Disease management system and method including analysis of disease specific changes

• US 7,297,108 B2
• Filed: 10/01/2002
• Issued: 11/20/2007
• Est. Priority Date: 03/13/1997
• Status: Expired due to Fees

• Current Assignee: Healthways SC, LLC (Warner Bros. Discovery, Inc.)
• Original Assignee: Clinical Decision Support, LLC (Tivity Health, Inc.)
• Inventors: Iliff, Edwin C.
• Primary Examiner(s): Hindenburg; Max F.
• Assistant Examiner(s): Naqi; Sharick
• Application Number:
  US10/261,919
• Publication Number:
  US 20030036686A1
• Time in Patent Office: 1,876 Days
• Field of Search: 600300-301, 128903-905, 128920-925, 128/710, 128/904, 128897-898, 340/573.1, 705 1- 4, 607/32, 607/60, 702/19, 434/262
• US Class Current: 600/300
• 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 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 70/20 relating to practices or guidelines
• CPC Class Codes: G16H 70/60 relating to pathologies
• CPC Class Codes: G16H 80/00 ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation
• CPC Class Codes: Y10S 128/92 Computer assisted medical diagnostics
• CPC Class Codes: Y10S 128/925 Neural network

Abstract

A system and method for allowing a patient to access an automated process for managing a specified health problem called a disease. The system performs disease management in a fully automated manner, using periodic interactive dialogs with the patient to obtain health state measurements from the patient, to evaluate and assess the progress of the patient'"'"'s disease, to review and adjust therapy to optimal levels, and to give the patient medical advice for administering treatment and handling symptom flare-ups and acute episodes of the disease. The medical records are updated, the progression of the disease is stored and tracked, and the patient'"'"'s preferences for treatment are stored and then used to offer medical advice based on the current state of the disease. A prestored general disease trend curve is compared against a patient specific disease trend curve, and the system makes an automated response such as adjusting therapy.

Claims

1. A computerized critical curve assessment method,

comprising:

providing a critical curve for a particular disease;

providing a plurality of health parameters in an electronic medical record corresponding to a particular patient having been diagnosed with the particular disease; and

comparing at least one of the health parameters to the critical curve to obtain health assessment information.

2. The method of claim 1, wherein a recommendation is made if, based on the comparison, a threshold is reached.

3. The method of claim 2, wherein a disease therapy is adjusted if, based on the comparison, a threshold is reached.

4. The method of claim 1, wherein the health parameters include objective parameters.

5. The method of claim 1, wherein the health parameters include subjective parameters.

6. The method of claim 5, wherein the subjective parameters comprise health data perceived or felt by the particular patient.

7. The method of claim 1, wherein at least one of the health parameters is measured by use of a medical instrument.

8. The method of claim 1, additionally comprising generating a patient specific critical curve, comprising:

determining disease specific health parameters from the patient'"'"'s electronic medical record;

adding current health parameters to the patient'"'"'s electronic medical record; and

plotting a patient specific curve consisting of health parameters measured against time.

9. The method of claim 8, additionally comprising performing statistical analysis on the patient specific critical curve.

10. The method of claim 9, additionally comprising:

comparing values from the patient specific critical curve to the critical curve to determine if a threshold has been met; and

indicating medical treatment if the value threshold has been met.

11. The method of claim 10, additionally comprising comparing the slope of the patient specific critical curve to the slope of the critical curve if the value threshold has not been met, wherein if the critical curve slope exceeds the patient specific critical curve slope, medical treatment is indicated.

12. The method of claim 1, wherein a critical curve is a plurality of critical curves and providing a critical curve for a particular disease comprises providing critical curves for a plurality of health parameters of interest for the particular disease, each critical curve corresponding to a selected one of the health parameters of interest.

13. The method of claim 12, wherein comparing at least one of the health parameters to the critical curve comprises comparing at least one of the health parameters of the electronic medical record to the critical curve of the corresponding health parameter of interest.

14. A system for performing a computerized critical curve assessment, the system comprising:

a computer;

a storage, in data communication with the computer, configured to store an electronic medical record corresponding to each particular patient of a plurality of patients; and

a disease management module executed by the computer and configured to;

access a critical curve for a disease,

generate a plurality of health parameters in the electronic medical record

corresponding to a particular patient having been diagnosed with the disease, and

compare at least one of the health parameters to the critical curve to obtain health assessment information.

15. The system of claim 14, wherein the computer is a portable computing device.

16. The system of claim 14, wherein the computer is a hand-held device having a wireless communication capability.

17. The system of claim 14, wherein the disease management module makes a recommendation if, based on the comparison, a threshold is reached.

18. The system of claim 17, wherein the threshold corresponds to a function of the critical curve.

19. The system of claim 17, wherein the threshold corresponds to a critical portion or point of the critical curve.

20. The system of claim 17, wherein the threshold corresponds to a critical slope of the critical curve.

21. The system of claim 14, wherein the disease management module adjusts a disease therapy if, based on the comparison, a threshold is reached.

