Panel diagnostic method and system

• US 7,780,595 B2
• Filed: 05/14/2004
• Issued: 08/24/2010
• Est. Priority Date: 05/15/2003
• Status: Active Grant

• Current Assignee: Healthways SC, LLC (Warner Bros. Discovery, Inc.)
• Original Assignee: Clinical Decision Support, LLC (Tivity Health, Inc.)
• Inventors: Iliff, Edwin C.
• Primary Examiner(s): Johnson, III; Henry M
• Assistant Examiner(s): SYED, ATIA K
• Application Number:
  US10/846,165
• Publication Number:
  US 20050010088A1
• Time in Patent Office: 2,293 Days
• Field of Search: 600/300, 600/301
• US Class Current: 600/300
• 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 50/20 for computer-aided diagnosis, e.g. based on medical expert systems

Abstract

A method and system for computerized medical diagnostics is disclosed. Beginning with interacting with a patient or a healthcare professional via a diagnostic module to obtain patient health items, the system automatically obtains an initial differential diagnosis and multiple strategy differential diagnoses based on the patient health items. In one embodiment, each strategy differential diagnosis is obtained with different analysis criteria of the patient health items. At least a portion of the strategy differential diagnoses are compared and a panel differential diagnosis based on the compared differential diagnoses is determined. The initial diagnosis and the panel differential diagnosis are reconciled so as to recommend an action or provide a diagnosis to the patient or the healthcare professional.

Claims

1. A computerized medical diagnostic system, the system comprising:

a diagnostic module configured to interact with a patient or a healthcare professional, obtain associated patient health items representative of the health of the patient via input, and provide an initial differential diagnosis; and

a panel module in data communication with the diagnostic module, the panel module comprising a plurality of diagnostic strategy processes, each of which generates a corresponding strategy differential diagnosis based on the patient health items, wherein the panel module compares at least a portion of the strategy differential diagnoses to thereby generate a panel differential diagnosis;

a computing environment operative to execute the modules, the computing environment comprising at least one processor; and

wherein the initial differential diagnosis and the panel differential diagnosis are reconciled so as to recommend an action or provide a diagnosis via output to the patient or the healthcare professional.

2. The system defined in claim 1, wherein the panel module additionally comprises a moderator module in data communication with the one or more diagnostic strategy processes and the diagnostic module, wherein the moderator evaluates the results of each diagnostic strategy process and generates the panel differential diagnosis by comparing the strategy differential diagnoses and reordering the panel differential diagnosis accordingly.

3. The system defined in claim 2, wherein each diagnostic strategy process is assigned a weight for each one of a diagnosis associated with a selected chief complaint.

4. The system defined in claim 2, wherein each diagnostic strategy process is assigned a weight for each diagnosis in its differential diagnosis.

5. The system defined in claim 3, wherein the panel differential diagnosis is reordered in decreasing levels of probability after the assigned weight is applied.

6. The system defined in claim 3, wherein the weight is dynamic and changes dependent on a position in a disease timeline for the patient.

7. The system defined in. Claim 3, wherein the weight is dynamic and changes dependent on a position in a consultation timeline for the patient.

8. The system defined in claim 2, wherein the diagnostic module repetitively selects a patient health item to be evaluated, evaluates the patient health item, and provides the results of the evaluation to the diagnostic strategy processes.

9. The system defined in claim 8, wherein the influence of at least one of the diagnostic strategy processes on the moderator changes after each patient health item is evaluated.

10. The system defined in claim 9, wherein at least one strategy process updates its respective strategy differential diagnosis after each patient health item is evaluated.

11. The system defined in claim 8, wherein the diagnostic module establishes a synergy weight based on the evaluated patient health item, and provides the synergy weight to the diagnostic strategy processes so as to affect the prioritization within the strategy differential diagnoses.

12. The system defined in claim 11, wherein the influence of at least one of the diagnostic strategy processes on the moderator changes after the synergy weight is established.

