U.S. patent application number 09/970506 was filed with the patent office on 2002-04-18 for electronic medical records system.
Invention is credited to Evans, Jae A..
Application Number | 20020046346 09/970506 |
Document ID | / |
Family ID | 24896891 |
Filed Date | 2002-04-18 |
United States Patent
Application |
20020046346 |
Kind Code |
A1 |
Evans, Jae A. |
April 18, 2002 |
Electronic medical records system
Abstract
A medical records system that creates and maintains all patient
data electronically. The system captures patient data, such as
patient complaints, lab orders, medications, diagnoses, and
procedures, at its source at the time of entry using a graphical
user interface having touch screens. Using pen-based portable
computers with wireless connections to a computer network,
authorized healthcare providers can access, analyze, update and
electronically annotate patient data even while other providers are
using the same patient record. The system likewise permits instant,
sophisticated analysis of patient data to identify relationships
among the data considered. Moreover, the system includes the
capability to access reference databases for consultation regarding
allergies, medication interactions and practice guidelines. The
system also includes the capability to incorporate legacy data,
such as paper files and mainframe data, for a patient.
Inventors: |
Evans, Jae A.; (Carlsbad,
CA) |
Correspondence
Address: |
KNOBBE MARTENS OLSON & BEAR LLP
620 NEWPORT CENTER DRIVE
SIXTEENTH FLOOR
NEWPORT BEACH
CA
92660
US
|
Family ID: |
24896891 |
Appl. No.: |
09/970506 |
Filed: |
October 3, 2001 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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09970506 |
Oct 3, 2001 |
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09628390 |
Aug 1, 2000 |
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09628390 |
Aug 1, 2000 |
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09333170 |
Jun 14, 1999 |
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09333170 |
Jun 14, 1999 |
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08721182 |
Sep 27, 1996 |
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Current U.S.
Class: |
726/3 ; 705/3;
707/999.009 |
Current CPC
Class: |
Y10S 707/99931 20130101;
G16H 50/70 20180101; G16H 80/00 20180101; G16H 10/65 20180101; G16H
10/60 20180101; G16H 20/10 20180101; G16H 40/67 20180101; Y10S
707/99933 20130101 |
Class at
Publication: |
713/200 ; 707/9;
705/3 |
International
Class: |
H04L 009/32; G06F
012/14 |
Claims
What is claimed is:
1. A medical records system, comprising: a point of care system to
capture patient data at a point of care wherein the point of care
system comprises: a patient data capture to enter information
provided by a patient; a clinical data capture, in data
communication with the patient data capture, to enter clinical data
for the patient; an encounter data capture, in data communication
with the patient data capture, to enter diagnoses and procedures
administered to the patient; progress notes, in data communication
with the patient data capture, the clinical data capture and the
encounter data capture, to enter information related to changes in
the patient's condition; a patient data repository, in
communication with the point of care system and with external
systems, to store and organize the patient data for access by the
point of care system; a medication data capture, in data
communication with the patient data capture and the progress notes,
to enter medication information for the patient; and a practice
guideline for reference to accepted medical practices, wherein the
practice guideline communicates with the patient data capture, the
clinical data capture, the progress notes and the encounter data
capture.
2. A medical records system, comprising: a point of care system to
capture patient data at a point of care; and a patient data
repository, in communication with the point of care system and with
external systems, to store and organize the patient data for access
by the point of care system, wherein the patient data repository
comprises: a patient locator having a patient identifier; a data
manager, in communication with the patient locator, to organize
patient data for storage and retrieval using the patient
identifier; a data interface, in communication with the data
manager, to transmit patient data to external systems and to
receive patient data from the external systems; a cache, in
communication with the data manager, to temporarily store the
patient data for retrieval, wherein the cache is located on a
server computer, and wherein the cache is distributed across a
computer network; and a data archive, in communication with the
cache, to permanently store the patient data.
3. The medical records system of claim 2, wherein the data archive
comprises a jukebox having at least one storage device.
4. The medical records system of claim 3, wherein the at least one
storage device is a recordable optical disk.
5. The medical records system of claim 3, wherein the at least one
storage device is a magnetic disk drive.
6. The medical records system of claim 2, wherein the data
interface comprises: a communication interface to send and receive
patient data from external systems; an interface manager, in
communication with the communication interface, to set the
communication interface for either transmission or receipt of the
patient data from the external systems; and a data handler, in
communication with the interface manager and with the communication
interface, to convert selected patient data into a selected data
format.
7. A medical records system comprising: a point of care system to
capture patient data at a point of care wherein the patient data
includes clinical data and progress notes; a patient data
repository, in communication with the point of care system and with
external systems, to store and organize the patient data for access
by the point of care system; and a reference database in
communication with the point of care system, wherein the reference
database comprises: a diagnosis module having diagnosis codes
indicative of a condition of a patient; a procedure module, in
communication with the diagnosis module, having procedure codes
indicative of a treatment to administer to the patient; and a
medication manager, in communication with the diagnosis module and
with the procedure module, having information on medication to
administer to the patient.
8. A medical records system comprising: a point of care system to
capture patient data at a point of care; a patient data repository,
in communication with the point of care system and with external
systems, to store and organize the patient data for access by the
point of care systems; and a legacy data system in communication
with the patient data repository, wherein the legacy data system
comprises: a data source having patient data, wherein the data
source comprises physical data, and wherein the data source
comprises a computer network having electronically stored patient
data; and a converter, in communication with the data source, to
convert the patient data into a selected format for transfer to the
patient data repository.
9. The medical records system of claim 8, wherein the converter
comprises a scanner.
10. A medical records system, comprising: a point of care system to
capture patient data at a point of care wherein the point of care
system provides for annotation of the patient data, wherein the
annotation acknowledges review of the patient data, and wherein the
annotation includes instructions for patient care; and a patient
data repository, in communication with the point of care system and
with external systems, to store and organize the patient data for
access by the point of care system.
11. The medical records system of claim 10, wherein the annotation
indicates approval.
12. A method of using an electronic medical records system,
comprising: capturing patient data electronically at the point of
care; organizing the patient data so as to form a patient record;
filing the patient record; retrieving the patient record to access
the patient data for use in the care of a patient, wherein
retrieving the patient record includes annotating the patient data;
and evaluating the patient data so as to make a diagnosis.
13. The method of claim 12, wherein evaluating the patient data
comprises consulting a diagnosis module to review diagnosis
information.
14. The method of claim 12, further comprising prescribing a
medication.
15. The method of claim 14, wherein prescribing a medication
comprises consulting a medication manager to review medication
information.
