U.S. patent application number 15/692086 was filed with the patent office on 2017-12-21 for systems and methods to optimize radiology exam distribution.
The applicant listed for this patent is General Electric Company. Invention is credited to Vineet Ahuja, Jeff Chu, Rhonda Eckstein, Shaoyu Feigler, Eric Jester, Madhu Seepani, Charlotte Mae Shelton, Arun Viswanath, Jiaohuan Wang.
Application Number | 20170364643 15/692086 |
Document ID | / |
Family ID | 53183375 |
Filed Date | 2017-12-21 |
United States Patent
Application |
20170364643 |
Kind Code |
A1 |
Jester; Eric ; et
al. |
December 21, 2017 |
SYSTEMS AND METHODS TO OPTIMIZE RADIOLOGY EXAM DISTRIBUTION
Abstract
Example methods, systems, and computer readable media are
disclosed to allocate a medical exam. An example method includes
identifying an exam characteristic associated with the medical
exam. The example method includes determining a plurality of
allocation scores for a plurality of radiologists by comparing the
exam characteristic to a radiologist characteristic for each of the
plurality of radiologists. The example method includes determining
one of the plurality of allocation scores with a highest value. The
example method includes allocating the medical exam to one of the
plurality of radiologists associated with the one of the plurality
of allocation scores with the highest value. The example method
includes marking the medical exam as allocated to the one of the
plurality of radiologists associated with the one of the plurality
of allocation scores with the highest value. The example method
includes providing an indication that the medical exam is allocated
via a graphical user interface.
Inventors: |
Jester; Eric; (Hoffman
Estates, IL) ; Viswanath; Arun; (Lake Zurich, IL)
; Seepani; Madhu; (Lake In The Hills, IL) ;
Feigler; Shaoyu; (Barrington, IL) ; Chu; Jeff;
(Buffalo Grove, IL) ; Wang; Jiaohuan; (Schaumburg,
IL) ; Ahuja; Vineet; (Palatine, IL) ; Shelton;
Charlotte Mae; (Gilbert, AZ) ; Eckstein; Rhonda;
(Baileyton, AL) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
General Electric Company |
Schenectady |
NY |
US |
|
|
Family ID: |
53183375 |
Appl. No.: |
15/692086 |
Filed: |
August 31, 2017 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
|
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14091801 |
Nov 27, 2013 |
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15692086 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
G16H 30/20 20180101;
G16H 40/20 20180101; G06F 19/321 20130101 |
International
Class: |
G06F 19/00 20110101
G06F019/00 |
Claims
1. A system comprising a processor configured to implement: an exam
distributor to: identify a characteristic of a medical exam;
allocate the exam to a first radiologist based on the exam
characteristic and a radiologist characteristic for the first
radiologist; detect a status of a wait flag associated with the
first radiologist, the status of the wait flag to be based on a
user input received via a first graphical user interface; monitor a
first work queue associated with the first radiologist; and
automatically deliver the medical exam to the first work queue or a
second work queue for a second radiologist based on the status of
the wait flag and the monitoring of the first work queue, the first
work queue and the second work queue to be displayed via the first
graphical user interface.
2. The system of claim 1, wherein the exam distributor is to verify
the delivery of the medical exam to the second radiologist based on
a priority rule for the exam.
3. The system of claim 1, wherein exam distributor is to monitor an
availability of the first radiologist based on the wait flag.
4. The system of claim 1, wherein the exam distributor is to
automatically adjust a placement of the medical exam in the first
work queue relative to a second medical exam in the first work
queue based on the availability of the first radiologist.
5. The system of claim 1, wherein the exam distributor is to
monitor the first work queue relative to at least one of a first
work queue threshold for the first radiologist or a second work
queue threshold for the second radiologist.
6. The system of claim 5, wherein the exam distributor is to select
the first work queue or the second work queue to receive the
medical exam based on a threshold review time for the medical
exam.
7. The system of claim 1, wherein the exam distributor is to
display the first queue or the second queue via a second graphical
user interface to be viewed by the one of the first radiologist or
the second radiologist.
8. A method comprising: identifying, by executing an instruction
with a processor, a characteristic of a medical exam; allocating,
by executing an instruction with the processor, the exam to a first
radiologist based on the exam characteristic and a radiologist
characteristic for the first radiologist; detecting, by executing
an instruction with the processor, a status of a wait flag
associated with the first radiologist, the status of the wait flag
to be based on a user input received via a first graphical user
interface; monitoring, by executing an instruction with the
processor, a first work queue associated with the first
radiologist; and automatically delivering, by executing an
instruction with the processor, the medical exam to the first work
queue or a second work queue for a second radiologist based on the
status of the wait flag and the monitoring of the first work queue,
the first work queue and the second work queue to be displayed via
the first graphical user interface.
9. The method of claim 8, further including verifying the delivery
of the medical exam to the second radiologist based on a priority
rule for the exam.
10. The method of claim 8, further including monitoring an
availability of the first radiologist based on the wait flag.
11. The method of claim 8, further including automatically
adjusting a placement of the medical exam in the first work queue
relative to a second medical exam in the first work queue based on
the availability of the first radiologist.
12. The method of claim 8, further including monitoring the first
work queue relative to at least one of a first work queue threshold
for the first radiologist or a second work queue threshold for the
second radiologist.
13. The method of claim 12, further including selecting the first
work queue or the second work queue to receive the medical exam
based on a threshold review time for the medical exam.
14. The method of claim 8, further including displaying the first
queue or the second queue via a second graphical user interface to
be viewed by the one of the first radiologist or the second
radiologist.
15. A non-transitory computer readable storage medium comprising
instructions that, when executed, cause a machine to at least:
identify a characteristic of a medical exam; allocate the exam to a
first radiologist based on the exam characteristic and a
radiologist characteristic for the first radiologist; detect a
status of a wait flag associated with the first radiologist, the
status of the wait flag to be based on a user input received via a
first graphical user interface; monitor a first work queue
associated with the first radiologist; and automatically deliver
the medical exam to the first work queue or a second work queue for
a second radiologist based on the status of the wait flag and the
monitoring of the first work queue, the first work queue and the
second work queue to be displayed via the first graphical user
interface.
16. The non-transitory computer readable storage medium of claim
15, wherein the instructions further cause the machine to verify
the delivery of the medical exam to the second radiologist based on
a priority rule for the exam.
17. The non-transitory computer readable storage medium of claim
15, wherein the instructions further cause the machine to monitor
an availability of the first radiologist based on the wait
flag.
18. The non-transitory computer readable storage medium of claim
15, wherein the instructions further cause the machine to
automatically adjust a placement of the medical exam in the first
work queue relative to a second medical exam in the first work
queue based on the availability of the first radiologist.
19. The non-transitory computer readable storage medium of claim
15, wherein the instructions further cause the machine to monitor
the first work queue relative to at least one of a first work queue
threshold for the first radiologist or a second work queue
threshold for the second radiologist.
20. The non-transitory computer readable storage medium of claim
15, wherein the instructions further cause the machine to display
the first queue or the second queue via a second graphical user
interface to be viewed by the one of the first radiologist or the
second radiologist.
Description
RELATED APPLICATIONS
[0001] This patent arises as a continuation of U.S. patent
application Ser. No. 14/091,801, entitled "Systems and Methods to
Optimize Radiology Exam Distribution," filed Nov. 27, 2013. U.S.
patent application Ser. No. 14/091,801 is hereby incorporated by
reference in its entirety.
FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT
[0002] [Not Applicable]
MICROFICHE/COPYRIGHT REFERENCE
[0003] [Not Applicable]
BACKGROUND
[0004] Healthcare environments, such as hospitals or clinics,
include information systems, such as hospital information systems
(HIS), radiology information systems (RIS), clinical information
systems (CIS), and cardiovascular information systems (CVIS), and
storage systems, such as picture archiving and communication
systems (PACS), library information systems (LIS), and electronic
medical records (EMR). Information stored can include patient
medication orders, medical histories, imaging data, test results,
diagnosis information, management information, and/or scheduling
information, for example.
BRIEF SUMMARY
[0005] Example methods, systems, and computer readable media are
disclosed to allocate a medical exam. An example method includes
identifying an exam characteristic associated with the medical
exam. The example method includes determining a plurality of
allocation scores for a plurality of radiologists by comparing the
exam characteristic to a radiologist characteristic for each of the
plurality of radiologists. The example method includes determining
one of the plurality of allocation scores with a highest value. The
example method includes allocating the medical exam to one of the
plurality of radiologists associated with the one of the plurality
of allocation scores with the highest value. The example method
includes marking the medical exam as allocated to the one of the
plurality of radiologists associated with the one of the plurality
of allocation scores with the highest value. The example method
includes providing an indication that the medical exam is allocated
via a graphical user interface.
[0006] An example system includes an allocation manager to identify
an exam characteristic associated with the medical exam. The
example allocation manager is to determine a plurality of
allocation scores for a plurality of radiologists by comparing the
exam characteristic to a radiologist characteristic for each of the
plurality of radiologists. The example allocation manager is to
determine one of the plurality of allocation scores with a highest
value. The example allocation manager is to allocate the medical
exam to one of the plurality of radiologists associated with the
one of the plurality of allocation scores with the highest value.
The example allocation manager is to mark the medical exam as
allocated to the one of the plurality of radiologists associated
with the one of the plurality of allocation scores with the highest
value. The example allocation manager is to provide an indication
that the medical exam is allocated via a graphical user
interface.
[0007] An example tangible computer readable storage medium
comprises instructions that, when executed, cause a computing
device to identify an exam characteristic associated with the
medical exam. The example instructions cause the computing device
to determine a plurality of allocation scores for a plurality of
radiologists by comparing the exam characteristic to a radiologist
characteristic for each of the plurality of radiologists. The
example instructions cause the computing device to determine one of
the plurality of allocation scores with a highest value. The
example instructions cause the computing device to allocate the
medical exam to one of the plurality of radiologists associated
with the one of the plurality of allocation scores with the highest
value. The example instructions cause the computing device to mark
the medical exam as allocated to the one of the plurality of
radiologists associated with the one of the plurality of allocation
scores with the highest value. The example instructions cause the
computing device to provide an indication that the medical exam is
allocated via a graphical user interface.
BRIEF DESCRIPTION OF SEVERAL VIEWS OF THE DRAWINGS
[0008] FIG. 1 illustrates a block diagram of an example medical
exam distributor in an example healthcare system.
[0009] FIG. 2 illustrates another block diagram of the example
medical exam distributor in an example healthcare system.
[0010] FIG. 3 is a flow diagram illustrating an example method for
creating radiologist profiles at the example medical exam
distributor of FIGS. 1 and/or 2.
[0011] FIG. 4 is a flow diagram illustrating an example method for
initiating use of the example medical exam distributor of FIGS. 1
and/or 2.
[0012] FIG. 5 illustrates a flow diagram illustrating an example
method for assigning a radiologist at the example medical exam
distributor of FIGS. 1 and/or 2.
[0013] FIG. 6 illustrates a flow diagram illustrating an example
method for allocating a radiologist at the example medical exam
distributor of FIGS. 1 and/or 2.
[0014] FIG. 7 illustrates a flow diagram illustrating an example
method for determining allocation scores at the example medical
exam distributor of FIGS. 1 and/or 2.
[0015] FIG. 8 illustrates a flow diagram illustrating an example
method for applying load-balancing rules at the example medical
exam distributor of FIGS. 1 and/or 2.
[0016] FIG. 9 illustrates a flow diagram illustrating another
example method for assigning a radiologist at the example medical
exam distributor of FIGS. 1 and/or 2.
[0017] FIG. 10 illustrates an example interface created by the
example medical exam distributor of FIGS. 1 and/or 2.
[0018] FIG. 11 illustrates another example interface created by the
example medical exam distributor of FIGS. 1 and/or 2.
[0019] FIG. 12 shows a block diagram of the example medical exam
distributor of FIGS. 1 and/or 2.
[0020] FIG. 13 shows a block diagram of an example processor system
that may be used to implement systems and methods described
herein.
