U.S. patent application number 10/313898 was filed with the patent office on 2003-09-18 for method and structure for electronically transmitting a text document and linked information.
This patent application is currently assigned to Amicas, Inc.. Invention is credited to Doyle, Sean, Gropper, Adrian.
Application Number | 20030177446 10/313898 |
Document ID | / |
Family ID | 28041566 |
Filed Date | 2003-09-18 |
United States Patent
Application |
20030177446 |
Kind Code |
A1 |
Gropper, Adrian ; et
al. |
September 18, 2003 |
Method and structure for electronically transmitting a text
document and linked information
Abstract
Method and structure for creating an electronically
transmittable document having links therein which does not affect
the integrity of the document as provided. The information is
formatted to have a text portion, and an endnote portion, the
endnote portion being independent of the text portion. The endnote
portion includes link information for linking identified portions
of the text with other ancillary link information.
Inventors: |
Gropper, Adrian; (Watertown,
MA) ; Doyle, Sean; (Watertown, MA) |
Correspondence
Address: |
TESTA, HURWITZ & THIBEAULT, LLP
HIGH STREET TOWER
125 HIGH STREET
BOSTON
MA
02110
US
|
Assignee: |
Amicas, Inc.
Brighton
MA
|
Family ID: |
28041566 |
Appl. No.: |
10/313898 |
Filed: |
December 6, 2002 |
Related U.S. Patent Documents
|
|
|
|
|
|
Application
Number |
Filing Date |
Patent Number |
|
|
10313898 |
Dec 6, 2002 |
|
|
|
09304204 |
May 3, 1999 |
|
|
|
Current U.S.
Class: |
715/248 ;
715/205; 715/256 |
Current CPC
Class: |
G16H 15/00 20180101;
G16H 30/40 20180101; G06F 40/134 20200101 |
Class at
Publication: |
715/522 |
International
Class: |
G06F 015/00 |
Claims
What is claimed is:
1. A format for a linked report electronically transmittable to a
terminal, the report format comprising a text section, and an
endnote section, the endnote section being independent of the text
section and including information for linking portions of text
contained in the text section to predetermined link
information.
2. The format of claim 1, wherein said link information includes an
image.
3. The format of claim 1, wherein said endnote section comprises at
least one endnote, said endnote including character information for
identifying the address within the text which is to be linked and
view state information, the view state information further
including at least a link information address corresponding to the
address from which the link information can be retrieved.
4. The format of claim 3, wherein said view state information also
includes image brightness information, image color information,
annotations to an image, image overlay and transformations.
5. The format of claim 3, wherein said view state information
includes an external web site address.
6. The format of claim 3, wherein said link information address
includes the address within a repository of stored images for a
predetermined image.
7. The format of claim 1, wherein said endnote section includes a
plurality of endnotes.
8. The format of claim 3, wherein said view state information is in
extensible mark up language.
9. The format of claim 3, wherein said endnote includes a check
sum.
10. The format of claim 3, wherein said endnote includes a workflow
state information portion.
11. The format of claim 1, further comprising an end marker, said
end mark being a signature.
12. A method for creating a linked report which is electronically
transmittable through a terminal comprising the steps of: creating
the text for a report; retrieving link information to be displayed
along with the text in association with a predetermined portion of
the text; creating an independent endnote containing information
sufficient to link said predetermined text portion and link
information; and attaching the endnote to the report after the
text.
13. The method of claim 12, further comprising the step of counting
at least the characters within the text to obtain a character
address for each character within the text; the link information
including an image, obtaining view state information for said
image, the view state information including at least a link
information address corresponding to the address from which the
link information can be retrieved; said endnote including the
character address of the predetermined portion and the link
information address.
14. The method of claim 13, wherein said endnote further includes
image brightness information, image color information, image
annotations, and image overlay.
15. The method of claim 12, wherein said endnote includes text
modification instructions for modifying the display of the
predetermined portion of the text to indicate that characters
contained in the predetermined portions are linked.
16. The method of claim 12, wherein the link information includes
an image.
17. The method of claim 11, further comprising the step of
providing an end of text marker after the text and attaching the
endnote to the report after the end of the text marker.
18. The method of claim 17, wherein the end of text marker is a
signature.
