Patent Application
20190114394
Providers of healthcare services, such as clinicians, prescribe or recommend various orders to treat ailments or conditions diagnosed in patients. An “order” is a request for one or more actions to be performed by healthcare personnel. The orders may include, for instance, medications, medical equipment or supplies, laboratory tests, or medical services, examples of which include imaging diagnostics or surgical procedures, or other appropriate treatments, procedures or therapies.
Increasingly, clinicians are utilizing electronic order management systems to enter and manage orders for their patients. One example of such an electronic order management system is the POWERORDERS application available from Cerner Corporation of North Kansas City, Mo. For instance, using such an order management system, a physician or other clinician wishing to prescribe a medication for a particular patient may initiate an order for the medication, entering details for the medication order. After initiating the order, the clinician may “sign” the order, indicating to the order management system to process the order. These electronic order management systems have advanced the state of the art well beyond and provide many efficiencies over traditional ordering methods where a clinician writes out a hardcopy of the order. With electronic order management systems, orders may be quickly transmitted to an entity that can fulfill the order, such as a pharmacy or laboratory department. Additionally, previous orders for one or more patients may be recalled by clinicians having access to a healthcare network connected with the electronic order management system, such orders being stored, for instance, in patient-specific electronic health or medical records. This allows clinicians remote from the patient, or remote from other clinicians that have placed orders, to review the ordering history for the patient.
Embodiments of the present invention generally relate to computerized systems and methods that facilitate inputting orders into an electronic order management system based on diagnoses entered into patient care applications. In accordance with the technology described herein, a diagnosis is received via a user interface provided by a patient care application. A type of order for the diagnosis is determined from a data store mapping each of a number of diagnoses to one or more types of orders available for entry to the electronic order management system. An order entry user interface for submitting orders to the electronic order management system is launched, and an order corresponding to the type of order identified for the diagnosis is input into the order entry user interface. The order can be reviewed by a clinician and submitted via the electronic order management system for processing and fulfillment.
This summary is provided to introduce a selection of concepts in a simplified form that are further described below in the Detailed Description. This summary is not intended to identify key features or essential features of the claimed subject matter, nor is it intended to be used as an aid in determining the scope of the claimed subject matter.
The present invention is described in detail below with reference to the attached drawing figures, wherein:
The subject matter of the present invention is described with specificity herein to meet statutory requirements. However, the description itself is not intended to limit the scope of this patent. Rather, the inventors have contemplated that the claimed subject matter might also be embodied in other ways, to include different steps or combinations of steps similar to the ones described in this document, in conjunction with other present or future technologies. Moreover, although the terms “step” and/or “block” may be used herein to connote different components of methods employed, the terms should not be interpreted as implying any particular order among or between various steps herein disclosed unless and except when the order of individual steps is explicitly described.
While electronic order management systems provide many advantages and efficiencies over traditional ordering methods, some drawbacks are present in current solutions. For instance, the computer system for a healthcare facility often includes a number of different patient care applications for various domains within the healthcare facility. As specific examples, an emergency care department, pediatric department, and oncology department may each have its own specialized application. While each of these patient care applications may interface with an electronic order management system, this interface is not seamless. When a clinician is working within a patient care application and needs to enter an order, the clinician must launch an order application that presents an order entry user interface separate from the user interface from the patient care application. The clinician must then manually enter the order into the order entry user interface. This process is subject to error as context is lost when switching between the two user interfaces.
Embodiments of the present technology address the technical challenge of interfacing patient care applications with electronic order management systems. Generally, embodiments are directed to computerized methods and systems that facilitate inputting orders into an electronic order management system based on diagnoses entered into patient care applications. As used herein, a “diagnosis” includes any problem, complaint, physical symptom, or illness indicated for a patient or an identification of the source of any such problem, complaint, physical symptom, or illness. In accordance with the technology described herein, a diagnosis is received via a user interface provided by a patient care application. A type of order for the diagnosis is determined from a data store mapping each of a number of diagnoses to one or more types of orders available for entry to the electronic order management system. In some configurations, globally unique diagnoses codes are used to identify diagnoses in the data store. Using such globally unique diagnoses codes allows any number of diverse patient care applications to interface with the electronic order management system for the automatic selection an entry of orders for diagnoses. An order entry user interface for submitting orders to the electronic order management system is launched, and an order corresponding to the type of order identified for the diagnosis is input into the order entry user interface. The order can be reviewed by a clinician and submitted via the electronic order management system for processing and fulfillment.
