U.S. patent application number 09/880735 was filed with the patent office on 2002-02-14 for multiple patient monitoring system for proactive health management.
This patent application is currently assigned to Health Hero Network. Invention is credited to Brown, Stephen J..
Application Number | 20020019748 09/880735 |
Document ID | / |
Family ID | 26849486 |
Filed Date | 2002-02-14 |
United States Patent
Application |
20020019748 |
Kind Code |
A1 |
Brown, Stephen J. |
February 14, 2002 |
Multiple patient monitoring system for proactive health
management
Abstract
A system and method for monitoring a group of patients having a
chronic disease or ongoing health condition. The method includes
the step of collecting from each patient a corresponding set of
measurements of a control parameter of the health condition. Each
set of measurements has a collection date. A control value is
calculated for each patient from the corresponding set of
measurements. The method further includes the steps of generating
and displaying a group overview chart having one data point for
each patient. Each data point indicates the control value
calculated for the corresponding patient and a time period which
has elapsed since the collection date of the patient's
corresponding set of measurements. In a preferred embodiment, the
method includes the additional steps of selecting from the group
overview chart at least one of the patients represented thereon and
transmitting supervisory instructions to the at least one selected
patient.
Inventors: |
Brown, Stephen J.;
(Woodside, CA) |
Correspondence
Address: |
BLACK LOWE & GRAHAM
816 SECOND AVE.
SEATTLE
WA
98104
US
|
Assignee: |
Health Hero Network
|
Family ID: |
26849486 |
Appl. No.: |
09/880735 |
Filed: |
June 12, 2001 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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09880735 |
Jun 12, 2001 |
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09152353 |
Sep 14, 1998 |
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6246992 |
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09152353 |
Sep 14, 1998 |
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08732158 |
Oct 16, 1996 |
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5832448 |
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Current U.S.
Class: |
705/2 |
Current CPC
Class: |
A61B 5/0002 20130101;
G06Q 10/10 20130101; G16H 40/67 20180101; G16H 40/20 20180101; G16H
15/00 20180101; G16H 10/60 20180101; G16H 50/30 20180101 |
Class at
Publication: |
705/2 |
International
Class: |
G06F 017/60 |
Claims
I claim:
1. A method for monitoring a group of patients having a health
condition, said method comprising the following steps: a)
collecting from each of said patients a corresponding set of
measurements of a control parameter of the health condition, each
said set having a corresponding collection date; b) for each of
said patients, calculating from the corresponding set of
measurements a control value indicative of the patient's control
over the health condition; c) determining for each of said patients
a time period which has elapsed since the corresponding collection
date of the corresponding set of measurements; and d) generating
and displaying a group overview chart having a plurality of data
points, wherein each of said data points represents one
corresponding patient and indicates the control value and the time
period determined for the corresponding patient.
2. The method of claim 1, further comprising the steps of: a)
selecting from said group overview chart at least one of the
patients represented thereon; and b) transmitting supervisory
instructions to the at least one selected patient.
3. The method of claim 2, wherein said supervisory instructions are
transmitted in an electronic mail message.
4. The method of claim 2, wherein said supervisory instructions are
transmitted in a telephone message.
5. The method of claim 1, further comprising the steps of
determining a compliance of each of said patients with a prescribed
measurement regimen and indicating the compliance of each of said
patients on said group overview chart.
6. The method of claim 5, wherein each of said data points is
displayed on said group overview chart as a corresponding icon, and
wherein each said icon indicates the compliance of the
corresponding patient with said prescribed measurement regimen.
7. The method of claim 1, further comprising the steps of
determining for each of said patients a completeness of the
corresponding set of measurements, the completeness being
determined relative to a prescribed measurement regimen, and
indicating on said chart the completeness of the corresponding set
of measurements.
8. The method of claim 7, wherein each of said data points is
displayed on said group overview chart as a corresponding icon, and
wherein each said icon indicates the completeness of the
corresponding set of measurements collected from the corresponding
patient.
9. The method of claim 1, wherein the step of collecting from each
of said patients the corresponding set of measurements comprises
the steps of: a) providing each of said patients with a recording
device for recording the corresponding set of measurements; b)
transmitting the recorded sets of measurements from each said
recording device to a master patient database; and c) storing the
transmitted sets of measurements in said master patient
database.
10. The method of claim 9, wherein at least one of said recording
device comprises a remote monitoring device.
