Internet-based, customizable clinical information system

• US 7,286,997 B2
• Filed: 05/07/2003
• Issued: 10/23/2007
• Est. Priority Date: 05/07/2002
• Status: Expired due to Fees

• Current Assignee: Cembex Care Solutions LLC
• Original Assignee: Cembex Care Solutions LLC
• Inventors: Spector, Mark B., Fortson, Stanley R. Jr., Levy, Richard L., Neuss, Michael N.
• Primary Examiner(s): GILLIGAN, CHRISTOPHER L
• Application Number:
  US10/431,630
• Publication Number:
  US 20040024616A1
• Time in Patent Office: 1,630 Days
• Field of Search: 705/2, 705/3, 600/300, 709/238
• US Class Current: 705/2
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 20/10 relating to drugs or medications, e.g. for ensuring correct administration to patients
• 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 50/20 for computer-aided diagnosis, e.g. based on medical expert systems
• CPC Class Codes: G16H 70/20 relating to practices or guidelines

Abstract

An Internet-based, or Web-based, customizable clinical (patients'"'"' records and care) information system (“CIS”) is provided. More specifically, the clinical information system is Web/Internet based, whether it utilizes a browser-type user interface or a distributed application-type user interface; the clinical information system may include automatic disease staging and associated treatment planning and/or scheduling; the clinical information system may track certain events/submissions and sort such events/submissions into a physician'"'"'s in-box for on-line approval by the physician, where such approval causes the event/submission to become an addendum to the patient'"'"'s record; the clinical information system may be customizable by an administrator; the clinical information system may establish, and make available for on-line review and approval, patient care or standing orders over a weekend; the clinical information system may utilize patients'"'"' photographs to ensure accurate identification and proper treatment; and the clinical information system may create and store an audit trail record for all significant events.

Claims

1. A method for operating a computerized clinical information system for a healthcare facility comprising the steps of:

providing a clinical information system including a plurality of user computers operatively coupled to a global computer network, and at least one computer server operatively coupled to the global computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computer over the global computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data;

providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records;

linking a patient chart record with a primary physician;

logging into the computerized clinical information system using the software tool on a first one of the user computers by a user other than the primary physician;

entering an event for submission to the patient chart record by the user using the software tool on the first one of the user computers;

logging into the computerized clinical information system using the software tool on a second one of the user computers by the primary physician linked with the patient chart record;

in automatic response by the clinical information system to the step of entering the event for submission to the patient chart record, automatically routing the event by the clinical information system to the second one of the user computers in the form of an electronic message for review and approval by the primary physician;

reviewing and approving the event by the primary physician using the software tool on the second one of the user computers; and

adding the approved event to the patient chart record;

wherein the software tool on the second one of the user computers provides the primary physician with a graphical user interface that includes a plurality of graphical in-boxes, each of which is designated for a respective category of clinical events associated with the healthcare facility, and the routing step automatically detects a clinical event type for the event and routes the event to a first graphical in-box in the plurality of graphical in-boxes having the designated category associated with the detected clinical event type.

2. The method of claim 1, wherein the event is taken from a group consisting of:

a transcribed document;

a prescription;

an order;

a test result; and

a diagnosis.

3. The method of claim 2, wherein the method includes the step of displaying the event by the graphical user interface on the second one of the user computers in the first graphical in-box for the reviewing and approving step.

4. The method of claim 3, wherein the displaying step includes the step of displaying a plurality of events in the first graphical in-box.

5. The method of claim 3, wherein the graphical user interface on the second one of the user computers includes icons providing access to policies and procedures of the healthcare facility.

6. The method of claim 5, further comprising the steps of:

accessing the policies and procedures of the healthcare facility using the graphical user interface on the second one of the user computers; and

automatically recording information pertaining to the accessing step in an audit database in the clinical information memory source by the clinical information system in automatic response to the accessing step, such recorded information including one or more of the following;

an identity of a user accessing the policies and procedures;

a date of access;

a tune of access;

an identity of the policy or procedure accessed;

whereby such recorded information pertaining to the accessing step can be used to show that such policies and procedures have been reviewed by the primary physician during an accreditation process.

