Patient data mining for automated compliance

Abstract

A technique is provided for automatically generating performance measurement information. At least some of the obtained performance measurement information may be derived from unstructured data sources, such as free text physician notes, medical images, and waveforms. The performance measurement may be sent to a health care accreditation organization. The health care accreditation organization can use the performance measurement to evaluate a health care provider for its quality of patient care. Alternatively, performance measurement information can be provided directly to consumers.

Description

FIELD OF THE INVENTION

[0002] The present invention relates to medical information processing systems, and, more particularly to a computerized system and method for providing automated performance measurement information for health care organizations.

BACKGROUND OF THE INVENTION

[0003] Health care organizations need to generate various types of performance measurement information to determine how well they are progressing over time. Health care organizations typically use this information to determine areas of excellence within their organizations as well as those areas that need improvement. Performance measurement information provides an objective basis for planning and making budgeting decisions. In addition, performance measurement information can be used to demonstrate accountability to the public and to back up claims of quality. Frequently, performance measurement information is provided to accreditation organizations for compliance purposes.

[0004] The Joint Commission on Accreditation of Healthcare Organizations (JCAHO), an organization that accredits more than 4,700 hospitals nationwide, requires that participating hospitals provide certain types of performance measurement information. For example, JCAHO requires that participating hospitals provide information regarding patients treated for acute myocardial infarction (AMI). As one example of the type of information that must be provided, hospitals are required to indicate whether an AMI patient without aspirin contraindication received aspirin within 24 hours before or after hospital arrival. Because it is believed that early treatment with aspirin markedly reduces mortality for AMI, JCAHO requires hospitals to report this information.

[0005] Currently, performance measurement information must be collected from a myriad of structured and unstructured data sources to comply with accreditation requests. For example, it may be necessary to access numerous different databases, each with its own peculiar format. Worse, physician notes may have to be consulted. These notes usually are nothing more than free text dictations, and it may be very difficult to sift through the notes to gather the necessary information. As a result, the effort taken to collect this information is usually time consuming, expensive, and error prone. Furthermore, usually only a small sample of patient data can be supplied.

[0006] Given the importance of collecting accurate performance measurement information, it would be desirable and highly advantageous to provide new techniques for automatically generating performance measurement information for health care organizations.

SUMMARY OF THE INVENTION

[0007] The present invention provides a technique for automatically generating performance measurement information for health care organizations.

[0008] In various embodiments of the present invention, a method is provided that includes formulating a query based on a specified performance measurement category. This query is then executed to obtain performance measurement information. At least some of the obtained performance measurement information may be derived from unstructured data sources, such as free text physician notes.

[0009] The performance measurement information can be outputted. The performance measurement information may be sent to a health care accreditation organization. An example of a health care accreditation organization is the Joint Commission on Accreditation of Health Care Organizations (JCAHO).

[0010] Performance measurement information can include patient information from a health care provider being evaluated. For example, a health care accreditation organization may evaluate a hospital for its quality of care in treating heart attack patients. This patient information may include clinical information, financial information, and demographic information.

[0011] The obtained performance measurement information may be sampled from a patient population. Alternatively, it may be obtained for an entire patient population.

[0012] Performance measurement information may be generated by a health care provider, third party service provider, or an accreditation organization. The performance measurement information may be made available using a network, such as, for example, the Internet.

[0013] In various embodiments, an evaluation score of a health care provider may be calculated using the obtained performance measurement information. This evaluation score may be outputted for evaluating health care providers. Health care consumers may have the opportunity to view or download evaluation information via the Internet. Health care providers may be ranked according to the evaluation scores. Such rankings may be done for various performance measurement categories.

[0014] These and other aspects, features and advantages of the present invention will become apparent from the following detailed description of preferred embodiments, which is to be read in connection with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

[0015] FIG. 1 is a block diagram of a computer processing system to which the present invention may be applied according to an embodiment of the present invention;

[0016] FIG. 2 shows an exemplary automated performance measurement information system in accordance with an embodiment of the present invention;

[0017] FIG. 3 shows an exemplary query for selecting performance measurement information; and

[0018] FIG. 4 shows a flow diagram outlining an exemplary technique for automatically generating performance measurement information.

DESCRIPTION OF PREFERRED EMBODIMENTS

[0019] To facilitate a clear understanding of the present invention, illustrative examples are provided herein which describe certain aspects of the invention. However, it is to be appreciated that these illustrations are not meant to limit the scope of the invention, and are provided herein to illustrate certain concepts associated with the invention.

[0020] It is also to be understood that the present invention may be implemented in various forms of hardware, software, firmware, special purpose processors, or a combination thereof. Preferably, the present invention is implemented in software as a program tangibly embodied on a program storage device. The program may be uploaded to, and executed by, a machine comprising any suitable architecture. Preferably, the machine is implemented on a computer platform having hardware such as one or more central processing units (CPU), a random access memory (RAM), and input/output (I/O) interface(s). The computer platform also includes an operating system and microinstruction code. The various processes and functions described herein may either be part of the microinstruction code or part of the program (or combination thereof) which is executed via the operating system. In addition, various other peripheral devices may be connected to the computer platform such as an additional data storage device and a printing device.

