US20160210005A9 - Quick-Connection for Brokered Engagements - Google Patents

Quick-Connection for Brokered Engagements Download PDF

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US20160210005A9
US20160210005A9 US13/792,551 US201313792551A US2016210005A9 US 20160210005 A9 US20160210005 A9 US 20160210005A9 US 201313792551 A US201313792551 A US 201313792551A US 2016210005 A9 US2016210005 A9 US 2016210005A9
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provider
consumer
user interface
server
providers
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US20140201665A1 (en
Inventor
Roy Schoenberg
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American Well Corp
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American Well Corp
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Priority claimed from US11/763,680 external-priority patent/US7590550B2/en
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Priority to US13/792,551 priority Critical patent/US20160210005A9/en
Assigned to AMERICAN WELL CORPORATION reassignment AMERICAN WELL CORPORATION ASSIGNMENT OF ASSIGNORS INTEREST (SEE DOCUMENT FOR DETAILS). Assignors: SCHOENBERG, ROY
Publication of US20140201665A1 publication Critical patent/US20140201665A1/en
Publication of US20160210005A9 publication Critical patent/US20160210005A9/en
Abandoned legal-status Critical Current

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    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06QINFORMATION 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
    • G06Q10/00Administration; Management
    • G06Q10/10Office automation; Time management
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06FELECTRIC DIGITAL DATA PROCESSING
    • G06F3/00Input arrangements for transferring data to be processed into a form capable of being handled by the computer; Output arrangements for transferring data from processing unit to output unit, e.g. interface arrangements
    • G06F3/01Input arrangements or combined input and output arrangements for interaction between user and computer
    • G06F3/048Interaction techniques based on graphical user interfaces [GUI]
    • G06F3/0484Interaction techniques based on graphical user interfaces [GUI] for the control of specific functions or operations, e.g. selecting or manipulating an object, an image or a displayed text element, setting a parameter value or selecting a range
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/20ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H40/00ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
    • G16H40/60ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
    • G16H40/63ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H80/00ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
    • HELECTRICITY
    • H04ELECTRIC COMMUNICATION TECHNIQUE
    • H04LTRANSMISSION OF DIGITAL INFORMATION, e.g. TELEGRAPHIC COMMUNICATION
    • H04L65/00Network arrangements, protocols or services for supporting real-time applications in data packet communication
    • H04L65/40Support for services or applications
    • H04L65/403Arrangements for multi-party communication, e.g. for conferences

Definitions

  • the present disclosure is directed to connecting consumers with service providers.
  • Some systems have been developed to connect consumers and their providers over the Internet and the World Wide Web. Some systems use e-mail messaging and web-based forms to increase the level of connectivity between a member of a health plan and his assigned health care provider. The consumer sends an e-mail or goes to a website that generates and sends a message (typically an e-mail or an e-mail type message) to a local provider. These types of services have been broadly referred to as “e-visits.”
  • Other health care solutions include technologically advanced telephone communication solutions that use advances in voice communication and data transmission technology to interconnect medical professionals with patients.
  • a computer-implemented method includes a computer-implemented method including generating a first graphical user interface for accessing a brokerage system for providing broker services to consumers from service providers, the graphical user interface rendering a plurality of controls that when selected by a consumer, sends a request to consult with a service provider of a type associated with the corresponding one of the plurality of controls, sending by the one or more computers the graphical user interface to a device used by the consumer, receiving the request, and sending to the consumer a second graphical user interface to enable the user to provide information to a service provider for use during a consultation with a service provider of the type associated with the corresponding one of the controls.
  • a computer program product tangibly stored on a computer readable storage device for providing broker services to consumers and service providers comprising instructions for causing a computer to generate a first graphical user interface for accessing a brokerage system for providing broker services to consumers from service providers, the graphical user interface rendering a plurality of controls that when selected by a consumer, sends a request to consult with a service provider of a type associated with the corresponding one of the plurality of controls, send the graphical user interface to a device used by the consumer, receive the request, and send to the consumer a second graphical user interface to enable the user to provide information to a service provider for use during a consultation with a service provider of the type associated with the corresponding one of the controls.
  • an apparatus includes a processor, memory in communication with the processor, and a computer program product stored on a computer readable medium for providing broker services to consumers and service providers, the computer program product comprising instructions for causing the processor to a processor, memory in communication with the processor, and a computer program product tangibly stored on a computer readable storage device for providing broker services to consumers and service providers, the computer program product comprising instructions for causing a computer to generate a first graphical user interface for accessing a brokerage system for providing broker services to consumers from service providers, the graphical user interface rendering a plurality of controls that when selected by a consumer, sends a request to consult with a service provider of a type associated with the corresponding one of the plurality of controls, send the graphical user interface to a device used by the consumer, receive the request, and send to the consumer a second graphical user interface to enable the user to provide information to a service provider for use during a consultation with a service provider of the type associated with the corresponding one of the controls.
  • the types are different types of providers. Selecting a control in the first user interface that allows a user to toggle between a quick connect mode of use of the graphical user interface and a mode of use that lists providers.
  • Consumers can engage with the system using various modalities, including registered user, guest user and anonymous user.
  • an anonymous user modality is very useful for those types of individuals that may have serious issues, but which are generally reluctant to discuss issues with strangers.
  • FIG. 1 is a diagrammatic view of an arrangement including a brokerage system.
  • FIGS. 2A and 2B are flow charts useful in understanding next consumer processing in a brokerage service.
  • FIG. 3 is block diagram of an availability process.
  • FIG. 4 is a block diagram of an alternative availability process.
  • FIG. 5 is a block diagram of a record.
  • FIGS. 5A and 5B are block diagrams of queue structures.
  • FIG. 6 is a screenshot of a graphical user interface for a welcome screen.
  • FIG. 7 is a screenshot of a graphical user interface for an availability management screen.
  • FIG. 8 is a block diagram of a queue structure.
  • FIG. 9 is a flow chart for assigning providers based on provider networks/provider practices.
  • FIG. 10 is a screenshot of a quick-connect graphical user interface.
  • FIG. 11 is a flow chart for assigning providers based on the quick-connect graphical user interface.
  • the system described below provides an integrated information and communication platform that enables consumers of services to access service providers to consult and to carry out such consultations in an efficient manner. Consumers are able to consult with an expert service provider even when the two parties are geographically separated.
  • This integrated platform is referred to as a brokerage system (or depending on the context brokerage service).
  • an exemplary networked computer system 10 for engaging a consumer in a brokered consultation with a service provider includes a computerized system or server 12 for processing requests from consumers 14 at client systems 14 a to engage with providers 16 at provider systems 16 a .
  • the networked computer system 10 implements a brokerage service embodied as web-based engagement brokerage.
  • the networked computer system 10 includes a web server 18 to receive on-line web-based requests and which provides web-based communication channels between a provider and a consumer using a web browser or the like.
  • the server 18 receives a request for a consultation.
  • the request is parsed to identify the particular ailment or concern, etc. of the patient 14 .
  • the server 12 includes an availability or presence tracking module 26 for tracking the availability of the service providers 16 . Availability or presence of service providers is tracked actively or passively.
  • one or more of the service providers 16 provides an indication to the server 12 that the one or more service providers are available to be contacted by consumers 14 and an indication of the mode by which the provider may be contacted.
  • the provider's computer, phone, or other terminal device periodically provides an indication of the provider's availability (e.g., available, online, idle, busy) to the server 12 and a mode (e.g., text, voice, video, etc.) by which he can be engaged.
  • the server 12 presumes that the service provider 16 is available by the service provider's actions, including connecting to the server 12 or registering the provider's local phone number with the system. In some examples of a passive system, the server 12 indicates the provider 16 to be available at all times until the provider logs off, except when the provider is actively engaged with a consumer 14 .
  • the server 12 also includes one or more processes in addition to the tracking module 26 , such as a scheduling module 28 .
  • the server 12 accesses one or more databases 27 .
  • the components of the server 12 and the web server 18 may be integrated or distributed in various combinations, as is commonly known in the art.
  • the networked computer system 10 allows a consumer 14 to communicate with a provider 16 .
  • the consumer 14 and provider 16 connect to the server 12 through a website or other interface on the web server 18 using client devices 14 a and 16 a , respectively.
  • Client devices 14 a and 16 a can be any combination of, e.g., personal digital assistants, cell phones, computer systems, media-player-type devices, and so forth.
  • the client devices 14 a and 16 a enable the consumers 14 to input and receive information as well as to communicate via video, audio, and/or text with the providers 16 .
  • the server 12 determines whether that provider is available. If that particular provider 16 is available, the server 12 assesses the various modes of communication that are available forwards connection information of the consumer 14 to the service provider 16 through one or more common modes of communication. The system selects a mode of communication to use based in part on the relative utility of the various modes.
  • a mode of engagement has both the consumer 14 and the provider 16 use web-based consoles, as this allows each of the other modes to be used as needed.
  • consumers and providers may launch chat sessions, voice calls, or video chats from within a web-based console like that shown in FIG. 2A , below.
  • a web based console also provides on-demand access to records, such as the consumer's medical history, and other information.
  • the server 12 connects that participant's console to whatever form of communication the other party has available. For example, if the consumer is on the phone and the provider is using a web browser, the server 12 may connect the consumer's phone call to a VoIP session that the provider can access through the web. If the provider 16 is not available, the server 12 identifies other available providers 16 that would meet the consumer 14 's needs. The server 12 enables the consumer 14 to send a message to the consumer's chosen provider.
  • the server 12 includes an access control facility 30 that manages and controls whether a particular consumer 14 can access the networked computer system 10 and what level or scope of access to the features, functions, and services the networked computer system 10 will provide.
  • the server also includes next consumer processing 30 a that selects the next consumer according to an algorithm that manages provider queues, but that allows a provider to access the next consumer at various stages of the provider's interaction with the server.
  • the server also includes availability management 30 b processing that allows the provider to control availability across provider networks and practices as will be discussed below.
  • Provider networks are groups of affiliated provider practices and/or affiliated service providers. However, not all provider practices need be associated with a provider network. For example, individual service providers are also able to register and enroll with the system. Individual service providers are independent service providers not affiliated with a provider network and need not be a provider practice. Thus in the example of FIG. 7 if the particular provider was doing business under her own name her name would appear in the dashboard.
  • Examples of provider networks are entities that sponsor/host instances of the on-line care brokerage system, examples of which are insurance companies, whereas examples of provider practices are individual employers or independent practices of providers such as physician practices or hospitals, clinics etc. that affiliate with a particular provider network. In some instances, some of the types of entities that are provider practices as stated above could sponsor/host instances of the on-line care brokerage system and thus be a provider network.
  • One of the significant distinctions between an entity that is viewed as a provider network and one that is viewed as a provider practice is that the provider network is responsible for providing the on-line care brokerage infrastructure either directly or by a hosting relationship with another entity and also is responsible for recruiting a supply of service providers.
  • the server 12 can cause a communication channel to be established between the consumer and the provider via a web browser or the like.
  • the server 12 identifies service providers 16 that are available at any given moment to communicate with a consumer about a particular product, service, or related topic or subject, for example, a medical condition.
  • the networked computer system 10 assimilates the discretionary or fractional availability windows of time offered by individual providers at stations 16 a into a continuous availability perception by consumers. Consumers will have little expectation that the same provider will be constantly available, rather, they expect that some provider will be available.
  • the networked computer system 10 services patients that are members of healthcare plans.
  • the service providers 16 may be physicians, and the service consumers 14 may be patients.
  • the service providers and service consumers may also be lawyers and clients, contractors and homeowners, or any other combination of a provider of services and a consumer of services.
  • the system enables the consumer to search for providers that are available at the time the consumer is searching, and enables the consumer to engage a provider on a transactional basis or for a one-time consultation.
  • a consumer can use the system for various purposes, such as a consultation or second opinion.
