Notice of Pre-AIA or AIA Status
This action is made in response to the amendments/remarks filed on December 24, 2025. This action is made FINAL.
The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA .
Response to Amendment
The amendment filed 12/24/2025 has been entered. Claims 1-20 remain pending in the application. The amendments have overcome the claim objections and 112(b) rejection previously set forth in the Non-Final Office Action mailed 8/27/2025.
Claim Rejections - 35 USC § 112
The following is a quotation of 35 U.S.C. 112(b):
(b) CONCLUSION.—The specification shall conclude with one or more claims particularly pointing out and distinctly claiming the subject matter which the inventor or a joint inventor regards as the invention.
The following is a quotation of 35 U.S.C. 112 (pre-AIA ), second paragraph:
The specification shall conclude with one or more claims particularly pointing out and distinctly claiming the subject matter which the applicant regards as his invention.
Claim 1 recites the limitation "A computer-implemented method for ranking selected entities in association with the at least one procedure" in lines 1-2. There is no previous mention of at least one procedure, and the claim should read as “A computer-implemented method for ranking selected entities in association with at least one procedure”. There is insufficient antecedent basis for this limitation in the claim.
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 1-20 are rejected under 35 U.S.C. 101 because the claimed invention is directed to an abstract idea without significantly more.
Independent Claims
Step 1 analysis:
Claim 1 is drawn to a method (i.e., process), Claim 14 is drawn to a system, and Claim 20 is drawn to a non-transitory computer readable medium (i.e., manufacture), which are all within the four statutory categories. (Step 1 – Yes, the claims fall into one of the statutory categories).
Step 2A analysis – Prong One:
Claim 1 recites:
A computer-implemented method for ranking selected entities in association with the at least one procedure and/or at least one condition, the method comprising:
collecting, using one or more processors, a plurality of data from one or more sources;
selecting, one or more procedures and/or conditions based on the collected data;
selecting, one or more entities based on the collected data;
for each one of the selected one or more procedures and/or conditions:
determining, using the one or more processors and using one or more models, a performance score for each of the one or more selected entities based on one or more performance indicators, wherein the one or more performance indicators include:
one or more risk-adjusted outcomes; and
generating, using the one or more processors, a rank for each of the one or more selected entities based on the performance score determined for each of the one or more selected entities; and
causing, using the one or more processors, a display of the rank for the one or more selected entities in association with the one or more procedures and/or conditions in a user interface of a device, wherein
the one or more risk-adjusted outcomes have been risk-adjusted based on one or more risk-adjustment variables, and
the one or more risk-adjustment variables include one or more:
age at admission; inbound transfer status; year of hospital admission; Elixhauser comorbidities; Medicare status code; socioeconomic status; condition cohort-specific covariates; surgical cohort-specific covariates; history of stroke; or Covid-19 diagnosis.
The series of steps as recited above falls within the “mental processes” grouping of abstract ideas, and describes concepts that can be performed in the human mind through observation, evaluation, judgement, and opinion. Selecting procedures, conditions, and entities, determining a score based on risk-adjusted outcomes, generating a rank, and the one or more risk-adjusted outcomes being risk-adjusted based on one or more risk-adjustment variables can all be performed in the human mind, with or without the use of a physical aid. Therefore, the claim recites an abstract idea of a mental process.
Claims 14 and 20 recite/describe nearly identical steps as claim 1 (and therefore also recite limitations that fall within this subject matter grouping of abstract ideas), and these claims are therefore determined to recite an abstract idea under the same analysis.
Step 2A analysis – Prong 2:
This judicial exception is not integrated into a practical application. Specifically, independent claims 1, 14, and 20 recite the following additional elements beyond the abstract idea: one or more processors, a display, a user interface, a device, a computing system, and a non-transitory computer readable medium. These limitations are recited at a high level of generality and amount to no more than mere instructions to apply the exception using generic computer components. The limitations do not impose any meaningful limits on practicing the abstract idea, and therefore do not integrate the abstract idea into a practical application (see MPEP 2106.05(f)).
Specifically, the term "processor" may refer to any device or portion of a device that processes electronic data (see specification [0097]). the computer system may operate in the capacity of a server or as a client user computer in a server-client user network environment, or as a peer computer system in a peer-to-peer (or distributed) network environment. The computer system can also be implemented as or incorporated into various devices (see specification [0098]). A display, such as a liquid crystal display (LCD), an organic light emitting diode (OLEO), a flat panel display, a solid-state display, a cathode ray tube (CRT), a projector, a printer or other now known or later developed display device for outputting determined information (see specification [00101]). The term "computer-readable medium" may also include any medium that is capable of storing, encoding, or carrying a set of instructions for execution by a processor (see specification [00105]).
The limitation “collecting a plurality of data from one or more sources” is mere data gathering and output recited at a high level of generality, and thus is insignificant extra-solution activity. See MPEP 2106.05(g) (“whether the limitation is significant”). In addition, all uses of the recited judicial exceptions require such data gathering and output, and, as such, these limitations do not impose any meaningful limits on the claim. These limitations amount to necessary data gathering and outputting. See MPEP 2106.05.
