WO1997050050A1

WO1997050050A1 - System for automated patient discharge planning

Info

Publication number: WO1997050050A1
Application number: PCT/US1997/011151
Authority: WO
Inventors: James E. Helmink; Chris A. Abernathy; Jeffrey S. Ramsey; Matthew W. Crane
Original assignee: Apex Information Services, Inc.
Priority date: 1996-06-27
Filing date: 1997-06-26
Publication date: 1997-12-31
Also published as: AU3580397A; CA2239358A1

Abstract

A system and method for automated patient discharge planning is disclosed. Using the present invention, a primary care facility discharge planner may use an automated procedure to place a patient in a secondary care facility anywhere in the United States regardless of the target location. The system comprises computers (10, 12), local and wide area network connections (14, 18), and application programs for accessing local and national databases (16, 20) containing information regarding secondary care facilities located throughout the United States. The method comprises the steps of entering a target location (30), determining whether a local or national database is to be searched (32), locating candidate secondary facility records (34) and transmitting patient information to select candidate facilities (38, 42). Reduced reliance on manual placement procedures results in significant cost savings due to a reduction in the patient's length of stay in the primary care facility.

Description

SYSTEM FOR AUTOMATED PATIENT DISCHARGE PLANNING

TECHNICAL FIELD

The present invention relates generally to a system for automated planning procedures

to accomplish the placement of hospital patients into facilities providing other levels of care.

More specifically, this invention relates to a computer system for locating a secondary care

facility, in a desired geographic region, that provides an appropriate level of care for a patient

who is ready to be discharged from a primary care facility. The system of the present

invention has been documented to reduce Hospital Length of Stay (LOS) an average of 2-3

days per patient for those patients going directly from hospitals to nursing homes. With use

of the present invention, cost savings for placing patients as soon as they are medically ready

to leave the hospital have been documented at over $ 1 ,000,000.00 per year at large hospitals.

BACKGROUND ART Discharge planning procedures are used by hospitals to place patients who require

continuing care following release from the hospital to facilities that provide an appropriate

level of care. For example, a patient may require a ventilator, tube feedings, wound care,

dialysis, etc. following discharge from the hospital. Facilities that provide various levels of

continuing care for discharged patients include nursing homes, rest homes, hospices, home

care settings, etc.

Today, most hospitals use manual discharge planning procedures. A hospital

discharge planner who is responsible for placing a patient in a nursing home starts the process

by calling nursing homes to explain the patient's needs and the condition of the patient. If the

nursing home is capable of providing the appropriate level of care, it then reviews its current

bed inventory to determine whether it can accept the patient. This typically requires the planner to call 10 or more facilities in order to locate one that may accommodate the patient. .

Furthermore, the planner may have time to call only a few facilities during the day because

the patient's needs and condition must be discussed at length with each facility's admissions

coordinator. This manual process is very time consuming because it takes many phone calls

to find a place for the patient. The planner may not reach the nursing home admissions

coordinator on the first call and therefore, must wait for a return call. When the coordinator

returns the call, the planner may not be available to accept it. Consequently, it may take

several days for the planner to place the patient. The process is inefficient for both planners

and admissions coordinators. More importantly, the cost to the hospital for every day that a

patient who is ready to leave is not transferred to another facility ranges between $400 and

$1200 per day.

Some hospitals today use planning procedures supported by a semi-automated system

that allows planners to access a database containing current bed inventories and limited

information regarding services provided for a number of facilities in a geographic region.

Generally, the database is remotely located so that the bed inventory may be kept current. To

use the system, the planner enters a minimal amount of patient information (e.g., relating

generally to the level of care required) and the patient's sex. The system then searches the

database to locate candidate facilities capable of providing the level of care required and with

an available bed based on the patient's sex, but does not provide a list of facilities in location

code sequence. The planner then uses manual procedures to contact the candidate facilities.

The reliance on manual procedures to contact the candidate facilities and discuss the patient

in detail greatly reduces the effectiveness of the semi-automated system.

