Iternet-based, customizable clinical information system

• US 20040024616A1
• Filed: 05/07/2003
• Published: 02/05/2004
• Est. Priority Date: 05/07/2002
• Status: Active Grant

• Current Assignee: Cembex Care Solutions LLC
• Original Assignee: Cembex Care Solutions LLC
• Inventors: Forston, Stanley R. Jr., Spector, Mark B., Levy, Richard L., Neuss, Michael N.
• Granted Patent: US 7,286,997 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• CPC Class Codes: G16H 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

An Internet-based, or Web-based, customizable clinical (patients'"'"' records and care) information system (“CIS”) is provided. More specifically, the clinical information system is Web/Internet based, whether it utilizes a browser-type user interface or a distributed application-type user interface; the clinical information system may include automatic disease staging and associated treatment planning and/or scheduling; the clinical information system may track certain events/submissions and sort such events/submissions into a physician'"'"'s in-box for on-line approval by the physician, where such approval causes the event/submission to become an addendum to the patient'"'"'s record; the clinical information system may be customizable by an administrator; the clinical information system may establish, and make available for on-line review and approval, patient care or standing orders over a weekend; the clinical information system may utilize patients'"'"' photographs to ensure accurate identification and proper treatment; and the clinical information system may create and store an audit trail record for all significant events.

Claims

1. A method for operating a computerized clinical information system for a healthcare facility comprising the steps of:

providing a clinical information system including a plurality of user computers operatively coupled to a global computer network, and at least one computer server operatively coupled to the global computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computers over the global computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data;

providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records;

linking a patient chart record with a primary physician;

logging into the computerized clinical information system using the software tool on a first one of the user computers by a user other than the primary physician;

entering an event for submission to the patient chart record by the user using the software tool on the first one of the user computers;

logging into the computerized clinical information system using the software tool on a second one of the user computers by the primary physician linked with the patient chart record;

routing the event to the second one of the user computers for review and approval by the primary physician;

reviewing and approving the event by the primary physician using the software tool on the second one of the user computers; and

adding the approved event to the patient chart record.

2. The method of claim 1, wherein the event is taken from a group consisting of:

a transcribed document;

a prescription;

an order;

a test result; and

a diagnosis.

3. The method of claim 2, wherein the software tool on the second one of the user computers provides the primary physician with a graphical user interface that includes a graphical in-box, and wherein the method includes the step of displaying the event by the graphical user interface on the second one of the user computers in the graphical in-box for the reviewing and approving step.

4. The method of claim 3, wherein the displaying step includes the step of displaying a plurality of events in the graphical in-box.

5. The method of claim 3, wherein the graphical user interface on the second one of the user computers includes a plurality of in-boxes, each of which is reserved for a particular category of events, and the displaying step includes the step of displaying sub-sets of the plurality of events in the respective plurality of in-boxes depending upon categories of the respective plurality of sub-sets.

6. The method of claim 5, wherein the plurality of in-boxes include a transcribed document in-box, a prescription in-box, and an order in-box.

7. The method of claim 6, wherein the plurality of in-boxes further include a test result in-box.

8. The method of claim 7, wherein the plurality of in-boxes further include a message in-box.

9. The method of claim 3, wherein the graphical user interface on the second one of the user computers includes icons providing access to policies and procedures of the healthcare facility.

10. The method of claim 9, further comprising the steps of:

accessing the policies and procedures of the healthcare facility using the graphical user interface on the second one of the user computers; and

recording information pertaining to the accessing step in an audit database in the clinical information memory source;

whereby such recorded information pertaining to the accessing step can be used to show that such policies and procedures have been reviewed by the primary physician during an accreditation process.

11. The method of claim 1, wherein the event is a diagnosis and the method further comprises the step of establishing a treatment program for the treatment of the diagnosed disease.

12. The method of claim 11, wherein the step of establishing a treatment program further includes the step of establishing a treatment schedule for implementing the treatment program.

13. The method of claim 12, wherein the clinical information memory source includes a plurality of use schedules for a corresponding plurality of the healthcare facility'"'"'s resources, and the step of establishing the treatment schedule includes the steps of updating the use schedules to reserve the healthcare facility'"'"'s resources in accordance with the treatment program.

14. The method of claim 13, wherein the updating step includes the steps of checking the use schedules for openings and filling openings in the use schedules according to the treatment program.

15. The method of claim 13, wherein the method further includes the step of adding the treatment schedule to the patient chart record.

16. The method of claim 13, wherein the step of establishing a treatment schedule includes the step of establishing a medication schedule.

17. The method of claim 16, wherein the clinical information memory source includes a medication inventory for the healthcare facility and the step of establishing a medication schedule includes the step of updating the medication inventory.

18. The method of claim 17, wherein the method further includes the step of adding the treatment schedule to the patient chart record.

19. The method of claim 12, wherein the method further includes the step of adding the treatment schedule to the patient chart record.

20. The method of claim 11, wherein the step of establishing a treatment program for the treatment of the diagnosed disease includes the step of applying a set of expert rules against the diagnosed disease.

