DCT
6:21-cv-01253
Decapolis Systems LLC v. Wise Health Services
I. Executive Summary and Procedural Information
- Parties & Counsel:
- Plaintiff: Decapolis Systems, LLC (Florida)
- Defendant: Wise Health Services (Texas)
- Plaintiff’s Counsel: Garteiser Honea, PLLC
- Case Identification: 6:21-cv-01253, W.D. Tex., 03/28/2022
- Venue Allegations: Plaintiff alleges venue is proper in the Western District of Texas because Defendant maintains its headquarters and physical business locations within the district, employs residents of the district, and generates substantial revenue from its business activities there.
- Core Dispute: Plaintiff alleges that Defendant’s electronic health record (EHR) systems and its "HealthConnect" online patient portal infringe patents related to the processing, management, and security of electronic healthcare information.
- Technical Context: The technology at issue addresses methods for managing electronic health records, including automating insurance claim generation from clinical data and providing patient-centric control and notification regarding access to their personal health information.
- Key Procedural History: The complaint notes that the asserted patents are expired but asserts they remain enforceable for purposes of seeking damages for past infringement. It also highlights that the patents have been "back-cited" in patents issued to industry participants such as IBM, Siemens, and Epic Systems. This is a First Amended Complaint.
Case Timeline
| Date | Event |
|---|---|
| 1999-12-18 | Priority Date for '040 & '048 Patents |
| 2008-12-09 | U.S. Patent No. 7,464,040 Issued |
| 2009-02-10 | U.S. Patent No. 7,490,048 Issued |
| 2022-03-28 | First Amended Complaint Filed |
II. Technology and Patent(s)-in-Suit Analysis
U.S. Patent No. 7,464,040: Apparatus and Method for Processing and/or for Providing Healthcare Information and/or Healthcare-Related Information (Issued Dec. 9, 2008)
The Invention Explained
- Problem Addressed: The patent’s background section describes a healthcare system where patient information is often inaccurate or incomplete due to reliance on patient memory and paper-based forms (Compl. ¶16; ’040 Patent, col. 1:49-60). This fragmentation and inefficiency in data collection and claims processing contribute to medical errors and rising healthcare costs (’040 Patent, col. 1:43-49, col. 2:5-15).
- The Patented Solution: The invention proposes a centralized, computer-implemented system to streamline the clinical and administrative workflow (’040 Patent, Abstract). In this system, a healthcare provider transmits patient information, such as a diagnosis and treatment plan, to a central processing computer. The central computer updates the patient's electronic record, and in response to that update, automatically generates an insurance claim suitable for electronic submission to the appropriate payer (’040 Patent, Abstract; Fig. 14B).
- Technical Importance: This technology aimed to create a direct, automated link between clinical documentation and the medical billing process, thereby reducing manual data entry, administrative overhead, and the potential for errors. (Compl. ¶18).
Key Claims at a Glance
- The complaint asserts independent claim 1 and dependent claim 46 (Compl. ¶59).
- Essential elements of independent claim 1 include:
- A receiver for receiving information regarding an individual from a provider's computer over the Internet, where the information includes clinical data such as a symptom or diagnosis.
- A remote database that stores information for multiple individuals, providers, and payers.
- A processing device that processes the received information by storing it in the database or updating the individual's healthcare record.
- The processing device automatically generates an insurance claim in response to the storing or updating of the healthcare record.
- The processing device transmits the generated insurance claim to a second computer associated with the healthcare insurer or payer.
- The complaint explicitly reserves the right to assert additional claims (Compl. ¶14).
U.S. Patent No. 7,490,048: Apparatus and Method for Processing and/or for Providing Healthcare Information and/or Healthcare-Related Information (Issued Feb. 10, 2009)
The Invention Explained
- Problem Addressed: The patent background identifies the need to maintain the privacy of patient healthcare records and to safeguard them, particularly by providing notification to patients when others access or modify their files (’048 Patent, col. 2:21-27).
- The Patented Solution: The invention describes a computer-implemented method for managing access to electronic health records based on pre-set restrictions or limitations (’048 Patent, col. 37:32-38). When an authorized or unauthorized entity requests access to a patient's file, the system processes the request, determines if it is allowed, and generates a notification message. This message, which may contain details of any actual change made to the record, is transmitted to the patient's communication device during or prior to the completion of the access event, providing a form of real-time auditing and control (’048 Patent, Abstract).
- Technical Importance: This system provides a patient-centric security model for electronic health records, empowering patients with real-time awareness and potential control over who accesses their sensitive information. (Compl. ¶18).
