U.S. patent application number 12/916780 was filed with the patent office on 2011-08-04 for method and apparatus for managing physician referrals.
This patent application is currently assigned to ZocDoc, Inc.. Invention is credited to Nikhil Ganju, Oliver D. Kharraz Tavakol, Cyrus E. Massoumi.
Application Number | 20110191122 12/916780 |
Document ID | / |
Family ID | 46024995 |
Filed Date | 2011-08-04 |
United States Patent
Application |
20110191122 |
Kind Code |
A1 |
Kharraz Tavakol; Oliver D. ;
et al. |
August 4, 2011 |
METHOD AND APPARATUS FOR MANAGING PHYSICIAN REFERRALS
Abstract
Method and apparatus for managing the physician referral
process, whereby a referring physician (e.g., a primary care
provider) refers a patient to another physician (e.g., a
specialist) for a particular medical procedure, analysis or care.
An aggregator provides systems and methods available to physicians
and their administrative staff (herein collectively referred to as
physicians or doctors) to: book appointments on behalf of their
patients online through a doctor directory and calendar function;
filter available doctors by specialty, subspecialty, procedure,
insurance participation and/or hospital network; transfer a
patient's personal information, medical history and pre-selected
insurance forms from one doctor's office to another's,
electronically; transfer and upload relevant forms and paperwork
via fax from one doctor's office to another; track referrals
historically (over time) on a by-doctor or by-patient basis;
facilitate referrals to and from doctors in a certain network or
group.
Inventors: |
Kharraz Tavakol; Oliver D.;
(New York, NY) ; Ganju; Nikhil; (New York, NY)
; Massoumi; Cyrus E.; (New York, NY) |
Assignee: |
ZocDoc, Inc.
New York
NY
|
Family ID: |
46024995 |
Appl. No.: |
12/916780 |
Filed: |
November 1, 2010 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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12210765 |
Sep 15, 2008 |
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12916780 |
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12210716 |
Sep 15, 2008 |
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12210765 |
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12210690 |
Sep 15, 2008 |
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12210716 |
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12210664 |
Sep 15, 2008 |
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12210690 |
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12722728 |
Mar 12, 2010 |
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12210664 |
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Current U.S.
Class: |
705/3 ;
705/2 |
Current CPC
Class: |
G06Q 10/10 20130101;
G16H 10/60 20180101; G06Q 40/08 20130101; G16H 40/20 20180101 |
Class at
Publication: |
705/3 ;
705/2 |
International
Class: |
G06Q 10/00 20060101
G06Q010/00; G06Q 50/00 20060101 G06Q050/00 |
Claims
1. An online physician referral apparatus comprising: a computer
apparatus for managing and storing a central managed database of
physician profiles and scheduling information for physicians
belonging to different provider groups, the database containing
both physician profile data (PPD) and available appointment times
for the physicians, wherein the PPD includes the physician's
specialty, location and insurance or payment information; and an
online portal, accessible by computer to referring physicians over
a network, for computer implemented filtering of the PPD and
available appointment times on behalf of a patient of the referring
physician, the portal including a user interface enabling the
referring physician to select and book on-line a referral
appointment on behalf of the patient with one of the physicians
based on a filtered combination of the available appointment times
and PPD.
2. The apparatus of claim 1, wherein: the portal comprises a Web
site and the user interface is accessible via a Web browser for
filtering and selecting the one physician for the referral
appointment.
3. The apparatus of claim 1, wherein: the PPD further includes one
or more of an affiliation of the physician with a provider group,
insurance carrier, insurance plan, and procedures performed.
4. The apparatus of claim 1, wherein: the database further includes
the selected booked appointments and patient records relevant to
such appointments.
5. The apparatus of claim 1, wherein: the database includes an
identifier for correlating patient and patient records.
6. A method for online booking of physician referrals comprising: a
referring physician accessing an online portal to a central managed
database of physician profile data (PPD) and available appointment
times for physicians belonging to different provider groups, the
PPD including the physician's specialty, location and insurance or
payment information; the referring physician performing the
following steps via the portal: filtering the PPD and available
appointment times on behalf of a patient of the referring physician
and selecting, on behalf of the patient, a referral appointment
with one of the physicians based on a filtered combination of the
available appointment times and PPD; entering identification
information for the patient; and booking the selected appointment
for the identified patient.
7. The method of claim 6, wherein the PPD further includes one or
more of an affiliation of the physician with a provider group,
insurance carrier, insurance plan, and procedures performed.
8. The method of claim 6, wherein the filtering step is based on
specialty and location and the portal displays a filtered listing
of the physicians and their available appointment times.
9. The method of claim 6, wherein in response to the filtering, the
portal displays a filtered listing of the physicians including
their respective name, specialty, location, and insurance or
payment information.
10. The method of claim 6, wherein the referring physician further
performs the step of tracking one or more selected
appointments.
11. The method of claim 10, wherein the tracking is performed based
on one or more of the selected physician and the patient.
12. The method of claim 6, further comprising the step of the
referring physician transferring patient information to the
selected physician.
13. The method of claim 6, further comprising the step of the
selected physician transferring patient information via the portal
to the referring physician.
14. The method of claim 6, further comprising the step of the
referring physician reviewing on the portal a booking history of
selected appointments.
15. The method of claim 14, wherein the booking history can be
filtered by the referring physician based upon one or more of the
patient, selected physician, specialty and date.
16. The method of claim 14, wherein the booking history comprises
one or more of: appointment status; clinical information; patient
identification information; selected physician; appointment time;
appointment history; and further actions regarding the patient.
17. The method of claim 6, further comprising the step of the
referring physician establishing communication via the portal with
one or more of the patient and the selected physician.
18. The method of claim 17, wherein the communications include one
or more of a reminder to the patient and providing patient
information to the selected physician.
19. The method of claim 17, further comprising the step of the
referring physician reviewing a history of the communications on
the portal.
20. The method of claim 6, further comprising the steps of the
portal displaying a description of the booked appointment and the
referring physician printing the displayed description and
providing the printed description to the patient.
21. The method of claim 6, wherein the portal is a website.
22. The method of claim 6, wherein patient information can be
uploaded by the referring physician to the portal.
23. The method of claim 6, wherein the patient information can be
uploaded by the selected physician to the portal.
24. A computer readable storage medium with instructions to one or
a plurality of computers for execution of the method of claim
6.
25. A method for online booking of physician referrals comprising:
a referring physician accessing an online portal to a central
managed database of physician profile data (PPD) and available
appointment times for physicians belonging to different provider
groups, the PPD including the physician's specialty, location and
insurance or payment information; the referring physician
performing the following steps via the portal: filtering the PPD on
behalf of a patient of the referring physician to select, on behalf
of the patient, one of the physicians based on the PPD; entering
identification information for the patient; and notifying the
selected physician electronically to arrange for a referral
appointment.
26. The method of claim 25 wherein, following the notification, the
referring physician transfers patient information to the selected
physician via the portal.
27. The method of claim 25, further comprising the step of the
referring physician tracking one or more of the appointment and the
patient's progress via the portal.
28. A system for managing patient referrals comprising: an online
portal, accessible by computer to a referring physician over a
network, providing access to a central managed database of
physician profile data (PPD) and available appointment times for
physicians belonging to different provider groups; the portal
including a user interface enabling the referring physician to
filter the PPD and available appointment times and select, on
behalf of a patient of the referring physician one of the
physicians for a referral appointment; the portal providing one or
more communication channels for communication between the referring
physician and one or more of the patient and the selected physician
for: initiating and tracking toward completion the referral
appointment of the patient with the selected physician; and
transferring of patient information.
29. A network based scheduling system, the system comprising: an
aggregator managed database containing information relevant to
referring physicians who periodically need to schedule referral
appointments with other physicians; a set of parameters associated
with each of a plurality of physicians accepting referral
appointments having available appointment times; a central
controller managing a referral appointment schedule for the
aggregator, wherein the central controller operates via a network
to: receive scheduling information via the network from the
physicians accepting referral appointments; supply available
appointment times via the network to the referring physicians, with
the supplied available appointment times determined by input
received from the referring physician on behalf of a patient of the
referring physician; wherein the controller supplies an available
appointment calendar via the network to the referring physician of
the available appointment times, and wherein the referring
physician can schedule an appointment via the network by selecting
a desired appointment time.
30. The system of claim 29, wherein the network is the
Internet.
31. The system of claim 29, wherein the aggregator provides a Web
portal accessible to the physicians for receiving and supplying the
scheduling and appointment times.
32. The system of claim 29, wherein the controller synchronizes the
available appointment times with the appointment calendars of the
physicians accepting referral appointments.
33. The system of claim 29, wherein the controller supplies a real
time master schedule via the network.
34. The system of claim 29, wherein the controller operates via the
network to supply tracking information relevant to the selected
appointment.
