U.S. patent application number 13/708725 was filed with the patent office on 2013-06-13 for system for automatically populating medical data.
The applicant listed for this patent is Jeffrey Lee McLaren, William Dyer Rodes, II. Invention is credited to Jeffrey Lee McLaren, William Dyer Rodes, II.
Application Number | 20130151285 13/708725 |
Document ID | / |
Family ID | 48572856 |
Filed Date | 2013-06-13 |
United States Patent
Application |
20130151285 |
Kind Code |
A1 |
McLaren; Jeffrey Lee ; et
al. |
June 13, 2013 |
SYSTEM FOR AUTOMATICALLY POPULATING MEDICAL DATA
Abstract
Techniques for managing a patient monitoring worksheet
accessible by mobile devices are supported. A system may include a
central medical information management system that maintains
information regarding ongoing treatment of patients. Medical
professionals may use mobile devices to access and display
information in a worksheet that can facilitate the tracking of
various categories of medical information such as drugs, fluids,
vital signs, physiological data, events, and laboratory
information. The worksheet may be separated into display sections
to support tracking of the various categories of medical
information over time. The system can permit the automatic
population of values for one or more categories of medical
information.
Inventors: |
McLaren; Jeffrey Lee;
(Nashville, TN) ; Rodes, II; William Dyer;
(Nashville, TN) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
McLaren; Jeffrey Lee
Rodes, II; William Dyer |
Nashville
Nashville |
TN
TN |
US
US |
|
|
Family ID: |
48572856 |
Appl. No.: |
13/708725 |
Filed: |
December 7, 2012 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
|
61630372 |
Dec 9, 2011 |
|
|
|
61685380 |
Mar 17, 2012 |
|
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Current U.S.
Class: |
705/3 |
Current CPC
Class: |
G06F 3/0484 20130101;
G16H 10/60 20180101; G06F 3/0485 20130101; G06F 3/04883
20130101 |
Class at
Publication: |
705/3 |
International
Class: |
G06F 19/00 20060101
G06F019/00 |
Claims
1. A handheld apparatus comprising: a display capable of receiving
touch-responsive user input; a memory maintaining a medical
information management application; and a processor operable, when
executing the medical information management application: to
present on the display a patient monitoring worksheet displaying
medical information relating to the delivery of medical care to a
patient, the patient monitoring worksheet having a maximum viewable
time range selected from the range of thirty minutes to four hours
and equally divided into a plurality of time intervals, and wherein
the patient monitoring worksheet comprises a plurality of
simultaneously viewable display sections comprising a drugs display
section, a fluids display section, a vital signs display section,
and a physiological data display section; the drugs display section
having a column listing a plurality of drugs and, for each of the
drugs, a row capable of tracking of an amount of the drug
administered for each of the time intervals, and wherein if a
number of the drugs exceeds a drug list threshold, the drugs
display section is vertically scrollable in response to
touch-screen gesture control; the fluids display section having a
column listing of a plurality of fluids and, for each of the
fluids, a row capable of tracking of an amount of the fluid
administered or expelled for each of the time intervals, and
wherein if a number of the fluids exceeds a fluid list threshold,
the fluids display section is vertically scrollable in response to
touch-screen gesture control; the vital signs display section
having a column indicating a scale and capable of tracking, for
each of the equally distributed subintervals of time, a heart rate
and a blood pressure of the patient charted on the scale; and the
physiological data display section having a column listing a
plurality of physiological data items and, for each of the
physiological data items, a row capable of tracking a value for the
physiological data item for each of the time intervals, and wherein
if a number of the physiological data items exceeds a physiological
data item list limit, the physiological data display section is
vertically scrollable in response to touch-screen gesture control;
wherein each of the time intervals of each of the display sections
is a subsection; to detect a beginning of a new time interval; to
determine selected ones of the subsections set for auto-population
of values; to determine values for the selected auto-population
subsections; and to present, using the display, the determined
values for the auto-population subsections.
2. The apparatus of claim 1, further comprising a wireless network
interface capable of coupling to a central medical information
management system and wherein the processor is further operable,
when executing the medical information management application: to
transmit the determined values to the medical information
management system; and to update the one of the plurality of
display sections associated with the selected subsection based on
the determined values.
3. The apparatus of claim 1, wherein the processor is further
operable, when executing the medical information management
application: to determine, for each subsection, whether information
tracked during that subsection is incomplete; and to present, using
the display, visual emphasis for the ones of the subsections with
incomplete information.
4. The apparatus of claim 3, wherein the processor is further
operable, when executing the medical information management
application: in a first mode of operation, to permit edit popups
only for the ones of the subsections with incomplete information;
in a second mode of operation, to permit edit popups for any of the
subsections; and to toggle between the first mode of operation and
the second mode of operation in response to user input.
5. The apparatus of claim 1, wherein the processor is further
operable, when executing the medical information management
application, to horizontally scroll tracked information for all of
the display sections in response to touch-screen gesture control to
permit display of different periods of time intervals.
6. The apparatus of claim 1, wherein the determined values for one
or more the selected auto-population subsections is based on one or
more monitored values.
7. The apparatus of claim 1, wherein the processor is further
operable, when executing the medical information management
application: in a first mode of operation, to present a laboratory
data display section having a column listing a plurality of
laboratory data items and, for each of the laboratory data items, a
row capable of tracking a value for the laboratory data item; in a
second mode of operation, to hide the laboratory data display
section; and to toggle between the first mode of operation and the
second mode of operation in response to user input.
8. The apparatus of claim 1, wherein the processor is further
operable, when executing the medical information management
application, to determine that a predefined time has passed after
completion of a patient care associated with the patient monitoring
worksheet; to determine one or more of the subsections having
incomplete tracked information; and to communicate a notification
indicating incomplete tracked information.
9. The apparatus of claim 1, wherein the plurality of display
sections further comprises an events display section and wherein
the processor is further operable, when executing the medical
information management application: to detect a touch-screen input
selection of a subsection of the events display section; to present
in a portion of the display an events edit popup for the selected
subsection of the events display section, the events edit popup
permitting selection of an event to be tracked in the subsection;
to transmit the selected event and a corresponding timestamp to a
central medical information management system; and to update the
subsection of the events display section with a visual indication
of the entered event.
10. The apparatus of claim 1, wherein the edit popup presents items
trackable in the selected subsection, and wherein the processor is
further operable, when executing the medical information management
application: to receive rapid entry selection of one or more of the
items; to determine that numeric values accompanying those items
are required; to receive a confirmation of the selected items
without receiving numeric values for one or more of the selected
items; to visually indicate each of the selected items in the
corresponding subsection of the patient monitoring worksheet; and
to visually emphasize the corresponding subsection of the patient
monitoring worksheet as incomplete.
11. The apparatus of claim 1, wherein the plurality of drugs for
the drugs display section, the plurality of fluids for the fluids
display section, and the plurality of physiological data items are
each defined by a corresponding template associated with a selected
practice location.
12. A method comprising: presenting, on a display capable of
receiving touch-responsive user input, a patient monitoring
worksheet displaying medical information relating to the delivery
of medical care to a patient, the patient monitoring worksheet
having a maximum viewable time range selected from the range of
thirty minutes to four hours and equally divided into a plurality
of time intervals, and wherein the patient monitoring worksheet
comprises a plurality of simultaneously viewable display sections
comprising a drugs display section, a fluids display section, a
vital signs display section, and a physiological data display
section; the drugs display section having a column listing a
plurality of drugs and, for each of the drugs, a row capable of
tracking of an amount of the drug administered for each of the time
intervals, and wherein if a number of the drugs exceeds a drug list
threshold, the drugs display section is vertically scrollable in
response to touch-screen gesture control; the fluids display
section having a column listing of a plurality of fluids and, for
each of the fluids, a row capable of tracking of an amount of the
fluid administered or expelled for each of the time intervals, and
wherein if a number of the fluids exceeds a fluid list threshold,
the fluids display section is vertically scrollable in response to
touch-screen gesture control; the vital signs display section
having a column indicating a scale and capable of tracking, for
each of the equally distributed subintervals of time, a heart rate
and a blood pressure of the patient charted on the scale; and the
physiological data display section having a column listing a
plurality of physiological data items and, for each of the
physiological data items, a row capable of tracking a value for the
physiological data item for each of the time intervals, and wherein
if a number of the physiological data items exceeds a physiological
data item list limit, the physiological data display section is
vertically scrollable in response to touch-screen gesture control;
wherein each of the time intervals of each of the display sections
is a subsection; detecting a beginning of a new time interval;
determining selected ones of the subsections set for
auto-population of values; determining values for the selected
auto-population subsections; and presenting, using the display, the
determined values for the auto-population subsections.
13. The method of claim 12, further comprising transmitting, using
a wireless network interface capable of coupling to a central
medical information management system, the determined values to the
medical information management system; and updating the one of the
plurality of display sections associated with the selected
subsection based on the determined values.
14. The method of claim 12, further comprising: determining, for
each subsection, whether information tracked during that subsection
is incomplete; and presenting, using the display, visual emphasis
for the ones of the subsections with incomplete information.
15. The method of claim 14, further comprising: in a first mode of
operation, permitting edit popups only for the ones of the
subsections with incomplete information; in a second mode of
operation, permitting edit popups for any of the subsections; and
toggling between the first mode of operation and the second mode of
operation in response to user input.
16. The method of claim 12, further comprising horizontally
scrolling tracked information for all of the display sections in
response to touch-screen gesture control to permit display of
different periods of time intervals.
17. The method of claim 12, wherein the determined values for one
or more the selected auto-population subsections is based on one or
more monitored values.
18. The method of claim 12, further comprising: in a first mode of
operation, presenting a laboratory data display section having a
column listing a plurality of laboratory data items and, for each
of the laboratory data items, a row capable of tracking a value for
the laboratory data item; in a second mode of operation, hiding the
laboratory data display section; and toggling between the first
mode of operation and the second mode of operation in response to
user input.
19. The method of claim 12, further comprising: determining that a
predefined time has passed after completion of a patient care
associated with the patient monitoring worksheet; determining one
or more of the subsections having incomplete tracked information;
and communicating a notification indicating incomplete tracked
information.
20. The method of claim 12, wherein the plurality of display
sections further comprises an events display section, the method
further comprising: detecting a touch-screen input selection of a
subsection of the events display section; presenting in a portion
of the display an events edit popup for the selected subsection of
the events display section, the events edit popup permitting
selection of an event to be tracked in the subsection; transmitting
the selected event and a corresponding timestamp to a central
medical information management system; and updating the subsection
of the events display section with a visual indication of the
entered event.
21. The method of claim 12, wherein the edit popup presents items
trackable in the selected subsection, the method further
comprising: receiving rapid entry selection of one or more of the
items; determining that numeric values accompanying those items are
required; receiving a confirmation of the selected items without
receiving numeric values for one or more of the selected items;
visually indicating each of the selected items in the corresponding
subsection of the patient monitoring worksheet; and visually
emphasizing the corresponding subsection of the patient monitoring
worksheet as incomplete.
22. The method of claim 12, wherein the plurality of drugs for the
drugs display section, the plurality of fluids for the fluids
display section, and the plurality of physiological data items are
each defined by a corresponding template associated with a selected
practice location.
