progress of critical illnesses and further with complex related multiple risk events, especially associated with a cohort of elderly persons.
  • the resource-pooling system comprises an event-driven core engine comprising critical illness triggers triggering in a patient dataflow pathway to provide risk protection for a specific risk exposure component based on received and stored payments of the risk exposure components
  • the resource-pooling system comprises a filter-module for capturing age-related parameters of risk exposure components and for filtering risk exposure components associated with an age-related parameter greater than a predefined age-threshold value by means of the predefined age-threshold value
  • the resource-pooling system comprises a predefined searchable table of acute and/or chronic critical illnesses parameters indicating the occurrence of dementia and/or heart attack and/or cancer and/or a stroke and/or coronary artery by-pass surgery, Alzheimer's disease and/
  • the critical illness triggers can for example comprise a trigger for triggering the occurrence of measuring parameters indicating dementia based on measuring parameters associated with the permanent clinical loss of the ability to remember and/or reason and/or perceive, understand, express and give effect to ideas in the patient dataflow pathway.
  • the critical illness triggers further can e.g. comprise a trigger for triggering measuring parameters indicating alcohol and/or drug abuse in the patient dataflow pathway, wherein upon triggering measuring parameters indicating alcohol and/or drug abuse the related risk exposure component is rejected from pooling of the risk and resources by means of the resource-pooling system.
  • the first parametric payment for example can technically be implemented in that it only is transferred by the triggering of the occurrence of measuring parameters indicating the critical illness of malignant cancer and/or a smaller incidence for ductal carcinoma in situ (DCIS) and/or early prostate carcinoma.
  • DCIS ductal carcinoma in situ
  • acute treatment phase parameters indicating surgery and/or chemotherapy and/or radiotherapy and/or reconstructive surgery can be triggered on the patient data flow pathway by means of a critical illness trigger by the core engine.
  • the total risk of the pooled risk exposure components comprises a first risk contribution of each pooled risk exposure components associated to risk exposure in relation to a first diagnosis of a critical illness, wherein the critical illness is comprised in a predefined searchable table of critical illnesses and wherein critical illness losses occur as a consequence to the first diagnosis of risk exposure components with one of the searchable critical illnesses, and that the total risk of the pooled risk exposure components comprises at least a second and/or successional risk contributions associated to risk exposure in relation to a second and/or successional critical illnesses, wherein the critical illnesses are comprised in the predefined searchable table of critical illness parameters, and wherein a critical illness loss losses occurs as a consequence to the second and/or successional diagnosis of risk exposure components with one of the searchable critical illnesses, and that in case of a triggering of an occurrence of a first or second or successional critical illness in the patient data flow pathway of a risk exposure component, a corresponding trigger-flag is set by means of the resource-pooling system and
  • the critical illness triggers comprise a trigger for triggering the occurrence of measuring parameters indicating dementia based on measuring parameters associated with the permanent clinical loss of the ability to remember and/or reason and/or perceive, understand, express and give effect to ideas in the patient dataflow pathway.
  • the triggering measuring parameters indicating dementia can e.g. comprise physical parameters and/or psychological parameters and/or biochemical parameters and/or cognitive factors based on adrenal exhaustion factors and/or food and chemical reactions factors and/or nutritional deficiencies factors and/or stress factors and/or depression factors, or denial factors, indicating confirmed impairment of cognitive functions.
  • the critical illness triggers triggering the first treatment phase of the chronic critical illness can e.g.
  • the critical illness triggers triggering an ongoing care or management phase of the chronic critical illness can e.g. comprise ongoing care or management phase parameters indicating permanent cognitive and/or motor impairment requiring continuous supervision of another person and/or ongoing care or management phase parameters indicating permanent cognitive and/or motor impairment requiring constant supervision of another person.
  • the critical illness triggers can e.g.
  • the critical illness triggers triggering the first treatment phase of the chronic critical illness can e.g. further comprise first treatment phase parameter indicating a measured time interval of the risk exposure component spend in hospital due to the triggered stroke.
  • the critical illness triggers triggering an ongoing care or management phase of the chronic critical illness comprise ongoing care or management phase parameters indicating permanent impairments of the cognitive functions and/or permanent cognitive and/or motor impairment requiring continuous supervision of another person and/or permanent cognitive and/or motor impairment requiring constant supervision of another person.
  • a second parametric payment is transferred due to the triggering of acute treatment phase parameters indicating surgery and/or
  • recovery phase parameters associated with terminal prognosis data can e.g. be triggered in a patient data flow pathway by means of a critical illness trigger of the core engine.
  • a third parametric payment is transferred by the triggering of the recovery phase parameters and/or terminal prognosis parameters.
  • the critical illness data of the patient dataflow pathway of the risk exposure component can e.g. additionally be transferred to an automated employee assistance system (EAP: Employee Assistance Program) providing automated support to the risk exposure component.
  • EAP Employee Assistance Program
  • the critical illness data of the patient dataflow pathway of the risk exposure component can e.g.
  • the patient dataflow pathway is e.g. monitored by the resource- pooling system by capturing patient-measuring parameters of the patient data flow pathway at least periodically and/or within predefined time frames or periods.
  • the patient data flow pathway can e.g. be dynamically monitored by the resource- pooling system in that it triggers patient-measuring parameters of the patient dataflow pathway transmitted from associated measuring systems.
  • the system has, furthermore, the advantage that smaller payments than in traditional critical illness systems are sufficient to allow for a safe operation of the system.
  • the operational aspects of the system are transparent for operators as well as covered risk units, since payment is transferred in response to certain triggers on the cancer patient's information pathways.
  • the system is able to provide an adaptable survival period e.g. 14, 21 or 28 days, to be confirmed or defined by the risk transfer.
  • the system is further able to provide the technical implementation of an automated system that is based on a drawdown payment operation or a predefined payment operation.