Key Claims at a Glance
- The complaint asserts claims 1, 2, 10, 20, and 22-40, identifying claim 20 as exemplary (Compl. ¶39).
- Essential elements of independent claim 20 include:
- Storing information regarding a restriction or limitation on a person's ability to access, obtain, or modify information in a patient's healthcare record.
- Processing, with a processor, a request by a person or entity to access, obtain, or modify information in the record.
- Determining, using the stored restriction, whether the person or entity is authorized.
- Generating a message that includes information about the requesting entity and any actual change, alteration, or modification made to the record.
- Transmitting the message to a communication device of the individual or patient over a communication network.
- The complaint explicitly reserves the right to assert additional claims (Compl. ¶14).
III. The Accused Instrumentality
Product Identification
- The complaint identifies the "Accused Instrumentalities" 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" (Compl. ¶31). A specific example provided is the "HealthConnect" online patient portal (Compl. ¶31, Fig. 2).
Functionality and Market Context
- The HealthConnect portal is described as a "secure, easy-to-use, online patient portal developed by Wise Health System to provide 24/7 access to your personal health information" (Compl. Fig. 2). This portal allows patients to view and download a "Summary of Care" record, which includes health issues, medications, lab reports, allergies, and medical history (Compl. Fig. 2). This portal is part of a broader system that allegedly includes a cloud database and framework for managing patient care, billing, accounting, and other administrative functions (Compl. ¶31). The complaint's screenshot of the HealthConnect webpage describes its purpose as helping patients become more actively involved in their own healthcare. (Compl. Fig. 2).
IV. Analysis of Infringement Allegations
U.S. Patent No. 7,464,040 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, wherein the information...is transmitted from a first computer...associated with a healthcare provider...via...the Internet... | The Accused Instrumentalities allegedly receive patient information transmitted from a healthcare provider's computer over the Internet or World Wide Web (Compl. ¶61). | ¶61 | col. 46:50-61 |
| a database or a memory device, wherein the database or the memory device is...remote from the first computer...[and] stores information regarding a plurality of individuals, a plurality of healthcare providers, and a plurality of healthcare insurers or healthcare payers... | The Accused Instrumentalities allegedly include a remote database or memory device that stores information regarding multiple individuals, healthcare providers, and healthcare insurers/payers (Compl. ¶61). | ¶61 | col. 46:62-67 |
| a processing device, wherein the processing device processes information for at least one of storing the information...in the database or the memory device and updating the healthcare record...of...the individual... | The Accused Instrumentalities allegedly include a processing device that processes patient information by storing it in the database and/or updating the patient’s healthcare record (Compl. ¶63). | ¶63 | col. 47:20-24 |
| wherein the processing device automatically generates an insurance claim in response to the storing of the information...or the updating of the healthcare record... | The Accused Instrumentalities allegedly include a processing device that "automatically generates an insurance claim in response to the storing of the information...or the updating of the healthcare record" (Compl. ¶63). | ¶63 | col. 47:25-30 |
| and further wherein the processing device transmits the insurance claim to the second computer or to the second communication device [associated with the healthcare insurer]. | The Accused Instrumentalities allegedly include a processing device that transmits the generated insurance claim to a computer associated with the healthcare insurer or payer (Compl. ¶63). | ¶63 | col. 47:36-40 |
- Identified Points of Contention:
- Technical Questions: A primary factual question is whether the accused EHR system's billing function operates in the specific manner claimed. The complaint alleges that the processing device "automatically generates an insurance claim in response to the storing of the information...or the updating of the healthcare record" (Compl. ¶63). The case may turn on evidence demonstrating whether the act of a clinician updating a patient record directly and automatically triggers the creation of a transmittable insurance claim, or whether these are separate functions requiring distinct user initiation.
