Unified Patient Data Aggregation for Healthcare Quality Standards

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Solution Overview

Problem

In managed care settings, there is a lack of integrated systems that can accurately diagnose and track patient health conditions across multiple data sources, leading to disjointed healthcare information and suboptimal quality of care, particularly for high-risk populations, due to variations in data collection and reporting between health programs.

Innovation Solution

A comprehensive system that aggregates patient data from various sources, including electronic health records, insurance claims, clinical lab results, and medication records, to provide a unified health profile, enabling healthcare providers to make informed decisions and ensure adherence to objective quality standards through dynamic workflow processes and decision support systems.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Quantity of substance

If multiple separate health programs and data sources are used to track patient information, then more comprehensive data coverage is achieved, but data integration and consistency deteriorate

Engineering Contradiction:

Improvedata coverageVSAvoiddata consistency

Core Design Contradiction:

Quantity of substanceVSStability of the object's composition

Solution Approach 1:

The patent merges multiple separate health program data sources into a single integrated system that consolidates patient information from different payors, providers, and health programs. This integration maintains data consistency while achieving comprehensive coverage by creating a unified view of patient health data across all sources.

Inventive Principle:

Principle #5Merging (Combining)

Solution Approach 2:

The system creates a universal data platform that can handle multiple types of health program data simultaneously - including but not limited to quality measures, claims data, electronic health records, and patient demographics. This multi-functional platform serves diverse data sources with a single consistent interface.

Inventive Principle:

Principle #6Universality (Multi-functionality)

2Reliability

If comprehensive patient data aggregation from multiple sources is implemented, then quality of care assessment is improved, but system complexity increases

Engineering Contradiction:

Improvequality of care assessmentVSAvoidsystem complexity

Core Design Contradiction:

ReliabilityVSDevice complexity

Solution Approach 1:

The patent introduces an intermediary integrated system that acts as a mediator between multiple data sources and the quality assessment processes. This intermediary layer standardizes data formats, handles data integration logic, and presents unified information to providers and administrators, thereby improving assessment reliability without exposing the full complexity of the underlying multi-source architecture.

Inventive Principle:

Principle #24Intermediary (Mediator)

3Ease of manufacture

If manual tracking of health maintenance programs is used, then implementation simplicity is maintained, but accuracy and timeliness of care delivery deteriorate

Engineering Contradiction:

Improveimplementation simplicityVSAvoidcare delivery accuracy

Core Design Contradiction:

Ease of manufactureVSMeasurement precision

Solution Approach 1:

The system enables self-service automated tracking where the integrated platform automatically monitors patient health maintenance program participation, tracks quality measure completion, and alerts providers to gaps in care. This automated self-tracking eliminates manual processes while maintaining simplicity for users through intuitive interfaces and automated notifications.

Inventive Principle:

Principle #25Self-service

4Loss of energy

If referral and utilization management processes are enforced, then cost control is improved, but continuum of care is limited

Engineering Contradiction:

Improvehealthcare costVSAvoidcontinuum of care

Core Design Contradiction:

Loss of energyVSAdaptability or versatility

Solution Approach 1:

The patent implements dynamic referral and utilization management that adapts to individual patient needs and conditions. The system automatically adjusts care coordination based on real-time data from multiple sources, enabling flexible continuum of care while maintaining cost control through evidence-based utilization decisions rather than rigid protocols.

Inventive Principle:

Principle #15Dynamics

Data Source

PatentUS11429930B2Methods for optimizing managed healthcare administration and achieving objective quality standards

Publication Date: 2022.08.30 QUALITY STANDARDS

AI summary

Healthcare is administered to members/enrollees of a healthcare plan according to objective quality standards. A patient population of eligible members/enrollees is identified and for each member/enrollee, medical information is aggregated via a web-based compilation of medical data from multiple sources that is continuously updated so as to provide an accurate, up-to-date and readily accessible compilation of a member/enrollee past diagnoses, healthcare history, medical procedures, medications and the like. Such member/enrollees are continuously tracked, on an individual basis, and monitored to ensure healthcare is delivered for a variety of specific medical conditions pursuant to objective health program quality criteria.