7. The method of claim 1, wherein the plurality of graphical in-boxes include a transcribed document in-box, a prescription in-box, and an order in-box, and the routing step automatically routes events to the transcribed document in-box in response to a detection that the event is a transcribed document automatically routes events to the prescription in-box in response to a detection that the event is a prescription and automatically routes events to the order in-box in response to a detection that the event is an order.

8. The method of claim 7, wherein the plurality of graphical in-boxes further include a test result in-box, and the routing step automatically routes events to the test result in-box in response to a detection that the event is a test result.

9. The method of claim 8, wherein the plurality of graphical in-boxes further include a message in-box, and the routing step automatically routes events to the message in-box in response to a detection that the event is a message.

10. The method of claim 1, wherein the event is a diagnosis and the method further comprises the step of automatically establishing a treatment program by the clinical information system, in automatic response to she approval of the diagnosis by the primary physician in the reviewing and approving step, for the treatment of the diagnosed disease.

11. The method of claim 10, wherein the step of automatically establishing a treatment program further includes the step of automatically establishing a treatment schedule by the clinical information system, in automatic response to the establishment of the treatment program, for implementing the treatment program.

12. The method of claim 11, wherein the clinical information memory source includes a plurality of use schedules for a corresponding plurality of the healthcare facility'"'"'s resources, and the step of, in automatic response to the establishment of the treatment schedule, automatically establishing the treatment schedule includes the steps of automatically updating the use schedules by the clinical information system to reserve the healthcare facility'"'"'s resources in accordance with the treatment program.

13. The method of claim 12, wherein the method further includes the step of adding the treatment schedule to the patient chart record.

14. The method of claim 11, wherein the method further includes the step of adding the treatment schedule to the patient chart record.

15. The method of claim 1, wherein information pertaining to the routing, reviewing and approving steps are recorded automatically by the clinical information system in a central audit database, such information including one or more of the following:

an identity of the user using the software tool on the first one of the user computers;

a date of entry of the event;

a time of entry of the event;

a copy of the event as entered by the user using the software tool on the first one of the user computers;

an identity of the primary physician;

a date of approval of the event by the primary physician;

a time of approval of the event by the primary physician;

a copy of the event as approved by the primary physician.

16. The method of claim 1, wherein the reviewing and approving steps include the step of modifying the event by the primary physician.

17. The method of claim 16, wherein versions of the event existing before and after the modifying step are stored in a central audit database.

18. The method of claim 1, wherein the electronic message includes a document for consideration by the primary physician, and the method further comprises the step of forwarding, with the assistance of the computerized clinical information system the document to a third party destination.

19. The method of claim 1, wherein the electronic message includes a document for consideration by the primary physician, and the method further comprises the step of faxing, with the assistance of the computerized clinical information system, the document to a third party.

20. A method for operating a computerized clinical information system for a healthcare facility comprising the steps of:

providing a clinical information system including a plurality of user computers operatively coupled to a global computer network, end at least one computer server operatively coupled to the global computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computer over the global computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data, the clinical information memory source includes a plurality of use schedules for a corresponding plurality of the healthcare facility'"'"'s resources;

providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records and a plurality of use schedules for a corresponding plurality of the healthcare facility'"'"'s resources;

linking a patient chart record with a primary physician;

logging into the computerized clinical information system using the software tool on a first one of the user computers by a user other than the primary physician;

entering a diagnosis for submission to the patient chart record by the user using the software tool on the first one of the user computers;

logging into the computerized clinical information system using the software tool on a second one of the user computers by the primary physician linked with the patient chart record;

automatically renting the diagnosis by the clinical information system to the second one of the user computers in the form of an electronic message for review and approval by the primary physician;

reviewing and approving the diagnosis by the primary physician using the software tool on the second one of the user computers;

adding the approved diagnosis to the patient chart record;

automatically establishing a treatment program by the clinical information system for the treatment of the diagnosed disease;

automatically establishing a treatment schedule by the clinical information system for implementing the treatment program; and

automatically checking the use schedules for openings by the clinical information system and automatically filling openings in the use schedules by the clinical information system according to the treatment program;

wherein the software tool an the second one of the user computers provides the second one of the user computers with a graphical user interface that includes a plurality of graphical in boxes, each of which is designated for a respective category of clinical events associated with the healthcare facility, and the routing step automatically detects a clinical event type for the diagnosis and routes the diagnosis to a first graphical in-box in the plurality of graphical in-boxes having the designated category associated with the detected clinical event time.

