ZA201007236B - Identification of patients of a healthcare system - Google Patents

Identification of patients of a healthcare system Download PDF

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Publication number
ZA201007236B
ZA201007236B ZA2010/07236A ZA201007236A ZA201007236B ZA 201007236 B ZA201007236 B ZA 201007236B ZA 2010/07236 A ZA2010/07236 A ZA 2010/07236A ZA 201007236 A ZA201007236 A ZA 201007236A ZA 201007236 B ZA201007236 B ZA 201007236B
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ZA
South Africa
Prior art keywords
patient
database
healthcare
medical aid
biometric
Prior art date
Application number
ZA2010/07236A
Inventor
Der Merwe Ingrid Van
Der Merwe Stefan Van
Original Assignee
Arbomode (Pty) Ltd
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Publication date
Application filed by Arbomode (Pty) Ltd filed Critical Arbomode (Pty) Ltd
Priority to ZA2010/07236A priority Critical patent/ZA201007236B/en
Publication of ZA201007236B publication Critical patent/ZA201007236B/en

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Description

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Identification of Patients of a Healthcare System
THIS INVENTION relates to a method of identifying patients of a healthcare system. The method also relates to a healthcare patient identification system.
The invention is expected to be particularly advantageously applicable to healthcare systems wherein doctors, medical aid schemes and healthcare institutes such as hospitals are deployed and interact with one another to deliver seamless healthcare services to patients and through which payment of the services are handled. Accordingly, such applications should particularly, but not exclusively, be borne in mind when considering this specification. It should be appreciated that the terms patient and medical aid scheme member as used throughout the specification are likely to be the same entity.
Background of the Invention
Generally, healthcare systems provide services to private patients and medical aid scheme member patients. In the latter case, patients subscribe to a medical aid scheme that covers the costs associated with the treatment, at least in part, including but not limited to doctor's consultations, hospitalisation and prescription medicines. Typically, a medical aid : patient presents proof of medical aid membership before admission to hospital or at a doctor's rooms before consultation. Depending on the type of membership, the patient may be required to make an upfront cash payment or apply for pre-authorization to their medical aid.
The patient is subsequently treated, whereafter either the doctor or the patient submits a claim to the medical aid scheme for approval and re-imbursement of fees. Regardless of the process, the patient, medical aid scheme and healthcare provider represent parties that interact in some manner to effect delivery and payment of services.
Proper identification and verification of the parties is required to ensure accuracy of transactions between the parties and prevent fraudulent claims and payment of the claims by the medical aid scheme. Existing healthcare systems of the kind have several drawbacks, amongst them the disconnected hosting of patient details by treatment centres (including doctors’ rooms, hospitals and clinics) and member details by medical aid schemes, resulting in possible miscommunication and breach of systems security. Patients identify themselves at
PA = 9010/07236 treatment centres by physically presenting medical scheme membership cards that are cumbersome to authenticate and thus are seldom verified against the identity of a patient.
The inventor has developed an improved method of identifying patients of healthcare systems and an improved identification system which addresses some of the drawbacks.
Summary of the Invention
According to a first aspect of the invention there is provided a method of identifying a patient of a healthcare system which includes: physiological biometric scanning of the patient to create a patient biometric identity and capturing of the patient biometric identity onto a database; matching of the patient biometric identity to a pre-loaded medical aid scheme member biometric identity of the database to create a related patient-member identity pair; confirming the patient-member identity pair match to any one or more of a healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
The method may include capturing of at least one medical aid scheme member detail onto the database and associating the member detail with the member biometric identity prior to matching the patient biometric identity to the member biometric identity.
The at least one medical aid scheme member detail may include, but is not limited to, any one or more of a member's medical aid scheme membership status, cover type, pre- authorization requirement, available funds, member personal details, treatment history, outstanding balance, member photograph, national identification number, and passport number.
Confirming the patient-member identity pair match may include electronically sending of the at least one medical aid scheme member detail to the any one or more of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
Confirming the patient-member identity pair match may include electronically receiving of the at least one medical aid scheme member detail at the any one or more of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
[J EF 9010/07236
The method may include assessing the electronically received patient-member identity pair at the any one or more of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party for approval of service to the patient.
