System and method for providing patient record synchronization in a healthcare setting

• US 20050071194A1
• Filed: 03/05/2004
• Published: 03/31/2005
• Est. Priority Date: 09/30/2003
• Status: Active Grant

• Current Assignee: Epic Systems Corporation
• Original Assignee: Epic Systems Corporation
• Inventors: Giesler, Andrew M.E., Bormann, Daniel S., Grover, Sameer, Cornelius, Aaron T., Hansen, Jason L., Escher, Timothy W., Peytchev, Vassil D., Michalski, Clifford L.
• Granted Patent: US 8,825,502 B2
• Time in Patent Office: Days
• US Class Current: 705/2
• CPC Class Codes: A61B 5/0022 Monitoring a patient using a global network, e.g. telephone networks, internet
• CPC Class Codes: G06F 16/273 Asynchronous replication or reconciliation
• CPC Class Codes: G06Q 50/22 Social work or social welfare, e.g. community support activities or counselling services
• CPC Class Codes: G16H 10/60 for patient-specific data, e.g. for electronic patient records
• CPC Class Codes: G16H 40/00 ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices

Abstract

A system provides an information sharing architecture that allows physically separate healthcare information systems, called “deployments,” to share and exchange information. The collection of these participating deployments is referred to as the “Community,” and systems within the Community sometimes store records for patients in common. The system allows participants in the Community to share information on data changes to these patients, and to reconcile concurrent and conflicting updates to the patient'"'"'s record.

Claims

1. An enterprise healthcare information management system comprising:

a first deployment and a second deployment;

each deployment including data stored within a data structure, the data at least relating to a data entity of the enterprise healthcare system and each deployment operable for autonomous management of the data stored within its respective data structure;

a communication network communicatively coupling the first and second deployments; and

each deployment having a data correspondence functionality facilitating reconciliation, manipulation, modification or synchronization of data stored in the data structures of either of the first and second deployments.

2. The enterprise healthcare information management system of claim 1, wherein the data correspondence functionality comprises at least one of a data mapping functionality;

a version management functionality and a conflict resolution functionality.

3. The enterprise healthcare information management system of claim 1, wherein the data correspondence functionality is operable to communicate modified or changed data stored at one of the first and second deployments to the other of the first and second deployments.

4. The enterprise healthcare information management system of claim 1, the data structure of the first deployment being configurable separate and apart from the data structure of the second deployment.

5. The enterprise healthcare information management system of claim 4, wherein the data correspondence functionality is operable to resolve configuration or version differences between the data structure of the first deployment and the data structure of the second data structure.

6. The enterprise healthcare information management system of claim 4, wherein the data structure of the first deployment corresponds to a data structure associated with a first enterprise healthcare information management system vendor and the data structure of the second deployment corresponds to a data structure associated with a second enterprise healthcare information management system vendor.

7. The enterprise healthcare information management system of claim 1, wherein the data comprises multiple instances of data associated with a data entity of the healthcare enterprise management system stored within the data structure of each of the first and second deployments.

8. The enterprise healthcare information management system of claim 1, wherein the data entity comprises at least one of:

a patient, a healthcare provider;

a healthcare administrator;

a benefits provider and a benefits administrator.

9. The enterprise healthcare information management system of claim 1, wherein data associated with a data entity comprises a data record and the data record is logically associated, “

homed,”

with one of the first or second deployments.

10. The enterprise healthcare information management system of claim 9, wherein a first portion of the data record is physically stored within the data structure of the first deployment and a second portion of the data record is physically stored within the data structure of the second deployment.

11. The enterprise healthcare information management system of claim 9, wherein the logical association of the data record is changeable between the first deployment and the second deployment.

12. The enterprise healthcare information management system of claim 1, wherein data associated with a data entity comprises a single virtual data record associated with one of the first deployment and the second deployment and a physical data portion stored within the data structure of at least one of the first deployment and the second deployment.

13. The enterprise healthcare information management system of claim 1, wherein the first and second deployments are at least one of physically and virtually remotely located from each other.

