Method and system for maintaining and updating computerized medical records

• US 5,899,998 A
• Filed: 08/31/1995
• Issued: 05/04/1999
• Est. Priority Date: 08/31/1995
• Status: Expired due to Term

• Current Assignee: Medcard Systems Incorporated
• Original Assignee: Medcard Systems Incorporated
• Inventors: Krumme, Christopher, McGauley, James L.
• Primary Examiner(s): Amsbury, Wayne
• Assistant Examiner(s): RONES, CHARLES
• Application Number:
  US08/521,826
• Time in Patent Office: 1,342 Days
• Field of Search: 370/477, 370/235, 395/76, 395/800, 395/608, 395/768, 395/615, 395/203, 395/601, 395/200.18, 395/200.09, 395/202, 395/769, 395/238, 340/825.54, 379/221, 707/8, 707/10, 707/202, 707/104, 705/40, 705/3, 382/380, 445/466
• US Class Current: 709/201
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 10/65 stored on portable record carriers, e.g. on smartcards, RFID tags or CD
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: Y10S 707/955 Object-oriented
• CPC Class Codes: Y10S 707/956 Hierarchical
• CPC Class Codes: Y10S 707/966 Distributed
• CPC Class Codes: Y10S 707/975 Portable database architecture
• CPC Class Codes: Y10S 707/99938 Concurrency, e.g. lock management in shared database
• CPC Class Codes: Y10S 707/99945 Object-oriented database structure processing

Abstract

A distributed database architecture stores medical information in a self-updating system that employs point-of-service stations disposed at convenient medical service locations. Each patient carries a portable data carrier such as a smart card that contains the patient'"'"'s complete medical history. Interaction between the portable data carriers and the point-of-service stations effects a virtual communication link that ties the distributed databases together without the need for online or live data connections. The point-of-service stations are also interconnected over a communications network through a switching station that likewise does not rely on online, live communication. The database system uses an object-oriented update object to distribute data that has been generated when a portable data carrier is not physically present and to automatically distribute data without the necessity of accessing a masterfile.

Claims

1. A computer system for maintaining the currency of data in distributed databases, comprising:

a data communication network;

a plurality of physically separate databases, each of said databases including means for communicating with said data communication network, said databases collectively defining said distributed databases;

a processor having interface for supplying an input instruction to modify the contents of the distributed databases;

said processor being coupled to said data communication network;

said processor being operable to generate an update object in response to said instruction and to place said update object in said data communication network;

said update object having a self-contained processing tag for causing said update object to be intelligently routed along said data communication network to at least one of said plurality of databases and for causing said one of said plurality of databases to automatically modify its contents in accordance with said input instruction;

said update object further having an object-oriented data structure that defines independently created field objects and record objects, said field objects and said field objects each having stored attributes that record information about processes performed on those objects;

said data structure encapsulating data for storing information independent of said distributed databases, said data structure defining a nested, hierarchial relationship such that said field objects are encapsulated within said record objects and wherein said record objects encapsulated within said update object;

said update object thereby being configured to automatically store data and to automatically store in said attributes an historic record of processes performed on said data as said update object is routed anywhere throughout said communication network.

2. The system of claim 1 wherein said data communication network comprises a system employing a portable data carrier having memory for storing and transferring data among said plurality of databases.

3. The system of claim 1 wherein said data communication network comprises a telecommunication network.

4. The system of claim 1 wherein said data communication network comprises in combination:

a system employing a portable data carrier having memory for storing and transferring data among said plurality of databases; and

a telecommunication network.

5. The system of claim 1 wherein said data communication network is coupled to a routing processor responsive to said processing tag in intelligently routing said update object along said data communication network.

6. The system of claim 1 wherein said processing tag of said update object comprises a data structure for storing a destination datum for causing said update object to be intelligently routed along said data communication network.

7. The system of claim 1 wherein said data communication network is coupled to a routing processor and wherein said processing tag of said update object comprises a data structure for storing a destination datum that is accessed by said routing processor in causing said update object to be intelligently routed along said data communication network.

8. The system of claim 1 wherein at least one of said databases includes a database processor responsive to said processing tag in modifying the contents of its database.

9. The system of claim 1 wherein said processing tag of said update object comprises a data structure for storing an operation datum based on said input instruction for use in automatically modifying the contents of at least one of said databases.

10. The system of claim 1 wherein at least one of said databases includes a database processor and wherein said processing tag of said update object comprises a data structure for storing an operation datum based on said input instruction that is accessed by said database processor in modifying the contents of said one of said databases.