23. A system comprising: a central medical information management
system operable to maintain a plurality of patient monitoring
worksheets that correspond to patients associated with a medical
practice at a practice location during a predetermined period of
time, wherein each of the patient monitoring worksheets includes a
patient identifier; one or more medical information management
applications each residing on a wireless handheld device and
operable, when executed, to: present, on a display capable of
receiving touch-responsive user input, a patient monitoring
worksheet displaying medical information relating to the delivery
of medical care to a patient, the patient monitoring worksheet
having a maximum viewable time range selected from the range of
thirty minutes to four hours and equally divided into a plurality
of time intervals, and wherein the patient monitoring worksheet
comprises a plurality of simultaneously viewable display sections
comprising a drugs display section, a fluids display section, a
vital signs display section, and a physiological data display
section; the drugs display section having a column listing a
plurality of drugs and, for each of the drugs, a row capable of
tracking of an amount of the drug administered for each of the time
intervals, and wherein if a number of the drugs exceeds a drug list
threshold, the drugs display section is vertically scrollable in
response to touch-screen gesture control; the fluids display
section having a column listing of a plurality of fluids and, for
each of the fluids, a row capable of tracking of an amount of the
fluid administered or expelled for each of the time intervals, and
wherein if a number of the fluids exceeds a fluid list threshold,
the fluids display section is vertically scrollable in response to
touch-screen gesture control; the vital signs display section
having a column indicating a scale and capable of tracking, for
each of the equally distributed subintervals of time, a heart rate
and a blood pressure of the patient charted on the scale; and the
physiological data display section having a column listing a
plurality of physiological data items and, for each of the
physiological data items, a row capable of tracking a value for the
physiological data item for each of the time intervals, and wherein
if a number of the physiological data items exceeds a physiological
data item list limit, the physiological data display section is
vertically scrollable in response to touch-screen gesture control;
wherein each of the time intervals of each of the display sections
is a subsection; detect a beginning of a new time interval;
determine selected ones of the subsections set for auto-population
of values; determine values for the selected auto-population
subsections; and present, using the display, the determined values
for the auto-population subsections.
24. The system of claim 23, wherein each of the one or more medical
information management applications is further operable, when
executed, to: transmit, using a wireless network interface capable
of coupling to a central medical information management system, the
determined values to the medical information management system; and
update the one of the plurality of display sections associated with
the selected subsection based on the determined values.
25. The system of claim 23, wherein each of the one or more medical
information management applications is further operable, when
executed, to: determine, for each subsection, whether information
tracked during that subsection is incomplete; and present, using
the display, visual emphasis for the ones of the subsections with
incomplete information.
26. The system of claim 25, wherein each of the one or more medical
information management applications is further operable, when
executed, to: in a first mode of operation, permit edit popups only
for the ones of the subsections with incomplete information; in a
second mode of operation, permit edit popups for any of the
subsections; and toggle between the first mode of operation and the
second mode of operation in response to user input.
27. The system of claim 23, wherein each of the one or more medical
information management applications is further operable, when
executed, to horizontally scroll tracked information for all of the
display sections in response to touch-screen gesture control to
permit display of different periods of time intervals.
28. The system of claim 23, wherein the determined values for one
or more the selected auto-population subsections is based on one or
more monitored values.
29. The system of claim 23, wherein each of the one or more medical
information management applications is further operable, when
executed, to: in a first mode of operation, present a laboratory
data display section having a column listing a plurality of
laboratory data items and, for each of the laboratory data items, a
row capable of tracking a value for the laboratory data item; in a
second mode of operation, hide the laboratory data display section;
and toggle between the first mode of operation and the second mode
of operation in response to user input.
30. The system of claim 23, wherein each of the one or more medical
information management applications is further operable, when
executed, to: determine that a predefined time has passed after
completion of a patient care associated with the patient monitoring
worksheet; determine one or more of the subsections having
incomplete tracked information; and communicate a notification
indicating incomplete tracked information.
31. The system of claim 23, wherein the plurality of display
sections further comprises an events display section and wherein
each of the one or more medical information management applications
is further operable, when executed, to: detect a touch-screen input
selection of a subsection of the events display section; present in
a portion of the display an events edit popup for the selected
subsection of the events display section, the events edit popup
permitting selection of an event to be tracked in the subsection;
transmit the selected event and a corresponding timestamp to a
central medical information management system; and update the
subsection of the events display section with a visual indication
of the entered event.
32. The system of claim 23, wherein each of the one or more medical
information management applications is further operable, when
executed, to: receive rapid entry selection of one or more of the
items; determine that numeric values accompanying those items are
required; receive a confirmation of the selected items without
receiving numeric values for one or more of the selected items;
visually indicate each of the selected items in the corresponding
subsection of the patient monitoring worksheet; and visually
emphasize the corresponding subsection of the patient monitoring
worksheet as incomplete.
33. The system of claim 23, wherein the plurality of drugs for the
drugs display section, the plurality of fluids for the fluids
display section, and the plurality of physiological data items are
each defined by a corresponding template associated with a selected
practice location.
Description
RELATED APPLICATIONS
[0001] This application claims benefit to U.S. Provisional
Application No. 61/630,372, filed Dec. 9, 2011, and U.S.
Provisional Application No. 61/685,380, filed Mar. 17, 2012, all of
which are incorporated herein by reference.
TECHNICAL FIELD
[0002] The present disclosure relates generally to managing medical
data, and more specifically to managing medical records and charts
for one or more medical practices.
BACKGROUND
[0003] Medical professionals record, use and share medical records
and charts for patients at various medical care establishments. For
this purpose, medical professionals may use various physical files,
written displays, and electronic systems. For example, many
anesthesia care establishments use forms, charts, or other
paperwork to track relevant information regarding patient care. For
example, anesthesia professionals and other peri-operative service
providers may use specially designed paper forms to document
clinical data related to a surgical anesthesia case. Such
documentation may be also used to record patient treatment events
and generate corresponding invoices.
SUMMARY
[0004] In accordance with the present disclosure, a mobile
electronic chart is provided which substantially eliminates or
reduces disadvantages and problems associated with previous systems
and methods.
[0005] According to a particular embodiment, a handheld apparatus
is provided, which includes a display capable of receiving
touch-responsive user input, a memory for maintaining a medical
information management application, and a processor capable of
executing the medical information management application to
implement various features. In particular, the medical information
management application may present a patient monitoring worksheet
on the display. The patient monitoring worksheet may display
medical information relating to the delivery of medical care to a
patient. The patient monitoring worksheet may also include multiple
simultaneously viewable display sections for tracking various
categories of medical information. For example, the display
sections may include a drugs display section, a fluids display
section, a vital signs display section, and a physiological data
display section. In particular embodiments, the patient monitoring
worksheet has a maximum viewable time range selected from the range
of thirty minutes to four hours and be equally divided into a
multiple time intervals which may represent a subsection. In
particular implementations, the medical information management
applicant may detect the beginning of a new time interval,
determine one or more subsections for the automatic population of
values, determine the values for those subsections, and present the
determined values for those subsections on display.
[0006] Particular embodiments provide various technical advantages.
These techniques facilitate the charting of medical information
related to patient care or physiological events as they occur. For
example, anesthesia professionals or other peri-operative service
providers may record vital signs measurements, drug
administrations, fluid administrations/output measurements, case
milestone time recording, time-based annotations, physiologic
monitor values measurements, laboratory values measurements, care
provider attendance, case involvement timeframes, medical history,
surgical diagnosis, surgical procedures, anesthetic procedures,
patient conditions, drug allergies, and patient identifying
information. In particular embodiments, the system may receive
physiologic monitored values, vital signs and other data
electronically from equipment in the operating room. Certain
embodiments may provide seamless rapid entry of patient related
data such that active patient care is not interrupted during a
medical procedure. In this regard, indications of incomplete data
may be provided for later completion by the user. Charted medical
information can be viewed concurrently by multiple users and may
also be used in generating medical care invoices.
[0007] Particular embodiments provide alerts to notify users of the
presence of incomplete data. Such techniques may include notifying
a user about incomplete data on a predetermined notification
schedule defined for the practice. In this manner, a medical
practice may ensure that patient care related information is
completed by the user in close time proximity to the medical care
events thereby limiting inaccuracies in data values.
[0008] Particular embodiments use templates. Templates may define
the default drugs, fluids, events, vital signs, monitored
physiological data, and laboratory information available to a user.
Templates may be specific to a practice or a procedure and can be
modified as needed by an administrator. In certain embodiments,
templates may also provide common values for the recorded data.
Templates may also define the list of additional drugs, fluids,
vital signs, monitored physiological data, or laboratory
information that may be added by the user as needed during a
particular case.
[0009] Other technical advantages of the present invention will be
readily apparent to one skilled in the art from the following
figures, descriptions, and claims. Moreover, while specific
advantages have been enumerated above, various embodiments may
include all, some, or none of the enumerated advantages.
BRIEF DESCRIPTION OF THE DRAWINGS
[0010] FIG. 1 is a block diagram illustrating a system environment
with elements that interoperate to manage and display medical case
information including medical chart information;
[0011] FIG. 2 is a block diagram illustrating an example medical
information management system for facilitating management of
medical case information including medical chart information;
[0012] FIG. 3 is a block diagram illustrating an example embodiment
of a handheld device for executing a medical information management
application for displaying and tracking medical case information
including medical chart information;
[0013] FIG. 4 is a system architecture diagram describing an
example user interface for a medical chart facilitated by a medical
information management application operating on a handheld
device;
[0014] FIG. 5 illustrates an example view for adding drug tracking
information to an electronic medical chart through a graphical user
interface of a handheld device;
[0015] FIG. 6 illustrates an example view for adding fluid tracking
information to an electronic medical chart through a graphical user
interface of a handheld device;
[0016] FIG. 7 illustrates an example view for adding events to an
electronic medical chart through a graphical user interface of a
handheld device;
[0017] FIG. 8 illustrates an example view displaying incomplete
data on an electronic medical chart presented through a graphical
user interface of a handheld device; and
[0018] FIG. 9 illustrates an example edit view of an electronic
medical chart presented through a graphical user interface of a
handheld device.
DESCRIPTION OF EXAMPLE EMBODIMENTS
[0019] FIG. 1 is a block diagram illustrating a system 100 with
elements that interoperate to manage and display medical case
information. The elements of system 100 can support a number of
different operations, including maintaining a central, unified
repository of patient and case information for one or more
practices, facilitating maintenance and display of a graphical
electronic medical chart, enabling entry and display of drugs,
fluids, events, vital signs, physiological data, and laboratory
information regarding the patient, facilitating presentation and
alerting of incomplete data in conjunction with particular patient
treatment episodes, and providing an intuitive graphical user
interface for interacting with the system. Systems and methods of
maintaining, recording, and displaying an electronic medical chart
according to this disclosure may be provided in conjunction with
the medical case management techniques disclosed in U.S. patent
application Ser. Nos. 12/789,783; 12/789,858; 12/789,900;
12/789,962; and 12/790,011, the disclosures of which are
incorporated herein by reference.
[0020] Medical professionals can use the medical information and
functionality of system 100 to manage one or more cases for a
particular medical practice with one or more practice locations.
