Patent ID: 8666761
Filing Date: 2014-03-04
Classification: G06Q,G16H

Abstract:
1. A method for coordinated healthcare delivery for use with a controller, said controller including a processor and a memory communicatively coupled to said processor and having instructions that are executable by said processor, said method comprising: generating a base target population of patients by analyzing, using said processor, claim data of each of a plurality of patients to determine a subset of said plurality of patients who are expected to realize a higher benefit from enrolling in a coordinated healthcare delivery program than other patients of said plurality of patients, wherein said base target population of patients is said subset of said plurality of patients; generating, by said processor, a list of one or more patients in said base target population of patients that have had a previous contact with a clinician; providing, using said processor, said claim data of each patient in said list of one or more patients in said base target population of patients to said clinician; receiving, using said processor, for each patient of said base target population of patients in said list of one or more patients, an indication from said clinician with whom said patient has had said previous contact as to whether said patient is an appropriate candidate for enrollment in said coordinated healthcare delivery program, wherein said clinician with whom said patient has had said previous contact provides said indication based on a review of said claim data of said patient; generating, using said processor, a final target population of patients, wherein said final target population of patients is a subset of said base target population of patients, wherein each patient of said final target population of patients has been indicated, by said clinician with whom said patient has had said previous contact, to be an appropriate candidate for enrollment in said coordinated healthcare delivery program based on said review of said claim data of said patient; contacting patients from said final target population of patients, wherein, for each patient, said contact is made by said clinician with whom said patient has had said previous contact; providing an identification of an adjusted target population of patients to a case manager responsible for enrolling patients from said adjusted target population of patients in said coordinated healthcare delivery program, wherein said adjusted target population comprises each patient from said final target population of patients who has agreed, during said contact by said clinician with whom said patient has had said previous contact, to be contacted by said case manager for enrollment in said coordinated healthcare delivery program after said contact by said clinician; contacting said patients from said adjusted target population of patients for enrollment in said coordinated healthcare delivery program, wherein, for each patient, said contact is made by said case manager after receiving said identification of said adjusted target population of patients; enrolling at least one patient from said adjusted target population of patients in said coordinated healthcare delivery program, wherein said enrolling is performed by said case manager after receiving said identification of said adjusted target population of patients; and generating a care plan for each enrolled patient, wherein said care plan is developed based upon interaction between one or more of said enrolled patient, said clinician with whom said enrolled patient has had said previous contact, and a nurse coach.