11. The system of claim 1 wherein said data communication network is coupled to a routing processor having an associated memory for storing a routing rules set.

12. The system of claim 1 wherein said processing tag of said update object comprises a data structure for storing a destination datum that is used according to predefined rules to cause said update object to be intelligently routed along said data communication networks.

13. The system of claim 1 wherein said processing tag of said update object comprises a data structure for storing a destination datum that is used according to predefined rules to cause said update object to be intelligently routed to a selected one of said databases.

14. The system of claim 1 wherein said data communication network is coupled to a routing processor having an associated memory for storing a routing rules set and wherein said processing tag of said update object comprises a data structure for storing a destination datum that is accessed by said routing processor and used in accordance with said routing rules to cause said update object to be intelligently routed along said data communication network.

15. The system of claim 1 wherein said data communication network includes a routing processor having an associated memory for storing a routing rules set and wherein said processing tag of said update object comprises a data structure for storing a destination datum that is used according to said routing rules to cause said update object to be intelligently routed to a selected one of said databases.

16. The system of claim 1 wherein at least one of said databases includes a database processor and an associated memory for storing an operation processing rules set.

17. The system of claim 1 wherein said processing tag of said update object comprises a data structure for storing an operation datum based on said input instruction that is used according to predefined rules to automatically modify the contents of at least one of said databases.

18. The system of claim 1 wherein at least one of said databases includes a database processor and an associated memory for storing an operation processing rules set and wherein said processing tag of said update object comprises a data structure for storing an operation datum based on said input instruction that is accessed by said database processor and used in accordance with said operation processing rules to automatically modify the contents of at least one of said databases.

19. The system of claim 1 wherein said data communication network includes a routing processor having an associated memory for storing a routing rules set and wherein said processing tag of said update object comprises a data structure for storing a destination datum that is accessed by said routing processor and used in accordance with said routing rules to cause said update object to be intelligently routed to at least a selected one of said databases, and

wherein at least said selected one of said databases includes a database processor and an associated memory for storing an operation processing rules set and wherein said processing tag of said update object comprises a data structure for storing an operation datum based on said input instruction that is accessed by said database processor and used in accordance with said operation processing rules to automatically modify the contents of said selected one of said databases.

20. A computer-implemented method of maintaining the currency of data in distributed databases consisting of a plurality of physically separate databases, comprising:

receiving an input instruction corresponding to a request to modify data in said distributed databases;

using said input instruction to generate an update object that includes a self-contained processing tag;

said update object further having an object-oriented data structure that defines independently created field objects and record objects, said field objects and said field objects each having stored attributes that record information about processes performed on those objects;

said data structure encapsulating data for storing information independent of said distributed databases, said data structure defining a nested, hierarchial relationship such that said field objects are encapsulated within said record objects and wherein said record objects encapsulated within said update object;

said update object thereby being configured to automatically store data and to automatically store in said attributes an historic record of processes performed on said data as said update object is routed anywhere throughout said communication network;

conveying said update object to at least a selected one of said plurality of databases using said processing tag to cause said update object to be intelligently routed to said selected one of said databases;

further using said processing tag to cause said selected one of said databases to automatically modify its respective contents in accordance with said input instruction.

21. The method of claim 20 further comprising employing a portable data carrier to convey said update object by storing the contents of said update object in said portable data carrier and physically transporting said portable data carrier between said selected databases.

22. The method of claim 20 further comprising using a telecommunication network to transmit said update object between said selected databases.

23. The method of claim 20 further comprising using a data communication network that employs, in combination, a portable data carrier and a telecommunication network and wherein said conveying step is performed by at least one of the following methods:

(a) by storing said update object in said portable data carrier and physically transporting said portable data carrier between said databases and

(b) by transmitting said update object over said telecommunication network.

24. The method of claim 20 wherein at least a first one of said plurality of databases has an associated processor and wherein said method further comprises using said associated processor to write to a processing tag a datum indicative of a destination database to which the update object is intelligently routed.

25. The method of claim 20 wherein at least a first one of said plurality of databases has an associated processor and wherein said method further comprises using said associated processor to write to a processing tag a datum to specify a selected one of a plurality of data manipulation processes.

26. The method of claim 20 wherein at least a first one of said plurality of databases has an associated processor and wherein said method further comprises using said associated processor to read said processing tag and to intelligently route said update object to a second one of said plurality of databases in accordance with said processing tag.

27. The method of claim 20 wherein at least a first one of said plurality of databases has an associated processor and wherein said method further comprises using said associated processor to read said processing tag and to route said update object to a communication network.

