U.S. patent application number 11/033097 was filed with the patent office on 2005-07-21 for health-care systems and methods.
Invention is credited to Abolfathi, Amir, Breeland, Joe, Etheridge, David, Shelton, Jason.
Application Number | 20050159986 11/033097 |
Document ID | / |
Family ID | 34752694 |
Filed Date | 2005-07-21 |
United States Patent
Application |
20050159986 |
Kind Code |
A1 |
Breeland, Joe ; et
al. |
July 21, 2005 |
Health-care systems and methods
Abstract
A virtual health-care electronic commerce community includes a
network to communicate information relating to the community; one
or more patients coupled to the network; one or more treating
professionals coupled to the network; and a server coupled to the
network, the server storing data for each patient and performing
patient data visualization in response to a user request.
Inventors: |
Breeland, Joe; (Austin,
TX) ; Abolfathi, Amir; (Menlo Park, CA) ;
Etheridge, David; (El Granada, CA) ; Shelton,
Jason; (El Granada, CA) |
Correspondence
Address: |
ALIGN TECHNOLOGY, INC.
ATTENTION: SCOTT SMITH
881 MARTIN AVENUE
SANTA CLARA
CA
95050
US
|
Family ID: |
34752694 |
Appl. No.: |
11/033097 |
Filed: |
January 11, 2005 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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11033097 |
Jan 11, 2005 |
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10205026 |
Jul 26, 2002 |
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10205026 |
Jul 26, 2002 |
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09534461 |
Mar 24, 2000 |
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Current U.S.
Class: |
705/3 ;
703/11 |
Current CPC
Class: |
G16H 10/60 20180101;
G06Q 30/06 20130101 |
Class at
Publication: |
705/003 ;
703/011 |
International
Class: |
G06F 017/60 |
Claims
What is claimed is:
1. A virtual health-care electronic commerce community, comprising:
a network to communicate information relating to the community; one
or more patients coupled to the network; one or more treating
professionals coupled to the network; and a server coupled to the
network, the server storing data for each patient and facilitating
secured data sharing by the community.
2. The community of claim 1, wherein the treating professional
views one or more of the following patient data visualization over
the network: a right buccal view; a left buccal view; a posterior
view; an anterior view; a mandibular occlusal view; a maxillary
occlusal view; an overjet view; a left distal molar view; a left
lingual view; a lingual incisor view; a right lingual view; a right
distal molar view; an upper jaw view; and a lower jaw view.
3. The community of claim 1, wherein the treating professionals
include dentists or orthodontists.
4. The community of claim 1, further comprising one or more
partners coupled to the network.
5. The community of claim 4, wherein the partners include a
financing partner.
6. The community of claim 4, wherein the partners include a
supplier.
7. The community of claim 4, wherein the partners include a
delivery company.
8. The community of claim 1, wherein the treating professionals
perform office management operations using the server.
9. The community of claim 8, wherein the office management
operations include one or more of the following: patient
scheduling, patient accounting, and claim processing.
10. The community of claim 1, wherein the treating professionals
share a patient's information with a second authorized treating
professional for consultation.
11. A computer-implemented method for performing dental-related
electronic commerce, comprising: transmitting teeth data associated
a patient from a dental server to a treating professional computer
over the Internet upon an authorized request; displaying a
three-dimensional computer model of the teeth at the treating
professional computer using a browser; allowing a treating
professional to manipulate the three-dimensional computer model of
the teeth using the browser; transmitting the computer model from
the treating professional computer to the server; and generating an
appliance to treat the patient based on the computer model of the
teeth.
12. The method of claim 11, further comprising providing financing
options for the patient using one or more financing partners.
13. The method of claim 11, further comprising offering an on-line
shop geared to the patient's dental requirements.
14. The method of claim 11, further comprising providing office
management utilities for the treating professional.
15. The method of claim 14, wherein the office management utilities
include one or more of the following: patient scheduling, patient
accounting, and claim processing.
16. The method of claim 11, wherein allowing a treating
professional to manipulate the three-dimensional computer model of
the teeth using the browser further comprises displaying a
plurality of dental views.
17. The method of claim 16, wherein the dental views include one or
more of the following: a right buccal view; a left buccal view; a
posterior view; an anterior view; a mandibular occlusal view; a
maxillary occlusal view; an overjet view; a left distal molar view;
a left lingual view; a lingual incisor view; a right lingual view;
a right distal molar view; an upper jaw view; and a lower jaw
view.
18. The method of claim 11, wherein allowing a treating
professional to manipulate the three-dimensional computer model of
the teeth using the browser further comprises clicking on a tooth
to adjust its position.
19. The method of claim 18, further comprising displaying x, y and
z axis to allow the treating professional to adjust the position of
the tooth.
20. The method of claim 11, further comprising providing
supplemental services to the patient, including teeth whitening
services.
21. A server to support a health-care electronic commerce community
with one or more patients and one or more service providers,
comprising: a processor adapted to communicate with a network; a
data storage device coupled to the processor and adapted to store
data for each patient; and software to communicate 3D patient data
in response to a patient request.
22. The server of claim 21, further comprising a browser adapted to
receive the patient request and transmitting the request to the
server.
23. The server of claim 22, wherein the browser further comprises a
viewer plug-in to visualize patient data in 3D.
24. The server of claim 21, wherein the providers service one or
more of the following health-care applications: dentistry
applications, cosmetic augmentation, hair-care enhancements,
liposuction, plastic or reconstructive surgery.
Description
RELATED APPLICATION
[0001] This application is a continuation of U.S. application Ser.
No. 10/205,026, filed Jul. 23, 2002, which is a
continuation-in-part of U.S. application Ser. No. 09/534,461, filed
Mar. 24, 2000, the content of which are hereby incorporated herein
by reference.
BACKGROUND
[0002] The Internet has become a significant medium for
communication and commerce and has enabled millions of people to
share information and conduct business electronically. The unique
characteristics of the Internet, such as its ability to provide
enhanced communication, rich text, and graphic environment, provide
an ideal support for a wide variety of electronic commerce
transactions. For example, a consumer can search, review, and
extensively shop a number of competing chains in an instant. As
such, consumers benefit by being able to obtain a good price
relatively quickly and easily.
[0003] On-line retailers also benefit, since these retailers can
carry a larger number of products at a lower cost and with greater
merchandising flexibility without the physical constraints faced by
traditional retailers. Additionally, they can assist the consumer's
purchase decision by providing relevant information and enabling
consumers to shop at their convenience by remaining open 24 hours a
day, seven days a week. Online retailers can also provide
personalized services and use direct marketing efforts based on
information provided by customers.
[0004] As such, the Internet has evolved into a unique sales and
marketing channel. The ubiquity and convenience of the Internet
makes it ideal for dispensing information on certain topics that
traditionally require visits to specialists. For example, certain
consumers may be interested in products and services associated
with orthodontics and dentofacial orthopedics that specializes in
the diagnosis, prevention and treatment of dental and facial
irregularities ("malocclusion" or "bad bite"). The orthodontic
treatment process typically uses corrective appliances such as
braces and/or other fixed or removable appliances to bring the
teeth, lips and jaws into proper alignment and to achieve a facial
balance. The pervasiveness of the Internet makes it an ideal source
for information relating to these products and services.
SUMMARY
[0005] In one aspect, a virtual health-care electronic commerce
community includes a network to communicate information relating to
the community; one or more patients coupled to the network; one or
more treating professionals coupled to the network; and a server
coupled to the network, the server storing data for each patient
and securely sharing health-care information for authorized
professionals.
[0006] Implementations of the above aspect may include one or more
of the following. The treating professional can view one or more of
the following patient data visualization over the network: a right
buccal view; a left buccal view; a posterior view; an anterior
view; a mandibular occlusal view; a maxillary occlusal view; an
overjet view; a left distal molar view; a left lingual view; a
lingual incisor view; a right lingual view; a right distal molar
view; an upper jaw view; and a lower jaw view. The treating
professionals can include dentists or orthodontists working singly
or in combination with other professionals. One or more partners
can be connected to the network. The partners can be a financing
partner, a supplier, or a delivery company. The treating
professionals can perform office management operations using the
server. The office management operations include one or more of the
following: patient scheduling, patient accounting, and claim
processing. The patients and the treating professionals can access
the server using browsers. The treating professionals can share the
patient's information with another authorized treating professional
for consultations and assistance, among others.
[0007] In another aspect, a method for performing dental-related
electronic commerce includes transmitting teeth data associated
with a patient from a dental server to a treating professional
computer over the Internet upon an authorized request; displaying a
three-dimensional computer model of the teeth at the treating
professional computer using a browser; allowing a treating
professional to manipulate the three-dimensional computer model of
the teeth using the browser or an application running on a patient
computer; transmitting the computer model from the treating
professional computer to the server; and generating an appliance to
treat the patient based on the computer model of the teeth.
[0008] Implementations of the above aspect may include one or more
of the following. The system can provide financing options for the
patient using one or more financing partners. The system can offer
an on-line shop geared to the patient's dental requirements and/or
office needs/supplies. The system also allows a treating
professional to manipulate the three-dimensional computer model of
the teeth using the browser or an application running on a local
computer and further comprises displaying a plurality of dental
views.
[0009] A treating professional can manipulate the three-dimensional
computer model of the teeth using the browser and may further
comprise clicking on a tooth to adjust its position. The system can
display x, y and z axes to allow the treating professional to
adjust the position of the tooth. Treating professionals can show
the models to other authorized professionals. Supplemental services
can also be offered to the patient, including teeth whitening
services.
