Adaptive communication methods and systems for facilitating the gathering, distribution and delivery of information related to medical care

• US 7,436,311 B2
• Filed: 12/22/2005
• Issued: 10/14/2008
• Est. Priority Date: 01/25/2002
• Status: Expired due to Term

• Current Assignee: Koninklijke Philips N.V.
• Original Assignee: Medcommunications Corporation
• Inventors: Bergens, Michael U., Rapaport, Seymour A., Rinehart, Eric R., Clarke, Jeffrey E., Rapaport, Jeffrey A.
• Primary Examiner(s): Nguyen; Phung
• Application Number:
  US11/317,597
• Publication Number:
  US 20060161457A1
• Time in Patent Office: 1,027 Days
• Field of Search: 340/573.1, 340/539.1, 340/457, 340/3.1, 600/300, 705/3, 705/9, 379/88.22, 379/37, 379/38
• US Class Current: 340/573.1
• 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 40/20 for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
• 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

Abstract

Automated methods and systems are disclosed for persistently facilitating the timely gathering, monitoring, distribution and delivery of information related to medical care where such may include: (1) finding a communications channel for effectively attempting a message delivery to a specific target person at a specified time; (2) adaptively finding a targeted recipient even if the latter is highly mobile and/or has travel patterns or communications-channel preferences that change over time; (3) verifying that a targeted recipient has actually received an attempted delivery within an applicable time limit; (4) automatically recognizing that an urgent message delivery-attempt was not timely completed and adaptively alerting responsible entities of the in completion; and (5) automatically recognizing that an urgent change or non change of condition has occurred by virtue of information gathered during an automated or manually-conducted Interview where physician expected positive progress prior to Interview and adaptively alerting responsible entities of the changed or unchanged condition based on the urgency of the change or non-change.

Claims

1. A follow-up scheduling and monitoring mechanism for automatically assisting a care-concerned person in scheduling and persistently following up with one or more health or medical care follow up actions following a first care-related situation constituted by at least one of the following situations:

(0.1) completion of a first examination where an initial assessment of patient condition was made and one or more follow up medical tests were ordered;

(0.2) incompletion of a care-related communication delivery-attempt where said incompletion of the delivery-attempt calls for relatively prompt attention thereto;

(0.3) incompletion of a care-related task where said incompletion of the care-related task calls for relatively prompt attention thereto; and

(0.4) an unexpected change or a lack of expected change in a medical condition of a given patient where said unexpected change or lack of expected change calls for relatively prompt attention thereto;

where said follow-up scheduling and monitoring mechanism comprises;

(a) adaptive scheduling means for automatically and adaptively scheduling one or more attention-giving, follow up actions that are to be provided in an adaptively persistent manner following the first care-related situation; and

(b) patient attribute defining means for defining one or more health-related attributes of the under-care patient which can affect the adaptively persistent carrying out of said, one or more attention-giving, follow up actions that are to be provided.

2. The follow-up scheduling and monitoring mechanism of claim 1 wherein said at least one care-concerned person includes a member of the group comprising a medical service provider and a medical assistant.

3. The follow-up scheduling and monitoring mechanism of claim 1 wherein said first care-related situation is constituted at least by said situation (0.4) involving an unexpected change or a lack of expected change in a medical condition of a given patient and wherein:

(a.1) said adaptive scheduling means includes first means for scheduling delivery of one or more alert messages to corresponding one or more care-concerned persons relating to said situation (0.4); and

(a.2) said adaptive scheduling means includes second means responsive to said one or more health-related attributes of the patient attribute defining means, the second means being for prioritizing alert messages sent to the corresponding one or more care-concerned persons in accordance with severity of said situation (0.4) as determined at least from said health-related attributes.

4. The follow-up scheduling and monitoring mechanism of claim 1 and further comprising:

(c) communication history recording means for recording indications of successfully delivered and/or completed providings of said follow up actions and/or of failed deliveries or of failed completions of said follow up actions.

