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A system and method for compliance checking

IP.com Disclosure Number: IPCOM000210883D
Publication Date: 2011-Sep-14
Document File: 7 page(s) / 140K

Publishing Venue

The IP.com Prior Art Database

Abstract

Although, clinical guidelines are regarded as best practice for physicians, physician activities are not always compliant with guideline decisions. In this disclosure, a system and method for guideline-based compliance checking with clinician activities is proposed. Specifically, our solution will address three incompliance problems. First is that guideline recommends, clinician did, but differently. Second is that guideline recommends, but clinician did nothing. Third is that guideline does not recommend, but clinician did. In the literature, rules or computational logics were used to check the first incompliance problem, leaving the second and third incompliance problems unsolved. Differently, our disclosure leverages the timeline of clinical data, to address all the three incompliance problems in an efficient and effective way.

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Page 01 of 7

A system and method for compliance checking

Clinical guidelines are systematically developed statements to assist practitioner and patient decisions about appropriate healthcare for specific clinical circumstances. Although it has been widely accepted that clinical guidelines can improve the quality of healthcare while reducing the cost, clinician activities are not always compliant with guidelines.

For instance, use of metformin is recommended for people who are newly diagnosed as diabetes mellitus and overweight with HbA1c <= 9%, referring to the diabetic guideline. However, reviewing clinical documentsof an overweight diabetic patient, his first prescription was use of sulphonylurea and at that time, his HbA1c lab test result was 7.6%. That is, the clinician who firstly prescribed for the patient did not act compliantly with the diabetic guideline.

With a wider adoption of clinical guidelines in healthcare, the incompliance report becomes more and more important. First, it is required by executives of care providers, and actually, such incompliance reports provide a good performance measurement for clinicians. Second, it is expected by insurance companies, and imaginably, if most of clinician activities are incompliant in some healthcare entity, then this entity may be removed from the assigned list of insurance hospitals.

In this trend,

we propose a system and method for guideline-based compliance checking with clinician activities. Actually, pre arts mainly focused on providing

clinical decision support at point of care,

with byproduct of compliance checking.

The so-called "point of care" means that compliance checking can be

conducted by interaction with clinicians. However,

when facing to historical clinical data, incompliance needs be detected in a retrospective way, and

the above

example illustrated that we need to dig out patientstates and clinician activities among clinical documents. Thus, our challenge is how to find an efficient and effective way to identify the following three incompliance categories.

To check the correctness of clinical activity: that is, guideline recommends, clinician did, but differently To check the sufficiency of clinical activity: that is, guideline recommends, but clinician did nothing
To check the necessity of clinical activity: that is, guideline does not recommend, but clinician did

Below illustrates our compliance reports.

1



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In this disclosure,

we propose a system and method for guideline-based

                                               compliance checking with clinician activities. Below is our system architecture. The two components in solid box, i.e., data coordinatorand compliance checker, are our components,

while the dashed one, i.e., a decision maker, is

an external

component. With input of clinical data, the data coordinator is responsible to generate two intermediate objects, one is the clinician activity (as shown in arrow1) and the other is the pati...