Accordingly, aspects of the technology described herein provide, among other things, a process of entering orders into an electronic order management system that is initiated from separate patient care applications in an integrated fashion so that human input and other errors may be reduced. At the same time, adherence to clinical best practices and other guidelines may be increased, resulting in fewer erroneous orders. This provides a more seamless integration between disparate patient care applications and an electronic order management system that was previously not available.
Referring to the drawings in general, and initially to
It should be understood that the system 100 shown in
Among other components not shown, the system 100 includes a variety of patient care applications, such as applications 102, 104, 106, that can interact with an electronic order management system 108. The patient care applications 102, 104, 106 can be any of a number of different types of healthcare-related solutions that clinicians may employ when diagnosing and treating patients. For instance, the patient care applications 102, 104, 106 can include solutions for emergency rooms, pediatrics, and oncology to name a few.
The electronic order management system 108 can perform the tasks of accepting, validating, scheduling and otherwise processing orders for final implementation. According to embodiments of the invention in one regard, the electronic order management system 108 may be, include or interface to the PowerOrders® platform commercially available from Cerner Corp. Other platforms are possible. Among other things, the electronic order management system 108 may verify that equipment, technicians, laboratory time or other schedules or resources are available to perform entered orders. The electronic order management system 108 may likewise check or validate the clinical propriety of orders, for instance to validate that one test may be safely performed an hour or other scheduled time after another test, or to scan for contraindications to an administered procedure, such as allergies to imaging dyes. In embodiments, the electronic order management system 108 interfaces with computerized solutions for order completion, such as the order fulfillment systems 116, 118. The order fulfillment systems 116, 118 may include, for instance, electronic pharmacy or laboratory management systems.
In one embodiment, the system 100 operates within a comprehensive clinical computing system similar to the exemplary medical information system 700 described below with reference to
As shown in
The order selection component 112 selects orders using a mappings data store 114. The mappings data store 114 includes mappings of one or more types of orders to each of a number of diagnoses available to the system 100. In other words, each mapping corresponds with a diagnosis and identifies one or more types of orders for the diagnosis. In some configurations, a globally unique diagnosis code is used to identify each diagnosis. By using a globally unique diagnosis code for each diagnosis, the system 100 supports the interaction of diverse patient care applications (e.g., applications 102, 104, 106) with the electronic order management system 108. Each of the patient care applications 102, 104, 106, order selection component 112, and mappings data store 114 can use the globally unique diagnosis codes to uniquely identify diagnoses. However, as explained in further detail below, the use of such globally unique diagnosis codes are not required, and the order selection component 112 can be configured to identify mappings for diagnoses from diverse patient care applications that do not support such globally unique diagnosis codes.
The mapping for each diagnosis in the mappings data store 114 can be generated for instance, using a user interface for associating orders with diagnoses, such as the user interface 200 shown in
In operation, after a diagnosis is entered into a patient care application, such as one of the patient care applications 102, 104, 106, the order selection component 112 determines one or more types of orders for the diagnosis using the mappings data store 114. More particularly, the order selection component 112 can employ a set of rules to select orders as a function of the diagnosis entered into the patient care application. In some configurations, the set of rules can initially include deriving a query that can be used to identifying a mapping for the diagnosis from the mappings data store 114. Because the electronic order management system 108 can interface with diverse patient applications, it's possible that each patient care application can provide different diagnosis information to the order selection component 112. For instance, some patient care applications can be configured to provide a diagnosis code (e.g., a globally unique diagnosis code) that corresponds with the diagnosis codes used by the mapping data store 112, such that a query can be generated based on the provided diagnosis code. In other instance, some patient care application may simply provide text for an entered diagnosis. In such instances, the patient care application can derive a text-based query based on the text provided by the patient care application that is used to query the mapping data store 112. Alternatively, a diagnosis code could be determined based on the text provided by the patient care application by querying a database of diagnosis codes for diagnoses, and the determined diagnosis code could be used to query the mapping data store 112.
