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 .
DETAILED ACTION
Response to Amendment
In the preliminary amendment dated 12/16/2024, the following occurred: Claims 1 and 6-7 have been amended, claims 2-4 and 8-22 have been cancelled, and claims 23-39 are new.
Claims 1, 5-7 and 23-39 are pending and have been examined.
Priority
Applicant’s claim for the benefit of a prior-filed application under 35 U.S.C. 119(e) or under 35 U.S.C. 120, 121, 365(c), or 386(c) is acknowledged. Applicant has not complied with one or more conditions for receiving the benefit of an earlier filing date under 35 U.S.C. 112(a) as follows:
The later-filed application must be an application for a patent for an invention which is also disclosed in the prior application (the parent or original nonprovisional application or provisional application). The disclosure of the invention in the parent application and in the later-filed application must be sufficient to comply with the requirements of 35 U.S.C. 112(a) or the first paragraph of pre-AIA 35 U.S.C. 112, except for the best mode requirement. See Transco Products, Inc. v. Performance Contracting, Inc., 38 F.3d 551, 32 USPQ2d 1077 (Fed. Cir. 1994)
The disclosure of at least the prior-filed application, non-provisional Application No. 16/351,299, fails to provide adequate support or enablement in the manner provided by 35 U.S.C. 112(a) for one or more claims of this application. For example, the independent claim 1 recites claim language in the body of the claim such that the scope of the claim is confined to a second “selecting…” operation, which is not disclosed by the non-provisional Application. Therefore, the instant Application 18/981,984 cannot claim benefit of at least non-provisional Application No. 16/351,299.
Specification
The incorporation of essential material in the specification by reference to an unpublished U.S. application, foreign application or patent, or to a publication is improper. Applicant is required to amend the disclosure to include the material incorporated by reference, if the material is relied upon to overcome any objection, rejection, or other requirement imposed by the Office. The amendment must be accompanied by a statement executed by the applicant, or a practitioner representing the applicant, stating that the material being inserted is the material previously incorporated by reference and that the amendment contains no new matter. 37 CFR 1.57(g).
The attempt to incorporate subject matter into this application by reference to “Physician Reporting Requirements for Injured Workers in California,” © Rand Corp., Santa Monica, CA (2017) is ineffective because the reference is to a publication and is improper.
Information Disclosure Statement
The Information Disclosure Statement(s) (IDS)(s) submitted on 02/28/2025 follow(s) the provisions of 37 CFR 1.97 and has/have been fully considered by the Examiner.
Claim Rejections - 35 USC § 112
The following is a quotation of the first paragraph of 35 U.S.C. 112(a):
(a) IN GENERAL.—The specification shall contain a written description of the invention, and of the manner and process of making and using it, in such full, clear, concise, and exact terms as to enable any person skilled in the art to which it pertains, or with which it is most nearly connected, to make and use the same, and shall set forth the best mode contemplated by the inventor or joint inventor of carrying out the invention.
Claims 1, 5-7 and 23-39 are rejected for lacking written description.
Claims 1, 23 and 27 are rejected under 35 U.S.C. §112(a) for lacking written description for the following recitations (claim 1 being representative):
“selecting, based on the injury, a particular impairment calculator from a plurality of impairment calculators, wherein accuracy and integrity of the impairment rating determination for an injured worker are verified using a statistical model and pattern recognition, wherein the statistical model evaluates input data for anomalies and outliers, and when no anomalies or outliers are found, the data is received by an impairment calculator, and when the pattern recognition detects data that falls within a specified range, an anomaly response is triggered”; and
This is a new matter rejection. New matter added to the claims shall be rejected under 112a. MPEP § 2163.06(I).
The Applicant’s Specification incorporates by reference U.S. Patent Application Serial No. 15/415,581 to Alchemy et al. (published US Patent No. 11,853,973), which discloses in claim 1 “selecting, based on the injury, a particular impairment calculator from a plurality of impairment calculators; and importing data from the clinical data set into one or more fields of the particular impairment calculator, wherein the particular impairment calculator applies a plurality of criteria for the injury, as defined by the at least one administrative rule sets, to determine an impairment value, wherein the impairment rating for the injury is based on the impairment value.” This is sufficient detail for the recited “selecting, based on the injury, a particular impairment calculator from a plurality of impairment calculators… wherein the particular impairment calculator applies a plurality of criteria for the injury, as defined by the at least one administrative rule sets, to determine an impairment rating for the injury”; however, this disclosure fails to provide support for “using a statistical model and pattern recognition, wherein the statistical model evaluates input data for anomalies and outliers, and when no anomalies or outliers are found, the data is received by an impairment calculator, and when the pattern recognition detects data that falls within a specified range, an anomaly response is triggered”. There is no disclosure describing these elements.
