Enhanced medical treatment system

• US 7,593,952 B2
• Filed: 04/09/1999
• Issued: 09/22/2009
• Est. Priority Date: 04/09/1999
• Status: Expired due to Fees

• Current Assignee: Andrew H. Soll, Liana Violet Soll
• Original Assignee: Andrew H. Soll, Liana Violet Soll
• Inventors: Soll, Liana Violet, Soll, Andrew H.
• Primary Examiner(s): AL HASHEMI, SANA A
• Application Number:
  US09/289,044
• Publication Number:
  US 20030055679A1
• Time in Patent Office: 3,819 Days
• Field of Search: 707100-102, 705/1, 705/2, 705/3, 600/300, 600/301, 434/236
• US Class Current: 1/1
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance
• 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 20/40 relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture
• 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 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: Y10S 707/99942 Manipulating data structure, e.g. compression, compaction, compilation
• CPC Class Codes: Y10S 707/99943 Generating database or data structure, e.g. via user interface
• CPC Class Codes: Y10S 707/99945 Object-oriented database structure processing

Abstract

This invention deals with an enhanced medical treatment system which seeks input from the patient and the physician about the medical problems faced by the patient. It analyzes this information and seeks to guide physicians to a correct diagnosis of the complaint. It also seeks to educate the patient about his/her medical problems and provides information about the problem. It is able to store all this information, so that a continues record of the patient'"'"'s visits and problems is kept on file and the physician is able to utilize the medical history to solve the patient'"'"'s current problems. With this system in place the medical establishment will be able to improve health care delivery to the patients and be able to better manage the process of the providing health care. Furthermore, this system will also lower the cost of providing health care without compromising on the quality of health care.

Claims

1. A data processing system comprising:

one or more computer processors programmed to receive health information from a patient using software operable to pose a logic-driven, branching series of questions to identify, discriminate current from past, and prioritize said patient'"'"'s major symptoms,

(a) wherein said major symptoms are ranked by priority to said patient; and

wherein exploratory questions are used to survey selected topics;

(b) wherein said exploratory questions ask about groups of related items;

(c) wherein said exploratory questions determine a time frame of relevance to said patient and the priority of a symptom or provisional problem,

(d) wherein said priority is characterized by one or more patient factors, selected from the group of;

patient'"'"'s priority for discussion with a clinician, severity of said symptom, impairment of functional abilities, impact on quality of life resulting from said symptom, or system criteria based on a potential clinical importance of said symptom;

(e) wherein said software is further operable to construct subsequent, more detailed questions from a database of potential questions, based upon said patient'"'"'s responses to said exploratory questions; and

(f) wherein said software is operable on the one or more computer processors or on a server distributed to the one or more computers over an Internet connection.

2. The system of claim 1, wherein said system is operable to integrate an assessment of characterization detail for related symptoms in a group of potentially associated symptoms;

(a) wherein potential associations between symptoms are identified at a time of authoring of interview content based upon clinical knowledge;

(b) wherein seventies of candidate symptoms in associations are obtained during the interview;

(c) wherein a most severe symptom in an association (hereinafter “

index complaint”

) is identified;

(d) wherein characterization detail is obtained about one or more index complaints, as appropriate for clinical importance or relevance to said patient;

(e) wherein an interview question is asked about whether any of said patient'"'"'s other symptoms in said association share features in common with said index complaint;

(f) wherein, where symptoms are associated or features are shared, no further characterization is performed, or subsequent interview questions characterizing associated symptoms are combined; and

(g) wherein a risk of frustrating said patient is reduced by detecting relations between symptoms, when they exist, or allowing symptoms to stand alone, when no association is identified.