After deriving a query, the set of rules used by the order selection component can include querying the mappings data store 114 to identify a mapping for the diagnosis entered into the patient care application and identify, from that mapping, one or more types of orders mapped to the diagnosis. As noted above, in some exemplary configurations, the mappings data store 114 comprises a database keyed on globally unique diagnosis codes. In such configurations, the order selection component 112 may determine the globally unique diagnosis code for the entered diagnosis and use the globally unique diagnosis to identify the mapping (i.e., record) for the diagnosis in the mappings data store 114.
For each type of order identified for the diagnosis, the order selection component 112 inputs an order into a user interface provided for submitting orders via the electronic order management system 108. The user interface can be provided, for instance, by the order application 110 or another application, such as one of the patient care applications 102, 104, 106. In some configurations, the order is generated by retrieving patient data from an electronic medical record for the patient and using the retrieved patient data to populate the order. The user interface with the entered orders is presented to a clinician, who can review the order and determine whether to submit the order for processing via the electronic order management system 108.
Turning now to
As shown at block 304, a user interface for entering orders for the patient is launched. In some configurations, the user interface is provided by the order application 110 of the electronic order management system 108 of
The user interface for entering orders can be launched in a number of different manners in accordance with various embodiments. In some configurations, the user interface is automatically launched in response to the diagnosis being entered into the patient care application. In other configurations, the user interface is launched in response to a user command. For instance, the patient care application could include a user interface element for launching the user interface. In further configurations, the user interface could be automatically launched based on the typical workflow of the patient care application.
A diagnosis code is determined for the diagnosis, as shown at block 306. In some configurations, the diagnosis code is an identifier that is globally unique for the order application and the patient care applications in which diagnoses can be entered. A data store with mappings of different types of diagnoses to different types of orders is accessed, as shown at block 308. A mapping for the diagnosis is identified at block 310. This may be done, for instance, by using the diagnosis code to identify a mapping with that diagnosis code. A type of order for the diagnosis is identified from the mapping, as shown at block 312. In some instances, multiple types of orders may be mapped to the diagnosis and identified.
An order of the type determined is generated and input into the user interface for entering orders, as shown at block 314. In instances in which multiple types of orders are mapped to the diagnosis, an order for each type of order is generated and input into the user interface. The generation of each order may include retrieving patient data for the patient (e.g., from an electronic medical record for the patient) and populating the order based on the retrieved patient data.
By way of example to illustrate,
In accordance with the technology described herein, orders can be automatically selected based on the diagnosis entered for a patient into the user interface 400, and the order can be input into a user interface for entering orders via an ordering application. For example,
As another example,
Having described embodiments of the present invention, an exemplary operating environment in which embodiments of the present invention may be implemented is described below in order to provide a general context for various aspects of the present invention. The exemplary computing system environment, for instance, a medical information computing system, on which embodiments of the present invention may be implemented is illustrated and designated generally as reference numeral 700 in
The present invention may be operational with numerous other general purpose or special purpose computing system environments or configurations. Examples of well-known computing systems, environments, and/or configurations that may be suitable for use with the present invention include, by way of example only, personal computers, server computers, hand-held or laptop devices, multiprocessor systems, microprocessor-based systems, set top boxes, programmable consumer electronics, network PCs, minicomputers, mainframe computers, distributed computing environments that include any of the above-mentioned systems or devices, and the like.
The present invention may be described in the general context of computer-executable instructions, such as program modules, being executed by a computer. Generally, program modules include, but are not limited to, routines, programs, objects, components, and data structures that perform particular tasks or implement particular abstract data types. The present invention may also be practiced in distributed computing environments where tasks are performed by remote processing devices that are linked through a communications network. In a distributed computing environment, program modules may be located in local and/or remote computer storage media including, by way of example only, memory storage devices.
