Disease management system and method including question version

• US 8,060,378 B2
• Filed: 10/30/2007
• Issued: 11/15/2011
• Est. Priority Date: 03/13/1997
• Status: Expired due to Term

• 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): O'Connor, Gerald J.
• Assistant Examiner(s): SEOH, MINNAH L
• Application Number:
  US11/929,609
• Publication Number:
  US 20080059232A1
• Time in Patent Office: 1,477 Days
• Field of Search: 705 2- 3, 434/322, 715/708
• US Class Current: 705/2
• 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 method of automated medical treatment for a patient comprising a question versions function, the method comprising:

storing a plurality of versions of questions in a data storage, the data storage in data communication with a computing device, the questions associated with at least one medical aspect of a patient, a first question version worded to inquire about a medical aspect of the patient and a second question version worded differently from the first to inquire about the medical aspect of the patient, the first question version and the second question version being members of a question set;

receiving, via direct interactive dialog between a user and the computing device, an input concerning the medical aspect of the patient;

retrieving the question set from the plurality of stored questions based on the input;

computing, in the computing device, a question version index (QVI) for the user, the QVI based on at least one of a linguistic selectivity within a single language, a language proficiency within the single language, a sensitivity factor, and a communication level of the user within the single language, the sensitivity factor a measure of the patient'"'"'s ability to accurately self-assess and communicate the patient'"'"'s symptoms;

storing the QVI of the user to the data storage;

selecting at least one question version from the retrieved question set, the selecting based on the QVI;

outputting the selected question version to the user to communicate at a desired communication level;

receiving an answer to the selected question version from the user; and

advising the user, via direct interactive dialog between the user and the computing device, of a diagnosis and medical treatment for the patient based in part on the answer.

2. The method of claim 1, wherein the degrees of sensitivity comprise different intonations of voice, commas, pauses, or different medical details to disclose to the user.

3. The method of claim 1, wherein the QVI computation comprises a patient'"'"'s age or disease.

4. The method of claim 1, wherein the QVI computation includes considerations associated with degrees of linguistic selectivity comprising the user'"'"'s gender, language spoken, or what medical details can be disclosed.

5. The method of claim 1, wherein the QVI computation includes considerations associated with degrees of language proficiency comprising different levels of education, intelligence, disease understanding, medical expertise, or medical history of the user.

6. The method of claim 1, further comprising communicating the selected question version to one of:

a patient or an agent of the patient and a healthcare provider or an agent of the healthcare provider.

7. The method of claim 1, wherein retrieving the question set includes retrieving a default question, wherein the default question is selected when none of the other retrieved question versions match the computed QVI.

8. The method of claim 1, wherein the first question version and the second question version may contain at least one common word.

9. An automated medical treatment system for assessing the health and modifying the therapy of a patient comprising:

a disease management module (DMM), implemented as a set of instructions executed by a computing device;

a plurality of versions of questions stored in a data storage, the data storage in data communication with the computing device, the questions associated with at least one medical aspect of a patient, a first question version worded to inquire about a medical aspect of the patient and a second question version worded to inquire about the medical aspect of the patient, the first question version and the second question version being members of a question set;

a question versions function in data communication with the DMM, the questions versions function configured to select a question set based on a response from a user, the question version function further configured to select a question from the set based on a question version index (QVI), the QVI based in part on a communication level of the user within a single language;

wherein the DMM is configured to;

receive an input via direct interactive dialog between the user and the computing device,

reference the questions versions function to select at least one question based on the QVI,

output the question to the user,

assess the health and modify the therapy of the patient based in part on a response to the question, and

communicate the health assessment and therapy modification to the user on a desired communication level.

10. The system of claim 9, wherein the DMM dynamically selects the QVI during a communication with the user.

11. The system of claim 10, wherein the dynamic selection of the QVI is based on the user'"'"'s responses or requests.

12. The system of claim 11, wherein the user comprises the patient or a healthcare provider.

13. The system of claim 9, wherein the question versions function provides a default question as one question version in the one or more question versions, wherein the default question is selected when the QVI does not match question versions other than the default question.

14. The system of claim 9, wherein the QVI is determined based on one or more of a user'"'"'s sensitivity level, linguistic selectivity level, education level, grammar knowledge, the user'"'"'s spoken language, how the user is related to a patient, what is currently known about the patient, what medical details can be disclosed to the user, or a language IQ test given as part of an initial health assessment.

15. The system of claim 9, wherein some of the question versions convey the same question using different words.

16. A non-transitory computer usable medium having computer readable program code embodied therein for automated medical treatment of a patient and for obtaining and monitoring the patient'"'"'s health data related to a disease, the computer readable program code comprising instructions for:

storing a set of question versions in a non-transitory data storage, the data storage in data connection with the computer usable medium;

receiving an input from a user;

determining a question version index (QVI), the QVI based on a stored variable representative of the user;

retrieving a set of question versions within a single language, the set determined by the input of the user, the set including a first question version worded to inquire about a medical aspect of the patient and a second question version worded to inquire about the medical aspect;

selecting a question version from the set of question versions based on the QVI;

communicating the question to the user;

receiving an answer to the question from the user;

storing the answer in the non-transitory data storage;

determining a change to the QVI based on the answer;

determining the medical treatment based in part on the answer; and

communicating the medical treatment to the user.

17. The computer usable medium of claim 16, wherein the QVI determination comprises information obtained during run time.

18. The computer usable medium of claim 16, wherein the user is a patient, patient'"'"'s agent, healthcare provider, or healthcare provider'"'"'s agent.

19. The computer usable medium of claim 18, wherein the patient is a human being in need of wellness care.

20. The computer usable medium of claim 16, wherein the set of question versions are written into a script.

21. The computer usable medium of claim 20, wherein the script comprises a default question in the set of question versions, wherein the default question is selected when the QVI has no other match with question versions in the set other than the default question.

22. A method comprising:

using a computer device or processor to perform the steps of;

storing, in a non-transitory data storage in data connection with the computer device, a plurality of groups of questions, each group associated with a medical aspect of a patient, each group further comprising a plurality of question versions, a first question version worded to inquire about the medical aspect of the patient and a second question version worded differently from the first to inquire about the medical aspect of the patient, the first question version associated with a first linguistic level of understanding of the user within a single language, the second question version associated with a second linguistic level of understanding of the user;

within the single language;

receiving an input from the user;

identifying the linguistic level of understanding of the user based on at least one of user education, intelligence, disease understanding, and medical expertise;

selecting one of the question groups based on the input from the user and the identified linguistic level;

selecting at least one question version from the selected question group;

asking the user the selected question;

receiving an answer to the selected question version from the user; and

advising the user, via direct interactive dialog between the user and the computing device, of a diagnosis and medical treatment for the patient based at least partly on the answer.

23. The method of claim 22, wherein the method additionally comprises modifying a selectivity ratio based on the identified linguistic level.