Patent Application
20190318290
© 2018 Priority Dispatch Corp. A portion of the disclosure of this patent document contains material that is subject to copyright protection. The copyright owner has no objection to the facsimile reproduction by anyone of the patent document or the patent disclosure, as it appears in the Patent and Trademark Office patent file or records, but otherwise reserves all copyright rights whatsoever. 37 CFR § 1.71(d).
The present disclosure relates to computer systems and methods for providing medical transfer interrogation, instruction, and dispatch. More specifically, the disclosure is directed to computer-implemented protocols to enable a dispatcher to process medical transfer requests in an accurate, consistent, and systematic manner by guiding the dispatcher during interrogation, response determination, and caller instruction.
Patient transfer services are a critical part of medical care when evaluation and care services at higher level or specialized care facilities are needed. For example, a patient in a rest home or long term care facility may require urgent or specialized medical treatment. When a patient is in transit, the patient may need access to medication, equipment, and trained personnel that were not available at a previous residence or facility.
Conventional medical transfer services do not recommend field response apparatuses based on vehicle types, acuity of care, medical equipment, or medications. As such, a vehicle may arrive that is not equipped to accommodate the patient or a vehicle may arrive with more equipment than is needed. For example, a vehicle may include basic life support (BLS) but advanced life support (ALS) is needed for the patient evaluation, care, and the transfer. Alternatively, an emergency medical technician may arrive in the assigned vehicle but a paramedic is needed. As can be appreciated, many different combinations of vehicles, medical personnel, equipment, and medicines are available, and suitable matches are needed to serve each patient and maximize personnel and vehicle response efficiency. Conventional systems require call centers to manually select resources based on available information. Without automated tracking and inventory matching (crew types, vehicles, medications, and equipment), insufficient or excessive resources may be inappropriately assigned to the medical transfer.
In scheduling a medical transfer, a dispatcher conducts an interrogation process with a caller calling on behalf of the patient. As disclosed herein, a medical transfer protocol provides a logic tree with preprogrammed inquiries to remove subjective variations based on individual dispatchers. Accordingly, uniform and consistent results are achieved with routine dispatcher training and protocol use and therefore extensive medical training for these dispatchers is not needed.
As disclosed herein, a medical transfer protocol also provides uniform and consistent billing codes for accurate payment processing and correct insurance reimbursement. The medical transfer protocol automatically selects the appropriate medical crew and vehicle and simultaneously provides a reliable determinant code that corresponds to a specific billing code. The billing code is based on the required equipment, medication, acuity level, and nature of the transport. As with the selection of the vehicle, the billing code is not left to the discretion of a dispatcher. In this manner, the billing code is determined based on the protocol and the determined facts at the time the medical transfer is requested.
The embodiments of the disclosure will be best understood by reference to the drawings, wherein like parts are designated by like numerals throughout. It will be readily understood that the components of the disclosed embodiments, as generally described and illustrated in the figures herein, could be arranged and designed in a wide variety of different configurations. Thus, the following detailed description of the embodiments of the systems and methods of the disclosure is not intended to limit the scope of the disclosure, as claimed, but is merely representative of possible embodiments of the disclosure. In addition, the steps of a method do not necessarily need to be executed in any specific order, or even sequentially, nor need the steps be executed only once, unless otherwise specified.
In some cases, well-known features, structures or operations are not shown or described in detail. Furthermore, the described features, structures, or operations may be combined in any suitable manner in one or more embodiments. It will also be readily understood that the components of the embodiments as generally described and illustrated in the figures herein could be arranged and designed in a wide variety of different configurations.
Several aspects of the embodiments described will be illustrated as software modules or components. As used herein, a software module or component may include any type of computer instruction or computer executable code located within a memory device and/or transmitted as electronic signals over a system bus or wired or wireless network. A software module may, for instance, comprise one or more physical or logical blocks of computer instructions, which may be organized as a routine, program, object, component, data structure, etc., that performs one or more tasks or implements particular abstract data types.