16. The method of claim 12, further comprising administering a
treatment.
17. The method of claim 16, wherein administering a treatment
comprises consulting a procedure module to review procedures to
administer the treatment.
18. A method of retrieving patient data in an electronic medical
records system having a patient data repository, comprising:
obtaining a patient identifier; locating a patient record
corresponding to the patient identifier in the patient data
repository, wherein the patient data repository includes a cache
and a data archive; determining the location of the patient data
within the patient record; and delivering the patient data.
19. The method of claim 18, further comprising delivering the
patient data when the patient data is located in the cache.
20. The method of claim 18, further comprising: moving the patient
data from the data archive when the patient data is not located in
the cache; and delivering the patient data.
21. A method of communicating with an external source having an
interface to an electronic medical records system, comprising:
finding an interface for the external source; connecting to the
external source using the interface; and converting patient data
for transfer between the external source and the electronic medical
records system, wherein converting patient data for transfer
comprises converting patient data for transfer from the electronic
medical records system to the external source, and wherein
converting patient data for transfer also comprises converting
patient data for transfer from the external source to the
electronic medical records system.
22. A program storage device storing instructions that when
executed perform the method, comprising: capturing patient data
electronically at the point of care; organizing the patient data so
as to form a patient record; filing the patient record; and
retrieving the patient record to access the patient data for use in
the care of a patient.
Description
RELATED APPLICATIONS
[0001] This application is a continuation of and incorporates by
reference, U.S. patent application Ser. No. 09/628,390, filed
August. 2000, which is a continuation of application Ser. No.
09/333,170, filed Jun. 14, 1999, now abandoned, which is a
continuation of U.S. Pat. No. 5,924,074, filed Sep. 27, 1996,
issued Jul. 13, 1999.
BACKGROUND OF THE INVENTION
[0002] 1. Field of the Invention
[0003] The present invention relates to electronic healthcare
systems, and more particularly, to a system for storage and
retrieval of electronic medical records in a computer environment,
such as a local or wide area network including portable
computers.
[0004] 2. Description of Related Technology
[0005] Healthcare providers, such as physicians, create large
volumes of patient information during the course of their business
at healthcare facilities, such as hospitals, clinics, laboratories
and medical offices. For example, when a patient visits a physician
for the first time, the physician generally creates a patient file
including the patient's medical history, current treatments,
medications, insurance and other pertinent information. This file
generally includes the results of patient visits, including
laboratory test results, the physician's diagnosis, medications
prescribed and treatments administered. During the course of the
patient relationship, the physician supplements the file to update
the patient's medical history. When the physician refers a patient
for treatment, tests or consultation, the referred physician,
hospital, clinic or laboratory typically creates and updates
similar files for the patient. These files may also include the
patient's billing, payment and scheduling records.
[0006] Healthcare providers can use electronic data processing to
automate the creation, use and maintenance of their patient
records. For example, in U.S. Pat. No. 5,277,188, assigned to New
England Medical Center Hospitals, Inc., Selker discloses a clinical
information reporting system having an electronic database
including electrocardiograph related patient data. Similarly,
Schneiderman discloses a computer system for recording
electrocardiograph and/or chest x-ray test results for a database
of patients in U.S. Pat. No. 5,099,424. In U.S. Pat. No. 4,315,309,
Coli discloses a patient report generating system for receiving,
storing and reporting medical test data for a patient population.
Mitchell, in U.S. Pat. No. 3,872,448, likewise discloses a system
for automatically handling and processing hospital data, such as
patient information and pathological test information using a
central processing apparatus. In U.S. Pat. No. 5,065,315, Garcia
discloses a computerized scheduling and reporting system for
managing information pertinent to a patient's stay in the hospital.
However, these electronic data processing systems can not handle
patient data in the wide variety of data formats typically produced
by healthcare providers, such as physicians, laboratories, clinics
and hospitals.
[0007] Physicians often use paper based forms and charts to
document their observations and diagnosis. Laboratories also
produce patient data in numerous forms, from x-ray and magnetic
resonance images to blood test concentrations and
electrocardiograph data. Clinics and hospitals may use a
combination of paper based charts and electronic data for patient
records. The same patient data may exist in remote patient files
located at clinics, hospitals, laboratories and physicians'
offices. Similarly, patient files at one healthcare provider
typically have different information than patient files at another
healthcare provider. When in use, patient files are generally not
available to other healthcare providers. In addition, at the time
of creation, patient data is generally not available for use by
remotely located healthcare providers. Moreover, relationships
among specific patient data, such as abnormal laboratory test
results, prescribed medications to address the abnormality, and
specific treatments administered by the physician, may not be
apparent within a patient file.
[0008] In the current environment, specific patient data is
difficult to access when needed for analysis. The creation of
patient data in remote locations exacerbates this problem. In
addition, the wide variety of data formats for patient data hinders
electronic processing and maintenance of patient files. Moreover,
the use of a patient's file by one healthcare provider can preclude
its simultaneous use by another healthcare provider. Ongoing
consolidation of healthcare providers into large health maintenance
organizations (HMOs) and preferred provider organizations (PPOs)
create issues in the transfer and maintenance of patient data in
large enterprises having numerous remote locations. Under these
circumstances, healthcare providers have difficulty providing
effective treatment for their patients.
SUMMARY OF THE INVENTION
[0009] The electronic medical record (EMR) system of the present
invention automates and simplifies existing methods of patient
chart creation, maintenance and retrieval. In contrast to other
systems, the present invention creates and maintains all patient
data electronically and thus can eliminate or supplement creating
and maintaining of physical data records. The EMR system furnishes
healthcare providers with an intuitive, easy-to-use, icon-based
interface that enables them to capture and analyze patient data
quickly and efficiently. Using the present invention, healthcare
providers enter patient data immediately at the point of care.
Thus, the EMR system captures each piece of data at its source at
the time of entry to provide a complete audit trail for all patient
data. In this manner, the EMR system transforms a patient chart
from a static record of a few clinical interactions into a dynamic,
real-time comprehensive record linked to an enterprise-wide
clinical database. In addition, the EMR system of the present
invention includes the capability to manage a wide variety of
patient data formats, including patient data from external sources,
such as laboratories and pharmacies. The EMR system can also
incorporate a patient's legacy data, such as a paper chart, into
the patient record as well as legacy data from mainframe
computers.
