DETAILED CORRESPONDANCE
The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA .
Status of claims
This final office action on merits is in response to the communication received on 11/07/2025. Claims 2, 7, 9-14, and 20 are cancelled. Amendments to claims 1, 3-5, 8, 15, and 18 are acknowledged and have been carefully considered. Claims 1, 3-6, 8, and 15-19 are pending and considered below.
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, 3-6, 8, and 15-19 are rejected under 35 U.S.C. 101 because the claimed invention is directed to an abstract idea without significantly more.
Step 1
Under step 1, the analysis is based on MPEP 2106.03, and claims 1, 3-6, and 15-19 are drawn to a method, and claim 8 is drawn to a system. Thus, each claim, on its face, is directed to one of the statutory categories (i.e., useful process, machine, manufacture, or composition of matter) of 35 U.S.C. 101.
Step 2A Prong One
Claims 1, 8, and 15 recites as a whole a method of organizing human activity (i.e., commercial or legal interactions (including agreements in the form of contracts, legal obligations, advertising, marketing or sales activities or behaviors, and business relations); and managing personal behavior or relationships or interactions between people, (including social activities, teaching, and following rules or instructions)) because the claim recites a method that allows users to returning a plurality of community-based organization programs that the patient qualifies for enrollment in based on the received patient attributes the server providing the plurality of community-based organization programs that the patient qualifies for enrollment in to a second electronic device; to refer a selected community-based organization program of the plurality of community-based organization programs that the patient qualifies for enrollment in from the second electronic device; in response to the received instruction, sending a referral to the selected community-based organization program, the referral including a control to request enrollment in the selected community-based organization program (claim 1), returning a plurality of community-based organization programs that the patient qualifies for enrollment to request enrollment in one of the plurality of community-based organization programs; providing the plurality of community-based organization programs that the patient qualifies for enrollment; to refer a selected community-based organization program of the plurality of community-based organization programs that the patient qualifies for enrollment; and in response to the received instruction, sending a referral the referral including a control to request enrollment in the selected community- based organization program (claim 8), and returning a plurality of community-based organization programs that the patient qualifies for enrollment, wherein each of the plurality of community-based organization programs has a respective available capacity of participants that can be enrolled in the community-based organization program and wherein the server automatically reduces the respective available capacity of one community-based organization program of the plurality of community-based organization programs when a participant enrolls in the one community-based organization program and wherein the plurality of community-based organization programs excludes community- based organization programs that have zero available capacity (claim 15). This is a method of commercial and legal interactions (eligibility determination, enrollment workflows, referral workflows) and managing personal interaction (coordinating interactions between patients, community based organizations, and referring patients). The mere nominal recitation of a generic server and computing devices do not take the claim out of the methods of administrative matching, referral, and enrollment coordination (claim 1), service eligibility determination, communication of available programs, and referral for enrollment (claim 8) and resource allocation, capacity management, and program availability tracking (claim 15). Thus, the claims recite an abstract idea.
Under Step 2A Prong Two
The claimed limitations, as per claim 1, include:
through a single secure network connection between a first electronic device and a server, receiving patient attributes of a patient at the server;
the server returning a plurality of community-based organization programs that the patient qualifies for enrollment in based on the received patient attributes the server providing the plurality of community-based organization programs that the patient qualifies for enrollment in to a second electronic device;
the server receiving an instruction to refer a selected community-based organization program of the plurality of community-based organization programs that the patient qualifies for enrollment in from the second electronic device; and
in response to the received instruction, the server sending a referral to the selected community-based organization program to the first computing device, the referral including a control to request enrollment in the selected community-based organization program.
The claimed limitations, as per claim 8, include:
a first electronic device;
a second electronic device;
a server; and
a network connecting the first electronic device, the second electronic device and the server;
wherein the server comprises: a network interface; and a processor configured to perform steps comprising: establishing a single secure network connection to the first electronic device through the network interface;
through the single secure network connection, receiving patient attributes of a patient;
establishing a second network connection to the first electronic device through the network interface; and
returning a plurality of community-based organization programs that the patient qualifies for enrollment in through the second network connection to the first electronic device such that the first electronic device can be used to request enrollment in one of the plurality of community-based organization programs;
providing the plurality of community-based organization programs that the patient qualifies for enrollment in to a second electronic device;
receiving an instruction to refer a selected community-based organization program of the plurality of community-based organization programs that the patient qualifies for enrollment in from the second electronic device; and
in response to the received instruction, sending a referral to the first computing device, the referral including a control to request enrollment in the selected community- based organization program.
The claimed limitations, as per claim 15, include:
a server receiving a single API call providing patient attributes of a patient;
the server returning a plurality of community-based organization programs that the patient qualifies for enrollment in response to a second API call, wherein each of the plurality of community-based organization programs has a respective available capacity of participants that can be enrolled in the community-based organization program and wherein the server automatically reduces the respective available capacity of one community-based organization program of the plurality of community-based organization programs when a participant enrolls in the one community-based organization program and wherein the plurality of community-based organization programs excludes community- based organization programs that have zero available capacity.
Examiner Note: underlined elements indicate additional elements of the claimed invention identified as performing the steps of the claimed invention.
The judicial exception expressed in claims 1, 8, and 15 are not integrated into a practical application. The claims as a whole merely describes how to generally “apply” the concepts of matching patients to eligible community based organization programs and facilitating program referral and enrollment workflows (claim 1), returning eligible programs, facilitating enrollment, and process referral instructions across multiple user devices (claim 8), and returning eligible programs based on patient attributes and program capacity upon enrollment (claim 15) in a computer environment. The claimed computer components (i.e., between a first electronic device and a server (claim 1), the server (claim 1, 8, and 15), the first computing device (claim 1 and 8), a first electronic device (claim 8), a second electronic device (claim 8), a network connecting the first electronic device, the second electronic device and the server; wherein the server comprises: a network interface; and a processor configured to perform steps comprising (claim 8), establishing a second network connection to the first electronic device through the network interface (claim 8), in through the second network connection to the first electronic device such that the first electronic device can be used (claim 8), in response to a second API call (claim 15)) are recited at a high level of generality and are merely invoked as tools to perform an existing process of determining eligibility, returning results, receiving instructions, and transmitting referrals. Simply implementing the abstract idea on a generic computer is not a practical application of the abstract idea. Accordingly, alone and in combination, these additional elements do not integrate the abstract idea into a practical application.
The judicial exception expressed in claims 1 and 8 are not integrated into a practical application. The abstract idea is merely carried out in a technical environment or field (i.e., a generic computer networking environment involving routine transmission and receipt of data between electronic devices and a server), however fails to contain meaningful limitations beyond generally linking the use of an abstract idea to a particular technological environment (see MPEP 2106.05(h)). The additional elements that are carried out in a technical environment includes through a single secure network connection (claim 1); and establishing a single secure network connection to the first electronic device through the network interface; through the single secure network connection (claim 8). Accordingly, alone and in combination, these additional elements do not integrate the abstract idea into a practical application.
The judicial exception expressed in claims 1, 8, and 15 are not integrated into a practical application. The claims recite the additional elements of receiving patient attributes of a patient (claims 1 and 8); receiving an instruction (claims 1 and 8); and receiving a single API call providing patient attributes of a patient (claim 15). These limitations are recited at a high level of generality (i.e., as a general means of collecting information for the use of enrollment, eligibility, and referral process), and amounts to merely data gathering, which is a form of insignificant extra-solution activity. Accordingly, even in combination, these additional elements do not integrate the abstract idea into a practical application. The claims are directed to an abstract idea.
Therefore, under step 2A, the claims are directed to the abstract idea, and require further analysis under Step 2B.