Users of system 100 can include medical professionals and
associated staff, such as surgeons, anesthesiologists, other
physicians, certified registered nurse anesthetists (CRNAs),
hospital management, billing personnel, medical record managers,
and any other medical staff. Under appropriate circumstances,
system 100 may further provide patients access to selected
information. According to particular embodiments, system 100 may be
used to manage information for one or more medical practices. A
medical practice is any organization of associated medical
professionals and associated personnel, such as a group of doctors
and support staff with a common specialty that potentially practice
at one or more different practice locations, a group of doctors and
support staff associated with a particular hospital, or any other
suitable organization of medical professionals. For example, an
anesthesia practice may include anesthesiologists, CRNAs, and other
support staff that practice at a set of particular medical
treatment facilities.
[0021] In the illustrated embodiment, system 100 includes a number
of elements interconnected by various networks, including a
communications network 102, a wireless telephony network 104, a
local area network 106, and a wireless network 108. Networks 102,
104, 106, and 108 represent communications equipment, including
hardware and any appropriate controlling logic, for interconnecting
elements and facilitating communication between these elements.
Communications network 102 may include local area networks (LANs),
metropolitan area networks (MANs), wide area networks (WANs), any
other public or private network, local, regional, or global
communication network, enterprise intranet, other suitable wireline
or wireless communication link, or any combination thereof.
Communications network 102 may include any combination of gateways,
routers, hubs, switches, access points, base stations, and any
other hardware, software, or a combination of the preceding that
may implement any suitable protocol. For illustrative purposes,
system 100 is also shown as including other specific types of
networks, including wireless telephony network 104, local area
network 106, and wireless network 108. The use of these or similar
networks facilitate seamless communication between components of
system 100 regardless of their geographic location or communication
protocols.
[0022] As illustrated, system 100 includes a wireless telephony
network 104 coupled to communications network 102. Wireless
telephony network 104 represents communications equipment,
including hardware and any appropriate controlling logic, for
interconnecting elements and facilitating communications by
wireless devices. Wireless telephony network 104 may include
gateways, call managers, routers, hubs, switches, access points,
base stations, cellular towers, radio networks, satellite telephone
equipment implementing appropriate protocols for wireless telephony
communications. While only one wireless telephony network 104 has
been illustrated, it should be understood that various embodiments
may operate using more than one wireless telephony network. In
addition, various embodiments may incorporate wireless telephony
networks 104 in other networks of system 100 such as, for example,
wireless network 108.
[0023] The illustrated embodiment of system 100 also includes a
local area network 106 coupled to communications network 102. Local
area network 106 represents communications equipment, including
hardware and any appropriate controlling logic, for interconnecting
elements within a limited network area (as compared with, for
example, wide area networks). Local area network 106 may include
any combination of gateways, routers, hubs, switches, access
points, base stations, and any other hardware, software or
combination thereof using suitable protocols to support
communications. For example, local area network 106 may be the
established network infrastructure deployed at a particular
hospital or other medical facility. While only one local area
network 106 has been illustrated, it should be understood that
various embodiments may operate using multiple local area networks
106. In addition, various embodiments may incorporate local area
networks 106 in other networks of system 100.
[0024] System 100 also includes wireless network 108 coupled to
communications network 102. Wireless network 108 represents
communications equipment, including hardware and any appropriate
controlling logic, for wirelessly interconnecting elements and
facilitating communication between other elements of system 100.
For example, wireless network 108 may operate according to one or
more of the 802.11 standards promulgated by the Institute of
Electrical and Electronic Engineers (IEEE). Wireless network 108
may include any combination of gateways, routers, hubs, switches,
access points, base stations, wireless telephone systems and any
other hardware, software, or combination thereof. While only one
wireless network 108 has been illustrated, it should be understood
that various embodiments may operate using multiple wireless
networks 108. In addition, various embodiments may incorporate
wireless networks 108 in other networks of communications network
102.
[0025] These networks interconnect other elements of system 100,
including mobile phones 110, a billing system 112, personal
computers (PCs) 114, patient information system 116, mobile devices
118, and a medical information management system 120. It should be
understood that while system 100 is illustrated as including
specific types of networks, various embodiments may operate using
any suitable arrangement and collection of networks that enable
appropriate communications.
[0026] Mobile phones 110 represent portable hardware and
appropriate controlling logic for providing telephony and/or
advanced data services. For example, mobile phones 110 may support
voice and data communications. Mobile phones 110 may include smart
phones capable of transmitting and receiving multiple forms of
media including but not limited to still audio, text messages,
video, images, and content from disparate services. As illustrated,
mobile phones 110 may be coupled to wireless telephony network 104
and capable of communicating to other components of system 100.
According to particular embodiments, system 100 may use mobile
phones to provide alerts or other information to medical
personnel.
[0027] Billing system 112 represents hardware, appropriate
controlling logic, and data associated with billing for medical
services. For example, billing system 112 may be a computer server
designed to manage billing for a particular medical practice, such
as an anesthesia practice. Billing system 112 may be network
accessible to facilitate communication with other elements of
system 100.
[0028] Personal computers (PCs) 114 represent general-purpose
computers, including appropriate hardware, controlling logic, and
data that may be used to interface with other system components
such as billing system 112, patient information system 116, mobile
devices 118, and medical information management system 120. For
example, PCs 114 may be workstations, laptops, netbooks, tablet
computers, personal data assistants (PDAs), or any other suitable
computing device. PCs 114 may support a wide variety of operations
such as web browsing, word processing, and managing business data.
According to particular embodiments, PCs 114 provide access,
potentially through web-based interfaces, to information managed by
other elements.
[0029] Patient information system 116 represents suitable hardware
components, controlling logic, and data for managing patient
information, such as patient demographic information, medical
histories, medical charts, laboratory information and/or other
relevant medical information such as practice employees and work
schedules. For instance, patient information system 116 may be
embodied in a computer system or a network of computers, which are
capable of maintaining patient information such as patient
identifiers, case identifiers, surgery types, date-of-birth,
surgery schedule, operating room, attending surgeon and/or
anesthesiologist, insurance information, medical history, medical
charts and laboratory information corresponding to particular
procedures and other patient-specific information as appropriate
for various aspects of a medical practice. Some embodiments of the
present disclosure may include a patient information system 116
deployed at a medical practice or other medical care facility,
while other embodiments may include a global patient information
system 116 for maintaining patient information. As illustrated,
patient information system 116 may be coupled to a network, such as
local area network 106, to facilitate communication to other
elements of system 100. While only one patient information system
116 is shown, it should be understood that various embodiments may
include multiple appropriately deployed patient information systems
116.
[0030] Mobile devices 118 represent any suitable portable hardware,
including appropriate controlling logic and data, capable of
communicating with remote devices to facilitate management of
medical information. For example, mobile devices 118 may include,
but are not necessarily limited to, mobile telephones, advanced
("smart") phones, personal digital assistants (PDAs), wireless
handsets, notebook computer systems, and tablet computer systems.
According to particular embodiments, mobile devices 118 include
wireless devices with advanced user interfaces, such as the APPLE
iPhone, iPod Touch, or iPad.
[0031] Medical information management system 120 represents any
appropriate combination of hardware, controlling logic, and data
for managing medical information and supporting interactive access
to that data from multiple remote (and potentially highly mobile)
devices. For example, medical information management system 120 may
include a networked server or collection of networked servers, or
could include in one or more virtual servers capable of acquiring
computing resources on-demand depending on the dynamically
determined needs of the system. Using virtual servers, medical
information management system 120 could be scaled dynamically based
on system requirements and real-time usage, without limiting
operation to a particular physical computer server having fixed
computing resources. This could facilitate the scalability,
efficient operation, high availability, and cost effectiveness of
the system. As illustrated, medical information management system
120 couples to networks, such as communications network 102, to
facilitate communication to other elements of system 100.
[0032] Particular embodiments are designed to operate in a network
environment that facilitates the retrieval and presentation of
medical data to end users, facilitating real-time tracking of
medical professional activity related to the provision of patient
care (events tracked at or near in time to the actual provision of
patient care) provided at a medical facility such as a hospital or
other medical care establishment. Systems, methods, and software
exemplified in the present disclosure may increase the coordination
of patient care, enhance the reliability of medical information,
and help ensure the accuracy of medical record keeping and
billing.
[0033] In operation, elements of system 100 operate together to
perform various medical information management functions including
but not limited to maintaining a central, unified repository of
patient and case information for one or more practices,
facilitating maintenance and display of a graphical electronic
medical chart, enabling entry and display of drugs, fluids, events,
vital signs, physiological data, and laboratory information
regarding the patient, facilitating presentation and alerting of
incomplete data in conjunction with particular patient treatment
episodes, and providing an intuitive graphical user interface for
interacting with the system.
[0034] For example, medical information management system 120 is
capable of maintaining a central, unified repository of electronic
medical chart information corresponding to a various medical
procedures for numerous patients of one or more medical practices.
In particular embodiments, the medical chart information may be
presented in an electronic patient monitoring worksheet having
various sections to facilitate the tracking of various categories
of medical information. Medical information management system 120
may maintain the drugs, fluids, events, vital signs, physiological
data, and laboratory information related to a patient and enable
users to dynamically track and record data values corresponding to
these categories for patients of one or more medical practices.
Medical information management system 120 can dynamically update
this information based on communications with medical personnel
using mobile devices 118 (or other suitable access devices).
Medical information management system 120 may also access and
exchange information with other information management and
processing elements of system 100. In particular embodiments,
medical information management system 120 acquires patient
management information from one or more patient information systems
116. For example, medical information management system 120 can
upload patient information for all patients scheduled for treatment
on a particular day. Medical information management system 120 may
also include configurable templates for medical charts based on
practice location or the particular medical procedure to be
performed by the patient. Thus, for example, the default choices
for drugs, fluids, events, vital signs, physiological data, and
laboratory information may be determined based on such
templates.
[0035] Medical information management system 120 maintains
information on patients and medical professional activity and
supports interactions with other devices to manage and display the
medical and logistics information. For instance, mobile devices 118
can access medical information management system 120 to download
information for display in the form of a graphical electronic
medical chart for the selected patient of a particular practice
location. In certain implementations, mobile devices 118 may
present the electronic medical chart information in a particular
tab of a tabbed interface where each tab provides information
related to a patient's treatment. Mobile devices 118 could further
interface with medical information management system 120 to receive
and manage more detailed patient treatment information through
other specialized interfaces, such as a case summary interface for
summarizing information for a case or a case details interface for
detailing the chronology and other medical events associated with a
case. For example, mobile devices 118 may present a graphical user
interface showing patient treatment records in tabbed interfaces
with the ability to list medical events for real-time tracking of
cases, and provide medical case chart information in a separate
tab. Users of mobile devices 118 can use these interfaces to
provide real-time entry of information corresponding to treatment
events including medical charting, which medical information
management system 120 can then use to update the case board and
medical chart This type of process uses the capture of treatment
information (such as billable events or other required records) to
feed other processes that, in typical systems, require separate
efforts to track, such as paper forms or charts that may be error
prone or lack the safeguards related to incomplete data as provided
by the present disclosure.
[0036] Particular embodiments support secure access to medical
information management system 120 using an access scheme designed
to maintain a high level of security while supporting user-friendly
access with devices that may have limited or non-traditional user
interfaces. The access techniques may use a combination of
authorization information checked in one or more steps, such as a
username, password, quick access code (such as a personal
identification number (PIN) or other string of characters or
gestures), secure hash, device identifiers, or other secure
authentication information. In certain embodiments, secure
authentication is a multi-step process that uses different types of
information provided at different stages of access. According to
particular embodiments, one step may involve device identification.
