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 .
Status of Claims
This office action for the 19/025685 application is in response to the communications filed January 16, 2025.
Claims 1-20 were initially submitted January 16, 2025.
Claims 1-20 are currently pending and considered below.
Claim Rejections - 35 USC § 101
35 U.S.C. 101 reads as follows:
Whoever invents or discovers any new and useful process, machine, manufacture, or composition of matter, or any new and useful improvement thereof, may obtain a patent therefor, subject to the conditions and requirements of this title.
Claims 1-20 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.
As per claim 1,
Step 1: The claim recites subject matter within a statutory category as a machine.
Step 2A is a two-prong inquiry, in which Prong 1 determines whether a claim recites a judicial exception. Prong 2 determines if the additional limitations of the claim integrates the recited judicial exception into a practical application. If the additional elements of the claim fail to integrate the judicial exception into a practical application, claim is directed to the recited judicial exception, see MPEP 2106.04(II)(A).
Step 2A Prong 1: The claim contains subject matter that recites an abstract idea, with the steps of managing healthcare services, comprising: allow a user to find healthcare providers based on specified search criteria, wherein the search criteria includes a health need or medical condition of the user that corresponds to a billing code for a medical procedure; insurer-negotiated pricing for the healthcare providers that offer the medical procedure corresponding to the billing code; ratings or reviews for the healthcare providers; allow the user to directly book appointments with selected healthcare providers through a calendar booking system; allow the user to directly pay healthcare providers through a payment system by connecting to payment information of the user; and allow the user to view their personal health records and insurance claims data gathered from electronic health record systems and insurance providers. These steps, as drafted, under the broadest reasonable interpretation recite:
certain methods of organizing human activity (e.g., fundamental economic principles or practices including: hedging; insurance; mitigating risk; etc., commercial or legal interactions including: agreements in the form of contracts; legal obligations; advertising, marketing or sales activities or behaviors; business relations; etc., managing personal behavior or relationships or interactions between people including: social activities; teaching; following rules or instructions; etc.) but for recitation of generic computer components. That is, other than reciting steps as performed by the generic computer components, nothing in the claim element precludes the step from being directed to certain methods of organizing human activity. The identified abstract idea, law of nature, or natural phenomenon identified above, in the context of this claim, encompasses a certain method of organizing human activity, namely managing personal behavior or relationships or interactions between people. This is because each of the limitations of the abstract idea recites a list of rules or instructions that a human person can follow in the course of their personal behavior. If a claim limitation, under its broadest reasonable interpretation, covers at least the recited methods of organizing human activity above, 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. See MPEP 2106.04(a).
Step 2A Prong 2: The claim does not recite additional elements that integrate the judicial exception into a practical application. In particular, the additional elements do not integrate the abstract idea into a practical application, other than the abstract idea per se, because the additional elements amount to no more than limitations which:
amount to mere instructions to apply an exception, see MPEP 2106.05(f), such as:
“A user interface system for”, “an online” which corresponds to merely using a computer as a tool to perform an abstract idea. Paragraph [0173] of the as-filed specification describes that the hardware that implements the step of the abstract idea amounts to nothing more than generic computer components. Implementing an abstract idea on a generic computer, does not integrate the abstract idea into a practical application in Step 2A Prong Two or add significantly more in Step 2B, similar to how the recitation of the computer in the claim in Alice amounted to mere instructions to apply the abstract idea of intermediated settlement on a generic computer.
add insignificant extra-solution activity to the abstract idea, see MPEP 2106.05(g), such as:
“a search interface configured to”, “a results interface configured to display”, “a provider rating interface configured to display”, “a scheduling interface configured to”, “a payment interface configured to”, and “a health records interface configured to” which corresponds to mere data gathering and/or output.
Accordingly, this claim is directed to an abstract idea.
Step 2B: The claim does not recite additional elements that amount to significantly more than the judicial exception. As discussed above with respect to discussion of integration of the abstract idea into a practical application, the additional elements amount to no more than mere instructions to apply an exception, add insignificant extra-solution activity to the abstract idea, and/or generally link the abstract idea to a particular technological environment or field of use. Additionally, the additional limitations, identified as insignificant extra-solution activity to the abstract idea, amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields such as:
computer functions that have been identified by the courts as well‐understood, routine, and conventional functions when they are claimed in a merely generic manner (e.g., at a high level of generality) or as insignificant extra-solution activity, see MPEP 2106.05(d)(II), such as:
“a search interface configured to”, “a results interface configured to display”, “a provider rating interface configured to display”, “a scheduling interface configured to”, “a payment interface configured to”, and “a health records interface configured to” which corresponds to receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 2,
Claim 2 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 2 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“allow the user to find healthcare providers within a geographic search area centered on a user-specified location” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“further comprising a geolocation interface configured to” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 3,
Claim 3 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 3 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“wherein the search criteria further includes a geographic location and a distance radius from the geographic location for finding healthcare providers.” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 4,
Claim 4 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 4 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“provider pricing information categorized by insurance plan options” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“wherein the results interface is further configured to display” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 5,
Claim 5 depends from claim 4 and inherits all the limitations of the claim from which it depends. Claim 5 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“wherein the insurance plan options include …pricing for all insurers, a specific insurer, or a specific insurer plan.” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“displaying” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 6,
Claim 6 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 6 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“provider ratings based on user reviews” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“wherein the provider rating interface displays” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 7,
Claim 7 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 7 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“allow the user to create an account by providing contact information, emergency contact information, health insurance information, and payment information” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“further comprising an account creation interface configured to” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 8,
Claim 8 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 8 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“a calendar view of available appointment times for a selected healthcare provider” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“wherein the scheduling interface is configured to display” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 9,
Claim 9 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 9 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“calculate patient costs for a healthcare service based on the insurer-negotiated pricing and health insurance information for the user” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“wherein the payment interface is configured to” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 10,
Claim 10 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 10 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“medical claims data and pharmacy claims data of the user” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“wherein the health records interface is configured to display” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 11,
