Physician Activity Tracking via Healthcare Transaction Analysis
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Solution Overview
Problem
Healthcare providers face challenges in determining the activity levels of physicians for business and marketing purposes, as existing systems lack efficient methods to track and analyze prescribing physician activity effectively.
Innovation Solution
A computer-implemented method and system that collect and process healthcare transaction requests to calculate activity measures for prescribing physicians, identifying them through their transaction records and ranking them based on their activity levels, utilizing a physician activity level module within a service provider system.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If healthcare providers manually track physician activity, then they can obtain activity information, but the process is time-consuming and inefficient
Solution Approach 1:
The patent replaces manual tracking methods with an automated computer-implemented system that collects healthcare transaction requests, identifies prescribing physicians, and calculates activity measures automatically. This substitution of mechanical/manual processes with automated computing operations resolves the contradiction by dramatically improving efficiency while reducing time consumption.
Solution Approach 2:
The system enables self-service by automatically gathering and processing physician activity data from existing healthcare transaction requests without requiring external manual intervention. The automated identification and calculation processes allow the system to serve its own data collection and analysis needs, improving productivity while minimizing time loss.
2Measurement precision
If existing systems are used to track physician activity, then some data can be obtained, but the measurement precision and accuracy are insufficient
Solution Approach 1:
The patent creates a multi-functional system that not only tracks physician activity but also identifies fraudulent patterns, calculates market size, and provides comprehensive business intelligence. This universal system handles multiple measurement and analysis functions within a single integrated platform, improving measurement precision without proportionally increasing complexity.
Solution Approach 2:
The system incorporates feedback mechanisms by continuously collecting healthcare transaction requests, calculating activity measures, and using this information to identify patterns of fraudulent activity. The feedback loop refines measurement precision over time as the system learns from accumulated data, achieving high accuracy without requiring overly complex initial system design.
3Reliability
If comprehensive physician activity data is collected, then accurate activity levels can be determined, but data collection and processing becomes complex
Solution Approach 1:
The patent segments the data collection and processing system into distinct functional modules: a collection component that gathers healthcare transaction requests, an identification component that extracts physician information, and a calculation component that determines activity measures. This segmentation improves reliability by ensuring each function is performed correctly while managing complexity through modular design.
Solution Approach 2:
The system introduces an intermediary processing layer that standardizes and structures raw healthcare transaction data before analysis. This intermediary component translates diverse transaction request formats into a unified structure, improving the reliability of activity determination while simplifying the overall processing complexity through standardized intermediate representations.
Data Source
AI summary
Systems and methods may determine prescribing physician activity levels. Information associated with a plurality of healthcare transaction requests that are received during a designated time period from at least one healthcare provider computer for communication to one or more claims processor computers may be collected. A respective prescribing physician for each of the plurality of received healthcare transaction requests may be identified. For each identified physician, a respective activity measure for the designated time period may be calculated based upon a respective number of the healthcare transaction requests identifying the physician.