For example, a particular mobile device 118 may have a secure
device hash or other suitable unique identifier that can be
registered with and verified by medical information management
system 120. Another step may involve a secure token or key that
uniquely maps to a particular medical practice (which may use
information from other steps, such as a secure device hash that
links a specific mobile device 118 to a particular medical
practice). Another step may involve providing a user name and
associated password, for example, by selecting a user name from a
list of available users and then providing a password that meets
certain length and character requirements. Another step may require
entry of a quick access code, such as a four or six number pin or a
particular pre-recorded gesture. These different steps and secure
authentication information may be combined and used at particular
times to ensure that access to medical information is suitably
restricted while allowing authorized users of mobile devices 118
relatively easy access to information. For example, after requiring
one or more relatively high-security authentication steps,
subsequent access over the course of some period of time may only
require a subset of credentials, such as a quick access code.
During that period of time, mobile device 118 could enter sleep
modes or other application and, upon a user wishing to restart
access to medical information, mobile device 118 would simply
require reentry of the quick access code. If mobile device 118 were
restarted or some extended period of time passed, system 100 could
require reprocessing through one or more of the higher security
steps.
[0037] After access is granted, the user may select a practice
location from a list of available practice locations for the
medical practice and thereby gain access to the corresponding
medical case information and functionality of the system. Following
authentication, mobile devices 118 and medical information
management system 120 may interoperate to present medical
information, including medical chart information, in an intuitive
graphical case board interface to the user. For example, the
electronic medical chart may enable the entry and display of drugs,
fluids, events, vital signs, physiological data, and laboratory
information regarding the patient, facilitate presentation and
alerting of incomplete data in conjunction with particular patient
treatment episodes, and provide an intuitive graphical user
interface for interacting with the system.
[0038] The graphical user interface allows medical professional
activity, case board information, medical charts, and patient
treatment records to be securely accessed and displayed. In
addition, this information can be used to track billing-related
events as a patient progresses through various medical events or
sub-events of a particular surgery or other medical procedure. For
example, mobile devices 118 may securely present a medical chart to
understand the treatment the patient is undertaking during a
medical procedure, where medical information management system 120
actually maintains all of this information. Similarly, PCs 114 may
securely access medical information management system 120 to view
similar information. Thus, for instance, an interface available at
PCs 114 may display patient information or medical events
maintained by medical information management system 120, portions
of which may be indirectly derived from other components of system
100 such as patient information system 116 or one or more mobile
devices 118.
[0039] System 100 may further provide incomplete data alerting
functionality that enables targeted messaging to appropriate
medical professionals using a variety of communication techniques
and protocols. Incomplete data alerts may occur automatically by
the system based on configurable notification templates and notify
users of the presence of incomplete data that requires user
attention. Additionally, alerts may take on a variety of forms
including voice, text, multimedia, or application specific (e.g.,
embedded notification in a customer medical information management
application running on mobile devices 118). In the case of
automatic notifications, alerting schemes may deliver alerts or
notifications on the occurrence of some predefined case event or on
a predefined interval after a patient treatment episode has been
completed. As discussed later in this disclosure, appropriate
indicators of incomplete data may be displayed using suitable color
schemes, shading, or shapes. Incomplete data alerts can be sent to
a variety of individuals and can based on various roles including
medical case role, team management role, or context-based role such
as those who respond to specific clinical changes. Incomplete data
alerts may also be delivered on disparate networks. For example,
medical information management system 120 may deliver an alert
message or notification via communications network 102 and wireless
telephony network 104 to mobile phones 110. Thus, medical
professionals may be notified of incomplete data in the form of
voice, text, or multimedia messages even after leaving the
associated medical facility.
[0040] Elements of system 100 may also facilitate coordination with
a billing system 112 to develop invoices and reports. For example,
medical information management system 120 may communicate with one
or more billing systems 112 to support billing-related functions.
Thus, medical information management system 120 can support billing
systems 112 to produce appropriate invoices for surgical
procedures, anesthesia services and/or other billing-related
medical events corresponding to a medical provider site (e.g., a
particular hospital or hospital floor) or individual patients.
Billing system 112 may then forward invoices or other billing
information to the appropriate insurance provider, patient, or
other responsible party. Thus, a billing system may be seamlessly
integrated with other functionality described in this disclosure to
perform various medical billing operations.
[0041] While system 100 is illustrated as including specific
components arranged in a particular configuration, it should be
understood that various embodiments may operate using any suitable
arrangement and collection of components capable of providing
functionality such as that described.
[0042] FIG. 2 is a block diagram illustrating a system 200
representing an example embodiment of medical information
management system 120 which has elements that interoperate to
facilitate the management of medical chart information. The
elements of system 200 can support a number of different operations
including maintaining a central unified repository of patient and
case information for one or more practices, which permits the
maintenance of medical chart information. The elements of system
200 may also facilitate incomplete data alerting in conjunction
with tracked medical cases and the graphical display of a user
interface for interacting with the system and the entry of medical
chart information from one or more devices such as mobile phones
110, PCs 114, and mobile devices 118.
[0043] System 200 represents any appropriate combination of
hardware, controlling logic, and data. For example, system 200 may
be one or more computer servers or virtual computer servers capable
of providing the appropriate functionality for centrally managing
patient and case information for one or more practices. As
illustrated, system 200 includes a web server 200, an alert module
204, a database 206, a standards-based application programming
interface (API) 208, business logic 210, and one or more processors
212.
[0044] Web server 202 represents any appropriate combination of
hardware, controlling logic and data for interfacing with remote
devices using web-based protocols to provide web-based access to
the medical information and functionality provided by system 200.
For example, web server 202 may be a web host that serves web pages
to facilitate access to some or all functions of system 200.
[0045] Alert module 204 represents any appropriate combination of
hardware, controlling logic, and data for facilitating incomplete
data alerting in conjunction with tracked medical cases and
activities of a medical care team. In addition, alert module 204
may be coupled to one or more networks such as a telephone network,
a wired or wireless computer networks, a cellular network, a radio
network, a satellite network, or any other appropriate network
capable of delivering alerts.
[0046] Database 206 represents any appropriate combination of
hardware, controlling logic, and data for maintaining patient
information, case information, medical chart information, medical
professional activity information, and other system-related data.
As illustrated, database 206 has various data components including
patient data, case data, medical chart data, user data, practice
data, templates, system metadata, location data, device registry
data, user access logs, and rules data.
[0047] Patient data includes information regarding patients tracked
by system 200. For example, for each patient tracked by system 200,
database 206 may maintain a patient identifier (such as a name),
general demographic information (such as the patient's
date-of-birth), and any appropriate responsible party or insurance
information.
[0048] Case data represents a collection of information
corresponding to a particular case associated with a scheduled
medical procedure for a patient at a defined medical facility. Such
information may include a case identifier or reference, information
on a procedure scheduled to occur or currently occurring (such as
surgery type), an assigned operating room, the attending physician
or anesthesiologist, records of the case chronology of a scheduled
medical procedure, various medical events in the case chronology,
involvement by specific medical professionals, medical chart
information, procedure and diagnostic codes, modifiers, and audit
logs corresponding to various medical events entered by specific
practice personnel. According to particular embodiments, system 200
updates case data based on real-time inputs from mobile devices
118. System 200 can provide patient treatment records to other
devices based on information maintained in patient and case
data.
[0049] User data represents a collection of information
corresponding to various users who interact with system 200,
including users of PCs 114, mobile phones 110, and mobile devices
118. Such user information may include authentication data such as
authorized users corresponding to a defined practice location, each
authorized user's passwords, each authorized user's system access
history, each authorized user's usage preferences, and other access
codes. This information can be used to provide secure access to
system 200 and as appropriate, prohibit unauthorized access to
medical information maintained by system 200.
[0050] Practice data represents practice wide settings and
preferences corresponding to a medical practice and, potentially,
for one or more specific practice locations. This may include rules
and policies for managing medical data instituted by a particular
medical practice. Practice data may also include a core set or
subset of medical procedure terminology for a medical practice or
procedure. Such medical procedure terminology may conform to
Current Procedural Terminology (CPT) or International
Classification of Diseases (ICD) codes. Such codes may be used in
conjunction with recording billing-related events for a particular
practice. Practice data may also include information related to
historic utilization and appropriate future allocation of medical
professional resources available to the practice. Other information
included in practice data may include billing report preferences,
billing export preferences, and any translation or transmission
settings necessary to communicate various reports to the defined
medical practice at a particular location. This information
facilitates the generation of billing reports and invoices in the
desired format for a practice.
[0051] Location data includes information corresponding to a
defined practice location, either tied to a particular medical
practice at that location or based on rules of information about
multiple medical practices that may provide care at that location.
Location data may include case chronology templates, medical chart
templates, checklist templates, quality control templates (such as
a physician quality reporting incentives (PQRI) template), and
other templates for capturing information in a form customized to a
particular practice location or practice location/medical practice
specified manner. These templates facilitate the recording of
medical chart information, medical events occurring in the field,
and real-time tracking of quality control measures. For example, a
case chronology template may define a set of rules regarding entry
of medical events associated with a procedure and include time
events or other entries. Templates may be modified and updated by a
web-based administrative capability.
[0052] Rules data defines permitted or prohibited activities
corresponding generally to users, medical professional roles,
specific medical practices, locations, medical procedures, or other
activities. For example, these rules may implement
practice-specific or location-specific policies affecting medical
professionals or relevant medical events. For example, a rule for
an anesthesia practice may prohibit an anesthesiologist from
managing more than four CRNAs. Thus these rules provide guidelines
for active case management in terms of a workflow that can be
specific to a medical specialty or a medical facility.
[0053] Standards-based API 208 represents hardware, appropriate
controlling logic, and data for interfacing with remote components
using standardized processes and protocols. For example,
standards-based API 208 may interface with patient information
systems 116 to retrieve patient information from one or more
medical practices. As another example, standards-based API 208 may
facilitate interactions with remote devices to support alerting
functions, such as through text messaging with mobile phones
110.
[0054] Business logic 210 represents hardware, controlling logic
and data associated that controls the fundamental operation and
administration of system 200, including interactions of elements to
provide the interactive medical information management processes
described herein. For example, business logic 210 may be software
for execution by one or more processors to provide a central
medical information management service that tracks medical
professional activity, medical chart information, and various other
aspects of patient care, and interfaces with mobile devices 118.
Processor 212 represents one or more computer processors for
executing business logic 210 or other software or controlling logic
associated with elements of system 200.
[0055] In operation, elements of system 200 operate together to
perform various functions of the present disclosure, including
maintaining a central, unified repository of patient data, case
information, and medical chart information for one or more
practices and facilitating the maintenance of medical professional
activity information, patient treatment information including case
chronology, medical chart information, and medical case summary
information. System 200 uses this information to support
applications on mobile devices 118 that can interface with and
graphically present that information. In addition, system 200
facilitates alerting for tracked medical cases including providing
notifications of incomplete data. Elements of system 200 can ensure
that users of system 200 are securely authenticated prior to
accessing medical information, medical chart information, and case
management functions. Accordingly, only those users who are
properly authenticated may interact with system 200.
