System and method for automatically generating evidence-based assignment of care providers to patients

• US 8,000,978 B2
• Filed: 08/13/2004
• Issued: 08/16/2011
• Est. Priority Date: 10/06/2003
• Status: Active Grant

• Current Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Original Assignee: Cerner Innovation, Inc. (Oracle Corporation)
• Inventors: Chamberlain, Jerald T., Wager, Douglas W.
• Primary Examiner(s): O'Connor; Gerald J.
• Assistant Examiner(s): Raj; Rajiv J
• Application Number:
  US10/917,337
• Publication Number:
  US 20050075904A1
• Time in Patent Office: 2,559 Days
• Field of Search: 705 2- 3, 600/300
• US Class Current: 705/2
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms

Abstract

Care provider assignments to a patient may be automatically generated based on clinical evidence, documentation, workload, infectious status and other factors. The patient'"'"'s chart may be accessed by a rules-based engine configured with rules to relate a patient'"'"'s clinical status and needs to qualifications, certifications, capabilities and skills of care providers to select the care provider best qualified to assign to the patient. For instance, care providers having specialized training may be identified for assignment to patients presenting with specialized needs. Graphical displays of available providers may be displayed to and overridden by a manager. Because patient needs are automatically aligned with provider capabilities, availability and other factors, the errors, oversights and inefficiencies of manual or informal assignment systems are avoided and better health care delivery can be realized.

Claims

1. A system for automatically assigning clinical care providers to patients, comprising:

a computerized clinical data store configured to store factors for a patient, the factors comprising one or more of patient acuity status, a patient workload estimate, patient morbidity status, patient mobility status, patient demographic data, patient immune condition status, patient infectious condition status, patient surgical status, patient ventilator status, patient life support status, patient pharmaceutical use status, patient one-to-one provider requirement status and patient preference data;

a care provider data store configured to store care provider factors;

the care provider factors comprising one or more of provider clinical qualifications, provider schedule, provider workload status and provider infectious exposure status;

a first assignment engine on a first computer, the first assignment engine configured to communicate with the clinical data store and the care provider data store to automatically generate a first care provider assignment of the patient to a first clinical care provider based on comparison of at least one of the patient factors or provider factors, wherein the first care provider assignment is automatically generated by invoking a rules-based assignment engine to access a rule set comprising an ordered weighting of an analysis of patient acuity status compared to provider clinical qualifications, an analysis of continuity of patient care, an analysis of provider workload status incorporating a patient workload estimate, and provider preference data, wherein continuity of patient care identifies a care provider that has been previously assigned to the patient; and

a reassignment engine, the reassignment engine communicating with the clinical data store and the care provider data store to automatically generate a reassignment of the patient to a second care provider by replacing the first care provider assignment based on a change that is received to one or more of the patient or care provider factors.

2. A system according to claim 1, wherein the patient factors comprise at least one of a patient chart, an electronic medical record, and a patient history.

3. A system according to claim 1, wherein the provider clinical qualifications comprise at least one of clinical certifications, experience level, and qualification for procedures or equipment operation.

4. A system according to claim 1, wherein the provider infectious exposure status comprises at least one of provider exposure to other potentially infectious patients, provider exposure to other potentially infectious providers, and provider exposure to potentially infectious sites.

5. A system according to claim 1, wherein the assignment engine comprises a rules-based assignment engine.

6. A system according to claim 5, wherein the rules-based assignment engine accesses a rule set to compare the patient factors to the provider factors.

7. A system according to claim 5, wherein the rule set is extensible.

8. A system according to claim 1, further comprising a management interface, communicating with the assignment engine, the management interface presenting an operator with a view of the results of the automatically generated patient assignments.

9. A system according to claim 8, wherein the management interface comprises a selector tool to permit the operator to accept or adjust the automatically generated patient assignments.

10. A system according to claim 9, wherein the management interface generates a contraindication notice to the operator when provider factors conflict with the patient factors for a provider assignment.

11. A system according to claim 1, wherein the provider is at least one of a nurse, a physician, a technician and a therapist.