5. An automated machine system for providing machine-supported customization in the provision of health care services to patients, the system comprising:

(a) first machine-readable storage having defined therein one or more representations of corresponding health care services that can be respectively delivered to one or more respective patients;

(b) second machine-readable storage having defined therein one or more representations of unique attributes currently associated with a unique one or more of said respective patients; and

(c) service formulating means for automatically providing customizable formulation support for formulating of a planned and deliverable health care service to a corresponding patient, wherein said service formulating means is operatively coupled to the second machine-readable storage for integrating the unique and current attributes of the corresponding patient with the customizable formulation support so that a customized health care service can be automatically planned and/or delivered based on said unique attributes of the corresponding patient.

6. The automated machine system of claim 5 wherein:

said planned and deliverable health care service includes one or more interviews to be delivered to the corresponding patient; and

(c.1) said service formulating means includes means for automatically integrating the unique attributes of the corresponding patient with customizable formulation support provided for formulating one or more deliverable interviews so that said one or more deliverable interviews can be automatically formulated based on said unique attributes of the corresponding patient.

7. The automated machine system of claim 5 wherein:

said unique attributes of a given patient include two or more of;

(b.1) identifications of service delivery channels preferred by the given patient;

(b.2) identifications of service delivery times preferred by the given patient for one or more of the identified service delivery channels;

(b.3) values of medication dosaging parameters useful for determining dosages of medication to be prescribed to the given patient, said medication dosaging parameters including an indication of a last known weight of the given patient;

(b.4) identifications of current medications the given patient is last known to be receiving;

(b.5) identifications of allergies the given patient is last known to have;

(b.6) identifications of chronic medical conditions the given patient is last known to have; and

(b.7) identifications of major hospitalizations or operations the given patient is last known to have had.

8. A method of adaptively and persistently following up on one or more health or medical care actions directed to a given medical patient, the method comprising:

(a) maintaining in machine-readable storage, one or more representations of unique attributes currently associated with a unique one or more of plural patients;

(b) referencing and using said representations of unique attributes (a) in an automatic or semiautomatic performance of at least one member of a follow up actions group consisting of;

(b.1) automatically delivering an interactive interview to a targeted patient;

(b.2) automatically updating said representations of unique attributes currently associated with a unique targeted patient by delivering and following through with a personal-data settings review interview with the unique targeted patient; and

(b.3) automatically and at least periodically conducting health maintenance interviews with the unique targeted patient and responsively updating said representations of unique attributes currently associated with a unique targeted patient.

9. A method of maintaining adaptive communicability with persons who are subject to variability in how each such person may be intelligently communicated with, the method comprising:

(a) maintaining in machine-readable storage, one or more representations of unique attribute data currently associated with respectively ones of plural persons to whom custom-formulated messages or custom-formulated interviews or custom-formulated alert signals are to be adaptively communicated;

(b) automatically attempting to conduct attribute updating interviews with one or more given ones of said plural persons and/or with pre-designated alternate delegates of respective ones of said plural persons to thereby obtain more current attribute data, if available, for said given persons;

(c) updating the corresponding attribute data in said machine-readable storage after having succeeded in automatically conducting one or more of said attribute updating interviews with corresponding given ones of said persons and/or with pre-designated alternate delegates of respective ones of said plural persons; and

(d) using attribute data obtained from said machine-readable storage after said updating to formulate at least one of;

(d.1) custom-formulated messages, (d.2) custom-formulated interviews, (d.3) custom-formulated alert signals and (d.4) custom-formulated delivery strategies for delivering messages and/or interviews and/or alerts to a targeted one or more of said plural persons and/or to alternate delegates pre-designated on behalf of respective ones of said plural persons.

10. The method of maintaining adaptive communicability according to claim 9 wherein:

(a.1) said maintained attribute data includes;

(a.1a) address data for connecting to specific communication modalities which are potentially available at one or more time periods to respective ones of said plural persons to whom custom-formulated messages or custom-formulated interviews or custom-formulated alert signals are to be adaptively communicated;

(a.1b) modality preference data for ordering the specific communication modalities of said plural persons according to respective way-to-contact-me preferences specified by the respective plural persons; and

(a.1c) contact time preference data for specifying preferred times of when to try and contact said plural persons according to respective times-to-try-and-contact-me preferences specified by the respective plural persons.

