Patent Application
20100169120
Typically, medical devices that are used to treat or care for a patient are not adequately linked to that patient in the patient's record, such as an electronic medical record (EMR). In many instances, this lack of linkage or association may lead to many inaccuracies and inconsistencies in treating the patient. For instance, when a caregiver, such as a nurse, begins an ordered dosage using an infusion pump, the nurse may write down or enter a start time of the infusion in the patient's record. An inaccuracy may arise when the start time is determined based on a watch or clock that is not accurate, or in sync with the watch or clock used to document the end time. Further, the lack of association between a patient and medical devices used to treat the patient may necessitate multiple queries in order to locate certain information related to the patient's treatment. For instance, even if a particular patient's record is queried and found, data from the medical devices used in conjunction with the patient's treatment may not be included in the record, but may require separate and multiple queries. In some cases, the data from the medical devices may be very difficult, or even impossible to locate.
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 defined by the claims.
Embodiments of the present invention provide systems and methods for associating patients, medical devices, and orders to one another. One or more medical devices may be connected to a component, such as a bus, that receives data from the medical devices and determines where the data should be sent. In one instance, services, such as a patient to device association service may request the receipt of data when a patient is associated to a particular medical device. This data may be published by the bus, in one instance, to the patient's electronic medical record, and may also be routed to a data store so that the data can be archived and queried by a caregiver in the future. Data may be continuously received from a particular medical device during a period of time that the medical device is connected to the bus, or a component therein. Initially, patients, medical devices, and orders may be identified in a number of ways, such as by scanning a barcode corresponding to the patient, device, or order, entering some type of identification corresponding to the patient, device, or order into a computing device (e.g., PDA or other handheld computing device), or searching an electronically searchable database that contains a plurality of identifications corresponding to patients, devices, and orders. Orders may be inherently associated to patients, as orders are typically made for a particular patient.
More particularly, a first aspect of an embodiment of the present invention includes a computer-implemented method for associating a patient to one or more medical devices. The method includes receiving an identification of the patient, and receiving an identification of a first medical device. In response to receiving the identifications of the patient and the first medical device, the patient and the first medical device are associated to one another. Further, the association of the identified patient and the first medical device is maintained until an occurrence of a disassociation event. A disassociation event includes a disassociation by a clinician, or an override caused by the association of another patient to the first medical device.
In a second aspect, embodiments of the present invention are directed toward a system for continually receiving data from a plurality of medical devices such that a patient, a medical device, and an order can be associated to one another. The system includes various components, including a receiving component for continually receiving data from at least one medical device during a period of time when the at least one medical device is online. The data is received from one of a direct feed from the at least one medical device, a device gateway, or a connectivity engine. Further, the system includes a data storing component for storing the continually received data from the at least one medical device so that the data can be accessed for querying and archiving, and a connectivity monitoring component for monitoring a connection of the at least one medical device. The method additionally includes a registration monitoring component for monitoring registration and deregistration events of the at least one medical device, and for maintaining a registry of the registration and deregistration events, and a determining component for determining a patient who is associated to the at least one medical device. A routing component for routing the data from the at least one medical device to an electronic medical record corresponding to the patient may also be included in the system, as well as a first publishing component for publishing patient test results corresponding to the at least one medical device to the electronic medical record corresponding to the patient.
A further aspect of an embodiment of the present invention takes the form of one or more computer-storage media having computer-executable instructions embodied thereon, that, when executed perform a method for associating an order to a medical device. Initially, the method involves receiving an identification of an order, wherein the order corresponds to a patient, and receiving an identification of a first medical device. In response to receiving the identifications of the order and the first medical device, the order and the first medical device may be associated to one another. Additionally, the method includes receiving a continuous data feed from the first medical device from a first time to a second time. In one embodiment, the first time occurs upon the association of the order and the first medical device, and the second time occurs upon a termination of the association of the order to the first medical device.
Embodiments are 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 elements 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.
Embodiments of the present invention provide systems, methods, and computer-readable media for, among other things, associating a patient and a medical device to one another, and for associating a medical device and an order to one another. Initially, a medical device may be any device, stationary or otherwise, that may be used to treat a patient in a hospital, doctor's office, etc. For exemplary purposes only and not limitation, medical devices may include monitors, ventilators, pumps (e.g., infusion pumps, balloon pumps), a patient's bed, sequential compression devices, electronic security devices, and the like. Some medical devices may be capable of being associated with orders, such as a patient's bed (e.g., order compliance data for a falls risk patient including head rails up and head angle of the bed), and others may not, such as monitors, ventilators, etc. Orders are typically given or made by clinicians who are authorized to give such orders, and may vary depending on the patient, or by type of device required, if any, to carry out a particular order.