Claim 11 depends from claim 10 and inherits all the limitations of the claim from which it depends. Claim 11 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“allow the user to request additional details related to medical claims from healthcare providers” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“wherein the health records interface is further configured to” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 12,
Claim 12 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 12 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“consolidated health records for the user gathered from multiple healthcare providers” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“wherein the health records interface is configured to display” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 13,
Claim 13 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 13 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“allow the user to view and manage health records for family members” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“further comprising a family member interface configured to” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 14,
Claim 14 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 14 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“allow the user to search for healthcare providers offering a specific medical screening or preventative service” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“wherein the search interface is further configured to” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 15,
Claim 15 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 15 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“geographic locations of healthcare providers on an interactive map” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“further comprising a provider map interface configured to display” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 16,
Claim 16 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 16 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“a mathematical breakdown of how patient costs are calculated from provider pricing, insurance deductibles, and other factors” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“further comprising a cost breakdown interface configured to display” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 17,
Claim 17 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 17 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“allow the user to search for healthcare providers without providing insurance information to obtain uninsured cash pricing” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“wherein the search interface is further configured to” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 18,
Claim 18 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 18 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“allow the user to provide consent for accessing the personal health records and insurance claims data of the user” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“further comprising a consent interface configured to” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 19,
Claim 19 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 19 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“suggested preventative health screening procedures for the user based on the age, biological sex, and health records of the user” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“further comprising a screening recommendations interface configured to display” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
As per claim 20,
Claim 20 depends from claim 1 and inherits all the limitations of the claim from which it depends. Claim 20 merely further defines the abstract idea and/or introduces additional elements that are insufficient to provide a practical application or something significantly more:
“receive the personal health records and insurance claims data of the user from the health records interface; analyze the personal health records and insurance claims data … identify preventative health screening procedures relevant to the user based on the analysis; … the identified preventative health screening procedures along with the ability to … find healthcare providers offering the identified screening procedures” further describes the abstract idea. This claim limitation is still directed to “Certain Methods of Organizing Human Activity” and therefore continues to recite an abstract idea.
“further including an analytics engine configured to:” and “using machine learning models trained on population health data;” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to merely using a computer as a tool to perform an abstract idea.
“and a screening recommendations interface configured to display” and “use the search interface to” further defines an additional element that was insufficient to provide a practical application and/or significantly more. The claim with this further defining limitation still corresponds to mere data gathering and/or output and receiving or transmitting data over a network.
Looking at the limitations of the claim as an ordered combination adds nothing that is not already present when looking at the elements taken individually. There is no indication that the combination of elements improves the functioning of a computer or improves any other technology. Their collective functions merely recite an abstract idea and/or provide conventional computer implementation which does not impose a meaningful limit to integrate the abstract idea into a practical application and/or amount to no more than limitations which amount to elements that have been recognized as well-understood, routine, and conventional activity in particular fields.
Claim Rejections - 35 USC § 103
In the event the determination of the status of the application as subject to AIA 35 U.S.C. 102 and 103 (or as subject to pre-AIA 35 U.S.C. 102 and 103) is incorrect, any correction of the statutory basis (i.e., changing from AIA to pre-AIA ) for the rejection will not be considered a new ground of rejection if the prior art relied upon, and the rationale supporting the rejection, would be the same under either status.
The following is a quotation of 35 U.S.C. 103 which forms the basis for all obviousness rejections set forth in this Office action:
A patent for a claimed invention may not be obtained, notwithstanding that the claimed invention is not identically disclosed as set forth in section 102, if the differences between the claimed invention and the prior art are such that the claimed invention as a whole would have been obvious before the effective filing date of the claimed invention to a person having ordinary skill in the art to which the claimed invention pertains. Patentability shall not be negated by the manner in which the invention was made.
The factual inquiries for establishing a background for determining obviousness under 35 U.S.C. 103 are summarized as follows:
1. Determining the scope and contents of the prior art.
2. Ascertaining the differences between the prior art and the claims at issue.
3. Resolving the level of ordinary skill in the pertinent art.
4. Considering objective evidence present in the application indicating obviousness or nonobviousness.
This application currently names joint inventors. In considering patentability of the claims the examiner presumes that the subject matter of the various claims was commonly owned as of the effective filing date of the claimed invention(s) absent any evidence to the contrary. Applicant is advised of the obligation under 37 CFR 1.56 to point out the inventor and effective filing dates of each claim that was not commonly owned as of the effective filing date of the later invention in order for the examiner to consider the applicability of 35 U.S.C. 102(b)(2)(C) for any potential 35 U.S.C. 102(a)(2) prior art against the later invention.
Claims 1-12 and 14-19 are rejected under 35 U.S.C. 103 as being unpatentable over Kharraz-Tavakol (US 2020/0279343) in view of Chmait et al. (US 2020/0365259; herein referred to as Chmait).
As per claim 1,
Kharraz-Tavakol teaches a user interface system for managing healthcare services, comprising: a search interface configured to allow a user to find healthcare providers based on specified search criteria, wherein the search criteria includes a health need or medical condition of the user for a medical procedure:
(Paragraphs [0007], [0029] and [0057] of Kharraz-Tavakol. The teaching describes a system and method to facilitate patient booking and management of healthcare appointments. The system is configured to receive a user search request and filter the mapped data based on the user search request to generate a list of available appointment times from the time block records that best satisfy the user search request. The system further comprises initiating requests based on one or more of: provider location zip codes, provider accepted insurance plans, provider specialties or procedures, provider profile data for a designated provider, and available appointment times for a designated provider.)
Kharraz-Tavakol further teaches a results interface configured to display healthcare providers that offer the medical procedure:
(Paragraphs [0088] and [0123] and Figure 9 of Kharraz-Tavakol. The teaching describes a webpage 310 (interactive user interface) for entering search requests and displaying search results in response to a user input search criteria 312. This interface includes the “Reason for Visit” drop down filter which corresponds to the procedure to be performed.)
