DETAILED ACTION
Acknowledgements
This office action is in response to the claims filed November 25, 2025.
Claims 1-10 and 12-20 are pending.
Notice of Pre-AIA or AIA Status
The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA .
Response to Amendment(s)
Claims 1-20 are pending.
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 1-10 and 12-20 are rejected to under 35 U.S.C 101 as not being directed to eligible subject matter based on the grounds set out in detail below:
Independent Claims 1, 15, and 19:
Eligibility Step 1 (does the subject matter fall within a statutory category?):Independent Claims 1 and 19 fall within the statutory category of machine. Independent claim 15 falls within the statutory category of method.
Eligibility Step 2A-1 (does the claim recite an abstract idea, law of nature, or natural phenomenon?): Independent claims 1, 15, and 19 claimed invention is directed to an abstract idea without significantly more.
The claim elements which set forth the abstract idea in the independent claim 1:
An automated triage comprising:
automatically: receive demographics data for a patient;
access or receive a medical history for the patient;
receive a medical complaint about a present medical condition;
triage the patient based on the demographic data, the medical history, and the medical complaint to determine a level of urgency of treatment needed by the patients
select an appointment service type for servicing the patient based on results of the triage to reduce unnecessary emergency room visits provide a response to the patient including the appointment service type selected;
and initiate the appointment by outputting at least one control signal to order, allocate, or reserve at least one resource for performance of the appointment without requiring nurse intervention.
The claim elements which set forth the abstract idea in the independent claim 15:
A method comprising:
Displaying a patient identification one or more fields configured to receive identification and
Displaying a triage…[…]…having one or more fields configured to receive medical complaint information;
determining a virtual care condition existence based on the medical complaint information;
displaying…[…]… where a virtual care condition exists;
and displaying …[…]…where no virtual care condition exists.
And automatically outputting to reserve at least one resource for the virtual visit or alternate care based on the determined condition existence without requiring nurse intervention.
The claim elements which set forth the abstract idea in the independent claim 19:
display a patient identification having one or more fields configured to receive identification or location information from a patient;
display a triage having one or more fields configured to receive medical complaint information;
determine a condition type based on the medical complaint information, wherein the condition type is one of a virtual care condition, an emergency condition, or a primary care condition;
display if a virtual care condition exists;
display if an emergency condition exists;
and display if a primary care condition exists.
And automatically output to order, allocate, or reserve at least one resource based on the determined condition type without requiring nurse intervention.
The abstract idea is “certain methods of organizing human activity” by following rules and instructions to triage a patient and order, allocate, reserve, or initiate an appointment for a patient (see MPEP § 2106.04(a)(2))
Eligibility Step 2A-2 (does the claim recite additional elements that integrate the judicial exception into a practical application?): For Independent claims 1, 15, and 19 judicial exception is not integrated into a practical application.
Independent claim 1 recites the additional claim elements below:
System with at least one memory configured to store a plurality of programmable instructions; and at least one processing device in communication with the at least one memory;
Examiner takes the applicable considerations stated in MPEP 2106.04 (d) and analyzes them below in light of the instant applications disclosure and claim elements as a whole.
The additional element, system with at least one memory configured to store a plurality of programmable instructions; and at least one processing device in communication with the at least one memory, is performing the abstract idea and is merely recited as “apply-it” or an equivalent as a general purpose compute tool to implement the abstract idea ( see page 29 lines 10-15)
Independent claim 15 recites the additional claim elements below:
a graphical user interface with display
a virtual visit screen
a primary care physician screen
at least one control signal
Examiner takes the applicable considerations stated in MPEP 2106.04 (d) and analyzes them below in light of the instant applications disclosure and claim elements as a whole.
No additional element is performing the abstract idea.
The remaining additional elements, (a), (b), (c), and (d), are merely recited as “apply-it” or an equivalent as tool to implement the abstract idea of gathering and outputting data.
Independent claim 19 recites the additional claim elements not already recited in independent claims 1 and 15 below:
A system- comprising one or more computer modules
an emergency department screen
Examiner takes the applicable considerations stated in MPEP 2106.04 (d) and analyzes them below in light of the instant applications disclosure and claim elements as a whole.
additional element (a) is performing the abstract idea merely recited as “apply-it” or an equivalent as tool to implement the abstract idea of gathering and outputting data.
The additional elements, (b), is merely recited as “apply-it” or an equivalent as tool to implement the abstract idea of gathering and outputting data.
Accordingly, independent claims 1, 15, and 19 as a whole do not integrate the recited abstract idea into a practical application (MPEP 2106.05(f) and 2106.04(d)(1).
Eligibility Step 2B (Does the claim amount to significantly more?): The independent claims do does not include additional elements that are sufficient to amount to significantly more than the judicial exception because the computer element as analyzed above in step 2A prong 2, is merely applying the abstract idea and therefore, does not amount to significantly more. The claim is patent ineligible.
Dependent Claims 2-10-12-4, 16-18, and 20
Eligibility Step 1 (does the subject matter fall within a statutory category?):The dependent claims 16-18 fall within the statutory category of method. The dependent claims 2-10, 12-14 and 20 fall within the statutory category of machine.
Eligibility Step 2A-1 (does the claim recite an abstract idea, law of nature, or natural phenomenon?): Dependent claims 2-10, 12-14, 16-18, and 20 claimed invention is directed to an abstract idea without significantly more. The claims continue to limit the independent claim 1, 15, and 19 abstract idea by (1) further limiting the appointment service, (2) further limiting gathering patient data, and (3) further limiting recommending a provider. Therefore, the dependent claims inherit the same abstract idea “certain methods of organizing human activity” by following rules and instructions to triage a patient and order, allocate, reserve, or initiate an appointment (see MPEP § 2106.04(a)(2))
Eligibility Step 2A-2 (does the claim recite additional elements that integrate the judicial exception into a practical application?): For claims 2-10, 12-14, 16-18, and 20 this judicial exception is not integrated into a practical application.
The dependent claims recite the below additional elements not already recited in the independent claims
Machine learning
a database
a virtual visit
a button
a virtual waiting room
Examiner takes the applicable considerations stated in MPEP 2106.04 (d) and analyzes them below in light of the instant applications disclosure and claim elements as a whole.
The additional elements, (a), is recited in the manner of generally linking the abstract idea to the technical environment of artificial intelligence
The additional elements, (c) and (e), are recited in the manner of generally linking the abstract idea to the technical environment of computer implementation
The additional elements, (b) and (d), are recited in the manner of apply-it or an equivalent to apply the abstract idea to gather and output data
Accordingly, the dependent claims as a whole do not integrate the recited abstract idea into a practical application (MPEP 2106.05(f) and 2106.04(d)(1).
Eligibility Step 2B (Does the claim amount to significantly more?): The dependent claims do not include additional elements that amount to significantly more for the same reasons given in Prong 2. The claims are patent ineligible.
Claim Rejections - 35 USC § 103
In the event the determination of the status of the application as subject to AIA 35 U.S.C. 102 and 103 (or as subject to pre-AIA 35 U.S.C. 102 and 103) is incorrect, any correction of the statutory basis (i.e., changing from AIA to pre-AIA ) for the rejection will not be considered a new ground of rejection if the prior art relied upon, and the rationale supporting the rejection, would be the same under either status.
