GREEN, W. T. et al.

Patent Trials and Appeals Board

Sep 12, 2019

13155084 - (D) (P.T.A.B. Sep. 12, 2019)

UNITED STATES PATENT AND TRADEMARK OFFICE
UNITED STATES DEPARTMENT OF COMMERCE
United States Patent and Trademark Office
Address: COMMISSIONER FOR PATENTS
P.O. Box 1450
Alexandria, Virginia 22313-1450
www.uspto.gov
APPLICATION NO. FILING DATE FIRST NAMED INVENTOR ATTORNEY DOCKET NO. CONFIRMATION NO.
13/155,084 06/07/2011 W. T. GREEN JR. 110751.00120 2297
27557 7590 09/12/2019
BLANK ROME LLP
1825 Eye Street NW
WASHINGTON, DC 20006-5403
EXAMINER
NGUYEN, TRAN N
ART UNIT PAPER NUMBER
3686
NOTIFICATION DATE DELIVERY MODE
09/12/2019 ELECTRONIC
Please find below and/or attached an Office communication concerning this application or proceeding.
The time period for reply, if any, is set in the attached communication.
Notice of the Office communication was sent electronically on above-indicated "Notification Date" to the
following e-mail address(es):
WashingtonDocketing@blankrome.com
PTOL-90A (Rev. 04/07)
UNITED STATES PATENT AND TRADEMARK OFFICE
____________

BEFORE THE PATENT TRIAL AND APPEAL BOARD
____________

Ex parte W. T. GREEN JR., W.T. GREEN III, JAMES T. INGRAM,
JASON COLQUITT, ANTONIO GERENA, MARK ANDERSON,
JOHNATHAN SAMPLES, and GREGORY H. SCHULENBURG
____________

Appeal 2018-007927
Application 13/155,084
Technology Center 3600
____________

Before JOHN A. JEFFERY, DENISE M. POTHIER, and
JUSTIN BUSCH, Administrative Patent Judges.

POTHIER, Administrative Patent Judge.

DECISION ON APPEAL
STATEMENT OF THE CASE
Appellant1,2 appeals under 35 U.S.C. § 134(a) from the Examiner’s
decision to reject claims 1–3, 6, 7, 21, and 25–42. Appeal Br. 2, 24 (Claims
App’x).

1 Throughout this opinion, we refer to the Final Action (Final Act.) mailed
July 13, 2017, the Advisory Action (Adv. Act.) mailed December 20, 2017,
the Appeal Brief (Appeal Br.) filed January 16, 2018, the Examiner’s
Answer (Ans.) mailed May 31, 2018, and the Reply Brief (Reply Br.) filed
July 31, 2018.
2 We use the word “Appellant” to refer to “applicant” as defined in 37
C.F.R. § 1.42. Appellant identifies the real party in interest as Greenway
Medical Technologies, Inc. Appeal Br. 2.
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Claims 4, 5, 8–20, and 22–243 have been canceled. Id. at 21 (Claims
App’x).
We AFFIRM.
Appellant’s invention relates to “a medical software system that
integrates each of the systems required to manage the different activities
performed at a healthcare practice . . . on a single technology platform so
that duplicate and/or inconsistent data is not captured, stored, and managed
by disparate, stand-alone systems.” Spec. ¶ 61, Fig. 1. The medical
software system “provides clinical decision support through the automation
of clinical and administrative flags that provide healthcare providers with
various alerts, reminders, and recommendations.” Id. ¶ 63.
Independent claim 1 exemplifies the claims at issue and reads as
follows:
1. A method for providing clinical decision support by an
integrated medical software system, the method comprising:
receiving input data via a user interface, the input data
including clinical data for a patient;
serializing, by a clinical module executed by a processor,
the input data into a standardized database language;
translating, by the clinical module executed by the
processor, the serialized input data into a controlled medical
vocabulary;
associating, by an interoperability engine executed by the
processor, the serialized input data with clinical coding;
placing, by the clinical module executed by the
processor, the input data into a first electronic clinical document
defined by a clinical document exchange standard specifying

3 Appellant omits claim 28 as a pending claim in the Status of Claims
section (Appeal Br. 2) but includes claim 28 as pending in the Claims
Appendix (id. at 22 (Claims App’x)). Claim 28 was introduced in an
amendment submitted August 4, 2016 and has not been canceled.
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the structure and semantics of the first electronic clinical
document;
communicating, by a communication component
executed by the processor, the first electronic clinical document
to a rule-based clinical decision support (CDS) system that
compares the input data with rules defined by evidence-based
medical knowledge and returns at least one clinical flag in an
electronic document defined by the clinical document exchange
standard based on the comparison; and
outputting an alert, warning, reminder, and/or
recommendation based on based on [sic] the at least one clinical
flag.

Appeal Br. 20 (Claims App’x).

THE PROVISIONAL DOUBLE PATENTING REJECTION
The Examiner rejected claims 1–3, 6, 7, 21, and 25–42 on the ground
of non-statutory provisional4 obviousness-type double patenting over (1)
claims 1–20 of Application No. 13/036,973; (2) claims 67, 68, 70, 72,
74–83, 85, 87, 89–96 of Application No. 10/202,627; and (3) claims 1–24 of
Application No. 12/392,998. Final Act. 3. In the Advisory Action,
however, the Examiner held the rejection “in abeyance.” Adv. Act. 2.
Accordingly, we presume this rejection is not before us.