Kharraz-Tavakol further teaches a provider rating interface configured to display ratings or reviews for the healthcare providers:
(Paragraphs [0008] and [0123] and Figure 9 of Kharraz-Tavakol. The teaching describes an interface (e.g., website or mobile application) for accessing healthcare appointment availability across multiple disparate sources (e.g., platforms) for the purpose of scheduling patient visits (appointments) and related tasks. The patient is able to filter availability (across multiple sources) based on his personal criteria, such as accepted insurance plan, location, gender, ratings, hospital affiliations, education, etc. Such filtering across platforms will be based on commonly formatted request parameters, despite the unaffiliated sources (platforms) having disparate filtering criteria, data formats, and/or availability data (e.g., appointment times or other limitations on appointment availability such as type of appointment, length of appointment, office location, etc). It can be seen in Figure 9 that each provider in the results interface has an interface for displaying the respective provider’s rating in the form of a number of stars)
Kharraz-Tavakol further teaches a scheduling interface configured to allow the user to directly book appointments with selected healthcare providers through an online calendar booking system:
(Paragraph [0123] and Figure 9 of Kharraz-Tavakol. The teaching describes windows with pull-down menus enable user selection of search parameters, here by specialty, location, and insurance. Below the search parameters is a display, here in row/column (grid) format, that identifies providers 312 having available appointment times 313 meeting the search criteria. The next three days are sequentially displayed across the page, with available appointment starting time slots 315 listed below the relevant day and aligned with the respective provider. The webpage also includes a map 314 with markers identifying the location of the provider's office for the associated available appointment time; a link 316 to request more information regarding the provider (view provider profile); and a link 317 to determine whether a provider would be considered within the network of the patient's insurance plan. The patient can select a time slot link 315 to book an appointment at the designated start time, by simply clicking on the link or hit the Book Online button 319.)
Kharraz-Tavakol does not explicitly teach that the health need or medical condition of the user for a medical procedure corresponds to a billing code, a results interface configured to display insurer-negotiated pricing for the healthcare providers that offer the medical procedure corresponding to the billing code, a payment interface configured to allow the user to directly pay healthcare providers through an online payment system by connecting to payment information of the user, or a health records interface configured to allow the user to view their personal health records and insurance claims data gathered from electronic health record systems and insurance providers.
However, Chmait teaches a medical management interface that incorporates billing codes in conjunction with particular procedures for a patient:
(Paragraph [0009] of Chmait. The teaching describes an apparatus facilitating a health care marketplace comprises a processor and memory storing processor-executable instructions that cause the processor to: receive, from a user, a payment for a bundle of health care services provided by a health care provider prior to the user visiting the health care provider; automatically generate receipt documentation responsive to receiving an order fulfillment notification from a health care provider indicating that the user received the bundle of health care services from the health care provider, wherein the receipt documentation includes one or more current procedural terminology (CPT) codes associated with the bundle of health care services; send, to the user, the receipt documentation formatted for display to the user and including a non-technical description of the one or more CPT codes; and send, to an insurance administrator for a health insurance plan of the user, the receipt documentation formatted as a health care claim. In this way, health care consumers can easily track their health care spending and health care providers no longer need to deal with writing and submitting health care claims to insurance administrators.)
Chmait further teaches a results interface configured to display insurer-negotiated pricing for the healthcare providers that offer the medical procedure corresponding to the billing code:
(Paragraph [0112] and Figure 6C of Chmait. The teaching describes that after a health care consumer places a query, say for a specific type of illness or health care service desired, using the search tool shown in interface 608 of FIG. 6B, interface 616 in FIG. 6C may be displayed. For example, interface 608 may comprise a health care consumer's e-commerce platform account home page, and illustrates how a consumer may utilize the search function by entering a desired health care service type and location information, such as a zip code or city. After entering search criteria and clicking the search button, the e-commerce platform retrieves results based on the search criteria. Interface 616 shows one example of how search results may be displayed to a health care consumer. The search results comprise a list of providers who provide the health care service that the consumer searched in the geographic location included in the query. Each result may include information such as the price for the service offered by the provider, a quality rating of the provider based on input from other health care consumers, information regarding the provider, and a comparison of the price offered by the provider to the average regional price. The price for the service offered by the provider may comprise an out-of-pocket cost to the consumer, which the e-commerce platform may determine based on, as non-limiting examples, the consumer's health care plan (e.g., deductible, contract rates, etc.), the applicable provider network, the fees established by the particular provider, and so on. As discussed above, each of the services and corresponding fees for each provider in the search results may be associated with a health care service bundle indicator that uniquely identifies the combination of service and provider. This pricing information is based on the insurance negotiated coverage.)
Chmait further teaches a payment interface configured to allow the user to directly pay healthcare providers through an online payment system by connecting to payment information of the user:
(Paragraph [0121] of Chmait. The teaching describes that after selecting a payment option, the health care consumer may select a button to securely submit payment for the health care service bundle. If the button is selected, the e-commerce platform processes the payment (or alternatively, coordinates with a payment processor to securely process the payment) which comprises the out-of-pocket cost to the consumer. Interface 656 in FIG. 6H may then be displayed to the consumer. Interface 656 includes an order confirmation for the purchased service bundle, and may include an order identification number, date of purchase, information regarding the service purchased, the out-of-pocket cost paid for the service, a cost breakdown, and information regarding how to schedule an appointment with the provider for the purchased service bundle. Assistance may be offered for setting up an appointment through the e-commerce platform. For example, a telephone hotline or messaging service may be provided by interface 656 for the consumer to contact a representative for the e-commerce platform who may assist the consumer in arranging the appointment.)