The following is a quotation of 35 U.S.C. 103 which forms the basis for all obviousness rejections set forth in this Office action:
A patent for a claimed invention may not be obtained, notwithstanding that the claimed invention is not identically disclosed as set forth in section 102, if the differences between the claimed invention and the prior art are such that the claimed invention as a whole would have been obvious before the effective filing date of the claimed invention to a person having ordinary skill in the art to which the claimed invention pertains. Patentability shall not be negated by the manner in which the invention was made.
Claims 1, 2, 3, 4, 5, 6, 7, 8, 11, 12, and 13 are rejected under 35 U.S.C. 102(a)(2) as being anticipated by Skowronski et. al (hereinafter Skowronski) (US20140019162A1) In view of Hosny et. al (hereinafter Hosny) (US11676709B2)
As per claim 1, Skowronski teaches:
An automated triage system comprising: at least one memory configured to store a plurality of programmable instructions; And at least one processing device in communication with the at least one memory; and wherein the at least one processing device, upon execution of the plurality of programmable instructions is caused to automatically: (abstract discloses, “An automated triage system may include a patient database, a patient information system, a prioritized ranking system, and a nurse control panel system. The patient information system can include a user interface module, a clinical decision rules database, and a data processing engine.” And see [0016] and see ([0045] discloses, “The insight engine server 140 (e.g., an automated triage system) can be a computing system that receives information from patients, compiles patient medical data, prioritizes (e.g., ranks) patients in a queue (e.g., a nurse queue). provides recommendations (e.g., recommended courses of action, urgency and level of care, articles describing self-care options, appointment Scheduling information, etc.) to be reviewed by a nurse or practitioner and/or to be viewed by a patient, provides a mechanism for nurses or practitioners to contact patients, and/or provides updated information to EMR systems, such as the EMR system 110. For example, the insight engine server 140 can generate questions to be answered by patients (e.g., via the one or more triage devices 130 and/or the one or more user devices 150). Based on the answered questions and medical data pulled from one or more EMR systems, the insight engine server 140 can prioritize or rank the patient in a queue (e.g., a nurse queue) to determine the order in which the patient will receive attention from a nurse and/or generate recommendations for patients. The insight engine server 140 can also flag possible complications based on the answered questions and the medical data pulled from one or more EMR systems. Contact information for a patient can be provided by the insight engine server 140 to the one or more triage devices 130 to allow nurses to contact patients. Any updated data provided by a nurse via the one or more triage devise 130 can be sent to the insight engine server 140, which can then forward such data to one or more EMR systems, such as the EMR system 110, for storage.” )
receive demographics data for a patient; access or receive a medical history for the patient; ([0096] discloses, “FIG. 8 illustrates a user interface 800 viewed by a nurse using a triage device. Such as the one or more triage devices 130, when the nurse accesses the web application executed by the triage nurse express module 320. As illustrated in FIG. 8, the user interface 800 includes triage nurse express button 802, encounter history button 804, patient encounter window 806, and current user and general functions pane 808.” And see [0098] discloses, “In an embodiment, the patient encounter window 806 is displayed when the triage nurse express button 802 is selected. The patient encounter window 806 displays pertinent information and actions a nurse can make regarding active encounters. The pertinent information and actions a nurse can take can be divided into four columns: patients/wait time column 810, patient history column 812, decision Support column 814, and recommendation column 816.” And see [0110] discloses, “In some embodiments, patient demographic and contact information are at the top of the patient history column 812.”)
receive a medical complaint about a present medical condition; ([0041] discloses, “In particular, the application offers several benefits. For example, nurses can get the benefit of complaint and health history before making outbound contact to patients. The result is that that nurses are better prepared to make care decisions and triage encounters are nearly 50% faster than current best practice in some embodiments. As another example, patients can get a sense of instant Support by being able to immediately convey their chief complaint—” and see [0111] discloses, “FIG. 12 illustrates a more detailed view of the patient history column 812. In certain embodiments, the patient history column 812 also includes the results of the automated patient interview, including chief complaint, treatments attempted, medications listed, and/or symptoms affirmed and symptoms denied, among others.”)
triage the patient based on the demographic data, the medical history, and the medical complaint to determine a level of urgency of treatment needed by the patients ([0059] discloses, “In some embodiments, the clinical decision support service module 310 is configured to implement triage protocols and provide emergency screening and prioritization (or ranking) of encounters (e.g., patients). The clinical decision support service module 310 can implement a variety of protocols, including the Wolters Kluwer telephone triage protocols and the Schmitt Thompson protocols, among others. The clinical decision support service module 310 can be built on top of the OpenCDS platform. In certain embodiments, the clinical decision support service module 310 accepts input in a data format such as a Continuity of Care Document (CCD) or Virtual Medical Record (VMR). The clinical decision Support service module 310 can then use rules to map this data to clinical concepts, which allow for data normalization of both the syntax and semantics, as well as merging from multiple Sources. The protocols can be implemented as rules that act upon the clinical concepts. These rules can specify things like triage level, which is used for emergency screening and/or prioritization (or ranking). For example, a patient's Symptoms can be mapped to specific clinical concepts, and rules applied to the specific clinical concepts may specify a triage level for that patient. Triage levels of patients can then be compared to perform emergency screening and/or prioritization or ranking of the patients (e.g., the more critical or serious the triage level, the higher the patient will be prioritized or ranked). Emergency screening can tell patients at the end of the interview to seek urgent care or call 911 right away if they have an emergent condition. Prioritization or ranking can separate encounters needing immediate attention from a nurse from those that can wait for a specified time period. The rules can also be used to implement a template response 722 (e.g., an email 722) with personalized health information based on the patient's complaint.”)
select an appointment service type for servicing the patient based on results of the triage to reduce unnecessary emergency room visits provide a response to the patient including the appointment service type selected; ([0080] discloses, “In some embodiments, the insight engine server 140 provides insight to make better decisions faster, and can even automate critical process steps. The insight engine server 140 can automatically collect and generate clinical documentation, recommend which kind of practitioner, when to sched ule the appointment, and/or provide educational articles among others. This can turn triage into a 1-click operation for the most common cases, can give patients better service, and/or can save providers a significant amount of money.” And see [0066] discloses, “In some embodiments, after the review is complete, the patient will be sent the information the nurse provided via message 308, including, but not limited to, appointment information…[…]…” and see Fig. 13A with recommendation for emergent care recommendation and Fig. 14B for example see Dr. Smith emergent level 2 type care)
Skowronski does not explicitly teach:
and initiate the appointment by outputting at least one control signal to order, allocate, or reserve at least one resource for performance of the appointment without requiring nurse intervention.
However, Hosny does teach:
and initiate the appointment by outputting at least one control signal to order, allocate, or reserve at least one resource for performance of the appointment without requiring nurse intervention. (Col. 5 lines 1-14 and see Col. 3 lines 55-64 and Col. 4 lines 1-4 discloses use of machine learning to determine an appointment for a patient through triage.)