The Applicant’s Specification incorporates by reference U.S. Patent Application Serial No. 15/415,581 to Alchemy et al. (published US Patent No. 11,853,973), which discloses in Fig. 7 and associated text “in the step 706, it is determined whether the recovery of the injured worker is stable. In some embodiments, recovery is stable when the injury measurements are within 10%. If in the step 706, it is determined that the injured worker is not stable, then the impairment repair loop and therapy continues, such as described within FIG. 5. If in the step 706, it is determined that recovery is stable, then in the step 710 it is verified that MMI has been achieved and a data package is sent to the oversight board and the one or more stakeholders in the step 714. After it is verified that MMI has been achieved, but the condition of the injured worker remains the same then the injured worker is checked for secondary injuries.” This is sufficient detail for the recited “accuracy and integrity of the impairment rating determination for an injured worker are verified”; however, this disclosure fails to provide support for “using a statistical model and pattern recognition, wherein the statistical model evaluates input data for anomalies and outliers, and when no anomalies or outliers are found, the data is received by an impairment calculator, and when the pattern recognition detects data that falls within a specified range, an anomaly response is triggered”. There is no disclosure describing these elements.
The Specification states (at pg. 3, first para.) “if the corrected injury impairment data, the tentative impairment rating and the recovery score index are not accurate, then the data is further scrutinized to fill any remaining inaccuracies and gaps. In some embodiments, the method comprises assigning a statistical level of confidence for the corrected injury impairment data for each corrected data gap.” This in combination with the disclosure in Application No. 15/415,581 is sufficient detail for the recited “importing data from the corrected impairment rating data set into one or more fields of the particular impairment calculator”; however, this disclosure fails to provide support for “using a statistical model and pattern recognition, wherein the statistical model evaluates input data for anomalies and outliers, and when no anomalies or outliers are found, the data is received by an impairment calculator, and when the pattern recognition detects data that falls within a specified range, an anomaly response is triggered”. There is no disclosure describing these elements.
Further, reciting “when no anomalies or outliers are found, the data is received by an impairment calculator” appears to be a negative limitation used to overcome the prior art. Regarding negative limitations, MPEP states that: "Any negative limitation or exclusionary proviso must have basis in the original disclosure. If alternative elements are positively recited in the specification, they may be explicitly excluded in the claims. … The mere absence of a positive recitation is not basis for an exclusion. Any claim containing a negative limitation, which does not have basis in the original disclosure, should be rejected under 35 U.S.C. 112(a) as failing to comply with the written description requirement". MPEP 2173.05(i). Clarification is respectfully requested.
The rejection of independent claims 1, 23 and 27 also applies to dependent claims 5-7, 24-26 and 28-39.
Double Patenting
The nonstatutory double patenting rejection is based on a judicially created doctrine grounded in public policy (a policy reflected in the statute) so as to prevent the unjustified or improper timewise extension of the “right to exclude” granted by a patent and to prevent possible harassment by multiple assignees. A nonstatutory obviousness-type double patenting rejection is appropriate where the conflicting claims are not identical, but at least one examined application claim is not patentably distinct from the reference claim(s) because the examined application claim is either anticipated by, or would have been obvious over, the reference claim(s). See, e.g., In re Berg, 140 F.3d 1428, 46 USPQ2d 1226 (Fed. Cir. 1998); In re Goodman, 11 F.3d 1046, 29 USPQ2d 2010 (Fed. Cir. 1993); In re Longi, 759 F.2d 887, 225 USPQ 645 (Fed. Cir. 1985); In re Van Ornum, 686 F.2d 937, 214 USPQ 761 (CCPA 1982); In re Vogel, 422 F.2d 438, 164 USPQ 619 (CCPA 1970); and In re Thorington, 418 F.2d 528, 163 USPQ
644 (CCPA 1969).
A timely filed terminal disclaimer in compliance with 37 CFR 1.321(c) or 1.321(d) may be used to overcome an actual or provisional rejection based on a nonstatutory double patenting ground provided the conflicting application or patent either is shown to be commonly owned with this application, or claims an invention made as a result of activities undertaken within the scope of a joint research agreement. See MPEP § 717.02 for applications subject to examination under the first inventor to file provisions of the AIA as explained in MPEP § 2159. See MPEP §§ 706.02(1)(1) -706.02(1)(3) for applications not subject to examination under the first inventor to file provisions of the AIA . A terminal disclaimer must be signed in compliance with 37 CFR 1.321 (b).
The USPTO Internet website contains terminal disclaimer forms which may be used. Please visit www.uspto.gov/patent/patents-forms. The filing date of the application in which the form is filed determines what form (e.g., PTO/SB/25, PTO/SB/26, PTO/AIA /25, or PTO/AIA /26) should be used. A web-based eTerminal Disclaimer may be filled out completely online using web-screens. An eTerminal Disclaimer that meets all requirements is auto-processed and approved immediately upon submission. For more information about eTerminal Disclaimers, refer to www.uspto.gov/patents/process/file/efs/guidance/eTD-info-l.jsp.