The additional elements do not show an improvement to the functioning of a computer or to any other technology, rather the additional elements perform general computing functions and do not indicate how the particular combination improves any technology or provides a technical solution to a technical problem. Accordingly, these additional elements, when considered separately and as an ordered combination, do not integrate the abstract idea into a practical application because they do not impose any meaningful limits on practicing the abstract idea. Therefore, Claims 1, 14, and 20 are directed to an abstract idea without practical application. (Step 2A – Prong 2: No, the additional elements are not integrated into a practical application).
Step 2B analysis:
As discussed above in “Step 2A analysis – Prong 2”, the identified additional elements in Independent Claims 1, 14, and 20 are equivalent to adding the words “apply it” on a generic computer, and/or generally link the use of the judicial exception to a particular technological environment or field of use. Therefore, the claims as a whole do not amount to significantly more than the judicial exception itself.
The additional element of "collecting a plurality of data from one or more sources" was found to be insignificant extra-solution activity in Step 2A, Prong Two, because it was determined to be an insignificant limitation as necessary data gathering and outputting. However, a conclusion that an additional element is insignificant extra-solution activity in Step 2A, Prong Two should be re-evaluated in Step 2B. See MPEP 2106.05, subsection I.A. At Step 2B, the evaluation of the insignificant extra-solution activity consideration takes into account whether or not the extra-solution activity is well understood, routine, and conventional in the field. See MPEP 2106.05(g).
Generic computer components recited as performing generic computer functions that are well understood, routine and conventional activities amount to no more than implementing the abstract idea with a computerized system. Here, the claim limitations are similar to receiving and sending information Page 8 Application/Control Number: 18/330,792 Art Unit: 3682 over a network (Symantec, 838 F.3d at 1321, 120 USPQ2d at 1362 (utilizing an intermediary computer to forward information); OJP Techs., Inc., v. Amazon.com, Inc., 788 F.3d 1359, 1363, 115 USPQ2d 1090, 1093 (Fed. Cir. 2015) (sending messages over a network); buySAFE, Inc. v. Google, Inc., 765 F.3d 1350, 1355, 112 USPQ2d 1093, 1096 (Fed. Cir. 2014) (computer receives and sends information over a network); See MPEP 2106.05(d)(ll)(i)).
The applicant’s specification discloses: the term "processor" may refer to any device or portion of a device that processes electronic data (see specification [0097]). the computer system may operate in the capacity of a server or as a client user computer in a server-client user network environment, or as a peer computer system in a peer-to-peer (or distributed) network environment. The computer system can also be implemented as or incorporated into various devices (see specification [0098]). A display, such as a liquid crystal display (LCD), an organic light emitting diode (OLEO), a flat panel display, a solid-state display, a cathode ray tube (CRT), a projector, a printer or other now known or later developed display device for outputting determined information (see specification [00101]). The term "computer-readable medium" may also include any medium that is capable of storing, encoding, or carrying a set of instructions for execution by a processor (see specification [00105]).
The claims do not include additional elements that are sufficient to amount to significantly more than the judicial exception because, as discussed above with respect to integration of the abstract idea into a practical application, using the additional elements to perform the steps for classification amount to no more than using computer related devices to implement the abstract idea.
The use of a computer or processor to merely automate or implement the abstract idea cannot provide significantly more than the abstract idea itself. (See MPEP 2106.05(f) where mere instructions to apply an exception does not render an abstract idea patent eligible). There is no indication that the additional limitations alone or in combination improves the functioning of a computer or any other technology, improves another technology or technical field, or effects a transformation or reduction of a particular article to a different state or thing. Therefore, the claims are not patent eligible. The Examiner has therefore determined that no additional element, or combination of additional claims elements is/are sufficient to ensure the claims amount to significantly more than the abstract idea identified above (Step 2B: Independent claims - NO).
Dependent Claims
Dependent Claims 2-13 and 15-19 are directed towards elements used to describe the one or more procedures and conditions, entities, models, process measures, structural measures, and sources. These elements fall within the “mental processes” grouping of abstract ideas, and describe concepts that can be performed in the human mind through observation, evaluation, judgement, and opinion. Therefore, the dependent claims recite an abstract idea of a mental process.
This judicial exception is not integrated into a practical application. Specifically, the dependent
claims recite the following additional elements beyond the abstract idea: a computer and a multi-level logistic regression model. These limitations are recited at a high level of generality and amount to no more than mere instructions to apply the exception using generic computer components. The limitations do not impose any meaningful limits on practicing the abstract idea, and therefore do not integrate the abstract idea into a practical application (see MPEP 2106.05(f)).
The additional elements do not show an improvement to the functioning of a computer or to
any other technology, rather the additional elements perform general computing functions and do not
indicate how the particular combination improves any technology or provides a technical solution to a
technical problem. Accordingly, these additional elements, when considered separately and as an
ordered combination, do not integrate the abstract idea into a practical application because they do not
impose any meaningful limits on practicing the abstract idea. Therefore, the dependent claims are
directed to an abstract idea without practical application. (Step 2A – Prong 2: No, the additional
elements are not integrated into a practical application).
