Note: Descriptions are shown in the official language in which they were submitted.
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SYSTEMS AND METHODS FOR DETERMINING AND PROVIDING A DISPLAY
OF A PLURALITY OF WELLNESS SCORES
RELATED APPLICATIONS
[0001] The present application is a NON-PROVISIONAL of, and claims priority
to, U.S. Provisional Patent Application Number 62/376,829, filed on 18
August 2016, entitled "SYSTEMS AND METHODS FOR DETERMINING
QUALITATIVE HEALTH TREATMENT OUTCOMES AND USES
THEREOF" which is incorporated, in its entirety, herein. The present
application is also a CONTINUATION-IN-PART, of and claims priority to,
U.S. Patent Application Number 15/427,962, filed on 08 February 2017
entitled "SYSTEMS AND METHODS FOR DETERMINING A WELLNESS
SCORE, AN IMPROVEMENT SCORE, AND/OR AN EFFECTIVENESS
SCORE WITH REGARD TO A MEDICAL CONDITION AND/OR MEDICAL
TREATMENT" all of which are incorporated, in their respective entireties,
herein.
FIELD OF THE INVENTION
[0002] The present invention relates to medical information technology. More
specifically, the present invention relates to systems and methods for
determining a wellness score, an improvement score, and/or an
effectiveness score with regard to a medical condition and/or treatment.
BACKGROUND
[0003] Current medical and healthcare systems lack universal outcome
measures. As a consequence, healthcare providers and patients are often
uncertain of which treatments are effective, and healthcare providers
cannot be judged by their true effectiveness at treating patients. This
inability to universally measure medical treatment effectiveness, combined
with the widespread availability of subjective online reviews of providers,
has resulted in physicians focusing on patient catering rather than patient
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care.1 Clinicians over utilize healthcare resources and over prescribe tests
and medications to make patients happy because their business models
are dependent on receiving good subjective reviews from patients rather
than delivering good end results. This phenomenon has been associated
with increased overall US healthcare costs, and increased mortality.2
SUMMARY
[0004] Systems and methods for determining a wellness score, an
improvement score, and/or an effectiveness score with regard to a medical
condition and/or medical treatment are herein provided. In one
embodiment a medical questionnaire may be provided to a patient via, for
example, a patient's personal electronic device (e.g., smart phone or tablet
computer). The medical questionnaire may be, for example, a medical
symptom questionnaire, a disease-specific medical symptom
questionnaire, a global medical symptom questionnaire, and a patient
reported outcome questionnaire.
[0005] The medical questionnaire may be associated with a scoring procedure
for scoring responses to the medical questionnaire. Both the scoring
procedure and an identifier of the medical questionnaire may be stored in
a scoring-procedure database so that the identifier of the medical
questionnaire may be used to retrieve the scoring procedure from the
scoring-procedure database.
[0006] In some instances, the medical questionnaire is provided to each of a
plurality of patients, responses to the medical questionnaire are received
from at least some of the plurality of patients, and a wellness score is
determined for at least some of the plurality of patients. Then, a disease-
specific registry of information, a diagnosis-specific registry of
information,
1 Porter M, Teisberg E, Redefining Heath Care: Creating Value-Based
Competition on Results, Harvard Business Review Press, Boston
Massachusetts, 2006.
2 Fenton, JJ et. al. The Cost of Satisfaction: A National Study of Patient
Satisfaction, Healthcare Utilization, Expenditures, and Mortality. Archives of
Internal Medicine 2012; 172(5):405-411.
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a treatment-specific registry of information, a patient-specific registry of
information, and/or a treatment-provider-specific registry of information
may be created using, for example, the responses to the medical
questionnaire received from at least some of the plurality of patients and/or
the wellness scores determined for the at least some of the patients. The
disease-specific registry of information, diagnosis-specific registry of
information, treatment-specific registry of information, patient-specific
registry of information, and/or treatment-provider-specific registry of
information may then be stored in a database. In some instances, this
storage may involve removing some, or all, patient identifying information
from the received responses to the medical questionnaire and the
determined wellness scores prior to creation of the least one disease-
specific registry of information, diagnosis-specific registry of information,
treatment-specific registry of information, patient-specific registry of
information, and treatment-provider-specific registry of information so that
no patient-identifying information is stored in the least one of one disease-
specific registry of information, diagnosis-specific registry of information,
treatment-specific registry of information, patient-specific registry of
information, and/or treatment-provider-specific registry of information.
[0007] In one embodiment, it may be determined whether the wellness score
falls below a minimum threshold and, if so, a notification that indicates the
wellness score is below the minimum threshold may be generated and
provision of the notification to a treatment provider may be facilitated via,
for example, communication of the notification to a personal electronic
device operated by the treatment provider (e.g., smart phone or pager). In
some instances, the treatment provider may be able to select the manner
(e.g., SMS text message or email) in which he or she wishes to be notified.
In some cases, the notification may include contact information of the
patient and/or a link to the patient's personal electronic device and/or
contact information (e.g., phone number or email address) so that when,
for example, the notification is received on a smart phone, the treatment
provider may use the information from the notification to directly call,
email, or otherwise contact, the patient. In some embodiments, the
treatment provider may be provided with a dashboard or other interface by
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which he or she may enter preferences for the threshold, how he or she
wishes to be contacted with the notification, and what he or she wishes to
be included in the notification. In some instances, the interface and/or
dashboard may also provide options for the treatment provider to set up
preferences for other treatment providers he or she may be associated
with and/or may establish global policies for thresholds and/or
notifications. In some cases, this interface may be managed by a
treatment administrator who sets thresholds and/or notification policies
according to rules and/or policies of a treatment facility and/or institution
via, for example, establishment of best practices for providing care to
patients.
[0008] On some occasions, it may be determined whether the wellness score
falls below a first minimum threshold and, upon determining that the
wellness score does fall below the first minimum threshold, determining
whether the wellness score falls below a second minimum threshold.
When the wellness score does fall below the second minimum threshold, a
notification that indicates the wellness score is below the second minimum
threshold may be generated. Provision of the notification to a treatment
provider may then be facilitated. In some circumstances, the first
threshold may be established for a more senior treatment provider (e.g.,
doctor or surgeon) and the second threshold may be established for a less
senior treatment provider (e.g., nurse or administrator).
[0009] On some occasions, a subsequent provision of the medical
questionnaire to the patient may be facilitated at, for example, a pre-
determined time and/or upon occurrence of an event (e.g., scheduling of a
treatment) and a subsequent set of responses to the medical
questionnaire from the patient may be received. The scoring procedure
may then be retrieved from the scoring-procedure database using the
identifier of the medical questionnaire and a subsequent wellness score
may be determined by applying the scoring procedure to the subsequent
set of responses. The subsequent wellness score may then be provided
to the patient.
[00010] On some occasions, an improvement score for the patient may
be determined using the wellness score and the subsequent wellness
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score and/or a difference in the wellness score and the subsequent
wellness score. Provision of the improvement score to the patient, a
treatment provider, treatment administrator, and/or treatment facility may
then be facilitated. At times, it may be determined whether the
improvement score falls below a minimum threshold and, if so, a
notification that indicates the improvement score is below the minimum
threshold may be generated and provision of the notification to a treatment
provider may be facilitated. In some cases, the notification may include
contact information of the patient and/or a link to the patient's personal
electronic device and/or contact information (e.g., phone number or email
address) so that when, for example, the notification is received on a smart
phone, the treatment provider may use the information from the notification
to directly call, email, or otherwise contact, the patient.
[00011] In some embodiments, an indication of a scheduling of the
treatment for the patient may be received prior to facilitating the provision
of the medical questionnaire to the patient. The scheduling of the
treatment may act as a trigger for the administration of a questionnaire to a
patient and, in response to the scheduling, a questionnaire database
storing a plurality of medical questionnaires or other OMDs may then be
accessed. In most instances, each medical questionnaire stored in the
questionnaire database is indexed with a treatment identifier, such as a
CPT code. The medical questionnaire that is indexed with an identifier of
the scheduled treatment for provision to the patient may then be selected
for provision to the patient and provision of the selected medical
questionnaire to the patient may be facilitated. On some occasions, a
patient may request receipt of an OMD via, for example, his or her
wellness account and/or may send an OMD to a friend or colleague via, for
example, a link to an OMD.
[00012] In some embodiments, accessing an electronic medical record
of the patient may be accessed and information about the patient from the
accessed electronic medical record may be extracted and correlated, for
example, the wellness score, the received set of responses, a diagnosis of
the patient, a treatment provided to the patient, and/or the medical
questionnaire.
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[00013] In one embodiment, an additional, or subsequent, medical
questionnaire may be provided to the patient upon, for example, an
expiration of a predetermined time period measured from, for example, a
time at which the patient received a treatment and/or a time at which the
set of responses was received from the patient, facilitating an additional
provision of the medical questionnaire to the patient. An additional set of
responses to the medical questionnaire may be received from the patient
and an additional wellness score may be determined by applying the
scoring procedure to the additional set of responses. The additional
wellness score may then be provided to the patient. In some cases, the
additional medical questionnaire is the same as the initially provided
questionnaire but, this need not always be the case. For example, the
initial medical questionnaire may include a first set of questions and the
additional medical questionnaire may include a second set of questions.
In another example, the initial medical questionnaire may include a first set
of questions and the additional medical questionnaire may include the first
set of questions and a second set of questions. A change between the
initial questionnaire and the additional medical questionnaire may be
triggered by, for example, a change in the patient's health or medical
condition and/or a change in the medical literature underlying use of the
initial medical questionnaire.
[00014] In some instances, the provision of the medical questionnaire to
the patient at a plurality of time points (e.g., daily, weekly, monthly,
quarterly, biannually, yearly, etc.) may be repeatedly facilitated so as to
monitor the patient's wellness over time (e.g., weeks, months, years,
decades). On occasion, a predicted and/or projected wellness score may
be determined for the patient. The projected wellness score may be
based on, for example, historical information from the patient's EMR,
information from other patients with one or more similar characteristics to
the patient, information from other patients with one or more similar
diagnoses to the patient, and/or information from other patients who have
undergone one or more treatments similar to the patient.
[00015] In some embodiments, a medical questionnaire may be selected
for provision to the patient responsively a received indication of at least
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one of a diagnosis and a treatment associated with the patient. Then, a
set of responses to the medical questionnaire may be received from the
patient. Next, the scoring procedure for the medical questionnaire may be
retrieved from the scoring-procedure database using the identifier of the
medical questionnaire. A wellness score for the patient may then be
determined by applying the scoring procedure to the set of responses.
Provision of the wellness score to the patient a treatment provider for the
patient, and/or a treatment administrator may then be facilitated. At times,
the wellness score may be provided to the patient automatically (e.g.,
without an action from a treatment provider, doctor, nurse, researcher,
clinician or treatment facility administrator).
[00016] In some instances, the wellness score is a raw wellness score
provided on a scale determined by the scoring procedure that is, for
example, not a base ten scale (i.e., not 0-10 or 0-100). In these instances,
the raw wellness score may be adjusted to be on a normalized (e.g., base
ten), scale thereby generating an adjusted wellness score. In some cases,
when, for example, a plurality of wellness scores are provided to a patient
this adjustment may involve normalizing all of the wellness scores so that
they are provided on the same scale and facilitating provision of the
wellness score to the patient may include facilitating provision of the
adjusted wellness score to the patient. In this way, different wellness
scores that are determined for the patient via a plurality of OMDs may be
more easily compared and understood, especially when they relate to the
same, or a similar treatment.
[00017] In some instances, a determined wellness score may be stored
in, for example, a score database maintained by a server and/or a data
storage device provided by the patient's personal electronic device. On
some occasions, the storage process may involve removing any and/or all
patient-identifying information from the wellness score. This may be
accomplished by, for example, associating a key or a binary string with, for
example, the patient, the set of responses, and/or the wellness score so
that it may be later retrieved without entry of patient-identifying
information
into a query.
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[00018] In some embodiments, the wellness score may be
communicated to a treatment facility computer system for storage in an
electronic medical record (EMR) database in communication with the
treatment facility computer system. Storage in the EMR may include
associating the wellness score with the patient and/or an anonymous
identifier for the patient. At times, patient-identifying information
associated with the wellness score may be removed from the wellness
score prior to communication of the wellness score to the treatment facility
computer system.
[00019] In some cases, facilitating provision of the wellness score to the
patient may include determining whether the medical questionnaire, a
diagnosis, a treatment the patient is scheduled to undergo and/or has
undergone pertains to the medical questionnaire, and/or a disease or
medical condition of the patient is associated with alternate terminology for
a name of the respective medical questionnaire, treatment, disease or
medical condition. Exemplary alternate terminology includes terms that
would be easily understood by those not trained in the medical arts (e.g.,
not doctors or nurses). For example, alternate terminology for a diagnosis
of a spiral fracture of the ulna may include "a broken arm" and alternate
terminology for a "bronchogenic carcinoma" diagnosis may be "lung
cancer."
[00020] The alternate terminology may be provided to the patient along
with the wellness score and/or the questionnaire responsively to a
determination that the medical questionnaire is associated with alternate
terminology. Providing the alternate terminology may have the effect of
assisting the patient with understanding what the wellness score relates to
so that he or she may have greater incite into their treatment and/or a
diagnosis and/or recovery therefrom.
[00021] In some embodiments, a plurality of medical questionnaires may
be provided to a patient at the same time. For example, a global health
medical questionnaire and a disease-specific medical questionnaire or two
different types of disease-specific medical questionnaires for the same
disease and/or different diseases may be provided to the patient. In these
embodiments, a first and second medical questionnaire may be provided
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to the patient and the second medical questionnaire may be different from
the first medical questionnaire. Both the first and second medical
questionnaires are associated with a first and second scoring procedure,
respectively for scoring the respective responses to the first and second
medical questionnaires. The first and second scoring procedures may be
associated with a respective first and second identifier of the medical
questionnaire and may be stored in a scoring-procedure database. The
first and second identifiers of the respective first and second medical
questionnaires may be used to retrieve the respective first and second
scoring procedures from the scoring-procedure database.
[00022] In this embodiment, the set of responses may include responses
to the first medical questionnaire and the second medical questionnaire
and each of the responses in the set of responses responsive the first
questionnaire grouped into a first set of responses. Then, the first scoring
procedure may be retrieved from the scoring-procedure database using
the identifier of the first medical questionnaire and a first wellness score
may be determined by applying the first scoring procedure to the first set
of responses. Next, each of the responses in the set of responses
responsive the second questionnaire may be grouped into a second set of
responses. The second scoring procedure may be retrieved from the
scoring-procedure database using the identifier of the second medical
questionnaire and a second wellness score may be determined by
applying the second scoring procedure to the second set of responses.
Then, provision of the first and second wellness scores to the patient via,
for example, a display provided by his or her personal electronic device,
may be facilitated. In some cases, a response included in the set of
responses may be grouped into both the first set of responses and the
second set of responses as me be the case when, for example, the first
and second medical questionnaires share a common question.
[00023] In some instances, facilitating provision of the wellness score
to the patient may include providing the patient with a numerical wellness
score and depicting a location for the numerical wellness score within a
graphically represented wellness score progress chart (e.g., a bar chart, a
graph, a pie chart, etc.) wherein a location of the numerical wellness score
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on the graphically represented wellness score progress chart is associated
with a magnitude of the numerical wellness score. In some instances, the
graphically represented wellness score progress chart may include a
minimum and/or maximum wellness score such that a relative distance
between the location of the numerical wellness score and the location of
the maximum numerical wellness score indicates how close the numerical
wellness score is to a maximum wellness score, which may be an
indication of overall wellness or how the patient is doing, or how much the
patient can expect his or her wellness to improve.
[00024] In a still further embodiment, a post-treatment provision of a
medical questionnaire to a patient may be facilitated (via, for example,
communication of the medical questionnaire to the patient's personal
electronic device and/or activation of the medical questionnaire already
stored on the patient's personal electronic device) after the patient
receives a treatment for a medical condition. The medical questionnaire
may be associated with a scoring procedure and the scoring procedure
and an identifier of the medical questionnaire may be stored in a scoring-
procedure database. The identifier of the medical questionnaire may be
used to retrieve the scoring procedure from the scoring-procedure
database.
[00025] A post-treatment set of responses to the medical questionnaire
may be received from the patient and the scoring procedure for the
medical questionnaire may be retrieved from the scoring-procedure
database using the identifier of the medical questionnaire. Then, a post-
treatment wellness score for the medical condition may be determined by
applying the scoring procedure to the post-treatment set of responses and
provision of the post-treatment wellness score to the patient may be
facilitated. On some occasions, provision of the medical questionnaire to
the patient at a plurality of time points after the patient receives the
treatment may be repeatedly facilitated at a plurality of time points.
[00026] In another embodiment, provision of a medical questionnaire to
each of a plurality of patients may be facilitated. The medical
questionnaire may be associated with a scoring procedure for scoring the
medical questionnaire and the scoring procedure and an identifier of the
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medical questionnaire may be stored in a scoring-procedure database.
The identifier of the medical questionnaire may be used to retrieve the
scoring procedure from the scoring-procedure database. Then, a set of
responses to the medical questionnaire may be received from the patient
and the scoring procedure may be retrieved from the scoring-procedure
database using the identifier of the medical questionnaire. A wellness
score for the medical condition may then be determined by applying the
scoring procedure to the set of responses and provision of the wellness
score to the patient may be facilitated. Then, at least one of the received
sets of responses may be mapped to the determined wellness score to
create a medical-condition-specific registry of information.
[00027] On some occasions, one or more patient characteristics for at
least some of the patients of the plurality of patients may be received and
the creation of the medical-condition-specific registry may further include
mapping the received patient characteristics to the medical condition. At
times, the patient characteristics may be provided by the patient's EMR
and/or the treatment provider and may not be received as a response to
the OMD. At times, provision of the medical questionnaire to the patient at
a plurality of time points after the patient receives the treatment may be
repeatedly facilitated.
[00028] In some instances, an electronic medical record of each patient
may be accessed and, for at least some of the patients, one or more
patient characteristics may be extracted from the electronic medical record
of the respective patient and the creation of the medical-condition-specific
registry may further include mapping the extracted one or more patient
characteristics to the medical condition and/or a wellness score.
[00029] Systems and computer-implemented methods for determining
and providing a display of a plurality of wellness scores with regard to a
medical condition and/or a medical treatment are herein described. The
plurality of wellness scores may all be for same patient and/or may be for
a plurality of patients who, in some instances, share one or more
characteristics, diagnoses, treatments, or comorbidities. Systems that
execute the methods and processes disclosed herein may include a server
and one or more client devices in the form of, for example, computers,
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tablet computers, and smart phones that may be operated by, for example,
patients, treatment providers, and other medical professionals,
researchers, administrators, and staff. At times the methods and
processes disclosed herein may be executed by personal electronic
devices that run one or more software applications configured to, for
example, administer a questionnaire, receive an answer from a
questionnaire, determine a wellness score, determine an improvement
score, store said received answers and scores, and provide one or more
graphic user interfaces or other displays to a user regarding same.
[00030] In one embodiment, a request to provide a plurality of wellness
scores for a plurality of patients who are each associated with at least one
of a patient characteristic, a treatment, and a diagnosis may be received
by, for example, a processor. The processor may be resident in, for
example, a server or a personal electronic device. One or more
databases that store a plurality of previously determined wellness scores
may then be accessed by the processor. Each of the previously
determined wellness scores stored in the database may be associated
with a patient and the patient characteristic, treatment, and/or diagnosis
included in the request. Then, a plurality of previously determined
wellness scores that match the patient characteristic, treatment, and/or
diagnosis in the request may be extracted from the database by the
processor. At times, extracting wellness scores may include selecting a
set of patients that are each associated with the patient characteristic,
treatment, and diagnosis and extracting a plurality of previously
determined wellness scores for each patient of the set of patients. Each of
the previously determined wellness scores for each patient of the set may
be associated with a different time period/interval (e.g., pre-treatment, 3
months following treatment, 6 months following treatment, and so on) so
that a series of wellness scores taken over a time span (which may be
specified by the user) may be extracted. In this way, wellness scores for
each patient within the set of patients may be viewed over the time span to
see how, for example, wellness scores for the patients within the set
change over time.
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[00031] In some cases, the request may include a request to provide
wellness scores for each of the plurality of patients over a series of
multiple time intervals (e.g., 3 consecutive time intervals, 6 consecutive
time intervals, time intervals that span a given time period (e.g., 6 months,
1 year, 10 years, etc.). In these cases, the database may be accessed to
extract wellness scores for each of the plurality of patients over a series of
multiple time intervals and display of the extracted wellness scores for
each of the plurality of patients over a series of multiple time intervals in
the interface may be facilitated.
[00032] Next, a display of the extracted plurality of previously
determined wellness scores may be prepared and provision of the display
on an interface provided by a display device (e.g., monitor or computer
screen) may be facilitated by the processor. In some embodiments, the
interface may be a patient wellness portal interface, treatment
effectiveness interface, and/or a treatment comparison interface. In some
embodiments, the plurality of previously determined wellness scores may
be displayed as points on a scatter graph. In these embodiments, on
occasion, the display of the extracted plurality of previously determined
wellness scores may be shown as a graph within the interface and the
wellness scores may be provided on a scale from 1-100 on the Y-axis and
time may be scaled in time intervals, days, months, quarter years, and
years on the X-axis.
[00033] In some embodiments, the plurality of previously determined
wellness scores are displayed as points on a graph and are divided into
two or more groups. At times, the previously determined wellness scores
relate to a treatment for a particular diagnosis and the grouping of the
previously determined wellness scores may comprise grouping them into a
first group and a second group. The first group may include previously
determined wellness scores for patients who are responsive to a treatment
and the second group may include previously determined wellness scores
for patients who are not responsive to a treatment. An indication of the
grouping (e.g., displaying the first group in one color and the second group
in another color and/or superimposing a first box around the first and a
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second box around second groups) may also be provided on the interface
provided by the display device.
[00034] In another embodiment, a request to provide one or more
previously determined wellness scores for a particular patient on the
interface may be received and a database storing one determined
wellness scores for the particular patient may be accessed and a plurality
of wellness scores for the patient may be extracted therefrom responsively
to the request. A display device may provide the display of the extracted
plurality of wellness scores on the interface.
[00035] In some instances, a request to provide a predicted wellness
score for a particular patient may be received. The requested predicted
wellness score may then be determined and display of the predicted
wellness score for the particular patient on the interface may be facilitated.
[00036] In some instances, the request to provide wellness scores
specifies a particular treatment, or combination of treatments, the patients
have undergone. A subsequent request to provide treatment compliance
information regarding the particular treatment may also be received and a
database storing treatment compliance information for patients who have
undergone the particular treatment, or combination of treatments, and who
are associated with the extracted wellness scores may be accessed and
the treatment compliance information may be extracted therefrom. Display
of the extracted treatment compliance information on the interface, or a
subsequently provided interface, may then be facilitated. The treatment
compliance information may be displayed as, for example, a graph, table,
or chart.
[00037] In some embodiments, the request to provide wellness scores
includes a request for wellness scores of patients who are associated with,
or have undergone, a particular treatment. In these embodiments, a
request to display side effect severity for the treatment on the interface
may be received. A database storing side effect severity information for
patients who have undergone the treatment may then be accessed and
the side effect severity information may be extracted therefrom
responsively to the request. In some instances, the patients may also be
associated with the extracted plurality of previously determined wellness
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scores. Display of the extracted side effect severity information on the
interface may then be facilitated.
[00038] Systems, methods, and devices for preparing one or more
treatment comparison graphs or interfaces and providing them to a user
are also herein disclosed. In these embodiments, a first request to display
a first plurality of wellness scores associated with a first set of patients
who
have received a first treatment for a diagnosis may be received. A second
request to display a second plurality of wellness scores associated with a
second set of patients who have received a second treatment for the
diagnosis may also be received. Then, a plurality of wellness scores may
be extracted from a database storing a plurality of previously determined
wellness scores responsively to the received requests. Then, a treatment
comparison interface may be prepared using the extracted plurality of
wellness scores and provision of the treatment comparison interface
displaying the first and second pluralities of wellness scores for each
patient in the first and second sets of patients as a function of time over a
time period may be facilitated. In some instances, the first and second
pluralities of wellness scores are displayed as points, or symbols, on a
graph. Additionally, or alternatively, a series of predicted wellness scores
are determined and each predicted wellness score in the series
corresponds to a different time interval.
[00039] In one embodiment, a third request to display treatment
compliance information associated with the treatment on the treatment
comparison interface may be received. The treatment compliance
information for the treatment may then be extracted from a database
storing treatment compliance information and provision of the extracted
treatment compliance information on the treatment comparison interface
may be facilitated responsively to the third request.
[00040] In another embodiment, a third request to provide treatment
compliance information regarding the first treatment on the treatment
comparison interface may be received and a database storing treatment
compliance information for patients who have undergone the first
treatment and are associated with the extracted plurality of wellness
scores may be accessed and the treatment compliance information may
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be extracted therefrom responsively to the third request. Display of the
extracted treatment compliance information on the treatment comparison
interface may then be facilitated. In some instances, a further, fourth
request to provide treatment compliance information regarding the second
treatment on the treatment comparison interface may be received. A
database storing treatment compliance information for patients who have
undergone the second treatment and are associated with the extracted
plurality of wellness scores and extracting the treatment compliance
information therefrom responsively to the fourth request may be accessed
and display of the extracted treatment compliance information on the
treatment comparison interface may be facilitated.
[00041] In yet another embodiment, a third request to provide side effect
severity information regarding the first treatment on the treatment
comparison interface may be received. A database storing side effect
severity information for patients who have undergone the first treatment
and are associated with the extracted plurality of wellness scores may
then be accessed and the side effect severity information may be
extracted therefrom responsively to the third request. Display of the
extracted side effect severity information on the treatment comparison
interface may then be facilitated. In some instances, a further fourth
request to provide side effect severity information regarding the second
treatment on the treatment comparison interface may be received. A
database storing side effect severity information for patients who have
undergone the second treatment and are associated with the extracted
plurality of wellness scores may then be accessed and the side effect
severity information may be extracted therefrom responsively to the fourth
request. Display of the extracted side effect severity information on the
treatment comparison interface may then be facilitated.
[00042] In a still further embodiment, a selection criterion regarding a
characteristic of the patients in the first set and/or the second set of
patients may be received. In these embodiments, the extracting may be
responsive to the received selection criteria.
[00043] In another embodiment, a request to add previously determined
wellness scores for a particular patient to the treatment comparison
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interface may be received. A database storing the previously determined
wellness scores for the particular patient may be accessed and the
requested previously determined wellness scores may be extracted
therefrom. Provision of the previously determined wellness scores on the
treatment comparison interface may then be facilitated responsively to the
request.
[00044] On some occasions, a request to add predicted wellness scores
for a particular patient when the particular patient receives the first
treatment to the treatment comparison interface may be received and one
or more predicted wellness scores for the particular patient when the
particular patient undergoes the first treatment may be determined.
Provision of predicted wellness scores for the particular patient on the
treatment comparison interface may then be facilitated responsively to the
request.
[00045] Systems, methods, and devices for the providing wellness
scores for a patient along with additional information regarding, for
example, the patient's health, treatments, or test results on a single
interface are also herein disclosed. The additional information may be
received from, for example, from the patient's electronic medical record
(EMR), a patient wellness account, a treatment provider of the patient,
and/or the patient. In one example, provision of an interface displaying a
plurality of wellness scores for a patient as a function of time over a time
period for display on a graph may be facilitated. The wellness scores may
relate to a particular treatment, diagnosis, and/or medical condition.
Provision of additional information from, for example, the patient's
electronic medical record (EMR) and/or patient wellness account for
display on the graph may then be facilitated. The additional information
may related to, for example, a treatment, a procedure, and/or a test result.
The information from the patient's EMR and/or wellness account may be
synchronized in time with the displayed wellness scores so that, for
example, correlation of the additional information with the wellness scores
may be achieved.
[00046] In some cases, the additional information includes a patient
note. In these cases, an icon or other symbol may be placed on the graph
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symbolizing that a patient note is available for viewing. The patient note
may include information regarding, for example, a life event of the patient,
something the patient wishes to remember regarding his or her
treatment/recovery, and/or something the patient wishes to communicate
to his or her treatment provider regarding his or her treatment/recovery.
The patient note (or icon representing the patient note) may be
synchronized in time with the displayed wellness scores so that it is in a
manner that corresponds to, for example, when it was received and/or
when the content of the note is relevant to the patient's treatment.
[00047] In some embodiments, a request to display patient compliance
information on the interface may be received. The patient compliance
information may comprise a plurality of patient compliance scores that
indicate a degree of compliance of the patient with treatment instructions
he or she has received. Provision of a plurality of patient compliance
scores on the graph, which may be synchronized in time with the
displayed wellness scores, may then be facilitated.
[00048] On some occasions, a request to display a linear regression line
representing an average change in the wellness scores over the time
period on the interface may be received. The average change in the
patient's wellness score may then be determined and provision of the
linear regression line representing the average change on the graph may
then be facilitated. In most cases, the linear regression line will be
synchronized in time with the displayed wellness scores.
[00049] Systems, methods, and devices for preparing predicted wellness
score/treatment outcome graphs are also herein described where at least
one criterion pertaining to at least one of a patient characteristic, a
treatment, a diagnosis, and a medical condition may be received and a
database storing a plurality of previously determined wellness scores,
each of the previously determined wellness scores being associated with
one or more criterion may be accessed. A plurality of wellness scores that
match the received criterion may then be extracted from the database and
display of the extracted plurality of wellness scores in an interface
provided by a display device may be facilitated. The wellness scores may
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be provided as, for example, as points on a scatter graph, lines on a bar
chart, or in a table on the interface.
[00050] In some instances, the plurality of previously determined
wellness scores are displayed as points on a graph and divided into one or
more groups according to one or more criterion. For example, when the
previously determined wellness scores relate to a treatment for a
diagnosis, the previously determined wellness scores may be divided into
a first group and a second group prior to facilitating display of the
extracted
plurality of wellness scores. The first group may include previously
determined wellness scores for patients who are responsive to a treatment
(e.g., the wellness scores of the patients show improvement over time)
and the second group including previously determined wellness scores for
patients who are not responsive to a treatment (e.g., the wellness scores
of the patients do not show improvement over time, or decline over time).
Then, display of the first and second groups of previously determined
wellness scores on the interface provided by the display device may be
facilitated by, for example, encircling the first and second group with a box
or circle, drawing one or more lines on the interface separating the groups,
using a distinct color or shape for the points on the graph representing
wellness scores in the first and second groups, etc.
[00051] In some embodiments, a set of patients that match the received
criterion may be selected and a plurality of previously determined wellness
scores for each patient of the set of patients may be extracted from the
database wherein each of the previously determined wellness scores
being associated with a different time period.
[00052] In another embodiment, the plurality of previously determined
wellness scores and criteria associated therewith may be analyzed and a
predicted wellness score for a patient may be determined based on the
analysis. Then, display of the predicted wellness score on the interface
may be facilitated.
[00053] Systems, methods, and devices for generating a combined
notification threshold and notifying a treatment provider using the
combined notification threshold are also herein disclosed. In some
instances, a value for a first notification threshold for a first type of
score
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associated with a treatment and/or a diagnosis may be received and a
value for a second notification threshold for a second type of score for the
treatment and diagnosis may also be received. Then, a combined
notification threshold for the treatment provider using the first and second
notification thresholds may be generated. The combined notification
threshold may indicate when the treatment provider should be notified
regarding value of the first score and the second score and/or the
combination of the first and second scores. In many cases, the first type
of score is a wellness score and the second type of score is an
improvement score. In some cases, the combined notification threshold
applies globally to all patients being treated by the treatment provider or
group of treatment providers. In other cases, the combined notification
threshold applies globally to all patients being treated with a certain
treatment or diagnosis by the treatment provider or group of treatment
providers. The notification thresholds may be specific to individual
patients, a patient characteristic, a medical condition, a treatment code, a
diagnostic code, a group of patient characteristics, a group of medical
conditions, a group of treatment codes, a group of diagnostic codes, or
combinations thereof.
[00054] In some embodiments, values for first and second scores of a
plurality of patients may be monitored as a background process and it may
be determined whether a value for the first score of a patient included in
the plurality is below the value for the first notification threshold. If so,
then
it may be determined whether a value for the second score of the patient is
below value for the second notification threshold. If so, a notification for
the treatment provider may be generated and provision of the notification
to the treatment provider may be facilitated. In some embodiments, a
preferred mode of communication (e.g., phone call, email, SMS text
message, page) for receipt of a notification for the treatment provider may
be received and the provision of the notification being facilitated using the
preferred mode of communication.
[00055] In some embodiments, a notation that a notification has been
generated for a patent and/or provided to the treatment provider may be
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entered into, for example, an electronic medical record, patient wellness
account, and/or treatment provider notes associated with the patient.
[00056] In some instances, the notification may be generated (e.g.,
values for the first and/or second notification thresholds may be entered)
via a graphical user interface (GUI) that displays the combined notification
threshold for the treatment provider in a graph. The GUI may include a
plurality of combined notification thresholds, each combined notification
thresholds of the plurality corresponding to a different one of at least a
treatment, a diagnosis, a treatment provider, and a patient.
[00057] In some embodiments, the treatment provider is a first treatment
provider and there is a second treatment provider. The first treatment
provider may be a doctor or supervising administrator (e.g., nurse
supervisor) and the second treatment provider may be a supervised
medical professional (e.g., resident, nurse, physician's assistant, etc.). A
value for a first notification threshold for the first type score associated
with
a treatment and/or a diagnosis may be received for a second treatment
provider. A value for a second notification threshold for the second type
score for the treatment and/or diagnosis may also be received. The value
for the first notification threshold and/or the second notification threshold
for the second treatment provider may be lower than the second
notification threshold for the first treatment provider. A second combined
notification threshold may then be generated for the second treatment
provider using the first and second notification thresholds for the second
treatment provider. The second combined notification threshold may
indicate when the second treatment provider should be notified regarding
a patient's first score and/or the second score.
BRIEF DESCRIPTION OF THE DRAWINGS
[00058] The present invention is illustrated by way of example, and not
limitation, in the figures of the accompanying drawings in which:
[00059] FIG. 1A is a block diagram of an exemplary system, in
accordance with some embodiments of the present invention;
[00060] FIG. 1B depicts an outcome measurement device (OMD)
response analyzer and score database, in accordance with some
embodiments of the present invention;
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[00061] FIG. 1C is a block diagram of an exemplary system, in
accordance with some embodiments of the present invention;
[00062] FIG. 2 depicts a system diagram of components that are used to
generate a matched treatment code and OMD database, in accordance
with some embodiments of the present invention;
[00063] FIG. 3 provides a flowchart of an exemplary process for
matching a treatment code and/or a diagnostic code with an OMD, in
accordance with some embodiments of the present invention;
[00064] FIG. 4 provides a flowchart of an exemplary process for
selecting an OMD to provide to and/or perform on a patient, providing the
OMD to the patient, and receiving a response thereto, in accordance with
some embodiments of the present invention;
[00065] FIG. 5 and FIG. 6 provide flowcharts of an exemplary processes
for selecting an OMD to provide to a patient, providing the OMD to the
patient, and receiving a response thereto, in accordance with some
embodiments of the present invention;
[00066] FIG. 7 provides a flowchart of an exemplary process for
determining a baseline recovery vector and/or a modified recovery vector
and building a data structure including same, in accordance with some
embodiments of the present invention;
[00067] FIG. 8 provides a flowchart of an exemplary process for
generating and/or modifying a wellness protocol for one or more
treatments, in accordance with some embodiments of the present
invention;
[00068] FIG. 9A provides a flowchart that illustrates an exemplary
process for generating and/or modifying a wellness protocol for one or
more treatments, in accordance with some embodiments of the present
invention;
[00069] FIG. 9B provides a flowchart that illustrates an exemplary
process for associating an OMD with a patient's wellness account, in
accordance with some embodiments of the present invention;
[00070] FIG. 10A and FIG. 10B provide flowcharts of an exemplary
process for providing one or more of a pre-treatment wellness score, post-
treatment wellness score and an improvement score to a patient,
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treatment provider, treatment facility and/or treatment administrator, in
accordance with some embodiments of the present invention;
[00071] FIG. 10C provides a flowchart of an exemplary process for
providing a wellness score to a patient, in accordance with some
embodiments of the present invention;
[00072] FIG. 10D provides a flowchart of an exemplary process for
providing a treatment compliance questionnaire to a patient, in accordance
with some embodiments of the present invention;
[00073] FIG. 11 provides a flowchart of a process for providing an
indication of patient's wellness to the patient, in accordance with some
embodiments of the present invention;
[00074] FIG. 12 provides a flowchart of an exemplary process for
determining an effectiveness score for treatment provider, treatment,
and/or treatment facility, in accordance with some embodiments of the
present invention;
[00075] FIG. 13A and FIG. 13B provide flowcharts of an exemplary
process for determining one or more treatment providers for a patient, in
accordance with some embodiments of the present invention;
[00076] FIG. 14A provides a flowchart of exemplary process for
conducting a medical inquiry and/or designing a medical study and
receiving study data related thereto, in accordance with some
embodiments of the present invention;
[00077] FIG. 14B provides a flowchart of exemplary process for
predicting a post-treatment wellness score for a patient, in accordance
with some embodiments of the present invention;
[00078] FIG. 14C provides a flowchart of exemplary process for
obtaining wellness scores and/or improvement scores for a patient or a
group of patients, in accordance with some embodiments of the present
invention;
[00079] FIGs. 15A-15C provide exemplary bar-chart representations of
wellness scores, in accordance with some embodiments of the present
invention;
[00080] FIG. 16A and FIG. 16B provide graphs that visually display
treatment effectiveness scores along the Y-axis as a function of time along
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the X-axis, in accordance with some embodiments of the present
invention;
[00081] FIGs. 17A-17K show exemplary interfaces provided by a
patient's wellness account, in accordance with some embodiments of the
present invention;
[00082] FIGs. 18A-18N provide screenshots of various user interfaces
by which a patient may be provided with information about his or her
health and/or wellness, in accordance with some embodiments of the
present invention;
[00083] FIGs. 19A-19C provide a series of interfaces responsive to a
request for a treatment provider, in accordance with some embodiments of
the present invention;
[00084] FIGs. 20A-20C are screen shots of exemplary care
management interfaces in accordance with some embodiments of the
present invention;
[00085] FIG. 20D is a screen shot of an exemplary combined threshold
graph interface, in accordance with some embodiments of the present
invention;
[00086] FIG. 20E is a screen shot of a first portion of an exemplary
interface showing a plurality of combined threshold graphs, in accordance
with some embodiments of the present invention;
[00087] FIG. 20F is a screen shot of a second portion of an exemplary
interface showing a plurality of combined threshold graphs, in accordance
with some embodiments of the present invention;
[00088] FIGs. 21A-21E depict screen shots from provided by a patient's
wellness to a patient who has undergone eye surgery in accordance with
some embodiments of the present invention;
[00089] FIGs. 22A-22E depict screen shots from provided by a patient's
wellness to a patient who has undergone shoulder surgery in accordance
with some embodiments of the present invention;
[00090] FIGs. 23A-23G provide screen shots of exemplary interfaces
provided to a treatment provider and/or treatment administrator for
associated one or more OMDs with a patient's wellness account and
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facilitating provision of the OMD to the patient in accordance with some
embodiments of the present invention;
[00091] FIGs. 24A-24E provide screen shots of exemplary interfaces
provided to a requester of information regarding treatment outcomes,
wellness scores, and/or improvement scores in accordance with some
embodiments of the present invention;
[00092] FIG. 25 depicts components of a computer system in which
computer readable instructions instantiating the methods of the present
invention may be stored and executed in accordance with some
embodiments of the present invention;
[00093] FIG. 26A and FIG. 26B provide flowcharts illustrating a process
for generating a combined notification threshold in accordance with some
embodiments of the present invention;
[00094] FIG. 27 provides a flowchart illustrating a process for notifying
a
treatment provider using a combined notification threshold in accordance
with some embodiments of the present invention;
[00095] FIG. 28A and FIG. 28B provide screen shots of exemplary
criteria selection interfaces in accordance with some embodiments of the
present invention;
[00096] FIG. 29 provides an exemplary flowchart for preparing and
presenting a patient wellness portal interface in accordance with some
embodiments of the present invention;
[00097] FIGs. 30A-30J provide screen shots of exemplary patient
wellness portal interfaces in accordance with some embodiments of the
present invention;
[00098] FIGs. 31A and FIG. 31B provide exemplary flowcharts of a
process for preparing and providing a treatment effectiveness interface in
accordance with some embodiments of the present invention;
[00099] FIGs. 32A-32D provide screen shots of exemplary patient
wellness portal interfaces in accordance with some embodiments of the
present invention;
[000100] FIG. 33A and FIG. 33B provide exemplary flowcharts of a
process for preparing and providing a treatment comparison interface in
accordance with some embodiments of the present invention;
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[000101] FIGs. 34A-34F provide screen shots of exemplary treatment
comparison interfaces in accordance with some embodiments of the
present invention;
[000102] FIG. 35A and FIG. 35B provides a flowchart of a process for
preparing and providing an interface showing wellness scores for patients
being treated by a treatment provider in accordance with some
embodiments of the present invention; and
[000103] FIGs. 36A-36C provide screen shots of exemplary wellness
score interfaces in accordance with some embodiments of the present
invention.
[000104] Throughout the drawings, the same reference numerals and
characters, unless otherwise stated, are used to denote like features,
elements, components, or portions of the illustrated embodiments.
Moreover, while the subject invention will now be described in detail with
reference to the drawings, the description is done in connection with the
illustrative embodiments. It is intended that changes and modifications can
be made to the described embodiments without departing from the true
scope and spirit of the subject invention as defined by the appended
claims.
WRITTEN DESCRIPTION
[000105] The present invention uses medical treatment and/or diagnosis
outcome data reported via one or more outcome measurement devices
(OMDs) to better understand, for example, the effectiveness of treatments
for a medical condition and various factors that may affect the
effectiveness of the treatments, recovery from a treatment, and/or
improvement in the medical condition. Outcome data may be, for
example, responses to patient reported outcome (PRO) instruments,
responses to questionnaires, laboratory data, physical function tests,
and/or responses to other OMDs.
[000106] Since the outcome data may be made publicly available, the
present invention provides patients with an opportunity to select there
treating clinicians based on the specific treatment outcomes from patients
with similar medical conditions who have received similar treatments. The
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public availability of the outcomes, along with the fact that the data can be
gathered without interaction with the clinician, may result in outcome data
that is substantially unbiased by, for example, clinicians, medical device
manufacturers, pharmaceutical companies, and/or others in the
medical/healthcare industry reporting their own results and outcomes.
Clinicians may be able to access the outcome data and, for example,
improve their practice of medicine and/or publish their analysis of the
outcome data in the medical literature to advance medical science. Since
outcome data obtained in this manner is likely to be unbiased, the
literature may be more likely to be trusted by other clinicians who are, for
example, looking to improve the effectiveness with which they provide
treatments, hence advancing medical science and improving healthcare
delivery at the same time.
[000107] Outcome data can also be used by, for example, treatment
providers, hospital centers, and insurance providers for quality assurance
and quality improvement purposes. Use of the outcome data may enable
hospitals and other treatment facilities to better discern which clinicians
fall
short of delivering a satisfactory level of care, and better defend their
decisions to terminate clinicians who under-perform. Outcome data of this
nature may also help patients better understand their medical condition,
treatment results, and/or recovery over time, by providing them a pre-
treatment baseline, and showing them their recovery over time and
compared to other patients with similar treatments, thereby improving, for
example, patients overall expectations for their treatment and
understanding of their recovery.
[000108] As used herein, the term "treatment" is broadly defined to cover
medical interventions to address physical and/or mental health issues and
may be responsive to a particular diagnosis or combination of diagnoses a
patient may receive. The term "treatment" may also encompass
diagnostic tests and a monitored lack of treatment as may be provided
with a placebo and/or wait-and-see type of approach. In some instances,
a treatment may address a cosmetic issue, as may be the case with
elective plastic surgery or certain dermatological procedures. The term
treatment may further incorporate alternative medical treatments, such as
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acupuncture that have recognized merit within the medical literature. A
treatment is typically performed by a healthcare professional, also referred
to herein as a treatment provider, in a healthcare administration facility,
also referred to herein as a treatment facility. Exemplary treatment
providers include healthcare professionals, healthcare providers, doctors,
nurse practitioners, physician's assistants, pharmacists, dentists,
orthodontists, chiropractors and nurses. In some instances, a particular
treatment provider may represent a group or team of healthcare
professionals as may be the case with a lead surgeon and a team of
doctors and nurses who support the lead surgeon during a surgical
procedure or a group of doctors who work together to address a complex
medical diagnosis such as cancer or cardiac disease. Exemplary
treatment facilities include hospitals, clinics and independent doctors'
offices.
[000109] In the past, it has been difficult to collect patient reported
outcomes from patients. There are many reasons for this including, but
not limited to, cumbersome presentation of questionnaires (e.g., PRO
instruments) to the patients, inefficient mechanisms by which the patient
responds to the questionnaires, and the lack of motivation for the patient to
provide information about his or her diagnosis, treatment, and/or recovery.