[0021] The foregoing summary, as well as the following detailed
description of certain examples of the present invention, will be
better understood when read in conjunction with the appended
drawings. For the purpose of illustrating the invention, certain
examples are shown in the drawings. It should be understood,
however, that the present invention is not limited to the
arrangements and instrumentality shown in the attached
drawings.
DETAILED DESCRIPTION OF CERTAIN EXAMPLES
[0022] Although the following discloses example methods, systems,
and tangible computer-readable media including, among other
components, software executed on hardware, it should be noted that
such methods and apparatus are merely illustrative and should not
be considered as limiting. For example, it is contemplated that any
or all of these hardware and software components could be embodied
exclusively in hardware, exclusively in software, exclusively in
firmware, or in any combination of hardware, software, and/or
firmware. Accordingly, while the following describes example
methods, systems, and tangible computer-readable media, the
examples provided are not the only way to implement such methods,
systems, and tangible computer-readable media.
[0023] When any of the appended claims are read to cover a purely
software and/or firmware implementation, in an embodiment, at least
one of the elements is hereby expressly defined to include a
tangible medium. As used herein, the term tangible computer
readable medium is expressly defined to include any type of
computer readable storage and to exclude propagating signals.
Additionally or alternatively, the example methods, systems, and
tangible computer-readable media can be implemented using coded
instructions (e.g., computer readable instructions) stored on a
non-transitory computer readable medium such as a flash memory, a
read-only memory (ROM), a random-access memory (RAM), a cache, or
any other storage media in which information is stored for any
duration (e.g., for extended time periods, permanently, brief
instances, for temporarily buffering, and/or for caching of the
information). As used herein, the term non-transitory computer
readable medium is expressly defined to include any type of
computer readable medium and to exclude propagating signals.
[0024] Many healthcare environments include radiology information
systems to facilitate patient examination and/or patient diagnosis.
For example, a radiology information system in a healthcare system
stores radiology reports, messages, warning, alerts, patient
scheduling information, patient demographic data, patient tracking
information, and/or physician and patient status monitors. A
radiology information system can also enable exam order entering
(e.g., ordering an x-ray of a patient) and image and film tracking
(e.g., tracking identities of one or more people that have checked
a film).
[0025] A medical exam may be ordered for a patient, and the medical
exam is assigned to a practitioner (e.g., a radiologist) to conduct
the exam. A practitioner may have a workflow comprising one or more
medical exams to be conducted and an order in which the one or more
medical exams are to be conducted. Examples described herein
provide a medical exam distributor to distribute medical exams on
behalf of, for example, a radiology information system. Example
exam distributors described herein enable efficient assignment
and/or allocation of medical exams to practitioners (e.g.,
radiologists) and management of practitioner workflows.
[0026] In some examples, profiles are created for radiologists to
be used by the example exam distributors to assign and/or allocate
medical exams. A radiologist profile can identify a radiologist, an
experience level of the radiologist (e.g., a resident, an
attending, etc.), a specialty associated with the radiologist
(e.g., emergency, pediatrics, etc.), a modality preferred by the
radiologist (e.g., a computed tomography (CT) scan, a magnetic
resonance imaging (MRI) exam, etc.), and/or a body part preferred
by the radiologist (e.g., abdomen, chest, etc.). A radiologist
profile can also identify days and/or times during which the
radiologist practices with the preferred specialty, modality,
and/or body part. For example, a radiologist may work in an
emergency department on Mondays and Tuesdays, and may work in a
pediatrics department on Wednesdays, Thursdays, and Fridays. A
radiologist profile can also identify locations at which the
radiologist practices the preferred specialty, modality, and/or
body part. For example, a radiologist may work at Hospital A on
Mondays and Tuesdays, and may work at Hospital B on Wednesdays,
Thursdays, and Fridays. In some examples, multiple profiles are
created for a radiologist. For example, if a radiologist works at
different locations, and/or works on different specialties,
modalities, and/or body parts at different days and/or times, a
profile can be created for the radiologist for each location, each
day, and/or each time. The radiologist profiles are used by the
example medical exam distributor to assign and/or allocate medical
exams and/or manage radiologist workflows.
[0027] In some examples, distribution rules are defined to enable
the assignment and/or allocation of medical exams. Distribution
rules include queue length rules, matching rules, priority rules,
and/or more generally, load-balancing rules that define the
allocation and assignment of exams in view of exam and radiologist
attributes. In some examples, a queue length rule defines a length
of a radiologist workflow. For example, a queue length rule defines
that a radiologist workflow comprises a queue length of five (e.g.,
a maximum of five exams can be assigned and/or allocated to a
radiologist at one time).
[0028] In some examples, matching rules define how radiologists are
to be matched with a medical exam to be distributed. A medical exam
to be distributed can be associated with a specialty, a modality,
and/or a body part. In some examples, a matching rule defines that
a radiologist is to be matched with a medical exam when a specialty
associated with the radiologist matches a specialty associated with
the medical exam, when a modality associated with the radiologist
matches a modality associated with the medical exam, and/or when a
body part associated with the radiologist matches a body part
associated with the medical exam. Matching rules also define point
values associated with a specialty match, a modality match, and/or
a body part match. Point values are used to weight the matching
process so that, for example, a match in a specialty is given more
weight than a match in a body part. For example, a match between a
specialty associated with a radiologist and a specialty associated
with a medical exam may afford the radiologist ten (10) points. A
match between a modality associated with a radiologist and a
modality associated with a medical exam may afford the radiologist
five (5) points. A match between a body part associated with a
radiologist and a body part associated with a medical exam may
afford the radiologist two (2) points.
[0029] In some examples, a priority and/or flag rule defines that a
medical exam marked with a priority flag is to be moved to a top
position or queue of a radiologist workflow such that the
radiologist will conduct the medical exam before conducting other
medical exams. For example, a radiologist may determine that a
medical exam is urgent and mark the exam with a priority flag. The
medical exam is then moved to the top of the radiologist
workflow.
[0030] In some examples, load-balancing rules are used to increase
the efficiency of the exam assignment and/or allocation process
and/or the exam review process. In some examples, a load-balancing
rule is used to increase a likelihood that a service level
agreement associated with a patient and/or a healthcare provider is
met. For example, a service level agreement (SLA) can include a
length of time during which a medical exam is to be conducted. In
such an example, a load-balancing rule defines that if the length
of time during which a medical exam is to be conducted is
approaching (e.g., within a threshold amount of time), the medical
exam is to be escalated and moved to the top of a radiologist
workflow (e.g., a first position of the workflow queue). For
example, if a medical exam is to be conducted within one hour to
maintain the time constraints of a service level agreement, the
medical exam will be moved to a top position or queue of a
radiologist workflow such that the radiologist will conduct the
medical exam before conducting other medical exams.
[0031] In some examples, a load-balancing rule is used to increase
a likelihood that a radiologist with sufficient experience is
assigned to a medical exam associated with a relative value unit
score. A relative value unit (RVU) score is a measure of value for
practitioner services. A relative value unit score can be
associated with a level of experience of a radiologist. For
example, a medical exam with a high relative value unit score may
be a more difficult exam to conduct and, thus, a more experienced
radiologist is to conduct the exam. In some examples, a
load-balancing rule defines that a medical exam is to be removed
from a radiologist workflow if the radiologist does not have
sufficient experience to conduct the medical exam based on a
relative value unit score of the medical exam.
[0032] In some examples, a medical exam is assigned to a
radiologist based on the load-balancing rules. For example, when a
medical exam is to be examined, a practitioner (e.g., an attending)
and/or an administrator can assign the medical exam to another
radiologist (e.g., a resident). Examples disclosed herein determine
if the assigned radiologist is available to examine the medical
exam using, for example, the profile of the assigned radiologist.
For example, if the profile of the assigned radiologist specifies
that the radiologist is at Hospital A, and the medical exam to be
assigned is at Hospital B, the radiologist is not available to be
assigned to the medical exam. If the radiologist is available,
examples disclosed herein assign the medical exam to the
radiologist.
[0033] If the radiologist is not available, the assigning
practitioner can specify whether to wait till the desired
radiologist is available to assign the medical exam to the desired
radiologist. If the assigning practitioner wishes to wait till the
desired radiologist is available, a waiting flag is set, and the
availability of the desired radiologist is monitored. Once
available, the desired radiologist is assigned to the medical exam.
If the assigning practitioner does not wish to wait till the
desired radiologist is available, examples disclosed herein
allocate the medical exam to another radiologist (e.g., the system
automatically selects a radiologist and moves the medical exam to
the selected radiologist's workflow).
[0034] In some examples, the radiologist accepts the assignment. If
the radiologist accepts the assignment of the medical exam, an
assignment flag is set, and the medical exam is moved to the
radiologist's workflow. In some examples, the radiologist declines
the assignment. For example, a radiologist may have a full workflow
and, thus, may not want to add the medical exam being assigned
(e.g., which may require removing another medical exam in the
radiologist's workflow). If the radiologist declines the
assignment, the medical exam may be assigned to another
radiologist. If the medical exam is not assigned to another
radiologist (e.g., if a practitioner does not select another
radiologist to take the exam), examples disclosed herein allocate
the medical exam to a radiologist (e.g., the system automatically
selects a radiologist and moves the medical exam to the selected
radiologist's workflow).
[0035] In some examples, a medical exam is allocated to a
radiologist. For example, a medical exam is allocated to a
radiologist when the medical exam has not been assigned by a
practitioner to a radiologist, and has not yet been automatically
assigned to a radiologist. To allocate a medical exam, examples
described herein identify exam characteristics of the medical exam.
Exam characteristics include, for example, location, experience
level, specialty, modality, and/or body part associated with the
medical exam to be allocated. Examples disclosed herein identify
available radiologists and use the matching rules and point values
to determine a radiologist that best matches the medical exam to be
allocated.
[0036] To determine a best match for the medical exam to be
allocated, examples described herein determine an allocation score
for each available radiologist for the medical exam. To determine
an allocation score, examples disclosed herein assign point values
for each characteristic associated with a radiologist that matches
a characteristic of the medical exam. For example, if the medical
exam is at a location that is the same as the radiologist, the
radiologist is assigned and/or allocated a location point value
(e.g., which has been previously specified during the defining of
the matching rules). If an experience level associated with the
medical exam (e.g., an experience level needed by a practitioner to
conduct the medical exam) is the same as an experience level of the
radiologist, the radiologist is assigned and/or allocated an
experience point value. If a specialty associated with the medical
exam is the same as a specialty associated with the radiologist,
the radiologist is assigned and/or allocated a specialty point
value. If a modality associated with the medical exam is the same
as a modality associated with the radiologist, the radiologist is
assigned and/or allocated a modality point value. If a body part
associated with the medical exam is the same as a body part
associated with the radiologist, the radiologist is assigned and/or
allocated a body part point value. Examples disclosed herein total
the point values assigned and/or allocated to the radiologist to
determine the overall allocation score. Allocation scores are
determined for each available radiologist so that the allocation
scores can be compared.
[0037] To compare allocations scores for available radiologists,
examples described herein prepare scorecards for each of the
available radiologists using the allocation scores. Example
scorecards identify the radiologist, the overall allocation score
of the radiologist, and each of the point values allocated to the
radiologist that make up the overall allocation score. The
scorecards can be viewed by a practitioner to see how well a
radiologist matches a medical exam to be allocated.
[0038] Examples disclosed herein determine the available
radiologist with the highest allocation score. If a particular
radiologist has the highest allocation score (e.g., a single
allocation score is the highest allocation score), the medical exam
is allocated to the radiologist with the highest allocation score.
If more than one radiologist has the highest allocation score
(e.g., if there is a tie between allocation scores), examples
described herein determine the radiologist with the highest
allocation score and the shortest workflow queue length. For
example, a first and a second radiologist may both obtain an
allocation score of twelve, but the first radiologist may have a
queue length of three while the second radiologist has a queue
length of four. Examples described herein allocate the medical exam
to the radiologist with the highest allocation score and the
shortest workflow queue length (e.g., the first radiologist) so
that the medical exam will be examined more quickly than if the
medical exam was allocated to a radiologist with a longer queue
length.