14. The enterprise healthcare information management system of claim 1, wherein the data correspondence functionality is operable to facilitate the communication of information from one of the first deployment and the second deployment to the other of the first deployment and the second deployment and to receive from the other deployment modified data and to store the modified data within the data structure of the one deployment.

15. An electronic patient health record system comprising:

a plurality of deployments, each deployment being configured to at least one of logically retain a first electronic patient health record and physically retain a second electronic patient health record, wherein the first and second patient health records comprise patient health record data; and

a network communicatively coupling the plurality of deployments such that patient health record data from a requested patient health record is communicated from a first deployment of the plurality of deployments to a second deployment of the plurality of deployments at the request of the second deployment;

wherein for each patient health record retained within the electronic patient health record system there is specified a home deployment of the plurality of deployments, the home deployment at least logically associated with patient health records assigned thereto.

16. The electronic patient health record system of claim 15, wherein at least one of the plurality of deployments, a cross-over deployment, is configured to physically retain patient health records at a highest current version level of the electronic patient health record system.

17. The electronic patient health record system of claim 15, wherein at least one of the plurality of deployments is configured to retain a master index of patient health records logically and physically retained within the electronic patient health record system.

18. The electronic medical record system of claim 17, wherein responsive to a request by the second deployment to receive patient health record data from a patient health record, the master index deployment provides to the second deployment home data for the requested patient health record, the home data identifying the home deployment for the patient health record containing the requested patient health record data.

19. The electronic medical record system of claim 15, wherein each deployment of the plurality of deployments is operable to create and maintain a table of the patient health records logically and physically retained within the electronic medical record system.

20. The electronic medical record system of claim 15, wherein the first patient health record and the second patient health record comprise portions of a single patient health record.

21. A method of communicating patient medical record data within an electronic patient health record system, the electronic patient health record system comprising a plurality of deployments, each deployment being operable to at least one of logically and physically retain patient health record data corresponding to patient health records, the plurality of deployments begin communicatively coupled by a network, the method comprising:

for each patient medical record, specifying a corresponding home deployment of the plurality of deployments;

determining the home deployment for a requested patient health record;

communicating from a requesting deployment a request to the home deployment corresponding to the requested patient health record data and the corresponding patient health record; and

communicating to the requesting deployment the requested patient health record data.

22. The method of claim 21, wherein the step of communicating to the requested deployment the requested patient health record data comprises communicating from a portion of the plurality of deployments patient health record data.

23. The method of claim 22, wherein the portion of the plurality of deployments comprises the home deployment for the patient health record corresponding to the requested patient health record data.

24. The method of claim 21, wherein the step of communicating comprises synchronizing the patient health record corresponding to the requested patient health record data between the home deployment for the patient health record and the requesting deployment.

25. The method of claim 21, comprising the steps of determining a change to the patient health record data occurring at the requesting deployment and communicating the change to the patient health record data to the home deployment, and updating the patient health record at the home deployment.

26. An enterprise healthcare information management system comprising:

at least a first deployment and a second deployment;

the first deployment having a first data structure with a first data structure configuration for storing data therein and the second deployment having a second data structure with a second data structure configuration, different from the first data structure configuration, for storing data therein, the data at least relating to a data entity of the enterprise healthcare system and each deployment operable for autonomous management of the data stored within its respective data structure;

a version skew deployment; and

a communication network communicatively coupling the first, second and version skew deployments,

wherein the version skew deployment is configured to physically retain patient medical records at a highest current version level of the enterprise healthcare information management system.

27. Within an enterprise healthcare information management system having at least one deployment, the deployment including data stored within a data structure, the data at least relating to a data entity of the enterprise healthcare system and the deployment being operable for autonomous management of the data stored within the data structure, a data record corresponding to the data entity comprising:

a first portion of the data record identifying a generation of the data record; and

a second portion of the date record identifying an update history of the data record.

28. The data record of claim 27, wherein the data entity comprises at least one of:

a patient, a healthcare provider;

a healthcare administrator;

a benefits provider and a benefits administrator.