4 We note that Application Nos. 13/036,973 and 12/392,998 issued as US
8,738,396 B2 on May 27, 2014, and US 8,606,593 B1 on December 10,
2013, respectively. The Manual of Patent Examining Procedure (MPEP)
discusses when an obviousness-type double patenting rejection should or
should not be provisional. See MPEP §§ 804(I)(A)–(B) (9th ed. rev.
08.2017 Jan. 2018). Also, Application No. 10/202,627 was abandoned on
March 21, 2019.
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THE INDEFINITENESS REJECTION
The Examiner rejected claims 3 and 33 under 35 U.S.C. § 112(b) or
35 U.S.C. § 112 (pre-AIA), second paragraph as being indefinite. Final Act.
4.5 In particular, the Examiner states there is insufficient antecedent basis
because claims 3 and 33 “recite the limitation ‘the’ various standards.” Id.
Appellant argues the various standards recited in the claims are proper nouns
that refer to specific technical standards known to those skilled in the art,
who can readily ascertain the standards’ specifics. Appeal Br. 5; Reply Br.
5. We agree.
Claims 3 and 33 each recite “the clinical document exchange standard
is at least one of the Clinical Document Architecture (CDA) standard, the
Continuity of Care Record (CCR) standard, and the Continuity of Care
Document (CCD) standard.” Appeal Br. 20, 23 (Claims App’x). To the
extent the Examiner finds that the claims are indefinite for reciting “the”
CDA, CCR, and CCD standards, failure to provide explicit antecedent basis
for a term in a claim does not per se render the claim indefinite. “[D]espite
the absence of explicit antecedent basis, if the scope of a claim would be
reasonably ascertainable by those skilled in the art, then the claim is not
indefinite.” Energizer Holdings, Inc. v. Int’l Trade Comm’n, 435 F.3d 1366,
1370–71 (Fed. Cir. 2006).
“A decision on whether a claim is [indefinite] under § 112, 2d para.,
requires a determination of whether those skilled in the art would understand
what is claimed when the claim is read in light of the specification.”

5 Later, the Examiner finds claims 26 and 33 recite “the” various standards.
Final Act. 4. We presume, as does Appellant (see Appeal Br. 4), that the
Examiner intended to refer to claims 3 and 33 reciting “the” various
standards and deem the Examiner’s typographical error to be harmless.
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Orthokinetics, Inc. v. Safety Travel Chairs, Inc., 806 F.2d 1565, 1576 (Fed.
Cir. 1986) (citations omitted). The Specification describes characteristics
and details regarding the CDA, CCR, and CCD standards, such that one
skilled in the art would have understood what is claimed when read in light
of the disclosure. See Spec. ¶ 95. For example, the Specification describes
the CCD standard as “a uniform clinical document exchange standard . . . for
specifying the structure and semantics of electronic documents” (i.e., a
structured XML standard developed by HL7 and ASTM) and the CDA
standard as “an exchange model for clinical documents . . . that uses various
coded vocabularies . . . .” Id. Similarly, the Specification describes the
CCR standard as “provid[ing] [a] patient health summary model for clinical
documents by identifying the most relevant and timely core health-related
information about a patient so that information can be sent electronically
from one healthcare provider to another.” Id.
Although the Examiner asserts “there are many publishers of the CDA
standard” (see Ans. 3) and “there is no single prevailing CDA standard in
the art” (Ans. 7), the Examiner does not substantiate this position. On other
hand and as noted, the Specification describes CDA as standard developed
by “HL7.” Spec. ¶ 95. Moreover, having the CDA standard published by
different publishers or certified by a national body does not illustrate the
resulting CDA standard that sets forth an exchange model (see id.) differs
from one publisher to another. See Ans. 4. In light of Appellant’s
arguments and the Specification, we determine that the meaning of the CDA,
CCR, and CCD standards in claims 3 and 33 would have been sufficiently
clear to one of ordinary skill in the art. See In re Packard, 751 F.3d 1307,
1314 (Fed. Cir. 2014).
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When weighing the evidence in the record, we are persuaded that the
Examiner erred in rejecting claims 3 and 33 under 35 U.S.C. § 112, second
paragraph.

THE PATENT-ELIGIBILITY REJECTION
Claims 1–3, 6, 7, 21, and 25–42 are rejected under 35 U.S.C. § 101 as
being directed to a judicial exception without significantly more. Final Act.
5–13. The Examiner determined that the claims are directed to an abstract
idea, namely “receiving input data, processing that input[,] and providing an
alert as the result of the processing” (id. at 6) and “managing the operations
of a physician practice” (Adv. Act. 6). The Examiner added that the claims
do not include additional elements or limitations individually or in
combination that are sufficient to amount to significantly more than the
judicial exception. Final Act. 6. Based on these determinations, the
Examiner concluded that the claims are ineligible under § 101. Id. at 5.
Appellant argues the focus of the claims is on a specific improvement
in computer capabilities. See Appeal Br. 13–18; Reply Br. 7. According to
Appellant, the claims recite elements directed to solving a technical problem
associated with providing the interoperability for transferring patient clinical
data from a clinical module to a rule-based CDS system so that the CDS
system understands the data. See Appeal Br. 13–17 (citing Spec. ¶¶ 14,
87–95); Reply Br. 7.

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ISSUE
Under § 101, has the Examiner erred in rejecting the claims by
determining that the claims are directed to judicially excepted, patent
ineligible subject matter?

