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公开(公告)号：US20090099865A1
公开(公告)日：2009-04-16
申请号：US11973754
申请日：2007-10-10
申请人： Solomon J. Zak , Rudra Duddala , Craig Johnson , Poladas James
发明人： Solomon J. Zak , Rudra Duddala , Craig Johnson , Poladas James
IPC分类号： G06Q50/00
摘要： Disclosed herein is a computer implemented method and system that addresses the need for utilization analysis and performance evaluation of providers in a health care organization. The health care data comprising health plan information of consumers, providers, claims, and hospitals is collected, translated, and organized in a structured relational format and stored in standard tables. The organized health care data is analyzed by calculating consumer statistics for a health plan using the health plan information of the consumers. The claims of the consumers are processed to classify the claims based on age, gender, disease, and comorbid conditions of the consumers. A plurality of costs of the health care organization is determined using one or more of the health plan information. The performance of the providers is assessed using the determined plurality of costs. The providers comprising primary care physicians are analyzed based on entire population of the associated consumers.
摘要翻译： 这里披露了一种计算机实现的方法和系统，其解决了在医疗保健组织中提供者的利用分析和性能评估的需要。 包括消费者，提供者，索赔和医院的健康计划信息的医疗保健数据以结构化关系格式收集，翻译和组织，并存储在标准表中。 通过使用消费者的健康计划信息计算卫生计划的消费者统计数据来分析有组织的保健数据。 对消费者的要求进行处理，根据消费者的年龄，性别，疾病和共病情况对索赔进行分类。 使用一个或多个健康计划信息来确定医疗机构的多个费用。 使用确定的多个成本来评估提供商的表现。 基于相关消费者的整体人群分析包括初级保健医师在内的提供者。
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公开(公告)号：US07987102B2
公开(公告)日：2011-07-26
申请号：US11973754
申请日：2007-10-10
申请人： Solomon J. Zak , Rudra Duddala , Craig Johnson , Poladas James
发明人： Solomon J. Zak , Rudra Duddala , Craig Johnson , Poladas James
摘要： Disclosed herein is a computer implemented method and system that addresses the need for utilization analysis and performance evaluation of providers in a health care organization. The health care data comprising health plan information of consumers, providers, claims, and hospitals is collected, translated, and organized in a structured relational format and stored in standard tables. The organized health care data is analyzed by calculating consumer statistics for a health plan using the health plan information of the consumers. The claims of the consumers are processed to classify the claims based on age, gender, disease, and comorbid conditions of the consumers. A plurality of costs of the health care organization is determined using one or more of the health plan information. The performance of the providers is assessed using the determined plurality of costs. The providers comprising primary care physicians are analyzed based on entire population of the associated consumers.
摘要翻译： 这里披露了一种计算机实现的方法和系统，其解决了在医疗保健组织中提供者的利用分析和性能评估的需要。 包括消费者，提供者，索赔和医院的健康计划信息的医疗保健数据以结构化关系格式收集，翻译和组织，并存储在标准表中。 通过使用消费者的健康计划信息计算卫生计划的消费者统计数据来分析有组织的保健数据。 对消费者的要求进行处理，根据消费者的年龄，性别，疾病和共病情况对索赔进行分类。 使用一个或多个健康计划信息来确定医疗机构的多个费用。 使用确定的多个成本来评估提供商的表现。 基于相关消费者的整体人群分析包括初级保健医师在内的提供者。
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