U.S. patent application number 15/355296 was filed with the patent office on 2021-12-09 for pharmacy management and administration with bedside real-time medical event data collection.
The applicant listed for this patent is Millennium Pharmacy Systems, Inc.. Invention is credited to Andrew Jonathan Lister, Ronald Leo McKillip, Christopher Lee Miller, Garick George Newtzie, Joseph B. Poliseo, Lena Elizabeth Sturgeon, Suresh-Kumar Venkata Vishnubhatla.
Application Number | 20210382965 15/355296 |
Document ID | / |
Family ID | 1000005983344 |
Filed Date | 2021-12-09 |
United States Patent
Application |
20210382965 |
Kind Code |
A9 |
Vishnubhatla; Suresh-Kumar Venkata
; et al. |
December 9, 2021 |
PHARMACY MANAGEMENT AND ADMINISTRATION WITH BEDSIDE REAL-TIME
MEDICAL EVENT DATA COLLECTION
Abstract
Methods and systems for automatically establishing an enhanced
electronic health record (EHR) for a patient include an automatic
data collection facility that collects data of a medically related
event in proximity to a patient upon occurrence of the event. The
collected data may include medication administration data such as
medication, time of administration, administration of a dosage of
medication, reaction data, and the like. The collected data is
communicated to a real-time data integration facility that
automatically integrates the data with a patient's electronic
health record to establish an enhanced electronic health
record.
Inventors: |
Vishnubhatla; Suresh-Kumar
Venkata; (Wexford, PA) ; Sturgeon; Lena
Elizabeth; (Washington, PA) ; Miller; Christopher
Lee; (Mercer, PA) ; McKillip; Ronald Leo;
(Seward, PA) ; Lister; Andrew Jonathan; (South
Bend, IL) ; Newtzie; Garick George; (Mars, PA)
; Poliseo; Joseph B.; (Southampton, PA) |
|
Applicant: |
Name |
City |
State |
Country |
Type |
Millennium Pharmacy Systems, Inc. |
Oakbrook |
IL |
US |
|
|
Prior
Publication: |
|
Document Identifier |
Publication Date |
|
US 20170262614 A1 |
September 14, 2017 |
|
|
Family ID: |
1000005983344 |
Appl. No.: |
15/355296 |
Filed: |
November 18, 2016 |
Related U.S. Patent Documents
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Application
Number |
Filing Date |
Patent Number |
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13568017 |
Aug 6, 2012 |
9501624 |
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15355296 |
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12765681 |
Apr 22, 2010 |
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13568017 |
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61315775 |
Mar 19, 2010 |
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61171767 |
Apr 22, 2009 |
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Current U.S.
Class: |
1/1 |
Current CPC
Class: |
G16Z 99/00 20190201;
G06Q 40/08 20130101; G06Q 10/06 20130101; G16H 50/70 20180101; G06Q
50/22 20130101; G16H 20/13 20180101; G16H 50/20 20180101; G16H
10/60 20180101 |
International
Class: |
G06F 19/00 20110101
G06F019/00; G06Q 50/24 20120101 G06Q050/24; G06Q 50/22 20120101
G06Q050/22; G06Q 10/06 20120101 G06Q010/06 |
Claims
1. A system for automatically establishing an enhanced electronic
heath record for a patient, comprising: an automatic data
collection facility for collecting data of a medically-related
event in proximity to a patient upon the occurrence of the event,
wherein the data of the medically-related event comprises
medication administration data; and a real-time data integration
facility in electronic communication with the automatic data
collection facility for automatically integrating the data of a
medically-related event with a patient's electronic health record
to establish the enhanced electronic health record.
2. The system of claim 1, wherein the automatic data collection
facility is a machine reader.
3. The system of claim 2, wherein the machine reader is a bar code
reader.
4. The system of claim 1, wherein the system further comprises an
input facility adapted to prompt a user to input additional data of
the medically-related event.
5. The system of claim 1, wherein the medication administration
data includes at least one of medication, time of administration,
dosage, and reaction data.
6. The system of claim 1, wherein the enhanced electronic health
record includes prescription management data for a medication that
is identifiable by the medication administration data.
7. The system of claim 1, wherein the enhanced electronic health
record includes data representing a prescription for the medication
and medication delivery data.
8. The system of claim 1, wherein the enhanced electronic health
record includes data representing caregiver treatment outcome
data.
9. The system of claim 1, wherein the enhanced electronic health
record includes data representing real-time collected vitals pre
and post administration.
10. The system of claim 1, wherein the enhanced electronic health
record includes data representing outcome prediction and variance
from prediction.
11. The system of claim 1, wherein the enhanced electronic health
record includes data representing historical data.
12. The system of claim 1, wherein the enhanced electronic health
record includes data representing facility admission data.
13. The system of claim 1, where medication administration data
includes administration of a dosage of medication.
14. The system of claim 1, wherein the data collection facility is
a reader device in electronic communication with a medication
administration facility and wherein the reader reads electronically
readable information on a packaging of a dosage of medication.
15. The system of claim 1, further including a healthcare related
dashboard that is updated in real-time and contemporaneously with
establishing the enhanced electronic health record.
16.-86. (canceled)
87. A system for maintaining a health information dashboard,
comprising: an automatic data collection facility for collecting
data of a medically-related event in proximity to a patient upon
the occurrence of the event, wherein the data of the
medically-related event comprises medication administration data; a
real-time data integration facility in electronic communication
with the automatic data collection facility for automatically
integrating the data of a medically-related event into a data
repository; and a user interface for displaying data from the data
repository, the displayed data facilitating management of health
care administration.
88. The system of claim 87, wherein the data from the data
repository is patient attribute data.
89. The system of claim 88, wherein the patient attribute data
comprises at least one of: health condition data, patient physical
activity data, patient treatment data, patient outcome data and
patient psychological data.
90. The system of claim 87, wherein the data from the data
repository is the patient's prescription data.
91. The system of claim 87, wherein the data from the data
repository is the patient's validated prescription data.
92. The system of claim 87, wherein the data from the data
repository is the patient's prescription history data.
93. The system of claim 87, wherein the data from the data
repository is the patient's prescription substitution data.
94. The system of claim 87, wherein the data from the data
repository relates to time of medication administration.
95. The system of claim 87, wherein the data from the data
repository relates to frequency of administration of the
medication.
96. The system of claim 87, wherein the data from the data
repository relates to dosage of medication administered to the
patient.
97. The system of claim 87, wherein the data from the data
repository relates to medication that was prescribed but not
administered.
98. The system of claim 87, wherein the data from the data
repository relates to outcome data.
99. The system of claim 87, wherein the outcome data is at least
one of: patient's response to medication administration, measure of
the patient's health condition, improvement or worsening of the
patient's health condition, improvement or worsening of a symptom,
onset of new symptoms, degree of pain, degree of fatigue, physical
functioning, emotional distress and social role participation.
100. The system of claim 87, wherein management of health care
administration comprises management of health care administration
of a facility.
101. The system of claim 87, wherein management of health care
administration comprises management of health care administration
of care planning for a patient.
102. The system of claim 87, wherein management of health care
administration comprises management of health care administration
of care planning for a plurality of patients.
103. The system of claim 87, wherein management of health care
administration comprises management of health care administration
of facility planning.
104. The system of claim 87, wherein management of health care
administration comprises management of health care administration
of insurance planning.
105. The system of claim 87, wherein management of health care
administration comprises management of health care administration
of prescription writing.
106. The system of claim 87, wherein management of health care
administration comprises management of health care administration
of prescription management.
107. The system of claim 87, wherein management of health care
administration comprises management of health care administration
of pharma-related planning.
108. The system of claim 87, wherein management of health care
administration comprises management of health care administration
of regulatory compliance.
109. The system of claim 87, wherein management of health care
administration comprises management of health care administration
of use of third-party healthcare data management facilities.
110. The system of claim 87, wherein management of health care
administration comprises management of health care administration
of medication administration.
111. The system of claim 87, wherein the data repository is an
enhanced electronic health record of a patient.
112. The system of claim 87, wherein the user interface display is
updated with the data of a medically-related event
contemporaneously with integrating the data of a medically-related
event into a data repository.
113. The system of claim 87, wherein the user interface is
populated contemporaneously with capture of patient attributes and
events.
114.-120. (canceled)
121. A system for predicting a health-related outcome of a patient
with a health condition, comprising: an automatic data collection
facility for collecting data of a medically-related event in
proximity to a patient upon the occurrence of the event, wherein
data of the medically-related event comprises automatically
collected medication administration data and outcome data; a
real-time data integration facility in electronic communication
with the automatic data collection facility for automatically
integrating the data of a medically-related event into a data
repository; and a prediction facility in electronic communication
with the data repository utilizing the data of a medically-related
event for predicting the health-related outcome.
122. The system of claim 121, wherein the outcome data is the
patient's response to the medication.
123. The system of claim 121, wherein the outcome data is a measure
of the patient's health condition.
124. The system of claim 121, wherein the outcome data relates to
at least one of an improvement or worsening of the patient's health
condition.
125. The system of claim 121, wherein the outcome data relates to
at least one of an improvement or worsening of a symptom associated
with the patient's health condition.
126. The system of claim 121, wherein the outcome data relates to
onset of new symptoms associated with the patient's health
condition.
127. The system of claim 121, wherein the outcome data relates to
degree of pain associated with the patient.
128. The system of claim 121, wherein the outcome data relates to
degree of fatigue associated with the patient.
129. The system of claim 121, wherein the outcome data relate to
physical functioning associated with the patient.
130. The system of claim 121, wherein the outcome data relate to
emotional distress associated with the patient.
131. The system of claim 121, wherein the outcome data relate to
social role participation associated with the patient.
132. The system of claim 121, wherein the automatic data collection
collects data from a medication container contemporaneously with
the medically-related event.
133. The system of claim 121, wherein the data of a
medically-related event includes data for a medication that was
prescribed but not administered during the occurrence of the
event.
134. The system of claim 121, wherein the outcome data is the
patient's response to the medication.
135. The system of claim 121, wherein the outcome data is a measure
of the patient's health condition.
136. The system of claim 121, wherein the outcome data relates to
at least one of an improvement or worsening of the patient's health
condition.
137. The system of claim 121, further comprising an input facility
to enter other data of the medically-related event.
138. The system of claim 137, wherein the other data comprises
patient health condition data patient.
139. The system of claim 137, wherein the other data comprises
physical activity data.
140. The system of claim 137, wherein the other data comprises
patient treatment data.
141. The system of claim 137, wherein the other data comprises
patient oral consumption data.
142. The system of claim 137, wherein the other data comprises
patient visitor data.
143. The system of claim 137, wherein the other data comprises
patient psychological data.
144. The system of claim 137, wherein the other data comprises
caregiver observations.
145. The system of claim 121, wherein the data repository is an
enhanced electronic health record of the patient.
146. The system of claim 121, wherein predicting the health-related
outcome is based on medically-related event data for a plurality of
patients in the data repository.
147. The system of claim 146, wherein the data repository includes
a plurality of real-time electronically updated patient enhanced
electronic health records.
148. The system of claim 121, wherein the prediction facility is
for collecting and organizing the outcome data for facilitating
clinical outcome prediction.
149. The system of claim 121, wherein the data repository includes
individual patient outcome data collected in real-time from a
plurality of individual patients.
150. The system of claim 121, wherein the prediction facility is
server executing machine learning software.
151. The system of claim 121, wherein the prediction facility is an
analytic workbench for drawing inferences as to whether certain
data in the data repository has statistical significance in the
outcome data.
152. The system of claim 121, wherein the prediction facility uses
statistical analysis techniques selected from the list containing
regression analysis, iterative analysis, complex modeling,
multivariable analytics, Analysis of Variance (ANOVA), Chi-square
test, Correlation, Factor analysis, Mann-Whitney U, Mean square
weighted deviation (MSWD), Pearson product-moment correlation
coefficient, Regression analysis, Spearman's rank correlation
coefficient, Student's t-test, Time series analysis, Bootstrap
& Jackknife Resampling, Statistical classification, Statistical
surveys, Structured data analysis (statistics), Survival analysis,
Multivariate discriminant analysis, Linear discriminant analysis,
Cluster analysis and Principal component analysis.
153. The system of claim 121, wherein predicting the health-related
outcome includes weighting the outcome data.
154. The system of claim 153, wherein weighting the outcome data is
based on financial data associated with a medication identifiable
by the medication administration data.
155. The system of claim 121, wherein further including maintaining
a long term care plan for the patient based on the predicted
health-related outcome.
156. The system of claim 121, wherein further including
facilitating prescription management based on the predicted
health-related outcome.
157. The system of claim 121, wherein further including updating
prescription management business rules based on the predicted
health-related outcome.
158. The system of claim 121, wherein further including updating a
pharmaceutical-related plan based on the predicted health-related
outcome.
159. The system of claim 121, wherein further including
facilitating management of regulatory compliance based on the
predicted health-related outcome.
160. The system of claim 121, wherein further including
facilitating prescription writing based on the predicted
health-related outcome.
161. The system of claim 121, wherein further including
facilitating management of insurance planning based on the
predicted health-related outcome.
162. The system of claim 121, wherein further including
facilitating management of facility planning based on the predicted
health-related outcome.
163. The system of claim 121, wherein further including
facilitating management of care planning for a plurality of
patients based on the predicted health-related outcome.
164. The system of claim 121 wherein further including facilitating
health care administration for a facility based on the predicted
health-related outcome.
165. A method for predicting a health-related outcome of a patient
with a health condition, comprising: collecting data of a
medically-related event with an automatic data collection facility
in proximity to a patient upon the occurrence of the event, wherein
the data of the medically-related event comprises automatically
collected medication administration data and event outcome data;
integrating in real-time the data of the medically-related event
automatically into a data repository; and utilizing the data of the
medically-related event for predicting the health-related
outcome.
166. The method of claim 165, wherein collecting data of a
medically-related event includes collecting data from a medication
container contemporaneously with the medically-related event.
167. The method of claim 165, wherein the data of a
medically-related event includes data for a medication that was
prescribed but not administered during the occurrence of the
event.
168. The method of claim 165, wherein the outcome data is the
patient's response to the medication.
169. The method of claim 165, wherein the outcome data is a measure
of the patient's health condition.
170. The method of claim 165, wherein the outcome data relates to
at least one of an improvement or worsening of the patient's health
condition.
171. A method for predicting a health-related outcome of a patient
with a health condition, comprising: collecting data of a
medically-related event with an automatic data collection facility
in proximity to a patient upon the occurrence of the event, wherein
the data of the medically-related event comprises raw medication
administration data and raw event outcome data; transforming with a
processor the raw medication administration data and raw event
outcome data collected by the automatic data collection facility
into a format suitable for use in a medical information data
repository; integrating in real-time the data of the
medically-related event automatically into the data repository; and
utilizing the data of the medically-related event for predicting
the health-related outcome.
172.-191. (canceled)
Description
CROSS-REFERENCE TO RELATED APPLICATIONS
[0001] This application is a continuation of U.S. patent
application Ser. No. 13/568,017, filed Aug. 6, 2012
(MILL-0004-U01-V01) which is a divisional of U.S. patent
application Ser. No. 12/765,681, filed Apr. 22, 2010
(MILL-0004-U01). U.S. patent application Ser. No. 12/765,681 claims
priority to U.S. Provisional Patent Application Ser. No.
61/171,767, filed Apr. 22, 2009 and to U.S. Provisional Patent
Application Ser. No. 61/315,775 filed Mar. 19, 2010.
[0002] Each of the above applications is hereby incorporated by
reference in its entirety.
BACKGROUND OF THE INVENTION
[0003] Field
[0004] This invention relates to systems, methods, and devices for
automated ordering, dispensing, reporting, and billing of
medication and the associated reporting and documentation of the
administration of medication.
[0005] Description of the Related Art
[0006] A common scenario with respect to the ordering, dispensing,
reporting, billing and documentation of a prescribed medication
begins with a physician's handwritten order. This handwritten order
must be transmitted to the pharmacy; typically the order is faxed.
In other instances, the order can be entered into an electronic
computerized physician order entry system "CPOE". A person at the
pharmacy reviews the physician order and enters the order into the
pharmacy's order management system. This is also the case even
where the order is an electronic order such as like one entered
into a CPOE system. That is, some sort of manual data entry step
takes place to get the order into the pharmacy's order management
system. After the data is manually entered, the drug interaction
and allergy verification takes place, which may be performed by a
software application which is part of the CPOE system or the
pharmacy's order management system. Once the drug interaction and
allergy verification step is complete, the pharmacist approves the
order, which allows it to be filled, and then the drug is dispensed
and packaged.
[0007] A common way to dispense medications is in a 30 day or a 7
day supply. In long-term care and other institutional-like
settings, for example, dispensed medications are delivered to the
facility where they will be administered to the patient 150. If
there is a change to a patient's prescription during the 30 day
cycle, for example, for which the medication was dispensed, then
the unused medication must be returned or destroyed. This adds an
additional burden to facilities in that they must adhere to proper
destruction procedures, and document them accordingly. Dealing with
ordered medications which have been dispensed and delivered, but
which are no longer current, places a heavy financial burden on
payers, (e.g. health care facilities, insurance companies,
patients, and the like), and on the pharmacies because many times
they are paying for a supply of medications that the patient never
uses.
[0008] Regarding the administration of the medication, regulations
require that the administration of the medication must be
documented with a certain degree of specificity and accuracy.
Regulations also require a review of such documentation, for
example, on a periodic basis. The administration process is further
complicated by brand and generic drugs and multiple brands within
the generic medications. Accurate maintenance of the records
requires the prescriber, dispensing pharmacy, and the administering
system and personnel to be in sync with respect to the
identification of the medications.
[0009] Patient symptom gathering is another area of concern with
respect to the accuracy and validity of common practices. At
patient touch points, clinicians are often required to listen to a
patient describe symptoms and enter those symptoms in a structured
language that allows medical personnel to understand how the
clinician views the patient report of symptoms. This process
naturally introduces misinformation, clinician bias, information
gaps, and other factors that contribute to the recorded symptom
being different than that reported by the patient. Patients
generally report symptoms (e.g. side effects) related to an
administration of a medication sooner and with more specificity
than is often reported in clinical studies, and the like.
[0010] During a patient interview (e.g. office visit), symptoms may
not always be reported because clinicians and patients are
distracted from this activity by reviewing test results and the
like. Ensuring that accurate, patient generated symptom reports are
captured at least with each patient touch point may be a critical
deficiency in medical practice. Also, in a report authored by a
patient, the symptoms tend to be more accurately described than
when the same patient is interviewed (orally) by a clinician.
Ensuring accurate and timely side effect reporting may be critical
to proper and effective medication management.
[0011] It is therefore an object of the invention to address the
shortcomings described above, along with others that are apparent
in this disclosure.
SUMMARY OF THE INVENTION
[0012] In embodiments, methods and systems for automatically
establishing an enhanced electronic health record (EHR) for a
patient in accordance with various embodiments of the present
invention may be provided. In embodiments, methods and systems may
include an automatic data collection facility and a real-time data
integration facility. In embodiments, the automatic data collection
facility may collect data of a medically related event in proximity
to a patient upon occurrence of the event. The data of the
medically-related event may include medication administration data
such as medication, time of administration, administration of a
dosage of medication, reaction data, and the like. In embodiments,
the real-time data integration facility may be in electronic
communication with the automatic data collection facility. The
real-time data integration facility may automatically integrate the
data of a medically-related event with a patient's EHR to establish
the enhanced EHR.
[0013] In embodiments, the automatic data collection facility may
be a machine reader, a reader device, and the like. The machine
reader may also be a bar code reader. In embodiments, the reader
device may be in electronic communication with a medication
administration facility. The reader device may read electronically
readable information on packaging of the dosage of medication. In
embodiments, a healthcare-related dashboard may be updated in
real-time and contemporaneously with establishing the enhanced
EHR.
[0014] In embodiments, the methods and systems for automatically
establishing an enhanced electronic health record (EHR) for the
patient may include an input facility adapted to prompt a user to
input additional data of the medically-related event.
[0015] In embodiments, the enhanced EHR may include prescription
management data for a medication that may be identifiable by the
medication administration data. Further, the enhanced EHR data may
represent a prescription for the medication and medication delivery
data, a caregiver treatment outcome data, real-time collected
vitals pre and post administration, outcome prediction and variance
from prediction, historical data, facility admission data, and the
like.
[0016] In embodiments, methods and systems for automatically
establishing an enhanced electronic health record (EHR) for a
patient in accordance with various embodiments of the present
invention may be provided. In embodiments, methods and systems may
include an automatic data collection facility and a real-time data
integration facility. The automatic data collection facility may
collect data of a medically-related event in proximity to a patient
upon occurrence of the event. The data of the medically-related
event may include medication administration data, such as
medication, time of administration, administration of a dosage of
medication, reaction data, and the like. Further, the real-time
data integration facility may automatically integrate in real-time
the data of a medically-related event with a patient's EHR to
establish the enhanced EHR.
[0017] In embodiments, the automatic data collection facility may
be a machine reader, a reader device, and the like. The machine
reader may also be a bar code reader. In embodiments, the reader
device may be in electronic communication with a medication
administration facility. Further, the data collection may include
reading electronically readable information on a packaging of the
dosage of medication with the reader device.
[0018] In embodiments, the methods and systems for automatically
establishing an enhanced electronic health record (EHR) for the
patient may include prompting a user to input additional data of
the medically-related event with a user interface associated with
the data collection facility.
[0019] In embodiments, a healthcare-related dashboard with a
portion of the medically-related event data may be updated in
real-time and contemporaneously with establishing the enhanced
EHR.
[0020] In embodiments, methods and systems for automatically
establishing an enhanced electronic health record (EHR) for a
patient in accordance with various embodiments of the present
invention may be provided. In embodiments, methods and systems may
include collecting data of a medically-related event with an
automatic data collection facility in proximity to a patient upon
occurrence of the event. The data of the medically-related event
may include raw medication administration data, such as medication,
time of administration, administration of a dosage of medication,
reaction data, and the like. The raw medication data may also
include a bar code. In embodiments, the raw medication
administration data collected by the automatic data collection
facility may be transformed with a processor into a format that may
be suitable for use in an enhanced electronic healthcare database
record. Further, the real-data of a medically-related event may be
integrated in real-time with a patient's EHR to establish the
enhanced EHR.
[0021] In embodiments, the automatic data collection facility may
be a machine reader, a reader device, and the like. The machine
reader may also be a bar code reader. In embodiments, the reader
device may be in electronic communication with a medication
administration facility. Further, the data collection may include
reading electronically readable information on a packaging of the
dosage of medication with the reader device.
[0022] In embodiments, the methods and systems for automatically
establishing an enhanced electronic health record (EHR) for the
patient may include prompting a user to input additional data of
the medically-related event into a user interface associated with
the data collection facility.
[0023] In embodiments, a healthcare-related dashboard with a
portion of the medically-related event data may be updated in
real-time and contemporaneously with establishing the enhanced
EHR.
[0024] In embodiments, methods and systems for automatically
maintaining an enhanced electronic health record (EHR) in
accordance with various embodiments of the present invention may be
provided. In embodiments, methods and systems may include an
automatic data collection facility and a real-time data integration
facility. In embodiments, the automatic data collection facility
may collect data of a healthcare-related event in proximity to a
patient upon occurrence of the event. The data of the
healthcare-related event may include medication administration
data, such as medication, time of administration, administration of
a dosage of medication, reaction data, and the like. In
embodiments, the real-time data integration facility may be in
electronic communication with the automatic data collection
facility. The real-time data integration facility may automatically
integrate the data of a healthcare-related event with a patient's
EHR to maintain the enhanced EHR.
[0025] In embodiments, the automatic data collection facility may
be a machine reader, a reader device, and the like. The machine
reader may also be a bar code reader. In embodiments, the reader
device may be in electronic communication with a medication
administration facility. The reader device may read electronically
readable information on packaging of the dosage of medication.
[0026] In embodiments, the methods and systems for automatically
establishing an enhanced electronic health record (EHR) for the
patient may include an input facility adapted to prompt a user to
input additional data of the health-related event. In embodiments,
a healthcare-related dashboard that may be updated in real-time and
contemporaneously with establishing the enhanced EHR.
[0027] In embodiments, the enhanced EHR may include prescription
management data for a medication that may be identifiable by the
medication administration data. Further, the enhanced EHR data may
represent a prescription for the medication and medication delivery
data, a caregiver treatment outcome data, real-time collected
vitals pre and post administration, outcome prediction and variance
from prediction, historical data, facility admission data, and the
like.
[0028] In embodiments, methods and systems for automatically
maintaining an enhanced electronic health record (EHR) for a
patient in accordance with various embodiments of the present
invention may be provided. In embodiments, methods and systems may
collect data of a healthcare-related event with an automatic data
collection facility in proximity to a patient upon occurrence of
the event. The data of the healthcare-related event may include
medication administration data such as medication, time of
administration, administration of a dosage of medication, reaction
data, and the like. In embodiments, the data of a
healthcare-related event may be integrated in real-time with a
patient's EHR to maintain the enhanced EHR.
[0029] In embodiments, the automatic data collection facility may
be a machine reader, a reader device, and the like. The machine
reader may also be a bar code reader. In embodiments, the reader
device may be in electronic communication with a medication
administration facility. The reader device may read
electronically-readable information on packaging of the dosage of
medication.
[0030] In embodiments, the methods and systems for automatically
establishing an enhanced electronic health record (EHR) for the
patient may include prompting a user to input additional data of
the healthcare-related event. In embodiments, a healthcare-related
dashboard with a portion of the healthcare-related event data may
be updated in real-time and contemporaneously with establishing the
enhanced EHR.
[0031] In embodiments, methods and systems for automatically
maintaining an enhanced electronic health record (EHR) for a
patient in accordance with various embodiments of the present
invention may be provided. In embodiments, methods and systems may
collect data of a healthcare-related event with an automatic data
collection facility in proximity to a patient upon occurrence of
the event. The data of the healthcare-related event may include raw
medication administration data, such as medication, time of
administration, administration of a dosage of medication, reaction
data, and the like. The raw medication data may also include a bar
code. In embodiments, the raw medication administration data
collected by the automatic data collection facility may be
transformed with a processor into a format that may be suitable for
use in an enhanced electronic healthcare database record. Further,
the data of a healthcare-related event may be integrated in
real-time with a patient's EHR to maintain the enhanced EHR.
[0032] In embodiments, the automatic data collection facility may
be a machine reader, a reader device, and the like. The machine
reader may also be a bar code reader. In embodiments, the reader
device may be in electronic communication with a medication
administration facility. In embodiments, the data collection may
include reading electronically readable information on a packaging
of the dosage of medication with the reader device.
[0033] In embodiments, the methods and systems for automatically
establishing an enhanced electronic health record (EHR) for the
patient may include prompting a user to input additional data of
the healthcare-related event into a user interface with the data
collection facility. In embodiments, a healthcare-related dashboard
with a portion of the healthcare-related event data may be updated
in real-time and contemporaneously with establishing the enhanced
EHR.
[0034] In embodiments, methods and systems for automatically
establishing an enhanced electronic health record (EHR) for a
patient in accordance with various embodiments of the present
invention may be provided. In embodiments, methods and systems may
collect data of a medically-related event with an automatic data
collection facility in proximity to a patient upon occurrence of
the event. The data of the medically-related event may include
medication administration data and another type of data of the
medically-related event. In embodiments, the medication
administration data may be medication, time of administration,
administration of a dosage of medication, reaction data, and the
like. In embodiments, the other type of the medically-related event
may include patient health condition data, patient physical
activity data, patient treatment data, patient oral consumption
data; patient visitor data, patient outcome data, patient
psychological data, and the like. In embodiments, the patient
health condition data may include patient vital signs, patient
blood chemistry results, and the like. In embodiments, the patient
physical activity data may include patient position and movement
facilitated by a caregiver, patient sleep data, and the like. In
embodiments, the patient treatment data may include bathing,
dressing, wound care, bed position adjustment, physical therapy,
psychotherapy, patient position adjustment, and the like. In
embodiments the patient oral consumption data may represent foods
prepared for the patient and foods consumed by the patient, fluids
consumed by the patient, non-prescription medications consumed by
the patient, and the like. In embodiments, the patient
psychological data may be collected by observation of the patient
by a caregiver observing the patient
[0035] In embodiments, methods and systems for automatically
maintaining an enhanced electronic health record (EHR) for a
patient in accordance with various embodiments of the present
invention may be provided. In embodiments, methods and systems may
include an automatic data collection facility and a real-time data
integration facility. In embodiments, the automatic data collection
facility may collect data of a medically-related event in proximity
to a patient upon occurrence of the event. The data of the
medically-related event may include medication administration data
that may include patient identification data that may be collected
from a medication container contemporaneously with the
medically-related event. In embodiments, the real-time data
integration facility may be in electronic communication with the
automatic data collection facility. The real-time data integration
facility may automatically integrate the data of a
medically-related event with a patient's EHR to maintain the
enhanced EHR.
[0036] In embodiments, methods and systems for automatically
maintaining an enhanced electronic health record (EHR) for a
patient in accordance with various embodiments of the present
invention may be provided. In embodiments, methods and systems may
include collecting data of a medically-related event in proximity
to a patient upon occurrence of the event with an automatic data
collection facility. The data of the medically-related event may
include medication administration data that may include patient
identification data that may be collected from a medication
container contemporaneously with the medically-related event. In
embodiments, the data of a medically-related event may be
integrated in real-time automatically with a patient's EHR to
maintain the enhanced EHR.
[0037] In embodiments, methods and systems for automatically
maintaining an enhanced electronic health record (EHR) for a
patient in accordance with various embodiments of the present
invention may be provided. In embodiments, methods and systems may
collect data of a medically-related event with an automatic data
collection facility in proximity to a patient upon occurrence of
the event. The data of the healthcare-related event may include raw
medication administration data. The raw medication administration
data may include patient identification data that may be collected
from a medication container contemporaneously with the
medically-related event. In embodiments, the raw medication
administration data collected by the automatic data collection
facility may be transformed with a processor into a format that may
be suitable for use in an enhanced electronic healthcare database
record. Further, the data of a medically-related event may be
integrated in real-time automatically with a patient's EHR to
maintain the enhanced EHR.
[0038] In embodiments, methods and systems for automatically
maintaining an enhanced electronic health record (EHR) for a
patient in accordance with various embodiments of the present
invention may be provided. In embodiments, methods and systems may
include an automatic data collection facility and a real-time data
integration facility. In embodiments, the automatic data collection
facility may collect data of a medically-related event in proximity
to a patient upon occurrence of the event. The data of the
medically-related event may include medication administration data.
In embodiments, the data of the medically-related event may include
data for a medication that was prescribed but not administered
during the occurrence of the event. In embodiments, the real-time
data integration facility may be in electronic communication with
the automatic data collection facility. The real-time data
integration facility may automatically integrate the data of a
medically-related event with a patient's EHR to establish the
enhanced EHR.
[0039] In embodiments, methods and systems for automatically
maintaining an enhanced electronic health record (EHR) for a
patient in accordance with various embodiments of the present
invention may be provided. In embodiments, methods and systems may
collect data of a medically-related event with an automatic data
collection facility in proximity to a patient upon occurrence of
the event. The data of the medically-related event may include
medication administration data. In embodiments, the data of the
medically-related event may include data for a medication that was
prescribed but not administered during the occurrence of the event.
Further, the data of a medically-related event may be integrated in
real-time automatically with a patient's EHR to maintain the
enhanced EHR.
[0040] In embodiments, methods and systems for automatically
maintaining an enhanced electronic health record (EHR) for a
patient in accordance with various embodiments of the present
invention may be provided. In embodiments, methods and systems may
collect data of a medically-related event with an automatic data
collection facility in proximity to a patient upon occurrence of
the event. In embodiments, the medically-related event may be a
medication administration event. Further, the data of the
medically-related event may include a raw data for a medication
that was prescribed but not administered during the occurrence of
the event. In embodiments, the raw data for a medication collected
by the automatic data collection facility may be transformed with a
processor into a format that may be suitable for use in an enhanced
electronic healthcare database record. Further, the data of a
medically-related event may be integrated in real-time
automatically with a patient's EHR to maintain the enhanced
EHR.
[0041] In embodiments, methods and systems for maintaining a health
information dashboard in accordance with various embodiments of the
present invention may be provided. In embodiments, methods and
systems may include an automatic data collection facility, a
real-time data integration facility, and a user interface. In
embodiments, the automatic data collection facility may collect
data of a medically-related event in proximity to a patient upon
the occurrence of the event. The data of the medically-related
event may include medication administration data. In embodiments,
the real-time data integration facility in electronic communication
with the automatic data collection facility may automatically
integrate the data of a medically-related event into a data
repository. Further, the user interface may display data from the
data repository. In embodiments, the displayed data may facilitate
management of health care administration.
[0042] In embodiments, the user interface display may be updated
with the data of a medically-related event contemporaneously with
integrating the data of a medically-related event into a data
repository.
[0043] In embodiments, the data repository may be an enhanced
electronic health record of a patient. In embodiments, the data
from the data repository may include patient attribute data,
patient's prescription data, patient's validated prescription data,
patient's prescription history data, and prescription substitution
data. In embodiments, the data repository may relate to the time of
medication administration, frequency of administration of the
medication, dosage of medication administered to the patient,
medication that was prescribed but not administered, and outcome
data. The patient attribute data may include health condition data,
patient physical activity data, patient treatment data, patient
outcome data, and patient psychological data. In embodiments, the
outcome data may include a patient's response to the medication,
measure of the patient's health condition, improvement or worsening
of the patient's health condition, improvement or worsening of a
symptom, onset of new symptoms, degree of pain, degree of fatigue,
physical functioning, emotional distress and social role
participation, and the like.
[0044] In embodiments, the management of health care administration
may include management of health care administration of a facility,
management of health care administration of care planning for one
or more patients, management of health care administration of
facility planning, management of health care administration of
insurance planning, management of health care administration of
prescription writing, management of health care administration of
prescription management, management of health care administration
of pharma-related planning, management of health care
administration of regulatory compliance, management of health care
administration of use of third-party healthcare data management
facilities, management of health care administration of medication
administration, and the like.
[0045] In embodiments, methods and systems for maintaining a health
information dashboard in accordance with various embodiments of the
present invention may be provided. The methods and systems may
include collecting data of a medically-related event with an
automatic data collection facility in proximity to a patient upon
the occurrence of the event. In embodiments, the data of a
medically-related event may include medication administration data.
In embodiments, the data of the medically-related event may be
integrated in real-time automatically in to a data repository.
Further, dashboard of a user interface data may be displayed from
the data repository, the displayed data facilitating management of
health care administration.
[0046] In embodiments, methods and systems for maintaining a health
information dashboard in accordance with various embodiments of the
present invention may be provided. The methods and systems may
include collecting data of a medically-related event with an
automatic data collection facility in proximity to a patient upon
the occurrence of the event. In embodiments, the data of
medically-related event may include raw medication administration
data. In embodiments, the data of the medically-related event may
be integrated in real-time automatically in to a data repository.
Further, dashboard of a user interface data may be displayed from
the data repository, the displayed data facilitating management of
health care administration.
[0047] In embodiments, methods and systems including a dashboard
system to manage the prescribing and administration of medication
in accordance with various embodiments of the present invention may
be provided. In embodiments, a medication administrator records
(MAR) facility may be configured to access a database having
information from a reporting source therein. The reporting source
may include an automatic data collection facility for collecting
data of a medically-related event in proximity to a patient upon
the occurrence of the event. The data of medically-related event
may include medication administration data. Further, a user
selectable dashboard definer may be configured to provide user
selectable options for defining the information from the MAR
facility to be presented in a report at a dashboard. In
embodiments, a display definer may be configured to operate in
conjunction with the user selectable dashboard definer to define
the format in which the report from the MAR facility is to be
presented at a dashboard.
