Invention Grant
- Patent Title: Computer-based systems and methods for action item evaluation and initiation via task data object generation
-
Application No.: US16904313Application Date: 2020-06-17
-
Publication No.: US11574731B2Publication Date: 2023-02-07
- Inventor: Scott D. Johnson , Mallory B. Van Horn , Michael B. Wentzien
- Applicant: Optum, Inc.
- Applicant Address: US MN Minnetonka
- Assignee: Optum, Inc.
- Current Assignee: Optum, Inc.
- Current Assignee Address: US MN Minnetonka
- Agency: Alston & Bird LLP
- Main IPC: G16H40/20
- IPC: G16H40/20 ; G06F9/48 ; G06Q10/10 ; G16H50/20 ; G06Q10/06 ; G16H10/60 ; H04L67/1097 ; G06F3/0482

Abstract:
To identify relevant action items (that may ultimately be reflected as claims data) for closing an identified gap in care reflected by combinations of disparate claims data records within a claims data store, a task-based interventional system executes rule-based models to determine action items eligible for closing a particular gap in care identified based on criteria associated with one or more programs. The task-based interventional system executes one or more machine-learning models to generate care scores associated with relevant entities associated with the identified gaps in care and generates a task data object comprising data indicative of an action item to close the gap in care together with executable jobs for initiating computer-based workflows to provide data indicative of the gap in care to relevant entities.
Public/Granted literature
Information query