11. The method of claim 9, wherein at least one of said recording
device comprises an electronic logbook.
12. The method of claim 1, wherein the control value calculated for
each of said patients comprises a mean value of the corresponding
set of measurements.
13. A system for monitoring a group of patients having a health
condition, said system comprising: a) a collection means for
collecting from each of said patients a corresponding set of
measurements of a control parameter of the health condition, each
said set having a corresponding collection date; b) a processor
means connected to said collection means for determining for each
of said patients: i) a control value calculated from the
corresponding set of measurements, the control value indicating the
patient's control over the health condition; and ii) a time period
which has elapsed since the corresponding collection date of the
corresponding set of measurements collected from the patient; said
processor means further including a chart generation means for
generating a group overview chart having a plurality of data
points, wherein each of said data points represents one
corresponding patient and indicates the control value and the time
period determined for the corresponding patient; and c) a display
means connected to said processor means for displaying said group
overview chart.
14. The system of claim 13, further comprising a selection means
connected to said processor means for selecting from said group
overview chart at least one of the patients represented thereon,
and wherein said processor means further includes an automated
response means for transmitting supervisory instructions to the at
least one selected patient.
15. The system of claim 14, wherein said automated response means
comprises an electronic mail means for transmitting said
supervisory instructions in an electronic mail message.
16. The system of claim 14, wherein said automated response means
comprises a telephone call processing means for transmitting said
supervisory instructions in a telephone message.
17. The system of claim 13, wherein said processor means further
includes means for determining a compliance of each of said
patients with a prescribed measurement regimen and wherein said
group overview chart includes means for indicating the compliance
of each of said patients with said prescribed measurement
regimen.
18. The system of claim 17, wherein said means for indicating the
compliance of each of said patients comprises a plurality of icons
displayed on said chart, each of said icons corresponding to one of
said data points and indicating the compliance of the one
corresponding patient represented by the corresponding data
point.
19. The system of claim 13, wherein said processor means further
includes means for determining for each of said patients a
completeness of the corresponding set of measurements, the
completeness being determined relative to a prescribed measurement
regimen, and wherein said group overview chart includes means for
indicating the completeness of the corresponding set of
measurements collected from each said patient.
20. The system of claim 19, wherein said means for indicating the
completeness of the corresponding set of measurements collected
from each said patient comprises a plurality of icons displayed on
said chart, each of said icons corresponding to one of said data
points and indicating the completeness of the corresponding set of
measurements collected from the one corresponding patient
represented by the corresponding data point.
21. The system of claim 13, wherein said collection means
comprises: a) a plurality of recording devices, each said recording
device recording the corresponding set of measurements for at least
one of said patients; b) a master patient database for storing each
said set of measurements recorded in said recording devices; and c)
a communication network for transmitting each said set of
measurements from said recording devices to said master patient
database.
22. The system of claim 21, wherein at least one of said recording
devices comprises a remote monitoring device.
23. The system of claim 21, wherein at least one of said recording
devices comprises an electronic logbook.
24. The system of claim 13, wherein the control value calculated
for each said patient comprises a mean value of the corresponding
set of measurements collected from the patient.
25. A method for monitoring a group of patients having a health
condition, said method comprising the following steps: a)
collecting from each of said patients at least one corresponding
set of measurements of a control parameter of the health condition,
each said set having a corresponding collection date; b) for each
of said patients, calculating from the at least one corresponding
set of measurements a control value indicative of the patient's
control over the health condition; c) determining for each of said
patients a time period which has elapsed since the corresponding
collection date of a set of measurements most recently collected
from the patient; and d) generating and displaying a group overview
chart having a plurality of data points, wherein each of said data
points represents one corresponding patient and indicates the
control value and the time period determined for the corresponding
patient; e) selecting from said group overview chart at least one
of the patients represented thereon; and f) transmitting
supervisory instructions to the at least one selected patient.
26. The method of claim 25, wherein said supervisory instructions
are transmitted in an electronic mail message.
27. The method of claim 25, wherein said supervisory instructions
are transmitted in a telephone message.
28. The method of claim 25, further comprising the steps of
determining a compliance of each of said patients with a prescribed
measurement regimen and displaying each of said data points on said
group overview chart as a corresponding icon, wherein each said
icon indicates the compliance of the corresponding patient with
said prescribed measurement regimen.