Other automated systems allow planners to access local databases containing

information regarding facilities within the geographic region of the hospital. These systems

A- allow the planner to enter detailed patient information regarding the patient's needs and

condition. To use the system, the planner enters information concerning the level of care

required, the services required, payor source information, etc. The system then searches the

local database to locate candidate facilities that meet the specific needs of the patient. The

planner may then arrange to have the detailed patient information, including the level of care

required and services required, transmitted automatically and simultaneously to the candidate

facilities. Each candidate facility reviews the comprehensive patient information and decides

whether it can accept the patient.

Although the automated processes are more convenient for planners and admissions

coordinators, the usefulness of these automated systems is limited by the fact that planners

cannot search for facilities outside the geographic region of the hospital. Planners frequently

search for facilities outside the geographic region of the hospital because the patient lives

outside the hospital's geographic region. In addition, planners are frequently asked to search

for facilities outside the hospital's geographic region by family members of the patient who

prefer a facility in their geographic region rather than the geographic region of the hospital.

For example, a patient in a hospital in Chicago may have a family member in Dallas who

would like to have the patient placed in a Dallas rather than a Chicago facility. To do so, the

planner must resort to the manual procedure. In many instances, the planner is not familiar

with facilities in the desired location so additional research must be done to learn about the

remote facilities before the planner may contact them. This increased reliance on manual

procedures results in increased costs to the hospital.

There is a need for a patient discharge planning system that reduces reliance on

manual procedures (i.e., manual procedures to research and learn about facilities, telephonic

communications to contact facilities and discuss patient needs, etc.) The present invention increases the capabilities of current automated planning systems by allowing planners to

place patients in facilities outside the geographic region of the hospital. After locating

candidate facilities, planners may arrange to have detailed and comprehensive patient

information transmitted to them automatically. The present invention reduces planning and

execution time so planners may assist a larger number of patients in a shorter period of time.

Alternatively, use of the present invention may reduce the number of planners needed to

process discharged patients. Hospital costs are reduced because patients are placed in

facilities 2 to 3 days faster than when manual procedures are used.

SUMMARY OF THE INVENTION

There is disclosed a system that automates planning discharge procedures for the

placement of a patient from a primary care facility (e.g., hospital, clinic, physician's office,

outpatient clinic, nursing home, rest home) to a secondary care facility (e.g., nursing home,

rest home, hospice, home care setting, clinic, physician's office.) It is contemplated that a

primary care facility could be any facility that provides services commensurate with the

patient's immediate needs. It is contemplated that a secondary care facility could be any

facility that provides services commensurate with the patient's long term needs. Therefore, it

is contemplated that, for example, a primary care facility could be a nursing home and a

secondary care facility could be a home care service. Also the secondary care facility could

be a community service such as "meals on wheels". The primary and secondary care

facilities could also be two different nursing homes.

The system is comprised of client computers that interact, via local and wide area

network connections, with server computers to locate information needed to place a patient.

Detailed information regarding secondary care facilities is stored in records in a national database located at a service bureau. Information from the national database is replicated in

records in local databases at primary care facilities throughout the United States. Patient

information is also stored in records in a local database. Planners placing a patient within the

geographic region of the primary care facility access the local database. Planners placing a

patient outside the geographic region of the primary care facility access a wide area network

connection to the national database in order to find secondary care facilities in the target

geographic region.

To begin the planning process, the planner enters the requirements and conditions of

the patient into a computer. The planner also enters a code (e.g., zip code) for the target

location of the secondary care facility. The system then determines whether the local

database or the national database is to be searched. If the target location is outside the

geographic region represented in the local database, a connection is made to the service

bureau national database. Using the location code, the system locates records from either the

local database or the national database for secondary care facilities that meet the patient's

specific requirements and conditions. The planner is then presented with a list of candidate

facilities that meet exactly the needs of the patient. The planner may then choose which

facilities to contact. The planner may contact facilities immediately using an automated

patient data transmission feature of the system. Using this feature, detailed patient

information is transmitted automatically to the candidate facilities thereby obviating the need

for the planner to use manual procedures to contact the facilities. The candidate facilities

willing to accept the patient may respond to the planner by calling, sending a fax, or sending

e-mail. The planner may then review the responses with the patient and family members to

determine which facility is most appropriate. The planner may then accept one of the offers

r from the candidate facilities and make final arrangements to place the patient and to complete

the discharge procedure.