35. The system of claim 34, wherein the tracking information
includes one or more of: patient contact information; patient
insurance information; affiliation of the physician accepting
referral appointments; patient information supplied by the
physician accepting referral appointments; patient information
supplied by the referral physician; patient clinical information;
appointment history information; physician notes concerning the
patient
Description
FIELD OF THE INVENTION
[0001] The present invention relates to a method and apparatus for
managing the physician referral process, whereby a referring
physician (e.g., a primary care provider) refers a patient to
another physician (e.g., a specialist) for a particular medical
procedure, analysis or care.
BACKGROUND
[0002] Comprehensive medical care often requires a patient to visit
more than just one doctor. While many patients have an established
and long-standing relationship with their primary care provider,
they are generally unfamiliar with more specialized doctors until
medical circumstances necessitate a referral to one. Upon receiving
a referral, the patient is usually the one left to arrange an
actual appointment with the specialist. There is little
transparency in this process, and under unfavorable circumstances a
patient may find himself/herself referred to a doctor with little
to no near-term availability, or a doctor who no longer accepts his
or her insurance. These hurdles may cause delays in medical care,
and in some cases even dissuade patients from complying with their
primary care provider's recommendation to seek additional medical
care from a specialist.
[0003] One proposed solution is for the primary care provider to
use a remote desktop session with the secondary care provider's
office to make an appointment while the patient is in communication
(e.g., on the phone) with the primary care provider. This is not a
desirable solution because: [0004] a) the primary care provider
needs to have remote desktop access to the secondary care
provider's office, which is a security risk; [0005] b) the primary
care provider's phone agent needs to be trained on how to use the
scheduling software in the secondary care office correctly, and
since there are potentially many different offices and scheduling
systems, this is not feasible nor scalable; [0006] c) the primary
care agent attempting to schedule the appointment does not know the
rules about when appointments can be made with the secondary care
provider, so often the appointment is not made.
[0007] The problems do not end with booking the referral
appointment. There is no protocol for rescheduling missed or
canceled appointments, sharing of patient information between the
primary and secondary care offices, follow-up appointments with the
primary care provider, etc.; each of these additional steps require
someone to reestablish communication between one or more of the
patient's primary care physician and the secondary care physician.
The inefficiencies in managing this process are a drain on both the
primary and secondary physicians. The patient, who has the least
amount of medical knowledge and often an inability to anticipate or
articulate the critical nature or timing of the referral, is left
calling one or both offices and communicating with a receptionist
who cannot independently determine what the next step in the
process should be, without again involving either the primary or
secondary care physicians.
[0008] The issues described above have been long-standing problems
for both physicians and patients, and substantially interfere with
the ability to provide appropriate and cost effective medical
care.
SUMMARY OF THE INVENTION
[0009] In one or more embodiments of the invention, an apparatus
and method are provided that allows doctors and their
administrative staff to manage the process of physician referrals,
whereby a patient is referred from one physician (the referring
physician) to another physician (the referred-to or receiving
physician) for a particular medical procedure, or analysis or
care.
[0010] In one embodiment, an aggregator provides systems and
methods available to physicians and their administrative staff
(herein collectively referred to as physicians or doctors) to:
[0011] book appointments on behalf of their patients online through
a doctor directory and calendar function; [0012] filter available
doctors by specialty, subspecialty, procedure, insurance
participation and/or hospital network; [0013] transfer a patient's
personal information, medical history and pre-selected insurance
forms from one doctor's office to another's, electronically; [0014]
transfer and upload relevant forms and paperwork via fax from one
doctor's office to another; [0015] track referrals historically
(over time) on a by-doctor or by-patient basis; [0016] facilitate
referrals to and from doctors in a certain network or group.
[0017] These new features bring significant benefits to doctors and
hospitals, increasing the efficiency of their workflows and
improving patient care while reducing administrative costs, patient
"leakage" (referrals outside the referring physician's network of
providers), and the probability of errors in patient care.
[0018] In further embodiments, there are provided systems and
methods for eliminating inefficiencies in the sharing of patient
information, enabling, for example, the referring doctor to track a
patient's progress after treatment by a specialist, thereby
eliminating uncertainty and allowing more effective treatment in
their next meeting.
[0019] In a further embodiment, systems and methods are provided
for reducing patient non-compliance (e.g., failure to book or
attend a scheduled appointment) with the physician referral process
by establishing communication channels with the patient and the
referred-to physician.
[0020] In a further embodiment, systems and methods are provided
for reviewing a patient's progress after a referral appointment, by
facilitating communications about the patient between the referring
physician and the referred-to physician.
[0021] In a further embodiment, systems and method are provided for
reviewing and reporting the results of one or more appointment
referrals, enabling the referring physician to analyze the patient
experience and/or quality of patient care, physician communication
and history of (e.g., willingness and ability to accept) referral
appointments by the referred-to physician.
[0022] In a further embodiment, systems and methods are provided
for facilitating referrals to in-network or otherwise affiliated
physicians.
[0023] In a further embodiment, systems and methods are provided
for ensuring patient care after a hospital discharge.
[0024] In a further embodiment, systems and methods are provided
for managing hospital emergency room capacity, including referring
select patients to available primary care providers with available
appointments to reduce the unnecessary use/expense of emergency
room facilities.
[0025] In a further embodiment, systems and methods are provided
for ensuring proper post emergency room care, enabling emergency
room discharge staff to make appointments with qualified physicians
to provide post-discharge care.
[0026] These and other embodiments of the invention are further
described in the following detailed description and accompanying
drawings.
[0027] According to one embodiment of the invention, an online
physician referral apparatus is provided comprising: [0028] a
computer apparatus for managing and storing a central managed
database of physician profiles and scheduling information for
physicians belonging to different provider groups, the database
containing both physician profile data (PPD) and available
appointment times for the physicians, wherein the PPD includes the
physician's specialty, location and insurance or payment
information; and [0029] an online portal, accessible by computer to
referring physicians over a network, for computer implemented
filtering of the PPD and available appointment times on behalf of a
patient of the referring physician, the portal including a user
interface enabling the referring physician to select and book
on-line a referral appointment on behalf of the patient with one of
the physicians based on a filtered combination of the available
appointment times and PPD.
[0030] In one embodiment, [0031] the portal comprises a Web site
and the user interface is accessible via a Web browser for
filtering and selecting the one physician for the referral
appointment.
[0032] In one embodiment, [0033] the PPD further includes one or
more of an affiliation of the physician with a provider group,
insurance carrier, insurance plan, and procedures performed.
[0034] In one embodiment, [0035] the database further includes the
selected booked appointments and patient records relevant to such
appointments.
[0036] In one embodiment, [0037] the database includes an
identifier for correlating patient and patient records.
[0038] According to another embodiment of the invention, a method
for online booking of physician referrals is provided comprising:
[0039] a referring physician accessing an online portal to a
central managed database of physician profile data (PPD) and
available appointment times for physicians belonging to different
provider groups, the PPD including the physician's specialty,
location and insurance or payment information; [0040] the referring
physician performing the following steps via the portal: [0041]
filtering the PPD and available appointment times on behalf of a
patient of the referring physician and selecting, on behalf of the
patient, a referral appointment with one of the physicians based on
a filtered combination of the available appointment times and PPD;
[0042] entering identification information for the patient; and
[0043] booking the selected appointment for the identified
patient.
[0044] In one embodiment, the PPD further includes one or more of
an affiliation of the physician with a provider group, insurance
carrier, insurance plan, and procedures performed.
[0045] In one embodiment, the filtering step is based on specialty
and location and the portal displays a filtered listing of the
physicians and their available appointment times.
[0046] In one embodiment, in response to the filtering, the portal
displays a filtered listing of the physicians including their
respective name, specialty, location, and insurance or payment
information.
[0047] In one embodiment, the referring physician further performs
the step of tracking one or more selected appointments.
[0048] In one embodiment, the tracking is performed based on one or
more of the selected physician and the patient.
[0049] In one embodiment, the method further comprises the step of
the referring physician transferring patient information to the
selected physician.
[0050] In one embodiment, the method further comprises the step of
the selected physician transferring patient information via the
portal to the referring physician.
[0051] In one embodiment, the method further comprises the step of
the referring physician reviewing on the portal a booking history
of selected appointments.
[0052] In one embodiment, the booking history can be filtered by
the referring physician based upon one or more of the patient,
selected physician, specialty and date.
[0053] In one embodiment, the booking history comprises one or more
of: [0054] appointment status; [0055] clinical information; [0056]
patient identification information; [0057] selected physician;
[0058] appointment time; [0059] appointment history; and [0060]
further actions regarding the patient.
[0061] In one embodiment, the method further comprises the step of
the referring physician establishing communication via the portal
with one or more of the patient and the selected physician.
[0062] In one embodiment, the communications include one or more of
a reminder to the patient and providing patient information to the
selected physician.
[0063] In one embodiment, the method further comprises the step of
the referring physician reviewing a history of the communications
on the portal.
[0064] In one embodiment the method further comprises the steps of
the portal displaying a description of the booked appointment and
the referring physician printing the displayed description and
providing the printed description to the patient.
[0065] In one embodiment, the portal is a website.
[0066] In one embodiment, the patient information can be uploaded
by the referring physician to the portal.
[0067] In one embodiment, the patient information can be uploaded
by the selected physician to the portal.
