Patent Application
20240127915
This invention relates generally to electronic medical records, and more particularly electronic medical records that are maintained and stored at an electronically accessible location that is physically remote from a healthcare/treatment facility that is providing health and medical care to a patient. More particularly, the invention relates to a method and system for backing up and maintaining such electronic records during a period of temporary loss of connectivity between the healthcare/treatment facility and the physically remote storage facility.
Hospitals, nursing homes, assisted living facilities and other places which provide health and medical care have long maintained medication administration records, sometimes referred to as MARs, and treatment administration records, sometimes referred to as TARs, to ensure and maintain the correct and orderly administration of medication, treatment and clinical documentation for patients. These institutions are increasingly converting their MARs and TARs to electronic formats. The electronic version of a MAR is commonly referred to as an eMAR, and the electronic version of a TAR is commonly referred to as an eTAR. eMARs and eTARS also are commonly known, both jointly and individually, by the nomenclature EHRs or EMRs or eMARs, short for electronic health/medical records. This electronic data serves as a record for drugs or treatments administered to a patient at a facility, or elsewhere, by healthcare professionals. eMARs and eTARs are often created on web-based software systems and electronically stored on host servers of eMAR/eTAR providers that are physically remote from the patient's treatment/care facility. All of a patient's healthcare providers have shared electronic access to the servers storing their patient's eMARs and eTARs by way of the internet. Though web-based eMAR/eTAR records are stored on a shared host computer maintained by an eMAR/eTAR, provider, problems arise when the treatment/care facilities are disconnected from the host computer, as for example, when internet service is temporarily interrupted. The loss of connectivity with the host computer, of course, does not alleviate the need to treat/medicate patients at the treatment/care facilities during the period when connectivity is lost.
Past attempts to address the potential loss of connectivity with a remote eMAR/eTAR provider have included local backups at the healthcare facilities. These systems commonly require a special program provided by the eMAR/eTAR provider that is installed on a personal computer located at the healthcare facility. Many of these systems require specialized setup knowledge and are required to comply with detailed system requirements set by the eMAR/eTAR provider. Errors in the setup of such programs can cause the backup records to be incomplete or corrupted, and the systems often lack any alerts or other indications to the healthcare facility that the backup might not be usable. Failure of the backups can be caused by a number of reasons, including failed or incomplete downloading, the primary server being down or being serviced during the time period that the locally installed software tries to retrieve the eMARs or eTARs, or corrupted data. Failures also obviously occur when healthcare facility loses it internet connectivity. Operability of these systems also sometimes require opening of insecure firewall ports on computers at the healthcare facility, constant monitoring of the locally installed programs, and specialized setup of the hard drives for which the local backups are stored to ensure compliance with regulations relating to encryption. Past backup systems also often compromise the confidentiality of a patient's personal health information contained in the backup records. The prior art backup systems have store medical information in a non-encrypted format, and have little, if any, safeguards that prevent unauthorized persons from accessing the backup computer, copying, deleting or modifying information in the data, or even temporarily removing the backup computer to a more private location to confidentiality for more extensive copying.
The invention ensures a healthcare facility has access to sufficient patient specific information and documentation for each of its patients in the event the connectivity between the healthcare facility and the host computer of the eMAR/eTAR provider is lost. The invention securely stores and manages updated and verifiably usable backup data in a file structure that accommodates use by a healthcare facility in the event electronic access to the host computer of the eMAR/eTAR provider is lost.
One aspect of the invention includes a system for backing up an electronic system that stores medication administration records and treatment administration records on a primary server electronically connected to a healthcare facility. The system includes a computer system located at a healthcare facility and a backup server. The backup server has a secure electronic connection to both the primary server for storing electronic medication administration records and treatment administration records and the computer at the healthcare facility. Though the tasking sequence can be altered, the backup server is configured to perform a variety of tasks including requesting and receiving patient specific medication and/or treatment records from the primary server for patients being treated at the healthcare facility over a secure electronic connection. A determination is made as to whether each record received from the primary server for storage on the backup server is acceptable. This determination is made by opening the record and using a computer-implemented process to determine the record's usability. Timestamps reflecting the time the record was last written upon by the primary server are used to determine whether any received record deemed usable is newer than any record for the healthcare facility that has been previously received from the primary server stored on the backup server. An identifier reflecting the identity of the healthcare facility rendering the medication or treatment to the patient identified in the record is created. A hash value is generated for each record by hashing a plurality of values representative of attributes of the created record, and the record is stored under the hashed value on the backup server in a folder associated with a particular healthcare facility. The values hashed can be, but are not necessarily, values representing the timestamp and the file name. The hashed value then is used to retrieve the file. The system transfers the saved records from the backup server to the computer system at the healthcare in response to a signal reflecting a loss of connectivity between the healthcare facility and the primary server.
