Prosecution Insights
Last updated: April 19, 2026
Application No. 18/401,762

SYSTEM AND METHOD FOR DETERMINING VERACITY OF PATIENT DIAGNOSES WITHIN ONE OR MORE ELECTRONIC HEALTH RECORDS

Final Rejection §101
Filed
Jan 02, 2024
Examiner
GILLIGAN, CHRISTOPHER L
Art Unit
3683
Tech Center
3600 — Transportation & Electronic Commerce
Assignee
Humana Inc.
OA Round
4 (Final)
57%
Grant Probability
Moderate
5-6
OA Rounds
3y 10m
To Grant
97%
With Interview

Examiner Intelligence

Grants 57% of resolved cases
57%
Career Allow Rate
278 granted / 486 resolved
+5.2% vs TC avg
Strong +40% interview lift
Without
With
+39.5%
Interview Lift
resolved cases with interview
Typical timeline
3y 10m
Avg Prosecution
32 currently pending
Career history
518
Total Applications
across all art units

Statute-Specific Performance

§101
28.6%
-11.4% vs TC avg
§103
36.5%
-3.5% vs TC avg
§102
12.0%
-28.0% vs TC avg
§112
16.0%
-24.0% vs TC avg
Black line = Tech Center average estimate • Based on career data from 486 resolved cases

