DETAILED ACTION
Notice of Pre-AIA or AIA Status
The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA .
Response to Arguments
101 Rejection
Applicant's arguments filed 12/30/2025 have been fully considered but they are not persuasive.
With respect to Applicant’s argument that “Claims 1-20 were rejected under 35 U.S.C. § 101 as allegedly directed to a judicial exception. In particular, the Office Action contends that various elements of claims are "mental process" and "insignificant extra-solution activity." Applicant respectfully traverses these rejections. … 17. The Example explains that the conventional methods for storing medical records "can lead to problems….. "a method organizing human activity," as the method "allows for users to access patients' medical records and receive updated patient information in real time from other users which is a method of managing interactions between people." Id at p. 18. Nonetheless, the 2019 PEG explains that "claim as a whole integrates the method of organizing human activity into a practical application" ….Based on these considerations, the 2019 PEG concludes that claim 1 is eligible”, Examiner respectfully disagrees.
Examiner cites that the present claims and Example 42 are not the same and therefore, the arguments are not persuasive.
The claims recites “identifying, first record” are insignificant extra solution activities and well-understood, routine and conventional activities (WURC) as evidenced by the court cases cited in MPEP 2106.05(d)(II) by at least "i. Receiving or transmitting data over a network, e.g., using the Internet to gather data, Symantec, 838 F.3d at 1321, … 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)" and/or "iv. Storing and retrieving information in memory, Versata Dev. Group, Inc. v. SAP Am., Inc., 793 F.3d 1306, … OIP Techs., 788 F.3d at 1363."; and/or "iv. Presenting offers and gathering statistics, OIP Techs., 788 F.3d at 1362-63, 115 USPQ2d at 1092-9". Therefore, the claims are not eligible.
With respect to Applicant’s argument that “Analogously, the instant claims integrate the any would-be purported abstract idea into a practical application. In the present application, the Specification observes that it "may be difficult to store and maintain electronic records on database" because (1) "the sheer volume of data may be massive" and (2) "the records data themselves may be tracked by different entities ... on separate databases with little to no direct integration (e.g., no communication or standard format)…. These and other technical improvements are reflected in the instant claims”, Examiner respectfully disagrees.
Examiner cites that Applicant’s arguments are not persuasive. Applicant argues that the claims are analogous to Example 42, however, the present claims and Example 42 are not similar, therefore, the arguments does not apply.
Additionally, the claim does not recite any particular data structure or technical implementation that would result in the asserted improvements. Applicant’s arguments on the Specification are not persuasive because the alleged improvements—such as reduced resource consumption and improved data integrity—are not reflected in the claim language. Rather, the claim recites identifying/generating/detecting the information using a recommendation engine to generate a likelihood score and comparing to a threshold are mental process and obtaining/receiving/transmitting information, presenting the result via a notification, are insignificant extra solution activities. Accordingly, the claim does not integrate the judicial exception into a practical application, and the rejection under 35 U.S.C. § 101 is maintained.
With respect to Applicant’s argument that “As with claim 1 in Example 42, the claim of the present application even if directed to the supposed abstract idea as a whole integrates the purported abstract idea into a practical application" by reciting specific improvements over prior systems. In particular, the recited features of "storing... the first record and the plurality of second records in a defined format of the database" and "transmit ... a notification message comprising the second record having the second
… Thus, independent claims 1-20, as well as claims 1-20 that depend therefrom recite patent eligible subject matter. Accordingly, Applicant respectfully requests withdrawal of the rejection of claims 1-20 under 35 U.S.C. § 101”, Examiner respectfully disagrees.
Examiner cites that Applicant’s arguments are not persuasive. Applicant argues that the claimed invention, similar to Example 42, integrates any alleged abstract idea into a practical application by reciting “specific improvements,” including storing records in a defined format and transmitting a notification message, which allegedly facilitate access, reduce resource consumption, and improve data quality and integrity. However, these features do not correspond to the technological solution described in Example 42. In particular, Example 42 is directed to converting non-standardized data from multiple systems into a standardized format to resolve interoperability issues and enable real-time access across different users and platforms. In contrast, claim 1 merely recites obtaining records from a plurality of services “having a plurality of formats” and storing the records in a “defined format,” without reciting any conversion, normalization, or specific mechanism for standardizing disparate data formats. The claim also does not recite any particular data structure or technical implementation that would achieve the alleged improvements.
Applicant’s arguments on the Specification are likewise not persuasive because the asserted benefits—such as facilitating access, decreasing consumption of computing resources, and improving data quality and integrity—are not reflected in the claim language. The claim does not specify how the defined format results in reduced resource usage or improved database performance, nor does it include any concrete steps that would produce such effects. Instead, the claim broadly recites identifying/generating/detecting the information using a recommendation engine to generate a likelihood score and comparing to a threshold are mental processes and obtaining/receiving/transmitting information, presenting the result via a notification, are insignificant extra solution activities. Accordingly, the claim does not integrate the judicial exception into a practical application and does not amount to significantly more than the abstract idea. Therefore, the rejection under 35 U.S.C. § 101 is maintained.
112the Rejection:
112th rejection has been withdrawn based on the amendments.
103 Rejections
Applicant’s arguments, see remarks, filed on 12/30/2025, with respect to the rejection(s) of claim(s) 1-20 under 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 Karikurve (US 2024/0070745) and in view of Bliss (US 2022/0129526).
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 of the following reasons:
Claims 1, 9, 17:
At Step 1:
The claims are directed to a “method”, "system" and “non-transitory computer readable medium” and thus directed to a statutory category.
