Method of determining mental health status in a computerized medical diagnostic system

• US 6,071,236 A
• Filed: 06/02/1998
• Issued: 06/06/2000
• Est. Priority Date: 12/29/1993
• Status: Expired due to Term

• Current Assignee: Clinical Decision Support, LLC (Tivity Health, Inc.)
• Original Assignee: First Opinion Corporation (Tivity Health, Inc.)
• Inventors: Iliff, Edwin C.
• Primary Examiner(s): O'Connor, Cary
• Assistant Examiner(s): ASTORINO, MICHAEL C
• Application Number:
  US09/088,940
• Time in Patent Office: 735 Days
• Field of Search: 600/300-301, 600/481, 600/500, 600/528, 600/538, 600/529, 128/920, 128/924, 128/925
• US Class Current: 600/300
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• CPC Class Codes: G16H 10/20 for electronic clinical trials or questionnaires
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 15/00 ICT specially adapted for medical reports, e.g. generation or transmission thereof
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• CPC Class Codes: G16H 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 40/63 for local operation
• 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: H04M 2201/40 using speech recognition
• CPC Class Codes: H04M 2203/355 Interactive dialogue design tools, features or methods
• CPC Class Codes: H04M 3/493 Interactive information services, e.g. directory enquiries ; Arrangements therefor, e.g. interactive voice response [IVR] systems or voice portals
• CPC Class Codes: Y10S 128/92 Computer assisted medical diagnostics
• CPC Class Codes: Y10S 128/925 Neural network
• CPC Class Codes: Y10S 706/924 Medical

Abstract

A system and method for providing computerized, knowledge-based medical diagnostic and treatment advice. The medical advice is provided to the general public over a telephone network. Two new authoring languages, interactive voice response and speech recognition are used to enable expert and general practitioner knowledge to be encoded for access by the public. "Metal" functions for time-density analysis of a number of factors regarding the number of medical complaints per unit of time are an integral part of the system. A semantic discrepancy evaluator routine along with a mental status examination are used to detect the consciousness level of a user of the system. A re-enter feature monitors the user'"'"'s changing condition over time. A symptom severity analysis helps to respond to the changing conditions. System sensitivity factors may be changed at a global level or other levels to adjust the system advice as necessary.

Claims

1. A method of mental status examination, using an automated medical advice or diagnostic system including a computer and input and output devices, the method comprising:

a) prestoring, a plurality of questions and corresponding expected answers in a computer memory;

b) automatically asking a patient a one of the plurality of prestored questions;

c) the computer executes instructions to process the answer so as to automatically receive the answer;

d) automatically comparing the answer to a corresponding prestored expected answer;

e) automatically ascribing a score to a result of the comparison;

f) automatically comparing the score to a predetermined threshold value; and

g) continuing an automated process of diagnosing a medical problem if the threshold value is achieved.

2. The method defined in claim 1, wherein the mental status examination takes place during a telephone consultation.

3. The method defined in claim 2, additionally comprising transferring the telephone consultation with the patient to a medical staff person if the threshold value is not achieved and an assistant for the patient is not available.

4. The method defined in claim 1, additionally comprising providing situation specific advice to the patient if the threshold value is not achieved.

18. The method defined in claim 1, additionally comprising collecting medical information from the patient.

19. The method defined in claim 18, additionally comprising storing the collected medical information for the patient in a pending file for off-line verification by a staff person if the threshold value is not achieved.

20. The method defined in claim 19, wherein the collected medical information for the patient is added to a patient'"'"'s past medical history file after off-line verification.

21. The method defined in claim 1, wherein continuing the process of diagnosing the medical problem includes collecting medical information from the patient.

22. The method defined in claim 21, wherein new medical information collected for the patient is added to a patient'"'"'s past medical history file at the completion of the process of diagnosing.

23. The method defined in claim 1, wherein continuing the process of diagnosing the medical problem occurs when an assistant for the patient is available and logs into an automated medical advice or diagnostic system.

