Digital disease management system

• US 5,940,802 A
• Filed: 03/17/1997
• Issued: 08/17/1999
• Est. Priority Date: 03/17/1997
• Status: Expired due to Term

• Current Assignee: The Board of Regents of the University of Colorado (University of Colorado System)
• Original Assignee: The Board of Regents of the University of Colorado (University of Colorado System)
• Inventors: Soderstrom Hopper, Gene M., Fransen, Stephen R., Hildebrand, P. Lloyd
• Primary Examiner(s): Poinvil, Frantzy
• Application Number:
  US08/819,157
• Time in Patent Office: 883 Days
• Field of Search: 705/1, 705/3, 705/4
• US Class Current: 705/3
• CPC Class Codes: G16H 20/00 ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
• 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 50/30 for calculating health indices; for individual health risk assessment
• CPC Class Codes: G16H 50/70 for mining of medical data, e.g. analysing previous cases of other patients
• CPC Class Codes: G16Z 99/00 Subject matter not provided for in other main groups of this subclass

Abstract

A method for improving the delivery of health care for patients. A first data signal being multimedia data which is indicative of a patient condition of a selected patient is input into a local computer. Clinical data, cost data and administrative data relating to the health of the selected patient are also input into the local computer. The first data signal is combined with the clinical data, cost data and administrative data to form a first patient information signal which is transmitted to a central computer. A predetermined disease stage is then assigned to the selected patient based on the first data signal. The disease stage is combined with the first patient information signal to form a second patient information signal. Then, a first array of risk factors is computed from a database containing a plurality of previously obtained individualized patient information records. A first predictive probability is then assigned to the selected patient based on the second patient information signal and the first array of risk factors. A first patient recommendation signal indicating one of the selected patient would benefit from immediate patient care and the selected patient would not benefit from immediate patient care is generated and then transmitted to the local computer. Both the second patient information signal and the first patient recommendation signal are transmitted to a regional computer in response to the first patient recommendation signal indicating that the selected patient requires immediate patient care.

Claims

1. A method for improving the delivery of health care for patients, comprising the steps of:

a. receiving a first patient information signal by a central facility computer, the first patient information signal being related to a selected patient and composed of multimedia data selected from the group comprising clinical data, cost data, administrative data, and combinations thereof;

b. assigning one of a plurality of predetermined disease stages to the selected patient based on information contained in the first patient information signal;

c. inputting the predetermined disease stage into the central facility computer;

d. assigning a first predictive probability to the selected patient by the central facility computer based on at least one of the first patient information signal, the disease stage and a first array of risk factors, the first array of risk factors being computed from a database containing a plurality of previously obtained individualized patient information records, each of the patient information records containing patient information relating to the patient care of an individual patient;

e. inputting the first predictive probability into the central facility computer;

f. generating a first patient recommendation signal by the central facility computer, the first patient recommendation signal indicating a recommendation selected from the group of recommendations comprising the selected patient would benefit from immediate patient care and the selected patient would not benefit from immediate patient care;

g. transmitting the first patient recommendation signal to a local computer;

h. receiving the first patient recommendation signal by the local computer; and

i. transmitting, from the central facility computer to a regional computer located at a regional treatment center, a second patient information signal in response to the first patient recommendation signal indicating that the selected patient would benefit from immediate patient care.

2. A method, as recited in claim 1, further comprising the step of:

j. rendering individualized patient care to the selected patient at the regional treatment center in accordance with the information contained in the second patient information signal.

3. A method, as recited in claim 2, further comprising the steps of:

k. transmitting, by the regional computer, a third patient information signal relating to the post-treatment health of the selected patient to the central facility, the third patient information signal being multimedia data which is selected from the group comprising clinical data, cost data, treatment parameter data, administrative data, and combinations thereof;

l. receiving the third patient information signal by the central facility computer; and

m. updating the database with at least the treatment parameter data contained within the third patient information signal.