11. The method of maintaining adaptive communicability according to claim 10 wherein:

(a.2) said maintained attribute data further includes;

(a.2a) automated formulation parameter data for assisting in automatic or semiautomatic formulation of medical treatment to be prescribed, if at all, to respective ones of said plural persons where the automated or semiautomated treatment formulating algorithm relies on at least one of patient'"'"'s currently-recorded age, patieynt'"'"'s currently-recorded height, patient'"'"'s currently-recorded weight, patient'"'"'s currently-recorded sex and patient'"'"'s currently-recorded medical status.

12. The method of maintaining adaptive communicability according to claim 11 wherein:

(a.2b) said medical treatment includes a possible prescribing of one or more medical interventions or medications at a given time and said automated or semiautomated treatment formulating algorithm relies on at least one of patient'"'"'s currently-recorded age, patient'"'"'s currently-recorded height, patient'"'"'s currently-recorded weight, patient'"'"'s currently-recorded sex and patient'"'"'s currently-recorded medical status for determining whether to prescribe and/or which to prescribe of said one or more medical interventions or medications.

13. The method of maintaining adaptive communicability according to claim 11 wherein:

(a.3) said maintained attribute data yet further includes;

(a.3a) contra-indication data for assisting in automatic formulation of medication to be prescribed, if at all, to respective ones of said plural persons where the automated formulation algorithm bypasses certain prescription options based on at least one of;

patient'"'"'s current allergies and patient'"'"'s current other medications.

14. The method of maintaining adaptive communicability according to claim 13 wherein:

(a.4) said maintained attribute data yet further includes;

(a.4a) current medical condition data for assisting in automatic formulation of medication to be prescribed, if at all, to respective ones of said plural persons where the automated formulation algorithm takes into account at least one of a patient'"'"'s current medical distress situations such as whether the patient currently suffers from hypertension and/or diabetes and/or if diabetes, how long from onset.

15. The method of maintaining adaptive communicability according to claim 9 wherein:

(a.1) said maintained attribute data includes;

(a.1a) medication parameter data for assisting in automatic formulation of medication to be prescribed, if at all, to respective ones of said plural persons where the automated prescription assisting algorithm relies on at least one of patient'"'"'s currently-recorded age, patient'"'"'s currently-recorded height, patient'"'"'s currently-recorded weight, patient'"'"'s currently-recorded sex and patient'"'"'s currently-recorded medical status.

16. The method of maintaining adaptive communicability according to claim 9 wherein:

(b.1) said automatic conducting of attribute updating interviews includes automatically and periodically conducting such updating interviews with one or more given ones of said plural persons or delegates pre-appointed on their behalf to thereby obtain more current attribute data, if available, for said given persons.

17. The method of maintaining adaptive communicability according to claim 9 wherein:

(c.1) prior to said updating of the corresponding attribute data in said machine-readable storage, the method includes performing a comparison of before and after attribute data.

18. The method of maintaining adaptive communicability according to claim 9 wherein:

(c.1) said updating of the corresponding attribute data in said machine-readable storage includes time and/or date stamping of the update changes.

19. The method of maintaining adaptive communicability according to claim 9 wherein:

(c.1) said updating of the corresponding attribute data in said machine-readable storage further includes performing scheduled archiving of attribute data.

20. The method of maintaining adaptive communicability according to claim 9 wherein:

(d.5) said plural persons include first medical care providers and said attribute data of one or more of the first medical care providers includes foreign access permission attributes for designating one or more other medical care providers who will have full or partial access to formulated one or more of said custom-formulated messages, custom-formulated interviews, and custom-formulated alert signals accessible to the first medical care providers.

21. The method of maintaining adaptive communicability according to claim 9 wherein:

(a.1) said maintained attribute data includes at least one of;

(a.1a) the person'"'"'s most recently-recorded blood sugar level;

(a.1b) the person'"'"'s most recently-recorded blood potassium level;

(a.1c) the person'"'"'s most recently-recorded blood pressure parameters;

(a.1d) the person'"'"'s most recently-recorded heart pulse rate;

(a.1e) the person'"'"'s most recently-recorded blood lipid parameters;

(a.1f) the person'"'"'s most recently-recorded urea nitrogen level;

(a.1g) the person'"'"'s most recently-recorded haptoglobin level; and

(a.1h) the person'"'"'s most recently-recorded calcium level.

