Abstract:
Amongst other things, the availability of service providers is tracked across one or more service provider networks. A status change of the service provider is identified on one or more of the service provider networks and the other service provider networks associated with the service provider is sent data indicating the changed status of the service provider.

Description:
CLAIM OF PRIORITY 
       [0001]    This application claims priority under 35 U.S.C. §119(e) to provisional U.S. Patent Application 60/997,231, filed on Oct. 2, 2007, the entire contents of which are hereby incorporated by reference. 
     
    
     BACKGROUND 
       [0002]    The present invention is directed to connecting consumers with service providers. 
         [0003]    Systems have been developed to connect consumers and their providers over the Internet and the World Wide Web. Some systems use e-mail messaging and web-based forms to increase the level of connectivity between a member of a health plan and his assigned health care provider. The consumer sends an e-mail or goes to a website that generates and sends a message (typically an e-mail or an e-mail type message) to a local provider. 
         [0004]    These types of services have been broadly referred to as “e-visits.” While generally viewed as an addition to the spectrum of services that may be desired by consumers, the benefits of such services are not clear. One of the concerns associated with offering additional communication channels, such as e-mail, is that it can result in over consumption of services, rather than provide for better coordination. 
         [0005]    Until recently, the notion of an electronic encounter was not even coded in the standard financial coding schemes used for submitting medical claims, preventing proper reimbursement of providers for such encounters. This gap has been recently corrected by the introduction of CPT (current procedural terminology) code 0074T, allowing providers to submit a reimbursement claim for an electronic encounter (e.g., e-visit) with their patients. Most plans at this time, however, do not include this service code as a covered service (i.e., a benefit) making it an out-of-pocket expense for members and an unattractive offering for providers (who need to charge members directly for such encounters). 
         [0006]    Recently, a number of health plans announced their intention to begin remunerating providers for electronic visits (i.e., paying a certain consideration for claims submitted with a CPT 0074T code). While limited to pilot projects, plans are embracing the notion of consumerism by offering advanced tools for consumers to become informed and acquire medical services. Facilitating timely and more organized communication between the member and their provider is perceived as a natural investment in the new consumer-driven healthcare world. While still at an early stage, interest in e-visits has picked up both in the commercial world as well as in the strategic planning sessions of health plans around the country. Vendors offering health portals for health plans typically now describe their roadmap for the incorporation (or interfacing with) e-visit platforms. 
       SUMMARY 
       [0007]    In general in one aspect, the availability of service providers is tracked across one or more service provider networks. A status change of the service provider is identified on one or more of the service provider networks and the other service provider networks associated with the service provider is sent data indicating the changed status of the service provider. One or more centralized brokerage systems are used to determine the service provider&#39;s status. The service provider and the service provider&#39;s status are registered with the centralized brokerage system. Data indicating that the service provider&#39;s status on one or more of the service provider&#39;s networks has changed is received. When the status of the service provider is available, the service provider is logged into the service provider networks associated with the service provider. 
         [0008]    Implementations may include one or more of the following features. The actions of tracking, identifying and sending are executed in response to receiving a request from a consumer of services using a first one of the service provider networks to consult with a service provider having a service provider profile that satisfies at least some attributes in a set of attributes that define a suitable service provider and identifying an available service provider associated with the first service provider network that has a service provider profile satisfying at least some of the attributes in the set of attributes. 
         [0009]    The service provider&#39;s status is coordinated across one or more service provider networks. The status of one or more service providers is pooled in a centralized brokerage system. 
     
    
     
       BRIEF DESCRIPTION OF THE FIGURES 
         [0010]      FIG. 1  is a diagrammatic view of an engagement brokerage service. 
           [0011]      FIGS. 2A ,  5 A- 5 D,  7 ,  8 , and  10  are screen images of a user interface for an engagement brokerage service. 
           [0012]      FIG. 2B  is a flow chart for an interactive voice response system interface for an engagement brokerage service. 
           [0013]      FIGS. 3 ,  4 A- 4 D,  6  are flow charts of processes used in an engagement brokerage system. 
           [0014]      FIG. 9  is a table of sample criteria used in an engagement brokerage system. 
           [0015]      FIG. 10  is an example of a provider interface. 
           [0016]      FIG. 11  is a diagram of a service provider associated with multiple service provider networks. 
           [0017]      FIG. 12  is a diagram of the individual brokerage systems of networks. 