At Step 2A, Prong One:
The claim recites the following limitations directed to an abstract idea:
-“identifying, , a second record indicating the second value relative to the first value, from applying a recommendation engine on the first record and the plurality of second records having the defined format” recites a mental process because human mind can identify a second record indicating the second value relative to the first vale by applying a recommendation engine (mental logic/algorithm) on the first record and plurality of records that has a format by evaluation and judgement of data.
-“in response to identifying the second record having the second value in the defined format, generating, , a score indicating a likelihood of the user to accept switching of the first record with the second record, based upon user data of the user received via a plurality of computing devices of a network environment” recites a mental process because human mind can generate a score indicating a likelihood of the user accept switching the records which has multiple formats by evaluation and judgement of data.
-“detecting, an occurrence of a triggering condition corresponding to the score indicating the likelihood of the user to accept switching of the first record with the second record satisfying a threshold” recites a mental process because human mind can detect an occurrence of a triggering condition associated with a likelihood of user to accept switching the first record with the second record satisfying a threshold by evaluation and judgment of data.
At Step 2A, Prong Two:
The claim recites the following additional elements:
-“by the server, from the database”, “at least one server having one or more processors coupled with memory”, “by the server”, “a non-transitory computer readable medium storing instructions, which when executed by at least one processor, cause the at least one processor to” which are all a high-level recitation of a generic computer components and represent mere instructions to apply the judicial exception on a computer as in MPEP 2106.05(f), which does not provide integration into a practical application and/or is Generally linking the use of the judicial exception to a particular technological environment or field of use by limiting it to a particular data source or type. See MPEP § 2106.05(h) and Electric Power, 830 F.3d at 1354, 119 USPQ2d at 1742 (limiting application of abstract idea to power grid data). Therefore, the limitation does not recite any improvement to the technology.
-“receiving, by a server, from a client of a user, a first record indicating (i) an instruction to be taken to address a condition, (ii) a first value for a receipt of the instruction, and (iii) a first service of a plurality of services through which the instruction is to be received”, is insignificant extra-solution activity as mere data gathering such as 'obtaining information'. See MPEP 2106.05(g).
-“obtaining, by the server, for storage on a database, a plurality of second records having a plurality of formats from the plurality of services, each of the plurality of second records indicating (i) the instruction, (ii) a respective second value for receipt of the instruction, and (iii) a corresponding second service of the plurality of services through which the instruction to be received” is insignificant extra-solution activity as mere data gathering such as 'obtaining information'. See MPEP 2106.05(g).
-“storing, by the server, on the database, the first record and the plurality of second records in a defined format of the database” is insignificant extra-solution activity as mere data gathering such as 'obtaining information'. See MPEP 2106.05(g).
-“transmitting, by the server, responsive to detecting the occurrence of the triggering condition, a notification message comprising the second record having the second value in the defined format to the client for presentation on a user interface to prompt the user to accept or reject the second record instead of the first record” is insignificant extra-solution activity as mere data gathering such as 'obtaining information'. See MPEP 2106.05(g).
Viewing the additional limitations together and the claim as a whole, nothing provides integration into a practical application.
At Step 2B:
The conclusions for the mere implementation using a computer are carried over and does not provide significantly more.
-“receiving, by a server, from a client of a user, a first record indicating (i) an instruction to be taken to address a condition, (ii) a first value for a receipt of the instruction, and (iii) a first service of a plurality of services through which the instruction is to be received” is WURC as evidenced by the court cases cited in MPEP 2106.05(d)(II) by at least "i. Receiving or transmitting data over a network, e.g., using the Internet to gather data, Symantec, 838 F.3d at 1321, … 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)"
-“obtaining, by the server, for storage on a database, a plurality of second records having a plurality of formats from the plurality of services, each of the plurality of second records indicating (i) the instruction, (ii) a respective second value for receipt of the instruction, and (iii) a corresponding second service of the plurality of services through which the instruction to be received” is WURC as evidenced by the court cases cited in MPEP 2106.05(d)(II) by at least "i. Receiving or transmitting data over a network, e.g., using the Internet to gather data, Symantec, 838 F.3d at 1321, … 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)".
-“storing, by the server, on the database, the first record and the plurality of second records in a defined format of the database” is WURC as evidenced by the court cases cited in MPEP 2106.05(d)(II) by at least "i. Receiving or transmitting data over a network, e.g., using the Internet to gather data, Symantec, 838 F.3d at 1321, … 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)" and/or
"iv. Storing and retrieving information in memory, Versata Dev. Group, Inc. v. SAP Am., Inc., 793 F.3d 1306, … OIP Techs., 788 F.3d at 1363."
-“ transmitting, by the server, responsive to detecting the occurrence of the triggering condition, a notification message comprising the second record having the second value in the defined format to the client for presentation on a user interface to prompt the user to accept or reject the second record instead of the first record” is WURC as evidenced by the court cases cited in MPEP 2106.05(d)(II) by at least "i. Receiving or transmitting data over a network, e.g., using the Internet to gather data, Symantec, 838 F.3d at 1321, … 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)" and/or "iv. Presenting offers and gathering statistics, OIP Techs., 788 F.3d at 1362-63, 115 USPQ2d at 1092-9".
Accordingly, at step 2B, these additional elements, both individually and in combination, do not amount to significantly more than the judicial exception. See MPEP § 2106.05. Therefore, the claim is not eligible subject matter under 35 U.S.C. 101.