(Example) Claims 1-3 and 6-36 are provisionally rejected on the grounds of non-statutory double patenting over claims 1 and 3-30 co-pending Application No. 16/309,221. Although the claims at issue are not identical, they are not patentably distinct from each other as set forth below.
Claims 1, 2, 23, and 24 recite substantially similar limitations to claim 1 and 17 of application 16/309,221. The subject matter in the instant application amounts to claims which are generally similar in scope. The additional limitations recited in the instant application pertaining to the graphical user interface are either nonfunctional descriptive materials (mini settings cards, process feature graphical element), labels/information equivalent to that presented in application 16/309,221 (card subset, card subset graphical elements), or addressed in a different writing style. Further, the step of change […] in response to a user using the one or more user-interactable settings in the instant claims is functionally equivalent to the step of modifying one or more settings recited in the ‘221 application.
Dependent Claims 3, 6-22, 25-36 recite similar limitations to dependent claims 3-16 and 18-30 of the ‘221 application and are also rejected as being obvious variations of the claims of the ‘221 application.
This is a provisional nonstatutory double patenting rejection because the patentably indistinct claims have not in fact been patented.
(Example) Claims 1-20 are rejected on the ground of nonstatutory double patenting as being unpatentable over claims 1-5, 7-12, 14-19 and 21-22 of prior U.S. Patent No. 12,170,143. Although the claims at issue are not identical, they are not patentably distinct from each other as set forth below.
Claims 1, 8 and 15 recite substantially similar (and broader) limitations to claims 1, 8 and 15 of the Patented parent case. The subject matter in the instant application amounts to claims which are generally similar or broader in scope. The limitations in the instant application are addressed in different writing styles, which also makes the claims at issue not identical; however, the language of the limitations is functionally equivalent, such that the claims are similar/patentably indistinct.
Dependent claims 2-7, 9-14 and 16-20 recite similar limitations to claims 1-5, 7-12, 14-19 and 21-22 of the Patent and are also rejected as being obvious variations of the claims of the Patent.
Double Patenting
The nonstatutory double patenting rejection is based on a judicially created doctrine grounded in public policy (a policy reflected in the statute) so as to prevent the unjustified or improper timewise extension of the “right to exclude” granted by a patent and to prevent possible harassment by multiple assignees. A nonstatutory obviousness-type double patenting rejection is appropriate where the conflicting claims are not identical, but at least one examined application claim is not patentably distinct from the reference claim(s) because the examined application claim is either anticipated by, or would have been obvious over, the reference claim(s). See, e.g., In re Berg, 140 F.3d 1428, 46 USPQ2d 1226 (Fed. Cir. 1998); In re Goodman, 11 F.3d 1046, 29 USPQ2d 2010 (Fed. Cir. 1993); In re Longi, 759 F.2d 887, 225 USPQ 645 (Fed. Cir. 1985); In re Van Ornum, 686 F.2d 937, 214 USPQ 761 (CCPA 1982); In re Vogel, 422 F.2d 438, 164 USPQ 619 (CCPA 1970); and In re Thorington, 418 F.2d 528, 163 USPQ
644 (CCPA 1969).
A timely filed terminal disclaimer in compliance with 37 CFR 1.321(c) or 1.321(d) may be used to overcome an actual or provisional rejection based on a nonstatutory double patenting ground provided the conflicting application or patent either is shown to be commonly owned with this application, or claims an invention made as a result of activities undertaken within the scope of a joint research agreement. See MPEP § 717.02 for applications subject to examination under the first inventor to file provisions of the AIA as explained in MPEP § 2159. See MPEP §§ 706.02(1)(1) -706.02(1)(3) for applications not subject to examination under the first inventor to file provisions of the AIA . A terminal disclaimer must be signed in compliance with 37 CFR 1.321 (b).
The USPTO Internet website contains terminal disclaimer forms which may be used. Please visit www.uspto.gov/patent/patents-forms. The filing date of the application in which the form is filed determines what form (e.g., PTO/SB/25, PTO/SB/26, PTO/AIA /25, or PTO/AIA /26) should be used. A web-based eTerminal Disclaimer may be filled out completely online using web-screens. An eTerminal Disclaimer that meets all requirements is auto-processed and approved immediately upon submission. For more information about eTerminal Disclaimers, refer to www.uspto.gov/patents/process/file/efs/guidance/eTD-info-l.jsp.
