U.S. patent application number 13/688836 was filed with the patent office on 2013-04-11 for system and method for collection of community health and administrative data.
This patent application is currently assigned to NOMORECLIPBOARD, LLC. The applicant listed for this patent is Nomoreclipboard, LLC. Invention is credited to Douglas R. Horner.
Application Number | 20130090945 13/688836 |
Document ID | / |
Family ID | 36126707 |
Filed Date | 2013-04-11 |
United States Patent
Application |
20130090945 |
Kind Code |
A1 |
Horner; Douglas R. |
April 11, 2013 |
SYSTEM AND METHOD FOR COLLECTION OF COMMUNITY HEALTH AND
ADMINISTRATIVE DATA
Abstract
A health care patient document system and method which enable
patients to enter clinical, administrative, and financial
information normally completed on a clipboard in a medical office
into a computerized system that stores the information. The patient
is then enabled to direct the stored information to any health care
provider whether the provider is enabled to receive the data
electronically nor not. For those provider clinicians and
organizations not enabled to receive the information
electronically, the system completes the paper-based forms already
in use within the organization and sends the completed form by
facsimile or mail delivery.
Inventors: |
Horner; Douglas R.; (Fort
Wayne, IN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Nomoreclipboard, LLC; |
Fort Wayne |
IN |
US |
|
|
Assignee: |
NOMORECLIPBOARD, LLC
FORT WAYNE
IN
|
Family ID: |
36126707 |
Appl. No.: |
13/688836 |
Filed: |
November 29, 2012 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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13294730 |
Nov 11, 2011 |
|
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13688836 |
|
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10957491 |
Oct 1, 2004 |
8060376 |
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13294730 |
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Current U.S.
Class: |
705/2 |
Current CPC
Class: |
G16H 10/20 20180101;
G16H 10/60 20180101 |
Class at
Publication: |
705/2 |
International
Class: |
G06Q 50/22 20060101
G06Q050/22 |
Claims
1. A computerized method for collecting medical information from
patients, the method comprising the steps of: storing the following
in a database: (1) a plurality of digitized images of substantially
blank clipboard forms for collecting patient information from a
plurality of health care providers, wherein at least a portion of
the clipboard forms have distinct predefined layouts with
predefined locations associated with answer spaces; (2) a plurality
of answers of a patient to a series of common questions from at
least a portion of the clipboard forms; (3) positional coordinates
of the predefined locations associated with the answer spaces for
respective clipboard forms; (4) data matching answers of the
patient with the positional coordinates for answer spaces
associated with respective clipboard forms; and (5) a location
where respective clipboard forms should be sent when completed;
providing a web-based system for allowing patient information to be
distributed in a respective clipboard form of a selected health
care provider, wherein the web-based system is configured to: allow
selection of a healthcare provider from a plurality of healthcare
providers to whom the patient's answers should be sent; populate a
clipboard form associated with the selected healthcare provider
with the patient's answers in the database so that the patient's
answers appear in the respective answer spaces corresponding to the
predefined layout for the selected healthcare provider's clipboard
form; and send the populated clipboard form to the selected
healthcare provider based on the location associated with the
clipboard form in the database.
Description
RELATED APPLICATIONS
[0001] This is a continuation application of U.S. patent
application Ser. No. 13/294,730, filed on Nov. 11, 2011, which was
a continuation of U.S. patent application Ser. No. 10/957,491,
filed on Oct. 1, 2004 (now U.S. Pat. No. 8,060,376). To the extent
not included below, these applications are hereby expressly
incorporated by reference in their entirety into the present
application.
SUMMARY OF THE INVENTION
[0002] The present invention is a patient entry health care/medical
information system and method which allows for patient entry to a
single data repository which is compatible with all of the
community's health care and medical systems, whether computer or
paper based. The present invention includes profiling the various
health care/medical information system entry forms (typically in
paper form), determining the contents of a single database that can
provide relevant patient information for all of those forms, and
generating a library of forms for each health care/medical
institution that can include the relevant patient information in a
form compatible with the institution's current system (typically in
paper form).
[0003] A third party service provider (TPS), not directly engaged
in providing health care services or directing patient referrals,
oversees and manages the system to ensure that providers are not
skeptical of either participating and/or promoting the system. Each
provider in the community is sent a letter asking them to send in
blank copies of all the clipboard paperwork they have patients
complete. The TPS provider then scans the clipboard paperwork sent
in by the providers and constructs a database of the form image,
the form type, the questions on the form, the details of the
questions, the position on the form where the answers should be
rendered (written), and how and where to send completed forms (i.e.
fax/mail). If the provider is capable of processing information
electronically, the format and protocol for that physician is
stored (i.e.: e-mail, h17, XML, etc.) and the nomenclature of the
electronic information (CPT/ICD9, NDDF, MediSpan, NDC, SNOMED,
etc).