In another aspect of the invention, the step of backing up the electronic health/medical records on the backup server includes storing the records in an encrypted format.
In another aspect of the invention, backing up the electronic health/medical records includes opening the records and verifying the completeness and usability of the records prior to storing them on the backup server.
In another aspect of the invention, the verification of the completeness and usability of the records prior to storing them on the backup server is performed by a computer-implemented process.
In another aspect of the invention, the computer-implemented process includes confirming the correctness of the encoding on the record.
In another aspect of the invention, the computer-implemented process includes determining whether the record had experienced any unexpected closing.
In another aspect of the invention, a determination is made of the date and time the record had last been written upon. In another aspect of the invention, the date and time the record had last been written upon is compared to the date and time of any previously saved version of that record.
In another aspect of the invention, the step of backing up electronic health/medical records from the primary storage system to the backup server includes saving the most recently downloaded version of the record on the backup server only if the date/time timestamp is newer than the time stamp of any previously saved version of the record.
In another aspect of the invention, the step of backing up electronic health/medical records from the primary storage system to the backup server includes maintaining the previously saved version of the record on the server and discarding the most recently downloaded version of the record if the previously saved version is newer than the most recently downloaded version.
In another aspect of the invention, the step of backing up electronic health/medical records from the primary storage system to the backup server further includes storing the downloaded records on the backup server under file names that differ from the file names of the primary storage system. In another aspect of the invention, the step of backing up electronic health/medical records from the primary storage system to the backup server further includes storing the downloaded records on the backup server under a file name that is created by hashing a plurality of values representative of attributes of the saved record.
In another aspect of the invention, one of the representative values that is hashed with the time stamp of the record reflecting the date and time the record was last written upon by the primary storage system.
In another aspect of the invention, the step of backing up electronic health/medical records from the primary storage system to the backup server by downloading copies of the records on the primary storage system to the backup server includes storing the records on the backup server in a file associated with a healthcare facility which administers medications or treatments to patients to which the records pertain.
In another aspect of the invention, the plurality of secure communication pathways between the backup server and computer system at the healthcare facility includes at least one cellular connection and at least on non-cellular connection.
In another aspect of the invention, a mobile computer system is used for receiving backup medication administration records and treatment administration records at a healthcare facility in the event connectivity between the healthcare facility and a primary server storing electronic medication administration records and treatment administration records is interrupted. The system includes a mobile cart and a processor supported by the mobile cart. The processor has multiple secure connections to a backup server having updated encrypted backup copies of medication administration and/or treatment administration records for patients at the healthcare facility. The processor is programmed to receive encrypted medication administration and/or treatment administration records over one of the secure connections in response to a signal generated in response to an interruption in connectivity between the healthcare facility and a records provider. A display, including an input device associated with the processor is provided for enabling a user to input to the processor and display information on the display. A sensor is associated with the processor for detecting whether the processor is connected to an operative power source. A battery is carried by the mobile cart for providing backup power to the processor, which processor is programmed to utilize power from the battery in response to a signal indicating a lack of power being supplied to the processor. A printer is associated with the processor and the battery, and the processor is programmed to decode encrypted medication administration and/or treatment administration records and actuate printing of the decoded medication administration records and/or treatment administration records in response to a signal indicating electrical power to the processor has been interrupted. The processor also is programmed to selectively print only medication administration records and/or treatment administration records for patients associated with the facility, or subpart thereof, with which the mobile cart is associated.
In another aspect of the invention, the multiple secure connections including at least one cellular connection and at least one non-secular connection.
In another aspect of the invention, the non-cellular connection includes an Ethernet connection. In another aspect of the invention, the records received by the processor over the secure connection are encrypted, and stored on the processor in encrypted format.
In another aspect of the invention, the input device for the processor and display is a computer peripheral. In another aspect of the invention, an electronic system stores medication administration records and treatment administration records of a primary server electronically connected to a healthcare facility. The system includes a computer system located at a healthcare facility and a backup server. The backup computer server has a secure electronic connection to both the primary server for storing electronic medication administration records and treatment administration records and the computer at the healthcare facility. The backup server is configured to request and receive patient specific medication and/or treatment records from the primary server over a first secure electronic connection for patients being treated at the healthcare facility. A determination is then made as to whether each record received from the primary server is acceptable for storage on the backup server by opening the record and using a computer-implemented process to determine the record's usability. A determination for each record is made by the computer-implemented process as to whether the record is newer than any previously received record received from the primary server for the healthcare facility stored on the backup server. Each record determined to be both usable by the computer-implemented process and newer than any previously stored record for the healthcare facility is saved. An identifier reflecting the identity of the healthcare facility rendering medication or treatment to the patient identified in the record is created and a hash value is created by hashing a plurality of values representative of attributes of the created record. The record is stored on the backup server in a folder associated with a particular healthcare facility under the hashed value. These records are transfer records from the backup server to the computer system at the healthcare in response to a signal reflecting a loss of connectivity between the healthcare facility and the primary server. In another aspect of the invention, the computer at the healthcare facility is configured to retrieve selective records of the transferred from the backup server by use of the hashed value.