It would be obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to combine Skowronski’s teachings of setting an appointment type as previously cited with Hosny’s teachings of utilizing machine learning to do this as previously cited, the motivation being Skowronski teaches in [0009] that intelligent online means lower costs, improve outcomes, and/or smooth operations thus it would be predictable to combine with Hosny’s teaching of machine learning as machine learning can make the intelligent online selection of appointment service type more efficient with improved accuracy and operations for improved patient outcomes.
As per claim 2, Skowronski teaches:
The system of claim 1; wherein the appointment service type includes a primary care physician type, a specialist type, an emergency virtual visit type, or an emergency room type. (see Fig. 13A and Fig. 4B both emergent type care and see [0059] discloses, “Triage levels of patients can then be compared to perform emergency screening and/or prioritization or ranking of the patients (e.g., the more critical or serious the triage level, the higher the patient will be prioritized or ranked). Emergency screening can tell patients at the end of the interview to seek urgent care or call 911 right away if they have an emergent condition.”)
As per claim 3, Skowronski teaches:
The system of claim 1; wherein the at least one processing device is further caused to prompt the patient, based on at least one of the demographic data and the medical record, for key clinical data, wherein receiving the medical complaint includes receiving the key clinical data. ([0062] discloses, “This can allow patients to identify the chief complaint, or the reason for their visit.” And see [0063] discloses, “In certain embodiments, if the reason is a medical problem, the insight engine server 140 can generate follow up questions about symptoms and history in order to make recommendations.” / examiner notes instant application defines key clinical data as a primary or secondary complaint see page 4 lines 3-4)
As per claim 4, Skowronski teaches:
The system of claim 3; wherein the key clinical data includes a primary medical complaint and a secondary medical complaint. ([0078] discloses, “ FIG. 6 illustrates the relationship between data, concepts, and rules. As illustrated in FIG. 6, interview data 602 includes shortness of breath and wheezing, custom interview data 604 includes short sentences, fever, and cough, and past history data 606 includes medicine 1 and medicine 2 (e.g., medicines taken by the patient in the past). Clinical concepts 608 includes shortness of breath, fever, wheezing, cough, and asthma. Triage level rules 610 includes shortness of breath, which results in an emergent triage level.” And see ex. 14B where cough is chief complaint but secondary complaints such as shortness of breath are reported)
As per claim 5, Skowronski teaches:
The system of claim 1; wherein the at least one processing device is further configured to generate a graphical user interface configured to be displayed on a display device for interacting with a user and receiving user input. ([0121] discloses, “FIG. 17 is a flowchart depicting an embodiment of a process 1700 for automating a triage system. In an embodiment, the process 1700 is performed by the insight engine server 140 of FIG.1. The process 1700 begins at block 1702. At block 1702, a connection to a computing device configured to display a user interface to a user is established over a secure network connection. In an embodiment, the computing device is a triage device. Such as triage device 130, or a user device, such as user device 150, operated by a patient.” And see [0122] discloses, “At block 1704, patient information data inputted by the user through the user interface is received.”)
As per claim 6, Skowronski teaches:
The system of claim 3; wherein the at least one processing device is further caused to determine if the patient is an existing patient or a new patient, wherein prompting the patient is further based on the determination. ([0012] discloses, “In certain embodiments, integration with the provider's Electronic Medical Record (EMR) can give access to the patients history, which will guide the triage decision.” / examiner notes under BRI having the patients history is determining if they are an existing patient and using this to guide triage)
As per claim 7, Skowronski teaches:
The system of claim 6, wherein the at least one processing device is further caused to provide a full record of care for analysis; to the patient; or to a provider of the patient, upon determining that the patient is an existing patient. ([0012] discloses, “In certain embodiments, integration with the provider's Electronic Medical Record (EMR) can give access to the patients history, which will guide the triage decision.”)
As per claim 8, Skowronski teaches:
The system of claim 1 wherein the at least one processing device is further caused to compare the user inputs to a triage database, wherein selection of the appointment service type is a function of a result of the comparison. ([0015] discloses, “The method further comprises accessing healthcare tri age protocols stored in a clinical decision rules database. The healthcare triage protocols may be configured to Solicit patient information data and to provide clinical determinations. The method further comprises accessing the patient information data stored in the patient database. The method further comprises applying the healthcare triage protocols to the patient information data. Application of the healthcare triage protocols may generate patient inquiries and a clinical determination.” And see [0059] discloses, “The protocols can be implemented as rules that act upon the clinical concepts. These rules can specify things like triage level, which is used for emergency screening and/or prioritization (or ranking). For example, a patient's Symptoms can be mapped to specific clinical concepts, and rules applied to the specific clinical concepts may specify a triage level for that patient. Triage levels of patients can then be compared to perform emergency screening and/or prioritization or ranking of the patients (e.g., the more critical or serious the triage level, the higher the patient will be prioritized or ranked).”)
As per claim 9, Skowronski does not teach:
The system of claim 1 wherein the at least one processing device is configured to apply machine learning to select the appointment service type - and automatically initiate the appointment by outputting at least one control signal to reserve specific resources without requiring nurse intervention.
However, Hosny does teach:
The system of claim 1 wherein the at least one processing device is configured to apply machine learning to select the appointment service type. (Col. 5 lines 1-14 and see Col. 3 lines 55-64 and Col. 4 lines 1-4 discloses use of machine learning to determine an appointment for a patient through triage.)
It would be obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to combine Skowronski’s teachings of setting an appointment type as previously cited with Hosny’s teachings of utilizing machine learning to do this as previously cited, the motivation being Skowronski teaches in [0009] that intelligent online means lower costs, improve outcomes, and/or smooth operations thus it would be predictable to comine with Hosny;s teaching of machine learning as machine learning can make the intelligent online selection of appointment service type more efficient with improved accuracy and operations for improved patient outcomes.
As per claim 12, Skowronski teaches:
The system of claim 1 wherein initiating the appointment includes prioritizing patients based on results of the triage and tracking wait time of the patient at the appointment as a function of prioritization of the patient. ([0044] discloses, “The one or more triage devices 130 can be located at the practitioners office or a hospital. The one or more triage devices 130 can be a portal that allows a nurse to interact with the insight engine server 140. In particular, the portal allows a nurse to prioritize patients, contact patients, schedule appointments for patients, provide patients with information, and/or access and/or modify patient medical data stored by one or more EMR systems, such as the EMR system 110.” And see Fig. 14B and Fig. 14D / examiner notes the instant application defines initiating an appointment on page 5 lines 4-22 as example triaging patients by priority and reserving the an appointment)
As per claim 13, Skowronski teaches:
The system of claim 1 wherein initiating the appointment includes prioritizing patients based on results of the triage and outputting at least one control signal to order, allocate, or reserve at least one resource for performance of the appointment as function of the prioritization of the patients. ([0044] discloses, “The one or more triage devices 130 can be located at the practitioners office or a hospital. The one or more triage devices 130 can be a portal that allows a nurse to interact with the insight engine server 140. In particular, the portal allows a nurse to prioritize patients, contact patients, schedule appointments for patients, provide patients with information, and/or access and/or modify patient medical data stored by one or more EMR systems, such as the EMR system 110.” And see Fig. 14B and Fig. 14D / examiner notes the instant application defines initiating an appointment on page 5 lines 4-22 as example triaging patients by priority and reserving the an appointment)
Claims 10 and 14 are rejected to under 35 U.S.C. 103 as being unpatentable over Skowronski et. al (hereinafter Skowronski) (US20140019162A1) in view of Hosny et. al (hereinafter Hosny) (US11676709B2) and In further view of Arshad et. al (hereinafter Arshad) (US20170011179A1)
As per claim 10, Skowronski and Hosny do not teach:
The system of claim 1 wherein the at least one processing device is configured to automatically recommend a service provider from a plurality of candidate service providers as a function of one or more of: patient affiliation with a service provider of the plurality of candidate service providers; acceptance of patient insurance location of the service provider; availability of one or more of a specialized practitioner, facilities, or equipment; cost quote or estimate; type of payment accepted; or patient preference.