As discussed above, the identified additional elements in Dependent Claims 2-13 and 15-19,
are equivalent to adding the words “apply it” on a generic computer, and/or generally link the use of the
judicial exception to a particular technological environment or field of use. Therefore, the claims as a
whole do not amount to significantly more than the judicial exception itself.
For the role of a computer in a computer implemented invention to be deemed meaningful in
the context of this analysis, it must involve more than performance of “well-understood, routine, [and]
conventional activities previously known to the industry.” Further, “the mere recitation of a generic
computer cannot transform a patent ineligible abstract idea into a patent-eligible invention.”
The use of a computer or processor to merely automate or implement the abstract idea cannot
provide significantly more than the abstract idea itself. (See MPEP 2106.05(f) where mere instructions to apply an exception does not render an abstract idea patent eligible). There is no indication that the
additional limitations alone or in combination improves the functioning of a computer or any other
technology, improves another technology or technical field, or effects a transformation or reduction of a
particular article to a different state or thing. Therefore, the claims are not patent eligible.
The Examiner has therefore determined that no additional element, or combination of
additional claims elements is/are sufficient to ensure the claims amount to significantly more than the
abstract idea identified above (Step 2B: Dependent claims - NO).
Claim Rejections - 35 USC § 103
In the event the determination of the status of the application as subject to AIA 35 U.S.C. 102 and 103 (or as subject to pre-AIA 35 U.S.C. 102 and 103) is incorrect, any correction of the statutory basis (i.e., changing from AIA to pre-AIA ) for the rejection will not be considered a new ground of rejection if the prior art relied upon, and the rationale supporting the rejection, would be the same under either status.
The following is a quotation of 35 U.S.C. 103 which forms the basis for all obviousness rejections set forth in this Office action:
A patent for a claimed invention may not be obtained, notwithstanding that the claimed invention is not identically disclosed as set forth in section 102, if the differences between the claimed invention and the prior art are such that the claimed invention as a whole would have been obvious before the effective filing date of the claimed invention to a person having ordinary skill in the art to which the claimed invention pertains. Patentability shall not be negated by the manner in which the invention was made.
Claims 1-5, 7, 9, 11-18, and 20 are rejected under 35 U.S.C. 103 as being unpatentable over Bachik et al. (US 2010/0169113) (hereinafter Bachik) in view of Dong et al., Rating Hospital Performance in China: Review of Publicly Available Measures and Development of a Ranking System (Hereinafter Dong), in further view of Osktrovsky et al. (US 2015/0220699) (hereinafter Ostrovsky).
Regarding Claim 1, Bachik discloses:
A computer-implemented method for ranking selected entities in association with the at least one procedure and/or at least one condition ([0019] The step of collecting data and programmatic information relevant to the service line may involve, for example, making personal observations, gathering demographic data from the surrounding geographic area, inspecting hospital facilities, interviewing hospital staff, administrators, and referral sources, analyzing financial data (such as market share), analyzing patient care data, and evaluating competitors of the hospital.), the method comprising,
collecting, using one or more processors ([0057] the computing device includes controllers that comprise computer processors), a plurality of data from one or more sources (See Fig. 1, [0008], [0019], [0034]: Collecting data relevant to the service line of the hospital);
selecting, one or more procedures and/or conditions based on the collected data ([0019] The step of collecting data and programmatic information relevant to the service line may involve, for example, making personal observations, gathering demographic data from the surrounding geographic area, inspecting hospital facilities, interviewing hospital staff, administrators, and referral sources, analyzing financial data (such as market share), analyzing patient care data, and evaluating competitors of the hospital. According to an exemplary embodiment of the present invention, the data collected should reflect strengths, weaknesses, opportunities, and potential threats to the service line of the hospital);
for each one of the one or more procedures and/or conditions: determining, using the one or more processors ([0057] the computing device includes controllers that comprise computer processors), a performance score for each of the one or more selected entities based on one or more performance indicators ([0034], Fig. 2: the scoring step of block 104 (FIG. 1) may involve scoring each category 10, subcategory 12, and/or subset 14, on a scale to produce raw score. ), wherein the one or more performance indicators include:
one or more risk-adjusted outcomes (Tables 1-10 of Bachik disclose several parameters for producing the score of the entities being measured, including provider performance, volume of staff available, training and education of staff, patient outcomes, and more.); and
causing a display for the one or more selected entities in association with the one or more procedures and/or conditions in a user interface of a device ([0056] System 200 includes computing device 202, such as a general purpose computer or a portable computing device having display 203).
However, Bachik does not disclose the following that is met by Dong:
selecting one or more entities based on the collected data (Pg. 4, Col. 1, par. 4: focused on the tertiary hospital sector based on the availability of current data as well as to provide an option for comparison with other available measures);
one or more models (Pg. 5, Col. 2, Par. 1-2: developed PCA/CATPCA models for each of the three domains of ranking)
generating a rank for each of the one or more selected entities based on the performance score determined for each of the one or more selected entities (Pg. 6, 7: The results of our CHDI rankings by score for the top 10 hospitals are shown in Table 6.);
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the system of Bachik with the method of Dong to include selecting the entities, incorporating a model, and generating a rank of the hospitals because it would allow for a more comprehensive ranking system that can be applied to low- and middle- income counties or regions as well as more developed countries (See Dong pg. 2, par. 3).
