System and method for automatic critical event notification

• US 5,942,986 A
• Filed: 08/09/1995
• Issued: 08/24/1999
• Est. Priority Date: 08/09/1995
• Status: Expired due to Term

• Current Assignee: Cedars-Sinai Medical Center (Cedars Sinai Health System)
• Original Assignee: Cedars-Sinai Medical Center (Cedars Sinai Health System)
• Inventors: Lobue, Mark, Shabot, Myron M.
• Primary Examiner(s): Holloway, III, Edwin C.
• Assistant Examiner(s): Wilson, Jr., William H.
• Application Number:
  US08/512,887
• Time in Patent Office: 1,476 Days
• Field of Search: 340/825.44, 340/825.47, 340/311.1, 340/825.69, 340/870.01, 340/539, 340/825.45, 455/31.1, 455/426, 379/38, 364/224.5, 364/224.6, 364/224.7, 364/276, 364/922, 364/922.2, 364/922.3, 364/922.4, 128/903, 128/904, 283/900, 370/310, 370/313, 370/314, 600/523, 600/513, 600/300, 600/438, 600/515, 706/924
• US Class Current: 340/7.29
• CPC Class Codes: G16H 40/67 for remote operation
• CPC Class Codes: G16H 50/70 for mining of medical data, e.g. analysing previous cases of other patients
• CPC Class Codes: Y10S 706/924 Medical

Abstract

A critical event notification system continuously monitors patient statistics and lab data to detect critical events, and automatically pages a responsible physician or physicians, each having an alphanumeric pager. In particular, a computer is used to continually access real-time data and multiple hospital databases which are periodically updated. These databases include patient chart databases, databases corresponding to patient history and databases maintained by various labs. The computer, preferably a clinical information system, is automatically provided with certain data, or periodically extracts it from other, relational databases. The computer automatically reviews this data, makes the critical event determination, and formulates an alphanumeric message that is informative as to the patient'"'"'s condition and the reasons why a critical event was detected. After automatically retrieving from a database a personal identification number ("PIN") for a remote pager of each physician responsible for the patient, the computer automatically establishes modem contact with a paging network, and causes the network to page each responsible physician and transmit to them the alphanumeric message. The alphanumeric message preferably indicates patient name, diagnosis, the event prompting the page, and the name and return telephone number of medical personnel at the hospital who are attending the particular patient.

Claims

1. An automatic critical event notification system, comprising:

a remote pager having a display screen and an identification number;

a paging system that selectively transmits a message to the remote pager using the identification number, to cause the remote pager to display the message;

data representing variable values of a parameter; and

a computer system electronically coupled to the paging system that is configured to unsolicitedly by not receiving instruction from the remote pager,

automatically receive the data and determine whether the values of the parameter have a predetermined relation with respect to a predefined quantity,

automatically formulate a particular message that indicates the existence of the relation, in response to the determination that values of the parameter satisfy the relations and

automatically send the particular message to the paging system in electronic format, together with the identification number for the remote device;

wherein the paging system automatically pages the particular remote pager identified by the identification number and sends to it the particular message indicating the existence of the relation.

2. A system according to claim 1, wherein:

the data represents values of a patient statistic;

the predefined quantity is a value of the statistic that represents a change in the condition of the patient for which it is appropriate to notify a physician; and

the predetermined relation represents values of the patient statistic which are one of greater than, less than and equal to the predefined quantity.

3. A system according to claims 1 or 2, wherein:

the system further comprises data for each one of a plurality of different parameters;

the predetermined relation is satisfied only when data for each one of the plurality of different parameters meets a predefined condition; and

the computer system is configured to, with respect to each one of the plurality of different parameters, compare data representing the corresponding one of the parameters with a corresponding predefined quantity, to determine whether the predetermined relation is satisfied.

4. A system according to claims 1 or 2, wherein:

the system further comprises a plurality of data inputs, each corresponding to a different medical patient, the data inputs each representing measurement of the same patient statistic;

the computer system includes a table that indicates a responsible user for each patient and a unique identification number for a remote pager corresponding to each user;

the computer system is configured to

determine whether the relation exists for each of the plurality of data inputs;

identify, responsive to a determination that the relation exists for a particular patient, a particular identification number that corresponds to the pager of a user corresponding to the particular patient; and

automatically, without receipt of instruction from a pager of a user, formulate and send the alphanumeric message to the user corresponding to the particular patient, via the paging network.