29. The method of claim 25, further comprising the steps of
determining for each of said patients a completeness of the
corresponding set of measurements most recently collected from the
patient, the completeness being determined relative to a prescribed
measurement regimen, and displaying each of said data points on
said group overview chart as a corresponding icon, wherein each
said icon indicates the completeness of the corresponding set of
measurements most recently collected from the corresponding
patient.
30. The method of claim 25, wherein the step of collecting from
each of said patients the at least one corresponding set of
measurements comprises the steps of: a) providing each of said
patients with a recording device for recording the at least one
corresponding set of measurements; b) transmitting the recorded
sets of measurements from each said recording device to a master
patient database; and c) storing the transmitted sets of
measurements in said master patient database.
31. The method of claim 30, wherein each said recording device
comprises a remote monitoring device.
32. The method of claim 30, wherein each said recording device
comprises an electronic logbook.
33. The method of claim 27, wherein the control value calculated
for each said patient comprises a mean value of the at least one
corresponding set of measurements collected from the patient.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation-in-part of copending
patent application 08/732,158 filed 10/16/96, which is herein
incorporated by reference.
BACKGROUND
[0002] 1. Field of the Iinvention
[0003] The present invention relates generally to computer systems
for managing healthcare, and in particular to a system and method
for proactively monitoring a group of patients having a chronic
disease or ongoing health condition.
[0004] 2. Description of Prior Art
[0005] Managing a chronic disease or ongoing health condition
requires the monitoring and controlling of a physical or mental
parameter of the health condition. Examples of these parameters
include blood glucose in diabetes, respiratory flow in asthma,
blood pressure in hypertension, cholesterol in cardiovascular
disease, weight in eating disorders, T-cell or viral count in HIV,
and frequency or timing of episodes in mental health disorders.
Because of the continuous nature of these health conditions, their
corresponding parameters must be monitored and controlled on a
regular basis by the patients themselves outside of a medical
clinic.
[0006] Typically, the patients monitor and control these parameters
in clinician assisted self-care or outpatient treatment programs.
While these outpatient treatment programs offer significant
advantages for patients and healthcare providers, they present the
assisting clinician with two problems in effectively managing the
medical priorities of his or her patients.
[0007] The first problem is in determining each patient's current
medical status. Since the patients themselves monitor their health
conditions, the clinician is often limited to learning each
patient's status strictly through patient initiated events, such as
an emergency visit or the delivery of the patient's latest medical
data. Even with the current availability of remote monitoring
devices that store and transmit medical data from a patient's home
to a clinic, the clinician must still wait for medical information
whose arrival depends on the patient's initiative.
[0008] As a result, the majority of the clinician's time is spent
with the patients who are the most motivated and eager for a
response, while the greatest medical needs remain with the
unmotivated patients who do not visit the clinician or transmit
their medical data. These unmotivated patients often develop urgent
medical needs that could have been prevented with proper medical
management. Consequently, the cost of treating their chronic health
conditions is much higher than one might expect given the
sophistication of current medical monitoring devices.
[0009] The second problem is in determining which patients are
having the greatest difficulty in controlling their health
condition so that the clinician may focus attention on these
patients. Unfortunately, most existing healthcare information
systems are only designed to display medical data on an individual
patient basis. Few systems have been developed that enable
clinician
[0010] 's to view medical data for an entire group of patients
simultaneously. Consequently, it is extremely difficult for a
clinician to prioritize his or her time and efforts in a manner
that optimizes care and minimizes costs and complications for the
entire group of patients.
[0011] Many systems have been developed for remote monitoring of a
group of patients. For example , U.S. Pat. No. 5,357,427 issued to
Langen et al. on Oct. 18, 1994 describes a system for simultaneous
remote monitoring of a group of high risk patients using artificial
intelligence. The system includes for each patient a remote
monitoring device, such as a blood pressure cuff, glucometer, etc.
The remote monitoring device is connected to a telemedical
interface box which transmits monitored data over a telephone line
to a data recording system. Data is also collected from each
patient using an artificial intelligence program that asks the
patient questions through a telephone. A computer is connected to
the recording system to display individual patient messages
indicating a current symptom of one of the patients.
[0012] Although Langen's system does allow simultaneous monitoring
of a group of patient's, it lacks a display mechanism for
simultaneously displaying summary data for the entire group of
patients. Langen's system also lacks a mechanism for indicating
which patients have been out of contact with the clinician and
therefore have an unknown current medical status. Consequently,
Langen's system is ineffective in aiding the clinician to
prioritize his or her time and efforts in managing the medical
priorities of an entire group of patients.