  • the system also provides the technical means, which can support different underwriting options, such as (i) underwritten with a set of questions, (ii) in/out underwriting, (iii) inclusion or exclusion of Pre-Existing Condition Exclusion (PECE) and/or a related Conditions
  • underwriting options such as (i) underwritten with a set of questions, (ii) in/out underwriting, (iii) inclusion or exclusion of Pre-Existing Condition Exclusion (PECE) and/or a related conditions
  • PECE-problems are based on the fact that resource-pooling systems are often required by an employer to create safety provisions, if there is a diagnosis of a critical illness in an employee, in order to provide a lump sum benefit for an employee (or the employee's spouse or children, if comprised in the risk transfer), who is diagnosed with one of the defined medical conditions or undergoes one of the listed surgical procedures.
  • IFA independent financial advisers
  • the above-mentioned objects for risk sharing of critical illness risks of a variable number of risk exposure components are achieved, particularly, by providing a dynamic self-sufficient risk protection for the risk exposure components by means of the critical illness insurance system based on a resource- pooling system, in that risk-related component data are processed by an assembly module of the resource-pooling system and the likelihood of said risk exposure is provided by means of the assembly module for one or a plurality of the pooled risk exposure components based on the risk-related component data, wherein the risk exposure components are connected to the resource-pooling system by means of a plurality of payment receiving modules, and payment data are received and stored by means of a payment data store from the risk exposure components for the pooling of their risks, and wherein the resource-pooling system triggers a patient dataflow pathway by means of critical illness triggers of an event-driven core engine in order to provide risk protection for a specific risk exposure component based on received and stored payments from the risk exposure components, in that a first risk contribution of each pooled risk exposure components
  • the receiving and preconditioned storage of payments from risk exposure components for the pooling of their risks is dynamically determined based on total risk and/or the likelihood of the risk exposure of the pooled risk exposure components.
  • This embodiment variant has, inter alia, the advantage that the operation of the resource-pooling system can be dynamically adapted to changing conditions of the pooled risk, as, for example, changing demographic conditions or changing age distributions or the like of the pooled risk components.
  • a further advantage is that the system needs no manual adaption, when it is operated in different environments, places or countries, because the size of the payments of the risk exposure components is directly related to the totally pooled risk.
  • the number of pooled risk exposure components is dynamically adapted, by means of the resource-pooling system, to a range where non-covariant occurring risks covered by the resource-pooling system affect only a relatively small proportion of the total pooled risk exposure components at a given time.
  • This variant has, inter alia, the advantage that the operational and financial stability of the system can be improved.
  • the critical illness triggers are dynamically adapted by means of an operating module based on time-correlated incidence data for a critical illness condition and/or diagnosis or treatment conditions indicating improvements in diagnosis or treatment.
  • This variant has, inter alia, the advantage that improvements in diagnosis or treatment can be dynamically captured by the system and dynamically affect the overall operation of the system based on the total risk of the pooled risk exposure components.
  • the first, second and third parametric payment are leveled by a predefined total payment sum determined at least based on the risk-related component data and/or on the likelihood of the risk exposure for one or a plurality of the pooled risk exposure components based on the risk-related
  • the predefined total payments can e.g. be leveled to any appropriate lump sum, such as, for example, $50,000 up to $500,000, or any other sum related to the total transferred risk and the amount of the periodic payments of the risk exposure component.
  • the critical illness trigger e.g.
  • each of said trigger-flags is assigned to a first dimension trigger channel, comprising a first trigger-level triggering occurrence parameters of the critical illness, a second trigger-level triggering acute treatment phase parameters, and a third trigger-level triggering recovery phase parameters associated with terminal prognosis data, and each of said trigger-flags is assigned to at least a second or higher dimension trigger channel, and comprises additional trigger- stages based on the first, second and/or third trigger-level of the first dimension trigger channel.
  • the critical illness trigger can also comprise multidimensional trigger channels, wherein each of said trigger-flags is assigned to a first dimension of a trigger channels comprising a first trigger-level relative to triggering occurrence parameters of the critical illness, a second trigger-level relative to triggering acute treatment phase parameters, and a third trigger-level relative to triggering recovery phase parameters associated with terminal prognosis data, and each of said trigger-flags is assigned to a second dimension of trigger channels comprising a first trigger-level triggering on a first stage of progression-measuring parameters of the occurred critical illness, and one or more higher trigger-levels triggering on higher stages of progression-measuring parameters of the occurred critical illness.
  • This variant inter alia, has the advantage that the draw-down payments or the payments of predefined amounts, which depend on the first, second or third trigger level, i.e. the different stages of triggers, allow for an adapted payment of the total sum that is dependent on the stage of the critical illness, as triggered by the system.
  • a periodic payment transfer from the risk exposure components to the resource pooling system via a plurality of payment receiving modules is requested by means of a monitoring module of the resource- pooling system, wherein the risk transfer or protection for the risk exposure components is interrupted by the monitoring module when the periodic transfer is no longer detectable by means of the monitoring module.
  • the request for periodic payment transfer can be interrupted automatically or waived by means of the monitoring module, when the occurrence of indicators for critical illness is triggered in the patient data flow pathway of a risk exposure component.
  • an independent verification critical illness trigger of the resource pooling system is activated in cases of a triggering of the occurrence of indicators for critical illness in the patient data flow pathway of a risk exposure component by means of the critical illness trigger and wherein the independent verification critical illness trigger additionally is triggering for the occurrence of indicators regarding critical illness in an alternative patient data flow pathway with independent measuring parameters from the primary patient data flow pathway in order to verify the occurrence of the critical illness at the risk exposure component.
  • the parametric draw-down transfer of payments is only assigned to the corresponding trigger-flag, if the occurrence of the critical illness at the risk exposure component is verified by the independent verification critical illness trigger.
  • the present invention also relates to a computer program product that includes computer program code means for controlling one or more processors of the control system in such a manner that the control system performs the proposed method; and it relates, in particular, to a computer program product that includes a computer-readable medium containing therein the computer program code means for the processors.
  • Figure 1 shows a block diagram illustrating schematically an exemplary parametric, event-driven critical illness insurance system based on a resource-pooling system 1 according to the invention for risk sharing of critical illness risks associated with elderly persons by providing a dynamic self-sufficient risk protection for a variable number of risk exposure components 21 , 22, 23, i.e. said elderly persons.