3. The system of claim 1 further operable to identify and measure severity and functional impact of a full range of multiple potentially overlapping physical and psychosocial symptoms in any combination;

(a) wherein an assessment uses screening questions relating to physical and psychosocial symptoms;

(b) wherein said psychosocial symptoms comprise at least one of the group of;

substance use, depression, anxiety, stress, somatization, health attitude, behavior, illness concern, and anxiety;

(c) wherein said overlapping physical and psychosocial symptoms comprise symptoms that are concurrent or that share location or other features potentially confusing to patients or physicians;

(d) wherein related symptoms are grouped in order to facilitate assessment of symptom severity, frequency, impact on functional abilities, and quality of life; and

(e) wherein separate scores are calculated for each of said symptom groups in order to determine whether said patient has one or more than one symptom complex and to separately assess severity and functional impact of each symptom group over time or in response to treatment for purposes of patient care, research, or quality assurance.

4. The system of claim 1 further operable to assess impairment in quality of life and functional abilities in relation to a plurality of symptoms and medical conditions;

(a) wherein quality of life questions are created to probe limitations in a plurality of general domains that may be related to one or more underlying medical condition;

(b) wherein said quality of life questions are asked without reference to whether a limitation is due to a health or emotional condition, symptoms, injury, or other problem; and

(c) wherein impact of each group of related symptoms or each health condition is determined by asking about resulting severity, frequency, or perceived impact on quality of life.

5. The system of claim 4,

(a) wherein said software is operable to display areas of general quality of life and functional abilities that said patient has reported are impaired, and to offer said patient choices about potential causes of such impairment;

and

(b) wherein said software is operable to sequentially display each of one or more general quality of life issues reported by said patient to be limited by symptoms or health conditions, list various symptoms and health conditions that said patient has reported are most severe, and offer response options to indicate a degree to which each symptom or health condition causes limitation of indicated general quality of life domains.

6. The system of claim 1 further operable to directly assess dimensions of the quality of care and provide feedback to clinicians or administrators about areas where action could be taken to correct apparent problems with said quality;

(a) wherein said system is operable to display questions regarding one or more of;

patient understanding of a health condition, patient health attitudes and behaviors, patient willingness to change health behaviors, patient perception of communication with a clinician and whether patients were heard and respected, patient observation about health care received, patient understanding of what to expect and what to watch out for regarding health conditions or treatment, patient understanding of treatment received, patient understanding of medications to be used, or patient compliance with medication and with treatment; and

(b) wherein patient-reported quality of care data are integrated into a clinical report and flagged to identify problem areas;

such quality improvement data are presented to clinicians with suggestions regarding correcting apparent problems with the quality of care;

or said software provides brief and focused education to a patient who needs or desires additional information about said patienfs health condition.

7. The system of claim 1, further operable to calculate a severity score based on patient data regarding severity of symptoms;

(a) wherein different levels of severity are assigned different values;

(b) wherein symptoms from a similar region or system of a patient'"'"'s body are grouped together, offering patients the option of confirming this association, after which a score assigned to each group is computed, and scores are reported to facilitate interpretation by a clinician with regard to relative importance of a symptom group and possible implications of observed symptom patterns, and given scores of a particular group across successive interviews of said patient, to reflect changes in severity over time; and

(c) wherein scores are reported to facilitate interpretation by a clinician with regard to relative importance of a symptom group and possible implications of observed symptom patterns, and, given scores of a particular group across successive interviews of said patient, to reflect changes in status over time.

8. The system of claim 1, further operable to:

(a) inform patients about routine procedures, surgeries or research for which informed consent is required, and using text, images, or video or audio presentations to educate the patient about said routine procedures, surgeries or research; and

(b) obtain informed consent from a patient who agrees to undergo at least one of said routine procedures, surgeries, or research.