[0056] For example, elements of system 200 are operable to maintain
a central, unified repository of patient information, medical chart
information, and case information for one or more medical
practices. In particular, processors 212 may execute appropriate
business logic 210 to communicate with one or more patient
information systems 116 to retrieve patient information
corresponding to a medical practice. System 200 stores information
in database 206, generates day-of-care information (for example,
based on patient information retrieved from one or more patient
information systems 116), communicates information from database
206 to computing devices (e.g. mobile phones 110, PCs 114, and/or
mobile devices 118), and receives updates, including real-time
information, from one or more computing devices. This information
can then be used by a graphical user interface to display and
facilitate real-time data entry and management of medical case and
chronology information. Any changes occurring at these computing
devices that are relevant to real-time case management including
medical chart information, and medical professional coordination
may then be received over a network. Accordingly, elements of
system 200 interact with one another to actively manage medical
case information as patients receive care.
[0057] As discussed above, system 200 may impose various
authentication requirements before permitting access to functions
and information of system 200. These may include one or more levels
of interactive authentication steps requiring user interactions as
well as ongoing, automated exchanges. For example, each
communication or request from a particular mobile device 118 may
include a secure device hash identifying that mobile device 118 to
system 200.
[0058] According to particular embodiments, system 200 implements a
multi-level access scheme that requires different types of
credentials at each level. For example, system 200 could require a
user name and password (potentially in combination with a device
hash) for first-level access and then a quick access code for
second level access and for re-access over some period of time.
System 200 may compare these received values with stored user data
according to business logic 210 to determine whether the user
identified in the request has appropriate credentials for accessing
the medical information and functionality of system 200. Using
these secure authentication means, system 200 can guarantee that
access to case information and specific patient medical data is
appropriately protected.
[0059] During operation, system 200 provides medical information,
such as case board, medical professional activity, or patient
treatment information, for presentation and use by graphical user
interfaces presented on mobile devices 118. To support this
functionality, system 200 maintains real-time tracking information
for patients receiving care, and activities of identified medical
professionals, provides the information to mobile devices 118, and
receives and processes requests to update the information. For
responding to medical case board and medical chart information
requests, medical data for multiple cases and charts may be
accessed for retrieving a subset of the details for forwarding to
the remote computing device to display on its graphical user
interface. For example, in response to a medical chart request from
mobile device 118, system 200 may compile selected information for
a particular patient scheduled to or receiving care at a practice
location for a medical practice associated with the requesting
mobile device 118 and then provide that information to the
requesting mobile device 118, for example, in a graphical
electronic medical chart.
[0060] Mobile devices 118 may also request information or provide
updates for particular cases or medical charts. In response, system
200 may provide responsive patient treatment records that include
details of the requested patient including medical chart
information extracted from database 206 (potentially with more
information than for case board requests). The accessed case data
may include medical professional activity data relative to the
case, procedure information, diagnosis information, medical chart
information, case chronology data such as medical events associated
with a particular case and any related checklist items. As
appropriate, system 200 may log requests or other access events in
the access logs of database 206 according to business logic 210 and
any corresponding rules maintained in the rules data of database
206.
[0061] In responding to information requests, system 200 may
process the response information as appropriate based on the
requesting computing device. Such processing may include formatting
the case board, patient treatment record, or medical chart
according to location data in database 206. For example, medical
chart information may be arranged according to a template that may
organize and populate sections of a medical chart according to
templates in the location data for a specific practice. For an
anesthesia or other appropriate practice those predefined sections
may correspond to drugs, fluids, events, vital signs, physiological
data, and laboratory information. Thus, the templates and other
information in the location data of database 206 instruct processor
212 and business logic 210 how a practice wishes the requested
information to be populated, organized, and delivered for
subsequent presentation on a graphical user interface of a
requesting computing device. However, some or all of the
customization and formatting of information may be handled by other
elements, such as mobile devices 118.
[0062] In addition to facilitating the display of chronological
stages at one or more remote computing devices, system 200 can also
receive real-time updates corresponding to specific billing-related
events such as the performance of a step in a medical procedure.
According to particular embodiments, some or all of these may be
"real-time," that is, provided from care-givers as (or very nearly
in time to) a patient receiving care indicated by an update. For
example, an anesthesiologist may use mobile device 118 to track, in
real-time, time spent with a patient or time spent actually
administering anesthesia from start to finish. Such durational
information may be provided to system 200 and maintained in an
appropriate time record of a patient treatment record or an
appropriate medical chart record. Updates may also include specific
events from the medical chart, or policy-based requirements of a
medical procedure. Once an update is processed, other computing
devices may securely receive case information including these
updates in the form of case board information, medical chart
information, patient treatment records, an alert, or other
appropriate form. In this manner, all medical professionals
associated with the case can be kept aware of any changes occurring
in real-time for a particular case.
[0063] During operation, system 200 may also provide alerting
functionality to notify medical professionals of relevant medical
events, incomplete data, or other concerns. According to particular
design considerations, alerts may be automatically generated or
user-initiated. For automatic alerts, system 200 is operable to
maintain a list of customizable events for which a alert should be
issued. For example, notifications of incomplete data may be sent
out as alerts according to customized policies regarding treatment
of incomplete data. Such policies may be practice or procedure
specific. In particular, database 206 may include a set of alert
rules specifying alerts, rules for triggering an alert (such as
occurrence of a particular event or a certain period of time after
completion of a patient treatment episode), and alert execution
information (such as contact information and procedures for
handling a triggered alert). Subsequent events, such as updates to
case data or presence of incomplete data can then trigger alerts.
For example, a medical establishment may have a policy that
incomplete data related to vital signs be addressed within 15
minutes after a patient treatment episode or logout of the system
in order to ensure data accuracy and completeness.
[0064] Alert module 204 may send an alert messages using any
appropriate formats and protocols, including voice, text, or
multimedia messages, based on the targeted device. As discussed,
the form and network for delivering an alert may be defined by the
contact information of the event trigger. For example, the contact
information may indicate that a supervising medical professional
wishes to be notified of relevant incomplete data fields in the
form of a text message using a short message service (SMS) network.
In certain implementations, alert system 204 may support
interactive alerts. For example, in addition to notifying
particular medical professionals of incomplete data, alert module
204 may facilitate the completion of incomplete data by providing
an interface for allowing medical professionals to enter
appropriate values in the medical chart or other case interface.
Accordingly, embodiments of the present disclosure support
configuring, sending, and receiving automatic alerts for
communicating medical events and incomplete data fields to medical
professionals.
[0065] Alert module 204 can also process user-initiated messages.
For example, a user of a particular mobile device 118 may choose to
alert other users to a particular event or information. Once the
case alert module 204 receives this user-initiated message, alert
module 204 can determine how, when, and where to send the message
based on the received message and intended recipient. In a similar
manner, alert module 204 can also receive responses to
user-initiated messages and forward them to the intended computing
devices. User-initiated messages may be sent in any suitable form
and using any appropriate network. For example, the messages may be
a text, voice, or multimedia message sent over a wired, wireless,
cellular, or any other network. Thus, system 200 allows medical
professionals to stay apprised of real-time changes to case
information and communicate with each other efficiently to assess
the requirements of immediate patient care and coordinate
effectively with each other.
[0066] System 200 may also interact with billing systems such as
billing system 112 to develop billing invoices and reports. In
particular, upon request or at defined intervals, system 200 may
access practice data residing at database 206 that defines report
preferences for delivery of billing-related events. In addition,
system 200 may access export preferences, and translation and
transmission settings for placing reports in appropriate form for
delivery to the billing system 112 corresponding to a medical
practice. Alternatively, export preferences may define the intended
destination of bill reports or invoices. Thus, insurance companies
and other responsible parties may receive a bill or an invoice
developed according to their predefined report preferences.
[0067] While system 200 is illustrated as including specific
components, it should be understood that various embodiments may
operate using any suitable arrangement and collection of
components.
[0068] FIG. 3 is a block diagram illustrating a mobile device 300
representing an example embodiment of mobile device 118. As
illustrated, mobile device 300 includes a number of components that
operate together to facilitate the management of medical
information. Mobile device 300 can support a number of different
operations, including receiving practice location and user
configuration information, case board information, medical chart
information, patient treatment information, and case summary
information for presentation and management on a graphical user
interface. In addition, mobile device 300 may facilitate the
transmission of alerts and tracking medical cases and medical
charts. Mobile device 300 is further operable to facilitate the
management of medical case assignments and roles through a
graphical user interface. Additionally, mobile device 300 is
capable of securely accessing medical case information from a
remote medical information management system using appropriate
authentication and secure access techniques.
[0069] As illustrated, mobile device 300 includes a number of
components for maintaining and displaying medical information.
Mobile device 300 may represent any suitable portable hardware,
including appropriate controlling logic and data capable of
communicating with remote devices and systems, receiving user
input, and displaying medical information. As shown, mobile device
300 includes several components, which may include a network
interface 302, a processor 304, a memory 306 and a user interface
308. The illustrated embodiment further discloses memory 306 as
including a non-volatile portion of memory 310 and a volatile
portion of memory 312.
[0070] Network interface 302 represents any appropriate combination
of hardware and controlling logic for coupling to one or more
networks. Network interface 302 may support any number of suitable
protocols for communicating on a communication network. For
example, network interface 302 may be a wireless local area network
interface, cellular network interface, satellite interface, and/or
any other appropriate interface for communicating on a
communication network. Network interface 302 may have multiple
interfaces for handling different communication protocols.
[0071] Processor 304 represents one or more processing elements,
including hardware, logic, and data capable of controlling the
operation of mobile device 300. For example, processor 304 may be a
computer processor for executing a medical information management
application stored in memory 306, or any other software or
controlling logic associated with mobile device 300, such as a
mobile operating system.
[0072] Memory 306 represents appropriate hardware and control logic
for maintaining a medical information management application and
case information including medical chart information corresponding
to one or more medical practices. Memory 306 may also include
storage for other data, such as a mobile operating system of mobile
device 300. As illustrated, memory 306 includes a non-volatile
portion 310 and a volatile portion 312. Non-volatile portion 310 of
memory 306 represents memory for maintaining persistent
applications and/or data. Volatile portion 312 of memory 306
represents storage for maintaining non-persistent applications
and/or data. According to particular design considerations, the
medical information management application and practice, location,
and user configuration data may be stored in the non-volatile
portion 310 of memory 306, while medical professional, location,
practice activity, patient data, and case information including
medical chart information retrieved from a medical information
management system may be stored in the volatile portion 312 of
memory 306. Such an implementation provides added security to
critical data and helps to ensure that confidential user, patient,
and/or case information is not readily accessible even if mobile
device 300 is lost or otherwise compromised. In some
implementations, some or all of the practice, location, and user
credentials may be stored in non-volatile memory to facilitate
seamless access and/or quick reentry into the system, while some
other credential may be stored in volatile memory to ensure that a
lost device cannot be improperly used.
[0073] Mobile device 300 also includes a user interface 308. User
interface 308 represents any appropriate combination of hardware,
control logic, and data for displaying information to a user and
receiving inputs from a user. Thus, user interface 308 includes any
input and/or output interface. For example, a user interface may be
a touch screen interface that is capable of both displaying
graphical information and receiving user inputs. User interface 308
of mobile device 300 may be used to display medical case
information including medical chart information using a medical
information management application, and receive real-time updates
of such information for appropriate processing and forwarding by
the medical information management application.