[0004] As many forms are received from the providers and entered
into the system of the present invention, the software will
recommend and physician reviewers will confirm a quorum of
questions that are common to most of the forms. This quorum of
questions in the database becomes the questionnaire that patients
will fill out online. This provides the biggest return for the
patient since they will only be asked questions once at
registration but the information could be used to populate the
forms of any of the providers in the database.
[0005] A patient visits the website to register with a username and
a password that is assigned to an account. The patient completes
the web-based questionnaire by answering the questions and the
responses are coded and stored associated to their account. The
patient's username and password are required to view and/or edit
their information. No one except that patient should be able to
access the information in the account from the website. As patients
need to send information to different providers, they would log
into the website, update the information if any changes are
necessary, and then select the physician they are to see soon. The
system may also prompt for additional questions that are not part
of the basic questionnaire and are specific to the physician and
the physician's office clipboard form (or other provider). The
system then stores the final responses, and populates the
physician's clipboard forms with the patient information in the
format specific for the physician and sends the forms to the
physician's office. It is also possible to allow patients to elect
to allow providers to update their medical information on the
website, although it is not necessary that providers have this
capacity.
[0006] The system of the present invention is a solution that
allows patients to enter their information once and electively send
that information to any provider they wish. The system of the
present invention formats the information for the specific
provider, and optionally prompts the patient with more detailed
questions that the provider may need to know. Since the dominant
method of formatting this information today is paper forms, the
system is adapted to produce a paper output of the electronic
information and duplicate the paper (and electronic if applicable)
forms that each provider in the community has in use. This method
of producing paper forms enables the patient to input medical
information into the computer once and then tell the computer to
complete the forms for several different providers.
[0007] The present invention provides a single point of entry for
patients to enter healthcare related information in a confidential
and secure fashion that is HIPAA compliant and does not interfere
with physician relationships with patients or referrers. The TPS
provider has no vested interest in steering patients to use one
provider over another, or recommend one therapy over another so
that physicians and providers can participate in the system without
concern that patients will be provided conflicting information.
Adoption of the system by providers is easy and does not require
anything except sending in their forms. Since the output of the
system of the present invention is their form filled out in a more
legible format, physicians should have no problem accepting the
forms.
[0008] The present invention, in one form, relates to a computer
server for providing access to patient data records. The computer
server includes a provider database, a patient interaction module,
and a provider interaction module. The provider database has a
plurality of provider patient documents, with at least one of the
plurality of providers having a patient document distinct from the
patient documents of the other of the plurality of providers. The
patient interaction module is adapted to obtain patient specific
information from a patient relating to information requested by the
plurality of provider patient documents. The provider interaction
module is adapted to transmit provider patient documents that
include patient specific information relating to a specific patient
in a format substantially identical to each of the providers.
[0009] The present invention, in another form, is a method for
creating a patient and health care provider document database.
First, a plurality of patient information documents is obtained
from a plurality of providers. Next, the plurality of patient
information documents is scanned and the patient information which
is identified in the patient information documents is determined. A
plurality of patient information template documents is created that
include patient specific information from a patient database.
Finally, a patient database is created that includes data fields
for patient information common to the plurality of patient
information documents.
[0010] Further aspects of the present invention involve the patient
interaction module being adapted to obtain at least one of the
following types of information: patient demographic, responsible
party, patient insurance, patient allergies, patient medications,
patient current medical problem list, patient family history,
patient social history, patient vaccination history, patient chief
complaint, patient history of present illness, and patient surgical
history. The patient interaction module is adapted to store patient
specific information in a data base file. The data base file may
include fields for at least one of the following types of
information: record identifying, personal identifying, patient
insurance/financial, advance directives, patient health status,
care documentation, care plan recommendation, and practitioners.
The database file further includes extension fields for containing
further information. The provider interaction module is further
adapted to transmit patient scheduling messages with a provider.
The provider interaction module is further adapted to transmit
patient documents by one of facsimile transmission, electronic data
interchange transmission, electronic mail transmission, or regular
mail delivery.