However, Arshad does teach:
The system of claim 1 wherein the at least one processing device is configured to automatically recommend a service provider from a plurality of candidate service providers as a function of one or more of: patient affiliation with a service provider of the plurality of candidate service providers; acceptance of patient insurance location of the service provider; availability of one or more of a specialized practitioner, facilities, or equipment; cost quote or estimate; type of payment accepted; or patient preference.([0286] discloses, “For example, with reference to Table 3, assuming that the patient selects the Abdomen (RLQ) as the ROI and selects only the highest order (e.g., the main selection) from the ROII selection such as the "lump' ROII selection. A provider is chosen from providers that can be assigned to all selections relating to the highest order selected ROII such as an internist and/or GP as the primary provider type, a gastroenterologist and/or hernia specialist as the secondary provider type, and a GP and Surgeon as the tertiary provider type. In this case, one of each provider type is selected for at least one of the primary through tertiary (or lowest order) or provider types are selected using a predetermined conflict resolution method Such using assigned weights for each provider type.” And see [0289] discloses, “Information such as provider availability (individually and/or as a group by provider type, state, etc.), waiting time (individually and/or as a group by physician type, state, etc.), patient rating, insurance type, payment type (e.g., insurance type), and/or other Suitable information are used as inputs to an algorithm Such as a heuristic analysis, etc., to determine the provider type and/or to select providers.” And see [0284] discloses, “If the patient enters an ROI corresponding to the eye, the system recognizes this and automatically selects a provider type(s) such as an eye specialist that the patient has historically selected for this CMI. This can conserve system resources and/or time.”)
It would be obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to combine Skowronski’s teachings of recommending a service provider such as Dr. Smith as previously cited and Hosny’s teachings of automation with Arshad’s teachings of recommending a service provider from multiple providers based on one or more factors as previously cited, the motivation being Skowronski teaches in [0009] and [0080] that intelligent online means lower costs, improve outcomes, and/or smooth operations and part of this is recommending a service provider by 1 click operations to save providers money thus it would be predictable to combine with Arshad’s teaching of using intelligent online selection means of automatic recommendation as a function of various factors for the patient to improve the efficiency and improve the follow through for patient visit to providers thus saving money and reducing resources.
As per claim 14, Skowronski and Hosny do not teach:
The system of claim 1 wherein the appointment is a virtual visit and initiating the appointment includes automatically providing a link to patient selected invitees to join the virtual visit.
However, Arshad does teach:
The system of claim 1 wherein the appointment is a virtual visit and initiating the appointment includes automatically providing a link to patient selected invitees to join the virtual visit. (And see [0230] discloses, “At the time of the appointment, the patient is sent a link and/or notifcation to enter the encounter room (e.g., video) for the appointment when the chosen provider is ready.”)
It would be obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to combine Skowronski’s teachings and Hosny’s teachings with Arshad’s teachings for the same reasons given above for claim 10.
Claims 15 and 18 are rejected to under 35 U.S.C. 103 as being unpatentable over Skowronski et. al (hereinafter Skowronski) (US20140019162A1) in view of Arshad et. al (hereinafter Arshad) (US20170011179A1) and in further view of Hosny et. al (hereinafter Hosny) (US11676709B2)
As per claim 15, Skowronski teaches
A method comprising: displaying a patient identification graphical user interface having one or more fields configured to receive identification and location information from a patient; displaying a triage graphical user interface having one or more fields configured to receive medical complaint information; (see fig. 13A-14D)
determining a virtual care condition existence based on the medical complaint information; ([0103] discloses, “As another example, patient scan be organized into a third priority list (e.g., not for triage) when the clinical decision support service module 310 flags or classifies the encounters as not requiring triage. For example, perhaps the patient has merely asked for information, like office hours, or has asked for a prescription refill” / examiner notes under BRI as one of ordinary skill would understand a virtual care condition is any non-emergent care condition that can be addressed through digital platforms)
…[…]…and displaying an alternate screen where no virtual care condition exists. (see Fig. 14D for example where an emergent situation exists and no virtual care condition exists)
However Skowronski does not teach:
displaying a virtual visit screen where a virtual care condition exists;
And automatically outputting at least one control signal to reserve at least one resource for the virtual visit or alternate care based on the determined condition existence without requiring nurse intervention.
However, Arshad does teach:
displaying a virtual visit screen where a virtual care condition exists; (see Fig. 28B- 37 disclosing ability to join a video encounter on a display screen between a physician and patient where the issue is non-emergent)
It would be obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to combine Skowronski’s teachings with Arshad’s teachings as previously cited, the motivation being Skowronski shows displays with various information on the complaints and virtual interviews as well as recommended appointments (see Figure 14D for e.g.) thus it would be predictable and a choice of what information is displayed and if the patient were non emergent and had a virtual care condition this could be displayed on the generic interface components in Skowronski making it not unpredictable to combine but rather a simple substitution of the information displayed given a patients priority.
However, Arshad also does not teach:
And automatically outputting at least one control signal to reserve at least one resource for the virtual visit or alternate care based on the determined condition existence without requiring nurse intervention.
However, Hosny does teach:
And automatically outputting at least one control signal to reserve at least one resource for the virtual visit or alternate care based on the determined condition existence without requiring nurse intervention. (Col. 5 lines 1-14 and see Col. 3 lines 55-64 and Col. 4 lines 1-4 discloses use of machine learning to determine an appointment for a patient through triage.)
It would be obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to combine Skowronski’s teachings and Hosny teachings with Arshad’s teachings as previously cited, the motivation being Skowronski shows displays with various information on the complaints and virtual interviews as well as recommended appointments (see Figure 14D for e.g.) thus it would be predictable and a choice of what information is displayed and if the patient were non emergent and had a virtual care condition this could be displayed on the generic interface components in Skowronski making it not unpredictable to combine but rather a simple substitution of the information displayed given a patients priority.
