Rules-base patient care system for use in healthcare locations

• US 20060271408A1
• Filed: 05/31/2006
• Published: 11/30/2006
• 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 7,315,825 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 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• 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 5/021 Measuring pressure in heart or blood vessels A61B5/0205 takes precedence
• CPC Class Codes: A61B 5/024 Detecting, measuring or recording pulse rate or heart rate A61B5/0205, A61B5/021 take precedence
• CPC Class Codes: A61B 5/412 Detecting or monitoring sepsis
• CPC Class Codes: G08B 21/04 responsive to non-activity, e.g. of elderly persons G08B21/06 takes precedence
• CPC Class Codes: G08B 21/0476 Cameras to detect unsafe condition, e.g. video cameras
• CPC Class Codes: G08B 21/182 Level alarms, e.g. alarms responsive to variables exceeding a threshold
• CPC Class Codes: G08B 25/08 using communication transmission lines G08B13/19658, G08B21/0286, G08B25/016 take precedence
• CPC Class Codes: G09B 23/28 for medicine
• 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
• 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: G16H 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring

Abstract

A rules-base patient care system for use in healthcare locations. A patient rules generator creates rules for the patients. Performance measures indicative of the ability of a rule to predict changes in the condition of the patient are acquired by the rules generator. A determination is made from the rules performance measures whether to revise the rule. A rules engine applies a rule to selected data elements stored in the database to produce an output indicative of a change in the medical condition of the patient. The output from the rules engine is used to determine if intervention is warranted.

Claims

1. A rules-based patient care system comprising:

a network;

a database accessible via the network, wherein the database comprises patient data elements indicative of a medical condition associated with a patient;

a rules engine connected to the network, wherein the rules engine is adapted for;

applying a patient rule to selected data elements stored in the database to produce an output indicative of a change in the medical condition of the patient; and

utilizing the output to determine if intervention is warranted; and

a patient rules generator connected to the network, wherein the patient rules generator is adapted for;

creating the patient rule;

acquiring rules performance measures indicative of the ability of the rule to predict the change in the condition of the patient; and

determining from the rules performance measures whether to revise the rule.

2. The system of claim 1, wherein the patient rule comprises an algorithm.

3. The system of claim 1, wherein the selected data elements comprise a physiological data element of the patient and a clinical data element of the patient.

4. The system of claim 1, wherein the selected data elements comprise a physiological data element of the patient and a medication data element of the patient.

5. The system of claim 1, wherein the selected data elements comprise a physiological data element of the patient and a laboratory data element of the patient.

6. The system of claim 1, wherein the selected data elements comprise a clinical data element of the patient and a laboratory data element of the patient.

7. The system of claim 1, wherein the selected data elements comprise a physiological data element of the patient and another physiological data element of the patient.

8. The system of claim 1, wherein the selected data elements comprise at least two data elements of the patient selected from the group consisting of a physiological data element, a clinical data element of the patient, a medication data element of the patient, and a laboratory data element of the patient.

9. The system of claim 1, wherein intervention comprises issuing a patient intervention protocol and order.

10. The system of claim 1, wherein intervention comprises issuing a patient release protocol and order.

11. The system of claim 1, wherein patient data elements are selected from the group consisting of physiological data elements and clinical data elements.

12. The system of claim 1, wherein the patient data elements indicative of the change in the medical condition of the patient comprise data indicative of improvement of the condition of the patient.

13. The system of claim 1, wherein the data indicative of the change in the medical condition of the patient comprise data indicative of degradation of the condition of the patient.

14. The system of claim 1, wherein the rules performance measures are derived from information provided by health care providers.

15. The system of claim 1, wherein patient rules generator is further adapted for:

accessing historical data, wherein the historical data comprises other patient data elements for a plurality of other patients and wherein the patient data elements of an other patient are associated with an outcome of the other patient;

applying multivariate analyses to the historical data to produce a result that relates the other patient data elements, the rule, and the other patient outcomes; and

generating a rules performance measure by comparing the result to the patient rule.

16. The system of claim 15, wherein patient rules generator is further adapted for generating a new rule from the result.

17. The system of claim 16, wherein the patient rules generator is further adapted for testing the new rule against the historical data.

18. The system of claim 1, wherein the system further comprises a site assessment module, wherein the site assessment module is adapted for:

receiving site assessment data, wherein the site assessment data are indicative of the capability of the patient care management system to provide diagnostic and treatment services to patients;

determining from the site assessment data service level measures indicative of a capability of the patient care management system to provide diagnostic and treatment services to patients; and

wherein the rules generator is further adapted for;

receiving service level measures;

creating the patient rule consistent with the service level measures.

19. The system of claim 18, wherein the site assessment module is further adapted for:

prompting a user for the site assessment data; and

determining the service level measures based on the user response.