[0048] In embodiments, the MAR facility may be configured to
determine an ordered medication for a patient and medication may be
administered to a patient covered by the patient's insurance. The
aggregate covered and non-covered medications may be determined
into sets. Further, the report may be generated, in real-time,
regarding the sets. In embodiments, the communication with the
reporting source may be real-time. In embodiments, the dashboard
may generate a display based on the continuously received data. In
embodiments, the display may feature analysis and report tools.
[0049] In embodiments, methods and systems for predicting a
health-related outcome of a patient with a health condition in
accordance with various embodiments of the present invention may be
provided. The methods and systems may include an automatic data
collection facility, real-time data integration facility, a
prediction facility, and the like. In embodiments, the automatic
data collection facility may collect data of a medically-related
event in proximity to a patient upon the occurrence of the event.
The data of the medically-related event may include automatically
collected medication administration data and outcome data. In
embodiments, the real-time data integration facility in electronic
communication with the automatic data collection facility may
automatically integrate the data of a medically-related event into
a data repository. In embodiments, the prediction facility in
electronic communication with the data repository may utilize the
data of a medically-related event for predicting the health-related
outcome.
[0050] In embodiments, the outcome data may include the patient's
response to the medication, a measure of the patient's health
condition, and the like. In embodiments, the outcome data may
relate to an improvement or worsening of the patient's health
condition, an improvement or worsening of a symptom associated with
the patient's health condition, onset of new symptoms associated
with the patient's health condition, degree of pain associated with
the patient, degree of fatigue associated with the patient,
physical functioning associated with the patient, emotional
distress associated with the patient, social role participation
associated with the patient, patient's response to the medication,
measure of the patient's health condition, an improvement or
worsening of the patient's health condition, and the like.
[0051] In embodiments, the automatic data collection may collect
data from a medication container contemporaneously with the
medically-related event. The data of a medically-related event may
include data for a medication that was prescribed but not
administered during the occurrence of the event.
[0052] In embodiments, an input facility may be present for
entering other data of the medically-related event. In embodiments,
the other data may include patient health condition data patient,
physical activity data, patient treatment data, patient oral
consumption data, patient visitor data, patient psychological data,
caregiver observations, and the like.
[0053] In embodiments, the prediction of the health-related outcome
may be based on medically-related event data for a plurality of
patients in the data repository. The data repository may include a
plurality of real-time electronically updated patient enhanced
electronic health records. The data repository may be an enhanced
electronic health record of the patient. Further, the data
repository may also include individual patient outcome data
collected in real-time from a plurality of individual patients.
[0054] In embodiments, the prediction facility may be for
collecting and organizing the outcome data for facilitating
clinical outcome prediction, server executing machine learning
software, an analytic workbench for drawing inferences as to
whether certain data in the data repository has statistical
significance in the outcome data.
[0055] In embodiments, the prediction facility may use statistical
analysis techniques selected from the list containing regression
analysis, iterative analysis, complex modeling, multivariable
analytics, Analysis of Variance (ANOVA), Chi-square test,
Correlation, Factor analysis, Mann-Whitney U, Mean square weighted
deviation (MSWD), Pearson product-moment correlation coefficient,
Regression analysis, Spearman's rank correlation coefficient,
Student's t-test, Time series analysis, Bootstrap & Jackknife
Resampling, Statistical classification, Statistical surveys,
Structured data analysis (statistics), Survival analysis,
Multivariate discriminant analysis, Linear discriminant analysis,
Cluster analysis, and Principal component analysis.
[0056] In embodiments, predicting the health-related outcome may
include weighting the outcome data. Further, weighting the outcome
data may be based on financial data associated with a medication
identifiable by the medication administration data. In embodiments,
based on the predicted health-related outcome long-term care plan
for the patient may be maintained, prescription management may be
facilitated, prescription management business rules may be updated,
a pharmaceutical-related plan may be updated, management of
regulatory compliance may be facilitated, prescription writing
based may be facilitated, facilitating management of insurance
planning, facilitating management of facility planning,
facilitating management of care planning for a plurality of
patients, and facilitating health care administration.
[0057] In embodiments, methods and systems for predicting a
health-related outcome of a patient with a health condition in
accordance with various embodiments of the present invention may be
provided. In embodiments, the data of a medically-related event may
be collected with an automatic data collection facility in
proximity to a patient upon the occurrence of the event. In
embodiments, the data of the medically-related event may include
automatically collected medication administration data and event
outcome data. Further, the data of the medically-related event may
be integrated in real-time automatically into a data repository.
Additionally, the data of the medically-related event may be
utilized for predicting the health-related outcome. In embodiments,
collecting data of a medically-related event may include collecting
data from a medication container contemporaneously with the
medically-related event. The data of a medically-related event may
include data for a medication that was prescribed, but not
administered during the occurrence of the event. In embodiments,
the outcome data is the patient's response to the medication, a
measure of the patient's health condition, and an improvement or
worsening of the patient's health condition.
[0058] In embodiments, methods and systems for predicting a
health-related outcome of a patient with a health condition in
accordance with various embodiments of the present invention may be
provided. In embodiments, the data of a medically-related event may
be collected with an automatic data collection facility in
proximity to a patient upon the occurrence of the event. The data
of the medically-related event may include automatically collected
raw medication administration data and raw event outcome data. The
raw medication administration data and raw event outcome data
collected by the automatic data collection facility may be
transformed with a processor into a format suitable for use in a
medical information data repository. Further, the data of the
medically-related event may be integrated in real-time
automatically into the data repository. Lastly, the data of the
medically-related event may be utilized for predicting the
health-related outcome.
[0059] In embodiments, methods and systems for managing
administration, billing, and filling orders for medication may be
provided. In embodiments, the methods and systems may include a
medication administration facility, a medication order and billing
facility, a reporting interface, an automatic data collection
facility, a real-time data integration facility, and the like. In
embodiments, the medication administration facility may
automatically receive data related to actual administration of
medications. In embodiments, the medication order and billing
facility may store data related to orders and cost of the
administered medication. In embodiments, the medication
administration facility, and the medication order and billing
facility may be a two-way communication in real-time. Further, the
medication administration facility and the medication order and
billing facility may be in real-time communication with the
reporting interface.
[0060] In embodiments, the data related to actual administration of
medications may be automatically received from an automatic data
collection facility for collecting medication administration data
in proximity to a patient upon the occurrence of the
administration.
[0061] In embodiments, the real-time data integration facility may
be in electronic communication with the medication administration
facility. The real-time data integration facility may automatically
integrate the data related to actual administration of medications
with a patient's electronic health record to establish the enhanced
electronic health record.
[0062] In embodiments, the real-time data integration facility may
be a two-way communication in real-time with the medication order
and billing facility and the medication administration facility,
and in real-time communication with the reporting interface.
[0063] These and other systems, methods, objects, features, and
advantages of the present invention will be apparent to those
skilled in the art from the following detailed description of the
preferred embodiment and the drawings. All documents mentioned
herein are hereby incorporated in their entirety by reference.
BRIEF DESCRIPTION OF THE FIGURES
[0064] The invention and the following detailed description of
certain embodiments thereof may be understood by reference to the
following figures:
[0065] FIG. 1 depicts a block diagram of a healthcare and pharmacy
data management and administration method and system (HPDMA);
[0066] FIG. 2 depicts a block diagram of a portion of the
HPDMA;
[0067] FIG. 3 depicts a block diagram of another portion of the
HPDMA;
[0068] FIG. 4 depicts a flow chart and exemplary structural
elements of a bed-side process of establishing an enhanced
electronic health record;
[0069] FIG. 5 depicts a flow chart and exemplary structural
elements of a bed-side process of maintaining an enhanced
electronic health record;
[0070] FIG. 6 depicts a flow chart and exemplary structural
elements of a bed-side process of collecting patient health
condition data to establish a enhanced electronic health
record;
[0071] FIG. 7 depicts a flow chart and exemplary structural
elements of a bed-side process of collecting patient psychological
data associated with a medically-related event to establish a
enhanced electronic health record;
[0072] FIG. 8 depicts a flow chart and exemplary structural
elements of a bed-side process of identifying medication based on
an enhanced electronic health record;
[0073] FIG. 9 depicts a flow chart and exemplary structural
elements of a bed-side process of collecting medication information
in association with a medically-related event;
[0074] FIG. 10 depicts a flow chart and exemplary structural
elements of a bed-side process of collecting non-administered
medication information in association with a medically-related
event;
[0075] FIG. 11 depicts a flow chart and exemplary structural
elements of a bed-side process of medically-related event data
collection for real-time updating of a dashboard;
[0076] FIG. 12 depicts a flow chart and exemplary structural
elements of a process of configuring a dashboard;
[0077] FIG. 13 depicts a flow chart and exemplary structural
elements of a process of predicting a medical event outcome;
[0078] FIG. 14 depicts a flow chart and exemplary structural
elements of a process of using medical event predicted outcomes in
a medical-related dashboard; and
[0079] FIG. 15 depicts a medicine administration dashboard.
DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENT(S)
[0080] FIG. 1 is a block diagram showing an overview of a
healthcare and pharmacy data management and administration method
and system (HPDMA) 100 that may facilitate ordering, dispensing,
reporting, billing, planning, outcome collection, outcome analysis
and prediction, third party data and services integration,
real-time data collection and transfer, user interfaces,
documentation, and the like related to a prescription, such as a
prescribed medication, and to various patient-related events and
outcomes, such as relating to a patient who is taking a prescribed
medication. Referring to FIG. 1, various facilities may be included
in the HPDMA 100 including a medical prescription (RX) validation
and selection facility 102 (alternatively referred to as a
medication management facility), a dispensing and marking facility
104, an RX delivery facility 108 (note items 102, 104, and 108 may
collectively be referred to as a prescription management facility
106), a prescription administration facility 110 (also referred to
herein as a medication administration facility), a patient
attributes and events facility 112, an outcome events facility 114,
an Enhanced Electronic Health Record (E-EHR)/an Enhanced Electronic
Medical Record (E-EMR) facility 118, an outcome facility 120, an
existing medical record facility 122, an outcome database facility
124, an outcome analytics facility 128, a rehabilitation and Long
Term Care ("LTC") facility 130, a third party integration facility
132, labs and imaging facility 134, an insurance and payments
facility 138, a regulatory facility 140, a pharmaceutical (pharma)
planning facility 142, a facility planning facility 144, an
insurance planning facility 148, a dashboard facility 150, a care
planning facility 152, a prescribing facility 154 and a third party
data facility 158. Each facility may individually be
communicatively connected together through a network, such as the
Internet, a proprietary network, a virtual private network, or the
like, to facilitate real-time data capture and communication of
data among the facilities. Although FIG. 1 depicts the facilities
described above and elsewhere herein, HPDMA 100 may not be limited
to only these facilities and may include other medical-related
facilities, such as other data facilities, care facilities,
prescription facilities, communication facilities, and the
like.
[0081] The prescribing facility 154 may allow a doctor, physician,
nurse, pharmacist, or a healthcare specialist to enter an order for
a prescription of a medication or other medical care items for a
patient. The HPDMA 100 may apply a plurality of identification
methods to uniquely identify, record, and document details of
person entering the orders. The prescribing facility 154 may be
communicatively coupled in real-time to a backbone network 103. The
backbone network 103 may be a network that may be communicatively
coupled to other facilities of the HPDMA 100 and elsewhere and may
carry medical data being communicated among the facilities, such as
real-time medical data event packets, files, or streams. The
exemplary medical event data being carried over the backbone 103
may include information from any of the facilities depicted in FIG.
1 including, without limitation prescribing units, care planning
facilities, laboratories and imaging centers, insurance and
payments units, rehabilitation and LTC facilities, electronic
medical record repositories, dashboards and databases, third-party
sites, healthcare facilities, and the like. In an exemplary case,
the backbone network 103 may be the Internet, an intranet, a Wide
Area Network, a Local Area Network, a wireless network, a personal
area network, a virtual private network, or any other type of
wired, wireless, or logical network including ad hoc, peer-to-peer,
hub-and-spoke, tree, ring, serial, infrastructure-type protocols,
and the like. The backbone network 103 may also facilitate secure
communication among different facilities of the HPDMA 100, using
firewalls, password protection, anti-virus protection, packet
inspection, spam filtering, and other security facilities.
[0082] Further, the prescribing facility 154 may obtain patient
information via the backbone network 103. The information may
include the medical history, clinical outcomes, allergic reactions
to certain types of drugs and similar kind of information related
to the patient. The prescribing facility 154 may also allow the
healthcare specialist to prescribe medication, such as through an
electronic order entry facility (not shown in FIG. 1). In an
example, the electronic order entry facility may comprise an
interface for aiding a healthcare specialist to prescribe the
medication or treatment for the patient. The prescribing facility
154 may present the obtained patient information to the healthcare
specialist to help facilitate prescribing appropriate medication or
treatment for the patient. Once the healthcare specialist enters
the prescription of the patient in the electronic order entry
facility, the prescribing facility 154 may communicate the
prescription to the backbone network 103 or may sent it directly to
the prescription management facility 106, and in embodiments
directly to the prescription validation/selection facility 102
therein. This communication may be done in real-time as an event.
Further, the prescription may be made available to all other
facilities of the HPDMA 100 via the backbone network 103.
[0083] In an embodiment of the invention, the prescription from the
prescription facility 154 may be raw prescription data associated
with the patient. The raw prescription data may not be in a format
that may be integrated with the E-EHR/E-EMR facility 118. The
prescription facility 154 may include a computer (not shown in the
FIG. 1) that may transform the raw prescription data to a format
such that it may be integrated with the patient's EHR in the
E-EHR/E-EMR facility 118.
[0084] The prescription may be received by an RX validation and
selection facility 102 either directly from the prescribing
facility 154 or over the backbone network 103 to which the RX
validation and selection facility 102 may be communicatively
coupled. The RX validation and selection facility 102 may be
configured to receive/send real-time event tracking data with other
patient medical related facilities. Further, the RX validation and
selection facility 102 may also obtain information regarding the
patient, including the past medical history of the patient,
treatment outcomes for the patient (from past or current
treatments), allergic reactions to certain types of drugs and
similar kinds of information. The RX validation and selection
facility 102 may thus embody various features to ensure improved
probability of selecting and delivering the appropriate medication
to the patient, such as modules for identifying patient allergies
or sensitivities, modules for identifying potential interactions
among medications prescribed or proposed to be prescribed, and
modules that use information or insights derived from the outcome
module 120, such as to propose medications that have produced
favorable outcomes in other similar patients.
[0085] In an exemplary case, the RX validation and selection
facility 102 may be a pharmacy facility and may include the
services of a pharmacist to validate the medical prescription of
the patient. In another exemplary case, the pharmacist may be
provided with a graphical user interface for performing validation
of the medical prescription. Further, in such an interface, a user
may utilize various buttons, list boxes, and text boxes for
viewing, entering and managing data, such as patient data,
medication data, outcome data, and order entry data. In order to
confirm the validity of data entered, the software underlying the
graphical user interface may validate the entered data, such as for
proper format and for the absence of various problems, such as
unfavorable interactions with other medications, conflict with
patient allergy information, indication of a likely unfavorable
outcome, deviation for standards (such as in units prescribed,
frequency of prescription, or the like).
[0086] By way of example, once the RX validation and selection
facility 102 has received the medical prescription and the other
details and information about the patient, the RX validation and
selection facility 102 may verify formulary compliance, determine
drug allergy information associated with the prescribed drugs, and
confirm the drug interaction information associated with the
prescribed medication. The RX validation and selection facility 102
may issue alerts or warnings to the pharmacist, the healthcare
specialist entering the medication order on a patient-by-patient
basis to provide an opportunity for the prescriber to consider the
prescription in light of these warnings and potentially make
adjustments in the prescription before the RX validation and
selection facility 102 accepts the order into its processing
facilities. After these activities have been accomplished and after
reviewing all the relevant patient information, a pharmacist
associated with the RX validation and selection facility 102 may
validate the patient medical prescription. This pharmacist-based
validation may be done as a manual confirmation that follows a
series of automated validation steps as described herein. The RX
validation and selection facility 102 may communicate the validated
prescription of the patient to other facilities of the HPDMA 100
via the backbone network 103.
[0087] In an embodiment of the invention, the validated
prescription from the RX validation and selection facility 102 may
be raw validated prescription data associated with the patient. The
raw validated prescription data may not be in a format that may be
integrated with the E-EHR/E-EMR facility 118. The RX validation and
selection facility 102 may include a computer (not shown in the
FIG. 1) that may transform the raw validated prescription data to a
format such that it may be integrated with the patient's EHR in the
E-EHR/E-EMR facility 118.
[0088] After the prescription has been validated, the validated
prescription may be received by the dispensing and marking facility
104. The validated prescription may be received with associated
information regarding formulary compliance, drug allergy
information, drug interaction information, brand versus generic
prescription requirements, non-active ingredients of generic
medications, costs and inventory information related to the
medication, and the like. The information may be provided via a
user interface which is accessible on a work station or maybe
sourced from other facilities or data sources, such as through the
backbone 103. The dispensing and marking facility 104 may receive
the validated prescription and the associated information in
real-time from the communicatively coupled back bone network 103.
In an exemplary case, the dispensing and marking facility 104 may
be a pharmacy or may include automated dispensing and labeling
machines within a pharmacy. Although, as with all facilities
described herein, this facility or portions thereof may be coded
instructions executed by various processing and/or computing means
disclosed herein. Further, the dispensing and marking facility 104
may prepare the medication order according to the validated
medication and may associate certain relevant data with the
medication orders. The associated data could include patient
identification information, the facility in which the patient
resides or receives care, locations within the facility (such as
wing, floor, room, and the like), patient insurance information,
facility personnel associated with/responsible for the patient,
administration frequency, and the like. The patient-related
information (e.g. patient attributes/events 112) may be received
either electronically via interfaces with other systems (e.g.
through the backbone 103) or via manual inputs.
[0089] The dispensing and marking facility 104 may determine which
medication to dispense based on the prescription, the frequency of
administration, and the like. In an example, based on inventory
availability, the dispensing and marking facility 104 may apply
business rules to select a medication that results in a different
frequency of medication administration. The dispensing and marking
facility 104 may also take into consideration patient care factors,
such as sleeping hours, daylight, and the like to determine a
time/date for each administration of the medication. This may be
called administration frequency type. In an exemplary case, a
frequency type is related to how many times per day a medication is
to be administered; for example, twice a day or three times a day.
Because "a day" may be defined as the waking hours of the patient,
a prescription that has a frequency type of 3 times per day may
result in prescription administration times of 7 AM, 4 PM, and 11
PM. For a patient that prefers to sleep later than 7 AM, the
administration times may be set to 9 AM, 5 PM, and 12 AM. Of course
other frequency-types and administration schedules are possible.
Another type of frequency may include set intervals, such as every
120 minutes, every 4 hours, etc. Set interval frequency types may
be adjusted based on the time that the patient is awake, the time
that a care provider would normally be administering medication
locally to the patient, and the like. It may be important to note
here the difference that exists in the two exemplary cases
mentioned above, which is illustrated by the example that every 12
hours is not the same as twice per day where the day is defined as
the waking hours of the patient. Therefore, the methods and systems
described herein are able to take into account a particular
treatment's Times of Administration ("TOA"), which typically varies
across different treatments, patients, environments, and the like.
In embodiments, a TOA pattern is determined based on observation of
outcomes using the outcome module 120, in particular to determine
the influence of different TOA patterns on patient outcomes for a
particular medication given to patients of particular types over
time.
[0090] Further, the dispensing and marking facility 104 may
communicate the medication orders and the data associated with it
to a medication dispensing machine. A medication dispensing machine
may dispense and pack the medications. In an example the
communication may be in HL 7 format. The medication dispensing
machine may be similar to the dispensing, packaging, and bar coding
systems currently commercially available, such as PEARSON MEDICAL'S
iPACKT60 (TRADEMARK). Such machines are able to receive
instructions regarding the medication to be dispensed, grouping of
the dispensed medications, and labeling or marking of the packaging
for the dispensed medications. Such machines also package the
dispensed medications. Such packaging may include bar-coded pillow
packs for the patient. Further the dispensing machine may be
located remotely. The remote dispensing of prescriptions may be
supported by automated dispensing machines such as in-facility
kiosks, third party home delivery chains, and the like. The remote
dispensing may include security to ensure proper authentication of
the recipient through means like identifiers, passwords, finger
scan, and the like.
[0091] Further, the medication dispensing machine may package the
dosages according to instructions from the dispensing and marking
facility 104, and is able to package the dosages according to data
associated with the medication order; for example, information
related to the patient's identity, the time of administration, the
facility in which the patient resides or receives care, locations
within the facility (such as wing, floor, room, and the like),
patient insurance information, facility personnel
associated/responsible for the patient, and administration
frequency. The dosages may be packaged in packaging comprising
human and barcode information regarding the particular dosage of
medications. Different dosage of medications for the same patients
may be grouped together in the same package resulting from
instructions to associate a patient's medication by patient
identifying information, the facility in which the patient resides
or receives care, locations within the facility (such as wing,
floor, room, and the like), patient insurance information, facility
personnel associated/responsible with the patient, administration
frequency, and the like.
[0092] Further the medications packaged for a single dose may be
labeled with the barcode, which may be a conventional bar code or
an advanced bar code, such as having graphical elements, human
readable elements, holograms, 2D or 3D features, or the like.
Identification information may also be embodied in a physical tag,
such as an RFID tag, or a chip, such as used in a smart card,
providing enhanced tracking functionality when coupled with an
appropriate reader or scanner. Such RFID, chip and similar hardware
embodiments should be understood as encompassed throughout this
disclosure where barcodes and similar identifying marks are
described herein. In an example, the single dose packages may be
referred to as pillow packs. The barcode or other identifier may
uniquely identify the patient, the prescription information, the
medication to be administered, and general dosing rules and
guidelines. The generation of this information may be automatic and
may be assembled from information received at the prescription
management facility 106, such as the information received from the
prescribing facility 154. Further, the information may be prepared
for use by the marking machine in the prescription management
facility 106 and the information may include data received from the
E-EHR/E-EMR facility 118. Further in an example, a pillow pack may
be limited, such as to no more than, for example, three different
medications so a patient may have more than one pillow pack for an
administration of medication. The pillow packs may be prepared
and/or delivered individually for each administration, for all
administrations in one day, in a three or four day supply, in a 30,
60, 90 day supply, and the like. In one preferred embodiment, each
administration of medication, as planned by a prescribed TOA
pattern, is packaged into a single pillow pack or similar package,
so that the probability of the patient selecting the wrong
medication, or the wrong amount of medication, is reduced.
[0093] Further, the dispensing and marking facility 104 may
communicate with a plurality of dispensing locations and signal the
locations to dispense specific medications. The signaling to the
locations may be based on a variety of factors including immediacy
of the need for the medication, geographic proximity, availability
and cost of transportation. The medication dispensing and marking
facility 104 may further recognize the category and composition
(liquid, solid, etc.) of the to-be-dispensed medication and route
the dispensing to the appropriate dispensing mechanism. The
labeling information may also be routed automatically to the
appropriate marking system. Further, the HPDMA 100 may have the
ability to keep track of the dispensed medications based on the
proposed time of administration, patient details and location of
the patient (e.g. in patient resident, day patient, emergency room,
clinic, third-party facility, residential home, personal address,
and the like). The information may be used to assist in the
accurate and efficient packaging of the medications and treatments
to be delivered to the correct location. Once delivered (as
described below), the HPDMA 100 may have the ability to
electronically read the information from the packages of
medications and treatments and confirm receipt by the appropriate
personnel at the designated location.
[0094] After the prescribed medication has been properly packaged
and instructions have been marked on it, the dispensed medication
may be sent for delivery. The RX delivery facility 108 may be
utilized for delivering the dispensed medications. It should be
noted that the portions of the computerized pharmacy services
disclosed in co-pending U.S. Nonprovisional patent application
having Ser. No. 10/134,293 filed Apr. 29, 2002 entitled CENTRALIZED
PHARMACY BUSINESS METHOD (the disclosure of which is incorporated
in its entirety herein by reference) may be utilized in providing
orders to customer facilities. The HPDMA 100 may support loading
the packaged prescriptions into medication carts. Carts may be
associated with particular care facility location properties such
as a particular facility, a floor in the facility, a wing of the
facility, etc. In this way, the packaged dosages having the
readable information thereon regarding the location of the patient,
or the cart in which the dosage should be stored, provide for easy
and efficient loading of the cart. The RX delivery facility 108 may
also communicate in real-time with the backbone network 103 and may
communicate the delivery details of the medication to other
facilities of the HPDMA 100 via the backbone network 103.
[0095] Also, because the dosages are packaged according to the
relevant associated data (as described above) rather than simply in
a 30-day supply per drug per patient (as is the conventional case),
the HPDMA 100 may allow users to select the duration of supply. In
an example, the medications packaged according to the above
disclosure may be provided in shorter supplies than the typical
30-day-supply. While the duration of supply could be of any time
duration, supplies for two to ten days may result in significant
cost savings by eliminating the amount of drugs that need to be
returned or destroyed due to stopped or changed orders.
[0096] Further, the prescription management facility 106 may be in
communication with an automated dispensing cabinet (ADC) on the
premises of a healthcare facility. The HPDMA 100 may perform the
functionality described above and may instruct the ADC to dispense
drugs once released.
[0097] The prescription management facility 106 may perform similar
functions as those described above, with the alternative or
additional functionality of being able to provide healthcare
facility professionals with the information necessary to dispense
medication from their own medication stores. Thus there may be a
medication storage device or automated dispensing cabinet ("ADC")
on a healthcare facility's premises, and in addition to the
facilities described above, a medication supply interface. The
prescription management facility 106 may be in electronic
communication with the medication supply interface, and may provide
notification which may be output through the medication supply
interface that the medication is approved for administration and
whether the medication is in the medication storage device. The
medication management facility 106 may be kept constantly up to
date with regard to the inventory of the medication storage
facility by the ordering and administration functions described
herein.
[0098] The elements within the area 106 shown in FIG. 1 may be
collectively referred to as a prescription management facility 106
and may include the RX validation and selection facility 102, the
dispensing and marking facility 104 and the RX delivery facility
108. The prescription management facility 106 may include other
facilities as well and may not be restricted to only these three
facilities. The prescription management facility 106 may include or
use an information technology infrastructure, such as including one
or more software applications, data storage facilities, and the
like that may be accessible via an electronic communication link,
such as the Internet or other network, such as any type of network
described herein.
[0099] Once the medication is delivered to the desired destination,
it may be administered. The administration of the medication may be
conducted at the prescription administration facility 110. The
prescription administration facility 110 may facilitate proper
administration and real-time data capture of prescription
administration information. The prescription administration
facility 110 may utilize technology-enabled devices such as
handheld barcode scanners, smart card chip readers, RFID readers,
hologram readers, or other devices, in certain preferred
embodiments used in proximity to the patient at the point and time
of administration, thereby increasing the probability that data
about administration accurately reflects real events. Such devices
may automatically read the coded information associated with the
medication. Such devices may communicate with other portable
computing devices such as smart phones, PDAs, laptop computers, or
other devices having a facility to enter data. The portable
computing devices and/or the scanners are in communication with
each facility described herein in connection with FIG. 1. At the
time of data collection, the use of handheld barcode scanners
combined with contemporaneous entry of patient data (often prompted
by the system at the time of scanning as will be described below)
may allow real-time capturing of information about the events
associated with and immediately after administering medications.
The handheld barcode scanner may also allow obtaining of the
real-time data and contextual information for the person performing
the administration. In an exemplary case, the person performing the
administration may be a patient, nurse, technician, physical
therapist, or some other care provider. Further, the prescription
administration facility 110 may access or communicate with a data
center that may provide information from any of a variety of
medical information related sources. Examples of data centers that
provide relevant medical information may include E-EHR/E-EMR 118,
outcome databases 124, third party databases 158, any of the
facilities depicted in FIG. 1, and the like. In an exemplary case,
such access may typically be through a wireless connection between
a technology enabled device being used in association with
administration 110 and a server or other networked device. Further,
the prescription administration facility 110 may be communicatively
coupled to the backbone network 103 and may communicate the
administration details in real-time to the other facilities via the
backbone network 103. The prescription administration facility 110
may include an integration facility for automatically integrating
data that may be captured in context of prescription administration
and that may be related to a medically-related event, healthcare
related events, patient health condition data, patient physical
activity data, patient treatment data, patient oral consumption
data, patient visitor data, patient outcome data patient
psychological data, patient vital signs, patient dietary and
nutritional data, and the like for establishing or maintaining a
patient's health record in association with the E-EHR/E-EMR
facility 118. In an embodiment of the invention, the data captured
in context of prescription administration may be referred to as
medication administration data. The prescription administration
facility 110 may also prompt a user of the technology enabled
prescription administration facility 110 device to enter (into the
portable computing device or the scanner for example) information
associated with administration of the dosages of medication and
also to verify that a dosage has been administered to the
patient.
[0100] In an embodiment of the invention, the medication
administration data from the prescription administration facility
110 may be raw medication administration data. The raw medication
administration data may not be in a format that may be integrated
with the E-EHR/E-EMR facility 118. The prescription administration
facility 110 may include a computer (not shown in the FIG. 1) that
may transform the raw medication administration data to a format
such that it may be integrated with the patient's EHR in the
E-EHR/E-EMR facility 118.
[0101] Further, the prescription administration facility 110 may
facilitate providing bedside prescription administration that may
further facilitate capturing all caregiver observations and
clinical events performed as part of the prescription
administration. The data associated with the caregiver observations
and clinical events performed may be captured in real-time at the
bedside as described above or may be captured later from notes
taken or entered into the system by the caregiver. Further, because
the information is collected at the bedside the prescription
administration facility 110 may collect information that may not
directly relate to the prescription administration activity. Such
information may alternatively be obtained by the patient attribute
and events facility 112. The information may be collected using
sensors. In an example the sensor may be an accelerometer or motion
detector that detects patient movements, such as standing, walking,
and the like. As will be described elsewhere herein, the
information may further be utilized to populate an E-EHR/E-EMR
facility 118 in real-time.
[0102] Further, in an embodiment of the invention, the medication
administration facility 110 may include a sensor that may detect
opening of a pillow pack of the medication or a bottle of the
medication or any other container containing the medication. In an
embodiment of the invention, the sensor may be able to identify the
geo-location of the medication package at the time the medication
package is opened. Further, the detected location may be recorded
in the E-EHR/E-EMR facility 118. In an embodiment of the invention,
the information about the detected location may be transmitted by
the sensor over a wireless network. In an example, the wireless
network may be a WiFi network. In another embodiment of the
invention, the information about the detected location may be
communicated through near field communication to a handheld
scanning device being used in the medication administration events.
In yet another embodiment of the invention, the information about
the detected location may be communicated through near field
communication to a mobile device being used in the medication
administration event. Further in embodiments of the invention, the
information about the location of the medication package at the
time the medication package is opened may also be recorded manually
at the time of administering that medication to the patient.
[0103] The bedside administration may further allow collecting data
associated with elderly patients and patients in LTC. This data may
include, without any limitations, psychiatric and psychologically
relevant observations, along with physical data. In an example,
when an elderly patient has undergone a heart surgery, the elderly
patients tend to go into depression or display symptoms of
psychosis that may be caused by or exacerbated by an administered
medication. As the HPDMA 100 allows bedside data collection of
prescription administration and treatment of the patient, the data
related to the mental state of the elderly patient or the patient
in the LTC may only be relevant if they are recorded by observing
the patient a significant amount of the time to allow observation
of changes. Further, this data may be recorded in the electronic
health record of the patient by the E-EHR/E-EMR facility 118.
Further, this data may be used as early indications of a related
condition of depression or psychosis and may facilitate the
prescription of additional medication or assigning of other
therapies known to prevent deterioration in the nascent symptoms.
In embodiments, the psychological observations may be associated
with TOA information, so that patterns in psychological effects of
medication administration can be observed and tracked, such as
using outcome module 120.
[0104] Further, at the time of administration, the administering
professional using the HPDMA 100 may scan the medication barcodes,
which may populate various fields in the administration facility
110 that may be displayed on a screen by or on the administration
facility 110 for verification and/or manual completion.
Alternatively, or in conjunction with the scanning, data that may
relate to the patient, care facility, care giver, environment,
observations, and the like as well as data relating to the
administration may be entered into the administration facility 110,
such as through a user interface. In an embodiment of the
invention, the handheld scanner scanning the medication barcodes or
other health monitoring devices providing the patient's health
condition data may generate a location data corresponding to the
medication that is being administered to the patient. In an
embodiment of the invention, the location data may be generated by
utilizing the Global Positioning System (GPS) facility embedded in
the handheld scanner or other monitoring devices. Once the
information is entered, and prior to administration, the
information is communicated to the medication management facility
106. If current information in the medication management facility
106 shows that there has been a change to the patient's medication,
a stop order, or the like, may be communicated to the
administration facility 110 and displayed via the interface on the
technology enabled administration device to the prescription
administrator. In this way, the HPDMA 100 may prevent the
administration of discontinued medications and ensure that the
correct medication and dosage is being administered at the right
time. The HPDMA 100 might require the caregiver to uniquely
identify themselves using a plurality of identification
methodologies. The collected identification information may be
validated, recorded, and stored to ensure compliance with
regulations and provide tracking information for the caregiver that
administered the treatments or care.
[0105] Further, the prescription administration facility 110 may
include a therapeutic equivalent facility which may accept
electronic medication orders and suggest therapeutic equivalents.
Drug products classified as therapeutically equivalent may be
substituted with the full expectation that the substituted product
may produce the same clinical effect and safety profile as the
prescribed product. Drug products may be considered to be
therapeutically equivalent if they meet criteria such as: they are
pharmaceutical equivalents (contain the same active ingredient(s);
dosage form and route of administration; and strength.); they are
assigned by FDA the same therapeutic equivalence codes starting
with the letter "A" To receive a letter "A", the FDA designates a
brand name drug or a generic drug to be the Reference Listed Drug
(RLD), and assigns therapeutic equivalence codes based on data that
a drug sponsor submits in an Abbreviated New Drug Application to
scientifically demonstrate that its product is bioequivalent (i.e.,
performs in the same manner as the Reference Listed Drug). The
therapeutic equivalent facility may contain a library of such
therapeutic equivalents and suggest them to the prescribing
professional upon order entry based on, for example, whether the
proscribed medication is on the patient's insurance formulary.
[0106] Further the HPDMA 100 may utilize the patient's information
including, but not limited to, age, sex, medical condition, current
diagnoses, and past medication history to guide the caregiver in
administering medication. Such information may, in various
embodiments, be provided with security to render it anonymous, such
as for compliance with regulatory requirements relating to patient
privacy.
[0107] The prescription administration facility 110 and the
prescription management facility 106 may allow capturing of the
information about the medications that may be prescribed but not
administered. Such cases may occur when a medication is prescribed
but the prescription is not filled, or when the prescription has
been filled in the pharmacy, but then the caregiver decides not to
administer that medication or the patient declines to take the
medication. The reasons for not administering the medication may
include, without any limitations, that patient feels better and
does not require the medication, that the patient identifies that
the side effect of the medication is too risky and hence declines
the medication, that the caregiver decides on a different
medication, or the like. For example, if side effects of the
medication include an upset stomach, and the patient already has an
upset stomach, the caregiver may conclude it does not want to
exacerbate that side effect with medication.
[0108] Further, once the medication is dispensed and the doctor or
the physician determines that a different medication is required
for the patient, some of the original medication goes unused. In
such a case, the status of the unused portion of the used
medication gets updated in real-time in E-EHR facility 118. The
insurance and payments facility 138 may obtain the information
associated with unused medication from the E-EHR facility 118 to
revise the billing accordingly. The pharmacy inventory status may
also be updated with information regarding the unused medication
and the unused medication may be returned back to the pharmacy or
destroyed. The medications for a patient in LTC or other in-patient
care facility may be dispensed from the pharmacy for one dose at a
time to avoid wasted medication or handling medications that may be
returned to the pharmacy. Thus, in certain preferred embodiments
the HPDMA 100 may track non-administered medication, such as for
outcome tracking, payment/reimbursement, and other purposes.
