U.S. patent application number 14/176698 was filed with the patent office on 2014-06-05 for patient check-in/scheduling kiosk.
This patent application is currently assigned to EPIC SYSTEMS CORPORATION. The applicant listed for this patent is Epic Systems Corporation. Invention is credited to Steven J. Larsen.
Application Number | 20140156302 14/176698 |
Document ID | / |
Family ID | 38534662 |
Filed Date | 2014-06-05 |
United States Patent
Application |
20140156302 |
Kind Code |
A1 |
Larsen; Steven J. |
June 5, 2014 |
PATIENT CHECK-IN/SCHEDULING KIOSK
Abstract
A method and system for facilitating activity scheduling for a
patient including the steps of providing an interface device for
checking a patient in at the facility, receiving identifying
information for the patient, identifying currently scheduled
appointments for the patient where the currently scheduled
appointments are associated with currently scheduled appointment
activities, identifying at least one additional unscheduled
activity for the patient in addition to the currently scheduled
appointment activities, identifying at least one suggested
appointment schedule including at least one open time slot during
which the patient may complete the additional unscheduled activity
and the currently scheduled appointment activities and presenting
the at least one suggested appointment schedule to the patient.
Inventors: |
Larsen; Steven J.; (Cross
Plains, WI) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Epic Systems Corporation |
Verona |
WI |
US |
|
|
Assignee: |
EPIC SYSTEMS CORPORATION
Verona
WI
|
Family ID: |
38534662 |
Appl. No.: |
14/176698 |
Filed: |
February 10, 2014 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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13453410 |
Apr 23, 2012 |
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14176698 |
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11786555 |
Apr 12, 2007 |
8165900 |
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13453410 |
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10914471 |
Aug 9, 2004 |
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11786555 |
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Current U.S.
Class: |
705/2 |
Current CPC
Class: |
G16H 10/60 20180101;
G16H 40/20 20180101; G06Q 10/109 20130101; G06Q 10/1095
20130101 |
Class at
Publication: |
705/2 |
International
Class: |
G06Q 10/10 20060101
G06Q010/10; G06Q 50/22 20060101 G06Q050/22 |
Claims
1. A system for time-optimizing scheduling for a patient at a
medical facility, the system comprising: a memory storing: a
resource schedule database identifying available resources and
corresponding time slots; a current appointment database that
stores currently scheduled appointments for the patient; and an
unscheduled activities database storing at least one of
prerequisites, unfulfilled orders, and elective opportunistic
activities corresponding to the patient; a processor linked to the
memory, the processor programmed to: access the current appointment
database to identify currently scheduled appointments for a
selected patient; access the unscheduled activities database to
identify at least one additional unscheduled activity for the
patient in addition to the currently scheduled appointment
activities; access the resources database to identify resources for
the unscheduled activity, and to identify a plurality of suggested
appointment schedules; identify at least one time-optimized
suggested appointment schedule including the additional unscheduled
elective opportunistic activity and the currently scheduled
appointment activities; and pushing the at least one time-optimized
suggested appointment schedule to a personal device corresponding
to the patient.
2. The system of claim 1, wherein the patient's personal device is
programmed to enable the patient to accept the at least one
time-optimized suggested appointment schedule.
3. The system of claim 1, wherein the patient's personal device is
programmed to revise the patient's currently scheduled appointments
to the time-optimized suggested appointment schedule.
4. The system of claim 1, wherein the processor is further
programmed to automatically push at least one time-optimized
suggested appointment schedule to the patient's personal device a
predetermined time before the currently scheduled appointment.
5. The system of claim 1, where the processor is further programmed
to automatically identify and push one or more time-optimized
suggested appointment schedule to the patient's personal device a
predetermined time prior to the appointment.
6. The system of claim 5, wherein the processor is programmed to
push the time-optimized suggested appointment schedule to the
patient's personal device within a range of one to two days prior
to the currently scheduled appointment.
7. The system of claim 11 wherein the patient's personal device
comprises at least one of a personal digital assistant and a cell
phone.
8. A system for scheduling an unrelated elective appointment in a
patient's current schedule at a medical facility, the system
comprising: an interface device for access by the patient; a memory
storing: a resource schedule database identifying available
resources and corresponding time slots; a current appointment
database that stores currently scheduled appointments for the
patient; and a best practices database storing elective
opportunistic activities corresponding to the patient; a processor
in communication with the interface device and the memory, the
processor programmed to receive patient login data, wherein the
processor is programmed to: identify the patient and access the
current appointment database to identify one or more currently
scheduled appointments for the patient and to identify current
circumstances corresponding to elective opportunistic activities
for the patient; access a stored set of rules, and to apply the
stored set of rules to the circumstances associated with the
patient to identify at least one additional unscheduled elective
opportunistic activity in the best practices corresponding to the
circumstances of the patient; access a resource schedule database
to identify resources for the elective opportunistic activity;
identify a plurality of suggested appointment schedules that
include an appointment time for the identified unscheduled elective
opportunistic activity and appointment time for the currently
scheduled appointment; and prompt the patient to select a schedule
and to selectively check in for the suggested appointments through
the interface, wherein the patient selectively schedules an
elective opportunistic activity along with the currently scheduled
appointments.
9. The system of claim 8, wherein the processor is further
programmed to evaluate scheduling constraints associated with the
unscheduled elective opportunistic activity to identify the
plurality of suggested appointment schedules.
10. The system of claim 9, wherein the scheduling constraint
comprises at least one of a fast limitation, a recovery period, and
a prerequisite.
11. The system of claim 8, wherein the interface is a personal
device accessed by the patient.
12. The system of claim 11, wherein the processor is further
programmed to push the plurality of schedules to the patient's
personal device.
13. The system of claim 11, wherein the patient's personal device
is programmed to enable the patient to accept the suggested
schedule.
14. The system of claim 11, wherein the patient's personal device
is programmed to revise the patient's currently scheduled
appointments.
15. The system of claim 11, wherein the processor is further
programmed to push an optimized schedule to the patient's personal
device a predetermined time before a scheduled appointment
occurs.
16. The system of claim 8, where the processor is further
programmed to automatically identify and push one or more time
shifted appointments to the patient's personal device to optimize
an appointment schedule a predetermined time prior to the
appointment.
17. The system of claim 11 wherein the patient's personal device is
a portable device that comprises at least one of a personal digital
assistant and a cell phone.
18. The system of claim 11, wherein the best practices are
correlated to the patient based on at least one of an age, a
gender, and a medical history.
19. The system of claim 8, wherein the interface device comprises a
kiosk positioned in a location for use by patients.
20. The system of claim 8, wherein the processor is further
programmed to determine whether the time for the currently
scheduled appointment is past, and if the time for the currently
scheduled program is past, to access the database, and to present a
new time for the currently scheduled appointment to the patient.
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. patent
application Ser. No. 13/453,410, filed on Apr. 23, 2012, which is a
continuation of U.S. patent application Ser. No. 11/786,555, filed
on Apr. 12, 2007, now U.S. Pat. No. 8,165,900 and titled "Patient
Check-in/Scheduling Kiosk", which is a continuation-in-part of U.S.
patent application Ser. No. 10/914,471 that was filed on Aug. 9,
2004 and titled "Electronic Appointment Scheduling For Medical
Resources" which is now abandoned, each of which are hereby
incorporated by reference in their entirety.
STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT
[0002] Not applicable.
BACKGROUND OF THE INVENTION
[0003] The present invention relates to electronic medical record
(EMR) systems and in particular to an EMR system allowing access to
and entry of data by a patient to request and schedule appointments
and medical resources for the patient.
[0004] Scheduling of medical providers, equipment, laboratory
services, and other resources for patient appointments is a
significant challenge in efficiently controlling medical resources
and costs. Typically, scheduling is controlled by employees in a
clinic or other medical facility, who communicate with the patients
by phone and arrange the schedules manually. While, in some cases,
these employees can arrange all of the resources required for a
visit, frequently patients are required to schedule multiple
procedures in a series of tests through a series of phone calls to
different employees handing scheduling for related, but separate,
facilities. Such arrangements can be time consuming and
inefficient, both for the patients and the medical facilities.
[0005] Enlisting patients as active participants in their own
healthcare can increase patient satisfaction and the quality of the
healthcare experience while decreasing the cost of providing that
care. One area in which patient satisfaction can be dramatically
improved, therefore, is in providing greater control and easier
access for the patient to request and schedule appointments for
medical care. Providing such control to the patient also affords
benefits to the medical facilities, as when scheduling is done by
the patient, there is a reduced need for scheduling personnel.
[0006] As it is desirable to allow patients access to scheduling of
their procedures in order to improve efficiency, a number of
medical communities have used the Internet to allow patients to
request, or in limited cases directly schedule appointments. These
systems, however, have not proved to be particularly efficient for
a number of reasons. First, known scheduling systems typically
provide scheduling capabilities only in predetermined increments of
time. These systems, therefore, cannot tailor the amount of time
necessary for an appointment to the reason for the appointment, and
therefore are not efficient in scheduling the time of medical
personnel and resources.
[0007] Second, when patients schedule their own appointments, it is
difficult for medical personnel to obtain necessary information
from and provide necessary information to the patients prior to the
visit. Therefore, for example, patients can arrive for
appointments, and spend up to an hour filling out forms prior to
meeting with a doctor. Additionally, as the medical practitioner
does not know the reason for the visit prior to the arrival of the
patient, the medical practitioner cannot prepare for the visit by
providing instructions to the patient prior to the visit. This
problem is particularly acute when evaluation of a medical problem
requires multiple steps, such as, for example, laboratory work
prior to meeting with a medical practitioner. Inadequate
information, therefore, often result in return visits, which could
have been easily avoided had sufficient information been available
to both the patient and the physician.
[0008] After appointments are scheduled and a short time before the
time slot reserved for an appointment, a patient travels to the
facility at which the appointment is scheduled to take place,
checks in for the appointment with a receptionist, completes
necessary forms, typically waits in a waiting room to be called for
the appointment, is moved into a room to participate in the
appointment and, after the appointment is completed, checks out
with a receptionist and leaves the facility at which the
appointment occurred. Here, to expedite the check-in process,
patient check-in kiosks are known that receive unique patient
identifying information from a patient during a check in process
and, when the identifying information is recognized by the kiosk,
the kiosk allows the patient to check in for appointments. An
exemplary check in kiosk is the MEDIKIOSK.TM. that by Galvanon.
[0009] In many cases it is optimal for a patient that is to
participate in several different activities (e.g., tests,
examinations, procedures, etc.) at a facility to schedule
appointments substantially consecutively (i.e., cluster
appointments) so that the patient can attend several appointments
during a single visit to the facility instead of requiring multiple
facility visits to complete the appointments. Thus, where a patient
has to participate in first through fourth different activities at
a facility, it may be desirable to schedule the first, second,
third and fourth activities for consecutive time slots at 8:00
a.m., 8:30 a.m., 9:00 a.m. and 9:30 a.m., respectively. Scheduling
software is known that allows patients or a facility scheduling
employee to view existing appointments and to select open time
slots for additional appointments that need to be scheduled for the
patient where the selected time slots are temporally proximate
currently scheduled appointments.
[0010] While appointment clustering is often optimal, sometimes
appointments cannot be clustered because, when the appointments are
scheduled, either (1) consecutive open time slots for resources
required to complete activities are not available, (2) the patient
associated with the appointments has previous time commitments that
will not allow clustering or (3) one of the tests is dependent on
the results of an earlier test. Thus, in many cases, despite
efforts to cluster, consecutive appointments may be spaced apart by
intermediate periods of an hour or more or appointments may have to
be made on separate days despite the fact that the appointments
will take place at the same facility.
[0011] One other scheduling issue that impedes optimal appointment
clustering is that resource availability, patient schedules and
unfulfilled orders often change in a fluid fashion so that the
constraints on clustering a specific subset of appointments change
over time. Thus, what a patient may think today is optimal
appointment scheduling for a subset of appointments to take place
two week from now may be far less than optimal next week or on the
day that the appointments are to occur. For instance, when a first
patient uses a kiosk to schedule first through third appointments
two weeks prior to the day on which the appointments are to occur,
schedules of resources required to complete the first through third
appointment activities may be such that a first one hour
intermediate period is required between the first and second
appointments and a second one hour intermediate period is required
between the second and third appointments. Nevertheless, on the day
that the first through third appointments are to take place, it may
be that a second patient cancels her appointment that was to occur
during the first one hour intermediate period so that, optimally,
the first patient's third appointment could be moved to the first
one hour intermediate period.
[0012] As another instance, when a first patient uses an online
kiosk to schedule first through third appointments approximately
two weeks prior to the time when the patient would like the
appointments to occur, the patient's own time commitments may not
allow the patient to schedule the three appointments on the same
day. Here assume that the patient's own time commitments require
that the patient schedule the first through third appointments on
first, second and third different days. In this example, it may be
that the patient's time commitments change two days prior to the
first appointment so that the patient could complete all of the
first through third appointments on the first day and thereby avoid
trips to the facility on the following two consecutive days.
[0013] As still one other instance, in many cases patient's are
unaware of or have forgotten activities in addition to activities
for which appointments have already been scheduled, that should be,
could be, must be, or have been ordered to be performed at a
facility prior to attending an appointment at the facility.
Exemplary activities that a patient may be unaware of or may have
forgotten include existing or standing physician orders for tests,
procedures, examinations, consultations, etc., routine best
practices procedures (e.g., a yearly physical for anyone over 50
years old, a yearly colonoscopy for men over 50 years old, etc.),
prerequisite activities required before specific types of
appointments, etc.
[0014] One solution to the problems associated with fluid patient
and resource schedules and changing activities associated with
patients has been to provide receptionists with access to
scheduling software to allow receptionists to optimize scheduling
whenever patient's check in for appointments. Here, known
receptionist check in software provides notices to receptionists
when a patient that is checking in has unfulfilled orders (i.e.,
physician orders for patients that have been requested but have not
been scheduled). When the receptionist recognizes that a patient
has unfulfilled orders, the receptionist has the ability to access
separate standard appointment scheduling software and search for
time slots to add appointments for the patient's unfulfilled
orders. When one or more time slots for one or more unfulfilled
orders is identified, if the patient agrees, the receptionist can
add the appointment to the patient's schedule.
[0015] While providing scheduling software to receptionists works
well in theory, in practice, this solution has not proven very
successful for several reasons. First, at many times medical
facility receptionists are inundated with patients checking in for
appointments and simply cannot take additional time with each
patient during check in to attempt to optimize patient appointment
clustering. This is particularly true in cases where receptionists
are required to use standard scheduling software to schedule new
appointments as standard scheduling software tends to be rather
complex and requires several steps and associated time to identify
and select possible time slots for activities.
[0016] Second, many receptionists are not well trained in how to
use scheduling software and therefore are uncomfortable tinkering
with currently scheduled appointments. This is particularly true in
cases where appropriateness of a time slot for an appointment may
hinge on many factors in addition to whether or not the time slot
is open for a required resource (e.g., rules governing which
procedures can follow other procedures, required pre-appointment
patient preparation, etc.).