The method may include hosting any one or more of the patient biometric identity, member biometric identity, patient-member pair and the at least one medical aid scheme member detail, hereinafter referred to as the patient-member data, at a central database sited remote from the any one or more of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
The capturing of the patient biometric identity onto the database may be take place at at least one local database sited proximate to the any one or more of the healthcare institute, hospital and doctor.
In use, prior to the biometric scanning of the patient and as will become more apparent hereunder, a customer approaches a medical aid scheme in view of enrolling with the scheme. The customer chooses to enrol with the scheme and so become a scheme member. Upon enrolment, the at least one member detail, for example the member's national
ID number, name and surname, is captured onto a database of the medical aid scheme. The at least one member detail is advantageously verified against an independent database such as a database of home-affairs to validate the member and upon successful validation, a palm of the hand of the member is biometrically scanned to create a member biometric identity.
The member biometric identity and at least one member detail are subsequently captured onto the database of the medical aid scheme, the database in one embodiment being sited locally at a site of the medical aid scheme. The at least one member detail is associated with the member biometric identity and both the member biometric identity and the at least one member detail are sent electronically to the central database and hosted at the central database.
Given that the enrolment of the member as described has been completed, we now turn to admission of a patient at a hospital for example. The palm of the patient is biometrically scanned to create the patient biometric identity which is captured onto a database of the hospital, the database of the hospital being sited locally at a site of the hospital. The patient biometric identity captured at the hospital is matched to the member biometric identity captured upon enrolment of the medical aid scheme member being hosted at the central database to create the related patient-member identity pair, whereafter the match and the at least one medical aid scheme member detail of the patient is confirmed to the hospital by electronically receiving the member-identity pair and member detail at the hospital. The detail is assessed for approval of service to the patient and a level of service to 5 the patient is established.
The at least one medical aid scheme member detail may be captured at a local database sited proximate to the medical aid scheme.
The method may include hosting of the patient-member data at the at least one local database of the any one or more of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
It should be appreciated that, regardless of the specific embodiment of the method as described above, the capturing of any of the patient biometric identity, member biometric identity, at least one medical aid scheme member detail, the matching of the identities and the confirming of the identities may occur in distributed fashion at a combination of the central database, local databases of the any one or more of the hospital, healthcare institute and doctor, and local database of the medical aid scheme. Likewise, the patient-member data may be hosted in distributed fashion across the local and central databases.
The method may include exchanging of the patient-member data mutually between the central database and the at least one local database of the any one or more of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
Exchanging of the patient-member data may include electronically sending the patient-member data from the central database to the at least one local database of the any one or more of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
Exchanging of the patient-member data may include electronically receiving the patient-member data from the central database at the at least one local database of the any one or more of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
I
) L 9010/07236
Creating of the patient-member pair may include comparing the patient biometric identity with the member biometric identity at any one or more of the central database and the at least one local database.
The exchanging of the member-patient data may include capturing of the member- patient data onto the central database from any one of a patient and member directly, via for example a mobile handset such as cellular phone.
Naturally, the mutual exchanging of the member-patient data may be facilitated by at least one computer software application for a user's operative controlling of the method of identifying the patients of the healthcare system.
Facilitation by the at least one computer software application may include, but is not limited to, exchanging of the member-patient data between the database (i.e. the central database and the at least one local database) and the software application. The facilitation of ) the mutual member-patient data may naturally also include interfacing with the system via at least one user interface, such as a graphical user interface and a web user interface.
The exchanging of the member-patient data may include the third party's requesting and receiving of the data. The third party's receiving of the data may include authorizing of a data request of a third party by any one or more of the patient and member.
Naturally, the third party’s requesting and receiving of the data may be provided for as a paid service.
The exchanging of the member-patient data may include any one of a member and patient requesting their own data, for example via SMS on a cellular telephone.
The exchanging of the member-patient data mutually between the central database and the at least one local database may include searching of the local database of the any one or more of the heaithcare institute, hospital, doctor, medical aid scheme and subscriber third party for the member-patient data.