The present invention provides a solution to these problems by providing
easy to use mechanisms for the delivery of questionnaires to the patient
(via a patient wellness account) and questionnaires that are easy to
understand and respond to. Furthermore, the present invention provides a
motivation for the patient to provide information regarding his or her
diagnosis, treatment, and/or recovery in the form of wellness and/or
improvement scores that provide the individual patient with valuable incite
into his or her own recovery and health or wellness. Often times, these
wellness and/or improvement scores are calculated in over a very short
time period (e.g., seconds or minutes) and provided to the patient very
quickly following his or her provision of information thereby providing
nearly immediate feedback to the user regarding his or her wellness. Thus,
the patient is motivated to provide the information because he or she can
track his or her own wellness as they progress through, for example, a
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treatment recovery process or manage a disease/diagnosis. For example,
one problem is that it's been difficult to collect PRO data from patients;
you've managed to make this information immediately useful to patients
(tracking their own progress) and also made it more likely that patient's will
provide longitudinal PRO information. Therefore I would include at least
one set of claims that directly speaks to these features:
[000110] Turning now to the figures, FIG. 1A provides a block diagram of
an exemplary system 100 that may be used to execute one or more of the
processes described herein. At a high level, system 100 includes a server
102, a patient device 128, a treatment provider device 124, and a
treatment facility computer system 134, all directly or indirectly
communicatively coupled to one another via Health Insurance Portability
and Accountability Act (HIPAA) compliance server 126. Patient device
128 may be any device (e.g., a smartphone, a laptop computer, a tablet
computer, a desktop computer, etc.) that enables communication between
a patient and other components of system 100. Similarly, treatment
provider device 124 may be any device (e.g., a smartphone, a tablet
computer, a laptop computer, a desktop computer, etc.) that enables
communication between a treatment provider and other components of
system 100. In some cases, treatment provider device 124 may also be a
device that is enabled to perform a specific healthcare treatment and/or
diagnostic task. For example, treatment provider device 124 may be a
network-connected treadmill or a network-connected ultrasound machine.
For simplicity, only one treatment provider device 124 is depicted, while it
is understood that in practice there may be a plurality of treatment provider
devices, one or more for each treatment provider. Similarly, while only
one patient device 128 is depicted, it is understood that in practice there
may be a plurality of patient devices, one or more for each patient. It
should also be understood that while the databases depicted in FIGs. 1A
and 1 B and discussed throughout may be a series of one or more
databases that may, in some instances, be geographically disparate.
[000111] Treatment facility computer system 134 may be a computer
system that is located in, and/or communicatively coupled to, a treatment
facility (i.e., a computer/server that is located in a doctor's office or
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treatment facility). Due to HIPAA regulations, treatment facility computer
system 134 and its associated patient electronic medical record (EMR)
database 130 may be protected by HIPAA-compliant firewall 140. As is
understood in the art, an EMR (as stored in EMR database 130) may
include notes prepared by a treatment provider regarding the health of a
patient, results of medical tests performed on a patient, treatments
administered on a patient, etc. Further due to HIPAA regulations, medical
records from treatment facility computer system 134 may be
communicated to treatment provider device 124, patient device 128 and
server 102 via HIPAA compliance server 126. It is understood that other
data (i.e., not patient-specific data) may be transmitted between treatment
provider device 124, patient device 128, sever 102 and facility computer
system 134 via a conventional communication network (e.g., the Internet,
a wired network, a wireless network, a private network, a public network,
routers, switches, etc.), which has not been depicted in FIG. 1A. Further,
it is understood that treatment provider device 124, patient device 128,
server 102 and facility computer system 134 may be communicatively
coupled to HIPAA compliance server 126 via a similar communication
network (although components 124, 128, 102 and 134 have been depicted
as being directly coupled to HIPAA compliance server 126 for simplicity of
illustration).
[000112] In one embodiment, HIPAA compliance server 126 may replace
any patient identifying information (e.g., patient name, social security
number, birthdate, address, etc.) in medical records with, for example, a
binary string to form anonym ized medical records containing no patient
identifying information (e.g., patient name, social security number,
birthdate, address, etc.). More generally, HIPAA compliance server 126
may replace any patient identifying information in medical data (e.g., EMR,
questionnaire responses provided by a patient, wellness scores computed
for a patient, etc.) with a binary string to form anonym ized medical data.
Such anonym ized medical data may be stored at HIPAA compliance
server 126, in various databases operated by server 102 (e.g., OMD
response database 110, score database 120, etc.), cloud-based storage
(e.g., Amazon Web services, Google Cloud platform or Microsoft Azure)
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(not depicted), etc. In the event the anonymized medical data is
intercepted by a malicious individual (e.g., a hacker), patient privacy will
still be preserved since the malicious individual will not be able to
associate the anonym ized medical data with any specific patient.
[000113] A mapping between respective binary strings and respective
patient identifying information may be securely stored (e.g., stored in an
encrypted manner) at HIPAA compliance server 126 (or other location).
Such mapping may enable an electronic device (e.g., server 102,
treatment provider device 124, and/or patient device 128) to access
medical data associated with a specific patient. The steps for an
electronic device to access the medical data of a patient may proceed as
follows. First, the electronic device may be authenticated by HIPAA
compliance server (e.g., the electronic device is required to provide the
proper credentials, such as a login identifier and password). Following
successful authentication, the electronic device may request medical data
concerning an exemplary patient, John Doe. HIPAA compliance server
126 may map the patient name of "John Doe" to "patient 001010" via the
mapping and/or indexing, and the medical data of patient 001010 may be
retrieved from a database which stores the anonym ized medical data (e.g.,
HIPAA compliance server 126, OMD response database 110, score
database 120, etc.). HIPAA compliance server 126 (or software providing
the functionality of HIPAA compliance server 126) may be provided by a
third party data service (e.g., TrueVault of Redwood City, CA and/or
Redox of Madison, WI). In the discussion below, server 102, treatment
provider device 124, patient device 128 and treatment facility computer
system 134 may be described to directly communicate various information
(e.g., patient medical records) with one another for ease of discussion, but
it is understood that in such communication, HIPAA compliance server 126
may perform the anonym ization and mapping processes described above
in order to ensure the communication complies with HIPAA regulations.
[000114] While server 102, treatment provider device 124 and patient
device 128 have been depicted as being located outside of HIPAA-
compliant firewall 140, this is not necessarily so. In another embodiment,
one or more of server 102, treatment provider device 124 and patient
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device 128 may be located within HIPAA-compliant firewall 140. If server
102, treatment provider device 124, patient device 128 and treatment
facility computer system 134 are all located within HIPAA compliant
firewall 140, HIPAA compliance server 126 may not be necessary, as
medical data would not need to be anonym ized within HIPAA compliant
firewall 140.
[000115] In one embodiment, the process flow for system 100 may
proceed as follows. Upon receiving a request from, for example, a
treatment provider, hospital administrator, and/or patient to schedule a
treatment, scheduler 136 may request server 102 to administer an
outcome measurement device (OMD) to and/or on that patient (or more
generally may request server 102 to initiate a process which eventually
results in an OMD being administered to and/or on that patient). In some
cases, the request to administer the OMD may be triggered via the entry of
a treatment code (e.g., a Current Procedural Terminology (CPT) code) or
a treatment/diagnostic test name into the patient's EMR (as stored in
patient EMR database 130), a treatment facility's billing software (e.g.,
billing program 138) and/or a treatment facility's scheduling software (e.g.,
scheduler 136). In some instances, a request to administer and OMD may
be triggered by a patient requesting receipt of an OMD via, for example,
his or her wellness account and/or a request to administer and OMD may
be triggered by a patient who requests to send an OMD to a friend or
colleague via, for example, a link to an OMD and/or an invitation to
respond to an OMD.
[000116] In some instances, when a treatment/diagnostic test name or
other related information (other than a treatment/diagnostic code) is
received, server 102 may interpret (using, for example, natural language
analysis) the treatment/diagnostic test name so that it matches one or
more treatment codes. In such cases, OMD selector 106 may determine
one or more OMDs that match the treatment code via matched treatment
code and OMD database 104. More generally, matched treatment code
and OMD database 104 may also include matches between treatment
names and OMDs, as well as diagnostic codes and OMDs.
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[000117] Next, OMD selector 106 may retrieve the one or more
determined OMDs from OMD database 108. The retrieved OMDs may be
provided to OMD administrator 112, which may administer the OMDs to
the patient via, for example, patient device 128. In the instance that the
retrieved OMDs are patient reported outcome (PRO) instruments, the PRO
instruments may be provided to patient device 128. Completed OMDs
(also called OMD responses) may be transmitted from patient device 128
and stored in OMD response database 110. More specifically, OMD
responses may be stored in OMD response database 110 in an
anonym ized fashion. For example, OMD responses may be indexed in
OMD response database 110 by a binary string, or other anonymous
identifier, rather than by a patient name. Similarly to the discussion above,
if an OMD response for a specific patient is desired, HIPAA compliance
server 126 may map the patient name to a binary string, and the OMD
response associated with that binary string may be retrieved from OMD
response database 110. For simplicity of discussion, the remainder of the
description will merely state that an OMD response of a patient is retrieved
from OMD response database 110, but it is understood that any such
retrieval may require the assistance of HIPAA compliance server 126.
[000118] Once the OMD has been completed, the treatment may be
scheduled for the patient. In other words, the completion of the OMD may
be a precondition for the scheduling of the treatment. Upon the patient
receiving the treatment, billing program 138 may notify server 102 that the
patient has received a treatment for his/her medical condition. In response
to such notification, a subsequent post-treatment OMD may be
administered on the patient by OMD administrator 112. In many cases,
the post-treatment OMD may be identical to the pre-treatment OMD, but in
some instances, the two OMDs may vary (e.g., in response to unforeseen
complications during the treatment, a post-treatment OMD which is
different from the pre-treatment OMD may be chosen). The response to
the post-treatment OMD may similarly be stored in OMD response
database 110.
[000119] OMD response analyzer 118 may analyze the OMD responses
stored in OMD response database 110 to generate one or more scores
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(e.g., a wellness score, an improvement score, a treatment effectiveness
score, a treatment provider effectiveness score, a treatment facility
effectiveness score, etc.). Such scores are described in more detail below
with regard to FIG. 1B. Such analysis may rely upon scoring procedures
stored in scoring procedure database 116. Such scoring may also rely
upon other considerations and/or esoteric factors 132 stored at patient
EMR database 130. In most circumstances, what may be referred to
herein as "other considerations" are factors that may directly, or closely,
relate to and/or have an impact on, a medical condition, diagnosis, and/or
treatment. For example, it is known that smoking has an impact on a
person's cardiovascular health. Thus, whether a person smokes may be
an "other consideration" for a patient's treatment related to cardiovascular
health. This relationship between cardiovascular health and smoking may
be indexed or otherwise stored in other consideration database 132. An
esoteric factor is one that is less directly related to a medical condition,
diagnosis, and/or treatment but may still have an impact thereon. For
example, a vegetarian diet may have an impact on a person's
cardiovascular health yet this impact may be less well understood when
compared with the impact of smoking on the same patient's cardiovascular
health. As such, a person's status as a vegetarian may be considered an
"esoteric factor."
[000120] The scores that are generated by OMD response analyzer 118
may be stored at score database 120. More specifically, scores may be
stored in score database 120 in an anonym ized fashion so as to, for
example, comply with HIPAA regulations or other data security
requirements/preferences. For instance, wellness scores associated with
a patient may be indexed by a binary string in score database 120 rather
than by a patient name.
[000121] Similarly to the discussion above, if a wellness score for a
specific patient is desired, the patient name may be mapped to a binary
string by HIPAA compliance server 126, and the wellness score
associated with the binary string may be retrieved from score database
120. For simplicity of discussion, the remainder of the description will
merely state that a wellness score for a patient is retrieved from score
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database 120, but it is understood that any such retrieval may require the
assistance of HIPAA compliance server 126. In some embodiments,
score database 120 may store pre-treatment wellness scores and/or post
treatment wellness scores. In some instances, score database 120 may
also store one or more of a disease-specific registry of information, a
diagnosis-specific registry of information, a treatment-specific registry of
information, a patient-specific registry of information, and a treatment-
provider-specific registry of information.
[000122] Finally, reporting module 122 may report the scores to one or
more of treatment provider device 124, patient device 128 and treatment
facility computer system 134. In addition to being communicatively
coupled to score database 120, reporting module 122 may be
communicatively coupled to treatment provider database 121 and
treatment facility database 123. Treatment provider database 121 may
store a collection of treatment provider names, indexed by one or more of
the location of the treatment provider, the specialty (or specialties) of the
treatment provider, service(s) provided by the treatment provider, a
treatment facility the treatment provider is associated with, etc. Treatment
provider database 121, in conjunction with score database 120, may allow
reporting module 122 to provide a patient with a collection of treatment
providers associated with one or more particular treatments located within
a certain geographical area. Further, the treatment providers may be
tagged with their respective treatment provider effectiveness scores
(described below in FIG. 1B). Similarly, treatment facility database 123
may store a collection of treatment facility names (e.g., hospital names),
indexed by one or more of the location of the treatment facility, service (or
services) provided by the treatment facility, etc. Treatment facility
database 123 in conjunction with score database 120 may allow reporting
module 122 to provide a patient with a collection of treatment facilities
associated with one or more particular treatments located within a certain
geographical area. Further, the treatment facilities may be tagged with
their respective treatment facility effectiveness scores (described below in
FIG. 1B). While not described in detail, it is understood that any
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communication to and from server 102 may involve the use of a
communication interface 114 (e.g., an Ethernet card) of server 102.
[000123] In addition to the request for a treatment, there are other events
that may prompt an OMD to be administered to a patient. In one example,
the scheduling of an initial appointment (e.g., a consultation) for a patient
to discuss a medical condition with a healthcare professional may prompt
an OMD to be administered to the patient. Administering an OMD to the
patient prior to this initial appointment may be useful for establishing a
baseline state of health for the patient, but the selection of the OMD may
have some complexity, as no treatment code, treatment name or
diagnostic code may yet be available when the initial appointment is
scheduled. In many instances, all that the patient will provide is a brief
description of the symptoms he/she may be experiencing (e.g., shortness
of breath, fever, etc.) In one embodiment, such symptoms may be
provided to OMD selector 106, which attempts to match the symptoms
with one or more treatment codes, treatment names or diagnostic codes.
[000124] Such matching by OMD selector 106 may be performed using a
learning machine. For instance, matches between, for example,
symptoms and treatment codes; symptom and treatment names; and/or
symptoms and diagnostic codes) may be provided by a healthcare
professional when treating patients, and such matches may be used to
train a model that can then be used to determine treatment codes,
treatment names or diagnostic codes based on, for example, a patient's
symptoms and/or treatment provider notes. Upon determining a treatment
code, treatment name, or a diagnostic code, OMD selector 106 may select
one or more OMDs based on matches provided in matched treatment
code and OMD database 104 (as described above). It is anticipated that
the determination of a treatment code, treatment name or diagnostic code
by OMD selector 106 may be, in some instances, an imperfect process, so
a healthcare provider, or other expert, may be asked to make any
necessary adjustments to the treatment code, treatment name and/or
diagnostic code determination, before OMD selector 106 selects the one
or more OMDs.
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[000125] As another example, the billing for a medical appointment during
which a patient discusses a medical condition with a healthcare
professional may prompt an OMD to be administered to the patient. More
specifically, billing program 138 may notify server 102 when a bill (or
invoice) is generated. If the billing for the appointment occurs after the
appointment has concluded, the bill may be associated with a diagnostic
code (which may be determined by the healthcare professional during the
medical appointment). OMD selector 106 may use the diagnostic code to
locate one or more appropriate OMDs for the patient with the assistance of
matched treatment code and OMD database 104.
[000126] In the examples provided above, it was assumed that an OMD is
administered to a patient via patient device 128. In other instances, a
medical professional may be required to administer the OMD to the
patient. For example, server 102 may notify treatment provider device 124
that one or more OMDs should be administered as part of, for example, a
medical examination of a patient. In one example, if a patient has recently
undergone cardiothoracic surgery, OMD administrator 112 may provide
one or more OMDs to treatment provider device 124 (e.g., the
Intrathoracic Gas Volume Test, Total Lung Capacity Test, Vital Capacity
Test, 6 Minute Walk Test, Aortic Insufficiency Test, Mitral Regurgitation
Test and/or Aortic Valve Area Test) that could, or should, be administered
to the patient during an exam and/or provide one or more mechanisms to
treatment provider device 124 (e.g., fillable forms) for the treatment
provider to enter the OMD responses.
[000127] FIG. 1 B depicts one embodiment of a system 150 that supports
the operation of OMD response analyzer 118 and score database 120
(and some associated components). OMD response analyzer 118 may
comprise wellness score determination module 152. In one embodiment,
wellness score determination module 152 retrieves responses to OMD
instrument from OMD response database 110, and further may retrieve a
scoring procedure associated with the OMD responses from scoring
procedure database 116. The scoring procedures may be indexed by an
identifier of an OMD, for which responses have been received, making for
easy retrieval of a corresponding scoring procedure. Various scoring
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procedures may be employed to score a completed OMD, and in one
embodiment, the generated score may be known as a "wellness score". In
some cases, a "wellness score" may serve to indicate how severe a
patient's symptoms are. In these cases, a low wellness/symptom severity
score may indicate that a patient's symptoms are relatively more severe
than a higher wellness/symptom severity score such that an increasing
wellness/symptom severity score indicates an improvement (i.e., decrease
in severity) in the symptoms.
[000128] In the case where an OMD is a questionnaire (or PRO
instrument), a certain weighing may be used to score or evaluate the
patient's responses. For example, certain responses that are more
objective in nature (e.g., heart rate, blood glucose level, etc.), may receive
greater weights (and hence have a greater influence on the wellness
score) than certain responses that are more subjective in nature (e.g.,
degree of pain, mood, etc.). The reverse scenario, of course, could be
true in which subjective responses receive a greater weight than objective
responses. Scores generated by wellness score determination module
152 may be stored in wellness score database 154. The wellness scores
may be indexed in various fashions, for ease of retrieval. In one
embodiment, wellness scores may be indexed according to one or more of
a patient identifier (e.g., binary string to protect patient privacy), medical
condition, treatment provider, treatment facility, time at which OMD was
completed, etc.
[000129] Improvement score determination module 156 may retrieve two
wellness scores for a patient (i.e., a first score calculated for an OMD
completed at a first time point and a second score calculated for an OMD
completed at a second time point) from wellness score database 154.
Improvement score determination module 156 may calculate the
difference between the first and second score, and such difference may be
known as an improvement score. More generally, the improvement score
may be called a health progression score, as the patient's health may
decline instead of improve. The improvement score may be stored in
improvement score database 158. In one refinement, a relative
improvement score may be calculated as the improvement score (i.e., the
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difference described above) normalized by a maximum improvement
score, which may be calculated based on, for example, other
considerations 132 stored in a patient's EMR. The maximum improvement
score may take into consideration other factors such as the state of a
patient prior to a medical treatment (e.g., if patient was in fairly good
health, the maximum improvement score might be lower than if the patient
was in poor health), and/or the age of a patient (e.g., younger patients
might have a higher maximum improvement score than older patients),
etc. An improvement score (or a relative improvement score) may be
stored in improvement score database 158. The improvement scores may
be indexed in various fashions, for ease of retrieval. In one embodiment,
improvement scores may be indexed according to one or more of a patient
identifier (e.g., binary string to protect patient privacy), medical
condition,
treatment provider, treatment facility, and time duration over which
improvement score was measured, etc.
[000130] Treatment effectiveness score determination module 160 may
calculate a treatment effectiveness score for a particular treatment based
on an improvement score (or a relative improvement score) that, for
example, measures the changes in a patient's health from prior to the
treatment to after the treatment or at various points (e.g., weeks, months,
etc.) after the treatment. In a simplistic embodiment, the treatment
effectiveness score may be set equal to an improvement score. In other
words, if the patient's condition improves a lot, the treatment may be
determined as very effective; if the patient's condition does not improve,
the treatment may be determined as not effective; if the patient's condition
gets worse, the treatment may be determined as not effective; and so on.
[000131] In an embodiment, the treatment effectiveness score may be set
equal to a relative improvement score. Such implementation might rate a
certain treatment as highly effective, even if a patient's condition were to
only improve by a small amount. For example, if patients suffering from a
medical condition typically only live three to six months with a conventional
treatment (leading to a low maximum improvement score), but a new
treatment allows a patient to live nine months, the new treatment would
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receive a high treatment effectiveness score, despite the fact that the
patient died after nine months.
[000132] In another embodiment, "other considerations" (as stored as
element 132 in patient EMR database 130) may be taken into account
when calculating the treatment effectiveness score. For example, if a
patient's EMR indicates that the patient has received two medical
treatments, and a relative improvement score is calculated based on a first
wellness score measured prior to the first medical treatment and a second
wellness score measured after the second medical treatment, it would not
be clear whether the improvement was due to the first medical treatment,
the second medical treatment, or both the first and second medical
treatment. In such instance, treatment effectiveness score determination
module 160 may generate an output of "undetermined".
[000133] As another example, if a patient's EMR notes, or if the patient's
OMD response(s) indicate, that a patient has experienced an injury (e.g.,
sprained ankle) following a treatment (e.g., knee surgery), an improvement
score (or more generally, a medical progression score) which measures
the patient's progress from before the treatment to after the subsequent
injury would not be used to calculate any treatment effectiveness score.
After all, the knee surgery could have been successful, allowing a patient
to resume normal daily activities, and the subsequent sprained ankle could
be the reason for a patient's current state of poor health.
[000134] As another example, if a patient's EMR notes, or if the patient's
OMD response(s) indicate, that a patient has not complied with pre-
treatment and/or post-treatment instructions, an improvement score (or
more generally, a medical progression score) which measures the
patient's progress from before a treatment to after the treatment may not
be used to calculate any treatment effectiveness score because the
patient's failure to comply with instructions may be a direct cause of a
delayed, or otherwise not successful recovery. For example, if the
treatment being evaluated is one that requires wound recovery (from, for
example, a surgical incision), the failure of a wound of a particular patient
to heal could have been due to the patient's non-compliance with post-
treatment instructions (e.g., failure to apply an antibiotic cream over the
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wound every other day), and not the treatment provider's lack of skill at
performing a surgical procedure.
[000135] Any treatment effectiveness scores may be stored in treatment
effectiveness score database 162. The treatment effectiveness scores
may be indexed in various fashions, for ease of retrieval. In one
embodiment, treatment effectiveness scores may be indexed according to
one or more of a patient identifier (e.g., binary string to protect patient
privacy), medical condition, treatment name, treatment provider, treatment
facility, etc.
[000136] Treatment provider score determination module 164 may
determine a treatment provider score for a treatment provider based on a
collection of treatment effectiveness scores (e.g., treatment effectiveness
scores aggregated for a group of patients treated by the treatment
provider). In a simplistic embodiment, the treatment provider score may
be determined as an average of the treatment effectiveness scores. In a
preferred embodiment, the treatment provider score may be determined as
a weighted average of the treatment effectiveness scores, where, for
example, the more recent treatment effectiveness scores may be given
higher weight. The treatment provider effectiveness scores may be stored
in treatment provider effectiveness score database 166. The treatment
provider effectiveness scores may be indexed in various fashions, for ease
of retrieval. In one embodiment, treatment provider effectiveness scores
may be indexed according to one or more of a medical condition,
treatment name, treatment provider, treatment facility, etc. Treatment
provider effectiveness score database 166 may be used in a doctor finder
application (described below) in which treatment providers in the proximity
of patient's location may be displayed along with their respective treatment
provider scores.
[000137] Treatment facility score determination module 168 may
determine a treatment facility effectiveness score for a treatment facility
based on a collection of treatment provider effectiveness scores (e.g.,
treatment provider effectiveness scores aggregated for a group of
treatment providers who work at the treatment facility). In a simplistic
embodiment, the treatment facility score may be determined as an
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average of treatment provider effectiveness scores for treatment providers
affiliated with the treatment facility. In one embodiment, the treatment
facility score may be determined as a weighted average of the treatment
provider effectiveness scores, with weights proportional to the number of
patients treated by each treatment provider. The treatment facility
effectiveness scores may be stored in treatment facility effectiveness
score database 170. The treatment facility effectiveness scores may be
indexed in various fashions, for ease of retrieval. In one embodiment,
treatment facility effectiveness scores may be indexed according to one or
more of a medical condition, treatment name, treatment facility, etc.
Treatment facility effectiveness score database 170 may be used in a
treatment facility finder application in which treatment facilities in the
proximity of a patient's location may be displayed along with their
respective treatment facility effectiveness scores.
[000138] FIG. 1C provides another exemplary system 103. System 103
is similar to system 100and includes many of the same components as
system 100. Additionally, system 103 includes a patient information
database 142 that stores, for example, information (e.g., demographic
information, diagnoses and/or treatments associated with the patient, etc.)
regarding one or more patients. At times the information stored in patient
information database 142 may be referred to as a personal medical history
because it is personal to the patient and not maintained by the treatment
provider or treatment facility in contrast to a traditional EMR. In some
embodiments, the patients may supply the information stored in patient
information database directly. Additionally, or alternatively, treatment
providers and/or treatment administrators may supply the information
stored in patient information database. In some embodiments, the data
stored in patient information database 142 may be similar to the
information stored in patient EMR database 130. Importantly, however,
the information stored in patient information database 142 is not managed
by a treatment facility. Rather, it is managed by an entity that manages
server 102 and, in this way, is separate from a treatment provider's
medical records. This enables greater portability of patient information for
the patient because individual patients are able to populate their own
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medical history information for storage in patient information database 142
and association with their respective patient accounts that may be
accessed by them at any time and shared with, for example, treatment
providers who do not have access to the patient EMR database 130, that
is operated by the treatment facility computer system 134.
[000139] Storing medical information as well as life events and other
factors that may impact their health in patient information database 142
separate in and apart from a treatment facility operated EMR provides
patients with the opportunity to create a medical narrative of their medical
condition, diagnosis, and/or treatment recovery that is scientifically and
medically robust. The patient may then share this narrative with others,
including caregivers and treatment providers without the need for complex
and time consuming procedures often required when sharing medical
information.
[000140] Additionally, or alternatively, because the information stored in
patient information database 142 is not operated by a particular treatment
facility, it may be accessible from a wide variety of geo-locations
(potentially world-wide) via a communication network like the Internet
without the need to go through a treatment provider interface.
[000141] In some embodiments, a personal medical history and/or other
data stored in patient information database 142 and/or score database 120
may be added to a patient's EMR and/or shared with a treatment provider
so that it may be, for example, added to the patient's EMR.
[000142] System 103 further includes a plurality of patient devices;
patient
device A 128A and patient device B 128B, both of which are coupled to
server 102, treatment facility computer system 134, HIPAA compliance
server 126 and/or treatment facility computer system 134. System 103
may include any number of patient devices 128 that may each be operated
by a separate patient.
[000143] In the embodiment of FIG. 1C, system 103 does not include
HIPAA-compliant firewall 140. Instead, patient-identifying information is
encrypted prior to passing between two or more system components
where privacy vulnerabilities may exist.
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[000144] In some embodiments, system 103 may also include a treatment
side effect database 146, which may store information regarding known
side effects for a plurality of treatments including, but not limited to,
pharmaceuticals, combinations of pharmaceuticals, physical therapy,
surgery, implants, prosthetics, and so on. Treatment side effects stored in
treatment side effect database 146 may be sourced from, for example,
medical literature, patient responses to OMDs, and/or information provided
by treatment providers and/or treatment administrators. In some
embodiments, treatment side effect information may be retrieved by server
102 from an external database such as OpenFDA and stored in, for
example, treatment side effect database 146. In some instances, the
information stored in treatment side effect database 146 may be organized
by one or more standard nomenclatures for treatments such as the
National Drug Code (NDC), the RxNorm normalized naming system for
generic and branded drugs, Unique Ingredient Identifier (U II) and/or
Structured Product Labeling (SPL).
[000145] Optionally, system 103 may include a third party computer
system 172 that may include a database 174, which may store, for
example, treatment side effect information and/or drug/treatment
indications. In some cases, the third-party computer system 172 may be
operated by an entity (e.g., the FDA, Center for Disease Control (CDC),
AMA, etc.) other than the entity operating server 102 or other components
of system 103.
[000146] Side effect data may be of particular use to oncologists, or
others who specialize in cancer treatment or treatments requiring
administration of a variety of pharmaceuticals so that the types of side
effects as well as their respective severities for particular medications or
combinations of medications may be assessed when, for example,
determining which medication, or combination of medications, may be the
most effective at treating a disease for a patient.
[000147] FIG. 2 depicts system diagram 200 of components that may be
used to generate a matched treatment code and OMD database. In one
embodiment, treatment and/or diagnostic code database 202 may provide
a number of standardized treatment and diagnostic codes to the treatment
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code/OMD matcher 206. Exemplary treatment and diagnostic code
databases 202 include a database operated by a third party (i.e., not a
patient or provider), such as a health insurance company or industry
group, or a database operated by a healthcare provider (e.g., a doctor)
and/or a treatment facility (e.g., a clinic or hospital).
[000148] The treatment and/or diagnostic codes provided by treatment
and/or diagnostic code database 202 may be standardized codes, such as
Current Procedural Terminology (CPT) codes, hospital procedure codes,
and/or diagnostic codes. In some instances, the codes may not be
standardized (i.e., may be specific to a particular treatment provider or
treatment facility) and, in these instances, the codes may be translated
into a standard code like a CPT code by, for example, treatment
code/OMD matcher 206. As disclosed herein, the treatment and/or
diagnostic codes may be referred to as CPT codes, but those of skill in the
art will recognize that any coding naming convention may be used in lieu
of CPT codes.
[000149] Third-party medical literature database 204 may be any
database that stores medical literature, including, but not limited to, a
database operated by a subscription service, a library, and/or a publisher
that provides medical literature. Third-party medical literature database
204 may provide medical literature to the treatment code/OMD matcher
206. The medical literature provided by third-party medical literature
database 204 might include scientifically rigorous literature related to the
medical arts and sciences, as well as literature peripheral to the medical
arts and sciences. In most cases, the medical literature provided by third-
party medical literature database 204 is vetted and/or accredited by one or
more recognized medical authorities. The medical literature may be in any
language and, in instances where a base language is preferred (e.g.,
English), a translation mechanism (not shown) configured to translate the
medical literature into the base language may be included in system 200.
[000150] Medical literature is generally understood by those of skill in
the
art as literature of scientific nature that is peer reviewed. Sources of
medical literature include, but are not limited to, the Journal of the
American Medical Association, the Journal of the American College of
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Cardiology, and the New England Journal of Medicine. Medical literature
may also include information published by the National Institutes of
Health's Patient-Reported Outcomes Measurement Information System
(NIH PROMIS). NIH PROMIS provides compiled sets of questions that
may be included in, for example, patient-reported outcome (PRO)
instruments based on peer groups for specific medical or treatment
specialties who agree on the proper questions to include in a particular set
of questions designed to measure an outcome. These groups of
questions may, or may not, be specifically validated in peer-reviewed
medical literature. In many instances, third-party medical literature
database 204 will be continuously maintained and updated so that it
provides the most up-to-date medical literature and continuously evolves
over time to capture advances in the medical field and patient care.
[000151] As described above, OMD database 108 may store a plurality of
OMDs. The OMDs may be any treatment- or outcome-monitoring device
(or vehicle) for monitoring a patient's outcome from a treatment or
procedure, including the lack of a treatment (e.g., where the treatment is
not taking any affirmative action as may be the case with a "wait and see"
type of approach). In some instances, OMDs may be vetted by the
medical establishment (in, for example, the medical literature or by a
particular treatment provider or treatment facility) and/or via clinical
trials
as effective tools for measuring a treatment outcome or a patient's rate of
recovery from a particular medical treatment or procedure.
[000152] OMDs are typically designed to gather information from a
patient with regard to a particular medical condition he or she may have
and/or a treatment the patient has received. An OMD may be designed to
gather treatment outcome data over a short (e.g., hours or days), medium
(e.g., weeks or months), and/or long (e.g., months or years) period of time.
Additionally, or alternatively, an OMD may be designed to gather
information regarding a patient's condition prior to a patient receiving a
treatment or procedure so as to, for example, establish a baseline degree
of wellness for the patient. In most instances, OMDs are tailored to
specific treatments and/or diagnoses and their use may be
advised/directed by one or more articles of medical literature.
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[000153] As mentioned above, one example of an OMD is a patient
reported outcome ("PRO") instrument. PRO instruments may include a
questionnaire and other documentation that supports the use and/or
rationale of the questionnaire. Exemplary PROs include the Kidney
Disease Quality of Life Instrument, the National Eye Institute Visual
Functioning Questionnaire, the Epilepsy Surgery Inventory, the Adult
Asthma Quality of Life Questionnaire (AQLQ), the Migraine Specific
Quality of Life Questionnaire (MSQOL), the Ankylosing Spondylitis Quality
of Life Questionnaire (ASQOL), and the Seattle Angina Questionnaire, to
name a few. In the past, PRO instruments have been used to obtain
patient reported treatment outcomes within the specific circumstances of
an academic medical study.
[000154] OMDs may also include, for example, bio-chemical tests (e.g.,
blood tests, biopsies, etc.) and objective measures of patient performance
as may be provided by, for example, a lung capacity test, an oximeter, or
an EKG machine. In some circumstances, a plurality of OMDs may be
used to, for example, gather different types of data regarding a patient's
condition prior to, or following, the patient receiving a treatment, or an
array of treatments. For example, when obtaining treatment outcome
information regarding cardiothoracic surgery, relevant OMDs may include
a Intrathoracic Gas Volume test, a Total Lung Capacity test, a Vital
Capacity test, a 6 Minute Walk Test, an Aortic insufficiency test, a Mitral
regurgitation test, and/or an Aortic valve area test, as well as a number of
PRO instruments.
[000155] Treatment code/OMD matcher 206 may be communicatively
coupled to treatment and/or diagnostic code source 202, third-party
medical literature source 204, OMD data source 108, and matched
treatment code and OMD database 104. Treatment code/OMD matcher
206 may be configured to match medical literature provided by third-party
medical literature source 204 with one or more treatment and/or diagnostic
codes provided by treatment and/or diagnostic code source 202.
Treatment code/OMD matcher 206 may further be configured to match
one or more OMDs with relevant medical literature and/or
treatment/diagnostic codes. A data structure that stores matched, or
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indexed, OMDs and treatment/diagnostic codes, such as matched
treatment code and OMD data structure 104 may then be built, populated,
and/or updated.
[000156] In some embodiments, a particular treatment and/or diagnostic
code may be associated with information, an OMD, and/or one or more
sets of instructions that may be executed upon the occurrence of one or
more events described herein via, for example, one or more of processes
300-900 and 1600-2200. This association may be stored in, for example,
matched treatment code and OMD database 104, OMD database 108,
treatment and/or diagnostic code database 202, for use by, for example,
OMD selector 106 and/or treatment code/OMD matcher 206.
[000157] In some cases, treatment and/or diagnostic codes may be
related to one another, as may be the case when a treatment and/or
diagnostic code shares common characteristics with another treatment
and/or diagnostic code. When treatment and/or diagnostic codes share
common characteristics, they may be grouped together. The grouping
information may be stored in, for example, matched treatment code and
OMD database 104, OMD database 108, treatment and/or diagnostic code
database 202, for use by, for example, OMD selector 106 and/or treatment
code/OMD matcher 206.
[000158] In some embodiments, treatment and/or diagnostic codes may
also be grouped together to link multiple steps of a treatment together as
may be desired for a treatment that requires multiple steps (e.g., a multi-
step surgery or chemotherapy treatment) or for a treatment that has
multiple facets (e.g., a surgery that has facets of pre-operation
preparation, anesthesia, performance of the surgery, an implanted device,
etc.). At times, a treatment may also be associated with other treatments
as may be required to revise or redo a treatment, such as a revision of a
knee replacement surgery or a repeat of a chemotherapy regimen to treat
cancer.
[000159] Treatment and/or diagnostic codes that are linked together may
be associated with the same, or similar, OMDs and/or scoring procedures
for analyzing responses to respective OMDs. In some instances, when a
particular piece of medical literature associates a particular treatment
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and/or diagnosis with an OMD for determining a level of effectiveness for
the treatment/diagnosis, other treatment and/or diagnostic codes that are
in a group with the particular treatment/diagnosis may also be associated
with this OMD. In this way, OMDs may be associated with treatment
and/or diagnostic codes even when the medical literature relating to a
particular OMD does not provide for such an explicit association. For
example, treatment codes associated with various aspects and/or types of
eye/retinal surgery may share common characteristics that may be
assessed via the same OMD (e.g., the National Eye Institute Visual
Function Questionnaire PRO instrument). Thus, some, or all, treatment
and/or diagnostic codes associated with eye or retinal surgery may be
associated with a common OMD in the form of the National Eye Institute
Visual Function Questionnaire PRO instrument whether or not a specific
piece of medical literature mentions such an association is
appropriate/required.
[000160] On some occasions, treatment and/or diagnostic codes may
also be linked to relatively general or all-purpose types of OMDs, or
questions to be inserted into and/or added to an OMD or questionnaire.
For example, one or more treatment and/or diagnostic codes (whether in a
group or not) may be associated with a treatment/diagnostic code specific
OMD as well as one or more general OMDs, such as a general quality of
life questionnaire that includes, for example, questions regarding a
patient's general health (e.g., level of pain, mobility, and so on) or an OMD
related to a blood pressure reading or a patient's weight.
[000161] The one or more treatment and/or diagnostic codes and/or
OMDs may be associated with, for example, alternate terminology (e.g., a
medical specialty, medical subspecialty, and/or procedure type) that may
be used to refer to the treatment and/or diagnostic code, an OMD, and/or
an aspect thereof. For example, a CPT treatment code of 67101, which is
associated with a "repair of retinal detachment by diathermy" treatment,
may be associated with one or more clinician descriptors like "enucleation
of eye," or patient descriptors like "repair of detached retina," and/or other
terms like "eye," "optical," "ocular," "eye surgery," "vision,"
"ophthalmology," etc. This terminology may be used to, for example,
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search for a treatment and/or diagnostic code and/or OMD that matches a
natural language entry into, for example, a surgical scheduler, such as
scheduler 136 and/or EMR. This terminology may also be used to
communicate with patients, who are more familiar with terms like "eye
surgery" than terms like "repair of retinal detachment by diathermy,"
regarding their treatment and/or recovery, and/or completion of an OMD.
In some instances, this terminology may be used to populate forms for
communication to a particular patient, a health insurance provider of the
patient, and/or a treatment provider of the patient.
[000162] In some embodiments, an OMD may be associated with one or
more characteristics such as an abbreviated name and/or documents,
such as scoring procedures for the OMD, a list of questions for a
questionnaire associated with the OMD, a license or copyright for the
OMD, and/or medical literature related to the OMD. When an OMD is
associated with medical literature, the OMD may be linked to the relevant
piece (or pieces) of medical literature so as to facilitate provision of the
relevant medical literature to, for example, a treatment administrator,
treatment provider, and/or patient. On some occasions, the OMD may
also be linked with relevant patient characteristics such as age, gender,
race, and so on.
[000163] In some instances, an OMD may be linked with a set or rules for
scoring/interpreting responses to an OMD, which may be referred to
herein as a "scoring procedure" and, in some cases, one or more subsets
of rules for scoring the OMD. Subsets of rules for a scoring procedure,
which may be referred to herein as "a sub-scoring procedure" may be
defined by, for example, patient characteristics (e.g., age, race, gender) or
other factors/considerations. In some cases, these scoring procedures
may also be associated with threshold values (on a scale of, for example,
1-100 or A-F) for scores that may define various stages of recovery. In
some instances, these preferred values are provided to patient as a
minimum wellness descriptor, or minimum wellness score, a 50% wellness
score, and a full wellness descriptor, or full wellness score. Examples of a
minimum well score and a maximum wellness score for knee function are
provided by interface 1813 as discussed below with regard to FIG. 18N. A
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full wellness score may also be referred to as a maximum wellness score.
These threshold values for a particular patient may be adjusted based on,
for example, a subset of rules that are appropriate for the patient or other
considerations (e.g., comorbidities, patient- or doctor-specific goals, etc.).
Information about other considerations may be stored in, for example,
other considerations element 132. Examples of patient-facing interfaces
that provide various wellness scores are provided by interfaces 1800-1813
of FIGs. 18A-18N.
[000164] In some embodiments, components of the systems disclosed
herein may be geographically distributed or may comprise two or more
physical devices. For example, server 102 may be embodied as two or
more servers 102 that communicate, and cooperate, with one another to
execute one or more of the processes described herein. Additionally, or
alternatively, some components (or portions of components) of server 102
may reside in different geographic locations. In some embodiments, one or
more components (or portions thereof) of the systems described herein
may reside within a cloud-computing infrastructure (e.g., a public cloud or
a private cloud). Communication between one or more of the components
(or portions of components) of the systems disclosed herein may be made
via, for example, a communication network like the Internet, a secure
network, and/or virtual private network (VP N).
[000165] FIG. 3 provides a flow chart of an exemplary process 300 for
matching a treatment and/or diagnostic code with an OMD. Process 300
may be executed by, for example, treatment code/OMD matcher 206. In
step 305, treatment request information, treatment codes, and/or
diagnostic codes may be received by, for example, treatment code/OMD
matcher 206 from, for example, treatment and/or diagnostic code
database 202. In instances where the received codes are not standard or
recognized codes (e.g., not CPT codes), they may be translated into a
recognized code using, for example, natural language analysis and/or
machine learning and/or alternate terminology associated with one or
more of the known treatment codes. In step 310, the medical literature
may be received and/or accessed via, for example, third-party medical
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literature database 204. In step 315, a plurality of OMDs may be received
and/or accessed via, for example, OMD database 108.
[000166] In step 320, a determination may be made as to whether a
particular article of medical literature included within the
received/accessed medical literature mentions one or more OMDs. When
the particular article of medical literature does not mention an OMD,
process 300 may end. Step 320 may be performed by, for example,
employing an individual to read the medical literature and manually
associate a particular article of medical literature with one or more OMDs
and/or characteristics. Additionally, or alternatively, step 320 may be
performed by one or more automated processes including, but not limited
to, keyword searching, a semantic language analysis, and/or a natural
language analysis. In some embodiments, step 320 may include one or
more quality review processes, such as review of the medical literature
and/or determinations regarding the medical literature's discussion of
OMDs and other medical issues by skilled professionals. Exemplary
skilled professionals include, but are not limited to, doctors, nurses,
treatment facility administrators, and academics or researchers skilled in
one or more medical fields.
[000167] Next, in step 325, one or more treatment and/or diagnostic
codes that match the OMD discussed in the particular article of medical
literature analyzed in step 320 may be determined. In some
embodiments, execution of step 325 may include association of various
terms or phrases that relate to the OMD. In some embodiments,
execution of step 325 may include determining whether one or more
treatment and/or diagnostic codes that share common characteristics with
the treatment and/or diagnostic code mentioned in the medical literature
(but are not specifically mentioned in the medical literature) should also be
associated with the OMD. In some instances, these treatment and/or
diagnostic codes that share common characteristics with the treatment
and/or diagnostic code mentioned in the medical literature may be
grouped with the treatment and/or diagnostic code mentioned in the
medical literature.
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[000168] Then, in step 330, a data structure that indicates how the
OMD(s) discussed by a particular article of medical literature are matched,
or otherwise associated with, treatment and/or diagnostic codes may be
built, modified, or updated. One example of the data structure that may be
built, modified, or updated in step 330 is matched treatment/diagnostic
code and OMD data structure 104.
[000169] In step 355, it may be determined whether or not the OMD
(when, for example, the OMD is a PRO instrument) is associated with a
scoring procedure or sub-scoring procedure and/or whether the medical
literature mentions a scoring procedure and/or sub-scoring procedure that
should be used with the OMD and, if so, the scoring procedure and/or sub-
scoring procedure may be associated with the OMD in the data structure
built and/or updated in step 330 (step 340). Additionally, or alternatively
the scoring procedure and/or sub-scoring procedure may be associated
with the OMD and/or medical literature in a different data structure, such
as scoring procedure database 116.
[000170] When the OMD is not associated with a scoring procedure (step
335), or when step 340 has been completed, a request for an OMD may
be received by, for example, OMD selector 106 (step 345). The request
may be received from, for example, a treatment provider via, for example,
treatment facility computer system 134 and/or treatment provider device
124. The request may also be received from a patient via, for example,
patient device 128. In some instances, a request for an OMD may be
automatically triggered upon receipt of a request to schedule a treatment
at, for example, treatment facility computer system 134 and/or treatment
provider device 124. In other instances, a request for an OMD may be
received as part of a scheduled OMD patient follow-up program, wherein a
patient is scheduled to receive one or more OMDs over a period of time so
as to, for example, obtain information regarding the patient's condition with
regard to the treatment (or otherwise) over time. For example, a patient
who undergoes knee replacement surgery may be set up with a patient
follow-up program so that the patient receives an OMD immediately
following surgery, two weeks after surgery, four weeks after surgery, six
months after surgery, and so on. Requests for OMDs that match the
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schedule may then be received at step 345. In some embodiments, a
request for an OMD may be triggered when a billing or accounting entity
associated with the treatment provider requests pre-approval of payment
from an insurance company for a treatment prior to the treatment being
performed.
[000171] When a request for an OMD is received, the data structure built
and/or updated in step 330 may be accessed (step 350) so that one or
more OMD(s) that match one or more criteria (e.g., a treatment code,
diagnostic code, interval of time since the treatment was performed on
patient, etc.) of the request may be determined or selected (step 355).
The determined or selected one or more OMD(s) may then be provided to
the requester and/or patient (step 360). In some embodiments, execution
of step 355 may include determining a scoring procedure that is
associated with the one or more determined OMDs. In these
embodiments, execution of step 360 may also include providing the
scoring procedure to the requester. In instances where a plurality of
OMDs are determined to match the request, execution of steps 355 and/or
360 may include determining a preferred OMD out of the plurality of
OMDs, or a combination of preferred OMDs. In some instances, this
determination may include consideration of one of more preferences of, for
example, a treatment provider or treatment facility and/or analysis of a
particular patient's medical condition as may be provided by the patient's
EMR. In this way, a requester may not have to determine which is the
best OMD for a particular set of circumstances or treatment code.
