WO2018089584A1 - Soins guidés par cna pour améliorer les résultats cliniques et diminuer les coûts totaux des soins - Google Patents
Soins guidés par cna pour améliorer les résultats cliniques et diminuer les coûts totaux des soins Download PDFInfo
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Classifications
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Definitions
- the COTA module can enable a comparison of data or of tracked outcomes between patients can identify a specific patient as a candidate for a specific treatment or drug, can communicate an analysis tool to the client device to facilitate analysis of, for instance, the classified and sorted data records or to enable comparison of Kaplan Meier curves, and can determine, based on the tracking, whether a specific doctor associated with a patient is treating the patient in accordance with treatment techniques of other doctors treating other (similar) patients.
- the COTA module may also transmit an alert to the client device upon the occurrence of a trigger.
- a trigger may be, for example, at diagnosis, at progression, at dose change, at drug change, at toxicity, when trending towards variance from a desired outcome, and/or at a specific time.
- the first face comprises interactions between a medical care provider, a computer containing a processor comprising a first COTA module, a first client device comprising a second COTA module that is communicatively linked to the first COTA via a network, and a payer. It enables a payer to transmit via the first client device comprising a second COTA module communicatively linked to the first COTA module of the processor, a communication over the network to the processor identifying a health care service under consideration for a patient whose health plan benefits cover the service;
- the described invention provides a method for improving clinical outcomes at a specific patient level and for decreasing total cost of care at a population level comprising: A. interactions between a medical care provider, a computer containing a processor comprising a first clinical outcome tracking and analysis module, a first client device comprising a second clinical outcome tracking and analysis module that is communicatively linked to the first clinical outcome tracking and analysis module via a network, and a payer; and B interactions between the computer containing the processor comprising a first clinical outcome tracking and analysis module, a second client device comprising a third clinical outcome tracking and analysis module communicatively linked to the first clinical outcome tracking and analysis module via the network, and a patient, the computer containing the processor comprising the first clinical outcome tracking and analysis module executing on the processor comprising the first clinical outcome tracking and analysis module, steps comprising: (a) accounting for biological variance upfront by grouping patients in a patient population, thereby effectively removing biological variance as a factor in value of care, and leaving treatment variance as a predominant factor in treatment
- the system further comprises, with permission from the patient and the selected medical professional, transmitting the personal health information of the patient from the first clinical outcome tracking and analysis module, to a computing device comprising a fourth clinical outcome tracking and analysis module at the selected medical professional's office.
- the variables selected by the payer include variables that identify certain attributes of the personal health information as a desired set of characteristics; one or more attributes added by the payer to the personal health information to identify the personal health information of each patient as being on an equal level of importance to other health information in the patient population database, or both.
- the described invention provides a non- transitory computer readable medium storing computer program instructions for facilitating interactions (A) between a medical care provider, a computer containing a processor comprising a first clinical outcome tracking and analysis module, a first client device comprising a second clinical outcome tracking and analysis module
- the one or more bundles of predetermined patient care services provides a predetermined course of treatment, cost certainty for treatment of the condition, or both.
- Fig. 4A is a block diagram illustrating use of the COTA module to sort data associated with colon cancer patients in accordance with an embodiment of the present disclosure
- Fig. 20 is a flow diagram of feedback support provided to a medical professional in accordance with an embodiment of the present disclosure
- Fig. 25 shows a graphical representation illustrating the COTA module's data generation and sorting for breast oncology - breast cancer from year 2008 to year 2013 tumor grade and stage in accordance with an embodiment of the present disclosure
- Fig. 27 shows a graphical representation illustrating overall survival outcomes for breast cancer patients in accordance with an embodiment of the present disclosure
- Fig. 2 illustrates a block diagram of a server computer 205 (also referred to below as server 205) communicating with a user computer (also referred to herein as client device) 210 and a user computer (also referred to herein as computing device) 230 over network 215 to provide a clinical outcome tracking and analysis (COTA) module 220 to the user computer 210 and/or user computer 230 in accordance with one embodiment.
- Server 205 may generate and/or serve web pages, for example, to be displayed by a browser (not shown) of user computer 210 and/or user computer 230 over network 215 such as the Internet.
- a server may also include one or more mass storage devices, one or more power supplies, one or more wired or wireless network interfaces, one or more input/output interfaces, or one or more operating systems, such as Windows® Server, Mac® OS X®, Unix®, Linux®, FreeBSD®, or the like.