13. The system defined in claim 8, wherein selected ones of the diagnostic strategy processes operate in an active mode, wherein the selected diagnostic strategy processes are configured to select a patient health item to be evaluated by the diagnostic module.

14. The system defined in claim 13, wherein the moderator ranks each selected patient health item based on the influence of each diagnostic strategy process operating in the active mode.

15. The system defined in claim 2, wherein the panel module additionally comprises a judge module in data communication with the moderator and the diagnostic module, and wherein the judge module reconciles the initial differential diagnosis and a differing differential diagnosis of the panel.

16. The system defined in claim 15, wherein the judge module reconciles by determining the more probable differential diagnosis based on previous performance of the panel diagnostic strategy processes.

17. The system defined in claim 15, wherein the judge module reconciles by blending the initial differential diagnosis and the differing differential diagnosis of the panel into a combined differential diagnosis.

18. The system defined in claim 15, wherein the judge module reconciles by allowing more time to elapse so that a particular diagnosis declares itself.

19. The system defined in claim 1, additionally comprising a judge module in data communication with the panel module and the diagnostic module, wherein the judge module reconciles the initial differential diagnosis and a differing differential diagnosis of the panel.

20. The system defined in claim 19, wherein the judge module reconciles by determining the more probable differential diagnosis based on previous performance of the panel diagnostic strategy processes.

21. The system defined in claim 19, wherein the judge module reconciles by blending the initial differential diagnosis and the differing differential diagnosis of the panel into a combined differential diagnosis.

22. The system defined in claim 1, wherein the system stores and accesses electronic medical records which are organized for each patient in a patient case, and wherein each of the diagnostic strategy processes interfaces with a copy of the patient case.

23. The system defined in claim 1, wherein at least one of the diagnostic strategy processes is concurrently executed with the diagnostic module.

24. The system defined in claim 1, wherein convergence of the differential diagnoses among the diagnostic strategy processes and the initial differential diagnosis adds a convergence weight to a score so as to generate the diagnosis.

25. The system defined in claim 1, wherein the panel module additionally comprises a registration interface for adding a new diagnostic strategy process to the panel module.

26. The system defined in claim 1, wherein the patient utilizes a patient proxy.

27. The system defined in claim 26, wherein the patient proxy is not a healthcare professional.

28. The system defined in claim 1, wherein the action comprises recommending that the patient consult with the diagnostic system at a future time.

29. The system defined in claim 1, wherein the action comprises requesting that the patient have a particular test or study performed.

30. The system defined in claim 29, wherein the test or study is performed by a laboratory.

31. The system defined in claim 29, wherein the test or study includes one or more types of imaging.

32. The system defined in claim 1, wherein one diagnostic strategy process comprises identifying a sequence of an onset of symptoms of a disease.

33. The system defined in claim 2, additionally comprising a data structure having weights for the diagnostic strategy processes corresponding to each one of a diagnosis associated with a selected chief complaint, wherein the weights are applied to a score for each of the diagnoses.

34. The system defined in claim 9, wherein influence comprises weighting.

62. The system defined in claim 1, wherein each strategy differential diagnosis updates its respective strategy based on the patient health items.

63. The system defined in claim 1, wherein each strategy differential diagnosis comprises a plurality of diseases.

65. The system of claim 1, wherein the initial diagnosis comprises at least a disease with an associated first weight and the panel differential diagnosis comprises at least the disease with an associated second weight different than the first weight.

35. A computerized medical diagnostic method, comprising:

interacting with a patient or a healthcare professional via a diagnostic module to obtain associated patient health items representative of the health of the patient;

automatically obtaining an initial differential diagnosis based on the patient health items;

automatically obtaining a plurality of strategy differential diagnoses based on the patient health items, each strategy differential diagnosis being obtained with different analysis criteria of the patient health items;

comparing at least a portion of the strategy differential diagnoses;

determining a panel differential diagnosis based on the compared differential diagnoses;

reconciling the initial diagnosis and the panel differential diagnosis so as to recommend an action or provide a diagnosis to the patient or the healthcare professional and

wherein the method is performed by one or more computing devices.