As per claim 18, Skowronski further teaches:
The method of claim 15 further comprising a non- transitory computer-readable medium storing executable code configured to cause at least one processor to perform the method. ([0016] discloses, “Another aspect of this disclosure provides a non transitory computer-readable medium comprising one or more program instructions recorded thereon, the instructions configured for execution by a computing system comprising one or more processors in order to cause the computing system to electronically connect over a network connection to a computing device configured to display a user interface to the user. The medium further comprises one or more program instructions recorded thereon to cause the computing system to receive patient information data inputted by the user though the user interface. The medium further comprises one or more program instructions recorded thereon to cause the computing system to electronically store the patient information data into a patient database. The medium further comprises one or more program instructions recorded thereon to cause the computing system to access healthcare triage protocols stored in a clinical decision rules database. The health care triage protocols may be configured to Solicit patient information data and to provide clinical determinations. The medium further comprises one or more program instructions recorded thereon to cause the computing system to access the patient information data stored in the patient database. The medium further comprises one or more program instructions recorded thereon to cause the computing system to apply the healthcare triage protocols to the patient information data. The medium further comprises one or more program instructions recorded thereon to cause the computing system to generate patient inquiries and a clinical determination based on application of the healthcare triage protocols to the patient information data. The medium further comprises one or more program instructions recorded thereon to cause the computing system to electronically process the clinical determination to determine a prioritized ranking score for the user. The medium further comprises one or more program instructions recorded thereon to cause the computing system to electronically process the prioritized ranking score to determine a patient ranking relative to one or more other users in a patient queue. The medium further comprises one or more program instructions recorded thereon to cause the computing system to dynamically generate data to dynamically display the patient queue in a second user interface displayed by a second computing device.”)
Claim 16 is rejected to under 35 U.S.C. 103 as being unpatentable over Skowronski et. al (hereinafter Skowronski) (US20140019162A1) in view of Arshad et. al (hereinafter Arshad) (US20170011179A1) in further view of Hosny et. al (hereinafter Hosny) (US11676709B2), and in even further view of Kiley (US20100174551A1)
As per claim 16, Skowronski, Hosny, and Arshad do not explicitly teach:
The method of claim 15 wherein the alternate screen includes an emergency department screen configured to provide instruction to the user to go to an emergency department and emergency department information based on location information if an emergency condition exists.
However, Kiley does teach:
The method of claim 15 wherein the alternate screen includes an emergency department screen configured to provide instruction to the user to go to an emergency department and emergency department information based on location information if an emergency condition exists. (see Fig. 3B see “important note”)
It would be obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to combine Skowronski’s teachings and Hosny’s teachings and Arshad’s teachings as previously cited with Kiley’s teachings as previously cited, the motivation being Skowronski shows displays with various information on the complaints and virtual interviews as well as recommended appointments for priority 1 emergent situations (see Figure 14D for e.g.) and calling 911 for emergent situations (see [0059]) and Arshad teaches calling 911 for emergent situations (e.g. fig. 8) thus it would be predictable and a choice of what information is displayed and if the patient were emergent and needed to go to emergency department this could be displayed on the generic interface components in Skowronski and Arshad as they are both concerned with making sure patients receive emergent help therefore improving the response and patient outcomes and making it not unpredictable to combine but rather a simple substitution of the information displayed given a patients priority.
Claims 19 and 20 are rejected to under 35 U.S.C. 103 as being unpatentable over Skowronski et. al (hereinafter Skowronski) (US20140019162A1) in view of Arshad et. al (hereinafter Arshad) (US20170011179A1) in view of Francois (US20200185100A1) and in further view of Hosny et. al (hereinafter Hosny) (US11676709B2)
As per claim 19, Skowronski further teaches:
A system- comprising one or more computer modules configured to: display a patient identification graphical user interface having one or more fields configured to receive identification or location information from a patient; (see Fig. 15 disclosing identification information of a patient)
display a triage graphical user interface having one or more fields configured to receive medical complaint information; (see Fig. 15, “chief complaint”)
determine a condition type based on the medical complaint information, wherein the condition type is one of a virtual care condition, an emergency condition, or a primary care condition; (see Fig. 15, “level 1 emergent to acute care for immediate assistance”)
…[…]…display an emergency department screen if an emergency condition exists; (see Fig. 15, “level 1 emergent to acute care for immediate assistance”)…[…]…
However, Skowronski does not teach:
display a virtual visit screen if a virtual care condition exists;
and display a primary care physician screen if a primary care condition exists.
And automatically output at least one control signal to order, allocate, or reserve at least one resource based on the determined condition type without requiring nurse intervention.
However, Arshad does teach:
display a virtual visit screen if a virtual care condition exists; (see Fig. 3B see “important note”)
It would be obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to combine Skowronski’s teachings with Arshad’s teachings for the same reasons given for claim 15.
However, Arshad also does not teach:
and display a primary care physician screen if a primary care condition exists.
And automatically output at least one control signal to order, allocate, or reserve at least one resource based on the determined condition type without requiring nurse intervention.
However, Francois does teach:
and display a primary care physician screen if a primary care condition exists. ([0164] discloses, “Triage directions may include instructing the patient to : contact his or her primary care physician or other health care provider to seek medical advice immediately , contact his or her primary care physician or other…[…]…Depending on the evaluation , triage directions , treatment directions , or both , may be provided to the patient . It should be understood that one or more triage directions and one or more treatment directions may be provided in any format and may be expressed in any way .” see [0175] discloses, “FIG . 3E shows a screen that instructs the patient to take certain medication and call the physician's office . FIG . 3F ) shows a screen instructing the patient to call 911.” And see [0172] discloses, “In certain embodiments of particular interest , the invention provides an application for use on a mobile phone , comprising a user interface ( patient interface ) through which patients can run health trackers , receive directions , and receive health statistics based on health data pertaining to them collected”)
It would be obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to combine Skowronski’s teachings and Arshad’s teachings as previously cited with Francois teachings of a primary physician screen recommendation as this is simple substitution of choice information on the screen and both Skowronski ([0009]) and Arshad ([0003]) are motivated to improve online means to make the process of healthcare services more efficient thus by automatically and clearly recommended a primary care physician patient communication is improved and inefficiencies are reduced in the overall healthcare workflow.
However, Francois also does not teach:
And automatically output at least one control signal to order, allocate, or reserve at least one resource based on the determined condition type without requiring nurse intervention.
However, Hosny does teach:
And automatically output at least one control signal to order, allocate, or reserve at least one resource based on the determined condition type without requiring nurse intervention. (Col. 5 lines 1-14 and see Col. 3 lines 55-64 and Col. 4 lines 1-4 discloses use of machine learning to determine an appointment for a patient through triage.)
It would be obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to combine Skowronski’s teachings of setting an appointment type as previously cited and Arshad’s teachings as previously cited and Francois teachings of a primary physician screen recommendation with Hosny’s teachings of utilizing machine learning to do this as previously cited, the motivation being Skowronski teaches in [0009] that intelligent online means lower costs, improve outcomes, and/or smooth operations thus it would be predictable to combine with Hosny’s teaching of machine learning as machine learning can make the intelligent online selection of appointment service type more efficient with improved accuracy and operations for improved patient outcomes
As per claim 20, Skowronski does not teach:
The system of claim 19 wherein the virtual care screen includes a join waiting room button configured to place the user into a virtual waiting room for a virtual care visit.