4. A method, as recited in claim 3, further comprising the steps of:

n. computing a second array of risk factors from the updated database;

o. assigning a second predictive probability to the selected patient based on the information contained in the third patient information signal and the second array of risk factors;

p. inputting the second predictive probability into the central facility computer; and

q. generating, by the central facility computer, a second patient recommendation signal indicating a recommendation selected from the group of recommendations comprising the selected patient would benefit from immediate patient care and the selected patient would not benefit from immediate patient care.

5. A method, as recited in claim 1, wherein the first patient information signal is transmitted by the local computer to the central facility computer.

6. A method for improving the delivery of health care for patients, comprising the steps of:

a. receiving a first patient information signal by a central facility computer, the first patient information signal being related to a selected patient and composed of multimedia data selected from the group comprising clinical data, cost data, administrative data, and combinations thereof;

b. assigning one of a plurality of predetermined disease stages to the selected patient based on information contained in the first patient information signal;

c. inputting the predetermined disease stage into the central facility computer;

d. assigning a first predictive probability to the selected patient by the central facility computer based on at least one of the first patient information signal, the disease stage and a first array of risk factors, the first array of risk factors being computed from a database containing a plurality of previously obtained individualized patient information records, each of the patient information records containing patient information relating to the patient care of an individual patient;

e. inputting the first predictive probability into the central facility computer;

f. generating a first patient recommendation signal by the central facility computer, the first patient recommendation signal indicating a recommendation selected from the group of recommendations comprising the selected patient would benefit from immediate patient care and the selected patient would not benefit from immediate patient care;

g. transmitting the first patient recommendation signal to a local computer;

h. receiving the first patient recommendation signal by the local computer; and

i. transmitting, from at least one of the central facility computer and the local computer to a regional computer located at a regional treatment center, a second patient information signal in response to the first patient recommendation signal indicating that the selected patient would benefit from immediate patient care.

7. A method, as recited in claim 6, further comprising the step of:

j. rendering individualized patient care to the selected patient at the regional treatment center in accordance with the information contained in the second patient information signal.

8. A method, as recited in claim 7, further comprising the steps of:

k. transmitting, by the regional computer, a third patient information signal relating to the post-treatment health of the selected patient to the central facility computer, the third patient information signal being multimedia data which is selected from the group comprising clinical data, cost data, treatment parameter data, administrative data, and combinations thereof;

l. receiving the third patient information signal by the central facility computer; and

m. updating the database with at least the treatment parameter data contained within the third patient information signal.

9. A method, as recited in claim 8, further comprising the steps of:

n. computing a second array of risk factors from the updated database;

o. assigning a second predictive probability to the selected patient based on the information contained in the third patient information signal and the second array of risk factors;

p. inputting the second predictive probability into the central facility computer; and

q. generating a second patient recommendation signal indicating a recommendation selected from the group of recommendations comprising the selected patient would benefit from immediate patient care and the selected patient would not benefit from immediate patient care.

10. A method, as recited in claim 6, wherein the first patient information signal is transmitted by the local computer to the central facility computer.

11. A method for improving the delivery of health care for patients, comprising the steps of:

a. receiving a first patient information signal relating to the health of a selected patient by a central facility computer, the first patient information signal being composed of multimedia data selected from the group comprising clinical data, cost data, administrative data, and combinations thereof, the clinical data being selected from the group of data comprising images of the selected patient'"'"'s eye, visual acuity, diastolic blood pressure, amount of insulin, type of diet, hemoglobin A1C levels, age, and length of time in which the selected patient has had diabetes, the cost data being selected from the group of data comprising personnel cost, equipment cost, depreciation cost, general and administrative costs and supplies cost, the administrative data being selected from the group of data comprising demographics, payer, scheduling, health system and which specialty physicians are managing the patient'"'"'s diabetes and complications of diabetes;

b. assigning one of a plurality of predetermined disease stages to the selected patient based on the clinical data contained in the first patient information signal;