Once a patient and device have been associated, data from that device may be continuously received until the patient and device are disassociated. For instance, a clinician or other user may choose to disassociate an existing association. This may be done in many ways, including scanning or otherwise identifying the patient and device, and selecting a disassociate button located on the screen display. In embodiments, checkboxes are displayed near each device identification to allow for a user to quickly select and disassociate a particular device from the patient who is identified on that screen display. Additionally, in yet another instance, an override caused by the association of another patient to a device may automatically cause a disassociation event to occur. When an indication is received to associate a patient with a medical device that is already associated to another patient, an alert may be provided to a user by way of a dialog box or other alert mechanism, which may allow the user to choose whether an override of the existing association should occur.
In embodiments of the present invention, medical devices and orders may be suggested based on one of many factors. In one instance, medical devices may be suggested based on various demographics of the identified patient, including, but not limited to, the patient's age, weight, or gender. Alternatively, medical devices may be suggested based on the patient's location in the hospital or medical building. For instance, if a patient is admitted to a hospital and will be located in an intensive care unit (ICU), devices that are typically used in an ICU or devices currently located in the ICU may be suggested as devices with which that patient may need to be associated. In another instance, medical devices may be suggested based upon an identified order. As will be discussed in greater detail below, certain orders correspond with certain devices, as they require certain devices to be carried out. Additionally, orders may be suggested based upon an identified patient, as orders are typically made for a particular patient.
In various embodiments of the present invention, data from various medical devices may be transferred or routed to a patient's electronic medical record (EMR). As utilized herein, the acronym “EMR” is not meant to be limiting, and may broadly refer to any or all aspects of the patient's medical record rendered in a digital format. Generally, the EMR is supported by systems configured to co-ordinate the storage and retrieval of individual records with the aid of computing devices. As such, a variety of types of healthcare-related information may be stored and accessed in this way. By way of example, the EMR may store one or more of the following types of information: patient demographic; medical history (e.g., examination and progress reports of health and illnesses); medicine and allergy lists/immunization status; laboratory test results, radiology images (e.g., X-rays, CTs, MRIs, etc.); evidence-based recommendations for specific medical conditions; a record of appointments and physician's notes; billing records; and data received from an associated medical device. Accordingly, systems that employ EMRs reduce medical errors, increase physician efficiency, and reduce costs, as well as promote standardization of healthcare.
Having briefly described embodiments of the present invention, an exemplary operating environment suitable for use in implementing embodiments of the present invention is described below.
Referring to the drawings in general, and initially to
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 association with local and/or remote computer storage media including, by way of example only, memory storage devices.
With continued reference to
The control server 22 typically includes therein, or has access to, a variety of computer-readable media, for instance, database cluster 24. Computer-readable media can be any available media that may be accessed by server 22, 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 non-removable 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 control server 22. 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 control server 22 may operate in a computer network 26 using logical connections to one or more remote computers 28. Remote computers 28 may be located at a variety of locations in a medical or research environment, for example, but not limited to, clinical laboratories (e.g., molecular diagnostic 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, laboratory technologists, genetic counselors, researchers, veterinarians, students, and the like. The remote computers 28 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 28 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 elements described above in relation to the control server 22. The devices can be personal digital assistants or other like devices.
Exemplary computer networks 26 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 control server 22 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 association with the control server 22, the database cluster 24, or any of the remote computers 28. 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 28. 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., control server 22 and remote computers 28) may be utilized.
In operation, a clinician may enter commands and information into the control server 22 or convey the commands and information to the control server 22 via one or more of the remote computers 28 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 control server 22. In addition to a monitor, the control server 22 and/or remote computers 28 may include other peripheral output devices, such as speakers and a printer.
Although many other internal components of the control server 22 and the remote computers 28 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 control server 22 and the remote computers 28 are not further disclosed herein.
Initially, the exemplary system architecture 200 includes device connectivity 210, device messaging services 212, and application services 214. The device connectivity 210 includes one or more medical devices that are connected to the device messaging services 212 such that the devices may, at a later time, be associated to a particular patient and/or an order. These devices may include, but are not limited to monitors, cardiac ventilators, balloon pumps, patient beds, infusion pumps, sequential compression devices, electronic security devices, vital signs devices, or any other device that a health care provider may use for a patient while the patient is in the hospital. These devices are shown in
Each medical device may communicate with the device messaging services 212 in a different way. For example, some devices, such as device 216, may utilize a device gateway 228. A gateway is generally a device that connects networks or other devices using different communications protocols so that information can be easily passed from one to the other. A gateway may both transfer information and convert it to a form compatible with the protocols used by the receiving network. Here, the device gateway assists in the transfer of data from the device 216 to the device messaging services 212. As will be described in greater detail below, an adapter, such as adapter 240 may be used in instances where the device gateway 228, was provided by the device manufacturer. The adapter 240 is typically used to facilitate communication from a consumer to the gateway over the consumer's protocol. It should be noted that an adapter may reside on or near the device messaging services, or may reside near the actual device or device gateway. In other instances, a device gateway may be a third-party device gateway 230. In these instances, an adapter may not be necessary, as the device messaging services 212 may already know what type of messages to expect from that device 218 through the third-party device gateway 230. Many different connection types may be utilized between devices, gateway servers, and components of the device messaging services 212, including, but not limited to, HL7 TCP/IP, a software development kit (SDK), RS 232, etc.