[0039] In some examples, a radiologist accepts or declines the
allocation of the medical exam. If the radiologist accepts the
allocation of the medical exam, an allocation flag is set and the
medical exam is moved to the radiologist's workflow. If the
radiologist declines the allocation of the medical exam, an
allocation rejection entry is recorded for the radiologist.
Examples described herein maintain logs of rejections of exam
allocations by radiologists so that a practitioner can review such
rejections. For example, if a radiologist is declining numerous
exam allocations and/or a particular type of exam allocation, a
practitioner (e.g., an attending) may wish to review this
information (e.g., so that the practitioner may intervene).
[0040] In some examples, load-balancing rules are applied once a
medical exam has been assigned and/or allocated to a radiologist.
Load-balancing rules are used to increase the efficiency of the
exam assignment and/or allocation process and/or the exam review
process. In some examples, it is determined if a priority flag has
been set for a medical exam. If a priority flag has been set, the
medical exam is moved to the top of the radiologist's workflow
(e.g., so that the medical exam will be conducted prior to other
medical exams in the workflow). If there is a service level
agreement associated with the medical exam, examples described
herein determine if there is sufficient time to perform the medical
exam before the expiry of the time period defined in the service
level agreement. If there is not sufficient time to perform the
medical exam, the medical exam is moved to the top of the
radiologist's workflow. If there is a relative value unit score
associated with the medical exam, examples described herein
determine if the experience level of the radiologist is sufficient
for the relative value unit score of the medical exam. For example,
a medical exam with a particular relative value unit score may
require the exam to be performed by a practitioner with a
particular level of experience. If the experience level of the
assigned and/or allocation radiologist is not sufficient for the
relative value unit score of the medical exam, an assignment and/or
allocation flag for the radiologist is removed so that the medical
exam is removed from the radiologist's workflow. The medical exam
can then be assigned and/or allocated to another radiologist.
[0041] In some examples, a radiologist assigns an available medical
exam to himself. For example, a radiologist can view all unassigned
and/or unallocated medical exams and select a particular medical
exam he wishes to perform. Examples described herein assign the
exam to the radiologist, set an assignment flag, and move the
selected medical exam to the radiologist's workflow. Examples
described herein determine if the queue length of the radiologist's
workflow exceeds a threshold queue length (e.g., it is determined
if the newly selected medical exam causes the workflow to be too
long). If the queue length of the radiologist's workflow exceeds
the threshold queue length, examples described herein determine the
medical exam in the workflow that has the lowest allocation score
(e.g., using the allocation scorecards). The assignment and/or
allocation flag is removed for the medical exam with the lowest
allocation score, and the medical exam is removed from the
radiologist's workflow.
[0042] In other examples, after applying one or more of the
load-balancing rules, the exam distributor 102 automatically
delivers an exam to a radiologist who is online and accessing the
system in real-time rather than delivering the exam to the
radiologist's work queue. For example, a radiologist can select to
receive exams to review in real-time such that the exam distributor
assigns the radiologist an exam based on the load-balancing rules;
the exam is presented for review via, for example, a reading tool
accessible via the user interface; and the radiologist reviews the
exam immediately or substantially immediately upon receiving the
exam via the reading tool, without the exam being queued in the
radiologist workflow for review at a later time. Thus, the exam
distributor 102 provides for flexibility in exam review by
delivering an exam to the radiologist's work queue for later review
or by providing substantially immediate access to the assigned exam
by auto-serving the exams to the radiologist.
[0043] FIG. 1 shows a block diagram of an example healthcare system
100 capable of implementing an example medical exam distributor
102. The example medical exam distributor 102 enables efficient
assignment and/or allocation of medical exams to radiologists and
management of radiologist workflows.
[0044] The example exam distributor 102 includes an example
assignment manager 104 and an example allocation manager 106. The
example assignment manager 104 controls assignments of medical
exams to radiologists. Exams are assigned to radiologists when
radiologists select themselves or other radiologists to conduct the
medical exams. The example allocation manager 106 controls
allocations of medical exams to radiologists. Exams are allocated
to radiologists when the exams have not been assigned by a
radiologist, and are to be automatically allotted to a
radiologist.
[0045] When a medical exam is assigned and/or allocated to a
radiologist, the example medical exam distributor 102 adds the
medical exam to a workflow associated with the radiologist. A
radiologist workflow includes a listing of medical exams to be
conducted by a radiologist, and an order in which the exams are to
be conducted. The radiologist workflow indicates what medical exams
have been assigned to the radiologist and what medical exams have
been allocated to the radiologist.
[0046] In operation, new medical exams 108 are ordered to be
conducted for a plurality of patients. The example assignment
manager 104 determines if any of the new medical exams 108 are to
be assigned to particular radiologists. New medical exams 108 will
be assigned to particular radiologists when a user makes a
selection of a medical exam and a selection of a particular
radiologist. If one of the new medical exams 108 is to be assigned
to a particular radiologist, the example assignment manager adds
the medical exam to the radiologist's workflow.
[0047] Medical exams that are not assigned to radiologists are
backlog exams 110. The example backlog exams 110 are stored by exam
type and/or characteristic (e.g., by location, specialty,
sub-specialty, modality, body part, etc.). The example allocation
manager 106 automatically allocates the backlog exams 110 to
radiologists based on the exam type and/or characteristic(s). The
example allocation manager 106 uses the exam characteristic(s) to
determine radiologists that best match the exams. When one of the
backlog exams 110 is allocated to a radiologist by the example
allocation manager 106, the exam is added to the radiologist's
workflow.
[0048] The illustrated example includes a first radiologist
workflow 112 and a second radiologist workflow 114. The example
first radiologist workflow 112 includes first assigned exams 116,
first allocated exams 118, and a first work queue 120. The first
assigned exams 116 show exams assigned by the example assignment
manager 104 to Radiologist 1 (e.g., Exam 2). The first allocated
exams 118 show exams allocated by the example allocation manager
106 to Radiologist 1 (e.g., Exam 1 and Exam 3). The first work
queue 120 shows the listing of exams to be conducted by Radiologist
1 (e.g., Exam 1, then Exam 2, then Exam 3).
[0049] The example second radiologist workflow 114 includes second
assigned exams 122, second allocated exams 124, and a second work
queue 126. The second assigned exams 122 show exams assigned by the
example assignment manager 104 to Radiologist 2 (e.g., Exam 5). The
second allocated exams 124 show exams allocated by the example
allocation manager 106 to Radiologist 2 (e.g., Exam 4). The second
work queue 126 shows the listing of exams to be conducted by
Radiologist 2 (e.g., Exam 4, then Exam 5).
[0050] FIG. 2 shows a block diagram of an example healthcare system
200 capable of implementing the example medical exam distributor
102 of FIG. 1. The example healthcare system 200 includes the
example medical exam distributor 102, a hospital information system
(HIS) 204, a radiology information system (RIS) 206, a picture
archiving and communication system (PACS) 208, an interface unit
210, a data center 212, and a workstation 214. In the illustrated
example, the HIS 204, the RIS 206, and the PACS 208 are housed in a
healthcare facility and locally archived. However, in other
implementations, the HIS 204, the RIS 206, and/or the PACS 208 can
be housed one or more other suitable locations. In certain
implementations, one or more of the PACS 208, RIS 206, HIS 204,
etc., can be implemented remotely via a thin client and/or
downloadable software solution. Furthermore, one or more components
of the healthcare system 200 can be combined and/or implemented
together. For example, the RIS 206 and/or the PACS 208 can be
integrated with the HIS 204; the PACS 208 can be integrated with
the RIS 206; and/or the three example information systems 204, 206,
and/or 208 can be integrated together. In other example
implementations, the healthcare system 200 includes a subset of the
illustrated information systems 204, 206, and/or 208. For example,
the healthcare system 200 can include only one or two of the HIS
204, the RIS 206, and/or the PACS 208. Information (e.g.,
scheduling, test results, observations, diagnosis, etc.) can be
entered into the HIS 204, the RIS 206, and/or the PACS 208 by
healthcare practitioners (e.g., radiologists, physicians, and/or
technicians) before and/or after patient examination. In some
examples, the medical exam distributor 202 is located in the RIS
206. In some examples, the example medical exam distributor 202 is
located separately or is included in any other suitable device of
the healthcare system 200.
[0051] The HIS 204 stores medical information such as clinical
reports, patient information, and/or administrative information
received from, for example, personnel at a hospital, clinic, and/or
a physician's office. The RIS 206 stores information such as, for
example, radiology reports, messages, warnings, alerts, patient
scheduling information, patient demographic data, patient tracking
information, and/or physician and patient status monitors.
Additionally, the RIS 206 enables exam order entry (e.g., ordering
an x-ray of a patient) and image and film tracking (e.g., tracking
identities of one or more people that have checked out a film). In
some examples, information in the RIS 206 is formatted according to
the HL-7 (Health Level Seven) clinical communication protocol.
[0052] The PACS 208 stores medical images (e.g., x-rays, scans,
three-dimensional renderings, etc.) as, for example, digital images
in a database or registry. In some examples, the medical images are
stored in the PACS 208 using the Digital Imaging and Communications
in Medicine ("DICOM") format. Images are stored in the PACS 208 by
healthcare practitioners (e.g., imaging technicians, physicians,
radiologists) after a medical imaging of a patient and/or are
automatically transmitted from medical imaging devices to the PACS
208 for storage. In some examples, the PACS 208 can also include a
display device and/or viewing workstation to enable a healthcare
practitioner or provider to communicate with the PACS 208.
[0053] The interface unit 210 includes a hospital information
system interface connection 216, a radiology information system
interface connection 218, a PACS interface connection 220, and a
data center interface connection 222. The interface unit 210
facilities communication among the HIS 204, the RIS 206, the PACS
208, and/or the data center 212. The interface connections 216,
218, 220, and 222 can be implemented by, for example, a Wide Area
Network ("WAN") such as a private network or the Internet.
[0054] Accordingly, the interface unit 210 includes one or more
communication components such as, for example, an Ethernet device,
an asynchronous transfer mode ("ATM") device, an 802.11 device, a
DSL modem, a cable modem, a cellular modem, etc. In turn, the data
center 212 communicates with the workstation 214, via a network
224, implemented at a plurality of locations (e.g., a hospital,
clinic, doctor's office, other medical office, or terminal, etc.).
The network 224 is implemented by, for example, the Internet, an
intranet, a private network, a wired or wireless Local Area
Network, and/or a wired or wireless Wide Area Network. In some
examples, the interface unit 210 also includes a broker (e.g., a
Mitra Imaging's PACS Broker) to allow medical information and
medical images to be transmitted together and stored together.
[0055] The interface unit 210 receives images, medical reports,
administrative information, and/or other clinical information from
the information systems 204, 206, 208 via the interface connections
216, 218, 220. If necessary (e.g., when different formats of the
received information are incompatible), the interface unit 210
translates or reformats (e.g., into Structured Query Language
("SQL") or standard text) the medical information, such as medical
reports, to be properly stored at the data center 212. The
reformatted medical information can be transmitted using a
transmission protocol to enable different medical information to
share common identification elements, such as a patient name or
social security number. Next, the interface unit 210 transmits the
medical information to the data center 212 via the data center
interface connection 222. Finally, medical information is stored in
the data center 212 in, for example, the DICOM format, which
enables medical images and corresponding medical information to be
transmitted and stored together.
[0056] The medical information is later viewable and easily
retrievable at the workstation 114 (e.g., by their common
identification element, such as a patient name or record number).
The workstation 214 can be any equipment (e.g., a personal
computer) capable of executing software that permits electronic
data (e.g., medical reports) and/or electronic medical images
(e.g., x-rays, ultrasounds, MRI scans, etc.) to be acquired,
stored, or transmitted for viewing and operation. The workstation
214 receives commands and/or other input from a user via, for
example, a keyboard, mouse, track ball, microphone, etc. The
workstation 214 is capable of implementing a user interface 226 to
enable a healthcare practitioner to interact with the healthcare
system 200. For example, in response to a request from a physician,
the user interface 226 presents a patient medical history.