  • the resource- pooling system 1 comprises an assembly module 5 to process risk- related component data 21 1 , 221 , 231 and to provide the likelihood 21 2, 222, 232 of said risk exposure for one or a plurality of the pooled risk exposure components 21 , 22, 23, wherein the risk exposure components 21 , 22, 23 are connected to the resource-pooling system 1 by means of a plurality of payment receiving modules 4 that are configured to receive and store 6 payments 214, 224, 234 from the risk exposure components 21 , 22, 23 for the pooling of their risks, and wherein the resource-pooling system 1 comprises an event- driven core engine 3 that comprises critical illness triggers 31 , 32, 33, which trigger a patient data flow pathway 21 3, 223, 233 to provide risk protection for a specific risk exposure component 21 , 22, 23.
  • the patient data flow pathway 213, 223, 233 is monitored by the resource-pooling system 1 in that patient measuring parameters of the patient data flow pathway 213, 223, 233 are captured, wherein the patient data flow pathway 213, 223, 233 is dynamically monitored and triggered for patient measuring parameters of the patient data flow pathway 213, 223, 233, which is transmitted from associated measuring systems.
  • Figure 2 shows a block diagram illustrating schematically exemplary trigger stages of the resource-pooling system, wherein reference number 1001 is assigned to the triggering of the critical illness, for example the malignant cancer.
  • Reference number 1002 designates the triggering of the treatment phase, such as, for example, surgery, chemotherapy, radiotherapy or medications of drugs etc.
  • Reference number 1003 designates the triggering of the recovery phase or the triggering of the terminal illness and/or the aftercare phase.
  • reference number 1004 designates the triggering of additional support services.
  • Reference number 1004 gives an example of additional trigger stages to the critical illness triggers 31 , 32, 33 of the core engine module 3.
  • Figure 3 shows a diagram illustrating schematically an exemplary payment drawdown as it can be provided by the resource pooling system 1 in case of triggering critical illness at a risk exposure component.
  • Figure 4 shows a block diagram illustrating schematically an exemplary parameterization of the risk exposure for critical illness of the risk exposure components 21 , 22, 23.
  • the reference numeral 520 gives the total transferred risk of a specific risk exposure component 21 , 22, 23 comprising at least a first risk contribution 51 1 , 521 , 531 for a first occurrence of a critical illness. Further, it comprises a second risk contribution 512, 522, 532 related to a second occurrence of a critical illness. It also can comprise third 513, 523, 533 and subsequent 51 i, 52i, 53i risk contributions thereafter; i.e., "i" herein denotes the i- ⁇ h risk distribution.
  • Figure 5 shows a diagram illustrating schematically the cumulative incidence of all mortality and dementia for elderly ICU survivors over three years, adjusting for mortality as a competing risk.
  • the dashed line is the cumulative incidence of all mortality during follow-up.
  • the solid line is the cumulative incidence of dementia after adjusting for mortality as a competing event.
  • Figure 6 shows a diagram illustrating schematically the cumulative incidence of dementia by five year age categories. Cumulative incidence of dementia, adjusted for mortality as a competing event, by age.
  • Figure 7 shows a diagram illustrating schematically the cumulative incidence of dementia, stratified by (A) infection or severe sepsis, (B) acute neurologic dysfunction, (C) acute renal replacement therapy. Cumulative incidence (A. long dashed line is for infection, short dashed line is for severe sepsis, solid line is for no infection; B. dashed line is for neurologic dysfunction, solid line is for none; C. dashed line is for acute RRT (renal replacement therapy), solid line is for none of dementia after adjusting for mortality as a competing event.
  • Figure 8 shows a flowchart illustrating schematically the exclusions of patients with previous indications of cognitive impairment for whom dementia could have been an escalation of a pre-existing condition resulting in the final cohort indicating the risk for related occurrence of dementia as critical illness for elderly.
  • Figure 1 illustrates, schematically, an architecture for a possible implementation of an embodiment of the parametric, event-driven resource-pooling system 1 for risk sharing of critical illness risks associated with elderly persons.
  • reference numeral 1 refers to the resource-pooling system for risk sharing of the risk exposure components 21 , 22, 23...
  • the resource-pooling system 1 provides a dynamic self-sufficient risk protection and corresponding risk protection structure for a variable number of risk exposure components 21 , 22, 23, i.e.; persons or individuals, by its means.
  • the system 1 includes at least one processor and associated memory modules.
  • the system 1 can also include one or more display units and operating elements, such as a keyboard, and/or graphical pointing devices as a computer mouse.
  • the resource- pooling system 1 is a technical device comprising electronic means that can be used by service providers in the field of risk transfer or insurance technology for risk transfer related to critical illness risks (CI) .
  • the invention seeks to technically capture, handle and automate complex related operations of the insurance industry.
  • An other aspect is to synchronize and adjust such operations based on technical means.
  • the resource-pooling system also achieves an reproducible operations with the desired technical, repetitious accuracy because it is completely based on technical means, process flow and process control/operation.
  • the resource-pooling system 1 comprises an assembly module 5 to process risk related component data 21 1 , 221 , 231 and to provide the likelihood 212, 222, 232 of said risk exposure for one or a plurality of the pooled risk exposure components 21 , 22, 23, etc. based on the risk-related component data 21 1 , 221 , 231 .
  • the resource-pooling system 1 can be implemented as a technical platform, which is developed and implemented to provide critical illness risk transfer through a plurality of (but at least one) payment receiving module 4.
  • the plurality of risk exposure components 21 , 22, 23 from a cohort of selected elderly persons, where during capturing the risk exposure components 21 , 22, 23 to be pooled by the system 1 , age-related parameters of risk exposure components are captured. Based on the captured age-related parameters the risk exposure
  • the filter module is filtered by means of a filter module, wherein by means of the filter module only risk exposure components 21 , 22, 23 associated with an age-related parameter greater than a predefined age-threshold value are allowed to be pooled by the system 1 .
  • the predefined age-threshold value can e.g. be set to 50 years or an appropriate other age allowing to select specific cohort of elderly persons.
  • the selection criterion can comprise further parameters as gender, origin, habits, urban or rural conglomeration etc.