[0010] In another aspect, a server supports a health-care
electronic commerce community with one or more patients and one or
more service providers. The server includes a processor adapted to
communicate with a network; a data storage device coupled to the
processor and adapted to store data for each patient; and software
to communicate 3D patient data in response to a patient
request.
[0011] Implementations can include one or more of the following. A
browser can receive the patient request and can transmit the
request to the server. The browser can use a viewer plug-in to
visualize patient data in 3D. Alternatively, an application running
on a local patient computer can visualize the patient data. The
providers can provide health-care services such as dentistry
applications, cosmetic augmentation, hair-care enhancements,
liposuction, or plastic or reconstructive surgery.
[0012] Advantages of the system may include one or more of the
following. The system supports a virtual community of dental
patients, dentists, specialists such as orthodontists and oral
surgeons, financial institutions, benefit providers and the
providers of dental equipment or services. For treating
professionals, such as dentists and orthodontists, the system
provides a one-stop solution for planning patient treatments,
managing communication with patients, storing patient records and
sharing records with relevant persons outside the doctor's office,
including for example, consulting professionals who advise the
doctor of preferred treatment plans. The system can act as the
repository for the file notes and visual imagery (photographs,
x-rays and virtual treatment plans) associated with the course of
treatment. The doctors can control access to the centralized
patient file. Various tools are provided to support the
interpretation of information and the diagnostic process. For
example, the system allows doctors to retrieve and analyze patient
information and to simulate present and potential patient dental
structure using two and three-dimensional visual imagery of the
patient's teeth and other anatomical structures. The system
supports visualization of the expected outcome of a particular
course of treatment. These images can enhance the patient's
understanding of the benefits of treatment and can act as a
valuable selling tool for the doctor. The system also provides
diagnostic decision-support capabilities such as visualizing the
placement of implantations, veneers and crowns before or after a
course of treatment to straighten the teeth. The system provides an
animated prediction of the suggested treatment that can help the
patient and the doctor to visualize the pace of treatment. Using
these tools, the doctor can easily and quickly view and/or edit the
treatment plan. When doctor and patient choose the final treatment
plan the system disseminates aspects of the plan and the relevant
patient records to the appropriate members of the virtual
community, thus reducing the cost and delay associated with
traditional physical shipment of patient information. Aspects of
the final treatment plan can be used to generate appliances used in
the physical treatment. The information associated with the
patient's treatment (visual images, virtual treatment plans, file
notes and the like) are digitized and maintained in a central
storage facility in a secure manner. Doctors and patients can have
access to these files without the need to extract files and models
from storage and with reduced risk of records being misplaced.
[0013] Administratively, the system allows a dental office to be
managed more efficiently without requiring the treating
professional to purchase and maintain special software. The system
keeps track of all patients that need to be contacted for an
appointment. Scheduling can be done automatically or can be
customized to the office's preference and availability of treating
professionals and supporting resources. Based on the appointments,
the system can electronically mail (email) patients with reminders.
Alternatively, the system can print reminder cards that can be
mailed to patients reminding them of their appointment. The system
can also automatically generate personalized correspondence to
patients relating to data collected in the initial exam and
treatment recommendations. Moreover, the patient can review the
treatment proposed by the treating professional anywhere.
[0014] The system also simplifies and streamlines the processing of
insurance claims to produce an orderly flow of information.
Insurance claims can flow through the treating professional's
office from pre-authorization to continuation of treatment with a
minimal amount of intervention. The system also provides accounting
functions to check out patients, post charges, setup contracts, add
comments to ledgers, post payments, adjust ledgers, and display all
transactions applied to specific ledgers.
[0015] Moreover, treating professionals can leverage the collective
purchasing power of the system by being able to order supplies
required or requested by patients directly through the system at a
discount. These supplies can be directly shipped to the patients,
thus avoiding overhead costs associated with handling the supplies.
Further, information reviewed or generated by the treating
professionals is provided through a secure on-line connection.
Thus, the patient's privacy as well as the treating professional's
sensitive office information is not compromised.
[0016] For patients, the system provides a broad array of
dental-care resources that help consumers find answers to their
critical dental questions and make informed purchasing decisions.
The system also enables people to share their experiences and to
support one another in managing their medical conditions. This is
done through forums where Internet users with interests and
concerns about their dental health can interact with each other, to
interact in a community environment and to access content created
by others.
[0017] The system is convenient to use and provides informative
shopping experience through which dental care services and
dental-related products can be dispensed. Consumers can access the
system using an intuitive, easy-to-use shopping interface that is
available 24 hours a day, seven days a week. Consumers can shop
quickly and conveniently from anywhere Internet access is
available. A customer can store his or her dental history and other
relevant dental information, as well as create personalized
shopping lists for quick and easy reordering of his or her dental
supplies.
BRIEF DESCRIPTION OF THE DRAWINGS
[0018] Other advantages will be apparent from the description that
follows, including the figures and claims, in which:
[0019] FIG. 1 is a diagram of an exemplary environment supporting
electronic commerce.
[0020] FIG. 2 is a diagram of a server structure and corresponding
link to a network, such as the internet, to support electronic
commerce within the context of an embodiment of the invention.
[0021] FIG. 3 is a structural diagram of a web site that may run on
the server of FIG. 2.
[0022] FIG. 4 is a flowchart of a process for selecting dental
services, from the perspective of a patient.
[0023] FIG. 5 is a flowchart of a process for providing dental
services, from the perspective of a treating professional.
[0024] FIG. 6 is a flowchart of a process to render 3D views of a
patient's teeth on a browser.
[0025] FIG. 7 is an exemplary output of the process of FIG. 6 using
the browser.
[0026] FIG. 8 is a diagram of a system for manufacturing
appliances.
[0027] FIG. 9 is a diagram illustrating a computer system to
support the fabrication of appliances.
[0028] FIG. 10 is a diagram schematically showing information flow
within and exterior of a network application according to an
embodiment of the invention.
[0029] FIG. 11 is a flowchart showing a case submission scheme
according to an embodiment of the invention.
[0030] FIG. 12 is a flowchart showing a case management scheme
according to an embodiment of the invention.
[0031] FIG. 13 shows a diagram illustrating potential activity on
the website upon submission of a new case.
[0032] FIG. 14 is a flowchart illustrating another aspect of a new
case submission, as well as a case review series of steps.
[0033] FIG. 15 is an exemplary home page of the web based
interface.
[0034] FIGS. 16-17 show exemplary treatment planning forms on a
website according to an embodiment of the invention.
[0035] FIG. 18A shows a web page depicting static image displays,
"before" and "after", of various views of a patient's gums and
teeth.
[0036] FIG. 18B shows a more detailed view of a static image from
FIG. 18A.
[0037] FIGS. 19-23 show an embodiment of a second opinion service
(SOS) that provides an opportunity for inexperienced professionals
to receive advice from experienced professionals in treating
patients.
DESCRIPTION
[0038] Referring now to FIG. 1, an environment supporting a dental
system 100 is shown. The system 100 communicates over a network 102
that can be a local area network or a wide area network such as the
Internet.
[0039] One or more patient computers 104-105 can be connected to
the network 102. In one embodiment where the network 102 is the
Internet, the patient computers execute a suitable browser such as
Navigator.RTM. from Netscape, Inc. or Internet Explorer.RTM. from
Microsoft Corp. By clicking on the highlighted text (or specific
graphic image), the user can jump from the current web page to a
new web page address associated with the link--with the new page
displayed on the screen. In this manner, the user can "surf the
web" by clicking on an almost endless succession of links going to
page after page all following a common thread as defined by the
text or graphic component of the link label.
[0040] Through the network 102, the patient computers 104-105 can
access a health server, for example a dental server 106 that houses
dental information. The dental server 106 serves a web site, a
portal, a vortal (vertical portal), or a content site for providing
dental-related information to interested parties such as dental
patients, dentists, orthodontists, and others. When sensitive
information is communicated through the dental server 106, such
information may be securely encrypted using Secure Socket Layer
("SSL") technology throughout the transaction. The server 106 can
be a stand-alone computer or can be a server farm that can
distribute processing and communication activity across a computer
network so that no single device is overwhelmed. During load
balancing, if one server is swamped with requests, excess requests
are forwarded to another server with more capacity.
[0041] The network 102 connects the dental server 106 to one or
more treating professional workstations 108-109. The workstations
108-109 allow treating professionals access to a plethora of
services provided by the dental server 106 such as patient
treatment and office management, among others. The dental server
106 stores information associated with patient history on-line in a
secure manner and also provides the treating professional a
comprehensive view of the patient's treatment history at any time
using a suitable browser, eliminating the need to pull treatment
files or charts or to search for misfiled or lost charts. The
dental server 106 also provides treating professionals with tools
to analyze patient data, for example, tools to reconstruct a 3D
model or rendering of the patient's teeth. For example, using the
browser, the treating professional can request the dental server
106 to animate the progress of the treatment plan. When the
treating professional arrives at a prescription or other final
designation or diagnosis, the treatment prescription is used to
automatically generate appliances, as described in more detail
below. Further, in addition to aiding treating professionals in
treating patients, the software allows the treating professional to
perform office management, purchasing and other logistical
operations using the browser and the dental server 106.
