US20160232320A1 - Systems and methods for patient health assessment - Google Patents
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- US20160232320A1 US20160232320A1 US14/619,440 US201514619440A US2016232320A1 US 20160232320 A1 US20160232320 A1 US 20160232320A1 US 201514619440 A US201514619440 A US 201514619440A US 2016232320 A1 US2016232320 A1 US 2016232320A1
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/20—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for electronic clinical trials or questionnaires
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/20—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for computer-aided diagnosis, e.g. based on medical expert systems
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
- G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
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Abstract
Systems and methods for patient health assessment are disclosed. A method includes: receiving medical data related to a patient stored in a database; identifying assessments to be performed by a case manager for the patient, each including questions to be answered; displaying, in a user interface of a case manager terminal, visual indicators that indicate a level of completeness of the assessments; displaying a listing of questions to be asked to the patient for a current assessment; receiving, in a data input field included in the user interface, input data from the case manager; and, in response to the input data, displaying in the user interface an updated listing of questions to be asked to the patient, where the updated listing of questions includes one or more questions that, when answered by the patient, advance the progress of completion of at least one of the one or more assessments.
Description
- This disclosure relates generally to the field of health care management and, more specifically, to systems and methods for patient health assessment.
- In conventional systems for patient health assessment, a case manger, such as a registered nurse or nurse practitioner, may contact a patient (e.g., by telephone) to perform one or more “assessments” on the patient. In conventional systems, an assessment includes a predefined series of questions to be asked to the patient. Some assessments are “linear,” meaning that the questions are asked in a certain order. The case manger typically asks the patient each question in order to solicit a response from the patient. Once all of the questions for an assessment have been answered, the assessment is deemed to be completed. The completed assessment can then be used by the case manager or other medical professionals to provide a care plan for the patient. In some instances, the case manager may have multiple assessments to complete with a patient.
- However, a problem exists with conventional case manager assessments when the patient interrupts the linear question list of an assessment to provide unrelated information or to ask his or her own questions to the case manager. Such events can derail an assessment and may cause confusion and unnecessary delays in completing the assessment. Because the assessment process is lengthened, patients can get frustrated with the process and may perceive the case manager as simply reading from a script and not actually caring about the patient's well-being. Case managers are often left with incomplete assessments and an array of notes to reconcile through data entry after a communications session is completed with the patient. As such, the conventional approach to case manager assessments is time-consuming and error-prone for the case manager, which may result in inadequate medical care provided to the patient.
- Accordingly, there remains a need for systems and methods for patient health assessment that overcome the drawbacks and limitations of current approaches.
- Embodiments of the disclosure provide systems and methods for patient health assessment. In one embodiment, a system includes a clinical data database and a case manager terminal computing device executing one or more processors for performing a patient health assessment. The case manager terminal computing device is configured to perform the step of: receiving, from a calculation engine module executing on a health organization server computing device, medical data related to the patient that is stored in the clinical data database; identifying one or more assessments to be performed by a case manager for the patient, wherein each assessment includes one or more questions to be answered by the patient; displaying, in a user interface on a display device, visual indicators that indicate a level of completeness of each of the one or more assessments; displaying in the user interface a listing of questions to be asked to the patient for a current assessment; receiving in a data input field included in the user interface, input data from the case manager; and in response to the input data, displaying in the user interface an updated listing of questions to be asked to the patient, wherein the updated listing of questions includes one or more questions that, when answered by the patient, advance the progress of completion of at least one of the one or more assessments. The health organization server computing device can be associated with a health insurance company or a health care provider, for example.
- Another embodiment of disclosure provides a computer-readable storage medium, system, or method for performing assessments that includes: receiving, from a calculation engine module executing on a server computing device, data related to a person that is stored in a database; identifying one or more assessments to be performed for the person, wherein each assessment includes one or more questions to be answered by the person; displaying, in a user interface on a display device of an assessor terminal computing device, visual indicators that indicate a level of completeness of each of the one or more assessments; displaying, in the user interface, a listing of questions to be asked to the person for a current assessment; receiving, in a data input field included in the user interface, input data from the assessor; and, in response to the input data, displaying in the user interface an updated listing of questions to be asked to the person, wherein the updated listing of questions includes one or more questions that, when answered by the person, advance the progress of completion of at least one of the one or more assessments.