22. The system of claim 21, wherein the threshold corresponds to a function of the critical curve.

23. The system of claim 21, wherein the threshold corresponds to a critical portion or point of the critical curve.

24. The system of claim 21, wherein the threshold corresponds to a critical slope of the critical curve.

25. The system of claim 14, wherein the health parameters include objective parameters.

26. The system of claim 14, wherein the health parameters include subjective parameters.

27. The system of claim 14, wherein the disease management module is configured to access a plurality of critical curves corresponding, respectively, to a plurality of health parameters of interest for the disease.

28. The system of claim 27, wherein the disease management module is configured to compare at least one of the health parameters of the electronic medical record to the critical curve of the corresponding health parameter of interest.

29. A system for performing a computerized critical curve assessment, the system comprising:

a computer;

means, in data communication with the computer, for storing electronic medical records corresponding to each particular patient of a plurality of patients; and

disease management means, executed by the computer, for;

accessing a critical curve for a particular disease,

generating a plurality of health parameters in a selected electronic medical record corresponding to a particular patient having been diagnosed with the particular disease, and

comparing at least one of the health parameters to the critical curve to obtain health assessment information.

30. The system of claim 29, wherein the computer is a portable computing device.

31. The system of claim 29, wherein the computer is a hand-held device having a wireless communication capability.

32. The system of claim 29, wherein the disease management means makes a recommendation if, based on the comparison, a threshold is reached.

33. The system of claim 29, wherein the disease management means adjusts a disease therapy if, based on the comparison, a threshold is reached.

34. The system of claim 29, wherein the health parameters include objective parameters.

35. The system of claim 29, wherein the health parameters include subjective parameters.

36. The system of claim 29, additionally comprising means for generating a patient specific critical curve, comprising:

means for determining disease specific health parameters from the patient'"'"'s electronic medical record;

means for adding current health parameters to the patient'"'"'s electronic medical record; and

means for plotting a patient specific curve consisting of health parameters measured against time.

37. The system of claim 36, additionally comprising means for performing statistical analysis on the patient specific critical curve.

38. The system of claim 37, additionally comprising:

means for comparing values from the patient specific critical curve to the critical curve to determine if a threshold has been met; and

means for indicating medical treatment if the value threshold has been met.

39. The system of claim 38, additionally comprising means for comparing the slope of the patient specific critical curve to the slope of the critical curve if the value threshold has not been met, wherein if the critical curve slope exceeds the patient specific critical curve slope, medical treatment is indicated.

40. A computer usable medium having computer readable program code embodied therein for performing a critical curve assessment, the computer readable code comprising instructions for:

accessing a critical curve for a particular disease;

generating a plurality of health parameters in an electronic medical record corresponding to a particular patient having been diagnosed with the particular disease; and

generating a comparison of at least one of the health parameters to the critical curve to obtain health assessment information.

41. The computer usable medium of claim 40, wherein the health parameters are input remotely via a telecommunications device.

42. The computer usable medium of claim 40, wherein the health parameters are input directly into a computer via a local peripheral device.

43. The computer usable medium of claim 40, additionally comprising instructions for making a recommendation if, based on the comparison, a threshold is reached.

44. The computer usable medium of claim 43, additionally comprising instructions for adjusting a therapy based on the recommendation made if a threshold is reached.

45. A computerized critical curve assessment system, comprising:

means for providing a critical curve for a particular disease;

means for providing a plurality of health parameters in an electronic medical record corresponding to a particular patient having been diagnosed with the particular disease; and

means for comparing at least one of the health parameters to the critical curve to obtain health assessment information.

46. A computerized method for generating a critical curve to assess a patient'"'"'s need for medical treatment, comprising:

determining disease specific health parameters from the patient'"'"'s medical history;

adding current health parameters, corresponding to a particular patient having been diagnosed with a particular disease, to the patient'"'"'s medical history;

plotting a patient specific curve consisting of health parameters measured against time;

performing statistical analysis on the patient specific critical curve;

accessing a standard critical curve for the disease;

comparing values from the patient specific critical curve to the standard critical curve to determine if a threshold has been met; and

indicating medical treatment if the value threshold has been met.

47. The method of claim 46, further comprising comparing the slope of the patient specific critical curve to the slope of the standard critical curve if the value threshold has not been met, wherein if the standard critical curve slope exceeds the patient specific critical curve slope, medical treatment is indicated.

48. A computerized system for generating a critical curve to assess a patient'"'"'s need for medical treatment, the system comprising:

means for determining disease specific health parameters from the patient'"'"'s medical history;

means for adding current health parameters, corresponding to a particular patient having been diagnosed with a particular disease, to the patient'"'"'s medical history;

means for plotting a patient specific curve consisting of health parameters measured against time;

means for performing statistical analysis on the patient specific critical curve;

means for accessing a standard critical curve for the disease;

means for comparing values from the patient specific critical curve to the standard critical curve to determine if a threshold has been met; and

means for indicating medical treatment if the value threshold has been met.

49. The system of claim 48, further comprising means for comparing the slope of the patient specific critical curve to the slope of the standard critical curve if the value threshold has not been met, wherein if the standard critical curve slope exceeds the patient specific critical curve slope, medical treatment is indicated.