[0068] In one embodiment, a computer readable storage medium is
provided with instructions to one or a plurality of computers for
execution of the described methods.
[0069] According to another embodiment of the invention, a method
for online booking of physician referrals is provided comprising:
[0070] a referring physician accessing an online portal to a
central managed database of physician profile data (PPD) and
available appointment times for physicians belonging to different
provider groups, the PPD including the physician's specialty,
location and insurance or payment information; [0071] the referring
physician performing the following steps via the portal: [0072]
filtering the PPD on behalf of a patient of the referring physician
to select, on behalf of the patient, one of the physicians based on
the PPD; [0073] entering identification information for the
patient; and [0074] notifying the selected physician electronically
to arrange for a referral appointment.
[0075] In one embodiment, following the notification, the referring
physician transfers patient information to the selected physician
via the portal.
[0076] In one embodiment, the method further comprises the step of
the referring physician tracking one or more of the appointment and
the patient's progress via the portal.
[0077] According to another embodiment of the invention, a system
for managing patient referrals is provided comprising: [0078] an
online portal, accessible by computer to a referring physician over
a network, providing access to a central managed database of
physician profile data (PPD) and available appointment times for
physicians belonging to different provider groups; [0079] the
portal including a user interface enabling the referring physician
to filter the
[0080] PPD and available appointment times and select, on behalf of
a patient of the referring physician one of the physicians for a
referral appointment; [0081] the portal providing one or more
communication channels for communication between the referring
physician and one or more of the patient and the selected physician
for: [0082] initiating and tracking toward completion the referral
appointment of the patient with the selected physician; and [0083]
transferring of patient information.
[0084] According to another embodiment of the invention, a network
based scheduling system is provided, the system comprising: [0085]
an aggregator managed database containing information relevant to
referring physicians who periodically need to schedule referral
appointments with other physicians; [0086] a set of parameters
associated with each of a plurality of physicians accepting
referral appointments having available appointment times; [0087] a
central controller managing a referral appointment schedule for the
aggregator, wherein the central controller operates via a network
to: [0088] receive scheduling information via the network from the
physicians accepting referral appointments; [0089] supply available
appointment times via the network to the referring physicians, with
the supplied available appointment times determined by input
received from the referring physician on behalf of a patient of the
referring physician; [0090] wherein the controller supplies an
available appointment calendar via the network to the referring
physician of the available appointment times, and wherein the
referring physician can schedule an appointment via the network by
selecting a desired appointment time.
[0091] In one embodiment, the network is the Internet.
[0092] In one embodiment, the aggregator provides a Web portal
accessible to the physicians for receiving and supplying the
scheduling and appointment times.
[0093] In one embodiment, the controller synchronizes the available
appointment times with the appointment calendars of the physicians
accepting referral appointments.
[0094] In one embodiment, the controller supplies a real time
master schedule via the network.
[0095] In one embodiment, the controller operates via the network
to supply tracking information relevant to the selected
appointment.
[0096] In one embodiment, the tracking information includes one or
more of: [0097] patient contact information; [0098] patient
insurance information; [0099] affiliation of the physician
accepting referral appointments; [0100] patient information
supplied by the physician accepting referral appointments; [0101]
patient information supplied by the referral physician; [0102]
patient clinical information; [0103] appointment history
information; [0104] physician notes concerning the patient
[0105] In one embodiment, the selecting is based on at least one of
the specialty and procedures performed.
[0106] In one embodiment, the selecting is based on the specialty,
location and insurance or payment information.
[0107] In one embodiment, the selecting is based on the
affiliation.
[0108] In one embodiment, the selecting is based on the insurance
or payment information and at least one of the specialty and
procedures performed.
[0109] In one embodiment, the referring physician selects one of
the displayed available appointment times.
[0110] In one embodiment, the filtering step is based on specialty,
location, and type of insurance or payment information and the
portal displays a filtered listing of the physicians and their
available appointment times.
[0111] In one embodiment, filtering step is based on at least one
of specialty, location, affiliation, procedures performed, and
insurance or payment information and the portal displays a filtered
listing of the physicians and their available appointment
times.
[0112] In one embodiment, the referring physician enters insurance
or payment information for the patient and the filtering step
includes filtering based upon a match of the physician's insurance
or payment information and the patient's insurance or payment
information.
[0113] In one embodiment, the insurance information comprises one
or more of an insurance carrier and an insurance plan.
[0114] In one embodiment, the referring physician enters a reason
for an appointment, and the filtering step includes filtering based
upon the entered reason.
[0115] In one embodiment, the patient identification information
comprises one or more of the patient's email address, phone number,
and name.
[0116] In one embodiment, the referring physician enters patient
identification information for a new patient not existing in the
database.
[0117] In one embodiment, the referring physician enters patient
identification information for an existing patient in the
database.
[0118] In one embodiment, the method further comprises the step of
registering the referring physician to allow access to the
portal.
[0119] In one embodiment, access to the portal is limited to
referring physicians previously registered with the portal.
[0120] In one embodiment, the PPD includes an affiliation of the
physician with a provider group and the tracking is performed based
on the affiliation of the physician.
[0121] In one embodiment, the patient information includes one or
more of clinical information, contact information, physician notes
and insurance forms.
[0122] In one embodiment, the booking history includes links to
additional information concerning one or more of the appointment,
the selected physician and the patient.
[0123] In one embodiment, the links include one or more of
insurance forms, patient clinical information, medical history,
physician notes and appointment history.
[0124] In one embodiment, the communication comprises sending an
electronic communication to the patient regarding the booked
appointment.
[0125] In one embodiment, the central managed database is
synchronized with one or more appointment calendars of the
different provider groups.
[0126] In one embodiment, the booked appointment is synchronized
automatically with a scheduling calendar of the selected
physician.
[0127] In one embodiment, the physicians are not required to be
registered with the portal.
[0128] In one embodiment, the central managed database further
includes patient information comprising one or more of patient
clinical information, patient contact information, patient
insurance form, patient test result, and appointment history.
[0129] In one embodiment, the referring physician is notified of a
missed appointment.
BRIEF DESCRIPTION OF THE FIGURES
[0130] FIG. 1 is a schematic representation of an exemplary
communications network for implementing various embodiments of the
present invention;
[0131] FIG. 2 is a block diagram of an exemplary computer on which
the software product(s) of the present invention may be
executed;
[0132] FIG. 3 is one example of a webpage from an aggregator's
website enabling a referring physician to identify potential
specialists for a referral appointment according to one embodiment
of the invention;
[0133] FIG. 4 is one example of an aggregator's webpage for
entering patient insurance or payment information;
[0134] FIG. 5 is one example of an aggregator's webpage for
entering patient information;
[0135] FIG. 6 is one example of an aggregator's webpage for
confirming the booking of a referral appointment;
[0136] FIG. 7 is one example of an aggregator's webpage for
printing confirmation of the referral booking;
[0137] FIG. 8 is one example of an aggregator's webpage allowing a
referring physician to review a booking history of referral
appointments;
[0138] FIG. 9 is one example of a more detailed webpage link to a
specific patient in the booking history of FIG. 8;
[0139] FIG. 10 is another example of a linked webpage from the
booking history of FIG. 8;
[0140] FIG. 11 is a schematic illustration of one method and
apparatus for booking referral appointments in which both the
referring physician and specialist utilize the Referral
Cockpit;
[0141] FIG. 12 is a schematic illustration of a method and
apparatus according to one embodiment of the invention in which the
referring physician postpones selection of a specific appointment
time;
[0142] FIG. 13 is a schematic illustration of a method and
apparatus according to one embodiment of the invention in which a
referring physician books a referral appointment outside the
Referral Cockpit system;
[0143] FIG. 14 is a schematic illustration of a method and
apparatus according to another embodiment of the invention in which
the referring physician books an appointment outside the Referral
Cockpit system;
[0144] FIG. 15 is a schematic illustration of a method and
apparatus according to another embodiment of the invention in which
an emergency room administrator books a referral appointment;
[0145] FIG. 16 is a schematic illustration of a method and
apparatus according to another embodiment of the invention in which
patient records are transferred via the aggregator;
[0146] FIG. 17 is one example of a database structure according to
one method and apparatus of the invention in which the aggregator
database uses stored doctor and patient data to enable the booking
of a referral appointment; and
[0147] FIG. 18 shows one example of database records according to
one embodiment of an apparatus and method of the invention
containing stored referral appointment information.
DETAILED DESCRIPTION
Network Communications
[0148] Apparatus and methods are described herein for improving the
patient referral process which enables online booking of healthcare
appointments on a centralized service provider's (aggregator's)
website. For these purposes, network based communications are
required between one or more of the aggregator, physician practice
groups, patients, hospitals and insurers. The block diagrams of one
such communication system is illustrated in FIG. 1 and is meant to
be representative only. Suitable hardware, communication protocols
and software languages for implementing the systems and methods of
various embodiments of the invention are readily known to those who
are skilled in the art and any discussion herein is not meant to
limit the scope of the invention.