PRINCIPLES OF LAW
An invention is patent eligible if it claims a “new and useful process,
machine, manufacture, or composition of matter.” 35 U.S.C. § 101.
However, the Supreme Court has long interpreted 35 U.S.C. § 101 to include
implicit exceptions: “[L]aws of nature, natural phenomena, and abstract
ideas” are not patentable. Mayo Collaborative Servs. v. Prometheus Labs.,
Inc., 566 U.S. 66, 70 (2012) (brackets in original) (citing Diamond v. Diehr,
450 U.S. 175, 185 (1981)).
In determining whether a claim falls within an excluded category, we
are guided by the Supreme Court’s two-step framework, described in Mayo
and Alice. Alice Corp. Pty. Ltd. v. CLS Bank Int’l, 573 U.S. 208, 217–18
(2014) (citing Mayo, 566 U.S. at 75–77). In accordance with that
framework, we first determine what concept the claim is “directed to.” See
Alice, 573 U.S. at 219 (“On their face, the claims before us are drawn to the
concept of intermediated settlement, i.e., the use of a third party to mitigate
settlement risk.”); see also Bilski v. Kappos, 561 U.S. 593, 611 (2010)
(“Claims 1 and 4 in petitioners’ application explain the basic concept of
hedging, or protecting against risk.”).
Concepts determined to be abstract ideas, and thus patent ineligible,
include certain methods of organizing human activity, such as fundamental
economic practices (Alice, 573 U.S. at 219–20; Bilski, 561 U.S. at 611);
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mathematical formulas (Parker v. Flook, 437 U.S. 584, 594–95 (1978)); and
mental processes (Gottschalk v. Benson, 409 U.S. 63, 69 (1972)). Concepts
determined to be patent eligible include physical and chemical processes,
such as “molding of rubber products” (Diehr, 450 U.S. at 193); “tanning,
dyeing, making water-proof cloth, vulcanizing India rubber, smelting ores”
(id. at 182 n.7 (quoting Corning v. Burden, 56 U.S. (15 How.) 252, 267–68
(1854))); and manufacturing flour (Benson, 409 U.S. at 69 (citing Cochrane
v. Deener, 94 U.S. 780, 785 (1876))).
In Diehr, the claim at issue recited a mathematical formula, but the
Supreme Court held that “[a] claim drawn to subject matter otherwise
statutory does not become nonstatutory simply because it uses a
mathematical formula.” Diehr, 450 U.S. at 187; see also id. at 191 (“We
view respondents’ claims as nothing more than a process for molding rubber
products and not as an attempt to patent a mathematical formula.”). That
said, the Supreme Court also indicated that a claim “seeking patent
protection for that formula in the abstract . . . is not accorded the protection
of our patent laws, . . . and this principle cannot be circumvented by
attempting to limit the use of the formula to a particular technological
environment.” Id. (citing Benson and Flook); see, e.g., id. at 187 (“It is now
commonplace that an application of a law of nature or mathematical formula
to a known structure or process may well be deserving of patent
protection.”).
If the claim is “directed to” an abstract idea, we turn to the second
step of the Alice and Mayo framework, where “we must examine the
elements of the claim to determine whether it contains an ‘inventive
concept’ sufficient to ‘transform’ the claimed abstract idea into a patent-
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eligible application.” Alice, 573 U.S. at 221 (quotation marks omitted). “A
claim that recites an abstract idea must include ‘additional features’ to
ensure ‘that the [claim] is more than a drafting effort designed to
monopolize the [abstract idea].’” Id. (quoting Mayo, 566 U.S. at 77).
“[M]erely requir[ing] generic computer implementation[] fail[s] to transform
that abstract idea into a patent-eligible invention.” Id.
In January 2019, the USPTO published revised guidance on the
application of § 101. 2019 Revised Patent Subject Matter Eligibility
Guidance, 84 Fed. Reg. 50 (Jan. 7, 2019) (“Revised Guidance”). Under the
Revised Guidance, we first look to whether the claim recites:
(1) any judicial exceptions, including certain groupings of abstract
ideas (i.e., mathematical concepts, certain methods of organizing
human activities such as a fundamental economic practice, or mental
processes) (Revised Guidance, 84 Fed. Reg. at 52–54); and
(2) additional elements that integrate the judicial exception into a
practical application (see the Manual of Patent Examining Procedure
(MPEP) §§ 2106.05(a)–(c), (e)–(h)) (Revised Guidance, 84 Fed. Reg.
at 53–55.
Only if a claim (1) recites a judicial exception, and (2) does not integrate that
exception into a practical application (“Revised Step 2A”), do we then look
to whether the claim:
(3) adds a specific limitation beyond the judicial exception that is not
well-understood, routine, and conventional in the field (see MPEP
§ 2106.05(d)); or
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(4) simply appends well-understood, routine, and conventional
activities previously known to the industry, specified at a high level of
generality, to the judicial exception.
See Revised Guidance, 84 Fed. Reg. at 56 (“Step 2B”).