[0042] In addition to communicating with patients and treating
professionals, the dental server 106 can communicate with one or
more partners 110 using the network 102. The partners 110 can be
product suppliers, service providers, or any suitable commercial
entities.
[0043] For example, one partner 110 can be a financing partner that
offers customers one or more electronic financing options. In one
implementation, the financing partner can be a credit card
processing company. The credit card processing company can accept a
customer's existing credit card or can issue the customer with a
new credit card. Further, the credit card can be issued under the
name of a third-party bank, the name of the credit card processing
company, or the name of the site supported by the dental server 106
under a co-branding arrangement.
[0044] The customer enters the sensitive data such as credit card
number, shipping address, among others, onto a purchase form. The
credit data is then submitted, collected and passed securely
through the dental server 106, e.g., using SSL. This data can be
processed in real-time online or can be collected by mail or
telephone and then entered by an operator. A processor at the
credit card processing company then verifies that the credit card
number is valid and is not stolen, among other anti-fraud measures.
If the credit card information is valid, the purchase price will be
reserved from the issuing bank of the consumer's credit card and
allocated to the account associated with the server 106.
Periodically, the credit card processor settles all accounts; it is
at this time that all monies move. Funds reserved are transmitted
from the issuing bank of the cardholder's credit card to the
account of the server 106. Also, discount fees are paid from these
funds, as they are moving.
[0045] Alternatively, the financing partner can debit from the
customer's checking account over the Internet. One such check
debiting services is the MerchanTrust.TM. Paperless Checks.TM.
Services, available from Merchant Commerce, Inc. These services
provide customers with the convenience of making online purchases
by checking account debits, with no manual data entry required of a
merchant. In this embodiment, a customer fills in a form at the
site with bank information printed at the bottom of his or her
personal check. The information is processed as an Electronic Funds
Transfer (EFT) to the customer's account using the Automated
Clearinghouse (ACH) payment system.
[0046] Yet another possible partner 110 is a dental supply retailer
providing an on-line shop on the web site to retail dental products
to the customers and treating professionals. The retailer can be a
co-branding partner that uses the brand name linked or suitably
associated with the web site of the server 106 such that users of
the server 106 would not know that the on-line shop is actually
operated by a third party. The retailer can offer dental products
for brushing, flossing, and cleaning of dental implants and
bridges. Other dental products include anti-plaque rinse and
plaque-fighting toothpaste. The retailer can also sell other
health-care-related products such as prescription drugs;
non-prescription drugs; personal care products; beauty and spa
products; vitamins; herbs and nutrition; and medical supplies.
Additionally, the retailer can serve the needs of the treating
professionals by offering products such as brackets, buccal tubes,
bands, archwire products, bonding adhesives, hand instruments,
systems, supplies and equipment.
[0047] Yet another partner 110 can be a shipping partner. The
shipping partner delivers dental supplies or goods received from a
multiplicity of producers and manufacturers for ultimate
distribution to each customer. The facilities for warehousing and
introduction of goods into a transportation stream for
redistribution are the so-called "cross-docking" facilities. The
article of supply or good flows in bulk from a producer or a
manufacturer to one or more cross-docking facilities owned by
either the shipping partner or the operator of the server 106. The
items are then be broken into smaller unit sizes and distributed to
the customers.
[0048] The above list of partners lists only exemplary partners and
is not an exhaustive list. Other possible partners include
value-added service providers such as third party software
providers who provide plug-in viewing and diagnostic enhancements
that can be used by the professionals.
[0049] The dental server 106 can perform dynamic targeting and
information gathering. The users provide demographic information
when they register for the service, and the dental server 106 can
track the users' behavior the entire time they are online. As a
result, the dental server 106 can deliver targeted advertisements
and can further measure their effectiveness. As examples, users can
receive ads from a brokerage firm when they are viewing sites
containing stock quotes or financial news, or receive promotions
from a bookseller when browsing sites containing book reviews. As
such, the dental server 106 can provide a prominent and sustained
advertising medium to the community. In contrast to most portal and
content sites which display advertising, the site remains with
users the entire time they are online. Once users are logged on,
the site remains in full view throughout the session, including
when they are waiting for pages to download, navigating the
Internet, or even engaging in non-browsing activities such as
sending or receiving e-mail. The constant visibility of the site
allows advertisements to be displayed for a specified period of
time.
[0050] In combination, the dental server 106 forms a hub that links
dental patients using patient computers 104-105, treating
professionals using workstations 108-109, and partners 110 into a
living electronic commerce (e-commerce) community.
[0051] FIG. 2 shows an embodiment of the dental server 106. The
dental server 106 includes a web server 140, a patient information
server 142, a resource planning (RP) server 144, a treatment server
146 and a streaming media server 148. In one embodiment, the RP
server 144 runs Microsoft SQL server and provides information
relating to a doctor or a patient such as address and history. When
a patient's case or a static snapshot of the case is needed, the
data is pulled from the patient information server 142. When media
data, such as video, needs to be streamed to a requesting viewer
such as a doctor or a patient, the streaming media server 148 can
send the stream. In one implementation, the streaming data is
stored in QuickTime format on a Linux-based server running the
QuickTime server software.
[0052] The servers can be clustered. In one embodiment using
Microsoft's Cluster Server, cluster-enabled applications such as
Microsoft's SQL Server and Exchange may be employed. With Cluster
Server, two servers can run applications at the same time. When one
server fails, the remaining server handles its application as well
as the failed server's applications. Next, the remaining server
adopts the IP address of the failed server and mounts one or more
data drives that the two systems share. The remaining server is
rebooted and applications such as SQL Server can be restarted and
reinitialized on this server. Persistent viewers can re-attach to
the server and continue to operate.
[0053] Referring now to FIG. 3, a diagram 200 shows various major
functions supported by the dental server 106. First, the process
200 may perform an automatic detection for the existence of a
browser welcome plug-in (step 202). If the welcome plug-in exists,
an introductory animation (Flash) is shown to the viewer (step
204). From step 202 or 204, the process 200 shows a home page (step
206) with one or more links. A link is created by having a word in
a text field (or a graphic image on a web page) linked to the
location of another web page via a string of information setting
forth the new web page address presented in hypertext transfer
protocol (HTTP), among others.
[0054] The user can navigate the home page to join a particular
site from a constellation of related sites. For instance, the user
can navigate to a patient's site (step 208), a doctor's site (step
210), a privacy statement site (step 212), one or more additional
sites or links (step 214), and an "About" site (step 216), among
others. The additional sites can be an on-line shopping store that
is co-branded with the web site hosted by the server 106, or the
on-line shopping store can be directly affiliated with a third
party such as planet-rx.com, among others. The additional sites can
also be third party value-added providers of products and/or
services.
[0055] FIG. 4 illustrates an exemplary usage of the system of FIG.
1 from a patient's perspective. First, a prospective patient using
a patient computer 104 visits the web site on the dental server 106
and identifies a treating professional meeting one or more criteria
(step 230), for example, a professional whose location is closest
to his or her home address. Next, the patient schedules an
appointment with the treating professional (step 232). At the
meeting, an assistant captures various anatomical data from the
patient by taking digital photographs of the face and teeth, taking
x-rays of the front, back, side, and top/bottom of the patient,
taking one or more impressions, among others (step 234). Next,
certain or all of this information is entered into a form on the
server 106. The data is then digitized (step 236), stored on the
dental server 106, and made available to treating professionals and
the patient over the Internet (step 238). Next, the server 106 and
one or more orthodontic treating persons process the patient data
and render the patient's teeth in a plurality of alternative final
states (step 240). Based on the choices, the patient selects a
desired final state (step 242).
[0056] In addition to performing orthodontic operations, the dental
server 106 can also perform other value-added services (step 244).
For example, processes executed by the dental server 106 can
simulate the color of the patient's enamel and show the color of
the teeth before and after bleaching. Further, processes on the
dental server 106 can simulate the color of the patient's silver
fillings (amalgam) and show the teeth after cosmetic work to cover
the amalgam (step 246). After visualizing the effects of the
operations, comparing the before and after operations, and
reviewing guideline pricing (step 248) for the orthodontic
operation as well as add-ons such as bleaching, the patient makes a
decision on the case (step 250).
[0057] Once the patient has accepted a particular treatment
selection, the dental server 106 offers the patient with one or
more financing options from one of its financial partners (step
256). Additionally, the dental server 106 can guide the patient to
an on-line shopping store to purchase products relating to his or
her dental health (step 258). For example, the patient can buy
cleaning supplies, brushes, and flossing supplies at a price
competitive to his or her traditional stores. Moreover, the
products can be delivered to the patient using one or more delivery
partners at a convenient time (step 260).
[0058] FIG. 5 illustrates an exemplary usage of the system of FIG.
1 from a treating professional's perspective. A prospective patient
uses a patient computer 104 and visits the web site on the dental
server 106 (step 280). The patient identifies a treating
professional and schedules an appointment with the treating
professional (step 281). Alternatively, a referring dentist can
refer the patient to the treating professional.
[0059] The referring dentist can visit the website on the dental
server 106 and use one or more dental esthetic tools to show
patients the potential benefits of treatment, e.g., anterior and
posterior esthetic restorations, and if the patient is interested,
refers the patient to the treating professional (step 282).
[0060] During an initial examination, the treating professional or
an assistant may take, e.g., a set of digital facial and intraoral
images which is uploaded to a secure, collaborative workspace on
the dental server 106 (step 284). The workspace is shared with the
referring dentist.
