Abstract: Predicting future healthcare costs is disclosed. A method includes: receiving medical care information (e.g., claims data) relating to patients; identifying, by a cost prediction module, a presence of one or more monitored events representing modifiable health risks when the claims data indicates that the patient is receiving medical care that is not in compliance with evidence-based medical standards; mapping, by the cost prediction module, each of the one or more monitored events to utilization and/or cost prediction values based on a status of each of the one or more monitored events; assigning, by the cost prediction module, for each of the one or more monitored events, a probability score for utilization of medical services based on the status of the monitored event; and calculating a prediction of future healthcare utilization and/or cost based on the probability score and status for each of the one or more monitored events.

Abstract: The present invention offers a comprehensive solution to care management which aggregates, integrates and stores clinical information from disparate sources. The system finds at-risk individuals before they experience preventable, high-cost medical events and stratifies high risk populations according to clinical criteria, which can include severity of disease states and co-morbidities. The system also compares the actual care an individual is receiving to established standards of clinical excellence and, if necessary, suggests pertinent medical care considerations to improve the care of medically mismanaged individuals. Another feature of the present invention may include a secure, patient-specific Web page which is automatically populated with a patient's own clinical information and can be personalized with customized, relevant healthcare information. The system allows users to design, facilitate and monitor clinical care plans and increase communications among physicians, nurses and patients.

Abstract: An automated system is described for presenting a patient with an online interactive personal health record (PHR) capable of delivering individualized alerts based on comparison of evidence-based standards of care to information related to the patient's actual medical care. A health care organization collects and processes medical care information, including clinical data relating to a patient in order to generate and deliver customized clinical alerts and personalized wellness alerts directly to the patient via the PHR. The PHR also solicits the patient's input for tracking of alert follow-up actions and allows the health care organization to track alert outcomes. Further embodiments include implementing a plurality of modules for providing real-time processing and delivery of clinical alerts and personalized wellness alerts to the patient via the PHR and to a health care provider via one or more health care provider applications, including disease management applications.

Abstract: An automated system is described for presenting a patient with an interactive personal health record (PHR) capable of delivering individualized alerts based on comparison of evidence-based, best standards of care to information related to the patient's actual medical care. This will assure the patient that the PHR is providing him or her with optimal health care. A health care organization collects and processes a wide spectrum of medical care information, including clinical data relating to a patient and condition-specific medical reference data, in order to generate and deliver customized alerts, including Care Considerations and personalized wellness alerts, directly to the patient via an online interactive personal health record (PHR). In addition to aggregating patient-specific medical record and alert information, the PHR also solicits the patient's input for tracking of alert follow-up actions and allows the health care organization to track alert outcomes.

Abstract: The present invention offers a comprehensive solution to care management which aggregates, integrates and stores clinical information from disparate sources. The system finds at-risk individuals before they experience preventable, high-cost medical events and stratifies high risk populations according to clinical criteria, which can include severity of disease states and co-morbidities. The system also compares the actual care an individual is receiving to established standards of clinical excellence and, if necessary, suggests pertinent medical care considerations to improve the care of medically mismanaged individuals. Another feature of the present invention may include a secure, patient-specific Web page which is automatically populated with a patient's own clinical information and can be personalized with customized, relevant healthcare information. The system allows users to design, facilitate and monitor clinical care plans and increase communications among physicians, nurses and patients.

Abstract: The present invention offers a comprehensive solution to care management which aggregates, integrates and stores clinical information from disparate sources. The system finds at-risk individuals before they experience preventable, high-cost medical events and stratifies high risk populations according to clinical criteria, which can include severity of disease states and co-morbidities. The system also compares the actual care an individual is receiving to established standards of clinical excellence and, if necessary, suggests pertinent medical care considerations to improve the care of medically mismanaged individuals. Another feature of the present invention may include a secure, patient-specific Web page which is automatically populated with a patient's own clinical information and can be personalized with customized, relevant healthcare information. The system allows users to design, facilitate and monitor clinical care plans and increase communications among physicians, nurses and patients.

Abstract: The present invention offers a comprehensive solution to care management which aggregates, integrates and stores clinical information from disparate sources. The system finds at-risk individuals before they experience preventable, high-cost medical events and stratifies high risk populations according to clinical criteria, which can include severity of disease states and co-morbidities. The system also compares the actual care an individual is receiving to established standards of clinical excellence and, if necessary, suggests pertinent medical care considerations to improve the care of medically mismanaged individuals. Another feature of the present invention may include a secure, patient-specific Web page which is automatically populated with a patient's own clinical information and can be personalized with customized, relevant healthcare information. The system allows users to design, facilitate and monitor clinical care plans and increase communications among physicians, nurses and patients.