| 摘要 |
The Disease Management system and method includes a Patient Medical Information source 100, a Predictive Health Outcome Modeling process 102, a process for Intervention At-risk Patients 103, and a source of disease management Modeling Guidelines 104. The Patient Medical Information source 101 is a database containing medical records of patients who participate in a healthcare provider's program. The Predictive Health Outcome Modeling process 102 produces a statistical model used to predict whether a patient with a particular disease is likely to suffer an adverse health outcome. The Intervention of At-risk Patients process 103 derives a list of at- risk patients who have a high risk of suffering an adverse health outcome and intervenes in the selected patient's healthcare treatment to decrease the possibility of such an adverse health outcome. The Predictive Health Outcome Modeling process 102 1) receives a sample group of patient medical data from the Patient Medical Information database 100 for a given disease, 2) receives pre-determined statistical information for generating predictive models, shown as the Modeling Guidelines 104, and 3) generates a particular predictive model for a particular disease to determine the probability of an adverse health outcome. The Intervention of At-risk Patient process 103 1) receives the predictive model provided by the Predictive Health Outcome Modeling process 102, 2) analyzes the individual patient specific medical data from the Patient Medical Information database 100, and 3) identifies a list of current patients that are at-risk of an adverse health outcome for a particular disease. The Intervention of At-risk Patient 103 process intervenes in the treatment process of the patients contained in the patient list through contact with the patient, physician, or healthcare provider, and the process requires externally generated information about treatment regimens for given stages of disease progression, as well as particular interventions.
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