c. inputting the predetermined disease stage into the central facility computer;

d. computing a first array of risk factors from a database containing a plurality of previously obtained individualized patient information records, each of the patient information records containing patient information relating to the patient care of an individual patient;

e. assigning a first predictive probability to the selected patient based on the information contained in the first patient information signal, the predetermined disease stage and the first array of risk factors;

f. inputting the first predictive probability into the central facility computer;

g. generating a first patient recommendation signal by the central facility computer, the first patient recommendation signal indicating a recommendation selected from the group of recommendations comprising the selected patient would benefit from immediate patient care and the selected patient would not benefit from immediate patient care;

h. transmitting the first patient recommendation signal to a local computer located at a local treatment facility;

i. receiving the first patient recommendation signal by the local computer; and

j. transmitting a second patient information signal to a regional computer located at a regional treatment center in response to the first patient recommendation signal indicating that the selected patient would benefit from immediate patient care.

12. A method, as recited in claim 11, wherein the second patient information signal is composed of the first patient information signal, the predetermined disease stage and the first patient recommendation signal and wherein the method further comprises the step of:

k. rendering individualized patient care to the eye of the selected patient at the regional treatment center in accordance with the information contained in the second patient information signal.

13. A method, as recited in claim 12, further comprising the steps of:

l. transmitting, by the regional computer, a third patient information signal to the central facility computer, the third patient information signal being composed of multimedia data selected from the group comprising clinical data and treatment parameter data relating to the post-treatment health of the selected patient, the treatment parameter data being selected from the group of data comprising date, diagnosis, eye treated, number of laser applications, laser spot size, laser power duration, laser wavelength, method of anesthesia, complications, area(s) of treatment, and combinations thereof;

m. receiving the third patient information signal by the central facility computer; and

n. updating the database with at least some of the treatment parameter data contained within the third patient information signal.

14. A method, as recited in claim 13, further comprising the steps of:

o. computing a second array of risk factors from the updated database by the central facility computer;

p. assigning a second predictive probability to the selected patient based on the third patient information signal and the second array of risk factors;

q. inputting the second predictive probability into the central facility computer; and

r. generating a second patient recommendation signal by the central facility computer, the second patient recommendation signal indicating a recommendation selected from a group of recommendations comprising the selected patient would benefit from immediate patient care and the selected patient would not benefit from immediate patient care.

15. A method, as recited in claim 11, further including the step of:

s. photographing the eye of the selected patient with a stereoscopic digital camera to provide a digitized image of the eye of the selected patient.

16. A method for improving the delivery of health care delivered to a selected patient, comprising the steps of:

a. photographing, at a local facility, the eye of a selected patient with a stereoscopic digital camera to provide clinical data composed of a first digitized image of the eye of the selected patient;

b. inputting, automatically, the first digitized image of the eye of the selected patient into a local computer which is located at the local facility;

c. inputting cost data, administrative data and additional clinical data relating to the health of the selected patient and the treatment of diabetic retinopathy into the local computer, the clinical data being selected from the group of data comprising visual acuity, diastolic blood pressure, amount of insulin, type of diet, hemoglobin A1C levels, age, length of time in which the selected patient has had diabetes, and combinations thereof, the cost data being selected from the group of data comprising personnel cost, equipment cost, depreciation cost, general and administrative costs, supplies cost, and combinations thereof, the administrative data being selected from the group of data comprising demographics, payer, scheduling, health system and which specialty physicians are managing the patient'"'"'s diabetes, complications of diabetes, and combinations thereof;

d. combining, by the local computer, the first digitized image of the eye of the selected patient with the clinical data, cost data and administrative data to form a first patient information signal relating to the treatment of diabetic retinopathy of the selected patient;

e. transmitting, by the local computer, the first patient information signal to a central computer which is located at a central information center, the central information center being located remotely from the local computer;

f. receiving and storing, by the central computer, the first patient information signal;