ANALYSIS
Appellant argues claims 1–3, 6, 7, 21, and 25–42 as a group. See
Appeal Br. 11–18. We select independent claim 1 as representative. See 37
C.F.R. § 41.37(c)(1)(iv). Claim 1’s subject matter falls within a statutory
category of patentable subject matter—a process. See Revised Guidance, 84
Fed. Reg. at 53–54.
Alice Step One
Despite falling within a statutory category, we determine whether
claim 1 as a whole is directed to a judicial exception, namely an abstract
idea. See Alice, 573 U.S. at 217. To this end, we determine (1) whether
claim 1 recites a judicial exception (“Revised Step 2A - Prong 1”) and, if so,
(2) whether the identified judicial exception is integrated into a practical
application (“Revised Step 2A – Prong 2”). See Revised Guidance, 84 Fed.
Reg. at 52–55. If both elements are satisfied, the claim is directed to a
judicial exception under the first step of the Alice/Mayo test. See id.
Revised Step 2A - Prong 1
In Revised Step 2A - Prong 1, we identify the claim’s specific
limitations that recite a judicial exception, and determine whether the
identified limitations fall within certain subject matter groupings, namely (a)
mathematical concepts (mathematical relationships, formulas, and
calculations); (b) certain methods of organizing human activity (e.g.,
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fundamental economic practices, commercial or legal interactions, and
managing personal behavior or interactions between people); or (c) mental
processes (e.g., concepts performed in the human mind including an
observation, evaluation, judgment, or opinion). See Revised Guidance, 84
Fed. Reg. at 52. We agree with the Examiner (see Final Act. 5) that claim 1
recites at least one judicial exception.
Claim 1 recites “[a] method for providing clinical decision support
. . . ,” the method comprising the following steps: (A) “receiving input data
. . . , the input data including clinical data for a patient,” (B) “serializing . . .
the input data into a standardized . . . language,” (C) “translating . . . the
serialized input data into a controlled medical vocabulary,” (D) “associating
. . . the serialized input data with clinical coding,” (E) “placing . . . the input
data into a first . . . clinical document defined by a clinical document
exchange standard specifying the structure and semantics of the first . . .
clinical document,” (F) “communicating . . . the first . . . clinical document
to a[n entity] that compares the input data with rules defined by evidence-
based medical knowledge and returns at least one clinical flag in . . . [a]
document defined by the clinical document exchange standard based on the
comparison,” and (G) “outputting an alert, warning, reminder, and/or
recommendation based on . . . the at least one clinical flag.” Id. (Claims
App’x) (“steps (A)–(G)”).
Steps (A)–(D), under their broadest reasonable interpretation, recite
interpreting received clinical data for a patient into standardized formats.
See id. (Claims App’x); see also Spec. ¶ 100. All these steps recite
processes that would occur normally in a human’s mind when interpreting
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received clinical data for a patient, which are operations within a physician’s
practice. See Adv. Act. 6.
For example, “receiving input data . . . , the input data including
clinical data for a patient,” as step (A) recites, is a process that a person can
perform mentally (or with pen and paper) by merely observing the input
data, such as a clinician can merely observe a patient’s medical condition
(e.g., patient has a fever, fatigue, and nasal congestion). Next, “serializing
. . . the input data into a standardized . . . language,” as step (B) recites,
encompasses a person evaluating such observed input data by mentally (or
with pen and paper) arranging the observed input data in parts using a
standardized language (e.g., English), such as the clinician can evaluate and
organize the patient’s self-described medical condition in one’s mind or can
memorialize the patient’s symptoms in a medical file in the standard
language. “[T]ranslating . . . the serialized input data into a controlled
medical vocabulary,” as step (C) recites, encompasses a person evaluating
such serialized input data by mentally (or with pen and paper) translating the
serialized input data into a controlled medical vocabulary, such as the
clinician can translate the symptoms into a controlled medical vocabulary
(e.g., patient may have influenza A). Next, “associating . . . the serialized
input data with clinical coding,” as step (D) recites encompasses a person
evaluating the serialized input data by mentally (or with pen and paper)
associating the serialized input data with clinical coding (e.g., associating
patient with clinical code 87804 to perform influenza testing).
Steps (E)–(G), under their broadest reasonable interpretation, recite
standardizing input data in a clinical document and generating an alert based
on comparing standardized input data with rules defined by medical
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knowledge. See Appeal Br. 20 (Claims App’x). These are processes that
also would occur normally in a human’s mind and are operations within a
physician’s practice. See Adv. Act. 6.
For example, “placing. . . the input data into a first . . . clinical
document defined by a clinical document exchange standard specifying the
structure and semantics of the first . . . clinical document,” as step (E)
recites, is a process that a person can perform with pen and paper by merely
evaluating such input data. To illustrate, a clinician can place observed
input data into specific clinical document fields with pen and paper (e.g., a
medical file document in English having a name field, an address field, an
age field, and a condition field). “[C]ommunicating . . . the first . . . clinical
document to a[n entity] that compares the input data with rules defined by
evidence-based medical knowledge and returns at least one clinical flag in
. . . [a] document defined by the clinical document exchange standard based
on the comparison,” as step (F) recites, encompasses a process that people
can perform mentally (or with pen and paper) by merely evaluating the first
clinical document into which input data was placed. For example, a second
clinician can mentally compare the first clinical document’s data (e.g., can
look at the patient’s medical file), apply rules defined by evidence-based
medical knowledge (e.g., medical handbooks/literature) to the data, and
include a flag (e.g., include a note that the patient has influenza A based on
tests) in the document using pen and paper based on the mental comparison.
Lastly, “outputting an alert, warning, reminder, and/or recommendation
based on . . . the at least one clinical flag,” as step (G) recites, encompasses a
process that a person can perform mentally (or with pen and paper) by
merely evaluating the at least one clinical flag. For example, the original
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clinician can read the medical file and inform the patient (e.g., email the
patient) describing the condition (e.g., output an alert) or recommending rest
(e.g., output a recommendation).
Thus, with the exception of generic computer-implementation recited
in claim 1, there is nothing in steps (A)–(G) that forecloses the steps from
being performed mentally or with pen and paper. See Univ. of Fla. Res.
Found. v. Gen. Elec. Co., 916 F.3d 1363, 1366–67 (2019) (indicating an
invention directed to integrating physiologic treatment data sought to
automate “pen and paper methodologies”); see Voter Verified, Inc. v.
Election Sys. & Software LLC, 887 F.3d 1376, 1384–86 (2018) (indicating a
method for self-verifying a ballot when voting, including data comparison, is
a mental process that can be performed by humans or with pen and paper)
(citing CyberSource Corp. v. Retail Decisions, Inc., 654 F.3d 1366, 1373
(Fed. Cir. 2011)); see Benson, 409 U.S. at 67 (indicating converting BCD
numbers to pure binary numbers can be done mentally and that “mental
processes ... are not patentable, as they are the basics tools of scientific and
technological work”).
For the above reasons, we conclude claim 1 as a whole recites mental
processes identified in the Revised Guidance. See Revised Guidance, 84
Fed. Reg. at 52. Accordingly, we determine claim 1 recites an abstract idea.
Revised Step 2A - Prong 2
Because claim 1 recites an abstract idea, we must determine whether
the abstract idea is integrated into a practical application, namely whether
the claim applies, relies on, or uses the abstract idea in a manner that
imposes a meaningful limit on the abstract idea, such that the claim is more
than a drafting effort designed to monopolize the abstract idea. See Revised
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Guidance, 84 Fed. Reg. at 53. We (1) identify whether there are any
additional, recited elements beyond the judicial exception, and (2) evaluate
those elements individually and collectively to determine whether they
integrate the exception into a practical application. See id., 84 Fed. Reg. at
54–55.
The additionally recited elements beyond the above-identified judicial
exceptions in claim 1 are “an integrated medical software system,” “a user
interface,” “a processor,” “a clinical module executed by the processor,”
“an interoperability engine executed by the processor,” “a communication
component executed by the processor,” “electronic clinical document,” a
“clinical flag in an electronic document,” and “a rule-based clinical decision
support (CDS) system.” Appeal Br. 20 (Claims App’x); see Final Act. 6.
When considering these elements individually or in combination, we
determine they do not integrate the above-identified judicial exception(s)
into a practical application.
Contrary to Appellant’s assertions (see Appeal Br. 13–18), the
additional elements beyond the identified judicial exceptions do not reflect
an improvement in a computer’s functioning or an improvement to other
technology or technical field as set forth in MPEP § 2106.05(a) and the
Revised Guidance, 84 Fed. Reg. at 55. See Ans. 8 (citing Spec. 19, 25–27,
37–38). Here, consistent with the disclosure as discussed below, the
additionally recited elements automate the above-identified abstract idea
(i.e., mental processes) using generic computer elements as tools but do not
constitute a patentable improvement in a computer or computer technology.
Appeal Br. 20 (Claims App’x); see Credit Acceptance Corp. v. Westlake
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Servs., 859 F.3d 1044, 1055 (Fed. Cir. 2017); see also Alice, 573 U.S. at
221, 223, 225; see Ans. 8.
For example, the claimed “processor” is merely a tool to perform
steps (B)–(F). Appeal Br. 20 (Claims App’x). Claim 1, however, does not
recite a technological improvement in the processor or how it operates. Id.
(Claims App’x); see also Spec. ¶ 79 (describing a central processor
generally). Similarly, the claimed “clinical module,” “interoperability
engine,” and “communication component,” each executed by the processor,
are software components to implement various recited functions (Appeal Br.
20 (Claims App’x)) rather than a recited improvement in a computer or
technology. See Spec. ¶¶ 201, 203, Figs. 5, 13–14 (describing and showing
clinical module 512 as a tool to implement clinical functions), ¶¶ 92–93
(describing the interoperability engine as tool to implement interoperability
functions), ¶ 170, Fig. 5 (describing and showing communication component
534 as a tool for communicating). Moreover, claim 1 does not recite a
computer or technological improvement in the recited “integrated medical
software system” or “rule-based clinical decision support (CDS) system.”
The disclosure similarly describes these components as tools to perform
steps in claim 1 rather than a technical improvement to these tools. See id.