[0149] FIG. 1 illustrates schematically network communications
among various server computers 4a, 4b, 4c, and 4d and client
computers 5a shown coupled together via a network or cloud 6 (e.g.,
the Internet) to communicate with one another using standard
communication protocols, such as TCP/IP. The servers can be any
type of server, including but not limited to a Windows, Unix, Linux
and/or Apple servers. Each server may have an attached data storage
system 3a, 3b, 3c and 3d for storing software applications and
data.
[0150] In accordance with one embodiment of the invention, the
network of FIG. 1 allows communications between a centralized
service provider (aggregator), multiple healthcare practitioner
practice groups, multiple hospitals, multiple insurers, and
multiple patients. The aggregator's server provides a network based
service to the practitioner groups, hospitals, insurers, and
patients, e.g. an aggregator's server 4a provides a web-based data
processing service and interface to each of the physician or
patient computers 5a, practice group servers 4b, hospital servers
4c, and insurance provider servers 4d, and can also communicate
electronically via email with each of these computers and servers.
The aggregator's server also communicates (e.g. web-based) with
each of the practice groups, hospitals and insurers via their
respective servers for retrieving data such as available
appointment times and other information for each of the practice
groups, hospitals and insurers in order to enable online booking
and confirmation of appointments on multiple websites. In
alternative embodiments, the aggregator's service is provided to
one or more practice groups, one or more hospitals, and/or one or
more insurance provider(s). For ease of description, a first
embodiment will refer to practice groups, it being understood that
the services can similarly be provided to other healthcare provider
groups.
[0151] FIG. 2 is a block diagram of one server 4 which includes a
processor 8, memory 9, data storage 10, disk drive 11,
keyboard/mouse 12, computer display 13 and network interface 14.
The components are coupled together and communicate via a system
bus 16. Various software modules of the present invention can be
loaded into data storage and during operation are transferred into
memory (e.g. RAM) for execution by the processor. A user may
manipulate the software and enter commands to the server using the
keyboard/mouse. The input/output may be viewed on the display
screen. The network interface couples the server to the Internet or
whatever type of network is used to connect the server with the
other computers and servers of the respective practice groups,
patients, hospitals, insurers and aggregator. Further, the server
may communicate with a storage array or storage network (e.g. SAN)
if there is a need to access large amounts of data. A database of
patient records, practice group (practitioner) records, and
associated scheduling records may be implemented as a relational
database and search engine with, for example, Microsoft's Active
Server Page Technology, SQL Server Technology, Database Artisan
Software, or database products from Oracle Corp., Redwood Shores,
Calif.
[0152] The software described herein may be implemented as various
modules, e.g. a web module, a database module, an email module, a
facsimile module, and standard application programming interfaces
(APIs). The web module may include a set of templates and icons to
enable the creation of web pages. It may include other tools to
allow one to create browser friendly websites. These tools enable
the creation of dynamic hypertext web pages to be accessed by the
practice groups, hospitals, insurers, patients and aggregator.
[0153] The database module may include a relational database and
search engine. The records, fields, search queries and other
features of the database are described below and suitable
alternatives will be apparent to persons who are skilled in the
art.
[0154] As used herein, database is meant to include any of various
types of data repositories and processes for indexing, searching,
storage and retrieval from such repositories.
[0155] The email module allows emails to be sent to/from patients,
practice groups, hospitals, insurers and the aggregator via the
respective server/computer. The emails can be sent manually by a
person operating the server and can be automatically generated by
the server. For example, the email module can be configured to
automatically query the database module and send email messages to
entities identified in the database module.
[0156] The software may include standard APIs so data and other
information can be exchanged with other software systems.
[0157] Each practice group server may include the group's own
practice management software and any other database of information
used by the practitioners in that group. As described below, the
aggregator may install software on the practice group's server for
uploading available appointment times to the aggregator's database
and otherwise automating and synchronizing the appointment
calendars of the practice group and the aggregator. The relevant
appointment booking information may be stored on one or both of the
aggregator and practice group servers and data storage systems.
Similarly, the aggregator may install software on a hospital's
server and/or insurer's server for the same or similar purposes
(e.g., exchange of profile information and/or appointment
scheduling information).
[0158] The database maintained by the aggregator may include
records of practitioner profile information and booking information
for the practice groups and their respective practitioners, the
hospitals and their affiliated practitioners, the insurance
providers and their participating practitioners, and each patient
who establishes an account with the aggregator. These records will
be described further below in various embodiments.
[0159] Various systems and methods for aggregating available
appointment times for multiple practitioner groups, including
search and display algorithms are described in the following
co-pending and commonly owned US Patent Applications: [0160] U.S.
Ser. No. 12/210,664 filed 15 Sep. 2008 entitled: CENTRALIZED
MARKETPLACE FOR HEALTHCARE APPOINTMENTS ACROSS PRACTICE GROUPS;
[0161] U.S. Ser. No. 12/210,690 filed 15 Sep. 2008 entitled:
CONSUMER PORTAL FOR HEALTHCARE APPOINTMENTS ACROSS PRACTICE GROUPS;
[0162] U.S. Ser. No. 12/210,765 filed 15 Sep. 2008 entitled: DATA
SYNCHRONIZATION FOR BOOKING OF HEALTHCARE APPOINTMENTS ACROSS
PRACTICE GROUPS; and [0163] U.S. Ser. No. 12/210,716 filed 15 Sep.
2008 entitled: PATIENT VERIFICATION FOR BOOKING OF HEALTHCARE
APPOINTMENTS ACROSS PRACTICE GROUPS. [0164] U.S. Ser. No.
12/722,728 filed 12 Mar. 2010 entitled: METHOD AND APPARATUS FOR
MANAGING PHYSICIAN PROFILE AND HEALTHCARE APPOINTMENT SERVICES.
Physicians and Practice Groups
[0165] In various embodiments of the invention disclosed herein,
the term "physician" or "doctor" refers to a physician
administering patient care, as well as to those members of his
staff responsible for maintaining the physician's calendar and/or
patient records. Though the term is used interchangeably, it should
be understood that in the exemplary figures and accompanying text,
each function is being performed by one or more persons that
perform such activities in a particular doctor's office on behalf
of a physician.
[0166] The term "specialist" is applied to a physician
administering secondary care to a patient after a referral from a
referring physician, and is also applied to other members of his
staff in the same manner as is done for a physician. It may be
possible for any given physician to in one situation be a
specialist (receiving a patient via referral), and in another be a
primary care physician (referring a patient to another physician
for specialized care).
[0167] Accordingly, in cases where primary care physicians and
specialists work in integrated facilities and/or share
administrative staff, the same staff member may process both the
referral and its receipt. However, even if this were the case,
there would still be authentication required on both ends of the
referral process, meaning that there would still be effectively two
users (one representing the referring physician, one the receiving
specialist) involved, even if there was only one actual person
responsible.
[0168] Further a "provider group" or "practice group" may be any
entity linking a group of doctors through shared facilities,
services, or referral agreements. This can include but should not
be limited to integrated multi-facility hospitals, insurance
networks, medical groups, and multi-doctor practices.
Online Booking of Referral Appointments
[0169] According to one embodiment of the invention, a portal
referred to herein as a Referral Cockpit enables a referring (e.g.,
primary care) provider's office to initiate a search for and then
select among a customized list of doctors based on a desired
patient procedure, specialty, accepted insurances, affiliation with
provider systems, and/or a number of further criteria (geographic
location, gender, etc.). The office can then choose from available
time slots in real time, and book a referral appointment online.
This makes it far easier to ensure that the patient can see a
specialist in close proximity and timely fashion. It also
eliminates the possibility that the patient may forego necessary
care due to the inconvenience of obtaining an appointment.
[0170] Each practice has the ability to edit their physician's
displayed availability, accepted procedures, and accepted insurance
plans. These data are stored on an aggregator database and made
available to other medical professionals with access to the system.
For many common practice management systems, availability can also
be synchronized automatically with the doctor's existing
calendar.
[0171] If a practice chooses not to display its availability in
real time (or is not technologically capable of having someone
maintain its calendar), or a patient does not yet want to decide on
a time, the referring practice can still make a tentative
appointment. A notification is then sent electronically to both the
patient and the receiving (referred-to) practice. The patient's
data now becomes accessible to the receiving practice, offering the
opportunity to send reminders and arrange for the appointment at a
later time.
[0172] Via the "Find Doctor" function (described below), a doctor
or practice manager can input a patient's desired procedure,
location, insurance provider and plan. These parameters serve to
filter the view of the database provided to the referring party,
and thus create a view of available appointments.
[0173] An example of an apparatus and method for online booking of
referral appointments will now be described with respect to FIGS.
3-10.
[0174] FIG. 3 is an example of a webpage 20 from an aggregator's
website which enables a referring physician to filter profile data
stored in the aggregator's central managed database for selecting
an acceptable physician for the referral appointment.