[0017] Third, even when a receptionist is trained in using
scheduling software and there is no backlog of patients checking in
for appointments, in many cases the receptionist opts not to
attempt to optimize patient schedules because there is no direct
benefit to the receptionist by performing the additional activities
(i.e., the benefit of an altered appointment is directly to the
patient and the facility that increases utilization rates of
resources, not the receptionist).
BRIEF SUMMARY OF THE INVENTION
[0018] The present invention provides a system for allowing
patients or proxies for those patients to electronically scheduling
medical resources. The system includes both a patient interface
terminal or interface device, such as an internet terminal or a
kiosk, and a computer system receiving time frame information and a
reason for a medical appointment scheduling information from the
patient interface terminal. Based on the information received, the
computer system identifies a requested medical service, identifies
resources required for the service, and presents schedule options
at the interface terminal based on the identified medical services
and resources. Because the reason for the visit is known, the
computer system can schedule a time frame based on the reason for
the appointment, thereby increasing efficiency. The resources
scheduled can include a medical practitioner, and can also be other
staff, a geographic office location, medical equipment, laboratory
time, a room, or other resource necessary for a selected healthcare
service. After schedule options are provided to the patient, the
computer system can accept an input from the patient interface
terminal to select an appointment from the schedule options, and
submit the appointment data to scheduling software for the
healthcare provider to directly schedule an appointment. As
described below, when scheduling an appointment, the system
automatically provides targeted questionnaires and necessary
information for the appointment to assure that both the patient and
the healthcare provider have necessary information before the
appointment. These steps increase efficiency in the healthcare
system, also as described more fully below.
[0019] In another aspect of the invention, the scheduling system
can receive a range of schedule times or a range of geographic
locations acceptable for the appointment, and can present schedule
options for resources available within the range of schedule times
or geographic locations. The scheduling system can also communicate
with a database providing data indicating appointment lengths for
different types of healthcare service appointments, and present a
schedule of options which accommodate an appointment of the
required length. The schedule options presented can also be
filtered to indicate only healthcare providers and resources that
can be coordinated in both time and geography to provide the
healthcare service.
[0020] In still another aspect of the invention, the scheduling
system can provide a reminder or alert notification to the patient
interface terminal. The alerts can be provided at either
predetermined intervals or at a time selected by the patient
through the patient interface terminal. The scheduling system can
also receive from the patient interface terminal a notice of
appointment cancellation and submits cancellation data to a
schedule for the resource.
[0021] In still another aspect of the invention, the scheduling
system can include a central database holding schedules for
healthcare providers and resources, and can accesses the central
database to identify healthcare providers for the service and
identify resources required for the service to present schedule
options according to common schedule openings of healthcare
providers and resources. The common schedule openings can also be
provided for healthcare providers and resources within a
predetermined geographic range.
[0022] In yet another aspect of the invention, the schedule system
of the present invention can accommodate the scheduling of
healthcare services requiring multiple sequential steps. The
computer system can identify healthcare providers and resources for
each step of the service, and provide different combinations of the
multiple providers and resources. Thus, for example, in a
multi-step process, the first step can require a laboratory test
and the computer system communicates with a database providing data
indicating laboratory test processing delay, and the computer
system can determine the appropriate steps to accommodate the
required delay. The scheduling system can also communicate with a
database or a web service (*i.e., Yahoo Traffic, etc.), a satellite
link, or any other technology that provides travel time delay
information between the geographic locations and present schedule
options which accommodate the travel time delay or present
information on travel time estimates or delays. The computer system
can also store the series of steps together in a log or other data
structure such that, if a cancellation request is received, all
steps for the procedure are cancelled.
[0023] In yet another aspect of the invention, a system for
scheduling patient appointments is provided which includes a
patient interface terminal, and a computer system scheduler
communicatively coupled to the patient interface terminal and to a
medical record database which includes medical data for specific
patients. The computer system is adapted to receive data from the
patient interface terminal to identify a patient making a request,
and to filter medical services available to the patient based on
the patient's identity. By identifying the patient, it is possible
to filter healthcare services, information, and data based on the
age, gender, patient medical and health history or other patient
characteristics, to provide improved and more appropriate/targeted
healthcare service. Thus, by integrating the check in software with
a patient's electronic medical record, the present invention
presents functionality that is far more useful than functions that
can be provided via known check in kiosks.
[0024] In yet another aspect of the invention, the computer system
can be further adapted to provide information to the patient based
on a reason for the medical appointment, and receive data from the
patient based on the reason for the medical appointment. In
particular, the computer system can provide detailed questionnaires
at the patient terminal which are tailored to obtain data for a
particular medical appointment and/or medical resource. To increase
efficiency, the computer system can also populate the questionnaire
with available data from a medical records database and/or filter
the questions provided to the patient based on known data about the
patient.
[0025] These particular objects and advantages may apply to only
some embodiments falling within the claims and thus do not define
the scope of the invention.
[0026] In addition, according to at least some embodiments of the
present invention, when a patient accesses a kiosk or interface
device to check in for an appointment, in addition to allowing the
patient to check in for currently scheduled appointments, the
check-in kiosk identifies one or more additional activities that
the patient may schedule temporally proximate the currently
scheduled appointments and provides the option to schedule those
activities. Here, the additional activities may include existing or
unfulfilled orders, routine best practices activities (e.g., a
yearly physical for all patients 50 years or older, etc.),
prerequisites for one or more of the appointments for which the
patient is attempting to check in, etc. Hereinafter, unless
indicated otherwise, the phrase "additional unscheduled activities"
will be used to refer generally to all unscheduled activities for a
patient that can be identified by an inventive system and includes
but is not to be limited to unfulfilled orders, prerequisites for
currently scheduled appointments, routine best practices
activities, activities that can automatically be identified via
examination of a patient's electronic medical record, etc.
[0027] In at least some cases it is contemplated that, in addition
to identifying additional unscheduled activities that may be
scheduled, the system may also identify resources required to
complete the activities, access resource schedules to identify open
time slots for the resources that are temporally proximate to
currently scheduled appointments, where two or more resources are
required at the same time for an activity, identify times slots
when all of the needed resources are available at the same time and
then suggest a new suggested appointment schedule that includes at
least one time slot for at least one of the additional
activities.
[0028] In some embodiments it is contemplated that the system will
examine all scheduling possibilities that may make sense for a
patient and present seemingly optimal possibilities first followed
by possibilities that seem less optimal when the seemingly more
optimal possibilities are rejected or not selected by a patient.
Here, "optimal" possibilities may include, for instance, time slits
that are within one hour of currently scheduled appointments or
that are between two currently scheduled appointments where
anticipated travel times can be accommodated while less optimal
possibilities may include time slots that are within a one to two
hour range of currently scheduled appointments and still less
optimal time slots may occur on subsequent days within one hour of
currently scheduled appointments that are to occur on the
subsequent days.
[0029] Thus, in some cases the system may even determine how
currently scheduled appointment time slots can be altered to best
optimize use of a patient's time by effective clustering. For
instance, in some cases the system may simply suggest that one or
more currently scheduled appointments be shifted to eliminate
intermediate times between consecutive appointments. In other cases
the system may suggest that a currently scheduled appointment be
shifted to a new time slot (e.g., one hour later than the original
time slot for the appointment) to allow an additional unscheduled
activity to be scheduled. In still other cases the system may
suggest that one or more additional unscheduled activities be added
to a patient's schedule either before currently scheduled
appointments (i.e., in a case where a patient arrives early to
check in for a first currently scheduled appointment), in between
two currently scheduled appointments or after a last scheduled
appointment.
[0030] In at least some embodiments, by providing scheduling tools
to patients upon check in, the additional work associated with
optimizing a patient's schedule is placed directly with the party
(i.e., the patient) who benefits most from optimized appointment
clustering. In this regard most patients would find it advantageous
to reduce the amount of time at, and minimize the number of trips
to, a facility to complete all required activities. For this reason
alone it is expected that optimized scheduling will increase
appreciably by providing check in kiosks that allow patients to
perform the optimization.
[0031] In addition, it has been recognized that, while a
conventional receptionist is often inundated with patients checking
in and therefore cannot take additional time with each patient to
attempt to optimize the patient's appointment schedule, a typical
patient has nothing to do at a medical facility other than attend
scheduled appointments and, in fact, often arrives several minutes
(e.g., 15-30 minutes or more) prior to the time slot reserved for a
first appointment during which the patient may have nothing to do.
Here, it is believed that providing schedule optimizing tools to a
patient at a time when the patient often has nothing better to do
will result in a higher level of scheduling optimization.
[0032] Furthermore, in some embodiments, when a patient arrives
late for a currently scheduled appointment, the check in kiosk may
be programmed to, after identifying the patient, indicate that the
patient is too late for the scheduled appointment, identify other
options for the appointment, present the other options to the
patient and allow the patient to reschedule the appointment without
requiring aid from a receptionist, a staff member or other facility
employee. Thus, for instance, where a patient arrives ten minutes
after an appointment was to be completed and therefore missed the
appointment, the check in kiosk may identify an open appointment
time slot 45 minutes later and may present that open slot as an
option for rescheduling. Where the open slot is accepted by the
patient, the kiosk would add the patient to the schedule. In
addition, here, because the patient would have a 45 minute waiting
period, the kiosk/system may be programmed to attempt to identify
other activities for the patient to fill in a portion of the 45
time slot.
[0033] Moreover, in at least some embodiments, scheduling options
are only offered to patients when seemingly optimal options or
options that are better than a current appointment schedule exist.
Thus, for instance, when a patient that is associated with three
additional unscheduled activities logs on to a check in kiosk to
check in for first and second currently scheduled appointments at
8:30 a.m. and 10:30 a.m., an inventive system may identify the
three additional unscheduled activities, identify resources
required to perform the unscheduled activities and determine if
there are any open time slots for the required resources that are
temporally proximate the current 8:30 and 10:30 appointments or if
the current appointments could be shifted to accommodate one or
more of the additional unscheduled activities. Here, if no open
slots are identified and none of the currently scheduled
appointments can be shifted to accommodate at least one of the
additional unscheduled activities, the system simply allows the
patient to check in for the currently scheduled appointments
without indicating that the patient has additional unscheduled
activities. In the alternative, where an open time slot is
identified for one or more of the additional unscheduled activities
or current appointments can be shifted to accommodate one or more
additional unscheduled activities, the system provides the option
to schedule the additional unscheduled activity(s). Thus, in at
least some embodiments, patients are only notified of additional
unscheduled activities when scheduling options are available.
[0034] Furthermore, in at least some embodiments, the scheduling
portion of the check in interface only provides a reduced set of
scheduling options which enables configuration of an extremely
simple and intuitive interface device. To this end, in the above
example where a patient is associated with three additional
unscheduled activities and is checking in for 8:30 a.m. and 10:30
a.m. appointments, it is likely that the patient will only want to
schedule one or more of the additional unscheduled activities for
the same day as the currently scheduled appointments if the
additional unscheduled activities can be scheduled temporally
proximate the currently scheduled appointments (e.g., within one
hour before the 8:30 appointment, within one hour after the 10:30
appointment or between the first and second appointments). Thus, at
check in, in at least some embodiments, the time range during which
scheduling options may be offered to a patient is automatically
selected by the system and is extremely limited. By limiting
scheduling times to a small period, the interface can be made
extremely simple and easy to use.
[0035] In at least some embodiments the check in kiosk may also be
used as a check out kiosk that allows a patient to attend to
various post appointment activities such as, for instance,
obtaining medication or care instructions, receiving referrals to
other physicians, obtaining a list of additional unscheduled
activities, scheduling additional unscheduled activities, etc.
Here, in at least some cases where a physician adds information to
a patient's electronic medical record during an appointment, an
inventive system may be programmed to glean information from the
patient's record that can be used to identify one or more
additional unscheduled activities to suggest to the patient.
[0036] At check out, instead of providing a simplified scheduling
interface, a more complete interface may be provided that allows
the patient to see a large number of scheduling options. In some
cases the check out scheduling interface may attempt to cluster
additional unscheduled activities with currently scheduled
appointments and, at least as an initial pass, may present a
seemingly optimal and simplified scheduling option, only providing
the more detailed scheduling interface when the simplified option
is rejected by a patient.
[0037] It is also contemplated that, in at least some embodiments,
the simplified scheduling interface may be added to a check-in
interface used by a receptionist or staff member to reduce the
amount of work and time required to optimize patient appointment
schedules thereby increasing the likelihood that receptionists will
attempt to optimize patient schedules. For instance, in some
embodiments, instead of simply indicating that unfulfilled orders
exist for a patient upon check-in and requiring a receptionist to
access separate scheduling software to attempt to add those
unfulfilled orders to a patients scheduled appointments, an
inventive system will, if possible, automatically identify a
suggested appointments schedule including at least one time slot
for at least one of the unfulfilled orders and present the option
to optimize to the receptionist. Thereafter, if the patient
consents, the suggested appointment schedule can be quickly
accepted and patient appointments updated accordingly.
[0038] Thus, at least some inventive embodiments include a method
for allowing a patient at a medical facility using a public kiosk
to schedule activities, the method comprising the steps of
providing the kiosk in a location for use by patients, via the
kiosk, receiving identifying information from the patient,
identifying currently scheduled appointments for the patient where
the currently scheduled appointments are associated with currently
scheduled appointment activities and initially scheduled
appointment time slots, identifying at least one additional
unscheduled activity for the patient in addition to the currently
scheduled appointment activities for the patient, identifying at
least one suggested appointment schedule including at least one
open time slot during which the patient may complete the additional
unscheduled activity and the currently scheduled appointment
activities and, via the kiosk, presenting the at least one
suggested appointment schedule to the patient.
[0039] At least some cases further include the step of receiving
input via the kiosk to accept the suggested appointment schedule
and automatically adding the additional unscheduled activity to the
appointment schedule to update the currently scheduled
appointments. In some cases the step of identifying at least one
additional unscheduled activity for the patient includes
identifying multiple additional unscheduled activities for the
patient in addition to the currently scheduled appointment
activities for the patient and wherein the step of identifying at
least one suggested appointment schedule includes identifying a
schedule that includes open time slots during which the patient may
complete each of the additional unscheduled activities and the
currently scheduled appointment activities. In some cases the step
of receiving identifying information occurs at a first time, the
method further including the step of allowing the patient to
check-in for any currently scheduled appointments that are
temporally proximate the first time. In some cases temporally
proximate appointments include appointments that occur within three
hours of the first time. In some cases the method is for use after
a first appointment has been completed and prior to the patient
exiting the facility wherein the at least one additional
unscheduled activity includes an unfulfilled order generated during
the first appointment. IN some embodiments the steps of receiving
input via the kiosk to accept the suggested appointment schedule
and automatically adding the additional unscheduled activity to the
appointment schedule to update the currently scheduled appointments
includes presenting a single icon via a display screen that, when
selected, causes the additional unscheduled activity to be added to
the appointment schedule and receiving input via the single
icon.