  • An example of details of a brokerage system is discussed in my U.S. Pat. No. 7,590,550 entitled: “Connecting Consumers with Service Providers”, the contents of which are incorporated herein in its entirety.
  • patients send 42 requests for services to the server 12 .
  • the requests may include various information such as patient identification, health plan information, plan sponsor, etc.
  • the request is sent to the networked computer system 10 and received 52 by the server 12 for access to an online-care program offered by the system 10 .
  • the server 12 finds (not shown) a suitable provider based on attribute matching or assigns a patient to a provider queue with the lowest number of patients waiting.
  • the server 12 places an entry for the patient in a queue discussed below.
  • the server also receives 54 at a time asynchronous to the requests (indicated by dashed line) a log-in from a provider.
  • the server generates 56 a service provider graphical user interface as welcome screen, having a next patient control ( FIG. 6 ).
  • This welcome screen is a top level screen in a set of user interfaces ( FIGS. 6, 7 ) that permit a provider to access the server 12 to manage the provider's experience with the brokerage system 10 .
  • the system sends 58 the welcome screen (see FIG. 5 ) to the provider, and waits for a selection from the provider.
  • the server determines 60 the action. If the action is next patient, (the provider selected the next patient control) the server 12 executes 62 an algorithm to determine the next patient from patient records in the provider's queues.
  • the server 12 retrieves 68 the next patient record and prepares a session 69 by determining from information received from the patient what services will be required during the session, determining eligibility for services, etc.
  • the server 12 establishes a communication channel between the patient and the provider.
  • the server 12 continues 62 with welcome processing.
  • the server 12 determines 80 the action received. For example from the welcome screen, the server can receive a provider's selection to manage availability 82 .
  • the server generates 84 a service provider availability management interface ( FIG. 6 ) with the next patient control and sends the interface to the provider's system.
  • the provider manages availability and at that screen at any time can also select the next patient or can select another patient.
  • the server 12 receives 90 from the provider's system a selection from the welcome screen that causes the server 12 to continue to the provider's home page (referred to as a “reverse provider practice graphical user interface”) for particular provider networks/practices, as discussed in my co-pending published, application “Reverse Provider Practice” Pub. No. US-2012-0284362-A1 assigned to the assignee of the present invention and incorporated herein by reference in its entirety.
  • the provider's home page allows the provider to access graphical user interface for individual provider networks that display the types of health services that are offered by the sponsor to consumers.
  • the server generates 92 a service provider home page interface for that provider with the home page also including the next patient control.
  • the provider accesses the home page and interacts with the server 12 though the home page.
  • the provider will engage with a consumer (patient).
  • a selection can be made from one of the interfaces sent by the server 12 such as the service provider availability management interface ( FIG. 6 ) or the service provider home page interface (not shown).
  • the server 12 executes 93 the next patient algorithm to determine the next patient from patient records in the provider's queues.
  • the server retrieves 95 the next patient record (and prepares a session not shown).
  • the server 12 then establishes 98 a communication channel between the patient and the provider to enable the patient to engage 99 with the provider.
  • the server 12 retrieves 96 the provider selected patient and the server establishes the channel 98 .
  • the server 12 prepares a user session (not shown) by determining from information received from the patient what services will be required during the session (see 69 , above FIG. 2A ). In one example, the server 12 retrieves those services that the sponsor has chosen to be offered services. A sponsor selects offered services based on various factors including costs and usage data. Usage data is indicative of an amount of health services being consumed, by consumers, for a particular type of health service. The various factors can also gender, age, health status of the insured, as well as the availability of the services, cost of the services and how often the services were selected by segments of insured groups of individuals. Also the server can prepare payment information, e.g., co-pays and the like.
  • the provider chooses a patient from a virtual waiting room.
  • the virtual waiting room can include not only registered user patients, but other patients such as patients that are guest or anonymous users.
  • the server 12 facilitates sessions between the patient and the provider by establishing the real time communication channel between devices/systems used by the patient and the provider with the channel being established through the server 12 .
  • the server 12 causes establishment of the communication channel between devices/systems by a join of communication channels or by sending the provider connection information to call the patient in a call back mode.
  • the server 12 tracks 100 the availability of providers 16 and in some embodiments, on-line consumers 14 .
  • the provider 16 indicates 104 (such as by setting a check box or selecting a menu entry or by responding to a voice prompt) to the tracking module 26 that he or she is available to interact with consumers 14 .
  • the provider 16 can also indicate 106 a to the tracking module 26 (such as by setting a check box or selecting a menu entry or by responding to a voice prompt) the modes (e.g., telephone, chat, video conference) by which a consumer 14 can be connected to the provider 16 .
  • the server 12 also includes availability management processing 30 b (discussed in FIG. 4 ) to access 105 the availability management interface.
  • the tracking module 26 determines 106 b the capabilities of the terminals 14 a and 16 a the consumer 14 and the provider 16 use to connect to the system (for example, by using a terminal-based program to analyze the hardware configuration of each terminal).
  • the tracking module 26 determines that the provider 16 can be engaged by text (e.g., chat or instant messenger), voice (e.g., VoIP) or video conference.
  • the tracking module 26 determines that the provider 16 can be engaged by text or voice, whereas, if the consumer connects to the networked computer system 10 via a telephone for a telephonic engagement the provider will reply with a telephone call to the consumer.
  • the tracking module 26 can also infer 106 c a provider's availability and modes of engagement by the provider's previously provided profile information and the terminal device through which the provider connects to the system. The availability information can be transferred 108 to scheduling.
  • Providers participating in the brokerage system 10 can have several states of availability at different times. States in which the provider may be available include “on-line”, in which the provider is logged-in and can immediately accept new engagements in any mode, “on-line (busy)”, in which the provider is logged-in but is currently occupied in another engagement, and “scheduled”, in which the provider is offline but is scheduled to be online at a designated time-point and can pre-schedule engagements for it. A provider can also be not-logged in and thus unavailable.
  • the provider can take messages as in offline state.
  • another state includes off-line, in which the provider is not logged in but can take message-based engagements (i.e., asynchronous engagements), out-of-office, in which the provider is not accepting engagements or messages, and “on call”, in which the provider is offline and can be paged to go to on-line status by the brokerage network if traffic load demands it (in some examples, consumers see this state as offline).
  • message-based engagements i.e., asynchronous engagements
  • out-of-office in which the provider is not accepting engagements or messages
  • on call in which the provider is offline and can be paged to go to on-line status by the brokerage network if traffic load demands it (in some examples, consumers see this state as offline).
  • the operating business model for the provider network employs a remuneration scheme for affiliated providers that helps assure that the consumers can find providers in designated professional domains in the online mode. For example, selected providers can be remunerated for being in the on-call mode to encourage on-line availability in case of low discretionary availability by other providers in their professional domain. On-call providers are also called into the on-line state when the fraction of on-line (busy) provider's domain exceeds a certain threshold.
  • provider availability management 30 b is shown.
  • the provider is presented with a user interface ( FIG. 6 ) that enables the provider to selectively control/manage his/her availability status across provider networks and provider practices of which the provider is affiliated with.
  • the provider sends (not shown) a request to the server 12 for an availability management interface ( FIG. 6 ) and server receives 113 one or more indications of the provider's availability status.
  • the provider sets 114 an availability status either for each provider practice within a provider network, or sets 115 an availability status across all provider practices within a provider network.
  • the server 12 receives provider set availability status indications 116 , the server repeats the process and at any juncture (such as after receiving an indication) transfers 117 the availability status information to the scheduling process 28 .
  • the server 12 thus tracks the provider's availability based not only on any current engagements by the provider, but also on provider set availability status indications over provider networks/provider practices.
  • the server will update the provider's status with particular provider networks/provider practices according to selections made by the provider. These selections will in general override default provider availability indications set by the server 12 .
  • a consumer (e.g., patient) record 125 is shown. This record is retrieved, e.g., from a queue consumers waiting to be serviced by a provider or from a database based on retrieving an entry from the queue of consumers waiting to be serviced by a provider.
  • the record includes various items 125 a - n of information regarding the consumer.
  • the tracking module 26 transfers 117 ( FIG. 4 ) information about the availability of providers 16 and the communication capabilities of the consumers 14 and the providers 16 to the scheduling module 28 .
  • the scheduling module 28 uses the tracking information to schedule providers with consumers.
  • the scheduling module 26 also uses provider set availability status indications to either allow entries into certain queues or not depending on the provider set status ( FIG. 8 ).
  • each provider e.g., “provider-a” to “provider-n” is associated with a queue, e.g., 120 a - 120 n , respectively.
  • the queue for each provider is filled by the server 12 with entries (as depicted as entries 1 through i and entries 1 through m) that correspond to requests for consultations with a provider. More specifically, as consumers access the networked computer system 10 and are processed through the intake process, entries representing the consumers are produced by the server 12 and those entries are queued.
  • the server 12 stores the entries in queues of those providers that the server 12 determines has the least number of entries, in order to balance provider utilization across the system 10 , and to otherwise minimize overall response time for consumers.
  • the server 12 produces an entry for storage in one of the queues (generally 120 ).
  • the server 12 examines the queues 120 a - 120 n of all providers that are suitable to provide a consultation with the consumer and the server chooses the queue of a suitable provider that has the least number of entries waiting to be processed.
  • the queue e.g., queue 120 a of the chosen provider (provider-a) is loaded with that entry.
  • the server 12 uses in one embodiment a first in first out priority scheme to retrieve an entry from the query. Selecting of the next patient control on one of the aforementioned graphical user interfaces would in this scheduling algorithm chose the entry that is oldest in the queue. That is, in servicing consumer requests, for a particular provider, the server 12 retrieves the entry of a consumer that is next to be serviced (the oldest entry in the queue 120 ). As the provider services that consumer, the server 12 removes the corresponding entry from that provider's queue and the server 12 promotes all remaining entries in that queue such that the next entry in the queue to be serviced will be now be the oldest entry.
  • the next patient algorithm applies a priority scheme based on a priority designation of patients with those designated as “high priority” being given precedence over lower priority designations.
  • Any number of priority designations can be used, with three being a workable number of designations.
  • Priority designations can be based on an initial triage that is made during an intake process using either a triage algorithm or a service representative's assessment based on information obtained during intake. Many factors can be considered including, e.g., severity of conditions, degree of overuse of the brokerage system either by specific individuals or collectively by individuals in provider practices, e.g., associated with a sponsor (e.g., an employer/plan), specific employer and/or plan, etc.
  • a sponsor e.g., an employer/plan
  • Priority can also be based on specific online practices (e.g., patients coming in through the “Emergency Management” practice are higher priority than the “Flu” practice). Priority can consider multiple ones of those factors. For example, the priority algorithm can give precedence to the patient triaged with high priority based on severity of medical conditions and which is the oldest in the queue.
  • the server 12 retrieves the entry of a consumer that is next to be serviced at a priority designation that is currently the highest designation having entries in the queue 120 .
  • the server 12 removes the corresponding entry from that provider's queue and the server 12 promotes all remaining entries in that queue at that designation such that the next entry in the queue to be serviced will be now be the oldest entry at that priority designation.
  • the server will retrieve the entry of a consumer that is next to be serviced at a priority designation in the queue 120 that is the next lowest priority.
  • the server 12 can also monitor the queues to insure that the queues are not filled with high priority designations for one provider at such a rate that the provider cannot service lower priority designations.
  • the queues (generally 120 ′) for each provider are sub-divided or represented as plural sub-queues with each of the sub-queues corresponding to an appointment “state.”
  • two queues 120 a - 1 to 120 a - 2 and 120 n - 1 to 120 n - 2 are shown for each of the providers, e.g., “provider-a” to “provider-n” with the sub-queues 120 a - 1 to 120 a - 2 and 120 n - 1 to 120 n - 2 representing, “waiting room” and “scheduled appointments” of the respective providers “provider-a” to “provider-n.”