21. The method of claim 20, wherein the diagnosed disease includes a stage of the diagnosed disease.

22. The method of claim 11, wherein the diagnosed disease includes a stage of the diagnosed disease and the method further comprises the steps of:

providing a disease staging software tool on one of the user computers, wherein the disease staging software tool includes a plurality of condition fields pertaining to diagnosed or recorded conditions of a patient and includes a set of expert rules for determining a stage of the disease based upon the diagnosed or recorded conditions of the patient;

completing the condition fields on the disease staging software tool by a user on the one of the user computers; and

processing the completed condition fields against the set of expert rules to determine the stage of the disease.

23. The method of claim 1, wherein information pertaining to the routing, reviewing and approving steps are recorded in a central audit database.

24. The method of claim 1, wherein the reviewing and approving steps include the step of modifying the event by the primary physician.

25. The method of claim 24, wherein versions of the event existing before and after the modifying step are stored in a central audit database.

26. A method for operating a computerized clinical information system for a healthcare facility comprising the steps of:

providing a clinical information system including a plurality of user computers operatively coupled to a global computer network, and at least one computer server operatively coupled to the global computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computers over the global computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data;

providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records;

logging into the computerized clinical information system using the software tool on a first one of the user computers by a user;

diagnosing a stage of a patient'"'"'s disease, the patient having a chart record in the electronic patient chart database;

adding the diagnosed disease stage to the patient'"'"'s chart record.

27. The method of claim 26 wherein the diagnosing step further comprises the steps of:

providing a disease staging graphical user interface by the software tool, the graphical user interface including a plurality of condition fields pertaining to diagnosed or recorded conditions of a patient, the software tool including a first set of expert rules for determining a stage of the disease based upon, at least in part, the diagnosed or recorded conditions of the patient entered into the graphical user interface;

entering information pertaining to the patient'"'"'s diagnosed or recorded conditions into the condition fields on the graphical user interface by a user on the one of the user computers; and

processing the completed condition fields against the first set of expert rules to determine the stage of the disease.

28. The method of claim 27, further comprising the step of establishing a treatment program for the treatment of the diagnosed disease stage.

29. The method of claim 28, wherein the step of establishing a treatment program further includes the step of establishing a treatment schedule for implementing the treatment program.

30. The method of claim 29, wherein the clinical information memory source includes a plurality of use schedules for a corresponding plurality of the healthcare facility'"'"'s resources, and the step of establishing the treatment schedule includes the steps of updating the use schedules to reserve the healthcare facility'"'"'s resources in accordance with the treatment program.

31. The method of claim 30, wherein the updating step includes the steps of checking the use schedules for openings and filling openings in the use schedules according to the treatment program.

32. The method of claim 30, wherein the method further includes the step of adding the treatment schedule to the patient'"'"'s chart record.

33. The method of claim 30, wherein the step of establishing a treatment schedule includes the step of establishing a medication schedule.

34. The method of claim 33, wherein the clinical information memory source includes a medication inventory for the healthcare facility and the step of establishing a medication schedule includes the step of updating the medication inventory.

35. The method of claim 34, wherein the method further includes the step of adding the treatment schedule to the patient'"'"'s chart record.

36. The method of claim 29, wherein the method further includes the step of adding the treatment schedule to the patient'"'"'s chart record.

37. The method of claim 28, wherein the step of establishing a treatment program for the treatment of the diagnosed disease stage includes the step of applying a second set of expert rules against the diagnosed disease stage.

38. The method of claim 27, wherein the condition fields provided by the graphical user interface are controlled by a set of stage diagnosis procedure rules, and the method further includes the steps of:

logging into the computerized clinical information system using the software tool on a second one of the user computers by an administrator;

customizing the stage diagnosis procedure rules by the administrator using the software tool on the second one of the user computers.

39. The method of claim 26, further comprising the step of establishing a treatment program for the treatment of the diagnosed disease stage.

40. The method of claim 39, wherein the step of establishing a treatment program further includes the step of establishing a treatment schedule for implementing the treatment program.

41. The method of claim 40, wherein the clinical information memory source includes a plurality of use schedules for a corresponding plurality of the healthcare facility'"'"'s resources, and the step of establishing the treatment schedule includes the steps of updating the use schedules to reserve the healthcare facility'"'"'s resources in accordance with the treatment program.

42. The method of claim 41, wherein the method further includes the step of adding the treatment schedule to the patient'"'"'s chart record.

43. The method of claim 41, wherein the step of establishing a treatment schedule includes the step of establishing a medication schedule.

44. The method of claim 43, wherein the clinical information memory source includes a medication inventory for the healthcare facility and the step of establishing a medication schedule includes the step of updating the medication inventory.

45. The method of claim 44, wherein the method further includes the step of adding the treatment schedule to the patient'"'"'s chart record.

46. The method of claim 40, wherein the method further includes the step of adding the treatment schedule to the patient'"'"'s chart record.

47. The method of claim 39, wherein the step of establishing a treatment program for the treatment of the diagnosed disease stage includes the step of applying a second set of expert rules against the diagnosed disease stage.

48. The method of claim 47, further comprising the steps of:

logging into the computerized clinical information system using the software tool on a second one of the user computers by an administrator;

customizing at least one of the first and second sets of expert rules by the administrator using the software tool on the second one of the user computers.