19. A method for reading a report electronically receivable at a
terminal, the report including a text section, and an endnote
section; the endnote section being independent of the text section
and signature section and including information for linking
predetermined portions of the text to predetermined link
information comprising the steps of: opening and displaying the
text at a terminal; activating the link; identifying the
appropriate endnote corresponding to the activated link; retrieving
link information at an address in accordance with information
included in the endnote; and displaying said retrieved link
information.
20. The method of the claim 19, wherein said endnote includes
instructions for modifying the display of the text to indicate the
portion of the text to be linked; and further comprising the step
of modifying the display of the text in accordance with the
instructions.
21. The method of claim 19, further comprising the step of
retrieving said link information from a repository.
22. The method of claim 19, wherein said link information is a web
site.
23. The method of claim 19, further comprising the steps of
providing an end marker at the end of the text section and reading
the text portion line by line into a temporary memory as text until
the signature is read, and operating on the endnote operation so
that each line of text is processed as a separate data
structure.
24. The method of claim 23, further comprising the step of
operating upon each line of text by inserting said line of text
into a Java Swing document, and modifying the text in accordance
with the instructions stored in the endnote to indicate where links
exist.
25. The method of claim 19, further comprising the steps of
providing an end marker at the end of the text section and reading
the text portion character by character into a temporary memory as
text until the signature is read, and operating on the endnote
operation so that each line of text is processed as a separate data
structure.
26. A method for creating a report based upon a protocol including
the steps of: creating an endnote having a workflow state portion
and encoding the protocol in said workflow state portion; the
endnote including a work state indicator, and storing a workflow
state in the work state indicator; and; performing a step in the
protocol and changing the workflow state value stored in said
workflow state indicator to indicate the performed step has been
completed.
27. The method of claim 26, further comprising the steps of
modifying the endnote to contain data for identifying a patient to
which the protocol is to be performed; increase the workflow state
value stored in the workflow state indicator; modify the endnote to
include specific protocol steps; increment the workflow state value
stored in the workflow state portion to indicate modification of
the endnote; perform the protocol; and increment the workflow state
value stored in the workflow state indicator to indicate
performance of the protocol;
28. The method of claim 27, further comprising the steps of
creating a link to results of the performed protocol; increment the
workflow state value in the workflow state indicator to indicate
the creation of the link; create a report by modifying the endnote
to include link and report address information; and incrementing
the workflow state value in the workflow state indicator.
29. The method of claim 28, wherein the report includes text
further comprising the step of creating the text; counting at least
the characters within the text to obtain a character address for
each character within the text; obtaining view state information
for said image, the view state information including at least a
link information address corresponding to the address from which
the results of the performed protocol can be retrieved; and said
endnote including the character address of a predetermined portion
of the text and the link information address.
30. The method of claim 29, wherein said endnote further includes
image brightness information, image color information, image
annotations, and image overlay.
31. The method of claim 29, wherein said endnote includes text
modification instructions for modifying the display of the
predetermined portion of the text to indicate that characters
contained in the predetermined portions are linked.
32. The method of claim 29, wherein the results of the performed
protocol include an image.
33. The method of claim 29, further comprising the step of
providing an end of text marker after the text and attaching the
endnote to the report after the end of the text marker.
34. The method of claim 33, wherein the end of text marker is a
signature.
35. A format for an endnote for use with a linked report
electronically transmittable to a terminal, the endnote comprising:
a character information portion for containing information for
identifying the address within text of the report to be linked with
ancillary information; view state information directed to the view
state of the ancillary information; and a workflow state
information portion for containing workflow state information.
36. The format for an endnote of claim 35, wherein the work state
information portion includes a work state indicator for storing a
workflow state therein.
37. The format of claim 35, wherein the view state information
portion includes at least a link information address corresponding
to the address from which the ancillary information can be
retrieved.
Description
BACKGROUND OF THE INVENTION
[0001] This invention is directed to a method for electronically
transmitting a text document along with linked information, and in
particular, for transmitting a text document with linked
information without interfering with or jeopardizing the integrity
of the text document.
[0002] It is known in the art to transmit text documents such as
reports or other types of information as an electronic data stream
to a distant terminal by way of Internet, intranet, or the like. It
is also known, to provide links within the text which allow the
user of the terminal to view one document and retrieve specified
associated material that is either associated with or related to
the portion of the document-text which contains the link.
