Patent Publication Number: US-2009222288-A1

Title: System and method for providing telephone access by patients to medical personnel

Description:
CROSS-REFERENCE TO RELATED APPLICATION 
     This application claims the benefit of U.S. Provisional Application Ser. No. 61/032,700, filed by Slater on Feb. 28, 2008, entitled “System and Method for Providing Telephone Access by Patients to Medical Personnel,” commonly assigned with this application and incorporated herein by reference. 
    
    
     TECHNICAL FIELD 
     This application is directed, in general, to a computer-based communication systems and, more specifically, to a system and method for providing telephone access by patients to medical personnel. 
     BACKGROUND 
     The physician-patient relationship has for many centuries been among the most personal and trusted of relationships. Unfortunately, the face of primary care is rapidly changing. Essentially gone are the days when a physician would call to follow up with a patient to see if the patient was still sick or discuss the patient&#39;s lab results in detail while waiting for the insurance company to reimburse the physician. The reason underlying this fundamental change is financial in nature. While the patient benefits from the interaction, the physician bears the ever-increasing cost of operating an office. 
     Most patients agree that their physician seems rushed or spends less time than what they would like, or expect. This is primarily due to the structure of a visit as the patient&#39;s insurance company (including Medicare) dictates. They do not pay for the patient&#39;s visit based on its length, but rather for a pre-determined amount based on which of five levels are billed. What this means is that if the patient&#39;s physician spends too much time in any one visit or even on the phone, the revenue will be insufficient to maintain the overhead of the office. As a result, a patient is likely to have health problems that go unaddressed because both the physician and the patient is compelled to keep up the pace the insurance company establishes. 
     SUMMARY 
     One aspect provides a physician/patient communication system. In one embodiment, the system includes: (1) an account manager configured to interact with at least one patient and at least one physician to allow at least one patient account and at least one physician account to be established, (2) a report generator coupled to the account manager and configured to provide one or more reports to the at least one patient and the at least one physician, (3) a matching engine coupled to the report generator and configured to match the at least one patient with the at least one physician and (4) a telephony interface coupled to the matching engine and configured to enable communication between the at least one patient and the at least one physician. 
     In another embodiment, the system includes: (1) an account manager configured to interact with at least one patient and at least one physician via one or more of: (1a) a browser, (1b) electronic mail and (1c) a telephone to allow at least one patient account and at least one physician account to be established, (2) a report generator coupled to the account manager and configured to provide one or more reports to the at least one patient and the at least one physician, (3) a matching engine coupled to the report generator and configured to match the at least one patient with the at least one physician and (4) a telephony interface coupled to the matching engine and configured to enable communication between the at least one patient and the at least one physician, the account manager, the report generator and the matching engine embodied at least in part in a sequence of software instructions executable in a general-purpose computer. 
     Another aspect provides a method of managing physician/patient communication. In one embodiment, the method includes: (1) interacting with at least one patient and at least one physician to allow at least one patient account and at least one physician account to be established, (2) providing one or more reports to the at least one patient and the at least one physician, (3) matching the at least one patient with the at least one physician and (4) enabling communication between the at least one patient and the at least one physician. 
    
    
     
       BRIEF DESCRIPTION 
       Reference is now made to the following descriptions taken in conjunction with the accompanying drawings, in which: 
         FIG. 1  is a block diagram illustrating a network environment in which embodiments of the invention may be practiced; 
         FIG. 2  is a block diagram illustrating a computer system suitable for implementing embodiments of the invention; 
         FIG. 3  is a block diagram illustrating the interconnection of the computer system of  FIG. 2  to client and host systems; 
         FIG. 4  is a block diagram of one embodiment of a physician/patient communication system constructed according to the principles of the invention; 
         FIG. 5  is a flow diagram of one embodiment of a method of managing physician/patient communication carried out according to the principles of the invention; 
         FIG. 6  is a portion of an image presentable on a computer monitor and regarding the establishing of an account for a patient; 
         FIG. 7  is a portion of an image presentable on a computer monitor and regarding billing details for a patient; 
         FIG. 8  is a portion of an image presentable on a computer monitor and regarding the addition of a patient to a given account; 
         FIG. 9  is a portion of an image presentable on a computer monitor and regarding the choosing of a payment plan for a subscribing patient; 
         FIG. 10  is a portion of an image presentable on a computer monitor and regarding medical service charge authorization for a subscribing patient; 
         FIG. 11  is a portion of an image presentable on a computer monitor and regarding biographical information details for a subscribing physician; 
         FIG. 12  is a portion of an image presentable on a computer monitor and regarding patient/physician matching; 
         FIG. 13  is a portion of an image presentable on a computer monitor and regarding summary information for a subscribing patient; 
         FIG. 14  is a portion of an image presentable on a computer monitor and regarding a list of patients for physicians; and 
         FIG. 15  is a portion of an image presentable on a computer monitor and regarding a waiting list for a subscribing physician. 