29. The data record of claim 27, wherein the data record comprises groups, and wherein each group has associated therewith a first portion identifying a generation of the group and a second portion identifying an update history of the group.

30. The data record of claim 27, wherein the first portion is associated with an current update level of the data record and wherein the second portion is associated with an update history by deployment for the data record.

31. The data record of claim 27, wherein the first portion and the second portion facilitate data conflict resolution.

32. The data record of claim 27, wherein the healthcare information management system comprises a plurality of communicatively coupled deployments, and wherein the update history table reflects each of the plurality of deployments contributing to the data record, and the generation represents a latest update attributable to a corresponding deployment.

33. The data record of claim 27, wherein the generation and update history table reflect sequential continuity of the data record.

34. A method of managing data within a healthcare information management system, the healthcare information management system comprising at least one deployment, the deployment including data stored within a data structures the data at least relating to a data entity of the enterprise healthcare system and the deployment being operable for autonomous management of the data stored within the data structure, a data record corresponding to the data entity and having a first portion identifying a generation of the data record and a second portion of the data record identifying an update history of the data record;

the method comprising the steps of;

receiving at a deployment of the healthcare information system a data record for a data entity;

updating at the deployment the data record; and

correspondingly incrementing the generation to a current generation and the update history table to reflect the updating deployment and the current generation.

35. The method of claim 34, comprising the steps of:

determining in the update history table a previous update attributable to the deployment; and

discarding from the update history table the previous update.

36. The method of claim 37, wherein the data record comprises a plurality of groups and each group has associated therewith a first portion and a second portion identifying a generation and an update history of the group.

37. The method of claim 34, wherein prior to the step of updating at the deployment the data record the method comprising the step of:

determining if the data record is sequentially continuous based upon the generation and the update history table.

38. The method of claim 37, wherein the step of determining if the data record is sequentially continuous based upon the generation and the update history table comprises:

determining the data record is an older but sequentially continuous data record; and

ignoring the older but sequentially continuous data record.

39. The method of claim 37, wherein the step of determining if the data record is sequentially continuous based upon the generation and the update history table comprises:

determining the data record is an older and sequentially non-continuous data record; and

implementing a conflict resolution process.

40. The method of claim 39, wherein the conflict resolution process comprises:

checking if the older and sequentially non-continuous data record is a duplicate data record.

41. The method of claim 40, wherein the step of checking if the older and sequentially non-continuous data record is a duplicate data record comprises evaluating the generation of the data record.

42. The method of claim 39, wherein the conflict resolution process comprises:

checking if the older and sequentially non-continuous data record is based upon previously stored data; and

retaining the older and sequentially non-continuous data record.

43. The method of claim 42, wherein the step of checking if the older and sequentially non-continuous data record is based upon previously stored data comprises determining if a current generation is represented in the update history table.

44. The method of claim 39, wherein the conflict resolution process comprises:

checking if the older and sequentially non-continuous data record is based upon previously stored data; and

ignoring the older and sequentially non-continuous data record.

45. The method of claim 44, wherein the step of checking if the older and sequentially non-continuous data record is based upon previously stored data comprises determining if a current generation corresponding to the deployment is represented in the update history table.

46. The method of claim 37, wherein the step of determining if the data record is sequentially continuous based upon the generation and the update history table comprises:

determining that the data record at the deployment is a newer data record.

47. An enterprise healthcare information management system comprising:

at least a first deployment and a second deployment;

the first deployment having a first data structure with a first data structure configuration for storing data therein and the second deployment having a second data structure with a second data structure configuration, different from the first data structure configuration, for storing data therein, the data at least relating to a data entity of the enterprise healthcare system and each deployment operable for autonomous management of the data stored within its respective data structure;

a communication network communicatively coupling the first and second deployments; and

each deployment having a data mapping functionality, the data mapping functionality operable to reconcile data stored in one of the first deployment and the second deployment for use in the other of the first deployment and the second deployment upon communication of data from the other deployment to the one deployment.