In certain embodiments, a particular software module may comprise disparate instructions stored in different locations of a memory device, which together implement the described functionality of the module. Indeed, a module may comprise a single instruction or many instructions, and may be distributed over several different code segments, among different programs, and across several memory devices. Some embodiments may be practiced in a distributed computing environment where tasks are performed by a remote processing device linked through a communications network. In a distributed computing environment, software modules may be located in local and/or remote memory storage devices. In addition, data being tied or rendered together in a database record may be resident in the same memory device, or across several memory devices, and may be linked together in fields of a record in a database across a network.
Suitable software to assist in implementing the invention is readily provided by those of skill in the pertinent art(s) using the teachings presented here and programming languages and tools, such as Java, Pascal, C++, C, database languages, APIs, SDKs, assembly, firmware, microcode, and/or other languages and tools. Suitable signal formats may be embodied in analog or digital form, with or without error detection and/or correction bits, packet headers, network addresses in a specific format, and/or other supporting data readily provided by those of skill in the pertinent art(s). [0013] A medical dispatch system disclosed herein may be computer-implemented in whole or in part on a digital computer. The digital computer includes a processor performing the required computations. The computer further includes a memory in electronic communication with the processor for storing a computer operating system. The computer operating systems may include MS-DOS, Windows, Unix, AIX, CLIX, QNX, OS/2, and Apple. Alternatively, it is expected that future embodiments will be adapted to execute on other future operating systems. The memory also stores application programs including a Computer Aided Dispatch (CAD) program, an emergency medical dispatch protocol, and a user interface program, and data storage. The computer further includes an output device, such as a display unit, for viewing the displayed instructions and inquiries and as a user input device for inputting response data.
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The medical transfer protocol 110 is initiated when a dispatcher 104 receives a call from a caller 114 requesting a medical transfer on behalf of the patient 112. In some instances, the patient 112 may call on his or her own behalf. The medical transfer protocol provides a logic tree with questions, possible responses from the caller 114, and possible instructions to the caller 114. The caller responses may in the logic lead to subsequent questions and/or instructions to the caller 114. The responses are processed according to predetermined logic to provide an appropriate medical transfer response. During the medical transfer protocol 110, the dispatcher 104 and/or the medical transfer protocol 110 will gather, inter alia, conditions and circumstances of the medical transfer and the patient's condition, discovered through interrogation, in order to dispatch an appropriate medial transfer service. The medial transfer protocol 110 facilitates uniform and consistent gathering of information relating to the transfer and dispatching of an appropriate medical transfer service. The appropriate medical transfer service may be determined, in part, through a system of logically assigning determinant codes as the protocol progresses (i.e., traverses) through the logic tree.
Exemplary embodiments of medical dispatch protocols with logic trees are disclosed in U.S. Pat. Nos. 5,857,966, 5,989,187, 6,004,266, 6,010,451, 6,053,864, 6,076,065, 6,078,894, 6,106,459, 6,607,481, 7,106,835, 7,645,234, 8,066,638, 8,103,523, 8,294,570, 8,335,298, 8,355,483, 8,396,191, 8,488,748, 8,670,526, 8,712,020, 8,873,719, 8,971,501, 9,319,859, 9,491,605, and 9,516,166 which are incorporated herein by reference.
The medical transfer protocol 110 includes and operates a determinant code calculator 116 to calculate a determinant code from the caller's responses to protocol questions. After processing the call, the determinant code calculator 116 generates a determinant code that indicates the urgency of a medical transfer. The protocol questions and the medical transfer deal directly with life-and-death decisions and the protocols discussed herein pass a rigorous medical review by a panel of doctors and EMS public safety experts who specialize in medical dispatch. The determinant codes may range, for example, from DELTA for generally very serious emergencies to ALPHA for generally less serious emergencies. When a determinant value is identified in one of the four levels (ALPHA—A, BRAVO—B, CHARLIE—C, and DELTA—D) the response configuration (e.g., the medical vehicles involved and the mode of response) is dispatched as indicated by the medical transfer protocol. If the protocol 110 determines that the medical transfer is not urgent, a request is sent to a non-emergency provider instead of dispatching an emergency response vehicle.
