U.S. patent application number 14/310887 was filed with the patent office on 2014-10-09 for system and method to manage delivery healthcare to a patient.
The applicant listed for this patent is General Electric Company. Invention is credited to Kunter Akbay, Andrew Day, GianFranco Doretto, Onur Dulgeroglu, Christopher Johnson, Marcia Peterson, David Toledano, Peter Tu.
Application Number | 20140303996 14/310887 |
Document ID | / |
Family ID | 40509398 |
Filed Date | 2014-10-09 |
United States Patent
Application |
20140303996 |
Kind Code |
A1 |
Johnson; Christopher ; et
al. |
October 9, 2014 |
SYSTEM AND METHOD TO MANAGE DELIVERY HEALTHCARE TO A PATIENT
Abstract
A system and method to manage delivery of healthcare via a
plurality of resources to a patient is provided. The system and
method track and output a signal representative of a location of at
least one of a series of resources relative to a control volume
associated with the patient, acquire at least one signal
representative of detecting ingress or egress of at least one of
the plurality of resources relative to the control volume; and
output a first signal representative of one of a series of
milestones as defined in a predetermined protocol in response to
detecting ingress or egress of at least one of the resources
relative to the control volume.
Inventors: |
Johnson; Christopher;
(Clifton Park, NY) ; Akbay; Kunter; (Niskauyna,
NY) ; Day; Andrew; (Pewaukee, WI) ; Doretto;
GianFranco; (Albany, NY) ; Tu; Peter;
(Niskauyna, NY) ; Dulgeroglu; Onur; (Niskauyna,
NY) ; Peterson; Marcia; (Elgin, IL) ;
Toledano; David; (Round Lake, NY) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
General Electric Company |
Schenectady |
NY |
US |
|
|
Family ID: |
40509398 |
Appl. No.: |
14/310887 |
Filed: |
June 20, 2014 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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12239270 |
Sep 26, 2008 |
8799008 |
|
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14310887 |
|
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60976582 |
Oct 1, 2007 |
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Current U.S.
Class: |
705/2 |
Current CPC
Class: |
G06Q 10/06 20130101;
G06Q 10/1095 20130101; G06F 19/00 20130101; G16H 40/60 20180101;
G16H 40/20 20180101 |
Class at
Publication: |
705/2 |
International
Class: |
G06F 19/00 20060101
G06F019/00 |
Claims
1. A method of managing delivery of healthcare via a plurality of
resources to a patient, the method comprising the steps of:
tracking and outputting a signal representative of a location of at
least one of the plurality of resources relative to a control
volume associated with the patient; acquiring at least one signal
representative of detecting ingress or egress of at least one of
the plurality of resources relative to the control volume; and
outputting a first signal representative of one of a plurality of
milestones as defined in a predetermined protocol in response to
detecting ingress or egress of at least one of the plurality of
resources relative to the control volume.
2. The method of claim 1, wherein the step of tracking includes
outputting at least one signal representative of an ingress or an
egress of at least one resource relative to a sterile zone within
the control volume.
3. The method of claim 1, wherein the step of tracking is performed
by more than one of the following: an optical tracking system, an
electromagnetic tracking system, an RFID tracking system, an IR
tracking system, a GPS tracking system, and a voice recognition
system, and wherein the step of tracking includes outputting at
least one signal representative of ingress or egress of one of the
plurality of resources relative to a sterile zone located within
the control volume.
4. The method of claim 3, further comprising the steps of
outputting a probability of ingress or egress of at least one of
the plurality of resources relative to the sterile zone, the
probability dependent on how many of or which of the different
tracking systems detects ingress or egress of the at least one of
the plurality of resources relative to the sterile zone.
5. The method of claim 4, wherein the step of outputting the
probability is dependent on a mathematical expression having a
first factor associated with detecting ingress or egress of the at
least one of the plurality of resources relative to the sterile
zone with a first tracking system and a second factor associated
with detecting ingress or egress of the at least one of the
plurality of resources relative to the sterile zone with a second
tracking system different than the first tracking system.
6. The method of claim 3, further comprising the steps of:
outputting a comparison of ingress of at least one of the plurality
resources to a sterile zone defined within the control volume
relative to egress of at least one of the plurality of resources
from the sterile zone, the ingress and egress as detected by one of
the tracking systems.
7. The method of claim 1, further comprising the steps of:
outputting a second signal representative of another of the
plurality of milestones as defined in a predetermined protocol in
response to the step of outputting the first signal; in combination
with one of the following steps: detecting ingress or egress of
another of the plurality of resources relative to the control
volume, and detecting a key text in a translation of an audio
recording where the key text is associated with executing the
another of the plurality of milestones and predetermined in a
protocol template for storage in a database.
8. The method of claim 1, further comprising the step of:
outputting a comparison of a predicted time for the milestone to
occur relative to a measured time of occurrence of outputting the
first signal representative of the milestone.