Office Action

§101
Notice of Pre-AIA or AIA Status The present application is being examined under the pre-AIA first to invent provisions. Response to Amendment In the amendment filed 01/02/2026, the following has occurred: claims 2-4, 6, 17-18, and 21 have been amended, claims 19-20 have been canceled, and claim 22 has been added. Now, claims 2-18 and 21-22 are pending. The previous rejections under 35 U.S.C. 112(a) and (b) are withdrawn based on the amendments to the claims. Claim Rejections - 35 USC § 101 35 U.S.C. 101 reads as follows: Whoever invents or discovers any new and useful process, machine, manufacture, or composition of matter, or any new and useful improvement thereof, may obtain a patent therefor, subject to the conditions and requirements of this title. Claims 2-18 and 21-22 are rejected under 35 U.S.C. 101 because the claimed invention is directed to an abstract idea without significantly more. Step 2A Prong One Claim 2 recites receiving health data for a patient comprising a diagnosis, diagnosis-specific dimension values, diagnosis specific weighting, and a diagnosis specific function comprising variables for each of the dimensions and weighting values; determining a veracity score for the diagnosis by applying the weighting values and the dimension values to the function; display the veracity score, the diagnosis, and supporting reasoning for the diagnosis comprising the dimension values provided in a format; display in association with the diagnosis a veracity feedback tool comprising user input options for indicating provider agreement or disagreement with the diagnoses and the supporting reasoning; receiving healthcare provider input data indicating selection of one of the agreement and disagreement options at the veracity feedback tool for the diagnosis; automatically adjusting the weighting values in response to the healthcare provider input data and storing the adjusted weighting values; and utilizing the adjusted weighting values in a subsequent veracity score determination. Claim 2, as drafted, given the broadest reasonable interpretation, but for the recitation of generic computer components, encompass Mathematical Concepts and Certain Methods of Organizing Human Activity. The steps of identifying dimensions, assigning weighting values to the dimensions based on a numerical scale, calculating a veracity score by adding weighting values for the dimensions, determining a veracity score by applying the weighting values and dimension values, and adjusting weighting values for use in subsequent scores are textual descriptions are applying mathematical operations. Mathematical Concepts includes mathematical relationships between variables or numbers and may be written in text format. See MPEP 2016.04(a)(2). Additionally, retrieving patient data and outputting results encompass manual personal interactions between people sharing medical information, which falls under the Certain Methods of Organizing Human Activity grouping of abstract ideas. Finally, providing a feedback tool, receiving user input of agreement or disagreement with the diagnosis to update data encompass a user being provided with a paper form to provide feedback on calculated results. This encompasses an individual following rules or instructions, which is a subgrouping of Certain Methods of Organizing Human Activity. Claim 17 recites health records, associated with patients and including diagnoses; functions, each of which is specific to one or more of the diagnoses; dimensions, each of which is specific to one or more of the diagnoses and includes a value, wherein said values of said dimensions comprise a type of entity which recorded the diagnosis, including one of an institution, the patient, and a caregiver associated with a level of training, the physical location of the diagnosis, including one of a nursing home, a hospital, a laboratory, and an imaging facility, the date of the diagnosis, related similar but different diagnoses from different entities, medication taken which suggest the particular diagnosis, medical procedures performed which suggest the particular diagnosis, and lab values which suggest the particular diagnosis; and weighting values, each of which is specific to one or more of the dimensions; and, on a diagnosis and patient specific basis: retrieve at least part of a particular health record of the health records for a particular patient; retrieve a particular function of the functions associated with a particular diagnosis contained within the particular health record; retrieve each of the values of the dimensions and each of the weighting values associated with the particular diagnosis; and apply each of the retrieved values of the dimensions and each of the retrieved weighting values to the retrieved function to arrive at a veracity score; display the particular diagnosis, the veracity score, and supporting reasoning for the veracity score; and a prompt requesting user input regarding veracity of the particular diagnosis, said prompt comprising a confirm indication and a disavow indication displayed in association with the supporting reasoning; receive user input comprising data indicating selection of one of the confirm indication and the disavow indication; and generate instruction to replace at least one of the one or more weighting values associated with the particular diagnosis with one or more updated weighting values, where the one or more updated weighting values is greater than the one or more weighting values to be replaced when the received user input indicated selection of the affirmation option, and where the one or more updated weighting values is less than the one or more weighting values to be replaced wherein the received user input indicated selection of the disavow option. Claim 17, as drafted, given the broadest reasonable interpretation, but for the recitation of generic computer components, encompass Mathematical Concepts and Certain Methods of Organizing Human Activity. The steps of establishing functions for a patient’s diagnosis, dimensions, and weighting values, and applying the functions, values, and dimensions to arrive at a veracity score, as well as performing these steps for updated values, are textual descriptions of applying mathematical operations. Mathematical Concepts includes mathematical relationships between variables or numbers and may be written in text format. See MPEP 2016.04(a)(2). Additionally, retrieving patient data and outputting results encompass manual personal interactions between people sharing medical information, which falls under the Certain Methods of Organizing Human Activity grouping of abstract ideas. Finally, providing a feedback tool, receiving user input of agreement or disagreement with the diagnosis to update data encompass a user being provided with a paper form to provide feedback on calculated results. This encompasses an individual following rules or instructions, which is a subgrouping of Certain Methods of Organizing Human Activity. Claims 3-16, 18, and 21-22 incorporate the abstract idea identified above and recite additional limitations