This disclosure, in general, relates to systems and methods for facilitating medical order fulfillment.
Increasingly, medical practices are turning to computational systems for managing patient data, appointment scheduling, and financial functions. In particular, hospitals rely on large integrated computer systems for tracking patients and supplies and for managing financial transactions, such as third party payer billing. Although such large integrated systems are improving with technology, such systems generally suffer from poor interfaces with healthcare providers and large overhead costs associated with management of computational systems. Typically, the large overhead cost associated with large integrated hospital computer systems makes such systems impractical for use in ambulatory medical facilities.
Ambulatory medical practices are also turning to computational systems for storing patient medical data, for scheduling appoints, and for tracking payment for services. Frequently, ambulatory medical practices, such as general physicians offices, or orthopedic specialists located outside of a hospital environment, rely on separate external service providers for facilitating or fulfilling medical orders, such as radiological orders or laboratory testing. In contrast to the large integrated hospital systems, computer systems typically available to ambulatory medical practices do not provide integration with computer systems of separate and remote service providers.
Moreover, recent changes to privacy laws within the United States restrict sharing of patient medical data between entities. Such restrictions apply to both large integrated hospital systems and separate ambulatory medical practices. In general, computational systems suitable for use in hospital environments or those computational systems suitable for use in ambulatory medical practices either fail to permit sharing of relevant patient data in accordance with privacy laws or permit an excessive amount of sharing, which may violate such laws.
As such, an improved computational system for use in ambulatory medical practices would be desirable.
The present disclosure may be better understood, and its numerous features and advantages made apparent to those skilled in the art by referencing the accompanying drawings.
In a particular embodiment, a system includes an encounter management system and a service provider system in communication with the encounter management system. The encounter management system is located at an ambulatory medical facility and the service provider system is located at a remote and separate ambulatory facility. In addition, the system may include a consultant system and an accounting system in communication with the service provider system. In a particular example, the encounter management system is configured to receive discrete medical findings data associated with a patient and to receive order data associated with that patient. The order data may be indicative of a medical order, such as an order for a medical procedure, imaging, or test. The order data may, for example, include an identifier of the order, an identifier of the encounter management system, and specific data about the order, such as which tests are to be performed, which methodologies are to be followed, and contact information associated with the patient. In addition, the encounter management system may receive finding selection data and communicate the order data and select findings data indicated by the finding selection data to a separate service provider system. Further, the service provider system may receive the order data and the select findings data and facilitate collection of order results data. The order results data and the select findings data may be communicated to a consultant system and the consultant system may provide consultant input data to the service provider system. The service provider system may forward the order results data and the consultant input data to the encounter management system. In response, the encounter management system may provide an interface to a healthcare professional based at least in part on the order results data and the consultant input data. The encounter management system and the service provider system may communication order status with the accounting system.
As illustrated in
Within the ambulatory medical facility 102, the encounter management system 104 may communicate with an input device 108. For example, the encounter management system 104 may provide interfaces and receive discrete medical findings data, finding selection data, and order data from the input device 108. In general, a finding is a single data element indicating a condition, a diagnosis, a complaint, a quality associated with a condition, a pathology, or any combination thereof In particular, a discrete medical finding includes an indicia or a medical finding such as a code, word, or tag of a medical vocabulary indicative of the medical finding. In an exemplary embodiment, the discrete medical finding is associated with a symptom. In another example, discrete medical finding is associated with a chief complaint. In a further example, the discrete medical finding is associated with a physical exam. In addition, the discrete medical finding may be associated with a diagnosis.
Order data is associated with an order requested by a healthcare professional. The order may be a request for a test, imaging, or procedure. In a particular example, the order is to be performed at a separate facility from the clinic at which the order is requested. The order data may, for example, include an order identifier, an ordering clinic identifier, and specific information about the order, such as which tests are to be performed, which methodologies are to be followed, and contact information for the patient. In addition, the order data may include a fulfillment clinic identifier. In a particular embodiment, the order data may also include patient scheduling information. For example, a laboratory order may include an order identifier, such as an identification number, patient information, such as a contact number or insurance information, and specific data associated with the order, such as, for an exemplary blood test, a request for performing a blood glucose level, an HIAC test, a total cholesterol test, and a triglyceride test. For an exemplary radiological order, the order data may include an order identifier, patient contact information, the type of radiological test, such as X-ray, CAT scan, or MRI, and an anatomical location. In a particular embodiment, radiological order data may include an anatomical drawing of a body or a portion of the body with an indicator as to locate the location of which the healthcare provider desires imaging. In a particular example, the input device 108 is a wireless computational device, such as an ultraportable computer or pad device, which interacts with a healthcare professional, such as a physician, nurse, or medical practitioner.