36. The method defined in claim 35, wherein comparing the differential diagnoses comprises:

compiling the strategy differential diagnoses into a panel differential diagnosis list; and

reordering the panel differential diagnosis list according to a predetermined criterion.

37. The method defined in claim 35, additionally comprising:

selecting the patient health item to be evaluated;

evaluating the patient health item; and

providing the results of the evaluation to the obtaining of differential diagnoses.

38. The method defined in claim 37, wherein the influence of at least one of the diagnostic strategy processes on the panel differential diagnosis changes after each patient health item is evaluated.

39. The method defined in claim 37, additionally comprising:

establishing a synergy weight based on the evaluated patient health item; and

providing the synergy weight to the obtaining of differential diagnoses.

40. The method defined in claim 39, wherein the influence of at least one of the diagnostic strategy processes on the panel differential diagnosis changes after the synergy weight is established.

41. The method defined in claim 35, wherein interacting with the patient includes identifying a set of candidate diseases.

42. The method defined in claim 41, wherein interacting with the patient further includes developing a list of patient health items to be evaluated based on the set of candidate diseases.

43. The method defined in claim 35, additionally comprising registering a new strategy differential diagnosis.

44. The method defined in claim 35, wherein automatically obtaining at least one of the strategy differential diagnoses includes operating in an active mode, wherein one or more patient health items to be evaluated are selected.

45. The method defined in claim 44, additionally comprising:

merging the selected patient health items; and

ranking the merged patient health items according to the influence of each strategy differential diagnosis.

46. The method defined in claim 35, additionally comprising identifying a patient proxy for the patient.

47. The method defined in claim 35, wherein recommending the action comprises recommending that the patient consult with the diagnostic method at a future time.

48. The method defined in claim 35, wherein recommending the action comprises requesting that the patient have a particular test or study performed.

49. The method defined in claim 35, wherein the obtaining of strategy differential diagnoses is concurrent with the obtaining of the initial differential diagnosis.

50. The method defined in claim 35, wherein the obtaining of a selected one of the strategy differential diagnoses comprises identifying a sequence of an onset of symptoms of a disease.

51. A computerized medical diagnostic system, comprising:

means for interacting with a patient or a healthcare professional via a diagnostic module to obtain associated patient health items representative of the health of the patient;

means for automatically obtaining an initial differential diagnosis based on the patient health items;

means for automatically obtaining a plurality of strategy differential diagnoses based on the patient health items, each strategy differential diagnosis being obtained with different analysis criteria of the patient health items;

means for comparing at least a portion of the strategy differential diagnoses;

means for determining a panel differential diagnosis based on the compared differential diagnoses; and

means for reconciling the initial diagnosis and the panel differential diagnosis so as to recommend an action or provide a diagnosis to the patient or the healthcare professional.

52. The system defined in claim 51, wherein the means for comparing the strategy differential diagnoses comprises:

means for compiling the strategy differential diagnoses into a panel differential diagnosis list; and

means for reordering the panel differential diagnosis list according to a predetermined criterion.

53. The system defined in claim 51, wherein the means for interacting with the patient includes means for identifying a set of candidate diseases.

54. The system defined in claim 53, wherein the means for interacting with the patient further includes means for developing a list of patient health items to be evaluated based on the set of candidate diseases.

55. The system defined in claim 51, additionally comprising means for registering a new strategy differential diagnosis.

56. The system defined in claim 51, wherein the means for automatically obtaining the plurality of strategy differential diagnoses includes means for operating in an active mode, wherein one or more patient health items to be evaluated are selected.

57. The system defined in claim 56, additionally comprising:

means for merging the selected patient health items; and

means for ranking the merged patient health items according to the influence of each strategy differential diagnosis.