  • the storage of the payments can be implemented by transferring and storing component-specific payment parameters.
  • the payment amount can be dynamically determined by means of the resource-pooling system 1 based on total risk of the overall pooled risk exposure components 21 , 22, 23.
  • the resource-pooling system 1 can comprise a monitoring module 8 requesting a periodic payment transfer from the risk exposure components 21 , 22, 23, etc. to the resource-pooling system 1 by means of the plurality of payment receiving modules 2, wherein the risk protection for the risk exposure components 21 , 22, 23 is interrupted by the monitoring module 8, when the periodic transfer is no longer detectable by means of the monitoring module 8.
  • the request for periodic payment transfers is automatically interrupted or waived by means of the monitoring module 8, if the occurrence 1001 of indicators for critical illness 71 , 72, 73 is triggered 31 in the patient data flow pathway of a risk exposure component 21 , 22, 23,...
  • the resource-pooling system 1 further comprises a predefined searchable table 7 of acute and/or chronic critical illnesses 71 , 72, 73 parameters indicating the
  • dementia and/or heart attack and/or cancer and/or a stroke and/or coronary artery by-pass surgery Alzheimer's disease and/or blindness and/or deafness and/or kidney failure and/or major organ transplant and/or multiple sclerosis and/or HIV/AIDS contracted by blood transfusion or during an operation and/or Parkinson's disease and/or paralysis of limb and/or terminal illness and/or other any definable and measurable critical illnesses in the patient dataflow pathway 213, 223, 233.
  • the triggers 31 , 32, 33 are uni- or bidirectionally connected with the predefined searchable table 7 of acute or chronic critical illnesses 71 , 72, 73, wherein the triggering 31 , 32, 33 is performed based on the acute and/or chronic critical illnesses 71 , 72, 73 parameters stored in the predefined searchable table 7.
  • the critical illness triggers 31 , 32, 33 can comprise a trigger 31 for triggering the occurrence of measuring parameters indicating dementia based on measuring parameters associated with the permanent clinical loss of the ability to remember and/or reason and/or perceive, understand, express and give effect to ideas in the patient dataflow pathway 213, 223, 233.
  • the critical illness triggers 31 , 32, 33 further can comprise a trigger 31 for triggering measuring parameters indicating alcohol and/or drug abuse in the patient dataflow pathway 213, 223, 233, wherein upon triggering measuring parameters indicating alcohol and/or drug abuse the related risk exposure component (21 , 22, 23, ...) is rejected from pooling of the risk and resources by means of the resource-pooling system 1 .
  • the resource-pooling system 1 includes a data storing module for capturing the risk-related component data and multiple functional modules; e.g., namely the payment receiving modules 4, the core engine 3 with the triggers 31 , 32, 33, the assembly module 5 or the operating module 30.
  • the functional modules can be implemented at least partly as programmed software modules stored on a computer readable medium, connected as fixed or removable to the processor(s) of system 1 or to associated automated systems.
  • the functional modules can also be implemented fully by means of hardware components, units and/or appropriately implemented modules.
  • system 1 can be connected via a network, such as a
  • the network can include a wired or wireless network; e.g., the Internet, a GSM network (Global System for Mobile Communication), an UMTS network (Universal Mobile Telecommunications System) and/or a WLAN (Wireless Local Region Network), and/or dedicated poin ⁇ - ⁇ o- point communication lines.
  • the technical electronic money schemes for the present system comprises adequate technical, organizational and procedural safeguard means in order to prevent, contain and detect threats to the security of the scheme, particularly the threat of counterfeits.
  • the resource-pooling system 1 comprises further all necessary technical means for electronic money transfer and association e.g. initiated by one or more associated payment receiving modules 4 over an electronic network.
  • the monetary parameters can be based on all possible electronic and transferable means as e.g. e-currency, e-money, electronic cash, electronic currency, digital money, digital cash, digital currency, or cyber currency etc., which can only be exchanged electronically.
  • the payment data store 6 provides the means for associating and storing monetary parameters associated with a single of the pooled risk exposure components 21 , 22, 23.
  • the present invention can involve the use of the mentioned network, such as e.g. computer networks or telecommunication networks, and/or the internet and digital stored value systems.
  • Electronic funds transfer (EFT), direct deposit, digital gold currency and virtual currency are further examples of electronic money.
  • the transfer can involve technologies, such as financial cryptography and technologies enabling the same.
  • the resource-pooling system 1 supports, for example, non-reversible transactions.
  • the advantage of this arrangement is that the operating costs of the electronic currency system are greatly reduced by not having to resolve payment disputes. However, this way, it is also possible for electronic currency transactions to clear instantly, making the funds available immediately to the system 1 .
  • This means that using hard electronic currency is more akin to a cash transaction.
  • soft electronic currency such as currency that allows for the reversal of payments, for example having a "clearing time" of 72 hours, or the like.
  • the way of the electronic monetary parameter exchange applies to all connected systems and modules related to the resource- pooling system 1 of the present invention, such as e.g. the payment receiving module 4.
  • the monetary parameter transfer to the resource-pooling system 1 can be initiated by a payment-receiving module 4 or on request of the resource-pooling system 1 .
  • the resource-pooling system 1 comprises an event-driven core engine 3 comprising critical illness triggers 31 , 32, 33 for triggering component-specific measuring parameters in the patient data flow pathway 213, 223, 233 of the assigned risk exposure components 21 , 22, 23
  • the patient data flow pathway 213, 223, 233 can e.g. be monitored by the resource-pooling system 1 , capturing patient-related measuring parameters of the patient data flow pathway 213, 223, 233 at least periodically and/or within predefined time periods.
  • the patient data flow pathway 213, 223, 233 can, for example, also be dynamically monitored by the resource-pooling system 1 , by triggering patient-measuring parameters of the patient data flow pathway 213, 223, 233 transmitted from associated measuring systems.
