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

• US 8,825,502 B2
• Filed: 03/05/2004
• Issued: 09/02/2014
• Est. Priority Date: 09/30/2003
• Status: Active Grant

• Current Assignee: Epic Systems Corporation
• Original Assignee: Epic Systems Corporation
• Inventors: Bormann, Daniel S., Cornelius, Aaron T., Escher, Timothy W., Grover, Sameer, Hansen, Jason L., Michalski, Clifford L., Peytchev, Vassil D., Giesler, Andrew M. E.
• Primary Examiner(s): Phongsvirajati, Sind
• Application Number:
  US10/794,933
• Publication Number:
  US 20050071194A1
• Time in Patent Office: 3,833 Days
• Field of Search: 705 2- 3
• 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. A healthcare information management system for synchronizing data in different instances of a first patient record that are maintained by different deployments and where the instances of the first patient record maintained by the different deployments may be updated simultaneously so that the first patient record maintained by different deployments may be different versions at any time, the system comprising:

a plurality of deployments including at least a first deployment wherein each deployment includes at least one server including a processor that runs a computer program, and each of the plurality of deployments maintains a generation level for the instance of the first patient record stored by the deployment;

a communication network communicatively coupling the first deployment server to other remote deployment servers;

wherein the first deployment server performs a program to carry out the steps of;

storing a first instance of the first patient record;

receiving updates to the first patient record from at least one other remote deployment accessing and modifying the patient record, the update including the generation level corresponding to the patient record at the other remote deployment;

determining when whether a received update builds on the first instance of the first patient record based on the generation level of the first instance and the generation level of the received update; and

when the received update builds on the first instance, using the update received from the remote deployment to reconcile the modification with the first instance of the first patient record thereby generating a new version of the first instance and publishes the reconciled modifications to all deployments while the remote deployment server is accessing and modifying the patient record;

when the received update does not build on the first instance, determining if the first instance was built on the incoming update and disregarding the update as a duplicate if the first instance builds on the incoming data; and

if the received update does not build on the first instance and the first instance does not build on the received update, moving the update to a conflict queue.

2. The system of claim 1 wherein the first deployment is further arranged to, when a request is received for a copy of the first patient record, transmit the first instance of the first patient record to the requesting deployment, the plurality of deployments including at least a second deployment arranged to request a copy of the first patient record from the first deployment, to receive the first patient record from the first deployment, to store the received first patient record as a second instance of the first patient record, to receive updates to the second instance of the first patient record and to provide the updates to the second instance of the first patient record to the first deployment.

3. The system of claim 2 wherein the first deployment is further arranged to, when an update is used to modify the first instance of the first patient record, publish the modification as an update to other system deployments that store instances of the first patient record.

4. The system of claim 3 wherein, when a deployment receives a published update, the receiving deployment is arranged to determine when the published update builds on the instance of the first patient record stored by the deployment and, when the published update builds on the instance of the first patient record stored by the deployment, to use the published update to modify the instance of the first patient record stored by the deployment.

5. The system of claim 3 wherein the first deployment is arranged to publish updates to other deployments at least one of (1) whenever the first deployment makes updates to the first instance;

(2) whenever the second deployment accesses the second instance of the first patient record and (3) periodically at specific trigger instances.

6. The system of claim 1 wherein a second deployment stores a second instance of the first patient record and transmits the update to the first patient record, the first deployment is arranged to determine that the received update builds on the first instance by determining that both the first deployment and the second deployment had the same version of the first patient record prior to the second deployment providing the update.

7. The system of claim 6 wherein the first deployment is arranged to determine that the received update builds on the first instance when the first deployment had an older version of the first patient record than the second deployment prior to the second deployment providing the update.

8. A healthcare information management system for synchronizing data in different instances of a first patient record that are maintained by different deployments and where the instances of the first patient record maintained by the different deployments may be updated simultaneously so that the first patient record maintained by different deployments may be different versions at any time, the system comprising:

a plurality of deployments including at least a first deployment wherein each deployment includes at least one server including a processor that runs a computer program, and each of the plurality of deployments maintains a generation level for the instance of the first patient record stored by the deployment;

a communication network communicatively coupling the first deployment server to the other deployment servers;

wherein the first deployment server performs a program to carry out the steps of;

storing a first instance of the first patient record;

receiving updates to the first patient record from at least one other deployment accessing and modifying the patient record, the update including a generation level for the patient record at the deployment;

determining when a received update builds on the first instance of the first patient record; and