Claims 1, 23 and 27 are provisionally rejected on the grounds of non-statutory double patenting over claims 1, 9 and 13 of US Application No. 15/415,581 now Patent No. 11,853,973 (reference Patent ‘973) in view of claims 1, 6 and 11 of US Application No. 16/653,508 now Patent No. 11,625,687 (reference Patent ‘687) and claims 1, 10, 20 and 27 of US Application No. 16/124,960 now Patent No. 12,165,209 (reference Patent ‘209). Although the claims at issue are not identical, they are not patentably distinct from each other as set forth below.
The table below exemplifies the issue with claim 1 of the instant application. The analogous claims 23 and 27 recite similar limitations to independent claim 1 of the instant Application and are also rejected as being obvious variations of the claims of the reference ‘973, ‘687 and ‘209 patents.
The Examiner has bolded the claim language that is the same between the claims of the instant application (claim 1 being representative) and corresponding claims of the reference patents.
Claims of Instant Application
Claims of Reference Patent ‘973
Claims of Reference Patent ‘687
Claims of Reference Patent ‘209
1. A computer implemented method of automatically supplementing data in an incomplete online data set, the method comprising:storing, at a storage device of a server computer, historical cohort data that includes a plurality of injury impairment rating data sets of a plurality of previous worker’s compensation claims;receiving, by the server computer from a client computer, a deficient injury impairment rating data set of a pending worker’s compensation claim;selecting at least one administrative rule set from a plurality of administrative rule sets;based on the at least one administrative rule set, performing real-time validation calculations of an observed data set as the observed data set is being entered, and alerting the treating clinician when the real-time validation calculations indicate that entered input data is outside expected data ranges for the injury;automatically rectifying, by the server computer, the deficient injury impairment rating data set, comprising:
accessing, by the server computer, at least a portion of the historical cohort data, wherein the portion of the historical cohort data includes one or more of the plurality of complete injury impairment rating data sets of one or more of the plurality of previous worker’s compensation claims;
comparing, by the server computer, the deficient injury impairment rating data set to at least the portion of the historical cohort data;
based on the comparison, identifying, by the server computer, one or more data set gaps in the deficient injury impairment rating data set of the pending worker’s compensation claim; and applying, by the server computer, statistical models to first data subsets of the portion of the historical cohort data to determine numerical properties from one of the first data subsets, wherein each of the first data subsets corresponds to a respective data set gap of the one or more data set gaps, and based on applying the statistical models, augmenting, by the server computer, the deficient injury impairment data set by filling the one or more data set gaps to obtain a corrected impairment rating data set for the pending worker’s compensation claim;
selecting, based on the injury, a particular impairment calculator from a plurality of impairment calculators, wherein accuracy and integrity of the impairment rating determination for an injured worker are verified using a statistical model and pattern recognition, wherein the statistical model evaluates input data for anomalies and outliers, and when no anomalies or outliers are found, the data is received by an impairment calculator, and when the pattern recognition detects data that falls within a specified range, an anomaly response is triggered; importing data from the corrected impairment rating data set into one or more fields of the particular impairment calculator, wherein the particular impairment calculator applies a plurality of criteria for the injury, as defined by the at least one administrative rule sets, to determine an impairment rating for the injury;
generating, by the server computer, a report based on the corrected impairment rating data set and the impairment rating.
1. A method of establishing a unique time frame for one or more stages of execution within an impairment repair process and reducing errors occurring during the impairment repair process, the method comprising: storing, by a server computer, a pre-employment injury status of a hired worker in a HIPAA compliant database; after an injury event, initiating a work related incident report for an injury associated with the injury event; based upon the incident report, defining, by the server computer, a treatment plan that includes a time frame for treatment and intervals for checkups, wherein the treatment plan defines one or more therapies and one or more stakeholder responsibilities, wherein the time frame and intervals are determined according to at least one administrative rule set; entering an impairment repair loop as defined by the treatment plan, wherein during the impairment repair loop: the one or more therapies defined by the treatment plan are executed; the one or more stakeholder responsibilities defined by the treatment plan are executed; a reminder is automatically sent to one or more stakeholders if the treatment plan is not followed, wherein the reminder sent to the one or more stakeholders is logged; a condition of the hired worker is obtained at an interval of the intervals, wherein the condition of the hired worker is one of improving, worsening, or is stable; and an impairment rating is output, wherein the impairment rating is determined by: receiving, by the server computer from a client computer, encrypted data including a digital clinical data set that includes an observed data set and completed therapies for the injury, wherein the observed data set is obtained from one or more tests performed by a treating clinician on the hired worker, wherein the clinical data set is encrypted by a shell program executing on the client computer and transmitted to the server computer by the shell program to improve computing performance at the server computer, wherein the shell program controls a graphical user interface guiding the treating clinician through data collection and entry process by: generating at least a pictorial prompt of a map for identifying an employer location and a treatment location, a selection menu to enable identification of at least one body part for the injury, and entry fields to enable input of the observed data set and the completed therapies for the injury, receiving the employer location, the treatment location, the at least one body part for the injury, the observed data set and the completed therapies for the injury via the pictorial prompt of the map, the selection menu, and the entry fields; selecting the at least one administrative rule set from a plurality of administrative rule sets based on the employer location and the treatment location; based on the at least one administrative rule set, performing real-time validation calculations of the observed data set as the observed data set is being entered and alerting the treating clinician when the real-time validation calculations indicate that entered input data is outside expected data ranges for the injury; decrypting the encrypted data to obtain the clinical data set; selecting, based on the injury, a particular impairment calculator from a plurality of impairment calculators; and importing data from the clinical data set into one or more fields of the particular impairment calculator, wherein the particular impairment calculator applies a plurality of criteria for the injury, as defined by the at least one administrative rule sets, to determine an impairment value, wherein the impairment rating for the injury is based on the impairment value; exiting the impairment repair loop when the condition of the hired worker is not improving, wherein exiting the impairment repair loop comprises generating a data package that includes data relating to the one or more therapies and the impairment rating; and transmitting the data package to a destination.