However, Bachik and Dong do not teach the following that is met by Ostrovsky:
the one or more risk-adjusted outcomes have been risk-adjusted based on one or more risk-adjustment variables ([0057]-[0059] Risk score may be dependent on factors used to adjust the risk score), and
the one or more risk-adjustment variables include one or more: age at admission; inbound transfer status; year of hospital admission; Elixhauser comorbidities; Medicare status code; socioeconomic status; condition cohort-specific covariates; surgical cohort-specific covariates; history of stroke; or Covid-19 diagnosis ([0008], [0059] the risk score may be dependent on other factors than just the intervention type. In some embodiments, information such as prior hospitalizations, prior occurrences of the same intervention type, and/or vital statistics (such as age, weight, height, gender, blood pressure, and/or the like) may be used to adjust the risk score for an intervention of an intervention type. The hospital admission risk may be obtained by computing a log transformation of the risk scores).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the method of Bachik and Dong with the risk-adjustment functions, as taught by Ostrovsky, because it may simplify calculation of the hospital admission risk 340 and allow for more meaningful clinical comparison to new risk factors and/or improvement after summation of the risk scores (See Ostrovsky [0105]).
Regarding Claim 2, the combination of Bachik, Dong, and Ostrovsky teaches The computer-implemented method of claim 1, and Bachik further teaches:
wherein the one or more procedures and/or conditions are selected based on one or more of: a frequency of admission, an ability to make entity-to-entity comparisons, or a presence of a sufficient degree of risk or complexity such that a quality of an entity’s performance is important ([0019] the data collected should reflect strengths, weaknesses, opportunities, and potential threats to the service line of the hospital).
Regarding Claim 3, the combination of Bachik, Dong, and Ostrovsky teaches The computer-implemented method of claim 1, and Dong further teaches:
The computer-implemented method of claim 1, wherein the one or more procedures and/or conditions are selected based on an inclusion criteria and/or an exclusion criteria (Dong pg. 5, par. 4: inclusion criteria, therefore, required hospitals to be a grade III, level A hospital, featuring on one of the lists of the four Chinese Hospital rankings in any previous year, and have at least 500 beds.).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the system of Bachik with the method of Dong to include the inclusion criteria because it allows for the ranking system to be comparable with other respective performance measures (See Dong Pg. 5, par. 4).
Regarding Claim 4, the combination of Bachik, Dong, and Ostrovsky teaches, The computer-implemented method of claim 3, and Dong further teaches:
wherein the inclusion criteria and/or the exclusion criteria are defined based on one or more of maximal homogeneity, maximal sample size, or minimal coding variation (Dong Pg. 5, par. 4 states that the inclusion of these hospitals over others was on the basis that these organizations continue to be the focus of attention in China given their prominence and popularity. These hospitals have also been the focus on other performance rankings in China; hence, the development of any new ranking system would be comparable with other respective performance measures. Therefore, Dong describes inclusion criteria that is based on maximal homogeneity).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the system of Bachik with the method of Dong to include the inclusion criteria because it allows for the ranking system to be comparable with other respective performance measures (See Dong Pg. 5, par. 4).
Regarding Claim 5, the combination of Bachik, Dong, and Ostrovsky teaches, The computer-implemented method of claim 1, and Dong further teaches:
The computer-implemented method of claim 1, wherein the one or more entities are selected by excluding, from a plurality of entities associated with a database, each entity that is associated with one or more attributes indicative of non-inclusion (See Dong Pg. 5, par. 4: Our inclusion criteria, therefore, required hospitals to be a grade III, level A hospital, featuring on one of the lists of the four Chinese Hospital rankings in any previous year, and have at least 500 beds. A total of 310 hospitals were thus deemed eligible for ranking under the full criteria. Therefore, the entities were selected by excluding hospital that did not meet the attributes of inclusion).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the system of Bachik with the method of Dong to include the inclusion criteria because it allows for the ranking system to be comparable with other respective performance measures (See Dong Pg. 5, par. 4).
Regarding Claim 7, the combination of Bachik, Dong, and Ostrovsky teaches, The computer-implemented method of claim 1, and Dong further teaches:
The computer-implemented method of claim 1, wherein the one or more models are selected by: evaluating model statistics for combinations of performance indicators (Dong Pg. 5, Col. 2, par. 2: We developed PCA/CATPCA models for each of the three domains of ranking, by evaluating model statistics for all possible combinations of indicators that included at least one indicator); and determining the one or more models associated with an optimal combination of one or more of: a number of performance indicators, a model fit, or consistency with models in related cohorts (Dong Pg. 5, Col. 2, par. 2: From the resulting list of candidate models showing acceptable fit statistics, we selected a final model for each domain, providing a combination of the number of indicators (models with more indicators produce more accurate component scores), number of outcomes, and model fit).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the system of Bachik with the method of Dong to include the model selection process because it provides a way to reduce the number of observed variables into a smaller number of linear, uncorrelated summary variables called principal components (PCs) that account for variation in observed variables (See Dong Pg. 5, Par. 5).