[0021] It is to be understood that, because some of the constituent system components and method steps depicted in the accompanying figures are preferably implemented in software, the actual connections between the system components (or the process steps) may differ depending upon the manner in which the present invention is programmed.

[0022] FIG. 1 is a block diagram of a computer processing system 100 to which the present invention may be applied according to an embodiment of the present invention. The system 100 includes at least one processor (hereinafter processor) 102 operatively coupled to other components via a system bus 104. A read-only memory (ROM) 106, a random access memory (RAM) 108, an I/O interface 110, a network interface 112, and external storage 114 are operatively coupled to the system bus 104. Various peripheral devices such as, for example, a display device, a disk storage device(e.g., a magnetic or optical disk storage device), a keyboard, and a mouse, may be operatively coupled to the system bus 104 by the I/O interface 110 or the network interface 112.

[0023] The computer system 100 may be a standalone system or be linked to a network via the network interface 112. The network interface 112 may be a hard-wired interface. However, in various exemplary embodiments, the network interface 112 can include any device suitable to transmit information to and from another device, such as a universal asynchronous receiver/transmitter (UART), a parallel digital interface, a software interface or any combination of known or later developed software and hardware. The network interface may be linked to various types of networks, including a local area network (LAN), a wide area network (WAN), an intranet, a virtual private network (VPN), and the Internet.

[0024] The external storage 114 may be implemented using a database management system (DBMS) managed by the processor 102 and residing on a memory such as a hard disk. However, it should be appreciated that the external storage 114 may be implemented on one or more additional computer systems. For example, the external storage 114 may include a data warehouse system residing on a separate computer system.

[0025] Those skilled in the art will appreciate that other alternative computing environments may be used without departing from the spirit and scope of the present invention.

[0026] Referring to FIG. 2, an automated performance measurement system 216 is illustrated. The automated performance measurement system 216 is shown connected to a data repository which contains structured patient information collected from one or more health care organization. This data repository is called a structured clinical patient record (CPR) 214. The CPR 214 is shown connected to a data miner 212 which mines high-quality structured clinical information from unstructured patient information 210.

[0027] Preferably, the structured CPR 214 is populated with patient information using data mining techniques described in “Patient Data Mining,” by Rao et al., Attorney Docket No. 2001P20906US01, copending U.S. patent application Ser. No. ______, filed herewith, which is incorporated by reference herein in its entirety.

[0028] That disclosure teaches a data mining framework for mining high-quality structured clinical information. The data mining framework includes a data miner that mines medical information from a computerized patient record based on domain-specific knowledge contained in a knowledge base. The data miner includes components for extracting information from the computerized patient record, combining all available evidence in a principled fashion over time, and drawing inferences from this combination process. The mined medical information is stored in a structured computerized patient record.

[0029] Referring again to FIG. 2, the automated performance measurement system 216 can be configured to generate performance measurement information for one or more performance measurement category. Once a performance measurement category is selected, a query can be formulated based on the selected performance measurement category.

[0030] The query is then executed to obtain performance measurement information. At least some of the obtained performance measurement information may be derived from unstructured data sources, such as, for example, free text, medical images and waveforms.

[0031] An exemplary query is shown in FIG. 3. In accordance with JCAHO accreditation requirements, hospitals must indicate whether an acute myocardial infarction (AMI) patient without aspirin contraindication received aspirin within 24 hours before or after hospital arrival. The query shows that all AMI patients are selected except those excluded under JCAHO guidelines. JCAHO excludes patients who are less than 18 years of age, transferred to another acute care hospital on day of arrival, received in transfer from another hospital, discharged on day of arrival, expired on day of arrival, left against medical advice on day of arrival, or have aspirin contraindications.

[0032] It should be appreciated that the query shown in FIG. 3 is shown for illustrative purposes only. Further, it is to be appreciated that the actual performance measurement categories used to implement the present invention can relate to any type of performance measurement, including those related to any aspect of health care quality, safety, or compliance with standards.

[0033] As mentioned previously, the performance measurement information can be sent to a health care accreditation organization such as JCAHO. The obtained performance measurement information may be sampled or obtained for an entire patient population.

[0034] Performance measurement information may be generated by a health care provider, third party service provider, or an accreditation organization. The performance measurement information may be made available using any suitable network.

[0035] In order to empower health care consumers, an evaluation score of a health care provider may be determined using the obtained performance measurement information. Consumers may view or download this evaluation information via the Internet, for example. Health care providers may be ranked according to the evaluation scores. Such rankings may be done for various performance measurement categories. For example, hospitals in a particular geographic area may be ranked according to quality of care in treating prostate cancer. There may be another list that ranks hospitals nationwide for quality of care in treating infectious diseases, etc.