  • Triggering the patient data flow pathway 213, 223, 233 which comprises dynamically recorded measuring parameters of the concerned risk exposure components 21 , 22, 23 the system 1 is able to detect the occurrence of a critical illness and dynamically monitor the different stages during the progress of the critical illness in order to provide appropriately adapted and gradated risk protection for a specific risk exposure component 21 , 22, 23
  • Such a risk protection structure is based on received and stored payments 214, 224, 234 from the related risk exposure component 21 , 22, 23 and/or related to the total risk of the resource-pooling system ,1 based on the overall transferred critical illness risks of all pooled risk exposure components 21 , 22, 23
  • Figure 2 shows a block diagram with possible trigger stages, wherein reference number 1001 is assigned to the triggering of the critical illness, for example cancer; reference number 1002 designates the triggering of the treatment phase, such as, for example, surgery, chemotherapy, radiotherapy or the administration of medication, etc.; reference number 1003 designates the triggering of the recovery phase or the triggering of the terminal illness and
  • Reference number 1004 gives an example of additional trigger stages to the critical illness triggers 31 , 32, 33 of the core engine module 3.
  • the critical illness triggers 31 , 32, 33 can e.g. comprise a trigger 31 for triggering the occurrence 1001 of the measuring parameters, indicating a heart attack and/or cancer and/or a stroke and/or coronary artery by-pass surgery in the patient data flow pathway 213, 223, 233.
  • the critical illness triggers 31 , 32, 33 can comprise a trigger 31 for triggering the occurrence 1001 of measuring parameters indicating Alzheimer's disease, dementia, blindness, deafness, kidney failure, major organ transplant, multiple sclerosis, HIV/AIDS contracted by blood transfusion or during an operation, Parkinson's disease, paralysis of limb, terminal illness in the patient data flow pathway 213, 223, 233.
  • the majority of cases of occurrences of critical illness are typically related to heart attack, stroke and cancer, as can be expected.
  • the average age of individual 21 , 22, 23, at which a critical illness can be detected in the patient data flow pathway 213, 223, 233, is ⁇ 41 years; however, this depends on the development of diagnostic and other medical means. These statistics are common for all countries where statistics are maintained.
  • the definitions of the stored trigger parameters 71 , 72, 73 of critical illness in the trigger table 7 can be dynamically adapted based on a monitoring of changing risks in the risk exposure components 21 , 22, 23.
  • the trigger parameters 71 , 72, 73 can be region-specific, country-specific and/or specific of the total pooled risk, adapted or changed.
  • New critical illnesses 71 , 72, 73 can be added, while others can be deleted from the triggerable list of critical illnesses by the resource-pooling system, owing to better treatments or other changed environmental conditions.
  • the critical illness triggers 31 , 32, 33 can be dynamically adapted by means of an operating module 30, based on time-correlated incidence dates of a critical illness condition and/or diagnosis or treatment conditions indicating improvements in diagnosis or treatment.
  • the amount of requested payments from the risk exposure components 21 , 22, 23 can be accordingly adjusted by the resource-pooling system 1 .
  • the receiving and preconditioned storage 6 of payments 214, 224, 234 from risk exposure components 21 , 22, 23, ... for the pooling of their risks can be determined dynamically, based on total risk 50 and/or the likelihood of the risk exposure of the pooled risk exposure components 21 , 22, 23, ...
  • the total risk 50 of the pooled risk exposure components 21 , 22, 23, ... can comprise several risk contributions, as it can comprise a first risk contribution 51 1 , 521 , 531 of each pooled risk exposure component 21 , 22, 23, ... that is associated with risk exposure in relation to a first diagnosis of a critical illness.
  • the triggering parameters 71 , 72, 73 of the covered critical illnesses is comprised and stored in a predefined searchable table 7, such as e.g. an appropriately structured hash table, of critical illnesses 71 , 72, 73, respectively critical illness parameters 71 , 72, 73.
  • the critical illness losses occur as a consequence to the first diagnosis of risk exposure components 21 , 22, 23, ...
  • the total risk 50 of the pooled risk exposure components 21 , 22, 23,... can further comprise a second risk contribution 512,522,523 and/or third or additional successional risk contributions
  • the critical illnesses 71 , 72, 73 for triggering the second risk contribution 512, 522, 523 and/or third or additional successional risk contributions 513/521 /...51 i/52i/53i are the same as for the first risk contribution and comprised in the predefined searchable table 7 of critical illness parameters 71 , 72, 73.
  • the total risk contribution is only based on a single triggering of an occurrence of a acute and/or chronic critical illness, i.e. the primary scheme is designed to be a single occurrence scheme following the diagnosis of specific condition, where there are multiple triggers following each diagnosis, enabling the system to handle chronic critical illness.
  • Figure 4 shows a block diagram with an exemplary parameterization of the risk exposure for critical illness of the risk exposure components 21 , 22, 23.
  • the reference numeral 520 gives the total transferred risk of a specific risk exposure component 21 , 22, 23 comprising a ⁇ least a first risk contribution 51 1 , 521 , 531 for a first occurrence of a critical illness. Further comprised is a second risk contribution 51 2, 522, 532 related to a second occurrence of a critical illness. Also comprised can be a third 51 3, 523, 533 and subsequent 51 i,52i,53i risk contribution; i.e., "i" denotes the i- ⁇ h risk distribution.
  • a corresponding trigger-flag is set by means of the resource-pooling system 1 and a parametric drawdown or predefined transfer of payments is assigned to this corresponding trigger-flag.
  • a loss associated with the first or second or successional critical illness (es) 71 , 72, 73 is distinctly covered by the resource-pooling system 1 , based on the respective trigger- flag and based on the received and stored payment parameters 214, 224, 234 from risk exposure components 21 , 22, 23 by the parametric draw-down or predefined transfer from the resource-pooling system 1 to the risk exposure component 21 , 22, 23,e ⁇ c.
  • the payment receiving module 4 can, as an input device, comprise one or more data processing units, displays and other operating elements, such as a keyboard and/or a computer mouse or another pointing device. As mentioned previously, the receiving operation of the payments with regard to the risk exposure components 21 , 22, 23 is monitored based on the stored component-specific payment parameters in the payment data store 6.
  • the different components of the resource-pooling system 1 can be connected via a network for signal transmission.