[0003] It is often desirable to combine multiple elements into a
single report. For example, written text may be combined with an
illustrative image corresponding to that text, or, the text may, in
fact, be describing or making comment on what is in the image. By
way of example, a medical report describing the symptoms of a
patient may include diagnostic images such as MRI, X-ray or the
like. More generally, a report that represents interpretation of
certain data such as the image or graphs or charts may include
illustrative examples from the data. The example data may be
included directly within the body of the report or it may be
included by reference through a link. Often, these reports are what
are known as signature reports, implying that the text of the
report has not been tampered with. This is required so that other
people making use of the report know that the report can be relied
upon.
[0004] It is known to combine the illustrative image or data with
the text, in effect linking the text through several methods. A
first method is to embed the image directly into the text of the
reports. However, such an embedding of the image in the report
either requires technical know-how by the person creating the
report who embeds the image into the report as they are writing it,
or requires a second party to embed the image after the report has
been completed. However, this brings into question the validity of
the report once someone besides the author has manipulated the text
to include the images. This is particularly important because any
change to the report could result in misdiagnosis or mistreatment.
Therefore, embedding pictures into a report after it has been
prepared could result in jeopardizing the integrity of the report
through inadvertent human error during the embedding process.
[0005] Furthermore, it is not always necessary that an image be
present to make sense of the medical report. Therefore, embedding
the image into the report may be a waste of screen space, text
space, and the time of the doctor who is trying to make a quick
study of the report.
[0006] To overcome these shortcomings, endnotes and web page
hyperlinks (HTML) are provided to link the text to a desired
address which will retrieve the required illustrative information
(link information) as needed and display the link information along
with the text. However, conventional endnotes in reports add
markers to the body of the report and invalidate the signature. The
HTML (hyperlink tags) also modify the body of the report and
furthermore require HTML capable terminals in order to process the
link.
[0007] Therefore, it is desired that a method be provided which
allows the linking of text to illustrate data or images as desired
which does not modify the text or interfere with the integrity of
the text. In other words, it does not invalidate the signature for
the report.
SUMMARY OF THE INVENTION
[0008] Generally speaking, in accordance with the invention, a
structure and method for enabling one or more portions of a text
report to be linked to ancillary information without modifying the
content of the report is provided. The method includes creating
text and counting characters while creating the text. At the
desired point where the text is to be linked to other information,
a command is given to create a link for the desired characters. The
desired characters could be a word, letters or a symbol. The
information to be linked is then identified. The character count
for the identified portion of the text and the information to be
linked, are then combined to form an endnote. When the text has
been completed, the endnote is attached to the end of the
document.
[0009] The endnote includes a marker indicating that an endnote
exists, character identifying information which identifies the
character in the text which constitutes the linked portion of the
text, modification information for modifying the display of the
text of those linked characters to signal that a link exists at
that position in the text, as well as the address of the
information to be linked. The information to be linked (link
information) may either be the address of stored images and data at
a repository, or maybe another related web site; or any other
addressable information.
[0010] In a preferred embodiment, the process may be repeated
several times to create multiple endnotes within the document. The
document may also include an end of document marker such as a
doctor's signature or other machine readable marker to facilitate
placing of the endnote as well as further maintaining independence
between the text and the endnote. Furthermore, the endnote may
include a view state of an image stored in a repository, the view
state including information such as the address within the
repository where the image is stored, the brightness, color, and
any annotations or overlays associated with the view state which
may have been created in conjunction with the report or image
transformation information.
[0011] Accordingly, it is an object of the invention to provide an
improved method for linking text data with ancillary data without
modifying the body of the text data.
[0012] Another object of the invention is providing a method for
displaying both text reports and associated linked information
which maintains the integrity of the report.
[0013] Yet another object of the invention is providing a method
for displaying a text report and linked information which does not
require special hardware or software for interpreting or storing
the linkage method.
[0014] Still other objects of the invention will, in part, be
obvious and will, in part, be apparent from the specification.
[0015] The invention accordingly comprises the several steps and
the relation of one or more of such steps with respect to each of
the others, and the apparatus embodying features of construction,
combination of elements, and arrangement of parts which are adapted
to affect such steps, all as exemplified in the following detailed
disclosure and the scope of the invention will be indicated in the
claims.