There is also disclosed a system for placement of a patient from a primary care facility

to a secondary care facility. The system is comprised of a) location data for regional

secondary care facilities, b) input for the desired location of the secondary care facility, and c)

a means for comparing the desired location input with location data for regional secondary

care facilities. The system is further comprised of d) a means for obtaining data on a

secondary care facility if the desired location is not found in the location data for regional

secondary care facilities. Representative location data for regional secondary care facilities

and for desired location input includes zip codes, area codes, and zones. The means for

obtaining data on a secondary care facility not found in the location data further comprises e)

a means for accessing a remote database containing data for secondary care facilities in a

plurality of regions and f) a means for searching a table to locate secondary care facilities

with location codes that are adjacent to the desired location.

There is also disclosed a method for the placement of a patient from a primary care

facility to a secondary care facility. The method comprises the steps of 1) obtaining and

storing patient data which includes a desired location of the secondary care facility, 2)

obtaining and storing data for secondary care facilities that are located in the geographic

region of the primary care facility, 3) comparing the patient data with the secondary care

facilities data, and if the comparison results in no matches, 4) obtaining and storing data for

secondary care facilities outside the geographic region of the primary care facility.

Additional patient data considered in locating a secondary care facility includes the level of

care required, the services required by the patient and patient financial information. The step

for obtaining and storing data for secondary care facilities outside the geographic region of

G the primary care facility further comprises the steps of 5) establishing a connection to a

remote database that contains data for secondary care facilities outside the geographic region

of the primary care facility and 6) searching for secondary care facilities with location codes

that match the desired location as well as for secondary care facilities that have location codes

adjacent to the desired location. Additional steps comprise 6) sending patient data to some of

the secondary care facilities located during the search for secondary care facilities outside the

geographic region of the primary care facility or selecting any requested facility not found in

the search and 7) responding to receipt of the patient data by sending electronic mail from the

located secondary care facilities to the primary care facility. Data for secondary care facilities

within a geographic region may be replicated from a remote database containing data for

secondary care facilities located in a plurality of geographic regions.

to a secondary care facility comprising a) a means for entering and storing patient data that

includes the desired location of the secondary care facility and optionally the level of care

required, the services required by the patient, and financial information of the patient, b) a

means for storing and retrieving regional secondary care facility data, c) a means for

comparing the patient data with the regional secondary care facility data, and if no matches are found, d) a means for obtaining secondary care facility data wherein the means comprise

e) a connection to a remote database containing secondary care facility data which is a

superset of the regional secondary care facility data, and f) a means for comparing the patient

data with the secondary care facility data in the remote database. Patient data may also

include financial information. The system further comprises g) a means for displaying results

of the comparisons between the patient data and secondary care facility data and h) a means

for transmitting the patient data to the displayed secondary care facilities. Regional secondary care facility data are replicated from a remote database containing secondary care

facility data for a plurality of regions and are stored in a local database. The means for

comparing the patient data with the secondary care facility data includes i) a means for

locating secondary care facilities with location codes matching the desired location and for

locating secondary care facilities with location codes adjacent to the desired location.

BRIEF DESCRIPTION OF THE DRAWINGS

Figure 1 is a block diagram of the primary elements for a preferred embodiment of the

present invention;

Figure 2 is a flowchart of the primary steps for a preferred embodiment of the present

invention; and Figure 3 is a flowchart of the steps for locating a facility based on a location code.

DETAILED DESCRIPTION OF THE INVENTION

Referring to Figure 1, a block diagram of the primary elements for a preferred

embodiment of the present invention is shown. To accomplish the system and method of the

present invention, primary care facility (e.g., hospital, clinic, outpatient clinic, nursing home,

physician's office) discharge planners interact with application programs running on client

computers 10, 12. The client application program is comprised of a series of screens that

allow for the entry of detailed patient information and review of information regarding

candidate secondary care facilities (e.g., nursing homes, rest homes, hospices, home care

settings). Preferably, the data entry screens resemble patient assessment documents (PAD)

which are standard documents used by many primary and secondary care facilities. The PAD

may include: • patient demographic information including name, address, sex, age, height,

weight, primary physician ,etc.