Following step 360, process 300 may end.
[000172] Below is one example of how process 300 may be executed.
Initially, a diagnostic and/or treatment code for a transcatheter aortic valve
treatment which is associated with the American Medical Association
(AMA) CPT code of 33361-33366 may be received (step 305). The
medical literature and/or OMDs may be accessed to determine whether
there is medical literature and/or OMDs that mentions a diagnosis or
treatment associated with the transcatheter aortic valve treatment (steps
310 and 315).
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[000173] A determination may then be made that one or more PRO
instruments or other OMDs are mentioned in the medical literature with
regard to transcatheter aortic valves treatments (step 320). For example,
a PRO instrument associated with a transcatheter aortic valve treatment
and/or an underlying disease state or diagnosis may be found in the
medical literature along with one or more papers (i.e., articles of medical
literature) that validate use of the PRO instrument and/or the OMD found
in the search (step 325). An example of a paper that explains how a
transcatheter aortic valve is used in patients is Reynolds MR, et al.,
"Health-Related Quality Of Life After Transcatheter Aortic Valve
Replacement in Inoperable Patients with Severe Aortic Stenosis",
Circulation. 2011 Nov 1; 124(18): 1964-72, and an example of a validating
paper for a PRO instrument used in connection with a transcatheter aortic
valve is "Development and Evaluation of the Kansas City Cardiomyopathy
Questionnaire: A New Health Status Measure for Heart Failure", Journal of
the American College of Cardiology, Vol. 35, No. 5, 2000. The validating
paper may also explain how the PRO instrument should be used and/or
how responses to the PRO instrument should be evaluated to determine,
for example, an effectiveness of the medical treatment. Thus, the
validating paper may provide a scoring procedure and/or sub-scoring
procedure for the OMD.
[000174] A data structure may then be built and/or updated to associate
the PRO, a disease state or diagnosis being treated with the transcatheter
aortic valve replacement treatment, and/or the medical literature found to
be associated with transcatheter aortic valve replacement treatments (step
330). In some instances, the questions or other information from the PRO
instrument may also be added to the data structure. More specifically, in
this example the Kansas City Cardiomyopathy Questionnaire, CPT codes
33361-33366, the actual PRO questions of the PRO instrument found in
the medical literature, and/or a schedule for administering the PRO
instrument may all be added to the data structure.
[000175] Then, when a patient is scheduled for transcatheter aortic valve
replacement with prosthetic valve via percutaneous femoral artery
approach treatment (AMA CPT 33361), a request for an OMD (step 345)
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may be received in response to the scheduling of the transcatheter aortic
valve replacement treatment. The data structure may be accessed (step
350) in order to determine one or more OMDs that match the scheduled
treatment (i.e., Kansas City Cardiomyopathy Questionnaire) (step 355).
Then, the Kansas City Cardiomyopathy Questionnaire may be sent to a
requester (e.g., whoever scheduled the treatment) and/or the patient
automatically without any further input from, for example, a treatment
provider, treatment facility, or patient (step 360).
[000176] FIG. 4 provides a flowchart 400 of an exemplary process for
selecting an OMD to provide to and/or perform on a patient, providing the
OMD to the patient, and receiving a response thereto. Process 400 may
be executed by, for example, any of the systems, system components,
and/or combination of components, included therein.
[000177] In step 405, a trigger for communication of an OMD to and/or
performance on a patient may be received. In some embodiments, the
trigger may be a request to schedule a treatment for a patient and may be
received by, for example, scheduler 136 of treatment facility computer
system 134. In other embodiments, the trigger may be an explicit request
by, for example, a treatment provider and/or patient to communicate an
OMD to the patient.
[000178] Often times, the trigger is associated with and/or includes a
treatment code, or codes, such as a CPT code. In some embodiments,
execution of step 405 may involve the entering of a treatment code into the
EMR of the patient. In other embodiments, execution of step 405 may
require the manual entry of a treatment into a scheduler 136 or billing
program 138. At times, manually entered treatments may not include a
treatment and/or diagnostic code. For example, a treatment facility may
schedule a patient for a treatment or the accounting department of a
treatment facility may bill a client for a treatment without entering a
treatment or diagnostic code into the patient's EMR. The scheduling
and/or billing information may then be analyzed to determine which, if any,
treatment and/or diagnostic codes are appropriate. This determination
may be performed using, for example, natural language analysis and/or
machine learning and/or alternate terminology that may be associated with
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information treatment codes and/or diagnostic codes and/or information
entered into an EMR, a scheduler, and/or an accounting system. In some
instances, the scheduling and/or billing information may be analyzed and a
preliminary determination of the appropriate treatment and/or diagnostic
codes for the information may be determined. Optionally, a skilled
professional (e.g., nurse or healthcare administrator) may then review the
preliminary determination and make any necessary adjustments to the
treatment and/or diagnostic code determination. Then, one or more OMDs
may be matched to the determined and/or adjusted treatment and/or
diagnostic codes.
[000179] In step 410, a determination may be made as to whether the
EMR of the patient should be accessed. If so, the EMR may be accessed
(in step 415) in order to, for example, obtain information regarding the
medical history of the patient, prior treatment codes associated with the
patient, prior treatment providers associated with the patient, and/or a
treatment provider associated with the received request to schedule the
patient for the treatment. Otherwise, the process continues to step 420.
[000180] The treatment code (or another information associated with the
trigger received in step 405) may then be used to select one or more
OMDs to be communicated to the patient (step 420). In circumstances
where process 400 includes step 415, information included within the
patient's EMR may also be used to select the OMD to be communicated to
the patient. In many instances, the selected OMD will be a PRO, or
medical, questionnaire to be completed by the patient. In some
embodiments, the OMD selected for communication to the patient is a pre-
treatment, or pre-operation, OMD. Execution of step 420 may include
OMD selector 106 consulting matched treatment code and OMD database
104 to determine an OMD that matches one or more treatment codes
associated with the trigger received in step 405, and OMD selector 106
retrieving the determined OMD from OMD database 108.
[000181] In some embodiments, execution of step 420 may include
consulting medical literature directly. For example, once a treatment code
is received or understood from information received, a source of medical
literature, such as third-party medical literature database 204, may be
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searched to find one or more OMDs that match, or are grouped with, a
treatment code and/or a diagnostic code that is associated with the
treatment code. In some instances, when multiple OMDs are associated
with a particular treatment and/or diagnostic code, the process for
selecting the OMD to be provided to the patient may include determining
which is the best OMD to communicate to the patient based on, for
example, the patient's EMR, treatment provider preference, and/or
treatment facility preference.
[000182] Next, in step 425, the OMD may be provided to the patient. The
OMD may be provided to the patient via any appropriate means including,
but not limited to, providing a fillable form to the patient and/or
communicating the OMD to a treatment provider device, such as treatment
provider device 124 or a computerized device, such as patient device 128.
In some instances, the fillable form may be provided in a hard copy format
(i.e., printed on paper).
[000183] Responses to the OMD may then be received from the patient
(step 430). In some circumstances, these responses may be the results of
one or more tests or other physical examinations performed on the patient
as suggested and/or required by the selected OMD. In other
circumstances, the responses may be one or more answers to a
questionnaire (e.g., a PRO or medical questionnaire).
[000184] In step 435, the received responses may be associated with, for
example, the patient, and/or one or more of a treatment provider,
treatment code, and/or diagnostic code mentioned in, for example, the
trigger and/or the patient's EMR. These associations may be stored in, for
example, a data storage device such as OMD response database 110
(step 440). In some instances, OMD administrator 112 may perform some
or all of step 435.
[000185] In step 445, a determination may be made as to whether the
treatment provider should be notified that the OMD has been completed.
If so, the treatment provider is notified that the OMD has been completed
(step 450). Otherwise, the process ends. In some embodiments, receipt
of this notification may be required in advance of commencement of the
treatment to be scheduled and/or performed. For example, if a patient is
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scheduling a surgical procedure, the treatment provider may require the
patient to complete the OMD in advance of the patient receiving the
surgical procedure.
[000186] FIG. 5 provides an example of how process 400 may be
executed. In the example of FIG. 5, a diagnosis of a rotator cuff tear is
made (step 505) and the trigger that is received in step 405 is an entry of a
surgical repair for a rotator cuff tear with CPT codes of 23410, 23412,
23420, and 29287 and a hospital procedure ICD-9 code of 83.63 (step
510) into, for example, a scheduler like scheduler 136. It is then
determined, using a process similar to that of step 420, that possible
OMDs (indicated in FIG. 5 as PRO instruments) appropriate for these CPT
codes are the American Shoulder and Elbow Surgeons Shoulder
Assessment (ASES), the Simple Shoulder Test (SST), and the Oxford
Shoulder Score (OSS) (step 515). The best OMD for the treatment code
may then be selected as the ASES based on, for example, the patient's
EMR, treatment provider preference, most recently used OMD in the
medical literature, and/or treatment facility preference (step 520).
[000187] FIG. 6 provides another example of how process 400 may be
executed. Initially, before a treatment is performed, a treatment code
(shown as a CPT code in the figure) is entered into a patient's EMR (step
605) and the appropriate OMD/PRO instrument is deployed to the patient
(step 610). The patient then completes the OMD/PRO instrument and
submits his/her responses to the treatment provider and/or treatment
facility (step 615) and the EMR allows the treatment to commence (step
620). The information supplied by the patient in step 615 is communicated
to an OMD/PRO instrument management system (step 625). The
OMD/PRO instrument management system may be similar to server 102.
The OMD/PRO instrument management system may then communicate
the received information to the treatment facility computer system 134 for
quality assessment, quality improvement, and/or academic purposes (step
630). The OMD/PRO instrument management system may also
communicate the received information with the public via, for example,
patient device 128, so that members of the public may, for example, make
an informed selection of a treatment provider/doctor (step 635).
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[000188] FIG. 6 also provides for post-treatment OMDs/PRO instruments,
whereby a post-treatment OMD/PRO instrument is sent to a patient
following a treatment at, for example, a predetermined time that may be
specific to, for example, each treatment type (step 640). Patient
responses to the post-treatment OMDs/PRO instrument may then be
submitted to the PRO management system (step 645) and steps 630
and/or 635 may be repeated with the post-treatment OMD/PRO
information and/or a combination of the pre-treatment and post treatment
OMD/PRO information (as, for example, an improvement score and/or
effectiveness score as will be discussed below).
[000189] FIG. 7 provides a flowchart of a process 700 for determining a
baseline recovery vector and/or a modified recovery vector and building a
data structure including same. The recovery vector and/or modified
recovery vector may, in some embodiments, be used to determine an
improvement score, wellness score, effectiveness score, all of which will
be discussed below.
[000190] Process 700 may be executed by, for example, any of the
systems or any component, or combination of components, thereof
disclosed herein. In FIG. 7, baseline is used to indicate a "typical
measured value" (i.e., measurements aggregated/averaged over a large
pool of patients). To avoid any potential confusion, it is noted that in FIGs.
15A-C, baseline is used to indicate a "pre-treatment data point" (i.e., a
baseline measurement before a treatment, used as a reference point for a
measurement after a treatment).
[000191] In step 705, the indicators of recovery from a treatment may be
received or accessed. Additionally or alternatively, in step 705, medical
literature and/or a scoring procedure for a treatment may be accessed
and/or received. Step 705 may be similar to, for example, step 310.
When, for example, indicators of recovery from a treatment are not directly
received in step 705, the medical literature may be analyzed to determine
indicators of recovery from a variety of treatments (step 710). In some
embodiments, execution of step 710 may include analyzing the medical
literature to determine what types of OMDs are appropriate for a particular
treatment or diagnosis and may also be used to determine expected or
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preferred treatment outcomes (e.g., ranges of values for diagnostic tests
performed on a patient or ranges of values for responses by the patient to
a PRO instrument/questionnaire) at various stages in a process of
recovering from a treatment. For example, if the medical literature
pertains to hip replacement treatments, the medical literature may be
analyzed to determine expected indicators of recovery (i.e., milestones) for
the treatment such as pain management, mobility, rate of infection, etc. in
the recovery from a hip replacement and when these milestones should be
met. In some instances, execution of step 710 includes determining one
or more treatment and/or diagnostic codes that are relevant to a particular
article of medical literature and/or an indicator of recovery from a treatment
discussed therein.
[000192] In step 715, one or more user-configured indicators of recovery
from a treatment or treatments may be received from, for example, a
treatment provider, treatment facility, treatment administrator, and/or
patient. Exemplary user-configured indicators of recovery include, but are
not limited to, tests to be performed to gauge a level of recovery, ranges of
scores on tests that indicate a level of recovery, preferred OMDs to be
used to measure treatment outcomes, preferred timing for the delivery of
OMDs to a patient, preferred timing for the execution of a test on a patient,
and so on.
[000193] Then, in step 720, a baseline recovery vector for the particular
treatment may be generated using, for example, the medical literature,
received indicators of recovery, and/or user-configured indicators of
recovery. The baseline recovery vector may serve to indicate, for
example, an expected rate of recovery from a treatment, milestones to be
achieved when recovering from a treatment, ranges of values for OMD
responses relating to the treatment, indicators of improvement in the
recovery from a treatment, target values for indicators of improvement in
the recovery from a treatment, and so on. In one embodiment, a baseline
recovery vector may be determined on a numerical (e.g., 0-100) scale,
while in another embodiment recovery may be determined based on
milestones in a treatment recovery process. The baseline recovery vector
may establish a trajectory of milestones (indicator) for treatment recovery
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over time. In some instances, the baseline recovery vector may be used
to determine, for example, values relating to a minimum wellness
descriptor, or minimum wellness score, a 50% wellness score, and a full
wellness descriptor or maximum wellness score. Interface 1813 of FIG.
18N, as discussed below, provides an example of a minimum and
maximum wellness score for knee function. The baseline recovery vector
may also incorporate various non-linear factors in recovery from a
treatment. For example, a baseline recovery vector for complex back
surgery may incorporate the relatively slow rate of recovery from potential
nerve damage caused by the surgery and the relatively faster rate of
recovery for mobility from the same surgery.
[000194] Optionally, when a treatment has contributing factors (step 722)
one or more contributing factors for the treatment and/or an underlying
diagnosis may be determined (step 725). On occasions when a treatment
has no contributing factors (step 722), process 700 may proceed directly
from step 720 to step 740. Exemplary contributing factors include, but are
not limited to, weight, age, gender, pre-existing conditions, and
comorbidities. Information regarding contributing factors may be stored in,
for example, a database like other considerations database 132 and/or
scoring procedure database 116
[000195] Then, in step 730, it may be determined how the one or more
contributing factors for the treatment and/or an underlying diagnosis may
impact the baseline recovery from the treatment. A particular treatment
may have more than one contributing factor and the determination of step
730 may incorporate determinations of relationships between one more
contributing factor and recovery.
[000196] The baseline recovery vector generated in step 720 may then be
modified to incorporate the one or more contributing factors (step 735).
Modification of the baseline recovery vector may include, for example,
increasing or decreasing the expected rate of recovery from the treatment,
adding or subtracting milestones from a recovery trajectory, modifying a
range of values for OMDs relating to the treatment, adding or subtracting
indicators of improvement in the recovery from a treatment, adjusting
target values for indicators of improvement in the recovery from a
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treatment, and so on. In many instances, steps 722, 725, 730, and/or 735
may be performed via accessing and/or analyzing the medical literature
received in step 705.
[000197] In step 740, a data structure including baseline and/or modified
recovery vector(s) may be built, edited, and/or updated to include the
baseline recovery vector and/or modified baseline recovery vector
generated in, for example, steps 720 and/or 735.
[000198] In some instances, one or more steps of process 700 may be
executed on an as-needed basis. In other instances, one or more steps of
process 700 may be executed at a preferred time so that the data
structure built/edited in step 740 may be accessed by one or more
components to, for example, execute a wellness protocol for a patient,
determine an improvement score, determine a wellness score, determine
an effectiveness score as discussed below. In some embodiments, the
baseline recovery vector and/or modified baseline recovery vector may be
stored in, for example, score database 120, scoring procedure database
116, and/or patient information database.
[000199] FIG. 8 provides a flowchart of a process 800 for generating
and/or modifying a wellness protocol for one or more treatments. Process
800 may be executed by, for example, any of the systems or any
component, or combination of components, thereof disclosed herein.
[000200] In step 805, the medical literature may be received. Execution
of step 805 may resemble execution of, for example, steps 310 and/or
705. A treatment code, diagnostic code, and/or other indicator for a
treatment may also be received (step 810). Exemplary other indicators for
a treatment include the scheduling of a treatment in a treatment provider's
scheduling program or entry of a treatment into a treatment provider's
billing or accounting program. Next, one or more OMDs and/or
questionnaires relevant to the treatment code, diagnostic code, or
treatment indicator may be determined (step 815). Execution of step 815
may involve execution of one or more steps of process 300 and/or 400.
[000201] In step 820, a schedule for delivery of the OMDs and/or
questionnaires to a patient, or group of patients, who has/have undergone,
or who is/are expected to undergo, a treatment associated with the
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treatment code, diagnostic code, or treatment indicator may be
determined. In some embodiments, step 820 may also include
determining when, or how, to access a patient's EMR to check for different
types of information such as test results or other measurements that may
be included in the patient's EMR. For example, the schedule may
determine that a patient's EMR should be checked at various intervals pre-
and/or post-treatment in order to determine lab results or other information
in order to, for example, track recovery from the treatment.
[000202] In step 825, a wellness protocol for a treatment associated with
the treatment code, diagnostic code, or treatment indicator may be
generated based on the determined schedule. The wellness protocol may
establish, for example, which types of OMDs are to be delivered to a
patient, when the OMDs are to be delivered to a patient, when a patient's
EMR should be accessed to retrieve test results, when a patient and/or
treatment provider should be reminded to administer and/or complete an
OMD, feedback mechanisms for a patient, treatment provider, and/or
treatment facility associated with the treatment, and so on.
[000203] In some embodiments, generation of a wellness protocol (step
825) may include incorporating one or more scoring protocols associated
with the OMDs incorporated into the wellness protocol. Additionally, or
alternatively, step 825 may also incorporating one or more baseline
recovery vectors and/or modified recovery vectors into the wellness
protocol.
[000204] Optionally, it may be determined whether there are any factors
that contribute to the treatment and/or recovery for a patient (step 830).
Exemplary contributing factors include, but are not limited to, weight, age,
gender, pre-existing conditions, medications, and comorbidities. When
there are contributing factors, it may be determined how the one or more
contributing factors for the treatment and/or an underlying diagnosis may
impact recovery from the treatment (step 835). The wellness protocol may
then be modified to incorporate the one or more contributing factors (step
840). Modification of the wellness protocol may include, for example,
increasing or decreasing a number of OMDs scheduled for delivery to a
patient, changing an OMD to be delivered to a patient, modifying when the
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OMDs are delivered to a patient, and so on. In many instances, steps 830
and/or 835 may be performed via accessing and/or analyzing the medical
literature received in step 805.
[000205] In step 845, a data structure including wellness protocol and/or
modified wellness protocol may be built, edited, and/or updated to include
the wellness protocol and/or modified wellness protocol generated in, for
example, step 825 and/or modified in step 840. Step 845 may be
executed when there are no contributing factors (i.e., following the NO
branch of step 830).
[000206] In some instances, one or more steps of process 800 may be
executed on an as-needed basis (e.g., in response to a request for a
wellness protocol for a particular patient). In other instances, one or more
steps of process 800 may be executed at a preferred time so that the data
structure built/edited in step 845 may be accessed by one or more
components to, for example, design and/or execute a wellness protocol for
a group of patient and/or recipients of a treatment.
[000207] FIG. 9A provides a flow chart of a process 900 for generating
and/or modifying a wellness protocol for one or more treatments. Process
900 may be executed by, for example, any of the systems or any
component, or combination of components, thereof disclosed herein.
[000208] In step 905, a request to generate a wellness account for a
patient may be received. The request may be received from, for example,
the patient, a treatment provider for the patient, a caregiver of the patient
(e.g., spouse or nurse), and/or a treatment facility. In some instances,
requests to generate a wellness account for a patient may be a component
to scheduling a treatment and/or recovering from a treatment. For
example, when a patient is scheduled for a surgery, part of the scheduling
process may include requesting (automatically or otherwise) generation of
a wellness account for a patient. The request may be received by, for
example, reporting module 122 and may be received from, for example,
patient device 128, treatment provider device 124, and/or treatment facility
computer system 134. Often times, the request will include information
about one or more treatments and/or diagnosis relevant to the patient. In
some embodiments, the request received in step 905 may be received
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from the patient via a software application running on his or her patient
device. The software application may be downloaded to the patient device
via an available method (e.g., activating a hyperlink, downloading from a
software selling platform, etc.).
[000209] In step 910, information about the patient may be received.
Information received in step 910 may include information regarding the
health of the patient and any factors contributing to the health of the
patient, treatment performance, or treatment recovery. Information about
the patient may be received from, for example, the patient's EMR, the
patient, the requester of step 905, a treatment provider, and/or a treatment
facility. Information about the patient may include, for example, age,
gender, comorbidities, whether or not the patient smokes, and so on. In
step 915, one or more factors that may contribute to the wellness and/or
recovery from a treatment may be determined based on, for example, the
information received in step 910 and/or the request.
[000210] Optionally, in step 920, a user and/or patient preference may be
received. Exemplary users are the requester of step 905, a treatment
provider, and/or a treatment facility. Exemplary patient and/or user
preferences include preferred aspects of the patient's wellness to monitor
via the wellness account, preferred treatment outcomes, preferred aspects
of the wellness account (e.g., whether reminders to interact with the
wellness account should be provided to the patient, preferred manners of
interacting with the wellness account, etc.), and so on. At times the user
and/or patient preference received in step 920 may relate to a scoring
procedure and/or modification of a baseline recovery vector to be applied
when scoring responses to OMDs responses received from the patient
and/or included in the patient's EMR. For example, a professional athlete
may have different recovery goals than a 75-year old man when
recovering from knee surgery and these varying recovery goals may be
received at step 920 for inclusion in the patient's wellness account and/or
a manner of scoring OMD responses received in connection with the
patient's wellness account.
[000211] Optionally, in step 925, a data structure that includes one or
more pre-generated wellness protocols, baseline recovery vectors, and/or
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modified baseline recovery vectors may be accessed and a wellness
protocol and an associated baseline recovery vector and/or modified
baseline recovery vector may be selected for the patient using, for
example, the information received and/or the determination of steps 905-
920 (step 930). Exemplary data structures accessed in step 925 are the
data structures built or modified in via execution of processes 700 and/or
800.
[000212] In step 935, a wellness account for the patient may be
generated. When steps 925 and 930 are executed, generation of the
wellness account in step 935 may include the assembly of the wellness
protocol and associated baseline recovery vector(s) and/or modified
baseline recovery vector(s) selected in step 930 into a wellness account
for the patient. When steps 925 and 930 are not executed, step 935 may
be executed by assembling information received and/or the determination
of steps 905-920 into a wellness account for the patient. In step 940, the
wellness account may be provided to the patient. Typically, the wellness
account will be provided to the patient via the patient's device, such as
patient device 128. In most cases, the wellness account will be provided
to the patient with a login requirement or other security protocol so as to
keep the information of the patient's wellness account private and secure.
[000213] Optionally, in step 945, it may be determined whether a
modification to the patient's wellness account is necessary or preferred.
When no modification to the patient wellness account is necessary or
preferred, process 900 may end. Modifications to the patient's account
may be necessary or preferred when, for example, the patient's health or
wellness changes (e.g., weight gain, medication change, smoking
cessation, etc.), when a wellness protocol and an associated, baseline
recovery vector, and/or modified baseline recovery vector associated with
the patient's wellness account is changed or modified, when a treatment
for the patient changes (e.g., change in medication or therapy regimen), a
new patient or treatment provider preference, and so on. When
modification to the patient wellness account is necessary or preferred, the
wellness account may be modified to accommodate whatever prompted
the determination that modification to the patient wellness account is
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necessary or preferred (step 950). At times, step 950 may be performed
in response to information received at step 945 (e.g., a notification that the
wellness account should be modified). In some instances, step 950 may
be performed using information accessed about the patient from, for
example, the patient's EMR and/or treatment provider. In some instances,
modification of the patient's wellness account may be triggered by a
change to the patient's EMR or a treatment provider protocol. For
example, if a treatment provider protocol changes to incorporate a new
medication or device into the treatment of a particular condition, the
patient's wellness account may be automatically modified to reflect it.
Likewise, if a change to a patient's EMR is made (e.g., a new allergy or
event (e.g., a cardiac event or a broken bone)) the patient's wellness
account may be automatically modified to reflect same. In some
instances, execution of step 950 may include re-executing steps 915, 925,
and/or 930 and/or prompting the patient to enter information into the
wellness account. In some embodiments, steps 945 and 950 may be
executed at a time considerably later than completion of step 940. For
instance, a patient's wellness account may be modified over the course of
days, months, years, and/or decades to keep pace with the patient's
changing medical condition over his or her lifespan. Following step 950,
the modified wellness account may be provided to the patient (step 955) in
a manner similar to that described with regard to step 940 and process
900 may end.
[000214] FIG. 9B provides a flowchart that illustrates an exemplary
process 901 for associating an OMD with a patient's wellness account and
determining a wellness score using a set of responses to the OMD.
Process 901 may be executed by, for example, any of the systems,
system components, or of system combination of components thereof
disclosed herein.
[000215] Initially, information (e.g., name, date of birth, address, social
security number, phone number, email address, etc.) regarding a new
(e.g., new to the treatment provider and/or treatment facility) patient, a
request to access information regarding an existing patient, and/or a
request to access a wellness account of an existing patient may be
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received (step 960). In some instances, the information regarding a new
patient received in step 960 may be used to establish and/or generate a
wellness account for the patient and/or preferences (e.g., language, mode
of communication with the patient, etc.) for the wellness account. In some
instances, the received request may be a search query. In many cases,
information regarding a new patient may be received from a treatment
provider and/or a person (e.g., nurse or administrative assistant) working
with the treatment provider via an interface like new patient data entry
interface 2301 of FIG. 23A, which provides a list 2308 of new patient data
entry fields for the new patient's first name, last name, date of birth,
social
security number, cell phone number, and email address. Of course, list
2308 not exclusive of new patient data that may be entered. For example,
list 2308 may include options to enter more/fewer and/or different types of
new patient data (e.g., care giver phone number, age, etc.). Information
regarding a search for an existing patient may be received via a patient
search interface like patient search interface 2302 of FIG. 23B. In the
case of interface 2301, a request for information regarding a patient with
the last name of Smith has been received (step 960).
[000216] Then, in step 962, a request to associate one or more OMDs
with the patient's wellness account and/or a request to modify an
association of an OMD with a patient's wellness account may be received
via, for example, an interface like interface 2303 of FIG. 23C. In the
example of interface 2303, the patient wellness account is for a patient
named Karen Smith who has a birthdate of December 28, 1979. Interface
2303 provides an array 2310 of scheduling buttons: monthly scheduling
button 2315A, quarterly scheduling button 2315B, biannually scheduling
button 2315C, and yearly scheduling button 2315D for the monthly,
quarterly, biannually, and yearly scheduling of the provision of a global
health OMD, a disease-specific OMD, or other questionnaire, to the
patient.
[000217] Interface 2303 also provides and an array 2320 of exemplary
disease specific buttons 2325A-2325R. Each of the disease specific
buttons 2325A-2325R is associated with one or more diseases,
symptoms, or medical conditions as well as one or more
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disease/symptom/medical condition specific OMDs to be provided to a
patient. Selection of one or more of disease specific buttons 2325A-
2325R facilitates association of the disease/symptom/medical condition
with the patient (via, for example, saving the association in the patient's
EMR) and association of the OMD(s) associated with the selected disease
specific buttons 2325A-2325R with the patient's wellness account so that
the respective OMD(s) may be provided to the patient at an appropriate
time and, in some instances, repeatedly provided to the patient at following
expiration of a pre-determined time period (e.g., day, week, month, year,
etc.) that may be established via selection of, for example, monthly
scheduling button 2315A, quarterly scheduling button 2315B, biannually
scheduling button 2315C, and yearly scheduling button 2315D.
[000218] In the example of interface 2303, array 2320 provides exemplary
disease specific buttons for atrial fibrillation 2325A, anxiety 2325B,
arthritis
2325C, asthma 2325D, back pain 2325E, benign prostatic hyperplasia
("BPH") 2325F, chronic pain 2325G, congestive heart failure ("CHF")
2325H, chronic obstructive pulmonary disease ("COPD") 23251, coronary
artery disease ("CAD") 2325J, depression 2325K, eczema 2325L, fatigue
2325M, gout 2325N, headache/migraines 23250,
heartburn/gastroesophageal reflux disease ("GERD") 2325P, inflammatory
bowel 2325Q, and osteoporosis 2325R. Array 2320 may provide any
appropriate number of disease specific buttons and, in some instances;
the disease specific buttons provided by array 2320 may be tailored for a
particular doctor or treatment provider preference. For example, if the
treatment provider is a cardiologist, then array 2320 may display disease
specific buttons that represent diseases that are common to the heart.
Likewise, if the treatment provider is a pediatrician, then array 2320 may
display disease specific buttons that represent diseases that are common
to the children. In other instances, the disease specific buttons provided
by array 2320 may be tailored for a patient, patient characteristic, or
treatment the patient has undergone. For example, if the patient is a 75-
year-old male, then array 2320 may display disease specific buttons that
represent diseases that are common to 75-year-old males. In another
example, if the patient has undergone a heart transplant, then array 2320
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may display disease specific buttons that represent diseases/conditions
that are common to heart transplant recipients. In some embodiments,
step 962 may be executed upon receiving a selection of one or more
disease specific buttons 2325A-2325R.
[000219] Next, in step 964, one or more OMDs may be associated with
the patient's wellness account responsively to the request received in step
962. For example, FIG. 23D shows an exemplary global health OMD
management interface 2304, which provides the treatment provider with
information regarding how often (in this case quarterly) the global health
OMD is provided to the patient as well as a message regarding when the
global health OMD has been sent, when the next global health OMD will
be sent, and an option to modify the scheduling of provision of the global
health OMD to the patient. Quarterly provision of the global health OMD to
the patient (in this case, Karen Smith) may be responsive to selection of
quarterly scheduling button 2315B on interface 2303, as shown on
interface 2304 of FIG. 23D.
[000220] In some embodiments, selection of one or more disease specific
buttons 2325A-2325R (step 962) may initiate association of an OMD
associated with the disease represented by the disease specific button to
be associated with the patient's (Karen Smith's) wellness account and/or
be provided to the patient (Karen Smith). FIG. 23E shows interface 2305,
which provides a list 2340 of current disease specific trackers associated
with the patient, Karen Smith. More particularly, list 2340 shows current
disease specific trackers for anxiety 2345A, depression 2355B, and
eczema 2345C, which were added to Karen Smith's wellness account
following selection of the anxiety disease specific button 2325B, the
depression disease specific button 2325K, and the eczema disease
specific button 2325L. List 2340 also provides a number of options 2350
for adding information to and/or modifying the patient's wellness account
with regard to each of the selected disease specific trackers. The options
2350 may be general to all disease specific trackers and/or specific to a
particular disease specific tracker. Exemplary options include 1) change
dose of medication, 2) add new medication, 3) add new treatment, and 4)
cancel tracking this diagnosis.
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[000221] In some embodiments, a treatment provider may associate one
treatment for a disease with a patient's wellness account (step 962) via an
interface like disease specific treatment interface 2306 of FIG. 23F.
Continuing the example of patient Karen Smith, upon selection of disease
specific tracker for anxiety 2345A, interface 2360 provides a list 2360 of
various treatments specific to the selected disease (i.e., anxiety). In this
example, list 2360 provides treatment selection buttons for treatment A
2365A, treatment B 2365B, treatment C 2365C, treatment D 2365D, and
treatment E 2365E. It will be understood by those of skill in the art that
treatments listed in list 2360 may be any form of treatment (e.g.,
medication, physical therapy, etc.) or dosage/frequency of treatment. In
most situations, the treatment selection buttons provided by list 2360 will
be specific to the disease/diagnosis associated with the selected disease
specific tracker but this need not always be the case.
[000222] In some instances, one or more of the treatments selected from
list 2360 may be used to select an OMD provided to the patient and/or
how a scoring procedure is applied to a set of responses to the OMD
received from the patient. Disease specific treatment interface 2306
provides a list 2360 of various treatments specific to the selected disease.
[000223] Once information that may be used to request/select an OMD
for provision to a patient is received from a treatment provider via, for
example, interaction with one or more of interfaces 2301-2306, the
requested/selected OMD may be associated with the patient's wellness
account (step 964) and the requested/selected OMD may be provided to
the patient via his or her wellness account as described herein (step 966).
Once the OMD is provided to the patient, a notification of such may be
provided to the treatment provider (step 968). FIG. 23 provides an
exemplary notification interface 2307 that demonstrates that an OMD
associated with anxiety and treatment B (the treatment from list 2360
selected by the treatment provider) has been sent to the patient, Karen
Smith.
[000224] Optionally, in step 970, the patient's wellness account and/or
EMR may be updated to indicate which OMD(s) are/have been associated
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with the patient's wellness account and/or which diagnosis and/or
treatment are/have been associated with the patient's wellness account.
[000225] In some embodiments, a patient's wellness account may be
portable between different treatment providers and/or treatment
administrators. For example, a patient may be able to share his or her
wellness account information with more than one treatment provider even
if the two or more treatment providers are not associated with the same
treatment facility and/or treatment administrator as may be the case when,
for example, a patient moves his or her residence from one location to
another or changes doctors or networks of doctors.
[000226] The portability of a patient's wellness account may be aided
when information included in the wellness account, such as a personal
medical history, is stored in patient information database 142 and/or score
database 120 and may be accessible via server 102 without requiring
server 102 to access patient EMR data in patient EMR database 130
and/or treatment facility computer system 134.
[000227] FIGs. 10A and 10B provide flowcharts that illustrate an
exemplary process 1000 for providing one or more of a pre-treatment
wellness score, post-treatment wellness score and an improvement score
to a patient, treatment provider, treatment facility and/or treatment
administrator. Process 1000 may be executed by, for example, any of the
systems and/or system components disclosed herein. In some instances,
execution of some or all steps of process 1000 may be referred to herein
as a recovery tracker or a wellness tracker. Often times, some, or all of
process 1000 may be facilitated by a software application running on the
patient's device (e.g., a smart phone or tablet computer) such as, patient
device 128 and the patient may interact with the software application via
an interface (e.g., touchscreen or keyboard) provided by the patient
device.
[000228] In some embodiments, process 1000 and/or portions of process
1000 may be executed with regard to and/or with assistance with a
patient's wellness account as generated by, for example execution of
processes 800 and/or 900 and described above with regard to FIGs. 8 and
9. Exemplary screenshots of interfaces that may be provided to a patient
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via his or her wellness account during execution of process 1000 and/or
portions of process 1000 are provided by FIGs. 17A-17G and 18A-18N,
which will be discussed in detail below with regard to these figures.
[000229] In some instances, a patient wellness account for the patient
may be set up by, for example, a treatment provider in advance of, or
following, the patient undergoing a particular treatment. In other
instances, the patient may sign up for his or her patient wellness account
independently of a treatment provider. Often times, the patient wellness
account for the patient will include information about the patient that is
relevant to the particular treatment or health condition. Optionally, in step
1005, an indication of an activation of a patient wellness account may be
received. In some instances, the indication may also include patient
identifying information and/or login information (e.g., username and
password) that comply with one or more security protocols. In some
instances, the indication received in step 1005 may be activation of an
icon, such as "wellness tracker" icon 1710 provided by a user interface,
such as home page interface 1700 of FIG. 17A.
[000230] Following the receipt of the patient's login information and
verification of same, access to the patient's wellness account may be
provided, via, for example, display of a landing page to the patient (step
1010). An exemplary landing page is provided by interface 1701 displayed
in FIG. 17B. Interface 1701 may provide patient information designed to
orient the patient to the patient account. For example, interface 1701
includes the patient's name (in this instance, Kate), a welcome message,
the name of the patient's doctor (in this instance, Dr. Rob Hilleran), a date
the treatment was administered, and an estimate of how long responding
to the OMD (usually in the form of a questionnaire) may take.
[000231] Whether or not steps 1005 and/or 1010 are performed, in step
1015, one or more OMDs, typically in the form of a questionnaire, to be
provided to the patient may be determined (step 1015). In one
embodiment, the determination of the OMD to provide to the patient may
be made via execution of some of process 300 as discussed above with
regard to FIG. 3 and/or execution of steps 405-430 of process 400 as
discussed above with regard to FIG. 4. In some embodiments, the OMD
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may be provided to the patient following a scheduling of the patient's
treatment. In such case, an identifier of the scheduled treatment may be
determined (e.g., a treatment identifier), and such treatment identifier may
be used as a key to look up a corresponding OMD in an OMD database (in
which OMDs and/or questionnaires are indexed by treatment identifiers).
The OMD/questionnaire database may be part of OMD database 108 in
FIG. 1.
[000232] In some environments, one or more OMDs to be provided to the
patient may be determined, or otherwise set up, as part of a
recovery/wellness tracker schedule when a patient wellness account is set
up and/or when a treatment is scheduled or performed. For example, a
schedule of OMDs may be established for a patient based on a treatment
the patient will receive and/or one or more other factors that may influence
a patient's recovery from the treatment. This determination may be
dependent upon, for example, OMDs deemed by, for example, the medical
literature, a treatment facility, a treatment provider, and/or the patient to
be
relevant to assessing the patient's treatment and/or recovery from
treatment.
[000233] Step 1015 may be executed by, for example, OMD selector 106.
In some embodiments, the OMD to be sent to the patient may be sent to
the patient's device, such as patient device 128, for storage and later
display to the patient. The OMD may be sent to the patient's electronic
device on, for example, an as-needed basis (e.g., in response to a request
from the patient's device for a OMD) and/or as a batch of OMDs that are
part of a previously determined recovery/wellness tracker program for a
particular treatment the patient has undergone. In one embodiment, the
OMD is provided to the electronic device of the patient while the patient is
not located within a treatment facility.
[000234] In one embodiment, step 1015 may include accessing an OMD
database (e.g., OMD database 108) that stores a plurality of OMDs. In the
database, each of the medical OMDs may be indexed with a treatment
identifier. Determining which OMD to provide may include determining an
identifier of the scheduled treatment, and selecting the OMD that is
indexed by the identifier of the scheduled treatment.
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[000235] In some instances, the OMD is at least one of a standardized
PRO instrument recommended by the medical literature, a medical
symptom OMD, a disease-specific medical symptom OMD, a global
medical symptom OMD, and a PRO questionnaire. In some instances, the
OMD uses computerized adaptive testing.
[000236] Additionally, or alternatively, the OMD selected for presentation
to the patient may be dependent on where, in the treatment cycle, the
patient is. For example, a first OMD may be scheduled for the initial OMD
and a second OMD may be scheduled for provision to the patient following
a predetermined time period (e.g., 1 week or 2 months from treatment
date).
[000237] In some embodiments, the determination of step 1015 may be
responsive to input from the patient. For example, the patient may request
to receive an OMD while logged into his or her patient account via, for
example, a user interface that provides one or more options for selecting
an OMD. Patients may wish to request provision of an OMD in order to,
for example, track their wellness with regard to one or more symptoms or
treatments that may, or may not, be part of the treatment and/or diagnosis
for which the patient wellness account is set up. For example, a patient
who is recovering from foot surgery (and has had a wellness account
established for tracking the patient's wellness with regard to the foot
surgery) may also wish to track his or her vision, eye wellness, and/or
memory. The patient may do this by requesting provision of OMDs that
relate to vision, eye wellness, and/or memory even though these OMDs do
not relate to the foot surgery for which the patient wellness account is set
up. In this way, the patient may monitor their wellness with, or without, the
supervision of their treatment provider, treatment facility, or treatment
administrator. In some instances, the patient account may not be
associated with a treatment provider, treatment facility, or treatment
administrator and may be completely run and managed by the patient him
or herself.
[000238] In step 1020, the determined OMD may be provided to the
patient before the patient receives a treatment for a medical condition.
The OMD may be in any appropriate format and may attempt to ascertain
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a patient's state of health (e.g., how far the patient can walk, how much
pain does the patient experience, the patient's mood, etc.).
[000239] FIGs. 17C-17E show exemplary OMDs in the form of
questionnaires that may be provided to the patient via interfaces 1702,
1703, and 1704, respectively when step 1020 is executed. For example,
interface 1702 provides a question 1720 to the patient (who is scheduled
to receive a hip replacement treatment) "after 6-9 blocks (about 1 mile)
please describe how you would walk." Interface 1702 then provides a
number of options/answers 1730 the patient may select to indicate his or
her answer to the question. Interface 1703 asks two questions 1720
regarding "how much trouble do you have with... 1) "stiffness in your hip?"
and 2) "decreased motion of your hip" and provides two sets of possible
answers 1730, one for each question, in the form of a ranking of none (1)
to extreme (5).
[000240] Interface 1704 presents an introductory paragraph 1750 that
explains the questions to be completed in interface 1704 and provides
directions for answering the questions. For example, the introductory
paragraph 1750 of interface 1704 states: The following questions concern
your physical function. By this we mean your ability to move around and
look after yourself. For each of the following activities please indicate the
degree of difficulty you have experienced in the last week due to your hip."
Interface 1704 then provides two questions 1720: 1) "descending stairs"
and 2) "ascending stairs," and provides two sets of possible answers 1730,
one for each of the questions, in the form of a ranking from none (1) to
extreme (5).
[000241] Next, in step 1025, a pre-treatment set of responses to the OMD
may be received before the patient receives the treatment. In one
embodiment, the pre-treatment set of responses may be stored in a
registry, which is specific to the medical condition (i.e., a disease-specific
registry). Such disease-specific registry may compile responses from a
plurality of patients who are being treated for a similar medical condition.
In one embodiment, a determination may be made as to whether the pre-
treatment set of responses answers all questions of the OMD. If not, a
prompt may be provided to the patient, which requests all questions of the
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OMD to be answered. The received pre-treatment set of responses may
then be stored and/or saved (step 1030). Storage of the pre-treatment set
of responses may include, for example, associating the pre-treatment set
of responses with the patient's wellness account. In some instances,
execution of step 1030 may include communicating the pre-treatment set
of responses to, for example, HIPAA compliance server 126, treatment
facility computer system 134, and/or server 102 for processing and/or
indexing. Storage of the pre-treatment set of responses may include, for
example, indexing the pre-treatment set of responses with, for example,
the patient's wellness account and/or EMR, one or more treatment
providers, treatments, and/or treatment facilities.
[000242] The pre-treatment set of responses may be scored using, for
example, a scoring procedure associated with the OMD provided in step
1015 in order to determine a pre-treatment wellness score for the medical
condition (step 1035). Step 1035 may be executed by, for example, the
patient device and/or a server like server 102. In some instances,
execution of step 1035 may include retrieving a scoring procedure from
scoring procedure database 116 using an identifier of the OMD. For
instance, an OMD may have an associated code (e.g., 2232), and such
code may be used to retrieve a scoring procedure from scoring procedure
database 116. Example scoring procedures include taking an average of
all the patient responses (e.g., assuming all responses are numeric),
taking a weighted average of the patient responses (e.g., weighting certain
responses higher than other responses), adjusting the range of patient
responses (e.g., changing responses choices from 1, 2, 3 to 1, 4, 6). In
some embodiments, execution of step 1035 also includes retrieval of a
sub-scoring procedure that may be specific to the patient (i.e., associated
with the patient's account or a co-morbidity of the patient) as may be
indicated by, for example, the patient's wellness account and/or EMR.
[000243] In step 1040, the pre-treatment wellness score may be stored.
Storage of the pre-treatment wellness score may include, for example,
associating the pre-treatment wellness score with the patient's wellness
account. In some instances, execution of step 1030 may include
communicating the pre-treatment wellness score to, for example, HIPAA
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compliance server 126, treatment facility computer system 134, and/or
server 102 for processing and/or indexing. Storage of the pre-treatment
wellness score may include, for example, indexing the pre-treatment
wellness score to, for example, the patient's wellness account and/or
EMR, one or more treatment providers, treatments, and/or treatment
facilities. After step 1040 and before step 1045, the patient may receive a
treatment for his/her medical condition.
[000244] In step 1045, a second, or post-treatment OMD may be provided
to the patient after the patient receives the treatment for the medical
condition. In some embodiments, the OMD provided in step 1045 is
identical to the OMD provided in step 1020, allowing for responses to the
twice-administered OMD to be compared. In other embodiments, the
OMD provided in step 1045 is not identical to the OMD provided in step
1020 when, for example, additional questions are added to the OMD (e.g.,
questions that are appropriate post-treatment but not pre-treatment,
questions that address a change in the patient's overall health, medical
condition, and/or treatment recovery, and so on). In these embodiments,
the questions of, and/or information requested by, the OMD provided in
step 1045 that are identical to the questions of, and/or information
requested by, the OMD provided in step 1020 may be directly compared;
and OMD provided in step 1045 that are not identical to the questions of,
and/or information requested by, the OMD provided in step 1020 may be
separately scored and/or otherwise accounted for.
