DETAILED ACTION
Notice to Applicant
This communication is in response to the application submitted December 2, 2024. The present application is a continuation of U.S. Patent App. No. 17/864,631 (now U.S. Patent No. 12,159,708) filed July 14, 2022, which is a Continuation-in-Part application of U.S. Patent App. No. 15/225,503 filed August 1, 2016 (now abandoned), which claims the benefit of U.S. Provisional Patent App. No. 62/387,534, filed Dec. 28, 2015. Claim 1 is cancelled. Claims 2 – 29 are presented for examination.
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 .
Claim Rejections - 35 USC § 101
35 U.S.C. 101 reads as follows:
Whoever invents or discovers any new and useful process, machine, manufacture, or composition of matter, or any new and useful improvement thereof, may obtain a patent therefor, subject to the conditions and requirements of this title.
Claims 2 – 29 are rejected under 35 U.S.C. 101 because the claimed invention is directed to a judicial exception (i.e., a law of nature, a natural phenomenon, or an abstract idea) without significantly more.
Step One
Claims 2 – 29 are drawn to a method and non-transitory computer-readable storage medium, which is/are statutory categories of invention (Step 1: YES).
Step 2A Prong One
Independent claims 1 and 16 recite a method ranking Healthcare Items, comprising physicians (including physician assistants and nurse practitioners), institutions and facilities (including hospitals and out- patient surgery centers), case managers, workers' compensation adjusters, treatment patterns and/or practices, plans, programs, and networks, based on quantified outcomes involved in treating healthcare needs of patients, the method comprising: organize patients' medical and pharmacy claims involving a Healthcare Item; identify one or more distinct root diagnosis for each patient's organized medical and pharmacy claims; accumulate all said organized claims related to a root diagnosis over an entire continuum of care for each identified root diagnosis, and then group together those accumulated claims by a specified measurement period of time; identify absence days attributable to each identified root diagnosis of each patient during the measurement period by juxtaposing dates for such patient's claims grouped under each corresponding root diagnosis against records demonstrating such patient's absence days from their respective employment; determine an absence cost for the identified absence days of each patient; combine for each root diagnosis of each patient a monetary cost attributed to all medical and pharmacy claims and said determined absence costs for each said root diagnosis; allocate to each Healthcare Item related to a claim grouped with a patient's root diagnosis both:(1) monetary cost attributed to each Healthcare Item's related claims grouped with a particular root diagnosis and related determined absence costs foreach corresponding treated patient having said particular root diagnosis, and (2) monetary cost attributed to all downstream claims and related determined absence costs determined from direct and indirect referrals of a patient for a particular root diagnosis made by such Healthcare Item to other Healthcare Items; determine, for each Healthcare Item, an average cost to treat a patient with a particular root diagnosis by: (1) combining monetary costs attributed to all patients' claims and absence costs attributed to each Healthcare Item when treating a particular root diagnosis over a determined period of time, (2) dividing by the total number of patients treated for said particular root diagnosis with respect to each such Healthcare Item; rank each individual Healthcare Item within its category of Healthcare Items by each root diagnosis based on each such Healthcare Item's average costs of medical and pharmacy claims plus absence costs for a patient with a particular root diagnosis, from best, having lowest average cost, to worst, having highest average cost; receive a search request for a Healthcare Item related to treating a particular root diagnosis; present said ranked Healthcare Items for each applicable particular root diagnosis: hierarchically ordered groups of the ranked Healthcare Items related to treating particular root diagnoses; hierarchically descending subsets of information related to each respective presented ranked Healthcare Item; in response to the user selecting a subset of presented information, providing the user access to said information.
The respective dependent claims 2 – 15 and 17 – 29, but for the inclusion of the additional elements specifically addressed below, provide recitations further limiting the invention of the independent claim(s).
The recited limitations, as drafted, under their broadest reasonable interpretation, cover certain methods of organizing human activity, as reflected in the specification, which states organizing medical and pharmacy claims, identifying the root diagnosis for each claim, collect all medical and pharmacy claims related to the root diagnosis of a patient, and group the claims together over a specific time period, identify employee absences due to the root diagnosis by comparing claim dates and employee absence dates, combine the cost of medical claims and employee absences for the root diagnosis, rank by the root diagnosis based on the average cost of medical claims and absences from lowest cost (best) to highest cost (worst), and present a hierarchically ordered list of items for each root diagnosis. If a claim limitation, under its broadest reasonable interpretation, covers managing personal behavior or relationships or interactions between people, then it falls within the “Certain Methods of Organizing Human Activity” grouping of abstract ideas. The present claims cover certain methods of organizing human activity because they address “a particular area of usefulness is in decreasing an employer's costs by identifying high value providers, defined as those providers who enable a self-insured employer's employees to return to work the most efficiently (i.e., at the lowest cost and in the least amount of time) and at or near pre-absence productivity levels” (paragraph 2 of the published specification). Accordingly, the claims recite an abstract idea(s) (Step 2A Prong One: YES).”