58. The system defined in claim 51, wherein recommending the action comprises means for recommending that the patient consult with the diagnostic method at a future time.

59. The system defined in claim 51, wherein recommending the action comprises means for requesting that the patient have a particular test or study performed.

60. The system defined in claim 51, wherein the means for automatically obtaining the plurality of strategy differential diagnoses operates concurrently with the means for obtaining the initial differential diagnosis.

61. The system defined in claim 51, wherein the means for automatically obtaining the plurality of strategy differential diagnoses comprises identifying a sequence of an onset of symptoms of a disease.

64. A computerized medical diagnostic system, comprising:

a diagnostic module configured to interact with a patient or a healthcare professional, obtain associated patient health items representative of health of the patient via input, and provide an initial differential diagnosis;

a panel module in data communication with the diagnostic module, the panel module comprising a plurality of different diagnostic strategy processes, each of which generates and updates a corresponding strategy differential diagnosis based on the patient health items, wherein the panel module compares a plurality of the differential diagnoses to thereby generate a panel differential diagnosis; and

a computing environment operative to execute the modules, the computing environment comprising at least one processor.

66. A computerized medical diagnostic system, comprising:

a module configured to interact with a user to obtain patient health items representative of the health of the patient via input;

an initial diagnostic module configured to make an initial differential diagnosis of a patient based on the obtained patient health items, wherein the initial differential diagnosis comprises at least a particular disease and a first weight associated with the particular disease;

a first strategy diagnostic module configured to make a first strategy differential diagnosis of the patient based on the obtained patient health items, wherein the first strategy differential diagnosis comprises at least the particular disease and a second weight associated with the particular disease different than the first weight associated with the particular disease;

a reconciliation module configured to reconcile the initial differential diagnosis and the first strategy differential diagnosis so as to recommend an action or provide a diagnosis to the user via output; and

a computing environment that executes the modules, the computing environment comprising at least one processor.

67. The system of claim 66, further comprising a second strategy diagnostic module configured to make a second strategy differential diagnosis of the patient based on the obtained patient health items, wherein the first and second strategy diagnostic modules employ different analytic criteria in providing a corresponding strategy differential diagnosis.

68. A computerized medical diagnostic system, comprising:

a module configured to interact with a user to obtain patient health items representative of the health of the patient via input;

a first strategy diagnostic module configured to make a first strategy differential diagnosis of the patient based on the obtained patient health items, wherein the first strategy differential diagnosis comprises at least a particular disease and a first weight associated with the particular disease;

a second strategy diagnostic module configured to make a second strategy differential diagnosis of the patient based on the obtained patient health items, wherein the second strategy differential diagnosis comprises at least the particular disease and a second weight associated with the particular disease;

a moderator module configured to provide a panel differential diagnosis based, at least in part, on the first strategy differential diagnosis and the second strategy differential diagnosis and to recommend an action or provide a diagnosis to the user via output; and

a computing environment that executes the modules, the computing environment comprising at least one processor.

69. One or more processor-readable storage devices having computer-executable instructions for one or more processors to perform a medical diagnostic method, the method comprising:

interacting with a patient or a healthcare professional via a diagnostic module to obtain associated patient health items representative of the health of the patient;

automatically obtaining an initial differential diagnosis based on the patient health items;

automatically obtaining a plurality of strategy differential diagnoses based on the patient health items, each strategy differential diagnosis being obtained with different analysis criteria of the patient health items;

comparing at least a portion of the strategy differential diagnoses;

determining a panel differential diagnosis based on the compared differential diagnoses, wherein the initial differential diagnosis comprises at least a disease with an associated first probability and the panel differential diagnosis comprises at least the disease with an associated second probability different from the first probability; and

reconciling the initial diagnosis and the panel differential diagnosis so as to recommend an action or provide a diagnosis to the patient or the healthcare professional.