[0057] The example data center 212 of FIG. 1 is an archive to store
information such as, for example, images, data, medical reports,
and/or, more generally, patient medical records. In addition, the
data center 212 can also serve as a central conduit to information
located at other sources such as, for example, local archives,
hospital information systems/radiology information systems (e.g.,
the HIS 204 and/or the RIS 206), or medical imaging/storage systems
(e.g., the PACS 208 and/or connected imaging modalities). That is,
the data center 212 can store links or indicators (e.g.,
identification numbers, patient names, or record numbers) to
information. In the illustrated example, the data center 212 is
managed by an application server provider ("ASP") and is located in
a centralized location that can be accessed by a plurality of
systems and facilities (e.g., hospitals, clinics, doctor's offices,
other medical offices, and/or terminals). In some examples, the
data center 212 can be spatially distant from the HIS 204, the RIS
206, and/or the PACS 208 (e.g., at General Electric.RTM.
headquarters).
[0058] The example data center 212 of FIG. 2 includes a server 228,
a database 230, and a record organizer 232. The server 228
receives, processes, and conveys information to and from the
components of the healthcare system 200. The database 230 stores
the medical information described herein and provides access
thereto. The example record organizer 232 of FIG. 2 manages patient
medical histories, for example. The record organizer 232 can also
assist in procedure scheduling, for example.
[0059] In many examples, a medical exam are ordered for a patient
(e.g., via the user interface 226 at the workstation 214), and the
medical exam is assigned to a practitioner (e.g., a radiologist) to
conduct the exam. A radiologist may have a workflow comprising one
or more medical exams to be conducted and an order in which the one
or more medical exams are to be conducted. The example medical exam
distributor 102 enables efficient assignment and/or allocation of
medical exams to radiologists and management of radiologist
workflows.
[0060] To enable efficient assignment and/or allocation of medical
exams, the example medical exam distributor 102 creates one or more
profiles for each radiologist capable of being assigned to a
medical exam to be conducted. A radiologist profile identifies a
radiologist, an experience level of the radiologist (e.g., a
resident, an attending, etc.), a specialty associated with the
radiologist (e.g., emergency, pediatrics, etc.), a modality
preferred by the radiologist (e.g., a computed tomography (CT)
scan, a magnetic resonance imaging (MRI) exam, etc.), and/or a body
part preferred by the radiologist (e.g., abdomen, chest, etc.). A
radiologist profile also identifies days and/or times during which
the radiologist practices with the preferred specialty, modality,
and/or body part. A radiologist profile also identifies locations
at which the radiologist practices the preferred specialty,
modality, and/or body part. In some examples, multiple profiles are
created for a radiologist. For example, if a radiologist works at
different locations, and/or works on different specialties,
modalities, and/or body parts at different days and/or times, a
profile is created for the radiologist for each location, each day,
and/or each time.
[0061] The radiologist profiles are used by the example medical
exam distributor 102 to assign and/or allocate medical exams and/or
manage radiologist workflows. As used herein, an assignment of a
medical exam refers to a selection of a practitioner to conduct a
medical exam. For example, a radiologist can select to assign a
medical exam to himself or to assign a medical exam to another
radiologist. A selection to assign a radiologist to a medical exam
can be made, for example, via the user interface 226. If an
assignment of a medical exam is made, the example medical exam
distributor 102 moves the medical exam to a workflow of the
assigned radiologist.
[0062] As used herein, an allocation of a medical exam refers to an
automatic assignment of a medical exam to a practitioner by the
example medical exam distributor 102 without user input. For
example, if a medical exam has not been assigned to a radiologist
(e.g., by a user), the example medical exam distributor 102
determines a radiologist to whom the medical exam is to be
allocated. To allocate a medical exam, the example medical exam
distributor 102 identifies exam characteristics of the medical
exam. Exam characteristics include, for example, location,
experience level, specialty, modality, and/or body part associated
with the medical exam to be allocated. The example medical exam
distributor 102 uses the exam characteristics and the radiologist
profiles to determine a radiologist that best matches the medical
exam to be allocated.
[0063] To determine a best match for the medical exam to be
allocated, the example medical exam distributor 102 determines an
allocation score for each available radiologist for the medical
exam. To determine an allocation score, the example medical exam
distributor 102 assigns point values for each characteristic
associated with a radiologist that matches a characteristic of the
medical exam. For example, if the medical exam is at a location
that is the same as the radiologist, the radiologist is assigned
and/or allocated a location point value. If an experience level
associated with the medical exam (e.g., an experience level needed
by a practitioner to conduct the medical exam) is the same as an
experience level of the radiologist, the radiologist is assigned
and/or allocated an experience point value. If a specialty
associated with the medical exam is the same as a specialty
associated with the radiologist, the radiologist is assigned and/or
allocated a specialty point value. If a modality associated with
the medical exam is the same as a modality associated with the
radiologist, the radiologist is assigned and/or allocated a
modality point value. If a body part associated with the medical
exam is the same as a body part associated with the radiologist,
the radiologist is assigned and/or allocated a body part point
value. The example medical exam distributor 102 totals the point
values assigned and/or allocated to the radiologist to determine
the overall allocation score. The example medical exam distributor
102 determines allocation scores for each available radiologist so
that the allocation scores can be compared.
[0064] The example medical exam distributor 102 determines the
available radiologist with the highest overall allocation score and
allocates the medical exam to the radiologist with the highest
overall allocation score. The example medical exam distributor 102
facilitates user assignment of medical exams and/or automatic
allocation of medical exams. The example medical exam distributor
102 enables efficient management of practitioner workflows.
[0065] Flowcharts representative of example machine readable
instructions for implementing the example campaign manager 102 of
FIG. 1 are shown in FIGS. 3, 4, 5, 6, 7, 8, and/or 9. In these
examples, the machine readable instructions comprise programs for
execution by a processor such as the processor 1312 shown in the
example processor platform 1300 discussed below in connection with
FIG. 13. The programs can be embodied in software stored on a
tangible computer readable storage medium such as a CD-ROM, a
floppy disk, a hard drive, a digital versatile disk (DVD), a
Blu-ray disk, or a memory associated with the processor 1312, but
the entire programs and/or parts thereof could alternatively be
executed by a device other than the processor 1312 and/or embodied
in firmware or dedicated hardware. Further, although the example
programs are described with reference to the flowcharts illustrated
in FIGS. 3, 4, 5, 6, 7, 8, and/or 9, many other methods of
implementing the example campaign manager 102 can alternatively be
used. For example, the order of execution of the blocks can be
changed, and/or some of the blocks described can be changed,
eliminated, or combined.
[0066] As mentioned above, the example processes of FIGS. 3, 4, 5,
6, 7, 8, and/or 9 can be implemented using coded instructions
(e.g., computer and/or machine readable instructions) stored on a
tangible computer readable storage medium such as a hard disk
drive, a flash memory, a read-only memory (ROM), a compact disk
(CD), a digital versatile disk (DVD), a cache, a random-access
memory (RAM) and/or any other storage device or storage disk in
which information is stored for any duration (e.g., for extended
time periods, permanently, for brief instances, for temporarily
buffering, and/or for caching of the information). As used herein,
the term tangible computer readable storage medium is expressly
defined to include any type of computer readable storage device
and/or storage disk and to exclude propagating signals and
transmission media. As used herein, "tangible computer readable
storage medium" and "tangible machine readable storage medium" are
used interchangeably. Additionally or alternatively, the example
processes of FIGS. 3, 4, 5, 6, 7, 8, and/or 9 can be implemented
using coded instructions (e.g., computer and/or machine readable
instructions) stored on a non-transitory computer and/or machine
readable medium such as a hard disk drive, a flash memory, a
read-only memory, a compact disk, a digital versatile disk, a
cache, a random-access memory and/or any other storage device or
storage disk in which information is stored for any duration (e.g.,
for extended time periods, permanently, for brief instances, for
temporarily buffering, and/or for caching of the information). As
used herein, the term non-transitory computer readable medium is
expressly defined to include any type of computer readable storage
device and/or storage disk and to exclude propagating signals and
transmission media. As used herein, when the phrase "at least" is
used as the transition term in a preamble of a claim, it is
open-ended in the same manner as the term "comprising" is open
ended.
[0067] FIG. 3 is a flow diagram illustrating an example method for
creating radiologist profiles and/or other identifying information
for particular radiologists at the example medical exam distributor
102 of FIGS. 1 and/or 2. Profiles are created for radiologists to
be used by the example exam distributor 102 to assign and/or
allocate medical exams. Initially, the example medical exam
distributor 102 determines if a new radiologist profile is to be
created (block 302). A new radiologist profile can be created, for
example, when the example medical exam distributor 102 is initially
implemented, when a new radiologist is employed, when a radiologist
has a new schedule, etc. A radiologist can create a new profile
using the example medical exam distributor 102 via, for example,
the user interface 226 of FIG. 2. Control remains at block 302
until a new radiologist profile is to be created.
[0068] When a new radiologist profile is to be created, a
radiologist for the profile is identified (block 304). An
experience level of the radiologist is then identified (block 306).
An experience level may be, for example, a number of years the
radiologist has been practicing and/or a title indicative of the
experience level such as a resident, an intern, an attending, etc.
A specialty, modality and/or body part preferred by the radiologist
are identified (block 308). A specialty preferred by the
radiologist may be, for example, pediatrics, emergency, etc. A
modality preferred by the radiologist may be, for example, a
computed tomography (CT) scan, a magnetic resonance imaging (MRI)
exam, etc. A body part preferred by a radiologist may be, for
example, an abdomen, a chest, etc. Identifying a specialty,
modality and/or body part preferred by the radiologist allows the
example medical exam distributor 102 to assign and/or allocate
exams to the radiologist that the radiologist may possess increased
skills in performing.
[0069] Days and/or times during which the radiologist practices
with the preferred specialty, modality, and/or body part are also
identified (block 310). For example, a radiologist may work in an
emergency department on Mondays and Tuesdays, and may work in a
pediatrics department on Wednesdays, Thursdays, and Fridays.
Locations at which the radiologist practices the preferred
specialty, modality, and/or body part are also identified (block
312). For example, a radiologist may work at Hospital A on Mondays
and Tuesdays, and may work at Hospital B on Wednesdays, Thursdays,
and Fridays. Identifying times, days, and/or locations during which
the radiologist is associated with particular medical areas enables
the example medical exam distributor 102 to efficiently assign
and/or allocate medical exams.
[0070] The example medical exam distributor 102 creates a profile
for the radiologist using the identified information (block 314).
The example medical exam distributor 102 stores the profile and
creates a visual representation of the profile for viewing at, for
example, the user interface 226.
[0071] The example medical exam distributor 102 determines if a
related profile is to be created for the radiologist (block 316).
In some examples, multiple profiles are created for a radiologist.
For example, if a radiologist works at different locations, and/or
works on different specialties, modalities, and/or body parts at
different days and/or times, a profile can be created for the
radiologist for each location, each day, and/or each time. If a
related profile is to be created, control returns to block 308
where a specialty, modality, and/or body part, and a time, day,
and/or location are identified to be associated with the
radiologist in a new profile. If a related profile is not to be
created, control returns to block 302.
[0072] FIG. 4 is a flow diagram illustrating an example method for
initiating use of the example medical exam distributor 102 of FIGS.
1 and/or 2. The example medical exam distributor 102 enables a user
to define distribution rules to be used in assigning and/or
allocating medical exams. Distribution rules include queue length
rules, matching rules, priority rules, and/or more generally,
load-balancing rules defining parameters for exam distribution
based on exam and radiologist attributes. Initially, a queue length
rule is defined to specify a length of a radiologist workflow
(block 402). For example, a queue length rule defines that a
radiologist workflow comprises a queue length of five (e.g., a
maximum of five exams may be assigned and/or allocated to a
radiologist at one time).