Chmait further teaches a health records interface configured to allow the user to view their personal health records and insurance claims data gathered from electronic health record systems and insurance providers:
(Paragraph [0123] and Figure 6J of Chmait. The teaching describes that after placing an order for a health care service bundle, the consumer schedules an appointment with the provider, visits the provider, and receives the purchased service. When visiting the provider, the consumer does not need to pay because the out-of-pocket costs to the consumer were purchased in advance. After the order is fulfilled, the consumer receives receipt documentation regarding the fulfilled service. Interface 672 in FIG. 6J shows example receipt documentation. In particular, the receipt documentation may include a plurality of information regarding the fulfilled order, including but not limited to member (consumer) information, health plan information, a payment summary, customer transactions (e.g., payments by the consumer), a service summary, patient details, provider details, claim information (e.g., procedure codes, procedure summaries, diagnoses, etc.), and so on. In some examples, the receipt documentation may further include a description of the services in user-friendly language. Here it is understood that the order number is the claims data, the procedure and diagnosis information is the personal health record and interface 672 is the health records interface configured to allow the user to view this data gathered from electronic health record systems and insurance providers)
It would have been obvious to one of ordinary skill in the art before the time of filing to add to the teaching of Kharraz-Tavakol, the teachings of Chmait. Paragraph [0031] of Chmait teaches that the present invention relates to an improved process where planned and predictable health care services are purchased and consumed at known prices. One of ordinary skill in the art in possession of Kharraz-Tavakol would have looked to Chmait to achieve this incentive with its own healthcare marketplace. One of ordinary skill in the art would have added to the teaching of Kharraz-Tavakol, the teaching of Chmait based on this incentive without yielding unexpected results.
As per claim 2,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Kharraz-Tavakol further teaches further comprising a geolocation interface configured to allow the user to find healthcare providers within a geographic search area centered on a user-specified location:
(Paragraph [0123] and Figure 9 of Kharraz-Tavakol. The teaching describes windows with pull-down menus enable user selection of search parameters, here by specialty, location, and insurance. Below the search parameters is a display, here in row/column (grid) format, that identifies providers 312 having available appointment times 313 meeting the search criteria. The next three days are sequentially displayed across the page, with available appointment starting time slots 315 listed below the relevant day and aligned with the respective provider. The webpage also includes a map 314 with markers identifying the location of the provider's office for the associated available appointment time; a link 316 to request more information regarding the provider (view provider profile); and a link 317 to determine whether a provider would be considered within the network of the patient's insurance plan. The patient can select a time slot link 315 to book an appointment at the designated start time, by simply clicking on the link or hit the Book Online button 319.)
As per claim 3,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Kharraz-Tavakol further teaches wherein the search criteria further includes a geographic location and a distance radius from the geographic location for finding healthcare providers:
(Paragraph [0123] and Figure 9 of Kharraz-Tavakol. The teaching describes windows with pull-down menus enable user selection of search parameters, here by specialty, location, and insurance. Below the search parameters is a display, here in row/column (grid) format, that identifies providers 312 having available appointment times 313 meeting the search criteria. The next three days are sequentially displayed across the page, with available appointment starting time slots 315 listed below the relevant day and aligned with the respective provider. The webpage also includes a map 314 with markers identifying the location of the provider's office for the associated available appointment time; a link 316 to request more information regarding the provider (view provider profile); and a link 317 to determine whether a provider would be considered within the network of the patient's insurance plan. The patient can select a time slot link 315 to book an appointment at the designated start time, by simply clicking on the link or hit the Book Online button 319.)
As per claim 4,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Chmait further teaches wherein the results interface is further configured to display provider pricing information categorized by insurance plan options:
(Paragraph [0112] and Figure 6C of Chmait. The teaching describes that after a health care consumer places a query, say for a specific type of illness or health care service desired, using the search tool shown in interface 608 of FIG. 6B, interface 616 in FIG. 6C may be displayed. For example, interface 608 may comprise a health care consumer's e-commerce platform account home page, and illustrates how a consumer may utilize the search function by entering a desired health care service type and location information, such as a zip code or city. After entering search criteria and clicking the search button, the e-commerce platform retrieves results based on the search criteria. Interface 616 shows one example of how search results may be displayed to a health care consumer. The search results comprise a list of providers who provide the health care service that the consumer searched in the geographic location included in the query. Each result may include information such as the price for the service offered by the provider, a quality rating of the provider based on input from other health care consumers, information regarding the provider, and a comparison of the price offered by the provider to the average regional price. The price for the service offered by the provider may comprise an out-of-pocket cost to the consumer, which the e-commerce platform may determine based on, as non-limiting examples, the consumer's health care plan (e.g., deductible, contract rates, etc.), the applicable provider network, the fees established by the particular provider, and so on. As discussed above, each of the services and corresponding fees for each provider in the search results may be associated with a health care service bundle indicator that uniquely identifies the combination of service and provider. This pricing information is based on the insurance negotiated coverage.)
As per claim 5,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 4.
Chmait further teaches wherein the insurance plan options include displaying pricing for all insurers, a specific insurer, or a specific insurer plan:
(Paragraph [0112] and Figure 6C of Chmait. The teaching describes that after a health care consumer places a query, say for a specific type of illness or health care service desired, using the search tool shown in interface 608 of FIG. 6B, interface 616 in FIG. 6C may be displayed. For example, interface 608 may comprise a health care consumer's e-commerce platform account home page, and illustrates how a consumer may utilize the search function by entering a desired health care service type and location information, such as a zip code or city. After entering search criteria and clicking the search button, the e-commerce platform retrieves results based on the search criteria. Interface 616 shows one example of how search results may be displayed to a health care consumer. The search results comprise a list of providers who provide the health care service that the consumer searched in the geographic location included in the query. Each result may include information such as the price for the service offered by the provider, a quality rating of the provider based on input from other health care consumers, information regarding the provider, and a comparison of the price offered by the provider to the average regional price. The price for the service offered by the provider may comprise an out-of-pocket cost to the consumer, which the e-commerce platform may determine based on, as non-limiting examples, the consumer's health care plan (e.g., deductible, contract rates, etc.), the applicable provider network, the fees established by the particular provider, and so on. As discussed above, each of the services and corresponding fees for each provider in the search results may be associated with a health care service bundle indicator that uniquely identifies the combination of service and provider. This pricing information is based on the insurance negotiated coverage.)