Other devices, such as device 220, may have an internal gateway or other component such that a gateway like 228 or 230 would not be needed. These devices may have all of the required capability built into it, and, if necessary, may even have their own adapters incorporated therein such that a separate adapter would not be necessary. Still other devices, such as devices 222, 224, and 226, may be legacy devices that are older and don't have networking built-ins. For example, it may not be possible to plug in a CAT 5 network to the legacy devices, the devices may not have wireless networking capabilities, etc. A serial port may be the only connection mechanism that exists on these devices. For these devices, a connectivity engine 238 and device adapters 232, 234, and 236 may be used. The device adapter is a hardware device that is affixed directly onto the medical device, and acts as the sole source of identification and connection to the connectivity engine 238. Device adapters 232, 234, and 236 are configurable with device specific information including, but not limited to, manufacturer, device name, device model, port settings, and the like. Device adapters 232, 234, and 236 may use various connection mechanisms to connect to the connectivity engine 238 including, but not limited to, Universal Serial Bus (USB) or Personal Area Network (PAN). The connectivity engine 238 is a piece of hardware that may be connected to devices 222, 224, and 226 either wirelessly or via a wired connection. Even if there is a wired connection between the connectivity engine 238 and a device, there may still be a wireless connection over a wireless network between the connectivity engine 238 and the device messaging services 212.
The connectivity engine 238 may also assist in detecting types of devices so that the appropriate driver may be loaded, which may be based on the make and model of the particular device. The connectivity engine 238 may be located on the device messaging services 212 or as part of the device subsystems 210, as illustrated in
The medical devices, either directly or indirectly through a gateway, connectivity engine, or other component are connected to the device messaging services 212. The device messaging services 212, in some embodiments, may generally include one or more adapters 240, one or more bus hosts, such as bus hosts 242 and 244, a main bus 246, a device lifecycle 248, a driver library 250, and a device message routing 252. As previously described, an adapter may be used when the device gateway, such as device gateway 228, is provided by the manufacturer of a device, for example. The adapter 240 assists to facilitate communication from a consumer to the gateway over the consumer's protocol. While one adapter 240 is illustrated in
A bus host, such as bus host 242 or 244 may be used to perform several functions, including, but not limited to, detecting hardware that is plugged in or directly connected to the host, loading appropriate device drivers after the device has been identified, dynamically locating and installing drivers if the driver is not currently present on the host, and for unloading the device driver after the device has been disconnected. A bus host may not be utilized for each and every medical device, but may be used for some that don't have device adapters, for example, which perform many of the functions listed above. The embodiment of
The main bus 246 provides connection framework, as it may create and manage all connections to the device messaging services 212. The main bus 246 also provides messaging architecture for the device messaging services 212. The main functionality of the main bus 246 includes providing general operational and management capabilities for connected devices, which may vary depending on the service that is subscribing or requesting the data from the devices.
A device lifecycle 248 may detect the presence of a device on the main bus 246. The device lifecycle 248 also may maintain an accurate directory of currently connected medical devices to the main bus 246 as various medical devices become connected. Further, it may ensure “active” connectivity of a medical device to the main bus 246 via a device heartbeat. A heartbeat is an indication given at a certain interval of time that a particular medical device is connected to the main bus 246. This interval may vary, and may be regular, such as every 20 seconds, for example. Additionally, the interval may depend on each medical device. As a medical device deregisters, or becomes unconnected to the main bus 246, the device lifecycle 248 may be responsible for sending out a notice of a disconnect event, and will then stop sending that device's heartbeat out to certain components that require that information. There are various phases of the device lifecycle 248, which may include, in one embodiment, a notification phase that notifies of an event generated at the device connection and of a device connected as directly to the main bus 246; an interrogation phase; an identification phase that identifies the vendor, make, model, etc. of each medical device and that finds and downloads the appropriate driver when necessary; an activation phase that loads the device driver and registers the medical devices; and an execution phase that is responsible for tracking the medical devices' heartbeats and gathers and transmits data to and from the medical devices.