[0073] Matching rules and point values are then defined (block
404). In some examples, matching rules define how radiologists are
to be matched with a medical exam to be distributed by the example
medical exam distributor 102. A medical exam to be distributed can
be associated with a specialty, a modality, and/or a body part, for
example. In some examples, a matching rule defines that a
radiologist is to be matched with a medical exam when a specialty
associated with the radiologist matches a specialty associated with
the medical exam, when a modality associated with the radiologist
matches a modality associated with the medical exam, and/or when a
body part associated with the radiologist matches a body part
associated with the medical exam, for example. Instead of or in
addition to a radiologist specialty, a radiologist's experience
with a certain type of exam (e.g., number of exams of the type
read, number of hours spent reviewing the type of exam, etc.) can
be a factor in matching, for example. Matching rules also define
point values associated with a specialty match, a modality match,
and/or a body part match. Point values are used to weight the
matching process so that, for example, a match in a specialty is
given more weight than a match in a body part. For example, a match
between a specialty associated with a radiologist and a specialty
associated with a medical exam may afford the radiologist ten (10)
points. A match between a modality associated with a radiologist
and a modality associated with a medical exam may afford the
radiologist five (5) points. A match between a body part associated
with a radiologist and a body part associated with a medical exam
may afford the radiologist two (2) points.
[0074] Priority rules are then defined (block 406). In some
examples, a priority rule defines that a medical exam marked with a
priority flag is to be moved to a top position or queue of a
radiologist workflow by the example medical exam distributor 102
such that the radiologist will conduct the medical exam before
conducting other medical exams. For example, a radiologist can
determine that a medical exam is urgent and mark the exam with a
priority flag. The example medical exam distributor 102 the moves
the medical exam to the top of the radiologist workflow. The
example method of FIG. 4 then ends.
[0075] In some examples, additional load-balancing rules are
defined for distributing exams (block 408). Such additional
load-balancing rules can be customized based on needs and/or goals
of the healthcare institution. For example, load-balancing rules
are used by the example medical exam distributor 102 to increase
the efficiency of the exam assignment and/or allocation process
and/or the exam review process. In some examples, a load-balancing
rule is used to increase a likelihood that a service level
agreement associated with a patient and/or a healthcare provider is
met. For example, a service level agreement can include a length of
time during which a medical exam is to be conducted. In such an
example, a load-balancing rule defines that if the length of time
during which a medical exam is to be conducted is approaching
(e.g., within a threshold amount of time), the example medical exam
distributor 102 is to escalate the medical exam and move the
medical exam to the top of a radiologist workflow. For example, if
a medical exam is to be conducted within one hour to maintain the
time constraints of a service level agreement, the example medical
exam distributor 102 moves the medical exam to a top position or
queue of a radiologist workflow such that the radiologist will
conduct the medical exam before conducting other medical exams.
[0076] In some examples, a load-balancing rule is used to increase
a likelihood that a radiologist with sufficient experience is
assigned to a medical exam associated with a relative value unit
score. A relative value unit (RVU) score is a measure of value for
practitioner services. A relative value unit score may be
associated with a level of experience of a radiologist. For
example, a medical exam with a high relative value unit score may
be a more difficult exam to conduct and, thus, a more experienced
radiologist is to conduct the exam. In some examples, a
load-balancing rule defines that the example medical exam
distributor is to remove a medical exam from a radiologist workflow
if the radiologist does not have sufficient experience to conduct
the medical exam based on a relative value unit score of the
medical exam. Additional load-balancing rules can be defined based
on network, institutional, and/or cross-intuitional workflow
targets.
[0077] FIG. 5 illustrates a flow diagram illustrating an example
method for assigning a radiologist at the example medical exam
distributor 102 of FIGS. 1 and/or 2. Initially, the example medical
exam distributor 102 determines if a radiology exam is to be
examined (block 502). Control remains at block 502 until a
radiology exam is ready to be examined. The example medical exam
distributor 102 then determines if a radiologist assignment has
been received (block 504). For example, when a medical exam is to
be examined, a practitioner (e.g., an attending) can assign the
medical exam to another radiologist (e.g., a resident). If a
radiologist assignment has not been received, control proceeds to
block 522, and the example medical exam distributor 102 allocates
the medical exam to a radiologist (e.g., the system automatically
selects a radiologist and moves the medical exam to the selected
radiologist's workflow) (block 522). An example method to allocate
a medical exam is discussed below in connection with FIG. 6.
[0078] If a radiologist assignment has been received, the example
medical exam distributor 102 determines if the radiologist is
available to examine the medical exam using, for example, the
profile of the assigned radiologist (block 506). For example, if
the profile of the radiologist specifies that the radiologist is at
Hospital A, and the medical exam to be assigned is at Hospital B,
the radiologist is not available to be assigned to the medical
exam.
[0079] If the radiologist is available, the example medical exam
distributor 102 assigns the medical exam to the radiologist (block
508). The example medical exam distributor 102 notifies the
radiologist of the exam assignment and determines if the
radiologist has accepted the exam assignment (block 510).
[0080] If the radiologist declines the assignment, the medical exam
is assigned to another radiologist (block 504). If the medical exam
is not assigned to another radiologist (e.g., if a practitioner
does not select another radiologist to take the exam), the example
medical exam distributor 102 allocates the medical exam to a
radiologist (block 522). In certain examples, the radiologist to
whom the exam is allocated is the same radiologist who refused the
assignment.
[0081] If the radiologist accepts the exam assignment, the example
medical exam distributor sets an assignment flag (block 512) and
moves the medical exam to the radiologist's workflow (block 514).
Moving the medical exam to the radiologist's workflow removes the
medical exam from the group of medical exams that have not yet been
assigned and/or allocated to a radiologist. The assigned medical
exam will be visible in the radiologist's workflow to enable the
radiologist to conduct the exam when the assigned medical exam is
at the top of the workflow queue.
[0082] If the radiologist is not available, the assigning
practitioner specifies whether to wait till the desired radiologist
is available to assign the medical exam to the desired radiologist
(block 516). If the assigning practitioner wishes to wait till the
desired radiologist is available, the example medical exam
distributor 102 sets a waiting flag (block 518), and monitors the
availability of the desired radiologist (block 520). Once the
desired radiologist is available (block 506), the example medical
exam distributor 102 assigns the desired radiologist to the medical
exam (block 508). If the assigning practitioner does not wish to
wait till the desired radiologist is available (block 516), the
example medical exam distributor 102 allocates the medical exam to
another radiologist (e.g., the system automatically selects a
radiologist and moves the medical exam to the selected
radiologist's workflow) (block 522). Control then returns to block
502 to determine if another radiology exam is to be examined.
[0083] FIG. 6 illustrates a flow diagram illustrating an example
method for allocating a radiologist at the example medical exam
distributor 102 of FIGS. 1 and/or 2. Initially, the example medical
exam distributor 102 determines if there is a medical exam that has
not been assigned and/or has not been allocated (block 602). For
example, a medical exam is to be allocated to a radiologist when
the medical exam has not been assigned by a practitioner to a
radiologist, and has not yet been automatically assigned to a
radiologist. Control remains at block 602 until there is an
unallocated and/or unassigned exam.
[0084] Once there is an unallocated and/or unassigned exam, the
example medical exam distributor 102 identifies exam
characteristics of the medical exam to be allocated (block 604).
Exam characteristics include, for example, location, experience
level, specialty, modality, and/or body part associated with the
medical exam to be allocated. The example medical exam distributor
102 identifies available radiologists (block 606). The example
medical exam distributor 102 identifies available radiologist using
radiologist profiles (e.g., if the radiologist is at the same
location as the medical exam to be allocated, the radiologist is
available to perform the medical exam). In some examples, a
radiologist indicates that he is available or not available (e.g.,
using a status indicator via the example user interface 226 of FIG.
2). For example, the radiologist can indicate that he is
unavailable to perform medical exams if he is currently conducting
a medical exam, if he is scheduled to attend a meeting, etc. Once
the example medical exam distributor 102 determines the available
radiologists (e.g., radiologists capable of performing the medical
exam to be allocated), the example medical exam distributor 102
determines allocation scores for the available radiologists (block
608). The example medical exam distributor 102 uses the matching
rules and point values defined using, for example, the method of
FIG. 4 to calculate allocations scores to determine a radiologist
that best matches the medical exam to be allocated. An example
method to determine an allocation score is described below in
connection with FIG. 7.
[0085] To compare allocations scores for available radiologists and
determines the best match, the example medical exam distributor 102
prepares scorecards for each of the available radiologists using
the allocation scores (block 610). Example scorecards identify the
radiologist, the overall allocation score of the radiologist, and
each of the point values allocated to the radiologist that make up
the overall allocation score (e.g., points allocated to the
radiologist for the location, experience level, specialty,
modality, and/or body part). The scorecards can be viewed by a
practitioner (e.g., via the user interface 226 of FIG. 2) to see
how well a radiologist matches a medical exam to be allocated. An
example scorecard is illustrated in FIG. 11.
[0086] The example medical exam distributor 102 determines the
available radiologist with the highest allocation score (block
612). The example medical exam distributor 102 determines if more
than one radiologist has the highest allocation score (e.g., if
there was a tie between allocation scores) (block 614). If a
particular radiologist has the highest allocation score (e.g., a
single allocation score is the highest allocation score), the
example medical exam distributor 102 allocates the medical exam to
the radiologist with the highest allocation score (block 618). If
more than one radiologist has the highest allocation score (e.g.,
if there is a tie between allocation scores), the example medical
exam distributor 102 determines the radiologist with the highest
allocation score and the shortest workflow queue length (block
616). For example, a first and a second radiologist may both obtain
an allocation score of twelve, but the first radiologist may have a
queue length of three while the second radiologist has a queue
length of four. The example medical exam distributor 102 allocates
the medical exam to the radiologist with the highest allocation
score and the shortest workflow queue length (e.g., the first
radiologist) (block 618) so that the medical exam will be examined
more quickly than if the medical exam was allocated to a
radiologist with a longer queue length.
[0087] The example medical exam distributor 102 then determines if
the exam allocation has been accepted by the radiologist (block
620). If the radiologist accepts the allocation of the medical
exam, the example medical exam distributor 102 sets an allocation
flag (block 622) In some examples, the example medical exam
distributor 102 optionally applies any remaining relevant
load-balancing rules to determine if any changes are to be made to
the exam allocation and/or the radiologist workflow to facilitate
compliance with hospital standards, to meet efficiency goals,
and/or to respond to user feedback (block 624). An example method
for applying load-balancing rules is described below in connection
with FIG. 8. The example medical exam distributor 102 moves the
medical exam to the radiologist's workflow (block 626). Moving the
medical exam to the radiologist's workflow enables the radiologist
to conduct the medical exam when the medical exam reaches the top
of the workflow queue.
[0088] If the radiologist declines the allocation of the medical
exam (block 620), the example medical exam distributor 102 records
an allocation rejection entry for the radiologist (block 628). The
example medical exam distributor 102 maintains logs of rejections
of exam allocations by radiologists so that a practitioner or
administrator can review such rejections. For example, if a
radiologist is declining numerous exam allocations and/or a
particular type of exam allocation, a practitioner (e.g., an
attending) may wish to review this information (e.g., so that the
practitioner may intervene). Control then returns to block 602 to
determine if another medical exam has yet to be assigned and/or
allocated.
[0089] FIG. 7 illustrates a flow diagram illustrating an example
method for determining allocation scores at the example medical
exam distributor 102 of FIGS. 1 and/or 2. To determine a best match
for a medical exam to be allocated, the example medical exam
distributor 102 determines an allocation score for each available
radiologist for the medical exam. Initially, the example medical
exam distributor 102 identifies an available radiologist and a
medical exam to be allocated (e.g., using the method of FIG. 6)
(block 702). To determine an allocation score, the example medical
exam distributor 102 assigns point values for each characteristic
associated with a radiologist that matches a characteristic of the
medical exam to be allocated. The example medical exam distributor
102 determines if the medical exam is at a location that is the
same as the radiologist (block 704). If the medical exam is not at
a location that is the same as the radiologist, control proceeds to
block 708. If the medical exam is at a location that is the same as
the radiologist, the example medical exam distributor 102 assigns
and/or allocates a location point value to the radiologist (e.g.,
which has been previously defined using the method of FIG. 4)
(block 706).