[0040] Other embodiments include a method for allowing a patient at
a medical facility using a public kiosk to simultaneously schedule
and check-in for an activity to be performed at the facility, the
method comprising the steps of providing the kiosk in a public
location for use by patients, providing an unfulfilled order
database that includes unfulfilled orders wherein an unfulfilled
order is an unscheduled activity requested by a clinician, via the
kiosk, receiving identifying information from the patient,
identifying at least a first unfulfilled order for the patient in
the unfulfilled order database, via the kiosk, presenting the first
unfulfilled order to the patient, via the kiosk, receiving input
indicating that the patient intends to check in for the unfulfilled
order and, upon receiving the input indicating that the patient
intends to check-in for the unfulfilled order, storing an
indication that the patient is checked in and placing the
unfulfilled order in a schedule queue to be performed.
[0041] Still other embodiments include a method for automating
patient checkout after an appointment, the method comprising the
steps of, during an appointment, receiving at least one activity
entry and storing the activity entry in a first EMR wherein an
activity entry includes data usable to determine that at least one
post-appointment follow-up activity associated with the activity
entry should be performed, after receiving at least one activity
entry: examining the EMR for any activity entries; and, when an
activity entry is identified, identifying post-appointment
follow-up activities associated with the identified activity entry,
providing the kiosk in a public location for use by patients, via
the kiosk, receiving identifying information from the patient,
identifying post-appointment follow-up activities associated with
the patient and, via the kiosk, presenting at least a subset of the
identified post-appointment follow-up activities.
[0042] Yet other embodiments include a method for facilitating
activity scheduling for a patient at a medical facility, the method
comprising the steps of providing an interface device for checking
a patient in at the facility for at least one currently scheduled
appointment, via the interface device, receiving identifying
information for the patient, identifying currently scheduled
appointments for the patient where the currently scheduled
appointments are associated with currently scheduled appointment
activities and initially scheduled appointment time slots,
identifying at least one additional unscheduled activity for the
patient in addition to the currently scheduled appointment
activities for the patient, identifying at least one suggested
appointment schedule including at least one open time slot during
which the patient may complete the additional unscheduled activity
and the currently scheduled appointment activities and, via the
interface device, presenting the at least one suggested appointment
schedule to the patient.
[0043] Other embodiments include a system for facilitating activity
scheduling for a patient at a medical facility, the system
comprising an interface device for checking a patient in at the
facility for at least one currently scheduled appointment, a
database that stores currently scheduled appointments for the
patient, a processor linked to the interface device and the
database, the processor programmed to, when the patient logs onto
the interface device: identifying currently scheduled appointments
for the patient where the currently scheduled appointments are
associated with currently scheduled appointment activities and
initially scheduled appointment time slots, identify at least one
additional unscheduled activity for the patient in addition to the
currently scheduled appointment activities for the patient,
identify at least one suggested appointment schedule including at
least one open time slot during which the patient may complete the
additional unscheduled activity and the currently scheduled
appointment activities and, via the interface device, present the
at least one suggested appointment schedule to the patient.
[0044] Some systems further include a database that stores
additional unscheduled activities for patients wherein the
processor is programmed to identify at least one additional
unscheduled activity for the patient by accessing the database that
stores additional unscheduled activities and identifying at least
one unscheduled activity for the patient in the database that
stores additional unscheduled activities. In the alternative, the
processor may be programmed to identify at least one additional
unscheduled activity for the patient by identifying circumstances
associated with the patient and applying a set of rules to
circumstances associated with the patient to identify the at least
one additional unscheduled activity.
[0045] Other embodiments include a method for facilitating activity
scheduling for a patient at a medical facility wherein the patient
has at least one currently scheduled appointment on a first day,
the method comprising the steps of providing an interface device
for checking the patient in at the facility for the at least one
currently scheduled appointment, during patient check in on the
first day, identifying all currently scheduled appointments for the
patient that are to occur on the first day where the currently
scheduled appointments are scheduled for initial time slots,
identifying at least one additional unscheduled activity for the
patient in addition to the currently scheduled appointments for the
patient that are to occur on the first day, identifying at least
one suggested appointment schedule including the currently
scheduled appointments for the patient that are to occur on the
first day and at least one open time slot that is temporally
proximate at least one of the initial time slots during which the
patient may complete the additional unscheduled activity and via
the interface device, presenting the at least one suggested
appointment schedule to the patient.
[0046] The foregoing and other objects and advantages of the
invention will appear from the following description. In the
description, reference is made to the accompanying drawings which
form a part hereof, and in which there is shown by way of
illustration a preferred embodiment of the invention. Such
embodiment does not necessarily represent the full scope of the
invention, however, and reference is made therefore to the claims
and herein for interpreting the scope of the invention.
BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS
[0047] FIG. 1 is a simplified block diagram of a computerized
interface for an EMR providing an Internet communication
channel;
[0048] FIG. 2 is a detailed block diagram of the interface of FIG.
1 showing a scheduler and associated scheduling databases;
[0049] FIG. 3 is a flow chart showing the steps of data flow for
retrieving a reason for an appointment from a patient;
[0050] FIG. 4 is a flow chart showing the steps for determining one
or more schedule option;
[0051] FIG. 5 is a flow chart showing the steps for scheduling an
appointment and providing reminders;
[0052] FIG. 6 is a schematic diagram illustrating an exemplary
check in/scheduling system according to at least some aspects of
the present invention;
[0053] FIG. 7 is a schematic diagram illustrating one example of
the resource schedule database of FIG. 6;
[0054] FIG. 8A is a schematic diagram illustrating one example of
the appointments database of FIG. 6;
[0055] FIG. 8B is a schematic diagram illustrating one example of
the unfulfilled orders database of FIG. 6;
[0056] FIG. 9 is a schematic diagram illustrating one example of
the prerequisites database of FIG. 6;
[0057] FIG. 10 is a schematic diagram illustrating one example of
the routine best practices database of FIG. 6;
[0058] FIG. 11 is a schematic diagram illustrating one example of
the follow up activities database of FIG. 6;
[0059] FIG. 12 is a for chart illustrating a method consistent with
at least some aspects of the present invention and may be performed
by the system shown in FIG. 6;
[0060] FIG. 13 is a screen shot that may be presented via one of
the kiosks in FIG. 6 to welcome a patient and to direct the patient
to take steps to identify himself;
[0061] FIG. 14 is a screen shot that may be presented via one of
the kiosks in FIG. 6 to guide a patient to insert a card into one
of the card readers of FIG. 6;
[0062] FIG. 15 is an exemplary kiosk screen shot inviting a patient
to confirm that the system of FIG. 6 has identified the correct
patient;
[0063] FIG. 16 is a kiosk screen shot that presents a main kiosk
menu for a patient to select from;
[0064] FIG. 17 is a kiosk screen shot which displays currently
schedules appointments for a patient to allow the patient to check
in for the appointments;
[0065] FIG. 18 is a kiosk screen shot that confirms that a patient
has checked in for appointments;
[0066] FIG. 19 is a kiosk screen shot that allows a patient to
either check in for scheduled appointments or see a suggest
appointment schedule that includes currently scheduled appointments
as well as at least one unfulfilled order time slot;
[0067] FIG. 20 is a kiosk screen shot that presents a suggested
appointment schedule to a patient;
[0068] FIG. 21 is a kiosk screen shot that confirms that a patient
has updated the patient schedule in a manner consistent with the
schedule suggested via the screen show shown in FIG. 20;
[0069] FIG. 22 is a sub-process that may comprise one of the
process blocks shown in FIG. 12;
[0070] FIG. 23 is a sub-process that may be substituted for a
portion of the process shown in FIG. 12 for identifying
opportunistic activities that can be scheduled and facilitating
scheduling of those activities prior to check in;
[0071] FIG. 24 is a kiosk screen shot that allows a patient to
either check in for currently scheduled appointments or schedule a
routine physical;
[0072] FIG. 25 is a kiosk screen shot that presents possible
appointment times for a physical;
[0073] FIG. 26 is a flow chart that may be substituted for a
portion of the flow chart shown in FIG. 12 for identifying
prerequisites to currently scheduled appointments when a patient
checks in and to facilitate scheduling of those prerequisites;
[0074] FIG. 27 is a kiosk screen shot which indicates that a
patient must schedule a prerequisite activity prior to checking in
for a currently scheduled appointment;
[0075] FIG. 28 is a kiosk screen shot that provides multiple time
slots for a prerequisite activity to be scheduled;
[0076] FIG. 29 is a flow chart consistent with at least some
aspects of the present invention for checking in patients for
unfulfilled orders that are not currently associated with reserved
appointment time slots;
[0077] FIG. 30 is a kiosk screen shot that indicates unfulfilled
orders that can be checked in on a walk in basis;
[0078] FIG. 31 is a kiosk screen shot that confirms that a patient
has been checked in for unfulfilled orders on a walk in basis;
[0079] FIG. 32 is a flow chart illustrating a method whereby a
physician enters information into an electronic medical record that
is thereafter gleaned and used to generate and store a list of
follow up activities for a patient associated with the electronic
medical records;
[0080] FIG. 33 is a flow chart illustrating a method whereby a
patient uses one of the kiosks shown in FIG. 6 to check out after
an appointment has been completed;
[0081] FIG. 34 is a kiosk screen shot that may be presented to a
patient during a check out procedure;
[0082] FIG. 35 is a kiosk screen shot indicating time slots that a
patient can select for scheduling follow up activities after an
appointment has been completed;
[0083] FIG. 36 is a kiosk screen shot for confirming that a patient
has scheduled an appointment during check out;
[0084] FIG. 37 is a sub-process that may be substituted for a
portion of the process shown in FIG. 12 for identifying currently
scheduled appointments that may be rescheduled in a more optimal
fashion;
[0085] FIG. 38 is an exemplary receptionist's terminal screen shot
that may be generated to facilitate simplified optimal patient
appointment scheduling;
[0086] FIG. 39 is a schematic illustrating an exemplary general
patient appointment schedule database that is consistent with at
least some aspects of the present invention;
[0087] FIG. 40 is a schematic of an exemplary estimated travel time
database that is consistent with at least some inventive
embodiments; and
[0088] FIG. 41 is a sub-process that may be substituted for a
portion of the method illustrated in FIG. 12 where the system
accounts for a patient's general schedule appointments and travel
times when attempting to identify an optimized schedule.
DETAILED DESCRIPTION OF THE INVENTION
[0089] Referring now to FIG. 1, a patient scheduling system 10 per
the present invention may include an interface module 12 standing
between a patient communication channel 14 and an EMR communication
channel 16, the latter communicating with an electronic medical
record (EMR) database 18. Generally the interface module 12 is a
program that may be physically located on an independent computer
or run on a computer shared with another function such as the EMR
database 18.
[0090] Generally, the EMR database 18 includes a complete medical
history of many patients collected from a variety of healthcare
sources 20 including physicians and other healthcare professionals
such as members of the staff at hospitals, clinics, and
laboratories communicating on standard EMR network 19. As will be
understood to those of ordinary skill in the art, the EMR database
18 includes biographical information describing the patient,
including the patient's age, gender, height and weight, and medical
history information including the patient's medical conditions,
previous medical procedures, medications, and laboratory test
results. The EMR database 18 may be centrally accessed by many
different healthcare sources 20 and thus serves as a path of
intercommunication among many individuals working together to
deliver healthcare.
[0091] The EMR database 18 is depicted as a single logical flat
file for simplicity but may be configured in any of a variety of
well known database formats including relational database
structure, object database structures and the like. The data of the
EMR database 18, like all medical records, is protected under
federal law to ensure that sensitive data of this record is not
released in a way that would violate a patient's privacy rights.
EMR databases may be obtained from a variety of commercial sources
including Epic Systems Corporation, the assignee of the present
invention, who sells an EMR database under the trade name of
"Chronicles" used with the "EpicCare" electronic medical record
software.
[0092] The patient communication channel 14 may join the interface
module 12 to a web server 22 providing a secure socket layer
connection to the Internet 24. The Internet 24 may in turn connect
a number of patient terminals 26 (only one shown for clarity)
implementing a browser and/or a kiosk 28, provided, for example, at
a doctor's office or elsewhere, either or both of which are used by
a patient 30.
[0093] The web server 22 includes a number of active web pages 32,
some of which will be described below, allowing the patient and/or
monitoring system 28 to transmit and receive data securely to and
from the web server 22. Incorporated into these web pages 32, for
example as a CGI script, is a program for authentication of the
patient's access to the web pages 32. The authentication control
program makes use of a log-in identifier/password validation table
34 both shown as logically held on the web server 22 but in the
preferred embodiment stored and executed remotely. The login
identifier/password validation table 34 holds one or more patient
specific tokens (for example, log-in identifiers and passwords but
possibly including instead or in addition biometric data and the
like) that ensure access to possibly sensitive medical data is not
freely available to unknown parties. The patient 30 may also allow
access to his or her medical records by a proxy or patient's
representative also stored as links in the log-in password/password
validation table 34 which gives each proxy a unique token.
Generally, the term "patient" as used herein should be considered
to include the patient and/or the patient's proxies. One important
proxy, of a parent for children, may be initiated as a reminder
based on knowledge about childbirth from the EMR.
[0094] The patient 30 must enter the text passwords and PIN
password upon every new communication session. The text password
and PIN password are not stored in cookie form on the patient
terminal 26 or kiosk 28 such as might make anyone with access to
the patient terminal 26 or kiosk 28 able to view or enter data on
behalf of the patient 30. The table 34 may also include provisions
allowing several different text passwords and PIN passwords to be
associated with the same patient so that proxy access may be had by
a patient's representative.
[0095] Data received by the web server 22 from the patient 30 is
marked with a patient identification number and forwarded along the
patient communication channel 14 as a patient identified message 36
to the interface module 12. Similar messages 36 may be received by
the web server 22 along the patient communication channel 14 from
the interface module and forwarded to the patient 30. Generally the
messages 36 will be formatted to act as queries or responses to
queries of or from the EMR database 18.
[0096] Referring still to FIG. 1, the interface module 12 may also
connect to a provider communication channel 40 possibly using all
or a portion of standard EMR network 19 allowing communication with
healthcare sources 20 via terminals 42 associated, for example,
with a primary care physician 44, a system administrator 46,
laboratory services, and other service and resource providers. The
resources may have access to the EMR database 18 directly per
normal conventions or through the interface module 12 as will be
described using a viewer/editor 48.
[0097] Access through the interface module 12 by the physician 44
also provides limited access to the patient 30. In this respect,
some patient data in messages 36 sent by the patient 30 can be
routed to a physician 44 and messages from the physician 44 may be
routed to the patient 30 in the form of secure communications. Such
email communications may also be initiated by the patient 30 as
will be described further below.