22. The method of maintaining adaptive communicability according to claim 9 wherein:

(d.5) said using of the attribute data to formulate includes at least one of;

(d.5a) custom-tailoring content presented in a formulated interview or message in response to said obtained attribute data;

(d.5b) custom-tailoring flow of dialog as presented in a formulated interview in response to said obtained attribute data;

(d.5c) in response to said obtained attribute data, custom-tailoring priority and/or delivery order and/or presentation order of formulated alerts, messages and/or interviews; and

(d.5d) in response to said obtained attribute data, custom-tailoring presentation style of a formulated interview or message.

23. The method of maintaining adaptive communicability according to claim 22 wherein:

(d.5a) said custom-tailoring of content includes selection of language to be used.

24. The method of maintaining adaptive communicability according to claim 9 wherein:

(d.5) said using of the attribute data to formulate includes;

(d.5a) automatically sending essentially all test results to corresponding patients as interviews calling for acknowledgement of receipt within predefined time windows after corresponding tests are performed, thereby assuring continued communicability with the corresponding patients and reinforcing in the corresponding patients the idea of expecting to receive essentially all test results within the predefined time windows.

25. The method of maintaining adaptive communicability according to claim 24 and further comprising:

(e) instructing patients to contact their respective medical providers if the patients are not timely informed of all their test results within said predefined time windows.

26. The method of maintaining adaptive communicability according to claim 25 and further comprising:

(f) recording as part of patient attributes acknowledgement behavior of patients in response to said automatic sending of essentially all test results.

27. The method of maintaining adaptive communicability according to claim 26 and further comprising:

(g) using said recorded acknowledgement behavior of patients as a predictor of next expected acknowledgement behavior for flagging out deviation as unexpected retrieval behavior.

28. The method of maintaining adaptive communicability according to claim 9 and further comprising:

(e) if said attempting to conduct update interviews fails to complete after a predefined number of tries or fails to complete after a predefined time has elapsed, automatically sending an alert to another person.

29. A machine system for maintaining adaptive communicability with persons who are subject to variability in how each such person may be intelligently communicated with, the machine system comprising:

(a) machine-readable storage adapted for storing one or more representations of unique attribute data currently associated with respectively ones of plural persons to whom custom-formulated messages or custom-formulated interviews or custom-formulated alert signals are to be adaptively communicated;

(b) update attempting means for automatically attempting to conduct attribute-updating, interactive communications with one or more given ones of said plural persons and/or with pre-designated alternate delegates of respective ones of said plural persons to thereby obtain more current attribute data, if available, for said given persons;

(c) attribute updating means for updating the corresponding attribute data in said machine-readable storage after having succeeded in automatically conducting one or more of said attribute-updating interactive communications with corresponding given ones of said persons and/or with pre-designated alternate delegates of respective ones of said plural persons; and

(d) attribute utilizing means for using attribute data obtained from said machine-readable storage after said updating to formulate at least one of;

(d.1) custom-formulated messages, (d.2) custom-formulated interviews, (d.3) custom-formulated alert signals and (d.4) custom-formulated delivery strategies for delivering messages and/or interviews and/or alerts to a targeted one or more of said plural persons and/or to alternate delegates pre-designated on behalf of respective ones of said plural persons.

30. The machine system of claim 29 wherein:

(a.1) said stored attribute data includes;

(a.1a) address data for connecting to specific communication modalities which are potentially available at one or more time periods to respective ones of said plural persons to whom custom-formulated messages or custom-formulated interviews or custom-formulated alert signals are to be adaptively communicated;

(a.1b) modality preference data for ordering the specific communication modalities of said plural persons according to respective way-to-contact-me preferences specified by the respective plural persons; and

(a.1c) contact time preference data for specifying preferred times of when to try and contact said plural persons according to respective times-to-try-and-contact-me preferences specified by the respective plural persons.