48. The enterprise healthcare information management system of claim 47, wherein the data mapping functionality is operable to perform database record pointer resolution.

49. The enterprise healthcare information management system of claim 47, wherein the data mapping functionality is operable to perform deployment-to-deployment record pointer resolution.

50. The enterprise healthcare information management system of claim 49, wherein the deployment-to-deployment record pointers comprise selection list data values.

51. The enterprise healthcare information management system of claim 47, wherein data associated with a data entity comprises a community identification and a local deployment identification.

52. The enterprise healthcare information management system of claim 47, wherein data associated with a data entity comprises a direct match identification.

53. The enterprise healthcare information management system of claim 47, wherein the data mapping functionality is operable responsive to a data type and a deployment type.

54. The enterprise healthcare information management system of claim 47, the healthcare information management system comprising a master file index, the data mapping functionality operable responsive to the master file index.

55. The enterprise healthcare information management system of claim 54, the healthcare information management system comprising a master index deployment, the master file index being associated with the master index deployment.

56. The enterprise healthcare information management system of claim 54, the healthcare information management system comprising a cross-deployment ID table, the data mapping functionality operable responsive to the cross-deployment ID table.

57. The enterprise healthcare information management system of claim 47, the data comprising a plurality of data fields, the data mapping functionality operable to reconcile data by data field matching.

58. The enterprise healthcare information management system of claim 47, wherein the communication of the data from the other deployment to the one deployment comprises a synchronization message, the data mapping functionality being responsive to the synchronization message.

59. The enterprise healthcare information management system of claim 58, wherein the synchronization message comprises an additional information available flag.

60. An enterprise healthcare information management system comprising:

at least a first deployment and a second deployment;

each deployment including data records stored within a data structure, each data record relating to a data entity of the enterprise healthcare system and each deployment operable for autonomous management of the data records stored within its respective data structure;

a communication network communicatively coupling the first and second deployments;

each data record having a first data portion and a second data portion; and

wherein responsive to a request by the second deployment to receive a data record, the first deployment is operable to synchronously communicate the first data portion and to asynchronously communicate the second data portion via the network.

61. The enterprise healthcare information management system of claim 60, wherein the first data portion is communicated prior to the second data portion.

62. The enterprise healthcare information management system of claim 60, wherein the first data portion is accessible by a user of the second deployment at the second deployment as the second data portion is communicated.

63. The enterprise healthcare information management system of claim 60, wherein the first data portion comprises a patient medical record summary.

64. The enterprise healthcare information management system of claim 63, wherein the patient medical record summary is read only.

65. A method of communicating patient health record data within an electronic patient health record system, the electronic patient health record system comprising a plurality of deployments, each deployment being operable to at least one of logically retain and physically retain patient health record data, the plurality of deployments being communicatively coupled by a network, the patient health record having a first portion and a second portion, the method comprising the steps of:

receiving a request at the first deployment to communicate a patient health record to the second deployment;

responsive to the request, synchronously communicating the first portion of the requested patient health record and asynchronously communicating the second portion of the requested patient health record.

66. The method of claim 65, wherein the first portion comprises a patient health record summary associated with the requested patient health record.

67. The method of claim 65, wherein the first portion is communicated prior to the second portion.

68. The method of claim 65, wherein during communication of the first and second portions, inhibiting access to received portions of the requested patient health record at the second deployment.

69. The method of claim 65, wherein during communication of the first and second portions, limiting access to received portions of the requested patient health record at the second deployment.

70. The method of claim 65, wherein during communication of the first and second portions, permitting access to received portions of the requested patient health record at the second deployment.

71. The method of claim 70, comprising marking the patient health record at the second deployment as being in conflict with the first deployment.

72. A method of communicating patient health record data within an electronic patient health record system, the electronic patient health record system comprising a plurality of deployments, each deployment being operable to at least one of logically and physically retain patient health record data corresponding to patient health records, the plurality of deployments begin communicatively coupled by a network, the method comprising:

requesting at a first deployment a patient health record from a second deployment;

communicating the requested patient health record from the second deployment to the first deployment;

establishing a subscription for updates to the patient health record data; and

communicating responsive to the subscription update patient health record data from the second deployment to the first deployment.