           [0018]      FIG. 13  is a flowchart of how a brokerage system notifies other brokerage system&#39;s of a service provider&#39;s availability. 
           [0019]      FIG. 14  is an diagram of a centralized brokerage system. 
           [0020]      FIG. 15  is a diagram of networks associated with a central repository. 
       
    
    
     DETAILED DESCRIPTION 
       [0021]    Overview 
         [0022]    The system described below provides an integrated information and communication platform that enables consumers of services to identify and prioritize service providers with whom they should consult and to carry out consultations with such service providers in an efficient manner. Consumers are able to consult on-line with an expert service provider, at a mutually convenient time and place, even when the two parties are geographically separated. This integrated platform is referred to herein as an engagement brokerage service (brokerage). 
         [0023]      FIG. 1  shows an example system  100  implementing the brokerage service. The system  100  includes a computerized system or server  110  for making connections between consumers  120 , at client systems  122 , and service providers  130 , at client systems  132 , over a network  140 , e.g., the Internet or other types of networks. The computerized system  110  may operate as a service running on a web server  102 . 
         [0024]    The computerized system  110  includes an availability or presence tracking module  112  for tracking the availability of the service providers  130 . Availability or presence is tracked actively or passively. In an active system, one or more of the service providers  130  provides an indication to the computerized system  110  that the one or more service providers are available to be contacted by consumers  120  and an indication of the mode by which the provider may be contacted. In some examples of an active system, the provider&#39;s computer, phone, or other terminal device periodically provides an indication of the provider&#39;s availability (e.g., available, online, idle, busy) to the system  110  and a mode (e.g., text, voice, video, etc.) by which he can be engaged. In a passive system, the computerized system  110  presumes that the service provider  130  is available by the service provider&#39;s actions, including connecting to the computerized system  110  or registering the provider&#39;s local phone number with the system. In some examples of a passive system, the system  110  indicates the provider  130  to be available at all times until the provider logs off, except when the provider is actively engaged with a consumer  120 . 
         [0025]    The computerized system  110  also includes one or more processes such as the tracking module  112  and a scheduling module  116 . The system  110  accesses one or more databases  118 . The components of the system  110  and the web server  102  may be integrated or distributed in various combinations as is commonly known in the art. 
         [0026]    Using the system  100 , a consumer  120  communicates with a provider  130 . The consumers  120  and providers  130  connect to the computerized system  110  through a website or other interface on the web server  102  using client devices  122  and  132 , respectively. Client devices  122  and  132  can be any combination of, e.g., personal digital assistants, land-line telephones, cell phones, computer systems, media-player-type devices, and so forth. The client devices  122  and  132  enable the consumers  120  to input and receive information as well as to communicate via video, audio, and/or text with the providers  130 . 
         [0027]    Limited by office hours and other patients, providers struggle with the idea of adding another service commitment to their existing workload. Patients sending queries to their providers can not expect an immediate response and are often asked to schedule an appointment for further evaluation. Providers are, however, often available at times that are not convenient for their patients, for example, in the event of a last-minute cancellation. Providers also may be available for e-visits during otherwise idle times, such as when home, during their commute, and so forth. The brokerage supplements existing provider availability to allow whichever providers are available at any given time to provide e-Visits to whichever consumers need a consultation at that time. Instead of relying on the unlikely availability of a specific provider for any given consumer, the brokerage connects the consumer to all online providers capable of addressing the consumer&#39;s needs. The brokerage has distinct features including the ability to engage in live communication with a suitable, selectable provider and the ability to do so on-demand. 
         [0028]    One advantage that the brokerage provides is that the brokerage constantly monitors the availability of a provider for an engagement and thus, consumers receive immediate attention to address their questions or concerns, since the brokerage will connect them to available service providers. In order to achieve such a level of availability, the system assimilates the discretionary or fractional availability windows of time offered by individual providers into a continuous availability perception by consumers. Since many of the services offered to consumers are on-demand, consumers have little expectation that the same provider will be constantly available, rather, they expect that some provider will be available. 
         [0029]    The computerized system  110  provides information and services to the consumers  120  in addition to connecting them with providers  130 . The computerized system  110  includes an access control facility  114 , which manages and controls whether a given consumer  120  may access the system  110  and what level or scope of access to the features, functions, and services the system  110  will provide. 