• level of care including subacute, rehabilitation hospital, rest home, hospice,

nursing home, etc.

• services required including occupational therapy, speech therapy, physical

therapy, chemotherapy, brain or spinal injury, tube feedings, dietary restrictions,

dialysis, etc.

• general medical information and results from lab tests

• general physician orders, prescriptions, special instructions

• detailed information regarding specific wound care, therapies needed, etc.

• guardian or family information

• financial, insurance, or payor source information

Use of a standard document format (e.g., PAD) facilitates communications between

primary and secondary care facilities and may obviate the need to translate documents or

records from one format to another. Furthermore, planners and admissions coordinators who

are familiar with the comprehensive information provided by the standard form may quickly

locate needed information and may use the form as the basis for communicating with one

another. Screens may also be provided for such functions as setting print and fax options, for

searching records, for reviewing candidate facilities, and for discharging a patient.

In a multi-user environment, client computers 10, 12 located throughout the primary

care facility and a database server 16 for the facility may be connected via a local area

network 14. Small primary care facilities may be serviced by a single computer. Preferably,

one of the computers at the primary care facility (e.g., a hospital server 16) is capable of

connecting to a remote, national database server 20 that contains information regarding f secondary care facilities throughout the country. A connection to the national database may

be made if the target location of the secondary care facility is outside the geographic region

represented in the local database. The national database may be located at a service bureau

responsible for maintaining it. The connection to the national database 20 may be established

through a wide area network 18, preferably, the Internet. For example, the computer may be

equipped with a modem (e.g., 28.8Kbps) to establish a dedicated Serial-Line Internet Protocol

(SLIP) or Point-to-Point Protocol (PPP) connection to the Internet. Alternatively, a private wide area network may be used.

The national database 20 containing secondary care facility data may be accessible

using a relational query language such as the industry standard SQL which is well known in

the art. Data for a secondary care facility may include location and contact data (including fax information and directions to the facility), level of care provided (e.g., rehabilitation

hospital, subacute, etc.), services provided (e.g., occupational/physical therapy, ventilators,

tube feedings, dialysis, etc.), payor source information. Preferably, each facility provides the

same comprehensive data so the same information is used for comparisons between facilities.

Data may be uploaded to the service bureau's computers or service bureau employees may

enter the data directly. The national database may also contain non-confidential, statistical

patient and placement information for tracking placements made with the system. Preferably,

the national database has a replication feature so data may be downloaded to primary care

facilities for local processing.

Preferably, the national database server is also equipped with a table, file, data

records, etc. that indicate the relative geographic location of each secondary care facility. For

example, the location data for each secondary care facility may include the zip code for the

facility. The server may then be equipped with a table that indicates which zip codes are adjacent to a particular zip code. For example, the table may indicate that zip code 43224 is

adjacent to 43211, 43201, and 43229 (among others). Given a particular zip code, records

with matching zip codes as well as records with zip codes surrounding the given zip code

may be retrieved. A given zip code and adjacent or surrounding zip codes thus define a

geographic region in which a particular group of secondary care facilities are located. The

number of adjacent or surrounding zip codes to be considered may be variable so that the

boundary of the geographic region may be expanded or contracted.

The primary care facility database server 16 preferably contains a subset of data from

the national database (i.e., the same secondary care facility data, but only for those facilities

within the geographic region of the primary care facility.) The use of a persistent connection

to the Internet allows the local database to be updated frequently (preferably, several times a

day) so discharge planners may access the most recent information regarding secondary care

facilities within the local geographic region. Access to recent information increases the

likelihood that proposed placements actually occur.