- Fig. 3 is a block diagram illustrating functions 300 provided by the COTA module 220 in accordance with one embodiment.
- Fig. 4A is a block diagram illustrating sorting data associated with colon cancer patients in accordance with one embodiment. Although described with respect to cancer, e.g., colon cancer, the description and figure can apply to any type of cancer or, in another embodiment, any type of disease for which there is data associated with patients. [0078] Data 410 is gathered for all cancers (or, in another embodiment, for more than one type of cancer, or, in other embodiments, for all cardiovascular diseases, pulmonary diseases, gastrointestinal diseases, neurological diseases, etc), and this data 410 is narrowed to a subset 420 relating to, e.g., colon cancer.
- This PHI is input for patient A into a browser.
- the PHI gets sent to a classification layer and a CNA is assigned, the CNA defining attributes of patient A's record, and then into the database, i.e., the set of patient attributes, which falls under this type of CNA, is joined to the CNA.
- the database will return all of patient A's information and the CNA assigned. Accordingly, the user immediately understands how this patient's symptoms/attributes should be handled, i.e., the user gets a snapshot of how that type of patient relates to other patients whose information is in the database.
- the string of digits representing the phenotype may be provided by representing characteristics of the phenotype as a directed graph.
- Fig. 4C illustratively depicts a directed graph 460 showing characteristics of a phenotype to provide a string of digits representing the phenotype in accordance with one embodiment.
- the directed graph 460 includes nodes representing phenotypes and edges representing a relationship between nodes. The graph is traced starting from root "start" node to nodes for a selected phenotype. Each edge is associated with a number.
- the string of digits representing the phenotype for the node address is provided as a combination of the numbers.
- Each bundle may also be associated with one or more nodes.
- the services included in each bundle may be determined by one or more medical professionals, a hospital, a group, an insurance company, etc. to optimize patient care and/or cost.
- a bundle may indicate a number of imaging scans, a drug or choice of drugs, a schedule of when to administer the drugs, an operation or procedure, a number and frequency of follow up visits, etc.
- the bundling of patient care services may be particularly useful for risk contracting.
- each bundle corresponding to a nodal address associated with a particular disease
- the data records for the clinically relevant patients are analyzed. Analyzing the data records may include tracking (e.g., in real time) clinical outcomes of patients associated with the disease.
- the outcomes may include, for example, delivered dose intensity, therapeutic agents received, dose, dose interval, and dose duration, incidence and severity of toxicity, cost, progression free survival (PFS), overall survival (OS), response rates, etc.
- the COTA module 220 may compare the tracked outcomes between patients.
- the COTA module 220 may also determine, based on the tracking, whether a specific doctor associated with a tracked patient is treating the patient in accordance with treatment techniques of other doctors treating other (similar) patients. In one embodiment, the COTA module 220 determines this based on the outcomes of many patients.
- the COTA module 220 may also include an analysis tool to the user computer 210 and/or user computer 230.
- This analysis tool may be a user interface that is accessible via a web page, a tab on an existing web page, a software application, an app, etc.
- the user interfaces as depicted in the figures herein are exemplary. This analysis tool may enable a user to compare, analyze, or further sort the data records.
- the health information may be received from the COTA module 220 executing on user computer 210.
- the health information of the patient may include the condition with which that the patient is diagnosed.
- the condition is selected with specificity by the patient via the COTA module 220 executing on user computer 210 from lists and sublists of conditions available in the database 240 of computer server 205.
- the COTA module 220 executing on server computer 205 determines a list of tests for further classifying the condition based on the received health information of the patient.
- the steps of Fig. 5B enable a patient diagnosed with a condition to optimize treatment options based on geographical limitations, clinical outcome, and cost criteria of the patient.
- Fig. 7 is a graphical representation illustrating a mobile device 705 (e.g., user computer 210) organizing alerts received by the device 705 in accordance with one embodiment.
- the COTA alerts received are listed by a title or subject, such as New Colon CA 710, New Renal Cell CA 715, Dose Adjustment 720, Drug
- Fig. 27 shows a graphical representation of an analysis screen 2700 illustrating overall survival outcomes for breast cancer patients in accordance with one embodiment.
- Fig. 28 shows a graphical representation 2800 illustrating survival outcomes for breast cancer as a comparison between Dr. John Doe (bold line) and the aggregate (non-bold line) parties, in accordance with one embodiment.