9. The method of claim 1, wherein the milestone is representative
of one of the following: prep of the patient to receive a medical
procedure, sedation of the patient to receive the medical
procedure, and close of the surgical site on the patient.
10. A system to manage delivery of healthcare via a plurality of
resources to a patient, the system comprising: at least one
tracking system operable to generate a signal representative of a
location of at least one of the plurality of resources relative to
a control volume associated with the patient; and a controller in
communication with the tracking system, the controller including a
processor in communication with a memory, the processor operable to
execute a plurality of program instructions stored in the memory,
the plurality of program instructions representative of the steps
of: acquiring at least one signal representative of detecting
ingress or egress of at least one of the plurality of resources
relative to the control volume; outputting a first signal
representative of one of a plurality of milestones as defined in a
predetermined protocol in response to detecting ingress or egress
of at least one of the plurality of resources relative to the
control volume.
11. The system of claim 10, wherein the tracking system comprises
more than one of the following: an optic tracking system, an
electromagnetic tracking system, an RFID tracking system, an IR
tracking system, a GPS tracking system, and a voice recognition
system, and wherein the tracking system generates at least one
signal representative of ingress or egress of one of the plurality
of resources relative to a sterile zone located within the control
volume.
12. The system of claim 11, further comprising program instructions
representative of the step of calculating a probability of ingress
or egress of at least one of the plurality of resources relative to
the sterile zone, the probability dependent on how many of or which
of the different tracking systems detects ingress or egress of the
at least one of the plurality of resources relative to the sterile
zone.
13. The system of claim 12, wherein outputting the probability is
dependent on a mathematical expression having a first factor
associated with detecting ingress or egress of the at least one of
the plurality of resources relative to the sterile zone with a
first tracking system and a second factor associated with detecting
ingress or egress of the at least one of the plurality of resources
relative to the sterile zone with a second tracking system
different than the first tracking system.
14. The system of claim 10, wherein the further comprising program
instructions representative of the steps of: outputting a
comparison of ingress of at least one of the plurality resources to
a sterile zone defined within the control volume relative to egress
of at least one of the plurality of resources from the sterile
zone, the ingress and egress as detected by the tracking
system.
15. The system of claim 10, further comprising outputting a second
signal representative of another of the plurality of milestones as
defined in a predetermined protocol in response to the step of
outputting the first signal, and in combination with at least one
of the following: detecting ingress or egress of another of the
plurality of resources relative to the control volume, and
detecting a key text in a translation of an audio recording where
the key text is associated with executing the another of the
plurality of milestones and predetermined in a protocol template
for storage in a database.
16. The system of claim 10, further comprising program instructions
representative of the steps of outputting a comparison of a
predicted time for the milestone to occur relative to a measured
time of occurrence of outputting the first signal representative of
the milestone.
17. The system of claim 10, further comprising an program
instructions representative of: calculating a variation between a
difference in a predicted schedule of time of use of the resource
and an actual time of use of the resource relative to a threshold;
and outputting an interdependency of the scheduled time of use of
the resource for the patient relative to another scheduled time of
use of the resource for another patient in response to calculating
the variation exceeds the threshold.
18. The system of claim 10, wherein the milestone is representative
of one of the following: prep of the patient to receive a medical
procedure, establishment of a sterile field, sedation of the
patient to receive the medical procedure, and close of a surgical
site on the patient.
Description
CROSS REFERENCE TO RELATED APPLICATIONS
[0001] The present application claims the benefit of priority to
U.S. Patent Application No. 12/239,270, filed on Sep. 26, 2008, for
"SYSTEM AND METHOD TO MANAGE DELIVERY HEALTHCARE TO A PATIENT"; and
to Provisional Application No. 60/976,582 entitled "Method To View
Biometrical Information and Dynamically Adapt Schedule and Process
Interdependencies with Clinical Process Decisioning" filed Oct. 1,
2007, each of which is hereby incorporated herein by reference in
its entirety.
BACKGROUND OF THE INVENTION
[0002] This invention generally relates to a system for and method
to manage delivery healthcare to a patient.
[0003] Infections can result in operation of hospitals or clinics
or other healthcare environments in association with interaction of
the healthcare provider with multiple patients, deliverables, or
surfaces over a time interval or at the surgical point of care. Not
only can infections be harmful to the health of the patient, but
also increase costs to treat the patient and can harm a reputation
of a healthcare institution.
BRIEF DESCRIPTION OF THE INVENTION
[0004] The subject matter described herein provides a system and
method to reduce the probability of infection rates associated with
delivery of healthcare in a healthcare environment. The subject
matter of the system and method described herein also enhances
visualization of the protocol in delivery of healthcare to the
patient without unduly interrupting or interfering with the
performance of the staff delivering the healthcare.
[0005] The above-mentioned shortcomings, disadvantages and problems
are addressed by the embodiments described herein in the following
description.