In a preferred embodiment of the present, subsets of data are replicated from the

remote, national database to local, primary care facility databases to increase the efficiency of

the system. Most patient placements are within the geographic region of the primary care

facility. Overall processing time may be reduced if planners are able to access a local

database to perform the majority of searches. Alternatively, all data from the national

database may be replicated locally. However, this approach requires a significant increase in

primary care facility computing resources without a commensurate increase in benefit. The

additional data are likely to be accessed infrequently at best and possibly, not at all.

Alternatively, all national and local data could be stored only at the service bureau so that

planners access only the national database. This approach requires a significant increase in

// computing resources for both the primary care facilities and the service bureau and does not

introduce any additional benefits. The increased burden placed on the service bureau would

result in increased search times, even for the placement of patients in local secondary care

facilities. The additional time required to place the patient results in increased costs to the

hospital.

Preferably, the primary care facility database server is also equipped with a table, file,

data records, etc. that indicate the relative geographic location of each secondary care facility

in the local area. For example, the primary care facility may have a zip code table arranged

similarly to the table for the national database server, but for only the zip codes represented in

the immediate geographic area of the facility.

Referring to Figure 2, the primary steps for a preferred embodiment of the present

invention are shown. To begin the discharge planning process, the user (i.e., planner) enters

patient information 30 into a computer. The patient information may include the level of care

required (e.g., rehabilitation hospital, assisted, subacute, etc.), the services that the patient

requires (e.g., a ventilator, tube feedings, wound care, dialysis, etc.), and payor source or

insurance information, etc. Preferably, as many services as needed by the patient may be

specified. Other data may be entered as well. Alternatively, the information may already be

stored so the user enters only a patient identifier to retrieve the patient's record from, for

example, a local database or the hospital database. The user also enters a code (e.g., zip code)

for the target or desired location of the secondary care facility. The system then determines

whether the local database or the national database is to be searched 32. If the target location

is outside the geographic region represented in the local database, a connection is made via a

wide area network to a remote, national database. Using the target location code, secondary

care facility records from either the local database or from the service bureau national database that meet the patient's specific requirements (i.e., level of care required, services

required, desired location, insurance or payor source information, etc.) are retrieved 34.

Records from candidate facilities that match the selection criteria are then presented to the

user 36. The user may then choose which candidate facilities to contact and optionally, print

profiles for each candidate facility 38. Candidate records may then be stored in the local

database for later retrieval 40. Finally, patient reports may be transmitted immediately to the

candidate facilities selected by the user 42. Preferably, the patient reports are in the form of

PADs as used by primary and secondary care facilities throughout the United States so that

each facility receives comprehensive patient information to consider. Patient reports may be

transmitted using means such as e-mail or fax and may be received by a variety of means

such as e-mail or a fax machine. The candidate facilities willing to accept the patient may

respond to the PADs by calling, sending a fax, or sending e-mail to the user.

In response to the candidate facility offers, the user makes final arrangements to place

the patient and to complete the discharge procedure. Using a facility profile feature of the

present invention, the user may print detailed profiles for each of the candidate facilities to

give to the patient and/or family members to aid them in selecting a facility. Preferably, the

profiles contain information about the services provided by the facility as well as contact

information and directions to locate the facility in the event family members would like to

visit the facility.

Referring to Figure 3, the steps for locating a facility based on a location code are

shown. A location code may be used to search a particular geographic region or area. In a

preferred embodiment of the present invention, the location code is a zip code. In an

alternative embodiment of the present invention, an area code may be used as a location code. Other types of encoding may be used to define geographic regions (e.g., associating each

secondary care facility with a zone, using a nearest neighbor algorithm, etc.)

To begin the process of locating secondary care facility records in a preferred

embodiment of the present invention, a target zip code entered by the user is compared with

local zip code information (e.g., stored in a table, file, database, etc.) to determine whether the

local secondary care facility database may be searched to locate a secondary care facility 50.

In most cases, the target zip code is the zip code of the patient or a family member of the

patient.

In a preferred embodiment of the present invention, zip code information is arranged

in a table to indicate which zip codes are adjacent to a given zip code. If the zip code is found

within the local zip code table 52, then local secondary care facility records are searched 54.