BRIEF DESCRIPTION OF THE DRAWINGS
[0016] For a fuller understanding of the invention, reference is
had to the following description in connection with the
accompanying drawing, in which:
[0017] FIG. 1 is a schematic view of a repository system which may
be operated in accordance with the invention;
[0018] FIG. 2 is a front plan view of a representative image of a
display utilizing the method in accordance with the invention;
[0019] FIG. 3 is a schematic diagram of the format of a document
constructed in accordance with the invention;
[0020] FIG. 4 is a schematic diagram of the format of an endnote
constructed in accordance with the invention;
[0021] FIG. 5 is a flow chart of a method for creating a document
to be transmitted in accordance with the invention;
[0022] FIG. 6 is a flow chart of the method for processing the
document for display in accordance with the invention; and
[0023] FIG. 7 is a flow chart of the method for creating an endnote
in accordance with a second embodiment of the invention.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0024] Reference is now made to FIGS. 1 and 2 which generally
depict a system 10 for employing the method for transmitting text
and linked information. System 10 includes a terminal 12 including
a screen 14, input/output keyboard 16 and a processor and scratch
buffer, (not shown) as known in the art for conventional PC
terminals. Terminal 12 is linked by either telephone, dedicated
wire, radio or the like to a remote (off site) repository 18 of
data. By way of example, repository 18 is a repository of X-ray
images stored at addresses a.sub.ll through a.sub.mn These images
are digitally stored and are transmitted as electronic images to
terminal 12 to be displayed. However repository 18 could easily be
any addressable local memory.
[0025] Generally, when creating a report 26, by way of example, a
medical report for a radiologist, the radiologist will retrieve the
desired images from repository 18 to be displayed on screen 14 as,
for example, image 20 of FIG. 2. At the same time, the radiologist
will prepare written text corresponding to the image utilizing
keyboard 16 which will be displayed as text 22 on terminal 12.
Terminal 12, utilizing the memory and the microprocessor, retains
information regarding the stored image such as the address in the
repository from which the image was retrieved, the brightness of
the image, the color of the image, any annotations to the image
which may have been made by the doctor preparing the report and any
overlays which may have been added to the report such as written
text 22 displayed on terminal screen 14. As the doctor prepares
their report 26, they may pull up further images 20 corresponding
to that specific portion of the report text 22 currently being
created. These images 20 are again retrieved from the repository of
images 18. Once the doctor has completed the written text of the
report, they place an end mark 28 such as an electronic signature
on the report to indicate their approval, and to indicated that the
document should not be tampered with.
[0026] In order to prevent the document from being tampered with
while still maintaining the integrity of the document, the entire
report 26 is treated as two separate sections. The written text 22
is treated as one element while the associated pictures 20 are
treated as a second separate element; the two being linked.
[0027] Reference is now made to FIG. 3 in which the format for the
written text portion 22 of report 26 is provided. The written text
22 includes the character string 23 which includes the characters
forming the words of the written text 22. A signature 28 including
an end of report mark is attached at the end of the characters 23
forming the report 26 and an endnote 30 containing information
corresponding to linked portions of the text 22 is attached to the
report 26 to the end of the document. When converted into an
electronic bit stream, they may be serially transmitted beginning
with text 22 and ending with endnote 30. As discussed below,
endnote 30 includes the information necessary to link the desired
image to the appropriate portion of text 22.
[0028] Reference is now made to FIG. 5 in which a flow chart
demonstrating the method for creating a report 26 having text 22
linked to images 20 is provided. In a first step 40, it is
determined whether or not the doctor wishes to retrieve an image
from repository 18. Assuming they are just beginning the report,
they may begin by retrieving an image 20 from repository 18
utilizing electronic data retrieval methods in step 42. The doctor
would then create text 22 corresponding to that image in a step 44
although, if necessary, the doctor could return to step 42, and
retrieve a second or third image 20 prior to creating text 22. As
the doctor creates text, terminal 12 counts the characters and/or
the lines of the text being typed, in effect, providing an address
for each character (letter, number, symbol) within text 22 of the
report 26.
[0029] If no image is to be retrieved in step 40, then the process
moves to step 44 where text 22 is created absent an image. It is
then determined whether or not a link should be created between the
retrieved image of step 42 and the text of step 44 in a step 48. If
no link is to be created either because text 22 does not correspond
sufficiently to retrieved image 20, or there is no retrieved image
20, then the process proceeds to a step 50 where it is determined
whether the end of text 22 has occurred. If the end of text 22 has
not occurred, then the process is returned to step 40 to determine
whether or not a first image 20 or following image 20 should be
retrieved.