As per claim 6,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Chmait further teaches wherein the provider rating interface displays provider ratings based on user reviews:
(Paragraph [0127] of Chmait. The teaching describes a comparison of providers selected via the search results interface. Detailed information regarding each provider may be displayed side-by-side for easy comparison, such as the price, how long each provider may take to provide the service, the distance of the provider from the consumer, the quality rating based on patient reviews, the specialty of the provider, the languages spoken by the provider, the hours that the provider is available, and so on.)
As per claim 7,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Chmait further teaches further comprising an account creation interface configured to allow the user to create an account by providing contact information, emergency contact information, health insurance information, and payment information:
(Paragraphs [0108] and [0109] of Chmait. The teaching describes a landing page for a health care consumer. Interface 600 includes a brief registration form, a login form, and an overview of the e-commerce platform features for a health care consumer. In some examples, the e-commerce platform may be available to a health care consumer through a health care plan offered by an employer of the health care consumer. In such examples, the registration form may require information identifying the health care consumer as an employee of the employer. In some examples, such as that depicted in interface 600, the registration form may include form inputs for a health care plan of the consumer so that the health care benefits plan may be linked to an account of the consumer. For example, the form may include inputs for name, gender, date of birth, contact information, health care plan member identification number, health care plan group number, and so on. As described herein, the e-commerce platform may use the health care consumer's health care benefits plan information to determine eligibility for services as well as compute out-of-pocket costs for the consumer based on the benefits. In some examples, the health care consumer may register for an account using interface 600. As shown, interface 600 includes form inputs for a user account, including but not limited to user name, password, and contact information. Here it is understood that the providing of contact information is the providing of all relevant contact information including emergency. Further it is understood that payment information would have been included here to determine out of pocket costs.)
As per claim 8,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Kharraz-Tavakol further teaches wherein the scheduling interface is configured to display a calendar view of available appointment times for a selected healthcare provider:
(Paragraphs [0115] and [0123] and Figure 9 of Kharraz-Tavakol. The teaching describes windows with pull-down menus enable user selection of search parameters, here by specialty, location, and insurance. Below the search parameters is a display, here in row/column (grid) format, that identifies providers 312 having available appointment times 313 meeting the search criteria. The next three days are sequentially displayed across the page, with available appointment starting time slots 315 listed below the relevant day and aligned with the respective provider. The webpage also includes a map 314 with markers identifying the location of the provider's office for the associated available appointment time; a link 316 to request more information regarding the provider (view provider profile); and a link 317 to determine whether a provider would be considered within the network of the patient's insurance plan. The patient can select a time slot link 315 to book an appointment at the designated start time, by simply clicking on the link or hit the Book Online button 319. A user calendar 139B (e.g., of booked appointments), and user-source communications 139C (that are processed by the system as previously described). The booking module 136 utilizes patient data 142 (which includes the user account information previously described) and available appointment data 144 stored in the storage module 140 to accomplish the booking and stores the booked appointment data on storage sub-module 145. A calendar sub-module 1398 receives booked appointment data from storage module 145 for generating a user-specific calendar of the user's booked appointments and other user (patient) data from storage sub-module 142. The calendar sub-module 1398 generates a graphical display, typically in a grid or other calendar format, on interface module 150 for review and navigation by user 103 via terminal 104, enabling the user to manage, edit and maintain an updated calendar of booked appointments and other patient data.)
As per claim 9,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Chmait further teaches wherein the payment interface is configured to calculate patient costs for a healthcare service based on the insurer-negotiated pricing and health insurance information for the user:
(Paragraph [0112] and Figure 6C of Chmait. The teaching describes that after a health care consumer places a query, say for a specific type of illness or health care service desired, using the search tool shown in interface 608 of FIG. 6B, interface 616 in FIG. 6C may be displayed. For example, interface 608 may comprise a health care consumer's e-commerce platform account home page, and illustrates how a consumer may utilize the search function by entering a desired health care service type and location information, such as a zip code or city. After entering search criteria and clicking the search button, the e-commerce platform retrieves results based on the search criteria. Interface 616 shows one example of how search results may be displayed to a health care consumer. The search results comprise a list of providers who provide the health care service that the consumer searched in the geographic location included in the query. Each result may include information such as the price for the service offered by the provider, a quality rating of the provider based on input from other health care consumers, information regarding the provider, and a comparison of the price offered by the provider to the average regional price. The price for the service offered by the provider may comprise an out-of-pocket cost to the consumer, which the e-commerce platform may determine based on, as non-limiting examples, the consumer's health care plan (e.g., deductible, contract rates, etc.), the applicable provider network, the fees established by the particular provider, and so on. As discussed above, each of the services and corresponding fees for each provider in the search results may be associated with a health care service bundle indicator that uniquely identifies the combination of service and provider. This pricing information is based on the insurance negotiated coverage.)
As per claim 10,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Chmait further teaches wherein the health records interface is configured to display medical claims data and pharmacy claims data of the user:
(Paragraphs [0002], [0122], [0123] and Figures 6I and 6J of Chmait. The teaching describes that after purchasing a service bundle, the health care consumer may view purchased orders, for example, via interface 664 of FIG. 6I. Interface 664 includes an overview of order history so that the consumer may have a record of purchased services. Interface 664 may also include a status of each order, wherein the status indicates whether the service has been fulfilled. Here it is understood that this interface can provide health records from a plurality of providers. The teaching describes that after placing an order for a health care service bundle, the consumer schedules an appointment with the provider, visits the provider, and receives the purchased service. When visiting the provider, the consumer does not need to pay because the out-of-pocket costs to the consumer were purchased in advance. After the order is fulfilled, the consumer receives receipt documentation regarding the fulfilled service. Interface 672 in FIG. 6J shows example receipt documentation. In particular, the receipt documentation may include a plurality of information regarding the fulfilled order, including but not limited to member (consumer) information, health plan information, a payment summary, customer transactions (e.g., payments by the consumer), a service summary, patient details, provider details, claim information (e.g., procedure codes, procedure summaries, diagnoses, etc.), and so on. In some examples, the receipt documentation may further include a description of the services in user-friendly language. Here it is understood that the order number is the claims data, the procedure and diagnosis information is the personal health record and interface 672 is the health records interface configured to allow the user to view this data gathered from electronic health record systems and insurance providers. The system anticipates the use of this platform for users to shop for prescriptions as well. When the claim information in 6J includes treatment in the form of a prescription this claim information would be present in this same interface.)