[0006] An embodiment of a method to manage delivery of healthcare
via a series of resources to a patient is provided. The method
comprises the steps of tracking and outputting a signal
representative of a location of at least one of the plurality of
resources relative to a control volume associated with the patient;
acquiring at least one signal representative of detecting ingress
or egress of at least one of the series of resources relative to
the control volume; and outputting a first signal representative of
one of a plurality of milestones as defined in a predetermined
protocol in response to detecting ingress or egress of at least one
of the series of resources relative to the control volume.
[0007] An embodiment of a system to manage delivery of healthcare
via a series of resources to a patient is provided. The system
comprises at least one tracking system operable to generate a
signal representative of a location of at least one of the series
of resources relative to a control volume associated with the
patient, and a controller in communication with the tracking
system. The controller includes a processor in communication with a
memory, the processor operable to execute a plurality of program
instructions stored in the memory. The plurality of program
instructions are representative of the steps of acquiring at least
one signal representative of detecting ingress or egress of at
least one of the plurality of resources relative to the control
volume; outputting a first signal representative of one of a
plurality of milestones as defined in a predetermined protocol in
response to detecting ingress or egress of at least one of the
plurality of resources relative to the control volume.
[0008] Systems and methods of varying scope are described herein.
In addition to the aspects and advantages described in this
summary, further aspects and advantages will become apparent by
reference to the drawings and with reference to the detailed
description that follows.
BRIEF DESCRIPTION OF THE DRAWINGS
[0009] FIG. 1 shows a schematic block diagram of an embodiment of a
system to manage delivery of healthcare to a patient.
[0010] FIG. 2 illustrates a schematic diagram of an embodiment of a
block of modules of program instructions to manage delivery of
healthcare to the patient.
[0011] FIG. 3 shows a flow diagram of an embodiment of a method to
delivery healthcare to the patient with the system of FIG. 1.
[0012] FIG. 4 shows a schematic diagram of an embodiment of a
dashboard illustrative of performance of the system of FIG. 1 and
method of FIG. 3.
DETAILED DESCRIPTION OF THE INVENTION
[0013] In the following detailed description, reference is made to
the accompanying drawings that form a part hereof, and in which is
shown by way of illustration specific embodiments, which may be
practiced. These embodiments are described in sufficient detail to
enable those skilled in the art to practice the embodiments, and it
is to be understood that other embodiments may be utilized and that
logical, mechanical, electrical and other changes may be made
without departing from the scope of the embodiments. The following
detailed description is, therefore, not to be taken in a limiting
sense.
[0014] The following is generally description subject matter is
described a perioperative example is presented. It can be
appreciated that monitored activity may occur in many venues for
deliver of care (e.g., home, ambulatory or inpatient settings).
[0015] FIG. 1 illustrates an embodiment of system 100 to manage
resources 105 in the delivery of healthcare to a patient 110. The
resources 105 can include personnel or staff 115 (e.g., surgeon,
clinician, nurse, anesthetist, technician, etc.) and medical
deliverables 120 (e.g., imaging system 125, table 130,
anesthesiology system 135, heart monitor system 140, respiratory
monitor system 150, miscellaneous items 152 such as
medications/anesthesia or contrast agents or instruments or
disposables or consumables, etc.) in the delivery of healthcare
(e.g., medical procedure) to the patient 110.
[0016] An embodiment of the imaging system 125 can include a mobile
radiological X-ray system having a gantry with a mobile C-arm in
support of a radiation source and detector operable to generate a
radiological image of a subject (not shown). Yet, the imaging
system 125 can be also fixed to the ground with miscellaneous
moving components. Although a mobile radiological imagine system is
shown, it should be understood that the type (e.g., X-ray, magnetic
resonant imaging (MRI), computed tomography (CT), ultrasound,
fluoroscopic, endoscopic, laparoscopic, etc.) of imaging systems
100 can vary.
[0017] The table 130 can be located for the surgeon to perform the
surgical procedure on the subject, as well as to position the
subject be imaged by the imaging system 125. The table 130 can be
configured to elevate, pan, tilt, or cradle so as to position the
imaged subject in a desirable fashion for imaging by the imaging
system 125.
[0018] Other medical deliverables 120 can include mechanical or
electro-mechanical devices or clothing that may be employed in a
conventional manner in performing a medical procedure. For example,
the surgeon attire can typically include a surgical mask 160, a cap
165, gloves 170, booties 175, protective eyewear 180, and a gown
185. The patient 110 can be covered with at least one drape 190
arranged with an opening for the surgical site 192 on the patient
110. The type and number of medical deliverables 120 can vary.
[0019] A tracking system 195 can be operable to periodically or
continuously track or monitor a static or change in location or
position or status of the miscellaneous resources 105, apparatus or
personnel described above, including the location of the surgeon or
other staff 115 and the patient 110. The embodiment of the tracking
system 120 can be in communication (e.g., wireless, wired, etc.)
with a controller 200. The controller 200 can also connected in
communication (e.g., wireless, wired, etc.) with the imaging system
125 other medical apparatuses (e.g., anesthesia machine, heart rate
monitor, blood pressure monitor, voice recognition, clinical
systems and health information systems, etc.) located in or outside
the surgical suite and employed in the deliver of healthcare to the
patient.