1. A method comprising: accessing, by a computing device, a storage repository that includes: historical cohort data that includes a plurality of complete data sets of a plurality of previous worker's compensation claims, wherein the historical cohort data is continuously updated as one or more data sets of one or more additional worker's compensation claims are completed, and a plurality of administrative rule sets; receiving, by the computing device from a client computer, encrypted data associated with a pending worker's compensation claim for an injured worker, wherein the encrypted data includes an initial subjective data set and an initial objective data set that … decrypting, by the computing device, the encrypted data to obtain the initial subjective data set and the initial objective data set; analyzing, by the computing device, the initial subjective data set and the initial objective data set to at least a portion of historical cohort data to determine one or more data gaps in the initial subjective data set and the initial objective data set; in response to determining the one or more data gaps, repairing, by the computing device, the initial subjective data set and the initial objective data set to generate a repaired subjective data set and a repaired objective data set based on the at least the portion of historical cohort data; comparing, by the computing device, the repaired subjective data set to the repaired objective data set to determine whether there is a parity for the repaired subjective data set and the repaired objective data set, and when the parity is below a threshold value, correcting, by the computing device, the repaired subjective data set and objective data set according to a historical accuracy database; based on the comparison, determining, by the computing device, functional limitations of work function of the injured worker, according to the plurality of administrative rule sets, wherein determining the functional limitations of work function of the injured worker comprises: determining a recovery score index based on at least the repaired objective data set; accessing a completed digital functional task form including work activities and associated values that are unique for the injured worker; parsing the completed digital functional task form to identify the activities and associated values included in the completed functional task form; using the associated values and the recovery score index to provide functional limitation recommendations for the work activities for returning to work.
1. A computer-implemented method of providing a deficiency analysis to improve quality and consistency of a clinician and quality and consistency across a medical provider network, the method comprising: receiving, at an administrative rule set database from a client computer, encrypted data including an observed data set for an injury, wherein the observed data set is obtained from one or more tests performed by a clinician on an injured worker and encrypted by a shell program executing on the client computer and transmitted to the administrative rule set database by the shell program to improve computing performance at the administrative rule set database, wherein the shell program controls a graphical user interface guiding the clinician through data collection and entry process by: driving a particular data collection sequence by dynamically generating a set of entry fields that is specific to the injured worker, wherein driving the specific data collection sequence comprises prompting a plurality of adaptively generated entry fields each based on at least the injury and a range of data entered in a previous entry field, thereby expanding the observed data set such that only necessary data is collected for an impairment rating determination of the injured worker, wherein input for a first body part affects a second body part based on a primary injury causing a secondary injury, which affects the impairment rating determination, wherein accuracy and integrity of the impairment rating determination for the injured worker are verified using statistical model and pattern recognition, wherein the statistical model evaluates input data for anomalies and outliers, and when the pattern recognition detects data that falls within a specified range, an anomaly response is triggered, …, wherein the administrative rule set database includes ideal data sets for injuries as determined according to the at least one administrative rule set; …; comparing, at the administrative rule set database, the observed data set to an ideal data set, of the ideal data sets, for the injury to determine deficiencies in the observed data set, including determining that the observed data set is authentic and not synthesized; based on the comparison of the observed data set to the ideal data set, determining, at the administrative rule set database, a risk score for the observed data set, wherein the risk score comprises a percentage of data missing from the observed data set as determined by the ideal data set; generating, by the administrative rule set database, a personalized online playlist of one or more educational modules, as determined from the comparison, for training the clinician to adhere to the at least one administrative rule set for the injury, wherein the one or more educational modules are ordered according to respective scores associated with the deficiencies in the observed data set; generating, by the administrative rule set database, a digital impairment deficiency report that includes the risk score and a hyperlink to the personalized online playlist; and performing simultaneous calculations with a calculator engine using the administrative rule set database, wherein the calculator engine utilizes logic for missing or incomplete data entry requests to ensure validity of dependent data.
