The present invention relates to user data acquisition and processing systems and in particular to data acquisition and processing systems used for scoring of an entity and/or the status or condition of the entity.
Screening techniques provide information for efficient early decision making. A fast method for determining a coarse initial estimate of the status or condition of an entity is to solicit answers to a set of predetermined questions, and to translate the answers to those questions into a value. Such a procedure is sometimes called scoring, and the value termed a score. Further testing and processing of the entity may be based on the initial score.
For example, in medical diagnosis and treatment, a predetermined set of medical questions, termed a score sheet, is used by a clinician. The clinician solicits and records answers to the questions from a particular patient and/or from other sources of data such as patient medical records, patient administrative records, laboratory tests, current medications as indicated by pharmacy records, patient monitoring and/or treatment devices, and so forth. From the answers to the set of questions in the score sheet, the clinician may calculate a value, termed a score, which is a coarse estimate of the patient condition.
Originally, such score sheets were implemented in paper form. This required manual action by the clinician to solicit and record answers from the patient; to locate, retrieve and evaluate relevant patient information from other data sources (i.e. administrative data, medical records, laboratory tests, pharmacy records, monitoring and/or treatment parameters, etc.); and to calculate the score. Electronic score sheets were developed to enable the clinician to interact with a processor to solicit and record answers to the questions. In addition, because the other relevant patient information data sources may be accessible by the processor, the clinician is able to access and evaluate those data sources and to manually type the answers into the electronic score sheet, without physically locating, retrieving and evaluating paper records. In addition, the processor is able to calculate the score from the answers provided by the clinician.
Whether in paper or electronic form, such score sheets are hard coded by developers. However, because the score sheets are hard coded, updates are burdensome, which often delays score sheet updates. For example, such score sheet updates may take months to be distributed from the developer location and to be implemented at a customer location. In addition, existing score sheet systems typically fail to provide a way for customers and/or users to customize a score sheet. That is, current score sheet systems are unable to adapt to the range of possible scores that may be needed by the different customers. For example, specific countries and/or hospital applications may require special unique scoring questions and/or score calculations. That is, customers and/or users may need to adapt their score sheets to accommodate new scoring calculation algorithms, regulatory requirements and/or updates to scoring algorithms in a time efficient manner. A system is desired which addresses these deficiencies and related problems.
In accordance with principles of the present invention, a system supporting acquisition and processing of user entered information includes a user interface processor for generating data representing at least one form composition display image. A user, using the form composition display image, is able to compose an electronic form comprising a set of questions to be answered by user data entry via at least one data entry display image. A form processor receives data, entered using the composed electronic form, concerning a particular entity and translates the received data into a value for use in supporting decision making for that particular entity.
In the drawing:
As used herein, a processor operates under the control of an executable application to (a) receive information from an input information device, (b) process the information by manipulating, analyzing, modifying, converting and/or transmitting the information, and/or (c) route the information to an output information device. A processor may use, or comprise the capabilities of, a controller or microprocessor, for example. The processor may operate with a display processor or generator. A display processor or generator is a known element for generating signals representing display images or portions thereof. A processor and a display processor comprise any combination of, hardware, firmware, and/or software.
An executable application as used herein comprises code or machine readable instructions for conditioning the processor to implement predetermined functions, such as those of an operating system, information acquisition system or other information processing system, for example, in response user command or input. An executable procedure is a segment of code or machine readable instruction, sub-routine, or other distinct section of code or portion of an executable application for performing one or more particular processes. These processes may include receiving input data and/or parameters, performing operations on received input data and/or performing functions in response to received input parameters, and providing resulting output data and/or parameters.
A user interface (UI), as used herein, comprises one or more display images, generated by the display processor under the control of the processor. The UI also includes an executable procedure or executable application. The executable procedure or executable application conditions the display processor to generate signals representing the UI display images. These signals are supplied to a display device which displays the image for viewing by the user. The executable procedure or executable application further receives signals from user input devices, such as a keyboard, mouse, light pen, touch screen or any other means allowing a user to provide data to the processor. The processor, under control of the executable procedure or executable application manipulates the UI display images in response to the signals received from the input devices. In this way, the user interacts with the display image using the input devices, enabling user interaction with the processor or other device.