21. A method for operating a computerized clinical information system for a healthcare facility comprising the steps of:

providing a clinical information system including a plurality of user computers operatively coupled to a global computer network, and at least one computer server operatively coupled to the global computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computer over the global computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data, the clinical information memory source includes a plurality of use schedules for a corresponding plurality of the healthcare facility'"'"'s resources;

providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records and a plurality of use schedules for a corresponding plurality of the healthcare facility'"'"'s resources;

automatically linking a patient chart record with a primary physician;

logging into the computerized clinical information system using the software tool on a first one of the user computers by a user other than the primary physician;

entering a diagnosis for submission to the patient chart record by the user using the software tool on the first one of the user computers;

logging into the computerized clinical information system using the software tool on a second one of the user computers by the primary physician linked with the patient chart record;

automatically routing the diagnosis by the clinical information system to the second one of the user computers in the form of an electronic message for review and approval by the primary physician;

reviewing and approving the diagnosis by the primary physician using the software tool on the second one of the user computers;

adding the approved diagnosis to the patient chart record;

automatically establishing a treatment program by the clinical information system for the treatment of the diagnosed disease;

automatically establishing a treatment schedule by the clinical information system for implementing the treatment program; and

automatically establishing a medication schedule by the clinical information system according to the treatment program;

wherein the software tool on the second one of the user computers provides the second one of the user computers with graphical user interface that includes a plurality of graphical in-boxes, each of which is designated for a respective category of clinical events associated with the healthcare facility, and the routing step automatically detects a clinical event type for the diagnosis and routes the diagnosis to a first graphical in-box in the plurality of graphical in-boxes having the designated category associated with the detected clinical event type.

22. The method of claim 21, wherein the clinical information memory source includes a medication inventory for the healthcare facility and the step of automatically establishing a medication schedule includes the step of automatically updating the medication inventory by the clinical information system in automatic response to the establishment of the medication schedule.

23. The method of claim 22, wherein the method further includes the step of adding the treatment schedule to the patient chart record.

24. A method for operating a computerized clinical information system for a healthcare facility comprising the steps of:

providing a clinical information system including a plurality of user computers operatively coupled to a global computer network, and at least one computer server operatively coupled to the global computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computer over the global computer network in a secure manner, each of the user computers operating a soft-ware tool allowing a user to view and modify at least certain of the clinical data;

providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records and a plurality of use schedules for a corresponding plurality of the healthcare facility'"'"'s resources;

linking a patient chart record with a primary physician;

logging into the computerized clinical information system using the software tool on a first one of the user computers by a user other than the primary physician;

entering a diagnosis for submission to the patient chart record by the user using the software tool on the first one of the user computers;

logging into the computerized clinical information system using the software tool on a second one of the user computers by the primary physician linked with the patient chart record;

automatically routing the diagnosis by the clinical information system to the second one of the user computers in the form of an electronic message for review and approval by the primary physician;

reviewing and approving the diagnosis by the primary physician using the software tool on the second one of the user computers;

adding the approved diagnosis to the record; and

automatically establishing a treatment program by the clinical information system for the treatment of the diagnosed disease, the step of automatically establishing a treatment program for the treatment of the diagnosed disease includes the step of automatically applying a set of electronically stored expert rules against the diagnosed disease byte clinical information system;

wherein the software tool on the second one of the user computers provides the second one of the user computers with a graphical user interface that includes a plurality of graphical in-boxes, each of which is designated for a respective category of clinical events associated with the healthcare facility, and the routing step automatically detects a clinical event type for the diagnosis and routes the diagnosis to a first graphical in-box in the plurality of graphical in-boxes having the designated category associated with the detected clinical event type.