[0109] The HPDMA 100 may further include the patient attributes and
events facility 112. The patient attributes and events facility 112
may monitor change in patient's attributes in response to the
prescribed medication. These changes may be communicated to other
facilities via the backbone network 103. The patient attributes and
events facility 112 may further track the events associated with
the patient after consuming the prescribed medication. These events
may be communicated in real-time to the other facilities via the
backbone network 103. Further, the changes in the events and
attributes of the patient may correspond to treatment outcomes.
Further the patient attributes and events facility 112 may obtain
the information collected at the bedside by the prescription
administration facility 110. This information may include, without
any limitation, on what side the patient is lying, how many times
the patient has turned his side, the position of the patient,
changes in the position of the patient, changes in the body
position of the patient, changes in the movement of the patient,
whether the patient is walking or standing or sitting or sleeping,
what the patient ate or consumed, whether the patient sleeping or
awake, how much did the patient eat, how much did the patient
drink, how much did the patient excrete and the like. The
information may further be associated with the caregiver and may
include, without any limitations, changing or dressing the bandages
of the patient, and the like. The monitoring of the patient's
attributes and events may provide various types of data including,
but not limited to, patient health condition data, patient physical
activity data, patient treatment data, patient outcome data,
patient psychological data and the like. Further, the various types
of data may be recorded by the E-EHR/E-EMR facility 118.
[0110] In an embodiment of the invention, the various types of data
from the patient attributes and events facility 112 may be raw
format and may include raw patient health condition data, raw
patient physical activity data, raw patient treatment data, raw
patient outcome data and raw patient psychological data. The raw
format of the various types of data may not be in a format that may
be integrated with the E-EHR/E-EMR facility 118. The patient
attributes and events facility 112 may include a computer (not
shown in the FIG. 1) that may transform the raw format of the
various types of data to a format such that it may be integrated
with the patient's EHR in the E-EHR/E-EMR facility 118.
[0111] The outcome events facility 114 may then obtain the outcomes
of the patient's attributes and the events. The outcome events
facility 114 may store the obtained treatment outcomes and may also
communicate them in real-time to the other facilities of the HPDMA
100 via the backbone network 103.
[0112] Further, the medical event streams on the backbone network
103, from different facilities of the HPDMA 100, may be utilized to
populate the E-EHR/E-EMR facility 118. The medical event stream may
include outcomes from prescription management events, healthcare
planning events, laboratory events, medical payment events and
treatment outcome events.
[0113] The E-EHR facility 118 may be associated with other
facilities as depicted in FIG. 1 and may exchange information (e.g.
real-time data) with these facilities. The E-EHR facility 118 may
maintain a collection of health records of an individual and/or a
group of individuals in a format that may be capable of being
shared across different medical facilities of the HPDMA 100 or with
external facilities. In an exemplary case, the health records may
be shared electronically through the Internet and the like.
Further, an E-EHR may include any related medical data and
information, such as medical history, allergies, pathology and
laboratory test results, medical scanning reports, region and
residential information, psychological data, and the like.
[0114] Further, the E-EHR facility 118 may encompass information
related to all the facilities of the HPDMA 100 including
administrative, nursing, lab, clinical, radiology, pharmacy, care
planning, imaging, insurance planning, facility planning,
rehabilitation, and the like. An electronic communication interface
may be provided for implementing receipt information by the E-EHR
facility 118 from the backbone network 103 and providing the
information from the E-EHR facility. Such an electronic interface
may thereby facilitate utilization of the E-EHR related information
anywhere within the HPDMA 100. For example, lab reports of a
patient stored in an E-EHR facility 118 may be utilized during care
planning to prepare a healthcare plan for a patient. Similarly,
patient data related to allergies and sensitivities may be utilized
by a doctor to prescribe relevant medicines and offer treatment
accordingly. Further, an E-EMR may be generated in association with
the E-EHR facility 118 and may be useful in an institution such as
a hospital, clinic, physician's office, nursing home/center and the
like.
[0115] Once the data from the medical event streams on the backbone
network 103 has been stored in the E-EHR/E-EMR facility 118, the
medical data may be utilized by various other facilities of the
HPDMA 100. The outcome facility 120 may obtain the treatment
outcome events from the E-EHR/E-EMR facility 118. The outcome
facility 120 may utilize the electronic interface of the
E-EHR/E-EMR facility 118 to obtain the treatment outcome data.
Further, the outcome facility 120 may have a bidirectional
communication with the E-EHR/E-EMR facility 118.
[0116] The E-EHR/E-EMR facility 118 may also be coupled to the
existing medical record facility 122. The existing medical record
facility 122 may include hard copy and/or a database that may store
the existing medical records of a patient or a group of
patients.
[0117] The outcome database facility 124 may be communicatively
coupled to the outcome facility 120 to obtain the treatments and
outcomes for the medication being administered to the patients. The
outcome database facility 124 may include a plurality of databases
that may store the treatments and outcomes data for a plurality of
similar patients. The outcome database facility 124 may also be
communicatively coupled to the backbone network 103 and may obtain
treatments and outcomes data in real-time. Further, the outcome
database facility 124 may communicate the treatment outcomes of the
patient to other facilities of the HPDMA 100 through the backbone
network 103.
[0118] Further, the outcome database facility 124 may be coupled to
the outcome analytics facility 128 that may utilize the treatment
outcomes of the patient to generate medical reports, medical
predictions and other medical analyses. The outcome analytics
facility 128 may utilize the demographic information associated
with the patient, information regarding the administration of the
medication and clinical outcomes, and the like to generate the
reports, predictions and other analyses. The administration
information may include the time of administration and the dose of
medication. The output of the outcome analytics facility may be
utilized by other facilities of the HPDMA 100. Further the outcome
analytics facility may access the third party data 158 to produce
the reports and predictions. Third-party data may include medical
studies, trials, FDA related data, orange book data, and the
like.
[0119] Further, the outcome data may be utilized to determine the
condition of the patient's health, adverse event for a particular
drug, sampling of patients with an infectious disease, monitoring
of patient flow during an epidemic, outcome of a clinical test, and
correlation of disease in case the clinical test is found to be
positive or some other kind of outcome related to healthcare data.
In this aspect, the outcome analytics facility 128 may include an
analytic workbench facility that may provide different modules for
conducting statistical analysis of the outcome data. Such an
analytic workbench facility may implement one or more statistical
techniques including, but not limited to, Analysis of Variance
(ANOVA), Chi-square test, Correlation, Factor analysis,
Mann-Whitney U, Mean square weighted deviation (MSWD), Pearson
product-moment correlation coefficient, Regression analysis,
Spearman's rank correlation coefficient, Student's t-test, Time
series analysis, Bootstrap & Jackknife Resampling, Statistical
classification, Statistical surveys, Structured data analysis
(statistics), Survival analysis, Multivariate discriminant
analysis, Linear discriminant analysis, Cluster analysis, Principal
component analysis, and the like.
[0120] By leveraging the real-time bed-side data collection
capabilities of the HPDMA 100 along with support for accessing a
plurality of enhanced electronic health records, the outcome
facilities (e.g. outcome facility 120, outcome database facility
124 and, outcome analytics facility 128) may facilitate rapidly
detecting an onset of an epidemic type situation. By combining
outcome analysis 128 with real-time data it may be possible to
identify patients infected with an infectious disease at the first
screening. For example, the various symptoms of an epidemic-type
disease may be stored in the outcomes database and a patient's
real-time symptoms may be captured and entered into the outcome
analytics facility 128 (e.g. analytics workbench) to facilitate
identifying a patient with such a disease. Likewise, the analysis
capabilities of the analytic workbench may support regression
analysis to facilitate determining genetic modification of a virus
over a period.
[0121] Similarly, real-time event data may be associated with the
outcome. The analytic workbench facility may perform statistical
analysis to determine whether the occurrence of a specific event is
significant to the outcome data. A feedback may be provided to the
associated medical specialist, in case the event is statistical and
significant to a specific patient. The analytic workbench facility
may be programmed to dynamically select the best algorithm in a
specific situation. Alternatively, the analytic workbench facility
may include a GUI enabling the user to select the algorithm to be
applied.
[0122] In association with the outcome analytics facility 128,
various machine learning techniques may be implemented using neural
networks to improve on the analytics as well as to facilitate
predicting outcomes. Various types of neural networks may be
employed including learning algorithms, reinforcement-learning
algorithms, supervised learning algorithms, and unsupervised
learning algorithms. Further, other techniques include genetic
algorithms, biological cybernetics, biologically inspired
computing, cerebella model articulation controllers, cognitive
architecture, cultured neuronal networks, neural network software,
neuro-fuzzy approaches, neuroscience, predictive analytics, radial
basis function networks, recurrent neural networks, self-organizing
maps, simulated reality, hidden markov models, kalman filters,
decision theory, support vector machines, tensor product networks,
time adaptive self-organizing maps, time delay neural networks and
the like.
[0123] Additionally, the analytic workbench facility may utilize
learning to train suitable techniques for optimum prediction. The
prediction of a future outcome based in part on an earlier outcome
may be an integral part of the analytic workbench facility. In this
regard, the analytic workbench facility may extrapolate data to
identify future events associated with the patient and raise an
alert to doctors about these future events. For example, outcomes
for a plurality of patients experiencing a range of symptoms who
have been administered a drug may be used to predict an outcome of
a patient with similar symptoms who may be prescribed a similar
drug. This predicted outcome may include certain side effects that
can be prevented with proper preventive treatment. Even if these
side effects were not present in the FDA trials before the drug was
allowed on the market, the analysis of outcomes combined with other
information collected by the HPDMA 100 may facilitate predicting
these outcomes in patients.
[0124] The machine learning techniques may utilize algorithms that
may perform various data mining operations on the data such as
classification, clustering and other data mining techniques known
in the art. To this end, the effect of various drugs on a
particular disease may be studied, and an identification relating
to the effect of the drug may be recorded. For example, brand X may
cause fewer side effects, when administered to children, than brand
Y. Likewise, in another example, brand Y may be more effective in
critical conditions. These analyses may help doctors and other
medical staff to create a knowledge map for treatment under
different conditions.
[0125] Machine learning may be performed by taking into account a
weight that reinforces a particular outcome. An initial set of
weights may be determined based on, for example, a prediction,
theory, hypothesis, or the like as to the importance of a
particular factor or factors, then adjusted by feeding actual
outcomes into the machine learning system. For example, the machine
learning may initially append a weight X if the drug is believed to
be suitable, then adjust the weight based on actual outcomes as
tracked in the outcome module 120. Likewise, if the administered
drug cures the patient slowly and subsequently allows the patient
to recover completely, a higher weight (XX) may be assigned by the
machine learning algorithm. Similarly, if an administered drug
results in quick recovery then a much higher weight (XXX) may be
assigned to the medication and/or treatment by the machine learning
algorithm. In an emergency situation, the doctors may use outcome
prediction based on machine-learning techniques employed in the
outcome analytics facility 128 to confirm an initial diagnosis that
may have been made by a field emergency medical technician. In
certain preferred embodiments weights will be multivariate, such as
taking into account the medication, the TOA pattern for the
medication, clinical treatment factors, psychological observations,
and the like. Similarly, the outcomes that are fed into the machine
learning system may vary, such as including extent and timing of
recovery, mitigation or exacerbation of side effects, financial
factors, observation of satisfaction or psychological factors, and
the like.
[0126] Further, clinical outcomes of the medication may be measured
using indicators like, but not limited to, disease control, risk
reduction, and health care analysis of the patient undergoing
treatment. Clinical outcomes of a medication may also be measured
using monetary terms by analyzing the economical perspective of the
medication. The method for measuring clinical outcomes in monetary
terms may include: a) determining the most appropriate clinical
outcome of the medication; b) establishing monetary investment on
achieving the most appropriate clinical outcome, and thereafter,
calculating a financial value for the most appropriate clinical
outcome as per the monetary investment for the medication.
[0127] The above calculated financial value may be an indicator of
the cost-benefit analysis of the medication. The financial value
may be calculated for a drug, treatments, a medical facility, a
health-care management solution, a disease reduction program, and
the like.
[0128] The financial value may be employed as an indicator for
ranking a medication, a drug, treatments, a medical facility, a
health-care management solution, a disease reduction program, and
the like. For example, there may be more than one effective
medication that may be used to treat a set of diagnosed symptoms;
one of these may be more expensive than the other but equally
beneficial with regard to alleviating symptoms of the patient. In
this scenario, the financial value may determine the selection of
the medicine in order to provide the best clinical outcome for the
dollars spent.
[0129] Other factors may be combined with the cost of medication to
arrive at the most effective financial outcome in offering
treatment. For instance, factors such as a pharmacy management
information system, the prescription management facility 106, the
insurance and payments facility 138, and the like, may be combined
to arrive at numerous alternative pharmacy management features. The
insurance company may select a specific pharmacy management feature
to reimburse the hospital or patient in the management of a
particular disease. Validation of an RX may include the rating of
the medication prescribed and that rating may influence the rate of
reimbursement that may be dispensed by the insurance company. For
instance, one pharmacy management feature may include an RX with
various factors such as expensive medications and additional
therapies such as alternative medicine and psychotherapy that may
be incidental to the patient's recovery; another pharmacy
management feature may include other factors that include less
expensive but efficacious medications and only those therapies such
as physiotherapy, drug therapy and occupational therapy that may be
most essential to the patient's recovery. In such a scenario, the
insurance company may have the option of preferring to pay for the
RX that it considers most suitable for treating the patient and,
based on validation of the RX, it may prefer to reimburse cost of
the latter line of treatment and reject the former.
[0130] Further, the output of the outcome analytics facility 128
may be utilized by the rehabilitation and LTC facility 130 to plan
a long term care or the rehabilitation treatment for the patient.
This planning may be based on the different parameters such as
background needs of the patient, medical equipment needs, home
healthcare environment needs, nutrition, supply, commodities,
education & training, and the like. These parameters may be
obtained from the reports and the predictions made by the outcome
analytics facility 128. Further the rehabilitation and LTC facility
130 may obtain real-time medical event streams from the backbone
network 103. The rehabilitation and LTC facility 130 may also
communicate its events to other facilities via the backbone network
103. Further, the E-EHR/E-EMR facility 118 may store the event
outcomes from the rehabilitation and LTC facility 130, thus
creating the enhanced or enriched version of an E-EHR.
[0131] Another embodiment of the invention may provide real-time
data regarding aspects of a long term health care facilities'
prescription and administration of drugs. The HPDMA 100 may include
a real-time reporting facility which is configured to store data
related to any one of the identities of the patients, the
identities of the personnel who care for or are responsible for the
patient, medications prescribed, medications that were returned or
destroyed, costs associated with medications that were not covered
or only partially covered by a payer, costs associated with
medications for which the health care facility had to pay, and the
like. The real-time reporting facility may associate any of the
above parameters with any other of the above parameters. The
real-time reporting facility may also provide up-to-the-minute and
time-based summary information regarding the above parameters and
any of the related parameters. Such information may be presented to
a user via the workstation, for example, with text, graphics,
charts, and the like.
[0132] The output of the outcome analytics facility 128 may be
utilized by the third party integration facility 132. A third party
integration facility 132 may facilitate the use of third party
tools, such as payment management tools, data quality tools,
research tools, language translation tools, data normalization
tools, and the like in association with the HDPMA 100 facilities,
methods, and systems depicted in an described in relation to FIG. 1
and other figures herein.
[0133] The labs and imaging facility 134 may also utilize the
predictions and reports associated with the patients from the
outcome analytics facility 128 to conduct diagnostic tests on the
patients. The labs and imaging facility 134 may further communicate
the laboratory outcomes for the patient to other facilities of the
HPDMA 100 and these outcomes may further populate the E-EHR/E-EMR
facility 118.
[0134] The reports and predictions from the outcome analytics
facility 128 may further be utilized by the insurance and payments
facility 138 to prepare billing reports for the patient. The
reports and predictions from the outcome analytics facility 128 may
include details about the medications administrated to the patient.
These details may be utilized by the insurance and payments
facility 138 to identify the reimbursement and the non
reimbursement medications. The insurance and payments facility 138
facility may further communicate these billing details over the
backbone network and these details may be utilized by the other
facilities of the HPDMA 100.
[0135] The output of the outcome analytics facility 128 may further
be utilized by the regulatory facility 140. The regulatory facility
140 may be involved in planning and decision making for improving
and meeting compliance, addressing existing deficiencies in the
processes, reducing business risks, and the like.
[0136] The output of the outcome analytics facility 128 may further
be utilized by the pharmacy planning facility 142. In an exemplary
case, the output of the outcome analytics facility 128 may reveal
that many people suffer from a side effect, e.g., stomach
infection, after taking a particular medication (and in
embodiments, such information is collected by prescription
administration facility as described herein). In light of this
observation, the pharmacy planning facility 142 may change the
prescription instructions. In extension to this, the pharmacy
planning facility 142 may also include devising methods and
processes to make this information public by means of improving
product packaging through print and electronic media, and the like.
The pharmacy planning facility 142 may further include development
of a medication that is easier to digest or development of a
medication that may suppress the side effects of the previous
drug.
[0137] The output of the outcome analytics facility 128 may further
be utilized by the facility planning facility 144. In an exemplary
case, the output may include the ratio of inpatient and outpatient
services, older and critically sick patient population, treatment
patterns, advancement in technology, health data related to
diseases and conditions (asthma, cholesterol, diabetes, heart
disease, hypertension, obesity, etc.), type of healthcare
(ambulatory services, ER visits, etc.), data related to injuries
(accidents, suicides, homicides, etc.), life stages and population
(births, deaths, women's health, children's health, state and
territorial distribution, etc.), lifestyle (drug use, smoking,
exercise, etc.), and the like. Further, a long term care center or
a facility may provide rehabilitative, restorative, and/or ongoing
skilled nursing care to patients or residents in need of assistance
with activities of daily living. This facility planning may require
specific consideration and design than the facility planning for a
general healthcare center since it may cater to the needs of a
specific group (e.g., elderly or homeless) that are otherwise not
able to get focused healthcare and attention. Examples of long-term
care facilities may include nursing homes, rehabilitation
facilities, inpatient behavioral health facilities, long-term
chronic care hospitals, and the like. Long term care facilities may
be designed to make them safe, functional, durable and relatively
easy to maintain. Some parameters to be considered while designing
long term care facilities may include design, layout, ambience,
color management, dining and food management, online and
kiosk-based layouts, ease of access for the handicapped and the
like. For example, the facilities may be designed to include
automatic ID scanners for residents using the dining facility; it
may also be designed to facilitate easy movement for a patient
confined to a wheelchair.
[0138] The output of the outcome analytics facility 128 may further
be utilized by the insurance planning facility 148. The planning by
the insurance planning facility 148 may be done regarding
coinsurance options, i.e., the amount that is required to be paid
for medical care in a fee-for-service plan after meeting the
deductibles. Further, the planning may also be performed regarding
the suitability and selection of insurance plans based on the
requirements of an individual. Examples of various plans may
include basic plans, Health maintenance (HMOs), Preferred Provider
Organizations (PPOs), Points of Service (POS), and the like. Other
aspects that may be significant for insurance planning may include
information on customary fee, exclusions, maximum out-of-pocket
expenses, non-cancellation cases, premium, and the like.
[0139] The output of the outcome analytics facility 128 may further
be utilized by the dashboard facility 150 to generate different
kinds of reports and to allow medical-related personnel to interact
with the facilities and/or data available through the HPDMA 100. In
an exemplary case, the dashboard facility may provide a specialist
dashboard, a clinical outcome dashboard, a Long Term Health Care
(LTC) administrator dashboard, a LTC facility specific dashboard, a
pharmacist dashboard, various planning dashboards, prescription
management dashboards, and the like. Each dashboard may have
different looks that may be represented by data entry or display
fields or tabs. The dashboards may be populated in real-time with
the data from any of the facilities depicted in FIG. 1 including
the E-HER facility 118. Further, the dashboard facility 150 may be
communicatively coupled to the backbone network 103 to allow
real-time updating of an onscreen display of a dashboard with
information collected in real-time (e.g. medication administration
or patient event data).
[0140] The output of the outcome analytics facility 128 may further
be utilized by the care planning facility 152. Care planning may
include the planning of any aspect of patient care and may be based
at least in part on data provided by an E-EHR/E-EMR 118, actual
outcomes 124, predicted outcomes, and other analytics provided by
the outcomes analytics facility 128. A physical rehabilitation
facility manager may adjust a schedule of care takers and
rehabilitation specialists based on the outcomes or predicted
outcomes for patients being treated in regional hospitals. A nurse
may be notified that a patient on her shift has recently started a
medication that, based on an outcome prediction, will make the
person thirsty, so that the nurse can ensure that the patient has
plenty of fluids available. These are only examples of a few
potential care planning facility 152 features and therefore are not
representative of all of the features of the care planning facility
152.
[0141] FIG. 2 is a detailed schematic depiction of an exemplary
embodiment of medication management facility 106. The medication
management facility 106 may include a medication validation and
billing facility 102 and an electronic order entry facility 204
accessible by a validation workstation 210 and coupled to a
medication dispensing machine 104 that may generate patient and
dose specific packaged medication 222. The medication management
facility 106 may also include a medication or RX delivery facility
108 that may include a medication cart 216 on which the dispense
medication 222 may be arranged so that it can be read by an id
reader 220 that may communicate directly or through a workstation
218 with the medication validation and billing facility 102, such
as through the Internet.
[0142] As with all facilities described herein, some of the
facilities depicted in FIG. 2 may be embodied as physical devices
(e.g. computers, machines, carts, packaged medicine, scanners, and
the like), and some may be embodied as either software or a
combination of software and hardware. In an example, electronic
order facility 204, medication validation and billing facility 102
may be embodied as one or more software applications executing on a
processor, such as a web server that is in communication with the
other devices as depicted in FIG. 2.
[0143] The electronic order entry facility 204 may include a user
interface for aiding a health specialist to enter electronic
medication orders and other prescription-type orders. The user
interface may be displayed on the validation workstation 210, a
prescribing facility 154 (as shown in FIG. 1), any other electronic
communication device (e.g. a mobile phone, a hand-held prescription
entry device, and the like). The medication validation facility 102
may use security-type identification methods to uniquely identify,
record, and document the person entering the orders. As described
herein, the medication validation and billing facility 102 may be
configured to facilitate verifying formulary compliance of the
ordered medication(s), determining drug allergy information
associated with the prescribed drugs, confirming the drug
interaction information associated with the entered electronic
medication orders, and other prescription validation, inventory
compliance checks, billing compliance checks, and the like. On the
basis of any of these or other validation checks performed by the
facility 102, a signal may be sent to the source (e.g. a
workstation, etc) of the electronic medication order to warn the
prescriber on a patient-by-patient basis. Such warnings may need to
be resolved before accepting the order.
[0144] To facilitate compliance with pharmacy regulations and
generally support a high degree of quality control, a user
interface accessible on the validation workstation 210 may include
a utility that may allow a pharmacist to approve the electronic
medication orders after having reviewed all the relevant
information. The approval of the electronic medication orders may
also herein be referred to as releasing the orders. Further, the
medication validation and billing facility 102 may associate
relevant data to the released orders, such as patient identifying
information, the facility in which the patient resides or receives
care, locations within the facility (such as wing, floor, room,
etc.), patient insurance information, facility personnel
associated/responsible for the patient, administration frequency,
and the like. The information regarding the patient may be received
either electronically via interfaces to other systems (e.g. as
depicted in FIG. 1) or via manual input (e.g. through a user
interface of the validation workstation 210).
[0145] After the medication order has been approved, the medication
validation and billing facility 102 may communicate the released
orders and the data associated therewith to a medication dispensing
machine 104. In an example, the communication between the
medication validation and billing facility 102, and the medication
dispensing machine 104 may be in HL7 format. The medication
dispensing machine 104 may also receive instructions regarding the
medications to be dispensed, how to group the dispensed
medications, and how to label the packaging of the dispensed
medications 222. On the basis of the received instructions, the
medication dispensing machine 104 may package the medications into
individually packaged dosages. The medication dispensing machine
104 may also package the dosages according to data associated with
the order, for example, information related to the patient's
identity, the time of administration, the facility in which the
patient resides or receives care, locations within the facility
(such as wing, floor, room, etc.), patient insurance information,
facility personnel associated/responsible for the patient,
administration frequency, medication cart number, and the like. The
dosages may be packaged in packaging comprising human and
electronically readable information regarding the particular dosage
of medications. Electronically readable information could, in
embodiments, be bar-coded, although any other traceable marking or
device may be employed (RFID, 2D code, matrix code, and the like).
In an example, the medication dispensing machine 104 may package
bar-coded pillow packs for the patient. Further, different dosages
of medications for the same patients could be grouped together in
the same package resulting from instructions to associate a
patient's medication by patient identifying information, the
facility in which the patient resides or receives care, locations
within the facility (such as wing, floor, room, etc.), patient
insurance information, facility personnel associated/responsible
with the patient, administration frequency, and the like.
[0146] Further in an embodiment of the invention, the dispensed
medications 222 may be packaged and transported to a health care
facility that may be local to the dispensing machine 104 or may be
remotely located. The dispensed medications 222 may be transported
(e.g. on a medication cart 216 into which the packaged medication
dosages may be loaded) from the dispensing machine 104 to a health
care facility. In an example, the health care facility may receive
a plurality of medication carts 216, each of which may be
associated with a particular location in the facility such as a
particular facility, a floor in the facility, a wing of the
facility, etc. In this way, the packaged dosages having readable
information thereon that describe the intended location of the
patient or the cart in which the dosage should be stored, may
provide for easy and efficient loading of a medication cart 216.
The dispensed medicine 222 may be automatically loaded onto one of
the medication cards 216 that may be located near the dispensing
machine 104. Alternatively, the dispensed medication 222 may be
transported in bulk to a distribution location (e.g. a nurse's
station or an in-house pharmacy) and loaded onto a medication card
216 manually.
[0147] To facilitate management of medications stored on a
medication cart 216, a reader 220 and a medication workstation 218
may be used in the processing of medicine cart-based dispensed
medications 222. One or more user interfaces displayed on the
medication workstation 218 may support various work flow processes
associated with medication dispensing, transport, delivery, and the
like. The reader 220 and medication workstation 218 may be used at
any of a variety of events (e.g. as defined by the work flows)
associated with the sorting, distribution, transport, delivery,
unpacking, administration, and disposal of dispensed medications
222. In an example of remote sorting and medication cart 216
loading, a person may use a code reader to capture a marked code on
a pillow pack of medication and select a medication cart loading
work flow. The captured data may be transmitted (e.g. over the
internet) to the medication validation and billing facility 102
where it may be used to lookup medication cart 216 loading
instructions that may then be sent back to the medication
workstation 218 to be used by the person loading the medication
cart 216. In an example of dispensed medication 222 being
transported in the medication cart 216, a person may scan a label
on the medication cart 222 and select a transportation work flow.
The scanned data may be communicated to the validation and billing
facility 102 which may respond with specific facility floor and
wing information that may be displayed on the medication
workstation 218. The person may use the displayed location
information to forward the medication cart 216. Upon arrival of the
medication card 216 at the designated floor/wing, a person (e.g. a
nurse) may scan the label on the cart 216 again to signify that the
cart 216 has been received. Further in the example, to begin
delivering the individual medication dosages to patients on the
wing, a nurse may scan the cart 216 label and select a final
delivery workflow on the medication workstation 218. Although the
exemplary embodiments described above include specific
communications with the medication validation and billing facility
102, some or all of these communications may be changed to support
batch information transfer. For example, when the medication cart
216 is loaded near the medication dispensing machine 104, a batch
of data representing the loaded cart 216 may be sent to medication
workstation 218 to facilitate autonomous handling of the loaded
cart 216 at the selected destination (e.g. long term care
facility). Other combinations of real-time and batched
communications are possible and are included herein.
[0148] FIG. 3 depicts a detailed diagrammatic view of an exemplary
embodiment of the outcome analytics facility 128, in accordance
with an embodiment of the invention. The outcome analytics facility
128 may be utilized to determine the condition of the patient's
health, adverse event for a particular drug, sampling of patients
with an infectious disease, monitoring of patient flow during an
epidemic, outcome of a clinical test, correlation of disease in
case the clinical test is found to be positive or some other kind
of outcome related to healthcare data, and many other types of
outcome analytics. Results of the outcome analytics facility 128
may be used by other facilities as depicted in FIG. 1 and its
accompanying descriptions.
[0149] The outcome analytics facility 128 may include an input
facility 302, an analytic workbench facility 304, a machine
learning facility 308, and an outcome weighting facility 310, and
an analytics technique facility 312. The input facility 302 may
facilitate receiving a variety of different types of outcome data
to be analyzed, such as data from the outcome databases 124, the
third party databases 158, and the like. Data that may be processed
by the outcome analytics facility 128 may include prescription
data, medication administration data, E-EHR/E-EMR data, data
associated with patient's attributes, third party data, treatment
outcomes and the like. The input facility 302 may provide some
initial data processing to normalize data and/or otherwise
transform it to be suitable for further analysis by the analytic
workbench facility 304, the machine learning facility 308, and/or
the outcome weighting facility 310. Further, the input facility 302
may provide data provided to the analytics facility 128 to
analytics processing facilities that may include the analytic
workbench facility 304 or the machine learning facility 308. For
example, the input facility 302 may provide a training data set to
the machine learning facility 308 for training the machine learning
facility 308. In another example, the input facility 302 may
optionally direct received outcome data to an outcome weighting
facility 310.
[0150] In an embodiment of the invention, the analytic workbench
facility 304 may predict an outcome of a medically-related event by
implementing one or more statistical techniques obtained from the
analytic technique facility 312. The analytic technique facility
312 may include, without any limitation, regression analysis,
iterative analysis, complex modeling, multivariable analytics,
Analysis of Variance (ANOVA), Chi-square test, Correlation, Factor
analysis, Mann-Whitney U, Mean square weighted deviation (MSWD),
Pearson product-moment correlation coefficient, Regression
analysis, Spearman's rank correlation coefficient, Student's
t-test, Time series analysis, Bootstrap & Jackknife Resampling,
Statistical classification, Statistical surveys, Structured data
analysis (statistics), Survival analysis, Multivariate discriminant
analysis, Linear discriminant analysis, Cluster analysis, Principal
component analysis, and the like. Depending on the type of
prediction or analysis function that is to be performed by the
analytics facility 128, one or more of these techniques may be
selected for use by the analytics engine. The analytic techniques
facility 312 may be a database of algorithms that may be accessible
to the analytics engine facility 304.
[0151] Similarly, real time event data may be associated with the
outcome. The analytic workbench facility 304 may perform
statistical analysis to determine whether the occurrence of a
specific event is significant to the outcome data. Feedback may be
provided from the analytics facility 128 to a caregiver in case the
event is statistical and significant to a specific patient. In
another embodiment, the analytic workbench facility 304 may include
a feedback loop that may be utilized for correcting the output
and/or the outcome. For example, the data provided to the analytics
engine facility 304 may have missing data; the missing data may be
fitted accordingly to the standard techniques known in the art. In
addition, the output may be fed back into the analytics engine
facility 304 for correcting the deviation of output to the actual
output; for example, degeneration of virus may follow a Poisson's
distribution rather than exponential distribution.
[0152] Further, the analytic workbench facility 304 may be
programmed to dynamically select the best algorithm in a specific
situation. Alternatively, the analytic workbench facility 304 may
include a GUI enabling the user to select the algorithm to be
applied. Additionally, the analytic workbench facility 304 may
utilize the previous learning to train in suitable techniques for
optimum prediction. In an embodiment, the prediction of the future
event based on the earlier event may be an integral part of the
analytic workbench facility 304. In this regard, the analytic
workbench facility 304 may extrapolate data to identify future
events associated with the patient and raise an alert to doctors
about these future events. For example, administration of aspirin
may reduce the phenomena of clotting in a patient; however, because
of an emergency, the drug (aspirin) may be administered to the
patient. In this scenario, the analytic workbench facility 304 may
alert the medical staff about the possible reduction in clotting of
blood. The doctor operating upon this patient may be informed in
advance in order to take remedial action.
[0153] In another embodiment of the invention, a machine learning
facility 308 may be implemented using neural networks to produce
the predicted outcomes. Various types of neural networks may be
employed including learning algorithms, reinforcement-learning
algorithms, supervised learning algorithms, and unsupervised
learning algorithms. Further, other techniques include genetic
algorithm, biological cybernetics, biologically inspired computing,
cerebella model articulation controller, cognitive architecture,
cultured neuronal networks, neural network software, neuro-fuzzy,
neuroscience, predictive analytics, radial basis function network,
recurrent neural networks, self-organizing map, simulated reality,
hidden markov model, kalman filter, decision theory, support vector
machine, tensor product network, time adaptive self-organizing map,
time delay neural network and the like.
[0154] Further, the machine learning facility 308 may be used to
perform various data mining operations on the data such as
classification, clustering and other data mining techniques known
in the art. To this end, the effect of various drugs on a
particular disease may be studied, and an identification relating
to the effect of the drug may be recorded. For example, brand X may
cause fewer side effects, when administered to children, than brand
Y. Likewise, in another example, brand Y may be more effective in
critical conditions. These analyses may help doctors and other
medical staff to create a knowledge map for treatment under
different conditions.
[0155] In an embodiment, machine learning may be performed by
taking into account a weight from an outcome weighting facility 310
that reinforces a particular result. For example, the machine
learning facility 308 may apply a weight X in an outcome prediction
if a drug associated with the prediction is found to be suitable.
Likewise, if the administered drug cures the patient slowly and
subsequently allows the patient to recover completely, a higher
weight (XX) may be assigned to the outcome in the machine learning
algorithm. Similarly, if an administered drug results in quick
recovery then a much higher weight (XXX) may be assigned to the
outcome in the machine learning algorithm. In an embodiment, both
the analytics engine facility 304 and the machine learning facility
308 may be simultaneously utilized for predicting the outcome of
the input data. For example, the input data may be first passed to
the analytics engine facility 304 and subsequently to the machine
learning facility 308 for determining the predicted data. In
another example, the input data may be first passed to the machine
learning facility 308 and subsequently to the analytics engine
facility 304 for determining the predicted data.
[0156] In another embodiment, a feedback loop may be provided in
association with the machine learning facility 308 to reintroduce a
part of the predicted outcome data back into the machine learning
facility 308. In this scenario, the feedback loop may either be a
positive feedback or a negative feedback, reinforcing the outcome
in the first case and damping the outcome in the latter case. In
another embodiment, the machine learning may be in the form of
weighted feedback and the weights introduced in the feedback loop
may determine the outcome of the predicted data.
[0157] FIG. 4 illustrates a process and system 400 for
automatically establishing an Enhanced Electronic Health Report
(E-EHR) with medication administration data of a medically-related
event that is automatically collected in real-time in proximity to
a patient, in accordance with an embodiment of the invention. The
process begins at step 402. At step 404, medication administration
data 408 of the medically-related event associated with the patient
may be collected. The step 404 of collecting the medication
administration data 408 of the medically-related event may be
accomplished by an automatic data collection facility in proximity
to the patient such as those described herein. In embodiments, the
automatic data collection facility may be a machine reader. In an
embodiment of the invention, the machine reader may be a handheld
barcode reader facility 410. The handheld barcode reader facility
410 may read the barcodes on the packaging of a dosage of
medication and may be in electronic communication with the
prescription administration facility (not shown in the FIG. 4). The
medication administration data 408 may be raw medication
identification data that may be transformed to be suitable or used
with a medication information database, or it may include the
medication, time of administration, dosage, reaction data, and
administration of a dosage of medication.
[0158] As described herein, additional data about the
medically-related event (which in embodiments may be the medication
administration data 408) may be fed into a computer 412. As an
example, a caregiver might scan the coded information on a
medication packet to initiate the process 400. The coded
information may be automatically read by the automatic data
collection facility. The medication administration facility (110 in
FIG. 1) may also prompt the user to enter other relevant data about
the patient's current condition at the time of medication
administration, which in embodiments such input may be into the
automatic data collection facility or into one of the various
smartphones, computing devices, etc. in electronic communication
with the automatic data collection facility and/or other facilities
disclosed in connection with FIG. 1.
