Abstract: A computerized system and method that allows healthcare providers to update the medical codes in health benefits provider member records using medical code models. Each medical code model has an identifier and associated medical codes. Each member record has a code model identifier that indicates which set of medical codes are appropriate for the member's medical conditions. In an example embodiment, the code model identifiers include a medical hierarchical condition code model, and an end-stage renal disease code model. When medical conditions are affirmed or added to a member's database medical record, the member's code model identifier is used to select the set of medical codes from which a computer user can choose. The use of the medical code model identifier limits a user's selection of medical codes and as a result, reduces the likelihood of medical record coding errors.

Abstract: Disclosed embodiments describe a system and method for identifying, evaluating and routing members of a healthcare benefits system to clinical interventions. The system includes various databases that comprise member claims data and provides the infrastructure to support the integration and exchange of data among representatives of a health benefits plan. It allows for more efficient use of information via the creation and evaluation of a clinical profile that is then used to identify the clinical interventions that may be appropriate for a member. The clinical data is matched to referral thresholds and other eligibility criteria for various clinical and disease management programs to identify appropriate interventions. Member progress in the interventions is tracked to determine whether additional interventions or actions may be needed to further engage the member in health-related activities. Members that do not respond to alerts for interventions may receive further alerts.

Abstract: An online game that provides a virtual village where users can communicate with one another, report information about themselves, and keep track of activities in the real world. Each user has an avatar that can be viewed by other users, and the avatars provide visual representations about the activities of their user. Users can participate in challenges with one another based on different activities, and activity data is either self-reported or reported by a variety of biometric devices. Activity data can provide a real-time visual representation of the activities of the users. Completion of activities and challenges earn users virtual points that may be used to obtain virtual rewards or real-life rewards. Calendars and other tools allow users to apprise others on their upcoming activities, as well as seek help or encouragement from others. Messaging capabilities allow users to share ideas and information through a variety of media.

Abstract: A centralized formulary system for maintaining formulary data to service the needs of multiple user groups. Formulary and drug information is updated automatically when received from outside sources. In addition to drug identifying data, line of business and utilization management protocol data is associated with the formulary data. The formulary data further comprises coverage data for health plans that use the formularies. The additional business data maintained in association with the formularies facilitates the retrieval and editing of formulary data for various business needs, including compliance with third party requirements. The system allows users to analyze formulary data, edit formulary data, produce reports regarding formulary data, and export files. The system also supports submission of formulary data to third party computer systems.

Abstract: The present invention is a system and method for providing medical care information to medical care providers identified through the analysis of electronic requests for reimbursement where such information may comprise treatment advice.

Abstract: A computerized health severity score predictive model for assigning a health severity score to a member of a health insurance member population is disclosed. The computerized system and method comprises a predictive model for scoring members. The predictive model is developed based on health insurance claim data. Member claim data may comprise eligibility, demographics, medical claims, pharmacy claims, pharmacy benefit management, laboratory test results, and disease management data. A utilization transition pattern is identified from a comparison of costs observed during a first year and a subsequent year. Members are segmented into groups according to predetermined segmenting rules derived from a segmentation model that applies the utilization transition pattern. The health severity score is thus based on demographic and clinical data as well as utilization transition pattern (or cost transition) data.

Abstract: A pharmaceutical verification (PV) camera system that captures an image of the contents of a vial on an automated dispensing line is closed. Faster image processing time is achieved by utilizing a learning algorithm that stores camera parameters for a successful image associated with data for a prescription processed on the automated dispensing line. During processing of a prescription order, when the vial contents and availability of stored parameters is confirmed, the stored parameters are transmitted to the camera and an image of the vial contents is captured and stored. When a previously un-encountered or un-trained vial is detected, the camera engages the autofocus feature to capture an image. The learning algorithm evaluates the image based on feedback from one or more metric. Upon agreement with the metric standards, an image is accepted and archived and the camera parameters associated with that vial prescription are stored for later use.

Abstract: An organization categorization system and method is disclosed. The organization categorization system and method relies on server data to discover which business organizations are consuming the finite resources of the server and in what proportions. Organizations are categorized according to their consumption of resources. The categorization system and method further ascribes a relative business value to each organization to facilitate the allocation of resources among the various organizations in a business. In an example embodiment, users of the server resources use the SAS programming language and the server resources execute SAS applications that support the SAS programming language. The organization categorization system and method connects an executed computer program to a business-defined classification of applicability to purpose.

Abstract: A computerized pain visualization system and method. A web-based application and interface allows individuals to anonymously share information about where they hurt or specific regions of the body that are most worrisome to them. The web-based application comprises a visual interface that supports selection of parts or regions on an image of a human body. The data becomes viewable and filterable by geographic location, age, sex, or a variety of other data sets collected from the anonymous users. In an example embodiment, Users register and sign in at a web site. A selectable body interface is presented and the user is prompted to select one or more pain locations on the virtual body. The user's selections are recorded in a database. Another page of the application presents a search option that facilitates searching and visualizing the data, filterable by users' registration information.

Abstract: An improved pharmaceutical vial processing system and method groups vials on an automated dispensing line according to diverting needs. The improved pharmaceutical vial processing system and method allows vials to travel in close groups. A diversion algorithm determines when gaps between vials are needed to reduce the likelihood that a mechanical diverting device engages the wrong vial to a new location on the dispensing line. The diversion algorithm identifies each vial that needs to be diverted to a target location and employs a “neighbor analysis” to determine whether a gap between neighboring vials is needed before a vial destined for the target station encounters a diverter. Vials that are destined for locations beyond the target station remain grouped. Vials that are behind a vial destined for the target station are held to introduce a gap between the vial destined for the target station and the remaining vials.