28. The method of claim 20 wherein at least a first one of said plurality of databases has an associated processor and wherein said method further comprises using said associated processor to read said processing tag and to route said update object to a routing processor coupled to a communication network.

29. The method of claim 20 wherein at least a first one of said plurality of databases has an associated processor and wherein said method further comprises using said associated processor to read said processing tag and to modify the contents of said first database in accordance with said processing tag.

30. The method of claim 20 further comprising conveying said update object over a data communication network to a routing processor.

31. The method of claim 20 further comprising:

conveying said update object over a data communication network to a routing processor; and

using said routing processor to route said update object to at least a second one of said plurality of databases over said data communication network.

32. The method of claim 20 wherein at least a first one of said databases includes an associated processor and wherein said method further comprises storing a routing rules set in a memory addressed by said associated processor and using associated processor to access said routing rules set and said processing tag to cause said update object to be routed along said data communication network.

33. The method of claim 20 wherein said data communication network includes an associated processor and wherein said method further comprises storing a routing rules set in a memory addressed by said associated processor and using said associated processor to access said routing rules set and said processing tag to cause said update object to be intelligently routed to a destination database.

34. The method of claim 20 wherein at least a first one of said plurality of databases has an associated processor and wherein said method further comprises storing an operation processing rules set in a memory addressed by said associated processor and using said associated processor to access said rules set and said processing tag and to modify the contents of said first database.

35. An information system for maintaining the currency of computerized records, comprising:

a first processor with associated first memory for storing a first database of computerized records;

a second processor with second memory for storing a second database of computerized records;

said first and second memories being disposed at physically separate locations;

a smart card having an embedded third processor and associated third memory for storing a third database of computerized records;

said first and second processors each having a port for interfacing with said smart card;

said smart card being;

operable as a client and server to said first and second databases;

physically transportable between said first and second databases; and

operable to propagate information between said first and second databases such that the currency of computerized records is maintained in said first, second and third databases;

wherein said first processor generates an update object for routing an element of information to said second database;

said update object further having an object-oriented data structure that defines independently created field objects and record objects, said field objects and said field objects each having stored attributes that record information about processes performed on those objects;

said data structure encapsulating data for storing information independent of said distributed databases, said data structure defining a nested, hierarchial relationship such that said field objects are encapsulated within said record objects and wherein said record objects encapsulated within said update object;

said update object thereby being configured to automatically store data and to automatically store in said attributes an historic record of processes performed on said data as said update object is routed anywhere throughout said communication network.

36. The information system of claim 35 wherein at least one of said first and third processors operate on both first and third databases to mutually update both first and third databases.

37. The information system of claim 35 wherein at least one of said second and third processors operate on both second and third databases to mutually update both second and third databases.

38. The information system of claim 35 wherein at least one of said processors generates an update object carried by said smart card.

39. The information system of claim 35 wherein said first processor generates an update object for routing an element of information to said second database, said update object including a processing tag to identify at least a selected one of a plurality of data processing operations;

and

wherein said second processor operates on the computerized records stored in said second database using said element of information in accordance with said processing tag.

40. A self-updating computer-implemented database system for storing elements of information comprising:

a computer-implemented system for generating an update object that stores an element of information and that includes a processing tag for specifying at least one of a plurality of predefined data manipulation processes and for causing said update object to be intelligently routed to at least one destination;

a second database with associated second processor for receiving said update object;

a second database with associated second processor for receiving said update object;

said update object further having an object-oriented data structure that defines independently created field objects and record objects, said field objects and said field objects each having stored attributes that record information about processes performed on those objects;

said data structure encapsulating data for storing information independent of said distributed databases, said data structure defining a nested, hierarchial relationship such that said field objects are encapsulated within said record objects and wherein said record objects encapsulated within said update object;

said update object thereby being configured to automatically store data and to automatically store in said attributes an historic record of processes performed on said data as said update object is routed anywhere throughout said communication network,

said first processor being responsive to the processing tag of said update object to;

(a) modify the contents of said first database in accordance with the data manipulation process specified by said processing tag;

(b) store said update object in said first database; and

(c) convey said update object to said second database in accordance with the destination specified by said processing tag;

said second processor being operative to;

(i) modify the contents of said second database in accordance with the data manipulation process specified by said processing tag; and

(ii) send an acknowledgment of receipt of said update object to said first processor;

said first processor being operative to initiate deletion of said update object from said first database in response to receipt of said acknowledgment from said second processor.

41. The system of claim 40 wherein said computer-implemented system generates said update object in response to input from a user of said database system.