Under step 2B
Claims 1, 8, and 15 do not include additional elements that are sufficient to amount to significantly more than the judicial exception. As discussed with respect to Step 2A, the claims as a whole merely describes how to generally “apply” the concept of matching patients to eligible community based organization programs and facilitating program referral and enrollment workflows (claim 1), returning eligible programs, facilitating enrollment, and process referral instructions across multiple user devices (claim 8), and returning eligible programs based on patient attributes and program capacity upon enrollment (claim 15) in a computer environment. Thus, even when viewed as a whole, nothing in the claims add significantly more (i.e., an inventive concept) to the abstract idea.
Claims 1 and 8 do not include additional elements that are sufficient to amount to significantly more than the judicial exception. As discussed with respect to Step 2A, the abstract idea is merely carried out in a technical environment or field, however fails to contain meaningful limitations beyond generally linking the use of an abstract idea to a particular technological environment. Thus, even when viewed as a whole, nothing in the claims add significantly more (i.e., an inventive concept) to the abstract idea.
For claims 1, 8 and 15, under step 2B, the additional elements of receiving patient attributes of a patient (claims 1 and 8); receiving an instruction (claims 1 and 8); and receiving a single API call providing patient attributes of a patient (claim 15) have been evaluated. The method and system perform a general function of receiving information with an enrollment, eligibility, and referral workflow which represents a well-understood, routine, and conventional activity in the field of networked computer systems and electronic data processing. The specification discloses that the server and processor is used in its ordinary capacity as a data input device and does not describe any improvement to the computer itself or to the functioning of the overall computer system (see [0037] and [0041]). Also noted in Electric Power Group, LLC v. Alstom S.A., 830 F.3d 1350, 1354, 119 USPQ2d 1739, 1742 (Fed. Cir. 2016), merely collecting information for analysis without a technological improvement does not add significantly more to an abstract idea. The use of the method and system is no more than collecting information before processing eligibility determination, referral, and enrollment, and does not integrate the abstract idea into a practical application. Therefore, the claims do not recite an inventive concept and is not patent eligible.
Claims 5, 6, and 16-19 recite no further additional elements, and only further narrow the abstract idea. The previously identified additional elements, individually and as a combination, do not integrate the narrowed abstract idea into a practical application for reasons similar to those explained above, and do not amount to significantly more than the narrowed abstract idea for reasons similar to those explained above.
Claims 3 and 4 recite the additional elements of to the first electronic device (claims 3 and 4), the server (claim 4), and a third electronic device (claim 4). However, this additional element amounts to implementing an abstract idea on a generic computing device. As such, these additional elements, when considered individually or in combination with the prior devices, do not integrate the abstract idea into a practical application or amount to significantly more than the abstract idea.
Thus, as the dependent claims remain directed to a judicial exception, and as the additional elements of the claims do not amount to significantly more, the dependent claims are not patent eligible.
Therefore, the claims here fail to contain any additional element(s) or combination of additional elements that can be considered as significantly more and the claim is rejected under 35 U.S.C. 101 for lacking eligible subject matter.
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.
The factual inquiries for establishing a background for determining obviousness under 35 U.S.C. 103 are summarized as follows:
1. Determining the scope and contents of the prior art.
2. Ascertaining the differences between the prior art and the claims at issue.
3. Resolving the level of ordinary skill in the pertinent art.
4. Considering objective evidence present in the application indicating obviousness or nonobviousness.
Claims 1, 3-6, and 8 are rejected under 35 U.S.C. 103 as being unpatentable over Hoffman et al. (U.S. Patent Publication 2019/0304599 A1), referred to hereinafter as Hoffman, in view of Stadler et al. (U.S. Patent Publication 2016/0125143 A1), referred to hereinafter as Stadler.
Regarding claim 1, Hoffman teaches a method comprising (Hoffman [0013] “FIG. 3 is a flow chart showing general stages involved in an example method for providing automated assistance program qualification and enrollment according to an embodiment”):
a server, receiving patient attributes of a patient at the server (Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.” and [0019] “If an assistance program policy requires supporting documentation, aspects further enable the user to upload the documentation and to provide a signature from a user computing device.”, and Hoffman [0006] “Aspects of the disclosure provide automated assistance program qualification and enrollment. An assistance program qualification and enrollment (APQE) system determines whether a user qualifies for an assistance program that offers assistance with an ongoing transaction record with a service provider. The APQE system generates a set of questions based on qualification data (used to make a qualification determination) that are not included in collected user data and financial data about the user. The user's qualification is based on an evaluation of the user data, financial data, and user-provided responses to the questions. If the user qualifies for the assistance program, an option is provided to the user to enroll in the assistance program. If additional information is needed to complete an enrollment process for the assistance program, an interface is provided that enables the user to provide the data for completing the process.”);
the server returning a plurality of community-based organization programs that the patient qualifies for enrollment in based on the received patient attributes (Hoffman [0030] “In example aspects, the self-service portal 140 is configured to generate a self-service portal user interface (UI) 120 for display on the user computing device 102 via the user agent. According to an aspect, the self-service portal 140 includes one or more application programming interfaces (APIs), which connect the self-service portal 140 to the APQE system 130 so that the self-service portal is able request an assistance program qualification questionnaire from the APQE system and to transmit data input by the user via the user computing device 102 to the APQE system for determining whether the user qualifies for an assistance program and to communicate that determination to the user.” and Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.”);
the server providing the plurality of community-based organization programs that the patient qualifies for enrollment (Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.”);
a selected community-based organization program of the plurality of community-based organization programs that the patient qualifies for enrollment (Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.”);
in response to the received instruction, to the selected community-based organization program, a control to request enrollment in the selected community-based organization program (Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.”).
Hoffman fails to explicitly teach through a single secure network connection between a first electronic device; to a second electronic device; the server receiving an instruction to refer and enrollment in from the second electronic device; and the server sending a referral and to the first computing device, the referral including.