         [0030]    The consumer  120  use the system  100  to find out more information about a topic of interest or, for example, a potential medical condition. The computerized system  110  identifies service providers  130  that are available at any given moment to communicate with a consumer about a particular product, service, or related topic or subject, for example, a medical condition. The computerized system  110  facilitates communication between the consumer  120  and provider  130 , enabling them to communicate, for example, via a data-network-facilitated video or voice communication channel (such as Voice over IP), land and mobile telephone network channels, and instant messaging or chat. In some examples, the availability of one or more providers  130  is tracked, and at the instant a consumer  120  desires to connect and communicate with a provider, the system  110  determines whether a provider is available. If a particular provider  130  is available, the system  110  assesses the various modes of communication that are available and connects the consumer  120  and the provider  130  through one or more common modes of communication. 
         [0031]    The system selects a mode of communication to use based in part on the relative utility of the various modes. The preferred mode for an engagement is for both the consumer  120  and the provider  130  to use web-based consoles, as this allows each of the other modes to be used as needed. For example, consumers and providers may launch chat sessions, voice calls, or video chats from within a web-based console like that shown in  FIG. 2A , below. A web based console also provides on-demand access to records, such as the consumer&#39;s medical history, and other information. If only one of the participants in an engagement has access to a web console, the system  110  connects that participant&#39;s console to whatever form of communication the other party has available. For example, if the consumer is on the phone and the provider is using a web browser, the system  110  may connect the consumer&#39;s phone call to a VoIP session that the provider can access through the web. 
         [0032]    If the provider  130  is not available, the system  110  identifies other available providers  130  that would meet the consumer  120 &#39;s needs. The system  110  enables the consumer  120  to send a message to the consumer&#39;s chosen provider. The consumer can also have the system  110  contact the consumer in the future when the chosen provider is available. 
         [0033]    By way of illustration, the system  100  connects members of healthcare plans with providers of healthcare products and services. For example, the service providers  130  may be physicians, and the service consumers  120  may be patients. The service providers and service consumers may also be lawyers and clients, contractors and homeowners, or any other combination of a provider of services and a consumer of services. 
         [0034]    The system enables the consumer to search for providers that are available at the time the consumer is searching and enables the consumer to engage a provider on a transactional basis or for a one-time consultation. A consumer is able to engage a world-renowned specialist for a consultation or second opinion, even though the specialist is located too far away from the consumer to become a regular client, patient, or consumer. The consumer can use that specialist&#39;s advice when considering services by a local service provider. For example, a patient in a suburban town with a rare condition may consult with a specialist in a distant city, and then, based on that consultation, select a local physician for treatment. 
         [0035]      FIG. 2A  shows a page  134  of the main user interface to the brokerage. Many of the web-based functions are also provided by an Interactive Voice Response (IVR) system, as discussed below. As noted the server  110  sends web pages like the page  134  to the consumer  120  and the provider  130  and receives responses from the consumer  120  and the provider  130 . In some examples, the application server provides a predefined sequence of web pages or voice prompts to the consumer  120  or the provider  130 .  FIG. 2  shows an interface intended for the consumer  120 . A similar interface is provided for providers  130 , as shown in  FIG. 10 . 
         [0036]    The web page  134  includes various elements to enable the consumer  120  (to input information. These interface elements include buttons  136   a  and text  136   b  to enable the consumer  120  to select information and to navigate the website Other standard elements (not shown) can include text boxes to receive textual information and menus (such as drop-down menus) to enable the consumer  120  to select information from a menu or list. 
         [0037]    Referring now to  FIG. 2B , an example of logic for use in an IVR system is shown. It is not intended that  FIG. 2B  be described in detail, since it is one of many possible logic flows for such a system and the exact details on questions and sequences is not important to an understanding of the concepts disclosed herein. In the IVR system, the voice prompts include questions or statements that elicit information from the consumer  120  and the provider  130  as shown. The consumer  120  and the provider  130  input information by speaking into the microphone of the telephone or other terminal device and their speech is stored as received or converted to text using voice recognition. In some examples, the questions are multiple choice questions and the consumer  120  or the provider  130  responds with spoken responses or by pressing buttons on the keypad of their phone or other terminal device. The IVR system follows a series of flow charts like the flowchart  138  in  FIG. 2B  and can include a menu system, in which case the consumer  120  or provider  130  moves forward or backward, or exits the system by pressing certain keys. 