[0098] Referring now to FIGS. 1 and 2, the interface module 12
includes a scheduler 70 which includes a set of rules for
scheduling appointments based on scheduling data found in a
schedule database 72, data from the EMR 18 and data input at the
server 22 by the patient 30 at a patient terminal which can be as
described above at terminal 26 or kiosk 28. The scheduling database
72 can include a procedure or reason database 74, one or more
resource database 76, time/procedure data 78 for correlating time
periods to selected reasons or procedures, and geographic data 80,
providing a location of a given resource and data correlating
expected time to travel between one resource and others. The
procedure or reason database 74 includes a series of possible
reasons for an appointment along with parameters for determining
whether a patient is eligible for the selected procedure, a list of
resources required for the requested procedure and special
instructions associated with the requested procedure. Such
instructions can include information required by the patient such
as, for example, the need for fasting prior to the procedure.
[0099] The resource database 76 can include medical resources which
can be, for example, individual practitioners, clinics, medical
equipment such as X-ray, CT, or MRI machines, laboratory resources
or other practitioners' equipment or processes that need to be used
in a medical procedure. Group meetings, such as educational
meetings scheduled for a group of patients, can also be a resource.
Detailed sets of questions (referred to hereafter as
questionnaires) for acquiring information required from the
patient, can be included with both the reason database 74 and the
resource database 76. The questionnaires can be provided to the
patient at the patient terminal 30, and the scheduler 70 therefore
obtains required data from the patient based on the medical reason
for the visit, the specific requirements of the provider or a
clinic, and based on the requirements for a specific resource.
Furthermore, patient information can be pulled from the EMR
database 18 to populate portions of the questionnaire prior to
providing the questionnaire to the patient, thereby minimizing the
amount of input information required from the patient and
increasing the efficiency of the scheduling system. Data from the
EMR database 18 can also be used to filter the questions provided
to the patient based on known data about the patient.
[0100] Although a number of separate databases with specific
information are shown and described, it will be apparent that there
are a number of ways to arrange and coordinate the data required
for the scheduling process, any of which could be used as described
herein. Furthermore, although the scheduling database 72 is shown
in conjunction with the interface module 12, it will be apparent
that the database can be provided at the server 22, as part of the
EMR 18, in a separate memory component accessible to parts of the
system, or elsewhere.
[0101] Referring now to FIGS. 3-5, the operation of the scheduler
70 (FIG. 2) is shown. Referring first to FIG. 3, based on the
patient identification, the scheduler 70 in process block 81
retrieves data from the EMR 18 (FIG. 1) regarding, for example, the
age, sex, and medical condition of the patient, and filters the
possible reasons for an appointment in reason database 74 based on
these patient parameters to eliminate error and/or unnecessary
selections. The scheduler 70 then queries the patient for a reason
for an appointment, preferably by providing a menu of possible
reasons on a page provided to the patient 30 from the web server
22. The user then selects a reason for the visit, as shown in
process block 82. Although the process has been described as
filtering possible reasons and presenting a menu, it will be
apparent that the reason could also be entered as text or voice
data. Furthermore, although shown and described as starting the
process with entering a reason, the order and type of questioning
could be varied such that, for example, the initial query is to
select a provider, department, specialty, or facility. Any or all
of these selections can be used to start the scheduling process.
Although the invention is descried with reference to a particular
order, the invention is not intended to be limited to any
particular order.
[0102] After the initial data, such as a reason, has been received,
the scheduler 70, in process block 84, requests detailed
information associated with the request. The data request can be in
the form of a questionnaire which can be, as described above,
provided to the patient at the terminal 26 or kiosk 28, or,
alternatively, retrieved from stored preferences selected by the
patient. This information can include, for example, medical
history, patient preferences such as language and gender of the
caregiver, time and place of appointment, and other information
required or desirable to process the request for an appointment.
Based on the more detailed information retrieved in block 84, the
scheduler 70 determines if multiple steps are required. For
example, a procedure can be a visit to a medical practitioner, or
consist of a multi-step process including laboratory testing and
analysis followed by an appointment with a medical practitioner to
review the results. Once the steps are determined, in process block
86 the scheduler 70 determines the resources required and, in
process block 88, continues to FIG. 4 for scheduling and resource
allocation.
[0103] Referring now to FIG. 4, in process block 89, the user is
given the option of selecting either a location for the procedure
or a medical provider, and in process block 90 resources are
filtered by the scheduler 70 based on whether the patient would
prefer a specific practitioner or a specific location. In process
block 92, the scheduler system 70 also requests a proposed time
frame for scheduling the procedure from the patient 30, and then
accesses calendars or schedules in resource database 76 for the
required resources for each step in the process. In process block
94, the scheduler 70 identifies common schedule openings between
the resources required within the time frame specified by the
patient. If the resource required cannot be scheduled within the
time frame selected, a patient message is displayed in process
block 98 and the patient is again queried regarding a proposed time
frame, or, alternatively, in process block 97, the scheduler 70
generates a list of alternatives. These alternatives can include,
for example, appointments at the same time but with different
providers, appointments at the same time but at a different
location, appointments with the same provider at a different time
on an adjacent date, etc. After this list is generated, the
scheduler proceeds to scheduling an appointment in process block
100.
[0104] If common schedule openings are found, in process block 96,
and more than one step is required for the procedure, the time
required for each step and the geographic distance between the
related resources in the various steps are retrieved from the
database 72, and the scheduler 70 determines whether the series of
steps are compatible such that a patient could, within the required
time frames, and within the cited geographical distances, complete
all the steps of the procedure. For example, therefore, if
laboratory tests are required before meeting with a medical
practitioner, the scheduler 70 retrieves data to determine the
amount of time that is required to process the laboratory data and
transmit it to the medical practitioner, and how long it will take
the patient to travel from the laboratory to the office of the
medical practitioner. If the time and geographical requirements can
be met, scheduling options are available. Once options are
determined by the scheduler 70, the process proceeds to allow a
patient to select a scheduling appointment from at least one and
preferably a series of possible appointments as shown in FIG. 5. If
not, the patient is returned to process block 92 and queried for
another time frame.
[0105] Referring now to FIG. 5, in process block 102, one or more
schedule opening have been determined and options for scheduling an
appointment are displayed to the patient. While a number of
possible schedule options can be displayed, the patient is
prevented from viewing the entire schedule of any given
practitioner or other resource. At no time, therefore, is the
entire schedule displayed to the patient. In process block 104, the
patient selects one of the scheduling options presented, and in
process block 106, the scheduler 70 allocates the selected
resources by revising the associated calendars in database 76 for
each of the providers and/or resources that are required. If the
procedure includes multiple steps, the scheduler 70 stores a
linkage or log of the separate steps which can be used both for
distributing information to the various resources in the log, and
also for changing or canceling appointments as described below.
[0106] In process block 108, the finalized scheduling data is
provided to the patient and the patient is provided with any
special instructions required for the procedure. This notification
can be provided directly to the kiosk 28 or computer 26, to a
secure messaging address provided by the patient, or in the
alternative through a voice automated voice-mail system or using
various other user-selectable communication methods. The
appointment data, instructions provided to the patient, the
questionnaire data, and any necessary history required from the EMR
18 are also provided to the service providers and/or resource
managers preferably through electronic communications such as
secure messaging. The data provided to medical personnel can be
filtered depending on the level of the service provider, and/or on
a need-to-know basis. Furthermore, any additional patient
questionnaires required from either the practitioner, a medical
facility, or required for the use of a given resource can also be
transmitted to the patient for completion, and the completed
questionnaires transmitted to the necessary parties. As described
above, patient information can be pulled from the EMR database 18
to populate portions of the questionnaire prior to providing the
questionnaire to the patient.
[0107] Once both the resources and the patient are notified, the
scheduler 70, in process block 112, schedules reminders to be sent
to the patient and/or service providers. The reminders can be
spaced either at a predetermined preset time or at a time frame
selected by the patient and/or service providers. Again, these
reminders can be e-mailed, provided through an automated voice-mail
system, or provided through other user-specified communication
channels such as secure messaging. After the reminders are
scheduled, the scheduler 70 continues to monitor for cancellation
either by the patient or one of the service provides or resources,
or for an appointment change or adjustment provided by the service
provider or a resource manager, as shown in process block 114. If a
cancellation or adjustment request is received, a cancellation or
adjustment notice is forwarded to the patient and to the associated
providers in process block 116. In the case of an adjustment, the
patient 30 can be given the option to accept the adjustment or
start the scheduling process over. If a cancellation occurs or an
adjustment is accepted, the calendars in database 76 for the
service providers and associated resources are revised to reflect
the fact that the time frames for use of the resources has changed.
As necessary, a request can be forwarded to the patient 30 to enter
a new time frame request. When an adjustment or a cancellation is
made to a multi-step procedure, the scheduler 70 retrieves the log
or linkage information for the steps, and cancels or adjusts all of
the steps in the procedure as required.
[0108] The present invention therefore provides a number of
important improvements in medical resource scheduling. As the
scheduler 70 is connected to a database of patient information, the
plausibility of a requested medical service can be verified for a
specific patient, thereby limiting scheduling errors which can
result in resources being tied up unnecessarily. Furthermore, the
present invention simplifies and improves the efficiency of patient
scheduling by limiting the number of personnel who need to be
involved in the scheduling process, and by automating both the
distribution of patient instructions and the collection of patient
data required for a selected medical procedure, resource, or
facility. Moreover, because the system is tied directly to patient
data, detailed information about the patient can be easily and
efficiently provided to medical service providers and managers with
minimal keying of data by either the patient or the medical
provider. Additionally, the scheduler 70 can tailor the length of
an appointment to the requested medical procedure, thereby
increasing the efficiency of medical practices. For medical
procedures having multiple steps, the scheduler 70 can verify both
time and geographic constraints, and further, can assure that all
resources are notified in the event of a cancellation. The
scheduler 70 can further filter the schedule options provided to a
patient to prevent the patient from viewing the entire schedule of
a service provider.
[0109] Although a specific data flow is described above, it will be
apparent that variations in the order of data flow and retrieval
can be made without departing from the invention. Furthermore,
although specific hardware configurations are described
schematically, it will be apparent that the invention can be used
in conjunction with any number of different hardware and
architecture configurations.
[0110] It is specifically, therefore, intended that the present
invention not be limited to the embodiments and illustrations
contained herein, but include modified forms of those embodiments
including portions of the embodiments and combinations of elements
of different embodiments as come within the scope of the following
claims.
[0111] The systems above generally teach a scheduling system that
can be used at any time and location to schedule appointments at a
medical facility. In addition, the above system contemplates
placement of patient scheduling kiosks (see 26 in FIG. 1) within a
medical facility to, as the label implies, facilitate patient
scheduling of appointments. It has been recognized that kiosks like
kiosk 26 in FIG. 1 can, in addition to being used to facilitate
scheduling, be used by patients at a medical facility to self
check-in for appointments thereby alleviating or substantially
reducing the need for receptionists or staff members throughout a
facility.
[0112] In addition, it has been recognized that one particularly
advantageous time at which to allow a patient to schedule
appointments is when the patient is currently located at a medical
facility at which activities associated with the appointments may
occur and, more specifically, when the patient is at a facility to
attend currently scheduled appointments. Thus, for instance, assume
that four orders already exist (i.e., there are four unfulfilled
orders where an unfulfilled order is an activity that has already
been prescribed for a patient by a physician but has yet to be
scheduled) for a first patient and that each of the four orders is
related to activities that will eventually be performed at a first
facility and that the first patient arrives at the first facility
for two currently scheduled appointments, a first appointment at
8:30 AM and the second appointment at 10:00 AM where it is
anticipated that the first appointment will only take 15 minutes so
that there is a 1 hour and 45 minute gap between the two
appointments. In addition, assume that the first patient arrives 35
minutes early at 7:55 AM for the first appointment (i.e., the 8:30
AM appointment). Here, the first patient has 35 minutes before the
8:30 AM appointment will likely have 1 hour and 45 minutes between
the first and second appointments and may have additional time
available after the second appointment is completed.
[0113] In the above case, it would be extremely valuable to the
first patient if, upon checking in at 7:55 AM for the first
appointment via a kiosk 26, the kiosk provides a reminder of the
four existing and currently unscheduled orders and notice of the
open time periods in the patient's appointment schedule so that the
first patient can contemplate how the open times could be used
effectively to complete some of the unfulfilled orders. It would
also be valuable if, in addition to indicating unfulfilled orders
and open time slots in the first patient's schedule, the kiosk also
provides the option to the first patient to schedule appointments
for the unfulfilled orders during any of the open times. Moreover,
it would be advantageous if the kiosk and associated system
components were programmed to, upon patient check-in, identify
resources required to perform activities associated with existing
unscheduled orders, examine schedules of the required resources and
provide scheduling options to the patient that do not conflict with
the patient's currently scheduled appointments.
[0114] Hereafter a check-in/scheduling system is described with
reference to FIGS. 6-40 where the system includes various
components that are similar to the components described above. In
at least some cases where components are similar, similar labels
are used in the figures. For instance, in FIG. 1, a patient kiosk
is labeled 26 and in FIG. 6 patient kiosks are each labeled with
number 26 followed by a small case letter (e.g., 26a, 26b, 26c,
etc.), in FIG. 1 a database is labeled 72 and in FIG. 6 a database
is labeled 72a, etc. Where components are similar to the components
described above, in the interest of simplifying this explanation,
the components described hereafter are not again described in
detail.
[0115] Prior to describing the check-in/scheduling system shown in
FIG. 6, it is helpful for consistency purposes to define some terms
and phrases. To this end, the term "activity" will be used
generally to refer to occurrences related to patients at a medical
facility such as examinations, tests, procedures, consultations,
etc. The phrase "currently scheduled appointments" will be used
hereinafter to refer to appointments for a patient that have
already been scheduled for specific time slots. Here, typically one
or more activities will be associated with each appointment and are
to occur during the appointment. The phrase "unfulfilled order"
will be used to refer to activities already ordered by a physician
that have not been completed and that have yet to be scheduled. The
phrase "suggested appointment schedule" will be used to refer to an
appointment schedule that includes at least one tentative time slot
for at least one unfulfilled order where the appointments have not
been scheduled and are merely suggested to a patient. The phrase
"additional unscheduled activities" will be used to refer generally
to all unscheduled activities for a patient that can be identified
by an inventive system and includes but is not to be limited to
unfulfilled orders, prerequisites for currently scheduled
appointments, routine best practices activities, activities that
can be automatically identified via examination of a patient's EMR,
etc. The term "patient" will be used in a broad sense to refer to a
person or a proxy for a person where the person is to participate
in some activity for a medical facility. Thus, for instance, Mr.
Bruce Johnson who is to participate in a full physical exam may be
a patient due to his participation in the examination or, Mr.
Johnson may be considered a patient for the purposes of checking in
and scheduling where his daughter Sophia is to participate in some
facility activity.