Stadler teaches through a single secure network connection between a first electronic device (Stadler [0045] “The care management service 410 includes a number of services such as an identification, stratification, and prioritization service 412, a care manager alignment service 414, and a care management outreach service 416. Each of the services 412, 414, and 416 may be in communication with one another via a network 450. The network 450 may include, without limitation, one or more local area networks (LANs) or wide area networks (WANs). The network 450 may be a secure network associated with a healthcare facility. The secure network 450 may require that a user log in and be authenticated in order to send and/or receive information over the network 450. Additionally, each of the services 412, 414, and 416 are in communication with a data store 446 and an end-user computing device 448 having a display screen.” and Stadler [0029] “Computer networks 106 comprise local area networks (LANs) and/or wide area networks (WANs). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet. When utilized in a WAN networking environment, the control server 102 might comprise a modem or other means for establishing communications over the WAN, such as the Internet. In a networking environment, program modules or portions thereof might be stored in association with the control server 102, the data store 104, or any of the remote computers 108. For example, various application programs may reside on the memory associated with any one or more of the remote computers 108. It will be appreciated by those of ordinary skill in the art that the network connections shown are exemplary and other means of establishing a communications link between the computers (e.g., control server 102 and remote computers 108) might be utilized.”);
to a second electronic device (Stadler [0024] “The present invention might be operational with numerous other purpose computing system environments or configurations. Examples of well-known computing systems, environments, and/or configurations that might be suitable for use with the present invention include personal computers, server computers, hand-held or laptop devices, multiprocessor systems, microprocessor-based systems, set top boxes, programmable consumer electronics, network PCs, minicomputers, mainframe computers, distributed computing environments that include any of the above-mentioned systems or devices, and the like.”, and Stadler [0025] “The present invention might be described in the general context of computer-executable instructions, such as program modules, being executed by a computer. Exemplary program modules comprise routines, programs, objects, components, and data structures that perform particular tasks or implement particular abstract data types. The present invention might be practiced in distributed computing environments where tasks are performed by remote processing devices that are linked through a communications network. In a distributed computing environment, program modules might be located in association with local and/or remote computer storage media (e.g., memory storage devices).”);
the server receiving an instruction to refer and enrollment in from the second electronic device (Stadler [0028] “The control server 102 might operate in a computer network 106 using logical connections to one or more remote computers 108. Remote computers 108 might be located at a variety of locations in a medical or research environment, including clinical laboratories (e.g., molecular diagnostic laboratories), hospitals and other inpatient settings, veterinary environments, ambulatory settings, medical billing and financial offices, hospital administration settings, home healthcare environments, and clinicians' offices. Clinicians may comprise a treating physician or physicians; specialists such as surgeons, radiologists, cardiologists, and oncologists; emergency medical technicians; physicians' assistants; nurse practitioners; nurses; nurses' aides; pharmacists; dieticians; microbiologists; laboratory experts; laboratory technologists; genetic counselors; researchers; veterinarians; students; and the like. The remote computers 108 might also be physically located in nontraditional medical care environments so that the entire healthcare community might be capable of integration on the network. The remote computers 108 might be personal computers, servers, routers, network PCs, peer devices, other common network nodes, or the like and might comprise some or all of the elements described above in relation to the control server 102. The devices can be personal digital assistants or other like devices.”, Stadler [0132] At a step 1214, it is further determined that the patient qualifies for a health intervention program, where the health intervention program has an associated set of recommendations. This determination may be carried out by a monitoring component such as the monitoring component 438 of FIG. 4. To determine that the patient qualifies for the health intervention program, the patient's health data is analyzed to determine if it meets certain criteria associated with the health intervention program. For example, a patient may qualify for a hypertension management program if the patient's systolic and diastolic pressures are above a threshold value for four consecutive measurements taken over a year period.”, and Stadler [0129] “At a step 1114, a welcome-to-service template is automatically selected and populated with patient-specific information by a populating component such as the populating component 440 of FIG. 4. The patient-specific information may be derived from the patient's health data and include the patient's name and other identifying information, a care manager that has been assigned to the patient, any care recommendations specific to the patient, and the like.”);
the server sending a referral and to the first computing device, the referral including (Stadler [0028] “The control server 102 might operate in a computer network 106 using logical connections to one or more remote computers 108. Remote computers 108 might be located at a variety of locations in a medical or research environment, including clinical laboratories (e.g., molecular diagnostic laboratories), hospitals and other inpatient settings, veterinary environments, ambulatory settings, medical billing and financial offices, hospital administration settings, home healthcare environments, and clinicians' offices. Clinicians may comprise a treating physician or physicians; specialists such as surgeons, radiologists, cardiologists, and oncologists; emergency medical technicians; physicians' assistants; nurse practitioners; nurses; nurses' aides; pharmacists; dieticians; microbiologists; laboratory experts; laboratory technologists; genetic counselors; researchers; veterinarians; students; and the like. The remote computers 108 might also be physically located in nontraditional medical care environments so that the entire healthcare community might be capable of integration on the network. The remote computers 108 might be personal computers, servers, routers, network PCs, peer devices, other common network nodes, or the like and might comprise some or all of the elements described above in relation to the control server 102. The devices can be personal digital assistants or other like devices.”).
It would have been obvious to one of ordinary skill in the art at the time of the invention to modify Hoffman’s automated assistance program qualification workflow to incorporate the multidevice communication architecture taught by Stadler. Hoffman teaches receiving patient attributes over a secure connection, determining qualifying assistance programs, sending the resulting list to a user facing device, and processing program related instructions such as enrollment requests. Stadler teaches a distributed environment in which a central server communicates with multiple remote computing devices, which include devices used by clinicians and other stakeholders, over secure networks and in which such devices perform program eligibility determinations, generate recommendations, and initiate program related actions. Combining these teachings represents a predictable use of prior art elements of extending Hoffman’s existing program communication workflow to multiple known device types in Stadler’s distributed architecture.
Also, a person of ordinary skill would have been motivated to implement Hoffman’s program eligibility data exchange and enrollment instruction workflow across multiple devices, as taught in Stadler, in order to improve coordination and enable referrals or selections from users other than the patient. Stadler teaches that remote devices generate patient specific program triggers and outreach actions, thereby suggesting that such devices should also be able to receive program information and send referral related instructions. Incorporating Stadler’s multidevice interactions into Hoffman’s system would have predictably allowed a second device, to view the qualifying programs and send a referral instruction to the server, improving workflow flexibility and efficiency
Regarding claim 3, Hoffman and Stadler teach the invention in claim 1, as discussed above, and further teach wherein returning the plurality of community-based organization programs to the first electronic device comprises providing at least one control for requesting enrollment in one of the plurality of community-based organization programs ((Hoffman [0057] In example aspects, the enrollment engine 170 is configured to generate an enrollment response based on the result(s) of additional user input determination(s). For example, responsive to the enrollment request, the enrollment engine 170 responds to the request with an API response that includes instructions for enabling the self-service portal 140 to generate a UI 120 including instructions for completing enrollment (e.g., instructions associated with additional user input or particular supporting documents needed from the user to complete the enrollment process for one or more selected assistance programs) and input controls (e.g., fillable data fields, checkboxes, dropdown lists, or selectable buttons) that enable the user to enter additional user input (e.g., user signature, demographic data, financial data, health-related data) and/or a document upload interface that enables the user to upload and transmit supporting documents (e.g., bank statements, tax documents, income documents) to the enrollment engine 170.” And Hoffman [0054] “The enrollment engine 170 is illustrative of one or more software applications, modules, or computing devices operative or configured to receive a request for enrollment in one or more assistance programs from the self-service portal 140. In example aspects, the enrollment engine 170 provides/exposes an enrollment API, which the self-service portal 140 can invoke to communicate an enrollment selection to the enrollment engine 170 as part of a request for automated enrollment in an assistance program. For example, the screening engine 160 includes one or more APIs, which connect the self-service portal 140 to the enrollment engine 170 so that the self-service portal is able send enrollment selections and the enrollment request.” and
Stadler [0029] “Computer networks 106 comprise local area networks (LANs) and/or wide area networks (WANs). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet. When utilized in a WAN networking environment, the control server 102 might comprise a modem or other means for establishing communications over the WAN, such as the Internet. In a networking environment, program modules or portions thereof might be stored in association with the control server 102, the data store 104, or any of the remote computers 108. For example, various application programs may reside on the memory associated with any one or more of the remote computers 108. It will be appreciated by those of ordinary skill in the art that the network connections shown are exemplary and other means of establishing a communications link between the computers (e.g., control server 102 and remote computers 108) might be utilized.”).
Therefore, it would be obvious to a PHOSITA before the effective filing date of the invention to adapt Hoffman’s enrollment user interface controls to the return of eligible community based organization programs, because Hoffman teaches including controls in the same API response that conveys program qualification results. Using known interface controls for a predictable purpose, which allow a user to request enrollment in a returned program, represents the predictable use of prior art elements according to their established functions. Accordingly, providing at least one control within the returned list of eligible programs would have been obvious.