A form, as used herein, is a type of UI display image. A form UI display image includes display elements, such as textual display, which prompt the user to enter particular information; and display elements, such as text boxes, check boxes etc., into which the user, using the input devices, may enter the particular information.
In operation, the user interface processor 22 interacts with a user termed a form composer via the first user interface device (2, 4, 5) to compose an electronic form. The electronic form consists of a set of questions. The user interface processor 22 generates data representing at least one form composition display image and provides this data to the monitor 5 in the first user interface device (2, 4, 5) which displays the form composition display image. The form composer interacts, via the first user interface device (2, 4, 5), with the form composition display image to compose individual questions in the set of questions. In response, the user interface processor 22 produces data representing the composed electronic form including at least one data entry display image. The data entry display image or images display the set of questions in the electronic form. This electronic form representative data is stored in the form data repository 24.
The operation of the user interface processor 22 may be better understood by reference to
The GUI 500 supports creation of an individual question of the set of questions. The right hand side of the GUI 500 lists the questions which are currently composed. Additional questions may be added and questions may be deleted. When a question is highlighted on the right hand side of the GUI 500, details about that question are displayed on the left hand side of the GUI 500 and those details may be edited by the form composer. In the illustrated embodiment, the “Heart rate (bpm)” question 503 is highlighted on the right hand side of the GUI 500. Thus, details about that question 503 are illustrated on the left hand side of the GUI 500.
Referring to the left hand side of the GUI 500, a section 502, labeled “Question” allows a form designer to designate a label or title or description of the question being composed by the GUI 500. In the illustrated embodiment, the question label is “Heart rate (bpm)”. This is the label displayed in the list of questions on the right hand side of the GUI 500.
A section 504, labeled “Question Type” allows the form composer to select from among a plurality of predetermined question types. In the illustrated embodiment, the form designer may, using the illustrated radio buttons, select one of five predetermined questions types, although one skilled in the art understands that other question types may also be allowed. A first type of question 504(a) is “Fill In”. This type is represented in the electronic form by a text box. The answer to a fill in question may be a textual value or a numeric value. The fill in question may include pre-calculations, i.e. calculations automatically made without user interaction based on the answers to sibling questions of this question; or post-calculations, i.e. calculations automatically made without user interaction after the answer has been filled in by the user. Fill in questions may also be of a pop-up type which means they initiate a pop-up box displaying a series of other questions. The answers to the pop-up questions may be processed to provide the answer to the fill in question.
A second type of question 504(b) is a “Decision Tree” question. This question may be represented by a ‘yes/no’ multiple choice question or by a check box. A decision tree question is answered by the user and controls the display of corresponding other subsets of questions, possibly including more decision tree questions. That is, a ‘yes’ answer will cause the subsequent display of a first subset of questions while a ‘no’ answer will cause the subsequent display of a second subset of questions.
A third type of question 504(c) is a “Multiple Choice” question. This question may be represented by a set of radio buttons. The user may select one of a predetermined plurality of answers as designated by the form composer. A fourth type of question 504(d) is a “Drop Down” question. This question is similar to a multiple choice question except that it is represented by an option or drop down list containing the predetermined plurality of answers. The user may select one of the answers designated by the form composer. A fifth type of question 504(e) is a “Check Box” question. A user may either select or unselect a check box, thus providing a ‘yes/no’, ‘true/false’, ‘present/not present’, etc., indication.
The form composer may specify that the answer to the question being composed be automatically retrieved from one of a plurality of data sources. A section 506, labeled “Answer Type” permits the form composer to specify a data source containing the answer to the question being composed. The form composer may select, using appropriate radio buttons, a data source to be associated with this question. In the illustrated embodiment, there are five different data sources: patient demographics 506(a), trends 506(b), laboratory results 506(c), scores 506(d), and user data entry 506(e). One skilled in the art understands that other data sources may be present and may be selected by the form composer to be associated with the question being composed.