  • the server using scheduling module 116 examines the queues of all providers that are suitable to provide a consultation with the consumer and chooses the appropriate sub-queue of a suitable provider that has the least number of entries waiting to be processed for the particular state, e.g., “waiting room” and “scheduled appointments.” More specifically, for “telephonic engagements” the server loads entries into the waiting room queue of the particular provider that has the fewest entries.
  • the server 12 retrieves the entry of a consumer that is next to be serviced from the waiting room for that provider.
  • the next to be serviced is according to the following priority the oldest entry in the waiting room.
  • the oldest entry priority would be adjusted when the server determines that the scheduled appointment queue of the provider has either an entry for a scheduled telephonic callback or scheduled appointment that has an scheduled appointment time that is either equal to the current time or would be within a time window where the servicing of a waiting room entry or a new request would adversely impact servicing of scheduled telephonic callback or scheduled appointment queued entries.
  • the system 10 could allocate a set time period of, e.g., 15 minutes to service a request. Accordingly, the server 12 would not select an entry from the waiting room queue if there was a scheduled appointment in, e.g., 10 minutes.
  • Telephonic engagements without any scheduling will generally be placed in and thus serviced from the waiting room sub-queue.
  • the provider services a consumer from its sub-queue all remaining entries (representing other consumers) in that sub-queue are promoted such that the next entry in the sub-queue to be serviced will be the next oldest entry.
  • the server 12 can execute the next patient algorithm that applies a priority scheme based on a priority designation of patients, as discussed above.
  • the priority designations are based on an initial triage made during an intake process considering several of the above mentioned factors.
  • the server 12 retrieves the entry of a consumer that is next to be serviced at a priority designation that is currently the highest designation having entries in either one of the provider's queues 120 ′. As the provider services that consumer, the server 12 removes the corresponding entry from that provider's queue and the server 12 promotes all remaining entries in that queue at that designation such that the next entry in the queue to be serviced will be now be the oldest entry at that priority designation. When all entries have been serviced from the queue with at that priority designation, the server will retrieve the entry of a consumer that is next to be serviced at a priority designation in the queue 120 that is the next lowest priority.
  • a graphical user interface 130 that the server 12 generates and sends to a device used by the provider is shown.
  • This interface 130 can be sent after a successful provider log-in to the server 12 , e.g., as a welcome screen.
  • Exemplary potential actions that can occur from the interface 130 include selection of the next patient via next patient control 131 a , managing availability via a manage availability control 131 b , and to continue to the provider's home page (as in co-pending published, application “Reverse Provider Practice” Pub. No. US-2012-0284362-A1) via selection of the home page control 131 c .
  • the home page allows the provider to sign into specific provider networks.
  • Other controls can be included in the welcome screen 130 .
  • the graphical user interface 140 depicts provider practices 142 .
  • the provider practices are arranged into one or more provider networks 144 .
  • Each provider will be presented with an instance of the graphical user interface that is tailored to that provider's practice.
  • provider-a is associated with three provider networks and several provider practices within each provider network.
  • provider-a is associated with three provider networks 144 , HMSA'S Online Care 144 a ; NowClinic 144 b ; and Online Care NY 144 c .
  • provider practices 142 are distributed according to their respective membership.
  • First Care Medical Associates 142 a and Second Care Medical Associates 142 b are included in the HMSA provider network.
  • Third Care Medical Associates 142 c and Waikiki General 142 d are among the seven provider practices (generally 142 ) under HMSA'S Online Care provider network.
  • others of the provider practices 142 are arranged under provider networks 144 b and 144 c.
  • Representations in the interface 140 for each of the provider practices include the following controls/regions juxtaposed each other in a row per provider practice: a control that indicates that there is an un-read message (e.g., e-mail) 145 from the corresponding network; a region that displays an availability indicator 146 , a control to set availability 147 ; a region that displays a number of consumers waiting 148 ; and a region 149 that displays the highest wait time of consumers in the particular provider practice.
  • Each of the provider networks (generally 144 ) include the following controls: a control to set availability 150 ; a region 151 that displays a total number of consumers waiting from all provider practices 142 within the particular provider network 144 ; and a region 152 that displays the highest wait time of consumers in the particular provider network.
  • HMSA'S Online Care provider network 144 a is an example where the provider as chosen to set availability status individually for each of the provider practices in HMSA'S Online Care provider network 144 a , e.g., First Care Medical Associates 142 a , Second Care Medical Associates 142 b , Third Care Medical Associates 142 c , Waikiki General 142 d and the remaining provider practices.
  • the Now Clinic Provider network (all available) and Online Care NY provider network all unavailable had the availability status of each provider practice in those provider networks set at the provider network level.
  • the interface 140 also includes a control 160 to allow the provider to add a network.
  • the control 160 when selected will cause the server 12 to retrieve from storage a listing of all networks that the provider is associated with and will allow the provider to add a network to the interface 140 .
  • the interface also includes a control 162 to allow the provider to remove a network.
  • the control 162 when selected will cause the server 12 to retrieve from storage the listing of all networks that the provider has on the interface 140 and will allow the provider to remove a network from the interface 140 . This functionality of adding and removing networks can be accomplished using various techniques.
  • the interface 140 includes a Next Patient control 164 for the entire interface 140 and Next Patient controls 166 a , 166 b and 166 c for each of the provider networks 144 a to 144 c , respectively.
  • Selection of the Next Patient control for the interface 140 will select the next patient according to a selection algorithm that is employed over all of the provider networks 144 , whereas selection of the Next Patient control for one of the provider networks will select the next patient in the corresponding provider network according to the selection algorithm employed.
  • the algorithms will only consider patients in the provider network corresponding to the selection of the Next Patient control.
  • the Next Patient control 166 c is greyed-out as is the Next Patient control 164 .
  • the Next Patient control 166 b is shown as active and the algorithm will select the next patient from among all of the provider practices in the Now Clinic provider network, whereas the Next Patient control 166 a also shown as active, however the algorithm will only select the next patient from among those provider practices in the HMSA'S Online Care provider network that the provider has set to the available status.
  • the queues (generally 180 ) for each provider are sub-divided or represented as plural sub-queues with each of the sub-queues corresponding to a provider network 144 ( FIG. 7 ).
  • the queues 180 a - 1 to 180 a - 3 are shown for the provider corresponding to the particular example of the interface shown in FIG. 7
  • sub-queues 180 n - 1 to 180 n - 2 are shown for a provider “n” that has only two provider networks with which the provider-n is associated, and that is associated with a different instance (not shown) of the interface of FIG. 7 .
  • Consumer entries in the sub-queues 180 a - 1 to 180 a - 3 and 180 n - 1 to 180 n - 2 representing provider networks include a provider practice indicator 183 that corresponds to a particular provider practice through which the consumer accessed the brokerage system 10 .
  • the scheduling module 28 would check the provider practice indicator 183 included with the entry, against the provider set availability status indications ( FIG. 7 ) to determine whether to assign that consumer to the provider.
  • the sub-queues 180 a - 1 to 180 a - 3 and 180 n - 1 to 180 n - 2 represent provider networks can be further sub-divided into sub-queues provider practices within a particular provider network.
  • the sub-queues 180 a - 1 to 180 a - 3 and 180 n - 1 to 180 n - 2 could be further sub-divided into “waiting room” and “scheduled appointments” states of the respective providers “provider-a” to “provider-n.”
  • the server 12 controls filling of the queues 180 by the provider's availability status set by the provider, via interface 140 ( FIG. 7 ) and how incoming requests are assigned.
  • An incoming request either includes a choice of provider or causes the server 12 to select the provider.
  • the server 12 will only send to the patient those providers that have sufficient matches and which have an available status of some type, e.g., currently available, waiting room etc. Receipt of the request with the selection will cause the server 12 to add an entry into the appropriate queue of the selected service provider, according to the provider set, availability status indications.
  • the server 12 When the server 12 determines the provider, the server 12 assigns incoming requests to providers based on availability statuses of the providers. Typically, each provider can be associated with many different provider practices 142 in different provider networks 144 . With providers having the ability to selectively control availability statuses, the server 12 assigns incoming requests to providers according to those statuses.
  • the server 12 receives 192 requests for engagements with service providers.
  • the server 12 determines 194 what, if any, provider practice/provider network the consumer that sent the request is associated with.
  • the server 12 searches 196 the queues for providers that can service the consumer request, according to the determined provider practice/provider network, if any. For consumer requests associated with a provider practice/provider network only those provider queues can be searched, whereas for consumer requests that are not associated with any provider practices/provider networks only queues of providers that handle out of network/practice requests are searched.
  • the server 12 will assimilate a listing of all open queues (queues where the provider has not indicated “not available” or queues of providers that are not logged in) according to the determined provider practice/provider network. For those providers that can service the provider practice/provider network associated with the request, and that are open, the server calculates 198 for each of those providers, a total number of patients waiting for each provider across all of the open queues (queues where the provider has not indicated “not available” or queues of providers that are not logged in) of the provider. The server 12 determines 200 which of those providers have the fewest total number of patients in all of the provider's queues. The server assigns 202 the incoming request to the provider with the fewest number of entries.
  • the server 12 When a provider has an availability status of “not available” in either a provider network 144 or a provider practice 142 ( FIG. 7 ), the server 12 will not assign request to the corresponding queues for that provider or consider that provider's overall total number of waiting patients, since that provider cannot at that juncture service the incoming request.
  • the server using scheduling module 28 examines the queues of all providers that are suitable to provide a consultation with the consumer and chooses the appropriate sub-queue of a suitable provider that has the least number of entries waiting to be processed for the provider network 144 or provider practice 142 .
  • a similar arrangement can be used for servicing and selecting providers for consumer requests that are not associated with any provider practice/provider network. That is, the server calculates for each of those providers of open queues that can service out of network/practice requests, a total number of patients waiting for each provider across all of the open queues (queues where the provider has not indicated “not available” or queues of providers that are not logged in) of the provider and determines those providers having the fewest total number of patients and assigns the incoming request to the provider with the fewest number of entries.
  • the system retrieves the entry of a consumer that is next to be serviced from the queue for that provider according to whether the provider manually selected a patient or selected one of the aforementioned instances of the Next Patient control according to the algorithm employed by the server for selection of a next patient.
  • the server 12 includes access control facility 30 that controls how consumers 14 access the system and to what extent or level the services provided by the system are made available to consumers.
  • the server 12 also stores and provides access to consumer information (e.g., contact information, credit and financial information, credit card information, health information, and other information related to the consumer and the services purchased or otherwise used by the consumer) and provider information (e.g., physician biographies, product and service information, health related content and information and any information the provider or the health plan wants to make available to members) and the access control facility 30 can prevent unauthorized access to this information.
  • the server 12 exports the consumer information for use in a provider's office or other facility.
  • consumers may select providers according to attributes of the provider, such as a geographical area where the provider is located or which professional organizations have accredited the provider (e.g., whether a doctor has board certification in cardiology). Any metrics within the provider profile can be used to define a list of providers that meet the consumer's preferences. In this case, the system will use the consumer's selection to override the least used scheme for populating provider queues.
  • attributes of the provider such as a geographical area where the provider is located or which professional organizations have accredited the provider (e.g., whether a doctor has board certification in cardiology).
  • Any metrics within the provider profile can be used to define a list of providers that meet the consumer's preferences. In this case, the system will use the consumer's selection to override the least used scheme for populating provider queues.
  • the quick-connect graphical user interface 210 for accessing various provider types though a brokerage system is shown.
  • the quick connect graphical user interface 210 is generated by the server 12 and sent to a user device, e.g., a tablet computing device 212 , as illustrated, a computer, and the like and the quick-connect graphical user interface 210 is used to quickly access and connect to the brokerage system 10 .
  • the quick-connect graphical user interface 210 is a minimal interface.
  • the quick-connect graphical user interface 210 renders a plurality of controls 216 that when selected by a consumer, sends a request to consult with a service provider of a type associated with the corresponding one of the plurality of controls.