     
    
    
     DETAILED DESCRIPTION 
     It should be understood that “physician,” as that term is used herein, includes not only medical doctors (MDs), but also osteopaths, chiropractors, dentists and veterinarians. Also, while “physician” normally refers only to those licensed to practice medicine, “physician” is also intended to encompass healthcare providers in general, including nurse practitioners, nurses, paramedics, psychologists and other counselors. 
     As stated above, a patient is likely to have health problems that go unaddressed because both physicians and patients are conforming to a pattern of conduct prompted by the reimbursement policies of insurance companies. What is needed is a way to reestablish the closer working relationship that existed beforehand. More specifically, what is needed is a way to reestablish communication between physicians and patients at the time of the patient&#39;s choosing. 
     In accordance with various embodiments of systems and methods described herein, a patient can now have access to a physician with the physician/patient communication system which routes the patient&#39;s call based on the patient&#39;s subscription status and the physician&#39;s hours of operations. Certain embodiments of the systems provide one or more of: ready access to questions regarding the patient&#39;s health without an insurance co-pay, straightforward solutions for simple illnesses, timely resolutions of a patient&#39;s questions or concerns, affordable service, a respecting of the patient&#39;s valuable time and a restoration of medically necessary communication between a physician and patient to improve both the patient&#39;s health and sense of well-being. 
     Physicians can augment their existing practice by providing their services through various embodiments of the disclosed system and method, while maintaining privacy and control over that access. By taking charge of the billing and controlling when calls are routed, the physician can focus on patient care. Most physicians are frustrated with the current healthcare system and its emphasis on volume of patients. However, most primary care physicians do not realize how frustrated the patients also are, or that many of those patients are willing to participate in a solution that would improve communication. The physician/patient communication system, as disclosed herein, allows patients a way to reach the patient&#39;s cell phone but, only during the times the physician allows. Patients pay (e.g., monthly) for this service and are seeking to minimize their loss of time for every time they need to talk directly with the physician. As physicians know, many health problems or questions are quickly resolvable with a direct phone call. However, until now this has been financially unacceptable for all concerned. Patients know that the physician deserves to be paid for the physician&#39;s time but they too spend a fortune in lost hours and wasted time simply getting access to the patient&#39;s advice. Many of these patients are willing to sign up for this program and are waiting for the physician to invite them. According to the various embodiments described herein, the physician&#39;s patients can select a physician as their physician. In certain embodiments, they then receive an access code which allows them to call in on a toll-free (e.g., “800”) line and then direct their incoming calls to the physician&#39;s telephone (e.g., “landline” phone or cell phone). Various embodiments of the system are capable of handling billing and set up while providing the following reports: a statement of patients in the physician&#39;s program and when they enrolled, a report of minutes used and number of calls for each patient and a summary of patient revenue and fees. The system may also provide payment (e.g., a check or electronic fund transfer) for fees earned. 
     According to one embodiment, if a patient chooses not to renew, that patient&#39;s access code will expire, and they will no longer be granted access to the physician. The patient is then relegated to seeing a physician in the normal course. According to a related embodiment, a physician can choose how many patients the physician will allow in the physician&#39;s program and what, if any, impact the physician will allow the program to have on the physician&#39;s work day. In one specific embodiment, the cost to the physician is such that break-even is reached at only three patients, meaning that the physician begins to experience net income when the fourth patient joins the program. 
     Before describing various embodiments of the system and method disclosed herein, a general discussion of computing and network environments within with the system can be embodied and the method carried out will be undertaken. 