[0011] Another aspect of the invention relates to a
machine-readable program storage device for storing encoded
instructions for a method of providing a patient information
document to a health care provider according to the foregoing
systems.
BACKGROUND OF THE INVENTION
[0012] 1. Field of the Invention
[0013] The invention relates to health care/medical information
software. More specifically, the field of the invention is that of
health care/medical information software for patient information in
health care systems.
[0014] 2. Description of the Related Art
[0015] Much time and many resources are spent by health care
institutions and medical service practitioners, such organizations
being referred to herein as "providers," collecting and
re-collecting medical information from patients. Because providers
have different requirements and workflow procedures based on
specialty, specialized forms are in use in separate offices.
Patients are forced to answer common administrative, financial, and
health related questions repeatedly, typically in the format of a
predefined paper form with spaces for hand written responses, as
they move from provider to provider over the course of care.
[0016] Standardization of paper based forms for collecting health
information have proven to be useful within an organization, but
providers across a community tend to have difficulty coming to a
consensus for standardization. The lack of consensus stems from
differences in types and resolution of health information
specialists collect, in particular health care institutions such as
insurance companies and hospitals may have differing types of
relevant information, as do hospitals, testing labs, and
physicians. Also, the workflow within those organizations dictates
the need for specialized forms and therefore requires those
organizations to manually transfer information from standard forms
to their custom forms.
[0017] The reason there has not been a wide spread adoption of
uniform health care patient forms is that standardized forms fail
to satisfy the diverse needs across the health care and medical
community and there is no standard for collecting electronic health
information and distributing it to every participant that require
such information.
[0018] Even those providers which have electronic systems have
different vendors that are expecting the data in different formats,
thus making it difficult to share patient information
electronically. Attempts to allow patients to enter their
information into electronic systems using web-based questionnaires
have had some success for individual organizations, but from the
patient perspective this algorithm is just marginally better than
the paper based process, making the patient to have to fill out all
the information repeatedly on different websites instead of on
different clipboards.
[0019] A patient based medical/health care information system must
be an elective process initiated by the patient and must ensure
compliance with HIPAA and other privacy legislation and
concerns.
[0020] Additional features and advantages of the gripper assembly
will become apparent to those skilled in the art upon consideration
of the following detailed description of the illustrated embodiment
exemplifying the best mode of carrying out the gripper assembly as
presently perceived.
BRIEF DESCRIPTION OF THE DRAWINGS
[0021] The above mentioned and other features and objects of this
invention, and the manner of attaining them, will become more
apparent and the invention itself will be better understood by
reference to the following description of an embodiment of the
invention taken in conjunction with the accompanying drawings,
wherein:
[0022] FIG. 1 is a flow chart diagram view of a patient
registration process using the methodology of the present
invention.
[0023] FIG. 2 is a flow chart diagram of the operation of the
present invention relating to the initial screening process.
[0024] FIG. 3 is a schematic relationship diagram of a database
record in accordance with one embodiment of the present
invention.
[0025] FIG. 4 is a flow chart diagram of the operation of the
present invention relating to the process of allowing a patient to
select a provider and send out their information to that provider,
optionally scheduling the appointment.
[0026] FIG. 5 is a flow chart diagram of the operation of the
present invention relating to document transmission.
[0027] FIG. 6 is a schematic relationship diagram of the
correspondence of forms to providers and provider groups in the
system of the present invention.
[0028] Corresponding reference characters indicate corresponding
parts throughout the several views. Although the drawings represent
embodiments of the present invention, the drawings are not
necessarily to scale and certain features may be exaggerated in
order to better illustrate and explain the present invention. The
exemplification set out herein illustrates an embodiment of the
invention, in one form, and such exemplifications are not to be
construed as limiting the scope of the invention in any manner.
DETAILED DESCRIPTION OF THE DRAWINGS
[0029] The embodiment disclosed below is not intended to be
exhaustive or limit the invention to the precise form disclosed in
the following detailed description. Rather, the embodiment is
chosen and described so that others skilled in the art may utilize
its teachings.
[0030] The detailed descriptions which follow are presented in part
in terms of algorithms and symbolic representations of operations
on data bits within a computer memory representing alphanumeric
characters or other information. These descriptions and
representations are the means used by those skilled in the art of
data processing arts to most effectively convey the substance of
their work to others skilled in the art.
[0031] An algorithm is here, and generally, conceived to be a
self-consistent sequence of steps leading to a desired result.