The method may include physiological biometric scanning of the member to create the member biometric identity and capturing of the member identity onto the database prior to the physiological biometric scanning of the patient.
N pA F ® L 9010/07236
The scanning of the member may include enrolling the member in the medical aid scheme. The enrolment of the member may include verifying any one or more of the identity and the at least one medical aid scheme member detail with a external party database such as a state-owned database.
The mutual exchanging of the member-patient data may be facilitated by personnel of a call centre.
The mutual exchanging of the member-patient data may include automatic updating of any of the central and at least one local databases mutually.
The physiological biometric scanning may be by way of biometric palm vein scanning. To this end, the palm vein scanning may include recursive validation of the patient biometric identity and the member biometric identity against the pre-loaded medical aid scheme member biometric identity of the database.
According to another aspect of the invention there is provided a healthcare patient identification system which includes: at least one biometric scanner operable to capture a patient biometric identity; at least one database connected to the biometric scanner, the database operable to host the scanned patient biometric identity and operable to match the patient biometric identity to a pre-loaded medical aid scheme member biometric identity for creating a related patient- member identity pair.
The database may be operable to host at least one medical aid scheme member detail as hereinbefore described.
The database may include at least one central database sited remote from any one or more of a healthcare institute, hospital, doctor, medical aid scheme and subscriber third party, the central database operable to host at least one of the patient-member identity pair and the at least one medical aid scheme member detail.
The database may include at least one local database sited proximate to any one or more of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
The at least one central database and at least one local database may include data communications interfaces for operative communication between the at least one database, at least one biometric scanner and mutual exchanging of the patient-member data between the at least one local database and at least one central database.
The healthcare patient identification system may include at least one software application for operative facilitation of the scanning and capturing of the patient biometric identity and member biometric identity, and mutual exchanging of the patient-member data.
The at least one software application may include at least one user interface, the at least one user interface being any one or more of a graphical user interface and a web user interface.
The biometric scanner may be a palm-vein biometric scanner.
The invention is now described, by way of non-limiting example, with reference to the accompanying diagrammatic drawings.
Drawings
In the drawings:
Figure 1 shows, schematically, a schematic block diagram of a healthcare patient identification system and a method of identifying a patient of a healthcare system in accordance with different aspects of the invention.
Figure 2 illustrates, by way of a software implementation flow diagram, an embodiment of a method of identifying a patient of a healthcare system in accordance with another aspect of the invention.
Figure 3 illustrates, by way of a software implementation flow diagram, another embodiment of the method of identifying a patient of a healthcare system according to yet another aspect of the invention.
0 E.9010/07236
Detailed Description of the Invention
With reference to figure 1 of the drawings, reference numeral 10 generally denotes an embodiment of a method of identifying a patient of a healthcare system by way of a schematic block diagram. Beginning at 12 and prior to physiological biometric scanning of a patient as will be seen hereunder, a customer 50 is approached by a medical aid scheme 52 for purchasing of a medical aid scheme membership by the customer 50. The customer 50 (hereafter referred to as the medical aid scheme member) accepts an offer to join the medical aid scheme and is enrolled in the scheme by the medical aid scheme 52 that is also representative of a medical aid database located at a site of the medical aid scheme.
At 14, a palm of the member is biometrically scanned to create a member biometric identity, and at least one medical aid member detail of the member, in this case the member's national identification number, name, surname and digital photograph is captured to the medical aid scheme database 52 along with the member biometric identity. The member biometric identity and member detail are hosted on the medical aid scheme database 52 and electronically sent to a central database 54 at 53, where the member biometric identity and member detail are concurrently hosted at the central database 54.
Turning now to a later time at which the enrolled member 50 requires medical attention, the member 50 presents himself as a patient 56 at a doctor's rooms and is required to provide details of his medical aid membership and identity in order to receive healthcare services from the doctor. At 58, the palm of the patient 56 is biometrically scanned to create a patient biometric identity and the scanned patient biometric identity is captured onto a practice database 59 located at a site proximate to the doctor's rooms.