[000245] In step 1050, a post-treatment set of responses to the OMD
provided in step 1045 may be received from the patient. In one
embodiment, the post-treatment set of responses may be stored in the
disease-specific registry. Further, a determination may be made as to
whether the post-treatment set of responses answers all questions of the
OMD. If not, a prompt may be provided to the patient, which requests all
questions of the OMD to be answered. In step 1055, the post-treatment
set of responses may be stored. Storage of the post-treatment set of
responses may include, for example, associating the pre-treatment set of
responses with the patient's wellness account. In some instances,
execution of step 1055 may include communicating the post-treatment set
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of responses to, for example, HIPAA compliance server 126, treatment
facility computer system 134, and/or server 102 for processing and/or
indexing. Storage of the post-treatment set of responses may include, for
example, indexing the post-treatment set of responses to, for example, the
patient's wellness account and/or EMR, one or more treatment providers,
treatments, and/or treatment facilities.
[000246] In step 1060, a post-treatment wellness score for the medical
condition may be determined by applying a scoring procedure, and where
appropriate, a sub-scoring procedure, to the post-treatment set of
responses. Such scoring procedure and sub-scoring procedure may be
identical to that retrieved in step 1035 and/or retrieved in a manner similar
to the execution of step 1035.
[000247] In step 1065, an improvement score may be calculated based
on the pre-treatment wellness score and the post-treatment wellness
score. In one embodiment, the improvement score may be calculated as
the post-treatment wellness score minus the pre-treatment wellness score.
More generally, the improvement score may be known as a "health
progression" score, accommodating the scenarios in which the patient's
condition stays the same or worsens following the treatment. Further
details regarding the calculation of an improvement score is provided
below with regard to FIGs. 15A-15C. The improvement score may then be
stored (step 1070) in a manner similar to, for example, step 1055.
[000248] In step 1075, feedback including one or more the pre-treatment
wellness score, post-treatment wellness score and the improvement score
may be provided to the patient via an interface, for example, like interfaces
1705 and 1706 of FIG. 17F and FIG. 17G, respectively, which will be
discussed in more detail below. The feedback may also be provided, for
example, to a treatment provider, a treatment facility, and/or a treatment
administrator. In one embodiment, the pre-treatment wellness score may
only be provided to the patient upon the pre-treatment set of responses
answering all questions of the OMD. In one embodiment, the post-
treatment wellness score may only be provided to the patient upon the
post-treatment set of responses answering all questions of the OMD.
Hence, the pre-treatment/post-treatment wellness score can serve as an
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incentive for a patient to complete the OMD. In some embodiments,
execution of step 1075 may include providing a patient/treatment
provider/treatment facility/treatment administrator with information
regarding medical literature that discusses the OMD provided to the
patient.
[000249] In some instances, the storage of steps 1030, 1040, 1055,
and/or 1070 may include entering the information being stored into and/or
indexing the information being stored to one or more of a medical-
condition-specific registry of information, a treatment-specific registry of
information, a disease-specific registry of information, a medical-condition-
specific registry of information, a diagnosis-specific registry of
information,
a treatment-facility- specific registry of information, and/or a treatment-
provider-specific registry of information. In some embodiments, the
storage of steps 1030, 1040, 1055, and/or 1070 may further include
indexing and/or correlating information from the patient's EMR with the
received responses, patient's pre-treatment wellness score, patient's post-
treatment wellness score, and/or the patient's improvement score thereby
creating a registry that includes patient-specific information (e.g., patients
height, weight, sex, race, income, medical comorbidities, medications,
etc.). In some embodiments, the information from the patient's EMR may
also be included in one or more of the medical-condition-specific registry
of information, treatment-specific registry of information, disease-specific
registry of information, medical-condition-specific registry of information,
diagnosis-specific registry of information, treatment-facility- specific
registry of information, and/or treatment-provider-specific registry of
information. All of these registries of information may be searched and/or
queried by, for example, a treatment provider and/or patient in order to, for
example, receive information regarding the performance or effectiveness
of a particular treatment for treating a diagnosed medical condition for a
patient with a set of characteristics or receive information regarding the
effectiveness of a treatment provider at providing a particular treatment for
a type of patient. Further information regarding this process is provided
below with regard to FIG. 14.
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[000250] In one embodiment, providing the pre-treatment wellness score,
post-treatment wellness score and/or improvement score to the patient,
treatment provider, a treatment facility, and/or a treatment administrator
does not involve an action from a treatment provider or treatment facility
administrator (e.g., doctor, nurse, researcher, clinician, etc.). In one
embodiment, the pre-treatment wellness score, post-treatment wellness
score and/or improvement score may be provided to the patient treatment
provider, a treatment facility, and/or a treatment administrator along with
an average pre-treatment wellness score, an average post-treatment
wellness score and an average improvement score (where the "average"
is calculated for a group of patients who are being treated for a similar
medical condition as the instant patient, and who also are in the same age
range, the same gender, etc. as the instant patient), allowing the patient,
treatment provider, a treatment facility, and/or a treatment administrator to,
for example, assess how much (or little) the patient's recovery process
deviates from the typical recovery process or estimate how long it may
take the patient to recover from the treatment.
[000251] In some instances, the feedback may be provided based on one
or more characteristics of the patient (e.g., age, gender, profession, etc.)
or a patient goal established before treatment. For example, if a patient
sets the goal that he or she wants to be able to walk for one mile without
knee pain following knee replacement surgery, the feedback provided to
the patient may indicate how close the patient is to that goal. The
additional feedback may be provided in any appropriate manner including,
but not limited to, a score (e.g., 0-100 or A-F), a word (e.g., needs
improvement, good, great), or an image (e.g., a linear regression graph
that shows recovery from the treatment over time or a pie chart that
provides feedback regarding the recovery rate of the patient when the
OMD is responded to). In most cases, the feedback will be specific to the
patient and responsive to the OMD responses. In some instances, the
feedback may indicate next steps for the treatment recovery process
and/or recommendations to assist with accelerating the pace of recovery
and/or maintaining a recovery state.
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[000252] In one embodiment, the pre-treatment wellness score, post-
treatment wellness score, and/or improvement score may be correlated
with information extracted from the electronic medial record (EMR) of the
patient. For instance, if the post-treatment wellness score is below a
certain threshold, the information form the EMR may be analyzed in order
to find a possible cause for the low post-treatment wellness score (e.g.,
the patient has a low level of blood clotting factors, the patient is
diabetic,
etc.).
[000253] Optionally, in step 1080, the pre-treatment wellness score, post-
treatment wellness score, and/or improvement score may be compared to
a minimum threshold. If one or more of the scores are below the minimum
threshold, a notification may be generated and provision of the notification
to a treatment provider, treatment facility, and/or treatment facility
administrator, alerting the treatment provider, treatment facility, and/or
treatment facility administrator to the abnormally low one or more scores
may be facilitated (step 1085). In some embodiments, a treatment
provider, treatment facility, and/or treatment facility administrator may
establish minimum wellness and/or improvement score thresholds for
various medical conditions, treatments, and other circumstances via an
interface like care management dashboard 2000 of FIG. 20A. Care
management dashboard 2000 is adapted for presentation to a particular
treatment provider, in this case, J.D. Smith and provides a number of
contact preferences (SMS text message to a phone number and/or by
email to an email address) by which the treatment provider may choose
how he or she is contacted when a wellness score falls below a certain
threshold. Interface 2000 also provides a table 2005 of medical conditions
for which a wellness score threshold may be established. In some
instances, the entries in table 2005 may be specific to a particular patient
(e.g., related to the patient's medical condition(s)) and in other instances,
the entries in table 2005 may be more generally applicable (e.g., level of
pain, mobility, etc.). More specifically, table 2005 enables Dr. Smith to set
a minimum wellness and/or improvement score thresholds for the medical
conditions of atrial fibrillation (<50), anxiety (<40), arthritis (<10),
asthma
(<30), back pain (<20), BPH (<40), chronic pain (<15), CHF (<40), COPD
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(<30), CAD (<30), depression (<20), eczema (<60), fatigue (<30), gout
(<40), headache/migraines (>10), GERD (<30), inflammatory bowel (<20),
and osteoporosis (<40). Should a wellness score for any of the patient's
Dr. Smith has associated with care management dashboard 2000 fall
below one of these established minimum thresholds, he or she would
receive a notification indicating as such. In some embodiments, an
interface like interface 2000 may be provided to another treatment provider
for the patient who, for example, an assistant to the treatment provider
(e.g., registered nurse, medical assistant, etc.) and, in this embodiments,
one or more of the thresholds may be set higher so that the assistant is
contacted when the score is below a higher number. For example, a
treatment provider may
set a chronic pain wellness score threshold of <15 and an assistant to the
treatment provider may set a chronic pain wellness score threshold of <30
so that he or she may follow up with the patient before his or her pain gets
too bad (i.e., wellness score drops to an unacceptable level).
[000254] In some instances, the threshold of step 1080 may be a
combined notification threshold. FIG. 26A provides a flowchart of an
exemplary process 2600 for generating a combined notification threshold
for a treatment provider, which may be adapted to generate a combined
notification threshold for a treatment administrator or other clinician and
providing a dashboard showing combined notification thresholds. Process
2600 may be executed by any of the systems and/or system components
disclosed herein.
[000255] In some instances, a combined notification threshold combines
at least two separate notification thresholds (e.g., a wellness score
notification threshold and an improvement score threshold) such that a
treatment provider will not be notified unless a patient's score(s) falls
below both of the at least two thresholds of the combined notification
threshold. In some circumstances, the combined notification threshold may
be specific to a particular patient characteristic, medical condition,
treatment code, and/or diagnostic code, or group of patient characteristics,
medical conditions, treatment codes, and/or diagnostic codes. In some
instances, values for combined notification thresholds may be responsive
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to best practices or rules established by, for example, a treatment
provider, a treatment administrator, or a medical authority (e.g., the
American Medical Association, or a governmental agency (e.g., CMS, NIH,
or FDA)). Additionally, or alternatively, combined notification thresholds
may be defined according to, for example, a treatment provider, treatment
administrator, and/or patient preference.
[000256] In some embodiments, combined notification thresholds may be
established for particular treatment and/or diagnostic codes such that they
are applied to all patients under a treatment provider's care in the same
manner and, in other embodiments, combined notification thresholds may
be tailored to meet the specific needs/preferences of an individual patient.
[000257] Initially, a value for a first notification threshold for one or
more
treatment and/or diagnostic codes may be received (step 2605). The value
for the first notification threshold may be specific to a patient, a group of
patients, and/or globally to all patients under the care of the treatment
provider. Then, a value for a second notification threshold for one or more
treatment and/or diagnostic codes may be received (step 2610). The
second notification threshold may be specific to a patient, a group of
patients, and/or globally to all patients under the care of the treatment
provider. In most instances, the first and second notification thresholds
will relate to the same treatment and/or diagnostic codes. In an exemplary
embodiment, the first notification threshold relates to a notification
threshold for a patient's wellness score for a medical condition (as defined
by, for example, a treatment and/or diagnostic code) and the second
notification threshold relates to a notification threshold for a patient's
improvement score for the medical condition. Values for the first and/or
second notification thresholds may be received from, for example, a
patient, a doctor, a nurse, a treatment facility administrator, and so on.
[000258] In some instances, execution of steps 2605 and 2610 may be
facilitated by interaction with a user interface like a MD notification care
management interface 2002 as shown in FIG. 20B and/or a CM
notification care management interface 2003 as shown in FIG. 20C. In
most instances, the MD notification care management interface 2002 may
be used to set combined notification thresholds for doctors or other
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treatment providers that are at a supervisory or management level for the
patient's care and the CM notification care management interface 2003
may be used to set combined notification thresholds for lower-level health
care providers such as nurses, physician assistants, residents, and the
like.
[000259] Interfaces 2002 and/or 2003 may be provided to, for example, a
treatment provider, treatment facility, and/or treatment administrator by, for
example, server 102 and/or a combination of server 102 and treatment
facility computer system 134. In some instances, interfaces 2002 and/or
2003 may be provided as part of a wellness account associated with the
treatment provider for whom the thresholds are set and, which provides a
contact information window 2010B, a first table 2015A of values for the
first notification threshold, and a second table 2020A of values for the
second notification threshold.
[000260] MD notification care management interface 2002 includes a first
checkbox, which when checked facilitates the establishment of minimum
wellness scores for the first notification threshold for a variety of medical
conditions, treatment codes, and/or diagnostic codes via, for example,
entry of minimum wellness score values for the medical conditions,
treatment codes and/or diagnostic codes in a first table 2015A. MD
notification care management interface 2002 also includes a second
checkbox, that when checked facilitates the establishment of minimum
improvement scores for the second notification threshold for the same
medical conditions, treatment codes, and/or diagnostic codes provided in
table 2015A via, for example, entry of minimum improvement score values
for the medical conditions, treatment codes and/or diagnostic codes in a
second table 2020A.
[000261] In the embodiment of FIG. 20B, first and second tables 2015A
and 2020A provide six different medical conditions, each of which are
associated with at least one diagnostic and/or treatment code. More
specifically, the medical conditions provided by first and second tables
2015A and 2020A are: atrial fibrillation, anxiety, fatigue, CHF, eczema,
and headache/migraine. Although first and second tables 2015A and
2020A includes six exemplary medical conditions, it will be understood by
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those of skill in the art that these tables may include any number of
medical conditions. In some instances, the medical conditions provided by
first and second tables 2015A and 2020A may be specific to a medical
specialty of a doctor or group of doctors associated with interface 2002 like
the medical conditions provided by table 2005.
[000262] Values for the wellness score notification thresholds (which may
be considered the first notification threshold of step 2605) and values for
the improvement score notification thresholds (which may be considered
the second notification threshold of step 2610) may be directly entered into
first table 2015A or second table 2020A, respectively via, for example,
manual entry of numerical values and/or selection of a value for a score
threshold from a drop-down selection or other list. In some embodiments,
the establishment of wellness score thresholds and/or improvement score
thresholds for the medical conditions of first and second tables 2015A and
2020A, respectively, may be done via a slider bar like the slider bars
presented in interface 2000.
[000263] In the embodiment of interface 2002, table 2015A establishes a
first notification threshold of a wellness score below 75 for atrial
fibrillation,
a first notification threshold of a wellness score below 40 for anxiety, a
first
notification threshold of a wellness score below 40 for fatigue, a first
notification threshold of a wellness score below 75 for CHF, a first
notification threshold of a wellness score below 25 for eczema, and a first
notification threshold of a wellness score below 40 for headache/migraine.
Table 2020A establishes a second notification threshold of an
improvement score below 50 for atrial fibrillation, a second notification
threshold of an improvement score below 30 for anxiety, a second
notification threshold of an improvement below 30 for fatigue, a second
notification threshold of an improvement score below 55 for CHF, a
second notification threshold of an improvement score below 15 for
eczema, and a second notification threshold of an improvement score
below 30 for headache/migraine.
[000264] In some instances, values for notification thresholds received in
steps 2605 and/or 2610 may be responsive to the severity or importance
of the medical condition, treatment, and/or diagnosis for which they
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pertain. For instance, in the example of the combined wellness and
improvement score notification thresholds set in interface 2002, the
combined notification threshold of <75 for wellness and <50 for atrial
fibrillation indicates that the doctor should be notified when both of these
conditions are met. Likewise, the combined wellness and improvement
score notification thresholds set in interface 2002, the combined
notification threshold of <25 for wellness and <15 for eczema indicates
that the doctor should be notified when both of these conditions are met.
Comparing these two combined notification thresholds indicates that a
patient's wellness/improvement atrial fibrillation is a higher priority to the
doctor than a patient's wellness/improvement with regard to eczema. In
another example, comparing the combined notification thresholds for atrial
fibrillation and CHF (wellness score <75 and improvement score <55)
indicates that both of these conditions are of similar priority to the doctor
and that the doctor is monitoring both of these conditions more closely
than he or she would monitor eczema.
[000265] FIG. 20C provides a screen shot of an exemplary care
management interface 2003 by which a combined notification threshold for
a care manager may be set. Exemplary care managers include nurses,
physician assistants, and other individuals or groups of individuals who
may be involved with the day-to-day monitoring of a patient's health and
wellness. Interface 2003 is similar in most respects to interface 2002, with
the exception that the contact information of contact information window
201 is for a CM with the email address of aroberts(gmail.com and phone
number of 310-893-7560.
[000266] The primary difference between interfaces 2002 and 2003 is that
the notification thresholds for both wellness and improvement scores used
to generate combined notification thresholds for the medical conditions are
higher than those set in interface 2002. In this way, a CM will be notified
should a patient's wellness and improvement slip below a higher threshold
than would trigger notification for a doctor monitoring the same patient for
the same medical condition, treatment code, and/or diagnostic code. More
specifically, first table 2015B sets a first notification threshold of a
wellness
score below 90 for atrial fibrillation, a first notification threshold of a
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wellness score below 60 for anxiety, a first notification threshold of a
wellness score below 60 for fatigue, a first notification threshold of a
wellness score below 90 for CHF, a first notification threshold of a
wellness score below 30 for eczema, and a first notification threshold of a
wellness score below 60 for headache/migraine. Table 2020B establishes
a second notification threshold of an improvement score below 70 for atrial
fibrillation, a second notification threshold of an improvement score below
55 for anxiety, a second notification threshold of an improvement below 55
for fatigue, a second notification threshold of an improvement score below
70 for CHF, a second notification threshold of an improvement score
below 25 for eczema, and a second notification threshold of an
improvement score below 55 for headache/migraine.
[000267] Continuing on with FIG. 26, a combined notification threshold for
the one or more treatment and/or diagnostic codes may then be generated
(step 2615) and stored (2620). In some embodiments, execution of step
2620 may also include storage of the received first notification threshold(s)
and/or second notification threshold(s) for the one or more treatment
and/or diagnostic codes.
[000268] In some embodiments, execution of step 2615 may include
generation of a series of if-then statements. For example, generation of a
combined notification threshold may include setting up a series of
parameters whereby if a score falls below the first notification threshold, it
is determined whether the score falls below the second notification
threshold. When it does, the relevant treatment provider or treatment
administrator may be notified. In another example, generation of a
combined notification threshold may include setting up a series of
parameters whereby if a score falls below the second notification
threshold, it is determined whether the score falls below the first
notification threshold. When it does, the relevant treatment provider or
treatment administrator may be notified.
[000269] On some occasions, generation of a combined notification
threshold may include a two (or more)-tier system of notification thresholds
whereby a combined notification threshold for a particular treatment and/or
diagnostic code for a doctor or other supervisory treatment provider may
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be lower than a combined notification threshold for particular treatment
and/or diagnostic code for a care manager or other treatment provider as
is the case with interfaces 2002 and 2003 discussed above.
[000270] Next, a dashboard or other interface showing the first
notification
threshold, second notification threshold, and/or combined notification
threshold for each of the one or more treatment and/or diagnostic codes
may be prepared (step 2625) and provision of the dashboard to a user
(e.g., treatment provider, treatment administrator, etc.) may be facilitated
(step 2630). FIG. 20D shows a screen shot of an exemplary interface
2004 that includes a combined threshold graph interface 2004 as may be
prepared in step 2625 and provided to the user in step 2630. The graph of
interface 2004 shows the notification thresholds set for the first
notification
threshold (in this instance, wellness score on a scale of 1-100) on the X-
axis and the second notification threshold (in this instance, improvement
score on a scale of 1-100%) on the Y-axis.
[000271] More particularly, interface 2004 provides a graph that shows
combined notification thresholds for a doctor and a care manager with
regard to the diagnosis and/or treatment code(s) for atrial fibrillation,
wherein the combined notification threshold for a doctor for atrial
fibrillation
is a wellness score below 75 and an improvement score below 50% and
the combined notification threshold for a care manager for atrial fibrillation
is a wellness score below 90 and an improvement score below 70%.
Information used to generate these combined notification thresholds may
be have been provided via, for example, interaction with an interface like
interfaces 2002 and/or 2003, described above.
[000272] FIG. 20E provides another exemplary interface 2005 by which a
user may view entered and/or generated combined notification thresholds
for a number of medical conditions, treatment codes, and/or diagnostic
codes for both a doctor and a care manager. More particularly, interface
2005, provides an array 2040 of six combined notification threshold graphs
2045A-2045F, each of which graphically show combined notification
thresholds for both doctors and care managers for atrial fibrillation in graph
2045A, anxiety in graph 2045B, fatigue in graph 2045C, CHF in graph
2045D, eczema in graph 2045E, and headache/migraine in graph 2045F.
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In the example of array 2040, the combined notification thresholds
provided by graphs 2045A-2045F correspond to the first and second
notification thresholds for a doctor and care manager entered into
interfaces 2003 and 2004, respectively.
[000273] In some embodiments, interface 2005 may also include a
contact information window 2010D, that provides notification preferences
(text message or email) as well as methods (text message phone number
or email address) for communicating a notification for the doctor and/or
care manager. Additionally, or alternatively, interface 2005 may also
include one or more messages or instructions for using the information
and/or how to interpret the graphs of array 2040.
[000274] In some embodiments, interface 2004 and/or 2005 may be
interactive so that, for example, selection of one or more of the combined
notification threshold graphs included therein triggers display of further
information about the selected graph and/or an interface like interfaces
2002 and/or 2003 so that the viewer may see information used to generate
the selected combined notification threshold graph and, in some instances,
modify the parameters thereof (i.e., adjust the first and/or second
notification threshold for the MD and/or care manager via interaction with
interfaces 2002 and/or 2003).
[000275] In yet another embodiment, a viewer may be able to move, or
reposition, graphs displayed in array 2040 to different locations on the
interface according to, for example, preference, priority, and/or relatedness
of medical conditions, treatment codes, and/or diagnostic codes related
thereto. For example, a viewer may want to reposition combined
notification threshold graph 2045D for CHF proximate to (e.g., underneath
or next to) the combined notification threshold graph 2045A for atrial
fibrillation because the two diagnosis codes (i.e., CHF and atrial
fibrillation)
relate to diseases of the heart and/or have the highest combined
notification thresholds of the graphs in array 2040.
[000276] It should be understood by those of skill in the art that although
the combined notification threshold graphs of interfaces 2004 and 2005
show two separate notification thresholds (i.e., one for doctor and one for
a care manager), this need not always be the case because the combined
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notification threshold graphs of interfaces 2004 and 2005 may be used to
show combined notification thresholds for any number (e.g., 1, 3, 4, 5,
etc.) of different individuals or groups of individuals. The present invention
also contemplates combined notification thresholds that incorporate three
or more notification thresholds.
[000277] FIG. 26B is a flowchart illustrating an exemplary process 2601
for facilitating provision of a notification to a treatment provider using a
combined wellness score and improvement score. Process 2601 may be
executed by, for example system 100 and/or any combination of
components disclosed herein.
[000278] Initially, in step 2632, a combined notification threshold for a
treatment provider may be received. The combined notification threshold
may include one or more thresholds for a wellness score and a treatment
score. In some instances, the combined notification threshold may be
generated for one or more treatment and/or diagnostic codes at step 2615
of process 2600.
[000279] Then, in step 2635, a wellness score and an improvement score
for a particular patient may be received. In some instances, the wellness
and/or improvement score may relate to a particular treatment and/or
diagnosis while, in other instances, the wellness and/or treatment scores
may not be so specific (e.g., a wellness and/or improvement score relating
to general health or wellness). Then, either step 2640 or step 2650 may
be performed. When step 2640 is performed, it may be determined if the
wellness score is below the wellness score of the combined notification
threshold (step 2640) and, if so, it may be determined if the improvement
score is below the improvement score of the combined notification
threshold (step 2645). When both the wellness and improvement scores
are below their respective thresholds, a notification to the treatment
provider indicating that the patient's wellness and improvement scores
have fallen below the combined notification threshold may be prepared
(step 2660) and stored (step 2665). Then, the notification may be
provided to the treatment provider (step 2670). The notification may be
provided in any manner including, but not limited to, an email, a phone
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call, a text message, a page, and a notification or flag added to the
patient's EMR or portal.
[000280] When step 2650 is performed, it may be determined if the
improvement score is below the improvement score of the combined
notification threshold (step 2650) and, if so, it may be determined if the
wellness score is below the wellness score of the combined notification
threshold (step 2655). When both the wellness and improvement scores
are below their respective thresholds, steps 2660-2670 may be performed.
[000281] When the determinations of steps 2640, 2645, 2650 or 2655 are
no, then process 2601 may end and no notification may be provided to the
treatment provider.
[000282] FIG. 27 is a flow chart illustrating an exemplary process 2700 for
generating and facilitating the communication of a notification responsively
to a determination that a patient's first and second score with regard to a
medical condition, treatment code, and/or diagnostic code has fallen below
a combined notification threshold. Process 2700 may be executed by, for
example system 100, system 103, and/or any combination of components
disclosed herein.
[000283] Initially, a combined notification threshold establishing a
notification threshold for both a first and second score may be received
(step 2702). Then, a patient's first score for a medical condition, treatment
code, and/or diagnostic code may be received (step 2705). The first score
may be, for example, a wellness score and/or an improvement score as
discussed herein. It may then be determined if the first score falls below
the first notification threshold of the combined notification threshold for
the
patient and/or medical condition, treatment code, and/or diagnostic code
(step 2710). If not, process 2700 may end. If so, then a second score
may be received (step 2715) and it may be determined whether the
second score falls below the second notification threshold (step 2720). If
not, then process 2700 may end. If so, then a notification for one or more
treatment providers associated with the patient may be generated (step
2725). The notification may include, for example, an indication that the
patient's first and second scores have fallen below the combined
notification threshold. The notification may also include, for example, a
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name of the patient, the relevant medical condition, treatment code, and/or
diagnostic code and contact information for the patient. The generated
notification (or information included in the notification or an indication
that
the notification was provided to a treatment provider) may then be stored
(step 2730) and provision of the notification to, for example, a treatment
provider may be facilitated (step 2735) via, for example, the contact
method selected when the combined notification threshold was
established (e.g., via selection of contact method from a contact
information window like contact information window(s) 2010A, 2010B, and
2010C). Following execution of step 2735, process 2700 may end.
[000284] In some instances, process 2700 may be performed such that
step 2715 is executed prior to execution of step 2705. In these instances,
step 2720 may be performed and, if the second score is above the second
notification threshold, then process 2700 may end. If the second score is
below the second notification threshold, then process 2700 may advance
to step 2705 and when the first score is below the first score notification
threshold, process 2700 may advance to step 2725.
[000285] In one embodiment, the notification may include contact
information of the patient, allowing the treatment provider to immediately
contact the patient. In one embodiment, the notification may be sent
according to one or more preferences of, for example, treatment provider,
treatment facility, and/or treatment facility administrator. In one example,
if
an improvement score is below 30% (when comparing, for example, a pre-
treatment wellness score and a first post-treatment wellness score), a
notification may be sent to a treatment facility administrator or care
management department for follow up by, for example, a nurse or case
manager for a treatment provider. In this same example, if an
improvement score is below 10% (when comparing, for example, a pre-
treatment wellness score and a first post-treatment wellness score), a
notification may be sent to the treatment provider for follow up. In some
embodiments, a treatment provider may be provided with an interface
showing one or more notifications he or she has received.
[000286] Interface 1705 of FIG. 17F provides exemplary patient feedback
in the form of a numerical wellness score 1760 (in this case 88) along with
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a message 1755 to the patient indicating, for example, when the patient
will be prompted to respond to another OMD (e.g., "We'll check in again in
3 months so you can track your recovery."). Interface 1706 of FIG. 17G
provides exemplary patient feedback in the form of a graph 1770 that
shows the patient's numerical wellness scores over time, including a pre-
op wellness score of 45, a post-treatment wellness score of 71 three
months after surgery and a post-treatment wellness score of 88 six months
after surgery. In the example of FIG. 17G, the post-treatment wellness
scores may also be called "recovery scores". As described above,
interface 1706 may also provide a progression of average wellness scores
over time in the form of graph 1775, thereby allowing the patient to assess
his or her recovery process relative to the typical recovery process.
[000287] In one embodiment, further information may be collected from
the patient before the treatment. For example, the information may
include the patient's compliance with pre-treatment instructions prior to the
treatment. In such case, a patient compliance question relating to the
patient's compliance with pre-treatment instructions before the treatment
may be determined. The determined patient compliance question may be
provided to the patient. A response to the patient compliance question
may be received from the patient. Finally, the received response may be
stored with a key that is used to retrieve the received response. The key
may include at least one of the treatments to be provided to the patient, a
treatment provider for the patient, a treatment facility used by the patient,
patient characteristics.
[000288] In another embodiment, further information may be collected
from the patient following the treatment. For example, the information may
include the patient's compliance with post-treatment instructions following
the treatment. In such case, a patient compliance question relating to the
patient's compliance with post-treatment instructions following the
treatment may be determined. The determined patient compliance
question may be provided to the patient. A response to the patient
compliance question may be received from the patient. Finally, the
received response may be stored with a key that is used to retrieve the
received response. The key may include at least one of the treatments
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provided to the patient, a treatment provider for the patient, a treatment
facility used by the patient, patient characteristics, and an outcome score
of the treatment.
[000289] In some instances, the treatment compliance information
collected from the patient pre- and/or post-treatment may include
administration of a medical-specialty-, treatment- and/or diagnosis-specific
treatment compliance questionnaire and FIG. 10D provides a flowchart of
an exemplary process 1002 for providing a treatment compliance
questionnaire to a patient.
[000290] Initially, in step 10005, a medical specialty, treatment, and/or
diagnosis for a patient may be received from, for example, a treatment
provider and/or a patient device like patient device 128 via the patient's
wellness account. Then, provision of a first question to the patient may be
facilitated (step 10010). In the example provided, the first question has
two possible answers: answer A and answer B. When answer A is
received (step 10015), then provision of a second question regarding the
substance of answer A to the patient may be facilitated (step 10020).
Then, in step 10025, an answer to the second question regarding answer
A may be received from the patient. When answer A is not received (i.e.,
answer B is received), then provision of a second question regarding the
substance of answer A to the patient may be facilitated (step 10030).
Next, in step 10035 an answer to the second question regarding answer B
may be received from the patient.
[000291] In step 10040 provision of a third question regarding the severity
of an impact of the subject matter of answer A or B on the patient's
compliance with pre-treatment and/or post-treatment instructions to the
patient may be facilitated. When an answer to the third question is
received (step 10045), then a patient compliance score regarding the
patient's pre- and/or post-treatment instructions may be determined using
the received answers to the first, second, and/or third questions (step
1050) and an indication of the determined patient's compliance score may
be provided to, for example, the patient, a treatment provider, a treatment
facility, a treatment administrator, and/or a caregiver (step 10055).
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[000292] The following is an example of how process 1002 may be
executed. In step 10005, a medical specialty of orthopedics and a
diagnosis of a hand injury diagnosis may be received. In step 10010, the
patient may be asked is your right hand injured? If yes, then the patient
may be asked if his or her activities and/or quality of life are significantly
limited by another body part other than his or her right hand (step 10020)?
If no, then the patient may be asked if his or her activities and/or quality
of
life are significantly limited by another body part other than his or her left
hand (step 10030)? When the answers at steps 10020 or 10030 are no,
then process 1002 may proceed to step 10040, and the patient may be
asked how severely his or her injury/diagnosis has impacted his or her
compliance with the pre- and/or post-treatment instructions (step 10040).
[000293] When the answers at steps 10020 or 10030 are yes, then
process 1002 may proceed to ask more questions in a manner that
repeats steps 10010, 10015, and 10030 but with different, follow-up,
questions. An example of follow-up questions includes asking the patient
which area (e.g., neck, back, left shoulder, right shoulder, left lower
extremity, right lower extremity, and so on) of his or her body is limiting
his
or her activities/quality of life. More questions may be progressively asked
until the nature of other aspects of the patient's health that may impact his
or her recovery or treatment compliance may be determined.
[000294] In one embodiment, the pre-treatment set of responses and the
post-treatment set of responses may be stored in OMD response
database 110 with a key that is used to retrieve at least one of the pre-
treatment set of responses and the post-treatment set of responses,
wherein the key includes at least one of the treatment provided to the
patient, a treatment provider for the patient, a treatment facility used by
the
patient, patient characteristics, and an outcome score of the treatment.
[000295] In some circumstances, the OMD provided to the patient in
process 1000, and/or the feedback provided to the patient may be
designed so as to encourage the patient to engage with the software
application providing the recovery/wellness tracker. For example, the
OMD may be designed so as to be easy to understand and respond to,
and the feedback to the patient may be provided in a manner easy for a
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patient with little medical knowledge to understand. In some instances, a
patient's response to the one or more OMDs may be a requirement that
must be fulfilled before a patient is permitted to receive treatment and/or
treatment recovery services. For example, a patient's response to the
OMDs may be a pre-condition for scheduling follow up appointments with
the provider of his or her treatment.
[000296] In one embodiment, the OMD may be provided to the patient at
a plurality of time points after the patient receives the treatment. More
specifically, upon an expiration of a predetermined time period measured
from at least one of a time at which the patient received the treatment and
a time at which the post-treatment set of responses was received from the
patient, an additional OMD may be provided to the patient, the additional
OMD being in addition to the OMDs provided at steps 1020 and 1045.
The additional post-treatment set of responses to the OMD may be
received from the patient. An additional post-treatment wellness score for
the medical condition may be determined by applying the scoring
procedure to the additional post-treatment set of responses.
Subsequently, the additional post-treatment wellness score may be
provided to the patient. The "recovery score" of 88 may be an example of
such an additional post-treatment wellness score.
[000297] In one embodiment, process 1000 may be performed on each of
a plurality of patients. In such case, a medical-condition-specific registry
of information, a treatment-specific registry of information, a treatment-
facility- specific registry of information, and/or a treatment-provider-
specific
registry of information may be created. In the medical-condition-specific
registry of information, one or more of the pre-treatment set of responses
(received from one or more patients), the pre-treatment wellness scores
(determined for one or more patients), the post-treatment set of responses
(received from one or more patients), the post-treatment wellness scores
(determined for one or more patients), and patient characteristics (e.g.,
patient characteristics extracted from a patient's EMR) may be mapped to
the medical condition, treatment, treatment facility, and/or treatment
provider as appropriate.
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[000298] In some embodiments, step 1015 and/or 1045 may include
determining multiple OMDs to provide to the patient. For example, if a
patient is undergoing a treatment for removing a cataract from an eye, it
may be determined in step 1015 that a combination of PRO questionnaires
and medical symptom questionnaires are appropriate to provide to the
patient. More specifically, it may be determined that the Catquest 9-SF
Visual Function Test is the most appropriate PRO instrument to use when
determining visual function for the patient and the NIH PROMIS Global
Health Short Form 1D is the most appropriate general health questionnaire
to provide to the patient so as to determine the patient's general state of
health. Both of these OMDs/questionnaires may be provided to the patient
in step 1020 via one or more interfaces like 17C-17E provided to the
patient via his or her wellness account and/or patient device. A set of
responses to the OMDs provided to the patient may be received (step
1025) and stored (step 1030).
[000299] Next, a pre-treatment wellness score for the medical
condition/treatment, in this case, a cataract, and the patient's general
health may be determined (step 1035) by applying a scoring procedure
associated with the Catquest 9-SF Visual Function Test to responses to
questions from the Catquest 9-SF Visual Function Test received in step
1025 and applying a scoring procedure associated with the NIH PROMIS
Global Health Short Form 1D to responses to questions from the NIH
PROMIS Global Health Short Form 1D received in step 1025. Then, a pre-
treatment wellness score for the patient's responses to the Catquest 9-SF
Visual Function Test and the NIH PROM IS Global Health Short Form 1D
may be determined (step 1035) and provided to the patient (step 1075) via
an interface like visual function interface 2101 of FIG. 21A and general
health wellness score interface 2102 of FIG. 21B. In some instances,
provision of the wellness scores to the patient may involve adjusting the
wellness score (e.g., putting on a scale of 1-100) so that it is more
meaningful to the patient. In some instances, adjusting the wellness score
may include normalizing the wellness score to be on a scale common to all
of the wellness scores provided to the patient (i.e., a normalized scale).
Additionally, or alternatively, provision of the wellness scores to the
patient
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may involve using commonly known terms/alternate terminology to refer to
what the wellness score is measuring. In the examples of visual function
interface 2101, the wellness score determined by the Catquest 9-SF
Visual Function Test has been provided along with a heading 2105A that
states what the test/OMD measures (in this case, visual function) in non-
medical alternate terms. In some instances, the information included in
heading 2105A (and the other headings disclosed herein) may be added
to the heading using alternate terminology associated with, for example,
the medical condition of the patient, a name of the OMD administered to
the patient, a treatment the patient is undergoing or has undergone, and
so on.
[000300] The visual function wellness score determined by scoring the
patient's responses to the Catquest 9-SF Visual Function Test has also
been converted to a number on a scale from 1-100 with an adjusted score
2115A of 41, which is provided to the patient on a graphically-represented
semi-circularly shaped wellness score progress chart 2110A with a
minimum (i.e., poor) score on one side and a maximum (i.e., excellent)
score on the other side. It will be understood by those of skill in the art
that
the shape/form of wellness score progress chart 2110A, as well as the
other wellness score progress charts disclosed herein may be different
from a semi-circle. For example, a wellness score progress chart may
take the form of a pie chart, a bar chart, and/or a graph. Interface 2102A
also provides a date 2120 at which the visual function wellness score was
determined (in this case, January 29th) and a message 2125A regarding
when the next result check will be (in this case, May 30th). Interface
2102A further provides a scrolling mechanism 2130 by which a patient
may scroll through the various (in this case, 3) wellness scoring interfaces
provided by his or her wellness account.
[000301] Visual function interface 2101 also includes a recovery timeline
icon 2135A, an add to calendar icon 2140, a question sources icon 2145A,
and leave feedback icon 2150. Selection of recovery timeline icon 2135A
causes a recovery timeline interface related to visual function to be
displayed, selection of add to calendar icon 2140 causes the next
scheduled administration of the OMD to be added to the patient's
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calendar, selection of question sources icon 2145A causes a question
sources interface that includes sources of medical literature related to the
Catquest 9-SF Visual Function Test and/or visual function to be displayed,
and selection of leave a feedback icon 2150 causes a feedback interface
to be displayed.
[000302] General health wellness score interface 2102 of FIG. 21B
provides an adjusted general health wellness score 2115B of 54 along a
graphically represented wellness score progress chart 2110B. The
general health wellness score is determined by applying the scoring
procedure for the NIH PROM IS Global Health Short Form 1D OMD to the
responses received thereto and adjusting and/or normalizing the
determined wellness score to be on a scale of 1-100. Interface 2102
includes a heading 2105B that states in non-medical language what the
wellness score provided by interface 2102 relates to. The information
included in heading 2105B may be added to the heading using alternate
terminology associated with, for example, the medical condition of the
patient, a name of the OMD administered to the patient, a treatment the
patient is undergoing or has undergone, and so on. Interface 2102B also
provides a date 2120 at which the general health wellness score has been
determined (in this case, January 29th) and a message 2125B regarding
when the next result check will be (in this case, May 30th).
[000303] General health interface 2102 also includes a recovery timeline
icon 2135B, add to calendar icon 2140, a question sources icon 2145B,
and leave feedback icon 2150. Selection of recovery timeline icon 2135B
causes a recovery timeline interface related to the patient's general health
wellness scores to be displayed and selection of question sources icon
2145B causes a question sources interface that lists sources of medical
literature related to the patient's general health and the NIH PROM IS
Global Health Short Form 1D OMD (i.e., the OMD used to determine the
patient's general health) to be displayed.
[000304] Pain interference wellness score interface 2103 of FIG. 21C
provides an adjusted pain interference wellness score 2115C of 63 along a
graphically represented wellness score progress chart 2110C. The pain
interference wellness score is determined by applying the scoring
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procedure for a NIH PROM IS CAT ¨ Pain Interference (Consequences)
OMD to responses received thereto via the patient's wellness account and
adjusting the determined wellness score to be on a scale of 1-100.
Interface 2103 includes a heading 2105C that states in non-medical
language what the wellness score provided by interface 2103 relates to
(i.e., pain interference). The information included in heading 2105C may
be added to the heading using alternate terminology associated with, for
example, the medical condition of the patient, a name of the OMD
administered to the patient, a treatment the patient is undergoing or has
undergone, and so on. Interface 2102C also provides a date 2120 at
which the pain interference score has been determined (in this case,
January 29th) and a message 2125C regarding when the next result check
will be (in this case, May 30th).
[000305] Pain interference interface 2103 also includes a recovery
timeline icon 2135C, add to calendar icon 2140, a question sources icon
2145C, and leave feedback icon 2150. Selection of recovery timeline icon
2135C causes a recovery timeline interface related to the patient's pain
interference wellness scores to be displayed and selection of question
sources icon 2145C causes a question sources interface that lists sources
of medical literature related to the patient's pain interference and the NIH
PROM IS CAT ¨ Pain Interference (Consequences) OMD to be displayed.
[000306] FIG. 21D provides an exemplary pain interference recovery
timeline interface 2104 for pain interference wellness scores and
projected/predicted pain interference wellness scores for the patient. Pain
interference recovery timeline interface 2104 may be provided to the
patient upon selection of recovery timeline icon 2135C and may provide
heading 2105C, and a recovery timeline graph 2155 that plots wellness
scores on a scale of 1-100 vs. time as measured in months. Graph 2155
provides the determined pain interference wellness score 2115C of pain
interference interface 2103 (i.e., 63), a first predicted/projected pain
interference wellness score 2160A, and a second predicted/projected pain
interference wellness score 2160B. Predicted/projected pain interference
wellness scores 2160A and 2160B may be determined via one or more
processes described herein.
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[000307] FIG. 21E provides an exemplary question sources interface
2106 that provides a list of exemplary sources of information 2165A and
2165B related to the OMDs provided to the patient, in this case papers
that discuss cataract surgery.
[000308] Continuing with this example, at a predetermined time (e.g., 3
months after the cataract surgery), the patient may be provided with the
Catquest 9-SF Visual Function Test and the NIH PROM IS Global Health
Short Form 1D questionnaires (step 1045) and a post-treatment set of
responses thereto may be received (step 1050) and stored (step 1055).
Then, a post-treatment wellness score for the medical condition/treatment
(cataract surgery) and the patient's general health may be determined
(step 1065) by applying a scoring procedure associated with the Catquest
9-SF Visual Function Test to responses to questions from the Catquest 9-
SF Visual Function Test received in step 1025 and applying a scoring
procedure associated with the NIH PROM IS Global Health Short Form 1D
to responses to questions from the NIH PROM IS Global Health Short
Form 1D received in step 1050. Then, a post-treatment wellness score for
the patient's visual function and general health may be determined (step
1060) and provided to the patient (step 1075). In some cases, these may
be separate scores and, in other cases, the scores may be combined into
a single overall post-treatment wellness score.
[000309] In another example, if a patient is undergoing a treatment for a
shoulder injury, it may be determined in step 1015 that a combination of
PRO questionnaires and medical symptom questionnaires are appropriate
to provide to the patient. More specifically, it may be determined that the
American Shoulder & Elbow Surgeons Assessment is the most
appropriate PRO instrument to use for determining shoulder function for
the patient, the NIH PROM IS CAT Pain Behavior questionnaire is the most
appropriate questionnaire to provide to the patient to determine how the
patient's behavior is effected by pain, the NIH PROM IS CAT Physical
Function questionnaire is the most appropriate questionnaire to provide to
the patient to determine how the patient's physical function is effected by
his/her shoulder injury, and the NIH PROM IS CAT Pain Interference
questionnaire is the most appropriate questionnaire to provide to the
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patient to determine how much the patient's pain interferes with his or her
daily life. These four questionnaires may be provided to the patient in step
1020 and a set of responses thereto may be received (step 1025) and
stored (step 1030).
[000310] Next, a pre-treatment wellness score for the medical condition,
in this case, a shoulder injury, may be determined (step 1035) by applying
a scoring procedure associated with the American Shoulder & Elbow
Surgeons Assessment to responses to questions from the American
Shoulder & Elbow Surgeons Assessment received in step 1025, applying
a scoring procedure associated with the NIH PROMIS CAT Pain Behavior
questionnaire to responses to questions from the NIH PROMIS CAT Pain
Behavior questionnaire received in step 1025, applying a scoring
procedure associated with the NIH PROMIS CAT Physical Function
questionnaire to responses to questions from the NIH PROMIS CAT
Physical Function questionnaire received in step 1025, and applying a
scoring procedure associated with the NIH PROMIS CAT Pain
Interference questionnaire to responses to questions from the NIH
PROMIS CAT Pain Interference questionnaire received in step 1025.
[000311] Then, a pre-treatment wellness score for the patient's shoulder
function, behavior due to pain, physical function, and pain interference
may be determined (step 1035) and provided to the patient (step 1075). In
some cases, these may be separate post-treatment wellness scores (i.e.,
one for each OMD) and, in other cases, the scores may be combined into
a single overall pre-treatment wellness score.
[000312] FIGs. 22A-22E provide a series of interfaces that are responsive
to providing the American Shoulder & Elbow Surgeons Assessment, NIH
PROMIS CAT Pain Behavior questionnaire, and NIH PROMIS CAT Pain
Interference questionnaire OMDs to the patient as may occur when a
treatment provider associates a shoulder-related injury diagnosis or
treatment with the patient via, for example, an interface like interface 2303
and/or 2402 of FIGs. 23C and 24B, respectively. For example, FIG. 22A
provides a shoulder function wellness score interface 2201 that provides a
graphically represented wellness score progress chart 2210A with a
shoulder function wellness score 2215A of 58, which is determined by
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applying a scoring procedure associated with the American Shoulder &
Elbow Surgeons Assessment to the patient's responses to that
questionnaire and adjusting the determined wellness score to be on an
adjusted scale of 0-100. Wellness score progress chart 2210A is also
associated with a date on which the wellness score was determined 2220
(i.e., January 26th) and a message regarding when the next administration
of the OMD will occur (i.e., your next result check: Apr 12th). Shoulder
function wellness score interface 2201 also provides a scrolling
mechanism 2230 by which a patient may advance through various (in this
case, four) interfaces associated with the patient's shoulder treatment
and/or wellness account.