Regarding Claim 9, the combination of Bachik, Dong, and Ostrovsky teaches, The computer-implemented method of claim 1, and Ostrovsky further discloses:
The computer-implemented method of claim 1, wherein the one or more risk-adjustment variables include: age at admission; inbound transfer status; and/or year of hospital admission ([0008], [0059] the risk score may be dependent on other factors than just the intervention type. In some embodiments, information such as prior hospitalizations, prior occurrences of the same intervention type, and/or vital statistics (such as age, weight, height, gender, blood pressure, and/or the like) may be used to adjust the risk score for an intervention of an intervention type. The hospital admission risk may be obtained by computing a log transformation of the risk scores).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the method of Bachik and Dong with the risk-adjustment functions, as taught by Ostrovsky, because it may simplify calculation of the hospital admission risk 340 and allow for more meaningful clinical comparison to new risk factors and/or improvement after summation of the risk scores (See Ostrovsky [0105]).
Regarding Claim 11, the combination of Bachik, Dong, and Ostrovsky teaches, The computer-implemented method of claim 1, and Bachik further teaches:
The computer-implemented method of claim 1, wherein the one or more performance indicators further comprises one or more process measures, and the one or more process measures include one or more of: worker flu immunization; noninvasive ventilation; patient experience; board certification; emergency room visits after chemotherapy; unplanned visits after colonoscopy; compliance with a septic shock bundle; or public transparency (Table 10 of Bachik describes categories involved in scoring the hospital entities, including Action plan to make consumer/patient's first experience a positive one; consumer inquiries tracked to evaluate success of activities/promotions. And the collection of data involves collecting patient care experience data (See Claim 2 of Bachik).
Regarding Claim 12, the combination of Bachik, Dong, and Ostrovsky teaches, The computer-implemented method of claim 1, and Bachik further teaches:
The computer-implemented method of claim 1, wherein the one or more performance indicators further comprises one or more structural measures, and the one or more structural measures include one or more of: volume of procedures; nurse staffing; or National Cancer Institute (NCI)-designated Cancer Center and/or American College of Surgeons (ACS) Commission on Cancer (Table 10 of Bachik describes categories involved in scoring the hospital entities, including Sufficient staffing mix throughout hours of operation and Patient visit volumes tracked (e.g., on a monthly basis) by site).
Regarding Claim 13, the combination of Bachik, Dong, and Ostrovsky teaches, The computer-implemented method of claim 1, and Bachik further teaches:
The computer-implemented method of claim 1, wherein the one or more sources include one or more of: publicly available indicators; Medicare Beneficiary Summary Files (MBSF); Medicare inpatient Limited Data Set Standard Analytical Files (LDS SAF); Medicare outpatient limited data set standard analytical files; Medicare Skilled Nursing Facility (SNF) limited data set standard analytical files; American Hospital Association (AHA) annual survey; Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS); Orthopedic Board Certification Data; or total volume data from American Hospital Directory (AHD) ([0019] The step of collecting data and programmatic information relevant to the service line may involve, for example, making personal observations, gathering demographic data from the surrounding geographic area, inspecting hospital facilities, interviewing hospital staff, administrators, and referral sources, analyzing financial data ( such as market share), analyzing patient care data, and evaluating competitors of the hospital.).
Regarding Claim 14, Bachik discloses:
A system comprising: one or more processors of a computing system ([0057] the computing device includes controllers that comprise computer processors); and
at least one non-transitory computer readable medium storing instructions which, when executed by the one or more processors, cause the one or more processors to perform operations comprising ([0057] Memory 204 is a computer readable medium and may be a single storage device or may include multiple storage devices, located either locally with system 200 or accessible across a network):
collecting a plurality of data from one or more sources (See Fig. 1, [0008], [0019], [0034]: Collecting data relevant to the service line of the hospital);
selecting, one or more procedures and/or conditions based on the collected data ([0019] The step of collecting data and programmatic information relevant to the service line may involve, for example, making personal observations, gathering demographic data from the surrounding geographic area, inspecting hospital facilities, interviewing hospital staff, administrators, and referral sources, analyzing financial data (such as market share), analyzing patient care data, and evaluating competitors of the hospital. According to an exemplary embodiment of the present invention, the data collected should reflect strengths, weaknesses, opportunities, and potential threats to the service line of the hospital);
for each one of the one or more procedures and/or conditions: determining, a performance score for each of the one or more selected entities based on one or more performance indicators ([0034], Fig. 2: the scoring step of block 104 (FIG. 1) may involve scoring each category 10, subcategory 12, and/or subset 14, on a scale to produce raw score.), wherein the one or more performance indicators include one or more risk-adjusted outcomes (Tables 1-10 of Bachik disclose several parameters for producing the score of the entities being measured, including provider performance, volume of staff available, training and education of staff, patient outcomes, and more.); and
causing a display of the rank for the one or more selected entities in association with the one or more procedures and/or conditions in a user interface of a device ([0056] System 200 includes computing device 202, such as a general purpose computer or a portable computing device having display 203).