12. A system according to claim 1, wherein the automatically generated patient assignments comprise assignments for at least one of a shift, a partial shift, a day, a week, a month, a case and an event.

13. A system according to claim 1, wherein generation of the automatically generated patient assignments is triggered by changed conditions comprising at least one of a change in patient census, a change in patient acuity, and a change in provider staffing or schedule.

14. A system according to claim 1, wherein the automatically generated patient assignments are based on prior automatically generated provider assignments generated to produce a minimum amount of assignment changes.

15. Computer storage media having computer-executable instructions stored thereon that, when executed by a computing device having a processor and memory, cause the computing device to perform a method for automatically assigning clinical care providers to patients, comprising:

accessing patient factors associated with a clinical patient;

accessing provider factors associated with a care provider;

comparing the patient factors and the provider factors;

invoking a rules-based assignment engine to automatically generate patient assignments by invoking a rules-based assignment engine to access a rule set comprising an ordered weighting of an analysis of patient acuity status compared to provider clinical qualifications, an analysis of continuity of patient care, an analysis of provider workload status incorporating a patient workload estimate, and provider preference data, wherein continuity of patient care identifies a care provider that has been previously assigned to the patient; and

;

automatically generating a patient reassignment by an assignment engine based on a change that is received to one or more of the patient factors and the provider factors.

16. The computer-readable media of claim 15, wherein the patient factors comprise at least one of a patient chart, an electronic medical record, and a patient history.

17. The computer-readable media of claim 16, wherein the patient factors comprise at least one of patient acuity status, a patient workload estimate, patient morbidity status, patient mobility status, patient demographic data, patient immune condition status, patient infectious condition status, patient surgical status, patient ventilator status, patient life support status, patient pharmaceutical use status, patient one-to-one provider requirement status and patient preference data.

18. The computer-readable media of claim 15, wherein the provider factors comprise at least one of provider clinical qualifications, provider schedule, provider workload status and provider infectious exposure status.

19. The computer-readable media of claim 18, wherein the provider clinical qualifications comprise at least one of clinical certifications, experience level, and qualification for procedures or equipment operation.

20. The computer-readable media of claim 18, wherein the provider infectious exposure status comprises at least one of provider exposure to other potentially infectious patients, provider exposure to other potentially infectious providers, and provider exposure to potentially infectious sites.

21. The computer-readable media of claim 15, wherein the rule set is extensible.

22. The computer-readable media of claim 15, further comprising presenting a management interface to an operator with a view of the results of the automatically generated patient assignments.

23. The computer-readable media of claim 22, wherein the management interface comprises a selector tool to permit the operator to accept or adjust the automatically generated patient assignments.

24. The computer-readable media of claim 23, further comprising generating a contraindication notice to the operator via the management interface when provider factors conflict with the patient factors for a provider assignment.

25. The computer-readable media of claim 15, wherein the provider is at least one of a nurse, a physician, a technician and a therapist.

26. The computer-readable media of claim 15, wherein the automatically generated patient assignments comprise assignments for at least one of a shift, a partial shift, a day, a week, a month, a case and an event.

27. The computer-readable media of claim 15, wherein the automatically generating is triggered by changed conditions comprising at least one of a change in patient census, a change in patient acuity, and a change in provider staffing or schedule.

28. The computer-readable media of claim 15, wherein the automatically generating comprises automatically generating patient assignments based on prior automatically generated provider assignments to produce a minimum amount of assignment changes.

29. A method for automatically generating an assignment of a clinical care provider to a patient, the assignment being generated according to a method comprising:

utilizing a first computing process executed by a computing device, accessing patient factors associated with a clinical patient;

utilizing a second computing process, accessing provider factors associated with a care provider;

utilizing a third computing process, comparing the patient factors and the provider factors;

utilizing a fourth computing process, invoking a rules-based assignment engine to access a rule set comprising an ordered weighting of an analysis of patient acuity status compared to provider clinical qualifications, an analysis of continuity of patient care, an analysis of provider workload status incorporating a patient workload estimate, and provider preference data, wherein continuity of patient care identifies a care provider that has been previously assigned to the patient;

utilizing a fifth computing process, applying the rule set to the patient factors and the provider factors to automatically generate a patient assignment;

utilizing a sixth computing process, automatically generating a patient assignment based on the outcome of applying the rule set; and

utilizing a seventh computing process, presenting a management interface to an operator with a view of the results of the automatically generated patient assignment, wherein the first, second, third, fourth, fifth, sixth and seventh computing processes are performed by one or more computing devices.

