System and method for standardizing care in a hospital environment

• US 20060122869A9
• Filed: 02/18/2005
• Published: 06/08/2006
• Est. Priority Date: 06/23/1999
• Status: Active Grant

• Current Assignee: Visicu Incorporated (Koninklijke Philips N.V.)
• Original Assignee: Visicu Incorporated (Koninklijke Philips N.V.)
• Inventors: Breslow, Michael, Rosenfeld, Brian A.
• Granted Patent: US 7,433,827 B2
• Time in Patent Office: Days
• US Class Current: 705/3
• CPC Class Codes: A61B 5/002 Monitoring the patient using a local or closed circuit, e.g. in a room or building A61B5/0017 takes precedence
• CPC Class Codes: A61B 5/0205 Simultaneously evaluating both cardiovascular conditions and different types of body conditions, e.g. heart and respiratory condition
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: A61B 5/411 Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: G08B 21/0211 Combination with medical sensor, e.g. for measuring heart rate, temperature
• CPC Class Codes: G08B 21/0476 Cameras to detect unsafe condition, e.g. video cameras
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/67 for remote operation
• 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
• CPC Class Codes: G16H 70/60 relating to pathologies
• CPC Class Codes: H04L 67/12 specially adapted for proprietary or special-purpose networking environments, e.g. medical networks, sensor networks, networks in vehicles or remote metering networks

Abstract

A system and method for standardizing care in a hospital environment. Information concerning the latest care and practice standards for a given condition is provided to a decision support module. The decision support module comprises decision support algorithms that reflect a standardize guideline of practice for a particular medical condition. The general categories of cardiovascular, endocrinology, general, gastrointestinal, hematology, infectious diseases, neurology, pharmacology, pulmonary, renal, surgery, toxicology, trauma all have guidelines and practice standards associated with them. Patient data and user input are inputted to the decision support algorithm. The user may be prompted for user input, and an assessment is made of the patient so as provide patient care advice for the patient. Examples of patient care advice are a diagnosis, a method of treatment, and a laboratory protocol.

Claims

1. A decision support system for standardizing treatment to hospitalized patients comprising:

a datastore, wherein the datastore comprises patient data elements indicative of a medical condition associated with a hospitalized patient; and

a decision support module adapted to;

access a decision support algorithm;

apply the decision support algorithm to selected patient data elements of the hospitalized patient;

receive input from a user;

apply the decision support algorithm to user input; and

provide patient care guidance to the user in response to results of applying the decision support algorithms to the selected patient data elements and the user input.

2. The system of claim 1, wherein a selected patient data element comprises a monitored data element generated by a patient monitoring device.

3. The system of claim 2, wherein the system further comprises a network interface, and wherein the network interface is adapted to receive a monitored data element from the hospitalized patients via a network.

4. The system of claim 2, wherein the monitored data element is selected from the group consisting of heart rate, systolic pressure, diastolic pressure, pulmonary artery wedge pressure, central venous pressure, mixed venous oxygen saturation, oxygen saturation, tidal volume, inspiratory pressure, positive end expiratory pressure, respiration rate, electroencephalography and bispectral index.

5. The system of claim 1, wherein a selected patient data element comprises a clinical data element.

6. The system of claim 5, wherein the clinical data element is selected from the group consisting of patient history, caregiver notes, laboratory reports, venous pressure, and urine output.

7. The system of claim 1, wherein the user input comprises a response to a question posed by the decision support algorithm.

8. The system of claim 7, wherein the decision support algorithm comprises a guideline selected from the list consisting of:

Acalculous Cholecystitis, Acute Pancreatitis Algorithms, Acute Renal Failure-Diagnosis, Acute Renal Failure-Management &

Treatment, Adrenal Insufficiency. Agitation and Anxiety, Depression &

Withdrawal, Aminoglycoside Dosing and Therapeutic Monitoring, an Amphotericin-B Treatment Guidelines, Analgesia, Antibiotic Classification &

Costs, Antibiograms Algorithm, Antibiotic associated Colitis Algorithm, ARDS;

Hemodynamic Management, ARDS;

Steroid Use, ARDS;