[0159] After the medication administration data 408 of the
medically-related event associated with the patient has been
collected at step 404, the handheld barcode reader facility 410 may
communicate via an electronic communication, the collected
medication administration data 408, to the computer 412, which may
represent any of the facilities depicted in FIG. 1 (e.g.
prescription management facility 106, prescribing facility 154,
outcome database module 124, and the like). In an embodiment of the
invention, the electronic communication may be the Internet.
Thereafter, at step 414 the medication administration data 408 and
other information may be integrated automatically in real-time with
the patient's EHR 418 to establish the E-EHR 420 of the patient.
The step 414 of integrating the medication administration data 408
and other information may be accomplished by using the computer
412. The step 414 may further include using the computer 412 to
transform the raw medication administration data so that it can be
integrated with the patient's EHR. The process ends at step
422.
[0160] FIG. 5 illustrates a process and system 500 for
automatically maintaining an E-EHR with prescription administration
data of a healthcare-related event that is automatically collected
in real-time in proximity to a patient, in accordance with an
embodiment of the invention. The process begins at step 502. At
step 504, the prescription administration data 508 of a
healthcare-related event associated with a patient may be
collected. The step 504 of collecting the prescription
administration data 508 of the medically-related event may be
accomplished by an automatic data collection facility in proximity
to the patient such as those described herein. In embodiments, the
automatic data collection facility may be a machine reader. In an
embodiment of the invention, the machine reader may be a handheld
barcode reader facility 510. The barcode reader facility 510 may
read the barcodes on the packaging of the dosage of medication and
may be in electronic communication with the prescription
administration facility (not shown in the FIG. 6). Further, the
prescription administration data 508 may be raw prescription
administration data that may be transformed to be suitable or used
with a medication information database.
[0161] As described herein, additional data about the
medically-related event (which in embodiments may be the
prescription administration data 508) may be fed into a computer
512. As an example, a caregiver might scan the coded information on
a medication packet to initiate the process 500. The coded
information may be automatically read by the automatic data
collection facility. The medication administration facility (110 in
FIG. 1) may also prompt the user to enter other relevant data about
the patient's current condition at the time of medication
administration.
[0162] After the prescription administration data 508 of the
medically-related event associated with the patient has been
collected at step 504, the handheld barcode reader facility 510 may
communicate via an electronic communication, the collected
prescription administration data 508, to the computer 512 which may
represent any of the facilities depicted in FIG. 1 (e.g.
prescription management facility 106, prescribing facility 154,
outcome database module 124, and the like). In an embodiment of the
invention, the electronic communication may be the Internet.
Thereafter, at step 514 the prescription administration data 508
and other information may be integrated automatically in real-time
with the patient's E-EHR facility 518 to maintain the E-EHR
facility 518. The step 514 of integrating the prescription
administration data 508 and other information may be accomplished
by using the computer 512. The step 514 may further include using
the computer 512 to transform the raw prescription administration
data 508 so that it can be integrated with the patient's EHR. The
process ends at step 520.
[0163] FIG. 6 illustrates a process and system 600 for
automatically establishing an E-EHR with patient health condition
data of a medically-related event that is automatically collected
in real-time in proximity to a patient, in accordance with an
embodiment of the invention. The process begins at step 602. At
step 604, patient health condition data 608 of the
medically-related event associated with the patient may be
collected. The step 604 of collecting the patient health condition
data 608 of the medically-related event may be accomplished by an
automatic data collection facility in proximity to the patient such
as those described herein. In embodiments, the automatic data
collection facility may be a health condition monitor. In an
embodiment of the invention, the health condition monitor may be a
handheld blood glucose monitoring facility 610. The handheld blood
glucose meter facility 610 may monitor the blood glucose level
associated with patient and may be in electronic communication with
the prescription administration facility (not shown in the FIG. 6).
The patient health condition data 608 may be raw health condition
data that may be transformed to be suitable or used with a
medication information database, or it may include patient vital
signs, patient blood chemistry results, and the like.
[0164] As described herein, additional data about the
medically-related event (which in embodiments may be the patient
health condition data 608) may be fed into a computer 612. As an
example, a caregiver might monitor the blood glucose level
associated with the patient by using the handheld blood glucose
monitoring facility 610 to initiate the process 600. The monitored
information may be automatically read by the automatic data
collection facility. The medication administration facility (110 in
FIG. 1) may also prompt the user to enter other relevant data about
the patient's current condition at the time of medication
administration.
[0165] After the patient health condition data 608 of the
medically-related event associated with the patient has been
collected at step 604, the handheld blood glucose monitoring
facility 610 may communicate via an electronic communication, the
collected patient health condition data 608, to the computer 612
which may represent any of the facilities depicted in FIG. 1 (e.g.
prescription management facility 106, prescribing facility 154,
outcome database module 124, and the like). In an embodiment of the
invention, the electronic communication may be the Internet.
Thereafter, at step 614 the patient health condition data 608 and
other information may be integrated automatically in real-time with
the patient's EHR facility 618 to establish the E-EHR facility 620
of the patient. The step 614 of integrating the patient health
condition data 608 and other information may be accomplished by
using the computer 612. The step 614 may further include using the
computer 612 to transform the raw health condition data so that it
can be integrated with the patient's EHR. The process ends at step
622.
[0166] FIG. 7 illustrates a process and system 700 for
automatically establishing an E-EHR with patient psychological data
of a medically-related event that is automatically collected in
real-time in proximity to a patient, in accordance with an
embodiment of the invention. The process begins at step 702. At
step 704, the patient psychological data 708 of the
medically-related event associated with the patient may be
collected. The step 704 of collecting the patient outcome data 708
of the medically-related event may be accomplished by an automatic
data collection facility in proximity to the patient such as those
described herein. In embodiments, the patient psychological data
708 may be collected upon observation of an occurrence of the
medically-relevant event. Further, the automatic data collection
facility may be a machine reader. In an embodiment of the
invention, the machine reader may be a handheld barcode reader
facility 710. The handheld barcode reader facility 710 may read the
barcodes on the packaging of a dosage of medication and may be in
electronic communication with the prescription administration
facility (not shown in the FIG. 7). Further, the patient
psychological data 708 may be raw psychological data that may be
transformed to be suitable or used with a medication information
database.
[0167] As described herein, additional data about the
medically-related event (which in embodiments may be the patient
psychological data 708) may be fed into a computer 712. As an
example, a caregiver might scan the coded information on a
medication packet to initiate the process 700. The coded
information may be automatically read by the automatic data
collection facility. The medication administration facility (110 in
FIG. 1) may also prompt the user to enter other relevant data about
the patient's current condition at the time of medication
administration.
[0168] After the patient psychological data 708 of the
medically-related event associated with the patient has been
collected at step 704, the handheld barcode reader facility 710 may
communicate via an electronic communication, the collected patient
psychological data 708, to the computer 712 which may represent any
of the facilities depicted in FIG. 1 (e.g. prescription management
facility 106, prescribing facility 154, outcome database module
124, and the like). In an embodiment of the invention, the
electronic communication may be the Internet. Thereafter, at step
714 the patient psychological data 708 and other information may be
integrated automatically with real-time into the patient's EHR
facility 718 to establish the E-EHR facility 720 of the patient.
The step 714 of integrating the patient psychological data 708 and
other information may be accomplished by using the computer 712.
The step 714 may further include using the computer 712 to
transform the raw psychological data so that it can be integrated
with the patient's EHR. The process ends at step 722.
[0169] FIG. 8 illustrates a process and system 800 for
automatically maintaining an E-EHR with administration data of a
prescription for a patient that is collected during a
medically-related event automatically and in real-time while in
proximity to the patient. The process begins at step 802. At step
804, prescription administration data 808 related to the
medically-related event associated with the patient may be
collected. The step 804 of collecting the prescription
administration data 808 of the medically-related event may be
accomplished by an automatic data collection facility in proximity
to the patient such as those described herein. In embodiments, the
prescription administration data 808 may be collected upon
observation of an occurrence of the medically-relevant event.
Further, the prescription administration data 808 may be
identifiable by the prescription management data in patient's EHR.
Further, the automatic data collection facility may be a machine
reader. In an embodiment of the invention, the machine reader may
be a handheld barcode reader facility 810. The handheld barcode
reader facility 810 may read the barcodes on the packaging of a
dosage of medication and may be in electronic communication with
the prescription administration facility (not shown in the FIG. 8).
Further, the prescription administration data 808 may be raw
prescription administration data that may be transformed to be
suitable or used with a medication information database.
[0170] As described herein, additional data about the
medically-related event (which in embodiments may be the
prescription administration data 808) may be fed into a computer
812. As an example, a caregiver might scan the coded information on
a medication packet to initiate the process 800. The coded
information may be automatically read by the automatic data
collection facility. The medication administration facility (110 in
FIG. 1) may also prompt the user to enter other relevant data about
the patient's current condition at the time of medication
administration.
[0171] After the prescription administration data 808 of the
medically-related event associated with the patient has been
collected at step 804, the handheld barcode reader facility 810 may
communicate via an electronic communication, the collected
prescription administration data 808, to the computer 812 which may
represent any of the facilities depicted in FIG. 1 (e.g.
prescription management facility 106, prescribing facility 154,
outcome database module 124, and the like). In an embodiment of the
invention, the electronic communication may be the Internet.
Thereafter, at step 814 the prescription administration data 808
and other information may be integrated automatically with
real-time into the patient's E-EHR facility 818 to maintain the
E-EHR facility 810. The step 814 of integrating the prescription
administration data 808 and other information may be accomplished
by using the computer 814. The step 814 may further include using
the computer 812 to transform the raw prescription administration
data so that it can be integrated with the patient's E-EHR facility
818. The process ends at step 820.
[0172] FIG. 9 illustrates a process and system 900 for
automatically maintaining an E-EHR with medication administration
data that includes patient identification data of a
medically-related event that is automatically collected in
real-time in proximity to a patient, in accordance with an
embodiment of the invention. The process begins at step 902. At
step 904, medication administration data 908 of the
medically-related event associated with the patient may be
collected. The step 904 of collecting the medication administration
data 908 of the medically-related event may be accomplished by an
automatic data collection facility in proximity to the patient such
as those described herein. In embodiments, the automatic data
collection facility may be a machine reader. In an embodiment of
the invention, the machine reader may be a handheld barcode reader
facility 910. The handheld barcode reader facility 910 may read the
barcodes on the packaging of a dosage of medication and may be in
electronic communication with the prescription administration
facility (not shown in the FIG. 9). The medication administration
data 908 may be raw medication identification data that may be
transformed to be suitable or used with a medication information
database, or it may include patient identification data that may be
collected from a medication container contemporaneously with the
medically-related event.
[0173] As described herein, additional data about the
medically-related event (which in embodiments may be the medication
administration data 908) may be fed into a computer 912. As an
example, a caregiver might scan the coded information on a
medication packet to initiate the process 900. The coded
information may be automatically read by the automatic data
collection facility. The medication administration facility (110 in
FIG. 1) may also prompt the user to enter other relevant data about
the patient's current condition at the time of medication
administration.
[0174] After the medication administration data 908 of the
medically-related event associated with the patient has been
collected at step 904, the handheld barcode reader facility 910 may
communicate via an electronic communication, the collected
medication administration data 908, to the computer 912 which may
represent any of the facilities depicted in FIG. 1 (e.g.
prescription management facility 106, prescribing facility 154,
outcome database module 124, and the like). In an embodiment of the
invention, the electronic communication may be the Internet.
Thereafter, at step 914 the medication administration data 908 and
other information may be integrated automatically in real time with
the patient's E-EHR 918 to maintain the E-EHR 918 of the patient.
The step 914 of integrating the medication administration data 908
and other information may be accomplished by using the computer
912. The step 914 may further include using the computer 912 to
transform the raw medication administration data so that it can be
integrated with the patient's EHR. The process terminates at step
920.
[0175] FIG. 10 illustrates a process and system 1000 for
automatically maintaining an E-EHR with medication administration
related data of medication that is not administered in a
medically-related event that is automatically collected in
real-time in proximity to a patient, in accordance with an
embodiment of the invention. The process begins at step 1002. At
step 1004, medication administration data 1008 of the
medically-related event associated with the patient may be
collected. The step 1004 of collecting the medication
administration data 1008 of the medically-related event may be
accomplished by an automatic data collection facility in proximity
to the patient such as those described herein. In embodiments, the
automatic data collection facility may be a machine reader. In an
embodiment of the invention, the machine reader may be a handheld
barcode reader facility 1010. The handheld barcode reader facility
1010 may read the barcodes on the packaging of a dosage of
medication and may be in electronic communication with the
prescription administration facility (not shown in the FIG. 10).
The medication administration data 1008 may be raw medication
identification data that may be transformed to be suitable or used
with a medication information database, or it may include a
medication data that was prescribed but not administered during the
occurrence of the event.
[0176] As described herein, additional data about the
medically-related event (which in embodiments may be the medication
administration data 1008) may be fed into a computer 1012. As an
example, a caregiver might scan the coded information on a
medication packet to initiate the process 1000. The coded
information may be automatically read by the automatic data
collection facility. The medication administration facility (110 in
FIG. 1) may also prompt the user to enter other relevant data about
the patient's current condition at the time of medication
administration.
[0177] After the medication administration data 1008 of the
medically-related event associated with the patient has been
collected at step 1004, the handheld barcode reader facility 1010
may communicate via an electronic communication, the collected
medication administration data 1008, to the computer 1012 which may
represent any of the facilities depicted in FIG. 1 (e.g.
prescription management facility 106, prescribing facility 154,
outcome database module 124, and the like). In an embodiment of the
invention, the electronic communication may be the Internet.
Thereafter, at step 1014 the medication administration data 1008
and other information may be integrated automatically in real time
with the patient's E-EHR 1018 to maintain the E-EHR 1018 of the
patient. The step 1014 of integrating the medication administration
data 1008 and other information may be accomplished by using the
computer 1012. The step 1014 may further include using the computer
1012 to transform the raw medication administration data so that it
can be integrated with the patient's EHR. The process ends at step
1020.
[0178] FIG. 11 illustrates a process and system 1100 for
maintaining a health information dashboard with medication
administration data of a medically-related event that is collected
in real-time in proximity to a patient, in accordance with an
embodiment of the invention. The process begins at step 1102. At
step 1104, medication administration data 1108 of the
medically-related event associated with the patient may be
collected. The step 1104 of collecting the medication
administration data 1008 of the medically-related event may be
accomplished by an automatic data collection facility in proximity
to the patient such as those described herein. In embodiments, the
automatic data collection facility may be a machine reader. In an
embodiment of the invention, the machine reader may be a handheld
barcode reader facility 1110. The handheld barcode reader facility
1110 may read the barcodes on the packaging of a dosage of
medication and may be in electronic communication with the
prescription administration facility (not shown in the FIG. 11).
The medication administration data 1108 may be raw medication
identification data that may be transformed to be suitable or used
with a medication information database, or it may include the
medication, time of administration, dosage, reaction data and
administration of a dosage of medication.
[0179] As described herein, additional data about the
medically-related event (which in embodiments may be the medication
administration data 1108) may be fed into a computer 1112. As an
example, a caregiver might scan the coded information on a
medication packet to initiate the process 1100. The coded
information may be automatically read by the automatic data
collection facility. The medication administration facility (110 in
FIG. 1) may also prompt the user to enter other relevant data about
the patient's current condition at the time of medication
administration. Further, the medication administration data 1108
may be raw medication identification data that may be transformed
to be suitable or used with a medication information database.
[0180] After, the medication administration data 1108 of the
medically-related event associated with the patient has been
collected at step 1104, the handheld barcode reader facility 1110
may communicate via an electronic communication, the collected
medication administration data 1108, to the computer 1112 which may
represent any of the facilities depicted in FIG. 1 (e.g.
prescription management facility 106, prescribing facility 154,
outcome database module 124, and the like). In an embodiment of the
invention, the electronic communication may be the Internet.
Thereafter, at step 1114 the medication administration data 1108
and other information may be integrated automatically in real time
with a data repository 1118. In an embodiment of the invention, the
data repository 1118 may be the E-EHR of the patient. The step 1114
of integrating the medication administration data 1008 and other
information may be accomplished by using the computer 1112. The
step 1114 may further include using the computer 1112 to transform
the raw medication administration data so that it can be integrated
with the data repository 1118.
[0181] At step 1120, after the medication administration data 1108
has been integrated with the data repository 1118, the medication
administration data 1108 may be displayed on a dashboard of a user
interface to facilitate the management of health care
administration for a facility. In an embodiment of the invention,
the step 1120 may be accomplished by using a computer 1122. The
computer 1112 may include: (a) an input data port to obtain the
medication administration data 1108 from the data repository 1118,
(b) a database for storing the obtained medical administration data
1108, (c) a Central Processing Unit (CPU) for processing the stored
medical administration data 1108, and (d) a user interface to
display the processed medication administration data 1108. The
process ends at step 1124.
[0182] FIG. 12 illustrates a process and system 1200 for managing
prescription and administration of a medication, in accordance with
an embodiment of the invention. The process begins at step 1202. At
step 1204, a database 1208 having information from a reporting
source may be accessed. In an embodiment of the invention, the
reporting source may include an automatic data collection facility
for collecting medication administration data 1210 of a
medically-related event in proximity to a patient upon the
occurrence of the event such as those described herein. In
embodiments, the automatic data collection facility may be a
machine reader. In an embodiment of the invention, the machine
reader may be a handheld barcode reader facility 1212. The handheld
barcode reader facility 1212 may read the barcodes on the packaging
of a dosage of medication and may be in electronic communication
with the prescription administration facility (not shown in the
FIG. 12). The medication administration data 1210 may be raw
medication identification data that may be transformed to be
suitable or used with a medication information database, or it may
include the medication, time of administration, dosage, reaction
data, and administration of a dosage of medication.
[0183] As described herein, additional data about the
medically-related event (which in embodiments may be the medication
administration data 1210) may be fed into a computer 1214. As an
example, a caregiver might scan the coded information on a
medication packet to initiate the process 1200. The coded
information may be automatically read by the automatic data
collection facility. The medication administration facility (110 in
FIG. 1) may also prompt the user to enter other relevant data about
the patient's current condition at the time of medication
administration.
[0184] After the information has been accessed from the reporting
source at step 1204, at step 1218, a user selectable dashboard
definer may be configured to provide user selectable options for
defining the information from the database 1208. In an embodiment
of the invention, the information from the database 1208 may be
defined to be presented in a report at a dashboard. In an
embodiment of the invention, the step 1218 may be accomplished by
using a computer 1220. The computer 1220 may include: (a) an input
data port to obtain the medication administration data 1210 from
the data repository 1118, (b) a database for storing the obtained
medical administration data 1210, (c) a Central Processing Unit
(CPU) for processing the stored medical administration data 1210,
and (d) a user interface to display the processed medication
administration data 1210. Further, at step 1222, a display definer
may be configured to operate in conjunction with the user
selectable dashboard definer to define the format in which the
report from the database 1208 may be presented at the dashboard.
The process ends at step 1224.
[0185] FIG. 13 illustrates a process and system 1300 for predicting
a health-related outcome of a patient with a health condition, in
accordance with an embodiment of the invention. The process begins
at step 1302. At step 1304, medication administration data 1308 and
patient health condition data 1310 of a medically-related event
associated with the patient may be collected. The step 1304 of
collecting the medication administration data 1308 and patient
health condition data 1310 of the medically-related event may be
accomplished by an automatic data collection facility in proximity
to the patient such as those described herein. In embodiments, the
automatic data collection facilities may be a machine reader,
health monitoring device, and the like. In an embodiment of the
invention, the machine reader may be a handheld barcode reader
facility 1312A. The handheld barcode reader facility 1312A may read
the barcodes on the packaging of a dosage of medication and may be
in electronic communication with the prescription administration
facility (not shown in the FIG. 13). In another embodiment of the
invention, the health monitoring device may be a handheld blood
glucose monitoring facility 1312B. The handheld blood glucose
monitoring facility 1312B may monitor the blood glucose level
associated with patient and may be in electronic communication with
the prescription administration facility (not shown in the FIG.
13). Further, the medication administration data 1308 may include
raw medication administration data that may be transformed to be
suitable or used with a medication information database, or may
include the medication, time of administration, dosage, reaction
data, and administration of a dosage of medication. Further, the
patient health condition data 1310 may be raw health condition data
that may be transformed to be suitable or used with a medication
information database, or it may include patient vital signs,
patient blood chemistry results, and the like.
[0186] As described herein, additional data about the
medically-related event (which in embodiments may be the
prescription administration data 1308 and the patient health
condition data 1310) may be fed into a computer 1314. As an
example, a caregiver might monitor the blood glucose level
associated with the patient by using the handheld blood glucose
monitoring facility 610 or might scan the coded information on a
medication packet to initiate the process 600. The monitored
information or the coded information may be automatically read by
the automatic data collection facility. The medication
administration facility (110 in FIG. 1) may also prompt the user to
enter other relevant data about the patient's current condition at
the time of medication administration.
[0187] After the medication administration data 1308 and the
patient health condition data 1310 of the medically-related event
associated with the patient has been collected at step 1304, the
handheld barcode reader facility 1310 and the handheld blood
glucose monitoring facility 1312B may communicate via an electronic
communication, the collected medication administration data 1308,
and the patient health condition data 1310 to the computer 1314
which (as in all embodiments herein) may represent or provide
access to any of the facilities depicted in FIG. 1 (e.g.
prescription management facility 106, prescribing facility 154,
outcome database module 124, and the like). In an embodiment of the
invention, the electronic communication may be the Internet.
Thereafter, at step 1318 the medication administration data 1308,
the patient health condition data 1310, and other information may
be integrated automatically in real-time with a data repository
1320. In an embodiment of the invention, the data repository 1320
may be the E-EHR of the patient. The step 1318 of integrating the
medication administration data 1308, the patient health condition
data 1310 and other information may be accomplished by using the
computer 1314. The step 1318 may further include using the computer
1314 to transform the raw medication administration data and the
raw health condition data so that it can be integrated with the
data repository 1320.
[0188] At step 1322, after the medication administration data 1308
and the patient health condition data 1310 has been integrated with
the data repository 1320, the medication administration data 1308
and the patient health condition data 1310 may be utilized for
predicting the heath record outcomes. In an embodiment of the
invention, the step 1322 may be accomplished by the outcome
analytics facility 1324. The functionality of the outcome analytics
facility 1324 may be similar to the outcome analytics facility 128
as depicted in FIG. 3. The process ends at step 1326.
[0189] FIG. 14 illustrates a process and system 1400 for predicting
a health-related outcome of a patient with a health condition, in
accordance with an embodiment of the invention. The process begins
at step 1402. At step 1404, medication administration data 1408 of
a medically-related event associated with the patient may be
collected. The step 1404 of collecting the medication
administration data 1408 of the medically-related event may be
accomplished by an automatic data collection facility in proximity
to the patient such as those described herein. In embodiments, the
automatic data collection facilities may be a machine reader. In an
embodiment of the invention, the machine reader may be a handheld
barcode reader facility 1410. The handheld barcode reader facility
1410 may read the barcodes on the packaging of a dosage of
medication and may be in electronic communication with the
prescription administration facility (not shown in the FIG. 14).
Further, the medication administration data 1408 may include raw
medication administration data that may be transformed to be
suitable or used with a medication information database, or may
include the medication, time of administration, dosage, reaction
data, and administration of a dosage of medication.
[0190] As described herein, additional data about the
medically-related event (which in embodiments may be the
prescription administration data 1408) may be fed into a computer
1412. As an example, a caregiver might scan the coded information
on a medication packet to initiate the process 1400. The coded
information may be automatically read by the automatic data
collection facility. The medication administration facility (110 in
FIG. 1) may also prompt the user to enter other relevant data about
the patient's current condition at the time of medication
administration.
[0191] After the medication administration data 1408 of the
medically-related event associated with the patient has been
collected at step 1404, the handheld barcode reader facility 1410
may communicate via an electronic communication, the collected
medication administration data 1408, to the computer 1412 which may
represent any of the facilities depicted in FIG. 1 (e.g.
prescription management facility 106, prescribing facility 154,
outcome database module 124, and the like). In an embodiment of the
invention, the electronic communication may be via the Internet.
Thereafter, at step 1414 the medication administration data 1408
and other information may be integrated automatically in real-time
with a data repository 1418. In an embodiment of the invention, the
data repository 1418 may be the E-EHR of the patient. The step 1414
of integrating the medication administration data 1408 and other
information may be accomplished by using the computer 1412. The
step 1414 may further include using the computer 1412 to transform
the raw medication administration data so that it may be integrated
with the data repository 1418.
[0192] At step 1420, after the medication administration data 1408
has been integrated with the data repository 1418, the medication
administration data 1408 may be utilized for predicting the heath
record outcomes. In an embodiment of the invention, the step 1420
may be accomplished by the outcome analytics facility 1422. The
functionality of the outcome analytics facility 1422 may be similar
to the outcome analytics facility 128 as depicted in FIG. 3.
Further at step 1424, the predicted output generated by the outcome
analytics facility 1422 may be utilized to facilitate prescription
management as depicted by pharmacy management dashboard 1426. The
process ends at step 1428.
[0193] The FIG. 15 illustrates an exemplary dashboard 1500 to
depict a medication administration event for a patient in the Long
Term Care (LTC), in accordance with an embodiment of the invention.
In an embodiment of the invention, the dashboard 1500 may be
populated with the real-time data from the E-EHR/E-EMR facility
(not shown in FIG. 1). Further, at the time of administration of
medication, the caregiver administering the medication to the
patient may utilize technology-enabled devices such as handheld
barcode scanners or other devices at the point of administration.
The use of handheld barcode scanners may allow real-time capturing
of information about the events associated with medication
administration. In an embodiment of the invention, the information
captured upon scanning of the barcodes may be displayed by the
dashboard in an area 1502. Further, the items depicted in area 1504
may also be loaded automatically on the dashboard as the barcodes
are detected by handheld barcode scanners. The items in the area
1504 may include, but not limited to, patient name, patient ID,
location of the patient, and the administrator/caregiver ID. In an
embodiment of the invention, the caregiver may confirm the items
displayed in the area 1504 by selecting an option YES as displayed
in area 1510A. In another embodiment of the invention, the
caregiver may reject the items displayed in the area 1504 by
selecting an option NO as displayed in the area 1510A.
[0194] Further, in an embodiment of the invention, after the
caregiver has confirmed the items displayed in area 1504, an area
1508 may get displayed automatically. In an embodiment of the
invention, the area 1508 may include the medication name that is
being administered to the patient. In an embodiment of the
invention, the caregiver may confirm the displayed medication in
the area 1508 by selecting an option YES as displayed in area
1510B. In another embodiment of the invention, the caregiver may
reject the displayed medication in the area 1508 by selecting an
option NO as displayed in the area 1510B.
[0195] Further, in an embodiment of the invention, after the
caregiver has confirmed the medication displayed in area 1508, an
area 1512 may get loaded automatically on the dashboard. The items
in the area 1512 may include, but not limited to, the
administration date, the administration time, the dose administered
to the patient, the medication prescription (RX) written for the
patient, the RX approved, the information about first filling of
the medication, the information about last filling of the
medication, the delivery date of the medication, and the like.
[0196] Further, in an embodiment of the invention, the dashboard
1500 may display an area 1514 to prompt the caregiver to enter
information about the medication administration event. The entered
information may include, but not limited to, administrator
observations, the details of the vitals associated with the
patient, the review of prior symptoms associated with the patient,
nay new symptoms after the medication was administered to the
patient, and the like.
[0197] Computer-based or electronic order entry may guide doctors,
nurses, and other authorized staff through quick and efficient
electronic ordering of medication, related treatment, and clinical
care services required by patients. The clinical care services may
include diet, nutrition, therapy, lab services, and the like. This
in turn may streamline the interaction between the
pharmacy/medication supply units and healthcare entities. Time
consumed in placing the orders via conventional mediums such as
phone calls and faxes may be reduced. In addition, automated, real
time alerts and warnings may be issued regarding allergies,
clinical interactions, dosage, duration issues, and generic
substitutions. Further, online help regarding medicines and
regulatory compliance may also be offered by the system. This
process may improve patient safety and reduce medication errors
through increased order accuracy. Further, less time may be spent
on ordering and chasing down incomplete, inaccurate, or missing
orders. Thus, the time saved through use of an automated system may
be utilized in better patient care.
[0198] Referring again to FIG. 1, various facilities for managing
and/or tracking different prescription management events, such as
validation, selection, dispensing, marking, and delivery are
depicted among several other facilities and features of the
invention. A prescription management facility 106 may include a
validation/selection facility 102, a dispensing and marking
facility 104 and a delivery facility 108 apart from other
facilities as shown in FIG. 1. These facilities may be configured
to receive/send real time event tracking data with other patient
medical related facilities. Real time tracked events from various
medical related event streams may be utilized by the prescription
management facility 106 for real time and automated entries,
processing, and checks. Medical event streams may include
information from prescribing units, care planning facilities,
laboratories & imaging centers, insurance & payments units,
rehabilitation and long term care facilities, electronic medical
record repositories, dashboards and databases, third party sites,
healthcare facilities, and the like.
[0199] The prescription management facility 106 may include one or
more interfaces that may facilitate entry of order data. Orders
associated with the various prescription management services may be
placed via any of several mediums including submitting an order
form over the Internet, accessing the interface through public
and/or private kiosks, submitting orders (e.g. prescriptions)
through mobile phones (SMS and calls), electronic fax,
system-to-system order transfer, wireless portable devices (e.g.
dedicated prescription management devices), and the like. For
example, a nursing home care provider secure website may be
designed wherein orders for patients may be entered by physicians,
medical consultants, nurses, healthcare staff, and the like. The
prescription management interface(s) may be configured with
security provisions that may restrict orders from being entered
and/or discontinued except by a nurse practitioner, doctor or a
specialist and not by any other facility staff or employee.
[0200] The prescription management facility 106 interface may
include a graphical user interface for order entry. In such an
interface, a user may utilize various buttons, list boxes, and text
boxes for entering and managing order data. In order to confirm the
validity of data entered, the software underlying the graphical
user interface may validate the entered data. For example, if the
age of the patient may only be recorded in numeric format,
JavaScript code embedded in the interface software may disallow the
entry of non-numeric data into the age field. Likewise, other
validation may be embedded into the graphical user interface to
ensure the validity of the data.
[0201] Orders entered in the prescription management facility 106
may allow selection and/or verification of record through an
interface such as GUI. As described above, the validation and
verification of order entered may be performed in real-time during
entry. For example, a nursing home portal may contain patient
profiles collected from various dashboards, electronic medical
records, databases, and the like. Access to the portal may require
user authentication.
[0202] In addition to real time validation of order data entered
into data fields of a user interface, user authentication may be
employed and may be provided in the form of login credentials,
encrypted passwords, voice-based authentication, physical
authentication, biometric (e.g., use of eye scan or finger prints),
and other types of user-based authentication. To further ensure
security of patient records, an order entered by a medical
practitioner may require authenticating the medical practitioner
for a particular patient by validating other aspects such as
referrals, signed patient agreements to be treated, and the like.
In addition, medical order entry may require selection of an order
type through menus or tabs that may be enabled for the
patient/provider combination and may correspond to various
parameters, such as new orders, admissions record, prior
authentication, history, allergies, physician's orders, and the
like.
[0203] Validating a physician's orders may include requiring access
to detailed information of the patient such as current diagnosis
and orders, discontinued orders, allergies and reactions, and the
like. Although this information may be collected in real time from
the prescription desk of the physician or medical consultant, a
judicious, error-free, quick, and responsive method of collecting
such real time information may be aided by using patient
identification (ID) numbers or codes. For example, there may be
approx. 250 patient entries with the name Allen Smith known to the
pharmacy management facilities. However, when Allen Smith's ID No.
SYS2244 is used, only the medical information that corresponds to a
particular Allen Smith may be fed in to the prescription management
system to access detailed patient information. Validation may rely
on information in the selected profile (e.g., the patient has been
prescribed two dosage of Aspirin EC oral tablets and one dosage of
Azathiocrine--50 mg tablets, to be consumed once a day at 8:00 AM
in the morning) to help avoid potentially dangerous discrepancies
in prescription management. In this example, new prescription
information (e.g., received from a physician's hand-held
prescribing unit) may indicate use of a particular drug; however,
the existing prescription information may indicate potential
adverse side effects due to this combination of medications. In
such a case, real-time validated information may be sent to the
physician's hand-held prescribing unit as an alert to possibly
adjust the prescription before the patient leaves the office.
Alternatively, the validated information may be sent as a reminder
to a nurse at the time of administration to ensure that the proper
precautions have been taken to allow the combination of medications
in the patient.
[0204] The prescription management facility 106 may rely on
information received from prescribing units, laboratories, imaging
units, and the like to ensure a prescription is validated. The
prescription management facility 106 may affect correlation between
the tests, results, dosage frequency (high, medium, low), and/or
efficacy of the prescribed drug for validation. For example, data
from imaging tests may indicate a very low bone density in a
patient who has been prescribed high dosage of steroids for a
problem unrelated to her bones. The correlation of the imaging data
with the new prescription for steroids may indicate potential
further deterioration of the patient's bone density; therefore
alerts and/or reminders may be sent to the concerned entities (e.g.
doctor, patients, prescription management facility, and the
attendants) regarding these potential damaging adverse effects.
[0205] Similarly, real time information may be collected from third
party sources, pharmacy planning units, regulatory databases, and
the like regarding the interaction, effects, and detailed reviews
of various drugs and their interaction. This may be helpful in
managing adverse reactions of various medicines on patients as well
as educating/informing healthcare professionals and doctors about
new findings on the drugs and their interaction. This process may
be specifically significant in cases where new drugs for chronic or
pandemic diseases are prescribed, consumed, and tested. This may be
explained with the help of the following example.
[0206] During a pandemic contagious virus spread, a particular
medication `X` may be prescribed. Real time information regarding
the usage, effects, and disposal (complete medication cycle) may be
collected and analyzed by the pharmacy planning and regulatory
units. Data may be collected from nursing care centers, hospitals,
patient responses, clinics, and the like that indicates that this
medicine `X` results in certain side effects such as nausea,
diarrhea, and extreme body ache. Clinical trials and analysis may
recommend that these side effects are suppressed if the medicine
`X` is supplemented with medicine `Y.` Information from clinical
trial laboratories may be sent in real time to the various
facilities including validation and selection facility of the
prescription management facility. Upon validation of the `order
entry` form for a patient, a safety check may be conducted to
ensure that medicine `X` and medicine `Y` are prescribed together
for any reported case of the above disease. Thus, the validation
and safety checks may be in real time and actionable.
[0207] The prescription management facility 106 may also include
automated insurance coverage checks. Information regarding the
patient's insurance plan, medicines and treatments covered under
that plan, and payment option details may be accessed in real time
by the prescription management facility 106. Verification of
insurance information may be significant since coverage of patients
within any particular insurance company may vary. As shown in FIG.
1, event information from insurance planning and insurance and
payments facilities may be collected in real time and shared with
the prescription management validation and selection facility 102.
The prescription management facility 106 may validate that a
medication being prescribed to a patient is covered by the
patient's policy with the insurance company to avoid use of
non-covered medications that may result in phenomenally high
expenses for the patient.
[0208] In another example, information regarding the validity and
payment details for a patient's insurance policy may be shared with
the medication facility. In case, the last premiums have not been
paid, the patient or his/her caretakers may be informed regarding
the same. In certain cases, provisions may be made to facilitate
payments from the closest kiosk within the healthcare facility.