¶¶ 92, 110, Fig. 5 (elements 500, 502). The recited “user interface” is also
described generally as a tool to receive input data. See id. ¶ 136, Fig. 7
(element 700).
As for the recited “electronic clinical document” and a “clinical flag
in an electronic document” in claim 7 (Appeal Br. 20 (Claims App’x)
(emphases added), these recited features merely automate the above-
identified abstract idea rather than improve on a computer or a technology.
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Appeal Br. 20 (Claims App’x). Thus, when considering the noted,
additional elements individually or in combination, they are to no more than
using computers as tools to perform the above-identified abstract idea.
To the extent that Appellant contends the recited steps (A)–(G) are an
“improvement to a clinical system such that it is interoperable with a rule-
based CDS system” (see Appeal Br. 17; Reply Br. 7), there is insufficient
persuasive evidence on this record to substantiate this contention.
Specifically, as noted above, we do not see a specific improvement in the
way the recited computer components operate when performing claim 1’s
steps (B)–(E) (see Appeal Br. 13–14, 17) to achieve the noted
interoperability between a clinical system and a rule-based CDS system.
The Specification fares no better, describing these components in purely
functional terms, such as they “serializ[e] . . . the input data into a
standardized . . . language,” they “translat[e] . . . the serialized input data
into a controlled medical vocabulary,” they “associate[e] . . . the serialized
input data with clinical coding,” and they “plac[e] . . . the input data into a
first . . . clinical document defined by a clinical document exchange standard
specifying the structure and semantics of the first . . . clinical document.”
See Spec. ¶¶ 79, 92, 100–102, 105, 201, Figs. 4–5. But, these mere
functions for coding and standardizing data that assist in interoperability are
not specific improvements to the way a computer operates or to computer
technology. See Univ. of Fla., 916 F.3d at 1368. The recited computer
components are essentially tools to implement or provide the disputed
interoperability, which can be considered as part of the above-identified
abstract idea.
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We also are not persuaded by Appellant’s arguments that the claimed
invention improves a computer’s functionality such as in Enfish, LLC v.
Microsoft Corp., 822 F.3d 1327 (Fed. Cir. 2016). See Appeal Br. 17. The
Enfish court explained that “[t]he Supreme Court has suggested that claims
‘purport[ing] to improve the functioning of the computer itself,’ or
‘improv[ing] an existing technological process’ might not succumb to the
abstract idea exception.” Enfish, 822 F.3d at 1335 (citing Alice, 573 U.S. at
222–25). The claims in Enfish were directed to an improved database
configuration that permitted faster searching for data. See id. at 1330–33,
1336. In contrast, as previously discussed, claim 1 does not recite an
advance in a data structure like Enfish that improves on a computer’s
functionality. See id. at 1336–37 (finding a “self-referential table for a
computer database” improves computer functionality itself).
To the extent Appellant contends that the claimed invention is eligible
because it is necessarily rooted in computer technology or overcomes a
problem specifically arising in computers as in DDR Holdings, LLC v.
Hotels.com, L.P., 773 F.3d 1245, 1257 (Fed. Cir. 2014), we disagree. See
Appeal Br. 17 (citing DDR). Here, providing clinical decision support using
an integrated medical system, as claim 1 recites, is not necessarily rooted in,
or a problem that arose in, the realm of computer technology as previously
explained.
Given the record, claim 1’s additional elements beyond the identified
judicial exceptions are not shown to improve a computer itself, another
technology, or technical field. See Revised Guidance, 84 Fed. Reg. at 55
(citing MPEP § 2106.05(a)). Nor do claim 1’s additional elements
implement the identified judicial exception with or use the judicial exception
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in conjunction with a particular machine or a particular transformation. See
id. (citing MPEP §§ 2106.05(a), § 2106.05(c)).
We add that certain steps in claim 1 may be considered insignificant
extra-solution activity. For example, step (A) can be considered
insignificant pre-solution data-gathering activity. See Ultramercial Inc. v.
Hulu LLC, 772 F.3d 709, 716 (Fed. Cir. 2014). Also, step (G) can be
considered insignificant post-solution activity that outputs an alert, warning,
reminder, and/or recommendation that is merely ancillary to the providing
clinical decision support focus of the claimed invention. See Flook, 437
U.S. at 590 (finding updating an alarm limit to be insignificant post-solution
activity); see also CyberSource, 654 F.3d at 1371 (discussing Flook and
post-solution activity). Thus, steps (A) and (G) do not integrate the judicial
exceptions into a practical application for these additional reasons. See
Guidance, 84 Fed. Reg. at 55 (citing MPEP § 2106.05(g)).
Lastly, Appellant discusses what claims 2, 3, 32, and 33 recite but
does not further explain how these claimed features are additional elements
to the above-identified judicial exception or improve a computer technology
or other technical field. See Appeal Br. 18.
For the above-stated reasons, we determine the additional elements
recited in claim 1 beyond the judicial exception, whether considered alone or
in combination, are not integrated into a practical application.
Alice Step Two, Step 2B
Because we determine claim 1 does not integrate the recited judicial
exception into a practical application, we need to consider whether the
additional elements add a specific limitation or combination of limitations
that are not well-understood, routine, or conventional activity in the field.
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See Revised Guidance, 84 Fed. Reg. at 56. If so, this indicates that an
inventive concept may be present. If, instead, the additional elements
simply append well-understood, routine, and conventional activities
previously known to the industry, specified at a high level of generality, to
the judicial exceptions, this indicates that an inventive concept may not be
present. Id.
Appellant contends the Examiner failed to provide any evidence that
claims’ limitations reciting a technical process was ever employed by any
clinical system at the time of the present invention, let alone being “well-
understood, routine, and conventional” to a skilled artisan. Reply Br. 8
(quoting Berkheimer v. HP Inc., 881 F.3d 1360, 1368 (Fed. Cir. 2018)). We
are not persuaded.
Many of the claim limitations that allegedly recite a technical process
on page 8 of the Reply Brief are not additional elements beyond the abstract
idea, but rather are directed to the identified abstract idea as noted
previously. See Guidance, 84 Fed. Reg. at 56 (instructing that additional
recited element(s) should be evaluated in Alice/Mayo step two to determine
whether they (1) add specific limitation(s) that are not well-understood,
routine, and conventional in the field, or (2) simply append well-understood,
routine, and conventional activities previously known to the industry (citing
MPEP § 2106.05(d)). Rather, the “integrated medical software system,”
“user interface,” “processor,” “clinical module executed by the processor,”
“processor,” “interoperability engine executed by the processor,”
“communication component executed by the processor,” “electronic clinical
document,” a “clinical flag in an electronic document,” and “rule-based
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clinical decision support (CDS) system” are the additional recited elements.
Appeal Br. 20 (Claims App’x); see Final Act. 6.
The generic computing functionality of the additional recited elements
are well-understood, routine, and conventional. For example, components,
such as interfaces (e.g., the recited “user interface”), networks (e.g., the
recited “communication component”), and databases or data structures (e.g.,
the recited “module,” “engine,” “electronic document,” and “flag” within the
electronic document) are generic computer components that do not satisfy
the inventive concept requirement. See, e.g., Mort. Grader, Inc. v. First
Choice Loan Servs. Inc., 811 F.3d 1314, 1324–25 (Fed. Cir. 2016). Also,
computer components that obtain data and issue automated instructions (e.g.,
the recited “processor,” “clinical module,” “interoperability engine,”
“communication component,” “integrated medical software system,” and
“rule-based” CDS system) are generic computer components performing
well-understood, routine, and conventional activities. See Alice, 573 U.S. at
225; see buySAFE, Inc. v. Google, Inc., 765 F.3d 1350, 1355 (Fed. Cir.
2014) (indicating a computer receiving information over a network is a
generic computer functionality and not inventive). The Specification also
describes components, such as the recited “processor,”, “user interface,” and
computer “system,” generically as previously noted. Spec. ¶¶ 78–80, 87; see
Ans. 8 (citing Spec. 25–27, 29–30, 37–38).
Appellant’s reliance on BASCOM Global Internet Services, Inc. v.
AT&T Mobility LLC, 827 F.3d 1341 (Fed. Cir. 2016) (Appeal Br. 17) is also
unpersuasive. The BASCOM court determined claims directed to a
technology-based solution to filter Internet content overcame existing
problems with other Internet filtering systems. Such problems were
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overcome by making a known filtering solution—namely a “one-size-fits
all” filter at an Internet Service Provider (ISP)—more dynamic and efficient
by individualized filtering at the ISP. BASCOM, 827 F.3d at 1351. This
customizable filtering solution improved the computer system’s performance
and was found patent-eligible. See id. But unlike the filtering
improvements in BASCOM that added significantly more to its abstract idea,
the claimed invention here uses generic computing components to
implement an abstract idea.
Appellant’s additional reliance on Amdocs (Israel) Ltd. v. Openet
Telecom, Inc., 841 F.3d 1288 (Fed. Cir. 2016) is likewise unavailing. See
Appeal Br. 17. The Amdocs court held that a claim reciting code for
enhancing a record was held eligible because the claim involved “an
unconventional technological solution (e.g., enhancing data in a distributed
fashion) to a technological problem (e.g., massive record flows which
previously required massive databases).” Amdocs, 841 F.3d at 1300.
Although the court recognized that this solution used generic components,
the recited enhancing function necessarily required these generic
components to operate in an unconventional manner to achieve an
improvement in computer functionality. See id. at 1300–01.
That is not the case on this record. Although the claimed invention
uses conventional computing components that receive and process data,
there is no persuasive evidence to show that these generic components
operate in an unconventional manner to achieve an improvement in
computer functionality like Amdocs or BASCOM.
Thus, Appellant fails to show sufficiently the recited additional
elements in claim 1 add a specific limitation or combination of limitations
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that is not well-understood, routine, or conventional activity in the field. For
the above reasons, the additional recited elements—considered individually
and as an ordered combination—do not add significantly more than the
abstract idea to provide an inventive concept under Alice/Mayo step two.
Conclusion
For the foregoing reasons, Appellant has not persuaded us of error in
the rejection of independent claim 1 and claims 2, 3, 6, 7, 21, and 25–42 for
similar reasons.

