Health plan rating system improvement program

Abstract

Methods and training programs for improving the level of quality of care within a healthcare plan. The methods include obtaining medical data from a population of patients within the plan, storing such data in electronic medical records embodied on a computer readable medium, evaluating at least one metric within the data via a computer capable of interpreting said electronic medical records, and presenting a notification if the metric is found to be below a standard for the metric. The training includes evaluating the healthcare plan's current practices, training the healthcare provider in improved practices, providing a system for recording medical documents, and training the healthcare provider in use of the system.

What is claimed is: 
     
         1 . A method of improving the level of quality of care within a healthcare plan comprising:
 (a) obtaining medical data from a population of patients within the plan;   (b) storing such data obtained in step (a) in electronic medical records embodied on a computer readable medium;   (c) evaluating at least one metric within said data stored in step (b) via a computer capable of interpreting said electronic medical records; and   (d) presenting a notification if the at least one metric evaluated in step (c) is found to be below a standard for said metric.   
     
     
         2 . The method of  claim 1 , wherein the at least one metric includes providing a disease screening. 
     
     
         3 . The method of  claim 1 , wherein the at least one metric includes providing a vaccination. 
     
     
         4 . The method of  claim 1 , wherein the at least one metric includes managing a chronic condition. 
     
     
         5 . A method of training healthcare plans to improve the level of quality of care within the plan, said method comprising the steps:
 (a) evaluating the healthcare plan's current practices;   (b) training the healthcare provider in improved practices;   (c) providing a system for recording medical documents, wherein the system comprises:
 (i) a computer readable medium capable of storing medical data obtained from a population of patients; 
 (ii) a computer with software capable of evaluating at least one metric of the data stored on the computer readable medium in comparison with a standard for the at least one metric; and 
 (iii) a notification system capable of presenting to the user of the system a warning if the at least one metric is found to be below the standard for such metric; and 
   (d) training the healthcare provider in use of said system.   
     
     
         6 . The method of  claim 5 , wherein the training provided in step (b) comprises instructing the healthcare plan to preemptively contact potential at-risk patients. 
     
     
         7 . A system for recording medical documents comprising:
 (a) a computer readable medium capable of storing medical data obtained from a population of patients;   (b) a computer with software capable of evaluating at least one metric of the data stored on the computer readable medium in comparison with a standard for the at least one metric; and   (c) a notification system capable of presenting to the user of the system a warning if the at least one metric is found to be below the standard for such metric.   
     
     
         8 . The system of  claim 7 , wherein the notification system presents a warning if the metric is the percentage of patients within a population receiving a disease screening and the percentage is below a standard assigned for screening said disease. 
     
     
         9 . The system of  claim 7 , wherein the notification system presents a warning if patients within a population are determined to be at-risk for medical complications based upon the patients' medical data.