[0175] The webpage entitled "Find Doctor" includes eight filtering
(input) windows 21-28 prompting the referring physician to enter or
select from a pull down menu, for the following items: doctor or
practice 21, location (zip code, neighborhood, or city) 22,
specialty 23, sub-specialty 24, reason for visit 25, insurance
company 26, insurance plan 27, and a checkbox to select "only show
doctor's with availability" 28. The referring physician enters the
appropriate information and then clicks the search button 29,
initiating the search of the aggregator's database based on the
entered filtering information. Not all items (fields) are required
for the search, rather the referring physician can pick among the
windows based upon his or her knowledge of the specific patient,
medical condition, desire to select a physician within an
affiliated network, and/or location. As one example, the referring
physician enters the specialty 23 and location 22. Below the
filtering windows 21-28 is a results window 30, containing a list
of potential receiving physicians that satisfy the filtering
criteria. In this example, there is a separate row of information
for each receiving physician; FIG. 3 shows the initial three rows
31, 32, 33 for the first three physicians. Each row includes a
first column containing a numbered map marker 34 which also appears
in another window 43 located on the upper right hand corner of the
page, the window 43 being a geographical display (street map)
showing the location of the physician's office by the same numbered
marker. If the physician has additional practice locations, this is
indicated by a link 42 (as shown for the physician in the second
row), wherein clicking on the link 42 will identify and display
additional map marker numbers, with corresponding markers on the
geographical display 43. Next to each map number 34, proceeding in
serial order across the page, there is provided (where available) a
photo of the physician 35 and name and contact information for the
physician 36; the information 36 may include a link for accessing
additional profile information concerning the physician. In the
next row there is a link 37 which prompts the user to enter the
patient insurance information at the top of the page (windows 26,
27), if not already provided. Next is a grid display 38 of
available appointment times for this physician. The grid includes
column headings across the top with designations 39 for various
days of the week, and an advance button to select subsequent weeks.
Below each day of the week, there are individual links 40 for each
available appointment time. This enables the referring physician to
simply click on an appointment time link 40, to select an
appointment on behalf of the patient. Alternatively, if a physician
does not wish to select an appointment time now, there is an
alternative process (link 41) enabling the patient to select an
appointment time at a later date, as discussed further below.
[0176] Assuming the referring physician has selected an appointment
time on the web page of FIG. 3, the selected appointment time for
the selected physician is then processed by the aggregator's
software and the aggregator's website displays web page 50 shown in
FIG. 4. In the left hand box labeled insurance 51, the referring
physician is now prompted to enter in the first filter window 52 a
reason for the patient's visit, which may be selected from a pull
down menu, and to confirm the patient's insurance details, namely
whether the patient is paying himself 53, whether the patient has
health insurance 54, entering the name of the insurance carrier 55,
and entering the name of the insurance plan 56. The referring
physician then hits the button 57 to confirm the entered
information. On the right hand side of this page 50, the display
includes the referred-to physician identification information 58,
the time and date of the selected appointment 59, the location of
the appointment 60 and a geographical display 61 with a map marker
showing the location of the appointment.
[0177] Once the referring physician clicks the confirmation button
57 in FIG. 4, the entered information is processed by the
aggregator's software and the aggregator's website returns a web
page 70 shown in FIG. 5. This page, entitled Patient Details,
includes on the left hand side a window 71 for entry of patient
identification information. There are two options, either the
referring physician enters identifying information for the patient
in the upper portion 72, to determine if the patient is previously
included in the aggregator database, or else the referring
physician creates a record for a new patient not previously
existing in the database, in the lower portion 79. Assuming the
patient already exists in the database, in this example he can be
located either by entering his email address in window 73 and
clicking the search button 74, or alternatively entering his phone
number in window 75 and his last name in window 76 and clicking the
search button 77. If no patient is found with the specified email,
the referring physician will be so notified at 78.
[0178] If the referring physician needs to create a new patient
record, the referring physician then enters the following
information in the designated boxes, the required information being
designated with an asterisk: email address in window 80, phone
number in window 81, whether the phone number is a cell phone in
window 82, patient first name 83, patient last name 84, patient zip
code 85, patient gender 86, and patient date of birth 87.
[0179] The referring physician then clicks the next button 88 and
the aggregator's software processes the entered information.
Meanwhile, on the right hand side of the page 70, there is again
shown, similar to the right hand portion of FIG. 4, the same
physician identification 58, time and date of the appointment 59,
location of the appointment 60, and geographical display 61. In
addition, there is shown in FIG. 5 the patient insurance
information 89 and reason for the visit 90.
[0180] Once the referring physician clicks one of buttons 74, 77 or
88 on web page 70, the process accepts the entered information and
returns a next web page 100 shown in FIG. 6. This page, entitled
"Confirm Booking", includes on the left hand side a window 101
which confirms the identity of the patient 102 and prompts the
referring physician to establish a communication channel with one
or more of the patient 103 and referred-to physician 106. Window
101 includes the patient's email address, to which an email
confirmation of the appointment will be sent 104. If the referring
physician wishes to also send a text reminder to the patient, he so
indicates this in input box 105. The referring physician can also
establish a communication channel 106 with the selected
(referred-to) physician. The referring physician may enter notes
concerning the patient and/or appointment in the entry window 107.
The referring physician may click a link 108 to send a
pre-completed referral form specific to the patient and his
insurance company, to the referred-to physician. The referring
physician may also elect to have files sent to the referred-to
physician, as indicated in window 109. Each of the selected files
110 is listed in a box, and a removal button 111 is provided in the
event the referring physician elects to not send the file. Entry
window 112 enables a physician to locate an additional file and
attached that file 113 to the transmission. Finally, the referring
physician clicks the book it button 114, whereby the selected
communications will be sent to the patient and referred-to
physician respectively. Web page 100 also displays the same
physician/appointment information 58-61 and 89-90 as the prior web
page 70.
[0181] After electing to book the appointment by clicking button
114 on web page 100, the process books the appointment and returns
a web page 120 with a booking receipt. The booking receipt includes
on the left-hand side a window 121 confirming the details of the
appointment, including the same information 58-60 and 89-90
provided in the prior web pages. In addition, the booking receipt
indicates whether a text reminder will be sent to the patient at
122, and includes any notes 123 entered by the referring physician.
The receipt indicates that a confirmation email has been sent to
the patient's email address at 125. The referring physician now has
the option to print the booking receipt and give a copy to the
patient, by clicking the print button 124. The booking receipt
further provides the patient with contact information for the
aggregator, enabling the patient to contact the aggregator if the
patient wishes to change or cancel the appointment. The referring
physician may now proceed to schedule a new appointment, by
clicking the new appointment button 127.
Transfer of Patient Records
[0182] Over the course of a multi-doctor treatment process, a
patient's medical records must often be transferred between several
offices. Each of these transfers carries with it the possibility of
document loss, and the frequent use of physical (paper) patient
records only serves to increase this risk. Patients themselves
often do not know which records and forms they will need, meaning
that despite their interest in ensuring an efficient transfer, they
are ill-equipped to do so.
[0183] There is no widely used standardized procedure in place to
efficiently facilitate transfer of records between offices, meaning
that a responsible patient and cooperative, well-organized
practices must be present to ensure each doctor is properly
informed. Three-way communication between the patient and both
practices is at best cumbersome, and at worst ineffective in
ensuring that records are transferred completely and in timely
fashion. Regional Health Information Organizations (RHIOs) do
attempt to solve this problem by integrating into clinical systems,
defining common ontologies and standardizing quantitative results.
However, these systems are typically limited to institutional
settings, don't filter information for what is necessary for the
referral, and thus tend to suffer from very limited adoption. They
tend to be used mostly in emergency settings where no referral was
made. Breakdowns in communication and record transfers can lead to
unnecessary procedures, inappropriate medication, and superfluous
testing that combine to create additional costs for patients and
insurance providers, all the while eroding trust in medical
providers and causing frustration on all sides.
[0184] According to further embodiments of the invention described
below, a method and apparatus are provided which allows different
practice groups to easily make patient information available to one
another. Furthermore, a referring doctor can track a patient's
progress after treatment by a specialist, eliminating uncertainty
and allowing for more effective treatment at their next meeting.
Document loss becomes a non-issue, as digitally archived documents
on the aggregator's servers cannot be lost or misplaced.
[0185] Personal patient contact and insurance plan data are stored
on the aggregator's central database, and made available to pass on
to a referred-to doctor. Patients' records are matched on the basis
of their email address or phone number registered with the
aggregator. This information can be transmitted automatically in
conjunction with the appointment request.
[0186] Insurance forms are saved in digital form in the
aggregator's database, and can be pre-filled with this data and
sent in digital form to the receiving practice in conjunction with
the appointment request. Records can be uploaded by scanning them,
or by faxing them under a system-generated cover page to the
aggregator (where in turn they are digitized automatically and
stored in the aggregator's database). For example, a
system-generated cover page may feature a bar code, which allows
the aggregator's computers to identify the faxed record and its
intended recipient, and forward it on automatically to that
location by email. Records can also be outputted as faxes at
practices where this is necessary or preferred. These processes
require no additional equipment other than that present today in
almost all medical offices, i.e., fax machine at minimum.
