System and method of improved recording of medical transactions

• US 20040249667A1
• Filed: 04/06/2004
• Published: 12/09/2004
• Est. Priority Date: 10/18/2001
• Status: Active Grant

• Current Assignee: Yeong K. Oon
• Original Assignee: Yeong K. Oon
• Inventors: Oon, Yeong K
• Granted Patent: US 7,555,425 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: G06F 40/30 Semantic analysis
• 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 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

This invention relates to the field of patient health care. In particular, it relates to medical informatics, and to systems and methods for recording medical transactions. A system for recording medical transactions is disclosed, the system comprising distinct and multi-linguistic representation layers, allowing the de novo composition and construction of medical transaction codes; including a user interface including means for inputting medical transactions in a semiotic form one, the semiotic form one input being a free form-type, abbreviation-oriented natural language textual input, a transaction parser-coder configured to parse said semiotic form one input and to convert it into coded medical transactions in a semiotic form two output, the transaction codes composed and constructed de novo, the semiotic form two output embodying high level machine-parseable computer language statements comprehensible to a high certainty level by human users, means for evoking a display of system reflection in the form of coded medical transactions in said semiotic form two and system-rated confidence levels representing the match between a code and correspondence with perceived user intent, means for receiving user selection input for verifying a selected coded medical transaction, and a transaction mapper configured to convert a semiotic form two input into a semiotic form three transaction by mapping the selected coded transaction into data row in a relational database to render the transaction data amenable to structured query language processing. There is further disclosed a computer-based method for the management of medical transactions, including storing each medical transaction as a transaction code in a data row in a database table, each transaction code including a genre key relating to the nature of the transaction, and including providing storage ledgers for each genre, such that each transaction can be retrieved and displayed as an entry in a storage ledger in accordance with its genre key. This allows medical transations to be treated akin to accounting transactions, signifying credits and debits in defined transaction ledgers.

Claims

1. A system for recording medical transactions, the system comprising distinct and multi-linguistic representation layers, allowing the de novo composition and construction of medical transaction codes;

including;

a user interface including means for inputting medical transactions in a semiotic form one, the semiotic form one input being a free form-type, abbreviation-oriented natural language textual input,

a transaction parser-coder configured to parse said semiotic form one input and to convert it into coded medical transactions in a semiotic form two output, the transaction codes composed and constructed de novo, the semiotic form two output embodying high level machine-parseable computer language statements comprehensible to a high certainty level by human users,

means for evoking a display of system reflection in the form of coded medical transactions in said semiotic form two and system-rated confidence levels representing the match between a code and correspondence with perceived user intent,

means for receiving user selection input for verifying a selected coded medical transaction, and

a transaction mapper configured to convert a semiotic form two input into a semiotic form three transaction by mapping the selected coded transaction into data row in a relational database to render the transaction data amenable to structured query language processing.

2. The system of claim 1, wherein the semiotic form one and the transaction parser-coder are designed to be misspelling intolerant and compatible with both brief and verbose free-form input.

3. The system of claim 1, the semiotic form three including the encapsulation of information pertaining to the genre and decomposition of the transaction, the system including means for analysis and viewing of transactions, and means for realising accrual functions in transaction debit and credit ledgers, to allow the synchronisation of distributed medical records.

4. The system of claim 3 for use in combination with a distributed network, including means for double entry accounting of transactions for medical record synchronization and accrual operations for selected transactions.

5. The system of claim 1 including a markup converter configured to convert a semiotic form two input or a semiotic form three input into a semiotic form four transaction by marking up with a language such as XML or SGML, in order to facilitate electronic sharing of medical data.

6. The system of claim 1 configured to allow input at any of the linguistic representation layers and to enable lay and professional users to create, interrogate, integrate, process, view, update and use a part or whole of the medical transaction data.

7. The system of claim 1 including a text editor having an interface for enabling a user to compose semiotic form one input using a minimal number of keystrokes to compose medical transactions during a clinical consultation to document medical history, findings, evaluations, management and planning, each key component of the transaction being abbreviated down to an abbreviation of maximum four characters.

8. The system of claim 7, the text editor interface including a single text pane for user entry of all types of medical transactions relating to patient health care.

9. The system of claim 8, said single text pane used to enter an entire narration of patient encounter notes, the system including means for and comprising means for enabling optional parsing of a selected part of said notes by selection of a text segment within said single text pane.

10. The system of claim 1, wherein the transaction parser-coder includes means to resolve instances of non-specification of genre and/or missing joiner attributes by parsing given semiotic form one input to infer and automatically insert missing genre and attributes to provide preemptive estimation of guess user intent.

11. The system of claim 1, configured for input of a semiotic form one text passage encapsulating multiple medical transactions comprising an entire medical consultation, said text passage demarcated into sentences by demarcation signifiers, the transaction parser-coder configured to parse the passage sentence by sentence.

