DCT
2:22-cv-00453
Decapolis Systems LLC v. Cima Healthcare Management Inc
I. Executive Summary and Procedural Information
- Parties & Counsel:
- Plaintiff: Decapolis Systems, LLC (Florida)
- Defendant: Cima Healthcare Management, Inc. (Nevada)
- Plaintiff’s Counsel: Garteiser Honea, PLLC
- Case Identification: 2:22-cv-00453, E.D. Tex., 11/22/2022
- Venue Allegations: Plaintiff alleges venue is proper in the Eastern District of Texas because Defendant maintains a regular and established business presence in the District, including the operation of hospitals.
- Core Dispute: Plaintiff alleges that Defendant’s electronic health record (EHR) systems and patient portals infringe patents related to methods for processing healthcare information, managing access to patient records, and automating insurance claim generation.
- Technical Context: The patents relate to centralized, networked systems for managing electronic health records, a technology domain critical to modern healthcare for improving data accuracy, provider coordination, and billing efficiency.
- Key Procedural History: The complaint does not allege any significant procedural history, such as prior litigation involving the patents-in-suit, Inter Partes Review proceedings, or relevant licensing history.
Case Timeline
| Date | Event |
|---|---|
| 1999-12-18 | Priority Date for ’040 and ’048 Patents |
| 2008-12-09 | U.S. Patent No. 7,464,040 Issued |
| 2009-02-10 | U.S. Patent No. 7,490,048 Issued |
| 2014-07-01 | Accused patient portal operational for data on or after this date |
| 2022-10-27 | Date of screenshot of accused instrumentality provided in complaint |
| 2022-11-22 | Complaint Filing Date |
II. Technology and Patent(s)-in-Suit Analysis
U.S. Patent No. 7,490,048 - "Apparatus And Method For Processing And/Or For Providing Healthcare Information And/Or Healthcare-Related Information"
The Invention Explained
- Problem Addressed: The patent describes problems in maintaining the privacy of patient healthcare records, safeguarding those records, and providing notification to patients when others have accessed or made changes to their files (’048 Patent, col. 2:20-28). This lack of transparency and control creates risks for patient privacy.
- The Patented Solution: The invention provides a computer-implemented method for managing and monitoring access to electronic health records. When a person or entity requests to access or modify a patient's record, the system processes the request and then generates and transmits a notification message to a communication device belonging to the patient (’048 Patent, Abstract). This transmission occurs concurrently with or prior to the completion of the record access or modification, providing the patient with timely awareness of activity related to their personal health information (’048 Patent, col. 56:1-16).
- Technical Importance: The claimed method provides a technical framework for an automated audit and notification system, giving patients direct insight into how their sensitive health information is being handled by providers and other entities.
Key Claims at a Glance
- The complaint asserts infringement of at least Claims 1, 2, 10, 20, and 22-40, with Claim 20 identified as exemplary (Compl. ¶36).
- Independent Claim 20 is a computer-implemented method comprising the following essential elements:
- receiving information regarding a restriction or limitation regarding an ability of a person or an entity to access, obtain, change, alter, and modify information contained in an individual’s or patient’s healthcare record;
- storing the information regarding the restriction or limitation;
- processing, with a processor, a request by a person or an entity to access, obtain, change, alter, and modify the information;
- determining, using the information regarding the restriction or limitation, whether the person or the entity is allowed or authorized to access, obtain, change, alter, and modify the information;
- generating a message containing information regarding the person or the entity making the request and an actual change, alteration, or modification made to the information;
- transmitting the message to a communication device of the individual or patient over a communication network.
- The complaint does not explicitly reserve the right to assert dependent claims but lists a range of them in its allegations (Compl. ¶36).
U.S. Patent No. 7,464,040 - "Apparatus And Method For Processing And/Or For Providing Healthcare Information And/Or Healthcare-Related Information"
The Invention Explained
- Problem Addressed: The patent specification describes a healthcare system where providers rely on patient-supplied information from questionnaires that may be insufficient, inaccurate, or incomplete, leading to diagnostic and treatment errors (’040 Patent, col. 1:50-60). It also notes that the paper-based and inefficient nature of insurance claims processing adds to rising healthcare costs (’040 Patent, col. 2:4-15).
- The Patented Solution: The invention is an apparatus that centralizes healthcare data processing. It includes a receiver for obtaining patient information from a provider's computer, a remote database for storing comprehensive patient and provider records, and a processing device. A key aspect of the solution is that the processing device automatically generates an insurance claim in response to the storing or updating of a patient's healthcare record, and then transmits that claim to the appropriate healthcare insurer or payer (’040 Patent, Abstract). Figure 14B of the patent depicts this workflow, showing "GENERATE CLAIM FORM" (1409) occurring after "UPDATE PATIENT'S RECORDS" (1408) (’040 Patent, Fig. 14B).