  • the network can comprise, e.g., a telecommunications network, such as a wired or wireless network, e.g., the internet, a GSM network (Global System for Mobile Communications) , an UMTS network (Universal Mobile Telecommunications System) and/or a WLAN (Wireless Local Area Network) , a Public Switched Telephone Network (PSTN) and/or dedicated point- to-point communication lines.
  • a telecommunications network such as a wired or wireless network, e.g., the internet, a GSM network (Global System for Mobile Communications) , an UMTS network (Universal Mobile Telecommunications System) and/or a WLAN (Wireless Local Area Network) , a Public Switched Telephone Network (PSTN) and/or dedicated point- to-point communication lines.
  • GSM Global System for Mobile Communications
  • UMTS Universal Mobile Telecommunications System
  • WLAN Wireless Local Area Network
  • the payment receiving module 4 and/or core engine 3 and the assembly module 5 can also comprise a plurality of interfaces for connecting to the telecommunications network adhering to the transmission standard or protocol.
  • the payment receiving module 4 can also be implemented as an external device relative to the resource-pooling system 1 , which provides the risk transfer service via the network for signal transmission, e.g. by a secured data transmission line.
  • a first parametric payment 21 1 is transferred by triggering the occurrence 1001 of the critical illness 71 , 72, 73 by means of the critical illness trigger 31 of the core engine 3, thus triggering the measuring parameters of the specific risk exposure component 21 , 22, 23 in the related patient data flow pathway 213, 223, 233.
  • the first, second and third parametric payments are denoted in "units" in the examples according to table 1 to 5 (see below) .
  • the amount of those units (table 1 to 5) are just examples and can be either set as fixed running parameters of the system 1 for the duration of the transferred risks or any other defined time frame, or dynamically adapted based upon possibly changing environmental boundary conditions, as e.g. medical or therapeutic cost, or based upon the total pooled resources by means of the system 1 .
  • the changing of the environmental boundary conditions can by dynamically triggered or captured by the system 1 .
  • One "unit” can be assigned to correspond to an equivalent in a specific currency (e.g. EUROs, dollars or Swiss francs).
  • the core engine 3 analogously to the resource-pooling system 1 and the other components of the system, is implemented based on underlying electronic components, steering codes and interacting interface devices, such as e.g. appropriate signal generation modules or other modules interacting electronically by means of appropriate signal generation between the different modules, devices, or the like.
  • the first parametric payment can be transferred by triggering 31 the occurrence 1001 of measuring parameters indicating the critical illness 71 , 72, 73 of malignant cancer and/or smaller incidence of ductal carcinoma in situ (DCIS) and/or early prostate carcinoma.
  • DCIS ductal carcinoma in situ
  • the critical illness triggers 31 , 32, 33 can comprise a trigger 31 for triggering the occurrence of measuring parameters indicating dementia based on measuring parameters associated with the permanent clinical loss of the ability to remember and/or reason and/or perceive, understand, express and give effect to ideas in the patient dataflow pathway 213, 223, 233.
  • the triggering measuring parameters indicating dementia can also comprise physical parameters and/or psychological parameters and/or biochemical parameters and/or cognitive factors based on adrenal exhaustion factors and/or food and chemical reactions factors and/or nutritional deficiencies factors and/or stress factors and/or depression factors, or denial factors, indicating confirmed impairment of cognitive functions.
  • the critical illness triggers 31 , 32, 33 can comprise a trigger 31 for triggering the occurrence of measuring parameters indicating stroke based on measuring
  • a second parametric payment 212 is transferred by triggering measuring parameters in the patient data flow pathway 213, 223, 233 indicating the initiation of an acute or first treatment phase 1002 by means of the critical illness trigger 32 of the core engine 3. This is achieved by triggering 32 in case of an acute critical illness 71 , 72, 73, of an acute treatment phase 1002 of the acute critical illness 71 , 72, 73 or, in case of a chronic critical illness 71 , 72, 73, by triggering 32 of a first treatment phase 1002 of the chronic critical illness 71 , 72, 73.
  • acute or first treatment phase parameters 1002 indicating surgery and/or chemotherapy and/or radiotherapy and/or
  • reconstructive surgery can be triggered in patient data flow pathway 213, 223, 233 by means of a critical illness trigger 32 of the core engine 3.
  • the second parametric payment can only be transferred by triggering 32 acute or first treatment phase parameters 1002, indicating surgery and/or chemotherapy and/or radiotherapy and/or reconstructive surgery.
  • the critical illness triggers for triggering 32 the first treatment phase 1002 of the chronic critical illness 71 , 72, 73 can comprise first treatment phase parame ⁇ erl 002 indicating psychiatric or old-age in- patient care associated with the risk exposure component 21 , 22, 23, ... comprising acute in-patient admission parameters as a result of deterioration in dementia status requiring for urgent treatment.
  • the critical illness triggers for triggering 32 the first treatment phase 1002 of the chronic critical illness 71 , 72, 73 can comprise first treatment phase parameter 1002 indicating a measured time interval of the risk exposure component 21 , 22, 23, ... spend in hospital due to the triggered stroke.
  • a third parametric payment 213 is transferred, in the case of an acute critical illness 71 , 72, 73, by a triggering 33 of an aftercare phase 1003 linked to terminal prognosis data of the acute critical illness 71 , 72, 73.
  • the third parametric payment 213 is transferred by a triggering 33 an ongoing care or management phase of the chronic critical illness 71 , 72, 73. I.e.
  • the third parametric payment 213 is transferred in case of an acute chronic illness by triggering measuring parameters in the patient data flow pathway 213, 223, 233 indicating the initiation of a recovery phase 1003 linked to terminal prognosis data by means of the critical illness trigger 33 by the core engine 3, and in case of a chronic critical illness analogously.
  • recovery phase parameters 1003 linked to or associated with terminal prognosis data are triggered in patient data flow pathway 213, 223, 233 by means of a critical illness trigger 33 by the core engine 3.
  • the third parametric payment is only transferable by triggering 33 recovery phase parameters and/or terminal prognosis parameters 1003 and/or ongoing care or management phase.
