Patent ID: 7493264
Filing Date: 2009-02-17
Classification: G06Q,G16H,Y10S

Abstract:
1. An interactive computer assisted method of reviewing, analyzing, and compiling patient profile information from a plurality of different sources into a centralized patient profile database, including an interactive survey designed to evaluate the health status of a health care consumer, said method comprising the steps of: (a) developing and updating interactive questions for the interactive survey of the patient to assess the overall health status wherein the survey questions are interactively modified, priority of questions reordered based on answers to the questions, and questions are automatically determined based on previous answers; (b) developing and updating rules for determining if the patient is likely to be a high utilization health care consumer; (c) periodically accessing the patient profile information from the centralized patient profile database and determining if at least one core survey was completed during a predetermined time interval; (d) utilizing the patient profile information stored in the centralized patient profile database and information received in said periodically accessing Step (c) to update core questions, and querying a predetermined number of the patient using at least one of the core survey and the updated core questions to determine if the patient is at risk; (e) collecting and storing in a computer storage system patient related information comprising demographic information, health care program availability and eligibility criteria, current health care participation information, patient medical claims, patient drug claims, prior medical history, prior drug usage patterns including nonprescription drug usage, patient behavior factors, and demand management program information; (f) interactively evaluating if the patient is likely to be the high utilization health care consumer responsive to said utilizing step (d) and said collecting and storing step (e), and optionally responsive to an outbound communication from a health care representative to the patient; (g) determining whether at least one intervention program may reduce health care utilization and improve health of the patient and wherein said determining is automatically executed by a computer analyzing results from said survey and said patient profile; (h) determining if the patient is eligible for the at least one intervention program; (i) when said determining step (h) determines that the patient is eligible, enrolling the patient in the at least one intervention program or other health care program; (j) generating reports on the state of the at least one intervention program responsive to said enrolling step (i), including patient drug utilization, patient evaluation, patient health, comparisons with respect to desired patient health, patient satisfaction, and other information; and (k) periodically updating patient profiles, and periodically modifying the rules for determining the risk behaviors for the high utilization health care consumer.