A driver library 250 may store a plurality of drivers that may be used and installed on particular devices, when required. Further, a device message routing component 252 handles routing messages from source to destination across the device messaging services 212. Messages may take on a variety of forms, and may contain vastly different types of content. Various types of messaging may include request and reply messaging, publish and subscribe messaging, and asynchronous one-way messaging. Request and reply messaging includes taking a message from a source, routing it to a single destination, and routing a reply message from the destination back to the original source. Publish and subscribe messaging involves a publisher sending messages out on a named topic, which may be received by multiple subscribers. Asynchronous one-way messaging includes doing requests and reply messaging without needing to receive a reply. The only receipt message may be an indication that the message was successfully sent.
With continued reference to
In various embodiments of the present invention, the services 260 run on the main bus 246, and thus together with the main bus 246, may provide additional functionality to the system as a whole. For example, when various services 260 run on the main bus 246, the main bus 246 may store discrete data posts, such as heart rate, systolic blood pressure, diastolic blood pressure, etc., in a data store, such as data store 264, for historical queries and archiving. Further, the main bus 246 may chart acquired discrete data into a patient's EMR; publish medical device outcomes, such as lab results and other test results, to a patient's EMR; and publish digital media from a device into a patient's EMR, publish infusion data, if required, and infusion events (e.g., infusion rate, volume infused, volume to be infused, rate change, begin bag, end bag) into a patient's EMR.
The application 268 works with the services 260 to facilitate specific functionality, such as a patient to device association. The application 268, in one embodiment, may be a user interface, such as the user interfaces illustrated in many of the figures associated with this application. Here, the user interfaces may be screen shots of associating a patient to a device, or to an order, for example. While one application 268 is illustrated in
While only a main bus 246 is illustrated in
The database 256, in one embodiment, may be sent patient, medical device, and order association information. For instance, identification of a patient and medical device that have been associated may be sent to the database 256. Any data that it released by the medical device may also be routed to the database 256 so that this information can be stored in a flowsheet, for example. A clinician may then make the decision as to what to do with the data. For example, the clinician may decide that certain data points should be included in the patient's chart, and the others may be completely deleted from the database 256. A specific example of this may be when a clinician looks at data in the database 256 that is associated with a certain patient. The data may include values at different times, such as 12:00 PM, 12:15 PM, and 12:30 PM. The clinician may not wish for all of these values to be entered into the patient's chart, but may choose, for example, just the 12:00 PM and 12:30 PM entries to officially document. Additionally, having this information in the database 256 allows for a higher accuracy. In one instance, a clinician may write down in a patient's chart that an infusion pump began at 12:10 PM, when it actually started at 12:06 PM. Having this information in the database 256 allows for the clinician to officially document accurate start and end times, as well as other values whose accuracy is important to the patient's health.
As previously discussed, various healthcare service providers 254 may wish to receive data or information regarding a particular medical device or patient. In this case, the adapters 240 may be configured to send this information via an HL7 or ASTM connection, for example, to the healthcare service providers 254. In one embodiment, the services 260 may communicate with various healthcare service providers 254, and this communication takes place via the main bus 246.
Turning now to
With continued reference to
Another option for identifying a patient may include searching a database for a specific patient. The database may include each patient who is currently admitted to the hospital, for example, and thus any patient who is admitted to the hospital may be easily found in the database. A search option is shown as item 312, and may allow a user, such as a clinician, to search for another or a different patient.
Device display area 314 may display any medical devices that have been identified or associated to the patient. As shown here, no medical devices have yet been either identified or associated with the patient identified in patient identification area 310. Similar to that described above in relation to identifying a patient, medical devices may be identified in many of the same ways. For example, a barcode located on or near a medical device, in one embodiment, may be scanned, and information corresponding to that medical device may be uploaded to a mobile or portable computing device for display. Or, an identification number or other identifier corresponding to the medical device may be entered, either manually or electronically, to the portable computing device, for example. Alternatively, and as previously described, a search function may allow a user to search (e.g., by using device search 318) for a specific medical device that is located in a database. A user may view selected devices by selecting item 316, and although these devices may not yet be associated with the identified patient, these devices may be viewed by the user by selecting item 316.
Embodiments of the present invention allow for a clinician to disassociate medical devices that are currently associated to a patient. In one aspect, a clinician may select specific medical devices, and select a disassociate button, such as button 320, and the selected medical devices will be disassociated from the patient. For example, upon a patient checking out of a hospital to return home, the devices that had been used to treat the patient, and thus had been associated to the patient, may be disassociated by the method described above. There are other ways that medical devices may be disassociated from a patient. For instance, a medical device may become disassociated by a patient when another patient becomes associated with that same medical device. This override may take place when a clinician is presented with a dialog box that indicates to the clinician that another patient is associated with that medical device. The clinician may have the option, in some embodiments, to override the existing association. Other methods of disassociating a patient from a medical device will become apparent in the discussion below.