As many calls for medical transfer are not medical emergencies, medical transfers are prioritized according to need and available resources. Medical transfers that are emergencies receive a higher priority and merit immediate evaluation and medical transfer. Medical transfers for patients with unique needs for emergency medical evaluation, medicines, medical equipment, vehicle equipment, and suitably trained personnel must be matched with appropriately. If the medical transfer is not urgent then lights-and-siren are not needed and will not be used thereby increasing the safety of all those on the road and in the emergency vehicles. While many medical transfers are not emergencies, all transfers can benefit from evaluation and the appropriate provision of post-dispatch or pre-arrival instructions. In some embodiments, prior to the arrival of the medical transfer, the medical transfer protocol 110 may provide instructions that are appropriate to the type of transfer such as the emergency nature of the transfer, physical condition of the patient, mental condition of the patient, medicinal patient needs, medical equipment needs for the patient, physical assistance needs for the patient, and the like.
The determinant code provides a categorization code of the type and level of the incident, the code is provided to a Computer Aided Dispatch (CAD) system 118, which is a tool used by dispatchers to track and allocate emergency response resources, for processing. The CAD system 112 may manage dispatcher tools for processing emergency calls, including but not limited to the emergency dispatch protocol 110 or the expedited dispatch protocol 116, communication resources (e.g.., radio system, alpha pager), mapping tools (e.g., global positioning system (GPS) technology, geographic information systems (GIS)), and vehicle location systems (e.g., automatic vehicle location (AVL)). The CAD system 118 may operate in whole or in part on a separate computer in communication with computer 106. The primary information used in this task is location information of both the incident and units, unit availability, and the type of incident. CAD systems may use third-party solutions, such as E-911, vehicle location transponders, and MDTs for automating the location and availability tasks.
The computer 106 may include a reporting module 120 to statistically measure the performance of individual staff and overall center performance. The statistics include compliance rates, call processing statistics, and peer measurements.
The dispatch center 102 includes telephony equipment 122, an input device 124, and an output device 126 to respond to calls and interface with the computer 106. The dispatcher 104 receives calls on the telephony equipment 122, identifies a call as requiring a medical transfer, and initiates the medical transfer protocol 110. In scheduling a medical transfer, the dispatcher 104 asks a series of questions and while some questions are intuitive some protocol questions may be missed if the dispatcher 104 is not guided. The medical transfer protocol 110 provides instructions that are expertly drafted to assist a novice caller in determining patient needs and condition to thereby provide a suitable medical transfer. The medical transfer protocol 110 may also provide expertly drafted first aid instructions to assist a caller 114 prior to the arrival of emergency responders.
The medical transfer protocol 110 may further include a billing code calculator 128 to generate a billing code based on the medical transfer service. The billing code calculator 128 receives information regarding the nature of the medical transfer, safety information, the vehicle, including vehicle equipment and medical supplies, the medical personnel, the time and date, the distance, and the nature of the destination. These factors determine a billing code that is generated at the time of request and may be used for invoice generation and insurance submission.
If Case Entry 202 determines that the medical transfer is due to an acute medical problem, the protocol 200 proceeds to an upcare medical transfer protocol 204. The unscheduled medical transfer may be for treatment and transport to an upcare medical facility. A determination 206 is made to confirm if the unscheduled transfer is due to an urgent life-threatening situation. If the caller 114 relays information to the dispatcher 104 that the patient 112 is unconscious and not breathing (or unconscious and breathing is uncertain, or conscious but not breathing where the failure to breathe has been verified), for whatever reason, a determinant code indicating an urgent life threatening condition is generated and a medical transfer is dispatched 208 immediately. The dispatched medical transfer may be a maximum emergency response, which may include resources such as emergency medical technicians, ambulances, paramedics, and other appropriate healthcare providers. The protocol 200 may make further interrogatories to confirm the life threat and provide pre-arrival instructions. The pre-arrival instructions can be tailored to the specific situation and/or condition of the patient, and may include treatment sequence scripts covering, inter alia, cardiac arrest, choking, and childbirth. For example, the treatment sequence scripts may enable the dispatcher to guide the caller in CPR, the Heimlich Maneuver, or emergency childbirth procedures. Typically, the result of properly conveyed (by the dispatcher) and executed (by the caller) instructions is a more viable patient at the time the emergency responders arrive.