Regarding claim 4, Hoffman and Stadler teach the invention in claim 3, as discussed above, and further teach further comprising: the server providing an indication to a third electronic device associated with a community-based organization that the patient has requested to enroll in one of the community- based organization's programs; and the server providing updates to the first electronic device indicating the current status of the request to enroll in one of the community-based organization's programs (Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.” , Hoffman [0061] “According to an aspect, the enrollment engine 170 is configured to execute the specific action and communicate the user's enrollment request to the corresponding assistance program system(s) 132, the corresponding service provider system(s) 104, and/or patient access workflow system 190. In some example aspects, the enrollment engine 170 invokes an API of the assistance program system(s) 132 and/or the service provider system(s) 104 to enroll the user in an assistance program. For example, the API connects the enrollment engine 170 to the assistance program system(s) 132, service provider system(s) 104, and/or patient access workflow system 190 associated with the provider system(s) so that the enrollment engine 170 is able to transmit an indication of the user's selection to enroll in an assistance program and associated data (e.g., user data 126, financial data 122, user inputs, supporting documents) to the corresponding assistance program system(s) 132, service provider system(s) 104, and in some examples, a patient access workflow system 190 associated with the provider system(s). Aspects of the APQE system 130 enable the user to gather and transmit sensitive supporting documents only when the user knows that he/she qualifies and has selected to enroll in an assistance program. As can be appreciated, this can improve data security, computing resources associated with uploading and transmitting the documents, and the user experience.” and Hoffman [0062] “According to an aspect, the enrollment engine 170 is configured to receive an indication of completion of the assistance program application and enrollment process from one or more of the assistance program system(s) 132, service provider system(s) 104, and patient access workflow system 190. Responsive to receiving the indication of completion, the enrollment engine 170 may update the data store 165 with an assistance program application and enrollment process status update. For example, the status of the user's assistance program application for and enrollment in an assistance program can be stored by the APQE system 130. In various examples, the ongoing transaction records 128 for the user may be updated with discounted obligation amounts. Accordingly, when the user uses these self-service portal 140 to view his/her obligations for services, the self-service portal obtains the updated discounted obligation amounts for display to the user. In some examples, the enrollment engine 170 may be configured to communicate the completion of the assistance program application to the user via the self-service portal 140 or via one or more other communication means (e.g., text message, email, phone call, mail).”, and
Stadler [0045] “The care management service 410 includes a number of services such as an identification, stratification, and prioritization service 412, a care manager alignment service 414, and a care management outreach service 416. Each of the services 412, 414, and 416 may be in communication with one another via a network 450. The network 450 may include, without limitation, one or more local area networks (LANs) or wide area networks (WANs). The network 450 may be a secure network associated with a healthcare facility. The secure network 450 may require that a user log in and be authenticated in order to send and/or receive information over the network 450. Additionally, each of the services 412, 414, and 416 are in communication with a data store 446 and an end-user computing device 448 having a display screen.” and Stadler [0029] “Computer networks 106 comprise local area networks (LANs) and/or wide area networks (WANs). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet. When utilized in a WAN networking environment, the control server 102 might comprise a modem or other means for establishing communications over the WAN, such as the Internet. In a networking environment, program modules or portions thereof might be stored in association with the control server 102, the data store 104, or any of the remote computers 108. For example, various application programs may reside on the memory associated with any one or more of the remote computers 108. It will be appreciated by those of ordinary skill in the art that the network connections shown are exemplary and other means of establishing a communications link between the computers (e.g., control server 102 and remote computers 108) might be utilized.”).
Therefore, it would be obvious to a PHOSITA before the effective filing date of the invention to combine these teachings so that the server not only forwards the enrollment request to the appropriate third party program system, but also provides updates back to the user’s original electronic device. Each step is a predictable extension of Hoffman’s described workflow, forwarding enrollment data to external systems and notifying users of application status, and aligns with Stadler’s multidevice, server centered communication model. Implementing these communications across multiple devices using known network techniques is simply applying established methods to yield the predictable result of keeping both the system and the user informed of enrollment progress.
Regarding claim 5, Hoffman and Stadler teach the invention in claim 1, as discussed above, and further teach wherein each of the plurality of community-based organization programs has an end date and the plurality of community-based organization programs excludes community-based organization programs with an end date before a current date (Hoffman [0073] “FIG. 3 is a flow chart showing general stages involved in an example method 300 for providing automated assistance program qualification and enrollment according to an embodiment. The method 300 begins at START OPERATION 302 and proceeds to OPERATION 304, where the method 300 uses the questionnaire generator 150 of the APQE system 130 to receive a request from the self-service portal 140 to determine whether the user qualifies for an assistance program to discount an obligation amount owed to a service provider for services received from the service provider. In various examples, the qualification request (3b) is received responsive to the user logging into the self-service portal 140, the self-service portal providing an indication of obligation amounts associated with one or more ongoing transaction records 128 related to services received from one or more service providers in a UI 120 for display to the user, and a user-selection to determine whether the user meets criteria for one or more assistance programs. In other example, the qualification request (3b) is automatically generated when an ongoing transaction record 128 for the user is received from a service provider system 104 by the APQE system 130. In an example aspect, the service provider system 104 may send a batch of new ongoing transaction records 128 to the APQE system 130 on a scheduled basis (e.g., daily, nightly, weekly). In another example aspect, the service provider system 104 may send a new ongoing transaction record 128 to the APQE system 130 when the new record is created. According to an aspect, the qualification request (3b) includes information identifying the user and the service provider associated with the ongoing transaction record 128.” and Hoffman [0065] 2a represents a user-initiated request for user account information (e.g., ongoing transaction records 128). For example, the user may use the self-service portal 140 to view ongoing transaction records 128 associated with one or more service provider account(s), to make online payments or set up payment plans, to schedule appointments, and, according to an aspect of the present disclosure, to qualify for and enroll in an assistance program.”
and Stadler [0081] “The system and methods described above allow clients or end-users, such as healthcare organizations to customize the process for identifying patients in their patient population who are eligible for care management services. End-users are able to customize what criteria are used to identify patients eligible for care management services, as well as to customize the order of identification versus stratification. Further, because the described system and methods utilize up-to-date patient data, patients eligible for care management services can be quickly identified and care management may be implemented at a time when it is most needed. Moreover, because patient data is continually received, the system and methods described allow for a pro-active surveillance approach to care management where patient data is continually monitored to determine if a particular patient, who was previously ineligible for care management services, becomes eligible for the services.”).
Therefore, it would be obvious to a PHOSITA before the effective filing date of the invention to recognized that, to ensure program qualification results remain accurate and actionable, it is necessary to exclude assistance programs or services that are no longer active. Because both references emphasize operating on updated information, it would have been obvious to incorporate temporal criteria, such as comparing a program’s end date against the current date, into the filtering logic. Excluding expired programs is the predictable use of known validity filtering to improve reliability of recommendations, and therefore represents an obvious modification of Hoffman in view of Stadler.
Regarding claim 6, Hoffman and Stadler teach the invention in claim 5, as discussed above, and further teach wherein for each community-based organization program, the end date is supplied by the community-based organization that provides the community- based organization program (Hoffman [0073] “FIG. 3 is a flow chart showing general stages involved in an example method 300 for providing automated assistance program qualification and enrollment according to an embodiment. The method 300 begins at START OPERATION 302 and proceeds to OPERATION 304, where the method 300 uses the questionnaire generator 150 of the APQE system 130 to receive a request from the self-service portal 140 to determine whether the user qualifies for an assistance program to discount an obligation amount owed to a service provider for services received from the service provider. In various examples, the qualification request (3b) is received responsive to the user logging into the self-service portal 140, the self-service portal providing an indication of obligation amounts associated with one or more ongoing transaction records 128 related to services received from one or more service providers in a UI 120 for display to the user, and a user-selection to determine whether the user meets criteria for one or more assistance programs. In other example, the qualification request (3b) is automatically generated when an ongoing transaction record 128 for the user is received from a service provider system 104 by the APQE system 130. In an example aspect, the service provider system 104 may send a batch of new ongoing transaction records 128 to the APQE system 130 on a scheduled basis (e.g., daily, nightly, weekly). In another example aspect, the service provider system 104 may send a new ongoing transaction record 128 to the APQE system 130 when the new record is created. According to an aspect, the qualification request (3b) includes information identifying the user and the service provider associated with the ongoing transaction record 128.” and Hoffman [0065] 2a represents a user-initiated request for user account information (e.g., ongoing transaction records 128). For example, the user may use the self-service portal 140 to view ongoing transaction records 128 associated with one or more service provider account(s), to make online payments or set up payment plans, to schedule appointments, and, according to an aspect of the present disclosure, to qualify for and enroll in an assistance program.”
and Stadler [0081] “The system and methods described above allow clients or end-users, such as healthcare organizations to customize the process for identifying patients in their patient population who are eligible for care management services. End-users are able to customize what criteria are used to identify patients eligible for care management services, as well as to customize the order of identification versus stratification. Further, because the described system and methods utilize up-to-date patient data, patients eligible for care management services can be quickly identified and care management may be implemented at a time when it is most needed. Moreover, because patient data is continually received, the system and methods described allow for a pro-active surveillance approach to care management where patient data is continually monitored to determine if a particular patient, who was previously ineligible for care management services, becomes eligible for the services.”).