These steps are those requiring physical manipulations of physical
quantities. Usually, though not necessarily, these quantities take
the form of electrical or magnetic signals capable of being stored,
transferred, combined, compared, and otherwise manipulated. It
proves convenient at times, principally for reasons of common
usage, to refer to these signals as bits, values, symbols,
characters, display data, terms, numbers, or the like. It should be
borne in mind, however, that all of these and similar terms are to
be associated with the appropriate physical quantities and are
merely used here as convenient labels applied to these
quantities.
[0032] Some algorithms may use data structures for both inputting
information and producing the desired result. Data structures
greatly facilitate data management by data processing systems, and
are not accessible except through sophisticated software systems.
Data structures are not the information content of a memory;
rather, they represent specific electronic structural elements
which impart a physical organization on the information stored in
memory. More than mere abstraction, the data structures are
specific electrical or magnetic structural elements in memory which
simultaneously represent complex data accurately and provide
increased efficiency in computer operation.
[0033] Further, the manipulations performed are often referred to
in terms, such as comparing or adding, commonly associated with
mental operations performed by a human operator. No such capability
of a human operator is necessary, or desirable in most cases, in
any of the operations described herein which form part of the
present invention; the operations are machine operations. Useful
machines for performing the operations of the present invention
include general purpose digital computers or other similar devices.
In all cases the distinction between the method operations in
operating a computer and the method of computation itself should be
recognized. The present invention relates to a method and apparatus
for operating a computer in processing electrical or other (e.g.,
mechanical, chemical) physical signals to generate other desired
physical signals.
[0034] The present invention also relates to an apparatus for
performing these operations. This apparatus may be specifically
constructed for the required purposes or it may comprise a general
purpose computer as selectively activated or reconfigured by a
computer program stored in the computer. The algorithms presented
herein are not inherently related to any particular computer or
other apparatus. In particular, various general purpose machines
may be used with programs written in accordance with the teachings
herein, or it may prove more convenient to construct a more
specialized apparatus to perform the required method steps. The
required structure for a variety of these machines will appear from
the description below.
[0035] The present invention deals with "object-oriented" software,
and particularly with an "object-oriented" operating system. The
"object-oriented" software is organized into "objects," each
comprising a block of computer instructions describing various
procedures ("methods") to be performed in response to "messages"
sent to the object or "events" which occur with the object. Such
operations include, for example, the manipulation of variables, the
activation of an object by an external event, and the transmission
of one or more messages to other objects.
[0036] Messages are sent and received between objects having
certain functions and knowledge to carry out processes. Messages
are generated in response to user instructions, for example, by a
user activating an icon with a "mouse" pointer generating an event.
Also, messages may be generated by an object in response to the
receipt of a message. When one of the objects receives a message,
the object carries out an operation (a message procedure)
corresponding to the message and, if necessary, returns a result of
the operation. Each object has a region where internal states
(instance variables) of the object itself are stored and where the
other objects are not allowed to access. One feature of the
object-oriented system is inheritance. For example, an object for
drawing a "circle" on a display may inherit functions and knowledge
from another object for drawing a "shape" on a display.
[0037] A programmer "programs" in an object-oriented programming
language by writing individual blocks of code each of which creates
an object by defining its methods. A collection of such objects
adapted to communicate with one another by means of messages
comprises an object-oriented program. Object-oriented computer
programming facilitates the modeling of interactive systems in that
each component of the system can be modeled with an object, the
behavior of each component being simulated by the methods of its
corresponding object, and the interactions between components being
simulated by messages transmitted between objects.
[0038] An operator may stimulate a collection of interrelated
objects comprising an object-oriented program by sending a message
to one of the objects. The receipt of the message may cause the
object to respond by carrying out predetermined functions which may
include sending additional messages to one or more other objects.
The other objects may in turn carry out additional functions in
response to the messages they receive, including sending still more
messages. In this manner, sequences of message and response may
continue indefinitely or may come to an end when all messages have
been responded to and no new messages are being sent. When modeling
systems utilizing an object-oriented language, a programmer need
only think in terms of how each component of a modeled system
responds to a stimulus and not in terms of the sequence of
operations to be performed in response to some stimulus. Such
sequence of operations naturally flows out of the interactions
between the objects in response to the stimulus and need not be
preordained by the programmer.
[0039] Although object-oriented programming makes simulation of
systems of interrelated components more intuitive, the operation of
an object-oriented program is often difficult to understand because
the sequence of operations carried out by an object-oriented
program is usually not immediately apparent from a software listing
as in the case for sequentially organized programs. Nor is it easy
to determine how an object-oriented program works through
observation of the readily apparent manifestations of its
operation. Most of the operations carried out by a computer in
response to a program are "invisible" to an observer since only a
relatively few steps in a program typically produce an observable
computer output.