[000313] Shoulder function wellness score interface 2201 has a heading
2205A that includes the name of the OMD (in this case, American
Shoulder & Elbow Surgeons Assessment) as well as what the OMD
measures in non-technical/medical language using alternate terminology
(in this case, shoulder function). A purpose of heading 2205A is to
describe the wellness score provided by interface 2201 in a meaningful
way to the patient. The information included in heading 2205A may be
added to the heading using alternate terminology associated with, for
example, the medical condition of the patient, a name of the OMD
administered to the patient, a treatment the patient is undergoing or has
undergone, and so on.
[000314] Shoulder function wellness score interface 2201 also includes a
recovery timeline icon 2235A, an add to calendar icon 2240, a question
sources icon 2245A, and a leave feedback icon 2250. Selection of
recovery timeline icon 2235A causes a recovery timeline interface related
to shoulder function to be displayed, selection of add to calendar icon
2240 causes the next scheduled administration of the OMD to be added to
the patient's calendar, selection of question sources icon 2245A causes a
question sources interface that includes sources of medical literature
related to the American Shoulder & Elbow Surgeons Assessment and/or
shoulder function to be displayed, and selection of leave a feedback icon
2150 causes a feedback interface to be displayed.
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[000315] FIG. 22B provides an exemplary behavior due to pain interface
2202 that provides a graphically represented wellness score progress
chart 2210B with a behavior due to pain wellness score 2215B of 22,
which is determined by applying a scoring procedure associated with the
NIH PROM IS CAT Pain Behavior questionnaire to the patient's responses
to that questionnaire and adjusting the determined wellness score to be on
an adjusted scale of 0-100. In this way both wellness scores (pain
behavior and shoulder function) are provided to the patient on the same
scale. Wellness score progress chart 2210B is also associated with a date
on which the wellness score was determined 2220 (i.e., January 26th) and
a message regarding when the next administration of the OMD will occur
(i.e., your next result check: Apr 12th). Behavior due to pain wellness
score interface 2205B also provides a scrolling mechanism 2230 by which
a patient may advance through various (in this case, four) interfaces
associated with the patient's shoulder treatment and/or wellness account.
[000316] Behavior due to pain wellness score interface 2202 has a
heading 2205B that includes the name of the OMD (in this case, NIH
PROM IS CAT Pain Behavior) as well as what the OMD measures in non-
technical/medical language in alternate terminology (in this case, behavior
due to pain). A purpose of heading 2205B is to describe the wellness
score provided by interface 2202 in a meaningful way to the patient and to
provide context for the wellness score. The information included in
heading 2205B may be added to the heading using alternate terminology
associated with, for example, the medical condition of the patient, a name
of the OMD administered to the patient, a treatment the patient is
undergoing or has undergone, and so on.
[000317] Behavior due to pain interface 2202 also includes a recovery
timeline icon 2235B, add to calendar icon 2240, a question sources icon
2245B, and leave feedback icon 2250. Selection of recovery timeline icon
2235B causes a recovery timeline interface related to behavior due to pain
to be displayed and selection of question sources icon 2245B causes a
question sources interface that includes sources of medical literature
related to the NIH PROM IS CAT Pain Behavior, pain, and/or shoulder
surgery to be displayed.
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[000318] FIG. 22C provides an exemplary physical function wellness
score interface 2203 that provides a graphically represented wellness
score progress chart 2210C with a physical function wellness score 2215C
of 22, which is determined by applying a scoring procedure associated
with the NIH PROMIS CAT Physical Function questionnaire to the
patient's responses to that questionnaire and adjusting the determined
wellness score to be on an adjusted scale of 0-100. Wellness score
progress chart 2210C is also associated with a date on which the wellness
score was determined 2220 (i.e., January 26th) and a message 2225C
regarding when the next administration of the OMD will occur (i.e., your
next result check: Apr 12th). Physical function wellness score interface
2203 also provides scrolling mechanism 2230.
[000319] Physical function wellness score interface 2203 has a heading
2205C that includes the name of the OMD (in this case, NIH PROMIS CAT
Physical function) as well as what the OMD measures in non-
technical/medical language (in this case, physical function). A purpose of
heading 2205C is to describe the wellness score provided by interface
2203 in a meaningful way to the patient and to provide context for the
wellness score so they can understand his or her medical condition and/or
treatment. The information included in heading 2205C may be added to
the heading using alternate terminology associated with, for example, the
medical condition of the patient, a name of the OMD administered to the
patient, a treatment the patient is undergoing or has undergone, and so
on.
[000320] Physical function interface 2203 also includes a recovery
timeline icon 2235C, add to calendar icon 2240, a question sources icon
2245C, and leave feedback icon 2250. Selection of recovery timeline icon
2235C causes a recovery timeline interface related to physical function to
be displayed and selection of question sources icon 2245C causes a
question sources interface that includes sources of medical literature
related to the NIH PROMIS CAT physical function OMD, pain, physical
function, and/or shoulder surgery to be displayed.
[000321] FIG. 22D provides an exemplary pain interference wellness
score interface 2204 that provides a graphically represented wellness
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score progress chart 2210D with a pain interference wellness score 2215D
of 34, which is determined by applying a scoring procedure associated
with the NIH PROMIS CAT Pain Interference questionnaire to the patient's
responses to that questionnaire and adjusting the determined wellness
score to be on an adjusted scale of 0-100. Wellness score progress chart
2210D is also associated with a date on which the wellness score was
determined 2220 (i.e., January 26th) and a message 2225D regarding
when the next administration of the OMD will occur (i.e., your next result
check: Apr 12th). Pain interference wellness score interface 2204 also
provides scrolling mechanism 2230.
[000322] Pain interference wellness score interface 2204 has a heading
2205D that includes the name of the OMD (in this case, NIH PROMIS CAT
Pain Interference) as well as what the OMD measures in non-
technical/medical language (in this case, pain interference function). A
purpose of heading 2205D is to describe the wellness score provided by
interface 2204 in a meaningful way to the patient and to provide context for
the wellness score so they can understand their medical condition and
treatment. The information included in heading 2205D may be added to
the heading using alternate terminology associated with, for example, the
medical condition of the patient, a name of the OMD administered to the
patient, a treatment the patient is undergoing or has undergone, and so
on.
[000323] Pain interference wellness score interface 2204 also includes a
recovery timeline icon 2235D, add to calendar icon 2240, a question
sources icon 2245D, and leave feedback icon 2250. Selection of recovery
timeline icon 2235D causes a recovery timeline interface related to pain
interference to be displayed and selection of question sources icon 2245D
causes a question sources interface that includes sources of medical
literature related to the NIH PROMIS CAT Pain Interference OMD, pain,
and/or shoulder surgery to be displayed.
[000324] FIG. 22E provides an exemplary pain interference recovery
timeline interface 2206 for pain interference wellness scores and
projected/predicted pain interference wellness scores for the patient. Pain
interference recovery timeline interface 2206 may be provided to the
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patient upon selection of recovery timeline icon 2235D and may provide
heading 2205D, and a recovery timeline graph 2255 that plots wellness
scores on a scale of 1-100 vs. time as measured in months. Graph 2255
provides the determined pain interference wellness score 2215D of pain
interference interface 2104 (i.e., 34), a first predicted/projected pain
interference wellness score 2260A, and a second predicted/projected pain
interference wellness score 2260B. Predicted/projected pain interference
wellness scores 2260A and 2260B may be determined via one or more
processes described herein.
[000325] Continuing with this example, at a predetermined time following
treatment for the shoulder injury (e.g., 3 months after shoulder surgery to
fix the shoulder injury, or April 12th), the patient may be provided with the
American Shoulder & Elbow Surgeons Assessment, the NIH PROMIS
CAT Pain Behavior questionnaire, the NIH PROMIS CAT Physical
Function questionnaire, and the NIH PROMIS CAT Pain Interference
questionnaire (step 1045) and a post-treatment set of responses thereto
may be received (step 1050) and stored (step 1055).
[000326] Then, a post-treatment wellness score for the medical
condition/treatment (shoulder surgery) for shoulder function, behavior due
to pain, physical function, and pain interference may be determined (step
1065) by applying a scoring procedure associated with the American
Shoulder & Elbow Surgeons Assessment to responses to questions from
the American Shoulder & Elbow Surgeons Assessment received in step
1050, applying a scoring procedure associated with the NIH PROMIS CAT
Pain Behavior questionnaire to responses to questions from the NIH
PROMIS CAT Pain Behavior questionnaire received in step 1050, applying
a scoring procedure associated with the NIH PROMIS CAT Physical
Function questionnaire to responses to questions from NIH PROMIS CAT
Physical Function questionnaire received in step 1050, and applying a
scoring procedure associated with the NIH PROMIS CAT Physical
Function questionnaire to responses to questions from NIH PROMIS CAT
Physical Function questionnaire received in step 1050.
[000327] Then, a post-treatment wellness score for the patient's shoulder
function, behavior due to pain, physical function, and pain interference
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may be determined (step 1060) and provided to the patient (step 1075). In
some cases, these may be separate scores (i.e., one for each) and, in
other cases, the scores may be combined into a single overall post-
treatment wellness score. Additionally, or alternatively, one or more of the
post-treatment wellness scores may be combined. For example, the post-
treatment wellness scores for shoulder function and physical function may
be combined into a single function post-treatment wellness score and/or
the post-treatment wellness scores for pain interference and pain behavior
may be combined into a single pain post-treatment wellness score.
[000328] In some embodiments, providing or facilitating the provision of a
wellness score (pre-treatment and/or post-treatment) and/or an
improvement score to a patient (step 1075) may include transforming
these scores into numbers and/or statements that are meaningful to,
and/or more easily understood by, the patient. In some instances, this
may involve converting a score calculated on a scale that is not readily
understood to a scale that is more easily understood by most
people/patient. Consider, for example, an OMD where the scoring
procedure indicates that a scale for wellness scores generated therefrom
is from 1-64 (with 64 being maximum wellness score). According to this
scale, a wellness score of 60 (which may also be considered a raw score)
is quite good. However, for people unaccustomed to scales of this type,
this wellness score may be misunderstood as a 60% wellness score when,
in reality, the adjusted, or percentage based, wellness score is 94%.
Thus, providing a wellness score of 94 to a patient is more meaningful to
him or her than the raw, unadjusted, score of 60.
[000329] Additionally, or alternatively, providing or facilitating the
provision of a wellness score (pre-treatment and/or post-treatment) and/or
an improvement score to a patient, treatment facility, treatment provider,
and/or treatment administrator (step 1075) may include adjusting the
wellness and/or improvement score(s) so that they are provided on a
common scale so that, for example, results from different OMDs that may
be scored using different scoring procedures and/or scales may be more
easily, for example, compared, averaged, analyzed, and understood. One
way to perform this adjustment is to perform a percentage calculation
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using the determined wellness score and/or improvement score and the
maximum wellness score; all of which may be determined on a scale
specific to the related OMD as follows:
Wellness Score *100% (Equation 1)
Maximum Wellness Score
[000330] Additionally, or alternatively, providing or facilitating the
provision of a wellness score (pre-treatment and/or post-treatment) and/or
an improvement score and/or facilitating provision of the OMD to a patient
may include using commonly understood terms for medically-related
information that may be meaningful to, and/or more easily understood by,
the patient instead of the medically precise terminology used to explain
medical treatment and/or an OMD to fellow medical professionals. In
some circumstances, providing the wellness and/or improvement scores to
the patient in this manner may include, for example, using the alternate
terminology associated with an OMD to which a patient has responded.
For example, if a patient has undergone a repair of retinal detachment by
diathermy treatment (which is associated with CPT treatment code of
67101), then references to the treatment provided to the patient in, for
example, steps 1020, 1045, and 1075 may refer to "eye surgery" or "vision
function" instead of "repair of retinal detachment by diathermy."
[000331] In another example, a patient undergoing rotator cuff repair
surgery may be provided with the American Shoulder & Elbow Surgeons
Assessment OMD in steps 1020 and/or 1045. However, when providing
questions to the patient in steps 1020 and/or 1045 the treatment may be
referred to as "shoulder surgery" rather than "rotator cuff repair surgery."
Likewise, instead of providing an "American Shoulder & Elbow Surgeons
Assessment" wellness or improvement score to the patient a "shoulder
function" or "shoulder pain" wellness or improvement score may be
provided to the patient in step 1075. Using terminology easily understood
by the patient, instead of medically specific terminology, makes the
wellness scores and/or improvement scores provided to the patient more
meaningful and more easily understood. Thus, the patient may have
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greater incite into his or her wellness and/or treatment recovery because
the medical information provided to them it is more easily understood by
him or her.
[000332] In some embodiments, a portion of process 1000 (e.g., steps
1045-1085) may be repeated over time (e.g., monthly, quarterly, etc.) to
periodically determine a patient's pre-treatment and/or post-treatment
wellness scores over time as, for example, one or more treatments for
underlying medical condition are administered. For example, FIG. 17H
provides an exemplary interface 1707 that provides a graph 1770 that
shows a patient's wellness scores from October 2015 through July 2016
with regard to a knee condition for a particular patient. In the embodiment
of FIG. 17H, the OMD used to determine the patient's wellness scores is
the NIH PROMIS Physical Function CAT questionnaire. This
questionnaire has been provided to the patient in October 2015,
November 2015, January 2016, March 2016, April 2016, and July 2016
and wellness scores determined from responses thereto are plotted on
graph 1770. Also shown on graph 1770 are the dates of various
treatments for the knee injury. More specifically, graph 1770 shows that
the patient was treated with a cortisone injection in October of 2015, a
knee arthroscopy in January of 2016 and a knee replacement in May of
2016. Using this graph, the patient and/or his or her treatment provider
and/or treatment facility can see how the medical condition has changed
over time with the administration of the 3 treatments (i.e., cortisone
injection, knee arthroscopy, and knee replacement). The patient and/or
his or her treatment provider and/or treatment facility may also use
historical wellness score information to make decisions regarding future
treatment. For example, the patient's wellness score for physical function
of his knee in October 2015 was 30. In November of 2015 it improved to
39 but then went down to 37 in January of 2016. The patient's post-knee
arthroscopy wellness score taken in late February of 2016 shows that the
patient's knee physical function improved after surgery to a wellness score
of 50 and then declined somewhat to 45 in April of 2016. The patient then
had a knee replacement in May of 2016 and his or her post-knee-
replacement-surgery wellness score improved to 70.
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[000333] FIG. 10C provides a flowchart of an exemplary process 1001 for
providing a wellness score to a patient, in accordance with some
embodiments of the present invention. Process 1001 may be executed
by, for example, any of the systems, system components, or of system
combination of components thereof disclosed herein. In some instances,
process 1001 may be executed solely by a patient's personal electronic
device, such as patient device 128 and, in other instances; process 1001
may be executed via communication between the patient's personal
electronic device and a server, such as server 102.
[000334] Initially, provision of an OMD and/or a set of OMDs to a patient
may be facilitated (step 1090). Step 1090 may be executed via, for
example, a patient wellness account running on the patient's device. In
some instances, provision of the OMD and/or set of OMDs may be
facilitated by communication of a hyperlink to the patient's device and
selection of the link, may facilitate provision of an interface like
interfaces
1702, 1702, and 1704, of FIGs. 17C-17E, respectively, to the patient and
which may provide the OMD and/or set of OMDs or questions therefrom to
the patient. In some circumstances, execution of step 1090 may be
responsive to a patient activating his or her wellness account via, for
example, selection of an icon provided by an interface like interfaces 1700
and 1701 of FIGs. 17A and 17B, respectively.
[000335] In step 1091, responses to the OMD and/or set of OMDs and/or
questions provided thereof may be received via, for example, interaction
with question and the response icons of an interface like interfaces 1702,
1702, and 1704, of FIGs. 17C-17E. Optionally, when a set of OMDs are
provided in step 1090, each of the received responses of the set of
responses may be associated with the OMD that provided the question
associated with the respective response so as to create one or more sets
of responses wherein each set of responses is associated with a
respective one OMD (step 1092). In this way the set of responses is
separated into sets that are appropriate for each OMD so that they may be
appropriately scored using a scoring procedure associated with the
respective OMD (step 1093).
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[000336] Next, in step 1094, a raw wellness score for each set of
responses may be determined using a scale established by the scoring
procedure so that when a plurality of OMDs are provided to the patient, a
raw wellness score for responses to each OMD is determined. Thus,
when a set of OMDs is provided in step 1090, a plurality of raw wellness
scores (e.g., one for each OMD) may be determined. Optionally, in step
1095, the raw score(s) may be adjusted and/or normalized to a preferred
scale (e.g., 0-10 or 0-100) so that, for example, all wellness scores
provided to the patient (as determined via scoring a plurality of OMDs) are
provided on the same scale. The preferred scale may be selected based
on scale that may be easily understood by the patient. At times, execution
of step 1095 may be unnecessary when, for example, the raw score is
already determined using the preferred scale (as may be the case when
the scale of the scoring procedure and the preferred scale is the same).
When multiple raw wellness scores are generated in step 1094, then
converting the raw wellness scores into adjusted wellness scores may
include normalizing the multiple raw scores to the same scale.
[000337] Then, in step 1096, provision of the adjusted wellness score(s)
may be facilitated via, for example, presentation of one or more interfaces
like interfaces 2101, 2102, 2103, 2104, 2201, 2202, 2202, 2203, 2204,
and/or 2205 provided by FIGs. 21A-21D and 22A-22E, respectively. In
some cases, the raw and/or adjusted wellness score may also be provided
to a treatment provider, treatment administrator, and/or caregiver. In step
1097, the raw and/or adjusted wellness score(s) may be stored in, for
example, score database 120 and/or the patient's device. In some
circumstances, the raw and/or adjusted wellness score(s) may be stored
in, for example, the patient's EMR and/or a registry of information such as
medical-condition-specific registry of information, treatment-specific
registry of information, disease-specific registry of information, medical-
condition-specific registry of information, diagnosis-specific registry of
information, treatment-facility-specific registry of information, and/or
treatment-provider-specific registry of information.
[000338] Optionally, a patient's interaction with his or her wellness
account may include entering and/or adding a patient note thereto. Patient
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notes may relate to a life event and/or stressor that may affect the patient's
health, recovery from a treatment, recovery from a diagnosis, wellness
score, and/or improvement score that the patient wishes to make his or
her treatment provider(s) aware of. A patient may enter a patient note into
his or her wellness account at any time (e.g., times other than providing
responses to a scheduled OMD). On most occasions, the patient note will
be added to the patient's wellness account and, in some instances, the
patient note may also be entered into the patient's EMR.
[000339] A patient may enter a patient note via interaction with one or
more interfaces, such as interfaces 1708, 1709, and/or 1711 as will be
discussed below with regard to FIGs. 171, 17J, and 17K, respectively.
Interface 1708 of FIG. 171 provides an introductory patient note interface
with an array 1771 of buttons 1770, each of which correspond to an
exemplary life event and/or stressor from which the patient may choose.
For example, array 1771 provides a got married button 1770A, a got
divorces button 1770B, a fell button 1770C, a changed job button 1770D,
a lost job button 1770E, a death in the family button 1770F, an illness of
loved one button 1770G, an automobile accident button 1770H, and a
moved houses button 17701. Array 1771 also includes an add a note
button 1775 by which a patient may add a patient note about a life event
and/or stressor not included in array 1771. A patient may interact with
interface 1708 by selecting a button 1770 (e.g., got divorced button
1770B) and, selection of the button may trigger display of a subsequent
interface 1709 into which a patient may enter information regarding the
selected life event/stressor. For example FIG. 17J provides an exemplary
interface 1709 into which the patient may enter further information (e.g.,
date, stress level as measured on a scale of, for example, 1-10 or 1-5)
following selection of got divorced button 1770B. More particularly,
interface1709 provides a selected life event (got a divorce) icon 1780
along with a field 1785 into which the patient may enter information (e.g.,
date or date range) about the selected life event 1780. On some
occasions, a patient may also enter narrative information to be included in
a patient note via interaction with an interface like interface 1711 of FIG.
17K, which proves a text entry field 1785, a done button 1791, and an add
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a note button 1792. The patient may indicate that his or her entry of a
patient note is complete upon selection of done button 1791 and may
indicate that he or she has more to add to this patient note and/or another
patient note to enter via selection of add a note button 1792. In some
embodiments, selection of done button 1791 triggers the saving of the
patient note to the patient's wellness account and/or EMR. In some
instances, selection of done button 1791 may trigger preparation and
transmission of a notification to a treatment provider. For example, if fall
button 1770C is selected by the patient, then his or her treatment provider
may be notified that the patient has fallen in, for example, a manner
consistent with the notifications disclosed herein.
[000340] FIG. 11 provides a flowchart of a process 1100 for providing an
indication of patient's wellness to the patient. Process 1100 may be
executed by, for example, any of the systems, components, or
combination of components thereof disclosed herein.
[000341] Optionally, in step 1105, a request to access a wellness account
for a patient may be received. Exemplary requesters include patients,
treatment providers, and/or caregivers for patients. The wellness account
for the patient may be the wellness account generated and/or modified via
execution of all, or part of, process 900 as described above. Exemplary
requests to access a wellness account include, but are not limited to,
opening, or starting, a software application that provides the wellness
account, and signing into a software application that provides the wellness
account. Often times, the request may be received via a patient device,
such as patient device 128. Then, in step 1110, information from the
wellness account may be provided to the patient. Exemplary information
provided at step 1110 includes a welcome message, an indication of
information to be entered into the patient's account, an initial wellness
indicator or score, and an indication of the patient's wellness the last time
he or she accessed the patient wellness account.
[000342] It may then be determined (whether or not steps 1105 and 1110
are executed) whether or not to provide the patient with an OMD (step
1115). Execution of step 1115 may involve accessing one or more
wellness protocol(s) associated with the patient's wellness account and
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determining whether the wellness protocol requires or recommends the
provision of an OMD to the patient and/or the occurrence of one or more
trigger events. Execution of step 1115 may also include determining
which OMD to provide to the patient and/or when to provide it. This
determination may also involve accessing one or more wellness
protocol(s) associated with the patient's wellness account and determining
which OMD(s) the wellness protocol requires or recommends providing to
the patient. When an OMD is not to be provided to the patient, process
1100 may end.
[000343] When an OMD is to be provided to the patient, a response, or
set of responses, to the OMD may be received in step 1120. The
response(s) may be received via, for example, an interface of the patient's
device and/or the patient's EMR. The received response may then be
compared to a baseline recovery vector and/or modified baseline recovery
vector associated with the patient wellness account (step 1125) and an
indication of the patient's wellness may be generated (step 1130) and
provided to the patient (step 1135) via, for example, an interface like the
interfaces provided in FIGs. 17F, 17G, and/or 18A-18N. Exemplary
indications of a patient's wellness include a pre-treatment wellness score,
a post-treatment wellness score, and/or an improvement score.
[000344] FIG. 12 provides a flowchart of an exemplary process 1200 for
determining an effectiveness score for treatment provider, treatment,
and/or treatment facility. Process 1200 may be performed by, for
example, any of the systems, system components or combination of
system components discussed herein.
[000345] Initially, a pre-treatment wellness score database, such as score
database 120, may be accessed in order to retrieve a pre-treatment
wellness score for a medical condition of a patient (step 1205). In some
instances, step 1205 may include the generation of a pre-treatment
wellness score via execution of, for example, process 1000. The pre-
treatment wellness score may assess one or more aspects (e.g., pain,
degree of mobility, average blood flow) of the medical condition of the
patient prior to the patient being treated for the medical condition.
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[000346] Next, an OMD (typically in the form of a questionnaire) may be
provided to the patient following the patient being treated for the medical
condition (step 1210). The OMD may be associated with and/or indexed
with one or more scoring procedures stored in, for example, a scoring-
procedures database such as scoring procedure database 116. In some
instances, the OMD and/or a process for selecting the OMD provided in
step 1210 may include determining a patient compliance question relating
to the patient's compliance with pre-treatment instructions for preparing for
the treatment and/or post-treatment instructions for recovering from the
treatment. In step 1215, responses to the OMD may be received from the
patient. Often times, the responses will indicate a state of the medical
condition following the treatment. In some cases, the received responses
may indicate a patient-perceived effectiveness of the treatment in treating
the medical condition.
[000347] Upon receipt of the responses, the scoring-procedures database
may be accessed to retrieve the one or more scoring procedures indexed
to the OMD that has been provided to the patient (step 1220) and the
received responses may be evaluated (or scored) using the retrieved one
or more scoring procedures (step 1225) to determine a post-treatment
wellness score for the medical condition based on the evaluation (step
1230). An improvement score for the patient's medical condition using the
pre-treatment wellness score and the post-treatment wellness score may
then be determined (step 1235). Exemplary processes for determining the
improvement score were described above with regard to FIG. 10B. In
some embodiments, when for example, an improvement score for a
patient is already available (as stored in, for example, score database 120)
steps 1205-1230 may not be performed and execution of step 1235 may
involved accessing the improvement score database 120 to retrieve an
improvement score for the patient.
[000348] Next, in step 1240, an effectiveness score for the treatment
provider, treatment and/or treatment facility may be determined based on
the improvement score of step 1235. The effectiveness score may serve
to indicate a degree of effectiveness for the treatment provider, treatment,
and/or treatment facility at providing the treatment and/or treating the
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medical condition. In may cases, process 1200 may be repeated with a
plurality of patients so as to determine an average, or weighted,
effectiveness score for a treatment provider and/or treatment facility
across the plurality of patients.
[000349] In circumstances where a patient compliance question was
included in the OMD provided via step 1210, determination of the
effectiveness score may also include analysis of the patient's response to
the patient compliance question to determine what, if any, impact the
patient's compliance may have had on the improvement score
determination and/or effectiveness of the treatment. For example, in some
embodiments, when a relatively small portion (e.g., 6%, 10%, or 15%) of
patients associated with a particular treatment provider and/or treatment
facility answer that they have not complied with the pre-treatment and/or
post-treatment instructions, one or more responses to the OMD received
in, for example, step 1215 may be disregarded (i.e., not used) when
determining the effectiveness score in step 1245. These responses may
be disregarded because the patient's failure to comply may adversely
affect their recovery through no fault of the treatment provider and/or
treatment facility.
[000350] If, however, a number of patients who report not complying with
pre-treatment and/or post-treatment instructions exceeds a threshold (e.g.,
10%, 20%, or 30%) then, this failure of compliance rate may indicate that
the treatment provider and/or treatment facility is not properly
administering pre-treatment and/or post-treatment instructions and/or
equipment for the care of the patient's medical condition, which may be an
indicator of how effective the treatment provider and/or treatment facility
is.
Thus, when a sufficiently high number of patients indicate that that they did
not comply with pre-treatment and/or post-treatment instructions the
responses received in step 1215 may be included in a determination of an
effectiveness score (step 1245) for the treatment provider and/or treatment
facility. In most instances, when a patient indicates a lack of compliance
with pre-treatment and/or post-treatment instructions, responses received
in step 1215 may not be used to determine the effectiveness score of the
treatment. In most cases, responses received in step 1215 may not be
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used to determine the effectiveness score of the treatment (step 1245)
because, in many cases, it may be assumed that compliance with pre-
treatment and/or post-treatment instructions is not a component of the
effectiveness of the treatment itself (i.e., removed from the treatment
provider and/or treatment facility).
[000351] Further details regarding how an effectiveness score may be
determined (i.e., execution of step 1245) are provided below with regard to
FIGs. 15A-15C.
[000352] In some instances, execution of step 1240 may include
accessing the patient's EMR to retrieve information regarding the patient's
medical condition (e.g., treatment outcome measurements, wellness
scores, improvement scores, prior treatments, general health, other
factors, etc.) and the determination of step 1240 may incorporate the
retrieved information.
[000353] The determined effectiveness score may then be stored in, for
example, a treatment-provider database (step 1245). Often times, storage
of the effectiveness score includes indexing the effectiveness score to the
treatment, the treatment provider, and/or other factors relating to the
treatment, patient (demographic information, comorbidities, etc.), or
medical condition. In some instances, storing the effectiveness score may
also include indexing the effectiveness score with one or more of the pre-
treatment wellness score, the post-treatment wellness score, the
improvement score, the treatment, and the patient.
[000354] When some, or all, of process 1200 is performed a plurality of
times thereby determining a plurality of effectiveness scores for the
treatment provider and each of the treatment provider effectiveness scores
are stored in treatment provider database 121 (or score database 120)
and indexed to the treatment provider, the treatment-provider database
upon, for example, receipt of a request for an effectiveness score for the
treatment provider, may be accessed to retrieve the effectiveness scores
for the treatment provider and the retrieved effectiveness scores may be
used to determine an effectiveness score for the treatment provider based
on an analysis of the retrieved improvement scores, which may also be
stored in the treatment-provider database.
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[000355] In some instances, process 1200 may be performed any number
of times for any number of treatment providers. In some instances,
process 1200 may be performed a number of times when a particular
treatment provider performs the same treatment (called treatment A for the
purposes of this example), thereby generating a plurality of effectiveness
scores for the particular treatment provider when he or she performs
treatment A. This plurality of effectiveness scores may then be processed,
or otherwise analyzed, in order to calculate an aggregate, or average,
effectiveness score for the particular treatment provider when performing
treatment A that may be more statistically robust than a single
effectiveness score determination. Additionally, or alternatively, process
1200 (or a portion thereof) may be performed for multiple treatment
providers who perform treatment A. In these instances, the effectiveness
scores for each treatment provider for performing treatment A may be
compared. It is important to note that for this example, any number of
esoteric factors and/or other considerations may be used to define the
characteristics of treatment A. Each of the effectiveness scores may be
stored in the treatment-provider database 121 (or score database 120)
and indexed to the respective treatment provider and, optionally, to the
treatment performed by the respective treatment provider and/or a
treatment facility associated with the respective treatment or treatment
provider. Then, for each treatment provider of the plurality, the treatment-
provider database may be accessed to retrieve the effectiveness scores
for the treatment provider.
[000356] When a request for an effectiveness score for at least one
treatment provider associated with a treatment and/or diagnosis is
received from a user, the treatment-provider database may be accessed to
retrieve the requested effectiveness score, which may, in turn be provided
to the user by, for example, facilitating display of the retrieved
effectiveness score to the user on a display device such as patient device
128 and/or treatment provider device 124. At times, the effectiveness
score may be displayed on a map as shown on interfaces 1901 and 1902
of FIGs. 19A and 19B, respectively
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[000357] In one embodiment, process 1200 and/or a portion thereof may
be performed more than once (e.g., twice, three times, etc.) as may be the
case when the OMD and/or medical questionnaire is associated with
multiple scoring procedures and/or a scoring procedure and one or more
sub-scoring procedures and one or more of the responses may be
separately evaluated using, for example, a first and second scoring
procedure. From there, a first post-treatment wellness score for the
medical condition may be determined based on analysis of one or more of
the responses using the first scoring procedure and a second post-
treatment wellness score for the medical condition may be determined
based on analysis of one or more of the responses using the second
scoring procedure.
[000358] Then, first and second improvement sub-scores for the patient's
medical condition may be determined using the pre-treatment wellness
score and the first and second post-treatment wellness scores,
respectively. The first and second improvement sub-scores may then be
used to re-calculate and/or modify the effectiveness score (for the
treatment provider) determined in step 1240.
[000359] At times, process 1200 may also include selecting received
responses received in step 1215 that are relevant to the treatment facility
and evaluating the selected responses using one or more scoring
procedures. That evaluation may then be used to determine an
effectiveness score for the treatment facility.
[000360] In some instances, process 1200 may be performed a plurality
of times for a plurality of patients and/or treatment providers who are
affiliated with a treatment facility or a plurality of treatment facilities in
order
to, for example, determine an effectiveness score of the treatment facility
and/or facilities. In one embodiment, determining an effectiveness score
of the treatment facility and/or facilities may include retrieving the
effectiveness scores for the treatment for each of the treatment providers
associated with a treatment facility and/or treatment facilities. The
retrieved effectiveness scores may be used to determine an effectiveness
score for the treatment facility/facilities, which may be stored in a score
database, like score database 120. Storage of the effectiveness score
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may include indexing the effectiveness score to the treatment facility
and/or treatment providers associated with the treatment facility.
[000361] In one embodiment, a treatment may be provided by more than
one treatment provider (e.g., a surgeon and a physical therapist or a
surgeon and an anesthesiologist). In this embodiment, a first set of
responses that are relevant to the first treatment provider may be selected
from the responses received in step 1215. The first selected set of
responses may then be evaluated using one or more appropriate scoring
procedures and a post-treatment wellness score for the medical condition
for the first treatment provider may be determined. Then, an improvement
score for the patient's medical condition as it relates to the first treatment
provider may be determined using the pre-treatment wellness score and
the post-treatment wellness score for the first treatment provider. This
improvement score may be used to determine an effectiveness score for
the first treatment provider, which may be stored in, a score database like
score database 120. This storage may include including indexing the
effectiveness score of the first treatment provider to the treatment and the
first treatment provider.
[000362] Then, a second set of responses that are relevant to the second
treatment provider may be selected from the responses received in step
1215. The second selected set of responses may then be evaluated using
one or more appropriate scoring procedures and a post-treatment
wellness score for the medical condition for the second treatment provider
may be determined. Then, an improvement score for the patient's medical
condition as it relates to the second treatment provider may be determined
using the pre-treatment wellness score and the post-treatment wellness
score for the second treatment provider. This improvement score may be
used to determine an effectiveness score for the second treatment
provider, which may be stored in the score database 120 and/or the
treatment provider database. This storage may include including indexing
the effectiveness score of the second treatment provider to the treatment
and the second treatment provider.
[000363] In some circumstances, process 1200 may be repeated upon,
for example, an expiration of a predetermined time period measured from
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performance of the treatment as may be determined by, for example, a
schedule of a patient's wellness account in order to determine a
subsequent effectiveness score for the treatment provider, which may be
based on, for example, the improvement score determined in step 1235
and/or a subsequent execution of step 1235. The subsequent
effectiveness score may provide insight into a treatment provider's
effectiveness at performing the treatment over time.
[000364] FIGs. 13A and 13B provide flowcharts of an exemplary process
1300 for determining one or more treatment providers for a patient.
Process 1300 begins in FIG. 13A and then continues in FIG. 13B.
Process 1300 may be executed by, for example, any of the systems,
system components, and/or combination of system components disclosed
herein.
[000365] Initially, in step 1301, a request for one or more treatment
providers may be received from a requester. Following such request,
various information may be received (described below in steps 1305,
1320, 1340, 1360 and 1375), and such information may be used to select
one or more treatment providers from a list of treatment providers for
provision to the requester. Exemplary requesters include, but are not
limited to, patients, treatment providers, and/or patient caregivers. In
some instances, the request received in step 1301 may be received via a
patient's wellness account.
[000366] In step 1305, patient symptom, diagnostic, and/or treatment
information may be received by, for example, reporting module 122 from,
for example, treatment provider device 124, patient device 128, and/or
treatment facility computer system 134. In some instances, the
information may be received from, for example, a patient, a caregiver,
and/or a treatment provider (collectively referred to herein as the
"requester") when he or she is attempting to gain information about one or
more treatment providers that may be appropriate for treating a particular
condition or diagnosis for the patient or for performing a particular
treatment. In some instances, the information received in step 1305 may
include one or more preferences of a requester for a treatment provider.
Exemplary preferences include location, area of specialization, board
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certification status, minimum treatment effectiveness scores, years of
experience, treatment provider gender, and/or hospital admission
privileges for a treatment provider. In some instances, the symptom,
diagnostic and/or treatment information received in step 1305 may be
associated with an account of the requester and/or patient that may
supply, for example, a medical history for the patient as well as other
information about the patient (e.g., preferences, age, lifestyle, etc.). In
some instances, the requester and/or patient wellness account may be
able to access and/or extract information from the patient's EMR as may
be stored in, for example, patient EMR database 130 and/or otherwise
associated with the patient's wellness account.
[000367] Next, in step 1310, it may be determined whether additional
information is needed to match the patient symptom, diagnostic, and/or
treatment information received in step 1305 with a treatment and/or
diagnostic code, such as, but not limited to a CPT code. For example, if a
requester enters non-specific diagnostic and/or treatment information in
step 1305, it may be difficult to ascertain the relevant treatment and/or
diagnostic code. Consider, for example, receiving symptom, diagnostic,
and/or treatment information that indicates the patient has a sore leg.
Execution of process 1300 will need more information to determine one or
more appropriate treatment providers for a "sore leg" because this
symptom may have many causes and many appropriate treatments.
[000368] When additional information regarding the symptom, diagnosis,
and/or treatment information is needed, it may be requested (step 1315)
and the requested information may be received in step 1320. Exemplary
methods of requesting more information include, but are not limited to,
asking the requester one or more questions about the patient's symptoms,
diagnosis and/or treatment information. In some instances, these
questions may be targeted, or focused, using information received in step
1305 and/or historical information about the patient that may be accessed,
for example, via the patient and/or requester account. The questions may
take any format (e.g., multiple choice, true/false, sliding scale, etc.) and,
in
some instances, may be used to gauge the severity of the patient
symptom or diagnosis. On some occasions, the request for additional
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information may be provided to the requester via an interface (e.g., visual
and/or audio) on his or her device (e.g., patient device 128 and/or
treatment provider device 124). In some embodiments, a patient may be
provided with a picture of an affected area of the body (e.g., a leg) and
asked to point to a location on the picture the pain where is most severe.
[000369] When additional information is not needed in step 1310 or when
the additional information is received in step 1320, a treatment and/or
diagnostic code matching the received information may be determined
(step 1325). In some instances, step 1325 may be performed by directly
and/or indirectly using the medical literature to assist with the
classification
of the received information as pertaining to one or more treatment and/or
diagnostic codes. On some occasions, step 1325 may be performed via
execution (in whole or in part) of one or more processes described herein
such as process 300 and/or 400.
[000370] In step 1330, it may be determined whether there are other
considerations that overlap and/or interact with a medical condition
associated with the determined treatment diagnostic code. For example,
certain treatment and/or diagnostic codes may be associated with one or
more other considerations as may be indicated and/or stored in other
consideration database 132. For example, a diagnostic code associated
with hypertension may be associated in, for example, other consideration
database 132, with factors such as weight, diet, whether or not the patient
smokes, etc. In another example, a diagnostic code associated with a
form of cancer may be associated with factors that are side effects (e.g.,
nausea, weight loss, insomnia, etc.) of known treatments for the form of
cancer the patient has symptoms of and/or has been diagnosed with. In a
further example, a diagnostic code that is associated with pregnancy may
be associated with factors such as age, weight, previous pregnancies,
diabetes, hypertension, prior miscarriages, etc. In some embodiments,
execution of step 1330 may be included directly and/or indirectly using the
medical literature to assist with determining one or more factors
overlapping with and/or pertaining to one or more treatment and/or
diagnostic codes. In some instances, other considerations and/or factors
that may interact with a medical condition associated with the determined
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treatment diagnostic code may include different aspects of a treatment that
may have been, or may need to be, performed.
[000371] In step 1335, information regarding the one or more other
considerations determined in step 1330 may be requested from the patient
and/or requester. Exemplary methods of requesting more information
include, but are not limited to, asking the requester one or more questions
about the patient's symptoms, diagnosis and/or treatment information via
an interface displayed on the patient's patient device, such as patient
device 128. In some instances, these questions may be targeted, or
focused, using information received in step 1305, step 1320, and/or
historical information about the patient that may be accessed, for example,
via the patient's EMR and/or patient wellness account. The questions may
take any format (e.g., multiple choice, true/false, sliding scale, etc.) and,
in
some instances, may be used to gauge the severity of the patient
symptom or diagnosis. On some occasions, the request for additional
information may be provided to the requester via an interface (e.g., visual
and/or audio) on his or her device (e.g., patient device 128 and/or
treatment provider device 124). In some embodiments, a patient's and/or
requester's answer to a question may trigger the request for still more
information. For example, if smoking is determined to be an other
consideration for a treatment and/or diagnostic code, the patient and/or
requester may be asked whether he or she smokes and, upon receiving
the information that the patient does smoke, one or more follow up
questions (e.g., how many cigarettes per day, how many years has he or
she been a smoker, etc.) may be asked via execution of step 1335. In
another example, if the treatment code determined in step 1325 is
card iothoracic surgery, then a number of other considerations, or sub-
treatments factor into the "cardiothoracic surgery" treatment, such as
anesthesia, wound care, post operative care, medication, etc. and the
information requested in step 1335 may relate to one or more of these
factors or sub-factors.
[000372] In step 1340, the requested additional information may be
received. When there are no other considerations in step 1330 and/or
when the additional information is received in step 1340, it may be
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determined whether enough information regarding the patient has been
received to determine one or more treatment providers that are
appropriate for the patient (step 1345, which is shown in FIG. 13B). When
enough information has been received, process 1300 advances to step
1380, which will be discussed below. When insufficient information has
been received (step 1345), step 1330 and/or 1310 may be repeated to
determine if there are additional other considerations associated with the
treatment and/or diagnostic code that may be relevant and then steps
1335-1345 may be repeated as well. Additionally, or alternatively, when
insufficient information has been received in step 1345, it may be
determined if one or more esoteric factors are known to be indirectly
related to the disease and/or treatment code (step 1350). Execution of
step 1350 may be performed by directly and/or indirectly using the medical
literature to assist with the classification of the received information as
pertaining to one or more treatment and/or diagnostic codes. Esoteric
factors include factors that do not contribute directly to the patient's
diagnosis and/or treatment but may, in some way, affect his or her health.
Exemplary esoteric factors include region of the country where a patient
lives or works, a patient's race or ethnicity, a patient's socio-economic
status, and so on. In some instances, when no esoteric factors are known,
process 1300 may repeat step(s) 1310 and/or 1330.
[000373] When there are one or more esoteric factors that relate to the
disease and/or treatment code, information regarding the esoteric factors
may be requested (step 1355). Exemplary methods of requesting more
information include, but are not limited to, asking the requester one or
more questions about the patient's symptoms, diagnosis and/or treatment
information. In some instances, these questions may be targeted, or
focused, using information received in step 1305, step 1325, step 1340,
and/or historical information about the patient that may be accessed via,
for example, the requester and/or the patient's wellness account. The
questions may take any format (e.g., multiple choice, true/false, sliding
scale, etc.) and, in some instances, may be used to gauge the severity of
the patient symptom or diagnosis. On some occasions, the request for
additional information may be provided to the requester via an interface
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(e.g., visual and/or audio) on his or her device (e.g., patient device 128
and/or treatment provider device 124). In some embodiments, a patient's
and/or requester's answer to a question may trigger the request for still
more information. For example, if an esoteric factor for a particular
treatment and/or diagnostic code is exposure to lead then, the request for
additional information may ask the patient and/or requester whether the
patient lives in a house that is more than 50 years old, whether the patient
lives in a house that has old paint, and/or whether the patient lives in an
area that is known to have lead in the water supply.
[000374] Optionally, in some instances, execution of process 1300 may
include determining whether or not to provide an OMD to a patient (step
1365). When step 1365 is performed, selection of the OMD to provide to
the patient may be based upon, for example, some, or all, of the
information received in process 1300. In some instances, selection of the
OMD to provide to the patient may include execution of some, or all, of
processes 300 and/or 400. When an OMD is to be provided to a patient, it
may be provided in step 1370 and a response to the OMD may be
received in step 1375. Responses to the OMD may be analyzed and/or
scored via execution of, for example, process 300 and/or 400.
[000375] When enough information to determine one or more appropriate
treatment provider(s) has been received (step 1345), when an OMD is not
to be provided to the patient and/or requester, and/or following step 1375,
one or more appropriate treatment providers for the patient may be
determined (step 1380). The determination of step 1380 may include, for
example, using the information received via process 1300 to determine
one or more treatment providers related to the information received. The
effectiveness scores for the treatment providers may be determined using,
for example, process(es) 400 and/or 600. In some instances, the
determination of step 1380 may include selecting a number of treatment
providers with the highest effectiveness scores related to the information
received. In some instances, a geo-location of the treatment provider may
be factored into the selection of the number of treatment providers.
[000376] In step 1385, the treatment providers (e.g., the name, contact
information, location thereof) determined in step 1380 may be provided to
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the patient and/or requester. The indication may be provided as, for
example, a list of appropriate treatment providers along with the treatment
provider's effectiveness scores for the patient's treatment and/or
diagnostic code, other considerations, esoteric factors, and/or OMD
information. Additionally, or alternatively, the appropriate treatment
providers may be provided to the patient and/or requester via icons
arranged on a map, similar to the treatment provider interface depicted in
FIGs. 19A-19C.
[000377] FIG. 14 provides a flowchart of exemplary process 1400 for
conducting a medical inquiry and/or designing a medical study and
receiving study data related thereto. Process 1400 may be performed by,
for example, any of the systems, system components, and/or combination
of system components discussed herein.