[0013] Another medical monitoring system designed to monitor a
group of patients is disclosed in U.S. Pat. No. 5,331,549 issued to
Crawford on Jul. 19, 1994. Crawford's system includes a plurality
of vital signs monitors for monitoring a plurality of patients,
each monitor providing continuous data to a central server. A
supervisory screen is connected to the server to display a normal
status or varying levels of alarm status of the vital signs of
individual patients. The system permits an overview display of a
hospital floor as well as a zoom in display of an individual
patient site. The system further provides a warning alarm signal
when any one or more vital signs of an individual patient is
outside of a predetermined limit.
[0014] While Crawford's system does allow simultaneous viewing of
the vital sign status of each patient in a group, it is only
directed at monitoring a group of patients who are continually
connected to their vital sign monitors. Crawford's overview screen
lacks any mechanism for indicating which patients have been out of
contact with a clinician since continual contact is assumed.
[0015] Further, the summary data presented for each patient on the
overview screen is limited to an indication of a normal state or
alarm state of each patient's vital signs. Consequently, the system
only allows a clinician to determine which patients are having the
greatest difficulty in controlling their health condition when an
actual emergency situation exists. Thus, Crawford's system is
effective as a medical alarm system, but of little use to a
clinician in managing the medical priorities of a group of patients
who are not continually monitored in a healthcare facility.
OBJECTS AND ADVANTAGES OF THE INVENTION
[0016] In view of the above, it is an object of the present
invention to provide a multiple patient monitoring system that
allows a clinician to view and manage the medical priorities of an
entire group of patients having a chronic health condition. It is
another object of the invention to provide a multiple patient
monitoring system that allows a clinician to communicate
proactively with unmotivated patients who have lost contact with
the clinician. A further object of the invention is to provide a
multiple patient monitoring system that allows a clinician to
optimize efforts and minimize costs in managing the medical needs
of the entire group of patients.
[0017] These and other objects and advantages will become more
apparent after consideration of the ensuing description and the
accompanying drawings.
SUMMARY OF THE INVENTION
[0018] The invention presents a system and method for monitoring a
group of patients having a chronic disease or ongoing health
condition. The method includes the step of collecting from each
patient a corresponding set of measurements of a control parameter
of the health condition. Each set of measurements has a
corresponding collection date. For each patient, a control value is
calculated from the corresponding set of measurements, the control
value indicating the patient's control over the health condition.
In the preferred embodiment, the control value calculated for each
patient comprises a mean value of the patient's corresponding set
of measurements.
[0019] The method also includes the step of determining for each
patient a time period which has elapsed since the collection date
of the patient's corresponding set of measurements. The method
further includes the steps of generating and displaying a group
overview chart having a plurality of data points. Each of the data
points on the chart represents one corresponding patient and
indicates the control value and the time period determined for the
corresponding patient.
[0020] In the preferred embodiment, the method includes the
additional steps of selecting from the group overview chart at
least one of the patients represented thereon and transmitting
supervisory instructions to the at least one selected patient. In
one embodiment, the supervisory instructions are transmitted in an
electronic mail message. In another embodiment, the supervisory
instructions are transmitted in an automated telephone message.
[0021] A preferred system for implementing the method of the
invention includes a plurality of recording devices, such as remote
monitoring devices or electronic logbooks, for recording the
corresponding set of measurements for each patient. The system also
includes a master patient database for receiving and storing each
set with a corresponding collection date. A communication network
connects the recording devices to the master patient database and
transmits the recorded sets of measurements therebetween.
[0022] A processor is connected to the database for determining for
each of the patients the control value and time period elapsed
since the collection date of the patient's corresponding set of
measurements. The processor further includes a chart generation
application for generating the group overview chart. A display is
connected to the processor for displaying the group overview
chart.
[0023] In the preferred embodiment, a selection device, such as a
mouse or keyboard, is connected to the processor for selecting from
the group overview chart at least one of the patients represented
thereon. In this embodiment, the processor further includes an
automated response application for transmitting supervisory
instructions to the at least one selected patient. In one
embodiment, the automated response application comprises a mail
merge application for generating and transmitting the supervisory
instructions in an electronic mail message. In another embodiment,
the automated response application comprises an automated telephone
call processing application for transmitting the supervisory
instructions in a telephone message.