Dependent Claims 5-7, 24-26 and 28-39 recite similar limitations to dependent claims 2-17 of the ‘973 patent and are also rejected as being obvious variations of the claims of the ‘687 and ‘209 patents.
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, 5-7 and 23-39 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.
Claims 1, 23, and 27 are rejected under 35 U.S.C. §101 because the claimed invention is directed to an abstract idea without significantly more.
Step 1 (YES)
Claims 1, 23, and 27 fall into at least one of the statutory categories (i.e., process or machine).
Step 2A1 (YES)
The claims recite an abstract idea. The identified abstract idea is as underlined (claim 1 being representative):
storing, at a storage device of a server computer, historical cohort data that includes a plurality of injury impairment rating data sets of a plurality of previous worker’s compensation claims;
receiving, by the server computer from a client computer, a deficient injury impairment rating data set of a pending worker’s compensation claim;
selecting at least one administrative rule set from a plurality of administrative rule sets;
based on the at least one administrative rule set, performing real-time validation calculations of an observed data set as the observed data set is being entered, and alerting the treating clinician when the real-time validation calculations indicate that entered input data is outside expected data ranges for the injury;
automatically rectifying, by the server computer, the deficient injury impairment rating data set, comprising:
accessing, by the server computer, at least a portion of the historical cohort data, wherein the portion of the historical cohort data includes one or more of the plurality of complete injury impairment rating data sets of one or more of the plurality of previous worker’s compensation claims;
comparing, by the server computer, the deficient injury impairment rating data set to at least the portion of the historical cohort data;
based on the comparison, identifying, by the server computer, one or more data set gaps in the deficient injury impairment rating data set of the pending worker’s compensation claim; and
applying, by the server computer, statistical models to first data subsets of the portion of the historical cohort data to determine numerical properties from one of the first data subsets, wherein each of the first data subsets corresponds to a respective data set gap of the one or more data set gaps, and based on applying the statistical models, augmenting, by the server computer, the deficient injury impairment data set by filling the one or more data set gaps to obtain a corrected impairment rating data set for the pending worker’s compensation claim;
selecting, based on the injury, a particular impairment calculator from a plurality of impairment calculators, wherein accuracy and integrity of the impairment rating determination for an injured worker are verified using a statistical model and pattern recognition, wherein the statistical model evaluates input data for anomalies and outliers, and when no anomalies or outliers are found, the data is received by an impairment calculator, and when the pattern recognition detects data that falls within a specified range, an anomaly response is triggered;
importing data from the corrected impairment rating data set into one or more fields of the particular impairment calculator, wherein the particular impairment calculator applies a plurality of criteria for the injury, as defined by the at least one administrative rule sets, to determine an impairment rating for the injury;
generating, by the server computer, a report based on the corrected impairment rating data set and the impairment rating.
The identified claim elements, as drafted, is a process that under the broadest reasonable interpretation (BRI) covers a method of organizing human activity (i.e., managing personal behavior or relationships or interactions between people including following rules or instructions) but for the recitation of generic computer component language (discussed infra). The claims encompass a series of rules or instructions for a person or persons to follow, with or without the aid of a computer, to automatically supplement data in an incomplete online data set (see Spec. pg. 1, para. 3-4 describing the impairment rating and injury claims adjudication processes as a human activities) in the manner described in the identified abstract idea, supra. For example, but for the generic computer component language, the claims encompass a person selecting a particular impairment calculator from a plurality of impairment calculators in the manner described in the identified abstract idea, supra (see ‘067 Application now Patent 11,461,973 incorporated by reference (at col. 22 lines 22-47): “The data sets are received at the impairment rating calculator 115, which comprises a set of spreadsheets into which the clinical data sets are imported”). The rules or instructions are the claimed steps as indicated supra.
Other than reciting generic computer components (discussed infra), i.e., a system implemented by a data processor (computer), the claimed invention amounts to managing personal behavior or interaction between people. The Examiner notes that certain “method[s] of organizing human activity” includes a person’s interaction with a computer (see MPEP 2106.04(a)(2)(II)). If a claim limitation, under its broadest reasonable interpretation, covers managing personal behavior or interactions between people but for the recitation of generic computer components, then it falls within the “certain methods of organizing human activity” grouping of abstract ideas. Accordingly, the claim recites an abstract idea.
Step 2A2 (NO)
The judicial exception, the above-identified abstract idea, is not integrated into a practical application. In particular, the claims recite the additional elements of one or more computer systems comprising one or more hardware processors and storage media, including a server computer or server device having a storage device and a client computer that implement the identified abstract idea (represented by claim 1). The additional elements aforementioned are not described by the applicant and are recited at a high-level of generality (i.e., a generic computer or computer component performing a generic computer or computer component function that facilitates the identified abstract idea) such that these amount no more than mere instructions to apply the exception using a generic computer component (see Specification, e.g., at Fig. 4 and associated text). See MPEP § 2106.04(d)(I). 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. The claims are directed to an abstract idea.