As per claim 11,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 10.
Chmait further teaches wherein the health records interface is further configured to allow the user to request additional details related to medical claims from healthcare providers.
(Paragraph [0122] and Figure 6I of Chmait. The teaching describes that after purchasing a service bundle, the health care consumer may view purchased orders, for example, via interface 664 of FIG. 6I. Interface 664 includes an overview of order history so that the consumer may have a record of purchased services. Interface 664 may also include a status of each order, wherein the status indicates whether the service has been fulfilled. Here it is understood that this interface can provide health records from a plurality of providers.)
(Paragraph [0123] and Figure 6J of Chmait. The teaching describes that after placing an order for a health care service bundle, the consumer schedules an appointment with the provider, visits the provider, and receives the purchased service. When visiting the provider, the consumer does not need to pay because the out-of-pocket costs to the consumer were purchased in advance. After the order is fulfilled, the consumer receives receipt documentation regarding the fulfilled service. Interface 672 in FIG. 6J shows example receipt documentation. In particular, the receipt documentation may include a plurality of information regarding the fulfilled order, including but not limited to member (consumer) information, health plan information, a payment summary, customer transactions (e.g., payments by the consumer), a service summary, patient details, provider details, claim information (e.g., procedure codes, procedure summaries, diagnoses, etc.), and so on. In some examples, the receipt documentation may further include a description of the services in user-friendly language. Here it is understood that the order number is the claims data, the procedure and diagnosis information is the personal health record and interface 672 is the health records interface configured to allow the user to view this data gathered from electronic health record systems and insurance providers)
As per claim 12,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Chmait further teaches wherein the health records interface is configured to display consolidated health records for the user gathered from multiple healthcare providers:
(Paragraph [0122] and Figure 6I of Chmait. The teaching describes that after purchasing a service bundle, the health care consumer may view purchased orders, for example, via interface 664 of FIG. 6I. Interface 664 includes an overview of order history so that the consumer may have a record of purchased services. Interface 664 may also include a status of each order, wherein the status indicates whether the service has been fulfilled. Here it is understood that this interface can provide health records from a plurality of providers.)
As per claim 14,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Kharraz-Tavakol further teaches wherein the search interface is further configured to allow the user to search for healthcare providers offering a specific medical screening or preventative service:
(Paragraphs [0088] and [0123] and Figure 9 of Kharraz-Tavakol. The teaching describes a webpage 310 (interactive user interface) for entering search requests and displaying search results in response to a user input search criteria 312. This interface includes the “Reason for Visit” drop down filter which corresponds to the procedure to be performed.)
As per claim 15,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Kharraz-Tavakol further comprising a provider map interface configured to display geographic locations of healthcare providers on an interactive map:
(Paragraph [0123] and Figure 9 of Kharraz-Tavakol. The teaching describes windows with pull-down menus enable user selection of search parameters, here by specialty, location, and insurance. Below the search parameters is a display, here in row/column (grid) format, that identifies providers 312 having available appointment times 313 meeting the search criteria. The next three days are sequentially displayed across the page, with available appointment starting time slots 315 listed below the relevant day and aligned with the respective provider. The webpage also includes a map 314 with markers identifying the location of the provider's office for the associated available appointment time; a link 316 to request more information regarding the provider (view provider profile); and a link 317 to determine whether a provider would be considered within the network of the patient's insurance plan. The patient can select a time slot link 315 to book an appointment at the designated start time, by simply clicking on the link or hit the Book Online button 319.)
As per claim 16,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Chmait further teaches further comprising a cost breakdown interface configured to display a mathematical breakdown of how patient costs are calculated from provider pricing, insurance deductibles, and other factors:
(Paragraph [0112] and Figure 6C of Chmait. The teaching describes that after a health care consumer places a query, say for a specific type of illness or health care service desired, using the search tool shown in interface 608 of FIG. 6B, interface 616 in FIG. 6C may be displayed. For example, interface 608 may comprise a health care consumer's e-commerce platform account home page, and illustrates how a consumer may utilize the search function by entering a desired health care service type and location information, such as a zip code or city. After entering search criteria and clicking the search button, the e-commerce platform retrieves results based on the search criteria. Interface 616 shows one example of how search results may be displayed to a health care consumer. The search results comprise a list of providers who provide the health care service that the consumer searched in the geographic location included in the query. Each result may include information such as the price for the service offered by the provider, a quality rating of the provider based on input from other health care consumers, information regarding the provider, and a comparison of the price offered by the provider to the average regional price. The price for the service offered by the provider may comprise an out-of-pocket cost to the consumer, which the e-commerce platform may determine based on, as non-limiting examples, the consumer's health care plan (e.g., deductible, contract rates, etc.), the applicable provider network, the fees established by the particular provider, and so on. As discussed above, each of the services and corresponding fees for each provider in the search results may be associated with a health care service bundle indicator that uniquely identifies the combination of service and provider. This pricing information is based on the insurance negotiated coverage.)