U.S. Patent No. 7,490,048 Infringement Allegations
| Claim Element (from Independent Claim 20) | Alleged Infringing Functionality | Complaint Citation | Patent Citation |
|---|---|---|---|
| storing the 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, the information contained in an individuals or patient's healthcare record... | The Accused Instrumentalities allegedly store information regarding restrictions on the ability of persons (e.g., providers, payers) to access or modify patient healthcare records (Compl. ¶44). | ¶44 | col. 59:53-60 |
| 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 Instrumentalities allegedly process requests from persons or entities to access or modify information contained in a patient's healthcare record (Compl. ¶44). | ¶44 | col. 59:61-65 |
| determining, using the information regarding the restriction or limitation, whether the person or the entity is allowed or authorized... | The Accused Instrumentalities allegedly use the stored restriction information to determine whether the requesting person or entity is authorized to access or modify the patient's record (Compl. ¶44). | ¶44 | col. 59:66-col. 60:4 |
| 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... | The Accused Instrumentalities allegedly generate a message containing information about the requesting entity and any actual changes made to the record (Compl. ¶44). | ¶44 | col. 60:5-12 |
| and transmitting the message to a communication device of the individual or patient via, on, or over, a communication network. | The Accused Instrumentalities allegedly transmit the generated message to the patient's communication device over a network (Compl. ¶44). | ¶44 | col. 60:13-16 |
- Identified Points of Contention:
- Scope Questions: The complaint alleges infringement through the HealthConnect portal, which provides patients "access to your personal health information" (Compl. ¶31, Fig. 2). A key question of claim scope will be whether simply making an updated record available for viewing within a secure portal constitutes "transmitting the message" as required by the claim, or if the claim requires a discrete, actively-pushed notification (e.g., an email, text, or alert) that is separate from the record itself.
V. Key Claim Terms for Construction
U.S. Patent No. 7,464,040
- The Term: "automatically generates an insurance claim in response to" (Claim 1)
- Context and Importance: This term defines the required causal and temporal link between the clinical act of updating a patient record and the administrative act of creating a bill. Its construction will be central to determining whether the accused EHR system's architecture and workflow fall within the claim scope. Practitioners may focus on this term because it distinguishes a tightly integrated, event-driven system from a more conventional, loosely coupled system where billing is a separate, manually initiated process.
- Intrinsic Evidence for Interpretation:
- Evidence for a Broader Interpretation: The specification describes a "comprehensive processing system" for healthcare that facilitates "claims processing" (’040 Patent, col. 2:59-62). This general language could support an interpretation where any system that uses clinical data to facilitate claim generation, even with intermediate steps, meets the limitation.
- Evidence for a Narrower Interpretation: The abstract states the claim is "automatically generated...in response to the storing of the information or the updating of the healthcare record." The flowchart in Figure 14B shows the "UPDATE PATIENT'S RECORDS" step (1408) leading directly to the "GENERATE CLAIM FORM" step (1409), suggesting an immediate, triggered action without intervening human steps. This may support a narrower construction requiring a direct, programmatic trigger.
U.S. Patent No. 7,490,048
- The Term: "transmitting the message to a communication device of the individual or patient" (Claim 20)
- Context and Importance: This term is critical because it defines how the patient is notified of access to their record. The infringement allegation hinges on whether the HealthConnect portal's functionality meets this limitation.
- Intrinsic Evidence for Interpretation:
- Evidence for a Broader Interpretation: The specification states that the "transmission of information, messages, and/or notification messages...can be effected via any one or more of e-mail messages, telephone messages, beeper or pager messages, physical mail delivery, electronic data transmission, and/or can be made via any other suitable...communication method" (’048 Patent, col. 27:1-6). This broad list of methods could support an argument that making information available for retrieval in a portal is a form of "electronic data transmission."
- Evidence for a Narrower Interpretation: The patent's abstract describes transmitting a "message containing information regarding the person or entity...and containing an actual change." This suggests a discrete data packet or notification, distinct from the entire record itself, is what is being transmitted. This could support a narrower reading that excludes merely providing access to view the underlying, modified record.
VI. Other Allegations
- Indirect Infringement: The complaint alleges inducement of infringement for both patents (Compl. ¶47, 66). The allegations are based on Defendant allegedly providing the Accused Instrumentalities and advertising their infringing use, thereby encouraging and instructing others (e.g., patients, providers) to use the systems in a manner that directly infringes the patent claims (Compl. ¶50, 69).
- Willful Infringement: The complaint alleges willfulness for both patents, asserting that Defendant's infringement "will now be willful through the filing and service of this Complaint" (Compl. ¶46, 65). It further alleges pre-suit willful blindness, based on Defendant having "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. ¶51, 70).
VII. Analyst’s Conclusion: Key Questions for the Case
- A core issue for the ’040 Patent will be one of functional operation: what evidence will demonstrate that the accused EHR system "automatically generates an insurance claim in response to" a clinical record update, as opposed to merely using the updated clinical data as an input for a separate, manually-initiated billing process? The distinction between a truly automated, event-triggered system and a merely streamlined workflow will be central to the infringement analysis.
- A key question for the ’048 Patent will be one of definitional scope: can the claim limitation "transmitting the message" be construed to cover a patient portal system that makes an updated health record available for a patient to view upon logging in, or does the claim require a discrete, actively-pushed notification (such as an email or alert) that is separate from the record itself and is triggered by the modification event?