Therefore, it would be obvious to a PHOSITA before the effective filing date of the invention to understand that program parameters, including enrollment availability, applicability conditions, and temporal limitations such as end dates, would be supplied by the organization administering each program. Sourcing program metadata (including end dates) from the originating organization is nothing more than using a known, conventional information flow to achieve a predictable result: ensuring the server’s eligibility screening uses authoritative, updated program definitions. Accordingly, it would have been obvious to obtain each program’s end date from the corresponding community-based organization.
Regarding claim 8, Hoffman teaches a system comprising (Hoffman [0006] “Aspects of the disclosure provide automated assistance program qualification and enrollment. An assistance program qualification and enrollment (APQE) system determines whether a user qualifies for an assistance program that offers assistance with an ongoing transaction record with a service provider.”):
a server (Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.” and [0019] “If an assistance program policy requires supporting documentation, aspects further enable the user to upload the documentation and to provide a signature from a user computing device.”); and
wherein the server comprises: a processor configured to perform steps comprising: ((Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.” and Hoffman [0021] “With reference to FIG. 1A, the example operating environment 100 includes a user computing device 102, one or more service provider systems 104 a-n (generally, 104), a data processor system 110, one or more third-party data source systems 106 a-n (generally, 106), and optionally one or more third-party assistance program systems 132 a-n.”);
receiving patient attributes of a patient (Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.” and [0019] “If an assistance program policy requires supporting documentation, aspects further enable the user to upload the documentation and to provide a signature from a user computing device.”, and Hoffman [0006] “Aspects of the disclosure provide automated assistance program qualification and enrollment. An assistance program qualification and enrollment (APQE) system determines whether a user qualifies for an assistance program that offers assistance with an ongoing transaction record with a service provider. The APQE system generates a set of questions based on qualification data (used to make a qualification determination) that are not included in collected user data and financial data about the user. The user's qualification is based on an evaluation of the user data, financial data, and user-provided responses to the questions. If the user qualifies for the assistance program, an option is provided to the user to enroll in the assistance program. If additional information is needed to complete an enrollment process for the assistance program, an interface is provided that enables the user to provide the data for completing the process.”);
returning a plurality of community-based organization programs that the patient qualifies for enrollment, to request enrollment in one of the plurality of community-based organization programs (Hoffman [0030] “In example aspects, the self-service portal 140 is configured to generate a self-service portal user interface (UI) 120 for display on the user computing device 102 via the user agent. According to an aspect, the self-service portal 140 includes one or more application programming interfaces (APIs), which connect the self-service portal 140 to the APQE system 130 so that the self-service portal is able request an assistance program qualification questionnaire from the APQE system and to transmit data input by the user via the user computing device 102 to the APQE system for determining whether the user qualifies for an assistance program and to communicate that determination to the user.” and Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.”);
providing the plurality of community-based organization programs that the patient qualifies for enrollment in (Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.”);
a selected community-based organization program of the plurality of community-based organization programs that the patient qualifies for enrollment in ((Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.”);
in response to the received instruction, a control to request enrollment in the selected community- based organization program (Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.”).
Hoffman fails to explicitly teach a first electronic device; a second electronic device; a network connecting the first electronic device, the second electronic device and the server; a network interface and establishing a single secure network connection to the first electronic device through the network interface; through the single secure network connection; establishing a second network connection to the first electronic device through the network interface; in through the second network connection to the first electronic device such that the first electronic device can be used; receiving an instruction to refer; and sending a referral to the first computing device, the referral including.
Stadler teaches a first electronic device ((Stadler [0029] “Computer networks 106 comprise local area networks (LANs) and/or wide area networks (WANs). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet. When utilized in a WAN networking environment, the control server 102 might comprise a modem or other means for establishing communications over the WAN, such as the Internet. In a networking environment, program modules or portions thereof might be stored in association with the control server 102, the data store 104, or any of the remote computers 108. For example, various application programs may reside on the memory associated with any one or more of the remote computers 108. It will be appreciated by those of ordinary skill in the art that the network connections shown are exemplary and other means of establishing a communications link between the computers (e.g., control server 102 and remote computers 108) might be utilized.”);
a second electronic device ((Stadler [0029] “Computer networks 106 comprise local area networks (LANs) and/or wide area networks (WANs). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet. When utilized in a WAN networking environment, the control server 102 might comprise a modem or other means for establishing communications over the WAN, such as the Internet. In a networking environment, program modules or portions thereof might be stored in association with the control server 102, the data store 104, or any of the remote computers 108. For example, various application programs may reside on the memory associated with any one or more of the remote computers 108. It will be appreciated by those of ordinary skill in the art that the network connections shown are exemplary and other means of establishing a communications link between the computers (e.g., control server 102 and remote computers 108) might be utilized.” and Stadler [0028] “The control server 102 might operate in a computer network 106 using logical connections to one or more remote computers 108. Remote computers 108 might be located at a variety of locations in a medical or research environment, including clinical laboratories (e.g., molecular diagnostic laboratories), hospitals and other inpatient settings, veterinary environments, ambulatory settings, medical billing and financial offices, hospital administration settings, home healthcare environments, and clinicians' offices.”);
a network connecting the first electronic device, the second electronic device and the server (Stadler [0045] “The care management service 410 includes a number of services such as an identification, stratification, and prioritization service 412, a care manager alignment service 414, and a care management outreach service 416. Each of the services 412, 414, and 416 may be in communication with one another via a network 450. The network 450 may include, without limitation, one or more local area networks (LANs) or wide area networks (WANs). The network 450 may be a secure network associated with a healthcare facility. The secure network 450 may require that a user log in and be authenticated in order to send and/or receive information over the network 450. Additionally, each of the services 412, 414, and 416 are in communication with a data store 446 and an end-user computing device 448 having a display screen.” and Stadler [0029] “Computer networks 106 comprise local area networks (LANs) and/or wide area networks (WANs). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet. When utilized in a WAN networking environment, the control server 102 might comprise a modem or other means for establishing communications over the WAN, such as the Internet. In a networking environment, program modules or portions thereof might be stored in association with the control server 102, the data store 104, or any of the remote computers 108. For example, various application programs may reside on the memory associated with any one or more of the remote computers 108. It will be appreciated by those of ordinary skill in the art that the network connections shown are exemplary and other means of establishing a communications link between the computers (e.g., control server 102 and remote computers 108) might be utilized.”);
a network interface and establishing a single secure network connection to the first electronic device through the network interface (Stadler [0045] “The care management service 410 includes a number of services such as an identification, stratification, and prioritization service 412, a care manager alignment service 414, and a care management outreach service 416. Each of the services 412, 414, and 416 may be in communication with one another via a network 450. The network 450 may include, without limitation, one or more local area networks (LANs) or wide area networks (WANs). The network 450 may be a secure network associated with a healthcare facility. The secure network 450 may require that a user log in and be authenticated in order to send and/or receive information over the network 450. Additionally, each of the services 412, 414, and 416 are in communication with a data store 446 and an end-user computing device 448 having a display screen.” and Stadler [0029] “Computer networks 106 comprise local area networks (LANs) and/or wide area networks (WANs). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet. When utilized in a WAN networking environment, the control server 102 might comprise a modem or other means for establishing communications over the WAN, such as the Internet. In a networking environment, program modules or portions thereof might be stored in association with the control server 102, the data store 104, or any of the remote computers 108. For example, various application programs may reside on the memory associated with any one or more of the remote computers 108. It will be appreciated by those of ordinary skill in the art that the network connections shown are exemplary and other means of establishing a communications link between the computers (e.g., control server 102 and remote computers 108) might be utilized.”);