Step 2B (NO)
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, the additional elements of one or more computer systems comprising one or more hardware processors and storage media, including a server computer or server device having a storage device and a client computer to perform the method (represented by claim 1) amount no more than mere instructions to apply the exception using a generic computer or generic computer component. Mere instructions to apply an exception using generic computer(s) and/or generic computer component(s) cannot provide an inventive concept (“significantly more”). See MPEP § 2106.05(f).
Dependent claims 5-7, 24-26 and 28-39, when analyzed as a whole, are similarly rejected under 35 U.S.C. §101 because the additional limitation(s) fail(s) to establish that the claim(s) is/are not directed to an abstract idea without significantly more. The claims, when considered alone or as an ordered combination, either (1) merely further define the abstract idea, (2) do not further limit the claim to a practical application, or (3) do not provide an inventive concept such that the claims are subject matter eligible.
Claim(s) 5-7, 32, 34-35, 38 merely further describe(s) the abstract idea (e.g. assigning a statistical level of confidence, separating injuries by type and class / applying administrative rule sets, identifying the break down within the impairment rating, driving a particular data collection sequence by dynamically generating a set of data entry fields that is specific to the pending worker, prompting a plurality of adaptively generated entry fields each based on at least the injury and a range of data entered in a previous data entry field, ). See analysis, supra.
Claim(s) 24-26, 28-31 and 37 merely further describe(s) the additional element(s) of the one or more computer systems comprising one or more hardware processors and storage media (e.g., assigning a statistical level of confidence, separating injuries by type and class / applying administrative rule sets, identifying the break down within the impairment rating, driving a particular data collection sequence by dynamically generating a set of entry fields that is specific to the pending worker, prompting a plurality of adaptively generated entry fields each based on at least the injury and a range of data entered in a previous entry field). See analysis, supra.
Claims 33, 36, and 39 merely further describe the server device (e.g., receiving data).
Claims 33, 36, and 39 further recite the additional element of a shell program executing on a client device that implements the identified abstract idea (e.g., collecting, encrypting, and/or transmitting data). The additional element is not described by the Applicant, is recited at a high-level of generality and is merely invoked as a tool to perform an existing process (MPEP § 2106.05(f)(2), see case involving a commonplace business method or mathematical algorithm being applied on a general-purpose computer within the “Other examples”), such that this amounts no more than mere instructions to apply the abstract idea using a general-purpose computer. See MPEP § 2106.04(d)(I); and Alice Corp. Pty. Ltd. V. CLS Bank Int’l, 134 S. Ct. 2347, 1357 (2014). 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. The claims are directed to an abstract idea.
The claims 33, 36 and 39 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, the additional element of a shell program executing on a client device to perform the method amounts no more than mere instructions to “apply it” with the exception by invoking an algorithm merely as a tool to perform an existing process (i.e., only recites the algorithm as a tool to apply data to an algorithm and report the results), in this case to collect unencrypted data and transmit encrypted data. The use of an encryption algorithm in its ordinary capacity to perform tasks in the identified abstract idea does not provide an inventive concept (“significantly more”). See MPEP § 2106.05(f). Accordingly, alone or in combination, the additional element does not provide significantly more. Thus, the claims are not patent eligible.
Subject Matter Free of Prior Art
The cited prior art of record fails to expressly teach or suggest, either alone or in combination, the features found within the independent claims 1, 23 and 27 as follows (claim 1 being representative):
automatically rectifying, by the server computer, the deficient injury impairment rating data set, comprising: … comparing, by the server computer, the deficient injury impairment rating data set to at least the portion of the historical cohort data; … and applying, by the server computer, statistical models to first data subsets of the portion of the historical cohort data to determine numerical properties from one of the first data subsets, wherein each of the first data subsets corresponds to a respective data set gap of the one or more data set gaps,
wherein accuracy and integrity of the impairment rating determination for an injured worker are verified using a statistical model and pattern recognition, wherein the statistical model evaluates input data for anomalies and outliers, and when no anomalies or outliers are found, the data is received by an impairment calculator, and when the pattern recognition detects data that falls within a specified range, an anomaly response is triggered;
selecting, based on the injury, a particular impairment calculator from a plurality of impairment calculators, wherein accuracy and integrity of the impairment rating determination for an injured worker are verified using a statistical model and pattern recognition, wherein the statistical model evaluates input data for anomalies and outliers, and when no anomalies or outliers are found, the data is received by an impairment calculator, and when the pattern recognition detects data that falls within a specified range, an anomaly response is triggered.