OBVIOUSNESS REJECTION OVER JOHNSON AND HACKER
Claims 1 and 31 are rejected under 35 U.S.C. § 103(a) as being
unpatentable over Johnson (US 5,664,109, issued Sept. 2, 1997) and Hacker
(US 6,988,075 B1, issued Jan. 17, 2006). See Final Act. 13–16. As for
independent claim 1, the Examiner finds Johnson teaches many of its
limitations. Id. at 14–15. Specifically, the Examiner finds Johnson teaches
receiving input data having clinical data for a patient (see id. at 14 (citing
Johnson 6:44–62, Fig. 2)) and its input data is placed into a first electronic
clinical document defined by a clinical document exchange standard (see id.
at 15 (citing Johnson 15:6–19)). The Examiner states that Johnson does not
teach communicating the first electronic clinical document to a rule-based
CDS system that (1) compares the input data with rules defined by evidence-
based medical knowledge and (2) returns at least one clinical flag in an
electronic document defined by the clinical document exchange standard
based on the comparison. The Examiner relies on Hacker in combination
with Johnson to teach these features in concluding that the claim would have
been obvious. See id. at 15–16 (citing Hacker 11:19–31).
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Appellant argues no proper combination of Johnson and Hacker
teaches or suggests an electronic document defined by a clinical document
exchange standard. See Appeal Br. 7. Appellant also argues Johnson does
not teach a clinical document exchange standard specifying a document’s
semantics. See id. Appellant further asserts the independent claims recite an
integrated medical software system that communicates a first electronic
clinical document to a rule-based CDS system such that it enables two-way
communication between the clinical module and the CDS system. Id. at 9.
Appellant argues no proper combination of Johnson and Hacker teaches a
clinical document exchange standard that enables the disputed two-way
communication. See id.