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FIG. 1 is a conceptual diagram of a system with reference to an overall healthcare environment, according to one embodiment. -
FIG. 2 is a schematic diagram illustrating an overview of a system for communicating with a health plan member, according to one embodiment. -
FIG. 3 is a block diagram of basic functional components for a server or cluster of servers configured to implement embodiments of the disclosure. -
FIG. 4 is a conceptual diagram illustrating non-linear assessments, according to one embodiment. -
FIG. 5 is a conceptual diagram illustrating non-linear assessments and a data input field for searching for questions to ask, according to one embodiment. -
FIG. 6 is a conceptual diagram illustrating software modules included in a calculation engine module to provide non-linear assessments, according to one embodiment. -
FIG. 7 is a flow diagram of method steps performed by a data link/merge module, according to one embodiment. -
FIG. 8 is a flow diagram of method steps performed by a suggestion module, according to one embodiment. -
FIG. 9 is a flow diagram of method steps performed by an assessment engine module, according to one embodiment. -
FIG. 10 is a flow diagram of method steps of question and assessment matching, according to one embodiment. -
FIG. 11 is a flow diagram of method steps for linking new questions to all associated assessments, according to one embodiment. -
FIGS. 12A-12D are screenshots that illustrate example user interface screens displayed on a case manager terminal while performing a patient encounter, according to some embodiments. - Embodiments of the disclosure provide systems and methods for conducting patient health assessments. According to the embodiment disclosed herein, a starting point (i.e., a question) for a case manager (also referred to as an “assessor”) to begin an assessment is suggested by to the case manager by a computer system. For example, the case manager may be using a computer that is executing software that provides the suggestion to the case manager. In other implementations, a software module executing on another computer system performs the analysis to determine which question to begin the assessment. While the assessment is taking place, the computer system dynamically changes the order of the questions depending on the patient's last statement. The computer system can also provide follow up questions depending on the patient's last statement. The computer system also allows the case manager to search for questions related to the topic of the conversation.
- Accordingly, embodiments of the disclosure empower the case manager to use their professional judgment to choose which question to ask next to the patient. This allows the direction of the conversation to drive the order of questions, enabling the ability to fluidly switch from one set of assessment questions to a completely separate set of questions, depending on the flow of the conversation. A level of completeness of each assessment can also be visually represented on a display device of the computer system operated by the case manager, which enables the case manager to effortlessly access various assessments to view remaining questions.
- Turning to
FIG. 1 , an implementation of a system contemplated by an embodiment of the disclosure is shown with reference to an overall healthcare environment, according to one embodiment. A patient (also referred to as a “subscriber” or “member” or “consumer”) 102 is a member of ahealth plan 104 of a health plan organization (“HPO”) 106. Thepatient 102 may subscribe to thehealth plan 104 through, for example, his or her employer. Alternatively, thepatient 102 may obtain benefits of thehealth plan 104 through a subscriber (e.g., a spouse or child of a subscriber can be a member of a health plan). The HPO 106 can be a health insurance company and thehealth plan 104 can be one of a number of health insurance or related products, such as a PPO (Preferred Provider Organization), HMO (Health Maintenance Organization), POS (Point-of-Service), or the like. Thehealth plan 104 can also be a consumer-directed health plan, such as a high deductible health plan, health reimbursement arrangement (HRA), health savings account (HSA), or the like. The patient'shealth plan 104 covers various health care services according to one of a variety of pre-arranged terms. Details for thepatient 102 and thecorresponding plan 104 are stored in amember database 108. The terms of theplan 104 can vary greatly from plan to plan according to (among other things): what types of services are provided, where the services are provided, by whom they are provided, the extent to which the patient is personally responsible for payment, amount of deductibles, etc. Generally, however, regardless of the specific plan subscribed to, when apatient 102 obtains health care services from aprovider 110, either thepatient 102 or theprovider 110 can submit a claim to the HPO 106 for reimbursement or payment. For analysis purposes, historical claim data is stored in aclaims database 112. - A health
care services provider 110 may have acontractual relationship 114 with the HPO 106. Under thecontract 114, theprovider 110 typically agrees to provide services tomembers 102 of the HPO 106 at scheduled rates. The rates are stored in afee schedule 118, preferably stored in afees database 120 maintained by the HPO 106. By contracting with the HPO 106, theprovider 110 generally increases the amount of business theprovider 110 receives frommembers 102, andmembers 102 generally receive a less expensive rate than they would otherwise receive for a health service provided by theprovider 110. The actual amount of out-of-pocket expense to be paid by apatient 102 may vary according to the terms of his health plan 104 (e.g., co-payments, co-insurance or deductibles may apply), but will generally be at most the contracted rate. -
FIG. 2 is a schematic diagram illustrating an overview of a system for communicating with a health plan member (e.g., patient 102), according to one embodiment. Ahealth plan organization 106 collects and processes a wide spectrum of medical care information relating to apatient 102 in order to attempt to mitigate risk of thepatient 102. A personal health record (PHR) 136 of apatient 102 may be configured to solicit the patient's input for entering additional pertinent medical information, tracking follow-up actions, and allowing thehealth plan organization 106 to track the patient's medical history. In some embodiments, the medical care information relating to the patient can include health risk appraisal (HRA) information, also referred to as a health risk appraisal, or health and well-being questionnaire. In one embodiment, the HRA is a questionnaire used to gather the pertinent medical information from thepatient 102. - When the