[0061] Next, the treating professional generates a dentofacial
treatment visualization showing the patient's face and smile before
and after treatment. The treating professional can also combine the
patient's face and an aligner into the intraoral image to show how
inconspicuous the appliance will be (step 285).
[0062] Once the patient requests treatment, the treating
professional takes impressions and a bite registration and sends
the information to the company (step 284). The treating
professional may also capture other data, such as by taking a
lateral ceph and a panorex (step 286), and upload them to the
company and/or workspace and/or website (287). The treating
professional may also generate or create a treating prescription or
plan and upload the same to the company and/or website and/or to
the workspace (step 288). At any time, the treating professional
may review the treatment plan and adjust or approve the same (step
290). The professional's assistant creates a separate workspace for
the patient, uploads selected "before and after" images to the
company and/or workspace and/or website and invites the patient to
review the images (step 292). The aligners may then be accordingly
fabricated as described below.
[0063] At the company, another professional reviews the records and
decides to accept or decline the case (step 296). If accepted, the
models are scanned, and the intraoral images are retrieved and used
to texture-map enamel and gingiva (step 298). The data is then sent
to the company and/or workspace and/or website and the treating
professional is notified (step 300).
[0064] In one embodiment, the tooth models may be posted on a
hypertext transfer protocol (http) web site for limited access by
the corresponding patients and treating clinicians. Since realistic
models have a large volume of data, the storage and transmission of
the models can be expensive and time-consuming. To reduce
transmission problems arising from the large size of the 3D model,
in one embodiment, data associated with the model is compressed.
The compression is done by modeling the teeth meshes as a curve
network before transmission to the treating professional or
website. Once the curve network is received, the 3D model is
reconstructed from the curve network for the treating professional
to analyze. More information on the compression is disclosed in
U.S. Pat. No. 6,633,789, issued Oct. 14, 2003, entitled "EFFICIENT
DATA REPRESENTATION OF TEETH MODEL", the contents of which are
hereby incorporated by reference in their entirety.
[0065] The treating professional can, at his or her convenience,
check the setup, and review the information sent in step 300 (step
302). The treating professionals can use a variety of tools to
interpret patient information. For example, the treating
professional can retrieve and analyze patient information through a
reconstructed 3D model of the patient's teeth and other anatomical
structures. The professional can view animations showing the
progress of the treatment plan to help the treating physician
visualize the pace of treatment. Using these tools, the treating
professional can easily and quickly view and/or edit the treatment
plan.
[0066] If necessary, the treating professional can adjust one or
more teeth positions at various intermediate stages of treatment
(step 304). A variety of diagnostic decision-support capabilities
such as automated teeth collision detection can be used to aid the
treating professional in adjusting the teeth positions.
[0067] When the treating professional arrives at a prescription or
other final designation, the treatment information is automatically
collected by the system over the Internet, thus eliminating the
cost and delay associated with the traditional physical shipping of
patient information (step 306). These modifications are then
retrofitted onto the dataset used to generate the aligners (step
308). The aligners may then be physically fabricated (step
294).
[0068] FIG. 6 shows a process 400 associated with a viewer that
allows the treating professional to visualize the patient's teeth
over the network 102 such as the Internet. In one embodiment,
during start-up, a browser checks for a viewer plug-in module
embodying the process 400 in a "plugins" subdirectory (Windows) or
Plug-ins folder (Mac OS) in the same folder or directory as the
browser (step 402). If the viewer plug-in module is available, the
browser looks for a MIME type and extension info from the version
resource. Through a TYPE attribute, the browser knows the MIME type
and can load a registered plug-in first and, if there are no
matches for the MIME type, the browser looks for a helper
application.
[0069] Once the viewer plug-in is identified, the browser loads the
viewer plug-in code into memory (step 404); initializes the viewer
plug-in (step 406); and creates a new instance of the viewer
plug-in (step 408). When the professional leaves the site or closes
the window, the viewer plug-in instance is deleted. When the last
instance of the viewer plug-in is deleted, the plug-in code is
unloaded from memory.
[0070] Next, data files are downloaded to the viewer plug-in (step
410). In one implementation, the viewer plug-in downloads a data
file from the dental server 102 using a suitable protocol such as a
file transfer protocol (FTP). The viewer plug-in uses the
downloaded file to present the treatment plan graphically to the
clinician. The viewer plug-in also can be used by the treatment
plan designer at the host site to view images of a patient's teeth.
FIG. 7 shows an exemplary user interface for the viewer plug-in of
FIG. 6. The professional can change views, select a particular
tooth and change its position as desired (step 412).
[0071] 3-D images of various orthodontic views can then be rendered
after each instruction from the treating professional is received
(step 414). In this process, an origin point, or "look from" point
associated with a camera view is generated. Next, a "look at" point
or a focus point associated with the camera view is determined. In
this system, the line from LookFromPoint to LookAtPoint defines the
direction the camera is shooting. Additionally, a camera Z vector,
or up vector, is determined.
[0072] Once the intermediate and final data sets have been created,
the appliances may be fabricated as illustrated in FIG. 8. Common
fabrication methods employ a rapid prototyping device 201 such as a
stereolithography machine. A particularly suitable rapid
prototyping machine is Model SLA-250/50 available from 3D Systems,
Valencia, Calif. The rapid prototyping machine 201 selectively
hardens a liquid or other non-hardened resin into a
three-dimensional structure which can be separated from the
remaining non-hardened resin, washed, and used either directly as
the appliance or indirectly as a mold for producing the appliance.
The prototyping machine 201 receives the individual digital data
sets and produces one structure corresponding to each of the
desired appliances. Generally, because the rapid prototyping
machine 201 may utilize a resin having non-optimum mechanical
properties and which may not be generally acceptable for patient
use, the prototyping machine typically is used to produce molds
which are, in effect, positive tooth models of each successive
stage of the treatment. After the positive models are prepared, a
conventional pressure or vacuum molding machine 251 is used to
produce the appliances from a more suitable material, such as 0.03
inch thermal forming dental material, available from Tru-Tain
Plastics, Rochester, Minn. Suitable pressure molding equipment is
available under the trade name BIOSTAR from Great Lakes
Orthodontics, Ltd., Tonawanda, N.Y. The molding machine 251
produces each of the appliances directly from the positive tooth
model and the desired material. Suitable vacuum molding machines
are available from Raintree Essix, Inc.
[0073] After production, the appliances can be supplied to the
treating professional all at one time. The appliances are marked in
some manner, typically by sequential numbering directly on the
appliances or on tags, pouches, or other items which are affixed to
or which enclose each appliance, to indicate their order of use.
Optionally, written instructions may accompany the system which set
forth that the patient is to wear the individual appliances in the
order marked on the appliances or elsewhere in the packaging. Use
of the appliances in such a manner will reposition the patient's
teeth progressively toward the final tooth arrangement.
[0074] Because a patient's teeth may respond differently than
originally expected, the treating clinician may wish to evaluate
the patient's progress during the course of treatment. The system
can also do this automatically, starting from a newly-measured
in-course dentition. If the patient's teeth do not progress as
planned, the clinician can revise the treatment plan as necessary
to bring the patient's treatment back on course or to design an
alternative treatment plan. The clinician may provide comments,
oral or written, for use in revising the treatment plan. The
clinician can also form another set of plaster castings of the
patient's teeth for digital imaging and manipulation. The clinician
may wish to limit initial aligner production to only a few
aligners, delaying production on subsequent aligners until the
patient's progress has been evaluated and alignment configuration
can be more accurately estimated.
[0075] FIG. 9 is a simplified block diagram of a data processing
system 500 that may be used to develop orthodontic treatment plans.
The data processing system 500 typically includes at least one
processor 502 that communicates with a number of peripheral devices
via bus subsystem 504. These peripheral devices typically include a
storage subsystem 506 (including a memory subsystem 508 and a file
storage subsystem 514), a set of user interface input and output
devices 518, and an interface to outside networks 516, including
the public switched telephone network. This interface is shown
schematically as "Modems and Network Interface" block 516, and is
coupled to corresponding interface devices in other data processing
systems via communication network interface 524. Data processing
system 500 could be a terminal or a low-end personal computer or a
high-end personal computer, workstation or mainframe.
[0076] The user interface input devices 518 typically include a
keyboard and may further include a pointing device and a scanner.
The pointing device may be an indirect pointing device such as a
mouse, trackball, touchpad, or graphics tablet, or a direct
pointing device such as a touch screen incorporated into the
display, or a three dimensional pointing device, such as the
gyroscopic pointing device described in U.S. Pat. No. 5,440,326.
Other types of user interface input devices, such as voice
recognition systems, can also be used. User interface output
devices typically include a printer and a display subsystem, which
includes a display controller and a display device coupled to the
controller. The display device may be a cathode ray tube (CRT), a
flat-panel device such as a liquid crystal display (LCD), or a
projection device. The display subsystem may also provide
non-visual display such as audio output.
[0077] Storage subsystem 506 maintains the basic required
programming and data constructs. The program modules discussed
above are typically stored in storage subsystem 506. As noted
above, storage subsystem 506 typically comprises a memory subsystem
508 and a file storage subsystem 514.
[0078] Memory subsystem 508 typically includes a number of memories
including a main random access memory (RAM) 510 for storage of
instructions and data during program execution and a read only
memory (ROM) 512 in which fixed instructions are stored. In the
case of Macintosh-compatible personal computer the ROM would
include portions of the operating system; in the case of
IBM-compatible personal computers, this would include the BIOS
(basic input/output system).