Claims 2,10, 18:
At Step 2A, Prong Two:
The claim recites the following additional elements:
-“receiving, by the server, from the client, an indication of an acceptance of the second record via the user interface” is insignificant extra-solution activity as mere data gathering such as 'obtaining information'. See MPEP 2106.05(g).
-“updating, by the server, on the database, a user account associated with the user to switch assignment from the first record to the second record” is insignificant extra-solution activity as selecting the data to be manipulated. See MPEP 2106.05(g).
Viewing the additional limitations together and the claim as a whole, nothing provides integration into a practical application.
At Step 2B:
The conclusions for the mere implementation using a computer are carried over and does not provide significantly more.
-“receiving, by the server, from the client, an indication of an acceptance of the second claim via the user interface” is WURC as evidenced by the court cases cited in MPEP 2106.05(d)(II) by at least "i. Receiving or transmitting data over a network, e.g., using the Internet to gather data, Symantec, 838 F.3d at 1321, … 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)".
-“updating, by the server, on the database, a user account associated with the user to switch assignment from the first record to the second record” is WURC as evidenced by the court cases cited in MPEP 2106.05(d)(II) by at least
"iv. Storing and retrieving information in memory, Versata Dev. Group, Inc. v. SAP Am., Inc., 793 F.3d 1306, … OIP Techs., 788 F.3d at 1363."
Accordingly, at step 2B, these additional elements, both individually and in combination, do not amount to significantly more than the judicial exception. See MPEP § 2106.05. Therefore, the claim is not eligible subject matter under 35 U.S.C. 101.
Claims 3,11, 19:
At Step 2A, Prong Two:
The claim recites the following additional elements:
-“transmitting, by the server, responsive to the indication of the acceptance, a second notification message to the second service to prompt for acceptance or rejection of the second record” is insignificant extra-solution activity as mere data gathering such as 'obtaining information'. See MPEP 2106.05(g).
-“receiving, by the server, from the second service, a second indication of acceptance of the second record” is insignificant extra-solution activity as mere data gathering such as 'obtaining information'. See MPEP 2106.05(g).
-“generating, by the server, information for an electronic device to be used by the user to receive the instruction through the second service at the second value” is insignificant extra-solution activity as mere data gathering such as 'obtaining information'. See MPEP 2106.05(g).
Viewing the additional limitations together and the claim as a whole, nothing provides integration into a practical application.
At Step 2B:
The conclusions for the mere implementation using a computer are carried over and does not provide significantly more.
-“transmitting, by the server, responsive to the indication of the acceptance, a second notification message to the second service to prompt for acceptance or rejection of the second record” is WURC as evidenced by the court cases cited in MPEP 2106.05(d)(II) by at least "i. Receiving or transmitting data over a network, e.g., using the Internet to gather data, Symantec, 838 F.3d at 1321, … 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)".
-“receiving, by the server, from the second service, a second indication of acceptance of the second record” is WURC as evidenced by the court cases cited in MPEP 2106.05(d)(II) by at least "i. Receiving or transmitting data over a network, e.g., using the Internet to gather data, Symantec, 838 F.3d at 1321, … 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)".
-“generating, by the server, information for an electronic device to be used by the user to receive the instruction through the second service at the second value” is WURC as evidenced by the court cases cited in MPEP 2106.05(d)(II) by at least "i. Receiving or transmitting data over a network, e.g., using the Internet to gather data, Symantec, 838 F.3d at 1321, … 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)".
Accordingly, at step 2B, these additional elements, both individually and in combination, do not amount to significantly more than the judicial exception. See MPEP § 2106.05. Therefore, the claim is not eligible subject matter under 35 U.S.C. 101.
Claims 4,12,20:
At Step 2A, Prong Two:
The claim recites the following additional elements:
-“receiving, by the server, from the client, an indication of a rejection of the second record via the user interface” is insignificant extra-solution activity as mere data gathering such as 'obtaining information'. See MPEP 2106.05(g).
-“continuing, by the server, to monitor the database for a third record from the plurality of second records from the plurality of services to switch the first record, responsive to the indication of the rejection” is insignificant extra-solution activity as mere data gathering such as 'obtaining information'. See MPEP 2106.05(g).
Viewing the additional limitations together and the claim as a whole, nothing provides integration into a practical application.
At Step 2B:
The conclusions for the mere implementation using a computer are carried over and does not provide significantly more.
-“receiving, by the server, from the client, an indication of a rejection of the second record via the user interface” is WURC as evidenced by the court cases cited in MPEP 2106.05(d)(II) by at least "i. Receiving or transmitting data over a network, e.g., using the Internet to gather data, Symantec, 838 F.3d at 1321, … 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)".
-“continuing, by the server, to monitor the database for a third record from the plurality of second records from the plurality of services to switch the first record, responsive to the indication of the rejection” is WURC as evidenced by the court cases cited in MPEP 2106.05(d)(II) by at least "i. Receiving or transmitting data over a network, e.g., using the Internet to gather data, Symantec, 838 F.3d at 1321, … 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)".
Accordingly, at step 2B, these additional elements, both individually and in combination, do not amount to significantly more than the judicial exception. See MPEP § 2106.05. Therefore, the claim is not eligible subject matter under 35 U.S.C. 101.
Claims 5,13:
At Step 2A, Prong One:
The claim recites the following limitations directed to an abstract idea:
“..identify, from the plurality of second records, the second record having one or more correspondences with the first record” recites a mental process because human mind can identify a second record having one or more correspondences with the first record from the plurality of records by evaluation and judgment.