[0090] The example medical exam distributor 102 determines if an
experience level associated with the medical exam (e.g., an
experience level needed by a practitioner to conduct the medical
exam) is the same as an experience level of the radiologist (block
708). If the experience level associated with the medical exam is
not the same as an experience level of the radiologist, control
proceeds to block 712. If the experience level associated with the
medical exam is the same as an experience level of the radiologist,
the example medical exam distributor 102 assigns and/or allocates
an experience point value to the radiologist (block 710).
[0091] The example medical exam distributor 102 determines if a
specialty associated with the medical exam is the same as a
specialty associated with the radiologist (block 712). If the
specialty associated with the medical exam is not the same as a
specialty associated with the radiologist, control proceeds to
block 716. If the specialty associated with the medical exam is the
same as a specialty associated with the radiologist, the example
medical exam distributor 102 assigns and/or allocates a specialty
point value to the radiologist (block 714).
[0092] The example medical exam distributor 102 determines if a
modality associated with the medical exam is the same as a modality
associated with the radiologist (block 716). If a modality
associated with the medical exam is not the same as a modality
associated with the radiologist, control proceeds to block 720. If
a modality associated with the medical exam is the same as a
modality associated with the radiologist, the example medical exam
distributor 102 assigns and/or allocates a modality point value to
the radiologist (block 718).
[0093] The example medical exam distributor 102 determines if a
body part associated with the medical exam is the same as a body
part associated with the radiologist (block 720). If a body part
associated with the medical exam is not the same as a body part
associated with the radiologist, control proceeds to block 724. If
a body part associated with the medical exam is the same as a body
part associated with the radiologist, the example medical exam
distributor 102 assigns and/or allocates a body part point value to
the radiologist (block 722).
[0094] The example medical exam distributor 102 totals the point
values assigned and/or allocated to the radiologist to determine
the overall allocation score (block 724). The example medical exam
distributor 102 determines if there is another available
radiologist for whom to determine an allocation score (block 726).
The example medical exam distributor 102 determines allocation
scores for each available radiologist so that the allocation scores
can be compared and a best match for the medical exam can be
determined. If there is another available radiologist, control
returns to block 702, and the radiologist is examined. If there is
not another available radiologist, the example method of FIG. 7
ends.
[0095] FIG. 8 illustrates a flow diagram illustrating an example
method for applying load-balancing rules at the example medical
exam distributor 102 of FIGS. 1 and/or 2. In some examples,
load-balancing rules are applied to distribute an exam to a
radiologist. In other examples, as shown in FIG. 8, the
load-balancing rules are applied and/or reapplied once a medical
exam has been assigned and/or allocated to a radiologist as part
of, for example, ongoing monitoring and optimization of the exam
distribution by the exam distributor 102. In some examples,
load-balancing rules are used to increase the efficiency of the
exam assignment and/or allocation process and/or the exam review
process. For example, if a radiologist is interrupted such that his
workstation is idle for a period of time and/or his work queue is
increasing, the exam distributor 102 automatically re-evaluates the
distribution of exams and applies the load-balancing to, for
example, prioritize an exam in the radiologist's work queue and/or
assign an exam to another radiologist.
[0096] Initially, the example medical exam distributor 102 accesses
the medical exam and the assigned and/or allocated radiologist
(block 802). The example medical exam distributor 102 determines if
a priority flag has been set for the medical exam (block 804). If a
priority flag has not been set, control proceeds to block 808. If a
priority flag has been set, the example medical exam distributor
102 moves the medical exam to the top of the radiologist's workflow
(e.g., so that the medical exam will be conducted prior to other
medical exams in the workflow) (block 806).
[0097] The example medical exam distributor 102 determines if there
is a service level agreement associated with the medical exam
(block 808). If there is not a service level agreement associated
with the medical exam, control proceeds to block 814. If there is a
service level agreement associated with the medical exam, the
example medical exam distributor 102 determines if there is
sufficient time to perform the medical exam before the expiry of
the time period defined in the service level agreement (e.g., if
the time to perform the exam review is less than a threshold)
(block 810). If there is sufficient time to perform the medical
exam, control proceeds to block 814. If there is not sufficient
time to perform the medical exam, the example medical exam
distributor 102 moves the medical exam to the top of the
radiologist's workflow (block 812).
[0098] The example medical exam distributor 102 determines if there
is a relative value unit score associated with the medical exam
(block 814). If there is not a relative value unit score associated
with the medical exam, the example method of FIG. 8 ends. If there
is a relative value unit score associated with the medical exam,
the example medical exam distributor 102 determines if an
experience level of the radiologist is sufficient for the relative
value unit score of the medical exam (block 816). For example, a
medical exam with a particular relative value unit score may
require the exam to be performed by a practitioner with a
particular level of experience. If the experience level of the
assigned and/or allocated radiologist is sufficient for the
relative value unit score, the example method of FIG. 8 ends. If
the experience level of the assigned and/or allocated radiologist
is not sufficient for the relative value unit score of the medical
exam, the example medical exam distributor 102 removes the
assignment and/or allocation flag for the radiologist (block 818)
and removes the medical exam from the radiologist's workflow (block
820). The medical exam is then be assigned and/or allocated to
another radiologist. The example method of FIG. 8 then ends.
[0099] FIG. 9 illustrates a flow diagram illustrating another
example method for assigning a radiologist at the example medical
exam distributor 102 of FIGS. 1 and/or 2. In some examples, a
radiologist assigns an available medical exam to himself.
Initially, the example medical exam distributor 102 determines if a
selection has been made by a user to view available exams (e.g.,
exams that have not yet been allocated and/or assigned) (block
902). Control remains at block 902 until a selection to view
available exams has been made.
[0100] Once a user has selected to view available exams, the
example medical exam distributor 102 collects medical exams that
have not yet been assigned and/or allocated (block 904). The
example medical exam distributor 102 displays the available medical
exams for the user via, for example, the user interface 226 of FIG.
2. The example medical exam distributor 102 determines if a user
has selected an available medical exam for assignment (block 908).
If the user does not select an exam for assignment, control returns
to block 902. If a user selects an available exam for assignment,
the example medical exam distributor 102 assigns the exam to the
selecting radiologist (block 910).
[0101] The example medical exam distributor 102 sets an assignment
flag (block 912) and moves the medical exam to the radiologist's
workflow (block 914).
[0102] The example medical exam distributor 102 determines if a
queue length of the radiologist's workflow exceeds a threshold
queue length (e.g., it is determined if the newly selected medical
exam causes the workflow to be too long) (block 916). If the queue
length of the radiologist's workflow exceeds the threshold queue
length (e.g., which can be defined using the example method of FIG.
4), the example medical exam distributor determines the medical
exam in the workflow that has the lowest allocation score (e.g.,
using the allocation scorecards) (block 918). The example medical
exam distributor removes the assignment and/or allocation flag for
the medical exam with the lowest allocation score (block 920), and
removes the medical exam from the radiologist's workflow (block
924). The removed medical exam can then be assigned and/or
allocated to another radiologist. Control then returns to block
902.
[0103] In operation, a radiologist accesses a medical exam workflow
via, for example, a user interface (e.g., the user interface 226 of
FIG. 2) at a workstation (e.g., the workstation 214 of FIG. 2). The
medical exam workflow includes a work queue of medical exams for
the radiologist to perform. The medical exams in the work queue are
assigned and/or allocated to the radiologist by the example medical
exam distributor 102.
[0104] For example, a medical exam in the work queue may have been
assigned to the radiologist by himself. In such an example, the
radiologist accessed a listing of available medical exams (e.g.,
medical exams not yet assigned and/or allocated to a radiologist),
determined a medical exam the radiologist would like to perform,
and then selected the medical exam. Once the radiologist selected
the medical exam, the example medical exam distributor 102 assigned
the medical exam to the radiologist, and moved the medical exam to
the radiologist's workflow. The example medical exam distributor
102 provides an indication in the workflow that this medical exam
has been assigned to the radiologist.
[0105] In some examples, a medical exam in the work queue was
assigned to the radiologist by another radiologist (e.g., a
supervisor). In such an example, the supervisor accessed a listing
of available medical exams (e.g., medical exams not yet assigned
and/or allocated to a radiologist), determined a medical exam and
radiologist the supervisor would like to assign, and then selected
the medical exam and the radiologist to perform the exam. Once the
supervisor selected the medical exam, the example medical exam
distributor 102 assigned the medical exam to the radiologist, and
moved the medical exam to the radiologist's workflow. The example
medical exam distributor 102 provides an indication in the workflow
that this medical exam has been assigned to the radiologist, who
assigned the medical exam, etc. In some examples, a medical exam in
the work queue was allocated to the radiologist by the example
medical exam distributor 102. In such an example, the medical exam
distributor 102 accessed an available medical exam and determined a
radiologist that would best match the medical exam. To determine
the best match, the example medical exam distributor 102 compared
characteristics of the medical exam (e.g., location, experience
level preferred, specialty, modality, body part, etc.) with
profiles of available radiologists (e.g., which specify location of
the radiologists, experience level of the radiologists, and
specialties, modalities, and/or body parts preferred by the
radiologists). The example medical exam distributor 102 assigned
allocation scores to the available radiologists based on how well
the exam characteristics match the radiologist profiles and
allocated the medical exam to the radiologist with the highest
score. The example medical exam distributor 102 moved the medical
exam to the workflow of the radiologist with the highest allocation
score. The radiologist (or other practitioner) can view the
radiologist scores (e.g., via a scorecard interface) to see how
and/or why the medical exam was allocated to the radiologist (e.g.,
the scores obtained by the radiologist illustrating that the
radiologist was the best match for the medical exam).
[0106] In some examples, the radiologist can view the assigned
and/or allocated medical exam and determine that he does not wish
to accept the assignment and/or allocation. If the radiologist
rejects the assignment and/or allocation of the medical exam, the
example medical exam distributor 102 removes the medical exam from
the radiologist's workflow, and assigns and/or allocates the
medical exam to another radiologist. If the radiologist rejects the
assignment and/or allocation of the medical exam, the example
medical exam distributor 102 logs an entry of the exam rejection so
that the radiologist's exam rejection activity can be monitored
(e.g., by the supervisor).
[0107] In some examples, a medical exam is moved to a top position
in the radiologist's workflow by the example medical exam
distributor 102. For example, if the medical exam distributor 102
determines that a medical exam is a priority, the example medical
exam distributor 102 moves the medical exam to the top of the
radiologist's workflow such that the radiologist will conduct the
medical exam when the radiologist exam becomes available (e.g.,
when the radiologist finishes an exam he is currently conducting).
The example medical exam distributor 102 automatically prioritizes
the radiologist's workflow without manipulation by the radiologist
(e.g., the radiologist is not required to monitor the priority of
medical exams in his workflow).
[0108] The example medical exam distributor 102 enables a
radiologist to easily view and control a medical exam workflow.
Using the example medical exam distributor 102, the radiologist can
see what medical exams have been assigned to the radiologist, what
exams have been allocated to the radiologist, why exam have been
allocated to the radiologist, what exams have priority and are to
be conducted before other exams, etc.
[0109] FIG. 10 illustrates an example interface 1000 created by the
example medical exam distributor 102 of FIGS. 1 and/or 2. The
example medical exam distributor 102 prepares the example interface
1000 to provide a user with a listing of medical exams and statuses
associated with those medical exams (e.g., whether the exams have
been assigned and/or allocated).
