Data Interpretation Terminal

Abstract

A data terminal for use in a computer-based medical screening system for the entry of interpretive data concerning X-ray pictures, ECG displays and the like. Data is visually verified before entry into a patient record in computer memory, and terminal operation is permitted only by an operator having a verified identification code.

Description

FIELD OF THE INVENTION

This invention relates to electronic data communication and more particularly to data terminals for the remote entry of data into a computer.

BACKGROUND OF THE INVENTION

In the automated medical screening of patients, a plurality of test stations are usually provided, each station being operative to provide a particular medical test and to enter data indicative of the results of such tests into a computer-based patient record. A particularly effective medical screening system is described in copending patent application Ser. No. 759,389, now U.S. Pat. No. 3,566,365, titled Multi-Phasic Medical Screening System, assigned to the assignee of the present invention. Test data is usually of an objective nature and is the result of specific tests performed on the patient. For example, in the analysis of blood and urine samples, test results obtained by well-known laboratory apparatus are entered into the patient record on a suitable terminal provided for the purpose. Similarly, test results respecting visual acuity, hearing, weight and height and the like are also entered into a patient record by means of respective data terminals. Certain medical tests such as radiology and cardiology tests require interpretation by a skilled physician in order to ascertain results of meaning in respect of the patient's medical condition. It would be advantageous, and it is an object of the present invention to provide, a data entry terminal by which information interpretative of X-ray pictures, an ECG and the like can be assembled and transmitted to a computer-based medical record for entry therein.

SUMMARY OF THE INVENTION

Briefly, a data entry terminal is provided for the real time entry of interpretive information into a computer-based medical record of a patient only by an operator having a valid identification code and in a manner which affords relatively simple and accurate operation. By virtue of the invention, interpretive phrases are entered into a patient record for later printing out in a form convenient and useful to an attending physician. Interpretations are entered by means of individual phrases which may be modified or deleted as subsequent entries are made. Operation of the terminal is enabled by means of an operator identification card which contains a coded representation of operator identity in order to permit terminal operation only by an authorized individual. Interpretive data transmitted by the terminal to the computer is returned to the terminal for display for purposes of data verification prior to entry into the patient record.

DESCRIPTION OF THE DRAWINGS

The invention will be more fully understood from the detailed description taken in conjunction with the accompanying drawings, in which:

FIG. 1 is a block diagram of a data entry system in which the invention is employed;

FIG. 2 is a pictorial view of a data interpretation terminal embodying the invention;

FIG. 3 is a block diagram of a data interpretation terminal according to the invention;

FIG. 4 is a diagrammatic representation of the data format of messages directed by the terminal to a computer; and

FIG. 5 is a diagrammatic representation of the data format of messages received by the terminal from a computer.

DETAILED DESCRIPTION OF THE INVENTION

A real time data entry system in which the invention is employed is illustrated in FIG. 1. A computer 10 is coupled to a data scanner 12 which, in turn, is coupled via a suitable transmission link 14 to a data interpretation terminal 16. Other like terminals may also be coupled to scanner 12, as can data terminals for other purposes such as described in the above-identified copending application. A teletypewriter 18 or other output device is also coupled to link 14 for providing a printed data output. As described in the aforesaid application, scanner 12 is operative to sequentially address each remote station, and to provide communication between each station and the computer for a selected interval of time, during which information is conveyed from the computer to the respective station and from a station back to the computer. Each data station is on-line with the computer at all times but is communicative therewith only during predetermined intervals.

The computer is typically of a type having a direct memory access capability such as a PDP-8I computer sold by the Digital Equipment Corporation. The data scanner 12 operative to control operation of the terminal 16 and to provide communication between the terminal and computer 10, as well as other data terminals and stations of the overall system, is described in the above-identified copending application.