patient 102 utilizes the services of one or morehealth care providers 110, a medical insurance carrier collects the associated clinical data 124 in order to administer the health insurance coverage for thepatient 102. Additionally, ahealth care provider 110, such as a physician or nurse, can enter clinical data 124 into one or more health care provider applications pursuant to a patient-health care provider interaction during an office visit or a disease management interaction. Clinical data 124 originates from medical services claims, pharmacy data, as well as from lab results, and includes information associated with the patient-health care provider interaction, including information related to the patient's diagnosis and treatment, medical procedures, drug prescription information, in-patient information, and health care provider notes, among other things. The medical insurance carrier and thehealth care provider 110, in turn, provide the clinical data 124 to thehealth plan organization 106, via one ormore networks 116, for storage in one or moremedical databases 132. Themedical databases 132 are administered by one or more server-based computers associated with thehealth plan organization 106 and comprise one or more medical data files located on a computer-readable medium, such as a hard disk drive, a CD-ROM, a tape drive, or the like. Themedical databases 132 may include a commercially available database software application capable of interfacing with other applications, running on the same or different server based computer, via a structured query language (SQL). In an embodiment, thenetwork 116 is a dedicated medical records network. Alternatively, or in addition, thenetwork 116 includes an Internet connection that comprises all or part of the network. - In some embodiments, an on-staff team of medical professionals within the
health plan organization 106 consults various sources ofhealth reference information 122, including evidence-based preventive health data, to establish and continuously or periodically revise a set of clinical rules 128 that reflect best evidenced-based medical standards of care for a plurality of conditions. The clinical rules 128 are stored in themedical database 132. - To supplement the clinical data 124 received from the insurance carrier, the
PHR 136 and/or an HRA questionnaire allow patient entry of additional pertinent medical information that is likely to be within the realm of patient's knowledge. Examples of patient-entered data include additional clinical data, such as patient's family history, use of non-prescription drugs, known allergies, unreported and/or untreated conditions (e.g., chronic low back pain, migraines, etc.), as well as results of self-administered medical tests (e.g., periodic blood pressure and/or blood sugar readings). Preferably, thePHR 136 facilitates the patient's task of creating a complete health record by automatically populating the data fields corresponding to the information derived from the medical claims, pharmacy data, and lab result-based clinical data 124. In one embodiment, patient-entered data also includes non-clinical data, such as upcoming doctor's appointments. In some embodiments, thePHR 136 gathers at least some of the patient-entered data via a health risk assessment tool (HRA) 130 that requests information regarding lifestyle, behaviors, family history, known chronic conditions (e.g., chronic back pain, migraines, etc.), and other medical data, to flag individuals at risk for one or more predetermined medical conditions (e.g., cancer, heart disease, diabetes, risk of stroke, etc.) pursuant to the processing by acalculation engine module 126, which a software module executed by one or more processors included in a computer system. Preferably, theHRA 130 presents thepatient 102 with questions that are relevant to his or her medical history and currently presented conditions. The risk assessment logic branches dynamically to relevant and/or critical questions, thereby saving the patient time and providing targeted results. The data entered by thepatient 102 into theHRA 130 also populates the corresponding data fields within other areas ofPHR 136. Thehealth plan organization 106 aggregates the clinical data 124 and the patient-entered data, as well as the health reference andmedical news information 122, into the medical database(s) 132 for subsequent processing via acalculation engine module 126. - The
health plan organization 106 includes a multi-dimensional analytical software application including acalculation engine module 126 comprising computer-readable instructions for performing analysis on the contents of themedical databases 132 in order to attempt to mitigate risk of thepatient 102. In some embodiments, a patient is stratified into one of three risk tiers, including a high risk tier, a moderate risk tier, and a low risk tier. Based on the risk tier of a patient and other engagement factors, the health plan organization can reach out to thepatient 102 viacommunications medium 134.Example communications media 134 include telephone, postal mail, email, text message, or other electronic or non-electronic communication media. In various embodiments, the type ofcommunication medium 134 used to reach out to or “engage” thepatient 102 depends on the risk tier and/or other engagement factors. Also, thecommunication medium 134 allows data transfer between thecalculation engine module 126 and thecase manager terminal 160 operated by acase manager 150. In some examples, thecase manager 150 is a registered nurse or nurse practitioner. - For example, a
case manager 150 may be notified that apatient 102 is the highest-risk tier and/or that the patient has received a poor lab result, via thecase manager terminal 160. This notification is received by thecase manager terminal 160 from thecalculation engine module 126. - The
case manager 150 may initiate a communications session with thepatent 102 via thecommunications medium 134, such as by placing a phone call to the patient. One goal of the case manager's interaction with the patient may be to identify the cause of a health problem with thepatient 102. This can be done by performing one or more “assessments” on the patients. In some embodiments, an assessment includes a series of questions to be asked to the patient. Some assessments may be “linear,” meaning that the questions should be asked in a certain order. In some embodiments, thecase manager 150 is provided with multiple recommended assessments to complete with a givenpatient 102. - However, as described above, a problem exists with conventional case manager assessments when the patient interrupts the linear question list of an assessment to provide unrelated information or to ask his or her own questions to the case manager. Such events can derail an assessment and may cause confusion and unnecessary delays in completing the assessment. Because the assessment process is lengthened, patients can get frustrated with the process and may perceive the case manager as simply reading from a script and not actually caring about the patient's well-being. Case managers are often left with incomplete assessments and an array of notes to reconcile through data entry after a communications session is completed with the patient. As such, the conventional approach to case manager assessments is time-consuming and error-prone for the case manager, which may result in inadequate medical care provided to the patient.