[0209] The prescription management facility 106 may also include
automated insurance claims processing checks. The information for
prescribed medications or indicative symptoms of a disease may be
shared with the insurance processing and payment facility. Other
information that may be shared may be frequency and duration of the
treatment, professional information of the surgeon or healthcare,
percentage of payment to be borne by the insurance company and the
like. This information may be automatically compared by the
prescription management facility 106 with information supplied by
the patient and any discrepancy between the two may be reported.
This automatic process may speed-up the portion of the prescription
management cycle related to insurance claims processing.
[0210] In an embodiment, the system may select and validate order
information for various information fields such as order type,
medication, dosage, frequency, day's supply, dispensing quantity,
special instructions, physician information, etc. This information
may be significant in facilitating automated medication
dispensation processes. For example, it may be pertinent to
correctly calculate the day's supply of medication and its
dispensing quantity based on the total length of the physician's
prescription.
[0211] Duplication of orders may be recorded in real time. In
response to any duplicate entry of order an error message may be
displayed, alerting the user of a duplicate entry. Order
information may also be validated for possible duplicate
orders.
[0212] The prescription management facility 106 may include
inventory management capabilities in that the system may match a
prescribed drug with the pharmacy inventory. Discrepancies, such as
low inventory, unavailability of a drug or its substitute, and the
like may result in an order for this particular drug being
prepared. Through proper inventory management, a medication
dispensing process associated with the pharmacy management
facilities may be a just-in-time dispensing process that may
judiciously assess the quantity and time of delivery for orders.
For a healthcare facility, the orders may also be dispensed as per
the internal organization or layout. For example, separate orders
may be prepared for separate floors (e.g., ground, first, second,
etc.) or by nursing station (pediatrics, dental, gynecology, etc.)
or by type of patients (inpatient or outpatient wards) Such an
automated medication dispensing process may reduce the dispensing
time required, mitigate financial risk and administrative burden
from unused quantities, and minimize wastes and unnecessary
expenses, thereby providing an efficient system capable of meeting
patient needs.
[0213] Automation, accuracy, and efficiency may be enhanced with
bar coded patient medicine packs that may be utilized in
combination with technology enabled medicine pack bar code readers
by healthcare professionals (e.g., nurses) to administer and track
in real time medications and treatments for each patient. The bar
coded med packs may ensure safe, proper, and timely administration
of drugs to patients. These bar codes may be read with the help of
scanners, camera-based mobile phones, or any other wired or
wireless device with scanning or imaging capabilities. The data
encoded in the bar code, matrix code, line code, 1D code and the
like may be a unique prescription identifier that also identifies
essential attributes of the prescription. For example, the code may
include a unique prescription identifier and a unique dosage
identifier. This information may be used to lookup further detailed
information about the planned medication administration event, such
as the medication, the dosage, the time of administration, the
patient, the expected location of the patient, and the like.
Alternatively, more extensive information may be coded into the
label or identifier that may include the patent name and ID for
example, to allow for manual or semi-automated verification of the
patient data by the nurse at the time of administration without the
need of a network connection to a facility such as the prescription
management facility 106.
[0214] The prescription management facility 106 may handle
automated refill orders and refill alerts to further improve
prescription management efficiency.
[0215] The prescription management facility 106 may include a
therapeutic equivalent facility which accepts electronic medication
orders and suggests therapeutic equivalents. Drug products
classified as therapeutically equivalent may be substituted with
the full expectation that the substituted product will produce the
same clinical effect and safety profile as the prescribed product.
In embodiments, drug products may be considered to be
therapeutically equivalent if they meet these criteria: they are
pharmaceutical equivalents (contain the same active ingredient(s);
dosage form and route of administration; and strength.); they are
assigned by FDA the same therapeutic designates a brand name drug
or a generic drug to be the Reference Listed Drug (RLD), and
assigns therapeutic equivalence codes based on data that a drug
sponsor submits in an Abbreviated New Drug Application to
scientifically demonstrate that its product is bioequivalent (i.e.,
performs in the same manner as the Reference Listed Drug). The
therapeutic equivalent facility may contain a library of such
therapeutic equivalents and suggests them to the prescribing
professional upon order entry based on for example, whether the
proscribed medication is on the patient's insurance formulary.
[0216] Real time tracking of medical events may be facilitated with
the help of a record system stored in a database. For this purpose,
one or more databases may be maintained, such as a distributed
database. A distributed database model may facilitate replication
of data so that failure of one of the nodes may not affect the
performance of the overall system (fault tolerance) and as a
result, the data may be available 24.times.7.
[0217] Data stored in the distributed database may be fragmented
horizontally, vertically or in a mixed mode, i.e., involving both
horizontal and vertical fragmentation for increasing the retrieval
of data. For example, the records for Pittsburgh may be
horizontally fragmented and stored in one of the distributed
database nodes located at Pittsburgh. By horizontally fragmenting
the records corresponding to Pittsburgh, the records for Pittsburgh
may be placed in a database node located at Pittsburgh. Usually,
patients and doctors residing in Pittsburgh may be serviced from
the database node located in Pittsburgh. Records corresponding to
other locations may be also be maintained at each location; that
is, a database node.
[0218] Data stored in the databases may include medical content in
the form of prescription by a doctor, surgical reports,
pathological tests, patient's medical history, and the like. While
legacy data may be stored in the database for record keeping, this
data may be continuously updated with real-time data received at
the database from various other facilities. Further, the database
may be enabled to update information in real-time. In an
embodiment, the database may be an OLAP Online Analytical
Processing.
[0219] The database may include capabilities of transforming the
data into a required format. For example, data may be received from
a number of facilities such as an Mill facility. This may require
transformation to an acceptable format before it may be stored in
the database. In this aspect, the database may itself include
software facilities for transforming data into an acceptable
format. Alternatively, data may undergo a transformation in a
transformation facility for converting the data into a format
acceptable for storing the same in the database.
[0220] The database may provide one or more streams to registered
data users regarding medical events. For example, an RSS feed may
be provided, and registered users may receive medical event data
related to their patients, latest trends in medical sciences, drug
developments, administration of new drugs to patients and their
outcomes and the like.
[0221] Data security may be ensured in the medical facility through
authentication requirements. For example, an entry for a record to
be stored in a database may only be made upon proper authentication
of a user along with an entry of his personal as well as log in
details. In another embodiment of a fully automated tracking and
record keeping database management system, unique log in
credentials may be provided to users who are registered with the
medical facility and corresponding details of users are gathered
and stored in a separate database once during registration. Any
subsequent correspondence from a registered user may be accompanied
with certain security checks to confirm already stored details of
the registered users. Further, various records of the database may
be encrypted for a secured access by an authorized and intended
person only. Encryption of the records of a database in the medical
facility implements an authorization protocol that can be decrypted
by a specific secured key only. In an embodiment, a token may be
issued to a user on any type of association with the database that
may enable further processing and assist in track keeping of
database communications. The token, in an embodiment, may be
generated using an automated system in the form of an email.
[0222] The information stored in databases may be utilized for
generating reports, sheets, updates, and sending auto-generated
emails to intended recipients. Such reports, updates and emails may
be customized for a particular person or a section of people.
Further, such customized reports and emails may be generated
periodically or on demand. The reports and emails may depict simple
medical information in textual form for a period of time,
statistical analysis based on data, forecasted details pertinent to
healthcare, medical suggestions and the like.
[0223] The pharmacy or medication unit may be either in-house or
remote. The in-house pharmacy system may be an automated, self
service dispensing system that may be located in the vicinity of
the healthcare facility. The system may be endowed with sufficient
stocks (e.g., 350 SKUs) to meet immediate patient medication needs
at any given time. In other cases, remote pharmacies may interact
with the healthcare facility via wired or wireless networks. The
medications and the packaging may be supplemented with
electronically readable information. The electronic/machine
readable information may be a RFID tag, barcode, optical disk, and
the like.
[0224] Remote dispensing of prescriptions may be supported by
automated dispensing machines such as in-facility kiosks, third
party home delivery chains, and the like. Remote dispensing may
include security to ensure proper authentication of the recipient
through such means as identifiers, passwords, finger scan, and the
like. Further, the medications usage from the dispenser may be
tracked using tags, scanners, or sensors.
[0225] Similarly to integrated prescription dispensing facilities,
remote dispensing means may be able to detect nearly exhausted
supply levels.
[0226] In accordance with embodiments of the present invention,
smart phones and other similar wired or wireless devices may be
used for implementing the given invention. Similar to a web
application, the present invention when enabled on a smart phone or
may be used for various functions for prescription management such
as order entry, safety checks and alerts, insurance coverage checks
and claims processing, medication dispensation, care planning, and
the like. Smartphone applications may take advantage of high
resolution interfaces available on some smart phones. The
interfaces may be graphical, tactical, touch-based, web-based,
gesture-based, intelligent user interface, motion tracking
interface, multi-screen interface, text user interface, voice user
interface, and the like. A prescription management smartphone
application may interact with various databases such as electronic
medical records database, regulatory database (e.g., FDA),
laboratories and imaging database, physician's health records, and
the like.
[0227] A smartphone application may alternatively be available for
patient use and may be used to create medication alerts for a
patient in real time. For example, information about a patients
purchase an over-the-counter generic drug may be captured in real
time and sent to the prescription management facility 106 where
validation may determine that other prescriptions that the user it
taking may result in a severe reaction to a composition in the
purchased drug. This information may be immediately broadcasted in
real time to the user's smartphone application or as an automated
voice call and/or a text message. In addition, information provided
in the alert may suggest substitutes that the user may
purchase.
[0228] The prescription management facility 106 may include a
physician ordering facility that may capture prescription behaviors
and/or practices of a physician to help improve validation, quality
of prescriptions, and the like. In an example, a physician may
routinely ask his nurse to submit prescriptions for him. The system
may recognize that prescriptions coming from a variety of nurses in
the doctor's office are all authorized by the same doctor and may
use this information to automatically associate prescriptions from
these nurses with this doctor.
[0229] In-patient facilities (hospitals, nursing homes, long term
care, residential rehabilitation centers, and the like) typically
collect new patient information during a patient admission process.
A pharmacy management facility may include built-in capabilities to
capture and/or receive complete patient information from a facility
admission module, thereby reducing the opportunities for
typographical or other human data entry errors. In addition,
admissions modules often automatically collect medical history
information (from the patient, a representative, or a medical
record). This information can be processed through the built-in
admissions information sharing modules and presented in a form that
is most useful to the prescription management, dispensing, and
validation facilities.
[0230] The invention may further include a prescription
administration facility 110 to facilitate proper administration and
real time data capture of prescription administration information.
By utilizing technology enabled devices such as handheld or other
devices at the point of administration, important information about
the events associated with and immediately after administering
medications may be captured in real time. Such technology enabled
devices may also benefit the administration process by providing
real time data and contextual information for the person performing
the administration (e.g. a patient, nurse, technician, physical
therapist, or other care provider). The prescription administration
facility 110 may access or communicate with a data center that may
provide information from any of a variety of medical information
related sources as depicted in FIG. 1. Such access may typically be
via a wireless connection.
[0231] In an exemplary case, the wireless connectivity may be
Internet. In other exemplary cases, the wireless connectivity may
be WI FI, WiMax, Bluetooth, Infrared and other similar types of
wireless technologies. In an embodiment of the invention, the
wireless connectivity may be a secured connectivity. The security
may be of different types including Wireless Encryption Protocol
(WEP), WI FI Protected Access Pre Shared Key (WPA-PSK), MAC address
filtering and the like. WEP works by establishing a shared key
between the clients (network cards) and the wireless router, then
using the key to encrypt and de-encrypt the data passing between
them. WPA-PSK is a WI FI standard that improves upon the security
features of WEP. To use WPA-PSK, a shared key or "pass phrase" is
set. Using Temporal Key Integrity Protocol (TKIP), WPA-PSK
automatically changes the keys at a preset time interval, thus
making breach of security difficult. In MAC address filtering, each
network adapter or card (wired or wireless) has a unique number
assigned to it called a MAC address. As a result, if a wireless USB
adapter is plugged into a computer, it will show its own MAC
address when connected to the Internet.
[0232] The technology enabled prescription administration facility
110 may facilitate providing bedside prescription administration
that may further facilitate capturing all care giver observations
and clinical events performed as part of the prescription
administration. The prescription administration facility 110 may
further provide step-by-step guidance and alerts for working with
and providing care for patients. The prescription administration
facility 110 may further guide nurses through administering and
documenting medication and treatment for each patient.
Patient-specific medication packs provided from the prescription
management facility 106 may include bar-codes that may facilitate
bedside verification for all medication and treatment at the moment
of administration. As described herein, the information captured on
the bar-code label or other identifier may include a unique
dosage-specific identifier that, when presented to the prescription
management facility 106, can be used to lookup all of the essential
patient information. Alternatively, essential patient information
may also be encoded in the identifier so that a caregiver may
manually or semi-automatically verify patient information without
the need of a network connection to the prescription management
facility 106. The prescription administration facility 110 may also
facilitate automatic collection of data for documentation of all
medication and treatment administration activities using bed-side
readers, scanner, proximity detectors, and the like. The bed-side
data capture facility 110 may include a plurality of visual and/or
audible prompts to which a nurse or other caregiver may response to
capture information that my not be readily captured automatically
in all instances (e.g. coloration of patient's skin, condition of
patient's hair, and the like). In an embodiment of the invention,
the prescription administration facility 110 may collect data that
includes, without limitations, medically-related event, healthcare
related events, patient health condition data, patient physical
activity data, patient treatment data, patient oral consumption
data, patient visitor data, patient outcome data and patient
psychological data. Further, the prescription administration
facility 110 may include a real-time data integration facility that
may provide integration of this collected data with the E-EHR/E-EMR
facility 118. In an example, the patient health condition data may
include the patient's vital signs collected automatically at the
time of medication administration and/or at other times, such as
through the use of wireless body monitors that may be in wireless
communication with the HPDMA 100. In another example, the patient
physical activity data may include patient's position and movement
facilitated by the caregiver and patient sleep data. In yet another
example, the patient treatment data may include bathing, dressing,
wound care, bed position adjustment, physical therapy,
psychotherapy and patient position adjustment. In yet another
example, patient oral consumption data may include foods prepared
for the patient and foods consumed by the patient, fluids consumed
by the patient and non-prescription medications consumed by the
patient.
[0233] The prescription administration facility 110 may also
collect medication administration data from coded information of
the packages of medications, for example, the medication pillow
packs. The medication administration data from the medication
pillow packs may include patient identification information. The
prescription administration facility 110 may also collect data for
the medication that was prescribed but not administered to the
patient.
[0234] Further, an electronic history of each activity and dosage
for automatic, anytime reporting and documentation may also be
achieved with the prescription administration facility 110. To help
with ensuring proper patient communication and care is provided by
all care givers, the prescription administration facility 110 may
access patient records to automatically display patient pictures,
medication pictures and additional information that may aid
verification and prescription safety. The prescription
administration facility 110 may further provide 24.times.7 access
to pharmacy experts through wireless connectivity capabilities
described herein.
[0235] Further in an embodiment of the invention, prescription
administration facilities may include integration of the computing
device with a scanner for scanning barcodes. The barcode scanning
recognition technology may capture medication data, patient data
(e.g. through scanning of a wristband, or other identifier),
administrator data (e.g. through scanning of the administrator ID
badge), and the like in real time and allow the caregivers to chart
and maintain all critical patient information as they administer.
At the time of prescription administration, the administering
professional using the prescription administration facility 110 may
scan barcodes, which will populate various fields in the
prescription administration tracking records. Alternatively, or in
conjunction with the scanning, the data relating to administration
may be entered into the prescription administration facility 110.
In embodiments, once the information is entered, and prior to
administration, the information may be validated such as through
communicating with the prescription management facility 106 data
servers. In an exemplary case, the barcode scanner (hereinafter the
barcode scanner will be interchangeably referred to barcode reader)
may be a handheld scanner. The handheld scanner may have a handle
and typically a trigger button for switching on the light source
associated with the scanner.
[0236] The barcode scanner may work with different technologies. In
an example, the barcode reader may be a Pen-type reader. The
Pen-type readers consist of a light source and a photodiode that
are placed next to each other in the tip of a pen or wand. To read
a bar code, the tip of the pen moves across the bars in a steady
motion. The photo-diode measures the intensity of the light
reflected back from the light source and generates a waveform that
is used to measure the widths of the bars and spaces in the bar
code. Dark bars in the bar code absorb light and white spaces
reflect light so that the voltage waveform generated by the photo
diode is a representation of the bar and space pattern in the bar
code. This waveform is decoded by the scanner.
[0237] In another example, the barcode scanner may be a laser
scanner. Laser scanners work the same way as pen type readers
except that they use a laser beam as the light source and typically
employ either a reciprocating mirror or a rotating prism to scan
the laser beam back and forth across the bar code. As with the pen
type reader, a photodiode is used to measure the intensity of the
light reflected back from the bar code. In both pen readers and
laser scanners, the light emitted by the reader is rapidly varied
in brightness with a data pattern and the photodiode receive
circuitry is designed to detect only signals with the same
modulated pattern.
[0238] In yet another example, the barcode reader may be a
Charge-Coupled Device (CCD) reader. The CCD readers use an array of
hundreds of tiny light sensors lined up in a row in the head of the
reader. Each sensor measures the intensity of the light immediately
in front of it. Each individual light sensor in the CCD reader is
extremely small and because there are hundreds of sensors lined up
in a row, a voltage pattern identical to the pattern in a bar code
is generated in the reader by sequentially measuring the voltages
across each sensor in the row. The difference between a CCD reader
and a pen or laser scanner is that the CCD reader is measuring
emitted ambient light from the bar code whereas pen or laser
scanners are measuring reflected light of a specific frequency
originating from the scanner itself.
[0239] In yet another example, the barcode reader may be camera
based readers. The camera based readers use a small video camera to
capture an image of a bar code. The reader then uses sophisticated
digital image processing techniques to decode the bar code. Video
cameras use the same CCD technology as in a CCD bar code reader
except that instead of having a single row of sensors, a video
camera has hundreds of rows of sensors arranged in a two
dimensional array so that they can generate an image.
[0240] In yet another example, the barcode reader may be
Omni-directional barcode scanner. The Omni-directional scanning
uses a series of straight or curved scanning lines of varying
directions in the form of a starburst, a lissajous pattern, or
other multi-angle arrangement are projected at the symbol and one
or more of them will be able to cross all of the symbol's bars and
spaces, no matter what the orientation.
[0241] Further in embodiments of the invention, the barcode scanner
may be connected to the computing device via a serial interface, a
proprietary interface, a keyboard wedge, a Universal Serial Bus
(USB) connector, any wireless network and the likes.
[0242] To ensure proper prescription administration, a variety of
validity checks may be performed, some of which have already been
described herein. Information related to the prescription
administration that may be validated include information such as
the number of times the medication is to be provided to the patient
in a day, the dosage of the medication, the details of the
personnel associated or the responsible with the patient, and the
like. Validation may fail if any criterion established relative to
these validation points is not met. In an example, if a nurse scans
a prescription medicine dosage pack for a patient but during
validation, the system determines that the patient has already
received a maximum daily dose within the last 24 hours, the system
may alert the nurse to the potential overdose. This validation may
be possible because the prescription administration facility 110
may allow real time access to medical record information and
prescription information provided by the prescription management
facilities and other facilities as depicted in FIG. 1. Validation
may also involve sending real time information collected during
bedside preparation for administration to the prescription
management facility to ensure that there has not been a change to
the patient's medication that may impact the administration to be
performed. In embodiments, this is made possible by the real-time
connectivity between the relevant facilities of the system
described in FIG. 1, which in this case includes the prescription
management facility and the prescription administration facility.
If so a stop order or the like may be communicated by the
medication management facility and displayed via an interface on
the prescription administration electronic device. In this way, the
system may prevent the administration of discontinued medications
and ensure that the correct medication and dosage is being
administered at the right time. Under certain conditions the system
might require the caregiver to uniquely identify himself or herself
using a plurality of identification methodologies. The collected
identification information may be recorded and stored to ensure
compliance with regulations and provide tracking information for
the caregiver that administered the treatments or care.
[0243] Data collected may include actual administration times, drug
administered, dosage, patient, personnel who performed the
administration (e.g. to track when a shift change has resulted in a
different nurse administering a prescription that the one who
prepared it from the pharmacy or medicine cart), timing and route
of administration (e.g. a refrigerated prescription may be
dispensed from a refrigerated storage but may not be administered
for several minutes or even hours due to limited staffing or large
patient load or the like), therapeutic equivalent considerations,
and the like.
[0244] The prescription administration facility 110 may also
provide alerts for the refills by scanning the barcodes. This alert
may notify the pharmacy that a refill for a particular medication
is required. Further, the prescription administration facilities
may calculate the expiry dates for the bulk items. A bulk item or
non-cycle medication is a medication that is not machine
dispensable for each dosage, the bulk items may include gels and
creams. The scanning of barcodes may further provide the
medications a list. The list may include information about which
medication is to given at what time and the like.
[0245] Further in an embodiment of the invention, the HPDMA 100 may
allow feeding of a Minimum Data Set (MDS) with the health status of
each patient. The MDS for each patient may be coupled to the care
planning facility 152 to develop individual care plans that outline
the appropriate interventions required to address specific
ailments, handicaps, and other health care needs. In an embodiment
of the invention, the coupling may be achieved by integrating the
medication administration record (MAR) of the patient into the MDS
of the patient. Further, a portion of the patient care plan may be
devised using an interface associated with the prescription
management facility 106. The care plan may provide a road map to
guide all the caregivers who are involved with the patient or
residents care. The MDS may provide a comprehensive assessment of
each patient's functional capabilities and may help care providers
(e.g. nursing home staff) to identify health problems associated
with the patient. A list of deficiencies with the patient's overall
health and well being may also be generated and recorded in
association with the MDS. On the basis of the health problems, a
proper plan for the patient may be devised for resolving the health
problems or improving the health of the patient.
[0246] The HPDMA 100 may also allow measuring and tracking of the
clinical outcomes for the patient which may allow devising of
effective health care plans for the patient. Further, a decision
making tool may be provided to the health care specialist to design
the health care plan for the patient. This decision tool may obtain
data associated with the patient from the prescription management
facility 106 and the medication administration facility 110. The
decision tool may also obtain anecdotal data, and the narrative
data provided by the nurses in the form of their notes and the ADL
information. In an embodiment of the invention, the decision tool
may also capture the nursing notes directly from the MAR charts.
Further, clinical algorithms may be provided that may suggest
changes in the patient's medication. These changes may include
change in dosage of the medication, change in the therapy and the
like. These changes may be based on the clinical outcomes of the
current medication and therapies administered to the patient.
Further, the different clinical outcomes may be for pain
management, treatment and prevention of pressure ulcers or bed
sores, disease specific behavior management related to using
anti-psychotic drugs or diabetes programs. Each type of clinical
outcome may require focus and collection of different kinds of data
associated with the disease and its outcome. Further, each type of
data may be data object for the MDS. The HPDMA 100 may also provide
different types of physiological sensors to populate data into the
MIDS.
[0247] The HPDMA 100 may also allow tracking of the electronic
ordering form for ordering the medication associated with the
prescription management facility 106 for populating the MDS. The
MDS may record different types of prompts that may occur while
filling up the electronic order form. The HPDMA 100 may also allow
tracking of the medication administration facility 110 for
populating the MDS. The MDS may record different types of prompts
that may occur while administrating the medication to the patient.
The prompts may include warnings and alerts. The HPDMA 100 may also
allow tracking of the documentation module for populating the
MDS.
[0248] Further in embodiments of the invention, the populated MDS
may be combined with additional features to facilitate
implementation of special instructions or to act as reminders. In
an example, a voice activated head set may be provided to the
patient in LTC; this headset may react to verbal inputs and record
what is said aloud by the patient and this data may be added to the
MDS. In another example, a nurse alarm system may be provided to
the LTC patient that alerts the nurse at a nurse station that the
patient needs to be attended to. In yet another example, wound
management tools may be linked to the MDS. This wound management
tool may be in the form of a mobile device application ("App") that
is able to scan the patient's wounds and the image may be
transmitted to the health care specialist who may then provide
advice on how to better manage the healing process of the wound.
This application is useful in situations where the patient care
facility is remotely located and the specialist is not readily
available. In addition, in some instances the second opinion of
another medical professional may be required and in this event, an
App may be useful in transmitting real life images of the condition
of the patient.
[0249] In yet another example, the MDS may be linked with pain
management tools. The relative intensity of the pain being felt by
the patient who may be terminally ill may be recorded and
transmitted to the MDS; this data may then be accessed by the
nurses and/or attending doctors and the pain management medication
may be altered accordingly. In this application, the dosage of the
pain medication will correspond exactly to the condition of the
patient on that day and excess or inadequate dosages based on
conditions recorded a few days ago may be avoided.
[0250] Further in embodiments of the invention, the MDS may be
populated with data received from the sources of the E-EHR facility
118. The sources of E-EHR facility may include, but not limited to,
the prescription management facility 106, the prescription
administration facility 110, the patient attributes and events
facility 112 and outcome events facility 114. The MDS may also be
populated with the new data elements within the E-EHR facility 118.
The HPDMA 100 may further provide data or format conversion
techniques that may support recording of data in the MDS directly
from the existing records in the E-EHR facility 118.
[0251] In an example of MDS data collection, a US federally
mandated Minimum Data Set of data to be collected periodically from
health care facilities to qualify for Medicare/Medicaid
reimbursement has been defined. Such an MDS is generally collected
first when a patient enters a facility in which MDS is required and
then again periodically as part of a Resident Assessment Program.
The methods and systems of data collection, real-time collection
and exchange, and the like as described herein for the HPDMA 100
may contribute to the effective and thorough collection of MDS at
any of a wide variety of patient touch points as described herein
and elsewhere. The use of technology enabled data collection device
to collect real-time data in proximity to patients may also
facilitate the collection, roll-up and transmission of MDS to State
and/or Federal authorities (e.g. at the Centers for Medicaid and
Medicare Services (CMS)).
[0252] The healthcare management platform 100 may provide recording
and charting of different kinds of information and events occurring
in the system. In an embodiment of the invention, this recording
and charting of information may be achieved by entering data in
various charts electronically. The HPDMA 100 may also provide a
plurality of different types of charts that may include information
collected from a wide diversity of important and potentially very
different information sources, some of which are described
herein.
[0253] In an embodiment of the invention, the HDMA 100 may provide
a reporting capability that may facilitate generating an Electronic
Medicine Administration Record (e-MAR) chart. A Medicine
Administration Record may include information about the patient and
his/her condition (name, DOB, ID number, personal physician,
allergies, general diagnosis); the name of the medication, the
medication abbreviation or code, the date that the medication was
started, the diagnosis/purpose/condition relevant to the
medication, the strength of the medication, the dosage form (e.g.
pills, drops, ointment, other), the dose, the route of
administration (mouth, ear, eye, intravenous, etc.), the frequency
of administration, the prescribed administration times, the length
of time that the prescription is to be given, and any special
precautions or contraindications; name of person administering
medication; and a chart of medication over time. The e-MAR chart
may be configured by accessing one or more databases (e.g. E-EHR,
outcome database, and the like as shown in FIG. 1) having
information from a plurality of reporting sources. In an embodiment
of the invention, the reporting sources may include, without
limitation, the prescription management facility 106, the
medication administration facility 110, the patient attributes and
outcomes facility 112, the E-EHR facility 118, and other medical
information and patient care facilities. In an embodiment of the
invention, the e-MAR chart may depict data that is directly
aggregated from the prescription management facility 106 and the
medication administration facility 110. Further, when a health
specialist or a physician enters a medical prescription through the
electronic order facility provided by the prescribing facility 154,
certain of that medical prescription data may get recorded into an
e-MAR chart, for example contraindications and duration of
prescription. The e-MAR chart may also be updated with medical
prescription validation data that may be obtained in real time for
the patient from aspects of the HPDMA 100, such as the marking and
dispensing facility 104.
[0254] The invention allows for a typical MAR to be enhanced with
additional information. In embodiments, the e-MAR chart may further
depict a record of the time at which the nurse is notified about
the medication for the patient, where the medication is available
and when the nurse was informed. The medication may be available at
the floor, the wing or the online medication cart. After the
medication is made available, the nurse may scan the barcode labels
to obtain information about the medication dosage, time for
medication, frequency of the medication and the like. The nurse may
compare the image of the patient in the system with the image
obtained from the bar code data. This comparison may confirm the
patient for which the medication has been received. All these
activities performed by the nurse after obtaining the medication
may get recorded in the e-MAR chart. The warnings or alerts that
the nurse may receive upon scanning the barcode may also get
recorded in the e-MAR chart. The alerts and warnings may be for a
particular drug allergy or reactions and the like. The e-MAR chart
may also include a record of the medication administered by the
nurse to the patient. Further, the e-MAR chart may include a record
of the forms filled by the nurses while administering to the
patient. In an embodiment of the invention, the recorded data in
the e-MAR chart may be used to populate the patient's health
records in the E-EHR facility 118. In another embodiment of the
invention, the recorded data in the e-MAR chart may be used to
populate the MDS.
[0255] In another embodiment of the invention, the HPDMA 100 may
provide an Electronic Treatment Authorization Request (e-TAR) form.
The e-TAR form may allow authorization requests to be created and
updated online. Enquires related to authorizations and responses
for requests made may also be conducted online. These online
activities may provide more accurate diagnosis code and may also
provide accurate billing codes. Further in an embodiment of the
invention, the data in the e-TAR form may be pulled in to the
prescription management facility 106. The physician or the health
specialist may utilize the authorization details filled for certain
types of drugs and treatments while prescribing the medication and
treatment for the patient. In another embodiment of the invention,
the details filled in the e-TAR form may be recorded as the EHR of
the patient in E-EHR facility 118. In yet another embodiment of the
invention, the details filled in the e-TAR form may be utilized to
populate the MDS.
[0256] In another embodiment of the invention TAR's are treatment
administration records and are created by assimilating the data
relative to the treatment of the patient (which as described herein
is collected in various ways including automatically via various
sources). Due to the system having the various facilities described
herein, which are (in embodiments) in real-time communication with
one another, typical information collected about the treatment of a
patient can be continually updated into a TAR. In this manner,
TAR's accessible through the system are always current and need not
be assembled retroactively as is the case with most MARs and TARs
currently.
[0257] Further in an embodiment of the invention, the HPDMA 100 may
facilitate providing charts for recording subsets of data, such as
a vital signs chart for depicting the vital signs of the patient
during administration. The different vital signs of the patient may
include, without limitations, body temperature, pulse rate (or
heart rate), blood pressure and respiratory rate. These vital signs
associated with patient may be measured by the health specialist
using the technology enabled automatic data collection devices
described herein that may automatically collect and/or generate
data suitable for displaying a vital signs chart.
[0258] Further in an embodiment of the invention, the HPDMA 100 may
facilitate providing charts for recording specialized assessments
through the use of the real-time data collection and transfer
capabilities described in reference to FIG. 1 (e.g. laboratory
and/or therapeutic services, and the like).
[0259] Report generation, dashboard interfaces, and the like may
provide essential means for accessing, managing, and using the
information that may be collected throughout the electronic real
time medical information collection and processing system depicted
in FIG. 1. Report generation and dashboard capabilities may be
provided by dashboard facility 150 depicted in FIG. 1. As depicted
in FIG. 1, the dashboard facility 150 may be communicatively
coupled in real time with any of the facilities show including the
group of facilities within the prescription administration
facilities 110, the prescription management facilities 106, and any
other facility depicted.
[0260] The real time reporting facilities may generate reports by
obtaining data from any of a plurality of data sources, such as the
sources depicted in FIG. 1. Dashboards as may be supported by the
real time reporting facilities may also be used to display the
obtained data in a coherent format that may allow viewing a wide
variety of important patient related information, such as the
identity of a patient, the personnel who cared for or who are
responsible for a patient, medical history and prognosis,
medications prescribed, medications that needed to be returned or
destroyed, costs associated with medications that were not covered
or only partially covered by a payer, costs associated with
medications for which the health care facility had to pay, and the
like. The real time reporting facility may also provide up to the
minute, time-based summary information regarding the above
parameters and any of the associated parameters. Such information
may be presented to a medical professional through a graphical user
interface with text, graphics, charts, images, audio, and the like.
In an embodiment, the graphical user interface may be associated
with a computing device including, a mobile device, a PDA, a
laptop, a smartphone and the like,
[0261] In an embodiment of the invention, the real time reporting
facility may provide a Long Term Care (LTC) administrator
dashboard. The LTC administrator dashboard may be utilized to
manage and plan the records and medication of patients that require
long term care. An LTC administrator dashboard may include the
facility configured to access a database having information from a
plurality of reporting sources. In an exemplary case, the reporting
sources may include the prescription management facility 106, the
medication billing and dispensing facility, the medication
dispensing machine, the medication administration facility, and an
electronic health records facility. The LTC administrator dashboard
may also include a user selectable dashboard definer configured to
provide user selectable options for defining the information from
the facility to be presented in a report at the dashboard. The LTC
administrator dashboard may further include a display definer
configured to operate in conjunction with the user selectable
dashboard definer to define the format in which the report from the
facility is to be presented at the dashboard.
[0262] The LTC administrator dashboard may include a facility to
provide the type and cost of drugs consumed by the patient in a
particular time period. Variable time periods may be provided by
the LTC administrator dashboard and for each selected time period
the dashboard may provide the type and cost of the drugs. This
facility may further provide the cost of drugs consumed by each
patient in a particular selected time period. In an exemplary case,
the LTC administrator dashboard may provide an interface for
selecting a particular time period and a search engine for
selecting a particular patient.
[0263] The LTC administrator dashboard may further provide a field
for obtaining insurance or Medicare costs. Many insurance plans and
Medicare do not pay for custodial care in which the patient
receives assistance with activities of daily living. These
activities may include dressing, bathing, using the bathroom and
mobility. Thus the LTC administrator dashboard may provide
information regarding the expenses that are covered by the
insurance plans and also those expenses which are not covered by
the insurance plans or Medicare.
[0264] Further, the LTC administrator dashboard may provide an
interface for resolving issues related to reimbursements. This
interface may optimize and increase the reimbursement for the care
provided, and reduce the non-reimbursed items for the patient and
the facility. In an exemplary case, the dashboard may keep track of
reimbursements for Part A services and Part B services for Medicare
as well as services that have not been reimbursed.
[0265] The LTC administrator dashboard may also provide an
interface to obtain and update the status of bed occupancy. The
interface may provide options to select a bed and a room for the
LTC patient. This may also support editing the patient's room
information, putting a bed on hold status for the patient,
maintaining the process of room/bed numbers as well as assigning
the wing/unit to those rooms/beds. Further, LTC administrator
dashboard may provide recalculations for differences in cost of
beds when a patient has been moved from one bed to another in the
same facility. Recalculations may also be needed when the bed is
used in different shifts by the same or different patients; e.g. a
patient may need the bed in the morning for dialysis and in the
evening for another related treatment.
[0266] The LTC administrator dashboard may provide a field for
maintaining drug utilization records. For instance, the LTC
administrator dashboard may record the specific drug used by the
patient in a particular medical condition, along with details of
dosage, time period during which drug was administered, reactions
or side effects of the said drug, resulting change in medication,
improved or deteriorated condition of patient after using that
specific drug, and the like. Further, the dashboard may provide
such an interface for each patient in the facility.
[0267] In another embodiment of the invention, the real time
reporting facility may provide an LTC facility specific dashboard.
The LTC facility specific dashboard may be utilized for specific
treatments and facilities that may be provided to the patients in
long term care. The LTC facility specific dashboard may include an
interface for obtaining Electronic-Medication Administration Record
(e-MAR, embodiments of which have been described above)
corresponding to a patient. The interface may provide the report
that may serve as a legal record of the drugs administered to the
patient at a particular facility by the nurse or any other
healthcare professional. The nurse or healthcare professional may
sign on the e-MAR at the time that the drug or device is
administered. An e-TAR report may also document that the treatment
that has been provided to the patient.
[0268] The LTC facility specific dashboard may also provide a field
for maintaining billing and claim records. This field may calculate
and provide bills corresponding to each patient for a desired time
period. The field may also provide preview of the monthly bills for
a particular patient.