[0110] In the illustrated example, the example interface 1000
includes a listing of example patients 1002 and associated medical
exams 1004. For example, Patient 2 is associated with Exam 2,
indicating that Exam 2 is to be conducted by a radiologist on
Patient 2. The example interface 1000 includes example assignment
status indicators 1006, example allocation status indicators 1008,
and example queue status indicators 1010. In the illustrated
example, the assignment status indicators 1006 are used to indicate
if an exam has been assigned to a radiologist. The example
allocation status indicators 1008 are used to indicate if an exam
has been allocated to a radiologist. The example queue status
indicators 1010 are used to indicate if an exam has reached a top
position of a workflow queue of a radiologist (e.g., indicating
that the exam will be performed next). The example interface 1000
also includes a listing of radiologists 1012 that have been
assigned and/or allocated to an exam.
[0111] In the illustrated example, Exam 2 has been assigned to
Radiologist 2, and Exam 4 has been allocated to Radiologist 1 by
the example medical exam distributor 102. Exam 4 is also at the top
of the workflow associated with Radiologist 1 such that Radiologist
1 will perform the Exam 4 when the Radiologist 1 becomes available.
In some examples, Exam 4 is selected to allow a user to view
scorecards illustrating how the example medical exam distributor
102 determined the allocation of the Exam 4. An example scorecard
interface is illustrated in FIG. 11.
[0112] FIG. 11 illustrates an example interface 1100 created by the
example medical exam distributor 102 of FIGS. 1 and/or 2. The
example interface 1100 illustrates example scorecards for a
plurality of radiologists 1102 for the allocation of Exam 4 of FIG.
10. The example interface 1100 illustrates experience level point
values 1104, specialty point values 1106, modality point values
1108, body part point values 1110, and total point values 1112
assigned to the plurality of radiologists 1102 during the medical
exam allocation process for the Exam 4 to be allocated. The example
medical exam distributor 102 allocates the Exam 4 to Radiologist 1
because Radiologist 1 has the highest total point value 1112 for
the plurality of radiologists 1102.
[0113] FIG. 12 shows a block diagram of the example medical exam
distributor 102 of FIGS. 1 and/or 2. The example medical exam
distributor 102 enables efficient assignment and/or allocation of
medical exams to practitioners (e.g., radiologists) and management
of practitioner workflows. The example medical exam distributor 102
of FIG. 12 includes an example user input 1202, an example database
1204, an example display 1206, an example profile creator 1208, an
example rules creator 1210, the example assignment manager 104 of
FIG. 1, and the example allocation manager 106 of FIG. 1.
[0114] The example database 1204 receives stores exam information,
including patient and physician information, as well as information
associated with the exam distributor 102, including, for example,
radiologist profiles and load-balancing rules. In some examples,
the database 1204 stores information associated with exams and
radiologists at a healthcare institution, such as a hospital. In
other examples, the database 1204 receives and stores exam and
radiologist information for more than one healthcare institution.
For example, several institutions (e.g., hospitals, outpatient
facilities, etc.) may affiliate with respect to exam distribution
and review such that a patient is examined at a first institution
and a radiologist at a second institution is assigned to review the
exam. In such examples, the database 1204 stores identifying
information associated with the institution where the exam was
performed to assist in the cross-enterprise distribution of
exams.
[0115] The example profile creator 1208 creates profiles for
radiologists to be used to assign and/or allocate medical exams to
radiologists. The example profile creator 1208 receives input from
a user via the example user input 1202 to identify a radiologist,
an experience level of the radiologist (e.g., a resident, an
attending, etc.), a specialty associated with the radiologist
(e.g., emergency, pediatrics, etc.), a modality preferred by the
radiologist (e.g., a computed tomography (CT) scan, a magnetic
resonance imaging (MRI) exam, etc.), and/or a body part preferred
by the radiologist (e.g., abdomen, chest, etc.). A radiologist
profile also identifies days and/or times during which the
radiologist practices with the preferred specialty, modality,
and/or body part. For example, a radiologist may work in an
emergency department on Mondays and Tuesdays, and may work in a
pediatrics department on Wednesdays, Thursdays, and Fridays. A
radiologist profile may also identify locations at which the
radiologist practices the preferred specialty, modality, and/or
body part. For example, a radiologist may work at Hospital A on
Mondays and Tuesdays, and may work at Hospital B on Wednesdays,
Thursdays, and Fridays. In some examples, the example profile
creator 1208 creates multiple profiles for a radiologist. For
example, if a radiologist works at different locations, and/or
works on different specialties, modalities, and/or body parts at
different days and/or times, the example profile creator 1208
creates a profile for the radiologist for each location, each day,
and/or each time. The example profile creator 1208 stores the
radiologist profiles at the example database 1204.
[0116] The example rules creator 1210 defines distribution rules to
enable the assignment and/or allocation of medical exams. The
example rules creator 1210 receives input from a user via the
example user input 1202 to define the distribution rules. In some
examples, automatic and/or default distribution rules are used by
the example rules creator 1210. Also, in examples where the exams
are received from more than one institution, the rules creator 1210
performs a mapping of identifiers associated with the exams and/or
the healthcare institutions to standardize exam distribution
between institutions. For example, factors such as exam modality,
body part, radiologist specialty, and/or institution location are
considered by the rules creator as part of defining load-balancing
rules. Such mapping across affiliated institutions provides for
consistency in applying the load-balancing rules and benchmarks for
comparing workload information between radiologists at different
institutions.
[0117] Distribution rules include queue length rules, matching
rules, priority rules, and/or other load-balancing rules defined by
exam and/or radiologist attributes. In some examples, a queue
length rule defines a length of a radiologist workflow. For
example, a queue length rule defines that a radiologist workflow
comprises a queue length of five (e.g., a maximum of five exams may
be assigned and/or allocated to a radiologist at one time).
[0118] In some examples, matching rules define how radiologists are
to be matched with a medical exam to be distributed. A medical exam
to be distributed is associated with a specialty, a modality,
and/or a body part. In some examples, a matching rule defines that
a radiologist is to be matched with a medical exam when a specialty
associated with the radiologist matches a specialty associated with
the medical exam, when a modality associated with the radiologist
matches a modality associated with the medical exam, and/or when a
body part associated with the radiologist matches a body part
associated with the medical exam. Matching rules also define point
values associated with a specialty match, a modality match, and/or
a body part match. Point values are used to weight the matching
process so that, for example, a match in a specialty is given more
weight than a match in a body part. For example, a match between a
specialty associated with a radiologist and a specialty associated
with a medical exam may afford the radiologist ten (10) points. A
match between a modality associated with a radiologist and a
modality associated with a medical exam may afford the radiologist
five (5) points. A match between a body part associated with a
radiologist and a body part associated with a medical exam may
afford the radiologist two (2) points.
[0119] In some examples, a priority rule defines that a medical
exam marked with a priority flag is to be moved to a top position
or queue of a radiologist workflow such that the radiologist will
conduct the medical exam before conducting other medical exams. For
example, a radiologist may determine that a medical exam is urgent
and mark the exam with a priority flag. The medical exam is then
moved to the top of the radiologist workflow. The distribution
rules defined by the example rules creator 1210 are stored at the
example database 1204.
[0120] In some examples, load-balancing rules are used to increase
the efficiency of the exam assignment and/or allocation process
and/or the exam review process. In some examples, a load-balancing
rule is used to increase a likelihood that a service level
agreement associated with a patient and/or a healthcare provider is
met. For example, a service level agreement can include a length of
time during which a medical exam is to be conducted. In such an
example, a load-balancing rule defines that if the length of time
during which a medical exam is to be conducted is approaching
(e.g., within a threshold amount of time), the medical exam is to
be escalated and moved to the top of a radiologist workflow. For
example, if a medical exam is to be conducted within one hour to
maintain the time constraints of a service level agreement, the
medical exam will be moved to a top position or queue of a
radiologist workflow such that the radiologist will conduct the
medical exam before conducting other medical exams.
[0121] In some examples, a load-balancing rule is used to increase
a likelihood that a radiologist with sufficient experience is
assigned to a medical exam associated with a relative value unit
score. A relative value unit (RVU) score is a measure of value for
practitioner services. A relative value unit score may be
associated with a level of experience of a radiologist. For
example, a medical exam with a high relative value unit score may
be a more difficult exam to conduct and, thus, a more experienced
radiologist is to conduct the exam. In some examples, a
load-balancing rule defines that a medical exam is to be removed
from a radiologist workflow if the radiologist does not have
sufficient experience to conduct the medical exam based on a
relative value unit score of the medical exam.
[0122] The example assignment manager 104 assigns medical exams to
radiologists automatically and/or in response to user input. In
some examples, the assignment manager 104 assigns exams
automatically based on the matching rules, the priority rules,
and/or, more generally, the load-balancing rules defined by the
rules creator 1210. In some examples, the automatic assignment is
based on a radiologist's schedule. For example, the example
assignment manager 104 determines if the assigned radiologist is
available to examine the medical exam using, for example, the
profile of the assigned radiologist stored at the example database
1204. For example, if the profile of the assigned radiologist
specifies that the radiologist is at Hospital A, and the medical
exam to be assigned is at Hospital B, the radiologist is not
available to be assigned to the medical exam. In some examples, a
radiologist indicates if he is available or not. If the radiologist
is available, the example assignment manager 104 assigns the
medical exam to the radiologist.
[0123] In some examples, the assignment manager 104 assigns the
exam to the examiner in response to instructions received from, for
example, the assigning practitioner. For example, if the preferred
radiologist is not available, the assigning practitioner specifies
whether to wait till the desired radiologist is available to assign
the medical exam to the desired radiologist or assigns the exam to
the offline radiologist. If the assigning practitioner wishes to
wait till the desired radiologist is available, the example
assignment manager sets a waiting flag, and monitors the
availability of the desired radiologist. Once available, the
example assignment manager 104 assigns the desired radiologist to
the medical exam. If the assigning practitioner does not wish to
wait till the desired radiologist is available, the example
allocation manager 106 allocates the medical exam to another
radiologist (e.g., the example allocation manager 106 automatically
selects a radiologist and moves the medical exam to the selected
radiologist's workflow). If the assigning practitioner prefers to
assign the exam to the offline radiologist, the assignment manager
104 assigns the medical exam to the radiologist in response to a
corresponding input from the assigning practitioner. Thus, the
assignment manager 104 responds to manual instructions provided by
an administrator.
[0124] In other examples, the assignment manager 104 assigns the
medical exam to a radiologist requested by a referring physician.
For example, a referring physician can request a radiologist based
on exam attributes, such as body part, modality, and/or difficulty
level, and/or based on a relationship with the specific
radiologist. In such examples, the exam distributor 102 assigns the
exam to the preferred radiologist. In other examples, the exam
distributor 102 applies the load-balancing rules to assign the exam
to another qualified radiologist if, for example, the preferred
radiologist is not available.
[0125] In some examples, the radiologist accepts the assignment
(e.g., via the user input 1202). If the radiologist accepts the
assignment of the medical exam, the example assignment manager 104
sets an assignment flag, and moves the medical exam to the
radiologist's workflow. In some examples, the radiologist declines
the assignment. For example, a radiologist may have a full workflow
and, thus, may not want to add the medical exam being assigned
(e.g., which may require removing another medical exam in the
radiologist's workflow). If the radiologist declines the
assignment, the example assignment manager 104 assigns the medical
exam to another radiologist (e.g., if a user selects another
radiologist for assignment). If the medical exam is not assigned to
another radiologist (e.g., if a practitioner does not select
another radiologist to take the exam), the example allocation
manager 106 allocates the medical exam to a radiologist.
[0126] In some examples, a radiologist assigns an available medical
exam to himself via the example user input 1202. For example, the
assignment manager 104 collects unassigned and/or unallocated exams
to be displayed for a radiologist via the example display 1206.