- Accordingly, embodiments of the disclosure provide for improved systems and methods for patient health assessment. According to various embodiments, a
case manger 150 opens a computer program on thecase manager terminal 160 to begin a new encounter with apatient 102. A visual dashboard or user interface is displayed on a display screen of thecase manager terminal 160 that includes a listing of assessments that are incomplete for thepatient 102, where each assessment includes one or more questions to be answered by thepatient 102. For each assessment, a visual indicator is displayed that indicates a level of completeness of the assessment (e.g., 0% complete, 25% complete, 100% complete, 3 of 10 questions answered, etc.). - The
case manger 150 begins by asking a question for one of the assessments that has not yet been answered. The initial question may be part of a “current assessment” and an initial set of questions to ask the patient from the current assessment may be provided to thecase manager terminal 160 based on analysis performed by thecalculation engine module 126. In some embodiments, thecalculation engine module 126 is part of thecase manager terminal 160. In other embodiments, thecalculation engine module 126 is in a separate computer system than thecase manager terminal 160, such as in a server of ahealth plan organization 106. - When the
patient 102 answers a question, the answer is recorded against the assessments that include that question, such as the current assessment. One or more recommended questions from the current may then be prompted to thecase manger 150 to ask the patient 102 (based on analysis performed by the calculation engine module 126). This process continues until thepatient 102 begins to get off-track, meaning that thepatient 102 begins to provide unsolicited information about things that thecase manger 150 has not asked that may or may not be relevant to the assessments that are yet to be completed. - In some embodiments, a data input field may be in displayed on the
case manager terminal 160 that allows thecase manger 150 to search for related question to the patient conversation, e.g., in situations where thepatient 102 has taken the conversation off-course. Based on the input in the data input field, thecase manager terminal 160, in conjunction with thecalculation engine module 126, may provide new recommendations for questions from one or more other assessments besides the current assessment to keep the conversation relevant to the present topic and to carry on with the progress of completing the assessments. As the new questions are asked and answered, progress is made towards completing multiple assessments in parallel while keeping the conversation relevant to topics that thepatient 102 is interested in discussing. - While the entity relationships described in
FIG. 2 are representative, those skilled in the art will realize that alternate arrangements are possible. In one embodiment, for example, thehealth plan organization 106 and the medical insurance carrier are the same entity. Alternatively, thehealth plan organization 106 is an independent service provider engaged in collecting, aggregating, and processing medical care data from a plurality of sources to provide a personal health record (PHR) service for one or more medical insurance carriers. In yet another embodiment, thehealth plan organization 106 provides PHR services to one or more employers by collecting data from one or more medical insurance carriers. In yet another implementation,case manager terminal 160 is part ofhealth plan organization 106. -
FIG. 3 is a block diagram of basic functional components for a server or cluster of servers configured to implement embodiments of the disclosure. For example,server 300 may represent the computer system that executes thecalculation engine module 126 and/orcase manager terminal 160 shown inFIG. 2 . In some embodiments,server 300 is configured to be a computer or computers operated by an insurance carrier and/or case manager. - The
server 300 includes one ormore processors 302,memory 304, andnetwork interface 306. In some embodiments, each of the components including the processor(s) 302,memory 304, andnetwork interface 306 is interconnected physically, communicatively, and/or operatively for inter-component communications. - As illustrated,
processors 302 are configured to implement functionality and/or process instructions for execution withinserver 300. For example,processors 302 execute instructions stored inmemory 304.Memory 304, which may be a non-transient, computer-readable storage medium, is configured to store information withinserver 300 during operation. In some embodiments,memory 304 includes a temporary memory, i.e., an area for information not to be maintained when theserver 300 is turned off. Examples of such temporary memory include volatile memories such as random access memories (RAM), dynamic random access memories (DRAM), and static random access memories (SRAM).Memory 304 also maintains program instructions for execution by theprocessors 302. - The
server 300 usesnetwork interface 306 to communicate with external devices via one or more networks, such as thenetwork 116 inFIG. 1 .Network interface 306 may also provide a phone or Internet-enabled voice and/or video connection between a case manager and a patient. Such networks may include one or more cellular networks, wireless networks, wired networks, fiber optics networks, and other types of networks through which communication between theserver 300 and an external device may be established.Network interface 306 may be a network interface card, such as an Ethernet card, an optical transceiver, a radio frequency transceiver, or any other type of device that can send and receive information. -
