Computerized medical diagnostic and treatment advice system including network access

• US 6,849,045 B2
• Filed: 11/19/2002
• Issued: 02/01/2005
• Est. Priority Date: 07/12/1996
• Status: Expired due to Fees

• Current Assignee: Clinical Decision Support, LLC (Tivity Health, Inc.)
• Original Assignee: First Opinion Corporation (Tivity Health, Inc.)
• Inventors: Iliff, Edwin C.
• Primary Examiner(s): Jones, Mary Beth
• Assistant Examiner(s): ASTORINO, MICHAEL C
• Application Number:
  US10/300,284
• Publication Number:
  US 20030135095A1
• Time in Patent Office: 805 Days
• Field of Search: 600300-301, 128897-898, 128920-925, 607/32, 607/60, 705 1- 4, 702/19, 3791061-1062, 434/262
• US Class Current: 600/300
• CPC Class Codes: A61B 2560/0271 using a remote monitoring unit
• 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: A61B 5/411 Detecting or monitoring allergy or intolerance reactions to an allergenic agent or substance
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• 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 40/63 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: 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 128/904 Telephone telemetry
• CPC Class Codes: Y10S 128/92 Computer assisted medical diagnostics
• CPC Class Codes: Y10S 128/925 Neural network

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 networks, such as a telephone network or a computer network. The invention also includes a stand-alone embodiment that may utilize occasional connectivity to a central computer by use of a network, such as the Internet. 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 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 system comprising:

a computing environment arranged to receive patient information, comprising;

a communications network;

a server computer connected to the network;

a client processor connected to the network and in data communication with the server computer via the network;

an input device, connected to the client processor, to receive patient information from a user who is the patient or a proxy or assistant thereto;

a script database;

an output device, connected to the client processor, to provide information indicative of a diagnosed medical condition information;

the environment executing programs for diagnosing by scoring a medical condition based on said patient information and communicating said diagnosed condition via said output device;

said programs comprising;

a plurality of medical complaint algorithms selectively executed based on at least a portion of the received information, wherein any one of the medical complaint algorithms scores at least a portion of the received information and diagnoses a medical condition associated with the executed medical complaint algorithm if the score reaches or passes a threshold;

and wherein the program is arranged to read data from, and write data to, a medical history database stored in association with the client processor or said server computer, wherein any such scored information transferred between the client processor and the server computer is securely transmitted;

and wherein each medical complaint algorithm is executed by said client processor, by a script engine program which is arranged;

to interpret a medical complaint script file comprising lists of disease data, symptom data and question data;

to output questions to said user;

to input answers from said user via said input device; and

to score said patient data and diagnose a said medical condition and update said medical history database using said scoring;

and wherein said server computer is arranged to selectively download a said medical complaint script file to said client processor.

2. The system of claim 1, wherein the medical condition comprises a disease.

3. The system of claim 1, wherein the communications network comprises the Internet.

4. The system of claim 1, wherein the client processor utilizes a web browser.

5. The system of claim 1, additionally comprising a treatment table accessed according to the diagnosed medical condition.

6. The system of claim 1, wherein each of the plurality of medical complaint algorithms is associated with one or more medical conditions.

7. The system of claim 1, wherein the diagnosed medical condition is communicated to a patient.

8. The system of claim 1, wherein the diagnosed medical condition is communicated to a physician.

9. The system of claim 8, wherein the score associated with the diagnosed medical condition is communicated to the physician.

10. The system of claim 1, wherein a plurality of potentially diagnosed medical conditions are accumulated into a differential diagnosis list.

11. The system of claim 10, wherein the differential diagnosis list is ordered based on degree of certainty.

12. The system of claim 1, wherein the threshold is modifiable by one or more sensitivity factors.

13. A medical diagnostic system comprising:

a computing environment arranged to receive patient information, comprising;

a communications network;

a server computer connected to the network;

a client processor connected to the network and in data communication with the server computer via the network;

an input device, connected to the client processor, to receive patient information from a patient or a proxy thereto;

an output device, connected to the client processor, to provide medical condition information to the patient;

the environment executing programs for diagnosing by scoring a medical condition based on said patient information and communicating said diagnosed condition via said output device;

said programs comprising;

a plurality of medical algorithms selectively executed based on at least a portion of the received information, wherein any one of the medical algorithms scores at least a portion of the received information and diagnoses a medical condition associated with the executed medical algorithm if the score reaches or passes a threshold;

and wherein the programs are arranged to read data from, and write data to, a medical history file stored in association with the client processor or said server computer;

and wherein each medical algorithm is executed by said client processor, by a script program which is arranged;

to output questions to said user;

to input answers from said user via said input device; and

to score said patient data and diagnose a said medical condition and update said medical history database.

14. The system defined in claim 13, wherein information transferred between the client processor and the server computer is securely transmitted.

15. The system defined in claim 13, wherein the script program processes a medical script file comprising lists of disease data, symptom data and question data.

16. The system defined in claim 15, wherein said server computer is arranged to selectively download a said medical script file to said client processor.