Ventilator Strategies, Asthma, Bleeding Patient, Bloodstream Infections, Blunt Cardiac Injury, Bradyarrhythmias, Brain Death, Bronchodilator Use in Ventilator Patients, Bronchoscopy &

Thoracentesis Guidelines, Candiduria, Cardiogenic Shock, CardioPulmonary Resuscitation Guideline, Catheter Related Septicemia, a Catheter Replacement Strategies, Cervical Cord Injury, Congestive Heart Failure, COPD Exacerbation &

Treatment, CXR (Indications), Dealing with Difficult patients and families, Diabetic Ketoacidosis, Dialysis, Diuretic Use, Drug Changes with Renal Dysfunction, Emergency Cardiac Pacing, Endocarditis Diagnosis and Treatment, Endocarditis Prophylaxis, End of Life Decisions, Endotracheal Tubes &

Tracheotomy, Ethical Guidelines, Febrile Neutropenia, FUO, Fluid Resuscitation, Guillain-Barre Syndrome, Heparin, Heparin-Induced Thrombocytopenia, Hepatic Encephalopathy, Hepatic Failure, HIV+Patient Infections, Hypercalcemia Diagnosis and Treatment, Hyperglycemia Insulin Treatment, Hyperkalemia;

Etiology &

Treatment, Hypernatremia;

Etiology &

Treatment, Hypertensive Crisis, Hypokalemia;

Etiology &

Treatment, Hyponatremia;

Etiology &

Treatment, Hypothermia, Identification of Cervical Cord Injury, Implantable Cardio-defibrillator, Intra-Aortic Balloon Device, Intracerebral Hemorrhage, Latex Allergy, Magnesium Administration, Management of Hypotension, Inotropes, Management of Patients with Ascites, Empiric Meningitis, Meningitis, a Myasthenia Gravis, Myocardial Infarction, Myocardial Infarction with left bundle branch block, Necrotizing Soft Tissue Infections, Neuromuscular Blockers, Neuromuscular Complications of Critical Illness, Non-Infectious Causes of Fever, Non-Traumatic Coma, Noninvasive Modes of Ventilation, Nutritional Management, Obstetrical Complication, Oliguria, Open Fractures, Ophthalmic Infections, Organ Procurement Guidelines, PA Catheter Guideline and Troubleshooting, Pancreatitis, Penetrating Abdominal Injury, Penetrating Chest Injury, Penicillin Allergy, Permanent Pacemaker and Indications, Pneumonia Community Acquired, Pneumonia Hospital Acquired, Post-Op Bleeding, Post-Op Hypertension, Post-Op Management of Abdominal Post-Op Management of Carotid, Post-Op Management of Open Heart, Post-Op Management of Thoracotomy, Post-Op Myocardial Ischemia (Non-Cardiac Arrhythmias after Cardiac Surgery), Post-Op Power Weaning, Pressure Ulcers, Pulmonary Embolism Diagnosis, Pulmonary Embolism Treatment, Respiratory Isolation, Sedation, Seizure, Status Epilepticus, Stroke, Sub-Arachnoid Hemorrhage, Supra-Ventricular Tachyarrhythmia, Supra-Ventricular Tachycardia, Wide Complex QRS Tachycardia, Therapeutic Drug Monitoring, Thrombocytopenia, Thrombolytic Therapy, Transfusion Guidelines, Traumatic Brain Injury, Assessment of Sedation, Sedation, Septic Shock, Bolus Sliding, Scale Midazolam, Short Term Sedation Process, Sinusitis, SIRS, Spinal Cord Injury, Steroid Replacement Strategy, Thyroid Disease, Transplant Infection Prophylaxis, Transplant Related Infections, Treatment of Airway Obstruction, Unknown Poisoning, Unstable Angina, Upper GI Bleeding Stress Prophylaxis, Vancomycin, Upper GI Bleeding Non-Variceal, Upper GI Bleeding Variceal, Use of Hematopoietic Growth Factors, Ventilator Weaning, Ventilator Weaning Protocol, Venous Thrombosis Diagnosis and Treatment, Venous Thromboembolism Prophylaxis, Ventricular Arrhythmia, Warfarin, Warfarin Dosing, and Wound Healing Strategies.