In another aspect of the invention, a method for using and updating medication administration records and treatment administration records at a treatment facility during periods during periods when electronic communication between the treatment facility and a server storing the records has been compromised includes the steps of electronically transferring copies of medication administration records and treatment administration records from a primary server to a backup server; storing the transferred copies on the backup server in an encrypted format; connecting the backup server to a computer system located at a healthcare facility through at least two independent secure connections; determining whenever an electronic communication connection between the primary server and the healthcare facility has been interrupted; transferring copies of the records on the backup computer to the computer at the healthcare facility in response to a determination the electronic communication connection between the primary server and the healthcare facility has been interrupted; and creating electronic copies of the records transferred to the computer at the healthcare facility.
In another aspect of the invention, the method also includes the step of charting patient specific information pertaining to the medication and/or treatment of patients at the healthcare facility on the electronic records created at the healthcare facility.
In a still further aspect of the invention, a machine-readable interface of an API associated with the charted electronic records is configured to interface and interact with a machine-readable interface on an API associated with the remote electronic medication administration system through a digital network. After the communication connection between the treatment facility and the remote electronic medication administration system has been reestablished, the machine-readable interface on the API associated with the charted electronic records is used to update information records on the primary server.
While the invention concludes with claims which particularly point out and distinctly claim the invention, it is believed the present invention will be better understood from the following description taken in conjunction with the accompanying drawings, in which like reference numbers identify the same elements in which:
Reference will now be made in detail to certain exemplary embodiments of the invention, examples of which are illustrated in the accompanying drawings.
Referring now to the drawings,
As schematically shown in
Due to complexities associated with internet security, the installation of these types of prior art programs at a healthcare facility typically requires considerable computer expertise. In order for the programs to work properly, strict compliance with a long list of system requirements is necessary, and insecure firewall ports of the computer at the healthcare facility sometimes needed to be opened to effectuate communication with the eMAR/eTAR host computer 14. Since the operability of some prior art backup systems was strictly dependent upon proper configuration of the program installed on the computer system 12, incorrect firewall or router settings could cause the downloaded backup records to be incomplete or otherwise prevent the recovery of complete records. Often times, the incompleteness or non-usability of the records is not discovered until it is too late, i.e., until after electronic connectivity between the local computer system 12 and the remote host computer is lost, and the nurse or other medical personal searches and attempts to retrieve the stored file from the local backup computer system 12. More particularly, it is not until the retrieved file is decompressed (as represented by the icon designated by numeral 20) that the record is found to be unusable.
Turning now to
If a file passes these computer-implemented integrity testing processes, it is determined to be complete and usable. For each file received from the eMAR/eTAR provider's host computer by the backup system 22 that is determined to be complete and usable, a time stamp on the file reflecting the date and time on which the file had last been written upon by the eMAR/eTAR provider is read. The backup computer system 22 then compares the timestamp for the most recently received record against any version of the same file previously saved by the computer system 22. As depicted by the blocks 34, 36, if the timestamp reflecting the time the file had last been written upon by the eMAR/eTAR provider is newer than the timestamp of the previously saved version, the newly downloaded version of the file is saved on the computer system 22 over the previously save version of the file. If, on the other hand, the timestamp reflecting the time the file had last been written upon by the eMAR/eTAR provider is older than the time stamp reflecting the time the previously saved version of the file was received by computer system 22, indicating a lack of activity in the time period since the previous version had been saved, the previously saved file is maintained on the computer 22, and the more recently downloaded version disregarded.
When files are saved on the computer system 22, they once again saved as compressed files, such as zip files. They are, however, saved with a different file structure than that used by the host computer of the eMAR/eTAR provider. Specifically, the saved files are compressed (preferably zipped) and stored in folders which correspond to a specific healthcare facility (or a portion thereof) under identifying file names that are secure and which correlate with a specific healthcare facility (or portion thereof).
The identifying file name used to store and retrieve the saved records is created by a hashing algorithm which hashes a plurality of values representative of attributes of the created record. Two attributes that are hashed in one of the preferred embodiments are the timestamp and file name, as depicted by block 38. The encrypted file is then stored in a healthcare administration record emergency backup database 40 accessible to healthcare facility users. The hash value is then used to retrieve the file from the database 40. In this way, the file is fully encrypted whenever it is saved on the backup system 22.