Claims 6,14:
At Step 2A, Prong Two:
The claim recites the following additional elements:
-“wherein the one or more correspondences includes at least one of a therapeutic correspondence or a generic correspondence between the instruction identified in the first record and the instruction identified in the second record” is Generally linking the use of the judicial exception to a particular technological environment or field of use by limiting it to a particular data source or type. See MPEP § 2106.05(h) and Electric Power, 830 F.3d at 1354, 119 USPQ2d at 1742 (limiting application of abstract idea to power grid data). Therefore, the limitation does not recite any improvement to the technology.
Viewing the additional limitations together and the claim as a whole, nothing provides integration into a practical application.
Claims 7, 15:
At Step 2A, Prong Two:
The claim recites the following additional elements:
-“wherein the recommendation engine is configured to use a machine learning model to select the second record from the plurality of second records based on the first record” is Generally linking the use of the judicial exception to a particular technological environment or field of use by limiting it to a particular data source or type. See MPEP § 2106.05(h) and Electric Power, 830 F.3d at 1354, 119 USPQ2d at 1742 (limiting application of abstract idea to power grid data). Therefore, the limitation does not recite any improvement to the technology.
Viewing the additional limitations together and the claim as a whole, nothing provides integration into a practical application.
Claims 8, 16:
At Step 2A, Prong Two:
The claim recites the following additional elements:
-“wherein the machine learning model is trained according to a training dataset comprising a plurality of examples each identifying (i) a sample record to be switched and (ii) a sample candidate record to switch with the sample record” is Generally linking the use of the judicial exception to a particular technological environment or field of use by limiting it to a particular data source or type. See MPEP § 2106.05(h) and Electric Power, 830 F.3d at 1354, 119 USPQ2d at 1742 (limiting application of abstract idea to power grid data). Therefore, the limitation does not recite any improvement to the technology.
Viewing the additional limitations together and the claim as a whole, nothing provides integration into a practical application.
Claim Rejections - 35 USC § 103
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.
Claim(s) 1, 5, 6, 7, 9, 13, 14, 15, 17 is/are rejected under 35 U.S.C. 103 as being unpatentable over Bogaerts et al. (US 2024/0404675) and in view of Karikurve (US 2024/0070745) and in view of Bliss (US 2022/0129526).
With respect to claim 1, Bogaerts teaches a method of querying databases for switching records, comprising ([0047, the DBMS may store data in multi-dimensional tables comprised of rows and columns, and manipulate, e.g., insert, query, update and/or delete, rows of data using programmatic operations], [0121, a user interface 1604 for providing the details about the problem and options for resolving it in the details and options page, and a user interface 1606 for confirming to the patient that their selection has been accepted in a success page], the databases stores information and the databases/data stores are queried to retrieve data and present alternate data for the user to accept):
receiving, by a server, from a client of a user, a first record indicating (i) an instruction to be taken to address a condition (fig. 9, [0112, The method 804 begins by receiving 902 prescription information, patient information and/or pharmacy information], [0177, At step 2002, prescription information may be received. For example, a prescription optimization system may receive a prescription for a patient that is in the process of being filled from a pharmacy computing system, user device (patient or prescriber), and/or other prescription request system], the medicine prescribed (the instruction) to be taken to address a health issue (a condition)), (ii) a first value for a receipt of the instruction ([0114, the prescription information may include prescription and related information provided by the prescription intake module 142 to the next best action module 150. This information may include the prescription, the prescriber, the patient, the price of the medication, etc], the medication (instruction) price (value)), and (iii) a first service of a plurality of services through which the instruction is to be received ([0066, The data interface and retrieval module 408 is also coupled to the PBM system 114 or the pharmacy computing device 108 to receive claim and insurance information], [0112, For example, the prescription information may be the drug being prescribed, the patient information may be the drugs the patient is taking or has taken in the past, insurance information may be which drugs are covered by insurance or alternative therapies approved… the method 804 may determine whether the cost for filling the prescription is more than a threshold above what the patient has historically paid for the prescription], [0177, a prescription optimization system may receive a prescription for a patient that is in the process of being filled from a pharmacy computing system, user device (patient or prescriber), and/or other prescription request system], the insurance companies/pharmacies (first service of plurality of service) through which the medicine is paid);
obtaining, by the server, for storage on a database, a plurality of second records from the plurality of services, each of the plurality of second records indicating (i) the instruction (fig. 10, [0113, In block 1004, one or more therapeutic alternatives to the prescription may be identified or mapped], [0124, Insurance coverage module 404 further includes a quantity change service 1822, an insurance plan change service 1824, a cash pay change service 1826], the therapeutic alternatives covered by the specific insurance or pharmacy/cash pay (services); the therapeutic alternatives (second record) covered by the pharmacies/insurance companies/cash pay (services) for the identified prescription (instructions)), (ii) a respective second value for receipt of the instruction ([0113, certain alternatives may be removed from the list based on whether they are covered by insurance or not], [0113, The method 806 continues to filter 1010 therapeutic alternatives based on eligibility and other criteria. For example, certain alternatives may be removed from the list based on whether they are covered by insurance or not. Additional therapeutic alternatives may be removed using other criteria, e.g., cost, medication type, or prior rejections by prescribers], the cost (value) for the therapeutic alternative (a second value) for the prescription (instruction)), and (iii) a corresponding second service of the plurality of services through which the instruction to be received ([0120, the prescription at the original pharmacy where the prescription was submitted, transfer the prescription to a pharmacy at a different location, or have the pharmacist contact the prescriber about a different lower cost alternative], [0169, one next best action service may be called to change the NDC value to a therapeutically equivalent indicated by the third-party insurer or based on a lookup table of historically paid patterns. In another example, a next best action service may be called to change the NDC value from a brand name to a generic equivalent or vice versa based on coverage by the particular insurance plan], [0124, Insurance coverage module 404 further includes a quantity change service 1822, an insurance plan change service 1824, a cash pay change service 1826], the therapeutic alternatives covered by the specific insurance or pharmacy/cash pay (services));