Turning now to
Status area 414 indicates that one device is available for being associated to the identified patient, as the medical device 418 shown in device display area has not yet been associated. Here, various information regarding the identified medical device may be displayed in the device display area, such as, for example, the name of the device, the vendor, the model, and status of the device. If the device is currently associated to another patient, this may be indicated as the status of the application. Here, the device 418 is available, as shown in the device display area. Checkbox 420 allows a user to select that particular device, and either remove it from the screen, associate the device to the identified patient (e.g., by using the associate button 426 once the checkbox 420 is checked), or to disassociate the device from the identified patient, depending on whether the device is currently associated or not. In one embodiment, item 420 may not be a checkbox, but may be an image that, when selected by a user, removes the selected device from the list for association.
The remove all button 416 allows for a user, such as a clinician, to remove all devices that are selected, such as if the devices have not yet been associated, but have been added as an identified device, as shown here. The view associations button 422 allows a user to view any medical devices that are currently associated to the identified patient. As with the patient, medical devices may be identified by one of many available methods, such as, but not limited to, scanning a barcode associated with the medical device, entering a device's name or other type of identification, searching for the device in a database containing a plurality of medical devices (e.g., by selecting the device search option 424), or the like.
Status area 514 indicates that there are seven devices that may be associated, upon each device having been checked, using checkboxes 520, 524, 528, 532, 536, 540, etc., and upon a user (e.g., clinician) selecting an associate button 548 located near the bottom of the illustrative screen display 500. Alternatively, a user may select one or more of the identified devices 518, 522, 526, 530, 534, 538, etc., and may select the remove all button 516 to remove the selected devices from the illustrative screen display 500. As previously described one or more medical devices may be added, or identified, and as such may appear in a device identification area on a screen display. Here, there are more devices identified than can be displayed in the area provided, and as such, a scroll bar 542 may be provided to allow for a user to quickly view medical devices that are not currently displayed in the device identification area.
In one embodiment, the devices are not yet associated until they are selected (e.g., by selecting each checkbox), and then associated. In an alternative embodiment, however, medical devices may be associated upon their identification. For example, a clinician may scan a barcode associated with a medical device. Upon scanning the barcode, the medical device may become automatically associated to the identified patient, instead of requiring the clinician to select the device once it has been identified, and then associating the device (e.g., by selecting the associate button 548). In yet another embodiment, any devices that are shown in the display area on the display will be associated when the associate button is selected, such that a user does not have the option to select or deselect the checkboxes to associate or disassociate the devices. Here, a view associations button 544 is provided to allow a user to view only those medical devices that have been associated to the identified patient, as identified in the patient identification area 510.
Medical devices that have been identified, and perhaps even associated, are displayed in a device identification area. Information that may be useful to a clinician may appear near the identification of the associated device. For instance, this information may include the originator, and the start time, which indicates the time that the device may have been first associated to the patient. This may be useful in that the clinician may go through the stored data for that device and retrieve particular information that may be needed in the future, starting with the time the device was first associated. As will be discussed below, a clinician may be able to retroactively associate a device to a patient, such as if the patient's treatment included the use of a particular medical device before a clinician had the opportunity to associate it.
Here, one device 618 has been associated, as indicated by the status area 614, which states “associated devices.” Further, a disassociate button 626 is located near the bottom of the illustrative screen display 600, which allows for a user to select a device (e.g., by selecting checkbox 620) to disassociate it. As a disassociate button 626 is shown on the display and not an associate button, which may assist the user in determining whether the device shown is associated or not. Here, since the disassociate button 626 is shown, the user may understand that the device 618 is already associated since there is not an option to associate the device. In one embodiment, once a device is no longer associated to the identified patient, the device identification may still appear in the device identification area. A select all button 616 is provided, and allows the user to remove the device from the screen display. In one embodiment, the device identification, and not the device name, will appear if the device is not currently on-line. Additionally, a view selected devices button 622 is also located near the bottom of the illustrative screen display 600, which may allow a user to view only those medical devices that are currently associated to the identified patient. Selecting button 622 may take a user back to a screen that allows the user to associate a new device to the patient. In one embodiment, associated devices are always displayed in the device identification area, but in another embodiment, associated devices are not displayed in the device identification area unless the view selected devices button 622 is selected.
Medical devices may be added or identified by a variety of means, such as, but not limited to, scanning a barcode associated with the device, entering some form of identification for the device into a portable computing device, or searching for the device in a database (e.g., by selecting a device search option 624).