  • the types of providers are a pharmacist, a nutritionist, an internist, and a beautician.
  • Selection of one of these controls 246 automatically launches a request that the server 12 uses to find the next available provider of the type selected.
  • the server 12 Upon receiving the selection and generating the request, the server 12 sends to the consumer device a second graphical user interface (not shown) to enable the consumer to provide information to a service provider for use during a consultation with a service provider of the type associated with the corresponding one of the controls 216 .
  • the controls 216 represent different specialties within a type of provider, e.g., an internist, ophthalmologist, and obstetrician/gynecologist with the type of physician.
  • the controls 216 are of different sub-specialties within a particular specialty, e.g., an endocrinologist, a gastroenterologist, and a cardiologist within the specialty of internal medicine.
  • the quick-connect graphical user interface 210 also includes a set of controls 218 in the quick-connect user interface 210 that allows a user to toggle between a quick connect mode of use (as illustrated by the quick-connect item being un-shaded in graphical user interface 210 ) and a provider selection mode that presents another graphical user interface that lists providers (not shown) but as discussed in U.S. Pat. No. 7,590,550 mentioned above.
  • the server 12 accesses 260 queues according to provider type, in response to receiving a selection of a provider type from the quick-connect graphical user interface 240 ( FIG. 10 ). This launches a request for the provider type to cause the server 12 to select 254 the provider of that type.
  • the selection of a provider type from the quick-connect graphical user interface 240 will launch an interface (not shown) that allows for a selection of provider made by the consumer based on attribute matching.
  • the server 12 will only send to the consumer those providers that have sufficient matches to attributes and which have an available status of some type, e.g., currently available, waiting room etc. Receipt of the request will cause the server 12 to add 256 an entry into an appropriate queue of the selected service provider.
  • the server 12 applies the processing of FIG. 5 where the server stores the entries in queues of those providers of the appropriate type that the server 12 determines has the least number of entries, in order to balance provider utilization across the system 10 , and to otherwise minimize overall response time for consumers, as generally discussed above.
  • the quick-connect graphical user interface 240 plural queue structures are provided according to a like plurality of provider types.
  • the queue arrangements of FIG. 5A, 5B or 8 for example are replicated according to the number of provider types, meaning that for whatever queue scheme and provider type scheme are employed there are queues for providers for each of the types associated with the controls on the interface.
  • the queue structure shown in FIG. 5B would be replicated for each type of provider.
  • Telephonic callbacks Consumers who wish for a telephonic consultation with a provider may use a traditional telephone to enter information, as discussed above, and hangs up and waits for a call-back from a suitable provider, as also discussed above. Providers are sent information concerning the consumer in order to understand the consumer's issue and a telephone number by which the provider contacts the consumer.
  • the networked computer system 10 allows consumers to engage provider's e.g., health professionals “on demand” based on provider availability. These engagements can be established in various ways as described in the above mentioned patent. These types of engagements include:
  • the website can support the use of licensed content packages from other vendors to meet the variable preferences of health plans.
  • key content vendors include HealthwiseTM, ADAMTM, Mayo ClinicTM and HealthDayTM.
  • Content libraries provided by such vendors offer a combination of articles, imagery, interactive tutorials and related tools that allow consumers to access content relevant for their health issues. Many health plans and major employers already possess a license for the use of one of these content packages.
  • Health Risk Assessments The system acquires information from consumers through automated interaction (e.g., rules-based interaction) in order to crystallize their needs (e.g., medical risks) and better direct them. Assessments span from general health to very specific medical conditions and follow a path of questioning that dynamically tailors itself based on information already retrieved (e.g., using predefined rules). As assessments progress, the system constructs engagement suggestions that the consumer can exercise. Each suggestion represents both the question to the provider and the type of provider appropriate to answer it. Consumers may choose to simply launch such engagements or apply their own discretion as to the phrasing and the selection of the recipient provider. This is discussed in more detail below in the context of the consumer advisor.
  • Asynchronous correspondence The lowest level of true provider interaction is by way of secure messaging.
  • the question or topic of the engagement is sent to a selected provider (whether online or not) and can be answered by this provider at her leisure. Turnaround times are monitored by the system and are part of the credentials of the provider used for her selection by consumers.
  • the system informs the consumer once a response has been received and can allow the consumer to redirect the question if he needs more urgent response time.
  • typical types of asynchronous correspondence include e-mail, instant messaging, text-messaging, voice mail messaging, VoIP messaging (i.e., leaving a message using VoIP), and paper letters (e.g., via the U.S. Postal Service).
  • Synchronous correspondence Several forms of synchronous correspondence allow the consumer and the provider to engage in real-time discussions.
  • Synchronous text correspondence This may be referred to as a “Chat” module where both sides of the engagement type their entries in response to each others' entries.
  • the form of communication may be entirely text based but is still a live communication. Examples include instant messaging and SMS messaging.
  • Web-based teleconferencing The use of broadband network connections allows for real-time voice transmission over the Internet in what is referred to as full duplex (i.e., both voice channels are open at the same time). Consumers can opt to have a voice conversation with their providers using, for example, their computer's speakers and microphone. Web-based teleconferencing may use VoIP, SIP, and other standard or proprietary technologies.
  • Telephonic conferencing Consers who wish for a direct telephonic communication with a provider or who are not comfortable using their computer may use a traditional telephone for interaction with a provider. The consumer may use a dial-in number and an access code that connects him to the brokerage's servers. Providers are linked to the servers via VoIP, other data-network-based voice systems, or their own telephones. Telephonic conferencing may also allow consumers to request “call me now” functions, in which the provider calls the consumer (directly or through the brokerage).
  • Video conferencing The system can support video conferencing to allow consumers to exhibit physical findings to providers if such disclosure is needed. Consumers and providers may also simply prefer face-to-face communication, even if remote. Small digital cameras, referred to as webcams, attached to or built in to personal computers or laptops can be used for this purpose. Video conferencing can be provided by standard software or by custom software provided by the brokerage. Alternatively, dedicated video conferencing communication equipment or telephones with built-in video capabilities can be used.
  • Semi synchronous correspondence Some engagements of a consumer with an online provider include both synchronous and asynchronous interactions. Part of the engagement takes place by immediate messaging between the two, but the provider may ask the consumer to take occasional asynchronous assessments if, for example, a generic line of question is desired. This allows the provider to operate more than one consumer engagement at a time while each consumer is constantly engaged.
  • semi-synchronous correspondence includes a combination of e-mail, instant messaging, test messaging, voice calls and mail messaging, and VoIP calls and VoIP messaging.
  • IVR Interactive Voice Response
  • the caller can navigate between options, listen to data-driven information, provide meaningful input, and engage system functions.
  • IVR engagements extend the reach of the system to the telephone as a portable consumer interface to launch an engagement in addition to the Web-based interface. Consumers select a pin code on the application to authenticate their identity if they call in.
  • Several types of engagements can be carried out through an IVR system using suitable logic such as described in the patent.
  • dial-in engagements the consumer calls in and invokes a telephonic engagement with an available provider.
  • the IVR system extends the consumer's ability to select a provider to the phone so that the consumer's interaction resembles one carried out on the Web.
  • the IVR system can also be used proactively to pursue consumers who need a follow-up.
  • the system recalls the provider with whom the follow-up is desired (or the type of provider in case the follow-up is not restricted to a specific provider), identifies that the provider is available for an engagement, and attempts to contact the consumer over the phone to establish a connection for the engagement. Once contacted, the consumer can decline or ask postpone the call. If the consumer takes the call, the connection is made.
  • the IVR system allows the consumer to park in a standby mode until the provider is available.
  • the provider is available, the system calls the consumer, identifies the provider to the consumer, and verifies that the consumer is still interested in pursuing the call with the provider. If the consumer is still interested, an engagement is connected.
  • the IVR interface allows consumers to interact with other services offered by the brokerage. For example, consumers can instruct the system to fax a transcript of their information to a fax machine that the consumer identifies by keying in or speaking its phone number. Using such a function, a consumer makes key information available to, e.g., emergency room personnel or to a provider in an office visit, without the need to plan, collect, print, and carry the information to that encounter.
  • IVR hardware is readily available from telecommunication vendors and can be programmed to operate in the context of the brokerage framework. Authentication is provided through a PIN number or by other standard methods.
  • the consumer information collected by the intake process may be stored in the databases 27 as part of the overall brokerage system.
  • the consumer information is protected and secured from unauthorized access and in compliance with the various legal requirements for storing private consumer information (for example, HIPPA governs access to an individual's health care information).
  • the database 27 may also the process logic and rules data including the business logic of an application or rules for a rules engine that implements the consumer advisor module.
  • the brokerage extends the result of any engagement to a physical point of care or service provider to allow continuation or escalation of services beyond those provided in the electronic encounter.
  • Embodiments can be implemented in digital electronic circuitry, or in computer hardware, firmware, software, or in combinations thereof.
  • Apparatus of the invention can be implemented in a computer program product tangibly embodied or stored in a machine-readable storage device for execution by a programmable processor; and method actions can be performed by a programmable processor executing a program of instructions to perform functions of the invention by operating on input data and generating output.
  • the invention can be implemented advantageously in one or more computer programs that are executable on a programmable system including at least one programmable processor coupled to receive data and instructions from, and to transmit data and instructions to, a data storage system, at least one input device, and at least one output device.
  • Each computer program can be implemented in a high-level procedural or object oriented programming language, or in assembly or machine language if desired; and in any case, the language can be a compiled or interpreted language.
  • Suitable processors include, by way of example, both general and special purpose microprocessors. Generally, a processor will receive instructions and data from a read-only memory and/or a random access memory. Generally, a computer will include one or more mass storage devices for storing data files; such devices include magnetic disks, such as internal hard disks and removable disks; magneto-optical disks; and optical disks. Storage devices suitable for tangibly embodying computer program instructions and data include all forms of non-volatile memory, including by way of example semiconductor memory devices, such as EPROM, EEPROM, and flash memory devices; magnetic disks such as internal hard disks and removable disks; magneto-optical disks; and CD_ROM disks. Any of the foregoing can be supplemented by, or incorporated in, ASICs (application-specific integrated circuits).
  • ASICs application-specific integrated circuits

Abstract

Described are techniques for accessing a brokerage system for providing broker services to consumers from various service providers. A graphical user interface renders a plurality of controls that when selected by a consumer, sends a request to consult with a service provider of a type associated with the corresponding one of the plurality of controls. Upon receiving the request a second graphical user interface is sent to enable the user to provide information to a service provider for use during a consultation with a service provider of the type associated with the corresponding one of the controls.

Description

  • This application claims priority under 35 U.S.C. §119 to U.S. Provisional Patent Application Ser. No. 61/753,528, filed Jan. 17, 2013, and entitled “Processing for Brokered Engagements”, the entire contents of which are hereby incorporated by reference.
  • BACKGROUND
  • The present disclosure is directed to connecting consumers with service providers.
  • Systems have been developed to connect consumers and their providers over the Internet and the World Wide Web. Some systems use e-mail messaging and web-based forms to increase the level of connectivity between a member of a health plan and his assigned health care provider. The consumer sends an e-mail or goes to a website that generates and sends a message (typically an e-mail or an e-mail type message) to a local provider. These types of services have been broadly referred to as “e-visits.” Other health care solutions include technologically advanced telephone communication solutions that use advances in voice communication and data transmission technology to interconnect medical professionals with patients.
  • SUMMARY
  • According to an aspect, a computer-implemented method includes a computer-implemented method including generating a first graphical user interface for accessing a brokerage system for providing broker services to consumers from service providers, the graphical user interface rendering a plurality of controls that when selected by a consumer, sends a request to consult with a service provider of a type associated with the corresponding one of the plurality of controls, sending by the one or more computers the graphical user interface to a device used by the consumer, receiving the request, and sending to the consumer a second graphical user interface to enable the user to provide information to a service provider for use during a consultation with a service provider of the type associated with the corresponding one of the controls.