[0079] File storage subsystem 514 provides persistent
(non-volatile) storage for program and data files, and typically
includes at least one hard disk drive and at least one floppy disk
drive (with associated removable media). There may also be other
devices such as a CD-ROM drive and optical drives (all with their
associated removable media). Additionally, the system may include
drives of the type with removable media cartridges. The removable
media cartridges may be, for example, hard disk cartridges, such as
those marketed by Syquest and others, and flexible disk cartridges,
such as those marketed by Iomega. One or more of the drives may be
located at a remote location, such as in a server on a local area
network or at a site on the Internet's World Wide Web.
[0080] In this context, the term "bus subsystem" is used
generically so as to include any mechanism for letting the various
components and subsystems communicate with each other as intended.
With the exception of the input devices and the display, the other
components need not be at the same physical location. Thus, for
example, portions of the file storage sub-system could be connected
via various local-area or wide-area network media, including
telephone lines. Similarly, the input devices and display need not
be at the same location as the processor, although it is
anticipated that personal computers and workstations typically will
be used.
[0081] Bus subsystem 504 is shown schematically as a single bus,
but a typical system has a number of buses such as a local bus and
one or more expansion buses (e.g., ADB, USB, SCSI, ISA, EISA, MCA,
NuBus, or PCI), as well as serial and parallel ports. Network
connections are usually established through a device such as a
network adapter on one of these expansion buses or a modem on a
serial port. The patient computer may be a desktop system or a
portable system.
[0082] Scanner 520 is responsible for scanning casts 521 of the
patient's teeth obtained either from the patient or from an
orthodontist and providing the scanned digital data set information
to data processing system 500 for further processing. In a
distributed environment, scanner 520 may be located at a remote
location and communicate scanned digital data set information to
data processing system 500 via network interface 524.
[0083] Fabrication machine 522 fabricates dental appliances 523
based on intermediate and final data set information received from
data processing system 500. In a distributed environment,
fabrication machine 522 may be located at a remote location and
receive data set information from data processing system 500 via
network interface 524.
[0084] Referring now to FIG. 10, a virtual orthodontic practice
system is shown. The system is a web-based transaction environment
that allows qualified orthodontists and dental practitioners to
submit malocclusion cases as candidates for treatment. The system
is also used for managing the cases accepted for treatment. The
treating professional can accomplish the case submission and case
management process entirely within the web-based environment. As
shown in FIG. 10, an orthodontist or treating professional 702
submits cases into a case submission system 710. The treating
professional can also view and manage the case using a case
management system 720. The case management system 720 also
interacts with a provider 712, which operates the system of FIG. 8
in producing aligners for patients based on instructions from the
treating professional 702.
[0085] FIG. 11 shows a process for submitting a new case. Case
submission is the process of creating and submitting a malocclusion
case as a candidate for the system's treatment, all within a
web-based environment. First, the user clicks on a Start a New Case
link to take the user to an On-line Treatment Planning Form where
the user can complete the On-line Treatment Planning form and
submit the form. The orthodontist or treatment professional
initiates the case submission process by first logging in to the
web application (step 730). The doctor information is updated (step
732). After a successful login, the treating professional can begin
the case creation process. The treating professional enters the
patient information (step 734), their practice information, the
billing (step 736) and shipping (step 738) information, and finally
the diagnosis (step 740) and treatment (step 742) plan. After the
case details are finished, the treating professional submits the
case information (step 744). Subsequently, the treating
professional can submit the associated digital images (step 746)
and x-rays (step 748). The submitted case is received by the
provider 712. This completes the case submission process.
[0086] Once the user has submitted the On-line Treatment Planning
Form, the user may print copies of the `Treatment Planning Form
Summary`, save one copy for the user's records, and place the
second copy in the Orthodontics Records box along with the same
materials the user typically sends to the system. Next, the user
prints a shipping label by clicking on the `Print UPS Label` button
that appears when the user submits a new case on-line. The shipping
label is affixed to the outside of an orthodontics records box that
contains a Treatment Planning Form Summary, a PVS impression of
each arch in a separate foam bag, a bite registration in a separate
foam bag, copies of the patient's x-rays, and copies of the
patient's photos (intraoral and extraoral), for example.
[0087] Referring now to the greater detail shown in FIG. 12, a
website activity diagram for submitting a new case is detailed.
First, a new case is started (step 800). This can be done using a
treatment planning form (step 802). The treatment planning form
allows the user to select a case type and to evaluate orthodontic
conditions that may be encountered. From step 800, the process then
captures doctor and patient information (step 804) using a doctor
and patient information form (step 806). This form verifies address
information and shipping information, patient information, and
allows the doctor to enter or otherwise select case refinement
coverage options, among others. From step 804, the doctor enters a
diagnosis (step 808). This can be done through a diagnosis form
(step 810). From step 808, the doctor then enters the treatment
goals (step 812). This can be done using a treatment goals form
(step 814). From step 812, the doctor then summarizes the case
(step 816) using a treatment plan summary preview (step 818). From
step 816, the case is submitted (step 820). This can be done using
a treatment plan summary (step 822). From step 822, a shipping
label is printed (step 824) using for example, a UPS label printing
process (step 824) as described above for cases that are shipped
using UPS.
[0088] Turning now to FIG. 13, the case management process is
detailed. Case management takes place after the treating
professional has submitted the case, and includes the recursive
review and approval process all taking place within the web
environment. The case management process ends when the treating
professional has finished and closed the case.
[0089] First, the treating professional submits the case (step 750)
as, e.g., shown in FIGS. 11 and 12. The system receives the case
over the network (step 752), and an experienced professional
reviewer reviews the case (step 754). The completed review is
submitted to the server (step 756) and the treating professional
can review and approve the case (step 758). Upon receiving
approval, the case manager accepts the case (step 760). The case is
then forwarded to the system of FIG. 9 to develop a computer model
(step 762). The computer model is then presented to the case
manager (step 764), who in turn forwards the model to the treating
professional for approval (step 766). The treating professional
reviews and if he or she accepts the treatment plan, sends an
approval to the case manager (step 768). The system of FIG. 9 then
manufacturers the aligners (step 770). The produced aligners are
then shipped (step 772) to the treating professional. Upon receipt
of the fabricated aligners (step 774), the treating professional
can finish the case (step 776). Upon conclusion of treatment, the
case is closed (step 778) and the system of FIG. 9 sends an
instruction to the case manager to close the case (step 780).
[0090] Referring now to FIG. 14, an online prescription workflow
for new cases is shown. First, a user logs in (step 850). In this
process, doctor information can be processed or input (step 852).
Next, a new case can be started (step 854). In this step, case type
information can be collected (step 856), patient information data
can be collected (step 858), diagnosis information can be collected
(step 860), or treatment goals can be collected (step 862). From
step 854, the case can be submitted (step 864). This can be done
over the network and a submission receipt can be delivered (step
866). Additional case submission information can also be submitted
(step 868). This additional information may include PVS
impressions, wax bites, x-rays, and digital images, among others.
The information from the case submitted and the additional case
submission data, if any, is then reviewed (step 870). The reviewer
can modify (step 872), accept (step 876), or reject (step 874) the
case.
[0091] One web-based implementation of FIGS. 10-14 is discussed
next. FIG. 15 shows an exemplary home page of the web-based
interface. The web-based system of FIGS. 15-18B allows users such
as doctors to manage the system practices on-line. The user can
view all aspects of the patients' cases on-line. The user can also
order advertising marketing materials, chat on-line with other
system doctors, review the system's how-to tutorials, and link to
the user's personal website.
[0092] The web-based system helps users such as the treating
doctors to ensure that appliances received from the provider 712
will treat the patient the way the user and provider intended. The
system does this with a dynamic 3-D animation called a virtual
treatment model. The system not only shows the user's patient's
teeth going through their projected movement as a result of wearing
the system appliances (aligners), but it also gives the user the
ability to manipulate the model in time and space to ensure the
treatment sequence is exactly what the user intended. The system
gives the user control over the aligners the user will receive: if
the animation the user sees does not depict the treatment or
outcome the user intended, the system allows the user to send
feedback to the provider 712 with instructions on how to re-set the
case. After the provider 712 has received the user's explicit
approval, the appliances are manufactured and sent to the user's
office.
[0093] When the user views the case online through the provider
712's web site (for example, at www.invisalign.com), the system
contacts the provider's computer system over the Internet and
downloads the treatment model to the user's computer, e.g., at work
or at home. The system then allows the user to play an animation
showing the treatment progressing over time, starting and stopping
at any point during the treatment. It also allows the user to
inspect the treatment from any angle, or from as far away or as
close as the user desires.
[0094] The system allows a treating professional, described below
as a "user", to view the status of all the cases at any point in
time. Within the home page 900, a Patient Chart appears on the
right hand side of the page. The chart is divided into two
columns--those cases that require action--Action Required 902--and
those that do not--No Action Required 904. Within these lists, a
status 908 will appear next to each patient's name 906. This status
908 identifies the current point of treatment for the patient 906.
For example, if the user has patient John Doe in the Action
Required column, and his status reads Awaiting Your Approval, the
user will need to view and approve of an aspect of Mr. Doe's file
in order to continue with his treatment.