identifying, by the server, from the database, a second record and indicating the second value relative to the first value, from applying a recommendation engine on the first record and the plurality of second records ([0113, Next, the method 806 prioritizes and presents 1012 a list of filtered therapeutic alternatives. The list of filtered therapeutic alternatives may be prioritized], the best therapeutic alternatives by applying a machine learning recommendation engine based on the cost/prices of the drugs);
detecting, by the server, an occurrence of a triggering condition (fig. 9, [0042, problem identification model 144 may respond to a claim rejection and next best action module 150 may determine one or more actions before initiating a resubmission service call to claim application 116. The formulary information 118 includes a list of prescription medications that are approved to be prescribed to patients covered by a particular insurance policy or insurer. The formulary information 118 may include formularies for any number of insurance policies as will be described in further detail below.], [0079, Data elements in the prescription category relate to information about the particular prescription itself such as eligibility for processing, status of the prescription as out of stock or on backorder], [0112, Next the method 804 determines 904 one or more drug cost problems. For example, the method 804 may determine whether the cost for filling the prescription is more than a threshold above what the patient has historically paid for the prescription, or what the system predicts the patient would be willing to pay based on past prescription costs], the detection of a problem is the triggering condition); and
transmitting, by the server, responsive to detecting the occurrence of the triggering condition, a notification message comprising the second record to the client for presentation on a user interface to prompt the user to accept or reject the second record instead of the first record ([0119, FIG. 14, the problem is that the order prescription is out of stock. Once the user selects an option and submits their choice, the prescription optimization system 140 generates the success page confirming to the patient that their choice has been received by the prescription optimization system 140], fig. 14; a message is displayed to the patient based on a triggering condition, i.e. medicine is out of stock and user is prompted with the radio button to accept or reject the second record i.e. have a pharmacist call regarding the alternatives).
Bogaerts does not explicitly teach a plurality of second records having a plurality of formats; storing, by the server, on the database, the first record and the plurality of second records in a defined format of the database;
in response to identifying the second record having the second value in the defined format, generating, by the server, a score indicating a likelihood of the user to accept switching of the first record with the second record, based upon user data of the user received via a plurality of computing devices of a network environment; detecting, by the server, an occurrence of a triggering condition corresponding to the score indicating the associated with a likelihood of the user to accept switching of the first record with the second record satisfying a threshold;
However, Karikurve teaches in response to identifying the second record having the second value , generating, by the server, a score indicating a likelihood of the user to accept switching of the first record with the second record, based upon user data of the user received via a plurality of computing devices of a network environment ([0037, The replacement analyzer 408 selects a list of candidate products for the input product. In some embodiments, the replacement analyzer 408 selects candidate products with a threshold number of the same characteristics as the input product…..the replacement analyzer may input features that relate to the user engagement with the products based on historical replacement data, such as a number of times (or percentage of times) that a candidate product has been used to replace the input product on the online concierge system 102. The replacement model 406 outputs a score that is indicative of whether a customer 104 would accept the candidate product as a replacement for the input product, i.e., a likelihood that the candidate product would be used to replace the input product], [00039, For each candidate product in the list, the replacement analyzer 408 inputs the candidate product and the input product to the replacement model 406, which outputs, for each candidate larger size variant, a likelihood that a user would select the candidate larger size variant as a replacement for an input product. In some embodiments, the replacement analyzer 408 may select a candidate replacement product from the larger size variants with the highest likelihood for replacing the input product], the replacement products are associated with values (second records with values), the replacement products (second records) are selected and in response to the selection the likelihood of users accepting the replacements products (switching) are generated based on the users previous selection);
detecting, by the server, an occurrence of a triggering condition corresponding to the score indicating the likelihood of the user to accept switching of the first record with the second record satisfying a threshold ([0056, The acceptance analyzer 416 applies 508 a machine learned acceptance model 414 to each candidate larger size variant to predict a likelihood that the user would accept a suggestion to replace the respective candidate larger size variant for the first item], [0056, the acceptance analyzer 416 may calculate a recommendation value by multiplying the predicted likelihood of a candidate larger size variant by the benefit value of the candidate larger size variant and compare the recommendation value to a threshold value. If the recommendation value is larger than the threshold value, the acceptance analyzer 416 recommends the candidate larger size variant as a replacement item for the first item], calculating a recommendation value based on a likelihood that a user would accept a replacement, comparing the recommendation value to a threshold, when the recommendation values exceed the threshold, the threshold is satisfied. The comparison operation determines that this condition is met (detecting a triggering condition), moreover, Bogaerts teaches detecting an occurrence condition in [0042]).
One of ordinary skill in the art would recognize that incorporating generating a score of likelihood of switching a record and detecting an occurrence and determining that the likelihood of user accept switching of record satisfies a threshold of Karikurve into the invention of Bogaerts to have a likelihood score of users switching records and comparing to a threshold to select most relevant data. Bogaerts/ Karikurve are analogous arts because each art teaches determining alternate options for selecting data.