         [0038]    Referring now to  FIG. 3 , the computerized system  110  tracks  142  the availability of providers  130  and consumers  120 . When a provider  130  logs  144  into the system  100 , the provider  130  indicates  146  (such as by setting a check box or selecting a menu entry or by responding to a voice prompt) to the tracking module  112  that he or she is available to interact with consumers  120 . The provider  130  can also indicate  148  to the tracking module  112  (such as by setting a check box or selecting a menu entry or by responding to a voice prompt) the modes (e.g., telephone, chat, video conference) by which a consumer  120  can be connected to the provider  130 . Alternatively, the tracking module  114  determines  150  the capabilities of the terminals  122  and  132  the consumer  120  and the provider  130  use to connect to the system (for example, by using a terminal-based program to analyze the hardware configuration of each terminal). Thus, if a provider  130  connects to the system  100  by a desktop computer and the provider has a video camera connected to that computer, the tracking module  112  determines  150  that the provider  130  can be engaged by text (e.g., chat or instant messenger), voice (e.g., VoIP) or video conference. Similarly, if a provider  130  connects to the system using a handheld device such as a PDA, the tracking module  112  determines  152  that the provider  130  can be engaged by text or voice. The tracking module  112  can also infer  152  a provider&#39;s availability and modes of engagement by the provider&#39;s previously provided profile information and the terminal device through which the provider connects to the system. 
         [0039]    Providers participating in the brokerage network can have several states of availability over time. States in which the provider may be available may include on-line, in which the provider is logged-in and can accept new engagements in any mode, on-line(busy), in which the provider is logged-in but is currently occupied in a video or telephonic engagement, and scheduled, in which the provider is offline but is scheduled to be online at a designated time-point and can pre-schedule engagements for it. While not online, the provider can take messages as in offline state. Other states may include off-line, in which the provider is not logged in but can take message-based engagements (i.e., asynchronous engagements), out-of-office, in which the provider is not accepting engagements or messages, and standby, in which the provider is offline and can be paged to Online status by the brokerage network if traffic load demands it (in some examples, consumers see this state as offline). 
         [0040]    The operating business model for the provider network employs a remuneration scheme for providers that helps assure that the consumers can find providers in designated professional domains (e.g., pediatrics) in the online mode. For example, selected providers can be remunerated for being in the standby mode to encourage their on-line availability in case of low discretionary availability by other-providers in their professional domain. Standby providers are also called into the on-line state when the fraction of on-line(busy) providers in their professional domain exceeds a certain threshold. In some examples, the transition of providers from standby to online and back to standby (in case of over capacity or idle capacity) is an automated function of the system. 
         [0041]    The tracking module  112  transfers  154  information about the availability and the communication capability of the consumers  120  and the providers  130  to the scheduling module  116  using, for example, one or more well-known presence protocols, such as Instant Messaging and Presence Service (IMPS), Session Initiation Protocol (SIP) for Instant Messaging and Presence Leveraging Extensions (SIMPLE), and the Extensible Messaging and Presence Protocol (XMPP). 
         [0042]    As noted, the system  100  includes access control facilities  114  that control how consumers  120  access the system and to what extent or level the services provided by the system are made available to consumers. The system  100  also stores and provides access to consumer information (e.g., contact information, credit and financial information, credit card information, health information, and other information related to the consumer and the services purchased or otherwise used by the consumer) and provider information (e.g., physician biographies, product and service information, health related content and information and any information the provider or the health plan wants to make available to members) and the access control facility  114  can prevent unauthorized access to this information. In some examples, the system  100  exports the consumer information for use in a provider&#39;s office or other facility. 
         [0043]    The system  100  interacts with consumers and available data sources to position and direct their health matters to appropriate care providers. Consumers can use various tools of physician and provider profiling to exercise choice in selecting the providers they wish to interact with. The brokerage facilitates the communication between the consumer and his selected providers, allowing the consumer to follow-up as needed to establish a comfort level in his care. The brokerage supports transfer of these communications and any other results of the eVisit to non-virtual care points if such escalation is needed. 