       FIG. 1  is a block diagram illustrating a network environment in which a system according to the invention may be practiced. As is illustrated in  FIG. 1 , network  100 , such as a private wide area network (WAN) or the Internet, includes a number of networked servers  110 ( 1 )-(N) that are accessible by client computers  120 ( 1 )-(N). 
     Communication between the client computers  120 ( 1 )-(N) and the servers  110 ( 1 )-(N) typically occurs over a publicly accessible network, such as a public switched telephone network (PSTN), a DSL connection, a cable modem connection or large bandwidth trunks (e.g., communications channels providing T1 or OC3 service). The client computers  120 ( 1 )-(N) access the servers  110 ( 1 )-(N) through, for example, a service provider. This might be, for example, an Internet Service Provider (ISP) such as America On-Line™, Prodigy™, CompuServe™ or the like. Access is typically had by executing application specific software (e.g., network connection software and a browser) on the given one of the client computers  120 ( 1 )-(N). 
     One or more of the client computers  120 ( 1 )-(N) and/or one or more of the servers  110 ( 1 )-(N) may be, for example, a computer system of any appropriate design, in general, including a mainframe, a mini-computer or a personal computer system. Such a computer system typically includes a system unit having a system processor and associated volatile and non-volatile memory, one or more display monitors and keyboards, one or more diskette drives, one or more fixed disk storage devices and one or more printers. These computer systems are typically information handling systems which are designed to provide computing power to one or more users, either locally or remotely. Such a computer system may also include one or a plurality of I/O devices (i.e., peripheral devices) which are coupled to the system processor and which perform specialized functions. Examples of I/O devices include modems, sound and video devices and specialized communication devices. Mass storage devices such as hard disks, CD-ROM drives and magneto-optical drives may also be provided, either as an integrated or peripheral device. One such example, computer system, discussed in terms of the client computers  120 ( 1 )-(N) is shown in detail in  FIG. 2 . 
     It will be noted that the variable identifier “N” is used in several instances in  FIG. 1  to more simply designate the final element (e.g., the servers  110 ( 1 )-(N) and the client computers  120 ( 1 )-(N)) of a series of related or similar elements (e.g., servers and client computers). The repeated use of such variable identifiers is not meant to imply a correlation between the sizes of such series of elements, although such correlation may exist. The use of such variable identifiers does not require that each series of elements has the same number of elements as another series delimited by the same variable identifier. Rather, in each instance of use, the variable identified by “N” may hold the same or a different value than other instances of the same variable identifier. 
       FIG. 2  depicts a block diagram of a computer system  210  suitable for implementing the invention and an example of one or more of the client computers  120 ( 1 )-(N). A computer system  210  includes a bus  212  which interconnects major subsystems of the computer system  210  such as a central processor  214 , a system memory  216  (typically random-access memory, or RAM, but which may also include read-only memory, or ROM, flash RAM, or the like), an input/output controller  218 , an external audio device such as a speaker system  220  via an audio output interface  222 , an external device such as a display screen  224  via a display adapter  226 , serial ports  228 ,  230 , a keyboard  232  (interfaced with a keyboard controller  233 ), a storage interface  234 , a floppy disk drive  236  operative to receive a floppy disk  238  and a CD-ROM drive  240  operative to receive a CD-ROM  242 . Also included are a mouse  246  (or other point-and-click device, coupled to the bus  212  via the serial port  228 ), a modem  247  (coupled to the bus  212  via the serial port  230 ) and a network interface  248  (coupled directly to the bus  212 ). 
     The bus  212  allows data communication between a central processor  214  and a system memory  216 , which may include RAM, ROM or flash memory, as previously noted. The RAM is generally the main memory into which the operating system and application programs are loaded and typically affords at least 16 megabytes of memory space. The ROM or flash memory may contain, among other code, the Basic Input-Output system (BIOS) which controls basic hardware operation such as the interaction with peripheral components. Applications resident with the computer system  210  are generally stored on and accessed via a computer readable medium, such as a hard disk drive (e.g., fixed disk  244 ), an optical drive (e.g., CD-ROM drive  240 ), a floppy disk unit  236  or other storage medium. Additionally, applications may be in the form of electronic signals modulated in accordance with the application and data communication technology when accessed via a network modem  247  or an interface  248 . 