[0116] Referring now to FIG. 6, an exemplary patient
check-in/scheduling system 10a is shown and includes a server 22a,
a database 72a, a network 24a (e.g., a local area network, a wide
area network, the Internet, etc.), and a plurality of patient
kiosks 26a, 26b, 26c, 26d, 26e and 26f. Server 22a runs software
programs that perform various methods/processes that are
contemplated by the present invention and to provide browser type
screen shots to the kiosks 26a, 26b, etc., and to receive input
from the kiosks. Each of kiosks 26a, 26b, etc., may take any of
several different forms including work stations, personal
computers, laptops, thin-client type devices, etc. Where the kiosks
are more than thin clients, in at least some embodiments each kiosk
may perform all or at least a subset of the steps required to
perform the inventive processes. When the kiosks are thin client
type devices, each kiosk operates primarily as a human-server
interface device for input/output between a patient and server 22a
where server 22a performs most or all of the inventive process
steps. Hereinafter, unless indicated otherwise and in the interest
of simplifying this explanation, it will be assumed that each kiosk
26a, 26b, etc., is a thin client type device.
[0117] Each of the kiosks 26, 265b, etc., is similarly constructed
and operates in a similar fashion and therefore, in the interest of
simplifying this explanation, only kiosk 26a will be described here
in any detail. Kiosk 26a includes a flat panel display 21, an input
device 27, a card reader 19 and a printer 17. Input device 27 is
shown as a keyboard but may include other input devices such as a
mouse device, a track ball type device, etc., and, is generally
provided for, as the label implies, entering information into
system 10a for use by server 22a. In the present case it will be
assumed that the input device(s) 27 includes a keyboard for
entering text type information and a mouse type device (not
illustrated) for moving a mouse controlled cursor (see 351 in FIG.
13) around on the screen of display 21.
[0118] Card reader 19 includes a slot for receiving identification
cards from patients for identification purposes. In this regard,
card 29 may be credit card, a driver's license, a dedicated
insurance card, a healthcare card, etc., from which, when slipped
into the reader 19, information can be read to uniquely identify a
patient using the card. To this end, prior to using one of the
kiosks to check in for an appointment it is contemplated that
patient identities will be associated with patient unique cards in
database 72a.
[0119] Database or memory storage device 72a is linked to server
22a and stores programs 13 performed by server 22a and various
databases that may be used by the server software to perform
inventive methods. To this end, exemplary databases included in
database 72a include a resource schedule database 31, a
prerequisites database 91 and a best practices database 130. In
addition, database 72a includes an electronic medical records
database 15 that, as the label implies, stores electronic medical
records (EMRs) for facility patients While EMRs often are extremely
detailed, for the purposes of this disclosure portions of the EMR
are particularly important. To this end, as shown in FIG. 6, EMR
database 15 includes additional databases including an appointments
database 69, an unfulfilled order database 71 and a follow-up
activities database 160. Here, while each of databases 69, 71 and
160 are referred to as separate databases in the interest of
simplifying this explanation, is should be appreciated that, in at
least some cases, each database 69, 71 and 160 may in fact include
data interspersed among separate patient EMRs. Thus, for instance,
appointments for a first patient Mr. Bruce Johnson may be stored as
part of Bruce Johnson's EMR while appointments for a second patient
Ms. Mary Claire Johnson may be stored as part of Mary Claire's
EMR.
[0120] Hereafter, simplified examples of each of the databases
shown in FIG. 6 are described as including table formats (e.g.,
rows and columns). Nevertheless, it should be appreciated that each
database may take any of several different forms and that the form
is not important. Rather, the substance of the databases is
important to the inventive methods and systems.
[0121] Referring to FIGS. 6 and 7, exemplary and simplified
resource schedule database 31 includes an activity/required
resource database 33 and a resource/schedule database 34.
Activity/required resource database 33 correlates activities that
may be performed at a facility and resources required to perform
those activities. To this end, database 33 includes an activity
column 37 and a required resource column 39. As the label implies,
activity column 37 lists various activities that may be preformed
at a medical facility. In FIG. 7, the exemplary activity list
includes, among other activities, a physical 41, an EKG 43,
etc.
[0122] Although a small number of activities are shown in FIG. 7,
it should be appreciated that a typical activity list at a typical
medical facility may include thousands of different activities. In
addition, it should be appreciated that some activities may be
complex, meaning that the activity has multiple characteristics.
For example, a complex activity may include a physical that has
been ordered by a specific physician (e.g., Dr. Jones) where the
activity has two characteristics, the first being the nature of the
activity (e.g., a physical) and the second being the ordering
physician (e.g., Dr. Jones). In this example, the ordering
physician may be important where different physicians require
different tests to complete a physical where the different tests
require different resources.
[0123] Referring still to FIG. 7, the required resource column 39
includes a subset of resources required or alternatively required
resources for each one of the activities listed in activity column
37. Thus, for instance, in the case of the physical activity 41 in
column 37, required resource column 39 indicates that any of
several different doctors including Jones, Smith and White, is
required to perform the physical (see 45 in FIG. 7). Similarly, for
the EKG activity in column 37, required resource column 39
indicates that any of several different technician (see 47) can
perform the EKG. In addition, required resource column 39 indicates
that one of three different EKG machines is required to perform the
EKG activity in column 37. In other cases, although not
illustrated, it is contemplated that three or more resources may be
required to perform or facilitate any one of the activities in
column 37 and, in those cases, column 38 would indicate each of the
required resources.
[0124] Referring yet again to FIG. 7, the resource/schedule
database 35 includes a resource column 49 that lists each of the
resources used at a facility. Exemplary resources listed in column
49 include Dr. Smith 53, Dr. Jones 55 and an MRI machine 57. Here,
while only three resources are listed in column 49, it should be
appreciated that at a typical medical facility there may be several
thousand different resources listed in column 49. In addition to
including resource column 49, resource/schedule database 35
includes a separate schedule in a schedule section 51 for each of
the resources listed in column 49. To this end, a portion of an
exemplary schedule 59 for Dr. Smith 53 is shown in FIG. 7. The
portion of Dr. Smith's schedule that is shown corresponds to the
dates 03/15/07 through 03/20/07 and shows Dr. Smith's schedule from
8:00 a.m. through 3:00 p.m. during each of the days. Bars 63 in the
schedule 59 represent currently scheduled time slots and spaces
between adjacent bars represent open time slots in Dr. Smith's
schedule. While only a portion of Dr. Smith's schedule is shown, it
should be appreciated that other parts of the schedule would
indicate Dr. Smith's availability during the remainder of each
business day and for other days during the calendar year. A small
portion 61 of Dr. Jones' schedule is also illustrated as is a small
portion (not labeled) of the MRI machine schedule.
[0125] Referring now to FIG. 8A, an exemplary patient appointments
database 69 is illustrated which includes a patient column 171 and
a schedule section 173. Patient column 171 lists all facility
patients including exemplary patients Bruce Johnson 175, Ava Snead
(not labeled) and Sophia Carea (not labeled). Schedule section 173,
like the resource schedule section 51 shown in FIG. 7, includes
separate currently scheduled appointments schedule for each patient
in column 171. An exemplary schedule for Bruce Johnson is labeled
177 and includes bars 179 and 181 that indicate time slots
associated with currently scheduled appointments. Although not
shown, database 69 would also store detailed information related to
each schedule appointment including resources required, appointment
location, information required by the patient prior to the
appointment, special pre-appointment patient instruction (e.g., for
some lab work and procedures patients need to fast for 12 hours
prior to occurrence of the activities, etc.), etc.
[0126] Referring now to FIG. 8B, exemplary unfulfilled orders
database 71 is shown and includes a patient column 73 and an
unfulfilled order column 75. Patient column 73 lists each client of
a medical facility. Exemplary clients in column 73, include Bruce
Johnson 77 and Sidney Johnson 79. Unfulfilled order column 75 lists
unfulfilled orders for each one of the clients in column 73. For
example, for Bruce Johnson 77 in column 73, column 75 lists three
unfulfilled orders 83 including a full blood work-up, an EKG and a
follow-up with Dr. Jones related to a skin rash. Similarly, for
Sidney Johnson 79, unfulfilled order column 75 lists two
unfulfilled orders 87 including a flu shot and a follow-up with Dr.
White related to a broken arm.
[0127] Referring once again to FIG. 6, the follow-up activities
database 160, prerequisites database 91 and best practices database
130 will be described in greater detail below with reference to
FIGS. 11, 9 and 10, respectively.
[0128] Referring now to FIG. 12, an exemplary method 200 that is
consistent with at least some aspects of the present invention is
illustrated for, referring also to FIG. 6, when a patient checks in
using one of the check-in kiosks, identifying existing unscheduled
orders for the patient, identifying time slots during which the
unfulfilled orders may be completed and that do not conflict with
currently scheduled appointments and enabling the patient to
schedule the unfulfilled orders for the suggested time slots.
[0129] Hereafter, in the interest of simplifying this explanation a
practical example of how method 200 progresses is provided.
Referring also to FIG. 6, hereinafter, it will be assumed that
system 10a is located at St. Mary's medical facility where kiosks
26a, 26b, etc., are positioned at various locations throughout the
facility. It will also be assumed that a patient, Mr. Bruce
Johnson, walks up to check-in kiosk 26a to use that kiosk to
check-in for two currently scheduled appointments including a first
appointment at 8:30 a.m. for a follow-up visit related to a hernia
operation with Dr. White and a second appointment at 10:30 a.m.
related to an exam regarding chest pain with Dr. Smith. In
addition, consistent with the unfulfilled orders database 71 shown
in FIG. 8B, it will be assumed that Bruce Johnson has three
unfulfilled orders including a full blood work-up, an EKG and a
follow-up with Dr. Jones related to a skin rash.
[0130] Referring still to FIGS. 6 and 12 and also to FIG. 13, at
block 204, when Mr. Johnson walks up to kiosk 26a to check-in for
his two appointments, Mr. Johnson is greeted with a greeting screen
shot 312 which includes instruction 314 near the top of the screen
shot and three mouse selectable icons 316, 318 and 320 which can be
selected by moving mouse controlled cursor 351 to a location over
any one of the icons and clicking to select the icon via one of the
mouse control buttons in a manner well known in the art. The
instructions 314 instruct the patient to indicate, via the mouse
selectable icons, how the patient would like to identify himself.
The selectable icons include a CREDIT CARD icon 316, a PERSONAL
HEALTH CARD icon 318 and PERSONAL INFORMATION icon 320. Where
PERSONAL INFORMATION icon 320 is selected, the user may enter a
user name and password in a manner like that described above to
uniquely identify the patient before receiving any information
about the patient's currently scheduled appointments or unfulfilled
orders.
[0131] Where either of the card icons 316 or 318 is selected,
Referring to FIG. 14, kiosk 26a provides a screen shot 340 with
instructions 342 indicating that the patient should insert his card
into the card reader 19. An image 344 of the card reader 19 may be
provided to help the user visually identify the card reader. In
addition to instructions 342 and image 344, screen shot 340
includes a BACK icon 346 and an EXIT icon 348. BACK icon 346 allows
the patient to skip back to screen 312 shown in FIG. 13 to change
the way the patient will identify himself. EXIT icon 348 generally
allows the patient to exit the check-in procedure. BACK and EXIT
icons are provided on all of the screen shots after screen shot 340
and operate in a similar fashion to allow a patient to back up
through the screen shots or exit the check-in procedure.
[0132] Referring still to FIGS. 6 and 12 and now also to FIG. 15,
after the patient inserts his card into reader 19, at block 204
server 22a obtains patient identifying information from the card.
Here, in FIG. 15, the server 22a queries the patient to make sure
that the patient is in fact Bruce Johnson. To this end, a picture
358 of the patient stored in a facility database (e.g., in the
patient's EMR) may be provided along with a mouse selectable
CONFIRM icon 364 to confirm that the server 22a identified the
correct patient via the patient's card. Once icon 346 is selected,
kiosk 26a provides screen shot 370 that includes instructions 372
along with five separate mouse selectable icons that enable the
patient to do various things via kiosk 26a. The exemplary icons
include a CHECK-IN FOR APPOINTMENTS icon 374, a CHECK-IN FOR
UNFULFILLED ORDERS (e.g., lab work) icon 376, an UP DATE PERSONAL
INFORMATION icon 378, a FIND A FACILITY LOCATION icon 380 and a
CHECK OUT AFTER APPOINTMENT icon 382. When icon 374 is selected,
server 22a facilitates a check-in procedure. When icon 376 is
selected, server 22a checks whether or not there are any
unfulfilled orders for the patient and may list those orders along
and provides tools for scheduling appointments for those orders.
When icon 378 is selected, server 22a may step through a procedure
that allow the patient to update his personal information stored by
server 22a. When icon 380 is selected, server 22a may step through
a way finder process to help the patient identify the location of
some resource (e.g., a doctor's office, a clinic, an examination
room, etc.) within the facility. When icon 382, is selected, kiosk
26a helps the patient step through a check out procedure.
[0133] Here, it will be assumed that Mr. Johnson has selected
CHECK-IN FOR APPOINTMENTS icon 374. Once icon 374 is selected,
server control passes to block 206 in FIG. 12. At block 206,
referring again to FIG. 8A, server 22a accesses appointments
database 69 and identifies currently scheduled appointments for the
patient for the current day. At block 210, referring also to FIG.
8B, server 22a accesses unfulfilled orders database 75 and locates
the unfulfilled orders for the patient. In the present example,
three unfulfilled orders 83 are associated with Bruce Johnson 77
and therefore, at block 210, server 22a identifies each of the
three unfulfilled orders. In addition, at block 210, server 22a
attempts to identify a suggested appointment schedule that includes
at least one time slot for one of the unfulfilled orders for Mr.
Johnson and time slots for each of the currently scheduled
activities or appointments.
[0134] At block 212, where server 22a is unable to identify a
suggested appointment schedule including the currently scheduled
appointments and at least one of the unfulfilled orders, control
passes to block 230 where server 22a presents the currently
scheduled appointments for Bruce Johnson so that the patient can
check-in. In this regard, referring to FIG. 17, an exemplary screen
shot that may be presented to the patient when server 22a is unable
to identify a suggested appointment schedule is shown. Screen shot
390 includes each of the currently scheduled appointments for Bruce
Johnson for the day including the follow up visit related to the
hernia operation with Dr. White 392 and an examination regarding
chest pain with Dr. Smith 394. In addition to listing the
appointments, screen shot 390 includes separate CHECK-IN icons 396
and 398 for each of Bruce Johnson's appointments 392 and 394,
respectively, that can be independently selected for checking in
for the associated appointment. Moreover, screen shot 390 includes
a CHECK-IN BOTH APPOINTMENTS NOW icon 400 that can be selected to
check-in both the 8:30 a.m. and 10:30 a.m. appointments.