[0095] Status categories that appear under Action Required can
include the following:
[0096] Awaiting Approval
[0097] Treatment Form Waiting to be Submitted
[0098] Case Refinement Waiting to be Submitted
[0099] Screening Form Waiting to be Submitted
[0100] Case Screening Result is Ready
[0101] Case on Hold Awaiting New Impressions
[0102] Case Waiting to be Resumed by Doctor
[0103] Midcourse Correction Waiting to be Submitted
[0104] Further Materials Required
[0105] Status categories that can appear under No Action Required
include the following:
[0106] Treatment Form Submitted to the Provider
[0107] Case Received and Under Review
[0108] Order Accepted by the Provider
[0109] Under Development
[0110] Shipments Scheduled
[0111] Aligners Shipped
[0112] Case Refinement Submitted
[0113] Case Currently Being Screened
[0114] Case Hold Requested by Doctor
[0115] Case Resume Requested by Doctor
[0116] Cancellation Requested by Doctor
[0117] Midcourse Correction Submitted
[0118] Certain status categories are now described in more
detail.
[0119] Treatment Form Waiting to be Submitted
[0120] This means that the user started a standard Online Treatment
Planning Form for a patient, but did not submit it to the provider
712. The case will be stored under this category until submitting
it.
[0121] Case Received and Under Review
[0122] Case Received and Under Review is a category of patients
whose clinical items (Treatment Planning Forms, PVS impressions,
Bite Registrations, X-rays, Photos) the provider 712 has received
and is in the process of confirming that these patients are
candidates for the system treatment. If the case is accepted for
treatment, the status will change to Order Accepted by the provider
712. If the case is not accepted for treatment, the status will
change to Order Not Accepted by the provider 712 and a
representative will notify the user's office.
[0123] Order Accepted
[0124] Order Accepted is a category of patients whose cases have
been accepted for treatment by the provider 712. The next status
the user will see for this patient will be Under Development. When
this patient's file has been developed, the status will then change
status to Awaiting Approval. At that time, feedback to the system
will be required in order to continue processing the case.
[0125] Under Development
[0126] Under Development is a category of patients whose files are
currently being developed by the provider 712. As noted above, when
the system is ready, the patient's status will change to Awaiting
Approval. At that time, feedback to the system will be required in
order to continue processing the case.
[0127] Awaiting Approval
[0128] Awaiting Approval is a category of patients whose files are
ready for review and feedback. To review a patient's file, the user
can click on the patient name in the home page. The user will be
linked to the patient's Summary Page where the user, e.g., can view
models. If the user accepts a patient's case, the status for the
patient will change to The Aligner in Production. If the user
requests modification of the file, the status will change back to
Under Development.
[0129] Shipments Scheduled
[0130] Shipments Scheduled is a category of patients whose the
aligners are currently being produced and are due to ship in the
near term. To view a patient's scheduled ship date, the user can
click on his or her name. The user will be linked to the patient's
Summary Page where the user can view the ship date. Once the
patient's aligners are shipped, the status will change to Aligners
Shipped.
[0131] Aligners Shipped
[0132] Aligners Shipped is a category of patients whose aligners
have already shipped. The user can check the date the aligners were
shipped by clicking on the patient's name. The user will be linked
to the patient's Summary Page where the user can view the ship
date. This is the last status for a patient.
[0133] Case Refinement Waiting to be Submitted
[0134] Case Refinement Waiting to be Submitted is a category of
patients whose Case Refinement Form the user started, but did not
yet submit to the provider 712. To submit this form for a patient,
the user can click on the patient's name. The user will be linked
to the patient's Summary Page. From this page the user can continue
filling out the form and submit it to the provider 712. Once the
form is submitted, the status will change to Case Refinement
Submitted.
[0135] Case Refinement Submitted
[0136] Case Refinement Submitted is a category of patients whose
Case Refinement Form the user submitted to the provider 712. Once
the provider 712 begins developing a new file for these patients,
the patient status will change to Under Development. When the
system is ready, the patient status will change to Awaiting
Approval. At that time, feedback to the system will be required in
order to continue processing the case.
[0137] Screening Form Waiting to be Submitted
[0138] Screening Form Waiting to be Submitted is a category of
patients whose Screening Forms the user started, but did not submit
to the provider 712. To submit this form for a patient, a user can
click on the patient's name. The user will be linked to the
patient's Summary Page. From this page the user can continue
filling out the form and submit it to the provider 712. Once the
form is submitted, the status will change to Case Currently Being
Screened.
[0139] Case Currently being Screened
[0140] Case Currently Being Screened is a category of patients
whose Screening Forms the user submitted to the provider 712. These
cases are currently being reviewed by the provider 712--when the
review process is complete, the patient status will change to Case
Screening Result is Ready.
[0141] Case Screening Result is Ready
[0142] Case Screening Result is Ready is a category of patients
whose Screening Forms the user submitted to the provider 712 and
whose results are ready for review. These cases are currently being
reviewed by the provider 712--when the review process is complete,
the patient status will change to Case Screening Result is Ready.
After that status is achieved review the case screening results for
a patient, the user can click on the patient's name.
[0143] Case on Hold Awaiting New Impressions
[0144] Case on Hold Awaiting New Impressions is a category of
patients whose cases have been placed on hold by the provider 712
due to unusable PVS impressions. When the provider 712 places a
case on hold, the user's office will be notified so that steps can
be taken to resume the case as quickly as possible.
[0145] Case Waiting to be Resumed by Doctor
[0146] Case Waiting to be Resumed by Doctor is a category of
patients whose cases the user has placed on hold--these cases will
remain on hold until the user resumes them. To resume a case, the
user can click on the patient's name. The user will be linked to
the patient's Summary Page. From this page the user can click on
the Resume This Case link.
[0147] Case Hold Requested by Doctor
[0148] Case Hold Requested by Doctor is a category of patients'
whose cases the user has requested that the provider 712 place on
hold. Before the provider 712 places the case on hold, the user
will be called to confirm that the user wants the provider 712 to
stop processing the case. Once the provider 712 has confirmed that
the user wants the case placed on hold, the status will change to
Case Waiting to be Resumed by Doctor. The user can then resume it
by clicking on the patient's name. The user will be linked to the
patient's Summary Page. From this page the user can click on the
Resume This Case link.
[0149] Case Resume Requested by Doctor
[0150] Case Hold Requested by Doctor is a category of patients
whose cases the user has requested that the provider 712 place on
hold. Before the provider 712 places the case on hold, the user's
office will be notified confirm that the user wants the provider
712 to stop processing the case. Once the provider 712 has
confirmed that the user wants the case placed on hold, the status
will change to Case Waiting to be Resumed by Doctor. The user can
then resume it by clicking on the patient's name. The user will be
linked to the patient's Summary Page. From this page the user can
click on the Resume This Case link.
[0151] Cancellation Requested by Doctor
[0152] Cancellation Requested by Doctor is a category of patients
whose cases the user has requested that the provider 712 cancel.
Before the provider 712 cancels a case, the user's office will be
called to confirm that the user wants the provider 712 to stop
processing the case. Once the provider 712 has confirmed that the
user wants the case cancelled, the case will be removed from the
database.
[0153] Midcourse Correction Form Waiting to be Submitted
[0154] Midcourse Correction Form Waiting to be Submitted is a
category of patients whose Midcourse Correction Forms the user
started, but did not submit to the provider 712. To later submit
this form for a patient, the user can click on the patient's name.
The user will be linked to the patient's Summary Page. From this
page the user can continue filling out the form and submit it to
the provider 712. Once the form is submitted, the status will
change to Midcourse Correction Submitted. Once the provider 712 has
had a chance to review the user's request, the patient status will
change to Under Development.
[0155] Midcourse Correction Submitted
[0156] Midcourse Correction Submitted is a category of patients'
whose Midcourse Correction Forms the user recently submitted to the
provider 712. Once the provider 712 has had a chance to review and
process the request, the patient status will change to Under
Development.
[0157] Further Materials Required
[0158] Further Materials Required is a category of patients whose
files are incomplete and cannot be processed further until
additional materials are sent to the provider 712. In most cases,
this means that the Submission Box sent to the provider 712 did not
include all necessary patient materials. When a case enters this
status, the provider 712 will call the user's office to let the
user know that further materials are required.
[0159] To view only certain cases, the user may click on the status
category in the Case Summary box that the user is interested in
viewing. For example, if the user would like to view only cases
that are in the Awaiting Approval phase, the user clicks on that
link. The patient chart on the right side of the page will now only
display cases in the Awaiting Approval phase.
[0160] To return to a view of all the cases, the user clicks on
Total to take the user back to the original patient chart. The user
can also sort cases within any patient list by clicking on one of
the column headings. For example, to sort cases by patient name,
the user may click on the Patient Name heading. The cases will now
be sorted in alphabetical order by patient name. The user can
always identify how the patient list is sorted by noting which
column heading is italicized.
[0161] Each of the patients in treatment has their own Patient
Summary Page. The Patient Summary Page allows the user to view all
aspects of a patient's case, from their file to their treatment
history. To access a Patient's Summary Page, the user clicks on the
name of the patient whose file the user would like to view. The
user can find a list of all the patients on the Home Page. From the
Patient Summary Page, the user can do each of the following:
[0162] View a Patient's Model
[0163] View Static Images
[0164] View Treatment History
[0165] View On-line Forms--Attachment and Reproximation
[0166] Create an Aligner Schedule
[0167] Place a Case on Hold
[0168] Cancel a Case
[0169] One function supported by the system is to enable the user
to complete an On-line Treatment Planning Form (see FIG. 16)
quickly and efficiently.