     The storage interface  234 , as with the other storage interfaces of the computer system  210 , may connect to a standard computer readable medium for storage and/or retrieval of information, such as a fixed disk drive  244 . The fixed disk drive  244  may be a part of computer system  210  or may be separate and accessed through other interface systems. Many other devices can be connected, such as a mouse  246  connected to the bus  212  via serial port  228 , a modem  247  connected to the bus  212  via serial port  230  and a network interface  248  connected directly to the bus  212 . The modem  247  may provide a direct connection to a remote server via a telephone link or to the Internet via an internet service provider (ISP). The network interface  248  may provide a direct connection to a remote server via a direct network link to the Internet via a POP (point of presence). The network interface  248  may provide such connection using wireless techniques, including digital cellular telephone connection, Cellular Digital Packet Data (CDPD) connection, digital satellite data connection or the like. 
     Many other devices or subsystems (not shown) may be connected in a similar manner (e.g., bar code readers, document scanners, digital cameras and so on). 
     Conversely, it is not necessary for all of the devices shown in  FIG. 2  to be present. The devices and subsystems may be interconnected in different ways from that shown in  FIG. 2 . The operation of a computer system such as that shown in  FIG. 2  is readily known in the art and is not discussed in detail in this application. Code to implement the invention may be stored in computer-readable storage media such as one or more of the system memory  216 , the fixed disk  244 , the CD-ROM  242  or the floppy disk  238 . Additionally, the computer system  210  may be any kind of computing device and so includes personal data assistants (PDAs), network appliance, X-window terminal or other such computing device. The operating system provided on the computer system  210  may be MS-DOS®, MS-Windows®, OS/2X, UNIX®, Linux® or other known operating system. The computer system  210  may also support a number of Internet access tools, including, for example, a Hypertext Transfer Protocol (HTTP)-compliant web browser having a JavaScript interpreter, such as Netscape Navigator® 3.0, Microsoft Explorer® 3.0 and the like. 
     The foregoing described embodiment wherein the different components are contained within different other components (e.g., the various elements shown as components of the computer system  210 ). It is to be understood that such depicted architectures are merely examples, and that in fact many other architectures can be implemented which achieve the same functionality. In an abstract, but still definite sense, any arrangement of components to achieve the same functionality is effectively “associated” such that the desired functionality is achieved. Hence, any two components herein combined to achieve a particular functionality can be seen as “associated with” each other such that the desired functionality is achieved, irrespective of architectures or intermediate components. Likewise, any two components so associated can also be viewed as being “operably connected,” or “operably coupled,” to each other to achieve the desired functionality. 
       FIG. 3  is a block diagram depicting a network  300  in which the computer system  210  is coupled to an internetwork  310 , which is coupled, in turn, to client systems  320 ,  330 , as well as a server  340 . An internetwork  310  (e.g., the Internet or a wide-area network, or WAN) is also capable of coupling the client systems  320 ,  330  and the server  340  to one another. With reference to the computer system  210 , the modem  247 , the network interface  248  or some other method can be used to provide connectivity from the computer system  210  to the internetwork  310 . The computer system  210 , the client system  320  and the client system  330  are able to access information on the server  340  using, for example, a web browser (not shown). Such a web browser allows the computer system  210 , as well as the client systems  320 ,  330 , to access data on the server  340  representing the pages of a website hosted on the server  340 . Protocols for exchanging data via the Internet are well known to those skilled in the art. Although  FIG. 3  depicts the use of the Internet for exchanging data, the invention is not limited to the Internet or any particular network-based environment. 
     Referring to  FIGS. 1 ,  2  and  3 , a browser running on the computer system  210  employs a TCP/IP connection to pass a request to the server  340 , which can run an HTTP “service” (e.g., under the WINDOWS® operating system) or a “daemon” (e.g., under the UNIX® operating system), for example. Such a request can be processed, for example, by contacting an HTTP server employing a protocol that can be used to communicate between the HTTP server and the client computer. The HTTP server then responds to the protocol, typically by sending a “web page” formatted as an HTML file. The browser interprets the HTML file and may form a visual representation of the same using local resources (e.g., fonts and colors). 
     Having undertaken a general discussion of computing and network environments within with the system can be embodied and the method carried out, various embodiments of the system and method disclosed herein will now be described. 