[0010] The present invention likewise provides instant access to a
patient's electronic medical record by authorized healthcare
providers from any geographical location. Thus, the EMR system
enables authorized healthcare providers to access and update
patient files using wireless pen-based personal computers. To
enable complete replacement of physical records, the present
invention permits healthcare providers, such as physicians or nurse
practitioners, to electronically annotate patient data. Thus, a
healthcare provider can acknowledge reviewing patient data, provide
instructions, such as prescriptions for medication to administer to
a patient, and approve recommendations for treatment by other
providers, all by electronically annotating a patient's record. In
addition, authorized healthcare providers can access a record while
other providers use the same record allowing for real-time
collaboration. The availability of electronic data permits instant,
sophisticated analysis of patient data. Moreover, the EMR system
enables enhanced analysis of patient data by providing access to
reference databases for diagnosis, procedures and medication.
[0011] One aspect of the present invention includes a medical
records system, comprising a point of care system to capture
patient data at a point of care and a patient data repository, in
communication with the point of care system and with external
systems, to store and organize the patient data for access by the
point of care system.
[0012] Another aspect of the present invention includes a medical
records system comprising a point of care system to capture data in
a patient record at a point of care, wherein the patient record
includes a patient identifier and at least one data structure
including the patient identifier and the data.
[0013] Yet another aspect of the present invention includes a
medical records system comprising a point of care system to capture
data at a point of care and a patient data repository, in
communication with the point of care system and with external
systems to store and organize the data in a patient record for
access by the point of care system, wherein the patient record
includes a patient identifier and at least one data structure
including the patient identifier and the data.
[0014] In addition, another aspect of the present invention
includes a method of using an electronic medical records system,
comprising the steps of capturing patient data electronically at
the point of care, organizing the patient data so as to form a
patient record, filing the patient record, and retrieving the
patient record to access the patient data for use in the care of a
patient.
[0015] Yet another aspect of the present invention includes a
method of retrieving patient data in an electronic medical records
system having a patient data repository, comprising the steps of
obtaining a patient identifier, locating a patient record
corresponding to the patient identifier in the patient data
repository, and determining the location of the patient data within
the patient record.
[0016] Another aspect of the present invention includes a method of
managing a patient data repository having a cache and a data
archive, comprising the steps of monitoring a status of data within
the cache, and moving the data to the data archive when the status
exceeds a threshold.
[0017] Still another aspect of the present invention includes a
method of communicating with an external source having an interface
to an electronic medical records system, comprising the steps of
finding an interface for the external source, connecting to the
external source using the interface, and converting patient data
for transfer between the external source and the electronic medical
records system.
BRIEF DESCRIPTION OF THE DRAWINGS
[0018] FIG. 1 is a block diagram illustrating the electronic
medical record (EMR) system architecture of the present
invention.
[0019] FIG. 2 is a flowchart illustrating the process flow of the
EMR system of the present invention.
[0020] FIG. 3 shows an example of a graphical user interface of the
EMR system useful for the scheduling of a patient appointment as
shown in FIG. 2.
[0021] FIG. 4 is a block diagram illustrating the structure of the
point of care system of FIG. 1.
[0022] FIG. 5 shows an example of a graphical user interface of the
point of care system of FIG. 4.
[0023] FIG. 6 shows an example of a new form window of the point of
care system of FIG. 4.
[0024] FIG. 7 shows an example of an annotate window of the point
of care system of FIG. 4.
[0025] FIG. 8 shows an example of a viewer window displaying an
image of patient data of the point of care system of FIG. 4.
[0026] FIG. 9 is a block diagram illustrating the structure of a
medication data capture in the point of care system of FIG. 4.
[0027] FIG. 10 is a block diagram illustrating the structure of a
practice guideline in the point of care system of FIG. 4.
[0028] FIG. 11 is a block diagram illustrating the structure of the
medication data capture and the practice guideline in the point of
care system of FIG. 4.
[0029] FIG. 12 is a block diagram illustrating the structure of the
patient data repository of FIG. 1.
[0030] FIG. 13 is a block diagram illustrating the structure of a
patient record within the patient data repository of FIG. 12.
[0031] FIG. 14 is an example of the patient record of FIG. 13.
[0032] FIG. 15a is a flowchart illustrating the process flow of the
patient data repository of FIG. 12.
[0033] FIG. 15b is a flowchart illustrating the process for a
transfer of data from a cache to a data archive in the patient data
repository of FIG. 12.
[0034] FIG. 16 is a block diagram illustrating the structure of the
data interface of FIG. 12.
[0035] FIG. 17a is a flowchart illustrating the process flow of the
data interface of FIG. 16 when receiving patient data from an
external source.
[0036] FIG. 17b is a flowchart illustrating the process flow of the
data interface of FIG. 16 when transmitting patient data to an
external source.
[0037] FIG. 18 is a block diagram illustrating the structure of the
reference database of FIG. 1.
[0038] FIG. 19 shows an example of a graphical user interface of
the point of care system of FIG. 4 having a reference access button
and a medication manager button.
[0039] FIG. 20 shows an example of a graphical user interface for
the diagnosis module and the procedure module of the reference
database of FIG. 18.
[0040] FIG. 21 shows an example of a graphical user interface for
the medication manager of the reference database of FIG. 18.
[0041] FIG. 22 shows an example of a medication interaction window
of the medication manager of FIG. 21.
[0042] FIG. 23 is a block diagram illustrating the structure of the
legacy data system of FIG. 1.
[0043] FIG. 24 is an example of a typical configuration for the
electronic medical records system of the present invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0044] The following detailed description of the preferred
embodiments presents a description of certain specific embodiments
to assist in understanding the claims. However, one may practice
the present invention in a multitude of different embodiments as
defined and covered by the claims.
[0045] For convenience, the description comprises three sections:
EMR System Architecture and Overview, EMR System Configurations and
Summary. The first section provides an overview of the EMR system
architecture, the following section describes EMR system
applications and preferred embodiments for practicing the EMR
system of the present invention, and the remaining section
summarizes advantageous features of the present invention.
[0046] I. EMR System Architecture and Overview
[0047] FIG. 1 illustrates the architecture of the EMR system.
Healthcare providers, such as physicians, at hospitals,
laboratories and clinics, generally capture and access patient data
using a point of care system 100 that communicates with a patient
data repository 102. Patient data, such as vital signs, x-ray
images and laboratory results, resides in the patient data
repository 102. The patient data repository 102 also communicates
with external sources to obtain patient data, such as laboratory
test results and x-ray images, and to transfer patient information,
such as prescriptions for medication, from the EMR system to other
healthcare providers. The point of care system 100 captures patient
data in real-time at the point of care, that is, where healthcare
providers interact with their patients. For example, physicians can
use a point of care system 100 to enter, access, process, analyze
and annotate data from patient records in real-time at the point of
care. Thus, using the point of care system 100, a physician, who
has many patients in a hospital, can visit each patient in their
room, access their electronic patient record there, enter results
of the current examination, evaluate their medical history,
electronically annotate their x-rays images and prescribe
medications and treatments instantaneously as the point of care
system 100 captures and organizes patient data into the patient
record stored in the patient data repository 102. The point of care
system 100 may likewise communicate with a reference database 104
to assist a healthcare provider in making diagnoses, prescribing
medications and administering treatments. Moreover, the patient
data repository 102 may also communicate with a legacy data system
106 to access pertinent patient data in paper files and mainframe
electronic databases.