[0020] An embodiment of the tracking system 195 can be operable to
periodically or continuously measure a location or position or
change thereof relative to a reference 205. An embodiment of the
reference 205 can include a control volume 210 or a sterile zone
215 (e.g., two- or three-dimensional space encompassing or
surrounding or located over the surgical site or other location of
interest) defined for the surgical procedure on the patient 110. An
embodiment of the tracking system 195 can be operable to define the
control volume 210 or the sterile zone 215 located therein, and to
track or detect the ingress or egress of resources 105 to or from
such. For example, assume the control volume 210 or sterile zone
215 can be shaped as a rectangular box having corners defined by
three-dimensional coordinates relative to the reference 205 (e.g.,
a fixed point on the table 130. Of course, the type (e.g., static
or dynamic) and location of the reference 205 can vary. The control
volume 210 or sterile zone 215 can be registered relative to the
fixed reference 205 prior to the delivery of healthcare to the
patient 110, and can be periodically updated during the delivery
procedure. The number, shapes, and dimensions of the control volume
205 or sterile field 215 can vary.
[0021] As shown in FIG. 1, an embodiment of the tracking system 195
employs electromagnetic technology 220 to measure the location or
movement of the resources 105. The tracking system 195 can include
an arrangement of transmitters in electromagnetic communication
with receivers to measure and output the signal representative of
the identifier and the location of the resources 105 for
communication to the controller 200. It should be understood that
the number, type and location of the electromagnetic transmitters
or receivers can vary.
[0022] The signal output from the electromagnetic technology 220 of
the tracking system 195 can also include position data indicative
of an orientation (e.g., an angle of rotation) or change thereof of
the resources 105 relative to the reference 205 (e.g., vertical,
horizontal, etc.). In an embodiment, the tracking system 195 can
electromagnetically measure a location and orientation of the
respective resources 105 capable of being tracked in such a manner.
Also, the tracking system 195 can be configured to
electromagnetically measure a position or change thereof of a
movable component of the resources 105 and to output a signal
representative thereof with an identifier for communication to the
controller 200.
[0023] The illustrated embodiment of the tracking system 195 can
further comprise transmitters and receivers configured to
communicate with a satellite (e.g., global positioning technology
225) so as to measure a precise location or movement of the
resources 105 or moveable components thereof for communication to
the controller 200.
[0024] The illustrated embodiment of the tracking system 195 can
further include optic technology 230 to measure the location or
orientation or change thereof of the resources (or moveable
components thereon) for communication to the controller 200. One
embodiment of the optic technology 230 can include a pair of camera
devices 235 and 240 operable to detect and generate a signal
representative of an identifier and a measured location and
orientation of optical markers 245 located on the resources 105. An
example of the optical markers 245 can include graphic symbols or
reflective material or patterns of unique identification or
orientation (e.g., three spaced-apart graphic representations) that
can be detected and tracked with the camera devices 235 and 240.
Yet, the type of optical markers 245 can vary.
[0025] Another embodiment of the tracking system 195 can employ at
least one camera 235, 240 operable to identify the resources 105
according to optical detecting and recognizing resources 105
according to association of predetermined shapes, patterns, color
contrasts, reflections, etc. or combination thereof acquired and
stored in the system 100, and thereby operable to track movement of
the resources 105 accordingly. Embodiments of the orientation of
multiple cameras 235, 240 can be orthogonal (one camera looking
down from ceiling and one camera looking across horizon) or in
parallel relation to one another, or a combination thereof, yet the
orientation can vary. Further, although two cameras 235, 240 are
shown, the number and type (e.g., video) of cameras and combination
thereof can vary.
[0026] Another embodiment of the tracking system 195 can include a
radio frequency (RF) or infrared (IR) identification system 250.
The RF/IR identification system 250 can include RFID transmitters
coupled in communication with RFID receivers to track location and
movement of resources (e.g., staff, medical deliverables, etc.)
that may enter to or from the surgical suite. In a like manner, the
RF/IR identification system 250 can otherwise or also include IR
technology that can be employed independently of or in combination
with the RFID technology to track movement of tags 255 coupled to
resources 105 of interest.
[0027] The tracking system 195 can further include a voice
recognition system 260. An embodiment of the voice recognition
system 260 can be operable to record speech of the surgeon or staff
115 and to perform voice recognition so as to translate speech to
alphanumeric language in a digital or analog context for
communication to the controller 200. The voice recognition system
260 can further be operable to parse the alphanumeric language for
key words or phrases or fragments thereof for communication to the
controller 200 for comparison to templates that include keywords,
phrases, or fragments thereof representative of protocol or steps
of the medical procedure being performed on the patient 110. The
system may utilize optics, computer vision and can request
confirmation feedback on the system's reasoning as to what process
step is being observed by said system. An example confirmation may
be a rule engine providing text to a speech generator asking the
surgeon if s/he is in fact at a given stem in a protocol as the
system has reasoned.
