System and method for automatically generating evidence-based assignment of care providers to patients

• US 20050075904A1
• Filed: 08/13/2004
• Published: 04/07/2005
• Est. Priority Date: 10/06/2003
• Status: Active Grant

• Current Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Original Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Inventors: Chamberlain, Jerald T., Wager, Douglas W.
• Granted Patent: US 8,000,978 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

A system and related techniques automatically generate optimized, best-match or sufficient assignments of care providers, such as physicians, nurses or technicians, to a patient based on clinical evidence, documentation, workload, infectious status and other factors. In embodiments, the patient'"'"'s chart or other clinical record may be accessed by a rules-based engine configured with rules which relate a patient'"'"'s clinical status and needs to the qualifications, certifications, capabilities and skills of care providers and select the care provider best qualified to service that patient'"'"'s clinical requirements. The pool of available care providers may for example be ascertained from personnel systems recording staff schedules and estimated workload, while the qualifications of each provider indicating the categories of patient care and support that provider is qualified to provide may be accessed from a provider data store. For instance, nurses or technicians trained or certified in acute, emergency or surgical care may be identified for assignment to high acuity patients, or those presenting special or advanced care demands. According to the invention in a further regard, the provider'"'"'s potential infectious exposure to other patients or from other sources may be screened to prevent that provider from being assigned to immune-compromised or other patients. Embodiments of the invention may present floor managers with a graphical display of available providers and generated assignments, which in embodiments the manager may override at their clinical discretion. Because patient needs are automatically aligned with provider capabilities, availability and other factors, the errors, oversights and inefficiencies of manual or informal assignment systems are avoided and better health care delivery can be realized.

Claims

1. A system for automatically assigning clinical care providers to patients, comprising:

a first interface to a clinical data store, the clinical data store storing patient factors;

a second interface to a care provider data store, the care provider data store storing provider factors; and

an assignment engine, the engine communicating with the first interface and the second interface to automatically generate patient assignments based on a comparison of at least the patient factors and the provider factors.

2. A system according to claim 1, wherein the patient factors comprise at least one of a patient chart, an electronic medical record, and a patient history.

3. A system according to claim 2, wherein the patient factors comprise at least one of patient acuity status, a patient workload estimate, patient morbidity status, patient mobility status, patient demographic data, patient immune condition status, patient infectious condition status, patient surgical status, patient ventilator status, patient life support status, patient pharmaceutical use status, patient one-to-one provider requirement status and patient preference data.

4. A system according to claim 1, wherein the provider factors comprise at least one of provider clinical qualifications, provider schedule, provider workload status and provider infectious exposure status.

5. A system according to claim 4, wherein the provider clinical qualifications comprise at least one of clinical certifications, experience level, and qualification for procedures or equipment operation.

6. A system according to claim 4, wherein the provider infectious exposure status comprises at least one of provider exposure to other potentially infectious patients, provider exposure to other potentially infectious providers, and provider exposure to potentially infectious sites.

7. A system according to claim 1, wherein the assignment engine comprises a rules-based assignment engine.

8. A system according to claim 7, wherein the rules-based assignment engine accesses a rule set to compare the patient factors to the provider factors.

9. A system according to claim 8, wherein the rule set comprises an ordered weighting of an analysis of patient acuity status compared to provider clinical qualifications, an analysis of continuity of patient care, an analysis of provider workload status incorporating a patient workload estimate, and provider preference data.

10. A system according to claim 7, wherein the rule set is extensible.

11. A system according to claim 1, further comprising a management interface, communicating with the assignment engine, the management interface presenting an operator with a view of the results of the automatically generated patient assignments.

12. A system according to claim 11, wherein the management interface comprises a selector tool to permit the operator to accept or adjust the automatically generated patient assignments.

13. A system according to claim 12, wherein the management interface generates a contraindication notice to the operator when provider factors conflict with the patient factors for a provider assignment.

14. A system according to claim 1, wherein the provider is at least one of a nurse, a physician, a technician and a therapist.

15. A system according to claim 1, wherein the automatically generated patient assignments comprise assignments for at least one of a shift, a partial shift, a day, a week, a month, a case and an event.

16. A system according to claim 1, wherein generation of the automatically generated patient assignments is triggered by changed conditions comprising at least one of a change in patient census, a change in patient acuity, and a change in provider staffing or schedule.

17. A system according to claim 1, wherein the automatically generated patient assignments are based on prior automatically generated provider assignments generated to produce a minimum amount of assignment changes.

18. A method for automatically assigning clinical care providers to patients, comprising:

accessing patient factors associated with a clinical patient;

accessing provider factors associated with a care provider;

comparing the patient factors and the provider factors; and

automatically generating patient assignments based on a comparison of at least the patient factors and the provider factors.

19. A method according to claim 18, wherein the patient factors comprise at least one of a patient chart, an electronic medical record, and a patient history.

20. A method according to claim 19, wherein the patient factors comprise at least one of patient acuity status, a patient workload estimate, patient morbidity status, patient mobility status, patient demographic data, patient immune condition status, patient infectious condition status, patient surgical status, patient ventilator status, patient life support status, patient pharmaceutical use status, patient one-to-one provider requirement status and patient preference data.

21. A method according to claim 18, wherein the provider factors comprise at least one of provider clinical qualifications, provider schedule, provider workload status and provider infectious exposure status.

22. A method according to claim 21, wherein the provider clinical qualifications comprise at least one of clinical certifications, experience level, and qualification for procedures or equipment operation.