that expand on the abstract idea, but for the recitation of generic computer components. For example, claims 3-16, 18, and 22 further expand on the dimensions, weighting values, veracity score, use of feedback, types of entities, location of diagnosis, and health record data used with dimension values. Claim 21 further defines the health data as a standardized diagnostic code (e.g. ICD9). As explained above, these recitations steps encompass Mathematical Concepts and Certain Methods of Organizing Human Activity. Step 2A Prong Two This judicial exception is not integrated into a practical application because the remaining elements amount to no more than general purpose computer components programmed to perform the abstract ideas along with insignificant, extra-solution data gathering and transmitting activity. Claims 2-16 and 21-22, directly or indirectly, recite the following generic computer components configured to implement the abstract idea: “electronically” performing steps, “electronically determining, at the one or more servers,” “electronically displaying, by way of the one or more servers and a visualization dashboard generator, and at an electronic device associated with one of the EMR systems,” “a veracity feedback tool comprising electronic interactive user input,” “by way of the one or more servers,” “at the one or more data stores,” “at the one or more servers.” Claims 17-18, directly or indirectly, recite the following generic computer components configured to implement the abstract idea: “health care provider devices, remote from one another and each comprising an electronic medical record (EMR) system); one or more data stores,” “data stored at the EMR systems,” “a diagnosis assessment unit comprising: a diagnosis veracity score unit,” “a visualization dashboard generator configured to display, at a particular one of the healthcare provider devices, a diagnosis dashboard” “a feedback processing system configured to: display, at the particular healthcare provider device,” “wherein the healthcare provider devices, the one or more data stores, and the diagnosis assessment unit are in electronic communication by way of the one or more networks comprising the internet.” Each of the above identified additional elements encompass generic computer components and the written description discloses the generic computer components including “a computer processor that has sufficient processing power, memory, display capabilities and wireless/wired connectivity circuitry” (see paragraph 0015). As set forth in the MPEP 2106.04(d) “merely including instructions to implement an abstract idea on a computer” is an example of when an abstract idea has not been integrated into a practical application. Claims 2-18 and 21-22, directly or indirectly, recite the following additional elements at a high level of generality, involving no more that extra-solution data gathering and transmitting activity: “electronically receiving, at one or more servers, by way of an internet connection, and from a plurality of disparate, remote electronic medical record (EMR) systems, electronic health data,” “electronically receiving, at the one or more servers and from the electronic device.” These additional elements are recited at a high degree of generality and are merely involved in insignificant extra solution data gathering and transmitting of data over a generic computer network. As set forth in MPEP 2106.05(g) insignificant, extra-solution activity, such as insignificant acquisition and data transmission, is an example of when an abstract idea has not been integrated into a practical application. Step 2B The claim(s) does/do not include additional elements that are sufficient to amount to significantly more than the judicial exception because as discussed above with respect to integration into a practical application, the additional elements are recited at a high level of generality, and the written description indicates that these elements are generic computer components. Using generic computer components to perform abstract ideas does not provide a necessary inventive concept. See Alice, 573 U.S. at 223 (“mere recitation of a generic computer cannot transform a patent-ineligible abstract idea into a patent-eligible invention.”). Insignificant, extra solution, data gathering activity (e.g. transmitting and receiving data over a computer network including the internet) has been found to not amount to significantly more than an abstract idea (see MPEP 2106.05(g) and Electric Power Group, LLC v. Alstom S.A., 830 F.3d 1350, 1354-55, 119 USPQ2d 1739, 1742 (Fed. Cir. 2016)). Storing and retrieving information in memory (e.g. receiving and storing data in one or more data stores) has been recognized as well-understood, routine, and conventional activity of a general-purpose computer (see MPEP 2106.05(d) and Versata Dev. Group, Inc. v. SAP Am., Inc., 793 F.3d 1306, 1334, 115 USPQ2d 1681, 1701 (Fed. Cir. 2015); OIP Techs., 788 F.3d at 1363, 115 USPQ2d at 1092-93). Affinity Labs of Texas v. DirecTV, LLC, 838 F.3d 1253, 120 USPQ2d 1201 (Fed. Cir. 2016)). Additionally, the aforementioned additional elements, considered in combination, do not provide an improvement to a technical field or provide a technical improvement to a technical problem. Therefore, whether considered alone or in combination, the additional elements do not amount to significantly more than the abstract idea. Differentiating Subject Matter Claims 2-18 and 21-22 distinguish over the prior art. The following is a statement of reasons for the indication of differentiating subject matter: The primary reason that claims 2-20 distinguish over the prior art is the inclusion of the combination of limitations of retrieving or accessing patient health records including a diagnoses, values of dimensions for the diagnoses, weighting values specific to the diagnoses for the dimensions, and a function for the diagnosis including the weighting values and variables, displaying, in association with each other, the veracity score, diagnosis, and weighting, and displaying a feedback tool in association with the displayed elements to receive user input agreeing or disagreeing with the diagnosis on the display, and using the feedback to update the weights for subsequent veracity scores. The closest prior art (St. Clair, Denekamp, PGPub 2011/0257988, and DeBruin, PGPub 2011/0119212) describes retrieving diagnosis data from a patient record, applying a weighted function specific to the diagnosis, receiving feedback, and displaying the results. However, the prior art does not describe the particular combination of displayed elements and feedback tool, used in combination to update weighting data for subsequent veracity scores, as recited in the combination of limitations. Response to Arguments In the remarks filed 01/02/2026, Applicant argues (1) the claimed visualization dashboard and electronic devices integrate the abstract idea into a practical application by facilitating human feedback through a specific feedback tool; (2) the claimed invention provides an improvement in network communication, similar