[0135] In FIG. 17, a MAIN MENU icon 402 is also provided that, when
selected, takes the patient back to the screen shot shown in FIG.
16 where the patient can select any of several different icons to
facilitate different activities. Many of the screen shots described
hereafter include a MAIN MENU icon 402 and, in each case, when the
MAIN MENU icon is selected, the patient is taken back to the screen
shot shown in FIG. 16.
[0136] Referring still to FIGS. 6, 12 and 17, at block 218, when
the patient selects icon 400 to check-in both appointments or
selects one of the CHECK-IN icons 396 or 398, control passes to
block 222 where server 22a stores an indication that the patient
has checked in for both appointments and may provide notice to a
receptionist, nurse, physician, etc. that the patient is present
and waiting. In addition, to confirm that check-in has been
completed, server 22a generates screen shot 410 shown in FIG. 18
which includes confirming language 412 indicating that the patient
has been checked in along with specific information 414 regarding
the checked in appointment. Screen shot 410 includes a PRINT icon
416 that, when selected, causes a confirmation sheet to be printed
out via printer 17 (see again FIG. 6) confirming that check-in has
been completed and providing the patient's schedule for the day.
Referring once again to block 218 in FIG. 12, if the patient opts
not to check-in for the appointments the process ends.
[0137] Referring still to FIGS. 6 and 12, and specifically to
decision block 212, when server 22a identifies at least one suggest
appointment schedule including at least one time slot for an
unfulfilled order and time slots for the currently scheduled
activities, control passes to block 220 where server 22a presents
the currently scheduled appointments and the option to schedule
unfulfilled orders. In this regard, see FIG. 19 which illustrates
an exemplary screen shot 418 including instructions 420, a CHECK-IN
FOR CURRENTLY SCHEDULED APPOINTMENTS icon 428 and a SEE SUGGESTED
SCHEDULE icon 430.
[0138] Referring also to FIG. 8B, while the unfulfilled orders
database 71 is shown to include three unfulfilled orders 83 for Mr.
Johnson 77, in the present example it will be assumed that only two
of the three unfulfilled orders for Mr. Johnson can be scheduled
along with Mr. Johnson's currently scheduled hernia follow up
appointment and chest pain examination appointment. More
specifically, here it is assumed that Mr. Johnson's unfulfilled
order for a follow up appointment with Dr. Jones related to a skin
rash cannot be scheduled with the currently scheduled appointments
either because available time slots for the follow up appointment
do not exist or the time slots that are available would conflict
with the currently scheduled appointments for the patient. Thus,
because two unfulfilled orders that may be scheduled with the
currently scheduled appointments are stored in the unfulfilled
orders database 71, instructions 420 indicate that there are two
activities in the database that need to be scheduled that may be
completed during the current day and requests that the patient
select one of icons 428 or 430 to either check-in for currently
scheduled appointments or to see a suggested schedule including the
two unfulfilled orders that can be scheduled for the current day,
respectively.
[0139] When icon 428 is selected to indicate that the patient would
like to check-in for the currently scheduled appointments, control
passes to block 230 where appointment check-in is facilitated as
described above. When icon 430 is selected to see the suggested
schedule including unfulfilled orders and currently scheduled
appointments, control passes from block 224 to block 226 where the
suggested appointment schedule is presented.
[0140] Referring now to FIG. 20, an exemplary screen shot 440 for
presenting the suggested schedule is illustrated that includes
instructions 442, a list 443 of current appointments and
unfulfilled orders that can be scheduled, an ACCEPT SUGGESTED
SCHEDULE icon 452, a REJECT SUGGESTED SCHEDULE icon 451 and a VIEW
OTHER POSSIBLE SCHEDULES icon 453. List 443 includes the currently
scheduled appointments at 8:30 a.m. and 10:30 a.m. for the hernia
follow up visit with Dr. White and the chest pain exam with Dr.
Smith 444 and 448, respectively, as well as the unscheduled
unfulfilled orders 446 and 450 related to the full blood work up
and EKG which are tentatively slotted for 9 and 11 a.m. time slots
as shown. The instructions 442 instruct the patient to accept one
of the icons 452, 451 or 453. Where the VIEW OTHER POSSIBLE
SCHEDULES icon 453 is selected, as the label suggests, the server
22a (see again FIG. 6) presents a second suggested schedule. Here,
where there is no second suggested schedule, icon 453 would not be
presented. Thus, server 22a, in at least some embodiments, is
programmed to identify if scheduling options exist and, only where
options exist, to present those options to patients.
[0141] Referring still to FIGS. 12 and 20, where REJECT SUGGESTED
SCHEDULE icon 451 is selected, control passes from block 227 back
up to block 230 where a screen shot akin to screen shot 390 in FIG.
17 is provided to allow the patient to check-in for the currently
scheduled appointments.
[0142] Referring to FIGS. 6, 12 and 20, where the patient selects
ACCEPT SUGGESTED SCHEDULE icon 452, control passes from block 227
to block 228 where server 22a stores the suggested schedule as the
currently scheduled appointments. In addition, as seen in FIG. 21,
when icon 451 is selected, server 22a provides a confirmation
screen shot 460 including confirmation language 462 and information
that specifies the accepted suggested schedule. Screen shot 460
also includes a CHECK-IN icon 465 that can be selected to check-in
any of the appointments listed via screen shot 460. Here, it is
contemplated that, if a patient selects CHECK-IN icon 465, a screen
shot similar to the FIG. 17 screen shot 390 would be provided to
facilitate check-in, albeit where the screen shot lists all four
appointments shown in FIG. 21 instead of the original two shown in
FIG. 17.
[0143] The example above includes a server 22a that attempts to
schedule unfulfilled orders around currently scheduled
appointments. In at least some embodiments it is contemplated that
where unfulfilled orders cannot be scheduled around currently
scheduled appointments, server 22a may be programmed to determine
if currently scheduled appointments can be modified to accommodate
one or more existing appointments and if so, may present a
suggested schedule including currently scheduled appointments that
have been shifted to different time slots and at least one
unfulfilled order.
[0144] Referring to FIG. 12 and also to FIG. 22, an exemplary
sub-process 210 for identifying a suggest appointment schedule that
may comprise block 210 in FIG. 12 is shown in FIG. 22. Referring
also to FIGS. 6 and 7, after server 22a identifies currently
scheduled appointments for the current day, control may pass to
block 472 where server 22a, for each unfulfilled order for a
patient in database 71 (see again FIG. 8B), accesses the resource
schedule database 31 to identify resources required to facilitate
the unfulfilled orders for the patient. To this end, server 22a
identifies each unfulfilled order corresponding to a patient in the
activity column 37 of database 33 and associated required resources
in column 39 for the activity in column 37. Thus, for instance, in
the present example where unfulfilled orders for Mr. Johnson in
database 71 include an EKG, server 22a identifies the resources 47
corresponding to the EKG activity 43 in database 33 at block
472.
[0145] Continuing, at block 474, server 22a identifies temporally
proximate open time slots for the identified required resources
that do not conflict with the patient's currently scheduled
appointments by accessing the resource/schedule database 35,
identifying each resource required in column 49 and then checking
the schedule corresponding to the resource to determine whether or
not the resource is available. Here, the phrase "temporally
proximate" may be defined differently depending on circumstances.
For example, temporally proximate may mean within one hour of the
beginning or end time of a previous or next consecutive currently
scheduled appointment or may include any time slot between two
other time slots that occur on the current day. At decision block
476, where at least one open nonconflicting temporally proximate
time slot exists, control passes to block 478 where server 22a
generates a suggested appointment schedule that includes the open
nonconflicting time slots after which control passes back to block
212 in FIG. 6.
[0146] Referring still to FIGS. 6 and 22, at block 476, when no
nonconflicting temporally proximate time slots have been
identified, control passes to block 480 where, in at least some
embodiments, server 22a determines whether or not the currently
scheduled appointments can be rescheduled to accommodate at least
one unfulfilled order. For example, in the present case it may be
that the only time that a EKG can be performed on the current day
for Bruce Johnson is at 8:30 a.m. which would be in direct conflict
with Bruce Johnson's currently scheduled follow up visit with Dr.
White. However, it may be that Dr. White has a time slot open for
11 a.m. on the current day in which case, by shifting the current
hernia operation follow up appointment to 11 a.m., the 8:30 a.m.
time slot could be opened up for the EKG. Where currently scheduled
appointments can be reshuffled to accommodate unfulfilled orders,
control passes to block 484 where server 22a generates a suggested
appointment schedule that includes the rescheduled appointment(s)
as well as the unfulfilled order(s) that can be accommodated. After
block 484 control passes back to block 212 in FIG. 6.
[0147] Referring still to FIG. 22, at block 482, if currently
scheduled appointments cannot be rescheduled to accommodate at
least one unfulfilled order, control passes to block 486 where
server 22a stores an indicator that no suggested appointment
schedule was identified after which control passes to block 212 in
FIG. 6.
[0148] The check-in/scheduling example above assumes that the only
constraint on scheduling unfulfilled orders and shifting currently
scheduled appointments is whether or not time slots are open and
resources are available. In at least some embodiments it is
contemplated that other scheduling constraints may be considered by
server 22a. For instance, for certain tests and procedures it may
be required that a patient fast for 12 hours prior to the test or
procedure. In this case, if an unfulfilled order is associated with
a test or procedure that requires 12 hours of fasting, the
unfulfilled orders database 71 in FIG. 8B may include information
specifying the 12 hours fast limitation which can be used by server
22a when determining whether or not to present the unfulfilled
order as part of a suggest appointment schedule. Similarly, the
appointment database 69 (see FIG. 8A) may include additional
constraints that need to be considered either prior to shifting a
currently scheduled appointment or that limit unfulfilled order
from being scheduled temporally proximate the appointments.
[0149] In addition, in at least some embodiments, server 22a may be
programmed to consider information in addition to unfulfilled
orders, currently scheduled appointments and resource availability
when attempting to identify a suggested appointment schedule. For
instance, where server 22a is programmed to know anticipated travel
times between the locations of different facility resources, server
22a may be programmed to take travel times into consideration when
attempting to identify suggested schedules. Similarly, where
patients typically need some time to recover from a specific type
of procedure or test, server 22a may be programmed to account for
an anticipated recovery period.
[0150] In addition to or instead of identifying unfulfilled orders
and potentially suggesting scheduling of those orders when a
patient checks in to a medical facility, the system 10a shown in
FIG. 6 may identify opportunistic scheduling activities or routine
best practices activities for patients upon check-in and suggest
scheduling of those opportunistic activities. Here, an
"opportunistic activity" is any medical activity that it would be
advisable the patient participate in. Here, opportunistic
activities may not include unfulfilled orders by physicians and
instead simply include activities, often elective, that may make
sense given a patient circumstances. For example, it may be that it
is standard medical best practice for all male patients over 50
years of age to have a yearly colonoscopy. Similarly, it may be
that for all patients over 50 years of age, regardless of gender,
it is standard medical practice for the patients to have a full
physical. Here, while the colonoscopy or physical may not be
ordered by a physician, patients may nevertheless want to
participate in those activities on a yearly basis as part of an
overall health regimen.
[0151] Referring once again to FIG. 6 and also now to FIG. 10, best
practices database 130 codifies various opportunistic scheduling
activities and, to that end, includes a patient column 132, a
rules/circumstances column 134 and an opportunistic activities
column 136. Patient column 132 lists facility clients and, to that
end, exemplary clients Bruce Johnson 138 and Sidney Johnson 140 are
listed in column 132. In column 136, opportunistic activities
associated with each one of the patients in column 132 are listed.
Exemplary opportunistic activities for Mr. Johnson include an
annual physical and a colonoscopy collectively identified by
numeral 144.
[0152] Rules/circumstances column 134 includes a separate rule or a
plurality of rules for each one of the opportunistic activities in
column 136 which indicates when the opportunistic activity should
be suggested to an associated patient. For example, exemplary rules
142 corresponding to the annual physical and colonoscopy activities
in column 136 require greater than 365 days since the last physical
or colonoscopy for the patient. For each patient the opportunistic
activities may be generated by server 22a automatically as a
function of the rules in column 134 or in some cases, a subset or
all of the opportunistic activities may be specified manually by a
facility employee.
[0153] Referring now to FIG. 23, an exemplary sub-process 490 that
may be substituted for blocks or steps 210, 212, 220 and 224 in
FIG. 12 is illustrated for suggesting and facilitating scheduling
of opportunistic activities. Referring also to FIGS. 6 and 10,
after server 22a identifies currently scheduled appointments for a
patient at block 206, control may pass to block 492. At block 492,
server 22a accesses the best practices database 130 and identifies
opportunistic activities for the patient where rules/circumstances
associated with the activities have been met (i.e., current patient
circumstances match the circumstances associated with the rule). In
addition, at block 492, server 22a may access the resource schedule
database 31 (see again FIG. 7) to identify resources required for
the opportunistic activities for the patient and time slots during
which those resources are available to perform the activities.
Here, as above, when at least one time slot is available for
completing an opportunistic activity where the time slot either
fits into the patient's currently scheduled appointments or can be
accommodated by shifting scheduled appointments, server 22a
identifies a suggested appointment schedule. At block 494, when
server 22a is unable to identify a suggested appointment schedule,
control passed back to block 230 in FIG. 12 where normal
appointment check-in occurs as described above. When server 22a
identifies at least one suggested appointment schedule at block
494, control passes to block 496 where the option to schedule
opportunistic activities is presented.
[0154] Referring now to FIG. 24, an exemplary screen shot 508 that
may be presented via kiosk 26a to indicate that an opportunistic
scheduling activity exists is shown. Screen shot 508 includes
instructions 510, a list of currently scheduled appointments
including appointment 512 and 514, a YES-SCHEDULE PHYSICAL NOW icon
516 and a NO-I WANT TO CHECK-IN icon 518. Here, instructions 510
indicate that the server 22a has identified at least one time slot
that does not conflict with the patient's currently scheduled
appointments during which a physical that is due can be completed.
In the present example, referring also to FIG. 10, it is assumed
that despite the fact that Bruce Johnson (i.e., the patient in the
present example) is also due for a colonoscopy, server 22a was
unable to identify an open and nonconflicting time slot during the
patients day to accommodate that procedure and therefore the
suggested appointment schedule reflected in screenshot 508 does not
suggest scheduling the colonoscopy for the current day.
[0155] Referring still to FIGS. 6, 23 and 24, when a patient
selects icon 518 at block 498 to reject scheduling the physical,
control passes back to block to 230 in FIG. 12 where the check-in
process continues. When the patient selects icon 516 at block 498,
control passes to block 226 in FIG. 12 where the suggested
appointment schedule is presented by server 22a. Referring to FIG.