[0028] Although one embodiment of the tracking system 195 is
described above, it should be understood that the number and types
(e.g., electromagnetic, optical, rF/IR, accelerometers, voice
recognition, etc. or combination thereof) of tracking technologies
and combinations thereof to locate positions or movement of
resources 105 or moveable components thereon can vary.
[0029] The controller 200 can be in wired or wireless communication
with one or more of the medical deliverables 120 or the tracking
system 195 so as to track movement or consumption or disposal of
the resources 105 between various states or locations. The
communication of the controller 200 with the tracking system 195
can be via a wireless connection (e.g., radio frequency, etc.) or
wired connection (e.g., communication bus, etc.) or combination
thereof. Communication can be direct, or over an Internet network
or an Ethernet network or a local area network (LAN).
[0030] An embodiment of the controller 200 can include a computer
in a desktop configuration or laptop configuration or central
workstation or kiosk or server or remote workstation. Yet, the type
of controller 200 can vary. The controller 200 generally includes
one or more processors 270 in communication with a memory 275
having a computer-readable storage medium (e.g., compact disc (CD),
DVD, memory stick, random access memory (RAM), random operating
memory (ROM), etc.). The storage medium is generally operable to
receive and record a plurality of programmable instructions for
execution by the processor 155.
[0031] Referring to FIG. 2, an embodiment of the memory 275
includes a program package 300 comprising a plurality of modules of
program instructions directed to a general structure to manage and
direct feedback related to acquired data associated with completion
of protocol during delivery of healthcare to the patient 110.
[0032] Module 305 includes program instructions directed receiving
and creating a protocol template for each process or procedure to
perform on the patient. When creating the protocol template, the
module 305 can receive and store the series of tasks or steps to
complete the procedure, milestones or events that demarcate
progress from start to end of the procedure, resources employed in
the procedure, and a predicted duration of time to complete one or
more tasks or to complete the overall procedure.
[0033] Module 310 includes program instructions directed to
creating or receiving mathematical models or algorithms
representative of event triggers or temporal relationships or logic
operable to reason or identify occurrence of the activity or step
or protocol.
[0034] Module 315 includes program instructions directed to
tracking, identifying or detecting the presence or movement of
multiple resources in the space or suite, or the ingress/egress
relative to certain created zones or volumes defined within the
space, employing data received from one or more of the tracking
technologies described above.
[0035] Module 320 includes program instructions directed to trigger
that an event has taken place or occurred is about to occur. The
mathematical models or algorithms can comprise multiple AND/OR
statements according to detection of movement or presence of
various resources in the space or suite being monitored with the
tracking system.
[0036] Module 325 includes program instructions representative of
comparator logic to track, detect or identify when a milestone
event has been reached or occurred. One embodiment of the
comparator logic can include AND/OR rule-based, evidentiary or
artificial intelligence based logic to trigger or equate that the
milestone event occurred if the tracking system provides data of
evidence of the presence or movement of one or more unique or
classifications of resources within the space or other smaller zone
or volume described below. Computer reasoned protocol and activity
steps not passing an adjustable threshold of certainty may be
configured to trigger and receive clarifying feedback (e.g., verbal
input or output).
[0037] Module 330 includes program instructions directed to
communicating feedback for storage in the memory 275. In one
example, images are not stored and the program instructions only
direct communication of the computer vision renderings and
reasoning.
[0038] Referring back to FIG. 1, an embodiment of the controller
200 is also connected in communication with an input device 350 and
an output device 355. The input device 350 can include one or
combination of a keyboard, touch-screen, remote computer
workstation, mouse, joystick, tracker ball, etc. or the like
operable to receive data from an operator. The output device 355
can include a display comprising one or combination of a monitor,
an alarm, light emitting diodes (LEDs), printer, audible speaker,
pager, personal data assistant (PDA), etc. operable to visually or
audibly show an output of the controller 200 for illustration to an
operator. The controller 200 can also be connected in communication
with a remote computer or workstation (not shown).
[0039] The system 100 can also be connected in communication with
miscellaneous other resources 105, including health information
systems (HIS).
[0040] FIG. 3 includes a flow diagram to illustrate an embodiment
of a method 400 of operation of the system 100 to manage workflow
in a surgical suite. It should also be understood that the sequence
of the acts or steps of the method 400 as discussed in the
foregoing description can vary. Also, it should be understood that
the method 400 may not require each act or step in the foregoing
description, or may include additional acts or steps not disclosed
herein. It should also be understood that one or more of the steps
of the method 400 can be represented as computer-readable program
instructions for execution by one or more processors 270 of the
controller 200.
