Expression of Clinical Logic with Positive and Negative Explainability

A computerized method carried out by at least one server having one or more processors for presenting information on why members of a population qualify or do not qualify for a health-related measure, the method comprising:

• receiving one or more sets of patient population health data;
• executing, using the one or more processors, a set of high-level clinical logic against the one or more sets of patient population health data to identify at least a first member of the population who does not qualify for the health-related measure and at least a second member of the population who does qualify for the health-related measure, the high-level clinical logic comprising at least a component expression comprising one or more components coupled by one or more logical operators, each component defined by one or more sub-criteria;
• for the at least the first member of the population, determining a first component of the one or more components in the component expression that disqualifies the first member from the health-related measure;
• for the first component, identifying which of the first component's one or more sub-criteria disqualified the first member from the health-related measure;
• and
• presenting on a user interface associated with an end-user:
• an indication that the first member did not qualify for the health-related measure, the indication including information regarding the first component and the first component's sub-criteria that disqualified the first member from the health-related measure, and an indication that the second member qualified for the health-related measure, the indication including information about the one or more components and the each component's one or more sub-criteria that qualified the second member for the health-related measure.

A computer-implemented system for processing population health data to identify and explain why members of a population qualify or do not qualify for a health-related measure, the system comprising:

• a runtime engine comprising:
• a receiving component operable to:
• a) receive one or more sets of patient population health data associated with the members of the population;
• a plurality of batch processing nodes operable to:
• a) execute a set of high-level clinical logic against the one or more sets of patient population health data to identify at least a first member of the population who qualifies for a health-related measure and a second member of the population who does not qualify for the health-related measure, wherein the set of high-level clinical logic comprises at least a component expression comprising one or more components coupled by one or more logical operators, each component defined by one or more sub-criteria, and
• b) for the second member who did not qualify for the health-related measure, execute a set of high-level clinical logic explainability rules against the second member's patient population health data to determine at least a first component of the one or more components that disqualified the second member from the health-related measure, and for the at least the first component, identify which of the first component's one or more sub-criteria disqualified the second member from the health-related measure;
• a result interpreter component operable to at least:
• a) present on a user interface associated with an end-user, information regarding the second member that did not qualify for the health-related measure, the information comprising at least the first component and the first component's sub-criteria that disqualified the second member from the health-related measure.