Meeting US Health Reform Mandates with Computerized Health Services Utilization Matching and Optimization

Abstract

Recent US health reform initiatives now require extensive consumer involvement through healthcare purchasing exchanges. The opportunity exists to monitor and plan for peak service needs in such an environment. The use of computational systems and methods for health services planning and utilization review have traditionally been employed in post-facto or financial analysis settings. In this technology review we propose one innovative model and attribute-based method that collects and analyzes indicators of consumers or patients within a defined network, accepts sensor data about individuals, and presents a set of health care service options at least partially based on the acceptance of indications of member attributes as well as sensor data about network actors.