through the single secure network connection (Stadler [0045] “The care management service 410 includes a number of services such as an identification, stratification, and prioritization service 412, a care manager alignment service 414, and a care management outreach service 416. Each of the services 412, 414, and 416 may be in communication with one another via a network 450. The network 450 may include, without limitation, one or more local area networks (LANs) or wide area networks (WANs). The network 450 may be a secure network associated with a healthcare facility. The secure network 450 may require that a user log in and be authenticated in order to send and/or receive information over the network 450. Additionally, each of the services 412, 414, and 416 are in communication with a data store 446 and an end-user computing device 448 having a display screen.” and Stadler [0029] “Computer networks 106 comprise local area networks (LANs) and/or wide area networks (WANs). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet. When utilized in a WAN networking environment, the control server 102 might comprise a modem or other means for establishing communications over the WAN, such as the Internet. In a networking environment, program modules or portions thereof might be stored in association with the control server 102, the data store 104, or any of the remote computers 108. For example, various application programs may reside on the memory associated with any one or more of the remote computers 108. It will be appreciated by those of ordinary skill in the art that the network connections shown are exemplary and other means of establishing a communications link between the computers (e.g., control server 102 and remote computers 108) might be utilized.”);
establishing a second network connection to the first electronic device through the network interface (Stadler [0045] “The care management service 410 includes a number of services such as an identification, stratification, and prioritization service 412, a care manager alignment service 414, and a care management outreach service 416. Each of the services 412, 414, and 416 may be in communication with one another via a network 450. The network 450 may include, without limitation, one or more local area networks (LANs) or wide area networks (WANs). The network 450 may be a secure network associated with a healthcare facility. The secure network 450 may require that a user log in and be authenticated in order to send and/or receive information over the network 450. Additionally, each of the services 412, 414, and 416 are in communication with a data store 446 and an end-user computing device 448 having a display screen.” and Stadler [0029] “Computer networks 106 comprise local area networks (LANs) and/or wide area networks (WANs). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet. When utilized in a WAN networking environment, the control server 102 might comprise a modem or other means for establishing communications over the WAN, such as the Internet. In a networking environment, program modules or portions thereof might be stored in association with the control server 102, the data store 104, or any of the remote computers 108. For example, various application programs may reside on the memory associated with any one or more of the remote computers 108. It will be appreciated by those of ordinary skill in the art that the network connections shown are exemplary and other means of establishing a communications link between the computers (e.g., control server 102 and remote computers 108) might be utilized.”);
in through the second network connection to the first electronic device such that the first electronic device can be used (Stadler [0045] “The care management service 410 includes a number of services such as an identification, stratification, and prioritization service 412, a care manager alignment service 414, and a care management outreach service 416. Each of the services 412, 414, and 416 may be in communication with one another via a network 450. The network 450 may include, without limitation, one or more local area networks (LANs) or wide area networks (WANs). The network 450 may be a secure network associated with a healthcare facility. The secure network 450 may require that a user log in and be authenticated in order to send and/or receive information over the network 450. Additionally, each of the services 412, 414, and 416 are in communication with a data store 446 and an end-user computing device 448 having a display screen.” and Stadler [0029] “Computer networks 106 comprise local area networks (LANs) and/or wide area networks (WANs). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet. When utilized in a WAN networking environment, the control server 102 might comprise a modem or other means for establishing communications over the WAN, such as the Internet. In a networking environment, program modules or portions thereof might be stored in association with the control server 102, the data store 104, or any of the remote computers 108. For example, various application programs may reside on the memory associated with any one or more of the remote computers 108. It will be appreciated by those of ordinary skill in the art that the network connections shown are exemplary and other means of establishing a communications link between the computers (e.g., control server 102 and remote computers 108) might be utilized.”);
receiving an instruction to refer (Stadler [0028] “The control server 102 might operate in a computer network 106 using logical connections to one or more remote computers 108. Remote computers 108 might be located at a variety of locations in a medical or research environment, including clinical laboratories (e.g., molecular diagnostic laboratories), hospitals and other inpatient settings, veterinary environments, ambulatory settings, medical billing and financial offices, hospital administration settings, home healthcare environments, and clinicians' offices. Clinicians may comprise a treating physician or physicians; specialists such as surgeons, radiologists, cardiologists, and oncologists; emergency medical technicians; physicians' assistants; nurse practitioners; nurses; nurses' aides; pharmacists; dieticians; microbiologists; laboratory experts; laboratory technologists; genetic counselors; researchers; veterinarians; students; and the like. The remote computers 108 might also be physically located in nontraditional medical care environments so that the entire healthcare community might be capable of integration on the network. The remote computers 108 might be personal computers, servers, routers, network PCs, peer devices, other common network nodes, or the like and might comprise some or all of the elements described above in relation to the control server 102. The devices can be personal digital assistants or other like devices.”, Stadler [0132] At a step 1214, it is further determined that the patient qualifies for a health intervention program, where the health intervention program has an associated set of recommendations. This determination may be carried out by a monitoring component such as the monitoring component 438 of FIG. 4. To determine that the patient qualifies for the health intervention program, the patient's health data is analyzed to determine if it meets certain criteria associated with the health intervention program. For example, a patient may qualify for a hypertension management program if the patient's systolic and diastolic pressures are above a threshold value for four consecutive measurements taken over a year period.”, and Stadler [0129] “At a step 1114, a welcome-to-service template is automatically selected and populated with patient-specific information by a populating component such as the populating component 440 of FIG. 4. The patient-specific information may be derived from the patient's health data and include the patient's name and other identifying information, a care manager that has been assigned to the patient, any care recommendations specific to the patient, and the like.”); and
sending a referral to the first computing device, the referral including (Stadler [0028] “The control server 102 might operate in a computer network 106 using logical connections to one or more remote computers 108. Remote computers 108 might be located at a variety of locations in a medical or research environment, including clinical laboratories (e.g., molecular diagnostic laboratories), hospitals and other inpatient settings, veterinary environments, ambulatory settings, medical billing and financial offices, hospital administration settings, home healthcare environments, and clinicians' offices. Clinicians may comprise a treating physician or physicians; specialists such as surgeons, radiologists, cardiologists, and oncologists; emergency medical technicians; physicians' assistants; nurse practitioners; nurses; nurses' aides; pharmacists; dieticians; microbiologists; laboratory experts; laboratory technologists; genetic counselors; researchers; veterinarians; students; and the like. The remote computers 108 might also be physically located in nontraditional medical care environments so that the entire healthcare community might be capable of integration on the network. The remote computers 108 might be personal computers, servers, routers, network PCs, peer devices, other common network nodes, or the like and might comprise some or all of the elements described above in relation to the control server 102. The devices can be personal digital assistants or other like devices.”).