ISSUES
Under § 103(a), has the Examiner erred in rejecting claim 1 by
determining Johnson and Hacker collectively would have taught or
suggested
(A) “a first electronic clinical document defined by a clinical
document exchange standard specifying the structure and semantics of the
first electronic clinical document” (“the clinical document limitation”) and
(B)
Communicating . . . the first electronic clinical document to a
rule-based clinical decision support (CDS) system that
compares the input data with rules defined by evidence-based
medical knowledge and returns at least one clinical flag in an
electronic document defined by the clinical document exchange
standard based on the comparison

(“the clinical flag limitation”)?

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ANALYSIS
A. The Clinical Document Limitation
We begin by construing the clinical document limitation of claim 1,
which calls for the document to be “defined by a clinical document
exchange standard.” Appeal Br. 20 (Claims App’x). A claim is given its
broadest reasonable construction “in light of the specification as it would be
interpreted by one of ordinary skill in the art.” In re Am. Acad. of Sci. Tech.
Ctr., 367 F.3d 1359, 1364 (Fed. Cir. 2004) (citation omitted). We presume
that claim terms have their ordinary and customary meaning. See In re
Translogic Tech., Inc., 504 F.3d 1249, 1257 (Fed. Cir. 2007) (“The ordinary
and customary meaning ‘is the meaning that the term would have to a person
of ordinary skill in the art in question”) (citation omitted).
The Specification does not define the term “clinical document
exchange standard.” See generally Spec. At best, the disclosure describes
“a uniform clinical document exchange standard, such as the Continuity of
Care Document (CCD) standard, for specifying the structure and semantics
of electronic documents in which data is captured.” Id. ¶ 95. Our emphasis,
however, underscores that this form of a clinical document exchange
standard is merely exemplary. One ordinary meaning for “standard” is
“something established by authority, custom, or general consent as a model
or example: CRITERION” and “something set up and established by
authority as a rule for the measure of quantity, weight, extent, value, or
quality.” Standard, The Merriam-Webster Online Dictionary, available at
https://www.merriam-webster.com/dictionary/standard (defs. 3 and 4) (last
visited August 28, 2019). Accordingly, the phrase “clinical document
exchange standard,” as broadly as recited in claim 1, is a criterion or rule for
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exchanging a clinical document that is established by authority, custom, or
general consent.
Based on this construction, we agree with the Examiner that Johnson
at least suggest the disputed clinical document limitation in claim 1. See
Final Act. 15; Ans. 4–5. Specifically, the Examiner relies on Johnson’s
chosen format of a document such that the document is compatible with a
subscriber as at least suggesting the clinical document limitation. See Final
Act. 15 (citing Johnson 15:6–19). To elaborate, Johnson’s subscriber selects
a document for viewing and transmits a request for the document to a server
network (112). See Johnson 15:6–8, Figs. 1, 8. Johnson’s server network
(112), in turn, transmits the document to a client system (114) “in a version
(e.g. text or image) and a format compatible with that system’s display
capabilities.” Id. 15:8–1 (emphasis added). Because Johnson’s transmitted
document is compatible with the system’s display capabilities (e.g.,
capabilities establish criteria or rules for displaying) (see id., 15:8–13, Fig. 7
(table 718)), this teaching in Johnson at least suggests the document is
defined by a criterion or rule established by some general consent for
exchanging the document (e.g., the recited “clinical document exchange
standard”).
Johnson, then, further suggests the transmitted document (the claimed
“first electronic clinical document”) is defined by a criterion or rule for
exchanging the document that is established by custom or general consent
(the claimed “clinical document exchange standard”) and specifies a version
(the claimed “structure”) and format (the claimed “semantics”) of the
document. Id., 15:6–19. For the above reasons and contrary to Appellant’s
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contentions (see Appeal Br. 7), Johnson at least suggests the clinical
document limitation.
B. The Clinical Flag Limitation
For the clinical flag limitation, Appellant contends one of ordinary
skill in the art would understand the CDS system “returns” the clinical flag
to the integrated medical software system because the integrated medical
software system performs a function “based on the at least one clinical flag.”
Appeal Br. 9. Appellant argues, therefore, the clinical document exchange
standard provides two-way communication between a clinical module and
the CDS system. See id. We disagree.
First, claim 1 recites a communication component executed by a
processor communicates the first electronic clinical document to a CDS
system and does not address communication between the CDS and a clinical
module as argued. See id. at 20 (Claims App’x). As broadly as recited, the
CDS system returns the clinical flag to a component other than the clinical
module. Accord Final Act. 28 (finding “the claim merely recites returning
without specifying the destination. For this reason, two-way communication
is not within the scope of the claim.”).
Second, regarding the assertion that Johnson’s document is not
“sufficiently interoperable with a second system such that the second system
can compare that data to rules defined by evidence-based medical
knowledge, as recited in the claims” (Appeal Br. 8 (bolding omitted)), we
are not persuaded. Appellant does not support this assertion with persuasive
evidence why Johnson’s document would not be interoperable with a second
system. See id. Moreover, the rejection turns to Hacker in combination with
Johnson to teach the feature in the clinical flag limitation related to a
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rule-based clinical decision support (CDS) system comparing the input data
with rules defined by evidence-based medical knowledge and returning at
least one clinical flag. Final Act. 15–16 (citing Hacker 11:19–31).
Appellant does not dispute these findings and conclusion related to Hacker,
which suggests two-way communication between an integrated medical
software system and a rule-based CDS system. See Appeal Br. 8–9.
Instead, Appellant alleges features are missing from the references
individually rather than considering the proposed combination. See id. But,
such arguments regarding Johnson’s or Hacker’s alleged individual
shortcoming are unavailing. See In re Merck & Co., 800 F.2d 1091, 1097
(Fed. Cir. 1986). Nor do we find availing Appellant’s contention that
“nothing in H[acker] teaches or suggests that the system is able to check
medical records for drug interactions as long as those records are received in
a document in ‘a format compatible with [that] system’s display
capabilities.’” Appeal Br. 8 (bolding omitted) (brackets in original). Such a
contention is not commensurate with the scope of the claim. See id. at 20
(Claims App’x).
For the foregoing reasons, Appellant has not persuaded us of error in
the rejection of independent claim 1 and independent claim 31, which recites
commensurate limitations.