[000378] In step 1405, a request for wellness scores (e.g., pre-treatment
and/or post-treatment), improvement scores, relative improvement scores,
and/or effectiveness scores regarding one or more factors directly or
indirectly relating to one or more diagnostic code(s) and/or treatment
code(s) may be received. The query may be received from a user, who
may be, for example, a treatment provider, a treatment facility
administrator, and/or a patient using one or more of, for example,
treatment provider device 124, and patient device 128. The query may be
received by, for example, reporting module 122. The query received in
step 1405 may also include one or more criteria not related to a diagnostic
and/or treatment code such as the location of a treatment provider,
demographic information for the patients, the presence of preexisting
conditions for a patient, pharmaceuticals used in conjunction with a
treatment and/or diagnostic code, and so on. At times, the query of step
1405 may include information from a patient's EMR and/or hypothetical
patient characteristics. When the query includes information from the
patient's EMR, that information may, at times, be indirectly (i.e.,
automatically) entered into or added onto the query. For example, if a
treatment provider is looking for information regarding an array of
treatment options for a particular patient's diagnosis, the treatment
provider may be able to enter his or her query directly through and/or by
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adding a link to the patient's EMR so that the treatment provider does not
have to enter all of the patient's characteristics into the query. In this
way,
a treatment provider may easily and effectively search for treatment
options for a patient that may be personalized to that patient's medical
condition or state of health.
[000379] In step 1410, a data structure that stores medical literature,
OMDs, wellness scores, improvement scores, relative improvement
scores, effectiveness scores, diagnostic codes, treatment codes, and/or
EMR data may be accessed. The accessed data structure may include
one or more of the medical-condition-specific registry of information,
treatment-specific registry of information, disease-specific registry of
information, medical-condition-specific registry of information, diagnosis-
specific registry of information, treatment-facility-specific registry of
information, and/or treatment-provider-specific registry of information.
[000380] In some embodiments, some, or all, of the data that is accessed
may be and/or may have been stripped of patient-identifying information
and may, therefore, be anonym ized. Exemplary data structures that may
be accessed in step 1410 include medical literature database 204, OMD
database 108, OMD response database 110, score database 120,
treatment and/or diagnostic code database 202 and patient EMR database
130.
[000381] Next, wellness scores, improvement scores, relative
improvement scores, and/or effectiveness scores provided by the
accessing of step 410 may be selected responsively to the received
request (step 1415). A table of an exemplary range of post-treatment
wellness scores for patients who are treated with a treatment having a
treatment code corresponding to knee replacement surgery is provided by
Table 1, below. More specifically, Table 1 provides a grid of post-
treatment wellness scores as the correspond to a primary factor knee
replacement implant type (implant A, implant B, or implant C) and a
secondary factor (none, drug A, drug B, drug C, technique A, technique B,
technique C, associated procedure A, associated procedure B, and
associated procedure C).
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[000382] It is important to note that the flowcharts provided in the
attached figures (as well as the discussion thereof) indicate ordered steps
for various processes. However, in some instances, the steps do not need
to be performed in the order provided. Thus, the order in which steps are
listed may not, in some instances, limit the scope of the invention.
[000383] In some embodiments, the present invention may provide a
portal for treatment providers and/or treatment facilities to view, monitor,
edit, and/or modify some, or all, of, for example, the patient-entered
information and/or determinations made herein. For example, a treatment
provider may access information and/or determinations regarding their
patients as described herein and may be enabled to filter, or otherwise
organize the data, by, for example, treatment type, treatment outcome
scores, contributing factors, patient demographic information, etc. In some
instances, this information may be used to generate clinically relevant
information that may be used to, for example, generate a publication
and/or medical literature.
[000384] It is important to note that effectiveness scores provided by the
systems and processes described herein are nearly absent of human bias.
This is because the effectiveness scores are objectively determined by an
entity other than the treatment provider or scientist conducting the
treatments or underlying research used to determine the effectiveness
scores. Stated differently, bias typically enters the medical literature
because doctors and scientists that sponsor clinical trials and FDA studies
gather, analyze, and publish the results, which can lead to bias because
the doctor or scientist has control of both the data and the analysis of the
data. The systems and processes described herein automatically
generate the clinical data without involvement of a clinician and, in some
instances, make the clinical data and effectiveness scores available to the
public for the first time ever.
[000385] The effectiveness scores generated by the systems and
processes described herein may be used to select the best treatments for
patients and may be used to assist treatment providers in providing better
treatments. Consider, for example, a treatment provider who has an
effectiveness score of 58 for rotator cuff repair, but wants to improve his or
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her score. He or she may consult a study published by another treatment
provider with an effectiveness score of 98 that is based on data generated
by the systems and processes described herein and 1) actually believe the
data because it is unbiased, and 2) be motivated to change to the
technique that the other treatment provider performs (because these other
treatment providers are being judged based on their result in an unbiased
manner).
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froononlingroonontoimptoolowtomigtootoontom
None 68 85 82
Drug A 68 95 80
Drug B 82 85 82
Drug C 100 90 94
Technique A 68 100 69
Technique B 88 98 100
Technique C 100 90 97
Associated 90 85 78
Procedure A
Associated 88 97 86
Procedure B
Associated 65 95 90
Procedure C
Table 1: Post-Treatment Wellness Scores for Primary and Secondary
Treatments
Relating to a Knee Replacement Treatment
[000387] The data in Table 1 may be used to make determinations
regarding the effect of various secondary treatments on the three primary
treatments, which correspond to the use of implant A, implant B, and
implant C during a knee replacement treatment. For example, Table 1
may be used to determine that treatment with implant A, when performed
without administration of a drug has a post-treatment wellness score of 68,
which may be unacceptably low. However, use of drug C along with
implant A may raise the post-treatment wellness for implant A to 100,
which may be considered an ideal outcome, or cure.
[000388] Table 1 may be further used to determine that use of implant A
with a secondary treatment of technique C produces a post-treatment
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wellness score of 100, use of implant B with a secondary treatment of
technique A produces a post-treatment wellness score of 100, and use of
implant C with a secondary treatment of technique B produces a post-
treatment wellness score of 100. Thus, a treatment provider and/or
treatment facility may choose which technique to use when performing a
knee replacement with implant A, implant B, and implant C.
[000389] In this way, treatment providers, treatment administrators,
treatment facilities can use the data provided in a table like Table 1 to
make decisions regarding which primary and secondary treatments may
be most effective for a particular treatment. The data provided by a table
like Table 1 may also be adjusted to factor in, for example, EMR data of
the patient (e.g., age, gender, pre-existing conditions), cost of treatment,
patient preference, insurance company preference, and/or treatment
provider preference. In some instances, the data in Table 1 may assume
that the pre-treatment wellness scores (i.e., prior to treatment) for the
patients are all identical, or substantially similar, thereby allowing for the
difference in post-treatment wellness scores to be attributable to the
secondary treatment.
[000390] In some embodiments, a table like Table 1 may be generated
using improvement scores instead of wellness scores via, for example,
analysis of and/or correlation of improvement scores for patients with a
particular diagnosis, or have undergone a particular primary treatment,
secondary treatment, combination of primary and secondary treatments,
and/or combination of primary and a plurality of secondary treatments.
[000391] In some embodiments, a table like Table 1 generated using
wellness and/or improvement scores may be generating via the use of one
or more correlation algorithms that correlate, for example, wellness and/or
improvement scores for patients (who may have various characteristics)
with various primary treatments, secondary treatments, combinations of
primary and secondary treatments and/or combinations of primary and a
plurality of secondary treatments. The correlation algorithm(s) may make
use of, for example, identifiers and/or tags associated with, for example,
patients under consideration, wellness scores, improvement scores,
primary treatments, secondary treatments, combinations of primary and
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secondary treatments and/or combinations of primary and a plurality of
secondary treatments. In some instances, the correlation algorithm may
form correlations between, for example, a treatment facility's entire EMR
record and the outcome of every treatment.
[000392] A table like Table 1 may be used by, for example, a treatment
provider and/or academic to see how treatments relate to one another
and, possibly, determine optimum (e.g., a score of 100) treatments and/or
combinations of treatments for patients who are associated with a
particular diagnosis. In one example, consider a diagnosis of lung cancer
where the standard of care is administration of 10 different
chemotherapeutic agents to all patients with this diagnosis. Analysis of
how other treatments these cancer patients are getting (e.g., for high blood
pressure, diabetes, etc.) effect the wellness and/or improvement scores of
the patients with the lung cancer diagnosis may lead to unexpected
findings regarding positive and/or negative interactions between the 10
different chemotherapeutic agents and the other treatments for diagnoses
not related to the cancer.
[000393] Optionally, in step 1420 a determination may be made as to
whether there are overlapping, other considerations, or secondary
treatment outcomes and/or factors that may affect an outcome for the
primary factor. If so, one or more relationships between the overlapping or
secondary factor outcomes may be determined (step 1425). In some
circumstances, the overlapping factors and/or other considerations may be
known to be associated with the treatment and/or diagnostic code(s)
associated with the request of step 1405 and, in other circumstances, the
overlapping factors and/or other considerations may be entered by the
requester as part of, and/or subsequent to receipt of, the request of step
1405. When there are no overlapping outcomes or factors, process 1400
may advance to step 1435, which will be discussed below.
[000394] In some embodiments, the information of a table like Table 1
may be analyzed and/or cross-correlated with overlapping factors and/or
other considerations in order to, for example, determine one or more
relationships between, for example, two or more of the implants, drugs,
techniques, and/or associated procedures (via, for example, step 1425)
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and the overlapping factors and/or other considerations. For example, an
overlapping factor may be the administration of vitamin B12 along with
implants A, B, and C in order to determine an effect thereof and step 1425
may determine that patients who received implant A, drug B, and vitamin
B12 had post-treatment wellness scores that were 5 points higher than
without vitamin B12. In some circumstances, the determination of step
1425 may be performed automatically and, in other circumstances, the
analysis may be performed by an individual or group of individuals (e.g.,
treatment providers).
[000395] In step 1430, the wellness scores, improvement scores, relative
improvement scores, and/or effectiveness scores selected in step 1415
may be modified to incorporate the overlapping treatments and/or factors
and/or the relationship therebetween and, in step 1435, the wellness
scores, relationships, and/or modified wellness scores may be provided to
the requester. Exemplary modifications include recalculation of a wellness
score or a determination of wellness score that includes footnotes or other
notations that incorporate the overlapping treatments and/or factors.
[000396] Process 700 and/or 1400 may be executed in order to determine
and provide, for example, wellness scores, improvement scores, relative
improvement scores, and/or effectiveness scores, relationships between
treatment codes and diagnosis codes, relationships between two or more
treatment codes, and so on. In this way, the output of process 1400 may
be personalized to a particular person, set of patient characteristics, set of
esoteric factors, and/or set of circumstances. In the example of a patient,
a request for wellness scores may be specific, or personalized to a
particular patient's medical condition and/or factors that may contribute to
a treatment outcome. For example, if a patient has been diagnosed with
breast cancer, the request received in steps 1405 may request post-
treatment wellness scores, improvement scores, relative improvement
scores, and/or effectiveness scores for a breast cancer diagnosis and/or
one or more treatments for breast cancer. The request may be very
specific and may indicate, for example, the particular type of breast cancer
the patient has, what stage the cancer is in, information about the cancer's
genome, where the cancer has metastasized to, and so on. Wellness
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scores, improvement scores, relative improvement scores, and/or
effectiveness scores associated with the diagnosis and/or treatment may
then be determined and provided to the requester. In some instances, the
wellness scores, improvement scores, relative improvement scores, and/or
effectiveness scores may be for theoretical treatments that may, or may
not, be performed on the patient. For example, a treatment provider may
run various scenarios with different treatment information to determine
which treatment has the highest post-treatment wellness score or
improvement score for the patient's diagnosis and/or treatment code.
[000397] In some instances, process 1400 may also be used to determine
wellness scores for addressing the side effects of a treatment. To
continue with the above example, process 1400 may be used to determine
post-treatment wellness scores, improvement scores, relative
improvement scores, and/or effectiveness scores for various treatments to
combat the side effects of cancer treatment. In another example, process
1400 may be used to determine post-treatment wellness scores,
improvement scores, relative improvement scores, and/or effectiveness
scores for post-treatment activity such as physical therapy, ice application,
or medication usage following a treatment for an orthopedic surgery.
[000398] For embodiments that incorporate determining whether there is
an overlapping treatment and/or factor (i.e., the answer for step 1420 is
yes), overlapping treatments and/or factors for the patient's treatment
and/or diagnosis may be provided. Exemplary overlapping outcomes
include treatments, other than the treatment indicated in the request of
steps 1405, that the patient is undergoing or considering undergoing.
Exemplary other considerations include a patient's age, gender, weight,
comorbidities, etc. Continuing the breast cancer example above, process
1400 may be used to determine post-treatment wellness scores,
improvement scores, relative improvement scores, and/or effectiveness
scores when two or more treatments (e.g., chemotherapy and radiation)
are combined.
[000399] In some instances, process 1400 may be executed in order to
generate a body of information and wellness scores that may be useful in
conducting a clinical (or scientific) analysis of treatment outcomes in a
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manner consistent with academic research. For example, an individual
may request wellness scores that incorporate a variety of different factors
and/or overlapping treatments or sets of different factors and/or
overlapping treatments and may use responses to these requests to draw
conclusions about treatment efficacy in a manner similar to the way
traditional clinical trials are conducted. The results provided by execution
of process 1400 may then be analyzed by one or more study authors and
these results and the analysis may be converted into a publication that
becomes part of the medical literature.
[000400] FIG. 14B provides a flowchart of exemplary process 1401 for
predicting a post-treatment wellness score for a patient. Process 1401
may be executed by, for example, any of the systems and/or system
components disclosed herein.
[000401] In step 1450, a request for a predicted post-treatment wellness
score for a treatment a patient has undergone or is expected to undergo
may be received. In many cases, the request may include information
about/characteristics of the patient such as, age, gender, height, weight,
race, comorbidities, previously administered treatments, medications
consumed by the patient and so on. At times, this patient information may
concern one or more other considerations as discussed above with regard
to process 1300 and FIG. 13. This patient information may be directly
added to the request via, for example, a fillable form and/or may be
extracted from the patient's EMR via, for example, an automatic extraction
process. In some cases, the request of step 1450 may be received via a
patient's wellness account when, for example, the patient is interacting
with his or her wellness account.
[000402] Next, in step 1455, a data structure that stores medical
literature, OMDs, wellness scores, improvement scores, relative
improvement scores, effectiveness scores, diagnostic codes, treatment
codes, and/or EMR data may be accessed. The accessed data structure
may also include one or more of the medical-condition-specific registry of
information, treatment-specific registry of information, disease-specific
registry of information, medical-condition-specific registry of information,
diagnosis-specific registry of information, treatment-facility-specific
registry
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of information, and/or treatment-provider-specific registry of information in
order to retrieve information responsive to and/or matching the request
(step 1460). The retrieved information may include, for example,
previously determined post-treatment wellness scores of other patients
who underwent the same, or a similar, treatment as the patient has
undergone or scheduled to undergo. In some instances, the retrieved
information may be specific to and/or relevant for one or more of the
patient characteristics associated with the request. For example, if the
patient for whom the request is made is a 65-year old woman with
osteoporosis who is 50 pounds overweight and the treatment the patient is
scheduled to receive is a knee replacement then, information relating to
female patients with who have undergone knee surgery, are within the age
range of 60-70 years of age, and who have osteoporosis may be retrieved
from the data structure in step 1460.
[000403] The retrieved information may be analyzed to determine a
predicted post-treatment wellness score for the patient (step 1465). This
analysis may include weighting or other statistical means to determine how
relevant the pre-determined post-treatment wellness scores are to the
patient and/or which characteristics of the patient are more likely to be
determinative to his or her recovery. In some instances, the analysis of
step 1465 may be performed using other factors and/or scoring
procedures used to determine the pre-calculated post-treatment wellness
scores as discussed above with regard to processes 1000 and/or 1300
and FIGs. 10 and 13, respectively. Continuing with the example above, if
it is known that the 65-year old patient scheduled for the knee replacement
is also allergic to pollen and wears glasses, the analysis of step 1465 may
not include this information as it has minimal relevance to how well the
patient is expected to recover from knee replacement surgery.
[000404] On some occasions, execution of step 1460 may include
analysis of one or more pre-treatment and/or post-treatment responses
received from the patient via, for example, process 1000. Additionally, or
alternatively, execution of step 1460 may include analysis of one or more
pre-treatment wellness scores and/or post-treatment wellness scores
determined for the patient via, for example, process 1000.
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[000405] In some instances, execution of step 1465 may include
determining a plurality, or series, of predicted post-treatment wellness
scores that may be spread out over time (e.g., every month, quarter, year,
etc.) so that a patient may see long-range predictions of his or her post-
treatment wellness scores. In some circumstances, the series of predicted
post-treatment wellness scores may be dynamically updated as time goes
by and the patient provides more information regarding his or her post-
treatment recovery.
[000406] In step 1470, provision of the predicted post-treatment wellness
score(s) to the requestor and/or patient may be facilitated. An exemplary
interface that displays predicted post-treatment wellness scores is
provided by FIGs. 17H and 18C, which provide an updated wellness
tracker interface 1802 that shows a predicted post-treatment wellness
score 1845 for a patient 3 months in the future.
[000407] FIG. 14C provides a flowchart of exemplary process 1402 for
obtaining wellness scores and/or improvement scores for a patient or a
group of patients. Process 1402 may be executed by, for example,
system 100 and/or a component or combination of components thereof
disclosed herein.
[000408] In step 1480, a request to view an outcome, a wellness (e.g.,
pre-treatment and/or post treatment) score and/or an improvement score
associated with a patient, a group of patients, a treatment, a treatment
provider may be received. The request may be received from, for
example, a treatment provider or a treatment administrator. At times, the
request may include a time period over which the requester would like to
see wellness and/or improvement scores. For example, the request may
be a request to view a patient's wellness over a 1, 5, or 10 year period.
Additionally, or alternatively, the request may include a request to view
wellness and/or improvement scores for patients associated with one or
more diseases, medical conditions, treatments and, optionally, in step
1482, may further include a request to view wellness and/or improvement
scores associated with one or more treatments or other considerations. In
some embodiments, the request may further include a request to view raw
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wellness and/or improvement scores and/or adjusted or normalized
wellness and/or improvement scores provided on a normalized scale.
[000409] In step 1484, a database of a wellness and/or improvement
score(s) and/or a disease-specific registry of information, a diagnosis-
specific registry of information, a treatment-specific registry of
information,
a patient-specific registry of information, and a treatment-provider-specific
registry of information such as score database 120 may be accessed
and/or queried to extract the requested wellness and/or improvement
scores (step 1486). Then, provision of the extracted outcome(s), wellness
score(s), and/or improvement score(s) to the requester may be facilitated
(step 1488). In some instances, execution of step 1488 may include
preparing a report that includes, for example, a table, chart, or graph.
[000410] FIGs. 24A-24E provide exemplary interfaces by which a request
may be received from requester and extracted outcomes, wellness scores,
and/or improvement scores may be provided to the requester. More
specifically, FIG. 24A provides an exemplary interface 2401 by which a
requester may enter some information and/or criteria for the request.
More specifically, interface 2401 includes a patient identifier text box
2406A into which a requester may enter, for example, a patient's name, an
anomyzed identifier associated with the patient, a date of birth, and/or a
health insurance identifier. Interface 2401 also includes a treatment
provider identifier text box 2405B into which a requester may enter, for
example, a name of a treatment provider or group of treatment providers.
Interface 2401 further includes a patient characteristic text box 2405C into
which a requester may enter, for example, a name of a treatment provider
or group of treatment providers In some embodiments, a requester may
enter multiple patient identifiers, multiple treatment providers, and/or
multiple patient characteristics separated by, for example, a comma or
semicolon into patient identifier text box 2406A, treatment provider
identifier text box 2405B, and patient characteristics text box 2405C.
[000411] Interface 2401 also includes a number of check boxes 2410 for
further clarifying the scope of the request/inquiry. More specifically,
interface 2401 includes a multiple patients check box 2410A, an outcomes
check box 2410B, a wellness scores check box 2410C, and an
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improvement scores check box 2401D. Selection of multiple patients
check box 2410A may enable a requester to request information regarding
multiple patients by, for example, causing display of another interface (not
shown) by which a requester may enter a plurality of patient identifiers.
Selection of outcomes check box 2410B may add a request to view
outcomes for the identified patient(s)/treatment provider(s) the request
received in step 1480. Likewise, selection of wellness scores check box
2410C and improvement scores check box 2401D may add a request to
view wellness scores and/or improvement scores, respectively, for the
identified patient(s)/treatment provider(s) associated with the request
received in step 1480.
[000412] FIG. 24B provides an exemplary diagnosis/medical condition
selection interface 2402, which provides a global health selection button
2415 as well as an array of disease/diagnosis-specific selection buttons
2420. Array 2420 may include any number of disease/diagnosis-specific
selection buttons 2425. Exemplary disease/diagnosis-specific selection
buttons 2425 include disease/diagnosis-specific selection buttons for atrial
fibrillation 2425A, anxiety 2425B, arthritis 2425C, asthma 2425D, back
pain 2425E, BPH 2425F, chronic pain 2425G, CHF 2425H, COPD 24251,
CAD 2425J, depression 2425K, eczema 2425L, fatigue 2425M, gout
2425N, headache/migraines 24250, heartburn/GERD 2425P,
inflammatory bowel 2425Q, and osteoporosis 2425R. Selection of global
health selection button 2415 and/or one or more disease/diagnosis-
specific selection buttons 2425 may add the associated criteria to the
request (step 1480). Interface 2403 may also provide a list 2417 of one or
more exemplary options that enable a requester to add criteria relating to
how the user would like to see the requested scores/information to his or
her request. The exemplary options included in list 2417 enable a
requester to request viewing wellness scores as raw scores (i.e. scored
according to the scale provided by the scoring procedure used to score
responses to an OMD underlying and/or used to generate the wellness
and/or improvement score), as an adjusted score (e.g., adjusted to be on a
scale from 1-100), and/or as an improvement score.
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[000413] Interface 2402 also provides a requester with a list 2418 of
options to select a time period over which to extract outcomes, wellness,
and/or improvement scores. For example, list 2418 provides a requester
with an option to select a report period (e.g., day, month, year-to-date,
decade, etc.) as well as an option to set a start and stop date within which
to extract outcomes, wellness, and/or improvement scores for provision to
the requester.
[000414] In one example, a requester selects CAD disease/diagnosis-
specific selection button 2425J from array 2420 to specify that the
requester would like to see outcomes/scores related to CAD for a specific
patient (in this case, Karen Smith) and also selects the option to
extract/view improvement scores (as opposed to outcomes or wellness
scores) for CAD from list 2417. Following this selection, a treatment
selection interface like treatment selection interface 2403 of FIG. 24C may
be provided to the requester. Treatment selection interface 2403 provides
the requester with a list 2430 of treatment options that he or she may
select so as to further refine the scope of the improvement scores returned
in response to the request (step 1482). List 2430 includes a treatment
option button for treatment A 2430A, treatment B 2430B, treatment C
2430C, treatment D 2430D, treatment E 2430E, treatment F 2430F, and
treatment G 2430G. It will be understood by those of skill in the art that
although the treatment selection buttons of interface 2403 may be used to
select any kind of treatment (e.g., medication, physical therapy, etc.) or
dosage/frequency of treatment. Furthermore, a treatment selection
interface like treatment selection interface 2403 may provide selection
options for a frequency or prescribed amount of treatment. In the case of
medication, this may be a dosage amount and/or frequency of dosage.
For other treatments (e.g., group therapy, physical therapy) a set of
frequency options may include weekly, bi-weekly, daily, etc.
[000415] Upon selecting a treatment selection button (in this case,
treatment selection button 2430D for treatment D), process 1402 may
advance to accessing a database (step 1484) to extract the requested set
of improvement scores for a particular patient (Karen Smith) over the time
frame established via entry of information into list 2418 (in this case, nine
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months). Then, an improvement score interface, like improvement score
interface 2404 of FIG. 24D, may be provided to the requester (step 1488).
Improvement score interface 2404 provides a graph 2440 of improvement
scores (shown as improvement % along the Y-axis) determined for the
selected patient (Karen Smith) over a nine-month time frame from January
2016 through September 2016 along with a trend line 2445 showing the
average change in improvement score (in this case approximately 0.667 or
67%) over the nine-month time period. Viewing the improvement scores
of the patient over time in this manner allows the requester to see data
regarding how the patient's condition (in this case, CAD) has improved (or
deteriorated) in response to receiving a treatment (in this case, treatment
D) over time. A treatment provider or other requester may use this
information to determine the overall effect of the selected treatment on the
patient's disease or symptoms of the disease.
[000416] FIG. 24E provides an exemplary wellness score interface 2405
for patient Karen Smith provided to a requester in response to receiving a
request for wellness scores over a ten-month time frame (i.e., October
2015 through July 2016) in relation to the disease/symptom chronic pain
associated with the patient's knee (via selection of the disease/diagnosis-
specific selection button 2425G for chronic pain from list 2420) and
administration of treatments A, B, and C (via selection of the treatment
option buttons for treatment A 2430A, treatment B 2430B, treatment C
2430C) on the patient within the selected 10-month time frame.
Exemplary wellness score interface 2405 includes a graph 2450 that
provides wellness score values determined in October 2015, November
2015, January 2016, late February 2016, April 2016, and July 2016 as well
as a trend line 2455 that shows the average change in wellness scores
over the ten-month time frame.
[000417] In some instances, a requester may desire to have information
regarding two different diagnoses for a patient or group of patients
provided to them in a single report so that they may simultaneously assess
how the wellness and/or improvement scores for the patient or the group
of patients are progressing with time. For example, a requester may wish
to view (via, for example, graph or table) how the wellness scores for a
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patient diagnosed with anxiety and depression have changed over a 1-
year time period. To generate such a report, the requester may enter the
patient name into interface 2401, select the disease/diagnosis-specific
selection buttons for anxiety 2425B and depression 2425K, and enter a 1-
year time period into list 2418. Then, for example, a graph showing the
wellness scores for the patient with regard to the patient's anxiety wellness
and depression wellness may be provided on the same graph so that, for
example, trends, similarities, and/or differences between the patient's
anxiety wellness and depression wellness may be observed. The
requester may, in some instances, also wish to see information regarding
the patient's overall, or global health, and may add this information to the
graph via selection of global health selection button 2415.
[000418] In another example, a requester may request information
regarding a patient's overall, or global health, via selection of global
health
selection button 2415 and the patient's headache/migraines wellness via
selection of the disease/diagnosis-specific selection buttons for
headache/migraines 24250 when receiving a treatment A (via selection of
treatment option buttons for treatment A 2430A) for the treatment of the
headaches/migraines to be simultaneously displayed on a single report as,
for example, a graph so as to, for example, monitor the effect of treatment
A on the patient's global wellness and/or headache/migraine wellness
scores so as to, for example, determine whether side effects of treatment
A are substantially impacting the patient's global wellness.
[000419] In a further example, a requester may request information
regarding improvement scores for a particular diagnosis for a plurality of
patients who are diagnosed with the same medical condition and treated
with a variety of treatments so as to, for example, determine the best
treatment for the diagnosis. This may be accomplished by, for example,
selecting multiple patients checkbox 2410A, selecting improvement scores
from list 2417, selecting a time period from list 2418, selecting a diagnosis
of interest (e.g., atrial fibrillation via selection of the disease/diagnosis-
specific selection buttons for atrial fibrillation 2425A), and then selecting
a
plurality of treatments of interest (e.g., treatments A, C, and D via
selection
of treatment option buttons for treatment A 2430A, 2430C, and 2430D,
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respectively). Optionally, the requester may also enter one or more
patient characteristics (e.g., age, gender, etc.) A report showing the
wellness scores for the plurality of patients who have been diagnosed with
atrial fibrillation (and share the optionally entered patient characteristics)
and have received treatments A, C, and D over the requested time period
may then be provided.
[000420] In yet another example, a requester may desire to receive
wellness and/or improvement scores for patients who have received a
combination of treatments. This may be accomplished by, for example,
selecting multiple patients checkbox 2410A, selecting wellness scores
from list 2417, selecting a time period from list 2418, selecting a diagnosis
of interest (e.g., atrial fibrillation via selection of the disease/diagnosis-
specific selection buttons for atrial fibrillation 2425A), and then selecting
a
plurality of combined primary and secondary treatments of interest (e.g., a
combination of primary treatment A and secondary treatment B; a
combination of primary treatment A and secondary treatment C, and a
combination of primary treatment D and secondary treatment B via
selection of a combination of treatment option buttons for 2430A, 2430B,
2430C, and 2430D, respectively). Optionally, the requester may also
enter one or more patient characteristics (e.g., age, gender, etc.) A report
showing the wellness scores for the plurality of patients who have been
diagnosed with atrial fibrillation (and share the optionally entered patient
characteristics) and have received the combination of treatments over the
requested time period may then be provided. In addition, the requester
may also request wellness scores for the diagnosis with just the primary
treatment holding all other request criteria the same. In this way, the
requester may see the effect of secondary treatments on the primary
treatment and see whether any secondary treatments are advantageous to
combine with a primary treatment.
[000421] In one exemplary embodiment, process 1400 and/or a portion
thereof may be executed to generate a controlled, randomized, and/or
multi-center (i.e., multi-location) clinical trial of a treatment for a
diagnosis.
This may be done in order to, for example, determine a best practice (e.g.,
a best treatment or best combination of treatments) for treating the
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diagnosis, a treatment that best improves the wellness scores associated
with the diagnosis, determine a contraindication for a treatment, verify an
indication for and/or valid reason to use, a treatment, and/or discover new
indications for and/or valid reasons to use a treatment. Such a study may
be executed by, for example, receiving a request for wellness scores
relating to a particular aspect of a patient's wellness and/or patient's with
a
particular diagnosis or combination of diagnoses, who have also received
a particular treatment at step 1405. At times, the particular aspect of the
patient's wellness and/or patient's diagnosis may not be directly related to
the particular treatment. Stated differently, the treatment included in the
request may not have any known/accepted indications for the diagnosis
associated with the patient. In this way, the user may request information
regarding one or more unintended, or unexpected, indications of the
treatment on a patient's health. The user may tailor this study by adding
one or more overlapping factors or other considerations to, for example,
the request of step 1405 in order to, for example, select for patients from
particular geographic locations, patients with consistent comorbidities,
patients treated by the same type of treatment facility, patients of the same
body weight, and so on. Thus, an effectiveness of the particular treatment
may be quickly assessed (via, for example, analysis of the results provided
at step 1435) for a variety of diagnoses across a plurality of patients who
may have similar and/or varying characteristics. These results may then
be utilized to validate a new indication for a treatment and/or guide the
research and development related to the treatment and/or diagnosis.
[000422] FIGs. 15A-15C provide exemplary bar-chart representations of
wellness scores for a particular patient or a group of patients associated
with a particular treatment provider in the form of bar charts 1500, 1520,
and 1555, respectively. The wellness scores of charts 1500, 1520, and
1555 of FIGs. 15A-15C, respectively, are scaled on an exemplary
numerical scale ranging from 0-10), with a score of 1 indicating a low or
poor score and 10 indicating a high, or excellent, score. It will be
appreciated that other scales (e.g., 0-20, 0-100, poor-satisfactory-
excellent) may be used for representing a wellness score without deviating
from the scope of the invention. Also, while a linear scale is used for bar
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charts 1500, 1520, and 1555 it is understood that a nonlinear scale (e.g.,
exponential or logarithmic scale) may be used instead.
[000423] FIG. 15A provides a bar chart 1500 representing a pre-treatment
wellness score, a post-treatment wellness score and an improvement
score for an exemplary patient. The pre-treatment wellness score, post-
treatment wellness score and improvement score may be determined via
execution of, for example, some or all of processes 300, 400, 500, 600,
700, 800, 900, 1000, and/or 1100.
[000424] In some instances, the patient's pre-treatment wellness score
may correspond with a state of health for a patient generally and/or with
regard to a particular medical condition with which the patient has been
diagnosed. For the purposes of the example FIG. 15A, the patient's pre-
treatment wellness score 1505 is determined to be 4.3, and is displayed as
a pre-treatment wellness score bar 1505 in a bar chart 1500.
[000425] An indicator of the patient's change in wellness (i.e., an
improvement score) following treatment (or how much the patient's
condition has improved/declined following treatment) may be shown as an
improvement bar 1510 and/or an improvement arrow 1515 (or both). In
the example of FIG. 15A, the patient's wellness score following a
treatment was 7.2, and the improvement in the patient's wellness score
was 2.9, as depicted in the improvement bar 1510 and improvement arrow
1515.
[000426] In some instances, a patient's health may not improve after
receiving a treatment, and could remain unchanged or worsen (e.g., there
may be unforeseen complications resulting from the treatment).
Therefore, any discussion of a "patient's improvement" may more
generally be recast as a patient's health progression (i.e., "improvement
bar" may be called a "health progression bar", etc.).
[000427] Another measure of a patient's improvement after a treatment
may be a measure of relative improvement (i.e., relative to a maximum
possible improvement score), also called a relative improvement score or
an improvement percentage. In mathematical notation, the relative
improvement score may be calculated as follows:
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improvement score
relative improvement score = . . * 100% (Equation 2)
maximum improvement score
This relative improvement score may be represented as a number and/or a
percentage.
Yet another way to determine a relative improvement score is as follows:
Wellness Score at time 2 ¨ Wellness Score at time 1
*100% (Equation 3)
Maximum Wellness Score¨ Wellness Score at time 1
[000428] For example, suppose a patient is being treated for an ACL
injury. The patient's pre-treatment wellness score, using a particular
OMD, prior to knee surgery is determined to be 12. Three months
following knee surgery, the patient's post-treatment wellness score (using
the particular OMD) is determined to be 36. Further, suppose that the
maximum wellness score for the particular OMD is 47. Based on the
mathematical equations presented above, the relative improvement score
of the patient may be calculated
6-12 * 100% = 68%.
47-12
Such an example is presented in a graphical form in the user interface 1813
depicted in FIG. 18N.
[000429] A motivation for the measure of relative improvement is that the
improvement following a treatment is expected to vary based on a number
of factors. For example, a younger patient may be expected to have a
greater degree of improvement as compared to an older patient. As
another example, a patient with a more severe injury (e.g., a bone
fracture) is expected to have a lower degree of improvement as compared
to a patient with a less severe injury (e.g., muscle tear).
[000430] As an approximation, a treatment effectiveness score for a
patient's recovery from a treatment may be set equal to the relative
improvement score. Such relationship is only an approximation because
there could be many factors to a patient's improving (or declining) health
that may not be a result of the treatment and/or the quality of the treatment
provider or treatment facility. For instance, a patient's health may improve
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solely due to the body's innate ability to heal itself (e.g., spontaneous
healing). As another example, a patient's health may decline (i.e.,
treatment recovery may not show an improvement) due to aging, stress
from a failed marriage, poor diet, or another reason unrelated to a
treatment. In some cases, it is expected that a relative improvement score
that is calculated soon after a treatment is performed is a more reliable
indicator of the treatment effectiveness than a relative improvement score
that is calculated years (or even decades) after a treatment, since the
immediate calculation of a relative improvement score can temporally
exclude many factors unrelated to the treatment. However, in other cases,
it may be true that a relative improvement score that is calculated several
months or years after a treatment may be a more reliable indicator of
treatment effectiveness than a relative improvement score that is
calculated immediately after a treatment, as some treatments may take
several months or longer before becoming effective (e.g., medication to
treat depression or other mental health issues).
[000431] FIG. 15B depicts a bar chart 1520, which compares
effectiveness scores for three treatment providers; treatment provider 1,
treatment provider 2, and treatment provider 3. In contrast to FIG. 15A,
the baseline bars 1525, 1535 and 1545 in FIG. 15B do not depict the pre-
treatment wellness scores for individual patients, but rather depict the
average pre-treatment wellness scores for three pools of patients that
were treated by treatment providers 1, 2 and 3, respectively. Often times
the patients within three pools will share at least some common
characteristics (e.g., middle aged, female, non-smoking, diabetics, etc.) so
that statistically significant differences in the effectiveness scores for the
treatment providers may be established. It is noted that the three pools of
patients are typically disjoint sets of patients, but it is possible for one
patient to have been treated by two or more of treatment providers 1, 2
and 3. Similarly, the improvement bars 1530, 1540 and 1550 do not
represent the improvement in wellness scores for individual patients
following a certain treatment (e.g., rotator cuff surgery), but rather the
average improvement (i.e., change) in wellness scores for the three pools
of patients that were treated by treatment providers 1, 2 and 3,
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respectively. In some circumstances, the treatments provided to the
patients of the three patient pools may be the same or very similar (e.g.,
associated with the same or similar treatment and/or diagnostic codes).
[000432] The average pre-treatment wellness scores for the two pools of
patients treated by treatment providers 2 and 3 are identical (i.e., 4.3),
allowing a comparison between the treatment effectiveness of treatment
providers 2 and 3. In the instant example, the average improvement in
wellness scores for the pool of patients treated by treatment provider 2
was 2.2, whereas the average improvement in wellness scores for the pool
of patients treated by treatment provider 2 was 2.9, indicating that
treatment provider 3 is potentially more effective at performing a certain
treatment (e.g., rotator cuff surgery) than treatment provider 2 for certain
types of patients (i.e., those that share the same characteristics as the
pool of patients).
[000433] Of the three treatment providers, the average improvement in
wellness scores for treatment provider 1 was the lowest at 2Ø Such
average improvement in wellness scores for treatment provider 1 may not,
however, indicate that treatment provider 1 is any less effective at
performing a given treatment (e.g., rotator cuff surgery) than treatment
providers 2 and 3. Rather, treatment provider 1 had a pool of patients with
a higher average pre-treatment wellness score than treatment providers 2
and 3 (e.g., a healthier group of patients), so it possible that the average
improvement average improvement in wellness scores for treatment
provider 1 was lower simply due to treatment provider 1 treating a group of
patients who were on average healthier before the treatment. It could be
the case that if treatment provider 1 instead treated the group of patients
that were treated by treatment provider 2, treatment provider 1 could
achieve the same (or better) average effectiveness score as treatment
provider 2. Therefore, it may be helpful for the average pre-treatment
wellness scores between two treatment providers to be the same (or at
least similar) before making a comparison between the effectiveness of
two treatment providers.
[000434] It is further noted that in the case of a treatment that involves
a
group of treatment providers (as is common for surgery or cancer
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treatment), the type of comparison of the effectiveness scores provided by
bar chart 1520 may between the groups of treatment providers or between
treatment providers within a group. However, if a more detailed
comparison of a particular treatment provider outside of his or her group
(e.g., a comparison of three surgeons) is desired, it may be necessary to
collect and/or analyze more data before making any inferences or
conclusions regarding the relative effectiveness of the three surgeons. For
example, data may need to be collected regarding factors that may impact
the effectiveness of the surgery other than the skill of the surgeon (e.g.,
the availability and relative skill of support staff present for each of the
surgeons when performing the surgery, the type of equipment available to
perform the surgery, etc.) so that meaningful comparisons between the
three surgeons may be made.
[000435] FIG. 15C illustrates that the patient pool (or the subset of
patients being analyzed) could alter the results of the bar chart. Assume
that the three treatment providers represented in the bar chart 1555 of
FIG. 15C are identical to the three treatment providers represented in the
bar chart 1520 of FIG. 15B. Further assume that the patient pools are
different between the bar charts. For instance, suppose the patient pool
represented in bar chart 1555 include females who are middle-aged, non-
smokers, and diabetic, whereas the patient pool represented in bar chart
1520 include females who are middle-aged, smokers, and diabetic. In the
example of FIGs. 15B and 15C, all the bars depicted in bar chart 1555 are
identical to the bars depicted in bar chart 1520 (i.e., bar 1560 is identical
to
bar 1525, bar 1570 is identical to bar 1535, and bar 1580 is identical to bar
1545) however, improvement bars 1565, 1575, and 1585 are different from
improvement bars 1530, 1540, and 1550. Assuming that the patient pools
of bar chart 1520 have a first set of characteristics (e.g., age, gender,
comorbidities) and the patient pools of bar chart 1550 have a second set
of characteristics, a comparison of bar chart 1520 with1555 may serve to
indicate which treatment provider is better at providing a treatment to a
patient with the first set of characteristics as opposed to the second set of
characteristics. For example, improvement bars 1565, 1575, and 1585
may indicate that treatment provider 1 is more effective (highest value for
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the improvement bar) at treating patients with a second set of
characteristics and treatment provider 3 is more effective at treating
patients with the first set of characteristics.
[000436] FIGs. 16A and 16B provide graphs 1600 and 1601, respectively,
that visually display treatment effectiveness scores on a scale (e.g.,
between 60 and 100) along the Y-axis as a function of time along the X-
axis. The Y-axis may be broken down into one or more ranges of values
(e.g., 60-70, 70-80 and 80-100) according to, for example, treatment
facility or treatment provider preference. The ranges may be set up by, for
example, a treatment facility, in order to assist in determinations of
treatment provider/doctor competency and/or quality of patient care. For
instance, a treatment effectiveness score range of 60-70, 70-80, and 80-
100 may indicate an unsatisfactory level of patient care, satisfactory level
of patient care and an excellent level of patient care, respectively. The
information displayed in FIGs. 16A and 16B may be used to establish, for
example, relative treatment provider quality which may, in turn, be used to
establish work assignments or privileges for particular treatments. For
example, doctors associated with a treatment effectiveness score range of
80-100 for a particular treatment may be assigned to perform that
particular treatment on more patients, while doctors associated with a
treatment effectiveness score range of 60-70 for a particular treatment
may be reassigned to perform an alternative treatment for which they have
higher treatment effectiveness scores. When a treatment effectiveness
score falls below a certain threshold (e.g., 75) and/or shows a downward
decline, this may trigger an intervention by a treatment facility according to
treatment facility rules and guidelines. Interventions may be as simple as
a quick conversation to determine a reason for the downward trend or as
severe as a revocation of privileges to perform the treatment at the
treatment facility.
[000437] Graphs, such as graphs 1600 and 1601, may be used to, for
example, track doctor performance for various treatments over time.
Graphs similar to graphs 1600 and 1601 may be used to track any
effectiveness score related to a treatment, diagnosis, and/or treatment
outcome over time using system 100. For example, graphs similar to 1600
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and 1601 may be generated that are treatment specific so that treatment
effectiveness scores for various treatments or procedures associated with
a diagnosis may be tracked over time. This information may be used to
assess, for example, which treatments work best over time or when/how a
change to a treatment procedure affects the treatment effectiveness score
for the procedure.
[000438] Returning to FIG. 16A, graph 1600 provides treatment
effectiveness scores for ACL reconstruction surgery, rotator cuff repair
surgery, and hip arthroscopy as performed by a first treatment provider, in
this case Dr. Smith, from the first quarter of 2011 to the second quarter of
2016 with the first range being between 60 and 70, the second range
being between 70 and 80, and the third range being between 80 and 100.
The graph 1600 demonstrates that Dr. Smith's treatment effectiveness
scores for rotator cuff repair surgery and hip arthroscopy treatments have
declined over time while Dr. Smith's effectiveness scores for ACL
reconstruction treatments have remained relatively constant over time.
These trends may indicate to, for example, hospital administration and/or
insurance companies that Dr. Smith's declining treatment effectiveness
scores are a cause for concern and that an investigation is warranted to
determine the reasons why the treatment effectiveness scores for Dr.
Smith's rotator cuff repair surgery and hip arthroscopy treatments have
declined over time.
[000439] In some instances, such as when a treatment effectiveness
score for a doctor's treatments falls below a predetermined number (e.g.,
60), the doctor's privileges to perform the treatment at the treatment
facility
may be revoked (e.g., the doctor's card key may be de-activated, the
doctor's name may be removed from the hospital directory, etc.). For
instance, because Dr. Smith's treatment effectiveness scores for hip
arthroscopy have been scored at 70 or below for three consecutive
quarters (Q4 2015¨ Q2 2016), treatment facility administrative staff may
decide to revoke Dr. Smith's privileges for performing hip arthroscopy
treatments according to, for example, a policy of the treatment facility.
[000440] In some instances, while declining treatment effectiveness
scores could indicate a declining quality of care, this is not always so, as
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there could be other factors that could cause declining treatment
effectiveness scores, other than a declining quality of care. For instance,
declining treatment effectiveness scores could be due to a mutation of a
virus or bacteria. For instance, an antibiotic resistant strain of bacteria
could develop, leading to patients recovering at a slower pace or not
recovering at all. As another example, a downturn in the economy could
cause patients to experience a greater degree of stress, leading to a
slower pace of recovery for patients. It should be evident that declining
treatment effectiveness scores exhibited in these scenarios might have
nothing to do with a declining quality of care. Nevertheless, declining
treatment effectiveness scores still might be a useful statistical indicator
that prompts an investigation into a root cause of the declining scores,
whether due to a declining quality of patient care or other factor.
[000441] Graph 1601 of FIG. 16B provides treatment effectiveness scores
for ACL reconstruction surgery, rotator cuff repair surgery, and hip
arthroscopy as performed by a second treatment provider, in this case Dr.
Jones, from the first quarter of 2011 to the second quarter of 2016 with the
first range being between 60 and 70, the second range being between 70
and 80, and the third being between 80 and 100. Graph 1601 may
demonstrate that Dr. Jones' treatment effectiveness scores for all three
treatments have increased over time in a manner consistent with a
surgeon who skills are improving.
[000442] It is, however, noted that treatment effectiveness scores may not
definitively be correlated with a treatment provider's skill, as there could
be
numerous factors that could cause increasing treatment effectiveness
scores, other than a treatment provider's skill. For example, a hospital
might receive a large grant from the government that allows the hospital to
purchase state of the art equipment, build new patient rooms, etc., which
contribute to increasing treatment effectiveness scores. As another
example, new cancer treatments may be developed which increase the
cancer remission rate of patients. In such case, it may be debatable
whether the improved treatment effectiveness is due to the skill of the
treatment provider or due to the new cancer treatments. Nevertheless,
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increasing treatment effectiveness scores still might be a useful statistical
indicator that prompts an analysis of the skill of a doctor.