[0170] On the Treatment Planning Form page the user can access the
following:
[0171] On-line Treatment Planning Form
[0172] Paper Treatment Planning Form
[0173] Case Refinement Form
[0174] Mid-course Correction Form
[0175] A template called Treatment Preferences can be used to allow
the user to enter treatment information one time--this information
is then incorporated into each form the user fills out, eliminating
the need to enter redundant information each time the user submits
a new case. The Treatment Preferences form will automatically
appear in a separate window when the user clicks on the Start a New
Case link for the first time. For each On-line Treatment Planning
Form the user fills out, at the beginning of the form the user is
given the option of activating the Treatment Preferences for that
form. The user can change the Treatment Preferences at any time by
clicking on the Treatment Preferences link that appears after the
user has clicked on the Start a New Case link.
[0176] In this system, the form does not allow the user to advance
to subsequent pages until the current page is completely filled
out. In addition, the form has built-in logic; it does not permit
the user to send in a form that has contradictory inputs, nor can
the user submit a case that does not meet predetermined case
selection criteria. These features greatly increase the likelihood
that each submitted case would be accepted for treatment. If the
user requires assistance in filling out the form, the user clicks
on the question mark symbol within the form to view the
comprehensive Help section.
[0177] Yet another feature is a Case Selection Expansion option.
Case Selection Expansion allows doctors experienced in the system
to submit cases beyond the limits of what is normally accepted
through the On-line Treatment Planning Form. If the user is an
experienced user who has submitted a large number of cases, the
user is eligible for Case Selection Expansion. Once classified as
an experienced user, the user will see a screen asking whether the
user would like to use the standard On-line Treatment Planning Form
or the Case Selection Expansion Form, which allows more
flexibility. If the user selects the Case Selection Expansion Form,
the user is prompted to sign a waiver. Besides relaxed case
selection criteria for the Case Selection Expansion Form, the user
will find the two submission forms are identical.
[0178] Yet another feature in this embodiment is case screening. If
the user is not sure whether a case is appropriate for system
treatment and would like feedback from the system, the user can use
the Case Screening feature. The user must be able to submit digital
photos on-line to use this feature. In one embodiment, to screen a
new case, the user clicks on a Case Screening link, enters the
office information and the patient's information, enters the
treatment plan and goals for the patient, and uploads digital
photos of the case--either individual photos or a composite photo.
After submission, a professional reviewer, at the provider end,
reviews and provides comments and/or suggestions for treatment. If
a patient's screening result is ready, that patient's status is
listed as Case Screening Result is Ready. The user can then click
on the patient's name to view the screening result and to submit
the case for treatment.
[0179] The system can also handle case refinement situations. Case
refinement occurs when additional aligners beyond the last stage
are needed to move a patient's teeth closer to the desired final
outcome approved by the user in the system. If the user has a case
that qualifies for Case Refinement, the user's next step is to
submit a Case Refinement Form for that case. Once the user has
submitted a Case Refinement Form, the user can track the status of
the form through the Home Page shown in FIG. 15. When the form is
submitted, the patient's status will change to Case Refinement
Submitted. When a new file begins production, the status will
change to Under Development. Once the file is ready for review, the
status will change again to Awaiting Approval.
[0180] In instances where clinical results deviate from the
original treatment plan such that the aligner(s) no longer fit, a
Mid-Course Correction is necessary. This may be due to any or a
combination of the following:
[0181] Patient underwent dental work during the course of
treatment
[0182] Poor patient compliance
[0183] Treatment goal has changed
[0184] Case has deviated from the approved course of treatment
[0185] If the user has a case that qualifies for Mid-Course
Correction, the next step is to submit a Mid-Course Correction Form
for that case. Once the user has submitted a Mid-Course Correction
Form, the user can track the status of the form through the Home
Page. When the form is submitted, the patient's status will change
to Mid-Course Correction Form Submitted. When a new file begins
production, the status will change to Under Development. Unlike
Case Refinement Cases, Mid-Course Correction files do not require
feedback. Once the file is ready, the status will change again to
Aligner Shipments Scheduled.
[0186] FIGS. 18A and 18B show exemplary views of static images of a
patient's teeth. The benefit of the static images is that they
provide the user with initial and final images of the depicted
treatment at a high resolution. To view a patient's static images,
the user can click on the View Static Images link within the
Options menu bar on the left side of a Patient's Summary Page.
Alternatively, the user can access static images by clicking on the
Static Images link at the bottom of a Patient's Summary Page. Once
viewing the images, the user can enlarge them for a better view by
clicking on them. The user can scroll the mouse over the image to
view the initial and final views of the patient's depicted
treatment. The bottom images provide a side-by-side comparison of
the initial and final views.
[0187] The system can also allow the user to view a patient's
dental model. To view a patient's file, the user clicks on the name
of the patient whose file the user would like to view. The user can
use the system to see many different views of a treatment model.
The user can zoom in and out, hide the upper and lower arches, and
rotate the model to allow viewing from different angles. The user
can choose to see the model, in one embodiment, from fourteen
different pre-set angles. The user can rotate a model to any angle,
making it seem to spin in the window. The user can position the
mouse inside the model window and click and hold the left mouse
button while dragging the mouse in the direction that the user
wants to move the model. The model rotates as the user moves the
mouse. As an example, the user can start with the right buccal view
of the model. The user must click and hold the left mouse button
and drag the mouse from right to left. As the user does so, the
model rotates so the user can see all of the teeth as the model
moves.
[0188] If the user would like to take a closer look at a model, the
user can zoom in. Conversely, if the user would like to see a view
of the model from further away, the user can zoom out. To zoom, the
user may press and hold the Control (Ctrl) key. Positioning the
mouse inside the model window, the user may click and hold the left
mouse button and drag the mouse up to zoom out and down to zoom in.
The further the user drags, the further the user will zoom.
Alternatively, if the mouse has a mouse wheel, the user can turn
the mouse wheel to zoom in and out. The user can also slide the
model up and down, and left and right. To slide the model, the user
may, e.g., press and hold the Shift key, then click and drag the
mouse. The model consequently moves in the direction of the mouse
motion. This motion can be useful when the user has a zoomed-in
view of the model, and the user wishes to view another part of the
model. The user can hide the upper or lower arch to see an
unobstructed view of the other arch. This is useful, for example,
when looking at the occlusal surface of either arch. To hide the
upper arch, the user may click the checked box next to Show Upper
Jaw in the left menu bar. The check mark is then removed and the
upper arch disappears from view. To hide the lower arch, the user
may click the checked box next to Show Lower Jaw in the Dialog box.
The check mark is then removed and the lower arch disappears from
view. When the user hides either arch, the user can still rotate
the model so the user can see it from various angles. Once the user
has hidden an arch, the user can show it again. To show an arch
once the user has hidden it, the user must re-select the Show Upper
Jaw or Show Lower Jaw check box from the left bar menu. When the
boxes show check marks, the arches are shown. The user can also
select the level of detail of the model. On the left menu bar, the
options Show Low Resolution and Show High Resolution appear. By
default, Show Low Resolution is selected. Alternatively, the user
can select Show High Resolution to show a more detailed version of
the model. To print a model in its current view, the user may click
the Print icon or right-click the mouse over the window and select
Print from the right mouse button menu. The animation allows the
user to see how a patient is projected to progress using the
system. Using the animation controls located in the lower right
corner of the model window, the user can play, stop, rewind and
fast-forward the animation. The user can also step forward or
backward through the animation stage by stage (e.g., where a stage
corresponds to one set of aligners). To play an animation, the user
clicks the Play button. The Play button then becomes the Stop
button. To stop an animation, the user clicks the Stop button. To
resume playing the animation, the Play button is clicked. When the
user rewinds an animation, the model returns to its beginning
position. To rewind an animation, the user can click the Rewind
(<<) button. To rewind the model stage-by-stage, the user can
click the Back (<) button and the model will rewind one stage.
When the user fast-forwards an animation, the model advances to its
final position. To fast-forward an animation, the user can click
the Fast Forward (>>) button. To view the model
stage-by-stage, the user can click the Forward (>) button and
the model will advance one stage.
[0189] Other features supported by the web-based system of FIG. 10
includes Viewing Current/Archived News; Viewing the Case Gallery
where the user can view before and after pictures of past system
patients by visiting the system Case Gallery; Downloading All Files
at Once, where the user can view the patients' cases without being
connected to the Internet by downloading a series of patient files;
Printing a List of All Patients; and a Message Board, where the
users talk with other system doctors to share experiences with the
product so the user can learn from and offer suggestions to other
doctors who are using the provider 712.
[0190] FIGS. 19-23 show one embodiment of a second opinion service
(SOS) that provides an opportunity for inexperienced professionals
to receive advice from experienced professionals in treating their
patients. Referring now to FIG. 19, a second opinion service
process 1000 is started when a doctor submitter receives notice on
his or her web page that a clinical check (CC) file is present and
awaits approval (1002). The CC file specifies teeth movement in
each treatment stage, where each stage causes teeth to be
incrementally moved. The CC file allows the doctor to visualize the
treatment plan, including the teeth position at each stage. In one
embodiment, the doctor sends a prescription to a provider/company
712 (FIG. 10). One such provider/company 712 is Align Technology,
Inc. in Santa Clara, Calif. The provider 712 generates a CC file
and allows the doctor to review and approve the CC file over the
Internet in this embodiment. In one embodiment, a web-based system
called Virtual Invisalign Practice (VIP) available from Align
Technology is used to securely communicate patient information over
the Web.