[0074] In particular embodiments, mobile device 300 is capable of
transmitting, receiving, and modifying medical case information
including medical chart information to track changes occurring in
real-time at a medical facility and forward such information to a
medical information management system. Mobile device 300 may be
used by medical professionals to receive real-time information
corresponding to one or more cases and enter real-time updates for
transmission to a medical information management system. Such
updates, in turn, can be delivered to other computing devices or
systems. In particular embodiments, mobile device 300 must transmit
updates to medical information management system 120, which
controls whether data is actually updated. Thus, a handheld device,
such as mobile device 300, enables medical case information to be
managed and coordinated between medical professionals actively
rendering care to one or more patients. For example, medical chart
information may be periodically updated in real-time during a
patient treatment episode.
[0075] In operation, elements of mobile device 300 perform various
functions including facilitating maintenance and display of a
graphical electronic medical chart, enabling entry and display of
drugs, fluids, events, vital signs, physiological data, and
laboratory information, facilitating recording of medical
professional activity information and patient treatment records
having case chronology information, permitting the transmission of
alerts for tracked medical cases including notifications of
incomplete data, providing an intuitive graphical user interface
for interacting with the system, enabling tracking of medical case
assignments and roles in addition to handing-off assignments and
roles between medical professionals, and facilitating secure
authentication and access techniques.
[0076] To provide a graphical case board including a medical chart,
mobile device 300 retrieves and presents information maintained by
medical information management system 120. For example, processor
304 may execute a medical information management application
residing in a nonvolatile portion 310 of memory 306 to receive
medical case board information. Once this information is received,
mobile device 300 may display a graphical medical chart using user
interface 308. In operation, user interface 308 may graphically
present a medical chart having multiple predefined sections in
predefined regions of the display. In particular embodiments, the
medical chart is presented in a distinct tab which may be selected
through the user interface 308. Other tabs may provide
functionality such as case board, case summary, and checklist items
as disclosed in U.S. patent application Ser. Nos. 12/789,783;
12/789,858; 12/789,900; 12/789,962; and 12/790,011.
[0077] In some embodiments, the predefined sections of the medical
chart may correspond to drugs administered, fluids entering the
patient and being expelled by the patient, events, vital signs such
as blood pressure and heart beat, physiological patient
information, and laboratory information. In certain embodiments,
physiological patient information and laboratory information may be
toggled on the display where one is shown at a given time depending
on user selection. Each of the sections of the medical chart may be
divided into time intervals and facilitate the recording of data
values corresponding to the medical information being recorded. For
example, in the drugs section, the values may correspond to a
discrete dosage value or a dosage value over time, time of
administration, or other appropriate values. On the other hand, the
events section may facilitate the timestamp and type of event
(e.g., tourniquet on). Thus, each section may permit the recording
of values relevant for the section or particular sub-item of a
section of the medical chart.
[0078] In operation, during each interval of time during a
procedure, the medical care professional using the system may enter
appropriate values in corresponding sections of the medical chart.
For example, the user may enter an appropriate systolic and
diastolic pressure for the current subinterval of time during a
medical procedure. In certain embodiments, automated data seeding
can be enabled, which may allow the user interface to automatically
generate values for specific time intervals for later verification
by the user. In such embodiments, the medical information
management application may generate automatic values based on an
algorithm or measured value for a current time interval if the user
does not specify particular values. For example, the medical
information management application may replicate the most recently
recorded value for systolic and diastolic pressure and heart beat
of the patient. In certain embodiments, according to particular
policies of the medical care establishment, the medical information
management application may indicate automatically generated
information as incomplete, for example, by using a particular color
scheme, a colored dot, shading the corresponding region, or other
appropriate indicator. In some embodiments, users may select an
incomplete data item to verify or adjust the data entry. In a
similar fashion, data in various sections of the medical chart
corresponding to drugs, fluids, events, vital signs, physiological
data, or laboratory information may be entered by the user or
automatically generated if automated data seeding is enabled.
[0079] In certain embodiments, the medical information management
application may generate notifications based on the presence of
incomplete data items. According to practice or procedure specific
templates or policies, users of the system may be reminded of the
presence of incomplete data. For example, after a predetermined
period of time after completion of a patient treatment episode, the
user responsible for data recording may be notified of the presence
of incomplete data. In some embodiments, other medical care
professionals (e.g., a supervisor) may also be notified as
appropriate. Notifications may be in any appropriate form such as
pop-up, text message, voice message, multimedia message or other
suitable mechanism. Notifications may be layered such that various
degrees of alerts are employed to encourage the user to complete
the incomplete data. In particular embodiments, the notification
layers are configurable according to practice or procedure specific
templates or policies.
[0080] In certain embodiments, mobile device 300 may facilitate
responding to alert messages, for example, to acknowledge the
receipt of the alert or to otherwise engage other medical
professionals to take appropriate action in response to the
indicated case event. In those embodiments, the response may be
received by user interface 308 and the medical information
management application being executed by processor 304 may process
the response for delivery to a remote medical information
management system over a communication network using network
interface 302. The medical information management system may then
process the response and forward corresponding messages to one or
more handheld devices and/or systems as appropriate.
[0081] While mobile device 300 is illustrated as including specific
components, it should be understood that various embodiments may
operate using any suitable arrangement and collection of
components.
[0082] FIG. 4 is a diagram illustrating an electronic medical chart
400 representing an example medical chart interface for a hand held
device interacting with a system according to the present
disclosure. As shown, medical chart 400 includes various elements
that together provide a user-friendly interface for interacting
with the medical chart. In the illustrated embodiment, medical
chart 400 is organized into multiple sections. For example, medical
chart 400 includes a drugs display section 402, a fluids display
section 404, a vital signs display section 406, and a physiological
data display section 408. In system 400, each of these sections
occupy a distinct area of the screen and are simultaneously
viewable. Each of these sections span a maximum viewable time range
410. The maximum viewable time range 410 is further divided into
equally distributed time intervals. In this embodiment, the maximum
viewable time range is two hours spanning 8 a.m. to 10 a.m. The
maximum viewable time range may correspond to the average length of
a typical procedure at a particular medical care establishment. In
other embodiments, the maximum viewable time range may vary between
approximately thirty minutes and four hours. The maximum viewable
time range 410 may be further divided into equally distributed time
intervals. For example, maximum viewable time range 410 may be
divided into fifteen minute time intervals. As shown, time interval
412 represents one of the equally distributed time intervals
spanning 8 a.m. to 8:15 a.m. Each of the display sections display
and facilitates recording of medical information about a particular
patient undergoing a specific medical procedure. For example, in
medical chart 400, the various sections displays and facilitates
entry of information regarding the drugs, fluids, events, vital
signs, monitored physiological information, and laboratory
information related to a patient undergoing anesthesia.
[0083] In certain embodiments, although the information displayed
may be limited to the maximum viewable time range 410, the user may
horizontally scroll the display to show events occurring prior to
the currently displayed time range. For example, if three hours has
elapsed and the maximum viewable time range is two hours, the user
may scroll back to view medical chart information for the first
hour. In one embodiment, horizontal scrolling may be activated by
swiping or providing suitable gestures on the screen in the
intended direction (e.g., left or right) in appropriate areas of
the screen. In some embodiments, a left or right gesture by the
user in a non-shaded or non-colored region may activate horizontal
scrolling. In those embodiments, shaded or colored regions may
indicate regions that contain incomplete data and which can be
activated to provide appropriate values to render the time interval
or subinterval complete. Other embodiments may have distinct
regions that facilitate horizontal scrolling and others that do not
allow such scrolling.
[0084] Certain embodiments may facilitate identifying time
intervals, subintervals or subsections of display section that
contain incomplete data. An incomplete time interval, subinterval
or subsection may be a current or past time interval, subinterval,
or subsection of the display section that includes data that
requires additional information or confirmation, such as partially
completed entries, automatically populated entries, or data entered
by rapid entry.
[0085] As illustrated, drugs display section 402 lists various
drugs administrable to the current patient. The displayed list of
drugs can be practice specific or procedure specific as
appropriate. The displayed list of drugs may be defined by a
template for the practice location or a particular user library
selected by the user. In the illustrated embodiment, drugs display
section 402 includes a drugs listing 414 specifying various drugs
that may be administered during a medical procedure to the patient.
Although drugs listing 414 shows ten drugs in this particular
embodiment of medical chart 400, drugs listing 414 can include less
or more than the drugs shown according to particular
implementations. In certain embodiments, when drugs listing 414 is
too long to be displayed simultaneously in the section allocated
for drugs display section 402, the drugs listing 414 is vertically
scrollable within the drugs display section 402. In those
embodiments, vertical scrolling may cause the entire section may
scroll accordingly to display the information corresponding to the
drugs viewable on the screen. Drugs display section 402 also
includes a add drugs button 416 which facilitates the addition or
subtraction of drugs listed in drugs listing 414.
[0086] In the illustrated embodiment, two ways of entering drug
related information into drugs display section 402 are shown. For
example, drugs values may be entered as a dosage that spans time
(i.e., a rate). For instance, drug rate entry 418 depicts the
oxygen in liters per minute being administered to the patient over
time. The solid lines indicate no change from the previous value
and the in time that the value does change, a new value is shown.
For example, as shown, O2 starts at ten liters per minute then
changes to two liters per minute and then continues until it
changes later to five liters per minute and then to ten. Drugs may
also be entered as a fixed dosage value as shown by drugs amount
entry 420. The illustrated drugs display section 402 also depicts
an incomplete time interval 422 that spans the same duration as
time interval 412 but represents the time interval starting at 9:45
a.m. to 10 a.m. As shown, incomplete time interval 422 is shaded to
indicate that at least one value of data in time interval 422 is
incomplete. In this particular example, time interval 422 is
indicated as incomplete because of incomplete drug entry 424 shown
as a colored dot in incomplete time interval 422. In this
particular embodiment of medical chart 400, the fact that
incomplete time interval 422 is shaded may indicate to the user
that this time interval is editable such that the user may select
this time interval and make an appropriate indication of the one or
more appropriate values such that this time interval is rendered
complete. In certain embodiments, only those time intervals
indicating incomplete data can be selected by the user to enter or
revise data values. In those embodiments, the remaining parts of
medical chart 400 will not be immediately editable to the user.
[0087] Medical chart 400 also illustrates a fluids display section
404. Fluids display section 404 represents the section on medical
chart 400 for displaying and recording all fluids that either enter
or are expelled by the patient. In this example, fluids display
section 404 displays four fluids in fluids listing 426. Fluids
display section 404 facilitates entry either by values over time or
as discrete values at a particular time. For example, fluids entry
428 indicates a value for a particular fluid being administered
over a span of time whereas fluids entry 430 shows a discrete
amount of fluid at a particular time. Fluids display section 404
also includes an add fluids button 432 that facilitates the
addition or removal of fluids listed in fluids listing 426. As with
drugs listing 414, fluids listing 426 can be vertically scrollable
if the number of fluids listed in fluids listing 426 exceeds the
area allocated for fluids section 404. In those embodiments where
fluids listing 426 is scrollable the entire section responds to
such scrolling such that the values corresponding to the displayed
drugs are shown in this section.