  • According to an aspect, a computer program product tangibly stored on a computer readable storage device for providing broker services to consumers and service providers, the computer program product comprising instructions for causing a computer to generate a first graphical user interface for accessing a brokerage system for providing broker services to consumers from service providers, the graphical user interface rendering a plurality of controls that when selected by a consumer, sends a request to consult with a service provider of a type associated with the corresponding one of the plurality of controls, send the graphical user interface to a device used by the consumer, receive the request, and send to the consumer a second graphical user interface to enable the user to provide information to a service provider for use during a consultation with a service provider of the type associated with the corresponding one of the controls.
  • According to an additional aspect, an apparatus includes a processor, memory in communication with the processor, and a computer program product stored on a computer readable medium for providing broker services to consumers and service providers, the computer program product comprising instructions for causing the processor to a processor, memory in communication with the processor, and a computer program product tangibly stored on a computer readable storage device for providing broker services to consumers and service providers, the computer program product comprising instructions for causing a computer to generate a first graphical user interface for accessing a brokerage system for providing broker services to consumers from service providers, the graphical user interface rendering a plurality of controls that when selected by a consumer, sends a request to consult with a service provider of a type associated with the corresponding one of the plurality of controls, send the graphical user interface to a device used by the consumer, receive the request, and send to the consumer a second graphical user interface to enable the user to provide information to a service provider for use during a consultation with a service provider of the type associated with the corresponding one of the controls.
  • The following are some of the features within the scope of the above aspects.
  • The types are different types of providers. Selecting a control in the first user interface that allows a user to toggle between a quick connect mode of use of the graphical user interface and a mode of use that lists providers.
  • One or more of the following advantages may be provided by one or more of the above aspects. Consumers can engage with the system using various modalities, including registered user, guest user and anonymous user. In particular an anonymous user modality is very useful for those types of individuals that may have serious issues, but which are generally reluctant to discuss issues with strangers.
  • BRIEF DESCRIPTION OF THE FIGURES
  • FIG. 1 is a diagrammatic view of an arrangement including a brokerage system.
  • FIGS. 2A and 2B are flow charts useful in understanding next consumer processing in a brokerage service.
  • FIG. 3 is block diagram of an availability process.
  • FIG. 4 is a block diagram of an alternative availability process.
  • FIG. 5 is a block diagram of a record.
  • FIGS. 5A and 5B are block diagrams of queue structures.
  • FIG. 6 is a screenshot of a graphical user interface for a welcome screen.
  • FIG. 7 is a screenshot of a graphical user interface for an availability management screen.
  • FIG. 8 is a block diagram of a queue structure.
  • FIG. 9 is a flow chart for assigning providers based on provider networks/provider practices.
  • FIG. 10 is a screenshot of a quick-connect graphical user interface.
  • FIG. 11 is a flow chart for assigning providers based on the quick-connect graphical user interface.
  • DETAILED DESCRIPTION
  • Overview
  • The system described below provides an integrated information and communication platform that enables consumers of services to access service providers to consult and to carry out such consultations in an efficient manner. Consumers are able to consult with an expert service provider even when the two parties are geographically separated. This integrated platform is referred to as a brokerage system (or depending on the context brokerage service).
  • Referring now to FIG. 1, an exemplary networked computer system 10 for engaging a consumer in a brokered consultation with a service provider includes a computerized system or server 12 for processing requests from consumers 14 at client systems 14 a to engage with providers 16 at provider systems 16 a. The networked computer system 10 implements a brokerage service embodied as web-based engagement brokerage. The networked computer system 10 includes a web server 18 to receive on-line web-based requests and which provides web-based communication channels between a provider and a consumer using a web browser or the like.
  • The server 18 receives a request for a consultation. The request is parsed to identify the particular ailment or concern, etc. of the patient 14. The server 12 includes an availability or presence tracking module 26 for tracking the availability of the service providers 16. Availability or presence of service providers is tracked actively or passively.
  • In an active system, one or more of the service providers 16 provides an indication to the server 12 that the one or more service providers are available to be contacted by consumers 14 and an indication of the mode by which the provider may be contacted. In some examples of an active system, the provider's computer, phone, or other terminal device periodically provides an indication of the provider's availability (e.g., available, online, idle, busy) to the server 12 and a mode (e.g., text, voice, video, etc.) by which he can be engaged.
  • In a passive system, the server 12 presumes that the service provider 16 is available by the service provider's actions, including connecting to the server 12 or registering the provider's local phone number with the system. In some examples of a passive system, the server 12 indicates the provider 16 to be available at all times until the provider logs off, except when the provider is actively engaged with a consumer 14.
  • The server 12 also includes one or more processes in addition to the tracking module 26, such as a scheduling module 28. The server 12 accesses one or more databases 27. The components of the server 12 and the web server 18 may be integrated or distributed in various combinations, as is commonly known in the art.
  • The networked computer system 10 allows a consumer 14 to communicate with a provider 16. The consumer 14 and provider 16 connect to the server 12 through a website or other interface on the web server 18 using client devices 14 a and 16 a, respectively. Client devices 14 a and 16 a can be any combination of, e.g., personal digital assistants, cell phones, computer systems, media-player-type devices, and so forth. The client devices 14 a and 16 a enable the consumers 14 to input and receive information as well as to communicate via video, audio, and/or text with the providers 16.
  • At the instant a consumer 14 desires to connect and communicate with a provider, the server 12 determines whether that provider is available. If that particular provider 16 is available, the server 12 assesses the various modes of communication that are available forwards connection information of the consumer 14 to the service provider 16 through one or more common modes of communication. The system selects a mode of communication to use based in part on the relative utility of the various modes.
  • A mode of engagement has both the consumer 14 and the provider 16 use web-based consoles, as this allows each of the other modes to be used as needed. For example, consumers and providers may launch chat sessions, voice calls, or video chats from within a web-based console like that shown in FIG. 2A, below. A web based console also provides on-demand access to records, such as the consumer's medical history, and other information. If only one of the participants in an engagement has access to a web console, the server 12 connects that participant's console to whatever form of communication the other party has available. For example, if the consumer is on the phone and the provider is using a web browser, the server 12 may connect the consumer's phone call to a VoIP session that the provider can access through the web. If the provider 16 is not available, the server 12 identifies other available providers 16 that would meet the consumer 14's needs. The server 12 enables the consumer 14 to send a message to the consumer's chosen provider.
  • The server 12 includes an access control facility 30 that manages and controls whether a particular consumer 14 can access the networked computer system 10 and what level or scope of access to the features, functions, and services the networked computer system 10 will provide. The server also includes next consumer processing 30 a that selects the next consumer according to an algorithm that manages provider queues, but that allows a provider to access the next consumer at various stages of the provider's interaction with the server. The server also includes availability management 30 b processing that allows the provider to control availability across provider networks and practices as will be discussed below.
  • Provider networks are groups of affiliated provider practices and/or affiliated service providers. However, not all provider practices need be associated with a provider network. For example, individual service providers are also able to register and enroll with the system. Individual service providers are independent service providers not affiliated with a provider network and need not be a provider practice. Thus in the example of FIG. 7 if the particular provider was doing business under her own name her name would appear in the dashboard.
  • Examples of provider networks are entities that sponsor/host instances of the on-line care brokerage system, examples of which are insurance companies, whereas examples of provider practices are individual employers or independent practices of providers such as physician practices or hospitals, clinics etc. that affiliate with a particular provider network. In some instances, some of the types of entities that are provider practices as stated above could sponsor/host instances of the on-line care brokerage system and thus be a provider network. One of the significant distinctions between an entity that is viewed as a provider network and one that is viewed as a provider practice is that the provider network is responsible for providing the on-line care brokerage infrastructure either directly or by a hosting relationship with another entity and also is responsible for recruiting a supply of service providers.
  • One advantage that the brokerage provides is that the brokerage constantly monitors the availability of a provider for an engagement. Thus, consumers receive relatively quick attention to address their questions or concerns. The server 12 can cause a communication channel to be established between the consumer and the provider via a web browser or the like. The server 12 identifies service providers 16 that are available at any given moment to communicate with a consumer about a particular product, service, or related topic or subject, for example, a medical condition.
  • In order to achieve such a level of availability, the networked computer system 10 assimilates the discretionary or fractional availability windows of time offered by individual providers at stations 16 a into a continuous availability perception by consumers. Consumers will have little expectation that the same provider will be constantly available, rather, they expect that some provider will be available.
  • By way of illustration, the networked computer system 10 services patients that are members of healthcare plans. For example, the service providers 16 may be physicians, and the service consumers 14 may be patients. The service providers and service consumers may also be lawyers and clients, contractors and homeowners, or any other combination of a provider of services and a consumer of services.
  • The system enables the consumer to search for providers that are available at the time the consumer is searching, and enables the consumer to engage a provider on a transactional basis or for a one-time consultation. A consumer can use the system for various purposes, such as a consultation or second opinion. An example of details of a brokerage system is discussed in my U.S. Pat. No. 7,590,550 entitled: “Connecting Consumers with Service Providers”, the contents of which are incorporated herein in its entirety.
  • Referring now to FIG. 2A, next patient processing 30 a for use in the networked computer system 10 is shown. In an embodiment, patients send 42 requests for services to the server 12. The requests may include various information such as patient identification, health plan information, plan sponsor, etc. The request is sent to the networked computer system 10 and received 52 by the server 12 for access to an online-care program offered by the system 10. The server 12 finds (not shown) a suitable provider based on attribute matching or assigns a patient to a provider queue with the lowest number of patients waiting. The server 12 places an entry for the patient in a queue discussed below.
  • The server also receives 54 at a time asynchronous to the requests (indicated by dashed line) a log-in from a provider. The server generates 56 a service provider graphical user interface as welcome screen, having a next patient control (FIG. 6). This welcome screen is a top level screen in a set of user interfaces (FIGS. 6, 7) that permit a provider to access the server 12 to manage the provider's experience with the brokerage system 10.
  • The system sends 58 the welcome screen (see FIG. 5) to the provider, and waits for a selection from the provider. When an action is received by the system, the server determines 60 the action. If the action is next patient, (the provider selected the next patient control) the server 12 executes 62 an algorithm to determine the next patient from patient records in the provider's queues. The server 12 retrieves 68 the next patient record and prepares a session 69 by determining from information received from the patient what services will be required during the session, determining eligibility for services, etc. The server 12 establishes a communication channel between the patient and the provider. When the action is not next patient, the server 12 continues 62 with welcome processing.
  • Referring now to FIG. 2B, when the server 12 receives any other selection from the welcome screen, the server 12 determines 80 the action received. For example from the welcome screen, the server can receive a provider's selection to manage availability 82. The server generates 84 a service provider availability management interface (FIG. 6) with the next patient control and sends the interface to the provider's system. The provider manages availability and at that screen at any time can also select the next patient or can select another patient. Alternatively, the server 12 receives 90 from the provider's system a selection from the welcome screen that causes the server 12 to continue to the provider's home page (referred to as a “reverse provider practice graphical user interface”) for particular provider networks/practices, as discussed in my co-pending published, application “Reverse Provider Practice” Pub. No. US-2012-0284362-A1 assigned to the assignee of the present invention and incorporated herein by reference in its entirety. Continuing to the provider's home page allows the provider to access graphical user interface for individual provider networks that display the types of health services that are offered by the sponsor to consumers.
  • In some implementations, the server generates 92 a service provider home page interface for that provider with the home page also including the next patient control. The provider accesses the home page and interacts with the server 12 though the home page.
  • At some point, the provider will engage with a consumer (patient). A selection can be made from one of the interfaces sent by the server 12 such as the service provider availability management interface (FIG. 6) or the service provider home page interface (not shown). If the selection is a next patient, (the provider selected the next patient control) the server 12 executes 93 the next patient algorithm to determine the next patient from patient records in the provider's queues. The server retrieves 95 the next patient record (and prepares a session not shown). The server 12 then establishes 98 a communication channel between the patient and the provider to enable the patient to engage 99 with the provider. When the selection is not next patient, the server 12 retrieves 96 the provider selected patient and the server establishes the channel 98.