9. The system of claim 1, wherein the patient care guidance is a diagnosis.

10. The system of claim 1, wherein the patient care guidance is a method of treatment.

11. The system of claim 1, wherein the patient care guidance is a laboratory protocol.

12. The system of claim 1, wherein the decision support module is further adapted to:

access an order writing module; and

issue an order from the order writing module.

13. The system of claim 12, wherein the order comprises authorization to administer medication to the hospitalized patient.

14. The system of claim 12, wherein the order comprises authorization to subject the hospitalized patient to a diagnostic procedure selected from the group consisting of a laboratory protocol, a ventilator protocol, a hemodynamic protocol, and a radiology test.

15. The system of claim 12, wherein the order comprises authorization to subject the hospitalized patient to a treatment procedure selected from the group consisting of a radiological procedure and a surgical procedure.

16. A method for standardizing care provided to hospitalized patients comprising:

accessing patient data elements indicative of a medical condition associated with a hospitalized patient;

accessing a decision support algorithm;

applying the decision support algorithm to selected patient data elements of the hospitalized patient;

receiving user input;

applying the decision support algorithm to user input; and

providing patient care guidance to the user in response to results of applying the decision support algorithms to the selected patient data elements and the user input.

17. The method for standardizing care provided to hospitalized patients of claim 16, wherein a selected patient data element comprises a monitored data element generated by a patient monitoring device.

18. The method for standardizing care provided to hospitalized patients of claim 17, wherein the selected patient data element is received from the patient monitoring device via a network.

19. The method for standardizing care provided to hospitalized patients of claim 17, wherein the monitored data element is selected from the group consisting of heart rate, systolic pressure, diastolic pressure, pulmonary artery wedge pressure, central venous pressure, mixed venous oxygen saturation, oxygen saturation, tidal volume, inspiratory pressure, positive end expiratory pressure, respiration rate, electroencephalography and bispectral index.

20. The method for standardizing care provided to hospitalized patients of claim 16, wherein the selected patient data element comprises a clinical data element.

21. The method for standardizing care provided to hospitalized patients of claim 20, wherein the clinical data element is selected from the group consisting of patient history, caregiver notes, laboratory reports, venous pressure, and urine output.

22. The method for standardizing care provided to hospitalized patients of claim 16, wherein the user input comprises a response to a question posed by the decision support algorithm.

23. The method for standardizing care provided to hospitalized patients of claim 22, wherein the decision support algorithm comprises a guideline selected from the list consisting of:

Acalculous Cholecystitis, Acute Pancreatitis Algorithms, Acute Renal Failure-Diagnosis, Acute Renal Failure-Management &

Treatment, Adrenal Insufficiency. Agitation and Anxiety, Depression &

Withdrawal, Aminoglycoside Dosing and Therapeutic Monitoring, an Amphotericin-B Treatment Guidelines, Analgesia, Antibiotic Classification &

Costs, Antibiograms Algorithm, Antibiotic associated Colitis Algorithm, ARDS;

Hemodynamic Management, ARDS;

Steroid Use, ARDS;

Ventilator Strategies, Asthma, Bleeding Patient, Bloodstream Infections, Blunt Cardiac Injury, Bradyarrhythmias, Brain Death, Bronchodilator Use in Ventilator Patients, Bronchoscopy &

Thoracentesis Guidelines, Candiduria, Cardiogenic Shock, CardioPulmonary Resuscitation Guideline, Catheter Related Septicemia, a Catheter Replacement Strategies, Cervical Cord Injury, Congestive Heart Failure, COPD Exacerbation &

Treatment, CXR (Indications), Dealing with Difficult patients and families, Diabetic Ketoacidosis, Dialysis, Diuretic Use, Drug Changes with Renal Dysfunction, Emergency Cardiac Pacing, Endocarditis Diagnosis and Treatment, Endocarditis Prophylaxis, End of Life Decisions, Endotracheal Tubes &

Tracheotomy, Ethical Guidelines, Febrile Neutropenia, FUO, Fluid Resuscitation, Guillain-Barre Syndrome, Heparin, Heparin-Induced Thrombocytopenia, Hepatic Encephalopathy, Hepatic Failure, HIV+Patient Infections, Hypercalcemia Diagnosis and Treatment, Hyperglycemia Insulin Treatment, Hyperkalemia;