[0269] The LTC facility specific dashboard may further provide a
field for providing the EHR, MAR, or any other data collected or
stored by the facilities described herein corresponding to
individual patients or group of patients. Data may include a range
of data in comprehensive or summary form, including demographics,
medical history, medication and allergies, immunization status,
laboratory test results, radiology images, and billing
information.
[0270] The LTC facility specific dashboard may also include an
electronic order facility. The electronic order facility may
include an interface for aiding an individual to a health care
facility to enter electronic medication, treatment and other
orders. The system in certain conditions may require additional
identification methods to uniquely identify, record, and document
the care giver entering the orders.
[0271] The LTC facility specific dashboard may further include a
facility for tracking the care plan and clinical outcome of the
patient. With this facility, the user may be able to track the
current care plan of the patient in run time. The facility may also
allow the user to track the clinical outcome of the patient. This
facility may provide the updated information of the care plan and
the clinical outcome.
[0272] Further, the LTC facility specific dashboard may also
provide a field to interchange the therapeutic data related to a
patient or a group of patients. This field may identify the most
cost effective drug for a based on the margin for a facility
availed by the patient. The field may also suggest a preferred list
of drugs for a particular medication for the patient. This
preference may depend on several factors including availability of
the drugs, cost and the like. Further in cases of emergencies, the
field may also suggest or change a particular medication with
blanket approvals. This may be useful as it may reduce cycle time
for taking approvals from individual doctors, other physicians and
pharmacists.
[0273] The LTC facility specific dashboard may further provide a
field for choosing the non-formulary drugs. The field may further
help the user to note a drug if the ordered medication is on the
formulary.
[0274] This dashboard may display data (which is collected in
real-time and which is continuously updated) about the medications
that are being prescribed and administered to each patient as well
as any other data collected by the system. It can be broken down by
facility, floor, wing, groups of facilities, etc. It can be broken
down by patient. The LTC administrator can also view a dashboard of
the costs of the medications that a patient is taking, the amount
of reimbursement the LTC will receive for the meds, the payment
history of the patient, and the like. The dashboard provides the
LTC administrator with the ability to can examiner such things as:
the most costly med, the most costly patient (in terms of meds
administered and prescribed), what nurse administers the most
medications. Any information collected by the system can be
selected and group according to user preference and/or preselected
parameters of patient, facility, floor, wing, groups of facilities,
attendant staff, dose, cost, reimbursed amount from patient,
insurance or any government program. This information may assist
the LTC admin in making operational decision regarding such things
as therapeutic equivalents, staff, and other facility needs.
[0275] In an embodiment of the invention, the real time reporting
facility may be useful for monitoring automated real time
surveillance or public safety monitoring. In an example, a
dashboard may be useful for monitoring surveillance activities
related to bioterrorism or epidemics. For instance, when the number
of patients suffering from a particular disease significantly
exceeds a normal occurrence number, a monitoring dashboard may be
updated by the real time surveillance facility to display a
potential indication of an outbreak of an epidemic. This
information could prove to be invaluable in implementing preventive
measures in a timely manner.
[0276] Further in an embodiment of an invention, the real time
reporting facility may provide dashboards for a wide variety of
uses and needs for different users to generate different kinds of
reports and manage various facilities. In an exemplary case, the
dashboards available may include a specialist dashboard, a clinical
outcome dashboard, a Long Term Health Care (LTC) administrator
dashboard, a LTC facility specific dashboard, a pharmacist
dashboard, various planning dashboards, prescription management
dashboards, and the like. Each different dashboard may have
different looks that may be represented by data entry or display
fields or tabs. The dashboards may be populated in real time with
the data from any of the facilities depicted in FIG. 1 including
the E-EHR/E-EMR facility 118 that may also be updated in real time
with patient healthcare related event data from any of the
electronic real time data collection facilities depicted in FIG. 1.
In an example, the patient healthcare related event data may
include administration events, treatment outcomes and patient touch
points. Further, the dashboards may include tracking facility (not
shown in figure) that may track and organize the information on the
care and cost being spent on the patients and correlate it to
previous/subsequent medical treatments.
[0277] Dashboards for specialists who are monitoring a patient such
as a neurological physician, an endocrinologist, a cardiologist and
a general physician may facilitate the collection and analysis of
various tests, procedures, observations, and the like that may be
conducted by or ordered by a specialist. Inputs from each of these
representative specialists may be collated in a single report that
each specialist may view through a specialist dashboard. By being
able to view real time information about the patient, events,
outcomes, tests, and the like, a medical specialist may provide
inputs for further medication of the patient (e.g. remotely).
[0278] Further, dashboards may be utilized to manage care planning.
Care planning dashboards may include a facility configured to
access a database having information from a plurality of reporting
sources, such as those sources depicted in FIG. 1 including,
without limitation the prescription management facility 106, the
medication administration facility 110, patient attributes and
outcomes 112, an Enhanced Electronic Health Records (E-EHR)
facility 118, and other medical information and patient care
facilities. A care planning dashboard may also facilitate preparing
different care plans for different patients. The care plans for any
patient may be based on the needs of the patients that may be
ascertained from profile information or medical history. For
example, an over-weight patient may be offered a weight reduction
care plan. Similarly, a person with high systolic blood pressure
may be offered a care plan that emphasizes exercise and restricted
food regime for controlling the blood pressure, and the like.
[0279] Dashboards may also be found in association with a clinical
outcome facility that may record anecdotal and empirical data
related to the patient care. A clinical outcome dashboard may
further include a user selectable dashboard definer configured to
provide user selectable options for defining the information
associated with the clinical outcome facility to be presented in a
report such as on a display of the dashboard. The dashboard may
also include a display definer configured to operate in conjunction
with the user selectable dashboard definer to define the format in
which the report from the clinical outcome facility is to be
presented at the dashboard.
[0280] The clinical outcomes dashboard may allow managing outcome
data such as the patient's information from various sources and may
include a diagnosis details, a history of the patient and related
past clinical outcomes. Any information in the clinical outcome
facility that may be managed by the clinical outcome dashboard may
have been collected automatically, such as by using multiple
sensors at a variety of patient medical information touch points
including the prescription management facility 106 (e.g. the
dispensing and marking facility), the prescription administration
facility 110, the outcome events facility 114, an external data
source not shown in FIG. 1, and the like.
[0281] The clinical outcome dashboard may further provide fields to
group the patients. The patients may be grouped on the basis of
their prognosis, medication, treatment, attending support staff,
doctor in charge, location of the patient, facility personnel
associated/responsible with the patient, and the like.
[0282] The clinical outcome dashboard may allow the user to input
test results of the clinical outcomes for different patients. In an
exemplary case, the dashboard may provide a menu of the different
tests that may be prescribed based on the diagnostic outcome. The
different tests may include lipid profile, glucose test, blood
test, sodium test, potassium test, liver function test or some
other type of medical tests. The dashboard may further update these
test results in real time.
[0283] The clinical outcome dashboard may further provide an
interface to obtain data from the prescription administration
facility 110. This data may include information about the type of
medication given to the patient, the time of administration, the
amount of dosage, reactions and the like. Data at the medication
administration facility may be updated in the real time and
thereafter the updated data may reflect on the dashboard.
[0284] The clinical outcome dashboard may further describe
different types of therapies that may be relevant to the patients'
condition. The different therapies may include Chemotherapy,
Physiotherapy, Surgical Intervention, Post-operative therapy,
Integrative Therapy, Cognitive Behavioral Therapy, Psychodynamic,
Developmental Therapy, and the like.
[0285] Based on the outcomes of the clinical tests, the clinical
outcome dashboard may provide or suggest new therapies or drugs for
the patients. In an example, if a patient is a diabetic and after
the clinical outcome it is identified that the patient also has
heart problems, then the dashboard may suggest a different drug for
the patient. Similar logic may be applied by the dashboard with
regard to therapies. In an embodiment of the invention, the
dashboard may apply a clinical algorithm tool to suggest new
therapies and drugs. For instance, a patient with a history of high
blood pressure and newly diagnosed with high diabetes may not be
prescribed the same medication as another patient who only suffers
from borderline diabetes.
[0286] The clinical outcome dashboard may further provide interface
to change the medication dosage of the patient. The change in
dosage could occur as an outcome of clinical trials on the patient.
This change will be communicated in the network and accordingly
instructions will be sent to the pharmacy. For instance, a high
blood pressure patient being treated with a specific drug may
require a change after it is found that he has developed a
persistent cough on account of that drug.
[0287] Further, the clinical outcome dashboard may allow the user
to segment the outcomes according to different fields. These fields
may be age of the patient, type of disease among patients, the
medication given to the patients and the like.
[0288] In yet another embodiment of the invention, the real time
reporting facility may provide a pharmacist dashboard. The
pharmacist dashboard may provide different fields to a pharmacist
while the medication is being verified and is being dispensed from
the pharmacy. The pharmacist dashboard may provide a field for
viewing the placed electronic orders.
[0289] The pharmacist dashboard may further provide a field to
track the data corresponding to patient. This data may be utilized
while verifying or altering the medications for patients.
[0290] The pharmacist dashboard may also provide a field to receive
and track the therapeutic interchanges for a patient for which the
blanket approvals have been provided.
[0291] The pharmacist dashboard may further provide tools and
analytics to a pharmacist to provide a better medication to the
patient. These tools may suggest drugs and therapies to the
pharmacist for the patient. The tools and analytics may apply some
algorithms and utilize past data, past history of the patient,
clinical outcomes, and the like to provide these suggestions to the
pharmacist.
[0292] In accordance with an embodiment of the present invention,
physician ordering facility may be provided for administering and
managing physician's prescribing practices for a variety of
functions, and specifically for a patient care function.
[0293] The physician ordering facility may utilize significant data
about the patient care from the history or previous records. The
data may include prescribing practices administered for predicting
or diagnosing a specific user in real time. The patient care
records may include variety of information fields such as
demographics, medical history, medication and allergies,
immunization status, laboratory test results, radiology images,
billing information, and the like.
[0294] Information from the Electronic Health/Medical Record
(EHR/EMR) may be utilized either standalone or in combination with
other data by the physician ordering facility. For example, a user
in case of emergency may be admitted in a hospital in Chicago,
while on a business trip. The identification number of user may be
used to access information from the EHR regarding the existing
health conditions, past prescriptions, and any special needs may be
accessed from his home town (for example, Kansas City). This may
facilitate immediate and effective medical response for the
user.
[0295] In an embodiment, the data from the EHR may be combined with
the aggregated data from third parties such as FDA regulation data.
The combined data may be further processed along with real time
pharmacy data (for example, from the closest neighborhood pharmacy
or drug store) to obtain relevant prescription information for the
patient.
[0296] In accordance with an embodiment of the present invention,
the information from the ERR/EMIR may be used to populate the
various fields of dashboards and similar other graphical
interfaces. Examples of such dashboards may include clinical
outcomes dashboard, long term care administrator dashboard, long
term care facility specific dashboard, pharmacist dashboard,
physician ordering facility dashboard, and the like. These
dashboards have been explained in conjunction with various examples
earlier in the description.
[0297] For creating fields corresponding to clinical outcomes
dashboard, information or documentation such as physician, nurse,
and other clinician notes, flow sheets, pre-operative notes,
transcriptions, medical records abstracts, advanced directives,
living wills, procedural consents, medical chat records,
physiological monitoring outcomes, and the like from the EHR may be
utilized.
[0298] In accordance with other embodiments of the present
invention, administration, nursing, laboratory, clinical, and
radiology etc. Data may be used in combination with the pharmacy
data to generate fields, tabs, menu, or interface for
dashboards.
[0299] In embodiments, the data may be a combination of system
data, system metadata, system patient information, contextual data
or some other type of data.
[0300] The administrative data may include information related to
registrations, admissions, discharge, transfer (RADT) data. The EHR
may include levels of information regarding patient (e.g., name,
demographics, next of kin, employer information, chief complaint,
patient disposition.)
[0301] The laboratory data may include orders, results from
laboratory instruments, schedules, billing, and other
administrative information. Similarly, radiology data may include
patient radiology data (e.g., orders, interpretations, patient
identification information), and images information.
[0302] Information for dashboard fields may also be obtained from
traditional patient records such as progress notes, reports,
medications, and orders of diagnostic patient data such as medical
images, electrocardiograms, scanned documents, and the like. In
embodiments, information from traditional medical records may be
directly utilized for generating the field codes for various
dashboards.
[0303] In other embodiments, information from traditional records
may be first recorded in electronic form such as in ERR/EMIR and
may be subsequently utilized by the dashboards.
[0304] For example, physician's scribbling and notes (e.g.,
response of a patient with a disjointed shoulder pain) in a
hospital facility during a visit may be entered manually into an
electronic database (e.g., spreadsheet). This information may be
used to generate or populate a field code `motor nerve response` in
the dashboard in the drill-down view.
[0305] In accordance with an embodiment of the present invention,
the content may be uploaded in the EMR/EHR in real time from
various sources. Examples of sources may include patient's
attribute events, prescriptions, care planning, long term,
laboratory data, and the like.
[0306] In accordance with an embodiment, ERR/EMIR data may be
utilized for administrating care planning facility. In addition,
this data may be utilized to create an interface for care planning
and management by healthcare professionals and staff
[0307] Data from electronic records that may be utilized for care
planning and administration may include information on office
visits, emergency rooms, hospital-in patients, hospital
out-patients, rehabilitation, long term care facilities for care
planning and nursing, and the like.
[0308] For example, information collected from EHRs of a number of
patients may indicate a growth in number of caretakers who stay
with the patients. In light of this information, the administrative
dashboards may be designed to include field codes related to
preferences for caretakers of patients (e.g., meal choices, special
needs).
[0309] Similarly, the information from EHR regarding special needs
of a patient under long term care and observations may be updated
and made available in real time to the nursing staff.
[0310] Care plan for an emergency room may be intensive and
focused. Multidisciplinary team of experts may be deployed in the
ER areas to meet the variety of situations. In addition,
individualized care plans may be developed for an emergency
department.
[0311] Similarly, care plan for a rehabilitation center may focus
on a number of parameters such as background needs of the patient,
medical equipment needs, home healthcare environment needs,
nutrition, supply, commodities, education & training, and the
like.
[0312] Also, the needs of inpatients and outpatients may be
different, emphasizing the need for different care plans for both
of them. Inpatients may require nutritional and daily care
(temporary) support such as bathing or dressing while outpatients
may prefer a short queuing time for medications and check-up.
[0313] Maternity wards may also require a well designed care
planning; for example, requirement for a hygienic and separate ward
for newborns and those with special needs.
[0314] All the needs described above may be carefully administered
by utilizing the data from the electronic records, existing medical
and hospital records.
[0315] In accordance with an embodiment of the present invention,
information from electronic health/medical records may also be used
for facility planning and operations.
[0316] Information from electronic health/medical records may be
related to the mix ratio of inpatient and outpatient services,
older and critically sick patient population, treatment patterns,
advancement in technology, health data related to diseases and
conditions (asthma, cholesterol, diabetes, heart disease,
hypertension, obesity, and the like), type of healthcare
(ambulatory services, ER visits, and the like), data related to
injuries (accidents, suicides, homicides, and the like), life
stages and population (births, deaths, women's health, children's
health, state and territorial distribution, and the like.),
lifestyle (drug use, smoking, exercise, and the like).
[0317] In embodiments, the in-patient data from EHR may include the
number of patients under `critical conditions.` In such cases, the
facility planning in terms of resource allocation, forecasting,
scheduling, and the like may be performed effectively.
[0318] Similarly, non-patient aggregated EHR content such as for
people accompanying the patients may be used to design the facility
operations. For example, a number of wait-in chairs, automatic
dispensers for basic utilities, coffee vending machines, and the
like may be installed in a given facility to cater to the needs of
the caretakers.
[0319] EHR/EMR data may also be helpful in planning facility
operations with regard to medication supply management. For
example, data from aggregated health records may be collected and
analyzed periodically to assess information fields corresponding to
medications. In case the records indicate high consumption patterns
for Zyprexa for schizophrenic symptoms, the medication supply
management system may collaborate with the pharma planning facility
to identify drugs that may be less expensive and may be used as a
substitute for Zyprexa.
[0320] Similarly, in case the records indicate that drugs
containing ibuprofen composition do not show high efficacy in a
particular group of individuals, substitutes such as herbal
substitutes or any other drug composition may be introduced in the
medications supply.
[0321] Facility design may facilitate smooth flow of medication
supply chain. A separate section or layout may be designed for
provision of medicines and other health related equipments and aids
such as belts, bandages, syringes, and the like.
[0322] In accordance with an embodiment of the present invention,
these medicine counters may also be self-help desk counters or
online kiosks. Provision of such medication centers may facilitate
smooth workflow for patients, administrators, guardians, etc.; they
may be effective due to reduction in time between diagnosis and
administration of medicines, and may be cost effective. In
addition, it may also reduce the problems associated with
non-availability of certain medications outside the hospital
premises.
[0323] In another embodiment of the present invention, enhanced
electronic health and medical records data may be utilized to plan
new services for the healthcare facility. The aggregated data
collected from E-EHRs may indicate that healthcare services may
need to be revamped and redesigned in order to facilitate growth.
For example, performance indicators in a rehabilitation center with
regard to information dispersed on the helpdesk may be collected
and analyzed. In case the results obtained from the collected data
indicate that approximately 65 percent of elderly people were not
able to follow instructions provided at the helpdesk, it may
indicate a need for improvements in the services (such as
requirement of hearing aids and friendly visual signage on the
helpdesk.)
[0324] Similarly, data collected from E-EHRs may be used to plan
for subscriber preferences. For example, `energy drink preference`
field codes of an E-EHR may indicate that more number of
individuals prefer `Drink X` over `Drink Y` suggesting that more
number of vending machines with `Drink X` may be installed. As an
alternate example, two subscribers providing packaging cartons for
medical supplies may be compared on the basis of the EHR data such
that subscriber `A` (whose packaging is found to be water proof has
been consistently rated better by the healthcare professionals) may
be chosen for a contractual agreement with the healthcare
facility.
[0325] In an embodiment, E-EHR data may also be used for planning
insurance coverage plans and insurance reimbursement processes.
[0326] For example, electronic records of a group of individuals
from a family may suggest a family based insurance plan; specific
information may be provided to these individuals regarding the
various aspects of a family insurance plan.
[0327] In certain cases, a generic profile of patients and their
caretakers saved in the electronic medical records may be utilized
for providing insurance planning facilities. For example, insurance
may be offered to an individual with a high risk job profile,
suggested by the records for people visiting a healthcare
center.
[0328] Further, E-EHR data regarding unused medications by any
individual in a given period may be used for insurance processing
such as payment/co-payment and reimbursement options.
[0329] In accordance with an embodiment of the present invention,
electronic data or health records may also be used for financial
modeling and reporting to assess performance of one or more
facilities.
[0330] With regard to financial modeling, variety of data both
primary and secondary information such as demographics, disease
patterns and trends, market segments, demand and supply dynamics,
competitive profiles, consumption patterns, and the like may be
collected from the health records, along with the information about
the tangible and intangible resources available with the healthcare
facility. This information may be further used to design
appropriate financial models with regard to healthcare business
valuation, cost of capital, portfolio options, risk modeling,
option pricing, and the like for the healthcare and medication
management facility.
[0331] In an embodiment, the estimated costs and financial
forecasts may be presented in the form of spreadsheets, reports,
and other such presentation formats.
[0332] For example, financial modeling may be performed based on
the data collected from health records regarding the diminishing
resources or obsolescence of a technology (e.g., health records
indicating a number of cases wherein a tumor was not detected in
the early stages due to existing technology limitations). This
activity may be helpful in justifying a future course of action for
a healthcare facility (e.g., justifying new technology acquisition
for ultrasound and imaging).
[0333] An enhanced electronic healthcare record (E-EHR) may be
associated with the facilities of the invention as depicted in FIG.
1 and elsewhere and may exchange information (e.g. real time data)
with the facilities. The E-EHR/E-EMR facility 118 may maintain a
collection of health records of individuals and/or groups in a
digital format that is capable of being shared across a medical
facility or with external facilities electronically such as through
Internet and the like. An E-EHR may include any medical related
data and information, such as a medical history, allergies,
pathology and laboratory test results, medical scanning reports,
region and residential information, and the like.
[0334] An enhanced E-EMR (E-EMR) may be generated in association
with the E-EHR/E-EMR facility 118 and may be useful in an
institution such as a hospital, clinic, physician's office, nursing
home/center and the like. The E-EHR/E-EMR facility 118 facility may
encompass information related to care across all settings and
services such as administrative, nursing, lab, clinical, radiology,
pharmacy, care planning, imaging, insurance planning, facility
planning, rehabilitation, and the like without limitations. An
electronic communication interface for implementing retrieval of
information by the E-EHR/E-EMR facility 118 and push-out of
information from the E-EHR/E-EMR facility 118 may be provided
thereby facilitating utilization of E-EHR related information
anywhere within an entire medical facility. For example, lab
reports of a patient stored in an E-EHR/E-EMR facility 118 may be
utilized during care planning to prepare a healthcare plan for a
patient. Similarly, data related to allergies and sensitivities for
a patient may be utilized by a doctor to prescribe relevant
medicine and offer treatment accordingly. The E-EHR/E-EMR facility
118 may interconnect electronically with a variety of medical
related facilities (e.g. those within and without a central
facility, those depicted in FIG. 1, and the like) thereby forming a
networked system where medical information of a patient or a group
of patients flows in real time.
[0335] The E-EHR/E-EMR facility 118 may capture information from
existing medical records as well as third party data sources. The
electronic health facility may be connected with various other
facilities for data collection using sensing and monitoring
devices. For example, updates regarding relevant information from
other facilities may be sensed by sensing and monitoring techniques
and automatically delivered to be updated with the E-EHR. In
embodiments, delivery and receipt of information may be facilitated
through wireless methods of communication. Similarly, any
information from the E-EHR may also be retrieved by other
facilities though wireless communication. In an embodiment, RSS
data feed may be utilized to automatically retrieve information for
an update with the E-EHR.
[0336] In accordance with an embodiment of the present invention,
the E-EHR/E-EMR facility 118 may include an automated data
discovery mechanism for tracking and collecting data from various
facilities including those depicted in FIG. 1 and within a medical
facility. The data discovery mechanism may collect prescription
data, caregiver data, facility data, care plan data, patient
identification details, outcome data and the like. In an example,
the E-EHR data discovery mechanism may form an interface with the
prescription management facility 106 to detect any updates,
changes, details, and the like that are provided by the
prescription management facility 106 and the like. The discovered
data may be used by the E-EHR/E-EMR facility 118 to update an E-EHR
or E-EMR which may be accessed on demand or automatically by other
facilities.
[0337] The E-EHR/E-EMR facility 118 may also organize and manage
the medical-related data and information in a systematic format
(e.g. sequentially). The organization and management of data by the
E-EHR/E-EMR facility 118 may be based determined needs for the
information by the various facilities as depicted in FIG. 1. For
example, separate databases may be maintained for information
related to distinct facilities, such as care planning, diagnosis,
labs and imaging, and the like. In another scenario, a data
management process may organize E-EHR data based on demography,
patients' index, and the like. In an embodiment, data organization
and management may be performed through computer implemented
methods. In accordance with this scenario, data may be gathered
from various packages and processed by a processing machine to map
the data content into a single or multiple headers or categories.
The categories may be decided by an administrator. Accordingly,
based on the segregation of data content into categories, an
identifier may be associated with each data item and stored in
databases. The data content may further be manipulated through this
identifier. Auto manipulation of data may also be performed by
implementing and running a set of rules.
[0338] The E-EHR data may be analyzed and used to develop
statistical models for health assessment of a group of people based
on parameters such as age, geography, lifestyle and the like. The
analysis and computations may be performed on overall data content.
The E-EHR analysis and computation may be performed to address
specific facility needs, such as care planning, labs and imaging,
prescription management, insurance and payments and the like.
Prescription management may benefit from E-EHR analysis by
receiving an analytical result that includes at least one
pharmacy-related data element in context of one or more
individuals' E-EHR data.
[0339] The E-EHR analysis and computations may be performed in
real-time to facilitate real-time solution exchange among the
various facilities within the medical profession, such as those
depicted in FIG. 1. In an example, data may be received by the
E-EHR/E-EMR facility 118 for entry into an individual's E-EHR. As
that E-EHR record is being updated, the data may also be analyzed
to provide real-time feedback to a prescription management facility
that is handling prescriptions for the individual. This real time
analysis and communication may be similarly applied to the other
facilities depicted in FIG. 1 and elsewhere.
[0340] In accordance with various embodiments, data security may be
ensured for the E-EHR through authentication requirements. For
example, a proper authentication of a user along with his personal
as well as log in details may be required during access and
operation of the E-EHR. In another embodiment of a fully automated
tracking and record keeping facility, unique log in credentials may
be provided to users who are registered with the medical facility
and corresponding details of users may be gathered and stored in a
separate database. Any subsequent correspondence with regard to the
E-EHR from a registered user may be accompanied with certain
security checks to confirm already stored details of the registered
users. Further, various levels of access associated with the E-EHR
may be encrypted for secured access by an authorized and intended
person only. Encryption may implement an authorization protocol
that may be decrypted by a specific secured key only. In an
embodiment, a token may be issued to a user on any type of
association with the E-EHR that may enable further processing and
assist in keeping track of user operations on the E-EHR. In an
embodiment, the token may be generated using an automated system in
the form of an auto-email.
[0341] In accordance with various embodiments of the present
invention, system data may be registered at a central location.
System data may include various software algorithms, operational
and support data, content of the E-EHR, respective metadata, and
definitions of metadata, attributes and characteristics associated
with the data content, and the like. The data content may include
semantics as well as representations. Further, the registered
system data may be linked with various other data sources and
interfaces through pointers. The central location associating
registry of the system data may be protected with data security and
encryption methods where only authenticated persons may find
access.
[0342] In accordance with an embodiment, various business rules may
be associated with the E-EHR. These business rules may include
details governing the flow of information from one facility to
another. For example, delivery of drugs and medicines from the
dispensing and marking facility 104 may be terminated in case
billing facility reports inadequate advance payments. Business
rules may be defined regarding information transfer from the E-EHR
to the prescription management facility 106 or to a physician's
prescribing device in case prescribed medicines are found to differ
from the prescribed guidelines on a patient's E-EHR.
[0343] The E-EHR may include and maintain a patient index that may
include a list that refers to all patients registered with a
medical facility. The patient index may be maintained on the basis
of names, geography or location of patients, type of association
such as temporary or permanent or with a specific facility such as
cardiac or orthopedic, and the like. It may be appreciated by a
person ordinarily skilled in the art that E-EHR may be referred to
by other names such as E-EMR and the like without limiting the
spirit and scope of the present invention.
[0344] As explained earlier, data may be sourced from a variety of
facilities, events, outcomes, actions, and the like to populate an
E-EHR or E-EMR. Some sources of E-EHR data in a healthcare
management facility may be related to medication and staff
administration, care and emergency planning, testing and
validation, regulation, delivery, and the like. Data that may be
sourced from events pertaining to the administration of
prescriptions may include date, time, location, dosage, prescriber,
patient, medication, generic medication, type or mode of
administration, undertakings, approvals, patient's mood and
responsiveness (before and after administration of medication),
patient's reactions after taking medication (comfort/discomfort),
patient's pain perception, patient's symptom perception, response
to side effects, other medications administered during same time
interval, patient's vital signs, presence/absence of other entities
during administration, change in patient's symptoms (e.g.
improvement and/or worsening of the symptoms), and the like. In an
example, in a hospital ward at least five out of ten patients are
given a dose of Drug X for treating a traumatic brain injury. The
reaction of patients to the drug in the form of mood swings,
behavior patterns, and responsiveness may be recorded in real time
and sent to the outcomes analytics or databases. This information
may be further integrated with the E-EHRs of the individuals. These
reactions and patterns may be observed and recorded by the
healthcare professionals such as staff, nurses, attendants, and the
like and may influence future course of action. These reactions and
response patterns may be automatically recorded, such as with
sensors for measuring changes in the blood pressure or nervous
reactions of the patients may be tracked. Emotions, moods, and
patient response may be detected by galvanic response sensors
attached to the skin (sense arousal, fear, anxiety); heart rate
sensors to sense agitation, stress, feeling of calm; Electromyogram
(EMG) sensors implanted in muscle tissues to measure nervousness
and relaxation; Electroencephalograph (EEG) scalp sensors for
measuring brain activity; Magnetic Resonance Imagery (MRI), and the
like.
[0345] Various data collection facilities may be provided for
gathering prescription administration data including mobile devices
such as PDAs, smart phones, tablet PCs, notebooks, and the like.
Other examples are described above and elsewhere herein. These
mobile devices may run on any operating system such as Windows
Mobile, Windows XP, Palm, RIM and Symbian-based operating systems.
These devices may be provided with data encryption, medication
verification software, scanning and tracking abilities, and user
interface such as a graphical user interface. In addition, these
mobile devices may be equipped with various applications to aid in
the data collection, entry, and analysis process related to a
medical condition of the patient. Of course, the mobile devices may
be provided with wired or wireless connectivity and may include
scanners for scanning barcodes on medications. Alternatively, the
mobile devices with an in-built barcode scanner may be provided.
The barcode scanning recognition technology may capture medication
data in real time and allow the staff or healthcare professionals
to chart and maintain all critical patient information as they
administer the medications. Examples of barcode scanners may
include handheld, pen-type, laser, CCD, camera-based,
omni-directional, and some other type of scanners. Alternatively
the scanner may be an RFID reader for reading RFID tags on
medications. The RFID data may be captured in real time and sent to
the E-EMR facility for recording.
[0346] In another embodiment, data collection facilities and
devices may be provided with a web interface. The web interface may
be accessed via an Internet, LAN, WAN, MAN, or some other type of
network. The web interface may be in the form of a dashboard. The
web interface may accept an input (command, request, information,
and the like) by generating web pages accessible via a web browser.
The web interface may be provided with security protocols for
preventing unauthorized access. Alternately, data collection may be
performed using a web application that may run on a SaaS-based
architecture. The access credentials such as login information may
be shared with the users (nurses, staff, administrators, and the
like.) for downloading and accessing the application over the
Internet. Upon accessing the application, a user
interface/dashboard/panel with a variety of select options in the
form of tabs, menus, dropdown lists, and the like may be provided
to the user. Following this, the user may enter the medication
administration event data for one or more patients.
[0347] In accordance with an embodiment of the present invention,
data collection may be facilitated via automatically generated
signals from tangible products such as medication supplies
(medicines, bandages, packets, and the like), nutritional food
packages, and the like. In embodiments, the medication supplies and
packages may be equipped with sensors, RFID sensors, tracking
equipments, and the like for detecting signals. For example,
opening a glucose bottle may send this information to a data
collection facility for further processing. The information may
include packaging date, manufacturing or batch number,
manufacturer's name and code, retail price, and other similar
details to the data collection facility. Similarly, opening a
packet of syringes or band-aids may signal the event information to
the data collection facility. In embodiments, this information in
combination with the location or spatial information such as GPRS
information may be used for tracking complete real time event
information.
[0348] Data may also be collected based on the observation recorded
via a web or vigilance camera. The camera may be a mobile
camera.
[0349] Data pertaining to events may be recorded, such as a
conversation between a healthcare professional and a patient. With
proper technology enabled devices, voice records may also be
converted into digital/EHRs.
[0350] Further, data may be collected from existing patient
records. In an embodiment, data from manual, hard copy records may
be transcribed. In certain cases, event dating may be provided to
the transcribed data for the purpose of records.
[0351] In accordance with another embodiment, data from E-EHR/E-EMR
facility 118 may be accessed by other facilities such as care
planning, rehabilitation, long term care facility, and the like,
through an E-EHR SaaS service.
[0352] Data in an E-EHR may also be managed manually, such as
through a user interface. E-EHR patient management user interfaces
may be provided with various functional fields to add a patient,
discharge a patient, and edit patient's (demographics, room number,
allergy, diagnosis, and the like) information. In an example, a
change in the room number information for a patient may be sent in
real time and updated in the patient's E-EHR.
[0353] Various facilities may interact with each other such that
the real time data flows among them. For example, data from the
administrative touch points (such as from a hospital ward) may be
collected and shared with the other facilities such as care
planning, billing, E-EMRs and the like.
[0354] The flow of data may be bi-directional between the
facilities, i.e., the data flow may be backward compatible. For
example, data sent from the patient's care department to the
orthopedic department may reflect multiple incidences of fractures;
this information may indicate osteoporosis and a bone density test
may be advised by the orthopedic department along with a blood test
to the care department with instructions indicating fragility of
patient's bones and advocating due care.
[0355] E-EHR may include data that may be related to financial
transactions such as billing, payment, insurance, and the like. For
example, a patient may be undergoing a test in a laboratory. Real
time information about the nature of test may be broadcasted to the
billing facility where an automatic receipt may be generated
indicating the amount to be paid by the patient based on the
insurance coverage availed by him (the insurance information may be
obtained in real time from the insurance facility).
[0356] Similarly, real time data from patient touch points such as
patient attributes/events facility may be utilized for various
insurance processing activities such as determining submittal
process and norms, eligibility benefits, coverage response, and the
like. Specifically for coverage response, real time data from
patient touch points may be used to ascertain events such as if a
given treatment/medicine is covered under an exceptional case, or
if it requires certain prerequisite events or conditions.
[0357] Likewise for payment options, real time patient E-EHR data
may be used for establishing conditions or procedures for
co-payment and reimbursement for unused medications.
[0358] E-EHR data collection may be related to new prescription
events. In an embodiment, data tracked in an E-EHR for a new
prescription by a doctor may include various aspects of the
medications such as brands, allowability for substituting generics,
dosage frequency/quantity, administration schedule and/or
requirements, durable goods, rehabilitation requirements
(treatment/therapy), and the like.
[0359] Data that may be stored with an E-EHR/E-EMR facility 118
(e.g. in an E-EHR) may also be collected from electronic orange
book (maintained by United States Food and Drug Administration)
regarding new information on approved drug products, generics,
proprietary name info, applicants/owners, legal protection, and
therapeutic equivalents. This information when made available in a
patient E-EHR may be updated in real time and the updated
information may be reflected in the markings on packaging of
medications; for example, information regarding the mode of
consumption, sun exposure, and the like may be printed on the label
of a medication bottle.
[0360] Data pertaining to new events may be shared with the
pharmacies and treatment and care centers such as long term care
and rehabilitation centers. In addition, the collected data may be
used to manage dispensing/supply chain operations at the pharmacy.
For example, a real time data collected for increased number of
cases for stomach flu may help the pharmacy schedule its delivery
side operations proactively. Similarly, data pertaining to
transactions for purchasing medications at the pharmacy windows may
also be tracked.
[0361] Pharmacy-related data tracking may include home delivery
orders for a mail order pharmacy may be tracked and recorded in the
E-EHR in real time (e.g. shipment from the pharmacy, in-route
tracking, delivery, and the like)
[0362] The E-EHR may also receive data pertaining to
patient-specific clinical outcomes from various sources such as
laboratories, imaging facility, regulatory facilities, third
parties, and the like. Outcome data may be provided electronically
from computerized systems associated with the facilities or with an
individual patient (e.g. web-based data entry by a patient).
Clinical outcome data may include real time data collected from
laboratory and imaging services such as tests requested, intake
notes, medical samples, electronic measurements, clinician readings
of results and notes, primary or specialists care reading and
notes, and the like.