It would have been obvious to one of ordinary skill in the art to modify Hoffman’s automated assistance program qualification system so that the server communicates qualifying program information and referral instructions to multiple electronic devices, as taught by Stadler. Hoffman teaches receiving patient attributes, determining the programs for which a patient qualifies, and communicating program actions such as enrollment requests via server managed interfaces. Stadler teaches a distributed computing environment in which a central server communicates with numerous remote electronic devices, such as clinician computers, care management devices, and other stakeholder devices, over secure networks to facilitate eligibility determinations, care program recommendations, and patient outreach. Using Stadler’s multidevice communication architecture in Hoffman’s workflow would have been a predictable and straightforward design choice to allow different stakeholders to receive the same program eligibility information and to initiate instructions related to patient care or enrollment.
Also, a person of ordinary skill would have been motivated to provide the qualifying program list to both a patient device and a second stakeholder device, and to allow that second device to send referral instructions back to the server. Stadler teaches that remote devices, such as care-manager systems determine patient eligibility for specific programs, generate program recommendations, and perform outreach steps on behalf of the patient. In this system, it would be natural and expected for these remote devices to receive the same program eligibility data that the patient's own device receives and to initiate actions on the patient’s behalf, including referring or selecting a program. Combining these teachings yields multiple devices receiving the qualifying program list, one of the devices providing a referral instruction back to the server, and the server sending a referral, including controls for enrollment, back to the appropriate device. Implementing Hoffman’s existing enrollment workflow across the multidevice architecture taught by Stadler would have predictably improved coordination among users and is therefore an obvious combination.
Claims 15-19 are rejected under 35 U.S.C. 103 as being unpatentable over Hoffman et al. (U.S. Patent Publication 2019/0304599 A1), referred to hereinafter as Hoffman, in view of Stadler et al. (U.S. Patent Publication 2016/0125143 A1), referred to hereinafter as Stadler and McSweeney et al. (U.S. Patent Publication 2024/0338260 A1), referred to hereinafter as McSweeney.
Regarding claim 15, Hoffman teaches a method comprising (Hoffman [0019] “The present disclosure provides a system, method, and computer readable storage device including computer readable instructions, which when executed by a processing unit, provide automated assistance program qualification and enrollment.”):
a server receiving a single API call providing patient attributes of a patient (Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.” and Hoffman [0019] “If an assistance program policy requires supporting documentation, aspects further enable the user to upload the documentation and to provide a signature from a user computing device.”, and Hoffman [0006] “Aspects of the disclosure provide automated assistance program qualification and enrollment. An assistance program qualification and enrollment (APQE) system determines whether a user qualifies for an assistance program that offers assistance with an ongoing transaction record with a service provider. The APQE system generates a set of questions based on qualification data (used to make a qualification determination) that are not included in collected user data and financial data about the user. The user's qualification is based on an evaluation of the user data, financial data, and user-provided responses to the questions. If the user qualifies for the assistance program, an option is provided to the user to enroll in the assistance program. If additional information is needed to complete an enrollment process for the assistance program, an interface is provided that enables the user to provide the data for completing the process.” and Hoffman [0030] “In example aspects, the self-service portal 140 is configured to generate a self-service portal user interface (UI) 120 for display on the user computing device 102 via the user agent. According to an aspect, the self-service portal 140 includes one or more application programming interfaces (APIs), which connect the self-service portal 140 to the APQE system 130 so that the self-service portal is able request an assistance program qualification questionnaire from the APQE system and to transmit data input by the user via the user computing device 102 to the APQE system for determining whether the user qualifies for an assistance program and to communicate that determination to the user.”);
the server returning a plurality of community-based organization programs that the patient qualifies for enrollment in response (Hoffman [0030] “In example aspects, the self-service portal 140 is configured to generate a self-service portal user interface (UI) 120 for display on the user computing device 102 via the user agent. According to an aspect, the self-service portal 140 includes one or more application programming interfaces (APIs), which connect the self-service portal 140 to the APQE system 130 so that the self-service portal is able request an assistance program qualification questionnaire from the APQE system and to transmit data input by the user via the user computing device 102 to the APQE system for determining whether the user qualifies for an assistance program and to communicate that determination to the user.”, Hoffman [0046] “In example aspects, the screening engine 160 provides/exposes a screening API, which the self-service portal 140 can invoke to communicate the user responses (to the questions 138 included in the questionnaire) to the screening engine 160 as part of a request for assistance program qualification results. For example, the screening engine 160 includes one or more APIs, which connect the self-service portal 140 to the screening engine 160 so that the self-service portal is able request assistance program qualification results from the screening engine, to transmit data input by the user via the user computing device 102 to the screening engine for determining whether the user qualifies for an assistance program, and to receive the determination results in an API response from the screening engine.”);
wherein each of the plurality of community-based organization programs has a respective available capacity of participants that can be enrolled in the community-based organization program and wherein the server, when a participant enrolls in the one community-based organization program and wherein the plurality of community-based organization programs excludes community- based organization programs that have zero available capacity ((Hoffman [0060] “Another example of a specific action defined by assistance program rules 116 can include an instruction to communicate an enrollment request to one or more of the assistance program system(s) 132, the service provider system(s) 104, and a patient access workflow system 190 associated with a service provider system. In various examples, the service provider system 104 may utilize a patient access workflow system 190 to perform one or more patient access workflow processes. An example of a patient access workflow system 190 includes the eCare NEXT® platform, available from EXPERIAN HEALTH, INC. of Franklin, Tenn. The patient access workflow system 190 may be implemented on a computing device (e.g., server computing device, a cloud-based server computing device, desktop computing device) of the service provider system 104 or in communication with the service provider system.” and Hoffman [0061] According to an aspect, the enrollment engine 170 is configured to execute the specific action and communicate the user's enrollment request to the corresponding assistance program system(s) 132, the corresponding service provider system(s) 104, and/or patient access workflow system 190. In some example aspects, the enrollment engine 170 invokes an API of the assistance program system(s) 132 and/or the service provider system(s) 104 to enroll the user in an assistance program. For example, the API connects the enrollment engine 170 to the assistance program system(s) 132, service provider system(s) 104, and/or patient access workflow system 190 associated with the provider system(s) so that the enrollment engine 170 is able to transmit an indication of the user's selection to enroll in an assistance program and associated data (e.g., user data 126, financial data 122, user inputs, supporting documents) to the corresponding assistance program system(s) 132, service provider system(s) 104, and in some examples, a patient access workflow system 190 associated with the provider system(s). Aspects of the APQE system 130 enable the user to gather and transmit sensitive supporting documents only when the user knows that he/she qualifies and has selected to enroll in an assistance program. As can be appreciated, this can improve data security, computing resources associated with uploading and transmitting the documents, and the user experience.”, Hoffman [0052] “In some examples, enrollment in one assistance program may conflict with enrollment in another assistance program based on certain assistance program rules 116 and/or service provider policies 118. In such cases, the screening engine 160 is configured to include instructions in the assistance program qualification results response that enable the self-service portal 140 to prevent conflicting enrollment selections. For example, if the user selects to enroll in a first assistance program and that program does not allow for enrollment in another assistance program, the self-service portal 140 can execute the instructions to disable input controls for selecting and enrolling in other (conflicting) assistance programs.”, and Hoffman [0053] “In example aspects, if the user does not qualify for an assistance program, the assistance program qualification results response includes a notification that the user does not qualify for an assistance program. In another example aspect, if the user does not qualify for an assistance program, the assistance program qualification results response includes a link to a settlement plan system configured to provide a settlement plan for the user to settle according to a schedule over a period of time.).”).
Hoffman fails to explicitly teach to a second API call; and automatically reduces the respective available capacity of one community-based organization program of the plurality of community-based organization programs.