The most remarkable prior art of record is as follows:
Alchemy et al. (US 11,461,848) for teaching methods of obtaining high accuracy impairment ratings and to assist data integrity in the impairment rating process (patented before the effective filing date, see Office action section 4 regarding priority issues).
Malone (US 2006/0287879) for teaching assessing and managing work-related musculoskeletal injuries: Methods, systems, and computer program products assess and manage work-related musculoskeletal injuries associated with one or more work sites. A method involves defining musculoskeletal injury categories and drawing relationships between the musculoskeletal injury categories by applying specialized medical knowledge. The relationships prevent informational disconnect between slightly disparate diagnoses between physicians who evaluate a same patient for the work-related musculoskeletal injury. The method also involves structuring storage of the relationships in a relational database, gathering for each work site, demographics and statistics on work-related musculoskeletal injuries associated with at least one of relatively high lost time or relatively high medical cost, and utilizing the relationships and the demographics to compile and retrieve data that facilitates prevention or improved resolution of the musculoskeletal injury. See abstract.
Fulton et al. (US 2017/0177810) for teaching system and method for insurance risk adjustment: Technologies for identifying coding/care gaps of an insurance claim include a computing device configured to receive an insurance claim from a healthcare provider, create a claim encounter reconciliation data pack (CERDP) based on the received insurance claim, and analyze the CERDP to identify whether any coding/care gaps exist in the received insurance claim. Upon determining any coding/care gaps, the computing device is additionally configured to provide an interface to the healthcare provider usable to view and resolve the identified coding/care gaps. The computing device is further configured to receive updated claim information as a function of the resolution of the identified coding/care gaps and transmit a related insurance claim to a corresponding health plan.
Conclusion
The prior art made of record and not relied upon is considered pertinent to applicant's disclosure:
McKown (US 8,615,409) for teaching a method that associates insurance payment linking information with litigation information and associates insurance payment information with the insurance payment linking information and the litigation information to identify a potential third-party claim or a potential subrogation claim. Associating the insurance payment linking information with the litigation information may further include associating at least one medical procedure code with at least some of the litigation information. See abstract.
Bansbach et al. (US 2018/0279919) for teaching sensing neuromuscular, physiological, biomechanical, and musculoskeletal activity.
Hutton et al. (US 7,778,849) for teaching data accuracy filter.
Beinat et al. (US 7,337,121) for teaching claim assessment model.
Iglesias et al. (US 2017/0154374) for teaching output adjustment and monitoring in accordance with resource unit performance.
Jeppson et al. (WO 2018/224937) for teaching medical coding quality control.
Luk et al. (US 7,813,944) for teaching detection of insurance premium fraud or abuse using a predictive software system.
Binns et al. (US 8,041,585) for teaching computerized medical modeling of group disability insurance using medical claims data.
Zizzamia et al. (US 2014/0058763) for teaching fraud detection methods and systems.
Ziobro (US 2017/0140489) for teaching methods and systems for rehabilitating injured operators evaluate injured and non-injured operators, medically, mentally, and occupationally.
Goetzke et al. (US 2002/0123906) for teaching chronic pain patient risk stratification system.
Goetzke et al. (US 2002/0128867) for teaching chronic pain patient identification system.
Groteke et al. (US 2024/0395410) for teaching integrated, AI-enabled value-based care measurement and objective risk assessment clinical and financial management system.
Any inquiry concerning this communication or earlier communications from the examiner should be directed to Jessica M Webb whose telephone number is (469)295-9173. The examiner can normally be reached Mon-Fri 9:00am-1:00pm CST.
Examiner interviews are available via telephone, in-person, and video conferencing using a USPTO supplied web-based collaboration tool. To schedule an interview, applicant is encouraged to use the USPTO Automated Interview Request (AIR) at http://www.uspto.gov/interviewpractice.
If attempts to reach the examiner by telephone are unsuccessful, the examiner’s supervisor, Robert Morgan can be reached on (571) 272-6773. The fax phone number for the organization where this application or proceeding is assigned is 571-273-8300.
Information regarding the status of published or unpublished applications may be obtained from Patent Center. Unpublished application information in Patent Center is available to registered users. To file and manage patent submissions in Patent Center, visit: https://patentcenter.uspto.gov. Visit https://www.uspto.gov/patents/apply/patent-center for more information about Patent Center and https://www.uspto.gov/patents/docx for information about filing in DOCX format. For additional questions, contact the Electronic Business Center (EBC) at 866-217-9197 (toll-free). If you would like assistance from a USPTO Customer Service Representative, call 800-786-9199 (IN USA OR CANADA) or 571-272-1000.
/J.M.W./Examiner, Art Unit 3683
/CHRISTOPHER L GILLIGAN/Primary Examiner, Art Unit 3683