[0041] Assume the method 400 can be directed to the surgeon and
staff 115 delivering a peri-operative procedure to the patient 110
on the table 130. Also assume that the delivery of healthcare can
be defined into a succession of tasks or steps of a protocol. The
succession of steps comprising the protocol can be stored in a
template 405 located in a database 410 of the memory 275. The
operator can update the list of resources 105 and tasks to perform
the protocol of the procedure via the protocol template 405 stored
in the database 410 at any time. One or more of the steps or tasks
can be associated with ingress or egress of one or more resources
105 into the control volume 210 or sterile zone 215. Also, one or
more of the steps of the protocol can be performed outside the
control volume 210 or sterile zone 215. Each step or task of the
protocol can be associated with a predicted time duration to
complete, that together with all of the steps comprise a total
predicted time duration to complete the protocol to deliver
healthcare to the patient 110. The protocol may further include
tasks or steps to complete (e.g., deliverables or room preparation,
cleanup, transfer of dirty equipment to be cleaned or introduction
of clean equipment to the space, etc.) even though the patient 110
may not present in a space 412 (e.g., surgical suite). Also assume
that protocol includes multiple events or milestones from start to
completion. One or more of the events or milestones can be
associated with detection or identification of multiple tasks or
detection of resources associated therewith or combination thereof.
The following discussion of an example can explain in more
detail.
[0042] Step 420 can include detecting or tracking the location of
the patient 110 in the control zone 210 or at the table 130. The
location of the patient 110 can be detected via the tracking system
195 employing one or more of the technologies (e.g., RFID, IR
technology, electromagnetic transmitters, motion detectors, (e.g.,
at the table), voice recognition, etc.) or a combination thereof
described above. Step 420 can include outputting a signal
representative of a milestone 422 of protocol execution as well as
that of confirming location of the patient 110 in the control
volume 210 or placement on the table 130.
[0043] Step 430 can include detecting the delivery of anesthesia to
the patient 110. Step 430 can include acquiring a communication
signal of such from the anesthesia machine 135, or acquiring a
voice recognition of an instruction of delivery of anesthesia to
the patient 110, comparison of a biometric measurement (e.g.,
respiratory rate or heart monitor of the patient 110) relative to a
threshold indicative of sedation, etc. Step 430 can include
outputting a signal representative of a milestone 432 of execution
of sedation of the patient 110.
[0044] Step 435 can include tracking removal of sterile or
non-sterile resources 105 and 145 and no reentry thereof of
contaminated resources 105 into the control volume 210.
[0045] Step 435 can include tracking of staff 115 within a
threshold distance of and for a threshold time relative to a hand
hygiene system 436 prior to detection of entry of the staff 115
into the control volume 210 employing one or combination of the
technologies of the tracking system 195 described above. Step 435
can include comparing a predicted duration (see 437 in FIG. 4) to
verify removal of non-sterile items to an actual measurement of
duration (see 438 in FIG. 4) to verify sterility of the control
volume 210.
[0046] Step 440 can include detecting preparation of the surgical
site 192 (e.g., shaving/scrubbing/application of disinfectant) on
the patient 110. An embodiment of step 440 can include detection
via signals acquired from the tracking system 195 (e.g., the
optical technology 230, the RFID/IR technology 250, the
electromagnetic technology 220, the voice recognition technology
260, etc.) indicative or representative of the staff 115 within a
threshold distance of the patient 110 or table 130 or within the
control volume 210 as defined by the tracking system 195. Step 440
can also include acquiring signals from the voice recognition
technology or system 260 representative of key words expressed by
the staff 115 indicating application or execution of
shaving/scrubbing/application of disinfectant at the surgical site
192 of the patient 110.
[0047] Step 445 can include calculation and outputting a signal
representative of the milestone 446 for completion of prep of the
patient 110. An embodiment of step 445 can include comparison of
the detected steps or tasks described above relative to the
protocol to identification completion of the event or milestone 446
of prep of the patient 110 to receive delivery of healthcare (e.g.,
the surgical procedure). Although the event or milestone 446 of
prep of the patient 110 is described with completion of one or more
of the tasks or steps described above, it should be understood that
the number and types of steps to associate with this or other
milestones can vary in combination or include different steps than
that described.
[0048] Step 450 can include detection of placement of the drape 190
over the patient 110. Step 450 can be performed upon visualization
of the authorization of milestone of the prep of the patient 110 in
step 445. Step 450 can include detecting entry of the drape 190
into the sterile zone 215 via one or combination of the tracking
technologies described above for placement of the drape 190 over
the surgical site 192 of the patient 110.
[0049] Step 455 can include detecting and outputting a signal
representative of a milestone 456 for defining or establishing the
sterile zone 215 over or around the surgical site 192 on the
patient 110. An embodiment of the sterile zone 215 can be a
three-dimensional portion of the control volume 210 or a
two-dimensional plane. Outputting the signal representative of the
milestone 456 can be in response to calculating according to an AND
logic function representative of acquiring signals representative
of completion or detection of more than one of following events:
the milestone 446 for prep of the patient 110, placement of the
surgical drape 190, and establishing the control volume 210.