when the received update builds on the first instance, using the update to reconcile and modify the first instance of the first patient record thereby generating a new version of the first instance and publishes the reconciled modifications to all deployments while the other deployment server is accessing and modifying the patient record;

wherein the first deployment maintains a first update history for the first instance of the first patient record, the first update history identifying at least a first subset of the deployments that previously contributed to the first instance of the first patient record along with generation levels indicating at least a subset of the generations of the first instance of the first patient record to which the first subset of deployments contributed; and

a second deployment maintains a second instance of the first patient record and a second update history for the second instance of the first patient record, the second update history identifying at least a second subset of the deployments that previously contributed to the second instance of the first patient record along with generation levels indicating at least a subset of the generations of the second instance of the first patient record to which the second subset of deployments contributed.

9. The system of claim 8 wherein a second deployment transmits the update and the second update history to the first deployment, the first deployment receives the update and the second update history from the second deployment and compares the first and second update histories to determine when the update received from the second deployment builds on the first instance of the first patient record.

10. The system of claim 8 wherein the first deployment is further arranged to, when a request is received for a copy of the first patient record, transmit the first instance of the first patient record to the requesting deployment, the plurality of deployments including at least a second deployment arranged to request a copy of the first patient record from the first deployment, to receive the first patient record from the first deployment, to store the received first patient record as a second instance of the first patient record, to receive updates to the second instance of the first patient record and to provide the updates to the second instance of the first patient record to the first deployment.

11. The system of claim 10 wherein the first deployment is further arranged to, when an update is used to modify the first instance of the first patient record, publish the modification as an update to other system deployments that store instances of the first patient record.

12. The system of claim 8 wherein, when (1) the received update does not build on the first instance, (2) the first instance does not build on the received update and (3) the first instance does not include the received update, the first deployment moves the update to a conflict queue.

13. A healthcare information management system for synchronizing data in different instances of a first patient record that are maintained by different deployments and where the instances of the first patient record maintained by the different deployments may be updated simultaneously so that the first patient record maintained by different deployments may be different versions at any time, the system comprising:

a plurality of deployments including at least a first deployment wherein each deployment includes at least one server including a processor that runs a computer program, and each of the plurality of deployments maintains a generation level for the instance of the first patient record stored by the deployment;

a communication network communicatively coupling the first deployment server to the other deployment servers;

wherein the first deployment server performs a program to carry out the steps of;

storing a first instance of the first patient record;

receiving updates to the first patient record from at least one other deployment accessing and modifying the patient record, the update including a generation level for the patient record at the deployment;

determining when a received update builds on the first instance of the first patient record; and

when the received update builds on the first instance, using the update to reconcile and modify the first instance of the first patient record thereby generating a new version of the first instance and publishes the reconciled modifications to all deployments while the other deployment server is accessing and modifying the patient record; and

wherein;

the first instance of the first patient record includes data in a first set of data groups;

a second deployment stores a second instance of the first patient record where the second instance includes data in a second set of data groups;

the first deployment maintains a separate update history for each of the data groups in the first set of data groups;

the second deployment maintains a separate update history for each of the data groups in the second set of data groups;

each update history identifying at least a subset of the deployments that previously contributed to the data group along with generation levels indicating at least a subset of the generations of the data group to which the subset of deployments contributed; and

wherein the second deployment provides the update and associated update histories to the first deployment;

the first deployment is arranged to carry out the step of determining when a received update builds on the first instance of the first patient record by using the received update histories and the update histories associated with the data groups in the first instance of the first patient record to determine, on a data group by data group basis, when an update to a data group builds on the instance of the data group in the first instance of the first patient record; and

wherein, the step of using the update to modify the first instance of the first patient record includes using only updates that build on instances of data groups in the first instance of the first patient record to update the first instance.

14. The system of claim 13 wherein the first deployment is further arranged to, when a request is received for a copy of the first patient record, transmit the first instance of the first patient record to the requesting deployment, the plurality of deployments including at least a second deployment arranged to request a copy of the first patient record from the first deployment, to receive the first patient record from the first deployment, to store the received first patient record as a second instance of the first patient record, to receive updates to the second instance of the first patient record and to provide the updates to the second instance of the first patient record to the first deployment.

15. The system of claim 14 wherein the first deployment is further arranged to, when an update is used to modify the first instance of the first patient record, publish the modification as an update to other system deployments that store instances of the first patient record.

16. The system of claim 13 wherein, when (1) the received update does not build on the first instance, (2) the first instance does not build on the received update and (3) the first instance does not include the received update, the first deployment moves the update to a conflict queue.