[000443] In some instances, treatment effectiveness scores for
treatments and/or treatment providers may be monitored and an
automated or semi-automated notification process (e.g., performed by a
software daemon) may be set up for a treatment facility and/or treatment
provider with the purpose of notifying the treatment facility and/or
treatment provider that treatment effectiveness scores for treatments
and/or treatment providers have fallen below a certain threshold. In this
way, a treatment facility administrator may monitor the treatment
effectiveness scores for the doctors with privileges to perform treatments
at the treatment facility (at which the administrator is employed) as a
background process.
[000444] FIGs. 18A-18N provide screenshots of various user interfaces
1800-1813 by which a patient may be provided with information about his
or her health and/or wellness. The information gathered from and/or
provided to a patient via interfaces 1800-1813 may be generated,
processed, analyzed, and/or stored in accordance with one or more
processes described herein. In most instances, the information provided
to a patient via the interfaces 1800-1813 of FIGs. 18A-18N will be
associated with the patient's wellness account as established/provided via
execution of one or more of process(es) 800, 900, 1000, and/or 1100.
[000445] Some of interfaces 1800-1813 refer to an xxxxxx wellness,
whereby the "xxxxxx" is a placeholder for a particular type of wellness
relevant to the patient and/or the subject of a patient's wellness account.
For example, if the patient is undergoing treatment for breast cancer, the
"xxxxxx" placeholder may be changed to "breast wellness." Likewise, if
the patient is undergoing treatment for a torn rotator cuff, the "xxxxxx"
placeholder may be changed to "rotator cuff wellness" or "shoulder
wellness." In some instances, the "xxxxxx" placeholder may indicate a
patient's name or user name.
[000446] Often times, interfaces 1800-1813 will relate to one particular
condition, diagnosis, or treatment for a patient but this need not always be
the case. For example, a patient's wellness account may be set up and/or
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modified according to, for example, process 800 and/or 900 to monitor
multiple conditions for which the patient is being treated. For example, the
wellness indicators may provide an indication of the patient's wellness with
regard to multiple conditions, diagnoses, and/or treatments. In some
circumstances, the wellness information may be determined relative to a
plurality of discrete conditions, diagnoses, and/or treatments and, in other
circumstances, the wellness information may be determined by
aggregating the plurality of determinations and/or determining an overall
wellness that factors in one or more of the conditions, diagnoses, and/or
treatments relevant to the patient.
[000447] FIG. 18A provides an initial interface 1800 that shows a patient
his or her wellness score 1825 prior to the patient undergoing a treatment
(i.e., a pre-treatment wellness score) along with a message providing
information regarding the wellness score (i.e., your pre-treatment xxxxxx
wellness score is"). In the example of FIG. 18A, the patient's pre-
treatment wellness score is 45. This score may be determined via
execution of, for example, process 1000 and/or 1100 as discussed above
with regard to FIGs. 10 and 11, respectively. For example, the wellness
score 1825 provided by initial interface 1800 may be analogous to the
indication of the patient's wellness provided to the patient via execution of
step 1035 or 1075 and/or a state of recovery and/or wellness provided to
the patient via execution of step 1135.
[000448] FIG. 18B shows a preliminary improvement tracker interface
1801 that provides a patient with an indicator of his or her wellness today
1825 (e.g., pre-treatment wellness score) as shown on a bar graph that
also provides an indicator of a zero wellness score. The wellness score of
preliminary improvement tracker interface 1801 is determined in a manner
similar to the determination of the wellness score of initial interface 1800.
FIG. 18B also provides a message, or heading ("improvement tracker"),
1830 that serves to indicate what the information on interface 1801 relates
to.
[000449] FIG. 18C provides an updated improvement tracker interface
1802 that shows a projection (or prediction) 1840 of the patient's wellness
within a given time period (shown as an improvement arrow), in this case,
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within three months along with a message 1845 regarding the projection
1840. 'The projection of the patient's wellness may be determined via
execution of process 1401 and/or use of a baseline and/or modified
recovery vector as discussed above with regard to processes 700, 900,
1100, and shown in FIGs. 7, 9, and 11, respectively. For example, the
patient may be undergoing treatment for a knee replacement and the pre-
treatment wellness score of 45 may indicate that he or she has limited
mobility and substantial knee pain. The projection of the patient's wellness
may be determined based on how much it is expected that the patient's
mobility will improve and pain will decrease using a baseline recovery
vector for knee replacements and/or a modified baseline recovery vector
for knee replacements that is modified according to, for example, one or
more other considerations related to the patient. For example, the
modified baseline recovery vector for knee replacements may incorporate
one or more other considerations stemming from, for example, the
patient's medical condition, age, gender, weight and/or the treatment itself
(e.g., type of replacement used, complexity of the surgery, etc.). In some
instances, the contributing factors may also incorporate post-treatment
activity such as physical therapy and medication. Additionally, or
alternatively, execution of some, or all, of process(es) 700, 900, and/or
1100 may be used to determine and/or assist with a determination of a
projection of the patient's wellness and/or wellness score.
[000450] FIG. 18D shows an interface 1803 similar to that of interface
1801, with the additional message 1850 (i.e., "We'll check back to help you
track it") indicating a next step in the wellness account and/or wellness
measurement process.
[000451] FIG. 18E shows an improvement interface 1804 that provides a
bar graph with an indication of a patient's first post-treatment wellness
score (i.e., current wellness, or wellness today) 1855, which has a score of
73 (i.e., wellness today), in relation to the patient's wellness at a previous
time 1825 (i.e., pre-treatment wellness) (which has a score of 45) and
provides an improvement arrow 1860 to demonstrate how much the
patient's wellness has improved. Determination of the patient's "wellness
today" may be made via execution of, for example, process 1100, 1200,
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1400. For example, the patient's wellness account may indicate that one
or more particular OMDs are to be provided to a patient (e.g., execution of
step 1020 and/or 1045) and, the received response to the OMD may be
compared with a baseline recovery vector and/or modified baseline
recovery vector associated with the patient wellness account to determine
the patient's "wellness today."
[000452] FIG. 18F shows an interface 1805 similar to that of interface
1804 with the exception that interface 1805 provides a message 1865A to
the patient indicating when the patient's wellness score will be calculated
again (i.e., "How will you be in 6 mo.?"). FIG. 18G shows an interface
1806 similar to that of interface 1804 with the exception that interface 1806
provides an encouraging message 1865B to the patient (i.e., "We'll check
back to help you track it"). The differing messages of interfaces 1805 and
1806 may provide an indication of, for example, a patient wellness account
configuration preference for the types of messages to be delivered.
[000453] FIG. 18H shows an interface 1807 that provides an indication of
a patient's current wellness, when the patient has not improved over a
given time period, in the form of a bar graph. In the example of interface
1807, the patient's wellness score has dropped from the pre-treatment
wellness score 1825 value of 45 to a first post-treatment wellness score
1855 value of 36 and, as such, the improvement arrow 1860 for interface
1807 is pointing downward (i.e., indicating that the wellness score has
decreased relative to the pre-treatment wellness score). FIG. 181 shows
an interface 1808 similar to that of interface 1807 with the exception that
interface 1808 provides a message 1865A to the patient indicating when
the patient's wellness score will be calculated again (i.e., "How will you be
in 6 mo.?") and an encouraging message 1865B to the patient (i.e., "We'll
check back to help you track it").
[000454] FIG. 18J shows an interface 1809 that provides an indication of
a patient's second wellness score 1870 (i.e., current wellness score at a
second check in point of the wellness protocol) associated with the
patient's wellness account. Interface 1809 provides a bar graph showing
that the patient's second post-treatment wellness score is 73 and also
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shows how the patient has improved from their pre-treatment wellness
score 1825 of 45 in the form of improvement arrow 1860.
[000455] FIG. 18K shows an interface 1810 similar to that of interface
1809 with the exception that interface 1810 provides message 1865A to
the patient indicating when the patient's wellness score will be calculated
again (i.e., "How will you be in 6 mo.?"). FIG. 18L shows an interface
1811 similar to that of interface 1809 with the exception that interface 1811
provides encouraging message 1865B to the patient (i.e., "We'll check
back to help you track it").
[000456] FIG. 18M shows an interface 1812 that provides an indication of
a patient's current wellness as compared to a baseline and/or modified
wellness vector (i.e., average in studies) for the treatment in the form of
two side-by-side bar graphs. The bar graph showing the baseline and/or
modified wellness vector provides an average pre-treatment wellness
score 1870 of 50, a first post-treatment wellness score 1875 of 79, and an
improvement in the wellness score 1880 with a value of 29.
[000457] FIG. 18N shows an interface 1813 that provides a patient's
wellness scores regarding his/her "knee function". As depicted in the bar
chart of interface 1813, the patient's pre-treatment wellness score is 12,
and the patient's first post-wellness score is 36. The minimum wellness
score of 1 is also depicted (corresponding to no mobility of the knee) and
the maximum wellness score of 47 is also depicted (corresponding to full
mobility of the knee, wherein the maximum value of "47" is established by
the OMD used to determine the wellness score), which provide reference
points for the patient's wellness scores. The improvement in the patient's
wellness score is 36-12 = 24, and the improvement score relative to the
maximum possible improvement score is 68%, calculated as ((36-12)/(47-
12))*1 00%.
[000458] Although not shown in interfaces 1800-1813, a patient's
wellness account may separately monitor different aspects of a treatment
recovery process and/or separately monitor different treatments and/or
diagnosis relevant to the patient wellness account. For example, a
patient's wellness account may separately monitor several indicators of a
patient's recovery from a treatment simultaneously using, for example,
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responses to one or more OMDs. Indicators of the patient's wellness with
regard to each of these indicators may then be provided to the patient via,
for example, interfaces like interfaces 1800-1813.
[000459] FIGs. 19A-19C provide a series of interfaces responsive to a
request (executed in, or example, step 1301, discussed above with regard
to FIG. 13) for a treatment provider who provides treatments for a
diagnosis of a rotator cuff tear and who is located in the New York, New
York geographical area.
[000460] FIG. 19A provides an exemplary treatment provider interface
1901 overlaid on a map of the requested geographical area. As can be
seen in FIG. 19A, interface 1901 provides a plurality of icons 1910 that
display an effectiveness score for each of a plurality of treatment providers
who are trained to treat patients with a rotator cuff tear diagnosis and/or
are trained to provide a rotator cuff repair treatment within a geographical
area. The icons 1910 of interface 1901 may be depicted with a plurality of
contrasting characteristics (e.g., contrasting in terms of shape, color,
texture, etc.) so that icons depicted with a first characteristic represent
treatment providers with a first range of effectiveness scores, icons
depicted with a second characteristic represent treatment providers with a
second range of effectiveness scores, and so on. In a preferred
embodiment, the ranges of effectiveness scores are non-overlapping
ranges. In the example of FIG. 19A, square icons 1910A represent
treatment providers with effective scores of 80 or above, circular icons
1910B represent treatment providers with effectiveness scores within the
range of 60-79, while triangular icons 1910C represent treatment providers
with effectiveness scores below 59. In this way, the patient can easily
determine the respective locations of the treatment providers, as well as
the treatment providers with the highest effectiveness scores for his or her
particular diagnosis or requested treatment.
[000461] FIG. 19B provides an alternative treatment provider map
interface 1902 with a slider bar 1920 positioned at the bottom of the
interface. The slider bar 1920 allows the patient to selectively display
treatment providers with an effectiveness score above a certain threshold.
In the example of FIG. 19C, the slider bar 1920 is set to a position that
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results in only the treatment providers with an effectiveness score above
80 to be displayed. Further, icons 1925 are depicted on (or over) the slider
bar at positions representative of their associated effectiveness scores,
allowing the patient to easily see a distribution of the treatment providers'
effectiveness scores (i.e., whether there are many treatment providers with
high effectiveness scores, whether there are many treatment providers
with low effectiveness scores, etc.).
[000462] A patient may access further information regarding any of the
treatment providers displayed on the interface by selecting the respective
icon (on the interface 1901 and/or 1902) that represents the treatment
provider. The further information regarding the treatment provider may be
presented to the patient via a treatment provider interface, such as the
treatment provider interface 1903 shown in FIG. 19C. Treatment provider
interface 1903 may provide, for example, address and other contact
information of the treatment provider, as well as one or more ways for the
patient to schedule an appointment with the treatment provider. Treatment
provider interface 1903 may also provide billing information (e.g., an
estimate of how much the selected procedure will cost) and/or health
insurance information (e.g., which health insurances are accepted by the
treatment provider). Such further information in addition to the
effectiveness scores discussed above may allow a patient to make a more
informed decision when selecting a treatment provider.
[000463] FIG. 25 depicts components of a computer system 2500 in which
computer readable instructions instantiating the methods of the present
invention may be stored and executed. As is apparent from the foregoing
discussion, aspects of the present invention involve the use of various
computer systems and computer readable storage media having
computer-readable instructions stored thereon. FIG. 25 provides an
example of a system 2500 that may be representative of any of the
computing systems (e.g., server 102, treatment provider device 124,
patent device 128, HIPAA compliance server 126, treatment facility
computer system 134, etc.) discussed herein. Examples of system 2500
may include a smartphone, a desktop, a laptop, a mainframe computer, an
embedded system, etc. Note, not all of the various computer systems
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have all of the features of system 2500. For example, certain ones of the
computer systems discussed above may not include a display inasmuch
as the display function may be provided by a client computer
communicatively coupled to the computer system or a display function
may be unnecessary. Such details are not critical to the present invention.
[000464] System 2500 includes a bus 2502 or other communication
mechanism for communicating information, and a processor 2504 coupled
with the bus 2502 for processing information. Computer system 2500 also
includes a main memory 2506, such as a random access memory (RAM)
or other dynamic storage device, coupled to the bus 2502 for storing
information and instructions to be executed by processor 2504. Main
memory 2506 also may be used for storing temporary variables or other
intermediate information during execution of instructions to be executed by
processor 2504. Computer system 2500 further includes a read only
memory (ROM) 2508 or other static storage device coupled to the bus
2502 for storing static information and instructions for the processor 2504.
A storage device 2510, for example a hard disk, flash memory-based
storage medium, or other storage medium from which processor 2504 can
read, is provided and coupled to the bus 2502 for storing information and
instructions (e.g., operating systems, applications programs and the like).
[000465] Computer system 2500 may be coupled via the bus 2502 to a
display 2512, such as a flat panel display, for displaying information to a
computer user. An input device 2514, such as a keyboard including
alphanumeric and other keys, may be coupled to the bus 2502 for
communicating information and command selections to the processor
2504. Another type of user input device is cursor control device 2516,
such as a mouse, a track pad, or similar input device for communicating
direction information and command selections to processor 2504 and for
controlling cursor movement on the display 2512. Other user interface
devices, such as microphones, speakers, etc. are not shown in detail but
may be involved with the receipt of user input and/or presentation of
output.
[000466] The processes referred to herein may be implemented by
processor 2504 executing appropriate sequences of computer-readable
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instructions contained in main memory 2506. Such instructions may be
read into main memory 2506 from another computer-readable medium,
such as storage device 2510, and execution of the sequences of
instructions contained in the main memory 2506 causes the processor
2504 to perform the associated actions. In alternative embodiments, hard-
wired circuitry or firmware-controlled processing units may be used in
place of or in combination with processor 2504 and its associated
computer software instructions to implement the invention. The computer-
readable instructions may be rendered in any computer language.
[000467] In general, all of the above process descriptions are meant to
encompass any series of logical steps performed in a sequence to
accomplish a given purpose, which is the hallmark of any computer-
executable application. Unless specifically stated otherwise, it should be
appreciated that throughout the description of the present invention, use of
terms such as "processing", "computing", "calculating", "determining",
"displaying", "receiving", "transmitting" or the like, refer to the action and
processes of an appropriately programmed computer system, such as
computer system 2500 or similar electronic computing device, that
manipulates and transforms data represented as physical (electronic)
quantities within its registers and memories into other data similarly
represented as physical quantities within its memories or registers or other
such information storage, transmission or display devices.
[000468] Computer system 2500 also includes a communication interface
2518 coupled to the bus 2502. Communication interface 2518 may
provide a two-way data communication channel with a computer network,
which provides connectivity to and among the various computer systems
discussed above. For example, communication interface 2518 may be a
local area network (LAN) card to provide a data communication connection
to a compatible LAN, which itself is communicatively coupled to the
Internet through one or more Internet service provider networks. The
precise details of such communication paths are not critical to the present
invention. What is important is that computer system 2500 can send and
receive messages and data through the communication interface 2518
and in that way communicate with hosts accessible via the Internet. It is
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noted that the components of system 2500 may be located in a single
device or located in a plurality of physically and/or geographically
distributed devices.
[000469] FIGs. 28A-28B provide exemplary criteria selection interfaces
2801 and 2802 for use with the present invention to execute, for example,
process 2900, 3100, and/or 3300 as will be discussed below with regard to
FIGs. 29, 31, and 33, respectively. Criteria selection interfaces 2801
and/or 2801 may be provided by, for example, any of the systems, system
components, or combination of system components disclosed herein.
Criteria selection interfaces 2801 and/or 2802 may be used by, for
example, a treatment provider, treatment administrator, patient, and/or
caregiver to select information with which to populate into an interface,
such as a patient wellness portal interface, a treatment effectiveness
interface, and/or a treatment comparison interface as will be discussed in
detail below.
[000470] Selection criteria interfaces 2801 and 2802 both provide arrays of
buttons that, when selected or activated by a user, cause criteria to be
selected and/or another related interface to be displayed so that further
information/criteria may be entered by the user regarding the type of
information he or she wants displayed on a subsequently-provided
interface. A user may select one or more buttons of selection criteria
interfaces 2801 and/or 2802 in any order or combination to create a
personalized display of desired information from which to, for example,
track a particular patient's progress/wellness over time, compare a
particular patient to other patients who may, or may not, share one or
more characteristics or attributes, or see the efficacy of a treatment (e.g.,
how the treatment effects wellness scores). The selection criteria
interfaces 2801 and 2802 may also provide a user with an opportunity to
select the type of information displayed on an interface as discussed
below.
[000471] While selection criteria interfaces 2801 and 2802 provide buttons,
other manners of entering selection criteria may be provided by selection
criteria interfaces 2801 and 2802 such as, but not limited to, drop down
menus, text entry boxes, and the like. It should be noted that the
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format/layout of interfaces 2801 and 2802 is just one example of how the
selection criteria may be arranged or displayed out on an interface. In
some instances, the selection criteria offered by the buttons of interfaces
2801 and 2802 may be tailored according to, for example, a user
preference, a treatment provider specialty, and/or a patient characteristic.
In some instances, the selection criteria of interfaces 2801 and/or 2802
may be dynamic such that when one selection criteria is selected, the
other selection criteria of the interfaces 2801 and/or 2802 dynamically
updates to add selection criteria that may be relevant to the selected
criteria and/or remove selection criteria that may not be relevant to the
selected criteria. Additionally, or alternatively, one or more of the buttons
provided by interfaces 2801 and/or 2802 may be responsive to a particular
patient of interest and, at times, selection criteria interfaces 2801 and/or
2802 may be prepopulated with information about the particular patient.
For example, when a patient is associated with a particular diagnostic or
treatment code, the buttons provided by selection criteria interfaces 2801
and/or 2802 may be responsive to the particular diagnostic or treatment
code.
[000472] The criteria selection interface 2801 of FIG. 28A provides three
selection-criteria arrays as follows: a particular patient
characteristics/attributes array 2805, a characteristics/attributes of
patients
of interest array 2815, and a features to display on an interface array
2825. It will be understood by those of skill in the art that any number of
arrays/categories of selection criteria may be provided by selection criteria
interface 2801. Each of these arrays 2805, 2815, and 2825 has a plurality
of exemplary buttons associated therewith. More particularly, patient
characteristics/attributes array 2805 has a button for a race 2810A,
ethnicity 2810B, birthplace 2810C, education level 2810D, average annual
income 2810E, gender 2810F, diagnosis 2810G, side effects 2810H,
comorbidities 28101, previous treatments 2810J, treatment compliance
2810K, and age 2810L. This list of buttons is not exhaustive and particular
patient characteristics/attributes array 2805 may include additional buttons
regarding, for example, the particular patient's sexual orientation, prior
diagnosis, lifestyle choices (e.g., vegetarian, alcohol consumption,
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smoking, amount of exercise, etc.) and so on. In some embodiments,
information associated with these buttons may be pre-populated from, for
example, the patient's EMR and/or personal medical history as stored in,
for example, patient information database 142.
[000473] The buttons of array 2805 facilitate selection of patient
characteristics/attributes that are of interest to the user and/or of
relevance
to comparisons with other patients who share may, or may not share, the
selected characteristics/attributes.
[000474] Characteristics/attributes of patients of interest array 2815
includes a plurality of buttons by which a user may select one or more
characteristics/attributes of patients of interest. Patients may be of
interest
when, for example, attempting to determine wellness scores for a plurality
of patients associated with an attribute like a diagnosis or treatment and/or
a characteristic like race, gender, or age that is similar to the particular
patient. Often times, there will be a statistically significant number of
patients of interest and this threshold (of statistical significance) may vary
according to a prevalence of a treatment and/or diagnosis. For example,
with rare treatments and/or diagnosis, new treatments or diagnosis, and/or
unusual combinations of treatments or diagnosis, a smaller sample size
may be all that is available and may therefore be considered statistically
significant.
[000475] Characteristics/attributes of patients of interest array 2815 has
a
button for race 2820A, ethnicity 2820B, birthplace 2820C, education level
2820D, average annual income 2820E, gender 2820F, diagnosis 2820G,
side effects 2820H, comorbidities 28201, previous treatments 2820J,
treatment compliance 2820K, and age 2820L. When preparing a patient
wellness portal interface, a treatment effectiveness interface, and/or a
treatment comparison interface, the buttons from array 2815 that are
selected may act to select, filter, and/or organize the data displayed on the
respective interface. In this way, the user may select patients with one or
more characteristics/attributes to view and compare in order to, for
example, see how a treatment affected wellness scores for patients with
one or more characteristics and/or attributes similar to a particular patient.
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[000476] Features to display on interface array 2825 provides a number of
options for a user when setting up and/or modifying a display provided by,
for example, a patient wellness portal interface, a treatment effectiveness
interface, and/or a treatment comparison interface. The options, or
selection criteria provided by array 2825 include a button to select a
minimum number of wellness scores 2830, a button to select a number of
time intervals 2830B, and a length of time button 2830C. Selection of one,
two, or all of these buttons (2830A, 2830B, and/or 2830C) may enable a
user to select for patients who have received a treatment for a certain
length of time. In this way, the user can gain information regarding the
short and long term effects of, for example, a particular treatment on the
patient's wellness scores over time. Array 2825 also includes a button for
wellness scores for a particular patient 2830D. Selection of this button
facilitates provision of wellness scores for a particular patient on a
display;
examples of which are provided by the graphs in display windows 3012B,
3210D and 3410F as will be discussed below. Selection of a predicted
wellness scores button 2830E may trigger the display of predicted
wellness scores for a particular patient and/or patients of interest as may
be seen in display window 3210D.
[000477] Array 2825 further includes a button for grouping wellness scores
provided by an interface into, for example, a group of scores for patients
who are considered responsive to a treatment and a group of patients who
are considered unresponsive as shown in, for example, interface 3203 as
discussed below. Array 2825 also includes a side effect severity button
2830G, which facilitates display of an indicator of side effect severity (as
indicated by, for example, responses of patients to OMDs) as shown in, for
example, interface 3205 as discussed below.
[000478] Array 2825 includes a wellness scores for a treatment button
2830H which facilitates display of wellness scores for a plurality of patients
on an interface, examples of which are shown in FIGs. 30B, 30C, 30E,
30F, 30G, 301, 30J, 32B-32E and 34B-34F. Array 2825 further includes an
average wellness score button 28301, which facilitates display of an
average wellness score on an interface. The average wellness score may
be shown as a linear regression line as in FIG. 30C and/or as a numerical
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value. The average wellness score may be provided for a particular
patient and/or a group of patients.
[000479] FIG. 28B illustrates criteria selection interface 2802,which
provides four treatment-specific criteria selection arrays 2835A, 2835B,
2835C, and 2835D each of which facilitate the selection of various
features for setting up and/or modifying a display provided by, for example,
a patient wellness portal interface, a treatment effectiveness interface,
and/or a treatment comparison interface with regard to a particular
diagnosis, in this case diagnosis A, represented by a diagnosis A button
2845A. While criteria selection interface 2802 only displays four
treatment-specific criteria selection arrays, it will be understood by those
of
skill in the art that any number of treatment-specific criteria selection
arrays may be provided by criteria selection interface 2802 and that these
arrays may be provided in any format.
[000480] Each treatment-specific criteria selection array 2835A, 2835B,
and 2835C includes a number of buttons that facilitate displays of
information regarding a treatment and a combination of treatments for
treatment-specific interface 2835D, as it relates to diagnosis A, on an
interface like patient wellness portal interface, a treatment effectiveness
interface, and/or a treatment comparison interface. Each treatment-
specific criteria selection array 2835A, 2835B, 2835C, and 2835 includes a
treatment specification button 2845A, 2845B, 2845C, and 2845,
respectively, that enables a user to select which treatment, or treatments,
for diagnosis A is of interest to the user. In some instances, the
treatments provided by treatment-specific criteria selection array 2835A,
2835B, 2835C, and 2835D will be relevant to, or the most commonly used,
treatments for diagnosis A and these treatments may be pre-selected
and/or pre-populated for the user responsively to his or her selection of the
diagnosis A. In some embodiments, a user may select, or enter a
treatment of interest into interface 2802 and thereby generate an array like
treatment-specific arrays 2835A, 2835B, 2835C, and 2835 for the
treatment of interest.
[000481] Each treatment-specific array 2835A, 2835B, 2835C, and 2835D
includes a number of sub-treatment buttons 2850A-2850L, respectively.
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The sub-treatment buttons 2850A-2850L facilitate selection of one or more
sub-treatments that correlate to the selected treatment A-D. Sub-
treatments include details of a treatment that are relevant to the treatment,
but are not the overall treatment. For example, a treatment may be
administration of medication and an associated sub-treatment may be the
dosage of the medication. Another example is when treatment A is a
surgical treatment, such as a knee replacement and the sub-treatments A,
B, and C may be type of knee replacement used, medication prescribed
for pain, and physical therapy regimen, respectively.
[000482] Each treatment-specific array 2835A, 2835B, 2835C, and 2835D
includes a number of side effect buttons A-K, respectively. The side effect
buttons A-K facilitate selection of one or more side effects and/or their
respective severity that correlate to the selected treatment A-D and/or sub-
treatments A-K. An example of how side effect severity may be displayed
on an interface is provided by 3405 as discussed below with reference to
FIG. 34E. Additionally, or alternatively, side effect information may be
displayed as a pop-up window or subsequently displayed interface.
[000483] Each treatment-specific criteria selection array 2835A, 2835B,
2835C, and 2835D also includes a treatment compliance button A-D,
respectively. The treatment compliance buttons A-D facilitate selection of
treatment compliance information for display on an interface; an example
of which is provided by interfaces 3006, 3007, and 3404 as discussed
below with reference to FIGs. 30F, 30G, and 34D, respectively.
[000484] FIG. 29 provides a flowchart illustrating an exemplary process
2900 for providing a patient wellness portal interface and populating the
interface with information. Often times the patient wellness portal interface
disclosed herein will be graphical user interfaces (GUI) that enable a user
to interact with the interface so as to add, subtract, and/or modify
information displayed on a particular patient wellness portal interface. In
some instances, the user may interact with the patient wellness portal
interface via, for example, a keyboard, mouse, and/or a touchscreen
interface. Process 2900 may be performed by, for example, any of the
systems, system components, or combination of system components
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disclosed herein including, but not limited to, patient device 128, 128A,
and/or 128B, treatment provider device 124, and/or server 102.
[000485] FIGs. 30A-30J provide exemplary patient wellness portal
interfaces 3001-3010, respectively, that may be generated via execution of
one or more steps of process 2900. Execution of process 2900 and/or
interaction with one or more of patient wellness portal interface(s) 3001-
3010 may provide an interface whereby a user (e.g., a treatment provider,
treatment administrator, and/or patient) may view information regarding a
particular patient's and/or a set of patient's health and wellness.
[000486] In some cases, the information provided by a patient wellness
portal interface may be extracted from a patient's EMR and/or personal
medical history as may be stored in, for example, an EMR database like
EMR database 130, a treatment facility computer system, such as
treatment facility computer system 135, a patient device, such as patient
device 128, a patient information database such as patient information
database 142, a treatment provider device, such as treatment provider
device 124, and/or a server, such as server 102. In some instances, the
information displayed by/on the patient portal wellness interface disclosed
herein will be specific to a particular diagnosis, treatment, patient
characteristic, and/or medical condition.
[000487] In step 2905, provision of a patient wellness portal interface,
like
patient wellness portal interfaces 3001-3010, may be facilitated. The
patient wellness portal interface may be provided to, for example, a
computer or other device offering a display such as patient device 128
and/or treatment provider device 124. In some instances, the patient
wellness portal interface provided via execution of step 2905 may be an
introductory patient wellness portal interface such as exemplary
introductory patient wellness portal interface 3001 shown in FIG. 30A.
Introductory patient wellness portal interface 3001 provides a display
window 3012A, a magnification adjustment device 3020, a Y-axis
associated with wellness scores scaled between 0 and 100, an X-axis
associated with time scaled in quarter years 3015, and an array of
exemplary buttons 3030, the selection of which will trigger the display, or
removal, of a type of information associated with the selected button on a
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patient wellness portal interface and/or a display window 3012 included
therein. In the embodiments of FIGs. 30A-30G, array 3030 includes a
wellness score button, a treatment compliance button, a patient note
button, a procedures button, a prescription/treatment button, and a test
results button. However, array 3030 may include additional buttons
regarding, for example, lifestyle information, patient weight, patient blood
pressure, and so on. Magnification adjustment device 3020 may include a
slider bar (as shown) and/or icons that may be selected to adjust the
magnification of information displayed in display window 3012 and/or a
portion thereof.
[000488] In step 2910, a patient identifier may be received. Exemplary
patient identifiers include, but are not limited to, patient name, date of
birth,
insurance identification number, phone number, email address, and so on.
Additionally, in some cases, information regarding a treatment, diagnosis,
and/or other medical information may be received in step 2910.
[000489] Optionally, in step 2915, an indication of a selection criteria
for
the display of wellness information, wellness score(s), and/or medical
information for the patient may be received. In some instances, the
indication may be received via, for example, a selection of one or more
buttons provided by array 3030. Optionally, in step 2920, an indication of a
selection of one or more treatments administered to the patient may be
received via, for example, a selection of one or more buttons provided by
array 3030.
[000490] In some instances, the patient identifier, selection criteria,
and/or
selected treatments may be received via an interface (not shown) that
provides, for example, text entry fields and one or more arrays of buttons
corresponding to, for example, a treatment, diagnosis, or OMD used. In
some cases, receipt of a patient identifier may trigger the display of
various treatments and/or diagnoses relevant to the patient so that a user
may select one or more treatments and/or diagnoses for which to receive
information (e.g., wellness scores, patient compliance information, etc.).
[000491] In step 2925, one or more databases (e.g., score database 120,
treatment provider database 121, treatment facility database 123, OMD
response database 110, patient EMR database 130, and/or patient
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information database 142) that correspond with the patient identifier,
received selection criteria, and/or treatments administered received in
steps 2910, 2915, and/or 2920 may be accessed. Then, data regarding
the patient identifier and, when appropriate, selection criteria and/or
treatments administered may be extracted from the accessed database(s)
(step 2930). In some embodiments, the indications received in steps 2915
and 2920 may be associated with, for example, one or more treatment
and/or diagnosis codes and this association may facilitate extraction of the
data from the databases in step 2930. Then, a graphic display (e.g., a line
graph, a bar chart, a table, etc.) may be prepared (step 2935) and
provision of the graphic display on a patient wellness portal interface may
be facilitated (step 2940).
[000492] FIG. 30B provides an exemplary patient wellness portal
interface 3002 with a display window 3012B that provides a graph of
representations of a plurality of pre-determined wellness scores 3040 for a
patient associated with the patient identifier received in step 2910 with
regard to the selection criteria received indicating that the patient wellness
portal interface 3002, in this case, the diagnosis of benign prostatic
hypertrophy as shown in heading 3008. In the example of the graph of
display window 3012B, the representations of wellness scores 3040 are
shown as circles with a numerical value of the wellness score shown
above the circles. The placement of the circle representing a wellness
score 3040 corresponds to the date the wellness score was determined
and that date's corresponding position along the X-axis and the value of
the wellness score and that value's corresponding position along the Y-
axis. Heading 3018 also provides a mechanism (e.g., OMD name, or
name of a group of OMDs used to determine a wellness score for the
patient) by which the wellness scores for the patient were determined with
regard to the diagnosis (in this case, the International Prostate Symptom
Score PRO). In some cases, heading 3008 may also include a patient's
name, age, identifier, date of birth, etc. (not shown).
[000493] The graph representations of wellness scores 3040 provided by
display window 2912B displays wellness scores, on a scale from 1-100, on
the X-axis 2910 as a function of time, measured in quarter years from Q2
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of 2014 to Q2 of 2017 along the X-axis 3015. Each of the representations
of wellness scores 3040 are connected with a line 3045 to the previous
and following representations of wellness score 3040 (as appropriate).
The representations of wellness scores 3040 displayed on the graph of
patient wellness portal interface 3002 are pre-calculated via any of the
methods using any of the systems described herein and, in some
instances, may be extracted from score database 120 and/or patient EMR
database 130.
[000494] In some embodiments, the graph of wellness scores displayed
in FIG. 30B may be provided responsive to a user's selection of wellness
score button within array 3030, which is an example of an indication of a
selection criteria that may be received in step 2915.
[000495] In some embodiments, the representations of the patient's
wellness scores 3040 may be displayed as individual scores as well as a
single linear regression line 3070 as provided by display window 3012C of
FIG. 30C. Linear regression line 3070 may be a statistically determined
using linear regression analysis of the wellness scores 3040 and, in some
instances, may serve to provide an average of the patient's wellness
scores 3040 over a period of time and, in some instances, may relate to
and/or be used to generate an average improvement score over the same
time period.
[000496] In some embodiments, a patient's relative progress (e.g.,
change in wellness score over time) may be shown on the graphs of, for
example, display window(s) 3012B and/or 3012C by, for example,
providing a visual distinction between an representation of a wellness
score 3040 that is higher than a previous representation of a wellness
score 3040 and a representation of a wellness score 3040 that is lower
than a previous representation of a wellness score 3040. For example,
the value of the first representation of a wellness score 3040 shown in the
graph of display window 3012B is 33 and the value of the second
representation of a wellness score 3040 shown in the graph of display
window 3012B is 38. Since the second representation of a wellness score
3040 is higher than the preceding representation of a wellness score 3040,
the second representation of a wellness score 3040 may be shown in a
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first color (e.g., green) or have a first format (e.g., smaller circle size or
shading within the circle) and/or the line 3045 extending between the first
and second wellness score representations 3040 may be a first color (e.g.,
green) or may have a particular format (e.g., bold, dashed, etc.). In
another example, the value of the third representation of a wellness score
3040 shown in the graph of display window 3012B is 45 and the value of
the fourth representation of a wellness score 3040 shown in the graph of
display window 3012B is 39. Since the fourth representation of a wellness
score 3040 is lower than the preceding representation of a wellness score
3040, the fourth representation of a wellness score 3040 may be shown in
a second color (e.g., red) or have a second format (e.g., larger circle size
or shading within the circle) and/or the line 3045 extending between the
third and fourth wellness score representations 3040 may be a second
color (e.g., red) or may have a particular format (e.g., bold, dashed, etc.).
[000497] FIG. 30D illustrates an exemplary patient wellness portal
interface 3004 with a display window 3012D that provides an indication of
when the treatments 3075, test results 3080, and procedures 3085
performed on, or determined for, the patient with regard to the benign
prostatic hypertrophy diagnosis have occurred within display window
3012D. Display of the treatments 3075 may be triggered following
selection of the treatment button of array 3030, display of test results 3080
may be triggered following selection of the test results button of array
3030, and display of procedures 3085 may be triggered following selection
of the procedures button of array 3030 via execution of, for example, steps
2915 and/or 2920.
[000498] As may be seen display window 3012D in FIG. 30D, the patient
was prescribed with a treatment 3075 of tamulosin HCL 0.4mg qd between
Q2 2014 and Q3 2014. Then, the patient's lab tests 3080 showed a PSA
of 2.8 ng/mL near Q1 of 2015 and between Q2 2015 and Q3 2015, the
patient was prescribed a treatment 3075 of an increased dosage of
tamulosin HCL 0.8mg qd. Then, the patient's lab tests 2980 showed a
PSA of 2.7 ng/m L near Q2 of 2016 and a transurethral prostatectomy
(TURP) procedure 2985 was performed near Q3 of 2016.
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[000499] In some embodiments, the indications of the treatments 3075,
test results 3080, procedures 3085 and/or indications of patient-entered
information 3050 provided by display window(s) 3012D, 3012E, 3012G,
3012H, 30121, and/or 3012J may be linked to further information
regarding, for example, the respective treatment, test result, procedure.
This further information may be provided to the user upon, for example,
selection of (e.g., clicking on) the respective treatment, test result,
procedure on the respective interface. In some instances, this further
information may be provided as a pop-up window on the respective
interface and, in other instances, this further information may be provided
as a separate page/interface. Exemplary further information includes, but
is not limited to, potential side effects from the selected treatment, test,
and/or procedure; the severity of the side effects from the selected
treatment, test, and/or procedure; expected costs associated with from the
selected treatment, test, and/or procedure; expected recovery time from
the selected treatment, test, and/or procedure; and so on. In some cases,
the further information may be provided by a third-party computer system
and/or data source such as treatment side effect database 146, third-party
computer system 172 and/or database 174.
[000500] FIG. 30E illustrates an exemplary patient wellness portal
interface 3005 with a display window 3012E that shows the
representations of wellness scores 3040 of display window 3012B, the
linear regression line 3070 of display window 3012C, along with the
treatments 3075, test results 3080, and procedures 3085 performed on, or
determined for, the patient with regard to the benign prostatic hypertrophy
diagnosis of display window 3012D superimposed upon one another so
that they may be simultaneously observed and analyzed by the user. As
may be seen, the patient's wellness score is 33 between Q2 and Q3 of
2014 and rises to 45 between Q1 and Q2 of 2015 during which time the
patient is being treated with Tamsulosin HCL 0.4mg qd. Near Q1 of 2015,
the patient's PSA lab value is 2.8ng/mland the wellness score declines to
35 near Q2 of 2015 at which point the treatment is changed to Tamsulosin
HCL 0.8mg qd after which the patient's wellness scores improve until
between Q42015 and Q1 of 2016 after which they begin to decline again.
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The patient's lab results show a PSA of 2.7 ng/ml between Q1 and Q2 of
2016 and a transurethral prostatectomy (TURP) is performed near Q3 of
2016. Following this procedure, the patient's wellness scores improved
substantially because the representations of wellness score 3040
determined just prior to treatment is a 48 and the representations of
wellness score 3040 approximately 1 year later is an 82.
[000501] FIG. 30F illustrates patient wellness portal interface 3006 that
includes a display window 3012F that shows a graph of representations of
wellness scores 3040 of display window 3012B along with a patient
compliance graph 3090 that graphically shows a determination of a
patient's treatment compliance (also referred to herein as a patient
compliance score) measured on a scale of 0-10 as shown on second Y-
axis 3081. Patient compliance scores may be determined via asking one
or more patient compliance questions when administering an OMD to the
patient via, for example, his or her wellness account in a manner similar to,
for example, including one or more patient compliance questions in the
OMD provided in step 1210 of process 1200 as discussed above with
regard to FIG. 12. A scale of 0-10 for the treatment compliance values is
provided on an X-axis 3081 opposite the X-axis 3010 displaying the
wellness score.
[000502] Display window 3012F also provides two patient note icons
3091 as well as an abbreviated patient note 3095. Patient note icons 3091
and/or abbreviated patient note 3095 may be displayed on display window
3012F following selection or other activation of patient note icon of array
3030. In some embodiments, abbreviated patient note 3095 may not
always be displayed on a display window 3012F. In these embodiments,
display of abbreviated patient note 3095 may be triggered upon selection
of an associated patient note icon 3091. Such a selection may occur
when the user maneuvers a cursor over the patient note 3091 (in a
manner similar to a mouse-over) or otherwise selects patient note icon
3091.
[000503] Information included in a patient note may be entered by, for
example, the patient via interaction with, for example, interfaces 1708,
1709, and/or 1711 discussed above with regard to FIGs. 171, 17J, and
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17K. Additionally, or alternatively, information included in a patient note
included in a patient note may be entered by the user, a treatment
provider, and/or treatment administrator who is aware of the subject of the
respective patient note. Selecting a patient note icon 3091 and/or
abbreviated patient note 3095 may trigger the display of a patient note
window (not shown) or other mechanism for displaying the content of the
patient note. Providing patient notes 3091 and/or abbreviated patient
notes 3095 on a graph in the manner displayed in FIG. 30F allows for the
user to observe possible correlations between, for example, wellness
scores or patient compliance and the content of the patient notes. This
may assist the user in determining if a life event is adversely affecting the
patient in a manner that may not be related to a treatment being
administered. For example, the patient's wellness score drops from a 39
between Q1 and Q2 of 2015 to a 35 between Q2 and Q3 of 2015. The 35
wellness score corresponds to a patient note that indicates there was a
death in the family. This death may have adversely affected the patient's
health independently of the treatment administered and a treatment
provider may use this information to determine that a change in treatment
may not be necessary even though the wellness score has declined.
Additionally, or alternatively, when a treatment provider observes a drop in
wellness score that correlates with a patient note indicating an adverse life
event, he or she may then take an action such as providing additional
resources (e.g., counseling or anti-depressants) to the treatment regime
for the patient.
[000504] FIG. 30G illustrates patient wellness portal interface 3007 which
includes a display window 3012G that shows the representations of
wellness scores 3040 of display window 3012B; the linear regression line
3070 of display window 3012C; the treatments 3075, test results 3080,
and procedures 3085 of display window 3012D; and the patient
compliance graph 3090, patient note icons 3091, and abbreviated patient
notes 3095 of display window 3012F all superimposed upon one another.
By viewing this information together, a patient, treatment provider, and/or
treatment administrator may observe correlations between the different
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types of data displayed and may make more holistic determinations
regarding how to manage the patient's treatment and care.
[000505] In some embodiments, a patient may desire to add information
about him- or herself into his or her wellness account particularly if this
information may be relevant to the patient's health and/or wellness.
Exemplary information a patient may enter into his or her wellness account
may include, but is not limited to over-the-counter medications (e.g.,
aspirin, vitamins, nutritional supplements, etc.), holistic healing methods
(e.g., acupuncture, meditation, yoga, etc.), dietary changes, exercise, and
so on. This information may be viewable/accessible to the patient and/or
his or her treatment provider, treatment facility, and/or treatment
administrator.
[000506] FIGs. 30H-30J provide exemplary interfaces 3009-3011,
respectively, whereby information entered by the patient may be displayed
in, for example, graph form in display windows 3012H-3012J, respectively.
More particularly, interface 3008 shows two indications of patient-entered
information 3050, the first indication 3050 being that the patient began
taking a multivitamin between Q2 and Q3 of 2014 and the second
indication 3050 being that the patient began practicing meditation between
Q3 and Q4 of 2015. Indications patient-entered information 3050 may be
displayed in display window 3012 H responsively to a selection of the
patient entered values button of an array 3031. The buttons of array 3031
are the same as the buttons of array 3030 with the exception that array
3031 includes a button for adding patient-entered values.
[000507] FIG. 301 shows the indications of patient-entered information
3050 of display window 3012H superimposed upon a graph of
representations of wellness scores 3040 as shown in FIG. 30B and FIG.
30J shows the indications of patient-entered information 3050 of display
window 3012J superimposed upon a graph of representations of wellness
scores 3040 of display window 3012B, the linear regression line 3070 of
display window 3012C, along with the treatments 3075, test results 3080,
and procedures 3085 performed on, or determined for, the patient with
regard to the benign prostatic hypertrophy diagnosis shown in FIG. 30E.
Thus, FIGs. 301 and 30J provide a viewer/user with the opportunity to
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simultaneously view different types of information that may impact a
patient's wellness and make observations and/or inferences therefrom.
For example, a treatment provider and/or patient may determine how the
various factors/types of information displayed on interfaces 30121 and/or
3012J may have impacted the patient's wellness scores and may be able
to draw inferences therefrom regarding, for example, whether a treatment
is effective or needs to be supplemented or changed.
[000508] FIGs. 30H-30J also make patient-entered information clearly
distinguishable (in this case by using an oval shape to display the
indications of patient-entered information 3050) from other information that
may be entered by a treatment provider and/or treatment administrator.
[000509] FIGs. 31A and 31 B provide flowcharts that illustrate an
exemplary process 3100 for displaying treatment effectiveness
information. Treatment effectiveness may be directly displayed and/or
patient wellness scores resulting from/following administration of a
treatment may be displayed. Process 3100 may be executed by, for
example, any of the systems, system components, or of system
combination of components thereof disclosed herein.