However, Arshad does teach:
The system of claim 19 wherein the virtual care screen includes a join waiting room button configured to place the user into a virtual waiting room for a virtual care visit. ([0224] discloses, “Once consent is obtained, the patient is then presented with a list of provider specialty types (step 596). The patient then selects a provider specialty type (step 598). If a provider of the selected type is available (step 600), then the estimated wait time is calculated and displayed to the patient (step 602). If the wait time is less thana threshold (step 606), the patient is notified to wait (step 608), the patient is placed in the immediate waiting room (step 610) and the patient is returned to the appointment landing page (step 520). When the provider is ready, the patient receives a notification to enter the encounter (e.g., video) for their appointment.” And see [0230] discloses, “At the time of the appointment, the patient is sent a link and/or notifcation to enter the encounter room (e.g., video) for the appointment when the chosen provider is ready.” And see [0246] discloses, “A diagram illustrating a second example mobile device screenshot of estimated wait time for the encounter with the healthcare provider is shown in FIG. 20. In one embodiment, a screenshot of a GUI, generally referenced 960, comprises text 962 informing the patient that the estimated wait time is 'X' minutes 964 (e.g., estimated wait time (E)); an option to wait in the immediate waiting room 966; and buttons for responding either “yes” or “no” 968.”)
It would be obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to combine Skowronski’s teachings with Arshad’s teachings as previously cited, the motivation being Skowronski teaches concern for wait times for patients and ensuring they do not get lost in the queue (see e.g. [0104]) therefore it would be an improvement in efficiency and wait times for Arshad’s combined waiting room to be provided and allow for further prioritization of patients and assuring they are one step closer to patient care for a recommended service appointment.
Claims 17 is rejected to under 35 U.S.C. 103 as being unpatentable over Skowronski et. al (hereinafter Skowronski) (US20140019162A1) in view of Arshad et. al (hereinafter Arshad) (US20170011179A1) In view of Hosny et. al (hereinafter Hosny) (US11676709B2) in further view of Kiley (US20100174551A1) and in even further view of Francois (US20200185100A1)
As per claim 17, Skowronski, Arshad, Hosny, and Kiley do not teach:
The method of claim 16 wherein the alternate screen includes a primary care physician screen instructing a user to contact their primary care physician if no emergency condition or virtual care condition exists.
However, Francois does each:
The method of claim 16 wherein the alternate screen includes a primary care physician screen instructing a user to contact their primary care physician if no emergency condition or virtual care condition exists. ([0164] discloses, “Triage directions may include instructing the patient to : contact his or her primary care physician or other health care provider to seek medical advice immediately , contact his or her primary care physician or other…[…]…Depending on the evaluation , triage directions , treatment directions , or both , may be provided to the patient . It should be understood that one or more triage directions and one or more treatment directions may be provided in any format and may be expressed in any way .” see [0175] discloses, “FIG . 3E shows a screen that instructs the patient to take certain medication and call the physician's office . FIG . 3F ) shows a screen instructing the patient to call 911.” And see [0172] discloses, “In certain embodiments of particular interest , the invention provides an application for use on a mobile phone , comprising a user interface ( patient interface ) through which patients can run health trackers , receive directions , and receive health statistics based on health data pertaining to them collected”)
It would be obvious to one of ordinary skill in the art before the effective filing date of the claimed invention to combine Skowronski’s, Hosny, Arshad’s, and Kiley’s teachings with Francois teachings for the same reasons given for claim 19.
Response to Arguments Regarding 35 U.S.C § 101 Rejections
Applicant argues on pages 2-4 of remarks that the amended claims are eligible under 35 U.S.C. § 101 based on the arguments below:
The amended independent claims now recite specific technical limitations that integrate the alleged abstract idea into a practical application by controlling physical resource allocation in healthcare facilities. Under the two-step Alice/Mayo framework, Prong Two of the test asks whether the claim recites additional elements that integrate the judicial exception into a practical application. MPEP § 2106.04(11)(2). In Prong Two, examiners evaluate whether the claim as a whole integrates the exception into a practical application of that exception. If the additional elements in the claim integrate the recited exception into a practical application of the exception, then the claim is not directed to the judicial exception and thus is patent eligible. Limitations the courts have found indicative that an additional element has integrated the exception into a practical application include an improvement in the functioning of a computer, or an improvement to other technology or technical field, and applying or using the judicial exception in some other meaningful way beyond generally linking the use of the judicial exception to a particular technological environment. MPEP § 2106.04(d)(1) and MPEP § 2106.05(e).
Amended claim 1 now recites that the at least one processing device is caused to "automatically initiate the appointment by outputting at least one control signal to order, allocate, or reserve at least one resource for performance of the appointment without requiring nurse intervention." This limitation transforms claim 1 beyond the alleged abstract idea of organizing human activity by requiring the system to actively control and allocate physical resources in healthcare facilities. As disclosed in the specification,"initiating the appointment can include outputting at least one control signal to order, allocate, or reserve at least one resource for performance of the appointment." As-Filed Specification, paragraph [017]. The specification further explains that "the automated triage service can output a control signal to order, allocate, or reserve resources (medications, personnel, room, equipment, etc.)." As-Filed Specification, paragraph [0047]. The specification describes how the automated triage system can "send control signals to reserve and physically setup a particular ER room with particular physical equipment and/or digital charts that are designated for a particular patient" and "send control signals to an electronic device used by medical practitioners assigned to work with a particular patient to direct them to the correct time and place, populate the electronic device with patient data and triage data about the patient." As-Filed Specification, paragraph [092]. Additionally, the system can "immediately alert a triage nurse through a text, an email, or other suitable communication channels and reserve physical resources (e.g., personnel, space and/or equipment) as needed to move the patient to collect vitals and move the patient to an examination or treatment room." As-Filed Specification, paragraph [068]. The control signal limitation as recited by amended claim 1 constitutes a technological improvement in healthcare resource management that goes beyond merely using a computer to perform abstract data analysis. This limitation causes tangible changes in the physical world by automatically controlling the allocation of medical personnel, rooms, and equipment based on triage results, thereby reducing wait times and improving patient outcomes through automated resource allocation without requiring nurse intervention or utilization of nursing time to allocate those resources. Amended claim 15 now recites "automatically outputting at least one control signal to reserve at least one resource for the virtual visit or alternate care based on the determined condition existence without requiring nurse intervention." This limitation integrates the judicial exception into a practical application by requiring the method to actively reserve physical resources for healthcare delivery based on the condition determination. The control signal limitation goes beyond abstract data gathering and display by requiring physical resource reservation that enables actual healthcare delivery, constituting a practical application that improves healthcare resource utilization and patient access to care.
Amended claim 19 now recites that the computer modules are configured to "automatically output at least one control signal to order, allocate, or reserve at least one resource based on the determined condition type without requiring nurse intervention." This limitation transforms the system beyond abstract condition determination by requiring active resource allocation based on the specific condition type determined. The control signal limitation integrates the abstract idea into a practical application by causing the system to automatically allocate healthcare resources based on the technical determination of condition type, thereby improving healthcare delivery efficiency.