[0363] Patient touch points may include the facilities and facility
in the healthcare management platform where real time event
tracking concerning various aspects of medical care may be
conducted. Personal records and documentation from these touch
points may include information such as capacity planning (number
and details regarding people working in the facility), time-in and
time-out management for employees and staff, and some other types
of information
[0364] Clinical outcomes may be a form of patient touch point, but
other data from other patient touch points may also be captured by
the E-EHR/E-EMR facility 118. Patient interviews, a common
healthcare practice, may include data that can be captured (e.g. in
real time) and delivered to the E-EHR (or to other facilities as
described herein). For example, conversations between a patient and
a rehabilitation specialist may be captured in the E-EHR (in the
form of handwritten notes, short-hand writings, graphical symbols,
voice recordings, and the like). Likewise, statistical information
(e.g. vital signs) such as body temperature, pulse rate, blood
pressure, respiratory rate, and the like may also be collected in
real time from patient touch points. Collection of vital signs
information may be a pre or post prescription administration
activity.
[0365] Real time data collection from patient touch points may be
used for improved pharmacy management in other ways including
patient-specific medication review when a prescription is received
in the prescription management facility 106. As an example, a
patient's E-EHR may indicate that the patient is being administered
a daily dose of ranitidine for treatment of a peptic ulcer. The
pharmacy management facility may receive a new prescription for the
patient for `nizatidine`. The new prescription information may
trigger the pharmacy management facility to retrieve the pertinent
portion of the patient's E-EHR to perform validation, generic
selection, and the like based on this information along with the
patient's condition(s), aptness, and potential side effects of
these medicines. The result may determine the course of
prescription for the patient. Further, real time patient response
for different treatments and/or medications may be stored as an
E-EMR record and may be used to provide feedback for pharmacy
development. For example, a response from a number of patients
regarding taste of a medicine may be provided as a feedback to the
concerned drug manufacturer.
[0366] E-EHRs may be maintained for easy, authentic and reliable
access. In an embodiment, the movement, adequate storage
requirements, and storage location of health records (e.g. in an
E-EHR or E-EMR) may be controlled to ensure that records may be
accessed in real time and at any given time. E-EHR maintenance may
include a records recovery solution. Other E-EHR maintenance
activities may support audit trail periodic evaluation. Further,
various control measures such as access monitoring, user
verification, authorized destruction and security controls may be
introduced to prevent unauthorized access, destruction, alteration
or removal or records, and the like.
[0367] Because individual facilities may choose to maintain
portions of patient records locally (or at least maintain certain
information separately from a comprehensive E-EHR) the E-EHR/E-EMR
facility 118 may facilitate ensuring data integrity across all the
records at all the locations. For example, if a person changes
his/her contact address in the records of the care planning
facility, it may be validated through the E-EHR/E-EMR facility 118
to ensure that the information is accurate. The representative at
the care planning facility receiving the new contact address
information may confirm with the patient that this information
should be applied to all of the patient's medical records before
signaling to the E-EHR to apply the change to the E-EHR
database.
[0368] Data from E-EMR/EHR may also be combined with other
non-E-EHR data such as clinical studies, drug interactions and
company data, and the like to facilitate a well informed decision
process making by the concerned healthcare professionals and/or
entities. For example, allergy information for a patient profile
may be combined with the real time pharmacy information on
substitutes to validate the prescribed medications for the
patient.
[0369] When combined with other data, E-EHR data may be used in a
variety of ways including creating prescription guidelines for
physicians and the attendants, determining the potential outcomes
of a prescribed medication/treatment administration. The potential
outcomes may be useful for avoiding adverse medication's reactions
or interactions, customizing dose in accordance with patient
perceptions, identifying ineffective medications for particular
patients, identifying patient profiles for high effectiveness of
medications, treating co-morbidity, identifying unexpected benefits
from unrelated conditions, linking perceived/actual benefits of
medications to other factors, and the like. For example, a pain
perception with medication administration may be dependent on other
factors such as alertness, physical activity, entertainment, mood,
and the like.
[0370] Further, the E-EHR may include information about a patient's
daily life (e.g. information on the nutrition, activity, exercise,
sleep patterns, and the like) which may be used during any
subsequent patient touch point. The E-EHR with this diversity of
information, including real time information as described herein
may be useful for a more comprehensive assessment of the patient,
such as during an emergency by EMTs, the emergency room nurses, and
other medical care professionals.
[0371] As discussed earlier, E-EHR/E-EMR data may also be useful
for insurance planning. Real time information regarding the
purchase/modification/renewal of health policies for a patient may
be updated in the records. Based on the records of an individual
regarding his own and family's needs, an insurance plan may be
offered to him. Alternatively, consolidation of E-EHR data from a
plurality of patients while maintaining confidentially of the
patients may benefit an insurance planning activity that may relate
to plans, coverage, rates, costs, payment processing, and the
like.
[0372] Real time health care data from electronic records (e.g.
EHR) may be advantageous for management and operation of a long
term care facility. Individual E-EHRs may be accessed to determine
eligibility for treatment in the facility, specialists and/or
equipment that would be needed at the facility to support the
individual, and the like. Consolidated E-EHR data may help with
planning of facility expansion, professional recruiting, and the
like.
[0373] In embodiments, real time data from enhanced E-EHRs may be
utilitarian for a physician or specialist with regard to
prescribing treatment and care. The dynamic, real time nature of
the E-EHR/E-EMR facility 118 and communications depicted in FIG. 1
and described herein may benefit the use of remote specialist
evaluation in real time of a patient that heretofore was unknown to
the specialist by making the information in the E-EHR current,
relevant, and continuously updated through the real time updating
capabilities described herein. In another example, a doctor may be
sensitized about the allergy conditions of a patient before
prescribing medications to him/her.
[0374] The E-EHR/E-EMR facility 118 may facilitate integrating data
received from various facilities including dispensing & marking
facility, Rx delivery, patient events, outcome events and the like.
The data may be received by the E-EHR/E-EMR facility 118 through
streaming data from these and other sources. This integration may
result in further improved enhanced electronic records for
patients. In addition, such an enhanced record may create
additional knowledge about the patient such as tendencies for
certain diseases that may be inherited.
[0375] In one embodiment, the enhancement may be in the form of
integration of the patient's insurance history with the medical
data. In another embodiment, the integration may be of data
associated with clinical trials. In yet another embodiment, the
data integration may be with a pharma co-vigilance database, drug
database, health database or some other type of health database. In
yet another embodiment, E-EHR/E-EMR facility 118 facilitated data
integration may enhance E-EHR and E-EMR databases by integrating
them with electronic patient check-ins, access to patient records
either at day or at night, instant messaging, transcription
facility, payment information, scheduling of health care,
electronic medical billing, claim management facility,
reimbursement facility, alert facility, order tracking, archiving,
reporting, and interfacing with tablet PC, PDA, Fax, scanner and
the like.
[0376] The E-EHR may be in a digital format that may include data
in comprehensive or summary form, such as medical history,
laboratory test results, billing information, and the like.
[0377] As described herein and elsewhere the E-EHR/E-EMR facility
118 may be an application that may be implemented in distributed
data storage systems that may be located at different locations so
that an enhanced E-EHR for a particular patient may be fragmented
at various locations based on a particular attribute of the patient
data. The attributes may be associated with patient history,
patient diagnosis, patient treatment and the like. In an
embodiment, distributed nodes of such a database may be
interconnected through a communication channel.
[0378] In accordance with various embodiments of the present
invention, the enhanced E-EHR may include a data integration
facility with features described herein above as well as providing
users with a unified view of the data. For example, the data
integration facility may feed data in real time from a variety of
sources to a clinical repository that may be viewed by customers.
Further, the data integration facility may enable hospitals,
clinics, and the like, to share and analyze the data with other
hospitals, regional health organizations, and the like. In one
scenario, the data integration facility may replicate the data
while loading the data into the health records and other
applications. The data integration facility may also store a backup
of the data in a second repository that may be used to feed the
data back to the enhanced E-EHRs in real time, in case the original
data is lost due to some reasons.
[0379] In another scenario, the E-EHR may include an Extraction
Transformation Load (ETL) facility. The ETL facility may be used in
association with the data integration facility that may enable
extraction of data, such as patient data from an outside source
such as lab reports, consultation reports from different clinics,
and the like. Extraction from the outside source may involve
converting the data into a format capable of undergoing
transformation processing. Thereafter, the data may be transformed
to meet technical and business requirements of a target database.
For instance, word-processing data might be translated into numbers
and letters, which are easier to track in a spreadsheet or database
program. Finally, data may be loaded into the target database. Some
databases may overwrite existing data with cumulative effect, with
frequent updating of extract data being done on daily, weekly or
monthly basis. Further, some databases may update the data in real
time.
[0380] In an embodiment, the E-EHR may also be provided with a
Statistical Analysis System (SAS). The SAS may facilitate data
entry, retrieval, management and mining of the data by the users.
For example, a user may enter information such as patient ID, name
of a patient, and the like, for retrieving details such as billing
information, medical history, and the like, about the patient from
an E-EHR. The retrieved data may be manipulated by the user and may
thereafter be extracted from the SAS. The SAS may also enable the
user to analyze data on the basis of medical history of the
patient, such as for the purpose of evaluating progress in medical
conditions of the patient, and the like. In another example, the
user may be able to obtain a statistical analysis of previous
reports of the patient that may be stored in an E-EHR. For example,
if a patient with blood group O positive needs to be administered
drug Y, the SAS may enable a user such as a doctor, a nurse, and
the like, to run a statistical analysis for finding the effect of
the drug Y on patient records with the same blood group. Such an
analysis may enable the user to find out whether the patient with
blood group O positive is allergic to drug Y or not. In case an
allergy is discovered, the SAS may trigger an alarm to caution a
physician regarding the allergy. The physician may then replace the
drug Y with another medicine that may not cause allergy in the
patient. In an embodiment, the statistical analysis may be run on
the basis of age of the patient, medical history of the patient,
and the like.
[0381] In accordance with various embodiments of the present
invention, the enhanced E-EHR may include Service Oriented
Architecture (SOA) that may help healthcare-related IT
organizations to improve patient treatment methods and billing
techniques. The SOA may enable IT organizations to focus on
improving the health information systems by removing
system-to-system communication problems and by making healthcare
organizations more adaptable to change. In another embodiment, the
SOA may also establish architecture standards for data formats and
system interfaces that may promote sharing of information. For
example, instead of mapping patient demographics from an E-EHR
system and each clinical system in a point-to-point fashion, the
SOA may enable the E-EHR application to abstract the differences in
the data and interfaces. Specifically, instead of having hundreds
of point-to-point interfaces in the E-EHR, there may be only one
service interface for each function that may greatly reduce
complexity and maintenance costs.
[0382] In an embodiment, the E-EHR application may enable the
patient-related data such as medical history, medical bills, and
the like, to be transmitted or received using data streams. In
embodiments, the data streams may be a communication medium that
exchange data to and from the healthcare platform. E-EHR may be
capable of producing a data stream that may be read by other health
systems and other data management systems. Representing the patient
data as a data stream may provide interoperability between systems
that may support continuous care of patients who move between
health care systems and facilitate merging of the patient data from
multiple sites of care for regional, national, and international
monitoring. Hence, the E-EHR application may include
functionalities for importing and exporting data between two health
care systems that may be accepted and transmitted in a standard
format.
[0383] Various security measures may be taken into consideration
while accessing an E-EHR. The security measures may be software
based or hardware based. The patient data saved in the E-EHR may be
secured by providing access control, such as password protection
and network-based admission control that limits access to
authorized users and devices only. Further, the security devices
associated with the network may provide protection for a wide range
of mobile devices that include servers, laptops, tablet PCs, and
personal digital assistants (PDAs) from intrusions and outbreaks,
such as worms, virus attacks, and the like.
[0384] Further, various technologies may be used by the E-EHR
application for collecting the patient data for maintaining
records. The records may include details such as medical history of
the patient, and the like. The records may be maintained by
healthcare organizations as well as by the patient. The E-EHR
application may enable automatic collection of external data such
as billing information, details of medical history of a patient,
and the like. For example, scanned images, records, and the like,
may be directly fed into a computer system of a clinic, health care
organization, and the like. Examples of the technologies may
include, without limitations, bar codes, radio frequency
identification (RFID) technology and voice recognition. For
example, bar codes may be used for capturing the external data; for
instance, information of drugs being administered to a patient may
be captured by a bar code reader device in real time. The captured
data may be related to medicines being administered to patients.
Similarly, the RFID technology may be used for the external data
related to medical assets. Further, RFID technology may eliminate
wastage of time that may be spent by doctors and nurses on
searching for supplies and equipment, thereby leaving more time for
them to attend to patients. The RFID technology may allow
improvement in quality, safety, efficiency and care coordination
within a hospital, a healthcare organization, and the like.
Additionally, the RFID technology may also be used in real-time
location tracking systems.
[0385] In an embodiment, an E-EHR application may provide voice
recognition technology for collecting data related to a patient.
The voice recognition technology may convert spoken words into text
in real time. The data collection process using voice recognition
technology may be more effective and may be performed more easily
when deployed in conjunction with a voice recognition facility. For
example, searches, queries, and form filling may be performed
faster by voice recognition than by using a keyboard. Likewise,
voice recognition technology may enable physicians to produce
records and reports for patients in real time.
[0386] In accordance with various embodiments of the present
invention, remote collaboration tools such as web cams,
chat/internet messenger (IM), and the like, may associated with the
E-EHR. For example, a web cam may enable a user to take a snap shot
of a patient's physical findings, especially for dermatological
conditions. The captured image may then be tagged to a medical
record for monitoring progress and treatment outcomes of the
patient.
[0387] In another embodiment, the E-EHR application may support
access of the data related to medical history of a patient, medical
insurance, and the like from a remote location by means of hand
held devices such as mobile phones, PDAs, and the like. For
example, physicians, clinicians, and the like, may access patient
data from any entity that is capable of connecting to the network,
regardless of where the records were originally stored or input. In
such a scenario, the E-EHR application may store copies of the
records on a server that may be accessed via a web browser.
Accordingly, a user may easily access, modify or transfer the
records of the patients to other hand held devices. In another
example, physicians may simply log into a remote system and may
retrieve the record of a patient to initiate treatment.
[0388] In yet another embodiment, the E-EHR application may be
capable of providing data in real time about patient care. For
example, if a patient is undergoing treatment in a hospital, the
E-EHR application may enable the medical records of the patient to
be updated in real time by a user such as a doctor, a nurse, and
the like, based on diagnosis of the patient, medicines being
administered currently to the patient, dosage of the medicines, and
the like. In another example, real time connectivity between a
pharmacy and a workstation of a doctor may provide information to
the doctor about availability in the pharmacy of various medicines
to be administered to the patient. In a similar manner, the E-EHR
application may provide real time data about various treatments
being conducted for a patient.
[0389] In accordance with various embodiments of the present
invention, machine learning (ML) techniques may allow the E-EHR
application to facilitate and enhance work of medical experts,
thereby improving the efficiency and quality of medical care
provided by medical experts. The ML methods may facilitate the
E-EHR application to automatically recognize complex patterns and
make intelligent decisions such as analysis of patient treatment
data, and the like, based on data that may be already available in
the E-EHR Examples. Further, the ML methods may be used to analyze
clinical parameters and their combinations for prognosis, e.g.
prediction of disease progression, for extraction of medical data,
and the like. The ML methods may also be used for data analysis,
such as interpretation of continuous data used in the Intensive
Care Unit; intelligent alarming during situations that may require
immediate action thereby resulting in efficient monitoring, and the
like.
[0390] In a scenario, the E-EHR application may also provide
assistance, such as vocal assistance, for enabling the user to
operate the E-EHR application efficiently. For example, if the user
encounters some problem in accessing the record of a patient, the
user may take the help of the voice assistance service offered by
the E-EHR application. In a scenario, the user wearing a headset
device may be able to listen to the voice-based assistance and act
accordingly.
[0391] Furthermore, a user may scan images of an injury, and the
like, captured through handheld devices such as mobile phone
camera, and the like. The E-EHR application may enable the user to
scan the images and save the scanned images, along with the records
of a patient. In an embodiment, the user may scan old medical
documents of the patient and may save them along with new
electronic data of the patient. In addition, the user may also
index the scanned documents in the E-EHR based on date of birth,
patient ID number, and the like.
[0392] In accordance with various embodiments of the present
invention, artificial intelligence based delivery networks may help
in automating the production of medical documentation. In an
example, the delivery network may optimize the storage of the
medical record. In another example, the delivery network may
enhance the retrieval of the record. Such delivery networks may
perform diagnosis and also make recommendations for therapy. For
example, a representative model may depict the symptoms of stomach
flu, along with typical clinical manifestations of stomach flu,
such as diarrhea, high temperature, nausea and loss of appetite.
Based on this symbolic model, an artificial intelligence delivery
network may automatically diagnose the disease based on input of
symptoms and provide advice on a course of treatment to be
followed.
[0393] In another embodiment, various identification technologies
such as a facial recognition system, biometrics, and the like, may
be utilized by the E-EHR application for automatically identifying
or verifying a user. For example, the E-EHR application may compare
selected features of the person with a facial database to allow
access to the record of a patient. The identification technologies
may be implemented owing to the patient's right of privacy and to
the need for security measures mandatory in healthcare.
[0394] The E-EHR application may set up a virtual private network
(VPN) that may be used by healthcare information systems of a
hospital, a healthcare organization, and the like. Healthcare
organizations may face hurdles in making secure patient records and
other sensitive health information due to widespread internet
usage. The VPN may allow patients, doctors, medical organizations,
insurance companies and government agencies, alike to communicate
effectively and economically. Further, the VPN may use passwords,
biometrics, two-factor authentication or other cryptographic
methods for securing records of the patients. Additionally, the
E-EHR application may provide secure tunnels from workstations to
order entry facility. For example, a user may enter an order for
medications from a workstation such as a care planning facility.
The order entered by the user may be viewed in real time by a
pharma planning facility. The pharma planning facility may send the
order to a prescription validation facility that may facilitate in
dispensing the ordered medications to a patient upon validation of
the order. The information transfer between two or more
workstations as described above may be done using the VPN.
[0395] Further in accordance with embodiments of the invention, the
system may include a voice activated care tracker facility. This
facility may allow the caregiver to track various activities
through voice commands. In an exemplary embodiment, the system may
store all the information relating to the patient. The caregiver
may interact with the system to provide various facilities to the
patient.
[0396] In an exemplary case, the tracker facility may track the
charting tool. The charting tool may include an enhanced Medication
Administration Record (MAR) chart. The caregiver may activate the
MAR chart with the help of voice commands.
[0397] The tracker facility may also monitor the Activities of
Daily Living (ADL). The ADL may include the daily life activities
like feeding, bathing, dressing, grooming and the like. The
caregiver may interact with the system to demand support staff for
helping the patient with daily activities. In an embodiment of the
invention, data related to the facilities provided for the daily
activities may be utilized to populate the MDS.
[0398] The voice activated care tracker facility may further be
utilized to track the medication to be dispensed to the patient.
The system may have the details of medication to be given to the
patient. The caregiver may confirm these details with the system
before providing the medication to the patient.
[0399] The voice activated care tracker facility may further allow
the caregiver to connect to the administrative or billing facility
for providing billing information. There may be scenarios when a
change in the medication may be required and it may be reflected in
the billing details of the patient. In such a case, the caregiver
with the help of voice activated care tracker facility may connect
to billing facility to update this information.
[0400] The voice activated care tracker facility may further allow
the caregiver to page other staff members or doctors for support in
caring for the patient. There may be cases when an elderly patient
may require a wheel chair for some kind of movement. The caregiver
may send a paging message to the desired staff member. The desired
staff member may receive this message through the system and make
the wheel chair available.
[0401] In an embodiment of the invention, the caregiver may
interact with the various facilities using a pair of headphones.
Further in another exemplary case, a voice activated care tracker
facility of the present invention may be used with third party
products such as ACCU-NURSE or CARE TRACKER.
[0402] Further in accordance with an embodiment of the invention,
the medication administration data stored on the data server may be
adapted to populate a Minimum Data Set (MDS). The MDS may be a part
of the U.S. federally mandated process for clinical assessment of
all residents in Medicare or Medicaid certified nursing homes. This
process provides a comprehensive assessment of each resident's
functional capabilities and helps nursing home staff identify
health problems. The MDS may be populated in different ways. In an
exemplary case, the MDS may be populated with data provided as per
the standards of National Council for Prescription Drug Programs
(NCPDP). NCPDP is any entity whose primary activities are
developing, coordinating, promulgating, revising, amending,
reissuing, interpreting, or otherwise maintaining standards that
address the interests of a wide base of users outside the standards
development organization. The membership of NCPDP provides
leadership and healthcare business solutions through education and
standards created using the consensus building process. NCPDP has
been named in the US federal legislation, along with the Health
Insurance Portability and Accountability Act and the Medicare
Prescription Drug, Improvement and Modernization Act.
[0403] In another exemplary scenario, the MDS may be populated by
providing data as per the standards of the Health Level Seven
International (HL7) feed. The HL7 provides standards for
interoperability that improve care delivery, optimize workflow,
reduce ambiguity and enhance knowledge transfer among all
stakeholders, including healthcare providers, government agencies,
the vendor community, fellow SDOs and patients.
[0404] In yet another exemplary case, an Extensible Markup Language
(XML) feed available as a web service may be captured by the MDS.
The XML feed is syndication feed parser for both RSS and Atom
feeds. It also implements feed auto-discovery for finding feeds,
given a Uniform Resource Identifier (URI). The XML feed supports
the following syndication feed formats: RSS 0.91, RSS 1.0, RSS 2.0
and Atom. The XML feed may provide a unified Application
Programming Interface (API) for parsing and using the various
syndication formats.
[0405] In yet another exemplary case, the MDS may be populated in
the manner of Software as a service (SaaS). SaaS is a model of
software deployment over the internet. With SaaS, a provider
licenses an application to customers for use as a service on
demand, either through a time subscription or a "pay-as-you-go"
model. In yet another exemplary case, the MDS may be populated
through Cloud computing. Cloud computing is Internet-based
computing, whereby shared resources, software and information are
provided to computers and other devices on-demand, like a public
utility.
[0406] In yet another exemplary case, the MDS may be populated
through a Service-Oriented Architecture (SOA). SOA is a flexible
set of design principles used during the phases of systems
development and integration. A deployed SOA-based architecture will
provide a loosely-integrated suite of services that can be used
within multiple business domains.
[0407] In yet another exemplary case, the MDS may be populated by
storing data in a database using the Structured Query Language
(SQL). The data may further be populated using .NET framework.
[0408] In yet another exemplary case, the MDS may be populated
using Java Server Pages (JSP), Active Server Pages (ASP) or
asynchronous JavaScript and XML (Ajax) front end.
[0409] The healthcare and pharmacy data management and
administration platform may further be implemented in different
environments. The different environments may include a Long Term
Care (LTC) facility, a Skilled Nursing Facility (SNF), and the
like. A LTC provides residential daily living and medical services
to a patient requiring extended medical attention. Such a facility
may provide rehabilitative, restorative, and/or ongoing skilled
nursing care to patients or residents in need of assistance with
activities of daily living. Long-term care facilities include
nursing homes, rehabilitation facilities, inpatient behavioral
health facilities, long-term chronic care hospitals, and the like.
The SNF is a place of residence for people who require constant
nursing care and have significant deficiencies with activities of
daily living. The SNF may include rehabilitation and various
medical and nursing procedures. In SNF, every patient is under the
direct supervision and care of a physician, such that the physician
may be available on an emergency basis. Further, the records of the
condition and care of every patient may be maintained, nursing
service may be available with at least one full-time registered
nurse on duty 24 hours a day. Also, the SNF may have appropriate
facilities for storing and dispensing drugs and biologics.
[0410] The healthcare and pharmacy data management and
administration platform may also be implemented through an
environment such as the Assisted Living Facility (ALF). An ALF may
provide supervision or assistance to those living in a Residential
Care Home, Assisted Care Living Facility, or a Personal Care Home;
they do not need constant nursing care but need help with
activities of daily living. Coordination of services by outside
health care providers and monitoring of patient activities to
ensure their health, safety, and well-being may also be provided.
Assistance may further include the administration or supervision of
medication, or personal care services provided by a trained staff
person.
[0411] Further, the healthcare and pharmacy data management and
administration platform may also provide assistance to patients who
choose an independent living environment. In times of illness or
disability due to advanced age, when managing activities of daily
living becomes difficult, help may be provided in the form of
limited time care by a healthcare provider who visits at specific
times to perform specific jobs such as administering medication,
bathing, grooming, cooking, feeding, and the like.
[0412] The healthcare and pharmacy data management and
administration platform may further be applied to different
environments of medication delivery. The healthcare platform may
provide different tools to reduce the delivery costs of the
medication. In an exemplary case, the delivery costs may be reduced
by hedging the fuel or gas prices. Hedging will reduce or eliminate
financial risk involved with variation in prices of gas. The
healthcare platform will take two positions in the equity or
commodity market that will offset each other if prices of gas
change.
[0413] The healthcare and pharmacy data management and
administration platform may also reduce the delivery costs by
cutting down some routes. This may be achieved by identifying the
routes at which less medication are delivered and are also longer.
Such routes may be cut down or the frequency of delivering the
medication may be reduced on these routes to save the
resources.
[0414] Further, the healthcare and pharmacy data management and
administration platform may apply some algorithms to identify the
proximity of the delivery destinations. By identifying the proximal
destinations, the healthcare platform may be able to control the
frequency of delivery of medication to these destinations or may
group the medication for the destinations that are close to each
other.
[0415] The healthcare and pharmacy data management and
administration platform may also apply Artificial Intelligence (AI)
based routing tools to identify the most efficient routes. In an
example, the healthcare platform may use Dijkstra's algorithm to
find the shortest route.
[0416] The healthcare and pharmacy data management and
administration platform may also reduce the cost of delivery in
real time routing. Deliveries may be regular deliveries or may be
sweep run that cover a range of delivery locations in a geographic
region or locale.
[0417] The healthcare and pharmacy data management and
administration platform may assist in grouping the delivery orders.
The grouping may be done on the basis of the facilities provided to
the patients. Patients availing the same physical facility may be
grouped together and medication for the entire group may be
delivered together. Orders may also be grouped on the basis of the
wing occupied by the patients. Orders for patients in the same wing
may be grouped together. Order may also be grouped on the basis of
the time of administration of a group of patients. In an example,
if the administration time for a group of patients is overlapping
then the order for all those patients may be grouped together.
Various other groupings are described herein and include grouping
by floor, wing, section, demographic, type of medication taken,
facility, group of facilities, geographic region, by attending
physician, by nursing staff, and the like. For medications that
have to be administered at various times throughout the day, all of
a patient's daily medication may be grouped by administration time
and delivered for a specific patient to a location from which a
healthcare provider can pull the medication at the required time.
For a group of patients receiving medications throughout the day,
the medication may be grouped by time of administration for the
group of patients and delivered to the caregiver location for that
group of patients (e.g. a wing of a patient floor in a long term
care facility).
[0418] The healthcare platform may further facilitate populating of
E-EHR with the clinical outcome data. Outcome data may include
patient response to medication, resolution or worsening of
symptoms, onset of new symptoms, and the like. The outcome data may
include pain, fatigue, physical functioning, emotional distress,
and social role participation that may have a major impact on
quality-of-life across a variety of chronic diseases.
[0419] The clinical outcome data may be obtained from various
sources. In an exemplary case, the clinical outcome data may be
obtained by providing a questionnaire over the web portal. Patients
may access the web portal and fill the questionnaire. The
questionnaire may be accessed through user name and password which
may be provided by the healthcare platform to the patient. Further,
the questionnaire may include interview based subjective questions.
The patient may also be asked to write his answers in free form as
to what he feels. The questions in the questionnaire may also be
provided in the form of multiple choices. Further, the healthcare
platform may provide incentives to the patients to fill the
questionnaire and provide the clinical outcomes. The incentives may
include providing discounts on filling the medical prescriptions.
Further, the discounts may be provided over self health testing
equipments. The self health testing equipments may include
equipments for measuring blood glucose level. The self health
testing equipment may also include blood pressure measuring
equipment. The healthcare platform may further provide incentives
for interaction over patient portals that are healthcare related
online web applications allowing patients to interact with their
doctors, physicians.
[0420] The clinical outcome data may also be collected from
diagnosis based news groups. These news groups may be online web
applications where the patients or participants may seek advice
about the treatment or medication from other patients or
participants who may have already experienced a similar kind
problem. The clinical outcome data from such news groups may be
collected by the healthcare platform by automatic scanning of
keywords. In an example, the keywords may include terms of a
particular medication, a particular diagnosis or treatment or any
type of clinical outcome. Further, these keywords may be weighted
differently by the healthcare platform.
[0421] The clinical outcome data may further be collected by
conducting regular visits of patient or participant at the doctor's
office. In other cases, the clinical outcome data may be collected
from the patient's house. The medical administration data
associated with the patient may be collected from the patient's
house. Further, the nurses may visit the patient's residence to
collect vitals associated with the patient and later obtain the
clinical outcomes with the help of these vitals. The vitals
associated with the patient may include body temperature, pulse
rate (or heart rate), blood pressure, and respiratory rate. The
clinical outcome data may further be obtained by visiting offices
of medical specialists. The medical specialists may include
Ophthalmologist, Endocrinologist Gastroenterologist, Gynecologist,
Hematologist, Laryngologist, Cardiologist, Neurologist, Orthopedic
surgeon, Oncologist, Pathologist, Pediatrician, Dermatologist,
Radiologist, Rheumatologist and other medical specialists.
[0422] The clinical outcome data may further be collected by
visiting emergency rooms of hospitals. The condition or the state
of the patient in the emergency room may be analyzed to obtain the
clinical outcome data.
[0423] Further, the clinical outcome data may be obtained by
diagnosing the patients in the hospital. The diagnosis may be
conducted by providing a questionnaire to the patients and asking
them to answer questions related to their health.
[0424] Further, the clinical outcome data may be obtained from
hospitals and clinics where the outpatients regularly visit. Such
outpatients may be provided a questionnaire related to the
treatment they are undergoing at the hospitals and clinics.
[0425] Further, the clinical outcome data may be obtained from
patients that are in long term care. The vitals of these patients
may be regularly obtained to analyze the outcome of the drugs. The
activity levels of these patients may also be monitored regularly
to obtain clinical outcomes. The outcomes may also be obtained by
analyzing the mood of the patient, the movement of the patients,
the type of activity they perform and the performance of their
tasks.
[0426] Another valuable source of clinical outcome data is that
collected bedside at contemporaneous with the administration of
medication. Upon administration of medications at the bedside, the
caregiver may be prompted to collect other relevant data. In a
preferred embodiment of the invention, the data related to outcomes
may be collected by the person administering the medication at the
time of administration, and thus may be entered into the HPDMA 100
along with the medication administration data. Therefore, the HPDMA
100 may include means for prompting the care giver to enter this
information at the time of administration.
[0427] Because HPDMA 100 provides for the real time tracking of
medication administration data plus the contemporaneous collection
of outcomes related to the medication, the outcome engine has the
ability to determine the efficacy of a drug--in effect, potentially
providing the ability to conduct ad hoc studies. For example, 6000
patients with condition A may exist. All 6000 of them are on drug
X. 3000 of them are on drug X for condition A and drug Y for
another condition. The 3000 on both drugs may fare better with
respect to condition A. The methods and systems described herein
allow one to extract such information and see connections that
might have not otherwise been seen. In another example, some
patients taking drug D may stop taking a medication before the full
prescribed amount is consumed because symptoms rapidly improve,
whereas others do not find improvement until the full course is
administered. Using the method and systems of the HPDMA 100 as
described herein to analyze the full enhanced electronic health
records of these two classes of patients, statistically relevant
factors among the classes of patients that may support the symptom
improvement findings may be detected.
[0428] In embodiments of the invention, the event outcome analytics
facility 124 may track the event outcomes that may be triggered
from the various facilities depicted in FIG. 1. These tracked event
outcomes may be collected in real time to be utilized by different
computer applications to provide various types of outputs. In
embodiments of the invention, the different types of outputs may
include, without any limitations, (1) predictions of treatment or
clinical outcomes, (2) predictions about costs of patient recovery
or recuperation, (3) grading or ratings for healthcare facilities,
healthcare professionals, medication effectiveness, and patient
acceptance, (4) reimbursements provided by the insurance companies
for different types of medications, and (5) customized clinical
trials databases.
[0429] The outcome analytics facility 124 may collect data in real
time from various sources and facilities. In an embodiment of the
system, the outcome analytics facility 124 may collect the events
outcome from a middleware facility. The middleware facility may be
a part of the three-tier architecture which may be provided by the
healthcare and pharmacy data management and administration 100. In
the three-tier architecture the presentation, the application
processing, and the data management may be logically separated to
each other. The middleware facility may allow the various
facilities, depicted in FIG. 1, to service data requests between a
user and a database. In embodiments of the invention, the database
may be associated with the E-EHR/E-EMR facility 118 or may be a
third party database. Further, the database may be accessed by the
dashboard facility 150 to present different types of reports to the
user. The access of the database may also be required by the
outcome analytics facility 124 to provide predictions related to
the outcomes.
[0430] Further in embodiments of the invention, the healthcare and
pharmacy data management and administration 100 may allow the
ordering of the collected data and the structuring of the collected
data into various medical databases. In an embodiment of the
invention, the structuring of the collected data may be based on
the different types of events. The different types of events may be
related to the prescribing facilities, the care planning
facilities, the laboratories & imaging centers, the insurance
& payments, the rehabilitation and long term care facilities,
the electronic medical record repositories, the dashboards and
databases, the third party sites, the healthcare facilities, and
the like. In another embodiment of the invention, the structuring
of the collected data may be based on the diagnosis details of the
one or more patients. In an example, the event outcome data
collected for a group of patients diagnosed with the same disease
may be structured together in a database. In yet another embodiment
of the invention, the structuring of the collected data may be
based on the treatment provided to the one or more patients. In yet
another embodiment of the invention, the structuring of the
collected data may be based on the nature of the outcomes. In yet
another embodiment of the invention, the structuring of the
collected data may be based on the demographics of the patients. In
examples the demographics of the patients may include their date of
birth, gender, birth year, country, postal code, ethnicity, blood
type, family doctor, insurance provider and the like.
[0431] Further in embodiments of the invention, the outcome
analytics facility 124 may perform a real time tracking of the
outcomes associated with the prescribing events and the pharmacy
fill events.
[0432] In embodiments, once the event outcome data associated with
the various facilities is collected, the collected data may be
utilized by different computer application facilities to provide
various types of outputs. Alternatively, the computer application
facilities may utilize the data from the E-EHR/E-EMR facility 118
to provide various types of outputs. In an embodiment of the
invention, the computer application facilities may utilize the
collected event outcome data to provide predicted outcome data.
[0433] In another embodiment of the invention, the computer
application facilities may utilize the collected event outcome data
to predict costs of a patient recovery or recuperation. The costs
of the patient recovery or recuperation may directly relate to
various parameters like, but not limited to, the cost of
administering a particular medication to the patient, the
reimbursements provided by the insurance companies for that
medication, the cost of long term care provided by the health care
facility, the cost of rehabilitation centers provided by the health
care facility, the cost involved in various types of laboratory
tests, the cost of admission in the healthcare facility and the
like. Further, the collected event outcome data, from different
facilities (depicted in FIG. 1) and other sources, may relate to
all these discussed parameters. The computer application facilities
may thus apply, known in the art, prediction and financial
algorithms on the collected event outcome data to predict the cost
of patient recovery.
[0434] In other embodiments of the invention, the computer
application facilities may utilize the collected event outcome data
to grade or provide ratings to facilities provided by the
healthcare facility, healthcare professionals, medication
effectiveness, and patient acceptance.
[0435] The effectiveness of a medication may be measured in terms
of its clinical outcomes. For example, equal number of dosages of
different medications, administered to a patient for a disease, may
yield different clinical outcomes. Thus, the medication that may
yield better and desirable clinical outcomes with less number of
dosages may be considered effective. A medication may also be
considered effective if the medication is able to cure more than
one disease. The effectiveness of a medication may also be measured
in monetary terms by analyzing the economical perspective of the
medication. For example, there may be more than one effective
medication that may be used to treat a set of diagnosed symptoms;
one of these may be more expensive than the other but equally
effective with regard to alleviating symptoms of the patient. In
this scenario, the financial value may determine the selection of
the medicine and the medication with less cost may be considered
more effective. Further, the collected event outcome data may
correspond to effectiveness of different types of medications. The
computer application facilities may apply, known in the art,
correlation algorithms to rate or grade the effectiveness of the
medications.