Referring now to
Item 714 is a status area that indicates to the user that there are devices that are currently associated to the identified patient. The embodiment of
Medical devices may be identified in much the same way as described for patients, such as by scanning a bar code associated with the device, entering a device identification into a portable computing display, or by searching for a device in a database, which may be accomplished by selecting a device search option 748. The database may contain only those devices located in a particular area of the hospital or doctor's office, or may contain devices located throughout the hospital. Further, only those devices that are associated to the identified patient may be displayed by selecting a view selected devices button 746, located near the bottom of the illustrative screen display 700. In one embodiment, selecting the view selected devices button 746 will take the user to the screen that allows a new association. Various buttons and options, while shown in specific locations on the illustrative screen display 700, may be located in other areas of the display. For example, the disassociate button 750 may be located near the top of the illustrative screen display 700 in one embodiment. This is contemplated to be within the scope of the present invention.
As shown in a patient identification area 810, no patient has been selected. A status area 812 indicates that one device is capable of being associated. This device, device 816 has been selected, as indicated by the checkbox 818. In one embodiment, the checkbox 818 is a clickable image used to remove the device from the display, and therefore from context. Prior to associating the device, a patient may be identified. Both the device and the patient may be identified in a variety of ways, such as, for instance, scanning a barcode associated with the patient or device, entering an identification that corresponds to the patient or device, or searching for the patient or device in a database. For devices, a device search option 822 may be selected to perform this search. A similar mechanism may be available to search for patients in a database. The database may contain all patients admitted to the hospital, or only those patients located in a certain section. Similarly, the database may contain only those devices located in a certain area of the hospital, or may contain all devices that could be available to the patient (e.g., all devices located in the hospital or surrounding area).
A user may choose to remove the device that has been selected, and may do so, in one embodiment, if the device is not currently associated to a patient. Here, the device cannot be associated, as no patient has yet to be identified. A remove all button 814 may be selected to remove a device that has been selected using the checkbox 818. Further, a view associations button 820 is presented on the illustrative screen display 800, but may not yet be able to be selected, as there currently are no associations. Similarly, an associate 824 button is available near the bottom of the illustrative screen display 800, but in one embodiment, may not be available for selection until a patient has been identified. Alternatively, in another embodiment, the associate button 824 may be available for selection, and may bring up a separate display that prompts the user to select a patient.
A view associations button 932 allows a user to view only those devices that have been associated to the identified device. This button may not be available for selection until a patient has been identified, and one or more associations have been made. As described above, an associate button 936 may allow a user, in one embodiment, to select a patient, and then will associate the selected devices to the identified patient. In another embodiment, however, the associate button 936 may not be available for selection until a patient has been identified.
Turning now to
Turning now to
A patient identification area 1410 identifies the patient, and gives other information regarding the patient, such as the patient's name, birth date, gender, age, etc. A device identification area 1412 identifies a medical device, and may also provide certain information about the device, as shown in the device identification area 1412. Item 1414 indicates that connected devices may be listed below. Here, there are no connected devices, as the device identified in the device identification area 1412 may not have been associated to the patient at the current time. Item 1415 indicates that orders may be listed below. Here, orders 1416, 1420, and 1424 are able to be seen on the display, although more may be accessible using a scroll bar, for example. In one embodiment, each order shown on the display may correspond to the patient identified in the patient identification area 1410. In most cases, orders are made for an individual patient, and may be carried out only for that patient and not any other patient. Therefore, if a patient has already been identified, such as is the case in the embodiment of
Orders 1416, 1420, and 1424 each have a checkbox, numbered 1418, 1422, and 1426, of which may be selected to perform different functions. In one instance, one or more orders may be selected and removed from the display. In another instance, if an order is currently associated, it may be selected and disassociated by selecting a disassociate button 1428. Alternatively, if an order is not currently associated, it may be selected and associated by selecting an associate button 1430. It should be noted that not all devices may require an order. For example, monitors, cardiac ventilators, balloon pumps, and other stationary devices may not require orders in order to be associated and used to treat a patient. On the other hand, devices such as, for example, a patient's bed, infusion pumps, sequential compression devices, and electronic security devices may require an order from an authorized caregiver in order to be used in association with a patient.
Adding the capability to associate an order, and therefore a patient, with a medical device, may greatly increase the level of accuracy in many respects. For example, a clinician, when executing an order, such as giving 1000 mL of dextrose 5% with 0.3% NaCl to a patient by way of a pump, may write down a start time according to the clinician's watch. The watch, however, may not be synched to the time kept by the system. If there is an association made between the order and the device, the exact start and end time will be kept in the system for that patient, and most or all inaccuracies will disappear. Further, having the capability of associating an order to a device allows for a much simpler method of searching for specific information. For example, if a clinician wishes to search for information on a certain device that has been used to treat a particular patient, the clinician needs only to locate the association of the order to the device, or even if it is an association of a patient to a device, and the information that the clinician needs is likely to be found in one spot. Other examples may include retrieving a volume infused over a period of time, or capturing and charting infusion events (e.g., rate change, begin bag) from the device as it relates to the order.