[0040] In the following description, several terms which are used
frequently have specialized meanings in the present context. The
term "object" relates to a set of computer instructions and
associated data which can be activated directly or indirectly by
the user. The terms "windowing environment," "running in windows,"
and "object oriented operating system" are used to denote a
computer user interface in which information is manipulated and
displayed on a video display such as within bounded regions on a
raster scanned video display. The terms "network," "local area
network," "LAN," "wide area network," or "WAN" mean two or more
computers which are connected in such a manner that messages may be
transmitted between the computers. In such computer networks,
typically one or more computers operate as a "server," a computer
with large storage devices such as hard disk drives and
communication hardware to operate peripheral devices such as
printers or modems. Other computers, termed "workstations," provide
a user interface so that users of computer networks can access the
network resources, such as shared data files, common peripheral
devices, and inter-workstation communication. Users activate
computer programs or network resources to create "processes" which
include both the general operation of the computer program along
with specific operating characteristics determined by input
variables and its environment.
[0041] The terms "desktop," "personal desktop facility," and "PDF"
mean a specific user interface which presents a menu or display of
objects with associated settings for the user associated with the
desktop, personal desktop facility, or PDF. When the PDF accesses a
network resource, which typically requires an application program
to execute on the remote server, the PDF calls an Application
Program Interface, or "API," to allow the user to provide commands
to the network resource and observe any output. Although the
following description details such operations in terms of a graphic
user interface using icons, the present invention may be practiced
with text based interfaces, or even with voice or visually
activated interfaces. The term "Browser" refers to a program which
is not necessarily apparent to the user, but which is responsible
for transmitting messages between the PDF and the network server
and for displaying and interacting with the network user. Browsers
are designed to utilize a communications protocol for transmission
of text and graphic information over a world wide network of
computers, namely the "World Wide Web" or simply the "Web."
Examples of Browsers compatible with the present invention include
the Navigator program sold by Netscape Corporation and the Internet
Explorer sold by Microsoft Corporation (Navigator and Internet
Explorer are trademarks of their respective owners). Although the
following description details such operations in terms of a graphic
user interface of a Browser, the present invention may be practiced
with text based interfaces, or even with voice or visually
activated interfaces, that have many of the functions of a graphic
based Browser.
[0042] Browsers display information which is formatted in a
Standard Generalized Markup Language ("SGML") or a HyperText Markup
Language ("HTML"), both being scripting languages which embed
non-visual codes in a text document through the use of special
ASCII text codes. Files in these formats may be easily transmitted
across computer networks, including global information networks
like the Internet, and allow the Browsers to display text, images,
and play audio and video recordings. The Web utilizes these data
file formats in conjunction with its communication protocol to
transmit such information between servers and workstations.
Browsers may also be programmed to display information provided in
an eXtensible Markup Language ("XML") file, with XML files being
capable of use with several Document Type Definitions ("DTD") and
thus more general in nature than SGML or HTML. The XML file may be
analogized to an object, as the data and the stylesheet formatting
are separately contained (formatting may be thought of as methods
of displaying information, thus an XML file has data and an
associated method).
[0043] The terms "personal digital assistant" or "PDA," as defined
above, means any handheld, mobile device that combines computing,
telephone, fax, e-mail and networking features. The terms "wireless
wide area network" or "WWAN" mean a wireless network that serves as
the medium for the transmission of data between a handheld device
and a computer. The term "synchronization" means the exchanging of
information between a handheld device and a desktop computer either
via wires or wirelessly. Synchronization ensures that the data on
both the handheld device and the desktop computer are
identical.
[0044] In wireless wide area networks, communication primarily
occurs through the transmission of radio signals over analog,
digital cellular, or personal communications service ("PCS")
networks. Signals may also be transmitted through microwaves and
other electromagnetic waves. At the present time, most wireless
data communication takes place across cellular systems using second
generation technology such as code-division multiple access
("CDMA"), time division multiple access ("TDMA"), the Global System
for Mobile Communications ("GSM"), personal digital cellular
("PDC"), or through packet-data technology over analog systems such
as cellular digital packet data ("CDPD") used on the Advance Mobile
Phone Service ("AMPS"). The terms "wireless application protocol"
or "WAP" mean a universal specification to facilitate the delivery
and presentation of web-based data on handheld and mobile devices
with small user interfaces.