- Technical Importance: This technology aims to create a tighter, automated integration between the clinical act of documenting a patient encounter and the administrative act of billing for it, potentially reducing errors and processing delays.
Key Claims at a Glance
- The complaint asserts infringement of at least Claims 1 and 46 (Compl. ¶56).
- Independent Claim 1 is an apparatus comprising the following essential elements:
- a receiver that receives information regarding an individual transmitted from a first computer associated with a healthcare provider over the Internet or World Wide Web;
- a database located remote from the first computer that stores information for pluralities of individuals, providers, and insurers/payers;
- a processing device that processes the received information for storing it in the database and updating the individual's healthcare record;
- wherein the processing device automatically generates an insurance claim in response to the storing or updating of the record;
- wherein the insurance claim is suitable for automatic submission to the insurer or payer;
- and wherein the processing device transmits the insurance claim to a second computer associated with the insurer or payer.
- The complaint does not explicitly reserve the right to assert dependent claims.
III. The Accused Instrumentality
Product Identification
- The "Accused Instrumentalities" are identified as a "plurality of electronic healthcare systems, platforms and services, including but not limited to a cloud-based electronic health records ('EHR') and practice management system and software for patients, payers, health registries, and insurers" (Compl. ¶31).
Functionality and Market Context
- The accused systems are alleged to provide a "cloud database and framework" for functions including managing patient care, billing, accounting, revenue management, and reporting (Compl. ¶31).
- The complaint provides a screenshot of the "Patient Portal" for Paris Regional Medical Center, one of Defendant's hospitals, as a specific example of the accused technology (Compl. ¶31, Figure 1). This portal, called "My Paris HEALTHLink," allegedly allows patients to "view your PRMC health records anytime, anywhere" (Compl. Figure 1).
- Plaintiff alleges Defendant owns, directs, and controls the operation of these systems and generates substantial revenue from them (Compl. ¶35, ¶55).
IV. Analysis of Infringement Allegations
'048 Patent Infringement Allegations
| Claim Element (from Independent Claim 20) | Alleged Infringing Functionality | Complaint Citation | Patent Citation |
|---|---|---|---|
| receiving information regarding a restriction or limitation regarding an ability of a person or an entity to at least one of access, obtain, change, alter, and modify, information contained in an individuals or patients healthcare record... | The accused systems receive information regarding restrictions on the ability to access or modify patient healthcare records. | ¶38 | col. 2:20-28 |
| processing, with a processor, a request by a person or an entity to at least one of access, obtain, change, alter, and modify, the information contained in an individuals or patient's healthcare record... | The accused systems process requests from persons or entities to access or modify information within a patient's healthcare record. | ¶41 | col. 46:50-57 |
| determining, using the information regarding the restriction or limitation, whether the person or the entity is allowed or authorized... | The accused systems use the stored restriction information to determine if a requesting person or entity is authorized to access the record. | ¶41 | col. 48:5-13 |
| generating a message containing at least one of information regarding the person or the entity making the request... and further wherein the message contains an actual change, alteration, or modification, made to the information... | The accused systems generate a message that includes information about the requesting entity and the specific modification made to the record. | ¶41 | col. 45:45-53 |
| transmitting the message to a communication device of the individual or patient via, on, or over, a communication network. | The accused systems transmit the generated message over a communication network to a device associated with the patient. | ¶41 | col. 45:60-67 |
Identified Points of Contention
- Scope Questions: A central question may be what constitutes "transmitting the message to a communication device of the individual or patient." The analysis may focus on whether making information available for viewing within a patient portal, which requires a user to actively log in, satisfies the "transmitting" limitation, or if the claim requires a "push" notification (e.g., an email, text message) sent directly to a device.
- Technical Questions: The complaint alleges in general terms that the accused systems perform the claimed steps. A key factual question will be what evidence shows that Defendant's system specifically generates a message containing the "actual change, alteration, or modification" and transmits this specific message content, rather than providing a more general alert that a record has been updated.