31. The machine system of claim 30 wherein:

(a.2) said stored attribute data further includes;

(a.2a) automated formulation parameter data for assisting in automatic or semiautomatic formulation of medical treatment to be prescribed, if at all, to respective ones of said plural persons where the automated or semiautomated treatment formulating algorithm relies on at least one of patient'"'"'s currently-recorded age, patient'"'"'s currently-recorded height, patient'"'"'s currently-recorded weight, patient'"'"'s currently-recorded sex and patient'"'"'s currently-recorded medical status.

32. The machine system of claim 31 and further comprising:

(a.2b) medical treatment assisting means, responsive to said automated formulation parameter data, the medical treatment assisting means being for assisting in automatic or semiautomatic formulation of one or more medical intervention actions at a given time, where said medical treatment assisting means uses at least one of patient'"'"'s currently-recorded age, patient'"'"'s currently-recorded height, patient'"'"'s currently-recorded weight, patient'"'"'s currently-recorded sex and patient'"'"'s currently-recorded medical status for determining what courses of medical intervention action to suggest.

33. The machine system of claim 31 wherein:

(a.3) said stored attribute data yet further includes;

(a.3a) contra-indication data for assisting in automatic formulation of medication to be prescribed, if at all, to respective ones of said plural persons where a utilized automated formulation algorithm bypasses certain prescription options based on at least one of;

patient'"'"'s current allergies and patient'"'"'s current other medications.

34. The machine system of claim 33 wherein:

(a.4) said stored attribute data yet further includes;

(a.4a) current medical condition data for assisting in automatic formulation of medication to be prescribed, if at all, to respective ones of said plural persons where a utilized automated formulation algorithm takes into account at least one of a patient'"'"'s current medical distress situations such as whether the patient currently suffers from hypertension and/or diabetes and/or if diabetes, how long from onset.

35. The machine system of claim 29 wherein:

(a.1) said stored attribute data includes;

(a.1a) medication parameter data for assisting in automatic formulation of medication to be prescribed, if at all, to respective ones of said plural persons where a system-utilized, automated prescription assisting algorithm relies on at least one of patient'"'"'s currently-recorded age, patient'"'"'s currently-recorded height, patient'"'"'s currently-recorded weight, patient'"'"'s currently-recorded sex and patient'"'"'s currently-recorded medical status.

36. The machine system of claim 29 wherein:

(b.1) said update attempting means includes periodic update attempting means for automatically and periodically attempting to conduct said attribute-updating, interactive communications.

37. The machine system of claim 29 and further comprising:

(c.1) attribute comparison means for performing comparisons of before and after attribute data corresponding to stored current attribute data prior to and after said updating of the corresponding attribute data in said machine-readable storage.

38. The machine system of claim 29 and further comprising:

(c.1) stamping means for time and/or date stamping of update changes made to said attribute data.

39. The machine system of claim 29 and further comprising:

(c.1) archiving means for archiving said stored attribute data on a scheduled basis.

40. The machine system of claim 29 wherein:

(d.5) said plural persons include first medical care providers and said stored attribute data of one or more of the first medical care providers includes foreign access permission attributes for designating one or more other medical care providers who will have full or partial access to formulated one or more of said custom-formulated messages, custom-formulated interviews, and custom-formulated alert signals accessible to the first medical care providers.

41. The machine system of claim 29 wherein:

(a.1) said stored attribute data includes at least one of;

(a.1a) the person'"'"'s most recently-recorded blood sugar level;

(a.1b) the person'"'"'s most recently-recorded blood potassium level;

(a.1c) the person'"'"'s most recently-recorded blood pressure parameters;

(a.1d) the person'"'"'s most recently-recorded heart pulse rate;

(a.1e) the person'"'"'s most recently-recorded blood lipid parameters;

(a.1f) the person'"'"'s most recently-recorded urea nitrogen level;

(a.1g) the person'"'"'s most recently-recorded haptoglobin level; and

(a.1h) the person'"'"'s most recently-recorded calcium level.