The interpretation terminal is shown in a typical packaging configuration in FIG. 2. The terminal includes a plurality of push buttons 20 for definition of interpretive phrases and of a number to accommodate particular test requirements. The push buttons 20 are of the illuminating type and are each labeled to specify a predetermined interpretive phrase. A plurality of illuminating push button operating controls are also provided and include a START button 22 for commencing terminal operation, and ENTER button 24 for causing entry of interpretive data into the computer base patient medical record, and control buttons 26 for governing a data entry sequence. The buttons 26A denote respective phrases which are to be formed by use of console buttons 20. The CLEAR FIELD button 26B causes the erasure of numeric information as displayed on the displays 30 and 32. The END button 26C is actuated to denote the completion of a data entry sequence.

A data entry keyboard 28 is provided to cause entry of numerical information identifying a patient. The patient identification number is displayed on a numerical display 30, which typically is a multi-digit Nixie tube display, for visual verification by the operator prior to its entry into the computer-based patient medical record. A second numerical display 32 is provided to display a predetermined checking digit which is also entered via keyboard 28. A slot 34 is provided in the front panel of the terminal for receiving an operator identification card 36 which contains a coded identification number which is read by an associated card reader for transmission thereof to the computer. The computer upon receipt of a valid operator identification code will cause transmission of command data to the terminal to initiate terminal operation. An annunciator display 49 is provided for displaying instructions to the terminal operator during the data entry process. In the illustrated embodiment, display 49 is of the rear projection type in which selected messages are projected upon a translucent screen for viewing by the operator. A buzzer is also provided within the terminal and is operative to warn of equipment malfunction or other illegal condition. A control 40 is provided for adjusting the volume of the signal buzzer and a test button 42 is also provided as a means for testing buzzer operation.

Three indicators are provided to instruct the terminal operator of steps to be performed and include an indicator 44, labeled PID, which upon illumination denotes a request for entry of a patient identification number via keyboard 28. A CHECK indicator 46 signals a request for entry of the predetermined check digit. A DATA indicator 48 signals a request for entry of interpretive data via controls 20 and 26.

The terminal is operative to direct data words to the computer and for receiving data words therefrom. Such data words will hereinafter be referred to as the computer bound word and the terminal bound word respectively. In the illustrated embodiment a 24-bit word format is employed. The computer bound word format is depicted in FIG. 4 and the terminal bound word format is depicted in FIG. 5. Two commands are employed for transmission from the terminal to the computer via a computer bound word. Command 1 contains data representing the actuated field indicators and console switches. Command 2, generated by actuation of START button 22, causes transmission to the computer of an operator identification number as read from the operator identification card 36. If the START button is depressed and no operator identification card is inserted, or if a card is inserted but contains an erroneous number, the computer will recognize the events and cause illumination of a suitable message (Illegal Data) on annunciator 38 to denote the illegal condition. If the computer receives a valid identification number, a terminal bound word is directed to the terminal to cause illumination of a Ready message on annunciator 38.

In the illustrated embodiment nine terminal bound word commands are employed. Command 1 causes information to be directed to the annunciator and buzzer, while commands 2 through 6 are employed to select banks of indicator lights associated with console buttons 20, 22, 24, and 26. Each console button lamp is illustrated by a single bit of a command, and the lamps are arranged in banks, each bank being associated with a command. Command 7 causes data to be written to displays 30 and 32; command 8 causes selected illumination of field lamps 44, 46, and 48; and command 9 is employed to clear the terminal registers. The station address is encoded in bit positions 1-7 of each terminal bound word command and the terminal is operative upon recognition of its address to permit decoding of the data content in the received command. The command identity is encoded in bits 8-11 of each computer bound word and terminal bound word. Bit 12 in the computer bound word when set denotes that data is to be entered by causing a computer interrupt.

Depression of a console button causes generation of a multi-bit code identifying that button and this data is assembled in a computer bound word for transmission to the computer. Upon receipt and decoding of this received data, the computer writes back in a terminal bound word to cause illumination of the button light associated with the selected console button. Information conveyed from the terminal to the computer is thus directed back to the terminal for purposes of verification. This information can be erased by depressing the button a second time. The computer, upon receipt of an identical button identification, recognizes this event as a command to erase the previously sent data.