[0191] In 1004, the doctor is given an opportunity to view the
proposed CC file (from provider 712) and comments are either
entered by him or by the provider/company 712. The doctor can view
files and other materials previously submitted such as x-rays,
photographs or comments (1006). From 1006, the doctor has the
opportunity to request a SOS by clicking a button, for example, the
doctor is shown an agreement form such as a waiver form (1008). In
one embodiment, the form describes each party's responsibilities
with respect to the SOS process. If the doctor agrees, the doctor
can proceed. Alternatively, if the doctor disagrees, the process
loops back to 1006. The doctor can also modify or accept the
ClinCheck file, in which case no change is noted in 1030-1032.
Also, the doctor can check on "what is SOS," and a frequently asked
question (FAQ) page is displayed at 1034.
[0192] In 1010-1012, if the doctor accepts the agreement, the
doctor enters a doctor identification of a consulting doctor or
planning doctor who plans or revises the treatment plan for the
requesting doctor. The system can perform a directory search at
1040. The system shows the consulting doctor's contact information
and gives the requesting doctor an opportunity to confirm. Once the
doctor verifies that there is no typographical error the doctor can
enter comments and send a message to the planning doctor to request
SOS assistance at 1014. At 1014, once the message has been sent,
the consulting doctor sees a status of "SOS Requested" on his home
page. At 1016, the information sent includes ClinCheck form,
prescription data, and supporting data such as X-rays, photos,
comments, static images, attachment forms and reproximation forms.
Next, buttons are disabled when the case status involves SOS
Request, Approve ClinCheck, and Modify ClinCheck, among others
(1018). At 1020-1024, after the SOS has been requested, the
requesting doctor can cancel the request before the planning doctor
has accepted the SOS. Upon requesting a cancellation, the doctor
has an option to include additional comments. At 1026, if a
cancellation occurs, a confirmation is generated to update the
patient status on the doctor's home page to indicate "SOS
Cancelled" (1028).
[0193] At 1050, upon submission of the SOS by the submitting
doctor, the planning doctor's home page will show a new patient
with status of "SOS Requested by Doc Name." At 1052, the patient
detail page shows recent comments and CC information. At 1054, when
the doctor clicks on the patient detail page, the doctor also views
all other details and information that the submitting doctor
has.
[0194] Turning now to FIG. 20, at 1100, the planning doctor's home
page shows an action item "SOS requested" by the requesting
doctor's name. The patient detail page is updated with the SOS
Requested by Doctor Name (1102). At 1104, the doctor can click on
the patient detail and review information from the submitting
doctor. At 1108, the comment to the doctor is captured (1106), and
upon transmission, the system updates the status as Comments Have
Been Sent (1108).
[0195] The planning/consulting doctor can look at the CC file and
decide if the doctor wishes to accept the case. If the doctor wants
to decline the case, the doctor can enter a comment and send to the
requesting doctor. Otherwise, the doctor can choose whether the
doctor wants to decline or agree, as shown in more details in FIGS.
21-22.
[0196] At 1110, when the planning doctor submits a comment to the
submitting doctor the submitting doctor will see a status item on
his home page as "Read comment" from the planning doctor. The
doctor clicks on the patient name and the doctor proceeds to 1112
where the doctor can review a particular patient's detail page and
the case comments. At 1114, if the doctor chooses to reply the
doctor can click on reply to enter comments to the planning doctor.
At 1116, when the requesting doctor clicks the send button, a
notification will be provided to provide feedback that a reply has
been sent to the planning doctor. At 1118, the doctor is taken to
the patient's detail page indicating "No action required--SOS
requested from doctor name." At 1120, when the doctor adds a
comment the planning doctor will then see a status change on his
web page stating that "Action is required SOS requested by doctor's
name". At 1122, when the doctor clicks on the patient's name the
doctor is taken to the patient's detail page, and at 1124, the
doctor can review the patient's detailed information, as previously
discussed.
[0197] Turning now to FIG. 21, at 1200--Planners VIP has the
patient name listed under "Action required" where status is "SOS
Requested." At 1202, the patient detail page is updated with the
Action "SOS Requested by Doctor Name." At 1204, the doctor reviews
the information and has the option to accept or decline the case.
If the doctor accepts the case, the process jumps to 1300 and if
not, the process proceeds to 1206, where the doctor sends a
cancellation request to the submitting doctor. At 1208, the doctor
can change his/her decision. In this case, the SOS Request is
declined and the submitter's page is updated with the status that
"ClinCheck Ready" at 1210. At 1212, if the doctor wants to continue
with SOS, the process shows the doctor a confirmation that his/her
message has been sent and the SOS request has been declined. At
1214, the doctor is shown the patient detail page where the doctor
views the patient's information. The buttons to Agree, Decline and
Comment are disabled at 1220.
[0198] At 1216, the doctor has the option to erase all information
relating to a patient's case so that the doctor will no longer have
a record of the patient on his web page. From either 1214 or 1216,
the home page can be accessed at 1218.
[0199] Turning now to FIG. 22, at 1304, doctor has accepted the SOS
case and the patient name is displayed on the web page and the
doctor can click on the patient's name to review the case
information. At 1306, the treatment detail is communicated. At
1308, the planning doctor can communicate with the submitting
doctor through comments. If the doctor chooses to comment, the
process jumps to 1100. If the doctor chooses to decline, the
process proceeds to 1200. At 1310, the doctor can accept the SOS
request and at 1320, once the doctor has accepted the SOS, a
confirmation is sent to both himself and to the submitting doctor.
If the SOS Request is accepted, the submitter's home page is
updated in 1312 and the patient detail page is updated in 1314. At
1316, the links such as Cancel SOS, Comment, among others are
disabled. The treatment prescription is updated at 1322, and the
process can update the VIP home page with action required as "SOS
Requested by Doctor Name" at 1300.
[0200] Once the doctor has accepted the SOS the doctor has the
option to modify the CC data as previously mentioned, which
proceeds to FIG. 23, or at any point during the SOS process the
doctor has the option to cancel SOS and go to 1100 or to 1200 as
displayed on FIG. 22. The doctor sees all the information available
to the submitting doctor. The planning doctor then has an option to
request modification of the ClinCheck (CC) file. The doctor can
also enter comments and request certain modifications and the
information is sent to the company/provider such as Align
Technology on behalf of the submitting doctor. If the doctor
agrees, the doctor can enter a comment to the submitting
doctor.
[0201] Referring now to FIG. 23, at 1400, the doctor can see the
patient name on the home page with action required "Complete SOS
for doctor name". When the doctor clicks on the patient's name the
doctor views all the same information the submitting doctor has in
his patient summary page at 1402. At 1406-1408, the doctor can
review the same information available to the submitting doctor. At
this point, the doctor can cancel SOS (go to 1200), or the doctor
can submit a comment to the submitting doctor (go to 1100).
[0202] From 1408, the ClinCheck modification request is sent to the
dental supplier such as Align Technology, Inc., at 1420. Upon
receipt by the supplier at 1422, the process notes that the CC file
is ready and loops to 1400.
[0203] If comments are to be shared with the submitter at 1430, the
submitter's home page is updated at 1432 and the patient detail
page is updated at 1434. Also, the treatment detail page is updated
at 1436.
[0204] Alternatively, the doctor can request to modify CC data, or
the doctor can enter comments to the company provider at 1410. If
so, notification is then provided to him that the comment has been
sent successfully to the company. At 1412, once the doctor submits
a comment to the company to request CC modification, the doctor's
VIP page is updated to show that No Action Required--"CC
Modification Requested". At 1450, when the planning doctor accepts
the modified clinical check file, the doctor can click on an SOS
complete button, at that point the doctor has the option to enter
additional comments that the doctor can then submit to the
submitting doctor. The case status is updated at 1452. At 1470, the
doctor then gets a confirmation. At 1472, the doctor has the option
to erase all patient information from his system upon completion of
the case. If he selects this option, at 1474, the doctor is
prompted to print out information on the case to be removed. At
1476, upon erasure, a notification will be provided that the case
has been erased. At 1478, when the doctor clicks on an OK button,
the doctor is returned to the VIP homepage.
[0205] At 1454, once the SOS work has been completed by the
planning doctor, the submitting doctor is notified that an updated
CC file awaits approval on his VIP homepage. At that point the
doctor can then click on the patient name. At 1456, the doctor can
see the patient detail information. At 1458, the doctor can click
on the updated CC file and view the modifications requested by the
planning doctor. At 1460, the doctor can accept the CC file if the
doctor approves of the proposed changes. If not, at 1462, the
doctor can request another modification of the CC file.
Alternatively, the doctor can request a second SOS to the same
planning doctor or a different planning doctor. If so, the process
loops to 1000.
[0206] The invention has been described in terms of particular
embodiments. Other embodiments are within the scope of the
following claims. For example, the three-dimensional scanning
techniques described above may be used to analyze material
characteristics, such as shrinkage and expansion, of the materials
that form the tooth castings and the aligners. Also, the 3D tooth
models and the graphical interface described above may be used to
assist clinicians that treat patients with conventional braces or
other conventional orthodontic appliances, in which case the
constraints applied to tooth movement would be modified
accordingly.
* * * * *
References