30. The method according to claim 29, wherein the patient factors comprise at least one of a patient chart, an electronic medical record, and a patient history.

31. The method according to claim 30, wherein the patient factors comprise at least one of patient acuity status, a patient workload estimate, patient morbidity status, patient mobility status, patient demographic data, patient immune condition status, patient infectious condition status, patient surgical status, patient ventilator status, patient life support status, patient pharmaceutical use status, patient one-to-one provider requirement status and patient preference data.

32. The method according to claim 29, wherein the provider factors comprise at least one of provider clinical qualifications, provider schedule, provider workload status and provider infectious exposure status.

33. The method according to claim 32, wherein the provider clinical qualifications comprise at least one of clinical certifications, experience level, and qualification for procedures or equipment operation.

34. The method according to claim 32, wherein the provider infectious exposure status comprises at least one of provider exposure to other potentially infectious patients, provider exposure to other potentially infectious providers, and provider exposure to potentially infectious sites.

35. The method according to claim 29, wherein the automatically generating comprises:

determining whether a threshold criteria is satisfied in the rule set; and

generating a set of qualified providers for narrowing based on further factors.

36. The method according to claim 35, wherein the further factors include one or more of schedule preferences, staff seniority, and first-available status.

37. The method according to claim 29, wherein the rule set is extensible.

38. The method according to claim 29, wherein the management interface comprises a selector tool to permit the operator to accept or adjust the automatically-generated patient assignments.

39. The method according to claim 38, further comprising generating a contraindication notice to the operator via the management interface when provider factors conflict with the patient factors for a provider assignment.

40. The method according to claim 29, wherein the provider is at least one of a nurse, a physician, a technician and a therapist.

41. The method according to claim 29, wherein the automatically generated assignment comprises assignments for at least one of a shift, a partial shift, a day, a week, a month, a case and an event.

42. The method according to claim 29, wherein the automatically generating is triggered by changed conditions comprising at least one of a change in patient census, patient intake, patient discharge, patient status, patient acuity, provider staffing, available care provider personnel, clinical staffing, or schedule.

43. The method according to claim 29, wherein the automatically generating comprises automatically generating a patient assignment based on a prior automatically generated provider assignment to produce a minimum amount of assignment change.

44. Non-transitory computer-readable media having computer executable instructions embodied thereon that, when executed by a computing device having a processor and a memory, cause the computing device to perform a method for excluding care providers from assignment to patients based on infectious status, comprising:

accessing an immune condition status associated with a patient;

accessing an infectious exposure status associated with a provider; and

automatically excluding the care provider from assignment to the patient by;

(1) invoking a rules-based assignment engine comparing the infectious exposure status of the provider with the immune condition status of the patient, wherein the rules-based assignment engine accesses a rule set including at least an ordered weighting of an analysis of patient acuity status compared to provider clinical qualifications, an analysis of patient care, an analysis of provider workload status incorporating a patient workload estimate, and provider preference data, wherein continuity of patient care identifies a care provider that has been previously assigned to the patient,

(2) the assignment engine creating an electronic exclusion of the care provider based on a conflict between the infectious exposure status and the immune condition status; and

(3) displaying a notice of the electronic exclusion on a management interface presented to an operator.

45. The computer-readable media of claim 44, wherein the infectious exposure status is determined at least in part by examination of one or more of patient assignment history, exposure to other potentially infectious patients, exposure to other potentially infectious providers, and exposure to potentially infectious sites.

46. The computer-readable media of claim 44, wherein the provider is at least one of a nurse, a physician, a technician and a therapist.

47. The computer-readable media of claim 44, wherein the infectious exposure status is tracked for a clinically relevant window of time after a prior potential infectious exposure.