As per claim 17,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Chmait wherein the search interface is further configured to allow the user to search for healthcare providers without providing insurance information to obtain uninsured cash pricing:
(Paragraph [0112] and Figure 6C of Chmait. The teaching describes that after a health care consumer places a query, say for a specific type of illness or health care service desired, using the search tool shown in interface 608 of FIG. 6B, interface 616 in FIG. 6C may be displayed. For example, interface 608 may comprise a health care consumer's e-commerce platform account home page, and illustrates how a consumer may utilize the search function by entering a desired health care service type and location information, such as a zip code or city. After entering search criteria and clicking the search button, the e-commerce platform retrieves results based on the search criteria. Interface 616 shows one example of how search results may be displayed to a health care consumer. The search results comprise a list of providers who provide the health care service that the consumer searched in the geographic location included in the query. Each result may include information such as the price for the service offered by the provider, a quality rating of the provider based on input from other health care consumers, information regarding the provider, and a comparison of the price offered by the provider to the average regional price. The price for the service offered by the provider may comprise an out-of-pocket cost to the consumer, which the e-commerce platform may determine based on, as non-limiting examples, the consumer's health care plan (e.g., deductible, contract rates, etc.), the applicable provider network, the fees established by the particular provider, and so on. As discussed above, each of the services and corresponding fees for each provider in the search results may be associated with a health care service bundle indicator that uniquely identifies the combination of service and provider. This pricing information is based on the insurance negotiated coverage. Here the “Provider Price” element would have been the price of service without the user providing insurance information)
As per claim 18,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Chmait further teaches further comprising a consent interface configured to allow the user to provide consent for accessing the personal health records and insurance claims data of the user:
(Paragraphs [0108] and [0109] and Figure 6A of Chmait. The teaching describes a landing page for a health care consumer. Interface 600 includes a brief registration form, a login form, and an overview of the e-commerce platform features for a health care consumer. In some examples, the e-commerce platform may be available to a health care consumer through a health care plan offered by an employer of the health care consumer. In such examples, the registration form may require information identifying the health care consumer as an employee of the employer. In some examples, such as that depicted in interface 600, the registration form may include form inputs for a health care plan of the consumer so that the health care benefits plan may be linked to an account of the consumer. For example, the form may include inputs for name, gender, date of birth, contact information, health care plan member identification number, health care plan group number, and so on. As described herein, the e-commerce platform may use the health care consumer's health care benefits plan information to determine eligibility for services as well as compute out-of-pocket costs for the consumer based on the benefits. In some examples, the health care consumer may register for an account using interface 600. As shown, interface 600 includes form inputs for a user account, including but not limited to user name, password, and contact information. Here it is understood that the providing of contact information is the providing of all relevant contact information including emergency. Further it is understood that payment information would have been included here to determine out of pocket costs. Additionally, the acceptance of the Terms of Use and Privacy Policy is construed as consent given for accessing the personal health records and insurance claims data of the user)
As per claim 19,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Chmait further teaches further comprising a screening recommendations interface configured to display suggested preventative health screening procedures for the user based on the age, biological sex, and health records of the user:
(Paragraph [0065] of Chmait. The teaching describes health care service bundle indicator may represent a specific set of health care services offered by a specific provider. For example, within a preventative care category, a service group may comprise a wellness exam denoted by the three-letter code WEL. A particular service within the wellness exam service group may comprise a group of common procedure terminology (CPT) codes, for example “Men's Wellness Exam, Age 60-64, Established Patient, History of Increased Blood Pressure, With Screening Colonoscopy” may be the plain language equivalent of the CPT codes 99396, 82947, 80061, and 60121. This particular combination of services may be assigned a two-number code, for example 17. Therefore the product code for this service may be WEL17. As described hereinabove, a health care service bundle indicator may include such a product code in addition to codes identifying a specific provider. For example, a provider location code for the NW Doctors Group located at 1234 SW Market Street in Portland, Oreg. may be denoted by NWD, while a provider code for a specific health care provider, say Dr. John Doe, working at the provider location may be denoted by the three-letter code JDO.)
Claim 13 is rejected under 35 U.S.C. 103 as being unpatentable over Kharraz-Tavakol and Chmait in further view of Tran (US 2012/0330109).
As per claim 13,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
The combined teaching of Kharraz-Tavakol and Chmait does not explicitly teach further comprising a family member interface configured to allow the user to view and manage health records for family members.
However, Tran teaches a patient profile platform that comprises a family member interface configured to allow the user to view and manage health records for family members:
(Paragraph [0031] of Tran. The teaching describes a Web based tools that allow easy access to patient information for authorized parties such as family members, neighbors, physicians, nurses, pharmacists, caregivers, and other affiliated parties to improve the Quality of Care for the patient.)
It would have been obvious to one of ordinary skill in the art before the time of filing to add to the combined teaching of Kharraz-Tavakol and Chmait, the family management features of Tran. Paragraph [0031] of Tran teaches that the use of record management of family members is helpful in improving the quality of care for the patient. This is incentive enough, though as applied to the combined teaching of Kharraz-Tavakol and Chmait, the specific incentive becomes more apparent. Older family members may have difficulty navigating the many interfaces of the combined teaching of Kharraz-Tavakol and Chmait. It would have been an obvious improvement in quality of care for a family member to manage the elder user’s account to lead to better patient outcomes. One of ordinary skill in the art would have added to the combined teaching of Kharraz-Tavakol and Chmait, the teaching of Tran based on this incentive without yielding unexpected results.
Claim 20 is rejected under 35 U.S.C. 103 as being unpatentable over Kharraz-Tavakol and Chmait in further view of Evans et al. (US 2020/03978655; herein referred to as Evans).
As per claim 20,
The combined teaching of Kharraz-Tavakol and Chmait teaches the limitations of claim 1.
Chmait further teaches further including an analytics engine configured to: receive the personal health records and insurance claims data of the user from the health records interface; analyze the personal health records and insurance claims data; identify preventative health screening procedures relevant to the user based on the analysis; and a screening recommendations interface configured to display the identified preventative health screening procedures along with the ability to use the search interface to find healthcare providers offering the identified screening procedures:
(Paragraph [0065] of Chmait. The teaching describes health care service bundle indicator may represent a specific set of health care services offered by a specific provider. For example, within a preventative care category, a service group may comprise a wellness exam denoted by the three-letter code WEL. A particular service within the wellness exam service group may comprise a group of common procedure terminology (CPT) codes, for example “Men's Wellness Exam, Age 60-64, Established Patient, History of Increased Blood Pressure, With Screening Colonoscopy” may be the plain language equivalent of the CPT codes 99396, 82947, 80061, and 60121. This particular combination of services may be assigned a two-number code, for example 17. Therefore the product code for this service may be WEL17. As described hereinabove, a health care service bundle indicator may include such a product code in addition to codes identifying a specific provider. For example, a provider location code for the NW Doctors Group located at 1234 SW Market Street in Portland, Oreg. may be denoted by NWD, while a provider code for a specific health care provider, say Dr. John Doe, working at the provider location may be denoted by the three-letter code JDO.)