5. An automatic critical event notification system, comprising:

detection means for unsolicitedly and electronically comparing data having variable values with at least one predefined quantity, to determine the existence of a predetermined relation;

message means for formulating an alphanumeric message that indicates the predetermined state, in response to the existence of the predetermined relation; and

remote transmission means for transmitting the alphanumeric message to the remote message receiving device in response to the existence of the predetermined relation;

wherein the predetermined relation is automatically detected from the data and the alphanumeric message is automatically, without receipt of instruction from a remote message receiving device, and electronically formulated and transmitted to the remote message receiving device.

6. A system according to claim 5, wherein:

the detection means includes multiple parameter means for receiving a plurality of data inputs, each representing a different parameter, and for determining and distinguishing each one of a plurality of predetermined relations, each relation corresponding to a condition relative to one or more parameters represented by the data inputs;

the message means includes multiple message means for formulating a different alphanumeric message for each predetermined relation in response to detection of such relation by the detection means; and

the remote transmission means receives each alphanumeric message formulated by the multiple message means and includes sending means for sending each alphanumeric message to the remote receiving device;

wherein each predetermined relation is automatically detected from the plurality of data inputs and a corresponding alphanumeric messages is automatically and electronically formulated and transmitted to the remote message receiving device.

7. A system according to claims 5 or 6, wherein:

the system further comprises addressing means for selecting one of a plurality of remote receiving devices that is to receive the alphanumeric message generated by the message means; and

the remote transmission means is responsively coupled to the addressing means to automatically send the alphanumeric message to a selected one of the remote receiving devices.

8. An automatic critical event notification system used to notify at least one of a plurality of users as to a critical event representative of the condition of at least one of a plurality of patients, comprising:

a remote pager carried by each user, each remote pager having an alphanumeric display and a unique personal identification number;

a pager network adapted to receive a message and a pager number sent via a communication device, the pager network responsive to selectively send the message to a particular remote pager identified by the pager number;

a database that receives electronic data representing each patient'"'"'s condition;

a computer system having a communication device, wherein the computer system, is configured to unsolicitedly, by not receiving instruction from the remote pager carried by each user, and automatically

monitor the database with respect to each one of the plurality of patients, to detect whether the data for represents a critical event and responsively indicate a detected critical event,

formulate an alphanumeric message indicating the existence of the detected critical event,

determine a user responsible for the care of the patient corresponding to the detected critical event and identify the particular personal identification number which corresponds to that user, and

control the communication device of the computer system to establish an electronic link with the pager network and

send the particular personal identification number to the pager network as the pager number, and

send the alphanumeric message to the pager network;

wherein

the pager network is automatically responsive to the computer system to send the alphanumeric message to the remote pager of the user responsible for the care of the particular patient, and

the alphanumeric display of the pager displays the alphanumeric message to thereby indicate the existence of the predetermined relation, thereby notifying the user of the predetermined relation without requiring a real-time human decision to page the user.

9. A system according to claim 8, wherein one of a plurality of nurses is also responsible for the care of each patient, and each nurse may be reached using a telephone number, and wherein:

said system further comprises a table of names of nurses and corresponding telephone number, indexed by patient;

the computer system is further configured to

determine from the table a particular nurse responsible for the care of the particular patient and identify the telephone number by which the particular nurse may be reached, and

formulate the alphanumeric message to include the name of the particular nurse and the telephone number by which the particular nurse may be reached; and

the alphanumeric display of the pager is caused to display the name of the particular nurse and the telephone number by which the particular nurse may be reached.

10. A system according to claims 8 or 9, wherein the alphanumeric message is formulated to includes the name of the particular patient.

11. A system according to claims 8 or 9, wherein the alphanumeric message is formulated to includes a prior diagnosis of a medical condition of the particular patient.

12. A system according to claims 8 or 9, wherein:

the computer system uses at least one table that

stores the personal identification number of each user, the name of each nurse and corresponding telephone number by which the nurse nay be reached, and

utilizes an index that permits a determination by the computer system of the identities of the personal identification number of the user and of the name of the nurse responsible for the care of the particular patient, as well as a telephone number by which the nurse may be reached; and

the computer system is configured to access the table to formulate the alphanumeric message and cause the paging of the user responsible for the care of the particular patient.

13. A system according to claims 1, 5 or 8, wherein:

the predetermined relation also includes the relation of averaged data being one of less than, greater than, and equal to the predefined quantity; and

the computer system includes a memory and software that causes it to

store the data in the memory,

periodically interrogate the memory to average the data samples to thereby produce the averaged data, and

compare the averaged data with the predefined quantity to detect the existence of the predetermined relation.

14. A system according to claims 1, 5 or 8, further comprising a sensor that generates the data as a data stream representing measurement of a physiological parameter made by the sensor.

15. A system according to claim 14, wherein the sensor is one of a blood gas sensor, a urimeter, a respirator, a heartbeat detector and an integrated medical station having at least one input which is periodically sampled by the integrated medical station.