The control signal limitations in amended claims 1, 15, and 19 amount to significantly more than the alleged abstract idea because they require the systems and methods to actively control physical healthcare resources rather than merely organizing information. These limitations constitute technological improvements to healthcare resource management systems that provide concrete benefits including reduced wait times, improved resource utilization, and better patient outcomes through automated allocation of medical personnel, facilities, and equipment. Dependent claims 2-10 and 12-14 are allowable for the same reasons as amended claim 1, as they depend from claim 1 and inherit the practical application provided by the control signal limitation. Dependent claims 16-18 are allowable for the same reasons as amended claim 15. Dependent claim 20 is allowable for the same reasons as amended claim 19. Applicant submits that the amendments to the independent claims cure the § 101 rejection by transforming the claims from abstract ideas into practical applications that actively control physical healthcare resources, thereby providing technological improvements to healthcare delivery systems. Accordingly, Applicant respectfully requests withdrawal of the § 101 rejection.
Examiner appreciates applicants argument but does not find it persuasive.
The MPEP states The Alice/Mayo two-part test is the only test that should be used to evaluate the eligibility of claims under examination. While the machine-or-transformation test is an important clue to eligibility, it should not be used as a separate test for eligibility. Instead it should be considered as part of the "integration" determination or "significantly more" determination articulated in the Alice/Mayo test. Bilski v. Kappos, 561 U.S. 593, 605, 95 USPQ2d 1001, 1007 (2010). See MPEP § 2106.04(d) for more information about evaluating whether a claim reciting a judicial exception is integrated into a practical application and MPEP § 2106.05(b) and MPEP § 2106.05(c) for more information about how the machine-or-transformation test fits into the Alice/Mayo two-part framework. The enumerated groupings of abstract ideas are defined as: 1) Mathematical concepts – mathematical relationships, mathematical formulas or equations, mathematical calculations (see MPEP § 2106.04(a)(2), subsection I); (Mathematical Calculations - A claim that recites a mathematical calculation, when the claim is given its broadest reasonable interpretation in light of the specification, will be considered as falling within the "mathematical concepts" grouping. A mathematical calculation is a mathematical operation (such as multiplication) or an act of calculating using mathematical methods to determine a variable or number, e.g., performing an arithmetic operation such as exponentiation. There is no particular word or set of words that indicates a claim recites a mathematical calculation. That is, a claim does not have to recite the word "calculating" in order to be considered a mathematical calculation. For example, a step of "determining" a variable or number using mathematical methods or "performing" a mathematical operation may also be considered mathematical calculations when the broadest reasonable interpretation of the claim in light of the specification encompasses a mathematical calculation.)
2) Certain methods of organizing human activity – fundamental economic principles or practices (including hedging, insurance, mitigating risk); commercial or legal interactions (including agreements in the form of contracts; legal obligations; advertising, marketing or sales activities or behaviors; business relations); managing personal behavior or relationships or interactions between people (including social activities, teaching, and following rules or instructions) (see MPEP § 2106.04(a)(2), subsection II); and
3) Mental processes – concepts performed in the human mind (including an observation, evaluation, judgment, opinion) (see MPEP § 2106.04(a)(2), subsection III).
Examiners should determine whether a claim recites an abstract idea by (1) identifying the specific limitation(s) in the claim under examination that the examiner believes recites an abstract idea, and (2) determining whether the identified limitations(s) fall within at least one of the groupings of abstract ideas listed above. Furthermore, the MPEP state in 2106.04(d), “Examiners evaluate integration into a practical application by: (1) identifying whether there are any additional elements recited in the claim beyond the judicial exception(s); and (2) evaluating those additional elements individually and in combination to determine whether they integrate the exception into a practical applications.”
Therefore, respectfully, examiner disagrees with the applicant as the claim limitations must be reviewed in light of the specification and the specification cannot be read into the claims. The positively recited in claim 1 (as representative) are directed to a judicial exception (i.e. certain methods of organizing human activity) following rules or instructions to triage a patient and order, allocate, reserve, or initiate an appointment. This is abstract in substance as a human can follow rules and instructions to triage a patient and order, allocate, reserve or initiate an appointment for a patient. Being implemented or automated by a computer environment for efficiency does not make the recited claim dispositive of being certain methods of organizing human activity. Additionally, the judicial exception (abstract idea) cannot integrate itself into a practical application but identification of any additional elements recited in the claim can be evaluated to determine if the additional elements integrate the exception into a practical application. The claims additional elements are not recited as being an improvement to a technology field or a technology confined to the computer environment in which the claims recite (see instant application page 29 lines 10-15). Moreover, the field of resource allocation is not reasonably understood to be a technological problem or technological issue the general purpose computer environment in which the claims are confined, instead it is a real world problem with human resources. Any improvement present is an improvement to the abstract idea. If applicant’s line of reasoning were correct Alice corp. would have been deemed eligible. Examiner maintains the claims are directed to an abstract idea and do not integrate into a practical application. Therefore, they also do not amount to significantly more.
Examiner maintains the 35 U.S.C § 101 rejection.
Response to Arguments Regarding 35 U.S.C § 102/103 Rejections
Applicant’s arguments on pages 5-6 of remarks have been considered but are moot because the new ground of rejection does not rely on any reference applied in the prior rejection of record for any teaching or matter specifically challenged in the argument.
Examiner maintains the 35 U.S.C § 103 rejection.
Applicants arguments on pages 7-10 of the remarks have been considered but are not found persuasive by examiner.
Applicant argues that amended claim 9 recites a system wherein the at least one processing device is configured to apply machine learning to select the appointment service type and automatically initiate the appointment by outputting at least one control signal to reserve specific resources without requiring nurse intervention. Amended claim 15 recites a method comprising displaying patient identification and triage graphical user interfaces, determining virtual care condition existence, displaying appropriate screens, and automatically outputting at least one control signal to reserve at least one resource for the virtual visit or alternate care based on the determined condition existence without requiring nurse intervention. Amended claim 19 recites a system comprising computer modules configured to display patient identification and triage interfaces, determine condition types, display appropriate screens based on condition types, and automatically output at least one control signal to order, allocate, or reserve at least one resource based on the determined condition type without requiring nurse intervention. The Examiner has alleged that the cited prior art references in combination teach or suggest the claimed limitations. The Examiner's position relies on combining Skowronski's triage system with additional references to allegedly render the amended claims obvious. Applicant respectfully disagrees with the Examiner's obviousness rejections and submits that the cited combinations fail to teach or suggest the critical "without requiring nurse intervention" limitations as recited by the amended independent claims. "The key to supporting any rejection under 35 U.S.C. 103 is the clear articulation of the reason(s) why the claimed invention would have been obvious. The Supreme Court in KSR Int'lCo. v. Teleflex Inc., 550 U.S. 398, 418, 82 USPQ2d 1385, 1396 (2007) noted that the analysis supporting a rejection under 35 U.S.C. 103 should be made explicit." The Examiner's rejections fail to adequately address how the cited combinations would eliminate the nurse intervention requirement that is fundamental to each reference's system architecture. Regarding amended claim 9, Skowronski specifically teaches that "the insight engine server 140 can prioritize or rank the patient in a queue (e.g., a nurse queue) to determine the order in which the patient will receive attention from a nurse and/or generate recommendations for patients." Skowronski et. al, paragraph [0045]. Skowronski further requires that "the nurse may be responsible for independently reviewing the available information and independently providing the appropriate triage recommendation to patients" and that "after the review is complete, the patient will be sent the information the nurse provided via message 308, including, but not limited to, appointment information." Skowronski et. al, paragraphs [0065]-[0066]. These teachings demonstrate that Skowronski's system architecture fundamentally depends on nurse review and approval before appointments are scheduled. The addition of Hosny's machine learning teachings does not eliminate this nurse intervention requirement, as the combination would still require nurse review before appointment initiation. Regarding amended claims 10, 14, and 15, these claims are allowable for the same reasons as amended claim 1, as they depend from or incorporate the automatic resource allocation without nurse intervention limitations. The Examiner's citations to Arshad do not adequately support the claimed limitations, as Arshad's provider selection teachings do not disclose automatic resource allocation that bypasses nurse review requirements.