Stadler teaches automatically reduces the respective available capacity of one community-based organization program of the plurality of community-based organization programs (Stradler [0065] “The identification component 420 is also configured to apply a threshold parameter to each of the criteria. The threshold parameter may be configured by a client, such as a healthcare facility, or it may be predefined. As an example, a threshold parameter for disease burden may be that the patient must have five or more chronic conditions to qualify for care management services, and a threshold parameter for amount of health system utilization may be that the patient must have had ten emergency department visits within one year to qualify for care management services.”).
Hoffman teaches receiving patient attributes through API interactions with a server-based qualification and enrollment system, determining eligibility for multiple programs, and communicating enrollment selections through server-to-system interactions. Stadler teaches threshold qualification logic, real time patient program eligibility, and administrative constraints used to filter programs based on configurable parameters such as disease burden, utilization thresholds, or other criteria. A person of ordinary skill would have recognized that Hoffman’s program eligibility workflow could be improved by incorporating Stadler’s threshold filtering logic to ensure that programs presented to the user remain valid and actionable. Because Stadler teaches configurable thresholds, the skilled artisan would have viewed program availability limits (such as capacity) as simply another threshold parameter, implemented in the same manner. Applying Stadler’s threshold exclusion rules to Hoffman’s program qualification list amounts to the predictable use of a known filtering technique to improve accuracy of results. Therefore, modifying Hoffman to exclude programs with zero remaining capacity and to decrement capacity upon enrollment would have been obvious.
McSweeney teaches to a second API call (McSweeney [0018] “The processor 202 may be configured to execute a graphical user interface (GUI) 212 and a REST API 214. The GUI 212 may be configured to receive user input specifying various command parameters and/or commands, which are subsequently executed by the management system 117. The REST API may be configured to provide API calls for executing the same commands that can also be executed through the GUI 212. By way of example, commands that are implemented by various calls of the API 214 include a get_volume command, a create_storage_group command, a create_host command, a get_volumes command, a create_storage_groups command, and a create_hosts command.” and mcSweeney [0019] The memory 204 may be configured to store a telemetry database 222 and a bulk-action database 224. The database 222 may identify one or more API calls that are received and/or executed by the API 214. For each of the identified API calls, the database 222 may identify one or more of the date and time when the call was received, the sender of the call, the type of the call, and/or any other suitable information. The database 224 may be configured to map each of a plurality of single-action API calls to a corresponding bulk-action API call. The single-action API calls that are identified in the database 224 may be calls provided by the API 214. The bulk-action API calls that are identified in the database 224 may be calls that are provided by the API 214. The database 224 is discussed in further detail with respect to FIG. 3.”).
Hoffman teaches using APIs to transmit patient data, receive eligibility determinations, and communicate enrollment instructions to external systems. McSweeney teaches the use of structured, single action and bulk action API calls, including maintaining databases identifying incoming API calls, mapping one API call to another, and executing state changing server operations through API interfaces. A person of ordinary skill in the art would have understood that Hoffman’s system, which already relies on API driven qualification and enrollment workflows, would benefit from McSweeney’s teaching of structured API call handling to add additional server side business logic operations. Integrating McSweeney’s API-based state change framework into Hoffman would have predictably enabled the server to track program state (remaining enrollment capacity), decrement that value upon receiving an enrollment selection, and exclude programs with no remaining availability in subsequent API responses. This is a straightforward combination of familiar API techniques to achieve the predictable result of maintaining accurate program availability when responding to API queries.
Claims 16-19 are analogous to claims 3-6, thus claims 16-19 are similarly analyzed and rejected in a manner consistent with the rejection of claims 3-6.
Response to Arguments
Applicant’s arguments and amendments, see Remarks/Amendments submitted on 11/07/2025 with respect to the rejection of the claims have been carefully considered and is addressed below.
Claim Rejections - 35 USC § 101
Applicant’s arguments have been carefully considered but are not persuasive. Applicant asserts that, following amendment, claims 1, 8, and 15 no longer recite a judicial exception because the comparison step was removed and the remaining limitations involve only device connections and communications that cannot be performed in the human mind. This argument is not persuasive for Step 2A, Prong 1. Even without an explicit comparison step, the claims continue to recite administrative matching, eligibility determination, referral workflows, enrollment coordination, and resource allocation activities, all of which fall squarely within the recognized abstract idea category of certain methods of organizing human activity. These activities remain abstract even when implemented through generic devices, networks, or API calls. Also, even though humans do not personally perform API calls does not preclude the claim from reciting organizing human activity and the underlying operations, identifying qualifying programs, excluding unavailable programs, referring patients, and managing enrollment are administrative practices merely automated on generic computer components.
Applicant’s arguments under Step 2A, Prong 2 are also not persuasive. Applicant states that the automatic capacity reduction and exclusion of zero-capacity programs in claim 15 constitutes a practical application that improves computer efficiency. However, this improvement is an improvement to the abstract business process of resource allocation and enrollment management, not an improvement to the functioning of a computer, server, network, or API. The use of API calls, network connections, or secure connections is recited at a high level of generality and merely uses generic computing components as tools for transmitting and receiving information. Such activity constitutes insignificant extra-solution activity and does not integrate the abstract idea into a practical application.
Under Step 2B, Applicant has not identified, nor do the claims recite, any additional element that constitutes an inventive concept. The claims merely automate well known administrative practices using routine computer components performing conventional functions, such as receiving data, filtering data, updating capacity values, returning results, and sending referral messages. The specification confirms that these components operate in their ordinary capacities. Accordingly, the rejection under 35 U.S.C. § 101 is maintained.
Claim Rejections - 35 USC § 103
Applicant’s arguments regarding claim 1 and 8 are not persuasive. Hoffman teaches a serve based qualification and enrollment system that communicates eligibility and enrollment information across multiple computing endpoints, including user devices, provider systems, and third-party program systems. Stadler further teaches a distributed healthcare computing environment in which a central server exchanges patient specific program information with multiple remote devices over secure networks. Using known network architectures to provide the same eligibility information to more than one device is a predictable and routine modification of Hoffman, especially because of Stadler’s teaching of multidevice communication and coordinated program eligibility workflows. Also, Hoffman’s enrollment request from the user device is functionally identical to the claimed instruction to refer, and Stadler teaches remote devices issuing such program related instructions to the server. It would therefore have been obvious to receive a referral instruction from any device containing the eligibility information, whether the first or second device.
Applicant’s arguments regarding claim 15 are also unpersuasive. Hoffman teaches managing enrollment constraints, conflicting program rules, and program specific eligibility criteria. Stadler teaches threshold exclusion of programs. McSweeney teaches server side APIs that update stored variables in response to API calls, including automatic adjustment of values associated with system state. Program capacity is also another predictable program attribute stored and updated by the server in the same manner as the other attributes Hoffman and McSweeney manage. Automatically decrementing capacity upon enrollment and excluding fully subscribed programs are ordinary design optimizations in any eligibility based or resource allocation system. Implementing this additional constraint using McSweeney’s API based state update mechanisms would have been an obvious and straightforward combination of known techniques.
For these reasons, the combinations of Hoffman with Stadler, and Hoffman, Stadler, and McSweeney render the claims obvious. Accordingly, the rejection under 35 U.S.C. § 103 is maintained.
Conclusion
The prior art made of record and not relied upon is considered pertinent to applicant's disclosure.
Jain et al. (U.S. Patent 11417418) teaches methods and systems for evaluating a candidate’s profile against multiple program profiles, scoring the candidates suitability for each program, selecting one or more eligible programs based on the scores, and transmitting the selection results to a client device for presentation.
Exner et al. (U.S. Patent Publication 2006/0026018 A1) teaches a system and method for determining applicant eligibility for multiple programs by streamlining the application process through a single interview, collecting shared data only once, and using data dependencies to minimize the amount of information required.
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.
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/K.R.L./Examiner, Art Unit 3685
/KAMBIZ ABDI/Supervisory Patent Examiner, Art Unit 3685