Devices 1520, 1524, 1528, and 1532 are the devices that have been suggested, in accordance with the identified patient. As described above, the devices may have been suggested based on one of the factors listed above. For example, based on the patient being eight years old, certain devices may be better suited for children. Alternatively, because the patient has been admitted to the ICU, certain devices that are used in the ICU may be suggested, as the patient would be in that location or portion of the hospital. As another example, the patient's condition may be such that certain devices are well known, or typically used to treat that condition. These devices may be suggested for use for this particular patient, and for that particular condition. Each device has a checkbox, items 1522, 1526, 1530, and 1534, and these checkboxes may be selected individually to perform certain functions (e.g., to associate or disassociate the devices), or may be selected all at the same time by selecting a select all checkbox 1518.
Item 1527 indicates that an order has not yet been associated with device 1524. As shown, devices 1520, 1528, and 1532 do not have similar indications as indication 1527. This may be for one of many reasons. Devices 1520, 1528, and 1532 may already have orders associated with them, but alternatively, devices 1520, 1528, and 1532 may be devices that do not require orders, such as monitors, ventilators, certain pumps, or other certain stationary devices.
A patient identification area 1610 includes information about the patient, such as the patient's name, date of birth, age, gender, and may even contain the location of the patient within the hospital or doctor's office, and an identification number that uniquely identifies the patient. The patient may be identified by any of the methods described herein, including, but not limited to, scanning a barcode associated with the patient, entering a patient identification into a computing device, such as a portable computing device or PDA, or by searching for the patient in a database that contains a plurality of patients. Here, connected devices 1614 indicates that although device 1612 has been identified, it has not yet been connected, or associated. Item 1616 indicates that suggested orders are shown below area 1616. Here, several orders may be suggested based on the patient and identified device 1612, but those that are displayed include orders 1618, 1622, and 1626. A scroll bar may indicate that more orders are available for viewing upon movement of the scroll bar. Each order includes a checkbox 1620, 1624, and 1628, each of which allows a user to select the order to associate it, disassociate it, or make other selections that may be available.
Each order shown may be accompanied by relevant information that corresponds to the order, and this information depends on the type of order that is given. Here, orders 1618, 1622, and 1626 include information regarding a rate, volume to infuse, and a dose. Additionally, orders that may include several components or ingredients (e.g., dextrose with NaCl, and potassium chloride), a user, such as a clinician, may have the option of choosing which ingredients to infuse at a particular time. Although the order, such as order 1618, may have two ingredients, a clinician may be responsible for making the decision as to which ingredients should be included initially, and which may be added at a later time. Here, dextrose 5% with 0.3% NaCl 1000 mL is listed as a separate ingredient from potassium chloride 40 mEq, allowing the clinician to decide which ingredients are appropriate at a specific time. In one embodiment, primary ingredients may not be capable of being selected or unselected by a user, but secondary ingredients may always be capable of being selected or unselected by a user. The primary ingredient may be the most important, and main ingredient, but the secondary ingredient may be optional, or may be required for only a portion of time.
Referring now to
Returning to the connected devices, each device identification may contain pertinent information, such as a device name, a device identification, and a status of the device, which may include a time that the device was connected or associated to the identified patient. Further, devices that may have an associated order may include an indication, such as indication 1724. Item 1724 allows a clinician to glance at the device listed under connected devices 1712 and determine that device 1720 has already been associated to an order, and that the association does not need to be made. In one embodiment, a user may be able to hover a mouse, for example, over an item, such as item 1724, to view details about the item. Here, hovering over item 1724 would allow for a user to view details about the order that is associated with device 1720.
Each device 1818, 1824, and 1830, in the embodiment of
At step 2020, an identification of a first medical device is received. Medical device identification may be received in the same way as patient identifications, as outlined above. For example, a barcode associated with the device may be scanned, identification information for the device may be entered into a computing device, a device may be searched for in a database, or the like. In response to receiving the identifications of the patient and the first medical device, the patient and the first medical device may be associated to one another at step 2040. Once an association has been formed between the patient and the first medical device, data from the first medical device may be continuously routed to a data store, where associations and related data are stored. At step 2050, the association of the patient and the first medical device is maintained until the occurrence of a disassociation event. While the association is maintained, as previously mentioned, data from the first medical device may be continuously routed and saved in a data store, such as, for example, data store 264 in
In one embodiment, a disassociation event may occur by a clinician disassociating the device from a patient (e.g., selecting the device by scanning it or selecting the checkbox, and selecting a disassociate button on a screen display). This may also be done by the selection of a patient and a device (e.g., selected by scanning a barcode or selecting a checkbox), followed by a clinician selecting a disassociate button on a screen display. Alternatively, more than one device may be disassociated at the same time. As previously described, a select all button may be available if it is desired that all of the devices be selected.