FIG. 4 is a conceptual diagram illustrating non-linear assessments, according to one embodiment. As shown inFIG. 4 ,various assessments 402 can be associated with a particular patient based on or quantified bydata inputs 404 for the patient.Example data inputs 404 include clinical data, administrative data, question responses, patient updates, personal data, financial data, among others, that are stored in a medical database. As shown inFIG. 4 , theassessments 402 can be categorized as incomplete, completed, periodical, or others. As described, each assessment includes one or more questions to be answered by the patient. When all the questions of an assessment are answered, the assessment is deemed “completed.” If at least one question remains unanswered, then the assessment is deemed “incomplete.” A “periodical” assessment, in some embodiments, is an assessment that should be administered to the patient on a periodic basis, e.g., once a year. - When a
case manger 150 logs into acase manager terminal 160 to begin apatient encounter 406, a user interface is displayed on thecase manager terminal 160 to thecase manager 150. The user interface may provide visual indications of which assessments are recommended to complete 414 and may provide arecommendation 408 of a question to ask the patient. Adata input field 410 may also be provided in the user interface to allow input by the case manager, e.g., of a patient response to a question that is off-topic. Thedata input field 410 may be a text field, a drop-down selection menu, radio button selection menu, or checkbox-based menu choices, among others. Anotes section 412 of the user interface may provide an input field where the case manager can input additional notes about the answer to the question. - When a patient answers a question, the data is transmitted from the
case manager terminal 160 to be stored in a database as data inputs 404 (e.g.,database 132 inFIG. 2 ) and is used by a calculation engine module (e.g.,calculation engine module 126 inFIG. 2 ) to generate anew question recommendation 408. The recommendation may be part of the same assessment as the previous question or from a different assessment. - Another user interface feature may include a table 416 of all questions for the recommended assessments 414, with one visual indicator indicting that a particular question has been answered and another visual indication indicating that a particular question has not been answered. For example, the visual indications may be different colors for questions that been answered and questions that have not been answered.
- According to some embodiments, the assessments can be completed in a non-linear manner in which questions from different assessments can be asked to the patient based on, for example, the flow of the conversation, as described in greater detail herein.
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FIG. 5 is a conceptual diagram illustrating non-linear assessments and adata input field 504 for searching for questions to ask at patient, according to one embodiment. As shown inFIG. 5 , when a case manager opens a new patient encounter, avisual indicator 502 may be displayed in a user interface showing which recommended assessments are to be completed. In the example inFIG. 5 , three assessments “A,” “B,” and “C” are yet to be completed. A fill-barvisual indicator 502 is shown inFIG. 5 , where the fill-bar is increased when a question for a particular assessment has been asked and answered until the fill-bar is full, which indicates that the assessment has been completed. - The user interface may also include a
data input field 504 for searching for questions to ask the patient. In one example scenario, suppose the case manager asked a particular question to the patient. The patient, instead of answering the question, provides some other information that does not answer the question that was asked. The case manager can input the other information provided by the patient (e.g., “Condition A” inFIG. 5 ) in thedata input field 504. The other information is transmitted back to thecalculation engine module 126 that processes the information to generate alisting 506 of recommended questions (e.g.,Questions 1A-6A inFIG. 5 ) to ask the patient based on the other information that was provided in thedata input field 504. The questions in thelisting 506 may questions that are need to complete the remaining assessments for the patient, but are also relevant to the flow of the conversation. As such, as questions are asked and answered, progress is made towards completing multiple assessments in parallel. Each question answered in the non-linear assessment may prompt follow-on questions to further satisfy the assessment requirements. -
FIG. 6 is a conceptual diagram illustrating software modules included in acalculation engine module 126 to provide non-linear assessments, according to one embodiment. As shown, thecalculation engine module 126 includes adata receiver module 602, a data link/merge module 604, asuggestion module 606, anassessment engine module 608, and anassessment view module 610. Each of the modules inFIG. 6 may be a software module comprising processor-executed instructions that are executed by one or more computers, such as a server of a health organization and/or a case manager terminal. - The
data receiver module 602 receives data from adatabase 132. In one embodiment, the data may be information provided in a data input field by a case manager during a patient encounter, where the data was input into the data input field by the case manager and transmitted from the case manager terminal to thedatabase 132. The data is transmitted from thedata receiver module 602 to the data link/merge module 604. -
FIG. 7 is a flow diagram of method steps performed by a data link/merge module, such as data link/merge module 604 inFIG. 6 , according to one embodiment. As shown, themethod 700 begins atstep 702, where the data link/merge module receives data identifiers. The data identifiers may include identifiers for the data received from thedata receiver module 602. In some embodiments, patient data is sorted in categories (e.g., clinical, financial, demographic, etc.) and is merged with reference data. This combined “patient object” is then associated with the appropriate assessment. Atstep 704, the data link/merge module sorts the data identifiers to data categories. Atstep 706, the data link/merge module links data sources to relevant identifiers. Atstep 708, the data link/merge module merges data sources relevant to the data identifiers. Atstep 710, the data link/merge module generates a data object for a patient state. Atstep 712, the data link/merge module links the data object to the current assessment. -