Regarding amended claims 16 and 18, Kiley teaches that "the triage nurse (or other designated party, such as, but not limited to, a physician or nurse practitioner) at the selected hospital is alerted of the new reservation request" and that "upon accessing the submitted patient information, the triage nurse, physician, physician's assistant, or other appropriate personal evaluate the information to determine the prospective patient's condition." Kiley, paragraphs [0044] and [0052]. These teachings confirm that healthcare professional review is necessary before any action is taken, which is contrary to the automatic resource reservation without nurse intervention as recited by amended claim 15.
Regarding amended claims 19 and 20, Francois teaches health care event modules where "an active T-plan may store information specifying procedures that the health care provider has ordered for that patient" and that "reminders are issued to the patient to definitively schedule a health management event, e.g., an appointment, in accordance with a timeframe specified for that event in the health care event module." Francois, paragraphs [0267] and [0271]. These teachings demonstrate required healthcare provider oversight and involvement in appointment scheduling, which is incompatible with the automatic resource allocation without healthcare provider confirmation as recited by amended claim 19.
Regarding claim 17, this claim is allowable for the same reasons as amended claim 15, as it depends from claim 15 which now recites automatic resource reservation without nurse intervention. The combination of all four references maintains the requirement for healthcare professional involvement and review at various stages of the triage and appointment process, which is eliminated by the automatic resource reservation limitation in amended claim 15.
"A prima facie case of obviousness may also be rebutted by showing that the art, in any material respect, teaches away from the claimed invention." U.S. v. Adams, 383 U.S. 39, 51-2 (1966). The cited references teach away from eliminating nurse intervention, as each reference's system architecture depends on healthcare professional review and oversight as a fundamental component of safe and effective patient care.
Applicant respectfully submits that the amended claims are allowable over the cited combinations and requests withdrawal of the § 103 rejections.
Examiner notes all arguments are in regards to the amended claim limitation of claim 1, 15, and 19 as well as claim 9 which recites “initiate the appointment by outputting at least one control signal to order, allocate, or reserve at least one resource for performance of the appointment without requiring nurse intervention.” And “and automatically outputting at least one control signal to reserve at least one resource for the virtual visit or alternate care based on the determined condition existence without requiring nurse intervention.” And “and automatically output at least one control signal to order, allocate, or reserve at least one resource based on the determined condition type without requiring nurse intervention.” And “automatically initiate the appointment by outputting at least one control signal to reserve specific resources without requiring nurse intervention.” respectively. Hosny is cited as teaching this new claim limitation. Examiner cited Hosny Col. 5 lines 1-14 and see Col. 3 lines 55-64 and Col. 4 lines 1-19 discloses use of machine learning to determine an appointment for a patient through triage. No other reference was cited as teaching this limitation. Furthermore, examiner notes the broadest reasonable interpretation of the claims limitation must be taken in light of the specification as one of ordinary skill in the art would understand. Furthermore, if no specific definition is given in specification the claim limitations must be interpreted for their plain meaning. (the claim recites “or” between the series of elements. Per MPEP § 2143.03, Language that suggests or makes a feature or step optional but does not require that feature or step does not limit the scope of a claim under the broadest reasonable claim interpretation. In addition, when a claim requires selection of an element from a list of alternatives, the prior art teaches the element if one of the alternatives is taught by the prior art. See, e.g., Fresenius USA, Inc. v. Baxter Int’l, Inc., 582 F.3d 1288, 1298, 92 USPQ2d 1163, 1171 (Fed. Cir. 2009). Examiner notes the claim construction recites the terms in claims 1 and 19 order, allocate, or reserve and then reserve in claim 15 in claim 9 initiate. These terms are interpreted as broad where there is no actual execution of an appointment but rather the claim construction under plain definition is to determine or hold or arrange for an appointment in some manner. The claims do recite without nurse intervention but do not limit the claim limitation to having no nurse review post or prior to the order, allocate, reserve, or initiate steps. Therefore, examiner maintains that Hosny teaches a machine learning system which automates the triage of a patient inclusive of scheduling an appointment. The system in Hosny gives no disclosure that the nurse intervention is required for this step. While it may disclose post schedule or hold/ arrangement/ initiate of appointment resources some review by physicians this does not make the teaching of Hosny insufficient under BRI. Finally, the test for obviousness is not whether the features of a secondary reference may be bodily incorporated into the structure of the primary reference; nor is it that the claimed invention must be expressly suggested in any one or all of the references. Rather, the test is what the combined teachings of the references would have suggested to those of ordinary skill in the art. See In re Keller, 642 F.2d 413, 208 USPQ 871 (CCPA 1981).
Examiner maintains the 35 U.S.C § 103 rejection.
Prior Art not cited but made of record
US20060047188A1 – Bohan
A method and System for automated patent intake and triage in the context of an emergency care center is provided. The System consists of a kiosk computer terminal, which is placed in a receiving area within the emergency treatment center and preferably includes a touch Screen interface, a variety of physiological monitoring devices and Software that collects and assesses the user input and physiological data to calculate the Severity of the patient's condition. This allows automated triage and prioritization of patients thereby freeing health care professional resources to perform other patient care functions.
US20180315488A1 – Miranda et. al
Disclosed are systems and methods for triaging , diagnosing , and treating patients. A question - answering device can receive input from a patient regarding the malady the patient is seeking treatment for . The question - answering device can determine based on the input from the patient a likely malady and a recommended course of treatment to cure the malady.
Conclusion
Applicant's amendment necessitated the new ground(s) of rejection presented in this Office action. Accordingly, THIS ACTION IS MADE FINAL. See MPEP § 706.07(a). 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 Ashley Elizabeth Evans whose telephone number is (571) 270-0110. The examiner can normally be reached Monday – Friday 8:00 AM – 5:00 PM.
If attempts to reach the examiner by telephone are unsuccessful, the examiner’s supervisor, Mamon Obeid can be reached on (571) 270-1813. The fax phone number for the organization where this application or proceeding is assigned 571-273-8300.
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/ASHLEY ELIZABETH EVANS/Examiner, Art Unit 3687
/MAMON OBEID/Supervisory Patent Examiner, Art Unit 3687