However, Bachik does not disclose the following that is met by Dong:
selecting one or more entities based on the collected data (Pg. 4, Col. 1, par. 4: focused on the tertiary hospital sector based on the availability of current data as well as to provide an option for comparison with other available measures);
one or more models (Pg. 5, Col. 2, Par. 1-2: developed PCA/CATPCA models for each of the three domains of ranking)
generating a rank for each of the one or more selected entities based on the performance score determined for each of the one or more selected entities (Pg. 6, 7: The results of our CHDI rankings by score for the top 10 hospitals are shown in Table 6.);
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the system of Bachik with the method of Dong to include selecting the entities, incorporating a model, and generating a rank of the hospitals because it would allow for a more comprehensive ranking system that can be applied to low- and middle- income counties or regions as well as more developed countries (See Dong pg. 2, par. 3).
However, Bachik and Dong do not teach the following that is met by Ostrovsky:
the one or more risk-adjusted outcomes have been risk-adjusted based on one or more risk-adjustment variables ([0057]-[0059] Risk score may be dependent on factors used to adjust the risk score), and
the one or more risk-adjustment variables include one or more: age at admission; inbound transfer status; year of hospital admission; Elixhauser comorbidities; Medicare status code; socioeconomic status; condition cohort-specific covariates; surgical cohort-specific covariates; history of stroke; or Covid-19 diagnosis ([0008], [0059] the risk score may be dependent on other factors than just the intervention type. In some embodiments, information such as prior hospitalizations, prior occurrences of the same intervention type, and/or vital statistics (such as age, weight, height, gender, blood pressure, and/or the like) may be used to adjust the risk score for an intervention of an intervention type. The hospital admission risk may be obtained by computing a log transformation of the risk scores).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the method of Bachik and Dong with the risk-adjustment functions, as taught by Ostrovsky, because it may simplify calculation of the hospital admission risk 340 and allow for more meaningful clinical comparison to new risk factors and/or improvement after summation of the risk scores (See Ostrovsky [0105]).
Regarding Claim 15, the combination of Bachik, Dong, and Ostrovsky teaches The system of claim 14, and Bachik further teaches:
wherein the one or more procedures and/or conditions are selected based on one or more of: a frequency of admission, an ability to make entity-to-entity comparisons, or a presence of a sufficient degree of risk or complexity such that a quality of an entity’s performance is important ([0019] the data collected should reflect strengths, weaknesses, opportunities, and potential threats to the service line of the hospital).
Regarding Claim 16, the combination of Bachik, Dong, and Ostrovsky teaches The system of claim 14, and Dong further teaches:
The system of claim 14, wherein the one or more procedures and/or conditions are selected based on an inclusion criteria and/or an exclusion criteria (Dong pg. 5, par. 4: inclusion criteria, therefore, required hospitals to be a grade III, level A hospital, featuring on one of the lists of the four Chinese Hospital rankings in any previous year, and have at least 500 beds.).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the system of Bachik with the method of Dong to include the inclusion criteria because it allows for the ranking system to be comparable with other respective performance measures (See Dong Pg. 5, par. 4).
Regarding Claim 17, the combination of Bachik, Dong, and Ostrovsky teaches, The system of claim 16, and Dong further teaches
wherein the inclusion criteria and/or the exclusion criteria are defined based on one or more of maximal homogeneity, maximal sample size, or minimal coding variation (Dong Pg. 5, par. 4 states that the inclusion of these hospitals over others was on the basis that these organizations continue to be the focus of attention in China given their prominence and popularity. These hospitals have also been the focus on other performance rankings in China; hence, the development of any new ranking system would be comparable with other respective performance measures. Therefore, Dong describes inclusion criteria that is based on maximal homogeneity).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the system of Bachik with the method of Dong to include the inclusion criteria because it allows for the ranking system to be comparable with other respective performance measures (See Dong Pg. 5, par. 4).
Regarding Claim 18, the combination of Bachik, Dong, and Ostrovsky teaches, The system of claim 14, and Dong further teaches:
The system of claim 14, wherein the one or more entities are selected by excluding, from a plurality of entities associated with a database, each entity that is associated with one or more attributes indicative of non-inclusion See Dong Pg. 5, par. 4: Our inclusion criteria, therefore, required hospitals to be a grade III, level A hospital, featuring on one of the lists of the four Chinese Hospital rankings in any previous year, and have at least 500 beds. A total of 310 hospitals were thus deemed eligible for ranking under the full criteria. Therefore, the entities were selected by excluding hospital that did not meet the attributes of inclusion).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the system of Bachik with the method of Dong to include the inclusion criteria because it allows for the ranking system to be comparable with other respective performance measures (See Dong Pg. 5, par. 4).