[0088] Vital signs display section 406 represents the section of
medical chart 400 that displays vitals signs corresponding to the
patient. In this particular example, the vital signs that are
recorded are the blood pressure and heart rate of this particular
patient. In certain embodiments, vital signs of the patient may be
recorded at a higher frequency than the data recorded in other
sections of medical chart 400. For example, in vital signs display
section 406, the vital signs of the patient are recorded at five
minute intervals such that there are at least three recordings
within each fifteen minute time interval. In this embodiment, blood
pressure is recorded as a line segment as depicted by blood
pressure line segment 434. As illustrated, blood pressure line
segment 434 spans a systolic pressure of approximately one hundred
fifty and a diastolic pressure of approximately eighty. Vital signs
display section 406 also displays the heartbeat of the patient in
intervals of five minutes. In this example, heartbeat indicator 436
shows a heartbeat of approximately ninety. In this embodiment of
vital signs display section 406, two incomplete vital signs
sections 438 are shown. Both of these subsections are shaded to
indicate that data in those subsections are incomplete.
[0089] In particular embodiments where automated data seeding is
enabled, vital signs are automatically generated according
predetermined algorithm as the current time progresses. For
example, in certain embodiments, the automatically generated vital
signs values may relate to the last recorded vital signs values.
For example, incomplete vital signs subsections 438 both replicate
the same value indicated by blood pressure line segment 434 and
heartbeat indicator 436. In this embodiment, incomplete vital signs
subsections 438 are user selectable for editing purposes to either
verify the data or to change the value to the appropriate value for
this patient for the corresponding time.
[0090] As illustrated, medical chart 400 also includes a
physiological data display section 408. Physiological data display
section 408 facilitates display and recording of physiological data
related to the patient. As shown, physiological data display
section 408 includes a monitored values list 440 which represents
various physiological information related to the patient. As with
the other display sections, physiological data corresponding to the
patient can be entered for each of a plurality of time intervals,
such as time interval 412. Medical chart 400 also includes a labs
button which facilitates toggling between the physiological data
display section 440 and another display related to laboratory
information corresponding to the patient. By selecting the labs
button 442, the user can quickly view lab values corresponding to
the patient that might be relevant for the patient's care. By
selecting the labs button 442 for a second time the user may be
returned to the physiological data display section 408. In other
embodiments, both the physiological data display section and the
laboratory information may be simultaneously viewable on the
display.
[0091] Medical chart 400 in the illustrated embodiment, includes an
auto-population indicator 444. The auto-population indicator 444
indicates whether medical data that is recorded on a periodic time
interval will be auto-populated based on one or more algorithms. As
discussed above, vital signs information may be auto-populated on a
periodic basis such as five minutes in certain embodiments. For
example, when auto-population takes place, the vital signs of a
patient may replicate the previously recorded value or be some
measured value obtained from the patient. For instance, the vital
signs information displayed in incomplete vital signs subsections
438 indicate values that replicate the values represented by blood
pressure line segment 434 and heartbeat indicator 436. In some
embodiments, auto-population of data values may render those data
values incomplete, which may be indicated by a suitable indicator,
such as a color scheme, shading, or specific shapes (e.g., dots).
In such instances of incomplete data, verification or adjustment
may be required by the user to finalize those values. In particular
embodiments, medical chart 400 also includes a next event indicator
446. As depicted, the next approaching event is anesthesia stop. In
particular embodiments, selecting the next event indicator causes
the user interface to transition to the next event. For example,
selecting anesthesia stop may end the current patient treatment
episode.
[0092] Medical chart 400 may also include an event section 450. In
the illustrated embodiment, events may represent actions that take
place during the treatment of a patient. Events may include actions
that may be needed as particular circumstances arise and may not be
necessary for every patient or medical procedure. For example, as
depicted, the first event is a tourniquet event 454 that took place
at approximately 8:40 a.m. Thus, the event section 450 enables the
user to enter events that may or may not occur in the ordinary
course but may be necessary during the treatment of a particular
patient. In this embodiment, add events button 452 allows the user
to enter specific events during the course of a medical procedure.
By selecting add events button 452, the user is presented with a
predefined list of common events to select from or the user may
alternatively select from a library of all events that might be
practice or procedure specific as configured by particular
templates.
[0093] Embodiments of the present disclosure provide charted data
regions or sections having modular vertical sections for distinct
presentation of data items for drugs, fluids, events, vital signs
and monitored physiologic data. In certain implementations, data
items for each section may contain multiple data elements such as
time of administration, type of administration, and dose of
administration. According to particular embodiments, data item
elements may be optional or required by the medical care
establishment and may be configurable via a web-based
administrative capability.
[0094] Data entry on a handheld apparatus according the present
disclosure may be by finger touch or by any other appropriate input
means such as a pen, stylus, keyboard, mouse, or other suitable
touch screen gesture control or user input mechanism. In certain
embodiments, the dimensions of the various sections of the medical
chart may be determined based on the input method. For example, if
finger touch is the preferred input method, the dimensions may be
larger than if a stylus or mouse were being used. In addition, the
dimensions of the sections of the medical chart may be adjusted in
real-time to account for overages in data recording. For example,
if the number of drugs being recorded exceeds the number of drugs
that can be shown on the display at one time and other sections
such as the monitored physiological data section has only a few
data items, the system may dynamically adjust the dimensions of the
two sections such that most of the recorded information can be
visually displayed simultaneously on the screen. Thus, sections of
the medical chart may be dynamically scaled up or down to
accommodate data overages or reductions in one or more sections or
based on the input mechanism.
[0095] While medical chart 400 is illustrated as including specific
elements, it should be understood that various embodiments may
implement an electronic medical chart interface using any
appropriate combination of elements for providing for facilitating
the display and recording of medical information related to a
patient.
[0096] FIG. 5 is an add drugs view illustrating a particular
embodiment of the electronic medical chart according to the present
disclosure. In the illustrated embodiment, various features of
system 500 are shown. For example, system 500 depicts an add drugs
button 502, add drugs display 504, rapid entry indicators 506, edit
drugs value selector 508, and add new drugs from library selector
510. System 500 facilitates the entry of drugs onto the electronic
medical chart such that drugs being administered to a patient can
be recorded and displayed.
[0097] In operation, selecting the add drugs button causes the add
drugs display 502 to appear as shown. A user of the medical chart
may select one or more drugs as appropriate for through the
interface. In a particular embodiment, the user may opt for rapid
entry of the displayed drugs by selecting the drugs but without
specifying the particular values corresponding to the drug being
administered. This may allow the user to quickly track the drugs
being administered and permit the user to complete the actual
values for those drugs at a later time at the user's convenience.
In this manner, acute patient care may be prioritized over
documentation. In certain embodiments, the rapid entry indicators
506 provide a visual indication to the user regarding the drugs
selected. In the illustrated embodiment, selecting the first four
drugs causes a check mark to be displayed next to each of those
drugs. According to particular embodiments, the user may return to
the medical chart to view or record other medical information
without entering a specific value for the drugs. The medical chart
may provide an appropriate indication of incomplete data in the
time interval associated with a rapid entry of drugs, such as a
colored dot for each drug or other appropriate indicator.
Alternatively, the user may enter specific values for the drugs
being administered to the patient by selecting edit drugs value
selector 508. Selecting the edit drugs value selector 508 may cause
system 500 to present a separate screen to allow the user to select
from common values of the drug or to enter a specific value for the
drug. In some embodiments, system 500 may include an add new drugs
from library selector 510 which allows the user to add drugs to add
drugs display 504. The library displayed may be configurable
according to the practice or the current medical procedure being
performed.
[0098] While system 500 is illustrated as including specific
elements, it should be understood that various embodiments may
implement an electronic medical chart interface using any
appropriate combination of elements for providing for facilitating
the display and recording of medical information related to a
patient.
[0099] FIG. 6 is an add fluids view illustrating a particular
embodiment of the electronic medical chart according to the present
disclosure. In the illustrated embodiment, various features of
system 600 are shown. For example, system 600 depicts an add fluids
button 602, add fluids display 604, rapid entry indicator 606, edit
fluids value selector 608, and an add new events from library
selector 610. System 600 facilitates the entry of fluids onto the
electronic medical chart such that fluids entering or being
expelled by the patient can be recorded and displayed.
[0100] In operation, selecting the add fluids button causes the add
fluids display 602 to appear as shown. A user of the medical chart
may select one or more fluids as appropriate for through the
interface. In a particular embodiment, the user may opt for rapid
entry of the displayed by selecting the fluids but without
specifying the particular values corresponding to the fluids
entering or leaving the patient. This may allow the user to quickly
track fluids and permit the user to complete the actual values for
those fluids at a later time at the user's convenience. In certain
embodiments, the rapid entry indicators 606 provide a visual
indication to the user regarding the fluids selected. In the
illustrated embodiment, selecting the second fluid causes a check
mark to be displayed next to the fluid. According to particular
embodiments, the user may return to the medical chart to view or
record other medical information without entering a specific value
for the fluids selected. The medical chart may provide an
appropriate indication of incomplete data in the time interval
associated with a rapid entry of fluids. Alternatively, the user
may enter specific values for the fluids being administered to the
patient by selecting edit fluids value selector 608. Selecting the
edit fluids value selector 608 may cause system 600 to present a
separate screen to allow the user to select from common values of
the fluid or to enter a specific value for the fluid. In some
embodiments, system 600 may include an add new fluids from library
selector 610 which allows the user to add fluids to add fluids
display 604. The library displayed may be configurable according to
the practice or the current medical procedure being performed.
[0101] While system 600 is illustrated as including specific
elements, it should be understood that various embodiments may
implement an electronic medical chart interface using any
appropriate combination of elements for providing for facilitating
the display and recording of medical information related to a
patient.
[0102] FIG. 7 is an add events view illustrating a particular
embodiment of the electronic medical chart according to the present
disclosure. In the illustrated embodiment, various features of
system 700 are shown. For example, system 700 depicts an add events
button 702, add events display 704, current time indicator 706,
edit events value selector 708, and an add new events from library
selector 710. System 700 facilitates the entry of events onto the
electronic medical chart such that events related to the patient's
care can be recorded and displayed.
[0103] In operation, selecting the add events button causes the add
events display 702 to appear as shown. A user of the medical chart
may select one or more events as appropriate for the medical
procedure through the interface. In a particular embodiment,
selecting a particular event may cause the current time to be
displayed next to the event. For example, the current time
indicator 706 next to "Induced Hypovelemia" in add events display
704 shows a current time of 8:15. The user may opt to accept this
time value and return to the medical chart to view or record other
related medical information. Alternatively, the user may change the
specific time value for the selected event by selecting edit events
value selector 708. Selecting the edit events value selector 708
causes system 700 to present a separate screen to allow the user to
select an appropriate time value for the event. In some
embodiments, system 700 may include an add new events from library
selector 710 which allows the user to add events to add events
display 704. The library displayed may be configurable according to
the practice or the current medical procedure being performed.
[0104] While system 700 is illustrated as including specific
elements, it should be understood that various embodiments may
implement an electronic medical chart interface using any
appropriate combination of elements for providing for facilitating
the display and recording of medical information related to a
patient.