[0036] Referring to FIG. 4, a flow diagram outlining an exemplary technique for automatically generating performance measurement information is illustrated. Beginning at step 401, a performance measurement category is selected. This may involve selecting from among several performance measurement categories that are presented to a user. (Of course, this step may be skipped if there is only one performance measurement category).

[0037] In step 402, a query is formulated based on the selected performance measurement category. (This may involve formulating a query such as the one shown in FIG. 3). The query may be formulated to select all patients for the performance measurement category or only a sample of them. The particular sample size may be input as a parameter value.

[0038] In step 402, the query is executed to obtain performance measurement information. At least some of the obtained performance measurement information may have been derived from unstructured information. Preferably, this information resides in a structured data repository that is populated using mined unstructured patient information, as described in “Patient Data Mining,” by Rao et al., Attorney Docket No. 2001P20906US01, copending U.S. patent application Ser. No. ______.

[0039] In step 404, a compliance report is formatted. While this step involves creating a report, it should be appreciated that there are many other ways to output performance measurement information. For instance, the performance measurement information may be output to a magnetic or optical disc, electronically transmitted, or displayed upon a screen.

[0040] In step 405, a determination is made as to whether any more reports are to be generated. If there are, then control returns back to step 401; otherwise, control continues to step 406 where the operation stops.

[0041] As shown in FIGS. 1-4, this invention is preferably implemented using a general purpose computer system. However the systems and methods of this invention can be implemented using any combination of one or more programmed general purpose computers, programmed microprocessors or micro-controllers and peripheral integrated circuit elements, ASIC or other integrated circuits, digital signal processors, hardwired electronic or logic circuits such as discrete element circuits, programmable logic devices such as a PLD, PLA, FPGA or PAL, or the like. In general, any device capable of implementing a finite state machine that is in turn capable of implementing the flowchart shown in FIG. 3 can be used to implement this system.

[0042] Although illustrative embodiments of the present invention have been described herein with reference to the accompanying drawings, it is to be understood that the invention is not limited to those precise embodiments, and that various other changes and modifications may be affected therein by one skilled in the art without departing from the scope or spirit of the invention.

Claims

1. A method for automatically generating performance measurement information for health care organizations, comprising the steps of: formulating a query based on a specified performance measurement category; and executing the query to obtain performance measurement information, at least some of the obtained performance measurement information obtained from mined data sources.

2. The method of claim 1, further including the step of outputting the obtained performance measurement information.

3. The method of claim 1, wherein the obtained performance measurement information includes patient information for a health care provider being evaluated.

4. The method of claim 3, wherein the patient information includes at least one of clinical information, financial information, and demographic information.

5. The method of claim 1, wherein the performance measurement categories includes one or more of acute myocardial infarction, heart failure, pneumonia, and pregnancy.

6. The method of claim 2, wherein the outputted performance measurement information is sent to a health care accreditation organization.

7. The method of claim 2, wherein the outputted performance measurement information includes compliance metrics determined by regulatory organizations.

8. The method of claim 6, wherein the health care accreditation organization accredits at least one of hospitals, ambulatory care facilities, assisted living facilities, behavioral health care facilities, long-term care facilities, office-based surgery facilities, home care providers, and laboratories.

9. The method of claim 1, wherein the obtained performance measurement information relates to the quality of care for the specified performance measurement category.

10. The method of claim 1, wherein the mined data sources include mined unstructured data sources.

11. The method of claim 1, wherein the obtained performance measurement information is sampled from a patient population.

12. The method of claim 1, wherein the obtained patient performance measurement information is obtained for an entire patient population for the specified performance measurement category.

13. The method of claim 2, wherein the outputted performance measurement information is sent to a health care accreditation organization.

14. The method of claim 1, further including the steps of: calculating an evaluation score of a health care provider using the obtained performance measurement information; and outputting the evaluation score for evaluating health care providers.

15. The method of claim 14, wherein the outputted evaluation scores are made available to consumers via the Internet.

16. The method of claim 15, wherein health care providers are ranked according to the evaluation scores.

17. The method of claim 16, wherein rankings are done for performance measurement categories.

18. The method of claim 1, wherein the performance measurement information is generated by a third party service provider.

19. The method of claim 2, wherein the outputted performance measurement information is output via the Internet.

20. The method of claim 1, wherein the performance measurement information is generated at a health care accreditation organization.

21. The method of claim 1, wherein the performance measurement information is probabilistic.

22. A program storage device readable by a machine, tangibly embodying a program of instructions executable on the machine to perform method steps for automatically generating performance measurement information for health care organizations, the method steps comprising: formulating a query based on a specified performance measurement category; and executing the query to obtain performance measurement information, at least some of the obtained performance measurement information obtained from mined unstructured data sources.