Regarding Claim 20, Bachik discloses:
A non-transitory computer readable medium ([0057] Memory 204 is a computer readable medium and may be a single storage device or may include multiple storage devices, located either locally with system 200 or accessible across a network), the non-transitory computer readable medium storing instructions which, when executed by one or more processors ([0057] the computing device includes controllers that comprise computer processors) of a computing system, cause the one or more processors to perform operations comprising:
collecting a plurality of data from one or more sources (See Fig. 1, [0008], [0019], [0034]: Collecting data relevant to the service line of the hospital);
selecting, one or more procedures and/or conditions based on the collected data ([0019] The step of collecting data and programmatic information relevant to the service line may involve, for example, making personal observations, gathering demographic data from the surrounding geographic area, inspecting hospital facilities, interviewing hospital staff, administrators, and referral sources, analyzing financial data (such as market share), analyzing patient care data, and evaluating competitors of the hospital. According to an exemplary embodiment of the present invention, the data collected should reflect strengths, weaknesses, opportunities, and potential threats to the service line of the hospital);
for each one of the one or more procedures and/or conditions: determining, a performance score for each of the one or more selected entities based on one or more performance indicators ([0034], Fig. 2: the scoring step of block 104 (FIG. 1) may involve scoring each category 10, subcategory 12, and/or subset 14, on a scale to produce raw score.), wherein the one or more performance indicators include one or more risk-adjusted outcomes (Tables 1-10 of Bachik disclose several parameters for producing the score of the entities being measured, including provider performance, volume of staff available, training and education of staff, patient outcomes, and more.); and
causing a display of the rank for the one or more selected entities in association with the one or more procedures and/or conditions in a user interface of a device ([0056] System 200 includes computing device 202, such as a general purpose computer or a portable computing device having display 203).
However, Bachik does not disclose the following that is met by Dong:
selecting one or more entities based on the collected data (Pg. 4, Col. 1, par. 4: focused on the tertiary hospital sector based on the availability of current data as well as to provide an option for comparison with other available measures);
one or more models (Pg. 5, Col. 2, Par. 1-2: developed PCA/CATPCA models for each of the three domains of ranking)
generating a rank for each of the one or more selected entities based on the performance score determined for each of the one or more selected entities (Pg. 6, 7: The results of our CHDI rankings by score for the top 10 hospitals are shown in Table 6.);
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the system of Bachik with the method of Dong to include selecting the entities, incorporating a model, and generating a rank of the hospitals because it would allow for a more comprehensive ranking system that can be applied to low- and middle- income counties or regions as well as more developed countries (See Dong pg. 2, par. 3).
However, Bachik and Dong do not teach the following that is met by Ostrovsky:
the one or more risk-adjusted outcomes have been risk-adjusted based on one or more risk-adjustment variables ([0057]-[0059] Risk score may be dependent on factors used to adjust the risk score), and
the one or more risk-adjustment variables include one or more: age at admission; inbound transfer status; year of hospital admission; Elixhauser comorbidities; Medicare status code; socioeconomic status; condition cohort-specific covariates; surgical cohort-specific covariates; history of stroke; or Covid-19 diagnosis ([0008], [0059] the risk score may be dependent on other factors than just the intervention type. In some embodiments, information such as prior hospitalizations, prior occurrences of the same intervention type, and/or vital statistics (such as age, weight, height, gender, blood pressure, and/or the like) may be used to adjust the risk score for an intervention of an intervention type. The hospital admission risk may be obtained by computing a log transformation of the risk scores).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the method of Bachik and Dong with the risk-adjustment functions, as taught by Ostrovsky, because it may simplify calculation of the hospital admission risk 340 and allow for more meaningful clinical comparison to new risk factors and/or improvement after summation of the risk scores (See Ostrovsky [0105]).
Claims 8 and 10 are rejected under 35 U.S.C. 103 as being unpatentable over Bachik et al. (US 2010/0169113) (hereinafter Bachik) in view of Dong et al., Rating Hospital Performance in China: Review of Publicly Available Measures and Development of a Ranking System (Hereinafter Dong), further in view of Ostrovsky et al. (US2015/0220699) (Hereinafter Ostrovsky), further in view of Forthman (US 2014/0207477).
Regarding Claim 8, the combination of Bachik, Dong, and Ostrovsky teaches, The computer-implemented method of claim 1, and Forthman further teaches:
The computer-implemented method of claim 1, wherein the one or more risk-adjusted outcomes have been risk-adjusted using a multi-level logistic regression model ([0027-31] Based on output derived from four (4) separate binary logistic regression models, the risk-adjusted quality indicators may be calculated).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the teaching of Bachik and Dong with the risk adjustment capabilities of Forthman because it allows the hospitals the ability to assimilate the various components of medical quality into a single, coherent measure of performance (Forthman [0022]).