In another embodiment, an indication may be received that a device that is currently associated to a patient has gone offline. One mechanism for determining whether a device is online or offline is a device heartbeat, which is described in relation to
In yet another embodiment, a user (e.g., clinician) may choose to override an existing association between another patient and a medical device so that a new patient is associated with the device. As described in relation to
As previously mentioned, more than one medical device may be associated to a particular patient. For instance, a second medical device whose identification was received may also be associated to the patient while the first medical device is also associated to the same patient. This association may also be maintained until the occurrence of a disassociation event, as discussed above. Further, a third medical device's identification may be received and may then be associated to the identified patient. This association may also be maintained or continued until the occurrence of a disassociation event. If, however, it is determined that any of the medical devices are associated with another patient, an option to override the existing association may be presented on a display device. If an indication of an override is received, the device and patient may be associated to one another, thus terminating the existing association.
As has been previously described, an order may also be associated to a medical device. An order may inherently belong to a particular patient, and thus association may not be required. If that is the case, the order may be associated to a medical device. An identification of an order may be received, such as by scanning a barcode corresponding to the order, entering an identification of the order into a computing device, or searching for an order in a database. Irrespective of which method is used to identify an order, it should be noted that more than one order may be identified and received. A medical device may then be associated to one or more of the identified orders.
Turning to
A continuous data feed from the first medical device is received at step 2150, and the data may continually be received from a first time to a second time. In one embodiment, the first time occurs upon the initial association of the order to the first medical device, and the second time occurs upon a termination of the association of the order to the first medical device, such as upon the occurrence of a disassociation event, as described above. Like associations between devices and patients, multiple orders may be associated to a device at the same time, or multiple devices may be associated to an order at the same time. Therefore, a second medical device may be associated to the identified order and may maintain that association until the occurrence of a disassociation event.
The main bus 2216, as described above, includes a plurality of components, each being responsible for tasks associated with providing data from the medical devices to various services and applications. A receiving component 2218 may continually receive data from at least one medical device 214 during a period of time when the medical device(s) is online. A device is online when the main bus 2216 is able to receive data from it. The data may be received from a direct feed, and may be received directly from the medical device, a device gateway, or a connectivity engine. A connectivity engine may be used for legacy devices that do not have the required connection mechanisms. In some instances, legacy devices are older devices, and may not have the most up-to-date connection mechanisms. The connectivity engine may assist in allowing even many legacy devices to be connected to it, so that the device can work with newer components.
A data storing component 2220 stores the continually received data from the medical device(s) 2214 so that the data can be accessed for querying and archiving. For example, once the data is stored, a user, such as a clinician, may want to search for particular data associated with a certain patient and a medical device. For this reason, the data that is stored may later be archived such that is can be queried.
A connectivity monitoring component 2222 monitors whether the devices are connected to the main bus 2216. This is done so that the main bus 2216 knows whether it can receive data from a particular medical device. If a medical device is not connected, it may not be able to be associated with a patient, as data cannot be retrieved from it.
A registration monitoring component 2224 monitors the registration and deregistration of the medical devices, and may also maintain a registry of the registration and deregistration events. Once it is determined that a device is connected, such as by the connectivity monitoring component 2222, the device may need to be registered in order to communicate and sent data to and from the other components, such as the main bus 2216. When the device goes offline, it may deregister, and a list of these events may be maintained by the registration monitoring component 2224.
A determining component 2226 determines a patient who is associated to the medical device, so that the data from the medical device can be properly associated with that patient. Once associated, a routing component 2228 routes the data from the medical device(s) to an electronic medical record (EMR) that corresponds to the patient. Further, a first publishing component 2230 publishes patient test results corresponding to the medical device(s) to the EMR that corresponds to the patient. Test results may be stored in a temporary storage until the results are transmitted to the EMR that corresponds to the patient.
In one embodiment, a second publishing component may publish digital media from the medical device(s) to the patient's EMR. Digital media may include video, audio, or other media that may need to be referenced regarding a patient in the future. In still another embodiment, a third publishing component may publish infusion data and infusion events into the patient's EMR, if the patient was associated with an infusion device, such as an infusion pump. The infusion data may include a rate of infusion (i.e., infusion rate) and a volume infused. The infusion events may include an infusion rate change or a time when the infusion begins or ends.
It will be understood that certain features and sub-combinations of utility may be employed without reference to features and sub-combinations and are contemplated within the scope of the claims. Furthermore, the steps performed need not be performed in the order described.
This application is related by subject matter to U.S. patent application Ser. No. ______ filed even date herewith and entitled “Patient to Device Association Based on Suggested Devices” (attorney docket number CRNI.143165A), which is assigned or under obligation of assignment to the same entity as this application, and incorporated in this application by reference.