[0045] The system of the present invention includes both an
internal and an external TPS provider module. The internal module
is used for the installation and maintenance of the system for a
community. In the context of the present invention, a community may
be limited to a relatively small geographic area; a larger
political area such as a township, county, or state; or the
community may encompass the entire nation. The internal module
includes software adapted to scan in the relevant forms from the
community and software to develop the definition of the patient
entry forms and underlying database according to a TPS model.
[0046] The internal module has scanning and forms definition
software which involves: scanning the forms received from the
providers (i.e., uncompleted patient screening forms); selecting
portions of each of the forms with a selection tool; and
interacting with a series of questions and answer definitions. The
system may employ physicians or other knowledgeable users to assist
in interpreting and checking the questions from the various forms
and format for the answers which shall become the data for the
internal module to maintain and provide access. The results of this
process include the creation of a master data entry form that
obtains the majority of patient data needed by the majority of the
community institutions.
[0047] The first step in the internal module is scanning the
existing paper forms and having a knowledge domain expert interpret
the form. The x and y coordinates of various pieces of information
asked by the form is first identified along with the height and
width of available space for the response. The substantive question
(i.e., the screening question) is then matched to the associated x
and y coordinates. There may be instances where there is no direct
correlating question, in which instance that portion of the form is
handled as a special case. In the course of using the internal
module with several forms, there may be sufficient special cases to
merit creating a new non-standard information field in the TPS
model. Some forms may have alternative questions that relate to the
same or similar information (for example, one form asking about
lung disease and the other about COPD, a disease affecting the
lungs, thus having similar but non-identical subject matter) and
the knowledge domain expert needs to decide on what information
field and permissible values are appropriate in the TPS model. This
allows for mapping of data from information fields in the TPS model
to the correct substantive response and area on a community
institution form. If no relationship exists between questions, or
the knowledge domain expert decides confusion may exist by
combining questions, the questions would remain separate and a
patient would be prompted to answer both. If a hierarchy exists, a
dependency can be documented that allows the system to prompt for
dependant questions only if paternal questions are answered in the
affirmative. The resulting template document is defined by the
coordinates of the positions (i.e., x, y, z-order, w, h, p-page)
for the responses to the questions
[0048] The external module includes interactive software to
interact and enable a dialog with the patient to elicit the
relevant patient information. In one form of the invention, a
website is provided for patients to enter information. For example,
the website may present dynamic questionnaires in a wizard format.
The wizard format would have such checks as blocking certain
questions (e.g., ask about sex) if certain information has already
been entered in the patient's history (e.g., pregnancy or
hysterectomy). Alternatively, the external module may include
interface software that enables the retrieval of all, or a sub-set,
of the relevant information from a smart card or another third
party data source. The general flow of the patient registration
process is shown in FIG. 1 as patient registration 100.
[0049] Patient Registration 100 typically starts at 102 with a
patient visiting a health care institution. First, that patient is
asked if the patient is an existing patient at step 104, and if so,
the patient's account is displayed as a welcome screen or other
appropriate indication in step 106. Next, if a referral is needed
in step 108, the patient is selected in step 110 and the patient
information is provided to referral process 112 (described in
greater detail below). If not a referral, then select patient step
114 determines if the patient has a previously created record in
the TPS system. If a record exists, it is displayed in step 116,
and if not, then the patient is encouraged to be added to the
system in step 118, and if accepting starts the register patient
step 120.
[0050] If this is not an existing patient in step 104, then the
health care institution proceeds to register account 122 to
initiate a patient registration on the TPS system, which begins
with step 124 where the initial identification information is
obtained to create the new patient record. Next is an initial
screening process step 126 which is described in greater detail
with regards to FIG. 2. After the initial screening, the patient
record is displayed in step 128, and if it is determined that more
patients are to be registered in step 130, the process starts fresh
at step 124.
[0051] In addition to typical patient entry starting with a patient
visit to a health care institute, an alternative entry point for
new patient records to the TPS system may start with step 132.
There existing electronic records are provided to be stored or
registered in step 134. Such new patient records may be updated in
136 to complete information that was not immediately apparent, and
finally the updated patient record is sent in step 138 into the TPS
system when the health care institution next registered in step
122.