The patient biometric identity is electronically sent from the practice database 59 to the central database 54 at 60, where the patient biometric identity is matched to the member biometric identity sent to the database at 53 and being hosted by the central database 54 to create a related patient-member identity pair. The patient-member identity pair and at least one member detail associated with the patient-member identity pair (hereinafter referred to as the patient-member data) is confirmed to the doctor at 62 by electronically sending the patient-member data from the central database 54 to the practice database 59 and by complimentary electronic receiving of the patient-member data at the practice database 59. The patient-member data is assessed at the practice database 59 for
@® ' approval of service to the patient 56, the assessment thus effectively verifying the patent biometric identity against the member biometric identity, so validating the identity of the member 50 and the patient 56.
Subsequent to the enrolment of the member 50 and doctor's treatment of the member that has become the patient 56, the patient 56 typically requires hospitalization and : presents himself at a hospital representing a hospital database 58 sited proximate to the hospital. At 64, the palm of the patient 56 is scanned at 57 to again create a patient biometric identity and the scanned patient biometric identity is captured onto the hospital database 64 at 59. The patient biometric identity is electronically sent from the hospital database 64 to the central database 54 at 66 where the patient biometric identity is matched to the member biometric identity sent to the database at 53 and being hosted by the central database 54 to again create a related patient-member identity pair. The patient-member data is confirmed to the hospital at 68 by electronically sending the patient-member data from the central database 54 to the hospital database 64 and by complimentarily receiving the patient-member data at the hospital database 64 for assessment and verification of the patient biometric identity against the member biometric identity.
Turning to reference numeral 70, a subscriber third party is denoted by 70, the : subscriber having access to the central database 54 in exchange for remuneration of patient- member data supplied to the subscriber 70. At 72, the subscriber 70 requests member-patient data from the central database 54, whereafter the request is sent to the medical aid scheme member 50 at 74 via for example an Short Message Service (SMS) request to a mobile handset of the member 50. The member authorizes the request at 74 via SMS service and the requested patient-member data is subsequently released to the subscriber third party 70.
At 76, the member 50 has a convenient option of releasing the requested patient-member data directly to the subscriber third party 70. Finally, the member 50 has the option to update patient-member data to the central database at 78 and request his patient-member data at 80, again for example via a handheld device such as a mobile telephone.
Naturally, the mutual exchanging of patient-member data including facilitation of the scanning, capturing, sending, receiving, assessing and verification of the patient-member data by a computer software application (not shown here), the software application extending to at least one interface for users’ of the healthcare system's interfacing with the system, the interfaces including for example a graphical user interface and a web user interface.
: ’ ) . £.90410/07236
The method as described above includes mutual exchanging of the patient- member data as exemplified at 53, 60, 62, 68 and 66 between the central database 54 and the local practice database 59 and local hospital database 64. It should be appreciated that the mutual exchanging of the patient-member data includes any one of real-time and batch updating of the patient-member data mutually between the central database 54 and the local databases 59 and 64 by manual or automatic sending and receiving of the patient-member data between the databases. :
Referring to figure 2 of the drawings, reference numeral 100 denotes generally a method of identifying a patient of a healthcare system in accordance with one aspect of the invention and particularly a software implementation diagram of one embodiment of this aspect of the invention.
At 102, a step of enrolling the medical aid scheme member 50 of figure 1 is initiated. The at least one member detail, i.e. the member's national identification number, name and surname is captured at 104, verified against an independent government database at 106 after retrieving the same at least one member detail from the independent database at 105 and logically checked at 108 through 110 to determine whether the member has already been enrolled or not. If not yet enrolled, the member detail is expanded by taking a digital photograph of the member and capturing the photograph onto the medical aid scheme database 52 of figure 1 at steps 112 through 115.
At 120, a member biometric identity is captured by way of a palm scanner, the scanning being a recursive scanning and scan validation process denoted and grouped by numeral 120 in accordance with steps in a software application of a readily available palm vein scanner, for example a marketed Fujitsu palm vein scanner. Upon completion of the scanning and verifying of the palm scan of the member, the member biometric identity is captured onto the medical aid database 52 of figure 1, whereafter the member biometric identity and at least one member detail are electronically sent to the central database 54 of figure 1.