23. A method according to claim 21, wherein the provider infectious exposure status comprises at least one of provider exposure to other potentially infectious patients, provider exposure to other potentially infectious providers, and provider exposure to potentially infectious sites.

24. A method according to claim 18, wherein the automatically generating comprises invoking a rules-based assignment engine.

25. A method according to claim 24, wherein the rules-based assignment engine accesses a rule set to compare the patient factors to the provider factors.

26. A method according to claim 25, wherein the rule set comprises an ordered weighting of an analysis of patient acuity status compared to provider clinical qualifications, an analysis of continuity of patient care, an analysis of provider workload status incorporating a patient workload estimate, and provider preference data.

27. A method according to claim 25, wherein the rule set is extensible.

28. A method according to claim 18, further comprising presenting a management interface to an operator with a view of the results of the automatically generated patient assignments.

29. A method according to claim 28, wherein the management interface comprises a selector tool to permit the operator to accept or adjust the automatically generated patient assignments.

30. A method according to claim 29, further comprising generating a contraindication notice to the operator via the management interface when provider factors conflict with the patient factors for a provider assignment.

31. A method according to claim 18, wherein the provider is at least one of a nurse, a physician, a technician and a therapist.

32. A method according to claim 18, wherein the automatically generated patient assignments comprise assignments for at least one of a shift, a partial shift, a day, a week, a month, a case and an event.

33. A method according to claim 18, wherein the automatically generating is triggered by changed conditions comprising at least one of a change in patient census, a change in patient acuity, and a change in provider staffing or schedule.

34. A method according to claim 18, wherein the automatically generating comprises automatically generating patient assignments based on prior automatically generated provider assignments to produce a minimum amount of assignment changes.

35. An automatically generated assignment of a clinical care provider to a patient, the assignment being generated according to a method of:

accessing patient factors associated with a clinical patient;

accessing provider factors associated with a care provider;

comparing the patient factors and the provider factors; and

automatically generating a patient assignment based on a comparison of at least the patient factors and the provider factors.

36. An automatically generated assignment according to claim 35, wherein the patient factors comprise at least one of a patient chart, an electronic medical record, and a patient history.

37. An automatically generated assignment according to claim 36, wherein the patient factors comprise at least one of patient acuity status, a patient workload estimate, patient morbidity status, patient mobility status, patient demographic data, patient immune condition status, patient infectious condition status, patient surgical status, patient ventilator status, patient life support status, patient pharmaceutical use status, patient one-to-one provider requirement status and patient preference data.

38. An automatically generated assignment according to claim 35, wherein the provider factors comprise at least one of provider clinical qualifications, provider schedule, provider workload status and provider infectious exposure status.

39. An automatically generated assignment according to claim 38, wherein the provider clinical qualifications comprise at least one of clinical certifications, experience level, and qualification for procedures or equipment operation.

40. An automatically generated assignment according to claim 38, wherein the provider infectious exposure status comprises at least one of provider exposure to other potentially infectious patients, provider exposure to other potentially infectious providers, and provider exposure to potentially infectious sites.

41. An automatically generated assignment according to claim 35, wherein the automatically generating comprises invoking a rules-based assignment engine.

42. An automatically generated assignment according to claim 41, wherein the rules-based assignment engine accesses a rule set to compare the patient factors to the provider factors.

43. An automatically generated assignment according to claim 42, wherein the rule set comprises an ordered weighting of an analysis of patient acuity status compared to provider clinical qualifications, an analysis of continuity of patient care, an analysis of provider workload status incorporating a patient workload estimate, and provider preference data.

44. An automatically generated assignment according to claim 42, wherein the rule set is extensible.

45. An automatically generated assignment according to claim 35, wherein the method further comprises presenting a management interface to an operator with a view of the results of the automatically generated patient assignments.

46. An automatically generated assignment according to claim 45, wherein the management interface comprises a selector tool to permit the operator to accept or adjust the automatically generated patient assignments.

47. An automatically generated assignment according to claim 46, further comprising generating a contraindication notice to the operator via the management interface when provider factors conflict with the patient factors for a provider assignment.

48. An automatically generated assignment according to claim 35, wherein the provider is at least one of a nurse, a physician, a technician and a therapist.

49. An automatically generated assignment according to claim 35, wherein the automatically generated assignment comprises assignments for at least one of a shift, a partial shift, a day, a week, a month, a case and an event.

50. An automatically generated assignment according to claim 35, wherein the automatically generating is triggered by changed conditions comprising at least one of a change in patient census, a change in patient acuity, and a change in provider staffing or schedule.

51. An automatically generated assignment according to claim 35, wherein the automatically generating comprises automatically generating a patient assignment based on a prior automatically generated provider assignment to produce a minimum amount of assignment change.

52. A method for excluding care providers from assignment to patients based on infectious status, comprising:

accessing an infectious exposure status associated with a provider; and

automatically excluding the care provider from assignment to a patient based at least on the infectious exposure status.

53. A method according to claim 52, further comprising:

accessing an immune condition status associated with the patient.

54. A method according to claim 53, wherein the automatically excluding the care provider comprises comparing the infectious exposure status with the immune condition status to automatically exclude the care provider based on a conflict between the infectious exposure status and the immune condition status.

55. A method according to claim 52, wherein the infectious exposure status is determined at least in part by examination of a patient assignment history for the provider.

56. A method according to claim 52, wherein the provider is at least one of a nurse, a physician, a technician and a therapist.

57. A method according to claim 52, wherein the infectious exposure status is tracked for a clinically relevant window of time after a prior potential infectious exposure.