Secure Healthcare Data Exchange Platform for Provider Verification
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Solution Overview
Problem
The current healthcare system faces challenges in efficiently sharing and updating patient and provider information among stakeholders, leading to fragmented communication networks, manual and time-consuming processes, and potential clerical errors due to outdated information and lack of integration between insurance and medical history verification.
Innovation Solution
A computer-implemented method for securely sharing and restricting data between healthcare stakeholders, utilizing a system of secure data aggregation and distribution (SOSDAD) that allows patients to book appointments, verify provider information, and consent for medical and insurance data transmission, with automated updates and compliance verification, facilitating timely and accurate information exchange.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If manual processes are used for information exchange between healthcare stakeholders, then data security and compliance control are maintained, but the process becomes time-consuming and prone to clerical errors
Solution Approach 1:
The patent introduces a centralized information exchange platform that acts as an intermediary between healthcare stakeholders (providers, payors, patients). This platform automates data sharing while maintaining security protocols and compliance controls, eliminating manual processes and reducing clerical errors while preserving data protection standards.
Solution Approach 2:
The patent replaces manual mechanical processes (paper forms, fax, phone verification) with automated electronic systems. The platform uses digital data exchange, automated verification workflows, and electronic consent management to substitute human-driven manual operations with automated computational processes, reducing time and errors while maintaining security through systematic controls.
2Reliability
If each provider maintains separate forms and processes for patient information, then data privacy and consent control are maintained, but information fragmentation and communication inefficiency occur
Solution Approach 1:
The patent creates a universal information exchange platform that serves multiple healthcare stakeholders (providers, payors, patients) with a single standardized system. This platform handles various functions (appointment scheduling, insurance verification, medical history sharing, consent management) through unified processes, eliminating the need for each provider to maintain separate forms and systems while preserving privacy controls through centralized security protocols.
Solution Approach 2:
The patent merges previously separate information systems and processes into a single integrated platform. By combining provider directories, appointment scheduling, insurance verification, and medical history exchange into one unified system, the patent eliminates information fragmentation while maintaining consent control through centralized authorization mechanisms that manage data access across all stakeholders.
3Reliability
If insurance verification is performed manually after treatment, then compliance with verification requirements is maintained, but the process occurs too late to prevent billing errors and requires additional call center resources
Solution Approach 1:
The patent performs insurance verification in advance of treatment through automated platform processes. When a patient schedules an appointment, the system automatically verifies insurance coverage, provider network status, and benefits information before the treatment occurs. This preliminary verification prevents billing errors upfront and eliminates the need for post-treatment verification calls, improving both compliance and billing efficiency.
Data Source
AI summary
A computer-implemented method of sharing and restricting data between healthcare stakeholders comprising the steps of requesting an appointment, confirming an appointment, verifying provider information, updating provider information, requesting patient medical history, requesting patient payment information.