[0048] Referring now to FIG. 2, a flowchart illustrates the
operation of the EMR system. For example, a patient having a
complaint contacts a healthcare provider 110, such as a physician,
to schedule an appointment. The EMR system obtains the patient
record 111 from the patient data repository 102 (FIG. 1) prior to
the scheduled appointment. The EMR system is also capable of
handling patients on a walk-in basis by scheduling an appointment
and requesting the patient's record immediately thereafter. The EMR
system updates the patient record 112 to include the complaint and
other information pertinent to the appointment, such as insurance
information. A healthcare provider, such as a physician, examines
the patient 113 using the point of care system 100 (FIG. 1) to make
a diagnosis and to treat the patient's condition. As determined at
114, if a diagnosis is not possible on the basis of this
examination, the physician may need to obtain additional clinical
data 115, such as laboratory tests and x-rays. When available, the
physician uses the point of care system 100 (FIG. 1) to evaluate
the results 116 and to examine the patient 113 again in light of
the results. Upon making a diagnosis, the physician may need to
prescribe medications 117 for the patient's condition. Similarly,
the physician may need to administer a treatment 118 to address the
patient's condition. At the conclusion of the patient's visit, the
EMR system files the patient's record 119 in the patient data
repository 102 (FIG. 1) for future reference.
[0049] In a preferred embodiment, the EMR system includes graphical
user interfaces to access system functions. For example, as shown
in FIG. 3, a chart puller window 120 enables a healthcare provider
to schedule a patient appointment using its point and click
interface. To schedule an appointment, a healthcare provider
activates the select button 121 with a pointing device, such as a
mouse or electronic pen, to obtain a list of patients. The
healthcare provider then scans the list to select the name of the
appropriate patient using a pointing device. The EMR system places
the name of the selected patient in the patient box 123. Similarly,
the healthcare provider uses the up/down buttons 125 to select an
appointment date and an appointment time. An adjacent box, such as
the date box 126, displays the selected date and time. Lastly, the
healthcare provider enters a textual description of the patient's
complaint in a reason box 127. Note that the healthcare provider
can review prior or future scheduled appointments by clicking on
the appointments button 128. Similarly, the healthcare provider can
track referrals by entering the identity of persons who referred
this patient to their care in the referral box 129.
[0050] Referring now to FIG. 4, a block diagram illustrates the
structure of the point of care system 100. The point of care system
100 includes the following modules: a patient data capture 140, a
clinical data capture 142, progress notes 144 and an encounter data
capture 146. During a patient visit, the healthcare provider (not
shown) can enter, review and annotate patient information, such as
family history, appointments, current medications and complaints,
using the patient data capture 140. The healthcare provider can
likewise enter, review and annotate clinical data obtained during
the visit, such as body temperature and blood pressure, using the
clinical data capture 142. Similarly, the healthcare provider can
enter laboratory data for patients with the clinical data capture
142. The clinical data capture 142 communicates with the patient
data capture 140 to assist in identifying needs for further
clinical data. For example, a family history of high blood pressure
may indicate a need to obtain the patient's blood pressure during
the visit. The patient data capture 140 also communicates with the
encounter data capture 146, where a healthcare provider can enter,
review and annotate data regarding diagnoses and procedures
administered to the patient. Moreover, the healthcare provider can
use the progress notes 144 to summarize details of the patient's
condition and to review the patient's progress over time. Thus, the
progress notes 144 communicates with the patient data capture 140,
the clinical data capture 142 and the encounter data capture
146.
[0051] Referring now to FIG. 5, in a preferred embodiment, the
point of care system 100 (FIG. 1) includes a graphical user
interface having a patient chart window 150 to capture patient
information. The point of care system 100 presents a patient record
graphically using a tabbed layout to organize patient data. The
patient chart window 150 includes tabs for patient data 151,
clinical data 152, encounter data 153 and progress notes 154.
Pointing and clicking on a tab on the patient chart window 150
opens a folder window 155 where a healthcare provider can enter and
review patient data within the folder. For example, to activate
progress notes 144 (FIG. 4), the healthcare provider selects the
progress notes tab 154 to display a list of progress note data in
the folder window 155. In a similar manner, to activate the patient
data capture 140, the clinical data capture 142 or the encounter
data capture 146, one selects the patient data tab 151, the
clinical data tab 142, or the encounter data tab 153,
respectively.
[0052] To enter patient data, the healthcare provider clicks on the
scroll down button 156 to select a form from a list of available
forms to enter patient data. This activates the new forms box 157.
The provider then points and clicks on the new form button 158. For
example, FIG. 6 shows a new form window 161 displaying the
pediatric problem form 162 selected by the healthcare provider
using the scroll down button 156 (FIG. 5). The healthcare provider
fills out the pediatric problem form 162 using an input device,
such as a keyboard, a mouse or an electronic pen. For example, the
provider uses a keyboard to enter text "6/7/96 Stomach Ache" 164
and an electronic pen to enter initials 166 for identification.
When done with patient data entry, the provider exits the form
using the File Menu 168 and the point of care system 100 returns
the provider to the patient chart window 150 (FIG. 5). Referring
back to FIG. 5, the new form appears as the top entry of the list
in the folder window 155.
[0053] Similarly, to annotate patient data, the healthcare provider
first selects an item to annotate by pointing and clicking on the
item in a list displayed in the folder window 155. The provider
then clicks on the annotate button 159 to open the item in an
annotate window 170, as shown in FIG. 7. For example, the annotate
window 170 of FIG. 7 displays a blood test result 172. As before,
the healthcare provider annotates the blood test result document
172 using an input device, such as a keyboard, a mouse or an
electronic pen. For example, the provider uses a keyboard to enter
text "Out of Range" 174 and an electronic pen to circle 176 the out
of range result. When done with annotations, the provider exits the
form using the File Menu 178 and the point of care system 100
returns the provider to the patient chart window 150 (FIG. 5). Note
that the point of care system 100 tracks the review of patient data
and identifies reviewed files with a mark 160 in the folder window
155. By annotating patient data, a healthcare provider, such as a
physician, can acknowledge reviewing patient data, provide
instructions, such as directions for additional tests and
procedures or prescriptions for medication to administer to the
patient, and approve recommendations for treatment by other
healthcare providers. Lastly, as shown in FIG. 8, a healthcare
provider uses the patient chart window 180 to view patient data.