Referring now to figure 3 of the drawings, reference numeral 200 denotes generally a method of identifying a patient of a healthcare system in accordance with another aspect of the invention and particularly a software implementation diagram of one
. @ embodiment of an aspect of the invention wherein the scanning and capturing of the patient biometric identity is performed at, for example, a hospital and associated hospital database such as the hospital 64 of figure 1. It is worth noting that the enrolment 202 of the member 50 of figure 1 may occur at the hospital 64 of figure 1 in similar fashion to the enrolment described in detail at 102 of figure 2. Consequently, the enrolment 202 is collectively indicated. Likewise, the steps of creating and capturing the patient biometric identity, here denoted generally by numeral 204, and the steps of verification of the identity denoted collectively by 206 follow the same logical form.
It should be appreciated that the method of identifying a patient and patient identification system as hereinbefore described may advantageously be integrated with private and government healthcare systems and institutions, for example by integrating the local and central databases of the system with existing private and government databases and integration with existing software applications and interfaces to provide a seamless healthcare identification and verification process.

Claims (37)

oo BN cL 13 Claims:
1. A method of identifying a patient of a healthcare system which includes: physiological biometric scanning of the patient to create a patient biometric identity and capturing of the patient biometric identity onto a database; matching of the patient biometric identity to a pre-loaded medical aid scheme member biometric identity of the database and creating of a related patient-member identity pair; and confirming of the patient-member identity pair match to at least any one of a healthcare institute, hospital, medical aid scheme and subscriber third party.
2. A method as claimed in claim 1 which includes capturing of at least one medical aid scheme member detail onto the database and associating the member detail with the member biometric identity prior to matching the patient biometric identity to the member biometric identity, the at least one medical aid scheme member detail including, but not limited to, any one or more of a member's medical aid scheme membership status, cover type, pre-authorization requirement, available funds, member personal details, treatment history, outstanding membership account balance, member identification photograph, national identification number, and passport number.
3. A method as claimed in claim 2 wherein confirming of the patient-member identity pair includes electronically sending of the at least one medical aid scheme member detail to the at least one of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
4. A method as claimed in claim 2 wherein confirming of the patient-member identity pair includes electronically receiving and assessing the at least one medical aid scheme member detail at the at least one of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party for approval of service to the patient.
5. A method as claimed in claim 2 which includes hosting at least one of the patient- member identity pair and at least one medical aid scheme member detail, in combination referred to as the patient-member data hereafter, at a central database sited remote from the at least one of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
. »010/07236
6. A method as claimed in claim 5 wherein any one or more of the scanning and capturing of the patient biometric identity and capturing of the medical aid scheme member detail takes place at at least one local database sited proximate to the at least one of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
7. A method as claimed in claim 6 which includes hosting the patient-member data at at least one of the local database of the at least one of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
8. A method as claimed in claim 7 which includes mutual exchanging of the patient- member data mutually between the central database and the at least one local database of the at least one of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
9. A method as claimed in claim 8 wherein the mutual exchanging of the patient-member data mutually includes sending the patient-member data from the central database to the at least one local database of the at least one of the healthcare institute, hospital, doctor medical aid scheme and subscriber third party.
10. A method as claimed in claim 8 wherein the mutual exchanging of the patient-member data includes receiving the patient-member data from the central database at the at least one local database of the at least one of the healthcare institute, hospital, doctor medical aid scheme and subscriber third party.
11. A method as claimed in claim 8 wherein the mutual exchanging of the patient-member data includes capturing of the patient-member data onto the central database from any of the patient and member directly, via for example a mobile handset such as a cellular phone.
12. A method as claimed in claim 8 wherein the mutual exchanging of the patient-member data includes facilitating scanning, capturing, sending, receiving, and assessing of the patient-member data by least one computer software application.
13. A method as claimed in claim 12 wherein the facilitation includes exchanging of the patient-member data between the central and at least one local database and the software application.