  • the critical illness triggers 31 ,32,33 for triggering an ongoing care or management phase of the chronic critical illness 71 , 72, 73 can comprise ongoing care or management phase parameters indicating permanent cognitive and/or motor impairment requiring continuous supervision of another person and/or ongoing care or management phase parameters indicating permanent cognitive and/or motor impairment requiring constant supervision of another person.
  • the critical illness triggers 31 ,32,33 for triggering an ongoing care or management phase of the chronic critical illness 71 , 72, 73 can comprise ongoing care or management phase parameters indicating permanent impairments of the cognitive functions and/or permanent cognitive and/or motor impairment requiring continuous supervision of another person and/or permanent cognitive and/or motor impairment requiring constant supervision of another person.
  • triggering 1001 takes effect, an occurrence of a first critical illness 71 , 72, 73 in the patient dataflow pathway 213, 223, 233 of a risk exposure component 21 , 22, 23, any associated loss is covered by the resource-pooling system 1 based on the received and stored payments 214, 224, 234 from risk exposure components 21 , 22, 23 by transferring a parametric diagnosis payment 2001 from the resource-pooling system 1 to the risk exposure component 21 , 22, 23, etc.;
  • triggering 1002 takes effect, an occurrence of an acute treatment phase or first treatment phase in the patient data flow pathway 213, 223, 233 of an associated loss is covered by the resource-pooling system 1 based on the received and stored payments 214, 224, 234 from risk exposure components 21 , 22, 23 by transferring a parametric treatment phase payment 2002 from the resource-pooling system 1 to the risk exposure component 21 , 22, 23, etc.; and if triggering 1003 takes effect, an occurrence of a recovery phase linked to terminal prognosis data or an ongoing care or
  • the first, second and third parametric payments can, for example, be leveled by a predefined total payment sum determined at least based on the risk-related component data 21 1 , 221 , 231 and/or the likelihood of the risk exposure for one or a plurality of the pooled risk exposure components 21 , 22, 23, etc., based on the risk-related component data 21 1 , 221 , 231 , wherein the first parametric payment is transferred up to 30% of said total payment sum, and the second parametric payment is transferred up to 50% of said total payment sum, and the third parametric payment is transferred up to the residual part given by said total payment sum minus the actual first parametric payment and the second parametric payment.
  • Such an exemplary payment draw-down as it can be provided by the resource-pooling system 1 in the event of a triggering of a critical illness at a risk exposure component is shown in the diagram of Figure 3.
  • the triggers 31 ,32, 33 are uni- or bidirectionally connected with the predefined searchable table 7 of acute or chronic critical illnesses 71 , 72, 73, wherein the triggering 31 , 32, 33 is performed based on the acute or chronic critical illnesses 71 , 72, 73 parameters stored in the predefined searchable table 7.
  • the predefined searchable table 7 is multidimensionally structured, e.g. as a
  • Each acute or chronic critical illnesses 71 , 72, 73, selectable in the multidimensional table has assigned to it triggerable measuring parameters according to the trigger-step to be performed by means of the resource- pooling system 1 , i.e. trigger 31 and/or trigger 32 and/or trigger 33.
  • the stored trigger parameters of trigger 31 , 32, 33 of the predefined searchable table 7 can for example comprise the following trigger dependencies.
  • the predefined searchable table 7 can also comprise a predefined amount for the first, second and/or third parametric payment assigned to the corresponding trigger 31 , 32, 33. The amount can be fixed for a time-period contracted with the risk-exposed component.
  • the transferable parametric payments from the pooled resources by means of the resource pooling system 1 are dynamically adaptable by the system 1 , for example based on the pooled resources or based upon dynamically checked changing medical conditions or other boundary condition to the system 1 respectively to the associated and transferred risks.
  • Trigger 31 Trigger 32 Trigger 33 (aftercare trigger
  • Cancer including 10 ⁇ 00 Radiotherapy - for 5000 Supportive/home 5000 invasive malignant Units conditions covered Units support (ADL's) - Units melanoma (excluding under cancer in situ definition to be agreed cancer in situ and other and main cancer
  • Units conditions covered Units licensed by EMA and under cancer in situ and supported by the main cancer definitions treating Oncologist as
  • Table 1 Trigger parameter stored in searchable table 7 measured in the patient data pathway related to cancer measuring parameters. As seen in table 1 , the maximal transferable units under trigger 31 are in this example 12 ⁇ 00 units, under trigger 32 25 ⁇ 00
  • Trigger 31 Trigger 32 Trigger 33 (aftercare trigger (diagnosis trigger parameter) (treatment trigger parameter for parameter)
  • CABG Coronary 9000
  • Table 2 Trigger parameter stored in searchable table 7 measured in the patient data pathway related to coronary artery disease measuring parameters (including heart attack).
  • the maximal transferable units under trigger 31 are in this example l O'OOO units, under trigger 32 25 ⁇ 00 units and under trigger 33 15 ⁇ 00 units
  • Table 3 Trigger parameter stored in searchable table 7 measured in the patient data pathway related to stroke measuring parameters.
  • the maximal transferable units under trigger 31 are in this example l O'OOO units, under trigger 32 l O'OOO units and under trigger 33 30 ⁇ 00 units
  • Trigger 31 Trigger 32
  • Trigger 33 On-going care (diagnosis trigger parameter) (On-going care trigger management trigger parameter) parameter for dementia)
  • Table 4 Trigger parameter stored in searchable table 7 measured in the patient data pathway related to dementia measuring parameters.
  • the maximal transferable units under trigger 31 are in this example l O'OOO units, under trigger 32 l O'OOO units and under trigger 33 30 ⁇ 00 units.
  • the deterioration can be measured in MMSE scores
  • Alzheimer's disease who are not receiving treatment lose two to four MMSE points each year, cf. h ⁇ p://www.alzheimers.org.uk/si ⁇ e/scrip ⁇ s/documen ⁇ s_info.php?documen ⁇ ID 121 .
  • Table 5 Trigger parameter stored in searchable table 7 measured in the patient data pathway related to hip fracture measuring parameters.
  • the maximal transferable units under trigger 31 are in this example l O'OOO units, under trigger 32 and 33 no units are transferred by means of the system 1.