[0030] If a link is to be created, a command is given to create a
link in step 52. This can be done by identifying the characters
which are to be linked by either highlighting utilizing a mouse
click technique as is known in the art, indicate the command
through keystroke, or orally. The information to be linked to the
text is identified in a step 54. This would be the corresponding
image 20 in the present example. The system would then obtain the
view state information presently being utilized by terminal 12 in
accordance with a step 56 to display image 20 with image overlay 24
(if present) in report 26. In a step 58, the system determines
which numbered characters, i.e., the address of the characters
within text 22 correspond to the link. An endnote 30 is created in
step 60 in which the character information is married to the view
state information to create the endnote. The process is then
returned to step 50 where it is determined whether or not the end
of the text has been reached.
[0031] Reference is now made to FIG. 4 in which the format for
endnote 30 is provided. The endnote includes two types of
information to be used by the system to link the portion of the
text 22 with the desired image 20 or other ancillary information;
1) the address of the character within text 22 that corresponds to
the linked image 20 as well as 2) view state information pertaining
to the linked image 20. Endnote 30 includes an endnote begin marker
70 to indicate to the terminal 12 that an endnote is present. The
next characters may be text information 72 including the character
address 74 within text 22 such as the line number and/or character
number and modification information 76 instructing system 12 how to
display text 22 to highlight the character to indicate that the
character is a linked portion of text 22; for example, to underline
that portion of the text with a link identifier 27 or to change the
colors of those characters to indicate to a user at terminal 12
that the text is, in fact, a link.
[0032] Endnote 30 includes a view state portion 78 which includes a
repository address 80 for the linked information, and may include a
brightness control command 82 and color command 84 to instruct
terminal 12 how to display image 20. The view state information
could also be image transformation information such as
magnification, subrectangle or the like. Furthermore, view state 78
may include annotations 86 made during the creation of the report
or the overlays 24 to be placed on image 20. With this information,
terminal 12 can determine the location of the link within text 22
as well as the information required to pull up the image associated
with that link if the link is, in fact, activated. Lastly, endnote
30 includes a check sum 85 to confirm the completeness and accuracy
of the endnote as well as to indicate the end of endnote 30.
[0033] Once endnote 30 is created in step 60, it is then determined
whether or not text 22 is complete in step 50. If text 22 is not
complete, it is then determined in step 40 whether an additional
image 20 is to be retrieved and, if not, further text 22 created in
step 44 and the process is repeated. If it is the end of the
written text 22 then an end of document mark 28 such as a signature
is applied to indicate the end of the document in a step 62 and the
previously created endnotes are attached to the document 26 after
the signature in a step 64.
[0034] It is preferable that an end mark be provided to separate
the endnotes from the text and to indicate to the terminal as well
as the user that the text portion has been completely transmitted.
However, the same function can be performed by an endnote presence
indicator such as endnote begin marker 70, located in each endnote.
Because the text is independent of the endnotes, an endnote
indicator can also signal to the terminal that text is complete and
processing of the endnotes should begin as discussed in detail
below.
[0035] Once the report has been prepared including the signature
and the endnotes, it can also be stored in a repository such as
repository 18, a separate report repository (not shown) or in the
memory of terminal 12 for later recall and used either by the same
doctor or by other persons requiring the information contained in
the report in a step 90. To retrieve the report, one would open and
display text 22 as retrieved from its storage area. The document is
read line by line into a temporary memory at terminal 12 as text
until the signature or end of report indicator is read. When this
data is encountered, the reading mode is changed from one of
downloading text 22 to one of operating on the endnote information.
As a result, each line of text is then processed as a separate data
structure.
[0036] In a preferred embodiment, endnote 30 in its entirety, or
merely components thereof, such as view state 78 are in XML
language. It is also contemplated that rather than providing view
state data 80 through 86, the address 80 of view state 78 could
correspond to a web site which is called up in conjunction with the
data being read from the report 26. The text 22 in the buffer is
then operated upon, for example, by being inserted into a Java
Swing document to modify the text in accordance with the
instructions 76 stored in endnote 30 to indicate where links exist
in the text 22. For example, the text is inserted using standard
text attributes and when the text is encountered, it must be
displayed as modified. The modifications, such as changing color or
underline, are inserted within the text as displayed, not within
text 22 itself.