First, the healthcare provider selects a view item 182 by either
pointing and clicking twice on the item in a list displayed in the
folder window 184 or by pointing at the item in the list and
pressing the view button 183. The double click opens a viewer
window 185 to display the view item 182. For example, the viewer
window 185 of FIG. 8 displays an x-ray 186. As before, the
healthcare provider may annotate the x-ray 186 with comments and
observations by clicking on the annotate button 187. The healthcare
provider may likewise close the viewer window 185 by clicking on
the close button 189.
[0054] Certain additional structures in the point of care system
100 (FIG. 1) will now be discussed with reference to FIGS. 9, 10
and 11. Referring now to FIG. 9, an optional medication data
capture 148 supplements the structure of the point of care system
100 of FIG. 4. A medication data capture 148 allows a healthcare
provider to monitor a patient's medications. The medication data
capture 148 communicates with the patient data capture 140 to
account for medications the patient is currently taking. The
medication data capture 148 similarly communicates with the
progress notes 144, where a practitioner can monitor changes in a
patient's condition resulting from medication therapies. Referring
now to FIG. 10, an optional practice guideline 149 supplements the
structure of the point of care system of FIG. 4. The practice
guideline 149 provides references for practitioners to consult
regarding courses of action to obtain a diagnosis and alternative
treatments for various conditions. The practice guideline 149
communicates with the patient data capture 140, the clinical data
capture 142 and the encounter data capture 146 to assist the
practitioner in selecting the appropriate course of action. The
practice guideline 149 likewise communicates with the progress
notes 144 to provide a healthcare provider with a historical
context of the patient's condition and alternative treatments
already attempted.
[0055] FIG. 11 shows a point of care system 100 having a medication
data capture 148 and a practice guideline 149. As before, the
medication data capture 148 communicates with the patient data
capture 140 and with the progress note 144. Similarly, the practice
guideline 149 communicates with patient data capture 140, the
clinical data capture 142, the encounter data capture 146 and the
progress note 144. However, the practice guideline 149 may now
communicate with the medication data capture 148 to address
situations where accepted practice guidelines require a healthcare
provider to prescribe and administer medications. In a preferred
embodiment, the point of care system 100 includes the graphical
user interface illustrated in FIG. 5. Referring back to FIG. 5, the
patient chart window 150 includes tabs for medication data 191 and
practice guidelines 193 that activate the medication data capture
148 and the practice guideline 149, respectively. Similarly,
pressing the medication manager button 192 activates the medication
data capture 148 and the practice guideline 149. A healthcare
provider can enter, review and annotate patient medication data and
practice guideline data as described previously.
[0056] Referring now to FIG. 12, a block diagram illustrates the
structure of the patient data repository 102. The patient data
repository 102 includes a patient locator 200, a data manager 202
and a data interface 204. The patient locator 200 generates a
unique patient identifier (PID) 221 (FIG. 14) for each patient and
creates and maintains a table having PIDs for all patients who have
data in the patient data repository 102. All data records related
to a patient 211, 212, 213, 214, 215, 216, 219 include and
reference the patient's unique PID as shown in FIG. 13.
[0057] With reference to FIG. 13, upon creation of a patient
record, the patient locator 200 creates a patient data structure
210 having the PID and the patient's name. In a preferred
embodiment, the patient data structure 210 includes pointers to
data structures having data within a patient record captured by the
point of care system 100 and incorporated from external sources
(e.g., a digital x-ray image file stored in a raster pixel format).
Thus, the patient data structure 210 maintains a pointer to an
interface files structure 211 having patient data transmitted from
external sources. The patient data structure 210 likewise maintains
pointers to a clinical data structure 212, a progress note
structure 213 and an encounter data structure 214. These data
structures include patient data captured by the clinical data
capture 142, progress notes 144 and encounter data capture 146,
respectively (FIG. 4). In another preferred embodiment, the patient
data structure 210 may include pointers to data structures having
data generated by the reference database 104 and transferred by the
legacy data system 106. Thus, the patient data structure 210 may
maintain pointers to a medication data structure 215 and a
guideline data structure 216. As described above, the medication
215 and guideline 216 data structures include patient data captured
by the medication data capture 148 and the practice guideline 149,
respectively. In this embodiment, a reference data structure 217
may maintain pointers to the encounter data structure 214 and to
the medication data structure 215 for access to reference
information contained in a reference database 104. Lastly, the
patient data structure 210 may maintain a pointer to a legacy files
structure 219 having patient data transmitted from the legacy data
system 106, such as an image of a patient chart.
[0058] FIG. 14 shows a logical view of a patient record 220
corresponding to the structure illustrated in FIG. 13. The patient
record 220 includes the PID generated by the patient locator 200
(FIG. 12) in the patient data repository 102 (FIG. 1). In addition,
the patient record 220 includes patient data in a variety of data
types generated by healthcare providers. Thus, the patient record
includes text data 223, such as electronic mail and word processing
documents from other healthcare providers, image data 225, such as
scanned physical documents, x-rays and CATSCANs, and audio data
227, such as a physician's dictation and voice mail. Lastly, the
patient record 220 has data tables 229, such as a physician's ICD9
diagnosis codes and CPT procedure codes. In view of the structure
of a patient record 220, referring back to FIG. 12, the data
manager 202 uses the PID to store and retrieve patient records.
Moreover, the data interface 204 permits communication with
external sources to obtain patient data, such as demographic data,
laboratory test results and x-ray images, and to transfer patient
information, such as prescriptions for medication, from the patient
data repository 102 to external healthcare providers.
[0059] With reference to FIG. 12, the patient data repository 102
may optionally include a cache 206 for temporary storage of patient
data and a data archive 208 for long term storage of patient data.
In this embodiment, the data manager 202 coordinates the transfer
of patient data to and from a data archive 208 into a cache 206.
For example, the data manager 202 may identify patient records that
a healthcare provider needs for appointments scheduled at a future
time and then transfer these patient records from the data archive
208 into the cache 206 for quick access prior to the scheduled
appointment. Similarly, the data manager 202 may purge from the
cache 206 records of patients who have not had recent appointments
and whose records are already archived. The data manager 202
likewise tracks the location and description of patient data within
the data archive 208 by associating the file name of the patient
data within a patient record 220 with the patient identifier 221.