Step 2A Prong Two
This judicial exception is not integrated into a practical application. The claims are abstract but for the inclusion of the additional elements including:
Claim 2: “computing environment comprising one or more processors and databases”, “computing environment”, “computer interface”, “interface”
Claims 6, 8: “loop of neural network and/or machine learning”
Claim 14: “interface”, “dashboards and/or reports available regarding one of the subsets of information when the user hovers a cursor over the subset of information”, “wherein in response to the user selecting a preview of a dashboard and/or report via the interface, providing the user access to said subset of information via the interface”
Claim 16: “non-transitory computer-readable medium having computer executable code”, “one or more processors”, “computer interface”, “interface”
Claims 17 – 19, 21 – 22, 24 – 27, 29: “non-transitory computer readable medium”
Claims 20, 23: “non-transitory computer readable medium”, “loop of neural network and/or machine learning”
Claim 28: “non-transitory computer readable medium”, “dashboards and/or reports available regarding one of the subsets of information when the user hovers a cursor over the subset of information”, “wherein in response to the user selecting a preview of a dashboard and/or report via the interface, providing the user access to said subset of information via the interface”
These features are additional elements that are recited at a high level of generality such that they amount to no more than mere instruction to apply the exception using generic computer components. See: MPEP 2106.05(f).
The additional elements are merely incidental or token additions to the claim that do not alter or affect how the process steps or functions in the abstract idea are performed. Therefore, the claimed additional elements do not add meaningful limitations to the indicated claims beyond a general linking to a technological environment. See: MPEP 2106.05(h).
The combination of these additional elements is no more than mere instructions to apply the exception using generic computer components. Accordingly, even in combination, these additional elements do not integrate the abstract idea into a practical application because they do not impose any meaningful limits on practicing the abstract idea.
Hence, the additional elements do not integrate the abstract idea into a practical application because they do not impose any meaningful limits on practicing the abstract idea. Accordingly, the claims are directed to an abstract idea (Step 2A Prong Two: NO).
Step 2B
The claims do not include additional elements that are sufficient to amount to significantly more than the judicial exception. As discussed above with respect to integration of the abstract idea into a practical application, using the additional elements to perform the abstract idea amounts to no more than mere instructions to apply the exception using generic components. Mere instructions to apply an exception using a generic components cannot provide an inventive concept. See MPEP 2106.05(f).
Further, the claimed additional elements, identified above, are not sufficient to amount to significantly more than the judicial exception because they are generic components that are not integrated into the claim because they are merely incidental or token additions to the claim that do not alter or affect how the process steps or functions in the abstract idea are performed. Therefore, the claimed additional elements do not add meaningful limitations to the indicated claims beyond a general linking to a technological environment. See: MPEP 2106.05(h).
Further, the claimed additional elements, identified above, are not sufficient to amount to significantly more than the judicial exception because they are generic components that are configured to perform well-understood, routine, and conventional activities previously known to the industry. See: MPEP 2106.05(d). Said additional elements are recited at a high level of generality and provide conventional functions that do not add meaningful limits to practicing the abstract idea.
Viewing the limitations as an ordered combination, the claims simply instruct the additional elements to implement the concept described above in the identification of abstract idea with routine, conventional activity specified at a high level of generality in a particular technological environment.
Hence, the claims as a whole, considering the additional elements individually and as an ordered combination, do not amount to significantly more than the abstract idea (Step 2B: NO).
Dependent claim(s) 2 – 15 and 17 – 29 when analyzed as a whole, considering the additional elements individually and/or as an ordered combination, are held to be patent ineligible under 35 U.S.C. 101 because the additional recited limitation(s) fail(s) to establish that the claim(s) is/are not directed to an abstract idea without significantly more. These claims fail to remedy the deficiencies of their parent claims above, and are therefore rejected for at least the same rationale as applied to their parent claims above, and incorporated herein.
Conclusion
The prior art made of record and not relied upon is considered pertinent to applicant's disclosure.
Tavola et al. (U.S Patent Number 11/636,497 B1) discloses a computer network architecture with machine learning and artificial intelligence and risk adjusted performance ranking of healthcare providers.
Leonardi (U.S Patent Number 11,182,459 B1) discloses an automated, comparative healthcare, financial, operational, and quality outcomes and performance benchmarking.
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KRISTINE K. RAPILLO
Examiner
Art Unit 3626
/KRISTINE K RAPILLO/Examiner, Art Unit 3682