Tracking the Referral Process
[0187] Further embodiments of the invention will now be described
which enable a referring physician to track his historical and
ongoing referral appointments. This tracking and management process
solves several recognized problems with current methods and can
enhance patient care. After a discussion of the problems this new
system and method addresses and overcomes, a specific embodiment
will be described with respect to FIGS. 8-10.
Reducing Patient Non-Compliance
[0188] Patient non-compliance is a major inefficiency factor in the
physician referral process. No patient can be relied upon
completely to book and attend a referred appointment. Referred
appointments not kept may endanger the patient's health, are lost
revenue for the receiving doctor, and may increase overall
healthcare costs if the patient's condition becomes worse because
he did not receive timely care.
[0189] Non-compliance can also cause legal problems, as a referring
physician may have a legal obligation to make a referral when it is
deemed to be necessary. Adverse health effects following
non-compliance in a system without standardized documentation
procedures exposes physicians to potential legal challenges--a
patient or a patient's relatives may become convinced that no
proper referral was given, and place the onus on the physician to
prove otherwise.
[0190] The Referral Cockpit described below increases the
likelihood of patient compliance. An appointment made at the time
of referral, in the referring doctor's office, and communicated to
the patient in writing and by e-mail is far more likely to lead to
a successful referral appointment than current procedures, which in
some cases are as basic as simply providing a patient with a list
of qualified specialists and contact information. Furthermore,
making a specific appointment through the Referral Cockpit involves
the receiving practice in the patient's care. This practice now has
the ability to contact a patient with reminders (see above),
further reducing non-compliance. The Referral Cockpit's
documentation functions ensure that compliance with legal referral
obligations is recorded and unquestionable.
[0191] The status of referral appointments past and scheduled can
be tracked by the referring practice using an "Appointment Status"
indicator as described below. A "Suggested Action" indicator
provides the doctor or his staff with one-click access to a
patient's contact information, further simplifying the process of
following up on referrals. A referring practice is thus also
informed immediately and automatically of a missed referral
appointment.
Post-Referral Reporting on Patients
[0192] At present, there is no convenient procedure doctors use to
follow up on a patient's progress after a referral appointment.
Primary care providers are obligated by law to follow up on
patients they have referred, but frequently are frustrated by the
need to proactively contact other practices. In many cases, several
attempts at contact must be made to administer a single patient, a
process that creates inefficiencies and extra costs while
increasing the likelihood of errors. Patient proactivity would
offer no solution in consideration of the fact that a layman
patient, in most cases lacks a sufficient understanding to pass
medical findings along effectively. This imperfect and haphazard
state of affairs has negative implications in terms of the quality
of care provided. It also hinders primary care providers from
scheduling follow-up appointments, which are important from a
medical standpoint and also generate revenue.
[0193] The present invention provides doctors with a tool for
managing communications on a patient-by-patient basis via the
Referral Cockpit. They can see their colleagues' (referred-to
physicians) findings and prepare themselves accordingly prior to
their follow-up appointment with a patient. Doctors can communicate
about patients through patient-specific channels, thus ensuring
that these exchanges are not forgotten amidst other work.
[0194] Documents can be easily made available using the
aggregator's database either by scanning or using the fax process
described earlier. The Referral Cockpit's search interface allows
for communications to be filtered on a patient-by-patient basis,
allowing each doctor to see the entire history of documentation and
data exchanged and offering a tangible improvement over prior means
of communication.
[0195] A "Booking History" search function (described below)
provides a doctor an overview of referrals given. Referrals can be
filtered by physician, specialty, and/or appointment date.
"Appointment Status" and "Suggested Action" functions can again be
used to provide a quick overview of steps to be taken for a
specific patient, eliminating the prior need to analyze each
patient's file and follow up where necessary.
Post-Referral Reporting on Doctors
[0196] By referring patients to another physician, a doctor
effectively grants a colleague access to trust-based doctor-patient
relationships that form the core of his or her business. It is
accordingly in the referring doctor's interest, both from a
professional standpoint and with a view to his or her own
reputation, to ensure that patients referred elsewhere receive care
quickly and efficiently, and that they are satisfied with their
patient experience. Without a tool to systematically track
post-referral care, doctors rely on intuition when deciding where
to refer their patients. Other than time consuming individual
follow-ups to every referral, there is little a doctor can do to
gain an overview of and assess the doctor-patient relationships
being built between "his" or "her" own patients and the specialists
he or she refers to.
[0197] Comprehensive reporting on referrals is a central feature of
the Referral Cockpit. This allows doctors to more objectively
evaluate professional relationships, which in turn should create
benefits for patients hoping to be referred to reliable and
competent doctors. Practices deficient in sharing documents,
accepting referred patients at the time desired, or making use of
information shared can be more easily identified.
[0198] Post-referral reporting on doctors is available via the
"Booking History" function using the same search interface as for
post-referral reporting on patients. The post-referral tracking can
be sorted based on referred-to physician.
Booking History
[0199] The embodiment illustrated in FIGS. 8-10 will now be
described. FIG. 8 shows a web page 130 on the aggregator's website
that enables the referring physician to track referral
appointments. The page, entitled "Booking History", includes a
number of filtering windows in an upper portion 131, enabling the
referring physician to filter based on selected criteria and
generate a booking history report. Here, the filtering windows
include two windows 132-133 for entering a date range, a window 134
for selecting a particular patient (or leaving the window 134 blank
to select all patients), a window 135 for selecting a specific
referred-to physician (or leaving the window 135 blank to select
all referred-to physicians), a window 136 for filtering based on
specialty of the referred-to physician, and a window 137 for
identifying a criteria for sorting the results, e.g., by patient
name or referred-to physician. By clicking the generate report
button 138, the aggregator's process filters the entered
information and generates a report, such as the booking history 140
shown in the lower portion of web page 130. Here, the booking
history report includes a grid of rows and columns, arranged in
reverse appointment date order, for a plurality of referral
appointments. Across the top of window 140 there are a plurality of
fields (column headings) 141 which include, in serial order across
the page: appointment status 142, results 143, patient name and
phone number 144, referred-to physician 145, appointment date 146,
appointment history 147, and suggested actions 148. Ten row entries
150-159 are illustrated below, each row being specific to a
particular referral appointment. For example, the first row entry
150 indicates that patient Michael Smith (field 144) was referred
to physician Alexander Arkansas (field 145) for an appointment on
May 24, 2010 (field 146), and that the appointment was booked on
May 2, 2010 (field 147). In the first column (field 142), Michael
Smith's appointment status is awaiting confirmation. In other row
entries, alternative appointment status indicators include
confirmed (row 152), rescheduled (row 153), patient cancelled (row
154), received results (rows 155 and 158), awaiting results (row
156), practice cancelled (row 157) and patient no-show (row 159).
In the results column 143, an icon is displayed if results of the
appointment have been stored on the aggregator's database. In the
last column 148, there is a link identifying a suggested action to
be taken, e.g., contact patient if the patient has either cancelled
or did not show up for the referral appointment. This prompts the
referring physician to communicate with the patient for
establishing a new appointment.
[0200] If this example (FIG. 8), the row entry 155 for patient
Richard Smith is highlighted and selected by the referring
physician on web page 130; this action causes a more detailed
referral history for the appointment to be displayed, as shown in
FIG. 9. In FIG. 9, the web page 170 now includes an enlarged window
171 with a referral summary for patient Richard Smith. The referral
summary includes, in serial order starting at the top of the window
171, identification of the referred-to physician, his specialty,
the reasons for the patient visit and the date and time of the
appointment 172. By clicking on the button 173, the received
results of the appointment can be displayed. Below box 172, there
is provided a link 174 for displaying the insurance referral form.
Below this, there is a box 175 for displaying the attachments,
namely the files shared by the referring and referred-to physicians
(three files are shown). For each file 176 three options (link or
checkbox) are provided enabling the referring physician to download
the file 177, remove the file 178, or refax the file to the
referred-to physician 179. In addition, the referring physician can
click a link 180 to add another attachment and click button 181 to
refax the selected attachments to the referred-to physician. Below
this, there is a results display 182 which here includes a link 183
for reviewing the EKG results of the appointment. Below this, there
is an entry box 184 enabling a physician to enter a message to the
patient, and a button 185 for sending the message to the patient.
Below this, there is provided (partially shown) a similar message
window 186 for entering a message to the referred-to doctor, and a
button (not shown) for sending the message to the referred-to
doctor.
[0201] FIG. 10 shows a complete referral summary in window 191 on
the web page 190. This alternative provides a more detailed report
for the selected patient Richard Smith and includes the same text
172 and button 173 as in FIG. 9. The referral summary provides an
audit trail 194 which lists in serial order going down the window,
a reverse chronological list of events concerning the referral
appointment. Here, the illustrated events include an entry 195 that
results were added to the aggregator's database by the referred-to
physician 195, a message sent to the referred-to doctor 196, a
message sent to the patient with a link to show the message 197,
patient confirmation 198, and various attachments that were faxed
199, 201-203 or added 200, 204 to the database.