BRIEF DESCRIPTION OF THE DRAWINGS
[0024] FIG. 1 is a schematic block diagram of a multiple patient
monitoring system according to the invention.
[0025] FIG. 2 is a schematic block diagram illustrating the
collecting of data from each patient according to the
invention.
[0026] FIG. 3 is a sample group overview chart according to the
invention.
[0027] FIGS. 4-5 are sample electronic mail messages containing
supervisory instructions for a patient.
[0028] FIG. 6 is a flow chart illustrating steps included in the
method of the invention.
[0029] FIG. 7 is a schematic block diagram of another multiple
patient monitoring system according to the invention.
[0030] FIG. 8 is a sample telephone message containing supervisory
instructions for a patient.
DESCRIPTION
[0031] A preferred embodiment of the invention is illustrated in
FIGS. 1-6. FIG. 1 shows the main components of a system for
monitoring a group of patients having an ongoing health condition.
A healthcare clinic 10 has a clinic server computer 12 that
includes a mail merge application 14, a mail server application 16,
a master patient database 18, and a patient overview application
20. Mail merge application 14 is designed to generate electronic
mail messages containing supervisory instructions to selected
patients in the group, as will be explained in the operation
section below. Mail server application 16 is a conventional
electronic mail server designed to transmit the generated
electronic mail messages to the selected patients.
[0032] Master patient database 18 is for storing patient data
relating to each patient managed by clinic 10. Overview application
20 is a controlling software application for performing various
calculations using the patient data stored in master patient
database 18 and for generating a group overview chart with the
patient data, as will be explained in detail below. Clinic server
12 is coupled to a modem M1 for connecting server 12 to a
communication network 34, preferably a public telephone network or
similar data transmission network.
[0033] A clinician workstation 22 is networked to clinic server 12.
Clinician workstation 22 is preferably a personal computer or
network terminal. Workstation 22 has a display 24 for displaying to
a clinician 30 a group overview chart 26. Workstation 22 further
includes a user selection device 28, such as a mouse or keyboard,
for selecting patients represented on group overview chart 26 to
receive supervisory instructions from clinician 30.
[0034] patient unit 38 for receiving electronic mail messages from
mail server 16 is located at a first patient site 36, typically the
patient's home. Patient unit 38 includes a message display 40 for
displaying the electronic mail messages. In the preferred
embodiment, patient unit 38 is a personal computer having a display
monitor. However, in alternative embodiments, patient unit 38 may
be any information processing and display unit, such as a network
terminal, a television set with a set-top cable converter box, a
personal digital assistant, or a video game system. Patient unit 38
is connected to a modem M2 such that patient unit 38 is networked
to communication network 34.
[0035] A recording device, such as a remote monitoring device 42,
is also connected to modem M2. Device 42 is for collecting from a
first patient 44 a corresponding set of measurements of a control
parameter of the patient's health condition, such as blood glucose
levels for a diabetic patient, peak flow rates for an asthmatic
patient, or blood pressure for a hypertension patient. Device 42 is
capable of recording each measurement in the set with a
corresponding measurement date and measurement time. Device 42 is
designed to record the set of measurements and transmit the
recorded set to database 18 through communication network 34. Such
monitoring devices for recording and transmitting measurements of a
parameter of a health condition are well known in the art.
[0036] A second patient site 46 includes the same equipment as
first patient site 36, with the exception of the recording device
used by a second patient 49. The recording device at second patient
site 46 is an electronic logbook 48 for recording a corresponding
set of measurements entered in logbook 48 by second patient 49.
Logbook 48 is capable of recording each measurement in the set with
a corresponding measurement date and measurement time. Logbook 48
is designed to transmit the set of measurements recorded therein to
database 18 through communication network 34. Such electronic
logbooks for recording and transmitting data are well known in the
art. The use of logbook 48 to record and transmit patient data
enables those patients with mental health conditions or other
condition whose control parameters may not be physically measured
to participate in the patient monitoring system.
[0037] For simplicity of illustration, only two patient sites and
two corresponding patients are shown in FIG. 1. It is obvious that
the system of the invention may be effectively used to monitor a
great number of patients. In a typical implementation, hundreds of
patient sites are connected to clinic server 12 via communication
network 34.