  • Table 5 is an example, where not all triggers are used, i.e. trigger 31 is the first and final trigger after triggering hip fracture measuring parameters in the patient data pathway (no on-going triggers 32 and/or 33). In the example
  • the critical illness triggers 31 , 32, 33 comprise multi-dimensional trigger channels.
  • Each of said trigger-flags is assigned to a first dimension trigger channel comprising a first trigger-level triggering 31 on occurrence parameter 1001 of the acute or chronic critical illness 71 , 72, 73, a second trigger-level triggering 32 on acute or first treatment phase parameter 1002, and a third trigger-level triggering 33 on recovery phase or ongoing care/management parameter 1003 linked to or associated with terminal prognosis data; and each of said trigger-flags is assigned to at least a second or higher dimension trigger channel and comprises additional trigger-stages based on the first, second and/or third trigger-levels of the first dimension trigger channel.
  • the critical illness trigger 31 , 32, 33 can e.g. comprise multi-dimensional trigger channels, wherein each of said trigger-flags is assigned to a first dimension of a trigger channel comprising a first trigger-level triggering 31 on occurrence parameter 1001 of the critical illness 71 , 72, 73, a second trigger-level triggering 32 on acute treatment phase parameter 1002, and a third trigger-level triggering 33 on recovery phase parameter 1003 linked to terminal prognosis data, and each of said trigger-flags is assigned to a second dimension of a trigger channel comprising a first trigger-level triggering 31 on a first stage of progression-measuring parameters of the occurrence 1001 with regard to critical illness 71 , 72, 73, and one or more higher trigger-levels triggering 32, 33 in higher stages of progression-measuring parameters of the occurred critical illness 71 , 72, 73.
  • the resource-pooling system 1 can be realized such that it transfers critical illness data in the patient data flow pathway 213, 223, 233 of the related risk exposure component 21 , 22, 23, etc., after triggering the occurrence of a critical illness 71 , 72, 73, to an automated employee assistance system (EAP: Employee Assistance Program) providing automated support to the risk exposure component 21 , 22, 23, etc.
  • EAP Employee Assistance Program
  • critical illness data in the patient data flow pathway 213, 223, 233 of the related risk exposure component 21 , 22, 23, etc. can be transferred to an alert system of an Citizens Advice Bureau (CAB) to activate automated or at least semi-automated CAB actions.
  • CAB Citizens Advice Bureau
  • an independent verification critical illness trigger of the resource-pooling system 1 can be activated in the event of a triggering of the occurrence 1001 of indicators for critical illness 71 , 72, 73 in the patient data flow pathway 213, 223, 233 of a risk exposure component 21 , 22, 23, etc. by means of the critical illness trigger 31 , and wherein the independent verification critical illness trigger additionally is triggering with regard to the occurrence 1001 indicators for critical illness 71 , 72, 73 in an alternative patient data flow pathway 215, 225, 235 with independent measuring parameters from the primary patient data flow pathway 213, 223, 233 to verify the occurrence 1001 of the critical illness 71 , 72, 73 at the risk exposure component 21 , 22, 23, etc.
  • the parametric draw-down or predefined transfer of payments is only assigned to the corresponding trigger-flag, if the occurrence 1001 of the critical illness 71 , 72, 73 at the risk exposure component 21 , 22, 23, etc. is verified by the independent verification critical illness trigger.

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Abstract

L'invention propose un système d'assurance maladie critique commandé par événement basé sur un système de groupement de ressources (1) et un procédé pour le partage de risque de risques de maladie critique associés aux personnes âgées en fournissant une protection contre les risques auto-suffisante dynamique pour un nombre variable de composants d'exposition à un risque (21, 22, 23) au moyen du système de groupement de ressources. Le système de groupement de ressources (1) comprend un module d'assemblage (5) pour traiter des données de composants relatives à un risque (211, 221, 231) et pour fournir la probabilité (212, 222, 232) de ladite exposition à un risque pour un ou une pluralité des composants d'exposition à un risque groupés (21, 22, 23, ...) sur la base des données de composants relatives à un risque (211, 221, 231). Les composants d'exposition à un risque (21, 22, 23) sont reliés au système de groupement de ressources (1) pour le groupement de leurs risques et de leurs ressources, et le système de groupement de ressources (1) comprend un moteur de noyau commandé par événements multiples (3) avec des déclencheurs de maladie critique (31, 32, 33) se déclenchant dans un passage de flux de données de patient (213, 223, 233) pour fournir une protection contre le risque pour un composant d'exposition à un risque spécifique (21, 22, 23) pour l'apparition de maladies aiguës et/ou critiques chroniques, telles que par exemple la démence et/ou une crise cardiaque. Le fonctionnement du système de groupement de ressources (1) est en outre pris en charge par une couverture de risque à déclencheurs multiples paramétrique.
EP13821495.2A 2013-10-17 2013-12-30 Système de groupement déclenché par des données de patient pour le partage de risque de risques de maladie critique chronique de cohortes de personnes âgées et procédé correspondant de ce système Ceased EP3058535A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP13821495.2A EP3058535A1 (fr) 2013-10-17 2013-12-30 Système de groupement déclenché par des données de patient pour le partage de risque de risques de maladie critique chronique de cohortes de personnes âgées et procédé correspondant de ce système

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
PCT/EP2013/071755 WO2015055248A1 (fr) 2013-10-17 2013-10-17 Système de nivellement paramétrique de partage de risques liés à des maladies graves et son procédé correspondant
PCT/EP2013/078137 WO2015055262A1 (fr) 2013-10-17 2013-12-30 Système de groupement déclenché par des données de patient pour le partage de risque de risques de maladie critique chronique de cohortes de personnes âgées et procédé correspondant de ce système
EP13821495.2A EP3058535A1 (fr) 2013-10-17 2013-12-30 Système de groupement déclenché par des données de patient pour le partage de risque de risques de maladie critique chronique de cohortes de personnes âgées et procédé correspondant de ce système

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EP3058535A1 true EP3058535A1 (fr) 2016-08-24

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Non-Patent Citations (2)

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