9. The system of claim 3 further operable to characterize key features and detect symptom patterns of potential diagnostic, or therapeutic, importance relating to characterization details, sensitization and cross-referral of nerves from viscera and body wall, and symptom reporting by the patient;

(a) wherein detecting symptoms in exploratory questions optionally triggers a detailed, systematic characterization of features, including at least one of the group of;

location, description, timing, precipitating factors, and relieving factors;

(b) wherein multiple symptoms and the characterization details are gathered and interpreted, wherein the characterization details include at least one of the group of;

expanded referral, overlapping patterns of precipitation and relief, use of multiple descriptive terms, and evidence of somatic (fibromuscular body wall) involvement;

(c) wherein a history of prior symptoms, or an absence thereof, provides evidence of the patient'"'"'s pattern of symptomatic response; and

(d) wherein said symptom patterns and the characterization details provide information implicating altered sensitization and cross-referral of nerves from viscera and body wall, and psychobehavioral dimensions of symptom reporting by the patient.

10. The system of claim 3 further operable to discover, discriminate, and measure multiple symptoms and uncover symptoms obscured by overlap with other existing or new symptoms;

(a) wherein targeted instructions are provided to educate the patient about a possibility of overlapping symptoms and how to discriminate the overlapping symptoms by focusing on characteristic features;

(b) wherein multiple symptoms may be discriminated by the patient as the same or different, based upon questions about the characteristic features,

(c) wherein obscured or overlapping symptoms can be suspected based upon a response indicating at least one of the group of;

two symptoms overlapping in location, timing, characteristic features such as a pattern of precipitation or relief, a symptom being described as both a pain and a discomfort, having expanded referral (being felt over a wide area), a character of the symptom being described by multiple terms, or a symptom pattern changing over time;

(d) wherein patients are offered an option of a response indicating that potentially overlapping symptoms are the same, related but not the same, different, or uncertain; and

(e) wherein optional branching series of questions are provided to gather further details for;

symptoms that are different or related but not the same, whereas subsequent questions are skipped for symptoms that are the same or where the patient is uncertain about a relationship of the symptoms.

11. The system of claim 1 further comprising a System Response Analyzer adapted to use logic to monitor the patient'"'"'s responses for an inconsistent response, the inconsistent response triggering a detailed assessment of patient consistency and veracity.

12. The system of claim 1 further operable to generate an agenda for a clinic session, the agenda comprising a list of symptoms ranked by patient or system priority;

wherein the agenda provides information for estimating a time required for a practitioner to see the patient and a skill level of the practitioner required to see the patient.

13. The system of claim 1 further operable to support problem management by physicians, wherein symptoms and active medical conditions (such as diabetes, chronic lung disease), are presented as a problem;

(a) wherein a physician module is provided to filter, sort, and review patient-entered, physician-entered, or system-imported data, and to add physician-entered data;

(b) wherein the problem name is editable by the physician;

(c) wherein the problem can be created, updated, merged or divided by the physician;

(d) wherein all data can be linked to a provisional problem, automatically by the physician module, or by the physician;

(e) wherein data entered by the patient or the physician, or imported by the system can be linked at entry or by system criteria;

to at least one type of data selected from the group of data for;

initial and return visit, symptom, medical condition, medical history, physical finding, test result, treatment type, response to treatment, side effects from treatment, plan for diagnosis, treatment plan, or problem summary; and

(f) wherein data can be filtered, sorted, and presented by criteria, the criteria providing a problem, data, physician author, activity status(activc or inactive problem), or data type.

14. The system of claim 1 further operable to support a return visit by the patient;

(a) wherein an agenda for the return visit may be set by;

a return visit agenda set by a physician at a prior visit, completion of remaining interview modules from the prior visit, research protocol, or administrative protocol, wherein the administrative protocol gathers quality assurance data;

(b) wherein at the return visit, the patient is queried about any reasons they have for the return visit;

(c) wherein the patient'"'"'s reason for the return visit can be compared with a physician'"'"'s reason for the patient'"'"'s return visit;

(d) wherein the patient is provided an option to review and update their prior symptoms and responses;

(e) wherein other symptoms are optionally surveyed to ascertain new developments; and

(f) wherein use of prescribed treatments by the patient can be sought as a measure of compliance.