[0052] Initial Screening Process 200 of FIG. 2 starts in step 202
with obtaining the patient identifying information before obtaining
information from the patient on various subjects. The steps in
initial screening process 200 may be completed on paper, either by
the patient or by an interview, or completed on a computer or other
device. These steps may occur in many different orders, with the
sequence shown in FIG. 2 being typical. Request demographics step
204 involves basic demographic information, such as race and sex,
and any associated primary care provider (PCP). Next, financial
information such as responsible party step 206 or insurance step
208 inquire as to those subjects. Clinical questions are also
typically asked such as allergies (step 210), medications (step
212), current problems (step 214), family history (step 216),
social questions (step 218), and/or surgical history (step 220).
Many of the clinical questions may have associated codes, some of
which are universal and others which may be particular for the
organization taking in the information. Once this information is
collected and entered into the patient record, the results may be
returned in step 222, by either printing a data sheet in the format
of the health care institution or transferring an electronic record
in the format of that institution.
[0053] For example, the first screen of the patient entry module
may include questions on certain demographics such as name, date of
birth, social security number or other identifying information, as
well as portions for choosing a username and password, including
confirmation screens. The wizard sections then may proceed with
questions such as: (1) Are you currently taking any medications?
Y/N (2) Do you have any allergies or intolerances to medication?
Y/N and (3) Do you have any other allergies? Y/N. Each of these
questions, if answered in the affirmative, may result in further
sections that provide data entry areas for responses, using either
free text and/or classified answers.
[0054] Information collected by the external module may include,
but is not limited to semi-static information (e.g., name, date of
birth, sex, address; insurance information such as company, policy
type and identification number, policy holder, insurance card);
past surgical history (including information on specific
procedures, with date and location information); past and/or
current pregnancies; past and/or current medical conditions (with
history of conditions and onsets); current conditions (e.g.,
diabetic, pregnancy, etc.); family history (with relevant medical
conditions, relationships, onset); social history (e.g., smoking,
drinking, exercise); current medications, allergies, and
intolerances (both medical and environmental); transient vitals
(e.g., re-affirming or changing height, weight, etc.); and
non-transient statistics and observations (e.g., blood type,
disabilities, etc.). The external module may also collect dynamic
information for each visit to a provider: chief complaint (i.e.,
the reason for the visit); review of symptoms; and allow for
patients and/or providers to edit information. Information editing
may include, but is not limited to, adding or discontinuing
conditions (where discontinued conditions may be retained for
medical history); adding or discontinuing medications (discontinue
may also notify a tolerance/allergy list). Apart from visits to a
provider, the external module may also allow users to maintain
and/or upload: a history of where they have forwarded information
and what was disclosed; lab results; views of DICOM or other image
files (e.g., Xray(CR), CT, MR, PET, US images); and images of other
reports.
[0055] The database which includes the patient information may
include an object model of a patient's conditions. Such a model is
schematically shown in FIG. 3. Data record 300 contains several
sections that generally correspond to the American Society for
Testing and Materials (ASTM) standard for the Continuity of Care
Record (CCR): CCR identification fields 302, Personal Identifying
Information (PII) fields 304, Patient Insurance/Financial
Information fields 306, Advance Directives fields 308, Patient
Health Status fields 310, Care Documentation fields 312, Care Plan
Recommendation fields 314, and Practitioners fields 316. In
addition to these basic fields, the CCR allows for extension fields
318 that may be associated with one or more of the defined fields
or for additional information relating generally to data record
300. Extensions 318 may include fields containing information such
as locally defined codes. The foregoing data record 300 may be
implemented in an XML format to facilitate data rendering on
various institution's forms and exchange with various computer
systems including systems using the HL7 standard.
[0056] With the present invention, the TPS may recoup its
investment in several distinct ways. In one form, the TPS may
operate as a subscription service, assessing a service fee to each
patient to maintain and distribute the patient's forms. In another
form, providers may subsidize payment or even pay the entire cost
of running the system. In still another form, insurance companies
may fund the system justifying the cost as avoiding problems
created by disparate advice and/or incompatible treatments that
occasionally result from different care providers acting on
disparate information about a patient and the treatment the patient
is receiving.
[0057] Access to the system may be provided through a network such
as a WAN, a cellular service, or the Internet. In this embodiment,
a patient would first access the TPS system and create a patient
account by completing basic information prior to visiting a health
care provider. When the patient visits a health care provider, the
provider receives the patient CCR, for example by printing out a
fully or partially completed paper form by facsimile or by
receiving a pre-printed form from the patient. If partially
completed, the health care provider completes the remaining
portions of the form and optionally updates
[0058] TPS on the missing data; for example, by sending an update
message or by synching the data records.