Referring to FIG. 3, the computer bound words and terminal bound words are conveyed over the system transmission link coupled to a shift register control 60 which is operative to convey data to and from a shift register 62, and which is also operative to control the serial and parallel data transfer thereof. The console buttons 64, which include the buttons 20, 22, 24 and 26 shown in FIG. 2, and the data keyboard 28, are coupled to a switch decoder 66 which is coupled to enter logic 68 and which has a second output coupled to a fan-in network 70. Enter logic 68 is coupled to an encoder 72, the output of which is coupled to selected bit positions of shift register 62. A card reader 74 is coupled to enter logic 68 and also to fan-in network 70 to provide a means for entry of an operator identification number in order to verify that data is being entered by an authorized individual.

The output of network 70 is coupled to selected bit positions of shift register 62. Shift register 62 is coupled to a station address decoder 76, which, in turn, is coupled to shift register control 60. The shift register is also coupled to a read/write decoder 78, an output of which is coupled to network 70. The shift register is also coupled to a plurality of buffers 80, 82 and 84, each of which also receives an input signal from the switch decoder 66. Each buffer 80, 82 and 84 is associated with a respective lamp driver 86, 88 and 90. Lamp driver 86 is operative to energize message lamps 92 of annunciator 38, while driver 88 is operative to energize field lamps 94. Lamp driver 90 is operative to energize the lamps 96 associated with console buttons 20, 22, 24, and 26. The shift register 62 is also coupled to a display decoder driver 98 by way of associated buffer 100. Decoder 98 is coupled to a display indicator 102 identified in FIG. 2 as displays 30 and 32.

Actuation of one or more console buttons 64 and keys of data keyboard 28 causes corresponding signals to be applied to switch decoder 66 which identify the actuated switches and which provide a coded representation of the actuated switch identify to enter logic 68 and fan-in network 70. Switch decoder 66 is itself the subject of copending application Ser. No. 29,422 titled Switch Coding Circuitry and assigned to the assignee of the present invention. Briefly, this switch decoder is operative to ascertain the identity of an actuated switch within an array of mechanically unrelated and electrically distinct input switches and to provide a coded switch signal which is free of contact bounce noise and which is representative of a valid switch actuation.

In its standby condition, the terminal will display the message Insert ID on annunciator 38 as decoded from a terminal bound word received from the computer. Upon insertion of an operator identity card in slot 34 and depression of START button 22, the operator identification number as read by card reader 74 is directed in a computer bound word to the computer which will ascertain whether the operator identification number is valid. If the number is not valid, the computer will direct a message to the terminal which will actuate an Illegal ID message on annunciator 38. If the identification number is valid, the computer will direct a message to the terminal which will cause illumination of field indicator 44 which signals the operator to enter the patient identification number. The indicator 44, as well as the other field indicators 46 and 48, are selectively activated by decoding of selected bits of a received terminal bound word by buffer 82 which, in turn, drives lamp driver 88 for actuation of the appropriate field lamps. Similarly, the annunciator messages are decoded by means of message buffer 80 which senses appropriate bits of a received word from the computer.

Upon entry of a patient identification number via keyboard 28, this data is directed to the computer and is returned to the terminal for energization of display 30 for visual verification by the operator. If the patient identification number is correct, actuation of ENTER button 24 causes entry of this number into computer memory. Upon depression of the ENTER button, the annunciator 38 will display a READY message, and indicator 46 will light to denote that a check digit is to be entered. A predetermined check digit is entered via keyboard 28, and if a valid digit is entered, indicator 48 will light calling for entry of interpretive data. Phrase I button 26A will also light, calling for entry of the first phrase, represented by buttons 20.

The operator will depress the buttons 20 associated with the phrases descriptive of the interpretation being conducted. Certain of the buttons 20 will describe abnormalities while certain other of the buttons will describe the location of these abnormalities. Other buttons are provided for qualifying statements such as "new finding." Depression of respective buttons 20 causes transmission of an associated code in a computer bound word to the computer which will direct the received code back to the terminal for illumination of the lamp associated with the actuated console button. Illumination of the button light indicates that the computer has received the information. Actuation of ENTER button 24 will cause entry of the previously transmitted interpretative data into the computer based medical record and will cause a terminal bound word command to be directed to the terminal for illumination of the Phrase II button 26A for entry of subsequent interpretive data. Interpretive statements are similarly entered for Phrase III and Phrase IV. The phrases entered via console buttons 20 are stored in the patient's medical record contained in computer memory. During readout of the interpretive data entered by the novel terminal, the computer under the government of appropriate software causes a narrative text to be printed in response to the stored interpretive statements.