When possible, the data manager 202 will group data associated with
a patient within the data archive 208 for rapid retrieval in a
manner similar to files within a directory in an operating system.
Thus, the data manager 202 assigns a directory to each patient
identifier and then stores patient data within this directory.
[0060] FIG. 15a illustrates the process flow for the patient data
repository 102 FIG. 1). For example, the point of care system 100
(FIG. 1) issues a request for patient data 250. With reference to
FIGS. 15a and 12, the patient locator 200 receives the request from
the point of care system 100 and, at 251 attempts to find the PID
for the record having the requested patient data. As determined at
252, if no PID is found, the patient locator 200 reports an error
253. At this point, the patient data repository 102 (FIG. 1) may
recover from the error 253 by either restarting the process or by
ending the process. Otherwise, the patient locator 200 communicates
the PID to the data manager 202. The data manager 202 locates the
patient record using the PID at 254. As determined at 255, in a
system without cache 206 and without a data archive 208, the data
manager 202 delivers the requested data 256 to the point of care
system 100. In a system having a cache 206 and a data archive 208,
the data manager 202 determines at 257 if the requested data exists
in the cache 206. If so, the data manager 202 delivers the
requested data 256 to the requester from the cache 206. Otherwise,
the data manager 202 first moves the data 258 from the data archive
208 to the cache 206 and then delivers the requested data 254 to
the requester from the cache 206.
[0061] In addition, FIG. 15b, in conjunction with FIG. 12,
illustrates the process for transferring data from a cache 206 to a
data archive 208. The data manager 202 monitors the contents of the
cache 206. To improve the performance of the cache 206, the data
manager 202 requests transfer 260 of data to the data archive 208
under certain conditions. For example, the data manager 202 may
purge the cache 206 when data requested for storage in the cache
would exceed its memory capacity. In this circumstance, the data
manager 202 first transfers to the data archive 208 signed files
and then data files in chronological order, i.e., oldest files
first. Similarly, a healthcare provider can specify a predetermined
time, such as 3 calendar days, or other selected conditions for
transfer to the data archive 208. As determined at 262, if the
cache 206 does not have the data to transfer, the process ends as
the data manager 202 ignores the request. As determined at 264, if
the data in the cache 206 is not ready for transfer, the process
ends and the data manager 202 queues the request for the next
transfer of data to the data archive 208. Data in the cache 206 is
ready for transfer when a physician has reviewed and accepted it
and when it has not been previously committed to the data archive
208. Otherwise, the data manager 202 transfers data from the cache
206 to the data archive 208 at 266.
[0062] Referring now to FIG. 16, the data interface 204 of the
patient data repository 102 includes an interface manager 270, a
data handler 272 and a communication interface 274. To transfer and
receive patient data from external sources (not shown), the
interface manager 270 communicates with a data handler 272 and a
communication interface 274. In addition, the communication
interface 274 communicates with the data handler 272 for conversion
of received external patient data into formats recognized by the
EMR system. The interface manager 270 creates and maintains an
interface registry of data formats for external sources. Prior to
data transfer or receipt by the EMR system, the interface manager
270 registers an interface for an external source. Upon
registration of an interface, the interface manager 270 can provide
the appropriate conversion routines for the data handler 272 to use
for transfer of data to and receipt of data from an external
source. These conversions are well understood by the relevant
technologist.
[0063] FIGS. 17a and 17b illustrate the operation of the data
interface 204 of the patient data repository 102 (FIG. 12).
Referring now to FIG. 17a, the data manager 202 issues a request
280 for patient data from an external source. At 282, the interface
manager 270 determines if the registry includes an interface for
the external source, such as a laboratory or pharmacy. As
determined at 282, if the registry includes an interface for the
external source, the communication interface 274 connects to the
external source 284 to receive patient data. The data handler 272
retrieves the appropriate conversion routine for the external
source to convert data 286. In a preferred embodiment, the data
handler 272 converts data from an external source into a database
table for the appropriate PID. Lastly, the data manager 202
incorporates converted data 288 into the patient record. Otherwise,
the interface manager 270 reports an error 289. The data manager
202 may recover from the error 289 in several ways. First, the data
manager 202 may invoke a module to register an interface for the
external source so as to allow the process to continue. Second, the
data manager 202 may end the process at this point. Lastly, the
data manager 202 may restart the process in the event the external
source was specified incorrectly.
[0064] Referring now to FIG. 17b, an external source requests data
290 from a patient record. As described above, the interface
manager 270 determines at 292 if the registry includes an interface
for the external source. As determined at 292, if the registry
includes an interface for the external source, the data manager 202
locates the requested data at 294 and the data handler 272 converts
requested data at 296 to the format required by the external
source. The communication interface 274 then sends the converted
data to the external source at 298. For example, the patient data
repository 102 may transmit a physician's prescription for
medication to a hospital or pharmacy. If the registry includes no
interface for the external source, the interface manager 270
reports an error 299. Similarly, as discussed above for the process
flow of FIG. 17a, the interface manager 270 may recover from the
error 299 by restarting the process, ending the process or invoking
a module to register the external source to allow the process to
continue.
[0065] Referring now to FIG. 18, a block diagram illustrates the
structure of the optional reference database 104 (FIG. 1). The
reference database 104 includes a diagnosis module 300, a
medication manager 302 and a procedure module 304. A healthcare
provider can use the reference database 104 for assistance in
diagnosing a patient's disease, prescribing medications and
ordering supplemental procedures to treat the disease. The
diagnosis module 300 communicates with a medication manager 302 to
obtain information on medications indicated by a diagnosis. The
medication manager 302 provides information on medications, such as
proper dosages, allergies, contraindications, adverse interactions
with other medications, and side effects. The diagnosis module 300
likewise communicates with a procedure module 304 to obtain
information on the proper administration of procedures indicated by
a diagnosis. The procedure module 304 provides information on
procedures for treatment as indicated by the diagnosis. In many
instances, the medication manager 302 communicates with the
procedure module 304 regarding the administration of various
medications.
[0066] In a preferred embodiment, the point of care system 100
provides access to the reference database 104 through a graphical
user interface having a patient chart window 310 shown in FIG. 19.
A healthcare provider accesses the diagnosis module 300 and the
procedure module 304 by pointing and clicking on a reference access
button 312.