[0038] FIG. 2 is a schematic block diagram illustrating the data
which is collected from each patient and stored in master patient
database 18. The data collected from each patient includes at least
one corresponding set of measurements 50 of the control parameter
of the health condition. Each set of measurements 50 includes at
least one measurement 52. Each measurement 52 includes a measured
control parameter value 54, such as a blood glucose level for a
diabetic patient, a peak flow rate for an asthmatic patient, or a
blood pressure reading for a hypertension patient. Each measurement
52 further includes a measurement date 56 and a measurement time
58.
[0039] The actual number of measurements in each set varies in
dependence upon the nature of the health condition being monitored
and the duration of time over which the measurements are recorded.
For example, diabetic patients typically measure their blood
glucose levels several times per day, so that these patients
preferably record 20 to 40 measurements in a typical week of
monitoring. However, hypertension patients may only be required to
measure their blood pressure once a week, so that these patients
would record only one measurement in a typical week of
monitoring.
[0040] Each set of measurements 50 is transmitted to database 18.
Database 18 stores patient records 60 for each patient
participating in the monitoring system. Each patient's records
include patient information 62 comprising a patient name, a patient
telephone number, and a patient electronic mail address. Each
patient's records also include each corresponding set of
measurements 50 received from the patient. Each set 50 has a
corresponding collection date 64.
[0041] In the preferred embodiment, collection date 64 is the date
the corresponding set of measurements are received by clinic server
12. In an alternative embodiment, collection date 64 is the date
the corresponding set of measurements are transmitted to the
clinic. In another embodiment, collection date 64 is the
measurement date 56 of a most recent measurement in the
corresponding set of measurements.
[0042] Overview application 20 is designed to perform various
calculations and comparisons using the patient data stored in
database 18. First, overview application 20 is designed to
calculate a control value for each patient from the patient's at
least one corresponding set of measurements. Each control value
indicates the corresponding patient's control over the health
condition. In the preferred embodiment, the control value
calculated for each patient is a mean value of the control
parameter values recorded by the patient over a preselected period
of time. In an alternative embodiment, the control value calculated
for each patient is a mean value of the control parameter values in
a set of measurements most recently collected from the patient.
[0043] The preselected period of time used to calculate the control
value varies in dependence upon the nature of the patient's health
condition. For example, a useful period of time for calculating a
mean blood glucose value for diabetes patients is typically one
week, while a useful period of time for calculating a mean daily
number of panic attacks for phobic patients is typically two weeks.
The actual period of time used to calculate the control value is
preselected and programmed in overview application 20 according to
guidelines prescribed by the clinician.
[0044] Second, overview application 20 is designed to determine for
each patient a time period which has elapsed since the collection
date of the set of measurements most recently collected from the
patient. For example, if a patient has only transmitted to the
clinic one set of measurements, overview application 20 determines
the time that has elapsed since the collection date of the one set.
If a patient has transmitted to the clinic multiple sets of
measurements, overview application 20 determines the time that has
elapsed since the most recent collection date.
[0045] Third, overview application 20 is designed to determine the
compliance of each patient with a clinician prescribed measurement
regimen. The prescribed measurement regimen preferably includes
prescribed measurement dates and prescribed measurement times. To
determine the compliance of each patient, overview application 20
compares each patient's actual measurement dates and times with the
prescribed measurement dates and times.
[0046] For example, it is usually important that a diabetic patient
measure his or her fasting blood glucose level every morning before
breakfast. Thus one prescribed measurement time for a diabetes
patient is 7 am, or similar pre-breakfast time. Overview
application 20 compares the diabetes patient's actual measurement
times with the prescribed pre-breakfast time to ensure that the
patient is complying with the measurement regimen. of course, many
other prescribed measurement regimens are possible and are selected
according to guidelines provided by the clinician.
[0047] In the preferred embodiment, the prescribed measurement
regimen also includes a prescribed number of measurements to be
taken by the patient over a prescribed time period. Overview
application 20 is further capable of determining a completeness of
each set of measurements relative to the prescribed measurement
regimen.
[0048] Continuing with the example of the diabetic patient, a
typical prescribed measurement regimen requires 3 measurements of
the patient's blood glucose level per day. In this example,
overview application 20 compares the actual number of measurements
recorded by the patient on each measurement date to the three
prescribed measurements per day to determine the completeness of
the set. Specific techniques for writing and implementing an
overview application that performs the calculations and comparisons
described above are well known in the art.