42. The system of claim 40 wherein said second processor is further operative to store said update object in said second database.

43. The system of claim 40 wherein the system includes a third database with associated third processor and wherein said second processor is further operative to convey said update object to said third processor.

44. The system of claim 40 further comprising a data communication network and wherein said first processor conveys said update object to said second processor over said communication network.

45. The system of claim 44 wherein said data communication network comprises a system employing a portable data carrier having memory for storing said update object.

46. The system of claim 44 wherein said data communication network comprises a telecommunication network.

47. The system of claim 44 wherein said data communication network comprises in combination:

a system employing a portable data carrier having memory for storing said update object; and

a telecommunication network.

48. The system of claim 44 wherein said data communication network is coupled to a routing processor for reading said processing tag and conveying said update object to at least said second database.

49. The system of claim 40 wherein said first and second databases are disposed at physically separate locations.

50. The system of claim 40 wherein said update object includes means for storing an identification datum that functions as a database key.

51. An information system for maintaining the currency of computerized records, comprising:

a first processor with associated first database of computerized records;

a second processor with associated second database of computerized records;

said first and second databases being disposed at physically separate locations;

a portable data carrier having a third processor and associated third database of computerized records;

said first and second processors each having a port for interfacing with said portable data carrier;

said portable data carrier being operable as a client and server to said first and second databases and physically transportable being said first and second processors to define a first communication channel that is operable to propagate information between said first and second databases;

at least one of said first and second processors having a routing rules set forth for causing at least one of said first and second processors to propagate information between said first and second databases over a second communication channel;

whereby said first and second communication channels collectively operate such that currency of computerized records is maintained in said first, second and third databases;

wherein said first processor generates an update object that is propagated over at least one of said first and second communication channels;

said update object further having an object-oriented data structure that defines independently created field objects and record objects, said field objects and said field objects each having stored attributes that record information about processes performed on those objects;

said data structure encapsulating data for storing information independent of said distributed databases, said data structure defining a nested, hierarchial relationship such that said field objects are encapsulated within said record objects and wherein said record objects encapsulated within said update object;

said update object thereby being configured to automatically store data and to automatically store in said attributes an historic record of processes performed on said data as said update object is routed anywhere throughout said communication network.

52. The information system of claim 51 wherein said portable data carrier is a smart card that includes said third processor and said third database.

53. The information system of claim 51 wherein the first database stores an update object containing a database modification processing tag;

wherein at least one of the first and third processors causes at least one of the first and third databases to be initially modified according to the processing tag and then at least one of the first and third processors updates the other of said first and third databases based on the information in said initially modified database;

and wherein at least one of the second and third processors updates the second database based on the information contained in third database upon the portable data carrier being physically transported to said second database.

54. The information system of claim 51 wherein the first processor generates an update object containing a routing tag and database modification tag, the first processor stores the update object in the first database and sends the update object along said second communication channel to the second processor based on said routing tag and said second processor modifies the second database based on said database modification tag.

55. The information system of claim 51 wherein said first processor has a processing rules set accessed by said first processor to generate an update object for routing an element of information to said second database.

56. The information system of claim 51 wherein said first processor has a first processing rules set accessed by said first processor to generate an update object for routing an element of information to said second database, said update object including a processing tag to identify at least a selected one of a plurality of data processing operations;

and

wherein said second processor has a second processing rules set accessed by said second processor to cause said second processor to operate on the computerized records stored in said second database using said element of information in accordance with said processing tag.

57. The information system of claim 51 wherein said second database includes an administrative services system.

58. An information system for maintaining the currency of computerized records in distributed databases, comprising:

a first database with associated first processor;

a second database with associated second processor;

said first and second databases being disposed at physically separate locations;

a first communication channel comprising a portable data carrier having a third database with associated third processor, the portable data carrier being operable as a client and server to said first and second databases and physically transportable between said first and second processors to propagate information between said first and second databases;

a second communication channel accessible by said first and second processors;

a first system for collectively updating said first, second and third databases, wherein;

(a) at least one of said first and third processors is operable to mutually update said first and third databases; and

(b) at least one of said second and third processors is operable to mutually update said second and third databases;

a second system for collectively updating said first and second databases, wherein;

(a) said first processor generates an update object having a processing tag for specifying at least one of a plurality of predefined data manipulation processes and for specifying at least one destination;

said update object further having an object-oriented data structure that defines independently created field objects and record objects, said field objects and said field objects each having stored attributes that record information about processes performed on those objects;

said data structure encapsulating data for storing information independent of said distributed databases, said data structure defining a nested, hierarchial relationship such that said field objects are encapsulated within said record objects and wherein said record objects encapsulated within said update object;

said update object thereby being configured to automatically store data and to automatically store in said attributes an historic record of processes performed on said data as said update object is routed anywhere throughout said communication network,

(b) said first processor modifies the contents of said first database in accordance with the data manipulation process specified by said processing tag;

(c) said first processor propagates said update object to said second processor along said second communication channel in accordance with the destination specified by said processing tag;

(d) said second processor modifies the contents of said second database in accordance with the data manipulation process specified by said processing tag;

whereby the currency of computerized records in said first, second and third databases are maintained current.