If the zip code is not found within the local zip code table 54, the user is given the option of

proceeding to search the national database. If the user decides to proceed, a connection is

made to the service bureau so the national database may be searched. After the connection is

established, a national zip code table is searched 56. If the zip code is found 58, then national

secondary care facility records are searched 60. If the zip code is not found 58, then an error

message is presented to the user 62. In an alternative embodiment of the present invention, a

connection to the national database may be established automatically when the target zip code

is not found in the local zip code table.

The remaining steps are the same whether the local database or the national database

is to be searched. A provider table with information about secondary care facilities in the

geographic region of the target zip code is read 64. (The provider table may contain complete

information about secondary care facilities or it may contain limited information and indices

to complete secondary care facility records.) Using information in the provider table to locate secondary care facility records, the selection criteria are then applied to the retrieved records.

Initially, records with the exact zip code as the target zip code are retrieved. If the facility

provides the level of care needed and otherwise meets the selection criteria (e.g., provides all

the services required by the patient, meets insurance requirements, etc.), then the record is

marked as a candidate facility. Next, if fewer than a pre-set number of candidate facilities

have been located (preferably, 36) 66, records with zip codes adjacent to the target zip code

are retrieved 68. The additional selection criteria are applied (i.e., level of care, services

required, payor source, etc.) to determine which records may be marked as candidate facilities

64. If fewer than a pre-set number of candidate facilities have been located (e.g., 36) 66,

records with zip codes adjacent to the zip codes retrieved in the previous step are located 68.

Once again, additional selection criteria are applied. The process repeats until a pre-set

number of candidate facilities have been retrieved or a pre-set number of adjacent zip codes

(preferably, 8) have been processed 66. The candidate facility records are presented to the

user for further consideration and processing as described above.

BEST MODE In actual use, the present invention is installed in a multi-user environment in a hospital and is used by discharge planners for placement of patients in regional and non-

regional nursing homes. The invention may be better understood in view of the following

example which is illustrative only and should not be construed as limiting the invention.

Example The present invention is installed in a multi-user environment in a hospital in

Cleveland, Ohio. The hospital's database server is equipped with a modem and Internet

domain name so that the hospital server may communicate, via the Internet, with the computers at a National Service Bureau. The National Service Bureau develops and

maintains a national database containing information regarding nursing homes located

throughout the United States. Servers at the National Service Bureau are also equipped with

commercially available zip code tables that indicate the zip codes adjacent to a given zip

code. Using the Internet connection between the National Service Bureau's server and the

hospital server, information regarding nursing homes in the Cleveland area is downloaded

from the national database to a local database on the hospital server. The hospital server is

also equipped with a commercially available zip code table that lists adjacent zip codes for

the local area.

A female patient in the Cleveland hospital is ready to be discharged from the hospital,

but needs to go to a nursing home and requires continuing care including a ventilator and dialysis. The patient is also covered by Medicare. The patient has a family member who

lives in Dallas and would like the patient to be placed in a nursing home in Dallas. A

discharge planner who has no knowledge of nursing homes in the Dallas area starts the

application program in which the present invention is embodied in order to start the planning

process. The planner enters the services required (ventilator, dialysis as indicated above), the

level of care needed (nursing home as indicated above), and payor source information

(Medicare as indicated above) so the facility matching process may begin. The planner also

enters the zip code of the Dallas family member — 75201.

First, the local zip code table is searched to determine whether the local database may

be searched. The Dallas zip code 75201 is not found in the Cleveland zip code table so the

planner is prompted to enter another zip code or to enter an "out-of-territory mode" so the

national database may be searched. The planner selects the out-of-territory option and a

connection is made to the National Service Bureau. Once connected to the National Service Bureau, the planner is prompted again for the Dallas zip code 75201. The national zip code

table is searched to determine whether nursing homes may be located for the Dallas zip code.

If the Dallas zip code 75201 is not found, the planner sees an error message. If the Dallas zip

code 75201 is found, the matching process begins.