16. A system according to claims 1, 5 or 8, wherein the data is formatted in a HL7 standard.

17. A system according to claims 1, 5 or 8, wherein the computer system includes at least two stand alone computers, and wherein:

the predefined quantity is a predefined value of critical event flag and the predetermined relation includes equality between selected data and the predefined value of the critical event flag;

a first stand alone computer (a) receives a data stream from each of a plurality of sensors, (b) adds to those data streams the critical event flag, to indicate the occurrence of a critical event, and (c) sends those data steams with the critical event flag to a second stand alone computer; and

the second stand alone computer includes a flag detection mechanism, the flag detection mechanism comparing the data streams received from the first stand alone computer with a predetermined quantity to detect an equality relation between the two, the computer system thereby determining that the predetermined relation exists.

18. A system according to claim 17, wherein:

the predetermined relation also includes a second relation of averaged data being one of less than, greater than, and equal to the predefined quantity; and

the second stand alone computer includes a memory and software that causes the second stand alone computer to

store the data streams received from the first stand alone computer in the memory,

periodically interrogate the memory to average samples from one of the data streams, to thereby produce the averaged data, and

compare the averaged data with the predefined quantity to detect the existence of the second relation.

19. A method of automatically notifying an individual of the existence of a critical value of a measurement parameter, using a computer system, a remote pager and a paging network, the computer system having a communications device that permits it to selectively communicate with the paging network, comprising:

using the computer system to automatically and unsolicitedly monitor data representing the measurement parameter by receiving that data with the computer system and automatically comparing the data with a predefined quantity to detect the existence of the critical value, thereby indicating the existence of a critical event;

in response to detection of the existence of the critical event and without receipt of instruction from the remote pager, causing the communications device to automatically establish a communications link between the paging network and the computer system; and

using the computer to transmit a message to the paging network which causes the paging network to automatically notify the remote pager.

20. A method of automatically notifying an individual having a remote pager with alphanumeric display capabilities of the existence of a critical event, said method using a paging network that can receive instructions to page the remote pager and transmit to it an alphanumeric message, a source of data and a computer system that is electrically connected to the source of data, said method comprising:

using the computer system to automatically, unsolicitedly, by not receiving instructions from a remote pager, and electronically receive the data from the data source and automatically check the data to detect the existence of a critical value in the data, to thereby determine that the critical event has occurred;

upon detection of the critical value,

automatically formulating with the computer system an alphanumeric message indicating the existence of the critical event,

causing the computer system to automatically establish a communications link with the paging network,

causing the computer system to transmit the alphanumeric message to the paging network;

wherein the paging network upon receipt of the message automatically transmits the alphanumeric message to the remote pager, and said method automatically detects the critical event and causes the remote pager to display the alphanumeric message indicating the existence of the critical event without requiring a human decision to page the remote pager.

21. A method according to claims 19 or 20, wherein the measurement parameter represents a patient statistic, and wherein the computer system is coupled to an electronic sensor that electronically measures the patient statistic and produces the data, the method further comprising:

periodically sampling the electronic sensor with the computer system to produce a series of sequential data samples representing the patient statistic over time; and

comparing the series of sequential data samples with the predefined quantity to determine the existence of the critical value.

22. A method according to claim 21, wherein comparing the series of sequential data samples includes calculating an average of selected samples within the series, and comparing the average to the predefined quantity.

23. A method according to claims 19 or 20 which monitors two different measurement parameters to detect the existence of the critical event, the method further comprising:

causing the computer system to compare data representing each of the measurement parameters with corresponding predefined quantities; and

detecting the existence of the critical event only when data for each of the measurement parameters bears a predetermined relation to the corresponding predefined quantities.

24. A method according to claims 19 or 20, wherein said method further uses a plurality of remote pagers, each remote pager having a unique personal identification number associated with it, as well as a table that identifies a subset of the plurality of remote pagers (by at least personal identification number) that is to be notified upon the detection of the critical event, said method further comprising:

upon detection of the critical event, causing the computer system to interrogate the table and extract from it each unique personal identification number that corresponds to a remote pager that is to be notified of the critical event; and

responsively causing the computer system to transmit to the paging network each personal identification number corresponding to a remote pager that is to be notified of the critical event;

wherein the paging network automatically pages each remote pager in the subset.

25. A method according to claim 24, wherein each pager includes an alphanumeric display and wherein:

the computer system is further used to generate an alphanumeric message that identifies the critical value of the parameter and its relation to the predefined quantity; and

the paging network automatically sends the alphanumeric message to each remote pager in the subset.