The combined teaching of Kharraz-Tavakol and Chmait does not explicitly teach using machine learning models trained on population health data.
However Evans teaches using machine learning models trained on population health data to determine a risk for the need of a colonoscopy:
(Paragraphs [0005] and [0034] of Evans. The teaching describes preparing, training, and deploying a machine learning algorithm for medical condition state determination include at least one processing unit comprising the machine learning algorithm. The at least one processing unit may be programmed to receive an image input, receive patient health data as input, encode the patient health data to convert the patient health data to encoded patient health data, transmit the encoded patient health data into the machine learning algorithm, and make a medical condition state determination based on the image input and the encoded patient health data, via the machine learning algorithm. The image input generally includes one or more images from an imaging device, such as from a colonoscopy or other medical imaging procedure. Machine learning algorithm 11 may be trained and/or deployed according to presently disclosed methods. In some examples, machine learning algorithm 11 may be trained using datasets with labels created by unsupervised labeling (which may also be referred to as auto-labeling), semi-supervised labeling, and/or supervised labeling, or manual labeling. In some examples, supervised labeling is performed before semi-supervised and/or unsupervised labeling. In some examples, supervised labeling and unsupervised labeling initially are performed to train machine learning algorithm 11, with semi-supervised labeling being performed as needed or desired to improve and/or refine labels in the dataset. As used herein, “supervised labeling” (or “manual labeling”) refers to labels that are assigned to images by a human, “semi-supervised labeling” refers to a process where a human labels a plurality of images (often a few hundred images), training a rudimentary machine learning algorithm using these labeled images, and then letting the trained algorithm make a guess at the labels for the rest of the thousands of images, then the human verifies that all those automatically assigned labels by the algorithm are indeed correct, and “unsupervised labeling” refers to automated algorithms for labeling training images without human supervision.)
It would have been obvious to one of ordinary skill in the art to add to the combined teaching of Kharraz-Tavakol and Chmait, the machine learning methods of Evans while screening for the need for a subject to receive a colonoscopy. Paragraph [0031] of Evans teaches that the machine learning models disclosed result in more accurate determinations of the medical state of a patient. One of ordinary skill in the art would have added to the combined teaching of Kharraz-Tavakol and Chmait, the teaching of Evans based on this incentive without yielding unexpected results.
The combined teaching of Kharraz-Tavakol, Chmait and Evans would have then taught further including an analytics engine configured to: receive the personal health records and insurance claims data of the user from the health records interface; analyze the personal health records and insurance claims data using machine learning models trained on population data; identify preventative health screening procedures relevant to the user based on the analysis; and a screening recommendations interface configured to display the identified preventative health screening procedures along with the ability to use the search interface to find healthcare providers offering the identified screening procedures:
(Paragraph [0065] of Chmait. The teaching describes health care service bundle indicator may represent a specific set of health care services offered by a specific provider. For example, within a preventative care category, a service group may comprise a wellness exam denoted by the three-letter code WEL. A particular service within the wellness exam service group may comprise a group of common procedure terminology (CPT) codes, for example “Men's Wellness Exam, Age 60-64, Established Patient, History of Increased Blood Pressure, With Screening Colonoscopy” may be the plain language equivalent of the CPT codes 99396, 82947, 80061, and 60121. This particular combination of services may be assigned a two-number code, for example 17. Therefore the product code for this service may be WEL17. As described hereinabove, a health care service bundle indicator may include such a product code in addition to codes identifying a specific provider. For example, a provider location code for the NW Doctors Group located at 1234 SW Market Street in Portland, Oreg. may be denoted by NWD, while a provider code for a specific health care provider, say Dr. John Doe, working at the provider location may be denoted by the three-letter code JDO.)
(Paragraphs [0005] and [0034] of Evans. The teaching describes preparing, training, and deploying a machine learning algorithm for medical condition state determination include at least one processing unit comprising the machine learning algorithm. The at least one processing unit may be programmed to receive an image input, receive patient health data as input, encode the patient health data to convert the patient health data to encoded patient health data, transmit the encoded patient health data into the machine learning algorithm, and make a medical condition state determination based on the image input and the encoded patient health data, via the machine learning algorithm. The image input generally includes one or more images from an imaging device, such as from a colonoscopy or other medical imaging procedure. Machine learning algorithm 11 may be trained and/or deployed according to presently disclosed methods. In some examples, machine learning algorithm 11 may be trained using datasets with labels created by unsupervised labeling (which may also be referred to as auto-labeling), semi-supervised labeling, and/or supervised labeling, or manual labeling. In some examples, supervised labeling is performed before semi-supervised and/or unsupervised labeling. In some examples, supervised labeling and unsupervised labeling initially are performed to train machine learning algorithm 11, with semi-supervised labeling being performed as needed or desired to improve and/or refine labels in the dataset. As used herein, “supervised labeling” (or “manual labeling”) refers to labels that are assigned to images by a human, “semi-supervised labeling” refers to a process where a human labels a plurality of images (often a few hundred images), training a rudimentary machine learning algorithm using these labeled images, and then letting the trained algorithm make a guess at the labels for the rest of the thousands of images, then the human verifies that all those automatically assigned labels by the algorithm are indeed correct, and “unsupervised labeling” refers to automated algorithms for labeling training images without human supervision.)
Conclusion
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/CHAD A NEWTON/Primary Examiner, Art Unit 3681