17. The system defined in claim 13, wherein the medical history file is updated using said scored patient data.

18. A medical diagnostic system comprising:

a computing environment arranged to receive patient information, comprising;

a communications network;

a server computer connected to the network;

a client processor connected to the network and in data communication with the server computer via the network;

an input device, connected to the client, to receive patient information; and

an output device, connected to the client, to provide information indicative of a diagnosed medical condition;

the environment executing a program for diagnosing by scoring a medical condition based on said patient information and communicating said diagnosed medical condition via said output device;

said program comprising;

at least one medical algorithm selectively executed based on at least portion of the received information, wherein the medical algorithm scores at least a portion of the received information and diagnoses a medical condition associated with the executed medical algorithm if the score reaches or passes a threshold; and

wherein the program is arranged to read data from, and write data to, a medical history file stored in association with the client processor or the server computer, and wherein the scoring by the medical algorithm is influenced by the data read from the medical history file.

19. The system defined in claim 18, wherein information transferred between the client processor and the server computer is securely transmitted.

20. The system defined in claim 18, wherein data communication between the server computer and the client processor is intermittent.

21. A computerized system for providing information to any one of a plurality of patients by communicating information over a computer network, the system comprising:

means for selectively executing at least one medical software code portion;

means for accessing a patient medical history during an evaluation process, wherein each patient is associated with at least one record containing medical information unique to the medical condition of the patient, and wherein the patient medical history is persistently stored in the at least one record;

means for determining medical advice particular to a medical condition associated with the medical software code portion through communication over the computer network with a selected one of the patients and with information stored in the patient medical history; and

means for providing the medical advice to the selected patient.

22. The system defined in claim 21, additionally comprising means for generating a diagnosis during the selective execution of the medical software code portion.

23. The system defined in claim 22, additionally comprising:

means for storing a treatment table on the computer network;

means for accessing the treatment table based on the diagnosis to select a treatment; and

means for communicating the selected treatment to the patient.

24. The system defined in claim 22, wherein the diagnosis comprises a single disease.

25. The system defined in claim 22, wherein the diagnosis comprises a differential diagnosis list.

26. The system defined in claim 21, additionally comprising means for protecting the medical history of the patient against unauthorized access.

27. The system defined in claim 21, wherein the patient medical history is stored at a central location on the computer network.

28. The system defined in claim 21, wherein at least a portion of the patient medical history resides at a client computer connected to the computer network.

36. The system defined in claim 21, wherein the communication with a selected one of the patients is stored as a patient consultation summary.

37. The system defined in claim 36, wherein a physician accesses and uses the patient consultation summary to make a diagnosis.

38. The system defined in claim 21, wherein the means for determining medical advice includes means for accessing an imaging modality table on the computer network.

39. The system defined in claim 21, wherein the means for determining medical advice includes means for accessing a laboratory test table on the computer network.

29. A computerized system for providing information to any one of a plurality of patients by communicating information over a computer network, the system comprising:

means for selectively executing at least one of a plurality of medical software code portions;

means for accessing a patient medical history during an evaluation process, wherein each patient is associated with at least one record containing medical information unique to the medical condition of the patient, and wherein the patient medical history is persistently stored;

means for determining medical advice particular to a medical condition associated with one of die medical software code portions through communication over the computer network with a selected one of the patients and with information stored in the patient medical history; and

means for providing the medical advice to the selected patient.

30. A computerized system having a user access means at least intermittent connection to a computer network for providing information to a patient, the system comprising:

means for receiving and selectively executing at a user access means at least one of a plurality of medical software code portions;

means for transmitting information indicative of the patient from the user access means, the information being capable of use for determining medical advice in conjunction with persistently stored patient information; and

means for receiving medical advice particular to a medical condition associated with one of the medical software code portions.

31. The system defined in claim 30, wherein the user access means utilizes a browser.

32. The system defined in claim 30, wherein the user access means utilizes a script engine.

33. The system defined in claim 30, wherein the persistently stored patient information comprises a patient medical history having a plurality of records.

34. The system defined in claim 30, wherein the computer network comprises the Internet.

35. The system defined in claim 30, wherein the computer network comprises an intranet.

40. The system defined in claim 30, wherein the user access means comprises a portable computing device.

41. The system defined in claim 40, wherein the portable computing device includes a wireless communication interface.

42. The system defined in claim 32, wherein the script engine is a brows plug-in.

43. The system defined in claim 30, wherein the user access means is configured for providing the medical advice comprising a diagnosis of a chief complaint.

44. The system defined in claim 30, wherein the user access means is configured for providing the medical advice comprising a diagnosis associated with a plurality of symptoms.

45. The system defined in claim 30, wherein the user access means is configured for providing the medical advice comprising a diagnosis associated with a plurality of signs.

46. The system defined in claim 30, wherein the user access means is configured for providing the medical advice comprising a diagnosis associated with one or more laboratory tests.

47. The system defined in claim 30, wherein the user access means is configured for providing the medical advice comprising a diagnosis associated with one or more imaging modalities.

48. The system defined in claim 32, wherein the persistently stored patient information resides on a local patient database.

49. The system defined in claim 32, wherein the persistently stored patient information resides on a remote patient database.

50. The system defined in claim 32, wherein the script engine accesses the persistently stored patient information.

51. The system defined in claim 48, wherein the script engine updates the local patient database.

52. The system defined in claim 49, wherein the script engine updates the remote patient database.

53. The system defined in claim 32, wherein the script engine evaluates the information indicative of the patient.

54. The system defined in claim 32, wherein the script engine executes the medical software code portions.

55. The system defined in claim 32, wherein the script engine develops a diagnosis.