In order to delete a phrase which has been previously entered, the phrase to be corrected is identified by actuation of the associated button 26A, which will cause transmission of a corresponding code to the computer. Upon receipt of this code word, the computer is operative to cancel information previously entered for the selected phrase. In this manner, data can be corrected in the patient record.

The invention is not to be limited by what has been particularly shown and described, except as indicated in the appended claims.

Claims

What is claimed is:

1. A data terminal for the entry of interpretative data into a computer-based medical record of a patient comprising:

a plurality of console buttons each representing a respective interpretive phrase which is to be entered into said medical record;

a plurality of control buttons for initiating respective control steps in said terminal;

a data keyboard for the manual entry of numerical data;

logic circuitry coupled to said console buttons, control buttons and data keyboard and operative upon actuation of said buttons and keyboard to provide digital signal representations of said actuated buttons and keyboard;

means for assembling said digital signal representations into data words for transmission to a computer;

means for decoding data words received from said computer;

means for visually displaying numerical data decoded from said computer data words;

means for visually indicating steps to be taken during terminal operation;

a plurality of indicator lamps, each associated with a respective console button and control button and each operative in response to a respective data word from said computer to indicate the receipt by said computer of corresponding data representing an interpretive phrase and a control step;

means for displaying messages decoded from said computer data words and indicative of terminal operation;

means for manually causing entry of data into said medical record after visual verification thereof;

means operative in response to an operator identification code for enabling terminal operation; and

wherein said logic circuitry includes:

a shift register having a serial input and serial output adapted for connection to a data transmission link;

an address decoder coupled to predetermined bit positions of said shift register and operative to provide an output indication upon receipt of a predetermined station address;

a read and write decoder coupled to predetermined bit positions of said shift register and operative to provide read and write command signals to said logic circuitry upon receipt of data words from said computer;

a plurality of data buffers, each coupled to predetermined bit positions of said shift register and each operative in response to data in said predetermined bit positions to provide an output signal;

a plurality of lamp drivers, each coupled to a respective data buffer, and each operative in response to a respective output signal therefrom to cause respective energization of said message displays, visual indicators and console and control button indicators; and

a display decoder coupled to a respective data buffer and operative to drive said numerical display means.

2. A data terminal for the entry of interpretive data into a computer-based medical record of a patient comprising:

a plurality of console buttons each representing a respective interpretive phrase which is to be entered into said medical record;

a plurality of control buttons for initiating respective control steps in said terminal;

a data keyboard for the manual entry of numerical data;

logic circuitry coupled to said console buttons, control buttons and data keyboard and operative upon actuation of said buttons and keyboard to provide digital signal representations of said actuated buttons and keyboard;

means for assembling said digital signal representations into data words for transmission to a computer;

means for decoding data words received from said computer;

means for visually displaying numerical data decoded from said computer data words;

means for visually indicating steps to be taken during terminal operation;

a plurality of visual indicators, each associated with a respective console button and control button and each operative in response to a respective data word from said computer to indicate the receipt by said computer of corresponding data representing an interpretive phrase and a control step;

means for displaying messages decoded from said computer data words and indicative of terminal operation;

means for manually causing entry of data into said medical record after visual verification thereof;

means operative in response to an operator identification code for enabling terminal operation; and

wherein said logic circuitry includes;

a shift register having a serial input and serial output adapted for connection to a data transmission link;

an address decoder coupled to predetermined bit positions of said shift register and operative to provide an output indication upon receipt of a predetermined station address;

a read and write decoder coupled to predetermined bit positions of said shift register and operative to provide read and write command signals to said logic circuitry upon receipt of data words from said computer;

a plurality of data buffers, each coupled to predetermined bit positions of said shift register and each operative in response to data in said predetermined bit positions to provide an output signal;

a plurality of drivers, each coupled to a respective data buffer, and each operative in response to a respective output signal therefrom to cause respective energization of said message displays, visual indicators and console and control button indicators; and

a display decoder coupled to a respective data buffer and operative to drive said numerical display means.