[0059] In another form, access may be provided at provider
locations, with patient access terminals or kiosks, where sessions
are initiated at the same point where patients conventionally fill
out the paper forms. Instead of the provider having to collect the
paper forms and separately enter the information into a computer
system, the TPS may forward a completed form to the provider by
several possible routes, such as by facsimile transmission, or
electronically to a printer or a computer database. Alternatively,
the provider may have the patient fill out a paper form and provide
the completed paper form to the TPS which may then scan in the
information on the patient and populate a patient record for future
visits. Providers may also enable its patients to enroll over a
browser connection so that the patient may complete an information
entry form before arriving at the providers' location.
[0060] One example of the flexibility afforded by the present
invention relates to the referral process, shown in FIG. 4 as
referral process 400. The process starts at step 404 where the
patient record may be obtained and updated, then a display selected
in step 406 depending on the providers involved. The referring
institution may have one form or format in its patient records, and
the institution receiving the referral may have a different form or
format. After the selection of display, additional screening may
occur in step 408 to obtain the additional information desired by
the institution receiving the referral. Such optional screening
steps may include obtaining a chief complaint (step 410), history
of present illness (HPI) details (step 412), and review of systems
(ROS) information (step 414). Once the additional information for
the referral receiving organization is obtained, the appointment
process may commence at step 416 by simply sending a form to the
receiving institution in step 418. The TPS system may additionally
interact with the receiving institution in step 420 to determine if
the patient already has an appointment (for example by the
referring institution calling and setting up the appointment
contemporaneously with the additional screening step 408). If not
scheduled, then the TPS system may determine if the provider can
schedule the appointment in step 422. If the provider allows TPS to
schedule, then at step 424 available appointment times are queried
in step 424, and available times are displayed in step 426 to allow
selection of an appointment time. Upon completion of the
appointment time selection, the new patient record tailored to the
receiving institution is sent out in step 428. If the patient
already had an appointment in step 420, the TPS system then
accesses the date in step 430 and sends out the patient record
tailored to the receiving institution in step 432. If the patient
does not have an appointment, but the provider does not allow TPS
access to schedule, then at step 422 the tailored patient record is
sent out in step 432 without the appointment time.
[0061] In the preceding examples, sending out the form to the
destination organization is referenced. FIG. 5 shows more of the
details of such a procedure. In send out step 502, the generation
of the tailored patient record is initially sent to determine the
method of delivery in step 504. If delivery is by mail, the
electronic patient record is rasterized in step 506 and spooled for
printing in step 508, with the rasterization corresponding to the
receiving institution's existing paper forms. If delivery is by
e-mail, then the electronic patient record is configured in a
tailored text layout in step 510 before spooling e-mail step 512
sends the appropriate patient form out. If delivery is by
facsimile, the process is similar to the mail version where
rasterization step 514 is performed in correspondence to the
receiving institution's existing forms and sent in spool facsimile
step 516. If delivery is by electronic data interchange (EDI), then
message layout and nominal translation step 518 configure the data
according to the receiving institutions EDI format and is sent by
spool deliver step 520. In all of these methods, a patient record
is delivered to the receiving institution in a format tailored to
the expectations of that receiving institution and the transmitting
institution's process resumes at step 522.
[0062] FIG. 6 shows conceptually the transformation process. Form
602 may have several aliases 604 that are forms with similar data
fields and information. A particular patient record may be
represented by several alternative paper forms, which may have
varying types and amounts of data. An alias may be a substitute
form or a form in an alternative media. For example, if a patient
manually enters information on the paper form of the original
institution, that data may be entered by the office into an
electronic alias. The TPS system may receive that information and
store it in another alias of the form. Finally, each of the aliases
may have corresponding forms at different institutions. The present
invention maximizes data commonality and consistency while
providing tailored data views for each participating
institution.
[0063] While this invention has been described as having an
exemplary design, the present invention may be further modified
within the spirit and scope of this disclosure. This application
is, therefore, intended to cover any variations, uses, or
adaptations of the invention using its general principles. Further,
this application is intended to cover such departures from the
present disclosure as come within known or customary practice in
the art to which this invention pertains been described with
reference to particular means, materials and embodiments, from the
foregoing description, one skilled in the art can easily ascertain
the essential characteristics of the present disclosure and various
changes and modifications may be made to adapt the various uses and
characteristics without departing from the spirit and scope of the
present invention as set forth in the following claims.
* * * * *