         [0044]    The brokerage can be considered as a first tier of medical care that is made available to consumers at home or at other locations. This first tier precedes typical entry points into a medical care setting, e.g., a physician&#39;s office or an emergency room. The brokerage enables consumers to explore concerns on, new or existing medical issues without the need to incur the time, cost, and emotional burden typically associated with the office visits or trips to the emergency room. To deliver such a comfort level, the system provides immediate access to tools that help define health issues, as well as, access to the appropriate automated and human mediated interventions. Consumers can discretionally engage (or escalate) the level of care they need to gain confidence in their management of such issues. The consumers&#39; choices in this area span both the type of credentials of the provider they interact with (e.g., a nurse versus a board certified specialist), as well as the level of intensity (mode and frequency) of their communications (e.g., messages versus full video dialogue). The brokerage can export the information and workup gained during an encounter to a subsequent tier of services, such as a specific medical office or the ER (as well as care management services if offered by the consumer&#39;s health plan, hospitals and so forth). As such, the brokerage manages more costly medical service consumption (demand management) and serves as a pervasive tool for impacting basic medical care and follow-up and encourages appropriate health behaviors for the customer population at large. 
         [0045]    There are various models for how consumers may gain access to the system. Consumers may purchase access to the system through a variety of models, including direct payment or as part of their insurance coverage. Health plans may provide access to their members as part of their service or as an optional added benefit. In some examples, health plans may receive information about their members&#39; use of the brokerage to allow, for example, better allocation of resources and overall management of member&#39;s health care consumption. Employers may purchase access to the brokerage for their employees through whichever health plans the employer offers. Self-insured employers may purchase access for their employees directly with the brokerage. Providers may be compensated in several ways and may offer their services to the brokerage either independently or as part of a framework such as a provider network. 
         [0046]    Similarly, there are numerous ways the brokerage can be packaged. As a health plan benefit, the brokerage expands a health plans ability to manage health care service consumption by their members. A health plan may provide access to the brokerage through an existing web portal through which members access benefit information and interact with their health plan. As an employee benefit, the brokerage supplements the employee&#39;s health coverage and may be presented, for example, through a human resources web site. In a direct-to-consumer situation, consumers may access the brokerage directly through its own web page. In some examples, the brokerage is implemented as an enterprise software system for a call center, such as one operated by a health care provider. Linked to other institutional users of the system (e.g., other participating providers), this can allow the provider to provide services to its patients that it cannot offer itself, such as 24-hour specialty consultations. The brokerage may also be used by a provider practice to allows its practitioners to provide care to the brokerage&#39;s members (and generate revenue) during off-hours or as a preliminary stage to office visits. This may also eliminate the need for an office visit with a primary care physician just to get a referral to a specialist. 
         [0047]    The brokerage provides compensation for products and services provided. Access to the system  100  may be provided on a subscription basis, with consumers paying a fee (either directly or indirectly through another party, such as a healthcare plan or health insurance provider) to be provided with a particular level of access to the system. In exchange for providing products or services, the service provider may receive compensation from the consumer or from an organization that pays for the products or services on behalf of the consumer, such as a health plan or a health insurance company. In instances in which the consumer pays directly, the operator of the interface to the system that connected the consumer to the service provider may be compensated. In one embodiment, the consumer pays the operator, which keeps a portion (e.g., a percentage, a flat fee, or a co-pay) and pays the remainder to the service provider. In another embodiment, the consumer or the service provider pays a flat fee or percentage of the fee for the engagement to the operator. Where the service provider&#39;s compensation is paid by a health plan or insurance company, the operator may be paid a flat fee or a percentage of the fee for the engagement transaction by the health plan or insurance company. Alternatively, the consumer or the service provider or both may pay a fee (a co-pay or service fee) to the operator for providing the connection. 
       The Consumer Interface 
       [0048]    Initiation of an Engagement 
         [0049]    A consumer  120  engages with the brokerage system  100  to access a service provider  130 . Several types of engagements may exist. Examples of these are described with respect to flowcharts in  FIGS. 4A to 4D  and user interface screens in  FIGS. 5A to 5D . 