[0050] Step 460 can include detecting or calculating and outputting
a signal representative of the milestone 462 of verification of the
staff 115 (e.g., surgeon, nurse, technician, etc.) to perform the
procedure having a sterile state and positioned in the control
volume 210 and/or positioned ready to perform the procedure.
Detection of the sterile state of the staff 115 can be performed
with tracking (e.g., optical, RFID, IR, electromagnetic, etc.) of
the staff 115 to be present for a threshold time within a
predetermined threshold distance of the hand hygiene or
sterilization station 436 (See FIG. 1).
[0051] Step 465 can include dynamic tracking of the control volume
210 to detect presence of predetermined resources 105 each having a
sterile state (as determined per RFID tracking of sterilization of
each resource 105 relative to a cleaning station (e.g., detection
of location in a cleaning room for a threshold time or within
threshold distance of hand hygiene station 436 for threshold time)
located therein to perform the procedure per the according to the
predetermined list of resources 105 stored in the template 405
associated with the procedure and stored in the database 410 at the
memory 275. Step 465 can include comparing one or more of the
tracking technologies of the tracking system 195 described above to
verify the identify of the resources 105 in the control volume
210.
[0052] Step 465 can include a technique referred to "counting out",
where the system 100 detects and outputs a list 466 (See FIG. 4) of
resources 105 (e.g., miscellaneous tools such as sponges,
catheters, scalpels, etc.) that enter the sterile zone 215 counting
out a list 467 (See FIG. 4) of resources 105 leaving the sterile
zone 215. Step 465 further includes tracking to detect and alarm if
entry of any non-sterile resources into the control volume 210 or
the sterile zone 215, or if the list 467 of resources 105 leaving
the sterile zone 215 does not equate to the list 466 of resources
105 that enter the sterile zone 215.
[0053] Step 465 can further include calculating and outputting a
probability 468 of ingress or egress of one or more resources 105
to or from the sterile zone or control volume. The probability 468
can be calculated dependent in a predetermined manner or algorithm
(e.g., linear relationship, logarithmic relationship, exponential,
weighted according to predetermined factors assigned to tracking
technologies, other parametric relationship, etc.) according to a
number of and type (e.g., RFID/IR system 250 may be more reliant on
detection than optical system 230) of technologies operable to
track movement of the resource 105. The probability 468 can also
increase in a manner described above with detection via voice
recognition of reference of the resource 105 relative to point in
time of ingress or egress to the control volume 210 or sterile zone
215, and relative to identification of the resources 105 in the
list as stored in the protocol template 405 to perform the
identified task occurring or for the overall procedure or process
to deliver healthcare to the patient 110.
[0054] Step 470 can include employing one or combination of the
tracking technologies (e.g., electromagnetic tracking system 220,
optical tracking system 230, voice recognition system 260, GPS
tracking system 225, RFID/IR system 250, etc.) of the tracking
system 195 to identify and output signals representative of
completion of miscellaneous predetermined tasks or milestones of
the procedure or process toward completion, as listed or described
in the protocol template 405.
[0055] Step 475 can include detecting and outputting the milestone
476 of ready or start to close the surgical site 192 of the patient
110. Step 475 can include calculating the milestone 476 to equate
to an AND logic function of receiving authorization of completion
of step 465 and acquiring signals representative of completion of
the tasks of the procedure as described in step 470.
[0056] Step 480 can include outputting a dashboard 500 (See FIG. 4)
including a temporal display of a predicted time and a measured
time to reach each milestone in the procedure described above for
illustration at the output device 355 (See FIG. 1). This step 480
can occur continuously from prior to start of the procedure to
conclusion of the procedure, providing updates to a central or
remote workstation of changes in predicted durations to deliver
healthcare to patients 110, changes to predicted time to complete,
and to display alerts to impact of updated duration of time of use
of resources 105 and later cleanup relative to subsequent
scheduling of the resources 105 for use in delivery of healthcare
on other patients 110.
[0057] FIG. 4 shows an embodiment of the output of data from the
system 100 for illustration in the dashboard 500 in managing the
delivery of healthcare to the patient 110. The dashboard 500 can
include graphic representations of one or more of the milestones or
events or tasks of the method 300 described above, including:
milestone 422 for entry of patient into the space, milestone 432
for sedation of patient 110, milestone 446 for prep of the patient
110, defining the control volume 210, milestone 456 for creating
sterile plane or zone 215, milestone 462 for positioning of staff
115 ready (e.g., sterile) to perform procedure, step of counting
out resources 105 employed in performing the procedure on or
delivery of healthcare to the patient 110, milestone 476 of ready
to close of surgical site 192 on patient 110, predicted duration of
time 437 between each milestone event, measured or actual time 438
between each milestone event, list 505 of ingress or egress of
resources 105 to or from the control volume 210, list 466, 467 of
ingress or egress of resources 105 detected to or from the sterile
zone 215, and graphic illustrations of an interdependency 520 of
resources 105 to their forward or later or subsequent schedule of
use or location or combination thereof in performance of procedures
on other patients 110. It should be understood that the type and
number of graphic representations comprising the dashboard 500 can
vary.