[0202] The above embodiments illustrate select features of the
invention for both online booking and tracking of referral
appointments. These same features are useful in a variety of
healthcare provider practices, as described further below.
Facilitating Referrals to In-Network and Affiliated Physicians
[0203] Large hospitals and hospital networks often employ or
maintain affiliations with primary care providers. Ideally, these
primary care providers should refer patients for secondary or
tertiary care within the hospital network they are affiliated with.
This would ensure continuity of care and records, benefiting the
patient, while benefiting the hospital. Without in-network
referrals, the cost of care at integrated facilities increases.
Similarly, investments that could benefit patients become more
difficult to undertake.
[0204] By offering instant access to each specialist's calendar
through the Referral Cockpit, a hospital or hospital group can
provide its physicians with a real incentive to refer within
network--speed and ease of use. Referrals within network can be
made significantly more quickly, increasing the speed of care.
Furthermore, search results within the Referral Cockpit can be
narrowed down to just in-network doctors, offering physicians a
quickly accessible view of professionals within their network. The
Cockpit's integrated document-sharing features also serve to ensure
continuity of care, reducing the hospital's exposure to malpractice
allegations. Finally, by adopting the Cockpit a hospital (group)
can ease for its administrators the task of monitoring a doctor's
use of their in-network colleagues when referring. Overall, the
likelihood of in-network referrals increases, creating benefits for
the hospital while improving the quality of care for patients.
[0205] The benefits described above occur by leveraging the
Referral Cockpit's individual functions, and applying them as an
enterprise solution rather than an improvement to a single
practice's infrastructure. Pre-selection of in-network doctors can
occur by accessing saved affiliation data stored on the
aggregator's database.
Ensuring Care After Hospital Discharges
[0206] A patient's need for medical care does not typically end
once discharged from a hospital. Usually, a number of follow-up
appointments are necessary. The hospital is obligated to instruct
the patient to undertake these if there exists a medical necessity.
However, at present, there exists no standardized framework for
ensuring that these appointments actually occur, or that
post-discharge care fulfills the objectives envisioned by a
hospital's physicians and their discharge teams.
[0207] Using the Referral Cockpit, a hospital's administrative
staff can instantly transfer records of and book appointments for a
patient about to be discharged. This fulfills the hospital's legal
obligations and decreases the likelihood of inadequate care after
discharge. Furthermore, it does also provide integrated hospital
facilities or hospitals operating within a large provider network
the opportunity to keep the patient in-network, especially in cases
where a patient may not have an existing relationship with the
medical provider(s) he or she is recommended to continue
seeing.
[0208] No additional functions of the Referral Cockpit, other than
those already described, are necessary to implement this
application.
Managing Emergency Care Facility Capacity
[0209] Many hospital emergency rooms are frequently over capacity.
They treat a variety of patients, ranging from those without
serious ailments to life-threatening cases. Furthermore, many
patients enter the emergency room simply because they do not have
immediate access to their preferred primary care provider, or
because they do not have a primary care provider. While primary
care capacity elsewhere goes unutilized, emergency rooms find
themselves struggling to cope with a deluge of patients, increasing
wait times for all as well as the risk of mistakes and inadequate
care.
[0210] Emergency room staff working with the Referral Cockpit can
identify low-priority cases, and access a real-time view of
available primary care providers in the vicinity. This helps
decrease waiting times, provides patients with faster access to
care, and allows physicians and medical staff to concentrate their
efforts on those patients in the greatest need of true emergency
care. Furthermore, the Referral Cockpit can be used to steer
patients to providers within the same provider network as the
emergency facility.
[0211] The Referral Cockpit's core functions, as described above,
are all equally applicable in this scenario. The Cockpit's
documentation features serve to create a record of the emergency
facility having fulfilled its obligation to provide care.
Ensuring Post-Emergency Care
[0212] In 2009, the Annals of Emergency Medicine published the
results of a study showing that fully 78% of emergency care
patients did not fully understand the instructions given to
them.sup.1. Of all patients, 34% found themselves unclear about
their post-emergency care. Furthermore, handwritten communication
was found to be a major source of patient confusion. Patients
unclear about what to do once they leave the emergency room are at
risk of eschewing needed follow-up care, causing adverse effects on
their health. Their situation can degenerate to the point where
more emergency care is required. This state of affairs is
inefficient, costly and dangerous, and exacerbated even further by
the fact that even comprehending patients are often found to be
non-compliant, as described above. .sup.1 "Patient Comprehension of
Emergency Department Care and Instructions: Are Patients Aware of
When They Do=Not Understand? Annals of Emergency Medicine, Vol. 53
Issue 4, April 2009. Study attached.
[0213] Emergency room staff can use the Referral Cockpit to make a
confirmed appointment with a physician qualified to provide
post-discharge care. Once this appointment is made, reminders can
be sent to the patient in the time leading up to the appointment,
and documents transferred electronically to the receiving
physician. Each of these steps increases the possibility of patient
compliance and efficient post-emergency care.
[0214] Emergency care facility staff can use the Referral Cockpit's
booking function to make appointments. The documentation functions
described above serve to ensure that the receiving physician is
well-informed before administering follow-up care.
EXAMPLES
[0215] FIGS. 11-16 further illustrate various embodiments of the
invention as described below.
[0216] FIG. 11 illustrates the following example:
[0217] Case 1--Referral Cockpit to Referral Cockpit [0218] 1.
Patient visits doctor, doctor performs diagnosis and determines
need for referral; [0219] 2. Doctor uses PC to log in to Referral
Cockpit; request information on availability of applicable doctors;
[0220] 3. PC sends request to aggregator server; [0221] 4. Server
searches connected database; [0222] 5. Server returns requested
information to PC/doctor, doctor then uses PC to choose specialist
to refer to book appointment, and transfer patient's records
electronically to aggregator server; [0223] 6. Server forwards
records, reservation to specialist's PC via server/database; [0224]
7. Specialist uses PC to log in to Referral Cockpit and view
appointment; contacts patient to confirm appointment, give
preparatory instructions, etc. [0225] 8. After appointment,
specialist uses PC to log into Referral Cockpit and transfer
updated records back to doctor via aggregator server.
[0226] FIG. 12 illustrates the following example:
[0227] Case 2--Referral Cockpit to Referral Cockpit, No Time Chosen
[0228] 1. Patient visits doctor, doctor performs diagnosis and
determines need for referral; [0229] 2. Doctor uses PC to log in to
Referral Cockpit; request information on availability of applicable
doctors; [0230] 3. PC sends request to aggregator server; [0231] 4.
Server searches connected database; [0232] 5. Server returns
requested information to PC/doctor, doctor then uses PC to choose
specialist, request appointment, and transfer patient's records
electronically to aggregator server; [0233] 6. Server forwards
records, request to specialist's PC via server/database; [0234] 7.
Patient and specialist communicate at a later time outside the
Referral Cockpit system (by email, phone, or personal conversation)
to find a suitable time for the appointment; [0235] 8. Specialist
uses PC to log in to Referral Cockpit and enter the appointment on
aggregator server, which updates database and makes updates visible
to doctor; [0236] 9. After appointment, specialist uses PC to log
into Referral Cockpit and transfer updated records back to doctor
via aggregator server.
[0237] FIG. 13 illustrates the following example:
[0238] Case 3--Referral to Practice Outside Cockpit System That
Uses PCs [0239] 1. Patient visits doctor, doctor performs diagnosis
and determines need for referral; [0240] 2. Doctor uses PC to log
in to Referral Cockpit; request referral to a non-connected
specialist; [0241] 3. PC sends request to aggregator server; [0242]
4. Server forwards email with request to specialist via his PC,
logs it on database; [0243] 5. Using PC, specialist contacts
patient and doctor (by phone/email) outside system to accept
request, make/confirm appointment; [0244] 6. Doctor uses PC to
enter reservation into database via aggregator server; transfer
patient documents (if necessary) to specialist electronically via
aggregator server and database; [0245] 7. After appointment,
specialist uses email/fax/mail to transfer updated records back to
aggregator server, which identifies them, updates database, and
forwards to doctor.
[0246] FIG. 14 illustrates the following example:
[0247] Case 4--Referral to Practice Outside Cockpit System Not
Using PCs [0248] 1. Patient visits doctor, doctor performs
diagnosis and determines need for referral; [0249] 2. Doctor uses
PC to log in to Referral Cockpit; request referral to a
non-connected specialist; [0250] 3. PC sends request to aggregator
server; [0251] 4. Server forwards reservation request to specialist
outside system via fax, logs it on database; [0252] 5. Specialist
contacts patient and doctor (probably by phone) to accept request
and make/confirm appointment; [0253] 6. Doctor uses PC to enter
reservation into database via aggregator server; uploads patient
information and documents to aggregator server--sever then outputs
these to specialist via fax; [0254] 7. After appointment,
specialist faxes updated records back to aggregator server, which
identifies them, updates database, and forwards to doctor.
[0255] FIG. 15 illustrates the following example:
[0256] Case 5--Referral Within a Hospital System [0257] 1. Patient
visits emergency room, doctor diagnoses need for referral to
specialist; [0258] 2. Emergency room administrator uses PC to log
in to Referral Cockpit, request information on availability to
doctors; [0259] 3. PC sends request to aggregator server; [0260] 4.