[0037] Once text 22 is presented this way, the link is activated
through methods known in the art such as a mouse click highlight on
screen 14 of terminal 12 or the like in a step 92. The system then
identifies the appropriate endnote 30 corresponding to those
identified characters by matching the character address data 74
with the position within text 22 that has been activated in step
94. The system then searches for the address 80 contained within
the endnote in accordance with a step 96 and retrieves the
information stored by way of example in repository 18, at that
address in accordance with a step 98. The image is then modified in
accordance with the information 82, 84, 86 and 24 in accordance
with a step 100 and is displayed as modified in accordance with
step 102.
[0038] If terminal 12 cannot understand endnote 30 and/or end off
text marker 28, then the report will be displayed as shown in FIG.
3 and link identifier 27 will not be shown. However, if terminal 12
does understand endnote 30 and can operate in accordance therewith
the report 26 will be displayed as shown in FIG. 2 if a link 27 is
selected to be activated by the user. The above explanation was
provided in connection with a medical report and associated medical
diagnostic images. However, the method works equally well with
graphs, or any other associated data which could be linked in the
same way images 20 are linked, the main difference being that a
view state data would now correspond to manipulation and
presentation of other ancillary data. Furthermore, the address link
could be to a web site of associated data. Lastly, the example was
given by way of a dedicated repository of information linked to a
terminal. It should be understood that the repository and terminal
can be linked as an Internet link, an intranet link, a dedicated
line, or wireless transmission.
[0039] By providing the report which is formatted to include an
endnote which contains information for linking a portion of the
text to other information such as an image, a linked report is
provided which is compatible with a legacy transcription system in
which hyperlinks can be added to a report after the report is
transcribed and signed using existing systems that are not
hyperlink aware. Furthermore, it allows the use of preexisting data
repositories without the requirement for special equipment. Lastly,
even systems that do not interpret the commands of the hyperlink
endnote will be able to display text 22 of report 26 without error
because the hyperlink information is contained outside of text 22,
not within it. The hyperlink endnote may be visible, but it will be
visible after the original signature and end of report marks.
[0040] As discussed, endnotes formatted as described lend
themselves to drafting reports which must be unaltered by their
very nature once they have been completed. Such reports form part
of a patient's medical records. The medical record is usually the
case overview for a patient which includes associated reports,
status, and logs describing the procedures, treatments, tests, and
doctors' comments for a particular patient.
[0041] As medicine is now practiced, the medical report can be
thought of as a plurality of protocols and procedures, each
protocol and/or procedure having definite steps, or tasks, each
task being capable of being performed by different individuals and
most likely encouraged to be performed by different individuals. A
procedure may have more than one protocol. Any protocol which can
be broken up into a plurality of steps can be considered to have a
workflow, the workflow being the totality of the steps required to
perform a protocol. For example, the steps outlined in connection
with FIG. 5 as described above may be considered the definitive
steps for the protocol of writing a report containing image data,
the workflow being each of the steps from the initial writing of
the text or retrieval of data through to the signature and
attachment of endnotes. In such a protocol, each of the steps is
performed by a single person, that being the commenting doctor.
However, the procedures that made the report doable, such as the
making of the X-ray images, would be a separate protocol of the
overall procedure for diagnosing a patient and could include
several steps such as ordering the X-rays to be taken, scheduling
the taking of the X-rays, the actual taking of the X-rays, and the
development of the X-rays. This protocol includes steps performed
by distinct individuals including maybe one doctor and several
technicians. Each discrete step is a state within the workflow and
can be considered the Workflow State. The endnote described above
in creating the report lends itself to tracking the workflow state
of a protocol within a procedure.
[0042] Reference is now made to FIG. 7 in which a flow chart for
utilizing the endnote for tracking the workflow state is provided.
An originator of a procedure for treating a patient's condition may
publish the procedure as a generic template including several
protocols to be performed prior to final treatment. Among each of
these protocols may be the preparing of several reports like report
26 described above. The template, published as a web page, may
consist of words and images describing the protocols and diagnostic
tests associated with the particular treatment. Each of these
protocols, for example, will result in a report. The originator of
the procedure would also create a generic endnote having a workflow
state portion 79 (which may also be in XML language) which will
store the protocol and workflow associated with the preparation of
the report in generic format to which later patient information can
be applied. In a step 90 a protocol for the procedure and the
workflow are encoded in the endnote. The inclusion of workflow
state portion 79 is only required when tracking work state. The
example given with references to FIGS. 1-5 above can obviously be
accomplished without a workflow portion 79.