Etiology &

Treatment, Hypernatremia;

Etiology &

Treatment, Hypertensive Crisis, Hypokalemia;

Etiology &

Treatment, Hyponatremia;

Etiology &

Treatment, Hypothermia, Identification of Cervical Cord Injury, Implantable Cardio-defibrillator, Intra-Aortic Balloon Device, Intracerebral Hemorrhage, Latex Allergy, Magnesium Administration, Management of Hypotension, Inotropes, Management of Patients with Ascites, Empiric Meningitis, Meningitis, a Myasthenia Gravis, Myocardial Infarction, Myocardial Infarction with left bundle branch block, Necrotizing Soft Tissue Infections, Neuromuscular Blockers, Neuromuscular Complications of Critical Illness, Non-Infectious Causes of Fever, Non-Traumatic Coma, Noninvasive Modes of Ventilation, Nutritional Management, Obstetrical Complication, Oliguria, Open Fractures, Ophthalmic Infections, Organ Procurement Guidelines, PA Catheter Guideline and Troubleshooting, Pancreatitis, Penetrating Abdominal Injury, Penetrating Chest Injury, Penicillin Allergy, Permanent Pacemaker and Indications, Pneumonia Community Acquired, Pneumonia Hospital Acquired, Post-Op Bleeding, Post-Op Hypertension, Post-Op Management of Abdominal Post-Op Management of Carotid, Post-Op Management of Open Heart, Post-Op Management of Thoracotomy, Post-Op Myocardial Ischemia (Non-Cardiac Arrhythmias after Cardiac Surgery), Post-Op Power Weaning, Pressure Ulcers, Pulmonary Embolism Diagnosis, Pulmonary Embolism Treatment, Respiratory Isolation, Sedation, Seizure, Status Epilepticus, Stroke, Sub-Arachnoid Hemorrhage, Supra-Ventricular Tachyarrhythmia, Supra-Ventricular Tachycardia, Wide Complex QRS Tachycardia, Therapeutic Drug Monitoring, Thrombocytopenia, Thrombolytic Therapy, Transfusion Guidelines, Traumatic Brain Injury, Assessment of Sedation, Sedation, Septic Shock, Bolus Sliding, Scale Midazolam, Short Term Sedation Process, Sinusitis, SIRS, Spinal Cord Injury, Steroid Replacement Strategy, Thyroid Disease, Transplant Infection Prophylaxis, Transplant Related Infections, Treatment of Airway Obstruction, Unknown Poisoning, Unstable Angina, Upper GI Bleeding Stress Prophylaxis, Vancomycin, Upper GI Bleeding Non-Variceal, Upper GI Bleeding Variceal, Use of Hematopoietic Growth Factors, Ventilator Weaning, Ventilator Weaning Protocol, Venous Thrombosis Diagnosis and Treatment, Venous Thromboembolism Prophylaxis, Ventricular Arrhythmia, Warfarin, Warfarin Dosing, and Wound Healing Strategies.

24. The method for standardizing care provided to hospitalized patients of claim 16, wherein the patient care guidance is a diagnosis.

25. The method for standardizing care provided to hospitalized patients of claim 16, wherein the patient care guidance is a method of treatment.

26. The method for standardizing care provided to hospitalized patients of claim 16, wherein the patient care guidance is a laboratory protocol.

27. The method for standardizing care provided to hospitalized patients of claim 16, further comprising:

accessing an order writing module; and

issuing an order from the order writing module.

28. The method for standardizing care provided to hospitalized patients of claim 27, wherein the order comprises authorization to administer medication to the hospitalized patient.

29. The method for standardizing care provided to hospitalized patients of claim 27, wherein the order comprises authorization to subject the hospitalized patient to a diagnostic procedure selected from the group consisting of to a laboratory protocol, a ventilator protocol, a hemodynamic protocol, and a radiology test.

30. The method for standardizing care provided to hospitalized patients of claim 27, wherein the order comprises authorization to subject the hospitalized patient a treatment procedure selected from the group consisting of a radiological procedure and a surgical procedure.