Decision support platform
A medical decision system is implemented as a computer platform that extracts electronic medical record information associated with a patient receiving medical care. The platform also outputs a graphical user interface that facilitates navigation by a user, of an electronic guideline selected based upon an identification of the patient receiving medical care or selected information from the extracted electronic medical record information. Moreover, the platform stores a value for a tuning parameter that affects clinical decision making. Also, the platform generates a customized, clinical pathway for the patient receiving medical care using the value of the tuning parameter, where the generated clinical pathway recommends a future clinical service for the patient receiving medical care, and the clinical pathway is reconciled with actual costs of care extracted from electronically retrieved cost information. Yet further, the platform outputs to a first display screen, the generated clinical pathway.
1 . A medical decision system, the system comprising:
a computer-implemented platform that carries out computer program code to:
electronically extract electronic medical record information associated with a patient receiving medical care from at least one medical records data source;
output to a graphical user interface, an electronic guideline, where:
the electronic guideline is selected based upon at least one of an identification of the patient receiving medical care or selected information from the extracted electronic medical record information; and
the graphical user interface facilitates navigation of the electronic guideline;
store a value for a tuning parameter that affects clinical decision making, where the value for the tuning parameter is determined based upon at least one of: the identification of the patient receiving medical care, the extracted electronic medical record information, or information extracted from the electronic guideline; and
output to a first display screen, a generated clinical pathway, where the generated clinical pathway comprises a customized, clinical pathway for the patient receiving medical care using the value of the tuning parameter, wherein the generated clinical pathway recommends a future clinical service for the patient receiving medical care, and the clinical pathway is reconciled with actual costs of care extracted from electronically retrieved cost information.
2 . The system of claim 1 , where the platform further carries out program code to:
output an interface that allows the user to manually specify at least one of the tuning parameter or the value of the tuning parameter.
3 . The system of claim 1 , wherein:
the tuning parameter corresponds to biosimilar substitution and the value of the tuning parameter corresponds to a pre-programmed, default substitute biosimilar that is automatically substituted by the platform against a corresponding biologic.
4 . The system of claim 1 , wherein:
the electronic guideline comprises a select one of a payer guideline or an insurance guideline; and
the customized clinical pathway for the patient receiving medical care includes a biosimilar that is extracted from the electronic guideline.
5 . The system of claim 1 , wherein:
the output to the first display screen comprises indicia designating at least two user-selectable options, where a first one of the options corresponds to a first regimen at a first cost and the second one of the options corresponds to a second regimen at a second cost that is different to the first cost.
6 . The system of claim 5 , wherein:
the platform interacts with a risk assessment engine that outputs for each of the at least two user-selectable options, at least one risk assessment for the associated regimen.
7 . The system of claim 1 , wherein the tuning parameter affects the clinical pathway based upon at least one of time, treatment, risk assessment, patient-profile similarity, patient profile differences, extraction of data from one or more electronic guidelines, or a trajectory to transition an out-of-guideline patient into a selected electronic guideline.
8 . The system of claim 1 , wherein the tuning parameter affects the clinical pathway based upon individualized cost.
9 . The system of claim 1 , wherein the tuning parameter affects the clinical pathway based upon at least one of: cost for a next step in treatment, cost for a particular treatment, cost based upon treatment for a period, cost based upon total treatment.
10 . The system of claim 1 , wherein:
the platform outputs a prediction of future costs based upon at least one of:
future events in the generated clinical pathway; or
detected changes representing a diversion in a treatment regimen defined by the generated clinical pathway.
11 . The system of claim 1 , wherein the platform further carries out program code to:
perform compliance monitoring of the patient receiving medical care by tracking progress of the patient relative to the generated clinical pathway; and
output at least one of:
a message indicating the patient remains on the clinical pathway; and
a message indicating that the patient has deviated from the clinical pathway.
12 . The system of claim 1 , wherein the platform further carries out program code to:
output an interface that enables the user to select or modify a current value of the tuning parameter; and
interact with a model component that generates a model that models possible outcomes for the patient receiving medical care by following the clinical pathway based upon a current value of the tuning parameter.
13 . The system of claim 1 , wherein:
the user comprises a clinician; and
the platform further carries out program code to implement a first interface, wherein the clinician interacts with the first interface of the platform to evaluate cost of care to follow the clinical pathway based upon episode cost.
14 . The system of claim 1 , wherein:
the user comprises a clinician;
the platform further carries out program code to implement a first interface, wherein the clinician interacts with the first interface to track a progress of the patient receiving medical care as a function of adherence to the electronic guideline and/or to compare regimens generated as part of the clinical pathway.
15 . The system of claim 1 , wherein:
the electronic guideline comprises at least one of a payer guideline or an insurance guideline.
16 . The system of claim 1 , wherein:
the electronic guideline comprises a clinical treatment guideline.
17 . The system of claim 1 , wherein:
the platform further carries out program code to:
implement a guideline interface that generates the electronic guideline, the guideline interface configured to:
extract a guideline document;
parse the extracted guideline document to obtain a guideline; and
convert the obtained guideline into graph data within a navigable guideline model.
18 . The system of claim 17 , wherein:
the future clinical service is determined by interacting with the electronic guideline via the navigable guideline model, to select the future clinical service as a node in the navigable guideline model.
19 . The system of claim 18 , wherein:
the graph data within the navigable guideline model includes at least two user selectable nodes;
user selection of a select one of the at least two user selectable nodes functions as a navigable input into the navigable electronic guideline so as to chart a patient progression through a treatment plan associated with the clinical pathway.
20 . A computer-implemented process for building a care plan that is customized for a patient receiving medical care, comprising:
carrying out, by a computer-implemented platform, computer program code for:
electronically extracting electronic medical record information associated with the patient receiving medical care from at least one medical records data source;
outputting by a graphical user interface, an electronic guideline, where:
the electronic guideline is selected based upon at least one of an identification of the patient receiving medical care or selected information from the extracted electronic medical record information; and
the graphical user interface facilitates navigation of the electronic guideline;
storing a value for a tuning parameter that affects clinical decision making, where the value for the tuning parameter is determined based upon at least one of: the identification of the patient receiving medical care, the extracted electronic medical record information, or information extracted from the electronic guideline;
outputting to a display screen, a generated clinical pathway for the patient receiving medical care using the value of the tuning parameter to custom tailor the care plan for the patient receiving medical care, wherein:
the generated clinical pathway recommends a future clinical service for the patient receiving medical care; and
the clinical pathway is reconciled with actual costs of care extracted from electronically retrieved cost information.
21 . The computer-implemented process of claim 20 further comprising:
outputting indicia designating at least two user-selectable options, where a first one of the options corresponds to a first regimen at a first cost and the second one of the options corresponds to a second regimen at a second cost that is different to the first cost.
22 . The computer-implemented process of claim 20 further comprising:
providing an interface to enable a user to select the tuning parameter so as to affect the clinical pathway based upon at least one of cost, time, treatment, risk assessment, patient-profile similarity, patient profile differences, electronic guidelines, or a trajectory to transition an out-of-guideline patient into an electronic guideline.
23 . The computer-implemented process of 20 further comprising:
generating the electronic guideline by:
extracting a document via the guideline interface;
parsing the extracted document to obtain a guideline; and
converting the obtained guideline into graph data within a navigable guideline model; and
recommending a future clinical service by interacting with the navigable guideline model to select the future clinical service as a node in the navigable guideline model.