         [0050]    Referring now to  FIG. 4A , a process  160  for establishing a consumer-initiated engagement is shown. In a consumer-initiated engagement, a consumer logs in  162  and communicates  164  a new matter he desires assistance or guidance on to the brokerage, for example, a health concern. For example, this is done on a web page  166 , as shown in  FIG. 5A . A component of the brokerage system  100 , such as the consumer advisor discussed below, assists the consumer in consolidating  168  his questions and helps select  170  the appropriate providers to answer them. The web page  166  includes some initial questions  172 , and another web page  174 , in  FIG. 5B , provides a user interface for entering additional criteria  176  to find a provider. A results page  178 , in  FIG. 5C , allows the consumer to select a specific provider  180  from a list  182  of providers identified based on the search criteria. Once a provider is selected and a mode of engagement is chosen  184  (see below), the scheduling module  116  establishes  186  the new engagement. In some examples, the brokerage associates  188  a unique identifier with participating consumers which can be used in subsequent interactions with the brokerage, such as associating records from multiple engagements. The consumer&#39;s health plan membership number or other similar, pre-existing identification can be used  190 . If the consumer does not already have  192  a number, one is generated  194 . The unique identifier can be used by the consumers to save their planned engagement for later retrieval. 
         [0051]    Referring now to  FIG. 4B , a process  196  for establishing a follow-up or prescheduled engagement is shown. Once an engagement is established  186  as in  FIG. 4A  or as one is completed  198 , the two parties can instruct  200  a component of the system  100 , such as the scheduling module  116 , to pursue the established engagement or a follow-up engagement at pre-defined schedules or at future time points. The system uses  202  e-mail, automated telephone communication, or any other method of communication to establish a convenient time for both parties to accomplish the follow-up and then prompts  204  them to do so  206 . 
         [0052]    Referring now to  FIG. 4C , a process  208  for a standby engagement is shown, with a user interface on a web page  210  in  FIG. 5D . A standby engagement is similar to a consumer-initialized engagement. In a standby engagement, the consumer selects  212  a provider  180  or type of provider and requests  214  that a component of the system  100 , such as the scheduling module  116 , to notify the consumer by an appropriate communication, for example, e-mail, text message, or an automated phone call, when the selected provider is online and accepting engagements. In the example of  FIG. 5D , the user has chosen to be called and input a phone number  216  and a limit  218  as to how long she will wait. The consumer request is placed  220  in a queue for the specific requested provider who is off-line (or for a type of provider for which all qualified providers are off-line). When the system determines  222  that the provider is available, the system notifies  224  the consumer. When notified, the consumer logs in  226  and is connected  228  to the provider. 
         [0053]    As an option, a standby list for a provider may provide preferential queuing for some consumers. For example, preferential queuing may be provided based on prior engagements with the provider (e.g., preference is given to follow-up engagements) or based on a service tier (e.g., frequent user status) of that consumer. The brokerage can be configured such that it collects information about the consumer (e.g., answers to initial intake questions) and provides the collected information to the specific service provider prior to initiating any further engagements. For example, a consumer can store information during a consumer-initiated engagement as described above, park the information, and wait to be contacted when the specific selected provider is available. 
         [0054]    Referring now to  FIG. 4D , a process  230  for an interventional engagement is shown. In addition to consumer-initiated engagements, a health plan (or another authorized entity) automatically instructs  232  the system to schedule  234  an engagement with one of its members. This scenario may be employed, for example, when a health plan member is consuming  236  costly charges or exhibits a high risk score. The system may also be authorized to automatically pursue  238  a low-intensity telephonic follow-up with members that would otherwise not be contacted for follow-up (e.g., Medicare or Medicaid patients). 
         [0055]    Provider Selection 
         [0056]    One capability of the brokerage is to extend a retail-like experience to the consumer. Consumers are able to spend time on the system to explore its participating providers whether they are currently available or are expected to be available at some other time. While the system can assist the consumer in identifying the most appropriate providers (see the consumer advisor function, below), it also allows the consumer to filter the provider list based on his preference and access a view of a provider availability matrix that changes as providers go on and off line. 
         [0057]    An example of an interface by which consumers can select providers in a variety of ways is shown in  FIG. 5B , mentioned above. In the health-care based example of the illustrated page  174 , various criteria  176  can be used to filter the available physicians. Basic details  240  indicate the consumer&#39;s preference for the type  240   a  and gender  240   b  of the provider and what modes of communication  240   c  the consumer wants to be able to use. The user can also specify demographics  242  including location  242   a  and languages spoken  242   b . Qualifications  244  may include education  244   a , years of experience  244   b , and various other criteria  244   c . The consumer&#39;s health plan may offer additional searching criteria  246 , such as whether a provider “must be in-network”  246   a  or whether the consumer can consult with an out-of-network provider  246   b . A consumer can also use a search box  248  to search for a provider by name. 