- Client device 2905 can also include one or more of a power supply 2926, network interface 2950, audio interface 2952, a display 2954 (e.g., a monitor or screen), keypad 2956, illuminator 2958, I/O interface 2960, a haptic interface 2962, a GPS 2964, a microphone 2966, a video camera, TV / radio tuner, audio/video capture card, sound card, analog audio input with A/D converter, modem, digital media input (HDMI, optical link), digital I/O ports (RS232, USB, FireWire, Thunderbolt), expansion slots (PCMCIA,
- a power supply 2926 e.g., network interface 2950, audio interface 2952, a display 2954 (e.g., a monitor or screen), keypad 2956, illuminator 2958, I/O interface 2960, a haptic interface 2962, a GPS 2964, a microphone 2966, a video camera, TV / radio tuner, audio/video capture card
- a module is a software, hardware, or firmware (or combinations thereof) system, process or functionality, or component thereof, that performs or facilitates the processes, features, and/or functions described herein (with or without human interaction or augmentation).
- a module can include sub-modules.
- Software components of a module may be stored on a computer readable medium. Modules may be integral to one or more servers, or be loaded and executed by one or more servers. One or more modules may be grouped into an engine or an application.
- persistent storage medium/media 3006 is a computer readable storage medium(s) that can be used to store software and data, e.g., an operating system and one or more application programs. Persistent storage medium/media 3006 can also be used to store device drivers, such as one or more of a digital camera driver, monitor driver, printer driver, scanner driver, or other device drivers, web pages, content files, playlists and other files. Persistent storage medium/media 3006 can further include program modules and data files used to implement one or more embodiments of the present disclosure.
- the first COTA module Upon exchanging a series of communications with the patient via the second client device comprising the third clinical outcome tracking and analysis module, the first COTA module does three things: it provides information to the patient so that the patient gets a complete medical evaluation of his/her condition (e.g., physical evaluation; laboratory evaluation; imaging, etc.) so that a CNA can be assigned; using the assigned CNA it shows the patient treatment options for the condition that optimize care and reduce risk of adverse variance; and it shows the patient doctors in his/her geographic area who follow CNA-Guided Care and have the best outcomes at an acceptable cost of care so that the patient can select a health care provider and a desired level of CNA-guided care, [00148] As depicted in Figure 32, from the payer's vantage point, the enabling tool can be effective to eliminate precertification for testing, diagnostics, and therapeutic choices; eliminate prior authorization; and eliminate the need for referrals.
- his/her condition e.g., physical evaluation; laboratory evaluation; imaging, etc.
- the enabling tool
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CA3042279A CA3042279A1 (fr) | 2016-11-14 | 2017-11-09 | Soins guides par cna pour ameliorer les resultats cliniques et diminuer les couts totaux des soins |
KR1020197017064A KR102579786B1 (ko) | 2016-11-14 | 2017-11-09 | 임상 결과들을 개선하고 총 케어 비용을 감소시키기 위한 cna-유도 케어 |
IL266481A IL266481B2 (en) | 2016-11-14 | 2017-11-09 | CNA-guided care to improve clinical outcomes and reduce the overall cost of care |
CN201780083458.XA CN110168659A (zh) | 2016-11-14 | 2017-11-09 | 用于改善临床结果并降低总护理费用的cna引导的护理 |
EP17869390.9A EP3539034A4 (fr) | 2016-11-14 | 2017-11-09 | Soins guidés par cna pour améliorer les résultats cliniques et diminuer les coûts totaux des soins |
JP2019546763A JP7079790B2 (ja) | 2016-11-14 | 2017-11-09 | 臨床転帰を改善し、総治療費を低減するためのcnaガイドケア |
JP2022083889A JP7355415B2 (ja) | 2016-11-14 | 2022-05-23 | 臨床転帰を改善し、総治療費を低減するためのcnaガイドケア |
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IL266481A (en) | 2019-07-31 |
KR20190077093A (ko) | 2019-07-02 |
EP3539034A1 (fr) | 2019-09-18 |
KR102579786B1 (ko) | 2023-09-15 |
EP3539034A4 (fr) | 2021-01-13 |
JP2020514888A (ja) | 2020-05-21 |
CN110168659A (zh) | 2019-08-23 |
CA3042279A1 (fr) | 2018-05-17 |
JP7355415B2 (ja) | 2023-10-03 |
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IL266481B1 (en) | 2024-03-01 |
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