3. A data terminal according to claim 2 wherein said means for visually indicating steps to be taken during terminal operation includes:

a patient identification indicator for visually indicating after said terminal operation is enabled that a patient identification number is to be entered;

a patient identification check indicator for visually indicating after entry of a valid patient identification number that a check number is to be entered; and

a data indicator for visually indicating after entry of a valid check number that interpretive phrase data is to be entered by said console buttons.

4. A data terminal according to claim 2 wherein said means for enabling terminal operation includes a card reader adapted to receive a coded identification card and to decode the operator identification number contained therein;

and wherein said circuit means is operative to transmit said identification number to said computer, the receipt of a valid or invalid identification number causing respective data words to be transmitted to said terminal to cause display of appropriate messages on said message display.

5. A data terminal according to claim 2 including:

a plurality of control indicators for denoting a succession of interpretive phrases which are to be entered by said console buttons to constitute a complete interpretive statement.

6. A data terminal for the entry of interpretive data into a compute-based medical record of a patient comprising:

a plurality of console buttons each representing a respective interpretive phrase which is to be entered into said medical record;

a plurality of control buttons representing a succession of interpretive phrases which are to be entered by said console buttons;

a data keyboard for the manual entry of numerical data;

a plurality of visual indicators each associated with a respective console button and a respective control button;

a multi-digit display for visually displaying numerical data;

a display for messages indicative of terminal operation;

means operative in response to an operator identification code for enabling terminal operation;

means including said data keyboard for transmitting a patient identification code to a computer for selection of the medical record stored in memory for an associated patient;

a plurality of visual indicators for denoting subsequent steps to be performed by a terminal operator in entering data;

electronic logic circuitry coupled to said console buttons, control buttons and data keyboard and operative upon actuation of said control buttons, control buttons and keyboard to provide digital signal representations of actuated ones thereof;

electronic circuit means for assembling said digital signal representations into data words for transmission to a computer, said circuit means including electronic data storage means for storing data, means for entering data representing an actuated console button, control button or keyboard into said storage means, and means for transmitting data in said storage means to said computer;

means for decoding data words received from said computer, each of said data words from said computer having an address portion for identifying said terminal and a data portion for controlling operation of said terminal indicators, said decoding means including:

means for energizing selected ones of said console and control button visual indicators;

means for causing the visual display of numerical data on said multi-digit display in response to the transmission by said circuit means to said computer of a data word representing such numerical data;

means for energizing selected ones of said subsequent step indicators in accordance with data entering steps to be performed;

means for displaying messages on said message display indicative of terminal operation; and

means for manually causing entry of numerical data into computer memory after visual verification thereof on said multi-digit display, and for causing entry of interpretive phrase data in said patient medical record after visual verification thereof on the visual indicators associated with actuated ones of said console buttons.

7. A data terminal according to claim 6 wherein said step denoting visual indicators include:

a patient identification indicator for visually indicating after said terminal is enabled that a patient identification number is to be entered;

a patient identification check indicator for visually indicating after entry of a valid patient identification number that a check digit is to be entered by said keyboard; and

a data indicator for visually indicating after entry of a valid check digit that interpretive phrase data is to be entered by said console buttons.

8. A data terminal according to claim 6 wherein said decoding means includes:

storage means having an input and output adapted for connection to a data transmission link coupled to said computer;

an address decoder coupled to said storage means and operative to provide an output indication upon receipt from said computer of a predetermined terminal address;

a read and write decoder coupled to said storage means and operative to provide read and write command signals to said terminal circuitry upon receipt of data words from said computer;

a plurality of data buffers each coupled to said storage means and each operative in response to predetermined data to provide an output signal; and

a plurality of drivers each coupled to a respective data buffer and each operative in response to a respective outlet signal therefrom to cause respective energization of said message display, numerical display, subsequent step indicators and console and control button indicators.