59. The system of claim 58 wherein said portable data carrier is a smart card that includes said third processor and said third database.

60. The information system of claim 58 wherein said first processor includes a user interface and wherein said first processor generates said update object based on information supplied through said user interface.

61. The information system of claim 58 wherein the first database stores an update object containing a database modification processing tag;

wherein at least one of the first and third processors causes at least one of said first and third databases to be initially modified according to the database modification processing tag and then at least one of the first and third processors updates the first database based on the information in the initially modified database;

and wherein at least one of the second and third processors updates the second database based on the information in the third database, upon the portable data carrier being physically transported to said second database.

62. The information system of claim 58 wherein the first processor generates an update object containing a routing tag and database modification tag, the first processor stores the update object in the first database and sends the update object along at least one of said first and second communication channels to the second processor based on said routing tag and said second processor modifies the second database based on said database modification tag.

63. The information system of claim 58 wherein said second database includes an administrative services system.

64. A self-updating, computer-implemented distributed database system for storing elements of information comprising:

a computer system for generating and storing data objects that include;

(a) a record object for storing an element of information;

(b) an update object for defining a relationship with at least one associated record object, said update object storing a processing tag;

said update object further having an object-oriented data structure that defines independently created field objects and record objects, said field objects and said field objects each having stored attributes that record information about processes performed on those objects;

said data structure encapsulating data for storing information independent of said distributed databases, said data structure defining a nested, hierarchial relationship such that said field objects are encapsulated within said record objects and wherein said record objects encapsulated within said update objects;

said update object thereby being configured to automatically store data and to automatically store in said attributes an historic record of processes performed on said data as said update object is routed anywhere throughout said communication network,

said computer system further generating a database system that comprises a collection of record objects that define a persistent portion of the database and a collection of update objects that define a transient portion of the database;

the database system being responsive to said processing tag for automatically updating the persistent portion of said database;

the database system further including a feedback mechanism comprising a second update object for systematically purging said update objects from the transient portion of the database.

65. The database system of claim 64 wherein said record object includes a field object for storing said element of information.

66. The database system of claim 64 wherein said update object includes an acknowledgement tag accessed by said feedback mechanism in purging said update objects from the transient portion of the database.

67. The database system of claim 64 wherein said processing tag comprises a routing tag and a database modification tag.

68. The database system of claim 64 wherein said record object includes a record identification tag.

69. The database system of claim 64 wherein at least one of said record objects and said update objects employs a variable length data storage mechanism.

70. The database system of claim 69 wherein said variable length storage mechanism uses a pointer system for data storage and retrieval.

71. The database system of claim 64 wherein said database system includes a first database having a first processor and wherein said feedback mechanism uses said first processor to read the processing tag of said update object and to store said update object in the transient portion of the first database.

72. The database system of claim 64 wherein said database system includes a first database having a first processor and a second database having a second processor and wherein said feedback mechanism uses said first processor to read the processing tag of said update object and to route said update object to said second database in accordance with said processing tag.

73. The database system of claim 64 wherein said database system includes a first database having a first processor and a second database having a second processor and wherein said feedback mechanism uses said second processor to generate a second update object having a second processing tag.

74. The database system of claim 73 wherein said second processing tag is an acknowledgement tag.

75. The database system of claim 64 wherein said database system includes a first database having a first processor and a second database having a second processor and wherein said feedback mechanism uses said second processor to transmit a second update object having second processing tag to said first processor.

76. The database system of claim 64 wherein said database system includes a first database having a first processor and a second database having a second processor;

wherein said feedback mechanism uses said first processor to read the processing tag of a first update object and to store said first update object in the transient portion of the first database;

wherein said feedback mechanism uses said first processor to transmit said first update object to said second processor;

wherein said feedback mechanism uses said second processor to transmit a second update object having a second processing tag to said first processor in response to said first update object; and

wherein said feedback mechanism uses said first processor to read said second processing tag and to modify said first database by deleting said first update object from said first database in response to said second processing tag.