The encounter management system 104 includes computer-implemented instructions 106 and a networking interface to the input device 108, such as a wireless or a wired networking interface. The computer-implemented instructions 106 may be stored in a memory 120 and may be operable by a processor within the encounter management system 104 to implement methods and functionality associated with the encounter management system 104. For example, the computer implemented instructions 106 may be operable by a processor to provide a discrete medical findings interface to the input device 108 and to receive data entered in the discrete medical findings input interface from the input device 108. In addition, the encounter management system 104 may provide an order interface to the input device 108 and may receive order data indicative of an order from the input device 108. Further, the encounter management system 104 may provide a findings selection interface to the input device 108. Through such an interface, a healthcare professional may select findings data to attach to an order. In addition, the encounter management system 104 may provide a service provider selection interface to the input device 108 through which a healthcare professional may select a service provider to whom the encounter management system 104 may forward the order data and selected findings data. In an exemplary embodiment, a list of service providers 136 is provided to the encounter management system 104 from the accounting system 118 as requested. Alternatively, the encounter management system 104 may periodically download the service provider list and store the service provider list in memory 120.
In an exemplary embodiment, the encounter management system 104 forwards order data and select findings data based on the findings selected by a healthcare professional to a service provider system 110. For example, the encounter management system 104 may communicate with the service provider system 110 through a dial-up modem or a network, such as a wide-area network or a global Internet. In addition, the service provider system 110 may communicate with the consultant system 114 and an accounting system 118 via a dial-up modem or a network.
The service provider system 110 may include computer-implemented instructions 112 stored in a memory 126 and operable by a processor to facilitate order data management and communication with systems, such as the encounter management system 104, the consultant system 114, and the accounting system 118. Upon receiving the order data and selected findings data, the service provider system 110 may store the order data 138 and select findings data 140 in the memory 126 and may initiate collection of data associated with the filling an order indicated by the order data 138. For example, the order may be a medical order relating to lab tests or radiological imaging to be performed on a patient. Initiating an order may, for example, include contacting the patient to schedule an appointment or may include collecting samples. In a particular example, the order relates to a radiological test such as a magnetic resonance imaging (MRI) image, an X-ray image, or a CAT scan image. In such an example, initiating an order may include scheduling time with a patient and performing the radiological test on the patient. Once the test is complete, the service provider system 110 may receive and store order results data 128 associated with the order. The order results data may, for example, include an order identifier, test results data, image data, or any combination thereof. In a particular example, the order results data may also include an identifier associated with the requesting clinic 102 or encounter management system 104
Upon receiving the order results data 128, the service provider system 110 may communicate with the consultant system 114. For example, the consultant system 114 may interface with a healthcare professional who provides input on test results, such as a radiologist. In addition, the service provider system 110 may provide the select findings data 140 received from the encounter management system 104 to the consultant system 114. The consultant system 114 may be located at the remote ambulatory facility 116 or may be located in a separate facility. Alternatively, the consultant system 114 may be implemented as a portion of or an interface to the service provider system 110.
In an exemplary embodiment, a healthcare professional, such as a radiologist, provides consultant input data 148 for storage in a memory 142 of the consultant system 114. Consultant input data 146 may include an order identifier and test findings data. Test findings data may, for example, include text or indicators of discrete medical findings. The consultant system 114 forwards the consultant input data 148 to the service provider system 110. The service provider system 110 may store the consultant input data 130 and may associate the consultant input data 130 with the order results data 128 and forward the order results data 128 and consultant input data 130 to the encounter management system 104. The consultant system 114 may also store the order results data 144 and select findings data 146 in memory 142.
After receiving the order results data 128 and before forwarding the order results data 128 to the encounter management system 104, the service provider system 110 may convert the data into a format for easy communication. Generally, in exemplary radiological applications, the order results data may be in a DCIM format. In a particular embodiment, the service provider system 110 may convert the DCIM format image to a compressed Internet format, such as JPEG, GIF, PNG, Bitmap, MPEG, or any combination thereof
In response to completion of the order, including taking or receiving the order results data 128, and optionally receiving the consultant input data 130, the service provider system 110 may communicate accounting information, such as order status, to the accounting system 118. The accounting system 118 is generally located at a separate facility from the ambulatory facilities 102 and 116. Alternatively, the accounting system 118 may be located at one or both of the facilities 102 and 116.