[0105] FIG. 8 is an automated data seeding view of a particular
embodiment of the electronic medical chart according to the present
disclosure. In the illustrated embodiment, various aspects of
system 800 are shown. For example, system 800 depicts a current
time tracker 802, an incomplete drugs time interval 804, a first
incomplete fluids time interval 806, a second incomplete fluids
time interval 808, vital signs editor 810, a first incomplete vital
signs time interval 812, a second incomplete vital signs time
interval 814, a third incomplete vital signs time interval 816, an
incomplete monitored values time interval 818, a request button
820, a present button 822, and a lookup button 824. System 800
illustrates various examples of automated data seeding in different
sections of the electronic medical chart. Particular values used in
automated data seeding can be determined according to a suitable
algorithm. For example, a particular implementation of automated
seeding may replicate the last previously recorded value. In
another example, the value may be ascertained through measurement
using appropriate instruments or by assessing the patient. In
particular embodiments, the use of automated data seeding may cause
the data item to be indicated as incomplete and require the user to
verify or adjust the automatically generated data value at an
appropriate time.
[0106] In certain embodiments, the activation of automated data
seeded may be conditioned on a medical milestone being entered
(e.g., anesthesia start or enter operating room). In certain
embodiments, once automated data seeding is activated, it may
proceed until a later medical milestone is reached (e.g.,
anesthesia stop or exit operating room). Such conditions for
automated data seeding activation and deactivation may be
configured by an administrator using the web-based administrative
capability. Moreover, the data elements that may be automatically
seeded and frequency of automated data seeding (e.g., every five
minutes or every fifteen minutes) may also be configurable.
[0107] As shown, current time tracker 802 indicates the current
time according to the medical chart. In certain embodiments,
current time tracker 802 may slide horizontally across the page to
keep track of the current time. Current time tracker 802 may act as
a boundary for automated seeding of data by not allowing any
automated seeding for times in the future. For example, in the
depicted embodiment, no automated seeding takes place to the right
of current time tracker 802. As illustrated, system 800 also
includes an incomplete drugs time interval 804 which is shaded to
indicate that it contains incomplete data. Incomplete drugs time
interval 804 demonstrates how automated data seeding for drugs may
take place in a particular embodiment. For example for the first
two drugs, the medical chart automatically selects values of two
and 1.8, respectively. These values may be verified by the user at
an appropriate time. In this example, the values that were
automatically generated for incomplete drugs time interval 804
differ from the previously recorded values. As discussed above, the
data values automatically generated may be defined by a suitable
algorithm or measured using appropriate medical instruments or
equipment. System 800 also includes a first incomplete fluids time
interval 806 and a second incomplete fluids time interval 808. As
depicted, both time intervals are shaded in this particular
embodiment to indicate that they contain incomplete data. Time
intervals 806 and 808 demonstrate the automated seeding of fluids
in a particular embodiment. For example, for the first fluid, the
medical chart automatically holds a value of 1000 ml across time
intervals 806 and 808. This value may be verified by the user at an
appropriate time.
[0108] In the vital signs display section, system 800 illustrates a
particular embodiment of vital signs editor 810. In operation, a
user can employ vital signs editor 810 to adjust the endpoints
corresponding to the systolic and diastolic blood pressure of the
patient. In this fashion, the user can specify the correct values
for the blood pressure of the patient at a particular subinterval
of time within a time interval. Similarly, the user can employ
vital signs editor 810 to adjust the heat beat by sliding the dot
associated with the heart beat in the appropriate direction to
increase or decrease the value. As shown, system 800 also
illustrates a first incomplete vital signs time interval 812, a
second incomplete vital signs time interval 814, and a third
incomplete vital signs time interval 816. In particular
embodiments, these time intervals are shaded to indicate that they
contain incomplete data to be verified by the user. In certain
embodiments, the blood pressure and heart beat values depicted in
time intervals 812, 814, and 816 have automatically seeded values.
As discussed above, these values may reflect the most recently
recorded value, measured values, or the results of any suitable
algorithm. For example, in the depicted embodiment, time intervals
812, 814, and 816 each have values that correspond to the
previously recorded values of blood pressure and heart beat of the
patient.
[0109] In the monitored values section, system 800 shows an
incomplete monitored values time interval 818. In particular
embodiments, time interval 818 is shaded to indicate that it
contains incomplete data that must be verified or adjusted by the
user. As illustrated, time interval 818 may contain automatically
seeded values for physiological data associated with the patient.
For example, in the depicted embodiment, time interval 818 contains
automatically seeded values that reflect the most recently recorded
values for each line of physiological data.
[0110] While system 800 is illustrated as including specific
elements, it should be understood that various embodiments may
implement an electronic medical chart interface using any
appropriate combination of elements for providing for facilitating
the display and recording of medical information related to a
patient.
[0111] FIG. 9 is an edit mode of a particular embodiment of the
electronic medical chart according to the present disclosure. In
the illustrated embodiment, various aspects of system 900 are
shown. For example, system 900 depicts an edit button 902, an
editable time interval 904, an edit drugs display 906, a current
drugs value 908, a drugs value selector 910, and a vital signs
subinterval 912. System 900 illustrates an edit mode of the medical
chart where all time intervals and subintervals are accessible for
editing by the user. The user may select any time interval, such as
editable time interval 904, to edit values in a particular section
of the medical chart.
[0112] In operation, a user may enter an edit mode of the medical
chart by selecting the edit button 902. In particular embodiments,
edit button 902 may be toggled between regular and edit modes. In
certain embodiments, when in regular mode, time intervals and
subintervals having incomplete data may be selected for editing by
the user. In edit mode, any time interval or subinterval of time
may be selected for editing by the user. As illustrated, selecting
edit button 902 causes all time intervals and subintervals of time
to be shaded, indicating that they are available for editing. For
example, time interval 904 may be activated by the user causing
edit drugs display 906 to be presented. As shown, edit drugs
display section includes a time range and a current drug value
corresponding to the time range for each drug. For example, current
drug value 908 indicates a drug value of 0.6 mg which can be edited
by the user. For example, a drugs value selector 910 may be
activated by the user to change the current drug value 908. The
user may then be presented with an interface for selecting among
common values or specify a particular value. System 900 also
illustrates a vital signs subinterval 912 which can be activated by
the user to edit the blood pressure and heart beat values for the
patient corresponding to that time subinterval. As illustrated, the
vital signs may be recorded on a more frequent schedule (e.g.,
every five minutes) compared to time intervals (e.g., every fifteen
minutes) in other sections of the medical chart.
[0113] As illustrated, system 800 also includes a request button
820, a present button 822, and a lookup button 824. These
interfaces may provide auxiliary functions for the medical chart
interface of system 800. In particular implementations, request
button 820 may provide the user with a list of canned texts
messages, such as simple message service (SMS) messages, for
communicating with other individuals. In other implementations, the
request button 820 may provide the user with the ability to send a
user specified text message to a user. Some implementations may
facilitate other forms of messaging including voice, instant
message, page, multimedia message, or other appropriate messaging
means. The present button 822, in particular embodiments, may
provide a user-friendly mechanism to notify others that the user is
presently attending to the patient and actively monitoring the
patient's condition. The presence of a user may be delivered by
voice, text, instant message, multimedia message, or other
appropriate delivery mechanism. In particular embodiments of system
800, the lookup button 824 may provide users with a list of
commonly used documents such as protocol documents, procedure
documents, medical cross-reference charts, or directories (e.g.,
phone numbers and/or extensions). Thus, the lookup button may
provide a convenient location for auxiliary information that may
become helpful during active patient care. The specific documents
that are presented when the lookup button 824 is activated may be
template or protocol driven. Thus, a the documents listed may be
specific to a medical care establishment, organization, or the
medical procedure being performed.
[0114] While system 800 is illustrated as including specific
elements, it should be understood that various embodiments may
implement an electronic medical chart interface using any
appropriate combination of elements for providing for facilitating
the display and recording of medical information related to a
patient.
[0115] Particular embodiments may facilitate the management and
notification of incomplete data. As discussed, incomplete data may
be present on the medical chart due to prioritization of acute
patient care over documentation. In some embodiments, users may
continue work on other cases even when incomplete data exists. In
those cases, the users and others may be reminded of the presence
of incomplete data. Incomplete data may exist as a result of rapid
data entry, automated data seeding, or a user decision not to
complete a required data item to prioritize patient care or for
other reasons. Incomplete data that requires user attention may be
configured by the medical establishment, medical organization, or
administrator. In some cases, the designation of incomplete data
may be driven by the circumstance, medical procedure, or nature of
the data element. For example, some incomplete data, such as the
patient's date of birth, may be derived from other medical systems
while other information, such as vital signs for a specific time
interval, may require immediate attention by the user to ensure
accuracy and completeness. A medical care establishment or medical
organization may require that certain data is entered by the user.
For example, an organization may stipulate that all cases require a
post-operation note or time to be recorded. In those cases, the
user will be presented with notifications on every case where this
information is incomplete. In other instances, case circumstances
may determine whether a particular data element must be completed.
For example, case circumstances may dictate that the drug lidocaine
be administered. In this situation, once the administration of
lidocaine is noted by the user, the user may be prompted later for
completion of all required aspects for that lidocaine
administration such as dose, method of administration, and time of
administration.
[0116] Certain embodiments may allow multiple layers of
notification to encourage users to appropriately address incomplete
data values. The layers of notification may be user configurable
and may enable notifications to be generated to other medical
personnel such as nurses, supervisors, or hospital administrators.
For example, in a first layer of notification, subtle visual
reminders during data entry and review may be employed to identify
incomplete data regions that may be edited by the user. In certain
embodiments, such visual reminders may include colored text, shaded
regions, flags, and/or specific color schemes. For instance, the
use of red text, red shaded regions, or red flags may indicate that
the corresponding data item is incomplete. In some embodiments, a
colored flag (e.g., red flag) may appear on the tab corresponding
to a category of medical information (e.g., chart) to indicate that
a data item corresponding to the tab contains incomplete data. In
this manner, a user may visually recognize that incomplete data
exists in particular tabs even if the user is not currently viewing
one of those tabs. This facilitates a high level view of categories
of medical information that contain incomplete data that the user
may need to address. In a similar fashion, colored flags may be
used in the margins of particular sections of category of medical
information to indicate regions in which incomplete data
exists.
[0117] Other embodiments may include a second layer of notification
where a more prominent notification is generated. For example, the
user may be notified at the end of a patient care episode or when
the user attempts to logout if incomplete data still remains. In
those instances, the user may receive an alert that is accompanied
by a sound or vibration which can be configured by the medical care
establishment or by an administrator. In some embodiments, the user
alert may involve a pop-up window indicating the specific elements
of incomplete data and present navigation options for completing
the incomplete data.
[0118] Particular embodiments may include a third layer of
notification where an alternate notification pathway is used to
notify the user and others of the presence of incomplete data. For
example, the user may be notified by text message, email, instant
message, page, pop-up, multimedia message, large screen display
highlight, printed output box listing, automated phone call, or
other appropriate notification mechanisms. Such notifications may
be user configurable. For example, a medical care establishment may
require such notifications to occur at periodic time intervals
after completion of a patient care episode if certain data still
remains incomplete. In those instances, the user may receive an
alert that is accompanied by a sound or vibration which can be
configured by the medical care establishment or by an
administrator. In some embodiments, the user alert may involve a
pop-up window indicating the specific elements of incomplete data
and present navigation options for completing the incomplete
data.
[0119] Although the present disclosure describes several
embodiments, it should be understood that a myriad of changes,
substitutions, and alterations can be made without departing from
the spirit and scope of the invention as defined by the appended
claims.
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