to DDR Holdings; In response to argument (1), while the examiner acknowledges that the claims recite numerous additional elements in the form of a visualization dashboard and multiple devices, it is respectfully maintained that all of these additional elements amount to no more than generic computer components used as tools to implement the abstract idea and insignificant, extra-solution data gathering and transmitting activity. Using a server, electronic devices, network/internet communication, and a visualization dashboard (such as a GUI) in combination defines a generic computer network architecture. This combination of elements amounts to no more than generic computer components used as a tool to implement the abstract idea. As set forth in the MPEP 2106.04(d) “merely including instructions to implement an abstract idea on a computer” is an example of when an abstract idea has not been integrated into a practical application. Additionally, improvements to determining veracity of patient diagnoses is not an improvement to a technical field. Rather this is a business improvement to the patient healthcare field. As explained at MPEP 2106.04(d)(1), one of the ways that an abstract idea may be integrated into a practical application is by disclosing and claiming an improvement to a technical field. Applicant further highlights the technical improvement as a specific visual output and feedback tool. However, the recited visual output is only specific in the content that is displayed, not a particular structure of the display. Dependent claim 4 further defines the visual output as a table with columns and rows. However, simply arranging output in a spreadsheet format does not provide a particular technical improvement. Importantly, the specification does not describe an output with rows and columns as providing a technical improvement. As set forth in MPEP 2106.04(d)(1) “ the specification should be evaluated to determine if the disclosure provides sufficient details such that one of ordinary skill in the art would recognize the claimed invention as providing an improvement…it must describe the invention such that the improvement would be apparent to one of ordinary skill in the art.” Here, the specification does not set forth such an improvement from a rows and columns display. In response to argument (2), the claims in DDR provide a technical solution to a problem rooted in computer technology. Simply adding a generic computing device that performs generic computer functions is not equivalent or similar to addressing an Internet or network centric challenge as is the case in DDR. While the claims are directed to a process that is performed on a computer, they are not directed to a technical challenge that is particular to the Internet. In fact, the claims are not directed to the use of the Internet at all or functions that are particular to the Internet such as the generation of a web page as is the case in the claims of DDR. Applicants highlight the use of a feedback tool on the visualization dashboard to receive feedback on the provided analysis. As set forth in the rejections, receive such user feedback is part of the abstract idea and providing a user interface to carry this out simply amounts to providing generic computer components to carry out this abstract idea. Therefore, because the claims fail to provide a technical solution to any network or Internet-centric challenges, the ordered combination of limitations do not amount to significantly more than the abstract idea. Additionally, with respect to paragraphs 0028-0029, the description of using feedback from providers to improve future diagnoses describes part of the managing of personal behavior, following rules or instructions, which is a subgrouping of Certain Methods of Organizing Human Activity. Conclusion THIS ACTION IS MADE FINAL. Applicant is reminded of the extension of time policy as set forth in 37 CFR 1.136(a). A shortened statutory period for reply to this final action is set to expire THREE MONTHS from the mailing date of this action. In the event a first reply is filed within TWO MONTHS of the mailing date of this final action and the advisory action is not mailed until after the end of the THREE-MONTH shortened statutory period, then the shortened statutory period will expire on the date the advisory action is mailed, and any nonprovisional extension fee (37 CFR 1.17(a)) pursuant to 37 CFR 1.136(a) will be calculated from the mailing date of the advisory action. In no event, however, will the statutory period for reply expire later than SIX MONTHS from the mailing date of this final action. Any inquiry concerning this communication or earlier communications from the examiner should be directed to C. Luke Gilligan whose telephone number is (571)272-6770. The examiner can normally be reached Monday through Friday 9:00 - 5:00. Examiner interviews are available via telephone, in-person, and video conferencing using a USPTO supplied web-based collaboration tool. To schedule an interview, applicant is encouraged to use the USPTO Automated Interview Request (AIR) at http://www.uspto.gov/interviewpractice. If attempts to reach the examiner by telephone are unsuccessful, the examiner’s supervisor, Robert Morgan can be reached on 571-272-6773. The fax phone number for the organization where this application or proceeding is assigned is 571-273-8300. Information regarding the status of published or unpublished applications may be obtained from Patent Center. Unpublished application information in Patent Center is available to registered users. To file and manage patent submissions in Patent Center, visit: https://patentcenter.uspto.gov. Visit https://www.uspto.gov/patents/apply/patent-center for more information about Patent Center and https://www.uspto.gov/patents/docx for information about filing in DOCX format. For additional questions, contact the Electronic Business Center (EBC) at 866-217-9197 (toll-free). If you would like assistance from a USPTO Customer Service Representative, call 800-786-9199 (IN USA OR CANADA) or 571-272-1000. C. Luke Gilligan Primary Examiner Art Unit 3683 /CHRISTOPHER L GILLIGAN/ Primary Examiner, Art Unit 3683
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Prosecution Timeline

Jan 02, 2024
Application Filed
Nov 15, 2024
Non-Final Rejection — §101
Feb 10, 2025
Response Filed
Mar 24, 2025
Final Rejection — §101
May 19, 2025
Response after Non-Final Action
Jun 26, 2025
Request for Continued Examination
Jun 30, 2025
Response after Non-Final Action
Oct 07, 2025
Non-Final Rejection — §101
Jan 02, 2026
Response Filed
Mar 02, 2026
Final Rejection — §101 (current)

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Study what changed to get past this examiner. Based on 5 most recent grants.

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Prosecution Projections

5-6
Expected OA Rounds
57%
Grant Probability
97%
With Interview (+39.5%)
3y 10m
Median Time to Grant
High
PTA Risk
Based on 486 resolved cases by this examiner. Grant probability derived from career allow rate.

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