5. A method of mental status examination, using an automated medical advice or diagnostic system including a computer and input and output devices the method comprising:

a) asking a patient a prestored question from a plurality of questions prestored in the computer;

b) receiving an answer to the question from the patient;

c) comparing the answer to at least one of a plurality of prestored expected answers corresponding to the prestored questions in the computer;

d) ascribing a score to the result of the comparison;

e) comparing the score to a predetermined threshold value, wherein the threshold value is indicative of mental status; and

f) repeating a) through d) a plurality of times, wherein the score accumulates after each repeating sequence.

6. The method defined in claim 5, wherein the asking and receiving are conducted remotely from the patient by a telephone connection to the computer.

7. The method defined in claim 6, wherein taking action appropriate to the mental status of the patient comprises transferring the telephone connection with the patient to a medical staff person.

8. The method defined in claim 5, wherein taking action appropriate to the mental status of the patient comprises providing situation specific advice to the patient.

9. The method defined in claim 5, additionally comprising providing patient specific advice to the patient based on the mental status of the patient as determined by the result of the score comparison.

10. The method defined in claim 5, additionally comprising continuing a process of diagnosing a medical problem of the patient based on the mental status of the patient as determined by the result of the score comparison.

11. The method defined in claim 5, additionally comprising collecting medical information from the patient.

12. The method defined in claim 11, wherein taking action appropriate to the mental status of the patient comprises storing the collected medical information for the patient in a pending file for off-line verification by a staff person.

13. The method defined in claim 5, wherein the question and the answer relate to a well-known fact.

14. The method defined in claim 5, additionally comprising:

g) providing the patient with a prestored information item;

h) waiting for a predetermined time interval;

i) asking the patient for the information item;

j) receiving an information response from the patient;

k) comparing the information response with the prestored information item to determine if the items match, wherein g) through k) occur prior to a) through f).

15. The method defined in claim 5, additionally comprising:

g) asking the patient for an information item;

h) receiving a first information response from the patient;

i) asking the patient for the information item using different words at a later time;

j) receiving a second information response from the patient;

k) comparing the first information response with the second information response to ensure consistent mental health, wherein g) through k) occur prior to a) through f).

16. The method defined in claim 5, additionally comprising:

asking one or more predetermined questions of the patient;

receiving answers to the predetermined questions;

ascertaining a chief complaint based on the received answers, wherein the system selectively continues with a) through f) based on the ascertained chief complaint.

17. The method defined in claim 5, additionally comprising:

accessing a medical history of the patient; and

identifying a chronic condition of the patient, wherein the system selectively continues with a) through f) based on the chronic condition.

24. A method of mental status examination, using an automated medical advice or diagnostic system including a computer and input and output devices the method comprising:

automatically providing a patient an item of information prestored in a computer memory;

automatically waiting a predetermined time interval;

automatically asking the patient about the item of information;

the computer executes instructions to process the answer so as to automatically receive the answer;

automatically comparing the answer to a prestored expected answer; and

automatically evaluating mental status of a patient based on the comparison.

25. The method defined in claim 24, additionally comprising resuming system operation if the results from the mental status evaluation do match.

26. The method defined in claim 24, additionally comprising terminating system with the patient taking action based on a mental status of the patient if the results from the mental status evaluation do not match.

27. A method of mental status examination, using an automated medical advice or diagnostic system including a computer and input and output devices, the method comprising:

automatically asking a patient for an item of information, wherein a first request for the item of information is prestored in a computer memory;

the computer executes instructions to process the answer so as to automatically receive a first answer;

automatically waiting a predetermined time interval;

automatically asking the patient about the item of information in a different manner, wherein a second request for the item of information is prestored in the computer memory;

the computer executes instructions to process the answer so as to automatically receive a second answer;

automatically comparing the first answer to the second answer; and

automatically evaluating mental status of a patient based on the comparison.

28. The method defined in claim 27, additionally comprising resuming system operation if the results from the mental status evaluation are consistent.

29. The method defined in claim 27, additionally comprising terminating system operation with the patient based on a mental status of the patient if the results from the mental status evaluation are not consistent.

30. The method defined in claim 27, wherein the first request and the second request are similar.

31. The method defined in claim 27, wherein the first request and the second request are different.