[0436] The collected event outcome data may also provide
information about the patient's acceptances to various types of
medications, treatments and facilities. The acceptances to
different types of medications and treatments may be measured by
the clinical or treatment outcomes. The acceptances to different
facilities (e.g. LTC and rehabilitation) of a healthcare facility
may be measured by the checking the number of patients opting for
those facilities. Further, the computer application facilities may
apply, known in the art, algorithms to rate or grade the
acceptances patients to various types of medications, treatments
and facilities. In an embodiment of the invention, the information
about the ratings of the facilities provided by the healthcare
facility, the ratings of the healthcare professionals, the ratings
of medication effectiveness, and the ratings of patient acceptances
may be sold to a publication company for publishing the information
in the articles of journals related to medical science.
[0437] In other embodiments of the invention, the computer
application facilities may utilize the collected event outcome data
to provide customized clinical trials database.
[0438] In an embodiment of the invention, the database storing the
collected event outcome data may be linked to a website of the
healthcare facility to provide non confidential information
including, but not limited to, ratings of healthcare professionals
associated with the healthcare facility, medication effectiveness
administered by the healthcare facility, patient acceptance to
administered medications and facilities provided by the healthcare
facility. The website of the healthcare facility may provide
information about the amount of reimbursements provided by
insurance companies to the administered medications, facilities
used and the like. In an example, a user or a potential patient of
the healthcare facility may visit the website provide by the
healthcare facility to check the reimbursements provided by
insurance companies for certain medications that are administered
by the health care facility. As the website is linked to the
database of collected event outcome data, the website upon applying
some known in the art algorithms may provide the reimbursement
details to the user. Further, the website may provide an updated
information to the user as the data is event outcome data is
tracked, collected and updated in real time.
[0439] The HPDMA 100 may include connecting in real-time a
diversity of data collection, storage, entry, display, management,
and maintenance systems. Each of these systems may have unique data
rules, formats, needs, and the like that may make sharing
healthcare related data among them challenging. One option for
dealing with these challenges is to implement software or
software-based computing systems that can operate between the
diverse facilities and databases forming a middleware that
facilitates consistently sharing data. Middleware may support data
format transformation, form filling, data field compliance
checking, business rules normalization, and the like that may allow
data from diverse systems to be shared and combined with high
quality results. Middleware may be embodied as software that
executes on computers, such as servers, clients, hosts, network
appliances, medical devices, and the like to allow data that may be
natively captured, entered, or stored by a computer associated with
a particular facility (e.g. medication administration) to be shared
with other facilities (e.g. as shown in FIG. 1) without requiring
the two facilities to have identical data formats, business rules,
and the like. Middleware may be a combination of software and
hardware that may be integrated with any facility depicted in FIG.
1 or that may be a self-standing system that is connected to the
backbone 103, or various combinations thereof.
[0440] A couple of exemplary cases may be helpful in understanding
how middleware may facilitate data sharing among the facilities
depicted in FIG. 1. In a first example, data from a laboratory
facility (e.g. mammography imaging lab) may include device specific
or industry standard image data, patient data, automated analysis
data, technician observations, radiologist interpretation data, and
the like. This data may be combined with mediation administration
data that may be captured partially from a device reader, from a
caregiver administering the medication, and from a prescription
management facility based on the device reader captured data to be
stored in an enhanced electronic health record. Ensuring that data
from these many sources can be effectively combined into one
enhanced electronic health record that can be used by other
facilities (e.g. dashboards, outcome analytics, various planning
facilities, and the like) may be accomplished with middleware. In a
second example, raw barcode data that may be captured by a hand
held scanner during a medication administration event may be
transferred in real-time to a pharmacy management dashboard for
display to a pharmacist. The raw barcode may be transformed by
middleware so that it can be properly displayed in the dashboard.
Because the raw barcode data may require further context to be
properly displayed in the dashboard, middleware may use the raw
barcode data to lookup patient information in an enhanced
electronic health record database, combine the patient information
with transformed medication data (e.g. from the raw barcode data)
and facilitate presenting the combined data to the pharmacy
dashboard.
[0441] The middleware methods and systems of the HPDMA 100 may be
used to transform data received from the diversity of facilities to
a common format based on pre-defined criteria for use in a common
datastore (e.g. an enhanced electronic health record). Middleware
may alternatively transform manually entered data into
machine-readable format. Middleware may also support structural
association of data, filtering of data, and the like.
[0442] The middleware facility may include processes that may
facilitate storage of data in the common datastore. In this aspect,
the data may be normalized before being stored in the datastore.
The normalization may facilitate reducing redundancy of data,
ensuring data consistency, optimizing data retrieval from a common
data store, and the like. In an example, the patient data may be
normalized by allocating a unique patient identification number for
all of a patient's data stored in the common data store. The
normalization may require that the unique patient identifiers
associated with each of the diversity of medical facilities be
transformed by the middleware to the unique patient identifier
[0443] Middleware may ensure that data is cleaned before storing it
into a common database. Cleaning of data may be accomplished by
filtering the data, breaking up complex data into uniform data
fields, and the like. In an example, a delimiter character may be
present in data being received from a patient attribute facility
and the delimiter may be removed by the middleware before the data
is recorded in the database. Alternatively, data received from a
prescribing facility may include brand name data for a
prescription. Middleware may support filing in a generic medication
field of an enhanced electronic health record based on the brand
name found in the prescription.
[0444] Middleware may be embodied in technologies such as SOAP, web
services, service-oriented architecture or other similar
technologies.
[0445] Middleware may facilitate distributing a common datastore,
such as an enhanced electronic health record across various
medical-related facilities (e.g. those depicted in FIG. 1) by
handling the data format transformation, correlation, lookups, and
the like needed to ensure that any view of the distributed data
exhibits consistency across the data sources. Likewise, middleware
may facilitate communication among the facilities through secure
means, such as virtual private networks and other network tunneling
techniques that work cooperatively with firewalls and the like.
[0446] Healthcare planning, also called Care Planning, is a key to
improving the health of the population of a region, a country, and
the like. In most countries, healthcare planning and management
takes place at national, regional or local level reflecting various
tiers of government for healthcare systems. Healthcare planning may
include offering various health facilities to citizens of a
country. Healthcare planning may be provided and/or maintained by
many entities such as governmental, non-profit, and private
entities. For example, healthcare organizations such as hospitals
can provide comprehensive medical facility planning services to
people. Healthcare planning may include various plans in accordance
with the requirement of people. For example, a family health plan
will be aimed at the full family while a group employee benefit
plan will be an employee welfare oriented plan established or
maintained by an employer or by an employee's organization. In
addition, a health plan may be a subscription-based medical care
arrangement offered by commercial insurance companies.
[0447] Efficient healthcare planning may require defining
appropriate goals and objectives that may further facilitate the
creation of appropriate strategies for implementing the same.
[0448] The data requirements to achieve the objectives and goals
for a care plan may be driven by a number of factors and/or macro
forces such as demography, role of government, environmental shift,
social set up, healthcare innovation and competition, regulations,
and the like. This may be apparent by way of a few examples that
are described below.
[0449] Healthcare planning may be aimed at improving the physical
and functional status of the public health based on the health
status and disease profiles for a given demography or region.
Therefore, access to timely, accurate, comprehensive, and diverse
medically-related event data may be important for healthcare
planning. For example, reduction of communicable disease profiles
in a Sub-Saharan region may be an objective for a healthcare entity
that may be more readily achieved with real-time data for patients
and others in the region. Similarly, the objective of healthcare
planning may be to meet the high levels of healthcare reforms
promised by the government. In such a scenario, measuring health
care quality, actions, results (outcomes), and the like is
essential to ensure that reform goals are met. The methods and
systems described herein may provide data for such healthcare
planning activities.
[0450] It is also known that diseases are linked to climate
changes. In light of this, the healthcare planning goal may be to
decrease medical plan utilization for environmentally borne
diseases such as malaria. By collecting bed-side data and
associating it with medical plan data, movement toward such a goal
may be measurable. With respect to healthcare innovations and
regulations, the objectives of care planning may be to make the
most effective branded drugs readily available and affordable for
those who demonstrate a need for such drugs. By collecting and
analyzing medication prescription, administration, and outcome
data, the methods and systems herein may facilitate determining an
efficacy of medications. In sum, the data needs of care planning
may encompass data related to prevention and control of health
problems, judicious planning, optimization, and utilization of
healthcare resources, and the like.
[0451] Care planning may require health data from various sources
that may be useful in planning patient treatment. This data may
relate to physiological, emotional, and environmental wellbeing of
an individual. For this purpose, medical history of a patient may
be utilized. Examples of physiological health data may include
weight, age, blood pressure, glucose levels, blood cells count,
hemoglobin levels, hypertension, cholesterol, stroke, pre-clampsia,
diabetes, allergy, seizures, asthma, and the like. Similarly,
emotional well being data may include information on stress levels,
lifestyle patterns, relationship issues, EQ quotients, any special
needs, and the like. Further, examples of environmental well being
may include information on exposure to pollution, neighborhood
conditions, food supply, and the like. These types of data may be
readily available to care planning activities by accessing an
enhanced electronic health record as described herein.
[0452] The healthcare plans may be offered to individuals or
customers based on their needs that may be ascertained from profile
information or medical history. This also forms the basis of
developing goal-oriented healthcare plans. For example, an
over-weight patient may be offered a weight reduction health plan
for achieving a desired weight. Similarly, a person with high
systolic blood pressure may be offered a health program that may
include exercise regime for controlling the blood pressure, and the
like. Not only can an enhanced electronic health record capture
patient conditions and changes, it can also include plan data (e.g.
weight goals, and the like) that makes the further assessment of a
patient's progress and predicting the outcome for treatments toward
the goal possible.
[0453] Care planning may be designed for specific needs of various
individuals. The healthcare needs for women, children, elderly,
professionals, defense personnel, and the like may differ
significantly from each other. For example, for women a health plan
focused on maintaining adequate bone density or maintaining
hormonal balance may be required and specifically for pregnant
women the health plan may be focused on overall nourishment.
Likewise, healthcare needs of children aged 2-8 may be different
from those of teenagers. For professionals with hectic working
hours, a plan that leverages the exercise and diet routine may be
preferred. Similarly, for the elderly or defense personnel a
specific weight or glucose level goal may be the focus of a health
plan. Ensuring that healthcare planning can encompass these very
diverse goals and needs may require access to a diversity of data
from a diversity of medical facilities, such as those described in
FIG. 1 of the present invention. The HPDMA 100 as described herein
may provide the means and capabilities to support achieving diverse
care planning goals.
[0454] Care planning may be designed based on patient touch points
such as office visits, emergency room visits (ERs), inpatient and
outpatient quarters, rehabilitation centers, and the like. For
example, data for a care plan for an emergency room may be
intensive and focused and may require real-time data collection,
access, and dashboarding. Multidisciplinary teams of experts may be
deployed in the ER areas to meet the variety of patient needs. In
addition, with real-time access to administration and outcome data
for a plurality of patients, detailed, individualized care plans
may be developed for an emergency department.
[0455] Similarly, a care plan for a rehabilitation center may focus
on a number of parameters such as background needs of the patient,
medical equipment needs, home healthcare environment needs,
nutrition, supply, commodities, education & training, and the
like, all of which may be determined from outcome and treatment
data of a wide diversity of rehabilitation center patients across
the country. Such data may be accessible in a nationally maintained
enhanced electronic health record system as described in FIG.
1.
[0456] Also, the needs of inpatients and outpatients may be
different, emphasizing the need for different care plans for both
of them. Inpatients may require nutritional and daily care
(temporary) support such as bathing or dressing while outpatients
may prefer a short queuing time for medications and check-up.
[0457] Maternity wards may also require a well designed care
planning. For example, requirement for a hygienic and separate ward
for newborns and those with special needs.
[0458] Insurance processing is a method of collectively pooling the
risks of insurance payouts across a diverse population.
Specifically for healthcare, risk for incurring medical and health
expenses may be pooled among the various entities (patients,
insurance companies, health professionals, etc.) Healthcare
insurance processing may include various data-related steps such as
data collection, data validation, insurance claims processing,
insurance clearance, payments, expense justification, recovery
analysis, and the like. The methods and systems described herein
may provide such data in real-time and over a long period of time
from a diversity of patients.
[0459] Data collection may be a highly significant step in the
insurance process. This may include collection of information
pertaining to a variety of data such as medical history of a
patient, current diagnosis, treatment prescribed,
therapist/surgeon/medical specialist information, follow-up
treatment, frequency and duration of treatment, amount/mode/process
of payment, and the like.
[0460] The medical history of a patient may include information
from physical examination of a patient for various elements such as
general survey, skin, head, eyes, ears, nose & sinus, mouth,
throat, neck, chest, tumor growth, lungs, heart, abdomen,
extremities, lymphatic blood vessels, neurological, and the like.
The medical history may also include information on previous
diagnoses, consultations, and examination by physicians or medical
practitioners. The medical history may also reveal if the patient
has utilized any diagnostic, therapeutic (surgical or non
surgical), and rehabilitation services in the past. An enhanced
electronic health record may combine current and past medical
treatment and outcome data for an individual across geographic
locations, insurance plans, life changes, and the like.
[0461] Current diagnosis information may include various
possibilities regarding the state of the current disease and
symptoms. For example, if a patient is admitted to a hospital with
complaints of severe pain in the pelvic region, a likely diagnosis
in this case may be `possible endometriosis.` Based on this
indicative information, the insurance processing may be conducted.
By providing access to data representing symptoms, treatment, and
outcomes of such a diagnosis across a large number of patients, the
HPDMA 100 may be found to be useful in determining the monetary
range for insurance claims that may be required for relevant
treatment options.
[0462] Information on medical practitioner, specialist, surgeon,
and physician may also be significant for insurance processing.
Because the charges and or expenses related to a medical treatment
may depend on the medical practitioner, knowing something about the
efficacy of a practitioner in treating a specific condition may
influence how much an insurance company may be willing to pay for
the practitioner's services. By allowing access to certain
information across a wide range of patients, the HDPMA 100 may
facilitate such efficacy determination.
[0463] Similarly, information regarding mode of payment such as
cash or credit, onetime or periodic may be useful for insurance
processing. In case the payment mode is credit-based, the issuing
bank information (name, location, policies) may be of importance
for insurance parties. While it may be preferable to limit access
to financial information that is associated with a patient, the
enhanced electronic health record as described herein may
facilitate making this information securely accessible and readily
linkable to other information in the record that may be pertinent
to insurance processing.
[0464] Further, insurance processing may also include information
regarding the payment/co-payment, and reimbursement options. By
ensuring that medication administration data is automatically and
accurately collected, it may be possible to collect data to support
reimbursement of out of pocket costs for unused medications.
[0465] A well planned and well designed facility may provide long
term benefit to a healthcare organization. This may also be
significant with respect to the organization's objectives such as
financial productivity, meeting demand for services and changes in
technology for healthcare, optimal utilization of already existing
healthcare resources, and the like. Healthcare providers and
planners may utilize healthcare data for devising solutions for
facility planning and space programming for healthcare
services.
[0466] Healthcare data for facility planning may be related to the
mix ratio of inpatient and outpatient services, older and
critically sick patient population, treatment patterns, advancement
in technology, health data related to diseases and conditions
(asthma, cholesterol, diabetes, heart disease, hypertension,
obesity, etc.), type of healthcare (ambulatory services, ER visits,
etc.), data related to injuries (accidents, suicides, homicides,
etc.), life stages and population (births, deaths, women's health,
children's health, state and territorial distribution, etc.),
lifestyle (drug use, smoking, exercise, etc.), and the like. Each
of these data fields and their role in healthcare facility planning
will be discussed in detail in the following description.
[0467] In accordance with various embodiments of the present
invention, healthcare data may be an aggregated or composite
healthcare data. The healthcare data may be obtained from public
sources such as statistics published by government agencies,
research groups, and web engines or from secondary sources such as
medical history or profile information of patients visiting a
healthcare facility.
[0468] The mix ratio of inpatient and outpatient services may be a
factor for facility planning. For example, a higher number of
outpatient services may be an indicator of an additional outpatient
ward. Similarly, an increasingly high number of older patient
populations may call for design of facilities that reduce waiting
time during admission and discharge, provision of wheelchairs,
canes, elevators, provision of chemist shops within the facility,
long term care units, and the like.
[0469] The advancement in technology for example, digital imaging
technology may affect facility design and planning for a healthcare
unit such as a diagnostic and interventional radiology facility or
laboratory. Conventionally, film-based imaging departments
constituted dark rooms, large file rooms, large central technical
work area, and a minimal preparation and recovery area. Current
advancements in technology require highly specialized and advanced
telecommunications infrastructure capable of rapid transmission of
large data files to workstations throughout the hospital,
physicians' offices in the community and even consulting
radiologists halfway around the world. Facility design may require
consideration of all such factors.
[0470] Data (public or secondary) regarding the diseases and
conditions may also be pertinent for facility planning and
management. Increased number of cases reported for asthma and
obesity may lead to designing of facilities that are dust free and
equipped with exercise apparatus, respectively.
[0471] A high number of emergency room visits may indicate a need
for designing the ERs and trauma centers such that the amount of
time taken to carry the injured to these facilities may be
minimized. These facilities may be designed near a small helipad
within the healthcare unit (if possible) for catering to emergency
situations such as disaster (fire, accident, earthquake, etc.)
[0472] Similarly, information pertaining to injuries may be useful
in integrating the main healthcare facilities with some additional
facilities. For example, if the statistics indicate high number of
suicide cases in a given region, centers for preventive treatment
(yoga, alternate medicine, meditation, community centers, etc.) may
be provided with a hospital.
[0473] Various life stages and population statistics (birth and
mortality rates, gender statistics, etc.) may be useful for
facility design. For example, an increase in the number of
children's health records in a community may indicate a need for
planning a child friendly healthcare center in that community.
Likewise, a disproportionate male-female child ratio in a
developing country may indicate need for a community center that
may act as an awareness camp for the masses.
[0474] A long term care center or a facility may provide
rehabilitative, restorative, and/or ongoing skilled nursing care to
patients or residents in need of assistance with activities of
daily living. This facility planning may require specific
consideration and design than the facility planning for a general
healthcare center since it may cater to the needs of a specific
group (e.g., elderly or homeless) that are otherwise not able to
get focused healthcare and attention. Examples of long-term care
facilities may include nursing homes, rehabilitation facilities,
inpatient behavioral health facilities, long-term chronic care
hospitals, and the like. Long term care facilities may be designed
to make them safe, functional, durable and relatively easy to
maintain. Some parameters to be considered while designing the long
term care facilities may include design, layout, ambience, color
management, dining and food management, online and kiosk-based
layouts, and the like. For example, the facilities may be designed
to include automatic ID scanners for residents using the dining
facility.
[0475] Facility operations may be planned by collecting aggregated
content from Enhanced Electronic Health Records (E-EHR as described
herein) of the patients in a healthcare center or hospital. The
E-EHR data may correspond to information regarding inpatients,
outpatient, staff, administrators, and the like. Based on these
records facility layout may be planned. For example, a yoga center
or gymnasium may be provided in close vicinity of the hospital for
the benefit of the healthcare professionals working in shifts or
emergency areas and who are not able to attend the same due to
unpredictable job demands.
[0476] Facility planning may also be related to medication supply
management. A separate section or layout may be designed for
provision of medicines and other health related equipments and aids
such as belts, bandages, syringes, etc.
[0477] In accordance with an embodiment of the present invention,
these medicine counters may also be self-help desk counters or
online kiosks. Provision of such medication centers may facilitate
smooth work flow for patients, administrators, guardians, etc., may
be effective due to reduction in time between diagnosis and
administration of medicines, and may be cost effective. In
addition, it may also reduce the problems associated with
non-availability of certain medications outside the hospital
premises. Determining how and when to effect a medication supply
facility (e.g. prescription management, medication inventory
management, packaging, dispensing and the like) may require
accurate and timely data collection about the prescriptions, a
prescriber, patients, medications prescribed, outcomes, and the
like being served by the facility and by other facilities. The
methods and systems described herein in association with the HPDMA
100 may provide such capabilities.
[0478] Further, these counters furnished with cost effective drugs
may minimize illegal sale of drugs. For example, Tamiflu for swine
flu may be sold at the hospital counters at lower price, thus
encouraging people not to buy the same illegally from outside
stores. In addition, this may help the government and health
agencies in maintaining proper supply and demand for emergency
medications by discouraging stocking of these medications
outside.
[0479] Facility planning may also involve scheduling of various
tasks and resources in a healthcare unit. Scheduling may include
scheduling patients for appointments, diagnosis, surgery, tests,
consultation; rooms for admission, clean-up, administration,
operations; healthcare professionals and specialists for meetings,
visits; and the like. By providing access to prescription
management data, that may include administration information such
as administration schedules, requirements, and the like, a facility
planning function operating in conjunction with the HPDMA 100 may
substantially improve the value and efficiency of such facility
planning.
[0480] Scheduling may be performed manually or automatically with
the aid of software and tools. This activity may be pertinent since
some of the tasks may be period specific. For example, radiation
treatments may be provided only on weekdays and not on weekends,
thereby, necessitating the need for scheduling the appointment of
the patients with the therapists from Monday to Friday.
[0481] In addition, scheduling may be significant to accommodate
any alterations or revisions in the pre-decided schedule; for
example, accommodating absence of one specialist by another on any
given day.
[0482] Furthermore, scheduling may be important for some activities
that may be sequential in nature. For example, scheduling a steam
bath after a therapeutic massage session. This type of scheduling
may facilitate optimization of given resources for an organization.
In sum, facility planning may require consideration of availability
of given resources and to address requirements for handicaps like
inability to climb staircase, visual impairment, special washroom
facilities, etc.
[0483] The HPDMA 100 may also be associated with insurance planning
facilities as depicted in FIG. 1. Insurance may be provided by
government-sponsored social insurance programs or from private
insurance companies and it may be applicable to an individual or to
a group. An objective of the insurance planning is to ensure
adequate medical coverage is provided to protect the covered groups
or individuals from unexpected healthcare expenses by payment of
premiums or taxes.
[0484] Insurance planning may use information provided by the
various facilities of the HPDMA 100 and in particular E-EHRs 118,
outcome databases 124, and the like to make adjustments in
available plans based on the suitability of such insurance plans
based for an individual. Plan parameters that may be impacted by
insurance planning may include customary fees, exclusions, maximum
out-of-pocket expenses, non-cancellation cases, premium, and the
like.
[0485] The accessibility of a large number of enhanced electronic
health records in an E-EHR database may facilitate establishing a
generic profile of patients and their caretakers for insurance
planning. For example, insurance planning using the generic profile
may result in a new insurance plan being offered to individuals
with a high risk job profile.
[0486] Pharmaceutical or pharmacy planning is another area that may
benefit from access to various data from the facilities and data
sources of the HPDMA 100, such as for devising pharmaceutical
related decisions. These data source may include medical history
data from the care planning or validation diagnosis aspect of the
HPDMA 1000, laboratories and imaging facilities, rehabilitation
facilities, databases of past medical records (e.g. E-EHR), third
party data sources, and the like.
[0487] In certain cases, market driven research may be required for
making a pharmacy related decision. The data from market research
may relate to marketplace environment, treatment choices available,
providers and patients profile, behavioral patterns, and the like.
At least a portion of such data may be derived from pertinent
information accessible in an E-EHR.
[0488] A data source such as outcome data (e.g. outcome database
124) may reveal that patients suffer from a side effect e.g.,
stomach infection after taking a particular medication. In light of
this observation, planning may be done regarding changing the
prescription instructions. In extension to this, pharmacy-related
planning may also include devising methods and processes to make
this possible side-effect and administration information public,
such as by means of improving product packaging broadcasting
through print and electronic media, and the like. Alternately,
pharmacy planning may include development of a medication that is
easier to digest or development of a medication that may suppress
the side effects of the previous drug.
[0489] Drug delivery mechanism may also be significant with regard
to pharmacy planning. By analyzing outcome data, it may be
determined that a particular oral drug formulation may not be
preferred by consumers because of its bitter taste so planning may
be done to prepare the drug in inhalable form.
[0490] Regulatory and compliance needs may be a cause of concern
for healthcare professionals since these regulations may directly
affect an organization's profitability and business success.
Accurate, comprehensive data collection may be essential to
properly complying with regulatory requirements. By providing
robust, detailed, timely, and comprehensive data collection,
medication tracking, administration record keeping, and the like,
the HPDMA 100 may provide individuals responsible for meeting
regulatory requirements with beneficial tools that ease such
compliance. Planning and decision making based on this information
may be improved with respect to improving and meeting compliance,
addressing existing deficiencies in the processes, reducing
business risks, and the like.
[0491] Collection of regulatory data may be necessary and
significant for the continuous monitoring and reassessment of a
drug's safety, quality, and efficacy/effectiveness. The HPDMA 100
may provide a platform for ensuring compliant data collection and
management.
[0492] The methods and systems described in connection with
facilities described herein, and the operational control of the
dispensing machine or any component of a facility described herein
(the "Subject Methods and Systems") may be deployed in part or in
whole through a machine that executes computer software, program
codes, and/or instructions on a processor. The Subject Methods and
Systems invention may be implemented as a method on the machine, as
a system or apparatus as part of or in relation to the machine, or
as a computer program product embodied in a computer readable
medium executing on one or more of the machines. The processor may
be part of a server, client, network infrastructure, mobile
computing platform, stationary computing platform, or other
computing platform. A processor may be any kind of computational or
processing device capable of executing program instructions, codes,
binary instructions and the like. The processor may be or include a
signal processor, digital processor, embedded processor,
microprocessor or any variant such as a co-processor (math
co-processor, graphic co-processor, communication co-processor and
the like) and the like that may directly or indirectly facilitate
execution of program code or program instructions stored thereon.
In addition, the processor may enable execution of multiple
programs, threads, and codes. The threads may be executed
simultaneously to enhance the performance of the processor and to
facilitate simultaneous operations of the application. By way of
implementation, methods, program codes, program instructions and
the like described herein may be implemented in one or more thread.
The thread may spawn other threads that may have assigned
priorities associated with them; the processor may execute these
threads based on priority or any other order based on instructions
provided in the program code. The processor, or any machine
utilizing one, may include memory that stores methods, codes,
instructions and programs as described herein and elsewhere. The
processor may access a storage medium through an interface that may
store methods, codes, and instructions as described herein and
elsewhere. The storage medium associated with the processor for
storing methods, programs, codes, program instructions or other
type of instructions capable of being executed by the computing or
processing device may include but may not be limited to one or more
of a CD-ROM, DVD, memory, hard disk, flash drive, RAM, ROM, cache
and the like.
[0493] A processor may include one or more cores that may enhance
speed and performance of a multiprocessor. The process may be a
dual core processor, quad core processors, other chip-level
multiprocessor and the like that combine two or more independent
cores (called a die).
[0494] The Subject Methods and Systems described herein may be
deployed in part or in whole through a machine that executes
computer software on a server, client, firewall, gateway, hub,
router, or other such computer and/or networking hardware. The
software program may be associated with a server that may include a
file server, print server, domain server, internet server, intranet
server and other variants such as secondary server, host server,
distributed server and the like. The server may include one or more
of memories, processors, computer readable media, storage media,
ports (physical and virtual), communication devices, and interfaces
capable of accessing other servers, clients, machines, and devices
through a wired or a wireless medium, and the like. The methods,
programs or codes as described herein and elsewhere may be executed
by the server. In addition, other devices required for execution of
methods as described in this application may be considered as a
part of the infrastructure associated with the server.
[0495] The server may provide an interface to other devices
including, without limitation, clients, other servers, printers,
database servers, print servers, file servers, communication
servers, distributed servers and the like. Additionally, this
coupling and/or connection may facilitate remote execution of
program across the network. The networking of some or all of these
devices may facilitate parallel processing of a program or method
at one or more location without deviating from the scope of the
invention. In addition, any of the devices attached to the server
through an interface may include at least one storage medium
capable of storing methods, programs, code and/or instructions. A
central repository may provide program instructions to be executed
on different devices. In this implementation, the remote repository
may act as a storage medium for program code, instructions, and
programs.
[0496] If the Subject Methods and Systems are embodied in a
software program, the software program may be associated with a
client that may include a file client, print client, domain client,
internet client, intranet client and other variants such as
secondary client, host client, distributed client and the like. The
client may include one or more of memories, processors, computer
readable media, storage media, ports (physical and virtual),
communication devices, and interfaces capable of accessing other
clients, servers, machines, and devices through a wired or a
wireless medium, and the like. The methods, programs or codes as
described herein and elsewhere may be executed by the client. In
addition, other devices required for execution of methods as
described in this application may be considered as a part of the
infrastructure associated with the client.
[0497] The client may provide an interface to other devices
including, without limitation, servers, other clients, printers,
database servers, print servers, file servers, communication
servers, distributed servers and the like. Additionally, this
coupling and/or connection may facilitate remote execution of
program across the network. The networking of some or all of these
devices may facilitate parallel processing of a program or method
at one or more location without deviating from the scope of the
invention. In addition, any of the devices attached to the client
through an interface may include at least one storage medium
capable of storing methods, programs, applications, code and/or
instructions. A central repository may provide program instructions
to be executed on different devices. In this implementation, the
remote repository may act as a storage medium for program code,
instructions, and programs.
[0498] The Subject Methods and Systems described herein may be
deployed in part or in whole through network infrastructures. The
network infrastructure may include elements such as computing
devices, servers, routers, hubs, firewalls, clients, personal
computers, communication devices, routing devices and other active
and passive devices, modules and/or components as known in the art.
The computing and/or non-computing device(s) associated with the
network infrastructure may include, apart from other components, a
storage medium such as flash memory, buffer, stack, RAM, ROM and
the like. The processes, methods, program codes, instructions
described herein and elsewhere may be executed by one or more of
the network infrastructural elements.
[0499] The methods, program codes, and instructions pertaining to
the Subject Methods and Systems described herein and elsewhere may
be implemented on a cellular network having multiple cells. The
cellular network may either be frequency division multiple access
(FOMA) network or code division multiple access (COMA) network. The
cellular network may include mobile devices, cell sites, base
stations, repeaters, antennas, towers, and the like. The cell
network may be a GSM, GPRS, 3G, EVOO, mesh, or other networks
types.
[0500] The methods, program codes, and instructions pertaining to
the Subject Methods and Systems described herein and elsewhere may
be implemented on or through mobile devices. The mobile devices may
include navigation devices, cell phones, mobile phones, mobile
personal digital assistants, laptops, palmtops, notebooks, pagers,
electronic books readers, music players and the like. These devices
may include, apart from other components, a storage medium such as
a flash memory, buffer, RAM, ROM and one or more computing devices.
The computing devices associated with mobile devices may be enabled
to execute program codes, methods, and instructions stored thereon.
Alternatively, the mobile devices may be configured to execute
instructions in collaboration with other devices. The mobile
devices may communicate with base stations interfaced with servers
and configured to execute program codes. The mobile devices may
communicate on a peer to peer network, mesh network, or other
communications network. The program code may be stored on the
storage medium associated with the server and executed by a
computing device embedded within the server. The base station may
include a computing device and a storage medium. The storage device
may store program codes and instructions executed by the computing
devices associated with the base station.
[0501] The computer software, program codes, and/or instructions
pertaining to the Subject Methods and Systems may be stored and/or
accessed on machine readable media that may include: computer
components, devices, and recording media that retain digital data
used for computing for some interval of time; semiconductor storage
known as random access memory (RAM); mass storage typically for
more permanent storage, such as optical discs, forms of magnetic
storage like hard disks, tapes, drums, cards and other types;
processor registers, cache memory, volatile memory, non-volatile
memory; optical storage such as CD, DVD; removable media such as
flash memory (e.g. USB sticks or keys), floppy disks, magnetic
tape, paper tape, punch cards, standalone RAM disks, Zip drives,
removable mass storage, off-line, and the like; other computer
memory such as dynamic memory, static memory, read/write storage,
mutable storage, read only, random access, sequential access,
location addressable, file addressable, content addressable,
network attached storage, storage area network, bar codes, magnetic
ink, and the like.
[0502] The Subject Methods and Systems described herein may
transform physical and/or or intangible items from one state to
another. The methods and systems described herein may also
transform data representing physical and/or intangible items from
one state to another.
[0503] The elements described and depicted herein, including in
flow charts and block diagrams throughout the figures, imply
logical boundaries between the elements. However, according to
software or hardware engineering practices, the depicted elements
and the functions thereof may be implemented on machines through
computer executable media having a processor capable of executing
program instructions stored thereon as a monolithic software
structure, as standalone software modules, or as modules that
employ external routines, code, services, and so forth, or any
combination of these, and all such implementations may be within
the scope of the present disclosure. Examples of such machines may
include, but may not be limited to, personal digital assistants,
laptops, personal computers, mobile phones, other handheld
computing devices, medical equipment, wired or wireless
communication devices, transducers, chips, calculators, satellites,
tablet PCs, electronic books, gadgets, electronic devices, devices
having artificial intelligence, computing devices, networking
equipments, servers, routers and the like. Furthermore, the
elements depicted in the flow chart and block diagrams or any other
logical component may be implemented on a machine capable of
executing program instructions. Thus, while the foregoing drawings
and descriptions set forth functional aspects of the disclosed
systems, no particular arrangement of software for implementing
these functional aspects should be inferred from these descriptions
unless explicitly stated or otherwise clear from the context.
Similarly, it will be appreciated that the various steps identified
and described above may be varied, and that the order of steps may
be adapted to particular applications of the techniques disclosed
herein. All such variations and modifications are intended to fall
within the scope of this disclosure. As such, the depiction and/or
description of an order for various steps should not be understood
to require a particular order of execution for those steps, unless
required by a particular application, or explicitly stated or
otherwise clear from the context.
[0504] The Subject Methods and Systems, and steps associated
therewith, may be realized in hardware, software or any combination
of hardware and software suitable for a particular application. The
hardware may include a general purpose computer and/or dedicated
computing device or specific computing device or particular aspect
or component of a specific computing device. The processes may be
realized in one or more microprocessors, microcontrollers, embedded
microcontrollers, programmable digital signal processors or other
programmable device, along with internal and/or external memory.
The processes may also, or instead, be embodied in an application
specific integrated circuit, a programmable gate array,
programmable array logic, or any other device or combination of
devices that may be configured to process electronic signals. It
will further be appreciated that one or more of the processes may
be realized as a computer executable code capable of being executed
on a machine readable medium.
[0505] The computer executable code may be created using a
structured programming language such as C, an object oriented
programming language such as C++, or any other high-level or
low-level programming language (including assembly languages,
hardware description languages, and database programming languages
and technologies) that may be stored, compiled or interpreted to
run on one of the above devices, as well as heterogeneous
combinations of processors, processor architectures, or
combinations of different hardware and software, or any other
machine capable of executing program instructions.
[0506] Thus, in one aspect, each method described above in
connection with the Subject Systems and Methods and combinations
thereof may be embodied in computer executable code that, when
executing on one or more computing devices, performs the steps
thereof. In another aspect, the methods may be embodied in systems
that perform the steps thereof, and may be distributed across
devices in a number of ways, or all of the functionality may be
integrated into a dedicated, standalone device or other hardware.
In another aspect, the means for performing the steps associated
with the processes described above may include any of the hardware
and/or software described above. All such permutations and
combinations are intended to fall within the scope of the present
disclosure.
[0507] While the invention has been disclosed in connection with
the preferred embodiments shown and described in detail, various
modifications and improvements thereon will become readily apparent
to those skilled in the art. Accordingly, the spirit and scope of
the present invention is not to be limited by the foregoing
examples, but is to be understood in the broadest sense allowable
bylaw.
[0508] All documents referenced herein are hereby incorporated by
reference.
* * * * *