The matching starts by locating all nursing homes with the exact zip code (75201) as

the Dallas zip code entered by the planner. Next, the level of care required (nursing home),

services required (ventilator, dialysis), and insurance information (Medicare) are compared

with the nursing home data to determine whether the nursing home is a candidate for the

patient. If a nursing home meets the selection criteria, a candidate record is written. Next, all

zip codes adjacent to the Dallas zip code 75201 are retrieved and saved (e.g., 75202, 75203,

75205). Nursing home records for the adjacent zip codes are then searched to determine

whether they meet the selection criteria. For nursing homes meeting the selection criteria,

candidate records are written. The records that do not match are discarded. Next, using the

adjacent zip codes (i.e., 75202, 75203, 75205) located in the previous step, their adjacent

codes are read and saved. The same process is repeated until either 36 candidate nursing

homes are found or 8 relative positions are processed.

After the search is completed, the candidate nursing home records for the Dallas area

are displayed on a candidate screen for the planner to review. The planner selects candidates

to contact. The system then automatically transmits detailed patient information to the

candidate nursing homes by connecting to a server at the National Service Bureau to locate

fax information for the selected candidate nursing homes. The PAD is then faxed

immediately to each selected candidate facility in the Dallas area. The admissions

coordinators for the nursing homes respond to the planner's faxed PAD by accepting the

Cleveland patient or requesting additional information. The planner then accepts the offer

/1 from the nursing home that best meets the needs of the patient and family member.

Arrangements may then be made to complete the discharge process and transport the

Cleveland patient to the Dallas nursing home. The planner is thus able to place the Cleveland

hospital patient in a Dallas nursing home without any prior knowledge of nursing homes in

the Dallas area.

Non-confidential information relating to the placement of the patient from a

Cleveland hospital to a Dallas nursing home may be collected and stored automatically by the system for tracking purposes. For example, the system may record the date the transaction

occurred, identification data for the originating and target facilities, data regarding the

services required, etc. so that placement data may be aggregated and reports on for example,

clinical demographics, may be generated.

INDUSTRIAL APPLICABILITY

With the present invention, a discharge planner may use an automated procedure to

place a patient in a secondary care facility regardless of the target location. The ability to use

an automated procedure to obtain candidate secondary care facility records and automatically

contact candidate facilities, regardless of target location, is unique to the present invention.

The present invention obviates the need for the discharge planner to resort to manual

procedures to place patients in secondary care facilities outside the geographic region of the

primary care facility. The reduction in the use of manual procedures results in significant

cost savings to primary care facilities. Use of the present invention in one clinic reduced the

Hospital Length of Stay (LOS) an average of 2-3 days per patient for those patients going

directly to nursing homes. The cost savings for the clinic equated to over $1,000,000.00 per

year.

/T The use of automated procedures to plan patient discharges facilitates the collection of

non-confidential data regarding patient placements. The data regarding each placement may

then be aggregated and analyzed to generate reports regarding facility demographics that may

be useful to both discharge planners and primary/secondary care facilities. For example,

planners and primary care facilities may obtain information regarding which secondary care

facilities are most likely to accept a certain type of patient. A secondary care facility may

obtain information regarding those primary care facilities that are most likely to place patients

in its facility. The data may also be aggregated and analyzed to determine the effectiveness

of the system itself. For example, usage of the system may be monitored so those facilities

that make the greatest number of placements and the fewest number of placements may be

contacted directly for suggestions on improving the system. Health care vendors may use this

information to determine what areas of the region are experiencing greater demand for

particular services such as dialysis, wound care, etc. This information may also be used by

nursing homes and home health providers to assess their services in relation to current market

conditions.

While the system and method herein described constitute a preferred embodiment of

this invention, it is to be understood that the invention is not limited by the particular

arrangement of computers, databases, and associated functionality. Changes may be made

therein without departing from the scope of the invention which is defined in the appended

claims.

/?

Claims

WHAT IS CLAIMED IS:

1. A system for placement of a patient from a primary care facility to a secondary care

facility, said system comprising:

a) location data for regional secondary care facilities;

b) input for desired location of said secondary care facility;

c) means for comparing input for desired location of said secondary care facility with

location data for regional secondary care facilities; and

d) means for obtaining data on a secondary care facility not found in said location

data for regional secondary care facilities.