25, an exemplary screen shot 530 which represents a second way to
present a suggested appointment schedule is shown. Here, instead of
listing currently scheduled appointments as well as opportunistic
activities that may be scheduled, multiple times for scheduling one
opportunistic activity are shown. In this case, screenshot 530
includes instructions 532, two separate times 9:15 a.m. and 11:30
a.m. for appointments for physicals with Dr. Naggi and Dr. Jones
shown at 534 and 536, respectively, SELECT icons 538 and 540
corresponding to possible appointments 534 and 536, respectively,
and OTHER TIMES icon 542. Here, where a patient selects one of
icons 538 or 540, the appointment 534 or 536 associated therewith
is indicated to server 22a. Where neither of the suggested
appointments 534 and 536 is optimal for a patient, patient may
select OTHER TIMES icon 542 to identify other time slots during
which the physical may be completed.
[0156] Here, it will be assumed that the patient selects the 11:30
a.m. appointment with Dr. Jones 536 which causes server 22a to add
that appointment to the currently scheduled appointment list in
database 69. After an appointment is added to the currently
scheduled list, control passes back up to block 320 in FIG. 12
where the currently scheduled appointments, including the
appointment associated with the opportunistic activity, are
presented for check-in.
[0157] In addition to or instead of identifying unfulfilled orders
and opportunistic activities to be suggested to patients upon
check-in for possible scheduling, in at least some embodiments it
is contemplated that there may be prerequisite requirements that
have to be met prior to allowing a patient to check-in for
particular types of appointments. For example, it may be standard
medical practice for a EKG to be performed prior to an appointment
with a physician regarding chest pain. Here, when a patient checks
in, sever 22a (see again FIG. 6) may be programmed to identify
prerequisites for currently scheduled appointments and to require
that those prerequisites be performed prior to check-in being
completed or at least that the prerequisites be scheduled for times
prior to appointments to be checked in.
[0158] Referring again to FIG. 6 and also now to FIG. 9, an
exemplary prerequisites database 91 is shown in FIG. 9 that
includes an activity column 93 and a prerequisite column 95.
Activity column 93 lists various activities that may be facilitated
at a facility while prerequisite column 95 lists a subset of
prerequisite for each of the activities in column 93 where the
subset of prerequisites include other activities that need to be
performed or at least scheduled to occur prior to check-in for one
of the activities in column 93. Thus, one of the activities in
column 93 is an appointment for chest pain and a prerequisite in
column 95 corresponding to the appointment for chest pain is that
an EKG be performed. Similarly, an appointment for shortness of
breath 99 in column 93 corresponds to two prerequisites 101 in
column 95 including an EKG and a full blood work up. While database
91 is simplified for the purposes of explaining this invention, it
should be appreciated that database 91 would be extremely complex
and include many hundreds if not thousands of different activities
that occur at a facility and associated prerequisites.
[0159] Referring to FIG. 26, an exemplary sub-process 580 that may
be substituted for blocks 210, 212, 220 and 224 is illustrated
wherein the sub-process is provided for identifying prerequisites
for appointments, indicating prerequisites to a patient upon
check-in and requiring the patient to schedule prerequisites prior
to check-in. Referring also to FIGS. 6, 9 and 12, after currently
scheduled appointments have been identified by server 22a at block
206, control may pass to block 582 in FIG. 26. At block 582, server
22a accesses prerequisites database 91 and identifies prerequisites
in column 95 for each of the activities (e.g., appointments) in
column 93. In addition, at block 582, server 22a may access
resource schedule database 31, identify resources required to
facilitate the prerequisite activities, identify open time slots
for each of the required resources and compare the open time slots
to the patient's appointments to identify a suggested appointment
schedule including at least one time slot for each prerequisite
where the identified time slots do not conflict with the currently
scheduled appointment time slots or where the appointments can be
shifted to other time slots to accommodate the prerequisites.
[0160] At block 584, when server 22a is unable to identify at least
one suggested appointment schedule, control passes to block 590
where kiosk 26a is used to indicate that the appointment associated
with the prerequisite that could not be scheduled cannot be
checked. Server 22a removes appointments from the currently
scheduled appointments when appointment prerequisites cannot be
met. Although not illustrated, at this point, it may be that server
22a refers patients to a facility receptionist for further
processing when prerequisites cannot be met. In the alternative,
server 22a may be programmed to identify time slots on subsequent
days for the canceled appointment and preceding prerequisite
appointments and may allow the patient to schedule those
appointments via kiosk 26a.
[0161] After block 590, control passes back to block 230 in FIG. 12
where check-in for appointments that have not been canceled
continues.
[0162] Referring still to FIGS. 6 and 26, at block 584, when server
22a identifies at least one suggested appointment schedule, control
passes to block 586 where the option to schedule prerequisites is
presented via kiosk 26a.
[0163] Referring now to FIG. 27, an exemplary screen shot 610 for
presenting an option to schedule prerequisites is shown. Screen
shot 610 includes instructions 612, information 614 that identifies
a follow up visit for hernia operation with Dr. White where no
prerequisite was required, information identifying an exam related
to chest pain with Dr. Smith, a CHECK-IN icon 618 associated with
the first appointment information 614 and a SCHEDULE EKG icon 620
associated with the second appointment information 616. Here, the
instructions 612 indicate that prior to the appointment with Dr.
Smith, the patient needs to have an EKG performed and also
indicates that time slots are available for an EKG prior to the
appointment with Dr. Smith. By selecting CHECK-IN icon 618, the
patient can check-in for his appointment at 8:30 a.m. with Dr.
White regarding his hernia operation. In the alternative, the
patient can select SCHEDULE EKG icon 620 to schedule an EKG prior
to the patient's appointment at 10:30 a.m. with Dr. Smith.
[0164] Referring now to FIG. 28, an exemplary screen shot 630 which
may be provided via kiosk 26a when the SCHEDULE EKG icon 620 in
FIG. 27 is selected is illustrated which presents a list of times
and corresponding SELECT icons for scheduling an EKG. To this end,
screen shot 630 lists the times including times 7:45 a.m., 9:15
a.m. and 9:45 a.m. and corresponding SELECT icons 640, 642 and 644,
respectively.
[0165] Referring to FIGS. 26 and 28, at block 588, when the patient
opts not to select one of the open timeslots for an EKG, control
passes to block 590 where server 22a indicates via kiosk 26a that
the appointment associated with the prerequisite cannot be checked
in and removes the appointment from the currently scheduled
appointments. After block 590, control passes back to block 230 in
FIG. 212 where check-in for appointments that have not been removed
from the currently scheduled appointments continues. At block 588,
when a patient selects one of the time slots suggested via screen
shot 630 in FIG. 28, control passes to block 226 in FIG. 12 where
the selected time is added to the currently scheduled appointments
and the check-in process continues.
[0166] Referring once again to FIG. 6, in at least some
embodiments, it is contemplated that kiosk 26a may be used by a
patient to check-in for an unfulfilled order to be processed at the
next available time instead of during an open time slot in a
resource schedule. Thus, for example, where lab work has been
ordered for a patient and no specific time slot has been reserved
for patient activities associated with the lab work, in at least
some embodiments, the patient may simply show up at a facility lab
and check-in without a previous appointment. Here, after checking
in, the patient's lab work would be added to a schedule queue to be
processed the next time resources required to complete the lab work
are available.
[0167] Referring now to FIG. 29, an exemplary process 690 that may
be performed via the system 10a of FIG. 6 is shown for checking in
patients that have existing unscheduled orders to be processed as
soon as resources required to perform those activities are
available. Referring also to FIG. 6, at block 692, patient
information is obtained from the patient via a kiosk 26a and the
patient is identified in the manner described above. Here, when the
main menu screen shot 370 of FIG. 16 is presented the patient
selects icon 376 to check in for unfulfilled orders. At block 694,
server 22a accesses an unfulfilled order's database (e.g., see 71
in FIG. 8B) and identifies unfulfilled orders for the patient for
the current day. In addition, it may be that some of the
unfulfilled orders require an advance appointment. Thus, for
example, in FIG. 8B, while a full blood work up and an EKG that
represent unfulfilled orders for Bruce Johnson may not need
advanced appointments, the follow-up with Dr. Jones related to a
skin rash may need to be made as an advanced appointment. Here, it
will be assumed that of unfulfilled orders 83 for Bruce Johnson,
only the first two (e.g., the full blood work up in the EKG) can be
scheduled on a walk in basis.
[0168] Referring still to FIGS. 6 and 29, at block 696, server 22a
presents the unfulfilled orders that can be checked in on a walk up
basis via kiosk 26. Referring also to FIG. 30, an exemplary screen
shot 710 for presenting unfulfilled orders that can be checked in
on a walk up basis is illustrated. Screen shot 710 includes
instructions 712, information identifying unfulfilled orders that
can be checked in on a walk in basis including a full blood work up
714 and an EKG 716 which are consistent with the database 71 shown
in FIG. 8B for Bruce Johnson. In addition, separate CHECK-IN icons
718 and 720 are provided for each of the unfulfilled orders 714 and
716, respectively, as well as a CHECK-IN ALL UNFULFILLED ORDERS
LISTED ABOVE NOW icon 722. In this case, either of the two orders,
714 or 716 may be checked in separately or, icon 722 may be
selected to check in both of orders 714 and 716 at the same
time.
[0169] Referring to FIGS. 6, 29 and 30, at block 698, server 22a
monitors to determine whether or not check-in has occurred. Where a
patient checks in for one or more of the unfulfilled orders at
block 698, control passes to block 702 where server 22a stores an
indication that the patient has checked in for one or more orders
and adds the one or more orders to a schedule queue to be performed
the next time resources required for the order or orders become
available.
[0170] Referring again to block 698 in FIG. 29, server 22a cycles
through block 698 and block 700 and back up to block 696 until the
patient either checks in at block 698 or selects an EXIT icon shown
at the bottom of the screen shot 710 in FIG. 30.
[0171] Referring to FIG. 31, an exemplary screen shot 730 for
confirming that a patient has been checked in for walk in
unfulfilled orders is shown which includes instructions 732 and a
list 734 of unfulfilled orders for which the patient is currently
checked in.
[0172] In addition to being useful when a patient is checking in
for an appointment or for scheduling appointments, kiosk 26a is
also useful for checking patients out after appointments have
occurred. In this regard, it is contemplated that, during any type
of medical activities that may occur during an appointment, entries
may be made into the patient's EMR where those entries can then be
used to identify post-appointment or follow-up activities that
should be performed as a matter of course. For example, it may be
that the St. Mary's facility requires specific follow-up activities
after certain types of appointments have been completed. For
example, where a physician sees a patient for chest pain, required
follow-up activities may be that the patient take two aspirin every
6 hours for the next 24 hours, that an EKG be performed and that
the patient come back for a follow-up visit within a two-week
period. As another example, whenever a skin condition XX occurs,
physicians at the facility may be required to refer the patient to
a specific facility dermatologist that specializes in treating the
specific condition.
[0173] Referring now to FIG. 11, an exemplary automatic follow-up
activities database 160 is illustrated that includes a record entry
column 162 and a follow-up activities column 164. Record entry
column 162 lists exemplary entries that may occur in an electronic
medical record including, among other entries, a chest pain entry
170 and a likely skin condition XX entry 174. Entries in column 162
may be purely textual so that direct matches have to appear in an
EMR to be recognized. In some cases input devices (e.g., see PDA
743 in FIG. 6) may include software that forces a physician to
specifically identify column 162 entries. For instance, a device
may present a symptoms list for selection by a physician where a
first selectable symptom is chest pain, a second symptom is trouble
urinating, etc. In addition, it should be appreciated that record
entries may take more complex forms such as, requiring combinations
of information in an electronic medical record. For example, one
entry may require chest pain, that the attending physician was Dr.
Jones and that the patient be a male over 50 years old whereas
another entry with a different subset of follow-up activities may
require chest pain, that the patient is over 50 years old and that
the attending physician was Dr. Smith.
[0174] Follow-up activities column 164 lists a subset of follow-up
activities for each one of the entries in record entry column 162.
For example, for the chest pain entry 170 in column 162, column 164
includes three follow-up activities 176 including instructions for
the patient to take two aspirin every 6 hours, a requirement for an
EKG to be performed and a requirement that a follow-up appointment
be scheduled for two weeks after the initial appointment.
Similarly, for the likely skin condition XX entry 174 in column
162, column 164 includes a referral to a specific facility
dermatologist 178. While database 160 is extremely simple, it
should be appreciated that database 160 would typically include
several thousand entries in column 162 and corresponding activities
in column 164.
[0175] Referring once again to FIG. 6, to facilitate entry input
into an electronic medical record, it will be assumed that a
physician uses handheld device 743 like a personal digital
assistant or the like. In the illustrated embodiment, device 743 is
wireless and links to network 24a via a wireless access point 745.
In the following example, it will be assumed that, during Bruce
Johnson's examination related to chest pain by Dr. Smith, Dr. Smith
uses device 743 to enter information into Bruce Johnson's
electronic medical record. In addition, it is assumed that, after
the appointment, Bruce Johnson again accesses kiosk 26a to obtain
information related to any follow-up activities.
[0176] Referring also to FIG. 32, a method 740 by which a physician
inputs entries into an electronic medical record and by which
server 22a identifies follow-up activities for record entries is
shown. At block 742, as Dr. Smith is examining Bruce Jones during
an appointment, the doctor inputs information into Bruce Johnson's
electronic medical record. Until the appointment is completed,
control loops from block 744 back to block 742 where additional
entries into the electronic medical record are made.
[0177] Once the appointment has been completed at block 744,
control passes to block 746 where server 22a accesses the automatic
follow-up activities database 160 (see again FIG. 11) and
identifies activity entries in column 162. At block 748, server 22a
examines Bruce Johnson's electronic medical record for any of the
record entries from column 162. At block 750, server 22a determines
whether or not any of the entries from column 162 appear in Bruce
Johnson's electronic medical record. Where none of the entries
appear in the record, the process ends. Where one or more of the
record entries from column 162 appear in the record, control passes
to block 752 where server 22a generates and stores a list of
follow-up activities corresponding to Bruce Johnson.
[0178] Referring now to FIG. 33, an exemplary method 770 that
facilitates patient checkout is illustrated. Referring also to FIG.
6, at block 772, server 22a obtains patient identifying information
and identifies the patient attempting check out. In the present
case, consistent with the examples above, it is assumed that Bruce
Johnson is in the process of checking out using kiosk 26a. To this
end, referring again to FIG. 16, after entering identifying
information, main menu screenshot 370 is presented and the patient
selects icon 382 to check out. At block 774, server 22a identifies
follow-up activities for Bruce Johnson and at block 776, the
follow-up activities are presented to the patient via kiosk
26a.
[0179] Referring now to FIG. 34, an exemplary screen shot 800 for
presenting follow-up activities is illustrated. Screen shot 800
includes instructions 802, information identifying two different
types of follow-up activities including instructions for
medications 804 and follow-up activity scheduling 808 and SELECT
icons 810 and 814 for each of the different types of follow-up
activities 804 and 808, respectively. By selecting icon 810, the
patient can obtain instructions for medication that should be
consumed. By selecting icon 814, the patient can schedule follow-up
activities.