[0049] Overview application 20 is further capable of generating
group overview chart 26. FIG. 3. illustrates a sample group
overview chart generated for a group of ten diabetes patients.
Chart 26 has ten data points, each data point representing one
corresponding patient and indicating the control value calculated
for the patient and the time period elapsed since the patient's
most recent collection date. In the preferred embodiment, each data
point is represented on chart 26 by a corresponding icon 66.
[0050] Each icon 66 indicates the compliance of the corresponding
patient with the prescribed measurement regimen. A chart key 68 is
provided on chart 26 to explain the significance of each icon's
appearance. Non-compliant patients are represented by flashing
icons, while compliant patients are represented by non-flashing
icons. In FIG. 3, the flashing icons having dotted borders, while
the non-flashing icons have solid borders. In an alternative
embodiment, noncompliant patients are represented by icons having a
first color, while compliant patients are represented by icons
having a second color.
[0051] Each icon 66 further indicates the completeness of the set
of measurements most recently collected from the corresponding
patient. Patients having complete sets are represented by filled
icons, while patients having sparse sets are represented by blank
icons. Of course, in alternative embodiments, the appearance of
each icon 66 may be varied in alternative ways to indicate the
compliance of the corresponding patient and the completeness of the
corresponding patient's measurements.
[0052] Chart 26 further includes a list box 70, a print list button
74, and a send message button 76. List box 70 is for displaying a
list of names of the patients selected from chart 26 by the
clinician. The icons corresponding to the selected patients are
highlighted, as represented by dotted circles 72. Print list button
74 is for sending the list of names to a printer (not shown) to
obtain a print out of the list. Send message button 76 is for
transmitting the list to mail merge application 14.
[0053] Referring to FIG. 4, mail merge application 14 is designed
to generate for each selected patient a corresponding electronic
mail message 78. Each message 78 contains supervisory instructions
for the corresponding patient. Mail merge application 14 is capable
of customizing each message 7
[0054] 8 to include for the corresponding patient, the patient's
name, the patient's electronic mail address, and the collection
date of the patient's most recent set of measurements. The
programming of a mail merge application to generate customized
messages in this manner is well known in the art. FIG. 5
illustrates an alternative message 80 containing different
instructions for each patient. Of course, messages containing many
other instructions are possible in alternative embodiments.
[0055] The operation of the preferred embodiment is illustrated in
FIG. 6. FIG. 6 is a flow chart showing a preferred method of using
the system to monitor a group of patients having a health
condition. Each patient is provided with a corresponding recording
device, such as remote monitoring device 42 or electronic logbook
48. In step 200, each patient records in his or her recording
device at least one corresponding set of measurements 50 of a
control parameter of the health condition. In step 202, the
recorded sets of measurements are transmitted from each recording
device to database 18 through network 34. Each set of measurements
is stored in database 18 with its corresponding collection date 64,
step 204.
[0056] In step 206, overview application 20 calculates for each
patient a control value from the patient's corresponding set of
measurements. Next, application 20 determines the compliance of
each patient with the prescribed measurement regimen by comparing
the actual measurement times of the patient's corresponding
measurements to the prescribed measurement times in the measurement
regimen, step 208.
[0057] In step 210, application 20 determines for each patient the
completeness relative to the prescribed measurement regimen of the
corresponding set of measurements most recently collected from the
patient. Application 20 then determines for each patient the time
period which has elapsed since the corresponding collection date 64
of the set of measurements most recently collected from the
patient, step 212.
[0058] Next application 20 generates group overview chart 26, step
214. In step 216, chart 26 is displayed on display 24, as shown in
FIG. 3. Each data point on chart 26 is displayed as a corresponding
icon 66. Each data point represents one corresponding patient and
indicates the control value and the elapsed time period determined
for the corresponding patient.
[0059] Each icon 66 indicates the compliance of the corresponding
patient with the prescribed measurement regimen. Each icon 66
further indicates the completeness of the corresponding set of
measurements most recently collected from the corresponding
patient. Thus chart 26 allows clinician 30 to easily determine
which patients in the group have been out of contact with clinic
10, which patients are having the greatest difficulty in
controlling the health condition, and which patients are having
difficulty complying with the prescribed treatment plan.