[0043] In effect, endnote 30 exists as a shell even though there is
no report 26 associated therewith. At this stage, endnote 30 is
merely a file on a web site. By way of example, the creating of the
template and the creating of the endnote shell may be, in fact, the
first two states of the protocol workflow. Therefore, to keep track
of the state, the number 2 or the word "endnote" may be stored in a
workflow state indicator 94 of endnote 30 in a step 93.
[0044] A physician, wishing to make use of the procedure and its
protocols may copy the work state for the procedure along with one
or more associated templates for creating reports from the web
site. The physician would then enter the patient name and other
information into the endnote 30 in a patient data portion 96 in a
step 98. This is the third step in the protocol and the physician,
either manually or automatically, enters either the number 3 in
state indicator 94 or the term "patient data" which alerts all
users of the endnote of the state of the workflow. This state is
stored in a step 100. The physician then may, either manually or
automatically, alert the various department that would perform the
protocols for a particular procedure.
[0045] By way of example, in the next state of the workflow,
someone may schedule a diagnostic protocol and modify endnote 30 in
a step 102 and changes the state stored in state indicator 94 by
either providing the word "schedule" or an incremented number in
state indicator 94 in accordance with a step 104. The protocol is
then performed, in this case a diagnostic protocol, to obtain the
raw data which is stored in repository 18 by way of example in a
step 106. Again, the state stored in state indicator 94 is
incremented to reflect the completion of this workflow state in a
step 108. At this stage, endnote 30 may be modified to contain
links to the created data in repository 18 by way of example or a
web site as stored in address 80 in a step 110.
[0046] In a step 112 a report is created as described above in
connection with creating report 26. Generally, a physician opens
the report which still contains only an endnote 30 having workflow
state information 79. This would correspond to a new state which
would be stored in state indicator 94. Then, the doctor would
either dictate report 26 or call up the raw data such as the images
20 stored in repository 18 which would correspond to another state
along the workflow requiring increment again of the state stored in
state indicator 94. The report is then transcribed to form text 23
again incrementing the state stored in indicator 94 and a signature
28 may be added and endnote 30 is modified to add the address
information 72 and view state information 78 as described above.
Once the report is completed, the workflow state portion is again
incremented to reflect the work state in step 113.
[0047] Another physician such as the primary care practitioner or
another specialist may access the medical record through the
endnote which would include the link to report 26 as well as the
workflow state stored in indicator 94 as well as the protocols
which have been performed in a step 114. Furthermore, the medical
record would include a plurality of these reports if necessary. As
the physician makes use of the report, this may also be a step
within the procedure or protocol and therefore the workflow state
indicator 94 is incremented again in a step 115 by changing the
number value or storing the term "reviewed".
[0048] The report structure allows the addition of information to a
report incrementally while remaining compatible with existing
report repository and display means. By appending this information
(for example, Workflow State, Image Link, Annotation and Digital
Signature components) in plain text to the end of the plain text
report, compatibility is maintained with the existing report
repository, transmission and even display (including paper
display). However, when the display is aware of the endnote format,
it enables a number of enhancements and manipulations of the
information associated with the report. The principal economic
value of this invention is that it enables many features and
benefits of Internet networks to be added to existing hospital and
departmental information systems without the delay and expense of
replacing major components of these systems. A further benefit of
the invention is that report templates can be developed (by
doctors, managed care organizations and pharmaceutical companies)
and freely intermixed in the same formal information repositories.
The different reports can carry vastly different protocols and
might, in a preferred embodiment put this information in XML
format.
[0049] By providing an endnote which can be used in connection with
the report which forms part of a medical record, it is possible to
create an electronic medical record including records of past
procedures, protocols and logs. As a result, medical records
linking a plurality of reports, protocols and procedures can be
electronically stored, linked and accessed.
[0050] It will thus be seen that the objects set forth above, among
those made apparent from the preceding description are efficiently
attained and, since certain changes may be made in carrying out the
above method and the construction set forth without departing from
the spirit and scope of the invention, it is intended that all
matter contained in the above description and shown in the
accompanying drawings shall be interpreted as illustrative and not
in a limiting sense.
[0051] It is also to be understood that the following claims are
intended to cover all of the generic and specific structures of the
invention herein described and all statements of the scope of the
invention which, as a matter of language, might be said to fall
there between.
* * * * *