14. A method as claimed in claim 12 wherein the facilitation by the at least one computer software application includes interfacing with the healthcare system via at least one user interface being any one of a graphical user interface and a web user interface.
15. A method as claimed in claim 8 wherein the exchanging of the patient-member data includes the third party's requesting and receiving of the patient-member data.
16. A method as claimed in claim 15 which includes authorizing of the third party's requesting and receiving of the patient-member data by any one of the patient and member.
17. A method as claimed in claim 8 wherein the exchanging of the patient-member data includes any one of the patient and member requesting of the patient-member data.
18. A method as claimed in claim 17 wherein the patient-member data is requested via a mobile handset of any one of the patient and member.
19. A method as claimed in claim 6 which includes electronically automatically updating of at least one of the central database and local database. i
20. A method as claimed in claim 6 which includes physiological biometric scanning of the member to create the member biometric identity and capturing of the member biometric identity onto any one of the local and central databases prior to the physiological biometric scanning of the patient.
21. A method as claimed in claim 20 wherein the scanning of the member includes enrolling the member in the medical aid scheme.
22. A method as claimed in claim 21 wherein enrolling of the member in the medical aid scheme includes verifying at least one of the identity and the at least one medical aid scheme member detail with a database independent of the healthcare system.
Soe — — = —- - So [ I
23. A method as claimed in claim 8 wherein the mutual exchanging of patient-member data is facilitated by personnel of a call centre.
24. A method as claimed in claim 20 wherein the physiological biometric scanning of is done by way of biometric palm vein scanning.
25. A method as claimed in claim 24 wherein the palm vein scanning includes recursive validation of the patient biometric identity and the member biometric identity against the captured medical aid scheme member biometric identity of any one of the central and local databases.
26. A healthcare patient identification system which includes: at least one biometric scanner operable to scan and capture a patient biometric identity; at least one database connected to the biometric scanner, the database operable to host the scanned patient biometric identity and operable to match the patient biometric identity to a pre-loaded medical aid scheme member biometric identity for creating a patient-member identity pair.
27. A healthcare patient identification system as claimed in claim 26 of which the at least one database is operable to host at least one medical aid scheme member detail.
28. A healthcare patient identification system as claimed in claim 27 of which the database includes at least one central database sited remote from any one or more of a healthcare institute, hospital, doctor, medical aid scheme and subscriber third party, the central database operable to host at least one of the patient-member identity pair and the at least one medical aid scheme member detail.
29. A healthcare patient identification system as claimed in claim 28 of which the database includes at least one local database sited proximate to any one or more of the healthcare institute, hospital, doctor, medical aid scheme and subscriber third party.
30. A healthcare patient identification system as claimed in claim 29 wherein the at least one central database and at least one local database includes data communications
Co interfaces for operative communication between the at least one database, at least one biometric scanner and mutual exchanging of the patient-member data between the at least one local database and at least one central database.
31. A healthcare patient identification system as claimed in claim 30 which includes at least one software application for operative facilitation of the scanning and capturing of the patient biometric identity and member biometric identity, and mutual exchanging of the patient-member data.
32. A healthcare patient identification system as claimed in claim 31 wherein the at least one software application includes at least one user interface, the at least one user interface being any one or more of a graphical user interface and a web user interface.
33. A healthcare patient identification system as claimed in claim 26 wherein the biometric scanner is a palm-vein biometric scanner.
34. A method of identifying a patient of a healthcare system as claimed in claim 1, substantially as hereinbefore described and illustrated.
35. A new method of identifying a patient of a healthcare system, substantially as hereinbefore described.
36. A healthcare patient identification system as claimed in claim 26, substantially as hereinbefore described and illustrated.
37. A new healthcare patient identification system substantially as hereinbefore described. DATED THIS 11" DAY OF OCTOBER 2010 NRL SMI VAN WYK, INC. APPLICANT'S PATENT ATTORNEYS oo }
ZA2010/07236A 2010-10-11 2010-10-11 Identification of patients of a healthcare system ZA201007236B (en)

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