In response to receiving the order results data and optionally, the consultant input data, the encounter management system 104 may store the order results data and optionally, the consultant input data in a storage memory, such as a database. In a particular example, the encounter management system 104 stores the consultant input data in a discrete medical findings database 122. In general, the discrete medical findings database 122 is configured to store discrete medical findings. In another example, the encounter management system 104 stores the order results data, such as an image, in an image format 124 and includes entries within a discrete medical findings database 122 to indicate the presence of such order results data. In addition, the encounter management system 104 may provide an order results interface to the input device 108 based at least in part on the order results data and optionally, the consultant input data.
In response to completion of the order, the encounter management system 104 may communicate with the accounting system 118 to indicate receipt of the order results data. The encounter management system 104 may also communicate with the accounting system 118 to indicate the existence or status of an order when the order data is received from the input device 108.
The accounting system 118 receives input from the encounter management system 104 and the service provider system 110 to track order fulfillment. For example, the encounter management system 104 may establish an order by communicating order data that includes a tracking number or order identifier to the accounting system 118. In response to receiving order data 138 or in response to receiving order results data 128, a service provider system 110 may communicate with the accounting system 118 to indicate a further status of the order. In addition, the service provider system 110, after optionally communicating with a consultant system 114 and receiving consultant input data 130, may communicate with the accounting system 118 to indicate the status of an order. Further, the service provider system 110 or the encounter management system 104 may communicate with the accounting system 118 to indicate completion of an order in response to completion of an order. The accounting system 118 may store the accounting data 134 associated with orders and their status in a memory 132. In an exemplary embodiment, the accounting system 118 may pay fees to a third party facilitator based at least in part on the accounting data 134. In addition, the accounting system 118 may store a list 136 of service providers. For example, the list 136 may include information about service providers that have an agreement to provide services through a fulfillment network.
Data entered on the interface 202 may be communicated with the encounter management system, which may store the findings data in a database. In a particular embodiment, the encounter management system stores the findings as discrete codes associated with the patient record, each code indicating a specific finding. Alternatively, the finding may be stored in accordance with a medical vocabulary such that key words indicate the findings. In general, a finding is a single data element indicating a condition, a diagnosis, a complaint, a quality associated with a condition, a pathology, or any combination thereof. In particular, a discrete medical finding indicates a code or word of a medical vocabulary indicative of a finding. In an exemplary embodiment, the discrete medical finding is associated with a symptom. In another example, discrete medical finding is associated with a chief complaint. In a further example, the discrete medical finding is associated with a physical exam. In addition, the discrete medical finding may be associated with a diagnosis.
In an exemplary embodiment, the encounter management system communicates via an input device with a healthcare provider to acquire discrete medical findings and order data. The encounter management system provides a select portion of the discrete medical findings and the order data to a separate service provider for fulfillment of the order. As illustrated in
In an embodiment, a patient may be directed to the service provider to facilitate completion of the order. For example, in the case of a laboratory, a patient may be directed to a laboratory location for bodily fluid sampling, such as urine sampling or blood sampling. In another example, a patient may be directed to an imaging facility for performing an X-ray, a CAT scan, or an MRI.
In addition to receiving the order data, the encounter management system 104 may receive findings selection data, as illustrated at 310. In an exemplary embodiment, the orders interface may include an interface for selecting a particular portion of the findings or the findings as a whole to accompany the order. In another exemplary embodiment, the findings selection data may be entered in a separate interface from the orders interface. Alternatively, the findings selection data may be stored as a default within the encounter management system 104. The findings selection data indicates particular findings that may accompany the order. For example, the findings selection data may indicate that current discrete medical findings associated with the current patient visit may be attached to the order data forwarded to a service provider. In another example, the findings selection data may indicate that all of the patient's medical history is to be included with or attached to the communication of the order data. In a further example, a healthcare provider may select a subset of the discrete medical findings associated with the patient to be included with the order data. The order data may, for example, include an order identifier and specific information about the order, such as which tests are to be performed, which methodologies are to be followed, and contact information for the patient. For example, a laboratory order may include an order identifier, such as an identification number, patient information, such as a contact number or insurance information, and specific data associated with the order, such as, for an exemplary blood test, a request for performing a blood glucose level, an HIAC test, a total cholesterol test, and a triglyceride test. For an exemplary radiological order, the order data may include an order identifier, patient contact information, the type of radiological test, such as X-ray, CAT scan, or MRI, and an anatomical location. In a particular embodiment, radiological order data may include an anatomical drawing of a body or a portion of the body with an indicator of the location of which the healthcare provider desires imaging.
On receiving the order data and the findings selection data, the encounter management system may communicate the order data and select findings data to a separate service provider located at a separate and distinct ambulatory location, as illustrated at 312. The select findings data may, for example, be a set of discrete medical findings that are selected by the healthcare provider and indicated by the findings selection data received from an input device via an interface. For example, the encounter management system may communicate with a separate service provider system located at a remote location. In addition, the encounter management system communicates an order status data to a facilitator accounting system, as illustrated at 314. The facilitator accounting system 314 may establish an order within the facilitator accounting system 314 and await further order status from a service provider system.