12. The system of claim 1 for use with medical transactions concerning a patient'"'"'s symptoms and signs, the transaction parser-coder including means to code for a related context of each transaction, the context based on implied or input contextual keywords, thereby enabling cognitive services to effect machine decision support.

13. The system of claim 1, wherein the transaction parser-coder is configured to provide decision support by auto-generating transaction codes representing recommended medical transactions in response to input transactions.

14. The system of claim 1, including means for modulating the transaction parser-coder in accordance with historical use of semiotic form one input by a user or the historical use of semiotic form one in the medical record of a particular patient.

42. The method of claim 41 for application to the system of claim 1, wherein each medical transaction is stored in semiotic form two, a one-to-one relationship existing between the column attributes of the table and said joiner attributes of the medical transaction.

43. The method of claim 42, wherein the table includes attributes matching all known joiner attributes of all possible coded transactions of semiotic form two, joiner attributes which may conflict with database system keywords being augmented by the addition of a superfluous character (such as an underscore character) to resolve any potential conflicts between joiner attributes and keywords.

44. The method of claim 42, wherein the table includes:

an attribute representing the whole transaction in semiotic form two;

an attribute representing the genre;

an attribute representing the cast of the transaction; and

an attribute representing the original text message expressed in semiotic form one.

45. The method of claim 42, wherein the data row in the data table can be used to reconstitute the original expressions represented in semiotic forms one and two, for purposes of exporting medical transactions and patient data.

47. The method of claim 39 for application to the system of claim 1 including generating, from each transaction, a series of transactions in a separate accrual table, the method utilizing the following steps:

i) posting each transaction in a transaction debit and/or a transaction credit ledger;

ii) evaluating accrual transactions to identify those stigmatised by an accrual operator (such as the plus ‘

+’

operator or the minus ‘

−

’

operator) and, if so identified, executing the following steps;

iii) using accrual transactions to compute a new heap transaction, based on an existing heap transaction in the credit side of an accrual table, in order to represent current information regarding a selected aspect of patient status;

iv) moving old heap transaction from the credit to the debit side of said accrual table; and

v) inserting a new computed heap transaction to the credit side of said accrual table.

48. The method of claim 47, wherein the new heap transaction in said accrual table includes the add or subtract operation of an accrual transaction operating on the previous heap transaction of the identical genre.

49. The method of claim 47, wherein said ledgers and said accrual table can be fully reconstituted from stored original medical transactions.

50. The method of claim 47, wherein the double entry into ledgers is carried out according to the genre and species of the transaction in order to meet the expectations/denouement views of patient data, and wherein said expectation/denouement views are selected from the group including:

(1) reason for encounter—

history/exam;

(2) history/exam—

evaluation;

(3) eval—

management;

(4) test—

test result;

(5) test result—

evaluation;

(6) management—

plan;

(7) plan—

goal;

(8) goal—

reason for encounter, and (9) the accrual ledger.

51. The method of claim 47, wherein change of accruals over time of one or more aspects of patient status are denoted by transactions generated de novo, and wherein the display of these accrual transactions denotes change of patient status over time.

52. The method of claim 47 including the steps of displaying of a patient health delta, representing the change in patient transaction data over time, utilising the generation of new heap transactions from accrual transactions, the posting of old heap transactions in a debit side of said accrual table, and the posting of new heap transaction in a credit side of said accrual table.

15. A computer-based method of recording medical transactions through de novo composition and construction of medical transaction codes;

including the steps of;

inputting medical transactions in a semiotic form one, the semiotic form one input being a free form-type, abbreviation-oriented natural language textual input,

parsing said semiotic form one input and converting it into coded medical transactions in a semiotic form two output, the transaction codes composed and constructed de novo, the semiotic form two output embodying high level machine-parseable computer language statements comprehensible to a high certainty level by human users,

evoking a display of system reflection in the form of coded medical transactions in said semiotic form two and system-rated confidence levels representing the match between a code and correspondence with perceived user intent,

receiving user selection input for verifying a selected coded medical transaction,

converting a semiotic form two input into a semiotic form three transaction by mapping the selected coded transaction into data row in a relational database to render the transaction data amenable to structured query language processing.

16. The method of claim 15, wherein each coded medical transaction in semiotic form two is classified into a genre selected from the group:

(a) reason for encounter;

genre@rfe;

(b) symptom/sign;

genre@hxpx;

(c) past history;

genre@hxpx;

(d)social history;

genre@hxpx;

(e) family history;

genre@hxpx;

(f) diagnosis or evaluation;

genre@eval;

(g) test;

genre@ix;

(h) test result;

genre@ix@find;

(i) drug or procedural treatment;

genre@mx;

(j) management plan—

prescription specification;

genre@plan; and

(k) management goal;

genre@goal.