Abstract: A system and method that generates a physiological imagery of one or more parts of a patient's body are provided. The system and method combine one or more parameters relating to a particular part of the body and then generates the physiological imagery for the part of the body wherein the physiological imagery may have a characteristic that changes based on the state of the patient.

Abstract: A pharmaceutical verification (PV) camera system that captures an image of the contents of a vial on an automated dispensing line is closed. Faster image processing time is achieved by utilizing a learning algorithm that stores camera parameters for a successful image associated with data for a prescription processed on the automated dispensing line. During processing of a prescription order, when the vial contents and availability of stored parameters is confirmed, the stored parameters are transmitted to the camera and an image of the vial contents is captured and stored. When a previously un-encountered or un-trained vial is detected, the camera engages the autofocus feature to capture an image. The learning algorithm evaluates the image based on feedback from one or more metric. Upon agreement with the metric standards, an image is accepted and archived and the camera parameters associated with that vial prescription are stored for later use.

Abstract: A system and method for delivering a product such as a pharmacy bottle from a conveyor system to a delivery container via a delivery chute. A control system in communication with the components of the system detects when a product is ready for release into the chute for delivery based on information obtained by a scanner on the conveyor system.

Abstract: A portable electronic device that assists in the maintenance of a healthy lifestyle by recording biometric measurement data, confirming completion of healthy activities, and generating graphs from biometric measurement data. The device may comprise a speaker for providing instructions to users as to how the portable device is to be used, results of biometric measurements, counting down the time remaining until a biometric measurement has been obtained, etc. The device may connect to a remote computer of a health care facility, health care provider, or insurance provider. Completion data for health activities is recorded. As the user completes measurements or other health activities such as appointments, the third party may provide a code for the user to record in the device to signal completion of the activity. The device may also be used to record data related to a user's participation in a rewards program.

Abstract: A computerized method and system for managing a multi-function, integrated account. The account may span multiple legal entities and contain both health and wealth data. The account may contain data pertaining to participants' health insurance, supplemental insurance, and other types of insurance (both health and non-health) and may track payment data, claim data, co-pays, etc. as well as data pertaining to the health of participants. Health data may further comprise information pertaining to participants' weight, body mass index, blood pressure, and fitness level. The multi-function account comprises financial data such as investment data, brokerage data, mortgage data, and savings, debit, and credit account data. Participants are further rewarded for partaking in certain health and financial activities and for performing certain health and financial tasks. Participants may dial a single telephone number or access a single web site in order to access the health and wealth data of the multi-function account.

Abstract: A computerized system and method for the creation and management of fundraising events. The system and method support creation of fundraising groups comprising team members that participate in physical activity to raise donations for a certain entity or organization. Individual team members utilize a device (e.g., pedometer) that measures activity during a specified time period. Pledges for donations are made by sponsors that log into a website and pledge to donate a certain amount of money based on the physical activity performed by a fundraising team member. Some fundraising groups may comprise multiple teams. Different teams of the same group may have different fundraising goals or objectives. The website of the system may link a fundraising group to its different fundraising teams. All teams of a fundraising group may raise money for a single entity or the teams of a fundraising group may raise funds for different entities.

Abstract: An online game that promotes physical activity by visually representing the comparative biometric data of a group of people. The biometric data may be collected using a variety of biometric devices. Each individual in the group selects an avatar for use in representing the biometric data. The biometric data is transmitted to a server and displayed collectively on a computer screen. Each individual's avatar is displayed on the screen and animated according the biometric data. In an example embodiment in which avatars are fish that are displayed on a fish tank background and the biometric data is steps counted by a pedometer, avatars associated with individuals having a higher step count are positioned above avatars for individuals having a lower step count. Biometric data may be collected from biometric devices at various time intervals and the display updated to reflect the changes in biometric data.

Abstract: An automated system and method for use by health coaches to provide health coaching services to members of a health benefits plan. The platform supports the entry of member data, completion and analysis of assessments, and the development of a health or wellness plan or program for each member. Coaches develop health and wellness plans or programs for members by defining goals and one or more activities for each goal. The platform supports tracking of progress toward goals. Calendaring and task features allow the coach to remain in contact with members. The level of interaction between a coach and a member varies according to the member's needs so the calendaring and task features provide flexibility in scheduling initial and follow-up communications. In addition to defining tasks, coaches may enter progress notes that also assist the coach in determining the level and type of communication to initiate.

Abstract: A system and method for promoting physical activity in children and recruiting individuals to participate in the program for physical activity. Promotion of physical activity is centered around an entertainment event such as a movie release. A variety of physical activities are related to the entertainment event to encourage and entice children to participate. Children and their parents are directed to a website where they can learn about the entertainment event and how they can participate in the physical activities as well as to recruit other children to participate. Children participate in the physical activities and then track their participation at the web site. Prizes and rewards are issued to reward the children for their participation in the activities and to keep them interested in the program. The program combines the entertainment event with online and real world experiences while keeping the children engaged in physical activities.

Abstract: A conveyor process and system for sorting objects having a plurality of inbound conveyors in a vertically stacked configuration and a plurality of diversion conveyors connected to the inbound conveyors for diverting objects transported on the inbound conveyors to a particular outbound conveyor.