Systems and Methods for Patient Retention in Network Through Referral Analytics

Abstract

A medical information navigation engine (“MINE”) is capable of inferring referral activity not reported into a referral workflow system by utilizing intent-based clustering of medical information. The intent based clustering reconciles received medical data, from a variety of sources, and then clusters the data by applying one or more clustering rules. After the referrals not otherwise reported are inferred, they may be utilized to generate metrics that can be utilized to enhance patient care, and reduce costs. Metrics may be generated for both in-network and out-of-network referrals in order to distinguish differences in reporting activity.

What is claimed is: 
     
         1 . In a medical information navigation engine (“MINE”), a method for referral analysis, the method comprising:
 inferring referral activity not reported into a referral workflow system utilizing intent-based clustering of medical information; 
 generating reporting metrics from the inferred referral activity; and 
 displaying the metrics on a dashboard. 
 
     
     
         2 . The method of  claim 1  wherein the intent-based clustering of medical information further comprises:
 receiving medical information from a plurality of medical sources; 
 reconciling the medical information; and 
 clustering the reconciled medical information, wherein the clustering includes applying at least one clustering rule to the reconciled medication information. 
 
     
     
         3 . The method of  claim 2  wherein the reconciling further comprises applying at least one similarity rule. 
     
     
         4 . The method of  claim 3  wherein the at least one similarity rule includes comparing patient data attributes. 
     
     
         5 . The method of  claim 4  further comprising computing a distance between the patient data attributes and clustered reconciled medical information. 
     
     
         6 . The method of  claim 5  wherein if the distance is less than a threshold, then the clustered reconciled medical information is included as a referral. 
     
     
         7 . The method of  claim 1  wherein the metric includes adding the inferred referral activity to reported referral activity to generate a combined referral number, and dividing the reported referral activity by the combined referral number. 
     
     
         8 . The method of  claim 7  wherein the metric is performed for in network referrals and out of network referrals. 
     
     
         9 . A medical information navigation engine (“MINE”) comprising:
 an inference engine configured to infer referral activity not reported into a referral workflow system utilizing intent-based clustering of medical information; 
 an analyzer configured to generate reporting metrics from the inferred referral activity; and 
 a display configured to display the metrics on a dashboard. 
 
     
     
         10 . The MINE of  claim 9  wherein the inference engine further comprises:
 a medical information interface configured to receive medical information from a plurality of medical sources; 
 a reconciliation engine configured to reconcile the medical information; and 
 an intent-based presentation engine configured to cluster the reconciled medical information, wherein the clustering includes applying at least one clustering rule to the reconciled medication information. 
 
     
     
         11 . The MINE of  claim 10  wherein the reconciling further comprises applying at least one similarity rule. 
     
     
         12 . The MINE of  claim 11  wherein the at least one similarity rule includes comparing patient data attributes. 
     
     
         13 . The MINE of  claim 12  wherein the intent-based presentation engine is further configured to compute a distance between the patient data attributes and clustered reconciled medical information. 
     
     
         14 . The MINE of  claim 13  wherein if the distance is less than a threshold, then the clustered reconciled medical information is included in a presentation cluster prepared for the user. 
     
     
         15 . The MINE of  claim 13  wherein the analyzer is further configured to generate the metrics by adding the inferred referral activity to reported referral activity to generate a combined referral number, and dividing the reported referral activity by the combined referral number. 
     
     
         16 . The MINE of  claim 11  wherein the analyzer is further configured to generate the metrics for in network referrals and out of network referrals.