Therefore, it would have been obvious to one of the ordinary skills in the art before the elective filing date to incorporate functionalities of Karikurve into the system of Bogaerts to have a system which will determining alternate options of data to select by the users for efficient recommendation of data. The motivation would be to have the alternate data options which has higher probability of acceptance by the user to improve users compliance and satisfaction of a system, also to make the system more cost effective and faster (Karikurve, [0002, To improve customer experience and account for varying availability], [0042, larger size variant replacement recommendations may improve customer experience due to customer's cost saving benefits]).
Bogaerts and Karikurve do not explicitly teach second records having a plurality of formats; storing, by the server, on the database, the first record and the plurality of second records in a defined format of the database;
t
However, Bliss teaches records having plurality of formats from the plurality of services ([0048, the tracking database may convert one or more formats of registration message into a standardized event log format for storage], plurality of formats from plurality of services);
storing, by the server, on the database, the first record and the plurality of second records in a defined format of the database ([0048, the tracking database may convert one or more formats of registration message into a standardized event log format for storage. At operation 430 the access log may be stored in a database], [0069, Registration manager 630 may receive registration messages and convert the registration message from a first format specified by an API to a second format for storage as a record in storage 660 according to a database schema], storing records in a database defined format);
records having the defined format; record having the second value in the defined format, , record having the second value in the defined format
One of ordinary skill in the art would recognize that incorporating plurality of formats of records and storing the plurality of formats in defined format of the database of Bliss into the invention of Bogaerts/Karikurve to have different formats of data. Bogaerts/Karikurve are analogous arts because each art teaches storing data into databases.
Therefore, it would have been obvious to one of the ordinary skills in the art before the elective filing date to incorporate functionalities of Bliss into the system of Bogaerts/Karikurve to have a system which will have multiple formats and store data in a database. The motivation would be to have consistent data processing, efficient querying of data and improving quality and integrity of data records (Bliss, [0021, This allows for sharing data between services and applications without restricting placement of the data to a small subset of available computing resources and at the same time removes the need for complex infrastructures and devices required for alternative solutions]).
With respect to claim 5, Bogaerts, Karikurve, Bliss in combination teach the method of claim 1, Bogaerts further teaches wherein the recommendation engine is configured to identify, from the plurality of second records, the second record having one or more correspondences with the first record ([0113, In block 1004, one or more therapeutic alternatives to the prescription may be identified or mapped], the alternative prescription is identified which corresponds to the first prescription).
With respect to claim 6, Bogaerts, Karikurve, Bliss in combination teach the method of claim 5, Bogaerts further teaches wherein the one or more correspondences includes at least one of a therapeutic correspondence or a generic correspondence between the instruction identified in the first record and the instruction identified in the second record (([0113, In block 1004, one or more therapeutic alternatives to the prescription may be identified or mapped], the alternative prescription is identified which corresponds to the first prescription).
With respect to claim 7, Bogaerts, Karikurve, Bliss in combination teach the method of claim 1, Bogaerts further teaches wherein the recommendation engine is configured to use a machine learning model to select the second record from the plurality of second records based on the first record ([0070, The machine learning model 412 may be steps, processes, functionalities, software executable by a processor, or a device including routines for determining which problems to provide to the therapeutic alternative recommendation 146 and the next best action module 150], the machine learning module to select the therapeutic alternatives (second record)).
Claim 9 encompasses the same scope of limitation of claim 1, in additions of at least one server having one or more processors coupled with memory, (Bogaerts, [0009, a system includes at least one processor and a memory. The memory stores instructions which, when executed, cause the at least one processor], a memory and processor). Therefore, claim 9 is rejected on the same basis of rejection of claim 1.
Claim 13 is rejected on the same basis of rejection of claim 5.
Claim 14 is rejected on the same basis of rejection of claim 6.
Claim 15 is rejected on the same basis of rejection of claim 7.
Claim 17 encompasses the same scope of limitation of claim 1, in additions of A non-transitory computer readable medium storing instructions, which when executed by at least one processor, cause the at least one processor to, (Bogaerts, [0009, a system includes at least one processor and a memory. The memory stores instructions which, when executed, cause the at least one processor], [0045, The drug database 128 can include one or more non-transitory computer-readable media for storing the data], non-transitory computer readable medium). Therefore, claim 17 is rejected on the same basis of rejection of claim 1.
Claim(s) 4, 12, 20 is/are rejected under 35 U.S.C. 103 as being unpatentable over Bogaerts et al. (US 2024/0404675) a and in view of Karikurve (US 2024/0070745) and in view of Bliss (US 2022/0129526) and in view of Smith et al. (7,734,483).
With respect to claim 4, Bogaerts, Karikurve and Bliss in combination teach the method of claim 1, but do not in combination teach receiving, by the server, from the client, an indication of a rejection of the second record via the user interface; continuing, by the server, to monitor the database for a third record from the plurality of second records from the plurality of services to switch the first record, responsive to the indication of the rejection.