73. The method of claim 72, comprising the step of unsubscribing from the patient health record.

74. The method of claim 73, wherein the step of unsubscribing comprises closing the patient health record at the first deployment.

75. The method of claim 73, wherein the step of unsubscribing comprises communicating an unsubscribe message.

76. The method of claim 73, wherein the step of unsubscribing comprises terminating the subscription following a time period.

77. The method of claim 72, comprising providing a notification broker communicatively coupled to the plurality of deployments via the network, and wherein the step of establishing a subscription comprises communicating a subscription message to the notification broker.

78. The method of claim 77, wherein the step of communicating responsive to the subscription update patient health record data from the second deployment to the first deployment comprises informing the notification broker regarding available updates, and communicating updates responsive to direction by the notification broker.

79. The method of claim 72, wherein the step of communicating responsive to the subscription update patient health record data from the second deployment to the first deployment comprises communicating only changed portions of the patient health record.

80. The method of claim 72, further comprising sending from the first deployment to the second deployment update record messages, and the method comprising updating the patient health record at the second deployment.

81. The method of claim 72, wherein the subscription is established based upon the request for the patient health record.

82. The method of claim 72, wherein the subscription is established based upon recipient criteria.

83. The method of claim 82, wherein the recipient criteria defines a potential recipient based upon a potential desire or need for the update.

84. The method of claim 83, wherein the subscription is established without action on the part of the recipient.

85. An enterprise healthcare information management system comprising:

at least a first deployment and a second deployment;

each deployment including data records stored within a data structure, each data record relating to a data entity of the enterprise healthcare system and each deployment operable for autonomous management of the data records stored within its respective data structure;

a notification broker deployment; and

a communication network communicatively coupling the first, second and notification broker deployments,

wherein the notification broker deployment is configured to manage subscribe communication of data record updates.

86. A method of communicating patient health record data within an electronic patient health record system, the electronic patient health record system comprising a plurality of deployments, each deployment being operable to at least one of logically and physically retain patient health record data corresponding to patient health records, the plurality of deployments begin communicatively coupled by a network, the method comprising:

determining an update to patient health record data within a patient health record;

determining the existence of at least one deployment subscribing to the patient health record; and

communicating the update to the at least one deployment responsive a trigger criteria.

87. The method of claim 86, comprising modifying update history data associated with the patient health record.

88. The method of claim 86, wherein the trigger criteria is based upon a data type associated with the update.

89. The method of claim 86, the patient health record system comprising a notification broker deployment, the notification broker deployment being communicatively coupled to the plurality of deployments via the network;

wherein the step of communicating the update comprises communicating the update via the notification broker deployment.

90. The method of claim 86, the patient health record being associated with a home deployment of the plurality of deployments;

wherein the step of communicating the update comprises communicating the update to the home deployment.

91. The method of claim 86, wherein the step of communicating the update comprises grouping a plurality of updates to form a batch and communicating the batch.

92. The method of claim 86, wherein the step of communicating the update comprises communicating only an update portion of the patient health record.

93. The method of claim 86, wherein the trigger criteria comprises logical points within an application workflow.

94. The method of claim 86, comprising checking, based upon a tracking criteria, a patient health record to determine if the patient health record should be tracked for changes, and tracking a patient health record responsive to the tracking criteria.

95. The method of claim 86, comprising identifying a first update and a second update, postponing communication of the second update pending communication of the first update.

96. The method of claim 95, comprising maintaining the second update in an update queue pending communication of the first update.

97. The method of claim 96, comprising processing updates from the update queue until the queue is empty.

98. The method of claim 86, comprising suspending the trigger criteria pending the step of communicating the update.

99. The method of claim 86, wherein the trigger criteria defines a plurality of trigger events.

100. The method of claim 86, comprising suspending the trigger criteria pending resolution of an active trigger.

101. The method of claim 86, wherein the update comprises a group of updates of a same update level.