  • The server 12 prepares a user session (not shown) by determining from information received from the patient what services will be required during the session (see 69, above FIG. 2A). In one example, the server 12 retrieves those services that the sponsor has chosen to be offered services. A sponsor selects offered services based on various factors including costs and usage data. Usage data is indicative of an amount of health services being consumed, by consumers, for a particular type of health service. The various factors can also gender, age, health status of the insured, as well as the availability of the services, cost of the services and how often the services were selected by segments of insured groups of individuals. Also the server can prepare payment information, e.g., co-pays and the like.
  • From the provider's viewpoint, the provider chooses a patient from a virtual waiting room. The virtual waiting room can include not only registered user patients, but other patients such as patients that are guest or anonymous users. The server 12 facilitates sessions between the patient and the provider by establishing the real time communication channel between devices/systems used by the patient and the provider with the channel being established through the server 12. In other implementations, the server 12 causes establishment of the communication channel between devices/systems by a join of communication channels or by sending the provider connection information to call the patient in a call back mode.
  • Referring now to FIG. 3, the server 12 tracks 100 the availability of providers 16 and in some embodiments, on-line consumers 14. When a provider 16 logs 102 into the networked computer system 10, the provider 16 indicates 104 (such as by setting a check box or selecting a menu entry or by responding to a voice prompt) to the tracking module 26 that he or she is available to interact with consumers 14. The provider 16 can also indicate 106 a to the tracking module 26 (such as by setting a check box or selecting a menu entry or by responding to a voice prompt) the modes (e.g., telephone, chat, video conference) by which a consumer 14 can be connected to the provider 16.
  • The server 12 also includes availability management processing 30 b (discussed in FIG. 4) to access 105 the availability management interface.
  • Alternatively, the tracking module 26 determines 106 b the capabilities of the terminals 14 a and 16 a the consumer 14 and the provider 16 use to connect to the system (for example, by using a terminal-based program to analyze the hardware configuration of each terminal). Thus, if a provider 16 connects to the networked computer system 10 by a desktop computer and the provider has a video camera connected to that computer, the tracking module 26 determines that the provider 16 can be engaged by text (e.g., chat or instant messenger), voice (e.g., VoIP) or video conference. Similarly, if a provider 16 connects to the system using a handheld device such as a PDA, the tracking module 26 determines that the provider 16 can be engaged by text or voice, whereas, if the consumer connects to the networked computer system 10 via a telephone for a telephonic engagement the provider will reply with a telephone call to the consumer. The tracking module 26 can also infer 106 c a provider's availability and modes of engagement by the provider's previously provided profile information and the terminal device through which the provider connects to the system. The availability information can be transferred 108 to scheduling.
  • Providers participating in the brokerage system 10 can have several states of availability at different times. States in which the provider may be available include “on-line”, in which the provider is logged-in and can immediately accept new engagements in any mode, “on-line (busy)”, in which the provider is logged-in but is currently occupied in another engagement, and “scheduled”, in which the provider is offline but is scheduled to be online at a designated time-point and can pre-schedule engagements for it. A provider can also be not-logged in and thus unavailable.
  • Also, while not online, the provider can take messages as in offline state. Thus, another state includes off-line, in which the provider is not logged in but can take message-based engagements (i.e., asynchronous engagements), out-of-office, in which the provider is not accepting engagements or messages, and “on call”, in which the provider is offline and can be paged to go to on-line status by the brokerage network if traffic load demands it (in some examples, consumers see this state as offline).
  • The operating business model for the provider network employs a remuneration scheme for affiliated providers that helps assure that the consumers can find providers in designated professional domains in the online mode. For example, selected providers can be remunerated for being in the on-call mode to encourage on-line availability in case of low discretionary availability by other providers in their professional domain. On-call providers are also called into the on-line state when the fraction of on-line (busy) provider's domain exceeds a certain threshold.
  • Referring now to FIG. 4, provider availability management 30 b is shown. In certain embodiments, the provider is presented with a user interface (FIG. 6) that enables the provider to selectively control/manage his/her availability status across provider networks and provider practices of which the provider is affiliated with. Thus, after log-in 112, the provider sends (not shown) a request to the server 12 for an availability management interface (FIG. 6) and server receives 113 one or more indications of the provider's availability status. The provider sets 114 an availability status either for each provider practice within a provider network, or sets 115 an availability status across all provider practices within a provider network. As the server 12 receives provider set availability status indications 116, the server repeats the process and at any juncture (such as after receiving an indication) transfers 117 the availability status information to the scheduling process 28.
  • The server 12 thus tracks the provider's availability based not only on any current engagements by the provider, but also on provider set availability status indications over provider networks/provider practices. The server will update the provider's status with particular provider networks/provider practices according to selections made by the provider. These selections will in general override default provider availability indications set by the server 12.
  • Referring now to FIG. 5, a consumer (e.g., patient) record 125 is shown. This record is retrieved, e.g., from a queue consumers waiting to be serviced by a provider or from a database based on retrieving an entry from the queue of consumers waiting to be serviced by a provider. The record includes various items 125 a-n of information regarding the consumer.
  • Referring now to FIG. 5A, the tracking module 26 (FIG. 1) transfers 117 (FIG. 4) information about the availability of providers 16 and the communication capabilities of the consumers 14 and the providers 16 to the scheduling module 28. The scheduling module 28 uses the tracking information to schedule providers with consumers. In some embodiments, the scheduling module 26 also uses provider set availability status indications to either allow entries into certain queues or not depending on the provider set status (FIG. 8).
  • In one embodiment, each provider, e.g., “provider-a” to “provider-n” is associated with a queue, e.g., 120 a-120 n, respectively. The queue for each provider is filled by the server 12 with entries (as depicted as entries 1 through i and entries 1 through m) that correspond to requests for consultations with a provider. More specifically, as consumers access the networked computer system 10 and are processed through the intake process, entries representing the consumers are produced by the server 12 and those entries are queued.
  • In one embodiment, the server 12 stores the entries in queues of those providers that the server 12 determines has the least number of entries, in order to balance provider utilization across the system 10, and to otherwise minimize overall response time for consumers. The server 12 produces an entry for storage in one of the queues (generally 120). The server 12 examines the queues 120 a-120 n of all providers that are suitable to provide a consultation with the consumer and the server chooses the queue of a suitable provider that has the least number of entries waiting to be processed. The queue, e.g., queue 120 a of the chosen provider (provider-a) is loaded with that entry.
  • To select entries from the queue, the server 12 uses in one embodiment a first in first out priority scheme to retrieve an entry from the query. Selecting of the next patient control on one of the aforementioned graphical user interfaces would in this scheduling algorithm chose the entry that is oldest in the queue. That is, in servicing consumer requests, for a particular provider, the server 12 retrieves the entry of a consumer that is next to be serviced (the oldest entry in the queue 120). As the provider services that consumer, the server 12 removes the corresponding entry from that provider's queue and the server 12 promotes all remaining entries in that queue such that the next entry in the queue to be serviced will be now be the oldest entry.
  • However, in an alternative embodiment, the next patient algorithm applies a priority scheme based on a priority designation of patients with those designated as “high priority” being given precedence over lower priority designations. Any number of priority designations can be used, with three being a workable number of designations. Priority designations can be based on an initial triage that is made during an intake process using either a triage algorithm or a service representative's assessment based on information obtained during intake. Many factors can be considered including, e.g., severity of conditions, degree of overuse of the brokerage system either by specific individuals or collectively by individuals in provider practices, e.g., associated with a sponsor (e.g., an employer/plan), specific employer and/or plan, etc. Priority can also be based on specific online practices (e.g., patients coming in through the “Emergency Management” practice are higher priority than the “Flu” practice). Priority can consider multiple ones of those factors. For example, the priority algorithm can give precedence to the patient triaged with high priority based on severity of medical conditions and which is the oldest in the queue.
  • With the factor-based priority scheme, for servicing consumer requests for a particular provider, the server 12 retrieves the entry of a consumer that is next to be serviced at a priority designation that is currently the highest designation having entries in the queue 120. As the provider services that consumer, the server 12 removes the corresponding entry from that provider's queue and the server 12 promotes all remaining entries in that queue at that designation such that the next entry in the queue to be serviced will be now be the oldest entry at that priority designation. When all entries have been serviced from the queue with at that priority designation, the server will retrieve the entry of a consumer that is next to be serviced at a priority designation in the queue 120 that is the next lowest priority. The server 12 can also monitor the queues to insure that the queues are not filled with high priority designations for one provider at such a rate that the provider cannot service lower priority designations.
  • Referring now to FIG. 5B, in an alternative embodiment, the queues (generally 120′) for each provider are sub-divided or represented as plural sub-queues with each of the sub-queues corresponding to an appointment “state.” In FIG. 5B, two queues 120 a-1 to 120 a-2 and 120 n-1 to 120 n-2 are shown for each of the providers, e.g., “provider-a” to “provider-n” with the sub-queues 120 a-1 to 120 a-2 and 120 n-1 to 120 n-2 representing, “waiting room” and “scheduled appointments” of the respective providers “provider-a” to “provider-n.”
  • In this embodiment, the server using scheduling module 116, examines the queues of all providers that are suitable to provide a consultation with the consumer and chooses the appropriate sub-queue of a suitable provider that has the least number of entries waiting to be processed for the particular state, e.g., “waiting room” and “scheduled appointments.” More specifically, for “telephonic engagements” the server loads entries into the waiting room queue of the particular provider that has the fewest entries.
  • In servicing requests, for a particular provider, the server 12 retrieves the entry of a consumer that is next to be serviced from the waiting room for that provider. The next to be serviced is according to the following priority the oldest entry in the waiting room. In brokerage systems that allow for telephonic generated requests with provider call-backs the oldest entry priority would be adjusted when the server determines that the scheduled appointment queue of the provider has either an entry for a scheduled telephonic callback or scheduled appointment that has an scheduled appointment time that is either equal to the current time or would be within a time window where the servicing of a waiting room entry or a new request would adversely impact servicing of scheduled telephonic callback or scheduled appointment queued entries. For example, in some embodiments the system 10 could allocate a set time period of, e.g., 15 minutes to service a request. Accordingly, the server 12 would not select an entry from the waiting room queue if there was a scheduled appointment in, e.g., 10 minutes.
  • Telephonic engagements without any scheduling will generally be placed in and thus serviced from the waiting room sub-queue. As the provider services a consumer from its sub-queue all remaining entries (representing other consumers) in that sub-queue are promoted such that the next entry in the sub-queue to be serviced will be the next oldest entry.
  • In another embodiment, the server 12 can execute the next patient algorithm that applies a priority scheme based on a priority designation of patients, as discussed above. Again, the priority designations are based on an initial triage made during an intake process considering several of the above mentioned factors.
  • With the factor-based priority scheme, for servicing consumer requests for a particular provider, the server 12 retrieves the entry of a consumer that is next to be serviced at a priority designation that is currently the highest designation having entries in either one of the provider's queues 120′. As the provider services that consumer, the server 12 removes the corresponding entry from that provider's queue and the server 12 promotes all remaining entries in that queue at that designation such that the next entry in the queue to be serviced will be now be the oldest entry at that priority designation. When all entries have been serviced from the queue with at that priority designation, the server will retrieve the entry of a consumer that is next to be serviced at a priority designation in the queue 120 that is the next lowest priority.
  • Referring now to FIG. 6, a graphical user interface 130 that the server 12 generates and sends to a device used by the provider is shown. This interface 130 can be sent after a successful provider log-in to the server 12, e.g., as a welcome screen. Exemplary potential actions that can occur from the interface 130 include selection of the next patient via next patient control 131 a, managing availability via a manage availability control 131 b, and to continue to the provider's home page (as in co-pending published, application “Reverse Provider Practice” Pub. No. US-2012-0284362-A1) via selection of the home page control 131 c. The home page allows the provider to sign into specific provider networks. Other controls can be included in the welcome screen 130.
