Patient-Provider Matching System Using Algorithmic Triage
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Solution Overview
Problem
Patients face challenges in selecting the appropriate healthcare provider due to lack of objective knowledge, leading to incorrect choices, increased costs, and unnecessary visits, with existing solutions failing to provide accurate guidance based on specific conditions and needs.
Innovation Solution
A secure, HIPAA-compliant medical information system, Kalypsys, that uses symptom triage, care focus, in-network provider selection, and a K score to match patients with suitable healthcare providers based on their specific needs, allowing for real-time scheduling and booking.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Ease of operation
If patients rely on word-of-mouth referrals or online reviews to select healthcare providers, then the selection process is simple and accessible, but the accuracy and objectivity of the selection is poor leading to incorrect choices
Solution Approach 1:
The patent introduces an intermediary system (processor and database) that objectively matches patients with healthcare providers based on multiple criteria including symptoms, conditions, insurance, and geography. This intermediary eliminates the need for patients to manually evaluate referrals or reviews, providing accurate matching while maintaining ease of access through automated processing.
Solution Approach 2:
The patent replaces the manual, subjective mechanical process of patient provider selection (evaluating referrals and reviews) with an automated computational system that processes patient information against provider databases using algorithms, thereby substituting human judgment with objective computational matching.
2Loss of time
If patients select healthcare providers without objective guidance, then the selection process is quick and requires minimal resources, but it results in multiple unnecessary visits and extended suffering time
Solution Approach 1:
The patent performs preliminary matching actions by pre-processing patient information against the healthcare provider database before the patient actually seeks care. This preliminary objective assessment ensures patients are directed to the most appropriate provider on first contact, preventing unnecessary visits and reducing both time loss and wasted healthcare resources.
3Measurement precision
If a comprehensive system with multiple criteria (symptoms, conditions, insurance, geography) is implemented for provider matching, then the accuracy of matching is improved, but the device complexity increases
Solution Approach 1:
The patent implements a universal processor-based system that handles multiple matching criteria (symptoms, conditions, insurance, geography) through a single integrated database and algorithmic framework. This multi-functional approach achieves high matching accuracy while managing complexity by consolidating diverse criteria into one cohesive system rather than separate systems for each criterion.
4Measurement precision
If objective quantification of patient satisfaction and provider performance is implemented, then the quality of selection guidance is improved, but the difficulty of detecting and measuring increases
Solution Approach 1:
The patent implements self-service mechanisms where patients automatically provide feedback on their healthcare experiences, and this feedback is automatically processed and integrated into the matching algorithm. This self-service approach enables objective quantification of satisfaction and performance while minimizing the complexity of data collection, as the system captures information directly from users during natural interactions.
Data Source
AI summary
A method for a patient to identify and select a health care provider to service the patient's particular need and subsequently schedule an appointment with the health care provider is described. Data regarding the patient and data regarding the provider are used to determine matching physicians to the patient's needs. The patient has the ability to select among matching physicians, rank ordered based on a combination of patient and other criteria, and the patient is offered an average rating for each physician, where the rating is based on reliable reviews of at least other patients.