'040 Patent Infringement Allegations
| Claim Element (from Independent Claim 1) | Alleged Infringing Functionality | Complaint Citation | Patent Citation |
|---|---|---|---|
| a receiver, wherein the receiver receives information regarding an individual... transmitted from a first computer... associated with a healthcare provider... via, on, or over, at least one of the Internet and the World Wide Web... | The accused systems receive patient information (e.g., symptoms, diagnosis, treatment) transmitted from a healthcare provider's computer over the Internet. | ¶58 | col. 16:3-7 |
| a database or a memory device... located at a location remote from the first computer... wherein the database... stores information regarding a plurality of individuals, a plurality of healthcare providers, and a plurality of healthcare insurers or healthcare payers. | Defendant's cloud-based EHR system is a remote database that stores information for numerous patients, providers, and payers. | ¶58 | col. 16:53-58 |
| a processing device... wherein the processing device automatically generates an insurance claim in response to the storing of the information regarding an individual in the database... or the updating of the healthcare record... | The accused systems include a processing device that, in response to storing or updating a patient's record, automatically generates an insurance claim. | ¶60 | col. 18:8-18 |
| wherein the processing device transmits the insurance claim to the second computer or to the second communication device... associated with the healthcare insurer or the healthcare payer... | The accused systems' processing device transmits the generated insurance claim to a computer system associated with the relevant insurer or payer. | ¶60 | col. 18:19-25 |
Identified Points of Contention
- Scope Questions: The dispute may center on the term "automatically generates an insurance claim." The question will be whether the accused system's billing and revenue management functions perform this step "automatically" as required by the claim, or if the process involves sufficient human intervention (e.g., manual coding review, batch processing triggers) to fall outside the scope of the claim as construed by the court.
- Technical Questions: A factual question for discovery will be the precise mechanism and workflow that links the clinical act of updating a patient record to the administrative act of generating a bill or insurance claim in Defendant's system, and whether this link operates "in response to the storing of the information" as claimed.
V. Key Claim Terms for Construction
For the ’048 Patent
- The Term: "communication device of the individual or patient" (Claim 20)
- Context and Importance: This term is critical because the infringement allegation hinges on whether the accused patient portal system "transmits" the required message to a device that falls within the claim's scope. Defendant may argue that a web portal is not a "device" in the same vein as a phone or pager, or that making information available for a "pull" by a user is not "transmitting" a message "to" the device.
- Intrinsic Evidence for Interpretation:
- Evidence for a Broader Interpretation: The specification provides a broad, non-limiting list of what can constitute a communication device, including a "personal computer, a home computer, a server computer, a network computer, a hand-held computer, a palmtop computer, a laptop computer," as well as telephones, pagers, and watches (’048 Patent, col. 15:5-13). This language may support an interpretation that includes the personal computers and mobile devices on which patients access the portal.
- Evidence for a Narrower Interpretation: An argument for a narrower construction could focus on the patent's emphasis on providing timely notification. Embodiments that function like a pager or beeper, which actively push alerts to a user, could be contrasted with a passive web portal that a patient must choose to access.
For the ’040 Patent
- The Term: "automatically generates an insurance claim" (Claim 1)
- Context and Importance: The degree of automation required by this term will be central to the infringement analysis. The case may turn on whether the accused system's process for creating a claim after a clinical encounter is sufficiently "automatic" to infringe, or if it is a multi-step, human-mediated process that falls outside the claim scope.
- Intrinsic Evidence for Interpretation:
- Evidence for a Broader Interpretation: The claim language links the automatic generation "in response to the storing of the information or the updating of the healthcare record." This could support an interpretation where the data entry itself is the trigger, even if subsequent processing steps exist. The patent's abstract describes the automatic generation as a direct response to the storing or updating action.
- Evidence for a Narrower Interpretation: The specification's flowcharts show claim generation (step 1409) occurring after a provider transmits a final diagnosis and treatment plan (step 1407) and patient records are updated (step 1408) (’040 Patent, Fig. 14B). This could suggest a more structured, sequential process rather than an instantaneous, purely machine-driven event, potentially allowing for arguments about the necessity of intermediate steps or reviews that break the chain of "automatic" generation.
VI. Other Allegations
- Indirect Infringement: The complaint alleges inducement of infringement for both patents. The allegations state that Defendant provides the accused systems and advertises their use, which allegedly causes others (e.g., healthcare professionals, patients) to directly infringe the patents in the United States (Compl. ¶44-47, ¶63-66).
- Willful Infringement: Willfulness is alleged for both patents on two grounds. First, Plaintiff asserts that infringement will be willful from the date Defendant was served with the complaint, establishing post-suit knowledge (Compl. ¶43, ¶62). Second, Plaintiff alleges pre-suit willful blindness, asserting on information and belief that Defendant "has a practice of not performing a review of the patent rights of others first for clearance or to assess infringement thereof prior to launching products and services" (Compl. ¶48, ¶67).
VII. Analyst’s Conclusion: Key Questions for the Case
- A core issue will be one of functional scope: does the accused EHR and patient portal system, as it actually operates, perform the specific functions required by the claims? Specifically, does making information available for viewing in a portal constitute "transmitting the message to a communication device of the individual" under the ’048 patent, and is the process of creating a bill from a clinical encounter sufficiently automated to be considered "automatically generat[ing] an insurance claim" under the ’040 patent?
- A key evidentiary question will be one of technical proof: the complaint describes the functionality of the accused systems in broad terms common to the EHR industry. The case will likely depend on Plaintiff's ability to obtain and present specific evidence from discovery detailing the precise software architecture and data workflows of Defendant's systems to demonstrate that they meet each limitation of the asserted claims.