  • Referring now to FIG. 7, a graphical user interface 140 for managing provider availability is shown. The graphical user interface 140 depicts provider practices 142. In some embodiments the provider practices are arranged into one or more provider networks 144. Each provider will be presented with an instance of the graphical user interface that is tailored to that provider's practice. Using “provider-a” as an example, provider-a, is associated with three provider networks and several provider practices within each provider network.
  • That is, as shown in FIG. 7, “provider-a” is associated with three provider networks 144, HMSA'S Online Care 144 a; NowClinic 144 b; and Online Care NY 144 c. Within each of provider networks 144 a-144 c, provider practices 142 are distributed according to their respective membership. In the HMSA provider network are included First Care Medical Associates 142 a and Second Care Medical Associates 142 b, Third Care Medical Associates 142 c and Waikiki General 142 d are among the seven provider practices (generally 142) under HMSA'S Online Care provider network. Similarly, others of the provider practices 142 are arranged under provider networks 144 b and 144 c.
  • Representations in the interface 140 for each of the provider practices (generally 142) include the following controls/regions juxtaposed each other in a row per provider practice: a control that indicates that there is an un-read message (e.g., e-mail) 145 from the corresponding network; a region that displays an availability indicator 146, a control to set availability 147; a region that displays a number of consumers waiting 148; and a region 149 that displays the highest wait time of consumers in the particular provider practice. Each of the provider networks (generally 144) include the following controls: a control to set availability 150; a region 151 that displays a total number of consumers waiting from all provider practices 142 within the particular provider network 144; and a region 152 that displays the highest wait time of consumers in the particular provider network.
  • Using HMSA'S Online Care provider network 144 a and First Care Medical Associates 142 a and Waikiki General 142 d provider practices to further illustrate, the interface 140 shows that the provider has set availability status in First Care Medical Associates 142 a as “Available” and has set availability status in Waikiki General 142 d as “Unavailable.” HMSA'S Online Care provider network 144 a is an example where the provider as chosen to set availability status individually for each of the provider practices in HMSA'S Online Care provider network 144 a, e.g., First Care Medical Associates 142 a, Second Care Medical Associates 142 b, Third Care Medical Associates 142 c, Waikiki General 142 d and the remaining provider practices. In contrast, the Now Clinic Provider network (all available) and Online Care NY provider network (all unavailable) had the availability status of each provider practice in those provider networks set at the provider network level.
  • The interface 140 also includes a control 160 to allow the provider to add a network. The control 160 when selected will cause the server 12 to retrieve from storage a listing of all networks that the provider is associated with and will allow the provider to add a network to the interface 140. Conversely, the interface also includes a control 162 to allow the provider to remove a network. The control 162 when selected will cause the server 12 to retrieve from storage the listing of all networks that the provider has on the interface 140 and will allow the provider to remove a network from the interface 140. This functionality of adding and removing networks can be accomplished using various techniques.
  • As also shown in FIG. 7, the interface 140 includes a Next Patient control 164 for the entire interface 140 and Next Patient controls 166 a, 166 b and 166 c for each of the provider networks 144 a to 144 c, respectively. Selection of the Next Patient control for the interface 140 will select the next patient according to a selection algorithm that is employed over all of the provider networks 144, whereas selection of the Next Patient control for one of the provider networks will select the next patient in the corresponding provider network according to the selection algorithm employed. In some embodiments, the algorithms will only consider patients in the provider network corresponding to the selection of the Next Patient control.
  • As also shown in FIG. 7, because the provider has chosen to be unavailable in Online Care NY, the Next Patient control 166 c is greyed-out as is the Next Patient control 164. The Next Patient control 166 b is shown as active and the algorithm will select the next patient from among all of the provider practices in the Now Clinic provider network, whereas the Next Patient control 166 a also shown as active, however the algorithm will only select the next patient from among those provider practices in the HMSA'S Online Care provider network that the provider has set to the available status.
  • Referring now to FIG. 8, an alternative queue structure 180 is shown. In this alternative, the queues (generally 180) for each provider are sub-divided or represented as plural sub-queues with each of the sub-queues corresponding to a provider network 144 (FIG. 7). Thus, three sub-queues 180 a-1 to 180 a-3 are shown for the provider corresponding to the particular example of the interface shown in FIG. 7, and sub-queues 180 n-1 to 180 n-2 are shown for a provider “n” that has only two provider networks with which the provider-n is associated, and that is associated with a different instance (not shown) of the interface of FIG. 7. Consumer entries in the sub-queues 180 a-1 to 180 a-3 and 180 n-1 to 180 n-2 representing provider networks include a provider practice indicator 183 that corresponds to a particular provider practice through which the consumer accessed the brokerage system 10. The scheduling module 28 would check the provider practice indicator 183 included with the entry, against the provider set availability status indications (FIG. 7) to determine whether to assign that consumer to the provider.
  • In an alternative, the sub-queues 180 a-1 to 180 a-3 and 180 n-1 to 180 n-2 represent provider networks can be further sub-divided into sub-queues provider practices within a particular provider network. In another alternative, the sub-queues 180 a-1 to 180 a-3 and 180 n-1 to 180 n-2 could be further sub-divided into “waiting room” and “scheduled appointments” states of the respective providers “provider-a” to “provider-n.”
  • Referring now to FIG. 9, the server 12 controls filling of the queues 180 by the provider's availability status set by the provider, via interface 140 (FIG. 7) and how incoming requests are assigned. An incoming request either includes a choice of provider or causes the server 12 to select the provider. When the incoming request includes a selection of provider made by the patient based on attribute matching, the server 12 will only send to the patient those providers that have sufficient matches and which have an available status of some type, e.g., currently available, waiting room etc. Receipt of the request with the selection will cause the server 12 to add an entry into the appropriate queue of the selected service provider, according to the provider set, availability status indications.
  • When the server 12 determines the provider, the server 12 assigns incoming requests to providers based on availability statuses of the providers. Typically, each provider can be associated with many different provider practices 142 in different provider networks 144. With providers having the ability to selectively control availability statuses, the server 12 assigns incoming requests to providers according to those statuses.
  • The server 12 receives 192 requests for engagements with service providers. The server 12 determines 194 what, if any, provider practice/provider network the consumer that sent the request is associated with. The server 12 searches 196 the queues for providers that can service the consumer request, according to the determined provider practice/provider network, if any. For consumer requests associated with a provider practice/provider network only those provider queues can be searched, whereas for consumer requests that are not associated with any provider practices/provider networks only queues of providers that handle out of network/practice requests are searched.
  • The server 12 will assimilate a listing of all open queues (queues where the provider has not indicated “not available” or queues of providers that are not logged in) according to the determined provider practice/provider network. For those providers that can service the provider practice/provider network associated with the request, and that are open, the server calculates 198 for each of those providers, a total number of patients waiting for each provider across all of the open queues (queues where the provider has not indicated “not available” or queues of providers that are not logged in) of the provider. The server 12 determines 200 which of those providers have the fewest total number of patients in all of the provider's queues. The server assigns 202 the incoming request to the provider with the fewest number of entries. When a provider has an availability status of “not available” in either a provider network 144 or a provider practice 142 (FIG. 7), the server 12 will not assign request to the corresponding queues for that provider or consider that provider's overall total number of waiting patients, since that provider cannot at that juncture service the incoming request. In this embodiment, the server using scheduling module 28, examines the queues of all providers that are suitable to provide a consultation with the consumer and chooses the appropriate sub-queue of a suitable provider that has the least number of entries waiting to be processed for the provider network 144 or provider practice 142.
  • A similar arrangement (not illustrated) can be used for servicing and selecting providers for consumer requests that are not associated with any provider practice/provider network. That is, the server calculates for each of those providers of open queues that can service out of network/practice requests, a total number of patients waiting for each provider across all of the open queues (queues where the provider has not indicated “not available” or queues of providers that are not logged in) of the provider and determines those providers having the fewest total number of patients and assigns the incoming request to the provider with the fewest number of entries.
  • In servicing requests, for a particular provider, the system retrieves the entry of a consumer that is next to be serviced from the queue for that provider according to whether the provider manually selected a patient or selected one of the aforementioned instances of the Next Patient control according to the algorithm employed by the server for selection of a next patient.
  • As noted, the server 12 includes access control facility 30 that controls how consumers 14 access the system and to what extent or level the services provided by the system are made available to consumers. The server 12 also stores and provides access to consumer information (e.g., contact information, credit and financial information, credit card information, health information, and other information related to the consumer and the services purchased or otherwise used by the consumer) and provider information (e.g., physician biographies, product and service information, health related content and information and any information the provider or the health plan wants to make available to members) and the access control facility 30 can prevent unauthorized access to this information. In some examples, the server 12 exports the consumer information for use in a provider's office or other facility.
  • In some embodiments, consumers may select providers according to attributes of the provider, such as a geographical area where the provider is located or which professional organizations have accredited the provider (e.g., whether a doctor has board certification in cardiology). Any metrics within the provider profile can be used to define a list of providers that meet the consumer's preferences. In this case, the system will use the consumer's selection to override the least used scheme for populating provider queues.
  • Referring now to FIG. 10, a quick-connect graphical user interface 210 for accessing various provider types though a brokerage system is shown. The quick connect graphical user interface 210 is generated by the server 12 and sent to a user device, e.g., a tablet computing device 212, as illustrated, a computer, and the like and the quick-connect graphical user interface 210 is used to quickly access and connect to the brokerage system 10. The quick-connect graphical user interface 210 is a minimal interface. The quick-connect graphical user interface 210 renders a plurality of controls 216 that when selected by a consumer, sends a request to consult with a service provider of a type associated with the corresponding one of the plurality of controls.
  • For example, as shown in FIG. 10, the types of providers are a pharmacist, a nutritionist, an internist, and a beautician. This is an example of a quick-connect graphical user interface 210 that allows quick connection with disparate provider types via a general brokerage system that handles brokering of provider availability across various different un-related types of providers. Selection of one of these controls 246 automatically launches a request that the server 12 uses to find the next available provider of the type selected. Upon receiving the selection and generating the request, the server 12 sends to the consumer device a second graphical user interface (not shown) to enable the consumer to provide information to a service provider for use during a consultation with a service provider of the type associated with the corresponding one of the controls 216.
  • In some embodiments, the controls 216 represent different specialties within a type of provider, e.g., an internist, ophthalmologist, and obstetrician/gynecologist with the type of physician. In other embodiments, the controls 216 are of different sub-specialties within a particular specialty, e.g., an endocrinologist, a gastroenterologist, and a cardiologist within the specialty of internal medicine.
  • The quick-connect graphical user interface 210 also includes a set of controls 218 in the quick-connect user interface 210 that allows a user to toggle between a quick connect mode of use (as illustrated by the quick-connect item being un-shaded in graphical user interface 210) and a provider selection mode that presents another graphical user interface that lists providers (not shown) but as discussed in U.S. Pat. No. 7,590,550 mentioned above.
  • Referring now to FIG. 11, the server 12 accesses 260 queues according to provider type, in response to receiving a selection of a provider type from the quick-connect graphical user interface 240 (FIG. 10). This launches a request for the provider type to cause the server 12 to select 254 the provider of that type. In some embodiments, the selection of a provider type from the quick-connect graphical user interface 240 will launch an interface (not shown) that allows for a selection of provider made by the consumer based on attribute matching. The server 12 will only send to the consumer those providers that have sufficient matches to attributes and which have an available status of some type, e.g., currently available, waiting room etc. Receipt of the request will cause the server 12 to add 256 an entry into an appropriate queue of the selected service provider.