Unassigned and/or unallocated exams are stored at, for example, the
database 1204. The radiologist can view the medical exams and
select a particular medical exam he wishes to perform via the
example user input 1202. The example assignment manager 104 assigns
the exam to the radiologist, sets an assignment flag, and moves the
selected medical exam to the radiologist's workflow. The example
assignment manager 104 also determines if a queue length of the
radiologist's workflow exceeds a threshold queue length (e.g., it
is determined if the newly selected medical exam causes the
workflow to be too long). If the queue length of the radiologist's
workflow exceeds the threshold queue length, the example assignment
manager 104 determines the medical exam in the workflow that has
the lowest allocation score (e.g., using the allocation
scorecards). The example assignment manager 104 removes the
assignment and/or allocation flag for the medical exam with the
lowest allocation score, and removes the medical exam from the
radiologist's workflow.
[0127] In some examples, the assignment manager 104 reviews and
processes the assignment status of exams in response to a discrete
activity detected by the assignment manager, such as a new exam
received by the exam distributor 102 or a decision by a radiologist
to reject an exam assignment. In other examples, the assignment
manager 104 reviews the exams in a batch configuration. In such
examples, the assignment manager 104 applies the load-balancing
rules to one or more exams requiring review at predetermined
intervals such that exams are assigned and distributed in
batches.
[0128] The example allocation manager 106 allocates medical exams
to radiologists. For example, the allocation manager 106 allocates
a medical exam to a radiologist when the medical exam has not been
assigned by a practitioner to a radiologist, and has not yet been
automatically assigned to a radiologist. To allocate a medical
exam, the example allocation manager 106 identifies exam
characteristics of the medical exam. Exam characteristics include,
for example, location, experience level, specialty, modality,
and/or body part associated with the medical exam to be allocated.
The example allocation manager 106 identifies available
radiologists and uses the matching rules and point values to
determine a radiologist that best matches the medical exam to be
allocated.
[0129] To determine a best match for the medical exam to be
allocated, the example allocation manager 106 determines an
allocation score for each available radiologist for the medical
exam. To determine an allocation score, the example allocation
manager assigns point values for each characteristic associated
with a radiologist that matches a characteristic of the medical
exam. For example, if the medical exam is at a location that is the
same as the radiologist, the example allocation manager 106 assigns
and/or allocates a location point value (e.g., which has been
previously specified during the defining of the matching rules) to
the radiologist. If an experience level associated with the medical
exam (e.g., an experience level needed by a practitioner to conduct
the medical exam) is the same as an experience level of the
radiologist, the example allocation manager 106 assigns and/or
allocates an experience point value to the radiologist. If a
specialty associated with the medical exam is the same as a
specialty associated with the radiologist, the example allocation
manager 106 assigns and/or allocates a specialty point value to the
radiologist. If a modality associated with the medical exam is the
same as a modality associated with the radiologist, the example
allocation manager 106 assigns and/or allocates a modality point
value to the radiologist. If a body part associated with the
medical exam is the same as a body part associated with the
radiologist, the example allocation manager 106 assigns and/or
allocates a body part point value to the radiologist. The example
allocation manager 106 totals the point values assigned and/or
allocated to the radiologist to determine the overall allocation
score. The example allocation manager 106 determines allocation
scores for each available radiologist so that the allocation scores
can be compared.
[0130] To compare allocations scores for available radiologists,
the example allocation manager 106 prepares scorecards for each of
the available radiologists using the allocation scores. Example
scorecards identify the radiologist, the overall allocation score
of the radiologist, and each of the point values allocated to the
radiologist that make up the overall allocation score. The
scorecards can be viewed by a practitioner via the example display
1206 to see how well a radiologist matches a medical exam to be
allocated.
[0131] The example allocation manager 106 determines the available
radiologist with the highest allocation score. If a particular
radiologist has the highest allocation score (e.g., a single
allocation score is the highest allocation score), the example
allocation manager 106 allocates the medical exam to the
radiologist with the highest allocation score. If more than one
radiologist has the highest allocation score (e.g., if there is a
tie between allocation scores), the example allocation manager 106
determines the radiologist with the highest allocation score and
the shortest workflow queue length. For example, a first and a
second radiologist can both obtain an allocation score of twelve,
but the first radiologist may have a queue length of three while
the second radiologist has a queue length of four. The example
allocation manager 106 allocates the medical exam to the
radiologist with the highest allocation score and the shortest
workflow queue length (e.g., the first radiologist) so that the
medical exam will be examined more quickly than if the medical exam
was allocated to a radiologist with a longer queue length.
[0132] In some examples, a radiologist accepts or declines the
allocation of the medical exam via the example user input 1202. If
the radiologist accepts the allocation of the medical exam, the
example allocation manager 106 sets an allocation flag and moves
the medical exam to the radiologist's workflow. If the radiologist
declines the allocation of the medical exam, the example allocation
manager 106 records an allocation rejection entry for the
radiologist. The example allocation manager 106 maintains logs of
rejections of exam allocations by radiologists so that a
practitioner can review such rejections. For example, if a
radiologist is declining numerous exam allocations and/or a
particular type of exam allocation, a practitioner (e.g., an
attending) may wish to review this information (e.g., so that the
practitioner may intervene).
[0133] The example allocation manager 106 also applies
load-balancing rules once a medical exam has been assigned and/or
allocated to a radiologist. Load-balancing rules are used to
increase the efficiency of the exam assignment and/or allocation
process and/or the exam review process. In some examples, the
example allocation manager 106 determines if a priority flag has
been set for a medical exam. If a priority flag has been set, the
example allocation manager 106 moves the medical exam to the top of
the radiologist's workflow (e.g., so that the medical exam will be
conducted prior to other medical exams in the workflow). If there
is a service level agreement associated with the medical exam, the
example allocation manager 106 determines if there is sufficient
time to perform the medical exam before the expiry of the time
period defined in the service level agreement. If there is not
sufficient time to perform the medical exam, the example allocation
manager 106 moves the medical exam to the top of the radiologist's
workflow. If there is a relative value unit score associated with
the medical exam, the example allocation manager 106 determines if
the experience level of the radiologist is sufficient for the
relative value unit score of the medical exam. For example, a
medical exam with a particular relative value unit score may
require the exam to be performed by a practitioner with a
particular level of experience. If the experience level of the
assigned and/or allocation radiologist is not sufficient for the
relative value unit score of the medical exam, the example
allocation manager 106 removes an assignment and/or allocation flag
for the radiologist so that the medical exam is removed from the
radiologist's workflow. The medical exam can then be assigned
and/or allocated to another radiologist by the example assignment
manager 104 and/or the example allocation manager 106.
[0134] While an example manner of implementing the medical exam
distributor 102 of FIGS. 1 and/or 2 is illustrated in FIG. 12, one
or more of the elements, processes and/or devices illustrated in
FIG. 12 can be combined, divided, re-arranged, omitted, eliminated
and/or implemented in any other way. Further, the example user
input 1202, the example database 1204, the example display 1206,
the example profile creator 1208, the example rules creator 1210,
the example assignment manager 104, the example allocation manager
106, and/or, more generally, the example medical exam distributor
102 of FIG. 12 can be implemented by hardware, software, firmware
and/or any combination of hardware, software and/or firmware. Thus,
for example, any of the example user input 1202, the example
database 1204, the example display 1206, the example profile
creator 1208, the example rules creator 1210, the example
assignment manager 104, the example allocation manager 106, and/or,
more generally, the example medical exam distributor 102 could be
implemented by one or more analog or digital circuit(s), logic
circuits, programmable processor(s), application specific
integrated circuit(s) (ASIC(s)), programmable logic device(s)
(PLD(s)) and/or field programmable logic device(s) (FPLD(s)). When
reading any of the apparatus or system claims of this patent to
cover a purely software and/or firmware implementation, at least
one of the example user input 1202, the example database 1204, the
example display 1206, the example profile creator 1208, the example
rules creator 1210, the example assignment manager 104, the example
allocation manager 106, and/or, more generally, the example medical
exam distributor 102 is/are hereby expressly defined to include a
tangible computer readable storage device or storage disk such as a
memory, a digital versatile disk (DVD), a compact disk (CD), a
Blu-ray disk, etc. storing the software and/or firmware. Further
still, the example medical exam distributor 102 of FIG. 12 can
include one or more elements, processes and/or devices in addition
to, or instead of, those illustrated in FIG. 12, and/or can include
more than one of any or all of the illustrated elements, processes
and devices.
[0135] FIG. 13 is a block diagram of an example processor platform
1300 capable of executing the instructions of FIGS. 3, 4, 5, 6, 7,
8, and/or 9 to implement the example medical exam distributor 102
of FIGS. 1, 2, and/or 10. The processor platform 1300 can be, for
example, a server, a personal computer, a mobile device (e.g., a
cell phone, a smart phone, a tablet such as an iPad.TM.), a
personal digital assistant (PDA), an Internet appliance, a DVD
player, a CD player, a digital video recorder, a Blu-ray player, a
gaming console, a personal video recorder, a set top box, or any
other type of computing device.
[0136] The processor platform 1300 of the illustrated example
includes a processor 1312. The processor 1312 of the illustrated
example is hardware. For example, the processor 1312 can be
implemented by one or more integrated circuits, logic circuits,
microprocessors or controllers from any desired family or
manufacturer.
[0137] The processor 1312 of the illustrated example includes a
local memory 1313 (e.g., a cache). The processor 1312 of the
illustrated example is in communication with a main memory
including a volatile memory 1314 and a non-volatile memory 1316 via
a bus 1318. The volatile memory 1314 can be implemented by
Synchronous Dynamic Random Access Memory (SDRAM), Dynamic Random
Access Memory (DRAM), RAMBUS Dynamic Random Access Memory (RDRAM)
and/or any other type of random access memory device. The
non-volatile memory 1316 can be implemented by flash memory and/or
any other desired type of memory device. Access to the main memory
1314, 1316 is controlled by a memory controller.
[0138] The processor platform 1300 of the illustrated example also
includes an interface circuit 1320. The interface circuit 1320 can
be implemented by any type of interface standard, such as an
Ethernet interface, a universal serial bus (USB), and/or a PCI
express interface.
[0139] In the illustrated example, one or more input devices 1322
are connected to the interface circuit 1320. The input device(s)
1322 permit(s) a user to enter data and commands into the processor
1312. The input device(s) can be implemented by, for example, an
audio sensor, a microphone, a camera (still or video), a keyboard,
a button, a mouse, a touchscreen, a track-pad, a trackball,
isopoint and/or a voice recognition system.
[0140] One or more output devices 1324 are also connected to the
interface circuit 1320 of the illustrated example. The output
devices 1324 can be implemented, for example, by display devices
(e.g., a light emitting diode (LED), an organic light emitting
diode (OLED), a liquid crystal display, a cathode ray tube display
(CRT), a touchscreen, a tactile output device, a light emitting
diode (LED), a printer and/or speakers). The interface circuit 1320
of the illustrated example, thus, typically includes a graphics
driver card, a graphics driver chip or a graphics driver
processor.
[0141] The interface circuit 1320 of the illustrated example also
includes a communication device such as a transmitter, a receiver,
a transceiver, a modem and/or network interface card to facilitate
exchange of data with external machines (e.g., computing devices of
any kind) via a network 1326 (e.g., an Ethernet connection, a
digital subscriber line (DSL), a telephone line, coaxial cable, a
cellular telephone system, etc.).
[0142] The processor platform 1300 of the illustrated example also
includes one or more mass storage devices 1328 for storing software
and/or data. Examples of such mass storage devices 1328 include
floppy disk drives, hard drive disks, compact disk drives, Blu-ray
disk drives, RAID systems, and digital versatile disk (DVD)
drives.
[0143] The coded instructions 1332 of FIGS. 3, 4, 5, 6, 7, 8,
and/or 9 can be stored in the mass storage device 1328, in the
volatile memory 1314, in the non-volatile memory 1316, and/or on a
removable tangible computer readable storage medium such as a CD or
DVD.
[0144] Although certain example methods, apparatus and articles of
manufacture have been disclosed herein, the scope of coverage of
this patent is not limited thereto. On the contrary, this patent
covers all methods, apparatus and articles of manufacture fairly
falling within the scope of the claims of this patent.
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