[0058] An example of a technique to identify interdependencies in
the scheduling of resources 105 is described in U.S. patent
application Ser. No. 112/040,646 to Johnson et al, entitled "Method
To View Schedule Interdependencies and Provide Proactive Clinical
Process Decision Support in Day View Form", filed on Feb. 29, 2008
and hereby incorporated herein by reference in its entirety.
Visualization of interdependency 520 in the scheduling or predicted
or actual timed events 437, 438 or milestones 422, 432, 456 of
performance of the resources 105 (see FIG. 1) can be illustrated as
a critical path (see dashed line and reference 525). Tasks and the
resources 105 (e.g., people, equipment, consumables, medications,
disposables, etc.) to perform the tasks in accordance to the
protocol can be predetermined and listed in association with
template 405 (See FIG. 1) so as direct scheduling of the resources
105 prior to delivery of care to the patient 110. The dashboard 500
can generally illustrate how the system 100 maps the precedence of
tasks to perform the protocol relative to a time scale (see dashed
line and reference 530) in the scheduling of the resources 105 to
deliver healthcare to multiple patient 110 over an extended period
(e.g., day) in association with predictions of the durations of
tasks to be completed with the resources 105. Forecast scheduling
of resources 105 and predicted durations of tasks 437 can be
updated manually or statistically over time with enabling the
providers of care to become aware of where delays and variances
occur.
[0059] The dashboard 500 can further include a comparison of
tracking of actual completion of events 438 or milestones 422, 432,
456 relative to list of tasks or milestones as described in
protocol template 405, actual or measured time of occurrence or
duration 438 of events or tasks relative to the prediction 437 of
time or duration of events or tasks, or a comparison of the
tracking of spatial distribution of resources 105 and defined
control volume 210 or sterile zone 215 (see FIG. 1) relative to a
predicted spatial distribution thereof according to data acquired
by the tracking system 195 in comparison to predetermined spatial
distribution as described or stored in the protocol template
405.
[0060] The system 100 and method 400 can employ multiple tracking
technologies, mathematical modeling techniques, and comparative
logic rules to output the visualization for illustration. Another
technical effect of the system 100 and method 400 can include
tracking and comparing the predetermined protocol standard relative
to actual events of protocol, time of events of protocol, and
standard versus spatial distribution of resources 105 and output
feedback of comparison for illustration. Another technical of the
system 100 and method 400 can include providing the above-described
technical effects of tracking and comparing in low-intrusive or
low-interruptive manner that minimally interferes with the
performance of the resources 105 executing the protocol.
[0061] One or more elements or constructions of one or more
embodiments of the subject matter described above may be combined
with one or more elements or constructions of other embodiments of
the subject matter described above and is not limiting on the
subject matter described herein.
[0062] A technical effect of the subject matter described herein
can include providing the system 100 and method 400 and dashboard
500 to visualize location and scheduling of the resources 105
(e.g., assets, people, consumables, apparatus and etc.) in the
delivery of healthcare to patients. The system 100 and method 200
and dashboard 500 can identify of problems (e.g., delays, missed
protocol, etc.) and the interdependence, status and relationship of
the resources 105 to the execution of protocol scheduled in the
future delivery of the healthcare to patients 110.
[0063] Another technical effect can include providing the system
100 and method 200 output proposed actionable decisions or to
automatically trigger actionable decisions in scheduling or
execution of protocol in response to the detection of problems in
the delivery of healthcare to patients. This technical effect can
be realized with visualization of the interdependencies of the
resources 105 in the past, present and future, as well as
visualization of the past, present and scheduled or predicted
future status (e.g., locations, scheduled cleaning, scheduled
breaks, scheduled unavailability of staff, etc.) of the resources
105 so as to simulate and visualization of potential or predicted
scenarios in the scheduling of resources 105. For example, the
system 100 or method 200 can simulate of the scheduling and
execution of protocol by the resources 105 so as to allow care
providers to scroll forward to uncover potential bottlenecks in the
future schedule and to receive list of alternative action options
(e.g., list of alternate available resources 105 and locations).
The system 100 and method 200 can also calculate or output a
confidence or probability in the simulation of the schedule of
resources 105. An embodiment of the system 100 and method 200 can
further output alerts to problems (e.g., delays, low confidence,
etc.) and interdependencies of scheduled resources 105 upon
comparison to acceptable or unacceptable thresholds of
variation.
[0064] This written description uses examples to disclose the
invention, including the best mode, and also to enable any person
skilled in the art to make and use the invention. The patentable
scope of the invention is defined by the claims, and may include
other examples that occur to those skilled in the art. Such other
examples are intended to be within the scope of the claims if they
have structural elements that do not differ from the literal
language of the claims, or if they include equivalent structural
elements with insubstantial differences from the literal languages
of the claims.
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