FIG. 8 is a flow diagram of method steps performed by a suggestion module, such assuggestion module 606 inFIG. 6 , according to one embodiment. As shown, themethod 800 begins atstep 802, where the suggestion module evaluates a search text from the case manager. For example, the search text may be input into thedata input field 504 described above. As such, when the conversation between the patient and the case manager shifts to a new topic, the case manager can type free text into thedata input field 504. The suggestion module associates the free text with available assessments and generates the next set of questions to present to the case manager. Atstep 804, the suggestion module evaluates a current assessment being administered to the patient. Atstep 806, the suggestion module identifies all linked data sources for the current assessment. Atstep 808, the suggestion module generates a new question list based on the search context. Atstep 810, the suggestion module links the new questions to all the associated assessments. -
FIG. 9 is a flow diagram of method steps performed by an assessment engine module, such asassessment engine module 608 inFIG. 6 , according to one embodiment. The assessment engine module is configured to select the next assessment and select the next set of questions to present to the case manager. As shown, themethod 900 begins atstep 902, where the assessment engine module receives a current assessment identifier and patient identifier. Atstep 904, the assessment engine module identifies new assessment content for a current assessment position. Atstep 906, the assessment engine module prioritizes new assessment questions and reduces a total number of questions by relevance to the current context. Atstep 908, the assessment engine module links new questions to all relevant assessments. Atstep 910, the assessment engine module assigns new priority questions to the current assessment. - Referring back to
FIG. 6 , new priority questions from the assessment engine module are transmitted to theassessment view module 610. Theassessment view module 610 communicates with the case manager terminal to display the new priority questions in the case manager terminal user interface to the case manager. -
FIG. 10 is a flow diagram of method steps of question and assessment matching, according to one embodiment. In some implementations, based on free text entry by the case manager, different assessments can be selected as being relevant to the free text entry. Certain questions can then the selected as being the appropriate questions to present.FIG. 10 is a visual representation of the background logic presented inFIGS. 8 and 9 . As shown, themethod 1000 begins atstep 1002, where the assessment engine module performs an initial matching of new content to the pool of possible assessment questions. The initial matching may be performed by executing any technically feasible matching algorithm, including deterministic or probabilistic matching algorithms. If exactly one match is found, then themethod 1000 proceeds to step 1004, where the assessment engine module returns the one match question. - If at
step 1002, zero matches are found, then themethod 1000 proceeds to step 1006, where the assessment engine module performs probabilistic matching to determine which remaining assessment questions are left to be answered based on the new content. At step the 1008, the assessment engine module performs a weighted priority sort of the remaining assessment questions are left to be answered. The matches are then returned at step 1004. - If at
step 1002, more than one match is found, then themethod 1000 proceeds to step 1010, where the assessment engine module performs further matching of the new content to assessment questions. The further matching may be any technically feasible matching algorithm, including deterministic or probabilistic matching. If, atstep 1010, exactly one match is found, the method proceeds to step 1004 where the match is returned. If, atstep 1010, more than one match is found, then themethod 1000 proceeds to step 1008, described above. -
FIG. 11 is a flow diagram of method steps for linking new questions to all associated assessments, according to one embodiment. In one implementation,FIG. 11 provides the logic for updating the next set of questions to be presented to the case manager. The intention of this process is to support the case manager in staying on task, making progress towards completing an assessment. As shown, themethod 1100 begins atstep 1102, where the calculation engine module evaluates a current assessment position for apatient 1102. Atstep 1104, the calculation engine module merges the assessment position with patient data to create an updated state for the patient. Atstep 1106, the calculation engine module generates a new question list for all relevant assessments for the patient. Atstep 1108, the calculation engine module reduces the total questions by a weighted priority for the patient and the current encounter. Atstep 1110, the calculation engine module links new questions to all associated assessments. -
FIGS. 12A-12D are screenshots that illustrate example user interface screens displayed on a case manager terminal while performing a patient encounter, according to some embodiments. As shown inFIG. 12A , auser interface 1200 includes an indicator of a current assessment 1202 (e.g., “Diabetes—Adult”) andnext questions 1206 to ask the patient for thecurrent assessment 1202. Additional recommendedassessments 1204 that are recommended to complete with the patient are also shown in theuser interface 1200.Visual indicators 1210 indicate to the case manager a level of completeness (e.g., completion percentage) of the various assessments to be completed and/or recommended to be completed. - Also shown in the
user interface 1200 is adata input field 1208 for the case manager to input information to find new questions to ask the patient. As described, the information provided in thedata input field 1208 may be information provided by the patient. - In some embodiments, during an assessment, the case manager can follow the scripted