[0067] As shown in FIG. 20, the reference access button 312
produces a reference window 330 including the graphical interfaces
for the diagnosis module 300 and the procedure module 304. For
example, to enter a diagnosis, a physician clicks on the scroll
down button 331 adjacent to the system box 332 to produce a list of
body systems. The physician selects the appropriate system and the
diagnosis module 300 enters the selected system in the system box
332 and provides a list having specific diagnosis codes for the
selected body system in the diagnosis box 334. The physician then
selects the appropriate diagnosis code and clicks on the add button
336 adjacent to the diagnosis selection box 337. The diagnosis
module 300 enters the selected diagnosis code to the diagnosis
selection box 337. The physician may repeat the above steps to add
multiple diagnosis codes to the diagnosis selection box 337. In a
similar manner, a physician uses the scroll down button 331
adjacent to the topic box 333 to select the appropriate procedure
topic. The procedure module 304 enters the selected procedure topic
in the topic box 333 and provides a list of procedure codes in the
procedure box 335. The physician now selects the appropriate
procedure code and adds it to the procedure selection box 338 by
clicking on the add button 336 adjacent to the procedure selection
box 338. The physician may likewise repeat the above steps to add
multiple procedure codes to the procedure selection box 338. The
physician completes entry of diagnoses and procedures by clicking
on the done button 339 to return to the patient chart window 310 of
FIG. 19.
[0068] The healthcare provider similarly accesses the medication
manager 302 (FIG. 18) by clicking on a medication button 192 (FIG.
19). Referring now to FIG. 21, the medication button 314 activates
a medication manager window 350. The physician can review the
patient's history by viewing the medication history box 351 and the
diagnosis history box 352 before prescribing any new medications.
The physician can also review any patient allergies in the allergy
box 353. The physician can select a medication by entering the name
of the medication in the name box 354. Note that as the physician
enters the root letters of a medication name, a list of medications
with the root letters appears in the medication list box 355. As
before, the physician selects a medication from the list by
clicking on it and the medication manager 302 places the selected
medication in a selection box 356. If there are no
contraindications or allergies for the patient, the physician
prescribes the medications listed in the selection box 356 by
clicking on the prescribe button 357.
[0069] Otherwise, if a contraindication exists, a warning appears
in a warning bar 358 to alert the physician. In view of the
warning, the physician can investigate the effects of the
medication by clicking on the results button 359. Referring now to
FIG. 22, the results button produces a medication interaction
window 361. A medication selection box 362 displays the medications
selected and under consideration by the physician. An allergy list
box 363 displays the patient's allergens. Folder tabs 364 include
labels describing the medication combinations and interactions. The
physician clicks on one of these folder tabs 364 to display the
contents of the folder in the viewing box 365. The physician can
then evaluate the information on the interaction including
potential adverse patient reactions. The physician clicks on the
done button 366 to return to the medication manager window 350 of
FIG. 21. The physician can make any needed revisions to the
medications selected in the manner described above. Afterwards, the
physician exits the medication manager 302 by clicking on the exit
button 360.
[0070] Referring now to FIG. 23, a block diagram illustrates the
structure of the optional legacy data system 106 as shown in FIG.
1. The legacy data system 106 includes a data source 370 and a
converter 372. The data source 370 comprises physical data 374,
such as paper based records and photographs, and electronic
mainframe data 376. The converter 372 receives information from the
data source 370 and transforms the information into an electronic
format compatible with the EMR system. For example, to input
physical data 374, such as paper or image based data, into a
patient record, the converter 372 comprises a scanner to digitize
the physical data into a binary file format for incorporation into
the patient's record. To input electronic mainframe data 376, the
converter 372 employs the same mechanism used for transfer or
receipt of patient data from external sources. As described before,
the converter 372 determines if an interface exists for the
mainframe data, selects the appropriate data handler and converts
the data into the proper format for incorporation into a patient
record.
[0071] II. EMR System Configurations
[0072] FIG. 24 illustrates one possible configuration for the EMR
system of the present invention. The system comprises a wide area
network (WAN) 402, the World Wide Web (Web) 404 portion of the
Internet, and remote web servers 406, 408, 410 communicating with
web browsers 412. The WAN 402 comprises a plurality of local area
network (LAN) servers supporting local and remotely located
healthcare providers. For example, the WAN 402 includes LANs
supporting Scripps Health 414 and Sharp Memorial 430 in San Diego
and Cedars Sinai 432 and Loma Linda 434 in Los Angeles, Calif. In
one presently preferred embodiment, the server comprises a
multi-processor personal computer having Intel Pentium processors,
such as a Compaq Proliant 4500R 5/100 Model 2, communicating with a
fault tolerant, error correcting storage device, such as a Hewlett
Packard 20XT Optical Jukebox having 20 gigabytes of storage
capacity. The LAN 400 includes a backup server 426 and several
peripherals, such as a scanner 424 to input documents and a laser
printer 422 to print out documents. In a preferred embodiment, the
LAN backbone comprises an Ethernet twisted pair cable configured in
a general star topology. Similarly, the scanner 424 comprises a
Fujitsu M3093EX scanner using Kofax KIPP ImageControls software and
the laser printer 422 comprises a Hewlett Packard LaserJet 4Plus.
Healthcare providers may access the LAN 400 using a desktop
computer 416, a laptop computer 418 or wireless pen computer 420.
In a preferred embodiment, the desktop computer 416 comprises a
Compaq Deskpro 5/75 Model 630, the laptop computer 418 comprises a
IBM ThinkPad 760CD and the pen computer 420 comprises a Fujitsu
Stylist 1000 configured with a Solectek AirLAN PCMCIA network
adapter for wireless LAN access. The EMR system also provides for
communication through the World Wide Web. For example, remote
healthcare providers may access the WAN 402 on the Web using the
domain name "www.westcst.com" 436. Thus, a healthcare provider
located in Boston, Mass. may access a patient record resident on
the Scripps Health server 414, located in San Diego, Calif., using
a web browser 412, such as Microsoft Explorer or Netscape
Navigator, communicating with a Web server in Boston, Mass. having
the domain name "www.boston.com" 406.
[0073] In a preferred embodiment, servers 414, 426, desktop 416, or
laptop 418 computers and peripherals, such as printers 422 or
scanners 424, communicate with each other and with the Web using a
network operating system, such as Microsoft Windows NT, Windows 95
or Windows for Workgroups. Similarly, pen computers 420 use the
Microsoft Windows for Pen Computing operating system. In another
preferred embodiment, the servers, computers and peripherals
communicate using an operating system supporting Web browsers on
computer networks, such as Unix, Novell Netware or Apple System
7.0. In yet another preferred embodiment, the EMR system includes
servers, computers and peripherals networked using mixed network
operating systems, such as Unix, Netware and Windows. For example,
the LAN 400 may operate on a Windows NT network operating system,
whereas the LAN 430 may operate on an Apple System 7.0 network, and
the Web server "www.boston.com" 406 may operate on a Unix operating
system. Thus, the EMR system supports communication among a variety
of hardware components, such as printers 422, scanners 424 and pen
computers 420, using a variety of network operating systems, such
as Windows, Netware or Unix. In a preferred embodiment, healthcare
providers, such as clinics and laboratories, may also communicate
with the EMR system using modem links and standard v.34 modem
devices, such as a US Robotics Sportster 28,800 modem.