OBVIOUSNESS REJECTION OVER JOHNSON, HACKER, AND INGLE
Claims 2, 3, 32, and 33 are rejected under 35 U.S.C. § 103(a) as being
unpatentable over Johnson, Hacker, and Ingle (US 2002/0138524 A1,
published Sept. 26, 2002). See Final Act. 17–18.
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Claims 2 and 32
Appellant does not dispute the rejection of dependent claims 2 and 32,
only asserting dependent claims 2 and 32 are patentable based on their
dependency to claims 1 and 31. See Appeal Br. 10. Because we are not
persuaded the rejection of independent claims 1 and 31 are in error, we
sustain the rejection of dependent claims 2 and 32.
Claims 3 and 33
Claim 3 depends from claim 2 and further recites “the clinical
document exchange standard is at least one of the Clinical Document
Architecture (CDA) standard, the Continuity of Care Record (CCR)
standard, and the Continuity of Care Document (CCD) standard.” Appeal
Br. 20 (Claims App’x). Based on the record before us, we find error in the
Examiner’s rejection of dependent claim 3.
The Examiner relies on Ingle’s teaching related to the Joint
Commission on Accreditation of Healthcare Organizations (JCAHO)
standards requiring a discharge summary to teach this claim limitation. See
Final Act. 18 (citing Ingle ¶¶ 7–8). Appellant argues a JCAHO standard is
not a CDA, CCR, or CCD standard. Appeal Br. 10. We agree.
Ingle’s Background Section discloses the JCAHO is a quality
oversight body for health care organizations and managed care in the United
States. Ingle ¶ 7. According to Ingle, the JCAHO’s information
management (IM) standards IM.7 through IM.7.2 require a discharge
summary when a patient is discharged from an accredited facility. Ingle
¶¶ 6, 8. But the Examiner has not sufficiently explained how Ingle’s
JCAHO’s standards at least suggest the recited CDA, CCR, or CCD standard
in claim 3.
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Additionally, in the Examiner’s Answer, the Examiner states “there is
nothing [to] prevent any medical system from adopting and interpreting its
own CDA standard, and there is no single prevailing CDA standard in the
art.” Ans. 7. The Examiner provides insufficient evidence to support this
statement. See id. Moreover, on the record, this explanation does not assist
sufficiently in demonstrating how Ingle’s standard teaches or suggests the
CDA, CCR, or CCD standard recited in claim 3. See id.
For the foregoing reasons, Appellant has persuaded us of error in the
rejection of dependent claim 3 and dependent claim 33, which recites
commensurate limitations.

THE REMAINING OBVIOUSNESS REJECTION
Claims 6, 7, 21, 25–30, and 34–42 are rejected under 35 U.S.C.
§ 103(a) as being unpatentable over Johnson, Hacker, and McIlroy (US
5,583,758, issued Dec. 10, 1996). Final Act. 19–26.
Appellant does not dispute the remaining obviousness rejection, only
asserting these claims are patentable based on their dependency from one of
claims 1 and 31. See Appeal Br. 10. Because we are not persuaded the
rejections of independent claims 1 and 31 are in error, we sustain the
rejections of dependent claims 6, 7, 21, 25–30, and 34–42.

DECISION
Claim(s) Rejected Basis Affirmed Reversed
3, 33 § 112(b) or §
112 ¶ 2 (pre-
AIA)
3, 33
1–3, 6, 7, 21, 25–
42
§ 101 1–3, 6, 7, 21, 25–42
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1, 31 § 103 Johnson,
Hacker
1, 31
2, 3, 32, 33 § 103 Johnson,
Hacker, Ingle
2, 32 3, 33
6, 7, 21, 25–30,
34–52
§ 103 Johnson,
Hacker,
McIlroy
6, 7, 21, 25–30, 34–
42

Overall Outcome 1–3, 6, 7, 21, 25–42

AFFIRMED