next questions 1206 or type a new topic into thedata input field 1208 in order to follow the patient's diversion “off-script.” - As shown in
FIG. 12B , the case manager has input thetext 1212 “blood pressure” into thedata input field 1208. In response, the user interface is updated to display alisting 1214 of recommended questions to ask the patient based on thetext 1212. In some embodiments, the questions displayed in thelisting 1214 are helpful toward completing one or more of the assessments being administered or recommended for the patient. - In the example in
FIG. 12B , the case manager may select the recommended question 1216 (i.e., “Do you know your most recent blood pressure?”), which causes the user interface shown inFIG. 12C to be displayed. InFIG. 12C , a listing ofquestions 1218 related to “recent blood pressure” are provided. Once the answers are complete, the case manager can click “Submit” 1220, which causes the user interface shown inFIG. 12D to be displayed. - As shown in
FIG. 12D , the answer to the blood pressure question(s) increase the completion progress of one of the recommendedassessments 1204, namely the “Chronic Obstructive Pulmonary Disease (COPD)”assessment 1222. Thecurrent assessment 1202, however, remains as “Diabetes—Adult.” - In sum, embodiments of the disclosure disclose dynamically changing the order of questions, providing follow-up questions based on a patient's response, and/or visually representing the level of completeness of numerous assessments that are simultaneously being completed based on the conversational flow of the assessment. By providing a data input field that can generate new questions to ask the patient, multiple assessments can be completed in parallel, while keeping the conversation relevant to the patient, which keeps the patient engaged and provides for better and faster assessment completion.
- Although embodiments of the disclosure provide for a
calculation engine module 126 as part of ahealth plan organization 106, other embodiments may include thecalculation engine module 126 as part of a server executed by a health care provider. In some embodiments, any entity that has access to clinical data from the patient's medical record may implement thecalculation engine module 126 to perform the features and functions disclosed herein. In still further embodiments, the assessment workflow described herein may implemented outside of the health care industry and is applicable to any industry that involves assessments, such as, for example, the financial assessments (e.g., assessments to determine a person's financial status, credit worthiness, level of credit to offer, set of terms to provide the customer, etc.), academic assessments, online dating or matchmaking assessments, and employment assessments, among others. - All references, including publications, patent applications and patents, cited herein are hereby incorporated by reference to the same extent as if each reference were individually and specifically indicated to be incorporated by reference and were set forth in its entirety herein.
- The use of the terms “a” and “an” and “the” and similar referents in the context of describing the disclosure (especially in the context of the following claims) are to be construed to cover both the singular and the plural, unless otherwise indicated herein or clearly contradicted by context. The terms “comprising,” “having,” “including,” and “containing” are to be construed as open-ended terms (i.e., meaning “including, but not limited to,”) unless otherwise noted. Recitation of ranges of values herein are merely intended to serve as a shorthand method of referring individually to each separate value falling within the range, unless otherwise indicated herein, and each separate value is incorporated into the specification as if it were individually recited herein. All methods described herein can be performed in any suitable order unless otherwise indicated herein or otherwise clearly contradicted by context. The use of any and all examples, or exemplary language (e.g., “such as”) provided herein, is intended merely to better illuminate the disclosure and does not pose a limitation on the scope of the disclosure unless otherwise claimed. No language in the specification should be construed as indicating any non-claimed element as essential to the practice of the disclosure.
- One embodiment of the disclosure may be implemented as a program product for use with a computer system. The program(s) of the program product define functions of the embodiments (including the methods described herein) and can be contained on a variety of computer-readable storage media. Illustrative computer-readable storage media include, but are not limited to: (i) non-writable storage media (e.g., read-only memory devices within a computer such as CD-ROM disks readable by a CD-ROM drive, flash memory, ROM chips or any type of solid-state non-volatile semiconductor memory) on which information is permanently stored; and (ii) writable storage media (e.g., floppy disks within a diskette drive or hard-disk drive or any type of solid-state random-access semiconductor memory) on which alterable information is stored.
- Preferred embodiments of this disclosure are described herein, including the best mode known to the inventors for carrying out the disclosure. Variations of those preferred embodiments may become apparent to those of ordinary skill in the art upon reading the foregoing description. The inventors expect skilled artisans to employ such variations as appropriate, and the inventors intend for the disclosure to be practiced otherwise than as specifically described herein. Accordingly, this disclosure includes all modifications and equivalents of the subject matter recited in the claims appended hereto as permitted by applicable law. Moreover, any combination of the above-described elements in all possible variations thereof is encompassed by the disclosure unless otherwise indicated herein or otherwise clearly contradicted by context.