g. transmitting, by the central computer, the first patient information signal to a data analysis system;

h. receiving, by the data analysis system, the first patient information signal;

i. assigning, by the data analysis system, a predetermined disease stage relating to diabetic retinopathy to the selected patient based on the first digitized image of the eye;

j. combining the disease stage with the first patient information signal to form a second patient information signal;

k. transmitting the second patient information signal to a disease management logic module;

l. receiving by the disease management logic module the second patient information signal;

m. computing a first array of risk factors by the disease management logic module, the first array of risk factors being selected from the group of risk factors comprising age, length of diabetes, diastolic blood pressure, HbA1C levels and combinations thereof from a database containing a plurality of previously obtained individualized patient information records, each of the patient information records containing patient information relating to the patient care of diabetic retinopathy of an individual patient;

n. assigning a first predictive probability to the selected patient based on the second patient information signal and the first array of risk factors;

o. inputting the first predictive probability into the disease management logic module;

p. generating a first patient recommendation signal based on the first predictive probability by the disease management logic module, the first patient recommendation signal including the disease stage assigned by the data analysis system, the first predictive probability and a predictive model of an individualized preferred treatment of diabetic retinopathy, the preferred treatment indicating a recommendation selected from a group of recommendations comprising the selected patient would benefit from immediate patient care and the selected patient would not benefit from immediate patient care;

q. transmitting the first patient recommendation signal from the disease management logic module to the central computer;

r. receiving the first patient recommendation signal by the central computer;

s. transmitting the first patient recommendation signal to the local computer;

t. receiving the first patient recommendation signal by the local computer;

u. outputting via the local computer the first patient recommendation signal to an output device such that the first patient recommendation signal is perceivable by a patient care provider;

v. transmitting, automatically, a third patient information signal indicative of both the second patient information signal and the first patient recommendation signal by the central computer to a regional computer located at a regional treatment center in response to the first patient recommendation signal indicating that the selected patient would benefit from immediate patient care, the regional treatment center being located remotely from the local facility;

w. receiving the third patient information signal by the regional computer;

x. outputting via the regional computer the third patient information signal to an output device such that the information relating to the selected patient which is contained within the third patient information signal is perceivable by a patient care provider located at the regional treatment center;

y. rendering individualized patient care to the selected patient in accordance with the third patient information signal;

z. photographing, at the regional treatment center, the eye of the selected patient with a stereoscopic digital camera after care has been rendered to the selected patient to provide a second digitized image of the eye of the selected patient;

aa. inputting, automatically, the second digitized image of the eye of the selected patient into the regional computer;

ab. inputting treatment parameters relating to the post-treatment health of the selected patient into the local computer, the treatment parameters being selected from a group comprising date, diagnosis, eye treated, number of laser applications, laser spot size, laser power duration, laser wavelength, method of anesthesia, complications, area(s) of treatment, and combinations thereof;

ac. combining, by the local computer, the second digitized image of the eye of the selected patient with the treatment parameter data to form a fourth patient information signal;

ad. transmitting the fourth patient information signal to the central computer from the regional computer;

ae. receiving the fourth patient information signal by the central computer;

af. transmitting the fourth patient information signal to the disease management logic module;

ag. receiving the fourth patient information signal by the disease management logic module;

ah. updating the database of the disease management logic module with the clinical data contained within the fourth patient information signal;

ai. computing a second array of risk factors from the updated database;

aj. assigning a second predictive probability to the selected patient based on the fourth patient information signal and the second array of risk factors;

ak. inputting the second predictive probability into the disease management logic module;

al. generating a second patient recommendation signal indicating a recommendation selected from a group of recommendations consisting of the selected patient would benefit from follow up patient care and the selected patient would not benefit from follow up patient care;

am. transmitting the second patient recommendation signal from the disease management logic module to the central computer;

an. receiving the second patient recommendation signal by the central computer; and

ao. transmitting the second patient recommendation signal to the local computer.