System for prevention of fraud in accounting for utilization of medical items

Patent metadata

Field	Value
Publication number	US-10922647-B2
Application number	US-201715813208-A
Country	US
Kind code	B2
Filing date	Nov 15, 2017
Priority date	Oct 2, 2014
Publication date	Feb 16, 2021
Grant date	Feb 16, 2021

Abstract

At the time of manufacture of medical items that are to be consumed during patient care, a unique identification number is assigned to each item and the number is encoded in an RFID tag attached to the item. The manufacturer registers the unique identification number for each individual medical item in a Unique Device Identification (UDI) Serialized Tracking Database. The UDI Serialized Tracking Database maps each unique identification number to each item's UDI number that has been assigned by the Food and Drug Administration. As each item is consumed during medical treatment and its cost is billed to payers, the unique identification number of the item is reported and verified. This provides for detection of certain types of fraud in the dispensing of medical items by validating that necessary supplies were actually used during patient care.

First claim

What is claimed is:

1. An apparatus for recording consumption of medical items used during performance of a medical procedure in a medical facility and for detecting fraud in reporting the consumption of the medial items, wherein the medical items are at least initially enclosed in wrappers having RFID tags disposed in or on the wrappers, wherein a unique identification number that uniquely identifies an individual medical item is encoded in each of the RFID tags, the apparatus comprising:
a database in which are stored:
Unique Device Identifier (UDI) numbers assigned by a governmental agency to identify specific types of medical items used in medical procedures; and
unique identification numbers encoded in the RFID tags, wherein each unique identification number is stored in the database in association with one of the UDI numbers that identifies the specific type of medical item identified by the unique identification number;

a shielded enclosure having an internal space for receiving the wrappers of the medical items, the shielded enclosure configured to attenuate radio frequency signals emanated from RFID tags disposed outside the shielded enclosure to levels that are substantially undetectable within the internal space;
one or more RFID antennas disposed within the shielded enclosure for receiving radio frequency signals emanated from RFID tags attached to the wrappers disposed within the internal space, wherein the radio frequency signals contain the unique identification numbers encoded in the RFID tags;
an RFID reader electrically connected to the one or more RFID antennas, the RFID reader for decoding the unique identification numbers contained in the radio frequency signals emanated from the RFID tags; and
a computer disposed in the medical facility that is in communication with the database and the RFID reader, the computer having a processor that executes instructions for:
(a) receiving the unique identification numbers decoded by the RFID reader;
(b) upon receipt of the unique identification numbers decoded by the RFID reader, accessing the UDI numbers and the unique identification numbers stored in the databases;
(c) generating a fraud alert message if any of the unique identification numbers decoded by the RFID reader for each medical item is not associated in the database with a UDI number assigned to identify the specific type of medical item identified by the unique identification number; and
(d) generating a fraud alert message if any unique identification number decoded by the RFID reader matches a unique identification number stored in the database in association with a medical item that was previously consumed in medical treatment of a patient.

2. The apparatus of claim 1 further comprising a waste bin that is disposable within the internal space of the shielded enclosure, the waste bin having an open top for receiving the used wrappers that are dropped into the waste bin during performance of the medical procedure.

3. The apparatus of claim 2 wherein the shielded enclosure includes a door in a sidewall of the shielded enclosure, the door covering an opening that is large enough to accommodate the waste bin.

4. The apparatus of claim 3 wherein:
the shielded enclosure includes a switch disposed adjacent the door, such that opening or closing the door engages the switch to cause a change in state of the switch; and
the RFID reader is electrically connected to the switch, wherein a change in state of the switch triggers the RFID reader to start or stop decoding information contained in the radio frequency signals emanated from the RFID tags.

5. The apparatus of claim 1 wherein the shielded enclosure includes an aperture through which the used wrappers may be deposited into the internal space as medical items are consumed during performance of the medical procedure, the aperture including means for attenuating radio frequency signals emanated from RFID tags disposed outside the shielded enclosure to levels that are substantially undetectable within the internal space.

6. The apparatus of claim 5 wherein the means for attenuating radio frequency signals emanated from RFID tags disposed outside the shielded enclosure comprise one or more covers disposed over the aperture.

7. A method for recording consumption of medical items used during performance of a medical procedure and for detecting fraud in reporting the consumption of the medial items, wherein the medical items are at least initially enclosed in wrappers having RFID tags disposed in or on the wrappers, wherein a unique identification number that uniquely identifies an individual medical item is encoded in each of the RFID tags, the apparatus comprising:
(a) storing in a database:
Unique Device Identifier (UDI) numbers assigned by a governmental agency to identify specific types of medical items used in medical procedures; and
unique identification numbers encoded in the RFID tags, wherein each unique identification number is stored in the database in association with one of the UDI numbers that identifies the specific type of medical item identified by the unique identification number;

(b) during the performance of the medical procedure, depositing the wrappers of the medical items into an internal space of a shielded enclosure that is configured to attenuate radio frequency signals emanated from RFID tags disposed outside the shielded enclosure to levels that are substantially undetectable within the internal space;
(c) receiving radio frequency signals emanated from RFID tags attached to the wrappers disposed within the internal space, wherein the radio frequency signals contain the unique identification numbers encoded in the RFID tags;
(d) decoding the unique identification numbers contained in the radio frequency signals emanated from the RFID tags;
(e) accessing the UDI numbers and the unique identification numbers stored in the database;
(f) generating a fraud alert message if any of the unique identification numbers decoded from the radio frequency signals is not associated with a UDI number assigned to identify the specific type of medical item identified by the unique identification number; and
(g) generating a fraud alert message if any of the unique identification numbers decoded from the radio frequency signals matches a unique identification number stored in the database in association with a medical item that was previously consumed during medical treatment of a patient.

8. The method of claim 7 wherein steps (e), (f) and (g) are performed by a computer that is disposed in the medical facility and is in electrical communication with the RFID reader, and wherein steps (e), (f) and (g) are performed automatically upon completion of step (d).

9. The method of claim 7 wherein steps (e), (f) and (g) are performed by a computer that is used by a medical bill payer entity that receives a bill listing the unique identification numbers decoded by the RFID reader, and wherein steps (e), (f) and (g) are performed upon entry into the computer of the unique identification numbers listed in the bill.

10. An apparatus for recording consumption of medical items used during performance of a medical procedure in a medical facility and for detecting fraud in reporting the consumption of the medial items, wherein the medical items are at least initially enclosed in wrappers having RFID tags disposed in or on the wrappers, wherein a unique identification number that uniquely identifies an individual medical item is encoded in each of the RFID tags, the apparatus comprising:
a database in which are stored:
Unique Device Identifier (UDI) numbers assigned by a governmental agency to identify specific types of medical items used

Assignees

• Deroyal Ind Inc

Inventors

• Debusk Brian C
• Smith Joe L
• Kaylor Mary E
• Mcbee Michael R

Classifications

• G16H10/60

  for patient-specific data, e.g. for electronic patient records · CPC title

• G06Q50/22

  Social work or social welfare, e.g. community support activities or counselling services · CPC title

• G16H40/20

  for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms · CPC title

• G06K7/10316

  using at least one antenna particularly designed for interrogating the wireless record carriers (antennas in general H01Q1/22) · CPC title

• G16H20/40

  relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture · CPC title