However, Smith teaches further comprising: receiving, by the server, from the client, an indication of a rejection of the second record via the user interface ([col. 21, lines 40-45, “Otherwise, at step 1730 the status of the opportunity is updated, which may mean canceling it and presenting different opportunities for the patient to choose from”], the cancelation of an alternative); and
continuing, by the server, to monitor the database for a third record from the plurality of second records from the plurality of services to switch the first record, responsive to the indication of the rejection ([col. 21, lines 40-45, “Otherwise, at step 1730 the status of the opportunity is updated, which may mean canceling it and presenting different opportunities for the patient to choose from”], [col. 21, lines 63-67, “ At step 1816, if the member has responded to the open opportunity savings then they are referred to the selection process. Otherwise, at step 1820, if a member participates in the co-pay modifier program, to encourage their response and selection of cost saving opportunities, various co-pay incentives can be offered”], if the member does not select the opportunity, then it displays other options from the database/cancelation of an alternative and presenting users with different options).
One of ordinary skill in the art would recognize that incorporating the functionalities i.e. giving users alternate options when the user reject one options of Smith into the invention of Bogaerts/Karikurve/Bliss to have multiple options to select from. Bogaerts/Karikurve/Bliss/Smith are analogous arts because each art teaches options for medicine for a patient.
Therefore, it would have been obvious to one of the ordinary skills in the art before the elective filing date to incorporate functionalities of Smith into the system of Bogaerts/Karikurve/Bliss to have a system which will determining alternate options of data to select by the users for efficient recommendation of data. The motivation would be to have multiple options presented to users to select the best option for a user to improve users compliance and satisfaction of a system, also to make the system more cost effective and faster (Smith, [col. 4, lines “client is efficiently participating in and taking advantage of the coverage and benefits included in their pharmaceutical benefit plan”]).
Claim 12 is rejected on the same basis of rejection of claim 4.
Claim 20 is rejected on the same basis of rejection of claim 4.
Claim(s) 2, 3, 10, 11, 18, 19 is/are rejected under 35 U.S.C. 103 as being unpatentable over Bogaerts et al. (US 2024/0404675) and in view of Karikurve (US 2024/0070745) and in view of Bliss (US 2022/0129526) and in view of Smith et al. (7,734,483) and in view of Lawless (US 2007/0168228).
With respect to claim 2, Bogaerts, Karikurve, Bliss in combination teach the method of claim 1, but do not explicitly teach comprising: receiving, by the server, from the client, an indication of an acceptance of the second record via the user interface; updating, by the server, on the database, a user account associated with the user to switch assignment from the first record to the second record.
However, Smith further teaches comprising: receiving, by the server, from the client, an indication of an acceptance of the second record via the user interface ([col. 6, lines 60-65, “At step 308, the enrollment process is completed once the patient has entered their prescription information and selected alternative medications. The enrollment process can also be limited to just patient information, with any analysis to be done at a later time”], the users can select the alternative medicine (second record));
a user account associated with the user to switch assignment from the first record to the second record ([col. 13, lines 9-12, “Health management database 525 is formed by databases of eligibility information 514, client profiles 516, claims 518, and non-prescription opportunities 526”], [col. 19, lines 47-49, “Using selection buttons 1224 and 1226 the patient can choose to remain with their current drug, or switch to the offered lower cost substitute drug”], [col. 22, lines 35-37, “ a system that allows members with a particular insurer and pharmacy benefit plan to save money by switching to lower cost drugs”], users profile are associated with users records and switching records).
One of ordinary skill in the art would recognize that incorporating accepting users choice of an alternate medicine and switching records information of Smith into the invention of Bogaerts/Karikurve/Bliss to have an option for selecting alternative medicine/service to select the most appropriate data for the user. Bogaerts/ Karikurve/Bliss/Smith are analogous arts because each art teaches selecting data.
Therefore, it would have been obvious to one of the ordinary skills in the art before the elective filing date to incorporate functionalities of Smith into the system of Bogaerts/Karikurve/Bliss to have a system which will determining alternate options of data to select by the users for efficient recommendation of data. The motivation would be to have select most appropriate medicine/plans to make the system faster and more accurate (Smith, [col. 4, lines “client is efficiently participating in and taking advantage of the coverage and benefits included in their pharmaceutical benefit plan”]).
Bogaerts, Karikurve, Bliss and Smith do not in combination explicitly teach updating, by the server, on the database, a user account associated with the user
However, Lawless teaches updating, by the server, on the database, a user account associated with the user databases 100, user interface 160, and wireless messaging platform 170], the users account is updated based on the modified information, Smith teaches switching records in fig. 17, 18).
One of ordinary skill in the art would recognize that incorporating updating user account based on modified data of Lawless into the invention of Bogaerts/ Karikurve/Bliss/Smith to updated account information. Bogaerts/Karikurve/Bliss/Smith are analogous arts because each art teaches medication options for users.
Therefore, it would have been obvious to one of the ordinary skills in the art before the elective filing date to incorporate functionalities of Lawless into the system of Bogaerts/ Karikurve/Bliss/Smith to have a system which will update user’s account. The motivation would be to have data consistency and accuracy and also to have better recommendation for future instances (Lawless, [0115, a single application optimizes the end-user experience and improves observance and compliance with the user's prescription drug treatment]).