[000510] FIGs. 32A-32D provide exemplary treatment effectiveness
interfaces 3201-3204. The treatment effectiveness interfaces 3201-3204
may be utilized to ascertain and/or visualize a plurality of previously
determined outcomes, or wellness scores, that correspond with an
application of a treatment, or combination of treatments, to a disease or
medical condition and/or combination of diseases and/or medical
conditions that a plurality of patients may have been diagnosed with. In
many instances, a user may wish to execute process 3100 and/or see the
information provided by interfaces 3201-3204 so as to determine how a
particular treatment affected wellness scores for patients who received the
treatment that share one or more characteristics with a particular patient
who is, for example, considering undergoing the particular treatment
and/or has undergone the treatment and would like information regarding
projected recovery (e.g., future wellness scores and/or improvement
scores). In some instances, the information may also be used to predict
future wellness scores for a patient.
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[000511] Process 3100 begins with facilitating provision of an introductory
treatment effectiveness interface and/or a criteria selection interface to a
display device (e.g., computer display or tablet computer screen) (step
3105). An exemplary introductory treatment effectiveness interface is
provided by FIG. 32A and an exemplary criteria selection interface is
provided by FIGs. 28A and 28B.
[000512] Exemplary introductory treatment effectiveness interface 3201
may be used by a user, such as a treatment provider, treatment
administrator, and/or patient to select various parameters for the display of
previously determined wellness scores for patients that have one or more
characteristics similar to a particular patient of interest following
administration of a treatment or combination of treatments. Often times,
the treatment effectiveness interface 3201 will enable the user to select
one or more diagnosis to which the treatment was responsive.
[000513] Introductory treatment effectiveness interface 3201 includes a
heading 3205, a display window 3210A, an X-axis 3215, a Y-axis 3220, an
array of selection criteria 3225, a magnification adjustment mechanism
3230, and an array 3235 of exemplary buttons, the selection of which will
trigger the display, or removal, of an associated type of information on
treatment effectiveness interface 3201 and/or a display window 3210A
included therein. In the embodiment of FIG. 32A, array 3235 includes a
wellness score button, a predicted wellness score button, a
prescription/treatment button, a similar patients button, and a compliance
button. The Y-axis 3215 corresponds to a wellness score shown on a
scale of 0-100 and the X-axis 3220 corresponds to time on a time intervals
(shown as TI1, TI2, TI3, etc.) of equal length. Exemplary lengths of time
for a TI include, but are not limited to a week, month, quarter year, half
year, year, and decade.
[000514] Heading 3205 includes information about the content displayed
via introductory treatment effectiveness interface 3201 and/or a display
window 3210A included therein. The heading of treatment effectiveness
interface 3201 includes a title in the form of "Treatment Effectiveness" and
a treatment of interest, in this case, "tamsulosin." Heading 3205 may also
include other information such as one or more patient characteristics (e.g.,
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age, gender, starting wellness score, BMI, diagnosis, etc.) not shown in
FIGs. 32A-32D. Array of selection criteria 3225 includes a variety of
criteria, or patient characteristics, that a user may select so as to filter
or
otherwise select or manipulate the previously determined wellness scores
provided in display window 3210A. The exemplary criteria provided in
array of selection criteria 3225 include a starting wellness score, age,
gender, and body mass index (BM!). Further selection criteria are
provided on criteria selection interface is provided as shown in FIGs. 28A
and 28B.
[000515] Next, in step 3110, an indication of a selected treatment and/or
criteria of interest may be received via, for example, user interaction with a
selection criteria provided by array 3225 and/or criteria selection interfaces
28A and/or 28B. Additionally, or alternatively, an indication of a selection
criteria for previously determined wellness scores, wellness information,
and/or medical information for patients who have undergone the treatment
selected in step 3110 may be received via, for example, user interaction
with a selection criteria provided by array 3225 and/or criteria selection
interfaces 28A and/or 28B.
[000516] Then, one or more databases like database score database
120, treatment provider database 121, treatment facility database 123,
OMD response database 110, patient EMR database 130, patient
information database 142, and/or treatment side effect database 146 may
be accessed (step 3120) and data that matches the received indications
for a plurality of patients or individuals may be extracted therefrom (step
3125).
[000517] In embodiments where the selection criteria of step 3115
includes a request for treatment side effect information, execution of step
3120 may include accessing treatment side effect database 146 for known
side effects of the first or second treatments as well as their severity.
Additionally, or alternatively, execution of step 3120 may include
accessing a third-party computer system and/or database (e.g., OpenFDA,
NDC, RxNorm, Ul, and/or SPL) to request information regarding side
effects for of treatment. In some cases, the third-party computer system
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and/or database may be third-party computer system 172 and/or database
174.
[000518] A graphic (or other type) display may then be prepared (step
3130) and provision of the prepared graphic display on a treatment
effectiveness interface may then be facilitated (step 3135). The graphic
display may be provided in, for example, a format for display in a display
window like display window 3210A-3210D on a computer or electronic
display device/screen. In some embodiments process 3100 may end
following execution of step 3135. In other embodiments, process 3100
may proceed to step 3140 and/or step 3155 as will be discussed in greater
detail below with regard to FIG. 31B.
[000519] FIG. 32B provides an exemplary treatment effectiveness
interface 3202 that shows wellness score information associated with
patients that match the indications received in steps 3110 and/or 3115 and
extracted in step 3125. The wellness score information is shown in display
window 3210B, responsively to, for example, a selection of the wellness
score button included in array 3235, as a scatter graph within display
window 3210B, wherein each point on the scatter graph indicates a
wellness score for a patient that matches the criteria selected in array of
selection criteria 3225 as determined at, or near, expiration of a time
interval (e.g., TI1, TI2, TI3, etc.) following administration of the initial
treatment. The wellness scores provided by the scatter graph are also
responsive to selection of prescription/treatment button of array 3225,
wherein the prescription/treatment is tamsulosin HCL 0.8mg qd so that the
wellness score points are displayed on the scatter graph for each time
interval (e.g., each quarter) following administration of the prescribed
treatment (i.e., tamsulosin HCL 0.8mg qd). In this way, the user may
observe how patients responded to the prescribed treatment over time.
[000520] As may be seen in the scatter graph within display window
3210B, the wellness scores for patients coincident with administration of
the tamsulosin treatment 3255 (i.e., TI1) are fairly similar to one another
(i.e., the range of wellness scores is relatively small). Then, at TI2, the
grouping of wellness scores begins to spread out with the wellness scores
of some patients improving more than for other patients. Then, at TI3, the
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grouping of wellness scores breaks into two groups, a group of higher
wellness scores (referred to herein as the "higher group") and a lower
group of wellness scores (referred to herein as the "lower group"). At TI4,
the wellness scores of the higher and lower groups improve slightly and
then these scores (i.e., the wellness scores at TI4) remain fairly constant
throughout T15-T17.
[000521] By observing the graph provided by display window 3202, a
trend of patients who are responsive to the tamsulosin treatment (i.e., the
higher group) and a trend of patients who are not responsive (i.e., the
lower group) may be seen. Treatment effectiveness interface 3203 of FIG.
32C provides the graph shown in display window 3210B with a visual
indication of responsive and non-responsive wellness scores
superimposed thereon. More specifically, display window 3210C of FIG.
32C provides a box surrounding the higher group 3240 and a box
surrounding the lower group 3245. Criteria for determining which wellness
scores fall into a "higher group" and a "lower group" may be established
by, for example, the medical literature (e.g., a study determining what level
of improvement in the wellness of a patient is to be expected from patients
who are responsive to a particular treatment), treatment provider
experience or preferences, treatment administrator preferences, and/or
patient expectations for his or her wellness score following treatment.
[000522] Turning now to FIG. 31B, optionally, a request to add previously
determined wellness scores for a particular patient to the graphic display
of step 3135 may be received (step 3140). Then, a database storing
previously determined wellness scores for the particular patient (e.g.,
score database 120 and/or patient information database 142) may be
accessed responsively to the received request (step 3145) and one or
more previously determined wellness scores for the patient may be
extracted from the database (step 3150).
[000523] Additionally, or alternatively to steps 3140-3150, a request to
add one or more predicted wellness scores for the patient may be received
(step 3155). Then, a predicted wellness score may be determined (step
3160). The one or more predicted wellness scores may be determined
via, for example, execution of process(es) 1400 and/or 1401 as discussed
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above with regard to FIGs. 14A and 14B, respectively. In some instances,
determining a predicted wellness score may include evaluation of
treatment efficacy based on the information included in the graphic display
of step 3135 and/or comparison of how patients with one or more
characteristics or attributes in common with the particular patient.
Predicted wellness scores for the particular patient may be determined for
one or more time intervals. In some instances, the number of time
intervals for which a predicted wellness score is to be determined may be
included in the request of step 3155.
[000524] In step 3165, a graphic display including the extracted wellness
scores for the particular patient and/or predicted wellness scores for the
particular patient may be prepared. In some embodiments, the graphic
display of step 3165 may be prepared separately from the graphic display
of step 3135 and, in other embodiments, the graphic display of step 3165
may be added to and/or superimposed upon the graphic display of step
3135 as shown in exemplary treatment effectiveness interface 3205 as
shown in FIG. 32. Once prepared, provision of a graphic display including
the extracted wellness scores and/or the predicted wellness scores for the
particular patient on a treatment effectiveness interface may be facilitated
(step 3170).
[000525] Treatment effectiveness interface 3204 of FIG. 32D provides the
scatter graph of display window 3210B along with a plurality of wellness
score values 3250 determined for/extracted from a database storing
previously determined wellness scores for a particular patient who is
undergoing the treatment selected in, for example, step 3110, from time
intervals T11-T15 and a predicted wellness score value 3260 for the patient
in TI6 superimposed thereon in display window 3201D. The wellness
scores 3250 may be determined using any of the methods and/or systems
described herein. The predicted wellness score 3255 may be determined
via, for example, process(es) 1400 and/or 1401 as discussed above with
regard to FIGs. 14A and 14B, respectively. Observing the patient's
wellness scores superimposed onto the wellness scores for the treatment
the patient is receiving for a plurality of other patients provides the
user/observer with incite into how the patient's wellness changes over time
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with administration of the treatment and how this progress compares with
other patients who may have one or more similar characteristics.
[000526] FIGs. 33A and 33B provide flowcharts that illustrate an
exemplary process 3300 for generating and providing a graphic display of
treatment comparison information. In most instances, the treatment
comparison information will be a comparison of two or more treatments for
a particular diagnosis or medical condition. Process 3300 may be
executed by, for example, any of the systems, system components, or of
system combination of components thereof disclosed herein.
[000527] FIGs. 34A- 34F provide exemplary treatment comparison
interfaces 3401-3406, respectively. The treatment comparison interfaces
3401-3406 may be utilized to ascertain and/or visualize a plurality of
previously determined outcomes, or wellness scores, that correspond with
an application of a first treatment and a second treatment (or more) to
patients associated with a particular diagnosis, disease, medical condition
and/or combination thereof. In many instances, a user may wish to
execute process 3300 and/or see the information provided by interfaces
3401-3406 to compare how two or more different treatments affected
wellness scores for patients who received the respective treatment. In
some cases, the patients associated with the displayed wellness scores
may share one or more characteristics with a particular patient (or the
particular patient's treatment provider) who is, for example, considering
undergoing/administering one of the treatments being compared and/or
has undergone one of the treatments being compared and would like
information regarding projected recovery (e.g., future wellness scores
and/or improvement scores). In some instances, the information may also
be used to predict future wellness scores for a patient resulting from
administration of different treatments.
[000528] Process 3300 begins with facilitating provision of an introductory
treatment comparison interface and/or a criteria selection interface to a
display device (e.g., computer display or tablet computer screen) (step
3305). An exemplary introductory treatment comparison interface is
provided by FIG. 34A.
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[000529] Exemplary introductory treatment comparison interface 3401
may be provided to/used by a user, such as a treatment provider,
treatment administrator, and/or patient to select various parameters for the
display of previously determined wellness scores for patients associated
with two or more treatments administered for particular diagnosis. The
patients may, or may not, have one or more characteristics similar to a
particular patient of interest. Often times, the introductory treatment
comparison interface 3401 will enable the user to select one or more
diagnosis to which the treatment was responsive.
[000530] Introductory treatment comparison interface 3401 includes a
heading 3305, a display window 3410A, an X-axis 3420, a Y-axis 3415, an
array of selection criteria 3425, and an array 3130 of exemplary buttons,
the selection of which will trigger the display, or removal, of an associated
type of information on treatment comparison interface 3401 and/or a
display window 3410A included therein. The Y-axis 3415 corresponds to a
wellness score shown on a scale of 0-100 and the X-axis 3420
corresponds to time on a time intervals (shown as TI1, TI2, TI3, etc.) of
equal length. Exemplary lengths of time for a TI include, but are not
limited to a week, month, quarter year, half year, year, and decade.
[000531] In the embodiment of FIG. 34A, array 3130 includes buttons
specific to the comparison of treatments as well as aspects of a treatment.
For example, array 3130 includes buttons that enable a user to display
wellness scores related to a first treatment (i.e., treatment A) and a second
treatment (i.e., treatment B). Array 3130 also includes buttons that enable
a user to display average treatment compliance information for the first
and second treatments (shown as "Treatment A; Avg. Compliance" and
"Treatment B; Avg. Compliance", respectively), information regarding a
first side effect of the first treatment (shown as "Treatment A; Side Effect
C"), information regarding a second side effect of the first treatment
(shown as "Treatment A; Side Effect D"), information regarding a first side
effect of the second treatment (shown as "Treatment B; Side Effect E"),
and information regarding a second side effect of the second treatment
(shown as "Treatment B; Side Effect F"). It will be understood by those of
skill in the art that any number of treatment options (e.g., treatments C, D,
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E, F, etc.) and their associated side effects and/or treatment compliance
may be provided by array 3130 and that a graph comparing, for example,
wellness scores for patients who receive different treatments may include
any number of wellness scores associated with any number of different
treatments.
[000532] In some embodiments, the buttons and/or the treatments or
treatment attributes they represent provided by array 3130 may be
responsive to, for example, a characteristic of the user (e.g., a treatment
provider with a known specialty, a patient with a known diagnosis, and so
on) and/or a selection criteria (e.g., diagnosis, treatment preference,
severity of side effects, number of known side effects, and so on) that may
be entered by the user via, for example, criteria selection interface(s) 2801
and/or 2802.
[000533] Heading 3305 includes information about the content displayed
via a treatment comparison interface 3401-3406 and/or a display window
3410A-3410F included therein. Heading 3305 of FIGs. 34A-34F explains
that the graph displayed in display windows 3410B-3410F relates to
patient wellness scores resulting from administration of a first treatment
(i.e., "Treatment A") and a second treatment (i.e., "Treatment B") over
time. Heading 3305 may also include other information such as one or
more factors, criteria, and/or patient characteristics (e.g., age, gender,
starting wellness score, BM I, diagnosis, etc.) used to generate a graphic
display provided by a respective treatment comparison interface. Array of
selection criteria 3425 includes a variety of criteria, or patient
characteristics, that a user may select so as to filter or otherwise select or
manipulate the previously determined wellness scores provided in display
window 3410A. The exemplary criteria provided in array of selection
criteria 3425 include a starting wellness score, age, gender, and body
mass index (BM!). Further selection criteria are provided on criteria
selection interface(s) 2801 and/or 2802 is provided as shown in FIG. 28A
and 28B, respectively.
[000534] Next, in step 3310, an indication of a first and a second selected
treatment may be received via, for example, user interaction with two
treatments selected from array 3130. In some cases, the selected first
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and second treatments will be associated with a diagnosis or diagnosis
code so that the user may observe compare the efficacy of two treatments
for the same diagnosis.
[000535] Optionally, in step 3315, an indication of a selection criteria
for
previously determined wellness scores, wellness information, and/or
medical information for patients who have undergone the first and/or
second treatment may also be received via, for example, user interaction
with array 3430 and/or criteria selection interfaces 2801 and/or 2802. In
most embodiments, the selection criteria of step 3315 will apply to both
previously determined wellness scores for both the first and second
treatments. However, in some circumstances, this may not be the case.
[000536] Then, one or more databases that store previously determined
wellness scores, wellness information, and/or medical information, all of
which are associated with a particular treatment, may be accessed (step
3320). Exemplary accessed databases include score database 120,
treatment provider database 121, treatment facility database 123, OMD
response database 110, patient EMR database 130, and/or patient
information database 142. Then, data that matches the selected first and
second treatments and, when step 3315 is executed, received indications
of one or more selection criteria for a plurality of patients or individuals
may be extracted from the accessed database (step 3325). A graphic (or
other type) display of a comparison between wellness scores resulting
from administration of the first and second treatments may then be
prepared (step 3330) and provision of the prepared treatment comparison
graphic display on a treatment comparison interface may then be
facilitated (step 3335). The graphic display may be provided in, for
example, a format for display in a display window like display window 3410
on a computer or electronic display device/screen. In some embodiments
process 3300 may end following execution of step 3335. In other
embodiments, process 3300 may proceed to step 3340 and/or step 3355
as will be discussed in greater detail below with regard to FIG. 33B.
[000537] FIG. 34B provides an exemplary treatment comparison interface
3402 that shows a graph of wellness scores, that have been previously
determined over a series of time intervals (TIO-T16), for patients who
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received either the first treatment (i.e., treatment A) or the second
treatment (i.e., treatment B) in display window 3410B. The graph of
display window 3410B is an example of a treatment comparison graphic
display that may be prepared via execution of step 3330 and provided on a
treatment comparison interface like treatment comparison interface 3402
which may be viewed by a user via a display device provided by, for
example, a patient device like patient device 128, a treatment provider
device like treatment provider device 128 and/or a treatment facility
computer system like treatment facility computer system 134 via execution
of step 3335. In embodiments where indications of one or more selection
criteria are received in step 3315, the wellness scores displayed on the
graph of display window 3410B may be responsive to the selection criteria
as well.
[000538] The wellness scores shown on the graph of display window
3410B are associated with treatment A are round in shape and the
wellness scores associated with treatment B are square in shape however,
it will be appreciated that any differentiation (e.g., color, size, etc.)
between
the wellness scores associated with treatment A and treatment B may be
used. Each of the wellness scores shown on the graph of display window
3410B are also associated with a time interval where TIO corresponds to
an initial wellness score determined prior to the initiation of any treatment
and each time interval following TIO corresponds to the passage of a
subsequent pre-determined period of time. A duration of time for the time
intervals may be established by, for example, the user and/or a standard
of care for the administration of questionnaires by which wellness scores
are determined and each of the pre-determined wellness scores extracted
in step 3325 will correspond with a time interval. In some instances, the
duration of the time intervals may be responsive to the treatment and/or an
underlying diagnosis. For example, for rapidly progressing conditions
such as some types of cancer the duration of a time interval may be as
short as a day or week and for other, more chronic diagnosis such as
diabetes or asthma, the duration of time intervals may be measured in
months, quarter-years, years, or decades. In most instances, the duration
of time for a time interval will be uniform across all patients. In this way,
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the user may observe and compare how patients responded to the first
and second treatment over time.
[000539] As may be seen in the graph within display window 3410B, the
initial/pre-treatment wellness scores for patients who will receive treatment
A or treatment B at TIO are fairly similar to one another. Then, at time TI1,
the wellness scores for patients who received treatment A are, in general,
higher than those patients who received treatment B but there is still a
considerable amount of overlap between the wellness scores of patients
who received treatment A and treatment B. By TI2, wellness scores of
patients who received treatment A are, as a group, higher than those for
patients who received treatment B. This trend continues for T13-T16 such
that it is clear that patients who receive treatment A have higher wellness
scores than those who receive treatment B over time.
[000540] FIG. 34C provides a treatment comparison interface 3403 in
which a graphic display of wellness scores resulting from administration of
the first and second treatments over time is provided in a display window
3410C. The graph of display window 3410C has an X-axis corresponding
to time with increments of quarter years from the fourth quarter of 2014
through the fourth quarter of 2016. The wellness scores displayed on the
graph of display window 3410C are the same as those displayed on the
graph of display window 3410B except that they are displayed as a
function of time measured in quarter years instead of at time intervals
measured from the initial administration of the first or second treatment.
Displaying wellness scores in this format allows the user to see how other
factors (e.g., the weather, seasons, pollen counts, geopolitical events, etc.)
correlated to the time of year and/or a date on the calendar may affect
wellness scores that may, or may not, be related to the efficacy of the first
or second treatments.
[000541] FIG. 34D provides a treatment comparison interface 3405 in
which a graphic display of wellness scores resulting from administration of
the first and second treatments over time along with treatment compliance
is provided in a display window 3410D. The graph of display window
3410D provides the graph of wellness scores provided by display window
3410B along with a graph of average treatment compliance values over
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time intervals T11-T16 for treatment A 3455 and treatment B 3460. The
average treatment compliance graphs 3455 and 3460 are scaled with
values from 1-10 along a second Y-axis 3450. The average treatment
compliance graphs 3455 and 3460 may be displayed within display
window 3410D responsively to a selection of Treatment A: Avg.
Compliance button and Treatment B: Avg. Compliance button provided by
array 3430.
[000542] Concurrently displaying wellness scores and average treatment
compliance information in the manner shown in graphic display 3410D
may enable a user to see correlations between treatment compliance and
wellness scores. In this way, it may be determined whether relatively low
wellness scores are resultant from poor treatment compliance or that the
treatment is not effective. The treatment compliance information of the
graph also provides an indication of how difficult the treatment may be to
comply with, which may be relevant for patients and their individual
abilities and/or lifestyles.
[000543] FIG. 34E provides a treatment comparison interface 3307 in
which a graphic display of wellness scores resulting from administration of
the first and second treatments over time along with side effect severity for
treatments A and B is provided in a display window 3410E. The graph of
display window 3410E provides the graph of wellness scores provided by
display window 3410B along with a graph of side effect severity values
over time intervals T11-TI6 for treatment A 3465 and treatment B 3470.
The side effect severity graphs 3465 and 3470 are scaled with values from
1-10 along a second Y-axis 3375. The side effect severity graphs 3465
and 3470 may be displayed within display window 3410E responsively to a
selection of Treatment A: Side Effect C button and Treatment B: Side
Effect E button provided by array 3430.
[000544] Concurrently displaying wellness scores and side effect severity
information in the manner shown in graphic display 3410E may enable a
user to see correlations between side effect severity and wellness scores.
In this way, it may be determined whether relatively the higher wellness
scores of treatment A are worth the increased severity of the side effects
resulting from the treatment. Treatment providers and patients may then
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decide together based on their tolerance for certain side effects which
treatment is better for them.
[000545] Turning now to FIG. 33B, optionally, a request to add previously
determined wellness scores for a particular patient to the graphic display
of step 3335 may be received (step 3340). Then, a database storing
previously determined wellness scores for the particular patient (e.g.,
score database 120 and/or patient information database 142) may be
accessed responsively to the received request (step 3345) and one or
more previously determined wellness scores for the patient may be
extracted from the accessed database (step 3350).
[000546] Additionally, or alternatively to steps 3340-3350, a request to
determine and add one or more predicted wellness scores for the patient
to the graphic display of step 3335 may be received (step 3355). The one
or more predicted wellness scores may be determined via, for example,
execution of process(es) 1400 and/or 1401 as discussed above with
regard to FIGs. 14A and 14B, respectively. In some instances,
determining a predicted wellness score may include evaluation of
treatment efficacy based on the information included in the graphic display
of step 3335 and/or comparison of how patients with one or more
characteristics or attributes in common with the particular patient.
Predicted wellness scores for the particular patient may be determined for
one or more time intervals. In some instances, the number of time
intervals for which a predicted wellness score is to be determined may be
included in the request of step 3355. In step 3360, a predicted wellness
score for the patient may be determined responsively to the request.
[000547] In step 3365, a graphic display including the extracted wellness
scores for the particular patient and/or predicted wellness scores for the
particular patient may be prepared. In some embodiments, the graphic
display of step 3365 may be prepared separately from the graphic display
of step 3335 and, in other embodiments, the graphic display of step 3365
may be added to and/or superimposed upon the graphic display of step
3335 as shown in treatment comparison interface 3306 of FIG. 34F in
which a graphic display of wellness scores resulting from administration of
the first and second treatments over time along with actual and predicted
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wellness scores determined for a particular patient is provided in a display
window 3410F. The graph of display window 3410F provides the graph of
wellness scores provided by display window 3410B along with a series of
predetermined wellness scores 3435 for a particular patient prior to
treatment at TIO and for three time intervals following treatment (TI1-T13)
superimposed thereon. The graph of display window 3410D further
includes a plurality of predicted wellness scores 3440 for the patient
should he or she continue to remain on treatment A for the three time
intervals following TI3 (i.e., TI4-T16). In addition, the graph of display
window 3410F further includes a plurality of predicted wellness scores
3445 for the patient if he or she were to receive treatment B. Displaying
wellness scores (both predicted and actual) in the manner of the graph
displayed in display window 3410F enables a user to see how
administration of a treatment may impact a patient's wellness scores over
time.
[000548] Once prepared, provision of the graphic display including the
extracted wellness scores for the particular patient and/or predicted
wellness scores for the particular patient on a treatment comparison
interface may be facilitated (step 3370).
[000549] FIG. 35A provides a flowchart of a process 3500 for preparing
and providing a wellness score interface for patients being treated by a
treatment provider, or group of treatment providers (sometimes referred to
herein as a "wellness score portal"). Process 3500 may be executed by
any of the systems, system components, and/or combination of system
components described herein. FIG. 36A provides a screen shot of an
exemplary wellness score interfaces 3601 that may be generated via
execution of process 3500 and/or a portion thereof.
[000550] Initially, in step 3505, a request to view wellness scores of a
group of patients being treated by a treatment provider, or a group of
treatment providers (e.g., treatment providers associated with a treatment
facility or medical practice) may be received from a user, who may be, for
example, a treatment provider, treatment administrator, assistant, or
patient via, for example, an electronic device operated by the user (e.g.,
computer, smart phone, etc. including, but not limited to, treatment
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provider device 124 and/or treatment facility computer system 134). The
request may be received by, for example, a processor included in, for
example, a server like server 102, a treatment provider device like
treatment provider device 124 and/or a treatment facility computer system
like treatment facility computer system 134. The request may further
include one or more diagnostic and/or treatment selections or code(s) of
interest along with one or more characteristics of patient. The request
may further include a user preference for viewing only the most-recently-
determined wellness scores.
[000551] In some embodiments, the request may include one or more
filters and/or selection criteria by which to select the information provided
in response to the request. For example, the user may request to see only
current wellness scores below a certain threshold, wellness scores relating
to a patient characteristic (e.g., age, gender, race, etc.) and/or wellness
scores associated with a diagnosis, combination of diagnoses, treatment,
combination of treatments, or a combination of diagnosis/diagnoses and
treatment(s).
[000552] In step 3510, a database (e.g., patient information database 142
and/or score database 120) storing previously determined wellness scores
for the plurality of patients may be accessed and the requested wellness
scores for each patient in the group of patients may be extracted therefrom
(step 3515). The database may also store wellness information and/or
medical information for the patients.
[000553] In some embodiments, the request may set a time interval (e.g.,
1 week, 1 month, 3 months, 6 months, 1 year, 2 years, 10 years) from
which wellness scores for each of the patients in the group are to be
extracted. In these instances, all of the wellness scores for each of the
patients in the group that have been determined over the set time interval.
Then, a wellness score interface that includes the extracted wellness
scores may be generated (step 3520) and provision of the wellness score
interface may be facilitated via, for example, transmission to a display
device included in, or communicatively coupled to, the electronic device
the user is using (e.g., treatment provider device 124 and/or a treatment
facility computer system 134) (step 3525).
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[000554] FIG. 35B provides a flowchart of a process 3501 for preparing
and providing a comparison wellness score interface for patients being
treated by a treatment provider, or group of treatment providers. Process
3501 may be executed by any of the systems, system components, and/or
combination of system components described herein. FIG. 36A provides a
screen shot of an exemplary wellness score interfaces 3601 that may be
generated via execution of process 3500 and/or a portion thereof.
[000555] Initially, in step 3502, a request to view compared wellness
scores for a group of patients being treated by a treatment provider, or a
group of treatment providers (e.g., treatment providers associated with a
treatment facility or medical practice) may be received from a user, who
may be, for example, a treatment provider, treatment administrator,
assistant, or patient via, for example, an electronic device operated by the
user (e.g., computer, smart phone, etc. including, but not limited to,
treatment provider device 124 and/or treatment facility computer system
134). The request may be received by, for example, a processor included
in, for example, a server like server 102, a treatment provider device like
treatment provider device 124 and/or a treatment facility computer system
like treatment facility computer system 134. The request may further
include one or more diagnostic and/or treatment selections or code(s) of
interest along with one or more characteristics of patient. The request
may further include a user preference for viewing the most-recently-
determined wellness scores, viewing a comparison between two or more
determined wellness scores (e.g., a most-recently determined wellness
score for individual patients and a wellness score determined immediately
prior to the current wellness score), or viewing a comparison between the
individual patient's first¨determined wellness score and the patient's most-
recently determined (i.e., current) wellness score.
[000556] In some embodiments, the request may include one or more
filters and/or selection criteria by which to select the information provided
in response to the request. For example, the user may request to see only
current wellness scores below a certain threshold, values of comparisons
between two or more wellness scores that fall below a certain threshold,
wellness scores relating to a patient characteristic (e.g., age, gender, race,
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etc.) and/or wellness scores and/or comparison values associated with a
diagnosis, combination of diagnoses, treatment, combination of
treatments, or a combination of diagnosis/diagnoses and treatment(s).
[000557] In step 3504, it may be determined if previously determined
comparison wellness score and/or improvement scores are available and,
if so, a database storing previously determined comparison wellness score
and/or improvement scores for patients may be accessed (step 3518) and
the requested previously determined comparison wellness score and/or
improvement scores for patients may be extracted therefrom (step 3522).
[000558] When previously determined comparison wellness score and/or
improvement scores are not available, a database (e.g., patient
information database 142 and/or score database 120) storing previously
determined wellness scores for the group of patients may be accessed
(step 3504) and the requested wellness scores for each patient in the
group of patients may be extracted therefrom (step 3506). The database
may also store wellness information and/or medical information for the
patients. On some occasions, the request may indicate which wellness
scores the user would like to see compared. Exemplary comparisons of
wellness scores include a comparison of the current (i.e., most-recently-
determined) wellness score and the wellness score determined
immediately prior to the current wellness score for each patient in the
group. On these occasions, extraction of these two scores facilitates a
comparison of the patient's recent (i.e., during the time period between the
determination of the current wellness score and the wellness score
determined immediately prior to the current wellness score)
recovery/wellness.
[000559] In other instances, the request may request comparison of a
first-determined wellness score, which in some cases may be a baseline
wellness score, and a current wellness score for each patient in the group.
In these instances, extraction of these two scores facilitates a comparison
of the patient's wellness over the timeline of their entire recovery (i.e.,
between the first-determined and current wellness scores) for each patient
in the group.
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[000560] In some embodiments, the request may set a time interval (e.g.,
1 week, 1 month, 3 months, 6 months, 1 year, 2 years, 10 years) from
which wellness scores for each of the patients in the group are to be
extracted. In these instances, all of the wellness scores for each of the
patients in the group that have been determined over the set time interval
may be extracted from the database and compared with one another to
determine, for example, one or more comparison scores, percentage
changes, and/or improvement scores over the respective time interval for
each of the patients in the group.
[000561] Next, the extracted wellness scores for each patient in the group
may be compared with one another (step 3512) to determine a delta (i.e.,
difference between the two or more scores), a percentage change
between the two or more scores, and/or an improvement score for each of
the respective patients in the group. An improvement score may be
determined via execution of process 1000 described above with regard to
FIGs. 10A-10C. Then, a comparison wellness score interface that
includes the results of the comparison of step 3514 may be generated
(step 3514). When the request received at step 3502 includes a request
to view current wellness scores for the patients, then generation of the
comparison wellness score interface may include adding the current
wellness scores thereto. Next, in step 3516, provision of the comparison
wellness score interface to the user may be facilitated via, for example,
transmission to a display device included in, or communicatively coupled
to, the electronic device the user is using (e.g., treatment provider device
124 and/or a treatment facility computer system 134).
[000562] FIGs. 36A-36C provide exemplary an exemplary wellness score
interface 3601 and exemplary comparison wellness score interfaces 3602
and 3602, respectively each of which may be prepared and provided to a
user via execution of process 3500. Wellness score interface 3601 may
be prepared and provided to a user via execution of process 3500 and
comparison wellness score interfaces 3602 and 3603 may be prepared
and provided to a user via execution of process 3501.
[000563] The wellness score interface 3601 of FIG. 36A provides a graph
of current wellness scores for patients associated with a group of
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diagnoses who are being treated by a treatment provider named Dr. Smith
within a display window. More specifically, wellness score interface 3601
provides a first heading 3605 indicating that the current wellness scores
for Dr. Smith are being displayed on wellness score interface 3601 and a
second heading 3615 indicating that the wellness scores displayed
thereon relate to a cardiac diagnosis consistent with all coronary artery
disease patients. In some environments, wellness score interface 3601
may further include a first button 3610A and a second button 3610B, the
selection of which may advance the user through a series of treatments,
diagnoses, and/or combinations thereof associated with Dr. Smith, another
doctor, or a group of doctors. In some embodiments, first and second
buttons 3610A and 3610B may be replaced with, for example, a text entry
field, tabs, or a drop down menu (not shown) by which a user may select
one or more preference(s) and/or enter one or more request(s) for the
display of information and what information is displayed on the interface.
For example, a user may request (via, for example, step 3505) to see
information and/or wellness scores related to a treatment provider, group
of treatment providers, patient diagnosis, treatment administered to a
patient, patient wellness scores, patient improvement scores, patient
wellness scores above or below a threshold score, patient wellness scores
above or below an improvement score threshold, and/or combinations
thereof.
[000564] Interface 3601 includes a display window 3630A and a patient
details table 3640A within which requested wellness scores might be
displayed. In the embodiment of interface 3601, display window 3630A
provides a scatter graph of a plurality of points representing wellness
scores 3655 for all of Dr. Smith's coronary artery disease patients as
indicated by headings 3605. A position of each of the points 3655 of the
graph within display window 3630A represents a magnitude of a wellness
score for an individual patient as measured on a scale of 0-100 along the
Y-axis along with when the wellness score was determined as measured
in calendar months (in this case, March 2016 through May 2016) along the
X-axis. The user may select the length of the time period over which
wellness scores are displayed via time adjustment mechanism 3635 which
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operates by sliding the circle to the left to decrease an interval of time
(to,
for example, 1 month, 2 weeks, etc.) over which wellness scores are
displayed and to the right to increase an interval of time (to, for example, 4
months, 6 months, a year, etc.) over which wellness scores are displayed.
Patient details table 3640A may provide, for example, the names of
patients and their numerical wellness scores that correspond to the points
3655 provided by the scatter graph of display window 3630A.
[000565] In some embodiments, points 3655 and/or the names and/or
wellness scores provided by patient details table 3540A may include one
or more links to further information regarding, for example, the patient
name, the wellness score, and/or the diagnosis of the patient associated
with the selected point 3655, wellness score, and/or patient name. This
further information may be displayed on interface 3601 as, for example, a
drop-down box and/or as a separate page (not shown). Exemplary further
information includes, but is not limited to, contact information for the
patient, more detailed analysis of the wellness score for the patient,
comorbidities, and/or one or more characteristics of the patient.
[000566] The wellness scores represented as points 3655 by the graph of
display window 3630A and listed in patient table 3640A may be extracted
from a database that stores previously determined wellness scores by, for
example, executing steps 3510 and 3515 of process 3500 described
above and wellness score interface 3601 may be generated via execution
of step 3520 and provide to the user via execution of step 3525.
[000567] In some embodiments, for example, when wellness scores of
patients being treated by a plurality of treatment providers (e.g., a group of
treatment providers) are requested, the points 3655 representing the
wellness scores for of the patients may be provided by the graph of display
window 3630A such that points 3655 representing wellness scores for
patients who are being treated by different treatment providers are visually
distinguishable from one another using, for example, different colors,
shapes, or sizes of the points 3655 with each respective color, shape,
and/or size representing one of the treatment providers within the
plurality/group.
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[000568] The comparison wellness score interface 3602 of FIG. 36B
provides a graph of compared wellness scores for patients associated with
a group of diagnoses who are being treated by a treatment provider
named Dr. Smith within a display window as indicated by first heading
3605. The second heading 3615 of comparison wellness score interface
indicates that the compared wellness scores displayed thereon relate to a
cardiac diagnosis consistent with all coronary artery disease patients. Like
wellness score interface 3601, comparison wellness score interface 3602
also includes first button 3610A and second button 3610B.
[000569] The compared wellness scores displayed on comparison
wellness score interface 3602 may be responsive to a user request
specifying that he or she would like to see the results of a comparison of
two or more wellness scores for each patient under a treatment provider's
(or group of treatment providers) care. At times the request may also
include a request to see the most-recently determined (i.e., current)
wellness score for each of the patients. At times, these requests (received
via execution of, for example, step 3502) to see information, wellness
score comparisons (which may also be referred to herein as an
improvement score), and/or wellness scores related to a treatment
provider, group of treatment providers, patient diagnosis, treatment
administered to a patient, patient wellness scores, patient improvement
scores, patient wellness scores above or below a threshold score, patient
wellness scores above or below an improvement score threshold, and/or
combinations thereof.
[000570] The comparison wellness scores displayed on comparison
wellness score interface 3602 may be previously determined comparison
wellness scores and/or improvement scores extracted from a database
storing same via, for example, execution of steps 3518 and 3522.
Additionally, or alternatively, the comparison wellness scores may be
determined by comparing two or more previously determined wellness
scores for a patient (via execution of, for example, steps 3506, 3508, and
3512). In many cases, the comparison wellness score will be a
percentage change between the first- and second-determined wellness
scores being compared where an improvement is a positive change and a
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decline is a negative change. The two compared wellness scores for a
patient may be, for example, his or her most-recently determined (i.e.,
current) wellness score and the wellness score determined immediately
prior to the current wellness score or the current wellness score and the
first-determined wellness score. The user may select between these two
options via selection of a % change from last taken option or a % change
from start (i.e., first-determined wellness score) option via the slider bar
provided by a type of wellness score comparison selection array 3650.
[000571] Interface 3602 includes a display window 3630B and a patient
details table 3640B within which requested wellness scores and/or
wellness score comparisons may be displayed. In the embodiment of
interface 3602, display window 3630B provides a scatter graph of a
plurality of points of four different types representing wellness score
comparisons for all of Dr. Smith's coronary artery disease patients as
indicated by headings 3605. The four different types of points displayed
are as follows: an improvement point 3660 (represented as a circle on the
graph of display window 3630B) that represents a positive change
between a previously-determined wellness score (e.g., a first-determined
wellness score or a wellness score determined prior to the patient's
current wellness score) and a later-determined wellness score (e.g., the
patient's current wellness score); a decline point 3665 (represented as a
triangle on the graph of display window 3630B) that represents a negative
change between the previously-determined wellness score and the later-
determined wellness score; a no change point (represented as a square
on the graph of display window 3630B) that represents no change
between the previously-determined wellness score and the later-
determined wellness score; and a baseline score point 3675 (represented
as a diamond on the graph of display window 3630B) that represents that
the wellness score displayed is the first-determined wellness score and
there are no available subsequently-determined wellness score. A key
3645 provided by comparison wellness score interface 3602 provides a
correlation of the symbols (circle, triangle, square, and diamond) used for
the various types of points provided by the graph of display window 3630B
and what the symbols mean as described above. In some embodiments,
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differences between the types of points may be represented by, for
example, differently sized symbols of the same type (e.g., small circles
indicate improvement points 3660 and larger circles represent decline
points 3665) or differently colored points (e.g., green points for
improvement points 3660, red points for decline points 3665, yellow points
for no change points 3670, and blue outlined white points for baseline
points 3675.
[000572] A position of each of the points of the graph within display
window 3630B represents a magnitude of a wellness score for an
individual patient as measured on a scale of 0-100 along the Y-axis along
with when the wellness score was determined as measured in calendar
months (in this case, March 2016 through May 2016) along the X-axis.
[000573] A patient details table 3640B may provide, for example, the
names of patients and the patient's corresponding wellness scores
(represented as "score"), comparison wellness score value (represented
as % change) and a status indicator indicating whether the comparison
wellness score indicates an improvement (represented by an arrow
pointing upward), a decline (represented by an arrow pointing downward),
no change (represented by a dash), and a baseline (represented by a note
only has baseline result"), each of which may correspond to the points
provided by the scatter graph of display window 3630B.
[000574] As with points 3655 and/or the names and/or wellness scores
provided by patient details table 3540A, points 3660, 3665, 3670, and/or
3675 and/or the names, wellness scores, and/or comparison wellness
score provided by patient details table 3540B may include one or more
links to further information regarding, for example, the patient name, the
wellness score, and/or the diagnosis of the patient associated with the
selected point 3660, 3665, 3670, or 3675, wellness score, comparison
wellness score, and/or patient name. This further information may be
displayed on interface 3602 as, for example, a drop-down box and/or as a
separate page (not shown). Exemplary further information includes, but is
not limited to, contact information for the patient, more detailed analysis of
the wellness score for the patient, comorbidities, and/or one or more
characteristics of the patient. Comparison interface 3603, provided by
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FIG. 36C, provides an example of how information linked to a selected
point 3680 displayed on a scatter graph of a display window 3630C.
Selected point 3680 may be visually distinct from the other points
(improvement points 3660, decline points 3665, no change points 3670,
and baseline points 3675) provided by the scatter graph of display window
3630C. For example, in the embodiment of comparison wellness score
interface 3603, a selected point 3680 is shown as being larger than the
other points 3660, 3665, 3670, and 3675 provided by the scatter graph of
display window 3630C. In this embodiment, selected point 3680
corresponds with a patient named Molly Gilbert and selection of this point
triggers display of the expanded/additional information about Molly shown
in patient details table 3640C. For example, the expanded/additional
information provided by patient details table 3640C includes Molly's
contact information/phone number (which may be linked to a set of
instructions capable of placing a phone call to Molly's phone number), the
time period over which the comparison wellness score has been
determined (represented by "% change since 1/12/17"), and a series of
wellness scores, comparison wellness scores, and status indicators that
represent wellness scores for various facets, or sub-diagnoses of Molly's
coronary artery disease diagnosis. More specifically, patient table 3640C
provides a wellness score, comparison wellness score, and status
indicator for exertionional limitations, angina stability, angina frequency,
and treatment satisfaction all of which are associated with a category of
chest pain along with a wellness score, comparison wellness score, and
status indicator for shortness of breath and mood. This additional
information allows the user to view further information about Molly, whose
wellness score for coronary artery disease is quite low with a value of 6
and declining with a declining % change of 8%, thereby indicating that she
may be in need of an intervention (e.g., phone call, treatment provider
office visit, etc.), change in treatment (e.g., medication or dosage), or
further/closer monitoring.
[000575] The information provided by the scatter graph(s) of display
windows 3640A, 3640B, and/or 3640C and/or the patient details table(s)
3640A, 3640B and/or 3640C may provide a high-level wellness status for
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the patients under a treatment provider's or group of treatment providers'
care, which may enable the user to quickly assess how the patients are
doing/feeling and whether or not they are improving. This information may
be used to, for example, establish priorities for when and/or how often the
patients in the group are treated, contacted, or physically observed (e.g.,
by an office visit) by the treatment provider or a person working with the
treatment provider, such as a nurse or medical student. Additionally, or
alternatively, the information provided by these interfaces and/or the
manner in which the information is displayed (e.g., color, placement of the
information, etc.) may serve as a notification that meets a single threshold
(e.g., for wellness score, or comparison wellness score for a patient)
and/or a combined threshold (e.g., for both wellness score and
comparison wellness score of a patient) as described herein. In some
cases, the patient names (and associated information) provided by patient
details table(s) 3640A, 3640B and/or 3640C may be sorted, or otherwise
filtered, so that the patients with the lowest wellness score and/or
comparison wellness score are positioned at the top of the list while
patients with higher wellness score and/or comparison wellness score are
positioned further down in the list of patients.
[000576] In some cases, interfaces like interfaces 3601, 3602, and/or
3603 may be prepared for patients who are in the hospital and may be
updated with daily, or hourly, wellness scores. This may be helpful in
establishing which treatment providers visit the patients while they are in
the hospital, how often they are visited, and whether further tests or
interventions are needed.
[000577] In some embodiments, for example, when the patients within the
group are being treated by a plurality of different treatment providers, the
points 3655, 3660, 3665, 3670, and/or 3675 representing the wellness
scores or comparison wellness score may be provided by the graph of
display windows 3630A, 3630B, and/or 3630C, respectively such that the
points indicate which treatment provider they are associated with by, for
example, using different colors, shapes, or sizes of the points with each
respective color, shape, and/or size representing one of the treatment
providers within the plurality/group.
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[000578] In some embodiments, the information included in and/or added
to a patient account may be downloadable from the patient account so that
it may be uploaded to into, for example, a treatment provider's records or
EMR for the patient. In some instances, one or more systems included
herein may process the information in a patient account so that it is
compatible with the device and/or software program to which it is
uploaded. A patient may do this directly by, for example, sending a copy
of his or her patient account to his or her treatment provider. Additionally,
or alternatively, a server, such as server 102 may prepare some or all data
from a patient account for export to, for example, a treatment provider
device such as treatment provider device 124, a treatment facility
computer system such as treatment facility computer system 134, and/or
an EMR database such as patient EMR database 130.
[000579] Thus, methods and systems for determining a pre-treatment
wellness score a post-treatment wellness score, an improvement score,
and/or an effectiveness score with regard to a medical treatment have
been described. It is to be understood that the above-description is
intended to be illustrative, and not restrictive. Many other embodiments
will be apparent to those of skill in the art upon reviewing the above
description. The scope of the invention should, therefore, be determined
with reference to the appended claims, along with the full scope of
equivalents to which such claims are entitled.
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