Claims (20)
1. A system, comprising:
a clinical data database; and
a case manager terminal computing device executing one or more processors for performing a patient health assessment, by performing the steps of:
receiving, from a calculation engine module executing on a health organization server computing device, medical data related to the patient that is stored in the clinical data database;
identifying one or more assessments to be performed by a case manager for the patient, wherein each assessment includes one or more questions to be answered by the patient;
displaying, in a user interface on a display device, visual indicators that indicate a level of completeness of each of the one or more assessments;
displaying in the user interface a listing of questions to be asked to the patient for a current assessment;
receiving in a data input field included in the user interface, input data from the case manager; and
in response to the input data, displaying in the user interface an updated listing of questions to be asked to the patient, wherein the updated listing of questions includes one or more questions that, when answered by the patient, advance the progress of completion of at least one of the one or more assessments.
2. The system of claim 1 , wherein the input data is transmitted from the case manager terminal computing device to the health organization server computing device, wherein the input data is processed by the calculation engine module executing on the health organization server computing device.
3. The system of claim 2 , wherein the updated listing of questions to be asked to the patient is received from the health organization server computing device based on the processing of the input data by the calculation engine module.
4. The system of claim 1 , wherein the one or more assessments includes a current assessment and a set of recommended assessments.
5. The system of claim 4 , wherein when a question included in the updated listing of questions is answered by the patient, the progress of completion is advanced of an assessment included in the set of recommended assessments.
6. The system of claim 1 , wherein, for each of the one or more assessments, a visual indicator indicating the level of completeness comprises a percentage of the questions in the assessment that have been answered.
7. The system of claim 6 , wherein, for each of the one or more assessments, the visual indicator is a fill-bar that increases each time a question is answered for the assessment.
8. The system of claim 1 , wherein the questions included in the updated listing of questions are determined by the calculation engine module executing on the health organization server computing device based on performing deterministic or probabilistic matching based on the input data.
9. The system of claim 1 , wherein the health organization server computing device is associated with a health insurance company or a health care provider.
10. A method, comprising:
receiving, from a calculation engine module executing on a health organization server computing device, medical data related to a patient that is stored in the clinical data database;
identifying one or more assessments to be performed by a case manager for the patient, wherein each assessment includes one or more questions to be answered by the patient;
displaying, in a user interface on a display device of a case manager terminal computing device, visual indicators that indicate a level of completeness of each of the one or more assessments;
displaying in the user interface a listing of questions to be asked to the patient for a current assessment;
receiving in a data input field included in the user interface, input data from the case manager; and
in response to the input data, displaying in the user interface an updated listing of questions to be asked to the patient, wherein the updated listing of questions includes one or more questions that, when answered by the patient, advance the progress of completion of at least one of the one or more assessments.
11. The method of claim 10 , wherein the input data is transmitted from the case manager terminal computing device to the health organization server computing device, wherein the input data is processed by the calculation engine module executing on the health organization server computing device.
12. The method of claim 11 , wherein the updated listing of questions to be asked to the patient is received from the health organization server computing device based on the processing of the input data by the calculation engine module.
13. The method of claim 10 , wherein the one or more assessments includes a current assessment and a set of recommended assessments.
14. The method of claim 13 , wherein when a question included in the updated listing of questions is answered by the patient, the progress of completion is advanced of an assessment included in the set of recommended assessments.
15. The method of claim 10 , wherein, for each of the one or more assessments, a visual indicator indicating the level of completeness comprises a percentage of the questions in the assessment that have been answered.
16. The method of claim 15 , wherein, for each of the one or more assessments, the visual indicator is a fill-bar that increases each time a question is answered for the assessment.
17. The method of claim 10 , wherein the questions included in the updated listing of questions are determined by the calculation engine module executing on the health organization server computing device based on performing deterministic or probabilistic matching based on the input data.
18. A non-transitory computer-readable storage medium storing instructions that, when executed by a processor, cause a computer system to perform the steps of:
receiving, from a calculation engine module executing on a server computing device, data related to a person that is stored in a database;
identifying one or more assessments to be performed for the person, wherein each assessment includes one or more questions to be answered by the person;
displaying, in a user interface on a display device of an assessor terminal computing device, visual indicators that indicate a level of completeness of each of the one or more assessments;
displaying, in the user interface, a listing of questions to be asked to the person for a current assessment;
receiving, in a data input field included in the user interface, input data from the assessor; and
in response to the input data, displaying in the user interface an updated listing of questions to be asked to the person, wherein the updated listing of questions includes one or more questions that, when answered by the person, advance the progress of completion of at least one of the one or more assessments.
19. The computer-readable storage medium of claim 18 , wherein the input data is transmitted from the assessor terminal computing device to the server computing device, wherein the input data is processed by the calculation engine module executing on the server computing device.
20. The computer-readable storage medium of claim 18 , wherein the one or more assessments are health assessments, financial assessments, academic assessments, personality assessments, or employment assessments.
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