With respect to claim 3, Bogaerts, Karikurve, Bliss, Smith and Lawless in combination teach the method of claim 2, Smith further teaches further comprising: transmitting, by the server, responsive to the indication of the acceptance, a second notification message to the second service to prompt for acceptance or rejection of the second record ([col. 20, lines 10-15, “The interface shows a patient's current prescription 1402 along with their newly selected drug 1404. Column 1406 shows who will be contacting the patient's doctor about the change in prescription. The selection buttons 1408 and 1410 allow the patient to select the pharmacy benefit manager or themselves, respectively. Contact information for the doctor 1412 is also shown on the interface”], a second notification is send to doctors/healthcare professional (second service) to accept the change, moreover, Bogaerts teaches services (insurance/pharmacy);
receiving, by the server, from the second service, a second indication of acceptance of the second record ([col. 20, lines 64-67, “To take an action with respect to a request, the doctor uses the selection boxes in column 1618. Options available to the doctor include, approved 1620, denied, and must see patient 1622. After the doctor has completed his selection he can submit them to the My Rx Choices using link 1624”]; [col. 21, lines 50-51, “The process begins at step 1802 after savings opportunities have been sent out for approval”], the doctor accepts the change); and
generating, by the server, information for an electronic device to be used by the user to receive the instruction through the second service at the second value ([col. 21, lines 55-60, “Once all the opportunities have been pulled, at step 1812 the approved ones can be formatted into a savings confirmation statement for the member. At step 1814, this communication is sent to the member. This communication can include a reminder of the additional savings opportunities. In a web interface, this communication can be another interface screen or popup box”], the savings (values) are sent to the members (users)). One of ordinary skill in the art would recognize that incorporating likelihood of switching a record of Smith into the invention of Bogaerts/ Karikurve/Bliss/Lawless to have a likelihood of a user to switch the record. Bogaerts/ Karikurve/Bliss/Lawless are analogous arts because each art teaches options for medicine.
Therefore, it would have been obvious to one of the ordinary skills in the art before the elective filing date to incorporate functionalities of Smith into the system of Bogaerts/Karikurve/Bliss/Lawless to have a system which will determining alternate options of data to select by the users for efficient recommendation of data. The motivation would be to have the alternate data options which has higher probability of acceptance by the user to improve users compliance and satisfaction of a system, also to make the system more cost effective and faster (Smith, [col. 4, lines “client is efficiently participating in and taking advantage of the coverage and benefits included in their pharmaceutical benefit plan”]).
Claim 10 is rejected on the same basis of rejection of claim 2.
Claim 11 is rejected on the same basis of rejection of claim 3.
Claim 18 is rejected on the same basis of rejection of claim 2.
Claim 19 is rejected on the same basis of rejection of claim 3.
Claim(s) 8, 16 is/are rejected under 35 U.S.C. 103 as being unpatentable over Bogaerts et al. (US 2024/0404675) and in view of Karikurve (US 2024/0070745) and in view of Bliss (US 2022/0129526) and in view of Balasubramanian (US 2024/0177211).
With respect to claim 8, Bogaerts, Karikurve, Bliss in combination teach the method of claim 7, Bogaerts further teaches wherein the machine learning model is trained according to a training dataset comprising a plurality of examples each identifying (i) a sample record to be switched and ([0159, a machine learning model similar to machine learning model 412 or machine learning model 710 may be trained based on training data labeled for specific rejection codes and corresponding next best actions to provide higher confidence next best action recommendations than general resolution machine learning model 1806], [0171, training data sets may be curated from data sets that are selected from and/or based on historical production data, but have been cleansed, labeled, and validated for specific model training purposes], the rejected/historical prescription record is the sample record to be switched and the machine learning model is trained with the rejected/historical data).
Bogaerts, Karikurve, Bliss in combination do not explicitly teach (ii) a sample candidate record to switch with the sample record.
However, Balasubramanian teaches (ii) a sample candidate record to switch with the sample record ([0062, The replacement model may be trained to optimize various metrics and may be treated as a positive training data item acceptance of a suggested replacement item by a user and as a negative training data item rejection of a suggested replacement item (e.g., the selection of an alternate replacement item)], [0064, the replacement score may be optimized based on historical training data for users' replacement item selections], the users selections of replacement data is used for training). One of ordinary skill in the art would recognize that incorporating the functionalities i.e. using a sample candidate record to switch with the sample record of Balasubramanian into the invention of Bogaerts/Karikurve/Bliss to train the system more accurately. Bogaerts/ Karikurve/Bliss/Balasubramanian are analogous arts because each art teaches data selection options.
Therefore, it would have been obvious to one of the ordinary skills in the art before the elective filing date to incorporate functionalities of Balasubramanian into the system of Bogaerts/Karikurve/Bliss to have a system which will train the machine learning model with a sample candidate record to switch with the sample record. The motivation would be to have train the machine learning model to give better recommendation for alternative/replacement options to user to make the system more efficient (Balasubramanian, [0008, his advantage for the source of an originally-ordered item may reduce the likelihood that substitute products are recommended from alternate or competing sources]).
Claim 16 is rejected on the same basis of rejection of claim 8.
Conclusion
Applicant's amendment necessitated the new ground(s) of rejection presented in this Office action. Accordingly, THIS ACTION IS MADE FINAL. See MPEP § 706.07(a). Applicant is reminded of the extension of time policy as set forth in 37 CFR 1.136(a).
A shortened statutory period for reply to this final action is set to expire THREE MONTHS from the mailing date of this action. In the event a first reply is filed within TWO MONTHS of the mailing date of this final action and the advisory action is not mailed until after the end of the THREE-MONTH shortened statutory period, then the shortened statutory period will expire on the date the advisory action is mailed, and any nonprovisional extension fee (37 CFR 1.17(a)) pursuant to 37 CFR 1.136(a) will be calculated from the mailing date of the advisory action. In no event, however, will the statutory period for reply expire later than SIX MONTHS from the mailing date of this final action.
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/FATIMA P MINA/ Examiner, Art Unit 2159 /MARC S SOMERS/ Primary Examiner, Art Unit 2159
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