The protocol 200 may guide the dispatcher through a secondary interrogation 210 focusing on the patient's medical condition or chief complaint. The protocol 204 may present a pre-scripted interrogation to enable a more orderly and detailed understanding of the patient so that the pre-hospital care provided by the emergency responders is appropriate for the severity of the patient's condition. The pre-scripted interrogation may include preprogrammed inquiries focused on gathering information relating to the chief complaint.
The secondary interrogation 210 may include instructions for the dispatcher 104 to remain on the telephone with the caller 114 to provide post-dispatch instructions regarding what to do, and what not to do, prior to the arrival of the emergency responders. The post-dispatch instructions help to prepare the patient 112 for, and to expedite, the emergency responders' work at the scene. Post-dispatch instructions may include preparing the patient for transport, prompting the collection of pertinent documents that will accompany the patient, and the relaying of any other pertinent information related to the transport.
If the patient's medical condition or chief complaint is determined 206 to be non-life threatening, then the protocol 200 continues with additional non-life threatening interrogations 212 or preprogrammed inquires to determine the nature of the medical condition, generate a determinate code, and dispatch 214 a medical transfer with an appropriate medical vehicle and trained medical personnel. In either dispatch 208 or 214, the medical transfer protocol 110 generates a determinant code and billing code.
If Case Entry 202 determines that the medical transfer is scheduled or routine and the patient 112 does not have an urgent medical need, then the protocol 200 routes to a schedule medical transfer protocol 216. The schedule medical transfer protocol 216 includes an interrogation 218 or preprogrammed inquires to query the caller 114 for the destination, nature of medical treatment, time and date of transfer, type of medical treatment required, type of medicine required, whether the patient 112 can walk or respond, and the like. The interrogation 218 may further inquire as to the weight of the patient 112 in order to determine if the medical vehicle must include mechanical lift assistance. Based on this information, the medical transfer protocol 110 generates a determinant code, billing code, and dispatches 220 a medical transfer with a suitably equipped medical vehicle at the scheduled time.
Case Entry 202 may determine that the medical transfer relates to mental health treatment, routine and scheduled or non-scheduled. If the patient 112 does not have an urgent medical need, then the protocol 200 routes to a mental health transfer protocol 222. The mental health protocol 222 includes interrogatories or preprogrammed inquires 224 to query the caller 114 for the destination, nature of mental health treatment, time and date of transfer, required medical treatment, medical equipment, or medicine during the transfer, whether the patient 112 can walk or respond, weight of the patient, and whether the patient is a threat to himself/herself or anyone else. Based on this information, the mental health transfer protocol 222 generates a determinant code, billing code, and dispatches 226 an appropriate medical transfer at the scheduled time.
If during interrogatories 218, 224, the dispatcher 104 receives information from the caller 114 to indicate any acute medical problems that are more significant this the current mental health issue, the protocol 200 may shunt directly to a determination 206 to verify the patient's condition. The protocol 200 at determination 206 guides the dispatcher 104 to gather information from the caller 114 to enable the dispatcher 104 to ascertain the patient's medical condition or chief complaint. The protocol 200 may then proceed as previously discussed above.
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As disclosed, a medical transfer protocol objectively selects appropriate resources based on the medical issue and/or chief complaint. The resources include the type of medical vehicle, the medical personnel staffing the vehicle, vehicle equipment, such as patient lift assist, medical equipment, and medicine. The medical transfer protocol also objectively calculates a determinant code and a billing code at the time of the medical transfer request. Accordingly, uniform and consistent results are achieved through the disclosed system and variance due to human subjectivity is minimized.
While specific embodiments and applications of the disclosure have been illustrated and described, it is to be understood that the disclosure is not limited to the precise configuration and components disclosed herein. Various modifications, changes, and variations apparent to those of skill in the art may be made in the arrangement, operation, and details of the methods and systems of the disclosure without departing from the spirit and scope of the disclosure.
