Computerized medical diagnostic and treatment advice system

• US 5,660,176 A
• Filed: 12/29/1993
• Issued: 08/26/1997
• Est. Priority Date: 12/29/1993
• Status: Expired due to Term

• Current Assignee: Clinical Decision Support, LLC (Tivity Health, Inc.)
• Original Assignee: First Opinion Corporation (Tivity Health, Inc.)
• Inventors: Iliff, Edwin C.
• Primary Examiner(s): Cohen, Lee S.
• Assistant Examiner(s): GILBERT, SAMUEL G
• Application Number:
  US08/176,041
• Time in Patent Office: 1,336 Days
• Field of Search: 128/630, 128/897, 128/898, 128/903, 128/904, 364/413.01, 364/413.02, 364/413.29
• US Class Current: 600/300
• CPC Class Codes: A61B 5/0002 Remote monitoring of patients using telemetry, e.g. transmission of vital signals via a communication network A61B5/07 takes precedence; transmission systems for measured values G08C; transmission H04B; transmission of digital information H04L; wireless communication networks H04W
• CPC Class Codes: A61B 5/4094 Diagnosing or monitoring seizure diseases, e.g. epilepsy
• 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 20/70 relating to mental therapies, e.g. psychological therapy or autogenous training
• CPC Class Codes: G16H 40/63 for local operation
• 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 70/20 relating to practices or guidelines
• CPC Class Codes: G16H 70/60 relating to pathologies
• CPC Class Codes: H04M 2201/40 using speech recognition speech recognition per se G10L15/00
• CPC Class Codes: H04M 2203/355 Interactive dialogue design tools, features or methods
• CPC Class Codes: H04M 3/493 Interactive information services, e.g. directory enquiries ; Arrangements therefor, e.g. interactive voice response [IVR] systems or voice portals
• CPC Class Codes: Y10S 128/92 Computer assisted medical diagnostics
• CPC Class Codes: Y10S 128/925 Neural network
• CPC Class Codes: Y10S 706/924 Medical

Abstract

A system and method for providing computerized, knowledge-based medical diagnostic and treatment advice. The medical advice is provided to the general public over a telephone network. Two new authoring languages, interactive voice response and speech recognition are used to enable expert and general practitioner knowledge to be encoded for access by the public. "Meta" functions for time-density analysis of a number of factors regarding the number of medical complaints per unit of time are an integral part of the system. A semantic discrepancy evaluator routine along with a mental status examination are used to detect the consciousness level of a user of the system. A re-enter feature monitors the user'"'"'s changing condition over time. A symptom severity analysis helps to respond to the changing conditions. System sensitivity factors may be changed at a global level or other levels to adjust the system advice as necessary.

Claims

1. A medical diagnostic and treatment advice system for providing information to a patient, comprising:

a computer;

input device, connected to the computer, to receive information from the patient;

an algorithm processor executing in the computer;

an output device, connected to the computer, to provide information to the patient;

a plurality of medical complaint algorithms selectively executed by the algorithm processor and providing medical advice, via the output device, said medical advice particular to a medical condition as determined through dialogue with the patient, wherein at least one of the medical complaint algorithms generates a diagnosis; and

a patient medical history database storing a past medical history file for each patient, the patient medical history database written and read by one of the medical complaint algorithms and stored in the computer.

2. The medical advice system defined in claim 1, wherein the algorithm processor comprises a symbol table and a parser.

3. The medical advice system defined in claim 2, wherein the algorithm processor additionally includes a run time stack.

4. The medical advice system defined in claim 1, wherein each of the medical complaint algorithms includes at least a portion of a node table, the node table comprising a plurality of node records, and further includes a plurality of list files.

5. The medical advice system defined in claim 4, wherein each list file is organized to include data of the following types:

play, next, and work.

6. The medical advice system defined in claim 1, wherein the algorithm processor includes means for loading a plurality of node blocks into the memory of the computer.

7. The medical advice system defined in claim 6, wherein each node block includes a reference to a selected list file.

8. The medical advice system defined in claim 6, wherein each node block includes data from a node record and a list file.

9. The medical advice system defined in claim 1, wherein the algorithm processor includes means for obtaining and storing the patient'"'"'s past medical history.

10. The medical advice system defined in claim 1, wherein the input device includes a keyboard.

11. The medical advice system defined in claim 1, wherein the input device includes a dual tone multiple frequency (DTMF) signal processing system.

12. The medical advice system defined in claim 1, wherein the input device includes an automatic speech recognition system.

13. The medical advice system defined in claim 1, wherein the output device includes a video display.

14. The medical advice system defined in claim 1, wherein the output device includes a speech playback system.

15. The medical advice system defined in claim 1, additionally comprising a treatment table stored in the computer, the treatment table selectively accessed by the patient based on the diagnosis provided by one of the medical complaint algorithms and wherein the selected treatment is communicated to the patient through the output device.

16. The medical advice system defined in claim 1, additionally comprising:

a consultation history database stored in the computer, the database comprising a time ordered sequence of records, each record including the following fields;

a date, a medical problem, an anatomical system, and a cause of the problem; and

means for analyzing the consultation history database using a match pattern, the match pattern indicative of a field of interest in the consultation history database, and wherein the analysis permits assessment of a change in the patient'"'"'s medical condition.

17. The medical advice system defined in claim 1, additionally comprising

a patient response database having a trace response file for each patient, the patient response database written by one of the medical complaint algorithms and stored in the computer.

18. The medical advice system defined in claim 1, wherein the diagnosis is communicated to the patient through the output device.

19. The medical advice system defined in claim 1, additionally including means for protecting security of a medical history of the patient.

20. The medical advice system defined in claim 19, wherein the means for protecting the security includes means for comparing voice prints.

21. The medical advice system defined in claim 19, wherein the system includes a function to assign a unique patient identification number to each patient using the system.

22. The medical advice system defined in claim 19, wherein the system includes a function to provide access to an assistant on behalf of the patient.

23. The medical advice system defined in claim 22, wherein the system includes a function to assign a unique assistant identification number to each assistant using the system.

24. The medical advice system defined in claim 22, wherein the system includes a function to provide access to the assistant on behalf of a selected patient until a predetermined date.

25. The medical advice system defined in claim 22, wherein the system includes a function to provide access to the assistant on behalf of a plurality of selected patients.

26. The medical advice system defined in claim 1, wherein the medical advice comprises the diagnosis and a score.

27. The medical advice system defined in claim 1, wherein the medical advice comprises a treatment.

28. The medical advice system defined in claim 1, wherein the input device includes a pointing/writing device.

29. The medical advice system defined in claim 1, wherein the output device includes a printer.

30. The medical advice system defined in claim 1, wherein the output device includes a facsimile device.