2. The system of claim 1 wherein said location data for regional secondary care facilities

and said input for desired location are selected from the group of zip codes, area

codes, or zones.

3. The system of claim 1 wherein said means for obtaining data on a secondary care

facility not found in said location data includes means for accessing a remote database

containing data for secondary care facilities in a plurality of regions.

4. The system of claim 1 wherein said means for obtaining data on a secondary care

facility not found in said location data includes means for searching a table to locate

secondary care facilities having location codes adjacent to said desired location.

5. The system of claim 1 further comprising means for recording non-confidential

information regarding said placement for statistical purposes.

6. The system of claim 1 wherein said primary care facility and said secondary care

facility may be selected from the group of hospital, clinic, outpatient clinic,

physician's office, community services, nursing home, rest home, hospice, and home

care setting.

7. A method for the placement of a patient from a primary care facility to a secondary

care facility, said method comprising the steps of:

a) obtaining and storing patient data, said patient data comprising a desired location

of said secondary care facility;

b) obtaining and storing data for secondary care facilities within a geographic region

of said primary care facility;

c) comparing said patient data with said data for secondary care facilities; and

d) obtaining and storing data for secondary care facilities outside said geographic

region of said primary care facility when no matches are found in c).

8. The method of claim 7 wherein said patient data further comprises level of care

required by said patient and services required by said patient.

9. The method of claim 7 wherein the step of locating data for secondary care facilities

outside said geographic region further comprises the steps of:

e) establishing a connection to a remote database containing data for secondary care

facilities outside said geographic region;

H f) locating secondary care facilities with location codes matching said desired

location of said secondary care facility; and

g) locating secondary care facilities with location codes adjacent to said desired

location of said secondary care facility.

10. The method of claim 9 further comprising the step of:

h) matching data for said secondary care facilities located in steps f) and g) with said

patient data.

11. The method of claim 10 further comprising the step of:

i) sending said patient data to select ones of said secondary care facilities matched in

step h).

12. The method of claim 11 further comprising the step of:

j) responding to receipt of said patient data by sending electronic mail from said

secondary care facilities selected in step i) to said primary care facility.

13. The method of claim 7 wherein said primary care facility and said secondary care

facility may be selected from the group of hospital, clinic, outpatient clinic,

care setting.

14. The method of claim 7 further comprising the step of recording non-confidential

information regarding said placement for aggregation and analysis.

15. The method of claim 7 wherein said data for secondary care facilities within a

geographic region are replicated from a remote database containing data for secondary

care facilities located in a plurality of geographic regions.

16. A system for placement of a patient from a primary care facility to a secondary care

facility, said system comprising:

a) means for entering and storing patient data, said patient data comprising desired location of said secondary care facility;

b) means for storing and retrieving regional secondary care facility data;

c) means for comparing said patient data with said regional secondary care

facility data;

d) means for obtaining secondary care facility data if no matches are found in

step c), said means comprising a connection to a remote database, said remote

database containing secondary care facility data which is a superset of said

regional secondary care facility data;

e) means for comparing said patient data with said secondary care facility data;

f) means for displaying results of step e); and

g) means for transmitting said patient data to secondary care facilities displayed

in step f).

17. The system of claim 16 wherein said regional secondary care facility data are stored in

a local database.

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18. The system of claim 16 wherein said regional secondary care facility data are

replicated from a remote database containing secondary care facility data for a

plurality of regions.

19. The system of claim 16 wherein said patient data further comprises financial or insurance information for said patient.

20. The system of claim 16 wherein said means for comparing said patient data with said

secondary care facility data includes means for locating secondary care facilities with

location codes matching said desired location and for locating secondary care facilities

with location codes adjacent to said desired location.

21. The system of claim 16 wherein said primary care facility and said secondary care

facility may be selected from the group of hospital, clinic, outpatient clinic,

care setting.

22. The system of claim 16 wherein said patient data additionally comprises the level of

care required by said patient.

23. The system of claim 16 wherein the patient data additionally comprises the services

required by said patient.

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