49. The method of claim 26, further comprising the steps of:

logging into the computerized clinical information system using the software tool on a second one of the user computers by an administrator;

customizing the first set of expert rules by the administrator using the software tool on the second one of the user computers.

50. A method for operating a computerized clinical information system for a healthcare facility comprising the steps of:

providing a clinical information system including a plurality of user computers operatively coupled to a global computer network, and at least one computer server operatively coupled to the global computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computers over the global computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data;

providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records; and

for each of the patient chart records, storing a digital image of the patient associated with the respective patient chart record.

51. The method of claim 50, further comprising the step of printing a tangible copy of a portion of the patient chart record, wherein the tangible copy includes a printed version of the digital image of patient stored in the patient chart record.

52. The method of claim 51, wherein the tangible copy includes a prescription label.

53. The method of claim 51, wherein the tangible copy includes an order.

54. The method of claim 51, wherein the tangible copy includes at least a portion of a treatment schedule.

55. A method for operating a computerized clinical information system for a healthcare facility comprising the steps of:

providing a clinical information system including a plurality of user computers operatively coupled to a global computer network, and at least one computer server operatively coupled to the global computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computers over the global computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data;

providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records;

linking a patient chart record with a primary physician;

logging into the computerized clinical information system using the software tool on a first one of the user computers by a user taken from a group consisting of a pharmacist, a pharmacy technician, a nurse, a non-primary physician and a pharmacy assistant;

entering at least one request taken from a group consisting of a new prescription, a prescription renewal, a treatment, a test and an order for approval by the primary physician by the user using the software tool on the first one of the user computers;

logging into the computerized clinical information system using the software tool on a second one of the user computers by the primary physician;

routing the request to the second one of the user computers for review and approval by the primary physician;

reviewing and approving the request by the primary physician using the software tool on the second one of the user computers; and

adding the approved request to the patient chart record.

56. The method of claim 55, further comprising the step of routing notice of approval of the request back to the user logged onto the computerized clinical information system.

57. The method of claim 56, wherein the patient chart record includes a digital image of the patient and the method further includes the step of printing a tangible copy of a portion of the patient chart record, wherein the tangible copy includes a printed version of the digital image of patient stored in the patient chart record.

58. The method of claim 57, wherein the tangible copy includes a prescription label.

59. The method of claim 57, wherein the tangible copy includes an order.

60. The method of claim 57, wherein the tangible copy includes at least a portion of a treatment schedule.

61. The method of claim 55, wherein:

the software tool on the first one of the user computers provides a first graphical user interface customized for use by the user; and

the software tool on the second one of the user computers provides a second graphical user interface customized for use by the primary physician.

62. The method of claim 61, wherein each of the first and second graphical user interfaces provide access to the patient chart record.

63. The method of claim 62, wherein each of the first and second graphical user interfaces provide access to one or more of the following functions:

drug-drug interaction checking;

drug-disease interaction checking;

drug warnings;

drug pharmacology;

pregnancy and lactation hazard information;

therapeutic duplication checking; and

drug-allergy checking.

64. The method of claim 61, wherein each of the first and second graphical user interfaces provide access to one or more of the following functions:

drug-drug interaction checking;

drug-disease interaction checking;

drug warnings;

drug pharmacology;

pregnancy and lactation hazard information;

therapeutic duplication checking; and

drug-allergy checking.

65. The method of claim 61, wherein each of the first and second graphical user interfaces provide access to the following functions:

drug-drug interaction checking;

drug-disease interaction checking;

drug warnings;

drug pharmacology;

pregnancy and lactation hazard information;

therapeutic duplication checking; and

drug-allergy checking.

66. The method of claim 61, wherein each of the first and second graphical user interfaces respectively provide the user and the primary physician a search engine function for searching for a particular patient chart record.

67. The method of claim 55, wherein the request is a request for weekend care.

68. The method of claim 67, wherein the second one of the user computers is a computer remote from the healthcare facility.

69. The method of claim 68, wherein the second one of the user computers is a hand-held computer.

70. The method of claim 55, wherein the second one of the user computers is a computer remote from the healthcare facility.

71. The method of claim 70, wherein the second one of the user computers is a hand-held computer.

72. The method of claim 55, wherein the request is one of a new prescription and an order and the method further includes the step of, prior to the routing step, automatically checking a requested dosage of the new prescription or order against safety guidelines.

73. The method of claim 72, wherein the step of automatically checking a requested dosage of the new prescription or order against safety guidelines includes the step of providing a minimum and maximum dosage for at least one of a patient'"'"'s body weight and a patient'"'"'s condition.

74. A method for operating a computerized clinical information system for a healthcare facility comprising the steps of:

providing a clinical information system including a plurality of user computers operatively coupled to a global computer network, and at least one computer server operatively coupled to the global computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computers over the global computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data, the operations of the clinical information system being controlled, at least in part, by a set of rules;

logging into the computerized clinical information system using the software tool on a first one of the user computers by an administrator;

modifying the set of rules by the administrator to customize the operations of the clinical information system.