         [0058]    Consumers may select providers according to attributes of the provider, such as a geographical area where the provider is located or which professional organizations have accredited the provider (e.g., whether a doctor has board certification in cardiology). Any metrics within the provider profile (discussed below) can be used to define a list of providers that meet the consumer&#39;s preferences. 
         [0059]    Once the consumer enters her search criteria  176 , the results are shown on the web page  178  in  FIG. 5C . As mentioned, a list  182  of providers is presented. This list may indicate each providers name  250  and rating  252  and whether the provider is available  254 . For the selected provider  180 , additional details are shown, including her picture  256 , specialty  258 , demographic information  260 , what types  262  of connections she can use for an engagement, and personal information  264 . Tools  266  allow the consumer to initiate or schedule an engagement. 
         [0060]    Providers already associated with the consumer may appear on the consumers&#39; short list. Association may be based on historical engagements and may extend to the health plan&#39;s feed of claims (i.e., all providers that submitted claims for the consumer). When reviewing the list of historical engagements, consumers are able to access the engagement audit and the ranking they have attributed to any engagements in the past. 
         [0061]    In certain modes of deployment, there are functional attributes that may impact the consumer&#39;s selection. In most health-plan distribution modes, consumers may opt (or be limited) to see only providers that are “in-network” according to their insurance coverage product. Selecting an “out-of-network” provider may incur higher out-of-pocket costs. Another example relates to a deployment of the system in disease management and health coaching settings (e.g., a call center). In this case, the plan may require that the consumer can select only nurses that are associated with the disease management program with which the consumer is associated. 
         [0062]    Regulations introduced by the federal government in August, 2006, require all federal bodies offering medical coverage (including Medicare, Medicaid, and military, and federal employee plans) to publish their ratings of health service providers (physicians and hospitals) to the general public. The system can allow the consumer to search such sites automatically for a selected provider prior to an engagement. Other sources of reference data may include state publications on morbidity, mortality, and legal actions against providers, or databases maintained by third parties. 
         [0063]    Once a consumer has defined a collection of criteria to filter and find a provider, the system can offer tools to shorten the process in the future. Consumers may be able to save criteria-sets as named searches and benefit from notifications when a search list surpasses a certain level of availability that may encourage the consumer to log in and communicate with a provider. 
         [0064]    Modes of Engagement 
         [0065]    The brokerage allows consumers to engage provider&#39;s e.g., health professionals “on demand” based on provider availability. Engagements can be established in various ways, including:
       1. Passive browsing—Reference health content is accessed on the brokerage&#39;s website. The website can support the use of licensed content packages from other vendors to meet the variable preferences of health plans. For example, key content vendors include Healthwise™, ADAM™, Mayo Clinic™ and HealthDay™. Content libraries provided by such vendors offer a combination of articles, imagery, interactive tutorials and related tools that allow consumers to access content relevant for their health issues. Many health plans and major employers already possess a license for the use of one of these content packages.   2. Health Risk Assessments—The system acquires information from consumers through automated interaction (e.g., rules-based interaction) in order to crystallize their needs (e.g., medical risks) and better direct them. Assessments span from general health to very specific medical conditions and follow a path of questioning that dynamically tailors itself based on information already retrieved (e.g., using predefined rules). As assessments progress, the system constructs engagement suggestions that the consumer can exercise. Each suggestion represents both the question to the provider and the type of provider appropriate to answer it. Consumers may choose to simply launch such engagements or apply their own discretion as to the phrasing and the selection of the recipient provider. This is discussed in more detail below in the context of the consumer advisor.   3. Asynchronous correspondence—The lowest level of true provider interaction is by way of secure messaging. The question or topic of the engagement is sent to a selected provider (whether online or not) and can be answered by this provider at her leisure. Turnaround times are monitored by the system and are part of the credentials of the provider used for her selection by consumers. The system informs the consumer once a response has been received and can allow the consumer to redirect the question if he needs more urgent response time. For example, typical types of asynchronous correspondence include e-mail, instant messaging, text-messaging, voice mail messaging, VoIP messaging (i.e., leaving a message using VoIP), and paper letters (e.g., via the U.S. Postal Service).   4. Synchronous correspondence—Several forms of synchronous correspondence allow the consumer and the provider to engage in real-time discussions.