Server searches connected database; [0261] 5. Server returns
requested information to ER admin. Admin chooses in-network
specialist to refer to, book appointment, and transfer patient's
records electronically to aggregator server; [0262] 6. Server
forwards records, reservation to specialist's PC via
server/database; [0263] 7. Specialist uses PC to log in to Referral
Cockpit and view appointment; contacts patient to confirm
appointment, give preparatory instructions, etc.--patient later
visits specialist; [0264] 8. After appointment, specialist uses PC
to log into Referral Cockpit and transfer updated records back to
ER admin via aggregator server.
[0265] FIG. 16 illustrates the following example:
[0266] Case 6--Paper Record Transfer Via Aggregator Server/Database
[0267] 1. Doctor scans paper records, which scanner transfers to
PC; [0268] 2. Doctor uses PC to log in to Referral Cockpit, upload
scanned records, which are then transmitted to aggregator server;
[0269] 3. Aggregator server matches records with existing patient
and case records, updates database, creates bar-coded cover page;
[0270] 4. Records are now forwarded directly to specialist via fax
or PC in fax or email form, and/or specialist can re-request
automated delivery or records as necessary via fax or PC at will,
and without again involving doctor. If specialist is outside
system, records he/she emails or faxes back to aggregator server
will automatically be identified using bar code, database will be
updated, and doctor sent records via Cockpit.
Database Structures
[0271] FIG. 17 illustrates one example of a database structure for
use in one or more embodiments of the method and apparatus of the
invention. An aggregator database uses various stored tables of
doctor, appointment, and user data for implementing the booking of
a referral appointment. As shown, the doctor information table 220
may include a unique physician identifier (ID), physician name,
specialty and sub-specialty identifiers, photo and physician
statement information. An appointment table 221 may include a
unique appointment identifier, practice identifier, physician
identifier, location identifier, procedure identifier, start and
end time for the procedure, a user identifier and duration. A user
table 222 may include a unique user identifier, name, user key,
gender and date of birth. This use of a relational database is
meant to be illustrative of just one possible embodiment and not
limiting.
[0272] FIG. 18 illustrates one example of a stored appointment
table for use in one or more method or apparatus embodiments of the
invention. The stored records of appointments in the aggregator's
database may include each of the following fields: [0273] ID;
[0274] practice ID; [0275] doctor ID; [0276] location ID; [0277]
procedure ID; [0278] start time; [0279] end time; [0280] user ID;
[0281] duration. Again, this is one example of a table of stored
referral appointment information utilizing the doctor, appointment
and patient information stored in the aggregator database and is
not meant to be limiting.
System, Method and Computer Program
[0282] As will be appreciated by one skilled in the art, the
present invention may be embodied as an apparatus or method,
including a computer system or computer program product.
Accordingly, unless specified to the contrary, the present
invention may take the form of an entirely hardware embodiment, an
entirely software embodiment (including firmware, resident
software, micro-code, etc.) or an embodiment combining software and
hardware aspects that may all generally be referred to herein as a
"circuit," "module" or "system." Furthermore, the present invention
may take the form of a computer program product embodied in any
tangible medium of expression having computer-usable program code
stored in the medium.
[0283] Any combination of one or more computer-usable or
computer-readable medium(s) may be utilized, unless specified to
the contrary herein. The computer-usable or computer-readable
medium may be, for example but not limited to, electronic,
magnetic, optical, electromagnetic, infrared, or semiconductor
storage mediums. More specific examples (a non-exhaustive list)
include: a portable computer diskette, a hard disk, a random access
memory (RAM), a read-only memory (ROM), an erasable programmable
read-only memory (EPROM or Flash memory), and a portable compact
disc read-only memory (CDROM), an optical storage device.
[0284] Computer program code for carrying out operations of the
present invention may be written in any combination of one or more
programming languages, including an object oriented programming
language such as Java, Smalltalk, C++, C#, JavaScript/Ajax and
similar programming languages. JavaScript, which relies on a
runtime environment in a web browser, is commonly used for website
development (e.g., writing functions that are embedded in or
included from HTML pages). JavaScript can be used as a scripting
language for implementing an Ajax-embedded webpage. Unless
otherwise specified, the program code may execute entirely on a
user's computer, partly on the user's (e.g., server or client)
computer, as a stand-alone software package, partly on a user's
computer and partly on a remote computer or entirely on the remote
computer or server. In the latter scenario, the remote computer may
be connected to the user's computer through any type of network,
including a local area network (LAN) or a wide area network (WAN),
or the connection may be made to an external computer (for example,
through the Internet using an Internet Service Provider).
[0285] A website is a collection of web pages posted on one or more
web servers, accessible via the Internet. A webpage is a document,
typically written in [X]HTML, that is generally accessible via
HTTP, a protocol that transfers information from a web server to a
display in the user's web browser. The collection of publically
accessible websites are referred to as the "World Wide Web".
[0286] Websites are written in, or dynamically converted to, HTML
(hyper text mark-up language) and are accessed using a software
interface known as the user agent. Web pages can be viewed or
otherwise accessed from a range of computer-based and
Internet-enabled devices of various types, including desktop
computers, laptop computers, PDA's and cell phones. A website is
posted on a computer system known as a web server, and it includes
software that retrieves and delivers the pages in response to
requests from the website users.
[0287] A dynamic website presents variable information that is
tailored to particular users. It may accept the user's input and
respond to a user's request. For example, the user can enter text
into a data entry field or form or select highlighted (linked)
options, which prompts the website to fulfill the request and
return a unique result. The aggregator's website, accessible in
various forms to patients, hospitals, insurers and practice groups,
includes such dynamic functionality.
[0288] A link or hyperlink, is a reference or navigation component
in a document to another section of the same document or to another
document on a different domain. A web browser usually displays a
link in some distinguishing way, e.g. in a different color, font or
style. When the user activates the link (e.g. by clicking on it
with the mouse) the browser will display the target of the
link.
[0289] As used herein, database and central database are not meant
to be limiting, and may reside in one or more locations and/or data
repositories. The aggregator's database is referred to as a central
database to distinguish it from the separate multiple databases of
the unaffiliated practice groups from which the aggregator combines
(aggregates) the available appointment times to be offered on the
aggregator's website. Database as used herein is not meant to be
limiting and may include various forms of data repositories and
applications for indexing, search, storage and retrieval of such
repositories.
[0290] The aggregator can, by collecting and storing this available
appointment data from a plurality of unaffiliated practice groups,
provide a much larger database of available appointment
times/specialties/procedures and can allow patients to book
appointments directly with the aggregator, without requiring the
patients to contact the practice group in any manner (by phone,
email or practice group website).
[0291] The present invention is described above with reference to
flowchart illustrations and/or block diagrams of methods, apparatus
and computer program products (systems) according to embodiments of
the invention. It will be understood that each block of the
flowchart illustrations and/or block diagrams, and combinations of
blocks in the flowchart illustrations and/or block diagrams, can be
implemented by computer program instructions. These computer
program instructions may be provided to a processor of a general
purpose computer, special purpose computer, or other programmable
data processing apparatus to produce a machine, such that the
instructions, which execute via the processor of the computer or
other programmable data processing apparatus, create means for
implementing the functions/acts specified in the flowchart and/or
block diagram block or blocks.
[0292] These computer program instructions may also be stored in a
computer-readable medium that can direct a computer or other
programmable data processing apparatus to function in a particular
manner, such that the instructions stored in the computer-readable
medium produce an article of manufacture including instruction
means which implement the function/act specified in the flowchart
and/or block diagram block or blocks.
[0293] The flowchart and block diagrams illustrate the
architecture, functionality, and operation of possible
implementations of systems, methods and computer program products
according to various embodiments of the present invention. In this
regard, each block in the flowchart or block diagrams may represent
a module, segment, or portion of code, which comprises one or more
executable instructions for implementing the specified logical
function(s). It should also be noted that, in some alternative
implementations, the functions noted in the block may occur out of
the order noted in the figures. For example, two blocks shown in
succession may, in fact, be executed substantially concurrently, or
the blocks may sometimes be executed in the reverse order,
depending upon the functionality involved. It will also be noted
that each block of the block diagrams and/or flowchart
illustration, and combinations of blocks in the block diagrams
and/or flowchart illustration, can be implemented by special
purpose hardware-based systems that perform the specified functions
or acts, or combinations of special purpose hardware and computer
instructions.
[0294] By way of example only, various described embodiments may be
implemented on processor based servers, such as any x86.sub.--64
processor based server, for example running a Windows Operating
System, e.g. Windows Server 2003, Windows XP/Vista, including
Microsoft's NET Framework (e.g. Net 2.0). The database programming
may be implemented in the SQL programming language (e.g. MS SQL
2005 and TSQL).
[0295] Modifications can be made to the previously described
embodiments of the present invention and without departing from the
scope of the invention, the embodiments being illustrative and not
restrictive.
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