Though the media storing the database 40 can reside at the healthcare facility, it is not necessary for the storage media to be physically at that location. It is often more efficient to store backup files remotely, and to store backup files for multiple facilities at a common location and on a common backup server. When this is done, however, it is imperative to provide multiple independent secure connections between the healthcare facility and the backup server where the database 40 is stored to ensure the healthcare has access to the backup records whenever connectivity between the healthcare facility and the host server of the eMAR/eTAR provider is lost. Locating the database 40 at a remote location also provides the backup data to be located at a physically secure facility, and assists in maintaining the confidentiality of patient health information and compliance with healthcare information confidentiality requirements. Additionally, the use of the present invention has audit trail capability, and can track any person who sees, opens or modifies data in the program.
As depicted in
In the event the healthcare facility is unable to connect with the remote host computer 26 of the eMAR/eTAR provider (see
As shown in
The emergency management backup system 50 also can be configured to automatically print each of the eMARs and eTARs downloaded into processor 52. The printing could occur at the printer 55 carried by the cart 50, or at any other secure location of the healthcare facility's choosing.
It there is loss of connectivity to the host computer of the eMAR/eTAR computer over an extended time, it might be desirable to continue to electronically chart, or document, any medications or treatments provided by the healthcare facility during the period backup records are being used. This electronic charting can occur in at least two ways, as schematically shown in
Once connectivity is once again established, it is necessary to communicate the information charted on the backup file to the eMAR/eTAR provider. This can be achieved in a number of ways, as represented by decision block 80. For example, one option, is to prepare an electronic eMAR/eTAR that can be printed off to be uploaded to the eMAR/eTAR provider's host computer once connectivity with that host computer is re-established, and the primary eMAR/eTAR system becomes operational. This option is depicted in the box 82.
Another option is to provide an application program interface (“API”) that allows communication between the healthcare administration emergency system 40 and the eMAR/eTAR host computer. The connection can be either one-way or bidirectional, so that either the eMAR/eTAR provider or healthcare facility can initiate the communication. With an API, the processor 52 on cart 50 takes the latest MAR/TAR data from the healthcare administration record emergency backup system 40, and creates a template(as depicted in block 84), which is populated with the eMAR/eTAR data from the backup file with the latest date. As shown in block 86, a database storage location is then created for a temporary database 88. As schematically represented by block 90, nurses can then use the mobile cart 50 to enter new medication/treatment data into the temporary database 88. Once re-establishment of the connectivity between the healthcare facility and the host computer 26 of the eMAR/eTAR provider is confirmed by the emergency backup system 40, the updated data is put in a format compatible with the host computer 26, and submitted to the eMAR/eTAR provider. Those skill in the art will undoubtedly appreciate that, though the communication between the eMAR/eTAR provider and healthcare facility is specifically disclosed in connection with a computer system mounted on a mobile cart, this aspect of the invention is not in any way limited to a mobile cart embodiment, and is applicable to any type of computer system at the healthcare facility in communication with the emergency healthcare system 50.
The foregoing description of the preferred embodiments of the present invention have been presented for purposes of illustration and description. It is not intended to be exhaustive or to limit the invention to the precise form disclosed. Obvious modifications or variations are possible in light of the above teachings. For example, the sequencing of the activities can vary from that described in the described embodiments, and except when specifically noted or necessarily implied, nothing in the specification or claims is intended to be restricted to any particular sequence of activities. As a further example, the invention was described with the use of a mobile cart at the healthcare facility. Those skilled in the art will readily appreciate that the invention is not limited to the use of a mobile cart. It will be further appreciated that the disclosed invention includes a number of different aspects, which can be employed separately or together. The embodiments were chosen and described to provide the best illustration of the principles of the invention and its practical application to thereby enable one of ordinary skill in the art to utilize the invention in various embodiments and with various modifications as are suited to the particular use contemplated. All such modifications and variations are within the scope of the invention as determined by the appended claims when interpreted in accordance with the breath to which they are fairly, legally and equitably entitled. The drawings and preferred embodiments do not and are not intended to limit the ordinary meaning of the claims in their fair and broad interpretation in any way.
This application claims priority to Provisional Application Number 62/450,802, filed Jan. 26, 2017, and to Provisional Application Number 62/534,944, filed Jul. 20, 2017.
| Number | Date | Country | |
|---|---|---|---|
| 62534944 | Jul 2017 | US | |
| 62450802 | Jan 2017 | US |
| Number | Date | Country | |
|---|---|---|---|
| Parent | 15800353 | Nov 2017 | US |
| Child | 18529793 | US |