[0060] Next, clinician 30 uses selection device 28 to select from
chart 26 at least one of the patients represented thereon, step
218. Typically, selection device 28 is a mouse or similar pointing
device, and clinician 30 selects patients from chart 26 by clicking
the icon corresponding to the patient. As clinician 30 selects each
patient, list box 78 displays the name of each selected patient.
Next clinician 30 selects send message button 76 to transmit the
list of selected patients to mail merge application 14.
[0061] Application 14 generates for each selected patient
corresponding electronic mail message 78. Each message 78 contains
supervisory instructions for the corresponding patient. Mail merge
application 14 customizes each message 78 to include for the
corresponding patient, the patient's name, the patient's electronic
mail address, and the collection date of the patient's most recent
set of measurements. In step 220, mail server application 16
transmits each message 78 through network 34 to the corresponding
patient. When the patients receive the supervisory instructions,
they continue the monitoring loop with clinician 30, step 226, by
returning to step 200 and repeating the method described.
[0062] The advantage of the multiple patient monitoring system of
the preferred embodiment is that it allows the clinician to view
and manage the medical priorities of an entire group of patients
simultaneously. It also allows the clinician to communicate
proactively with unmotivated patients who have lost contact with
the clinician before these patients develop urgent medical needs.
Consequently, the system allows the clinician to optimize efforts
and minimize costs in managing the care of the entire group of
patients.
[0063] A second embodiment of the invention is shown in FIGS. 7-8.
The second embodiment differs from the preferred embodiment in the
method of transmitting supervisory instructions to each patient
selected from chart 26. Referring to FIG. 7, clinic server 12
includes an automated telephone call processing application 82 in
place of mail merge application 14 and mail server application 16.
Call processing application 82 is designed to generate for each
selected patient a corresponding automated telephone message 88, as
shown in FIG. 8. Each message 88 contains supervisory instructions
for the corresponding patient.
[0064] Application 82 is capable of customizing each message 88 to
include for the corresponding patient the patient's name and the
collection date of the patient's most recent set of measurements.
The programming of an automated call processing application to
generate customized messages in this manner is well known in the
art. Referring again to FIG. 7, clinic server 12 is connected to a
telephone network 84 through a digital/tone signal converter Dl.
Each patient is provided with a dual tone multi-frequency telephone
86. Each telephone 86 is connected to telephone network 84 to
receive automated telephone messages from clinic server 12.
[0065] The operation of the second embodiment differs from the
operation of the preferred embodiment in that supervisory
instructions are transmitted to the selected patients in automated
telephone messages rather than in electronic mail messages.
Otherwise, the operation and advantages of the second embodiment
are identical to those of the preferred embodiment described
above.
SUMMARY, RAMIFICATIONS, AND SCOPE
[0066] Although the above description contains many specificities,
these should not be construed as limitations on the scope of the
invention but merely as illustrations of the presently preferred
embodiment. Many other embodiments of the invention are possible.
For example, in one alternative embodiment, each software
application located on the clinic server is loaded onto the
clinician workstation, and the clinic server is eliminated from the
system. The clinic server is presently preferred for performing
resource intensive operations, such as storing large amounts of
patient data, but the clinic server is not necessary to enable the
system and method of the invention- In embodiments that include the
clinic server, the clinic server need not be physically located at
the clinic. The server may be located off-site and networked to the
clinician computer.
[0067] Additionally, the preferred embodiment describes the use of
remote monitoring devices and electronic logbooks for collecting
data from each patient. However, many other methods of collecting
data from patients are possible in alternative embodiments. For
example, the patients could be provided with a paper based logbook
and an automated reader for digitizing and transmitting the logbook
information to the patient database. Alternatively, each patient
could mail or fax the logbook information to the clinic for entry
into the patient database. In another embodiment, the patients use
DTMF telephones to connect to the patient database and enter their
data through the telephone keypads.
[0068] Further, the electronic mail messages and automated
telephone message illustrated are exemplary of just one possible
embodiment of the invention. Many other messages may be generated
and transmitted to patients in alternative embodiments.
Additionally, the preferred embodiment describes a system and
method for monitoring patients having diabetes. However, the
invention is not limited to monitoring diabetic patients. The
system and method described are equally effective for monitoring
patients having asthma, hypertension, cardiovascular disease,
eating disorders, HIV, mental health disorders, or any other health
condition having a measurable control parameter.
[0069] Therefore the scope of the invention should be determined
not by the examples given but by the appended claims and their
legal equivalents.
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