       FIG. 4  is a block diagram of one embodiment of a physician/patient communication system  400  constructed according to the principles of the invention. The system  400  includes an account manager  401 , a report generator  402 , a matching engine  403  and a telephony interface  404 . In the illustrated embodiment, the account manager  401 , the report generator  402 , and the matching engine  403  are embodied as sequences of software instruction executable in a general-purpose computer that includes a processor  405  and memory  406 . The illustrated embodiment of the telephony interface  404  likewise includes sequences of software instructions executable in a general purpose computer, but also includes telephone interface hardware coupled to the processor  405  and the memory  406  that enables the system  400  to place, receive and connect telephone calls in a manner that will be described below. 
     One or more patients, represented in  FIG. 4  by a patient  410 , and one or more physicians, represented by a physician  440 , interact with the system  400  over time. The patient  410  has access to a computer network, such as the Internet, with which he may interact via a browser and electronic mail (“email”)  420 . The patient  410  also has access to a telephone  430 , which may be a landline or a cell phone. Likewise, the physician  440  has access to a computer network, such as the Internet, with which he may interact via a browser and email  450 . The physician  440  also has access to a telephone  460 , which may be a landline or a cell phone. 
     The account manager  401  is configured to interact with the patient  410  via the browser or email  420  or the telephone  430 . In the illustrated embodiment, the account manager  401  is configured to interact with the patient  410  via the browser  420 . The account manager  401  is configured to receive information from the patient  410  in order to establish an account with the system  400  for the patient  410 . In the illustrated embodiment, the account includes information identifying the patient  410  and allowing the system  400  to collect payments from the patient  410  for services rendered to the patient  410 . The account manager  401  is configured to interact with the patient  410  via the browser or email  420  or the telephone  430 . In the illustrated embodiment, the account manager  401  is also configured to interact with the physician  440  via the browser  450 . The account manager  401  is configured to receive information from the physician  440  in order to establish an account with the system  400  for the physician  440 . In the illustrated embodiment, the account includes information identifying the physician  440 , such as his biographical information, specialty, times during which the physician can accept calls, whether or not his practice accommodates the addition of additional patients and his billing rate. The information in the physician&#39;s account also allows the system  400  to send payments to the physician  440  for services rendered by the physician  440 . 
     The report generator  402  is configured to provide one or more reports to the patient  410  and the physician  440 . The reports may involve telephone calls made or received, date, time and duration of calls, identities of patients and physicians and details regarding payments payable, paid, receivable or received. The reports may also include reports to operators of the system  400  regarding its overall operation. 
     The matching engine  403  is configured to match physicians and patients. In an embodiment to be described, the matching engine  403  allows a patient to search for physicians by name, location or specialization and determine whether or not such physicians are open to taking additional patients. 
     The telephony interface  404  couples the system  400  to a public switched telephone network (PSTN) or a computer network, such as the Internet, for communication via voice-over-Internet-Protocol (VoIP). In various embodiments, the telephony interface  404  is capable of providing communication with patients and physicians allowing accounts to be established, reports to be provided, physician/patient matches to be made and phone calls to be made between patients and physicians. In one embodiment, the telephony interface  404  includes a conventional telephony board commercially available from Dialogic, Corporation, of Montreal, Quebec, Canada. In another embodiment, the telephony interface  404  is provided through VoiceShot, an Internet-based service for placing and receiving telephone calls, sending and receiving text messages, hosting interactive voice response applications and performing call center functions. VoiceShot is commercially available on the Internet at voiceshot.com. 
     In one specific embodiment, the patient  410  employs the telephone  430  to call the telephony interface  404 . The patient  410  then enters an access code. Upon verification, the telephony interface  404  places a call to the telephone  460  associated with the physician  440 , and services are rendered. In the illustrated embodiment, the system  400  does not allow the patient  410  to see the telephone number of the physician  440  and does not allow the patient to contact the physician outside of the system  400 . 
     The telephony interface  404  can supply information to the system  400  regarding the date, time and duration of call the call and even cause the call to be recorded if such is allowed and desired. In another specific embodiment, the patient  410  employs the browser  420  to call the telephony interface  404 . The patient  410  then enters an access code. Upon verification, the telephony interface  404  places a call to the browser  450  associated with the physician  440 , and services are rendered. The telephony interface  404  can supply information to the system  400  regarding the date, time and duration of call the call and even cause the call to be recorded if such is allowed and desired. Of course, the telephony interface  404  allows a call to be made from or to either the Internet or the PSTN. 