17. The method of claim 16, wherein each coded medical transaction belongs to a species, each species being a classification under a genre (eg &

ctx@seek[] and &

ctx@seek@re@view[] being two species of the genre@rfe).

18. The method of claim 15, wherein coded medical transactions in semiotic form two include segments comprising one or more thematic codes demarcated by punctuation characters, segments being joined together using attribute joiners to enable representation of all possible clinical scenarios.

19. The method of claim 15, including the step of enabling a user viewing coded and the non-coded segments of transactions in semiotic form two to augment uncoded segments with free text comments into uncoded segments.

20. The method of claim 15, including disaggregating a transaction in semiotic form two into two or more transactions.

21. The method of claim 15, including aggregating two or more transactions in semiotic form two into a single transaction.

22. The method of claim 15, including extracting a transaction in semiotic form two as an exoskeletal cast independent of the data content held within.

23. The method of claim 22, wherein the exoskeletal cast constrains the codes permitted within a segment to ensure semantic integrity.

24. The method of claim 15, wherein coded medical transactions in semiotic form two include a coda attribute containing the version number of a semiotic definition.

25. The method of claim 24, wherein the coda attribute additionally contains trailing information regarding user log data and/or system access data and/or user-specified comment data and/or user visibility data.

26. The method of claim 15, wherein each coded medical transaction in semiotic form two includes a genre specifications which contains an accrual trigger, such as a ‘

+’

character for an add action and a ‘

−

’

character for a subtraction action.

27. The method of claim 26, wherein use of a transaction with an accrual trigger operates on a heap transaction of an appropriate genre specification to generate a new accrual heap transaction in an accrual table.

28. The method of claim 15, including the step of converting a decision support heuristic into a semiotic form two transaction and processing and storing said support heuristic in the manner as a patient medical transaction.

29. The method of claim 15, wherein coded medical transactions in semiotic form two include embedded namespace constructs for import mapping of medical codes in otherwise incompatible formats.

30. The method of claim 29, wherein each said embedded namespace constructs comprises a key being a readable expression having components (a) a designated namespace, (b) a medical code in an otherwise incompatible format, (c) a relational operator to depict the quality of match, and (d) a self-descriptive term to obviate the need for a lookup table.

31. The method of claim 29, wherein the coded medical transactions are adapted to be format-agnostic.

32. The method of claim 15, wherein coded medical transactions in semiotic form two are configured to enable export mapping into medical codes in otherwise incompatible formats, including older numeric type codes using namespace nomenclature.

33. The method of claim 15, wherein a natural language textual input forms a subcomponent of a medical transaction once converted into semiotic form two.

34. The method of claim 15, wherein the step of converting into said semiotic form three transaction involves deconstruction of said medical transaction in semiotic form two in accordance with genre, transaction cast and joiner attributes, to be refactored into the data row in a table of transactions with genre and joiner attributes.

35. The method of claim 15, wherein semiotic form three transactions are stored in a fully parsed state in a relational database table.

36. The method of claim 15 including the step of a further transaction conversion to convert a semiotic form two input or a semiotic form three input into a semiotic form four transaction by marking up with a scripting language such as XML or SGML, in order to facilitate electronic sharing of medical data.

37. The method of claim 15, wherein each transaction includes a unique patient identifier categorised under a linnean classification system, the unique patient identifier being human readable and comprehensible.

38. The method of claim 37, wherein the unique patient identifier comprises a concatenated expression of its membership of the poly-genera of computed date of birth, sex, names of patient and forebears, and locality at a given point in time.

39. A computer-based method for management of medical transactions, including storing each medical transaction as a transaction code in a data row in a database table, each transaction code including a genre key relating to the nature of the transaction, and including providing storage ledgers for each genre, such that each transaction can be retrieved and displayed as an entry in a storage ledger in accordance with its genre key.

40. The method of claim 39, including providing debit and credit ledgers storage ledgers, and providing means for double entry of medical transactions in debit and credit ledgers with accrual accounting for medical data of active interest.

41. The method of claim 39, each medical transactions capable of including joiner attributes, the method including the step of mapping each transaction into a data row in a table that is columnated with attributes that map directly to the joiner attributes of the transaction.

46. The method of claim 39, rendered with a data abstraction capability to highlight current patient status, including the step of evaluating each transaction for an accrual trigger action stigmatised by an accrual operator (such as the plus ‘

+’

operator or the minus ‘

−

’

operator) in order to recompute a new accrual transaction in an accrual table, such that patient status can be brought up to date for display in transaction accrual views.

53. The method of claim 39, including, for audit purposes and to reduce the risk of unwanted or inadvertent tampering of medical records, the step of calculating checksums following each transaction.