20. The system of claim 18, wherein the patient care management system comprises a site assessment code and the site assessment module is further adapted for:

acquiring the site assessment code from the patient care management system; and

determining the service level measures at least in part based on the site assessment code.

21. The system of claim 18, wherein the service level measures comprise:

an inventory of available monitoring data elements;

an inventory of available diagnostic services;

an inventory of available surgical treatment services; and

an inventory of available laboratory services.

22. The system of claim 1, wherein the network is selected from the group consisting of a wired network, a wireless network, a satellite network, a public switched telephone network, an IP network, a packet switched network, a cell phone network, a cable network, and a coax network, a hybrid fiber coax network.

23. A method for managing the care of a patient:

acquiring patient data elements indicative of a medical condition associated with the patient;

creating a rule for the patient;

applying the rule to selected patient data elements to produce an output indicative of a change in the medical condition of the patient;

utilizing the output to determine if intervention is warranted;

acquiring rules performance measures indicative of the ability of the rule to predict the change in the condition of the patient; and

determining from the rules performance measures whether to revise the rule.

24. The method for managing the care of a patient of claim 23, wherein the patient rule comprises an algorithm.

25. The method for managing the care of a patient of claim 23, wherein the selected data elements comprise a physiological data element of the patient and a clinical data element of the patient.

26. The method for managing the care of a patient of claim 23, wherein the selected data elements comprise a physiological data element of the patient and a medication data element of the patient.

27. The method for managing the care of a patient of claim 23, wherein the selected data elements comprise a physiological data element of the patient and a laboratory data element of the patient.

28. The method for managing the care of a patient of claim 23, wherein the selected data elements comprise a clinical data element of the patient and a laboratory data element of the patient.

29. The method for managing the care of a patient of claim 23, wherein the selected data elements comprise a physiological data element of the patient and another physiological data element of the patient.

30. The method for managing the care of a patient of claim 23, wherein the selected data elements comprise at least two data elements of the patient selected from the group consisting of a physiological data element, a clinical data element of the patient, a medication data element of the patient, and a laboratory data element of the patient.

31. The method for managing the care of a patient of claim 23, wherein utilizing the output to determine if intervention is warranted comprises utilizing the output to determine whether to issue a patient intervention protocol and order.

32. The method for managing the care of a patient of claim 23, wherein utilizing the output to determine if intervention is warranted comprises utilizing the output to determine whether to issue a patient release protocol and order.

33. The method for managing the care of a patient of claim 23, wherein the patient data elements are selected from the group consisting of physiological data elements and clinical data elements.

34. The method for managing the care of a patient of claim 23, wherein the output indicative of the change in the medical condition of the patient comprises an output indicative of improvement of the condition of the patient.

35. The method for managing the care of a patient of claim 23, wherein the output indicative of the change in the medical condition of the patient comprise data indicative of degradation of the condition of the patient.

36. The method for managing the care of a patient of claim 23, wherein acquiring rules performance measures indicative of the ability of the rule to predict the change in the condition of the patient comprises deriving rules performance measures from information provided by health care providers.

37. The method for managing the care of a patient of claim 23, wherein acquiring rules performance measures indicative of the ability of the rule to predict the change in the condition of the patient comprises:

accessing historical data, wherein the historical data comprises other patient data elements for a plurality of other patients and wherein the patient data elements of an other patient are associated with an outcome of the other patient;

applying multivariate analyses to historical data to produce a result that relates the other patient data elements, the rule, and the other patient outcomes; and

generating a rules performance measure by comparing the result to the patient rule.

38. The method for managing the care of a patient of claim 37 further comprising generating a new rule from the result.

39. The method for managing the care of a patient of claim 38 further comprising testing the new rule against the historical data.

40. The method for managing the care of a patient of claim 23 further comprising:

receiving site assessment data, wherein the site assessment data are indicative of the capability of the patient care management system to provide diagnostic and treatment services to patients;

determining from the site assessment data service level measures of the patient care management system indicative of a capability of the patient care management system to provide diagnostic and treatment services to patients; and

and wherein creating the patient rule further comprises creating the rule consistent with the service level measures.

41. The method for managing the care of a patient of claim 40 further comprising:

prompting a user for the site assessment data; and

determining the service level measures based on the user response.

42. The method for managing the care of a patient of claim 40, wherein the patient care management system further comprises a site assessment code and the method further comprises:

acquiring the site assessment code from the patient care management system; and

determining the service level measures at least in part based on the site assessment code.

43. The method for managing the care of a patient of claim 40, wherein the service level measures comprise:

an inventory of available monitoring data elements;

an inventory of available diagnostic services;

an inventory of available surgical treatment services; and

an inventory of available laboratory services.