[0074] The EMR system includes several databases of electronic
information, such as the medication manager 302 and the data
manager 202. In a preferred embodiment, the EMR system implements a
relational database language that conforms to American National
Standards Institute (ANSI) standard SQL-92, a 580 page
specification for the SQL relational database language. A database
language standard specifies the semantics of various components of
database management systems (DBMS). In particular, it defines the
structures and operations of a data model implemented by the DBMS,
as well as other components that support data definition, data
access, security, programming language interface and data
administration. The SQL-92 standard specifies data definition, data
manipulation, and other associated facilities of a DBMS that
supports the relational data model. SQL is old in the art and
additional information on SQL-92 is available in ANSI specification
X3.135-1992, hereby incorporated by reference.
[0075] Similarly, in another preferred embodiment, relational
databases in the EMR system support the Open Database Connectivity
(ODBC) model. ODBC is an application program interface (API) that
allows client applications running under Microsoft Windows to
access data from a variety of data sources, including relational
and non-relational DBMS. These data sources may reside on a client
machine or they may be located on a remote server communicating
through a network common to the client machine. Under ODBC, data
sources may vary in complexity from shrink-wrap databases, such as
Microsoft Access, running under Windows on a client machine to more
sophisticated, proprietary relational DBMS running on a Unix server
or mainframe computer. For a client application to access data from
a data source, a dynamic link library (DLL) driver must exist for
each data source to be accessed. For additional information on ODBC
is available from Inside ODBC, by Karl Geiger, hereby incorporated
by reference.
[0076] III. Summary
[0077] The electronic medical record system of the present
invention advantageously overcomes several limitations of existing
technologies and alternatives. Because it is more efficient and
cost effective to move data, instead of physical records and
healthcare providers, the present invention eliminates the need to
create and maintain any physical data records. In contrast to other
systems, the present invention creates and maintains all patient
data electronically. Thus, there is no need to find, pull, move,
update, file and replace physical charts. As a result, healthcare
providers no longer require substantial shelving and storage space
for physical files. The present invention likewise eliminates the
mishandling, loss and destruction of patient data typically
associated with maintenance of physical data records.
[0078] Using the present invention, healthcare providers enter
patient data immediately at the point of care. Thus, the EMR system
captures each piece of data at its source at the time of entry,
including time and healthcare provider identification. The EMR
system thus provides a complete audit trail for all patient data.
The audit trail, in turn, permits inexpensive analysis of outcomes,
utilization and compliance. For example, outcomes typically refer
to the effectiveness of a treatment plan. Thus, the EMR system
enables a healthcare provider to analyze patient recovery times and
incurred costs to measure the efficacy of the treatment plan.
Similarly, utilization typically refers to how well available
resources are utilizing time. Thus, the EMR system provides the
capability to analyze utilization of physicians, nurses, staff and
equipment as well as time utilization for patients, such as wait
times for referrals, lab results and physician examinations.
Lastly, compliance typically refers to conformance with government
and accreditation standards and regulations. The EMR system
provides tools to enable healthcare providers to measure
conformance to standards and regulations. To facilitate entry of
patient data at the point of care, the invention provides touch
screens for entry of lab orders, medications, diagnoses and
procedures. The invention likewise provides instant access to a
patient's electronic medical record by authorized healthcare
providers from any geographical location. Thus, the EMR system
enables authorized healthcare providers to access and update
patient files using wireless pen-based personal computers. In
addition, authorized healthcare providers can access a record while
other healthcare providers use the same record. By providing
simultaneous access to patient data, the present invention enables
real-time collaboration among multiple healthcare providers.
[0079] The availability of electronic data permits instant,
sophisticated analysis of a patient's clinical data. Thus, the EMR
system can create graphs of a patient's vital signs and lab results
or the system can provide an analyze patient information to
identify medication interactions and allergies. Using the present
invention, a healthcare provider can likewise select, sort, and
analyze patient data to identify relationships among the data
considered. In addition, the EMR system provides flexibility in the
creation and maintenance of patient data repositories. Thus, the
present invention can support a large healthcare enterprise
distributed across a large geography as well as a single physician
office. Moreover, the present invention ensures patient
confidentiality through the use of a tiered password system. The
EMR system provides several levels of security for access to
patient data. For example, a system administrator may have global
password access to any patient data for system maintenance and
debug purposes, whereas physicians may have access only to patient
records within their specialty and nurses and staff may have access
to only those patient records within their immediate care. In
addition, a patient may request restricted access to their data by
only certain personnel. Thus, in contrast to physical records, the
EMR system provides superior protection of patient data.
[0080] In addition, the present invention is useful in legal,
manufacturing and general administration environments. For example,
the present invention is capable of organizing, maintaining and
protecting legal files in an attorney's office. Thus, the EMR
system can store and retrieve scanned images of paper documents,
such as deeds and assignments, as well as other native file
formats, such as word processing files. The EMR system organizes
and retrieves this data in a manner akin to that of a patient's
medical record. Upon entry of a client data into the EMR system,
attorneys can annotate documents, transfer information to and from
other systems, or create new data for automatic filing in the
client or case file. Similarly, the EMR system is useful for
management of procurement or regulatory data in a manufacturing
context. Thus, the EMR system can organize and maintain material
safety data sheets (MSDS) as well as other data pertinent to
materials procurement, such as conformance to specification
measurements and inspection data for received lots, in a
manufacturing environment. Lastly, the EMR system is useful for
general administrative files in any organization. For example, the
present invention is applicable to employee files in human
resources, customer files in sales and approved suppliers in
procurement. The EMR system can organize and retrieve data within
these files in the manner as patient data in a patient data record.
As discussed above, upon entry of a data into the EMR system, users
can annotate documents, transfer information to and from other
systems, or create new data for automatic filing in the respective
file.
[0081] Those skilled in the art may practice the principles of the
present invention in other specific forms without departing from
its spirit or essential characteristics. Accordingly, the disclosed
embodiments of the invention are merely illustrative and do not
serve to limit the scope of the invention set forth in the
following claims.
* * * * *