With continued reference to
The server 702 typically includes, or has access to, a variety of computer readable media, for instance, database cluster 704. Computer readable media can be any available media that may be accessed by server 702, and includes volatile and nonvolatile media, as well as removable and non-removable media. By way of example, and not limitation, computer readable media may include computer storage media and communication media. Computer storage media may include, without limitation, volatile and nonvolatile media, as well as removable and nonremovable media implemented in any method or technology for storage of information, such as computer readable instructions, data structures, program modules, or other data. In this regard, computer storage media may include, but is not limited to, RAM, ROM, EEPROM, flash memory or other memory technology, CD-ROM, digital versatile disks (DVDs) or other optical disk storage, magnetic cassettes, magnetic tape, magnetic disk storage, or other magnetic storage device, or any other medium which can be used to store the desired information and which may be accessed by the server 702. Computer storage media does not comprise signals per se. Communication media typically embodies computer readable instructions, data structures, program modules, or other data in a modulated data signal, such as a carrier wave or other transport mechanism, and may include any information delivery media. As used herein, the term “modulated data signal” refers to a signal that has one or more of its attributes set or changed in such a manner as to encode information in the signal. By way of example, and not limitation, communication media includes wired media such as a wired network or direct-wired connection, and wireless media such as acoustic, RF, infrared, and other wireless media. Combinations of any of the above also may be included within the scope of computer readable media.
The computer storage media discussed above and illustrated in
The server 702 may operate in a computer network 706 using logical connections to one or more remote computers 708. Remote computers 708 may be located at a variety of locations in a medical or research environment, for example, but not limited to, clinical laboratories, hospitals and other inpatient settings, veterinary environments, ambulatory settings, medical billing and financial offices, hospital administration settings, home health care environments, and clinicians' offices. Clinicians may include, but are not limited to, a treating physician or physicians, specialists such as surgeons, radiologists, cardiologists, and oncologists, emergency medical technicians, physicians' assistants, nurse practitioners, nurses, nurses' aides, pharmacists, dieticians, microbiologists, laboratory experts, genetic counselors, researchers, veterinarians, students, office assistants and the like. The remote computers 708 may also be physically located in non-traditional medical care environments so that the entire health care community may be capable of integration on the network. The remote computers 708 may be personal computers, servers, routers, network PCs, peer devices, other common network nodes, or the like, and may include some or all of the components described above in relation to the server 702. The devices can be personal digital assistants or other like devices.
Exemplary computer networks 706 may include, without limitation, local area networks (LANs) and/or wide area networks (WANs). Such networking environments are commonplace in offices, enterprise-wide computer networks, intranets, and the Internet. When utilized in a WAN networking environment, the server 702 may include a modem or other means for establishing communications over the WAN, such as the Internet. In a networked environment, program modules or portions thereof may be stored in the server 702, in the database cluster 704, or on any of the remote computers 708. For example, and not by way of limitation, various application programs may reside on the memory associated with any one or more of the remote computers 708. It will be appreciated by those of ordinary skill in the art that the network connections shown are exemplary and other means of establishing a communications link between the computers (e.g., server 702 and remote computers 708) may be utilized.
In operation, a user may enter commands and information into the server 702 or convey the commands and information to the server 702 via one or more of the remote computers 708 through input devices, such as a keyboard, a pointing device (commonly referred to as a mouse), a trackball, or a touch pad. Other input devices may include, without limitation, microphones, satellite dishes, scanners, or the like. Commands and information may also be sent directly from a remote healthcare device to the server 702. In addition to a monitor, the server 702 and/or remote computers 708 may include other peripheral output devices, such as speakers and a printer.
Although many other internal components of the server 702 and the remote computers 708 are not shown, those of ordinary skill in the art will appreciate that such components and their interconnection are well known. Accordingly, additional details concerning the internal construction of the server 702 and the remote computers 708 are not further disclosed herein.
As can be understood, embodiments of the present invention provide a system for detecting anomalous authentication activity in a client-server architecture. The present invention has been described in relation to particular embodiments, which are intended in all respects to be illustrative rather than restrictive. Alternative embodiments will become apparent to those of ordinary skill in the art to which the present invention pertains without departing from its scope.
From the foregoing, it will be seen that this invention is one well adapted to attain all the ends and objects set forth above, together with other advantages which are obvious and inherent to the system and method. It will be understood that certain features and subcombinations are of utility and may be employed without reference to other features and subcombinations. This is contemplated and within the scope of the claims.