42. The machine system of claim 29 wherein:

(d.5) said attribute utilizing means includes at least one of;

(d.5a) first utilizing means for custom-tailoring content presented in a formulated interview or message in response to said stored attribute data;

(d.5b) second utilizing means for custom-tailoring flow of dialog as presented in a formulated interview in response to said stored attribute data;

(d.5c) third utilizing means, responsive to said stored attribute data, for custom-tailoring priority and/or delivery order and/or presentation order of formulated alerts, messages and/or interviews; and

(d.5d) fourth utilizing means, responsive to said stored attribute data, for custom-tailoring presentation style of a formulated interview or message.

43. The machine system of claim 42 wherein:

(d.5a1) said first utilizing means for custom-tailoring of content includes language selection means for selecting a language to be used in providing said custom-tailorable content.

44. The machine system of claim 29 wherein:

(d.5) said attribute utilizing means includes;

(d.5a) consistent and persistent reporting means for automatically sending essentially all test results to corresponding patients as interviews calling for acknowledgement of receipt within predefined time windows after corresponding tests are performed, thereby assuring continued communicability with the corresponding patients and reinforcing in the corresponding patients the idea of expecting to consistently receive essentially all test results within the predefined time windows.

45. The machine system of claim 44 in combination with:

(e) a manufactured instruction that instructs patients to contact their respective medical providers if the patients are not timely informed of all their test results within said predefined time windows.

46. The machine system of claim 44 and further comprising:

(f) response recording means for recording as part of patient attributes acknowledgement behavior of respective patients in response to said consistent and persistent reporting means sending essentially all test results of the respective patients.

47. The machine system of claim 46 and further comprising:

(g) predicting and flagging means which uses said recorded acknowledgement behavior of patients for predicting next expected acknowledgement behavior and for flagging out deviation as unexpected retrieval behavior.

48. The machine system of claim 29 and further comprising:

(e) alerting means having first means for determining if said attempts by the update attempting means to conduct update interviews fail to complete after a predefined number of tries or fail to complete after a predefined time has elapsed, and having second means for automatically sending an alert to another person if said first means determines that one of said failures has occurred.

49. A manufactured and transmitted signal which has been transmitted by way of a pre-designated, first communication channel for purpose of attempting to make intelligent communication with a pre-designated, first target person said manufactured signal comprising one or more of:

(a) first testing content that questions whether the pre-designated, first target person has been reached by way of said pre-designated, first communication channel;

(b) second testing content that questions whether the first communication channel remains as a desired method of reaching the first target person in the future;

(c) third testing content that questions the first target person as to whether the first communication channel remains as a most preferred method of the first target person for reaching the first target person with similar transmitted signals in a designatable future time span;

(d) fourth testing content that questions the first target person as to whether the transmitted signal has been delivered at a convenient time for the first target person;

(e) fifth testing content that asks for biometric data of the first target person, where said biometric data includes at least one of;

(e.1) fingerprint data;

(e.2) voice-signature recognition data;

(e.3) retinal pattern data;

(e.4) current age data;

(e.5) current height data;

(e.6) current weight data;

(e.7) current sex data and;

(e.8) current medical status data .

50. The manufactured and transmitted signal of claim 49 wherein:

(e.8) current medical status data is included and includes at least one of;

(e.8a) contra-indication data for assisting in automatic formulation of medication to be prescribed, if at all, to said first target person where the contra-indication data includes at least one of;

the first person'"'"'s current allergies and the first person'"'"'s current medications;

(e.8b) identifications of chronic medical conditions the first person is last known to have; and

(e.8c) identifications of major hospitalizations or operations the first target person is last known to have had.

51. The manufactured and transmitted signal of claim 49 and further comprising:

(f) a presentable data section storing content data that can but does not have to be presented to said first target person; and

(g) a decision tree section storing dialog flow control data that defines how a dialog will be conducted with said first target person based on responses given by the first target person.

52. The manufactured and transmitted signal of claim 49 and further comprising:

(h) a collectible data section storing indications of response data that is to be attempted to be collected from said first target person.

53. The manufactured and transmitted signal of claim 49 and further comprising:

(h) an audit trail data section storing indications of when the transmitted signal was delivered to the first target person and/or what dialogs were presented and/or what responses or nonresponses were given by the first target person to the presented dialogs.