       FIG. 5  is a flow diagram of one embodiment of a method of managing physician/patient communication carried out according to the principles of the invention. The method begins in a start step  505 . 
     In a step  510 , physician accounts are established. In one embodiment, each physician provides contact and biographical information and specialty and indicates how many patients he is willing to accept and when he is available to take calls. 
     In a step  515 , patient accounts are established. In one embodiment, each patient provides contact and payment information. In a more specific embodiment, each patient selects a plan under which a certain level of service is provided for a fixed charge (i.e., a subscription). 
     In a step  520 , patients and physicians are matched with one another. Through a browse or search function, patients can see what physicians are available and can accept additional patients. The patients can then sign up with those physicians. 
     In a step  525 , communication is enabled between patients and physicians. Over time, patients make telephone calls through the system. The system keeps track of those calls, creating records of the same. In a step  530 , reports are provided to the patients and the physicians. A report to a patient may, for example, be made monthly and detail the times, dates, numbers and durations of calls made to physicians and relate the charges pertaining to such calls. A report to a physician may, for example, be made monthly and detail the times, dates, numbers and durations of calls made by patients and calculate the income, profit and effective billing rate of the physician. The method ends in an end step  535 . 
     Having described various examples of systems and methods falling within the scope of the invention, examples of screen shots will now be illustrated and described. The screen shots are, in general, representative of information provided to a subscribing patient via the browser  420  of  FIG. 4 . 
       FIG. 6  is a portion of an image (a screen shot) presentable on a computer monitor and regarding the establishing of an account for a patient. It is apparent that several fields are presented to a patient wishing to establish an account with the system. The patient fills in these fields, thereby presenting information to the system. 
       FIG. 7  is a portion of an image presentable on a computer monitor and regarding billing details for a patient. Several fields are presented to the patient allowing the patient to provide billing information to the system. In the illustrated embodiment, the billing information includes credit card information. 
       FIG. 8  is a portion of an image presentable on a computer monitor and regarding the addition of a patient to a given account. This feature, available in certain embodiments, allows more than one patient to be associated with a single account. For example, a head-of-household may wish to establish an account for himself and others in his household and pay for all patients using the same credit card. 
       FIG. 9  is a portion of an image presentable on a computer monitor and regarding the choosing of a payment plan for a subscribing patient. By means of this image, a patient can choose from among multiple plans, including subscriptions offering different levels of service. 
       FIG. 10  is a portion of an image presentable on a computer monitor and regarding medical service charge authorization for a subscribing patient. The patient can then confirm that he will be charged for the plan selected. 
       FIG. 11  is a portion of an image presentable on a computer monitor and regarding biographical information details for a subscribing physician. As described above, patients are matched to physicians. Unless a given patient is already aware of a given physician (perhaps through a preexisting relationship), biographical information allows patients to make informed decisions regarding physicians before selecting them to be their physicians. 
       FIG. 12  is a portion of an image presentable on a computer monitor and regarding patient/physician matching. By means of the fields presented in  FIG. 12 , a patient is allowed to browse or search for physicians appropriate for the desired consultation. 
       FIG. 13  is a portion of an image presentable on a computer monitor and regarding summary information for a subscribing patient. Having established an account and been matched with a physician, a patient can now be shown a summary of his status with the system. 
       FIG. 14  is a portion of an image presentable on a computer monitor and regarding a list of patients for physicians.  FIG. 14  is an example of a report providable to an operator of the system showing contact information for patients and relationships among patients and physicians. 
       FIG. 15  is a portion of an image presentable on a computer monitor and regarding a waiting list for a subscribing physician.  FIG. 15  is an example of a report providable to a physician whose practice is limited to a certain number of patients. The report shows whether or not that limit has been reached and, if the limit has been reached how many patients are on his waiting list. The report may assist the physician in determining whether his practice should be expanded. 
     Those skilled in the art to which this application relates will appreciate that other and further additions, deletions, substitutions and modifications may be made to the described embodiments.