25. The method of claim 24, wherein the diagnosed disease includes a stage of the diagnosed disease.

26. A method for operating a computerized clinical information system for a healthcare facility comprising the steps of:

providing a clinical information system including a plurality of user computers operatively coupled to a global computer network, and at least one computer sewer operatively coupled to the global computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the useR computer over the global computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at east certain of the clinical data;

providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records and a plurality of use schedules for a corresponding plurality of the healthcare facility'"'"'s resources;

linking a patient chart record with a primary physician;

logging into the computerized clinical information system using the software tool on a first one of the user computers by a user other than primary physician;

entering a diagnosis for submission to the patient chart record by the user using the software tool on the first one of the user computers;

logging into the computerized clinical information system using the software tool on a second one of the user computers by the primary physician linked with the patient chart record;

automatically routing the diagnosis by the clinical information system to the second one of the user computers in the form of an electronic message for review and approval by the primary physician;

reviewing and approving the diagnosis by the primary physician using the software tool on the second one of the user computers; and

adding the approved diagnosis to the patient chart record; and

automatically establishing a treatment program by the clinical information system for the treatment of the diagnosed disease;

wherein the diagnosed disease includes a stage of the diagnosed disease and the method further comprises the steps of;

providing a disease staging software tool on one of the user computers, wherein the disease staging software tool includes a plurality of condition fields pertaining to diagnosed or recorded conditions of a patient and includes a set of expert rules for determining a stage of the disease based upon the diagnosed or recorded conditions of the patient;

completing the condition fields on the disease staging software tool by a user on the one of the user computers; and

automatically processing the completed condition fields against the set of expert rules by the clinical information system to determine the stage of the disease in response to the step of completing the condition fields on the disease staging software tool by the user on the one of the user computers;

wherein the step of automatically establishing a treatment program by the clinical information system for the treatment of the diagnosed disease, automatically establishes a treatment program according to the determined stage of the disease; and

wherein the software tool on the second one of the user computers provides the second one of the user computers with a graphical user interface that includes a plurality of graphical in-boxes, each of which is designated for a respective category of clinical events associated with the healthcare facility, and the routing step automatically detects a clinical event type for the diagnosis and routes the diagnosis to a first graphical in-box in the plurality of graphical in-boxes having the designated category associated with the detected clinical event type.

27. A method for operating a computerized clinical information system for a healthcare facility comprising the steps of:

providing a clinical information system including a plurality of user computers operatively coupled to a global computer network, and at least one computer server operatively coupled to the global computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computers over the global computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data;

providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records;

linking a patient chart record with a primary physician;

logging into the computerized clinical information system using the software tool on a first one of the user computers by a user taken from a group consisting of a pharmacist, a pharmacy technician, a nurse, a non-primary physician and a pharmacy assistant;

entering at least one request taken from a group consisting of a new prescription and an order for approval by the primary physician by the user using the software tool on the fast one of the user computers;

in automatic response to the entering of the new prescription or order, automatically checking a requested dosage of the new prescription or order against safety guidelines by the clinical information system;

logging into the computerized clinical information system using the software tool on a second one of the user computers by the primary physician;

automatically routing the request to the second one of the user computers in the form of an electronic message for review and approval by the primary physician;

reviewing and approving the request by the primary physician using the software tool on the second one of the user computers; and

adding the approved request to the patient chart record;

wherein the soft-ware tool on the second one of the user computers provides the primary physician with a graphical user interface that includes a plurality of graphical in-boxes, each of which is designated for a respective category of clinical events associated with the healthcare facility, and the routing step automatically detects a clinical event type for the request and routes the request to a first graphical in-box in the plurality of graphical in-boxes having the designated category associated with the detected clinical event type.

28. The method of claim 27, wherein the step of automatically checking a requested dosage of the new prescription or order against safety guidelines includes the step of automatically providing a minimum and maximum dosage for at least one of a patient'"'"'s body weight and a patient'"'"'s of condition by the clinical information system in automatic response to the entering of the new prescription or order.