Regarding Claim 10, the combination of Bachik, Dong, and Ostrovsky teaches, The computer-implemented method of claim 1, and Forthman further teaches:
The computer-implemented method of claim 1, wherein the one or more risk-adjusted outcomes include one or more of: mortality within a pre-determined time period; unplanned readmission within a pre-determined time period; surgical site infection, hip replacement, knee replacement, Abdominal Aortic Aneurysm Repair (AAA), Heart Bypass Surgery (CABG), and Aortic Valve Surgery (AVR) cohorts; revision within a pre-determined time period, hip replacement, and knee replacement cohorts; prolonged hospitalization, leukemia, lymphoma and myeloma and procedure cohorts; discharge to a location other than a patient’s home; stroke on procedure date, CABG, AVR, and Transcatheter Aortic Valve Replacement (TAVR) cohorts; or time spent at home within a pre-determined time period of discharge ([0028]-[0031] Risk-Adjusted Mortality Index, Risk-Adjusted Complications Index, Risk-Adjusted Inpatient Quality Index, Risk-Adjusted Patient Safety Index).
It would have been obvious to one of ordinary skill in the art before the effective filing date to have combined the teaching of Bachik and Dong with the risk adjustment capabilities of Forthman because it allows the hospitals the ability to assimilate the various components of medical quality into a single, coherent measure of performance (Forthman [0022]).
Relevant Prior Art of Record Not Currently Being Applied
The relevant art made of record and not relied upon is considered pertinent to applicant’s disclosure.
Ma et al. (CN111048194A) describes a regional hospital performance assessment method which compares hospital in a certain region and utilizes standardization and homogenization.
Response to Arguments
Applicant's arguments filed 12/24/2025 have been fully considered but they are not persuasive. With respect to the previous 101 rejection, Applicant argues the claims provide a technological improvement in the field of ranking entities, however, the examiner respectfully disagrees. Selecting one or more procedures and/or conditions based on the collected data, selecting one or more entities based on the collected data, and for each selected procedure and condition, determining a performance score for each of the selected entities based on one or more risk-adjusted outcomes that have been risk-adjusted based on one or more risk-adjustment variables, where the risk- adjustment variables include one or more: age at admission; inbound transfer status; year of hospital admission; Elixhauser comorbidities; Medicare status code; socioeconomic status; condition cohort-specific covariates; surgical cohort-specific covariates; history of stroke; or Covid-19 diagnosis recites elements that can be performed in the human mind, and therefore falls within the mental processes grouping of abstract ideas. A person can select procedures, conditions, and entities (i.e., hospitals) to evaluate and determine a performance score for in their mind, and can adjust the score as needed in their mind as well. Thus, the claims do not provide a technological improvement.
Applicant’s arguments, see page 12 of Applicant’s Remarks, filed 12/24/2025, with respect to the rejection of claims 1-5, 11-18, and 20 under 35 U.S.C. 103 have been fully considered and are persuasive. Therefore, the rejection has been withdrawn. However, upon further consideration, a new ground(s) of rejection is made in view of newly found prior art reference Ostrovsky et al. Ostrovsky discloses risk-adjustment measures which can adjust the risk score of an entity based on various factors, including information such as prior hospitalizations, prior occurrences of the same intervention type, and/or vital statistics (such as age, weight, height, gender, blood pressure, and/or the like) (See Ostrovsky [0059]).
Regarding Claim 9 from the previous Non-Final Rejection mailed 08/27/2025, Claim 1, upon which Claim 9 depends, states: determining a performance score for each of the one or more selected entities based on one or more performance indicators, wherein the one or more performance indicators include one or more of: one or more risk-adjusted outcomes, one or more process measures, and one or more structural measures. Therefore, due to the conditional language and requirements of the claim, the one or more performance indicators including one or more risk-adjusted outcomes is not needed based on the requirements of Independent Claim 1. However, based on the current amendments to the claims, Claim 1 now requires performance indicators including one or more risk-adjusted outcomes and therefore, Claim 9 includes required variables which are now properly rejected over Ostrovsky.
Subject Matter Free of the Prior Art
The following is an examiner’s statement of subject matter free of the prior art: The limitations in Claims 6 and 19 stating: wherein the one or more attributes include one or more of: federal government ownership; an absence of Medicare provider number; an absence of clinically-integrated facility; a primary service (SERV) code indicating a service type other than a specific set of conditions; or a volume insufficient to allow estimation for at least one outcome is free of the prior art.
Conclusion
THIS ACTION IS MADE FINAL. Applicant is reminded of the extension of time policy as set forth in 37 CFR 1.136(a).
A shortened statutory period for reply to this final action is set to expire THREE MONTHS from the mailing date of this action. In the event a first reply is filed within TWO MONTHS of the mailing date of this final action and the advisory action is not mailed until after the end of the THREE-MONTH shortened statutory period, then the shortened statutory period will expire on the date the advisory action is mailed, and any nonprovisional extension fee (37 CFR 1.17(a)) pursuant to 37 CFR 1.136(a) will be calculated from the mailing date of the advisory action. In no event, however, will the statutory period for reply expire later than SIX MONTHS from the mailing date of this final action.
Any inquiry concerning this communication or earlier communications from the examiner should be directed to ALEXIS K VAN DUZER whose telephone number is (571)270-5832. The examiner can normally be reached Monday thru Thursday 8-5 CT.
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/A.K.V./Examiner, Art Unit 3682
/EVANGELINE BARR/Primary Examiner, Art Unit 3682