A section 508, labeled “Answer” permits the form composer to specify an identifier for the answer to this question. The identifier may be used when specifying subsequent calculations, such as pre-calculations for subsequent questions, post-calculations for this question or subsequent questions, calculation of the score value, and so forth. In the illustrated embodiment, the answer identifier is “HR (bpm)”.
The sections described above (502, 504, 506, 508) are generally applicable to all questions. The sections which follow solicit information from the form composer necessary to compose a question of the type specified by the question type entry in section 504. In the illustrated embodiment, the selected question type is ‘fill-in’ and the expected answer data is numeric. For numeric ‘fill-in’ questions, answer data is partitioned into ranges and the respective ranges are assigned corresponding score values. A section 510 in the GUI 500 allows the form composer to specify the ranges and to assign respective numerical score values to the ranges. A first range 510(a) consists of heart rates below 39 beats per minute (bpm) and is assigned a score value of 4; a second range 510(b) consists of heart rates between 40 and 54 bpm and is assigned a score value of 3; a third range 510(c) consists of heart rates between 55 and 69 bpm and is assigned a score value of 2; a fourth range 510(d) consists of heart rates between 70 and 109 bpm and is assigned a score value of 0; a fifth range 510(e) consists of heart rates between 110 and 139 bpm and is assigned a score value of 2; a sixth range 510(f) consists of heart rates between 140 and 179 bpm and is assigned a score value of 3; and a seventh range 510(g) consists of heart rates above 180 bpm and is assigned a score value of 4. An absolute maximum heart rate of 350 bpm is set in entry 510(h) and an absolute minimum heart rate of 0 bpm is set in entry 510(i). The form composer may edit the ranges and score values in section 510 and may add further ranges by filling in the entry 510(j) or delete a range by activating the “x” button for that range.
A section 512 may be checked to specify pre-calculations, as described above. Further sections (not shown but accessible using the scroll bar) are available for the form designer to designate other options and aspects of the question being composed, such as, for example, post-calculations.
The user interface processor 22 (
The questions may also be evaluated for roll up into a group. A group is a collection of questions the answers to which, in combination, may be used to calculate a group score value. Groups are “rolled up” by answering the grouped questions. The rolled up group score value may be: the summation of the score values for the answers to the questions in a group, the highest score value in the group, or some other combination of the score values for the answers to the questions in the group. In the illustrated embodiment, the “Heart rate (bpm)” question is part of the “Acute Physiology Score” group, as indicated by the label 514. The questions in this group are listed on the right hand side of the GUI 500, also indicated by the label 514.
More specifically, in the illustrated embodiment, each question in the group is associated with a score value. When the question “Heart rate (bpm)” is specified in a calculation, the score value for that question is substituted into the equation used to perform that calculation. That is, if the patient has a heart rate of 62, the score value for the “Heart rate (bpm)” question is 2. The score value 2, representing the heart rate, is used in the equation for calculating the group score. The group value, therefore, is a numeric value related to the respective score values for the questions in the group. The group score value, in turn, may be combined with other group score values, and/or with score values of other questions to form an overall score value. In this case, the group score value is represented by the name of the group. In
A master equation may be composed to calculate an overall score value. This equation can perform mathematical functions as well as apply basic mathematical operands. The master equation may access score values from the answers to individual questions and/or from the rolled up score from the answers to groups of questions.
As described above, data representing the electronic form, based on the entries made by the form composer in response to the form composition display images, such as those illustrated in
Referring again to
The respective questions composed by the form composer using the user interface processor 22 are represented by data in the form data repository 24. A portion of this data specifies a data entry image element enabling a data entry user to enter the required data. The form processor 26 reads the data and generates an electronic form graphical user interface containing the data entry image elements corresponding to the data in the form data repository 24.
The operation of the form processor 26 may be better understood by reference to
The list of questions on the right hand side of the GUI 500 in
The fifth question 414(e) is a decision tree question labeled “Arterial blood gases” and is represented by a multiple choice display element having two choices: “Yes' and “No”. If “yes” is chosen, then a display element (not shown) asking the series of questions listed on the right hand side of the GUI 500 (
Referring to group 402 “Chronic Health Points”, a first question 402(a), labeled “Liver biopsy-proven cirrhosis” is a multiple choice question. The multiple choice display element is represented by a set of radio buttons representing permitted answers: “elective”, “emergency”, and “none”. A data entry user selects the radio button representing the appropriate answer to the question. The remaining questions in the “Chronic Health Points” group 402 are also multiple choice questions.
