Automated Gap in Care Alert System for Patient Adherence
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Solution Overview
Problem
Current systems fail to effectively alert patients and care providers about potential gaps in patient care, leading to worsening health outcomes and increased healthcare costs, as they often rely on manual reminders that are inefficient and delayed, thereby increasing the likelihood of undesirable consequences.
Innovation Solution
A computer system analyzes patient medical data to detect approaching gaps in care and initiates automated alerts via phone calls, emails, or in-person visits to encourage timely action, utilizing a sophisticated algorithm that calculates optimal alert times based on historical data and treatment protocols to minimize delays and prevent adverse outcomes.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If automated alert systems are implemented to detect and notify patients about gaps in care, then the reliability of patient care adherence is improved, but the device complexity and implementation cost increase
Solution Approach 1:
The patent introduces a third-party automated alert system that acts as an intermediary between healthcare providers and patients. This system receives data from providers, processes it through algorithms, and sends notifications to patients, thereby improving adherence without requiring direct integration between all healthcare components.
Solution Approach 2:
The system enables patients to self-monitor their care status by automatically receiving alerts about upcoming appointments, prescription refills, and follow-up visits. The automated nature of the system allows patients to take initiative in managing their own care without requiring active intervention from providers.
2Ease of operation
If manual reminder systems are used to alert patients about care gaps, then the ease of operation is maintained, but the productivity and timeliness of alerts deteriorate
Solution Approach 1:
The patent replaces manual reminder processes with an automated electronic system. Instead of healthcare providers manually calling or messaging patients, the system automatically detects care gaps, processes information through algorithms, and sends notifications via phone calls, emails, or texts, thereby significantly improving alert timeliness while maintaining ease of use for patients.
3Measurement precision
If automated algorithms analyze medical data to detect gaps in care, then the measurement precision of care gaps is improved, but the device complexity and data processing requirements increase
Solution Approach 1:
The patent segments the complex task of gap detection into distinct analytical components. The system separately analyzes different types of care data (appointments, prescriptions, lab results), applies specific algorithms to each dataset, and then integrates the results. This segmentation allows for precise detection while managing processing complexity through modular design.
Solution Approach 2:
The system employs algorithms that dynamically adjust detection parameters based on patient-specific factors such as age, condition severity, and historical care patterns. By changing analytical parameters according to individual patient characteristics, the system achieves high measurement precision without requiring uniformly complex processing for all patients.
Data Source
AI summary
The present invention is a gap in care alert system for alerting someone associated with a patient (including in one embodiment the patient himself) that a gap in heath care will soon occur or in another embodiment that a gap in care has occurred for the patient based on the occurrence of a triggering event and the absence of a follow-up event occurring. Health insurance claims data may be used in the process to determine gaps in care.