[0180] Referring still to FIGS. 6 and 33 as well as FIG. 34, once
the patient selects one of icons 810 or 814 at block 778, control
passes to block 780 where server 22a determines whether or not the
follow-up activity selected includes scheduling an appointment.
Where scheduling activities have been selected, control passes to
block 782 where server 22a identifies and presents a suggested
appointment schedule. Referring also to FIG. 35, an exemplary
screen shot 820 for presenting a suggested appointment schedule is
illustrated. Screen shot 820 includes instructions 822 that
identify the activity to be scheduled. In addition, screen shot 820
includes different scheduled time slots 824 appropriate for
scheduling the activity as well as a plurality of select icons, a
separate icon 826 corresponding to each one of the time slots that
may be selected for scheduling the activity identified in the
instructions 822. A MORE TIMES icon 828 is provided to allow the
patient to view other times that may be available for scheduling
the activity. In the present example, it is assumed that Bruce
Johnson selects icon 826 corresponding to the 4:30 p.m. time slot
on Apr. 4, 2007. Once icon 826 has been selected to accept one of
the suggested schedules at block 784, control passes to block 786
where a suggested schedule is stored as a currently scheduled
appointment and a confirmation screen shot as shown in FIG. 36 is
presented.
[0181] Referring still to FIG. 33, at block 780, if the follow-up
activity selected is not a scheduling activity, control passes to
block 788 where server 22a determines whether or not the follow-up
activity includes printing instructions. Where instructions for
medication is the follow up activity, control passes to block 790
where instructions are printed for the patient. Block 792 in FIG.
33 represents other types of follow-up activity such as generation
of a referral, generating lab orders, etc.
[0182] In addition to generating suggested appointment schedules
for adding additional appointments to currently scheduled
appointments, in at least some embodiments, server 22a may be
programmed to analyze currently scheduled appointments to identify
more optimal schedules and to present suggested schedules that may
be more optimal. For instance, in the example above where Mr.
Johnson has first and second appointments at 8:30 a.m. and 10:30
a.m., if the anticipated duration of the first appointment is 15
minutes, if the schedules of resources required for the second
appointment permit, it may be preferred if the second appointment
is moved to a 9:00 a.m. time slot so that Mr. Johnson can finish up
more quickly. As another instance, referring again to FIG. 8A, it
can be seen that on Mar. 12, 2007 Mr. Johnson has an extended open
time slot between 9:00 a.m. and 10:30 a.m. appointments and that on
Apr. 20, 2007 Mr. Johnson has another appointment (see bar 181)
that, at least temporally, fits into the open time slot on Mar. 12,
2007. Here, the patient may prefer to schedule the Apr. 20, 2007
appointment in the Mar. 12, 2007 open time slot to avoid having to
make another trip to the facility.
[0183] Referring to FIG. 37, a sub-process 900 that may be
substituted in the FIG. 12 method for blocks 210, 212, 220, 224,
226 and 227 is illustrated for shifting currently scheduled
appointments when a patient checks in. Referring also to FIGS. 6
and 12, after current appointments are identified at block 206
control may pass to block 902 in FIG. 37. At block 902 server 22a
attempts to identify a suggested schedule appointment including
currently scheduled appointments that is more optimal than the
current schedule. At block 904, where no more optimal suggested
schedule is identified control passes to block 320 in FIG. 12 where
check in continues.
[0184] At block 904, where at least one more optimal suggested
schedule is identified control passes to block 906 where the
optimal schedule is presented. At block 908, if the patient decides
not to accept the seemingly optimal schedule control passes to
block 230 in FIG. 12. When the patient elects the optimal schedule
at block 908 control passes to block 228 in FIG. 12 where the
optimal schedule appointments are stored as currently scheduled
appointments.
[0185] While the inventive systems are generally described above in
the context of an exemplary patient self check-in kiosk, at least
some of the inventive concepts are useful in the context of a
receptionist check-in terminal. To this end, referring again to
FIG. 6, an exemplary receptionist terminal 950 is shown linked to
network 24a where the terminal 950 has components similar to the
components described above in the context of kiosk 26a. As in the
case of the patient kiosk, here it is contemplated that a
simplified check-in/scheduling interface would be provided to a
receptionist or staff member that makes it extremely easy for a
receptionist to identify schedule optimizing options and to modify
a patients schedule when desired.
[0186] Referring now also to FIG. 38, after a receptionist has
entered patient identifying information via terminal 1950, an
exemplary check-in/scheduling screenshot 960 corresponding to the
patient may be presented. As seen in FIG. 38, screenshot 960
includes abbreviated instructions 962, a current schedule
appointments section 964, a suggested schedule section 965 and a
plurality of mouse selectable button icons to facilitate checking
in. A CHECK-IN icon 966 may be selected to check in for currently
scheduled appointments at 8:30 a.m. and 10:30 a.m. that are
specified in section 964.
[0187] Section 965 presents a suggested schedule that includes the
currently scheduled 8:30 a.m. and 10:30 a.m. appointments as well
as suggested appointments at 9:00 a.m. and 11:00 a.m. for two
unfulfilled orders. The suggested unfulfilled order appointments
are visually distinguished in the suggested schedule so that the
receptionist can clearly distinguish suggested appointments. An
ACCEPT SUGGESTED SCHEDULE AND CHECK-IN icon 968 can be selected to
accept the schedule suggested in section 965 and to simultaneously
check-in for all four appointments. A SEE OTHER SUGGESTED SCHEDULES
icon 970 is selectable to view other suggested schedules if
desired.
[0188] Thus, referring still to FIG. 38, in addition to allowing a
receptionist to quickly check a patient in for currently scheduled
appointments in a fashion similar to existing check-in interfaces,
screen shot 960 provides an optimal suggested schedule for the
patient that can be accepted and for which a patient can be checked
in with the single click of a button 968.
[0189] In the case of receptionist terminal 950 it should be
appreciated that any of the features or enhancements above may be
enabled such as, for instance, identifying any type of additional
unscheduled activities that may be scheduled for a patient,
plugging open time slots when required resources are available,
shifting currently scheduled appointments to accommodate additional
activities, etc.
[0190] In at least some embodiments it is contemplated that the
system may, in addition to checking a patient's appointment
schedule database and/or resource schedule databases, be able to
access a patient's general schedule or calendar to determine if a
suggested appointment schedule will fit into the patient's general
schedule prior to suggesting the suggested appointment schedule. In
addition, in some cases the system may also have access to a
database that estimates travel times between locations (e.g., XL
Travel, Yahoo Travel, etc.) and may take into account travel times
between general schedule appointments for a patient prior to
suggesting an optimized appointment schedule.
[0191] To this end, an exemplary General Patient Appointment
Schedule Database 1000 is shown in FIG. 39. Database 1000 includes
schedule information for patient Bruce Johnson and, consistent with
the example above, includes appointments for two activities
associated with a medical facility that occur at 8:30 a.m. and
10:30 a.m. (see 179) on Mar. 12, 2007 and an appointment 181 on
Apr. 20, 2007 at 10 a.m. as well as other general appointments
(e.g., business meetings, etc.) shown as left to right upward cross
hatched bars from 9 a.m. to 10:30 a.m. (see 1002) and from 12:30
p.m. to 1:30 p.m. on Mar. 12, 2007 (see 1008) and on Apr. 20, 2007
from 8:40 a.m. to 9:50 a.m. (see 1004). The 10:30 a.m. appointment
on Mar. 12, 2007 is expected to last until 11 a.m. Thus, on Mar.
12, 2007 there is very little free time between appointments 179
and there is a one and a half hour time slot open between the
expected terminating time of the 10:30 a.m. appointment and the
beginning of the 12:30 p.m. appointment.
[0192] In the above case, when Mr. Johnson logs onto a check in
kiosk to check in for his 8:30 a.m. appointment, the system may be
programmed to automatically check Mr. Johnson's general schedule
when attempting to identify a suggested optimized schedule for Mr.
Johnson. In the above example, because there is very little free
time between the 8:30 a.m. and 10:30 a.m. appointments on Mar. 12,
2007, the system may not identify a suggested schedule that
includes a time slot intermediate the currently scheduled 8:30 and
10:30 appointments. However, because there is a 11/2 hour open slot
in the general patient schedule from 11:00 a.m. to 12:30 a.m., the
system may identify a time slot in that time range during which
resources are available that can be used to facilitate some
unfulfilled activity for the patient and may then suggest an
optimized schedule including the unfulfilled activity. Thus, for
instance, where the unfulfilled activity is expected to require 30
minutes to complete, the system may identify a time slot from 11:15
to 11:45 during which the unfulfilled activity can be scheduled and
may suggest that time to the patient.
[0193] In some cases the system may also be programmed to identify
an estimated time of travel between general appointment locations
and to take that estimated time into account when determining if a
schedule should be suggested. To this end, referring still to FIG.
39, in addition to storing scheduling information for a patient,
the schedule database 1000 may also store location information
associated with each or at least a subset of scheduled appointments
and facilities at which appointments may be scheduled. In FIG. 39
appointment locations are indicated by labels like "Loc-X",
"Loc-Y", etc., to indicate different geographic locations. Thus, as
shown, appointments 179 are to occur at location X, appointment
1002 is to occur at a location N and appointment 1008 is to occur
at location Y.
[0194] Prior to using a patient's general schedule database to
attempt to identify an optimized schedule for the patient, it is
assumed that server 22a (see again FIG. 6) would be provided access
to the patient's general schedule database in some fashion. Thus,
for instance, when the patient first accesses a check in kiosk or
registers to use check in kiosks with a receptionist or the like,
the patient may provide the patient's e-mail address or some code
that allows server 22a to access the patient's general schedule.
Here, the general schedule may be accessible in a "dumbed down"
format where schedule content is not provided to maintain the
patient's privacy. Any method for granting access to a patient's
general schedule that is known in the art could be used here. In
the alternative, in at least some cases, a patient may set up his
general schedule or calendar software to send updates to a medical
facility calendar/patient scheduling system so that the patient's
general appointments can be added to the patient's medical
appointments calendar in a secure fashion.
[0195] Referring to FIG. 40, an exemplary Estimated Travel Time
Database 1020 is illustrated that includes a Current Location
column 1022, a Destination Location Column 1024 and an Estimated
Travel Time column 1026. As the label implies, column 1022 lists
all locations within an area such as a municipality, a state, etc.
while column 1024, for each entry in column 1022, lists all
locations within the area while column 1026 indicates an estimated
travel time for each pair of locations in columns 1022 and 1024.
Thus, for instance, column 1026 indicates that the estimated travel
time between locations Loc-X and Loc-y is 20 minutes (see
1028).
[0196] Referring now to FIG. 41, a sub-process 1030 that may be
substituted for a portion of the process shown in FIG. 12 is
illustrated. Referring also to FIG. 12, after currently scheduled
medical facility of campus appointments are identified for a
current day at block 206, control may pass to block 1032 in FIG. 41
where any type of unscheduled activity for the patient can be
identified. Next, at block 1034 server 22a may access the resource
schedule database 312 shown in FIG. 7 as well as the general
patient schedule database shown in FIG. 39 and identify a suggested
appointment schedule that includes at least one time slot for at
least one unscheduled activity and time slots for the currently
scheduled activities that fit into the patient's general schedule
as well as the scheduled of resources required to complete the
activities. After block 1034 control may pass back to block 212 in
FIG. 12 where the process described above continues.
[0197] Where location information is stored in a patient's general
schedule as shown in FIG. 39 and where server 22a has access to a
travel time database as shown in FIG. 40, server may also
optionally access the travel time database 1020 and account for
estimated travel times when attempting to identify an optimized
schedule to suggest to the patient. Thus, for instance, in the
above example, where the travel time between locations X and Y is
estimated to be 20 minutes (see 1028 in FIG. 40) and the resources
required to complete a specific activity are needed for another
appointment until 11:45 a.m. on Mar. 12, 2007, even though Mr.
Johnson's schedule indicates that he has a time slot open from
11:45 a.m. to 12:15 p.m. on Mar. 12, 2007, the system would not
suggest the time slot because that would only leave Mr. Johnson 15
minutes to travel from location X to location Y and would render
Mr. Johnson late for his 12:30 appointment.
[0198] In other cases where the system does not have access to a
travel time database 1020, the system may be programmed to assume a
default estimated travel time between locations within an area
(i.e., a municipal area). Thus, for instance, in the case of
Madison Wis., a person can usually travel from one location to
another within the general area within 20 minutes so the default
estimated travel time may be 20 minutes and the system may use that
default time accordingly when attempting to identify a suggested
optimized schedule for a patient.
[0199] The foregoing description was primarily directed to a
preferred embodiment of the invention. Although some attention was
given to various alternatives within the scope of the invention, it
is anticipated that one skilled in the art will likely realize
additional alternatives that are now apparent from disclosure of
embodiments of the invention. For instance, in at least some cases
it is contemplated that the kiosks may be replaced by hand held
devices such as personal digital assistants, cell phones, etc.,
like the device 1050 shown in FIG. 6 which is meant to represent a
remote personal device. In this case, whenever an optimized
suggested schedule is identified, the schedule may be pushed to a
patient's portable device 1050 along with the ability to accept the
suggested schedule and revise the patients currently scheduled
appointments accordingly. In the alternative, some preset time
before an appointment occurs (e.g., one day), optimized schedules
may be identified and pushed to patients portable devices. Where
optimized schedules are automatically identified and pushed to
clients for consideration prior to check-in, one or more
appointments may be shifted to subsequent time slots to cluster
appointments optimally (e.g., a first scheduled appointment may be
shifted to a subsequent day to facilitate clustering). Here, the
idea is to push optimized scheduling options to patients at times
just prior (e.g., one to two days prior) to currently scheduled
appointments when a patient will likely know whether or not the
patient's schedule will accommodate the suggested optimized
schedule so that the patient can make an informed decision.
[0200] Moreover, while the simplified scheduling system described
above has many advantages, in at least some cases it is
contemplated that a kiosk may also present more detailed scheduling
options for time slots that are not temporally proximate currently
scheduled appointments when a patient checks in for an appointment.
Thus, it has been recognized that a good time to provide scheduling
options to a patient is upon check-in for a current appointment
when the patient may have some additional time to consider
scheduling options. Accordingly, the scope of the invention should
be determined from the following claims and not limited by the
above disclosure.
[0201] Furthermore, while the example above that considers a
patient's general schedule when attempting to identify a suggested
optimized schedule is described in the context of a check in kiosk,
it should be appreciated that other systems are contemplated that
provide this functionality to a patient and/or to a scheduling
employee or a receptionist. To this end, tying scheduling software
to patient's general scheduling or calendaring can allow anyone who
is scheduling appointments for patients to identify suggested
optimized schedules for patients that account for currently
scheduled general appointments as well as appointments associated
with a medical facility/campus/enterprise.
[0202] To apprise the public of the scope of this invention, the
following claims are made.
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