Patent CA-2924321-A1 (CA)
Title: System to provide for improved clinical/functional outcomes
Inventor: ALHIMIRI ALI
IPC: G16H40/20
Filed: 2016-03-21
Abstract: The present invention discloses a system, method and non-transitory software based computer writeable medium usable with a processor driven device for incentivizing service providers. A first subroutine assembles a best practices model in the form of a database downloadable to the processor device and which presents series of treatment options ranging from desirable to undesirable associated with a given type of service. A  second subroutine provides a decision support system interfacing with the best practices database and processor device, the support system providing any of a grading or awarding system for scoring, in real time, performance metrics for each of any number of providers of the service.  A third subroutine outputs to each of the providers, real time and continuously updated scoring of their performance metrics based upon the grading/awarding system. A fourth subroutine for incentivizing adherence by the providers to the best practices model by tying desirable performance metrics to financial incentives which are scaled to each treatment option. A further variant of the non-transitory computer writeable medium further integrates a predictive algorithm which includes a series of protocols including a first protocol or subroutine for establishing a risk profile through stratifying a designated ACO  population. A second subroutine operates by training the ACO doctors or other care providers in one or more of a series of medical related diagnosis and treatment programs. A third successive subroutine establishes one or more management pathways which are customizable by the ACO  leadership and through establishing a questioning protocol for modifying/customizing the base algorithm for any one or more of a variety of treatment sub-species. A fourth subroutine provides care provider (e.g. doctor) feedback on the desired best practices for the given diagnosis and treatment sub-species resulting from the question and answer protocol achieved in the third subroutine. A fifth subroutine results in the creation (again by the ACO or other provider) of a scorecard for each individual care provider (doctor, therapist, etc.), such based primarily upon patient outcome assessment and accounting for patient complexities. A third variant discloses a system, method and non-transitory software based computer writeable medium usable with a processor driven device for optimizing the diagnosis, treatment and resolution of worker injury events, such as associated with a workman compensation claim, and which improves upon the existing paper based module by synthesizing, in a digital environment, symptom, treatment and progress variables in a multi-party available format. A  further related rehabilitation module, such as not limited to a worker injury event but also including any injury event associated with a typical accountable care organization (insurer/other payor/etc.) in a general health application is provided for establishing and tracking a patient's functional independent (FEM) measurement score. As with the workman compensation module, the rehabilitation module integrates the establishment of current conditions, achievable goals, and time based tracking of the patient treatment (including time elapsed changes in response to flat line response indicating a non-effective treatment plan) in order to define a patient goal outcome and to optimize real time treatment and progress tracking to that goal.