  • In other embodiments, the server 12 applies the processing of FIG. 5 where the server stores the entries in queues of those providers of the appropriate type that the server 12 determines has the least number of entries, in order to balance provider utilization across the system 10, and to otherwise minimize overall response time for consumers, as generally discussed above.
  • With the quick-connect graphical user interface 240 plural queue structures are provided according to a like plurality of provider types. Thus, the queue arrangements of FIG. 5A, 5B or 8 for example are replicated according to the number of provider types, meaning that for whatever queue scheme and provider type scheme are employed there are queues for providers for each of the types associated with the controls on the interface. Thus, using FIG. 5B, the queue structure shown in FIG. 5B would be replicated for each type of provider.
  • Modes of Engagement
  • Telephonic callbacks—Consumers who wish for a telephonic consultation with a provider may use a traditional telephone to enter information, as discussed above, and hangs up and waits for a call-back from a suitable provider, as also discussed above. Providers are sent information concerning the consumer in order to understand the consumer's issue and a telephone number by which the provider contacts the consumer.
  • In some embodiments of the networked computer system 10, the networked computer system 10 allows consumers to engage provider's e.g., health professionals “on demand” based on provider availability. These engagements can be established in various ways as described in the above mentioned patent. These types of engagements include:
  • Passive browsing—Reference health content is accessed on the brokerage's website. The website can support the use of licensed content packages from other vendors to meet the variable preferences of health plans. For example, key content vendors include Healthwise™, ADAM™, Mayo Clinic™ and HealthDay™. Content libraries provided by such vendors offer a combination of articles, imagery, interactive tutorials and related tools that allow consumers to access content relevant for their health issues. Many health plans and major employers already possess a license for the use of one of these content packages.
  • Health Risk Assessments—The system acquires information from consumers through automated interaction (e.g., rules-based interaction) in order to crystallize their needs (e.g., medical risks) and better direct them. Assessments span from general health to very specific medical conditions and follow a path of questioning that dynamically tailors itself based on information already retrieved (e.g., using predefined rules). As assessments progress, the system constructs engagement suggestions that the consumer can exercise. Each suggestion represents both the question to the provider and the type of provider appropriate to answer it. Consumers may choose to simply launch such engagements or apply their own discretion as to the phrasing and the selection of the recipient provider. This is discussed in more detail below in the context of the consumer advisor.
  • Asynchronous correspondence—The lowest level of true provider interaction is by way of secure messaging. The question or topic of the engagement is sent to a selected provider (whether online or not) and can be answered by this provider at her leisure. Turnaround times are monitored by the system and are part of the credentials of the provider used for her selection by consumers. The system informs the consumer once a response has been received and can allow the consumer to redirect the question if he needs more urgent response time. For example, typical types of asynchronous correspondence include e-mail, instant messaging, text-messaging, voice mail messaging, VoIP messaging (i.e., leaving a message using VoIP), and paper letters (e.g., via the U.S. Postal Service).
  • Synchronous correspondence—Several forms of synchronous correspondence allow the consumer and the provider to engage in real-time discussions.
  • Synchronous text correspondence—This may be referred to as a “Chat” module where both sides of the engagement type their entries in response to each others' entries. The form of communication may be entirely text based but is still a live communication. Examples include instant messaging and SMS messaging.
  • Web-based teleconferencing—The use of broadband network connections allows for real-time voice transmission over the Internet in what is referred to as full duplex (i.e., both voice channels are open at the same time). Consumers can opt to have a voice conversation with their providers using, for example, their computer's speakers and microphone. Web-based teleconferencing may use VoIP, SIP, and other standard or proprietary technologies.
  • Telephonic conferencing—Consumers who wish for a direct telephonic communication with a provider or who are not comfortable using their computer may use a traditional telephone for interaction with a provider. The consumer may use a dial-in number and an access code that connects him to the brokerage's servers. Providers are linked to the servers via VoIP, other data-network-based voice systems, or their own telephones. Telephonic conferencing may also allow consumers to request “call me now” functions, in which the provider calls the consumer (directly or through the brokerage).
  • Video conferencing—The system can support video conferencing to allow consumers to exhibit physical findings to providers if such disclosure is needed. Consumers and providers may also simply prefer face-to-face communication, even if remote. Small digital cameras, referred to as webcams, attached to or built in to personal computers or laptops can be used for this purpose. Video conferencing can be provided by standard software or by custom software provided by the brokerage. Alternatively, dedicated video conferencing communication equipment or telephones with built-in video capabilities can be used.
  • Semi synchronous correspondence—Some engagements of a consumer with an online provider include both synchronous and asynchronous interactions. Part of the engagement takes place by immediate messaging between the two, but the provider may ask the consumer to take occasional asynchronous assessments if, for example, a generic line of question is desired. This allows the provider to operate more than one consumer engagement at a time while each consumer is constantly engaged. For example, semi-synchronous correspondence includes a combination of e-mail, instant messaging, test messaging, voice calls and mail messaging, and VoIP calls and VoIP messaging.
  • Interactive Voice Response Engagements
  • Interactive Voice Response (IVR) systems allow for the deployment of interactive audio menus over the phone. The caller can navigate between options, listen to data-driven information, provide meaningful input, and engage system functions. IVR engagements extend the reach of the system to the telephone as a portable consumer interface to launch an engagement in addition to the Web-based interface. Consumers select a pin code on the application to authenticate their identity if they call in. Several types of engagements can be carried out through an IVR system using suitable logic such as described in the patent. For dial-in engagements, the consumer calls in and invokes a telephonic engagement with an available provider. The IVR system extends the consumer's ability to select a provider to the phone so that the consumer's interaction resembles one carried out on the Web.
  • The IVR system can also be used proactively to pursue consumers who need a follow-up. At the time of a follow-up, the system recalls the provider with whom the follow-up is desired (or the type of provider in case the follow-up is not restricted to a specific provider), identifies that the provider is available for an engagement, and attempts to contact the consumer over the phone to establish a connection for the engagement. Once contacted, the consumer can decline or ask postpone the call. If the consumer takes the call, the connection is made. When consumers are pursuing an engagement with a provider that is either busy or currently offline, the IVR system allows the consumer to park in a standby mode until the provider is available. When the provider is available, the system calls the consumer, identifies the provider to the consumer, and verifies that the consumer is still interested in pursuing the call with the provider. If the consumer is still interested, an engagement is connected.
  • In addition to launching engagements, the IVR interface allows consumers to interact with other services offered by the brokerage. For example, consumers can instruct the system to fax a transcript of their information to a fax machine that the consumer identifies by keying in or speaking its phone number. Using such a function, a consumer makes key information available to, e.g., emergency room personnel or to a provider in an office visit, without the need to plan, collect, print, and carry the information to that encounter.
  • IVR hardware is readily available from telecommunication vendors and can be programmed to operate in the context of the brokerage framework. Authentication is provided through a PIN number or by other standard methods.
  • The consumer information collected by the intake process may be stored in the databases 27 as part of the overall brokerage system. In some examples, the consumer information is protected and secured from unauthorized access and in compliance with the various legal requirements for storing private consumer information (for example, HIPPA governs access to an individual's health care information). The database 27 may also the process logic and rules data including the business logic of an application or rules for a rules engine that implements the consumer advisor module.
  • The brokerage extends the result of any engagement to a physical point of care or service provider to allow continuation or escalation of services beyond those provided in the electronic encounter.
  • Embodiments can be implemented in digital electronic circuitry, or in computer hardware, firmware, software, or in combinations thereof. Apparatus of the invention can be implemented in a computer program product tangibly embodied or stored in a machine-readable storage device for execution by a programmable processor; and method actions can be performed by a programmable processor executing a program of instructions to perform functions of the invention by operating on input data and generating output. The invention can be implemented advantageously in one or more computer programs that are executable on a programmable system including at least one programmable processor coupled to receive data and instructions from, and to transmit data and instructions to, a data storage system, at least one input device, and at least one output device. Each computer program can be implemented in a high-level procedural or object oriented programming language, or in assembly or machine language if desired; and in any case, the language can be a compiled or interpreted language.
  • Suitable processors include, by way of example, both general and special purpose microprocessors. Generally, a processor will receive instructions and data from a read-only memory and/or a random access memory. Generally, a computer will include one or more mass storage devices for storing data files; such devices include magnetic disks, such as internal hard disks and removable disks; magneto-optical disks; and optical disks. Storage devices suitable for tangibly embodying computer program instructions and data include all forms of non-volatile memory, including by way of example semiconductor memory devices, such as EPROM, EEPROM, and flash memory devices; magnetic disks such as internal hard disks and removable disks; magneto-optical disks; and CD_ROM disks. Any of the foregoing can be supplemented by, or incorporated in, ASICs (application-specific integrated circuits).
  • Other embodiments are within the scope and spirit of the description claims. For example, due to the nature of software, functions described above can be implemented using software, hardware, firmware, hardwiring, or combinations of any of these. Features implementing functions may also be physically located at various positions, including being distributed such that portions of functions are implemented at different physical locations.

Claims (9)

What is claimed is:
1. A computer-implemented method comprising:
generating a first graphical user interface for accessing a brokerage system for providing broker services to consumers from service providers, the graphical user interface rendering a plurality of controls that when selected by a consumer, sends a request to consult with a service provider of a type associated with the corresponding one of the plurality of controls;
sending by the one or more computers the graphical user interface to a device used by the consumer;
receiving the request; and
sending to the consumer a second graphical user interface to enable the user to provide information to a service provider for use during a consultation with a service provider of the type associated with the corresponding one of the controls.
2. The method of claim 1, wherein the types are different types of providers.
3. The method of claim 1, further comprising:
receive a message by a user selecting a control in the first user interface that allows a user to toggle between a quick connect mode of use of the graphical user interface and a mode of use that lists providers.
4. A computer program product tangibly stored on a computer readable storage device for providing broker services to consumers and service providers, the computer program product comprising instructions for causing a computer to:
generate a first graphical user interface for accessing a brokerage system for providing broker services to consumers from service providers, the graphical user interface rendering a plurality of controls that when selected by a consumer, sends a request to consult with a service provider of a type associated with the corresponding one of the plurality of controls;
send the graphical user interface to a device used by the consumer;
receive the request; and
send to the consumer a second graphical user interface to enable the user to provide information to a service provider for use during a consultation with a service provider of the type associated with the corresponding one of the controls.
5. The product of claim 4 wherein the types are different types of providers.
6. The product of claim 4, further comprising:
receive a message by a user selecting a control in the first user interface that allows a user to toggle between a quick connect mode of use of the graphical user interface and a mode of use that lists providers.
7. An apparatus comprising:
a processor;
memory in communication with the processor; and
a computer program product tangibly stored on a computer readable storage device for providing broker services to consumers and service providers, the computer program product comprising instructions for causing a computer to:
generate a first graphical user interface for accessing a brokerage system for providing broker services to consumers from service providers, the graphical user interface rendering a plurality of controls that when selected by a consumer, sends a request to consult with a service provider of a type associated with the corresponding one of the plurality of controls;
send the graphical user interface to a device used by the consumer;
receive the request; and
send to the consumer a second graphical user interface to enable the user to provide information to a service provider for use during a consultation with a service provider of the type associated with the corresponding one of the controls.
8. The apparatus of claim 7 wherein the types are different types of providers.
9. The apparatus of claim 7, further comprising:
receive a message by a user selecting a control in the first user interface that allows a user to toggle between a quick connect mode of use of the graphical user interface and a mode of use that lists providers.
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US11/763,680 US7590550B2 (en) 2006-09-08 2007-06-15 Connecting consumers with service providers
US12/264,524 US8738727B2 (en) 2006-09-08 2008-11-04 Connecting consumers with service providers
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US20140201665A1 (en) 2014-07-17
US20140201649A1 (en) 2014-07-17
US9678636B2 (en) 2017-06-13
US20140200911A1 (en) 2014-07-17
US20160212182A9 (en) 2016-07-21
US20170213003A9 (en) 2017-07-27

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