One skilled in the art will understand that there is no limit to the number of groups and/or ungrouped questions which may be placed in an electronic form. One skilled in the art will also understand that multiple GUI display images, similar to the GUI 400 illustrated in
When the respective questions in a group have been answered, the answer score values are determined and are rolled up into a group score value. The group score values and answer score values for ungrouped questions are processed by a corresponding composite score valuing equation to calculate a composite score value. In
Referring again to
As described above, some of the answers to the questions composed by the form composer may be found in data sources.
In
In operation, the form processor 26 displays the display image or images associated with the electronic form, and interacts with a user via the second user interface device (12, 14, 15) to receive data representing answers to the questions in the electronic form, as described above. If the form composer has specified, e.g. in section 506 (
When a form composer associates a question with one of the data sources 120, data representing this association is stored in the database 106. This data includes the question, the data source associated with the data source, one or more communications protocols which may be used to access the data source, one or more formats in which the data in the data source may be stored and/or communicated. The database 106 may also store any other information necessary to access the data in the data sources 120, retrieve that data and insert it into the answer data entry elements in the electronic score sheet form automatically.
When the form processor 26 conditions the monitor 15 to display a question in a data entry display element, the form processor 26 accesses the database 106 to determine if that question is associated with a data source. If so, the form processor 26 conditions the communications processor 116 to bidirectionally communicate with the associated one (122, 124, 126, 128, 130, 132, 134, 136, 138, etc.) of the data sources 120 to identify the data in the data source which represents the answer to the associated question. The identified data is retrieved and sent to the form processor 26 via the communications processor 116 by that data source (122, 124, 126, 128, 130, 132, 134, 136, 138). The form processor 26 places that data in the answer data entry element associated with that question. The data entry user may then answer the remaining unanswered questions in the electronic score sheet form. The score value is then calculated based on the data entered by the user and the data automatically acquired from the data sources.
The data relating to the communications protocols and data formats allows the communications processor 116 to communicate with data sources 120 having any communications protocol and data format. By maintaining this data, different data sources 120 using different communications protocols and different data formats, manufactured by different manufacturers, may be properly accessed by the form processor 26 via the communications processor 116.
The transfer of the data from the data sources 120 into the electronic score sheet form is performed automatically. It may be initiated automatically with no user interaction, or may be initiated in response to a user command to process the composed form. In response to the user command, all associated data sources are accessed and the retrieved data placed in the electronic score sheet form.
In operation, the CPU 202 operates as a processor which executes the machine readable instructions forming an executable application and/or executable procedures. Those machine readable instructions are stored in the memory 204, which may consist of read-only memory (ROM) and/or read/write memory (RAM). The CPU 202 retrieves the machine readable instructions from the memory 204 and executes them to perform the operations of the information acquisition system, as described above.
In the illustrated embodiment, the I/O processor 208 includes a display processor which, in response to commands from the CPU 202, generates signals representing the GUI display images described above and illustrated in
Data may be retrieved from and stored in the mass storage device 206. For example, the mass storage device 206 may provide storage for the form data repository 24 (
Data may also be retrieved from and stored in electronic data storage media 216 via the removable storage interface 210. Any data may be stored in and/or retrieved from the electronic data storage media. More specifically, in the illustrated embodiment, the machine readable instructions in the executable application and/or executable procedures forming the information acquisition system may be stored in a electronic data storage medium. The CPU 202 may condition the I/O processor 208 to retrieve the executable application and/or executable procedures from the appropriate electronic data storage medium via the removable storage interface 210, and to store the executable application and/or executable procedures in the mass storage device 206 and/or the memory 204. The CPU 202 may then execute the executable application and/or executable procedures in the memory 204 to perform the information acquisition activities described above.
This is a non-provisional application of U.S. Provisional Application Ser. No. 60/617,179 filed Oct. 8, 2004.
Number | Date | Country | |
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60617179 | Oct 2004 | US |