As illustrated in method 400 of
Once the ordered tests have been performed, the service provider system 104 may receive the order results data, as illustrated at 406. For example, the order results data may include numerical test results of the blood test. In another example, the order data may include radiological images, such as X-ray images, MRI images, or CAT scan images. In addition, the order results data may include an order identifier, such as an order number or may include a clinic identifier, such as a clinic number associated with a requesting clinic.
Optionally, the service provider system may communicate the order results data and the select findings data to a consultant system, as illustrated at 408. For example, a radiologist may have a separate computer system that receives radiological images for analysis. The consultant may enter findings associated with the review or analysis of the order results data. For example, a radiologist may enter findings associated with analysis of an X-ray image. In a particular embodiment, the findings may be entered as discrete medical findings. In another embodiment, the findings may be entered as text, an audio dictation, a visual indication on an image associated with a test, a multimedia element, or any combination thereof. The consultant input data may be forwarded to the service provider system. Alternatively, the consultant input data may be forwarded to the encounter management system directly.
A service provider system receives the consultant input data, as illustrated at 410. In response, the service provider system communicates the order results data and optionally, the consultant input data to the encounter management system, as illustrated at 412. In an exemplary embodiment, the service provider system communicates the order results data and the consultant input data together within the same communication. Alternatively, the service provider system may communicate the order results data and optionally, the consultant input data separately in different communications. For example, the service provider system may communicate the order results data when the order results data is received and may communicate the optional consultant input data when it is received.
In addition, the service provider system communicates the order status to the accounting system, as illustrated at 414. For example, the service provider system may indicate to the accounting system that the order is complete. The accounting system may update the status of the order within a database.
In the case of radiological data, the order results data is frequently acquired in a format, such as digital imaging and communications in medicine (DCIM) format. As such, the service provider system may convert the radiological image into a different format, as illustrated in method 500 of
When communicated from the service provider system, the encounter management system receives the order results data and optionally the consultant input data, as illustrated at 602 of method 600 of
When accessed by a healthcare professional, the encounter management system may provide an order results interface based at least in part on the order result data and optionally, the consultant input data, as illustrated at 606. For example, an interface may be developed from the discrete medical findings provided by the order results data and optionally, the consultant input data. In another exemplary embodiment, an interface may be provided that includes radiological image data or text provided within the consulted input data.
The process for facilitating order fulfillment may be implemented by a third party provider. In an exemplary method 700 illustrated in
In a particular embodiment, the third party facilitator receives compensation from a contracted service provider, as illustrated at 708. In an exemplary embodiment, the compensation is based at least in part on the order facilitated by the third party facilitator. For example, the service provider may compensate the third party facilitator based on a number of orders placed and completed. In another example, the service provider may provide a flat fee to the facilitator based upon an order number parameter. In a further example, the service provider may be contracted using a combination of flat fee and volume based pricing.
Order types may be organized by headings. In a particular embodiment, a radiology heading 808 includes controls to select radiological tests, such as bone density tests, sonograms, CT scans, GI radiology test, mammographies, MRIs, nuclear medicine test, ultrasounds, urinary radiology tests, X-rays, or additional options. For those subcategories that include further subcategories, pop-up windows, such as 802 and 804 may be provided for navigating through the options.
As illustrated in
As part of the order interface or in a separate interface, the healthcare provider may be prompted to select findings data to be attached with or incorporated with the communication of the order data.
In an addition embodiment, to complete the order, the encounter management system may provide an interface 1400, as illustrated at
In a particular embodiment, a method of establishing an order includes receiving discrete medical findings data associated with a patient, receiving order data associated with the patient, receiving findings selection data indicative of at least a portion of the discrete medical findings data, and communicating the order data and select findings data to a separate service provider. The select findings data include at least the portion of the discrete medical findings data. In addition, a computer readable media may include computer-implemented instructions for performing such a method.
In another exemplary embodiment, method of performing a medical order includes receiving order data and select discrete medical findings data at a service provider system, receiving order results data associated with the order data at the service provider system, communicating the order results data and the select discrete medical findings data to a consultant system, receiving consultant input data from the consultant system at the service provider system, and communicating the order results data and the consultant input data to a encounter management system located at a remote ambulatory facility. In addition, a computer readable media may include computer-implemented instructions for performing such a method.
In a further exemplary embodiment, a method of performing a medical order includes receiving order data and select discrete medical findings data at a service provider system, receiving order results data associated with the order data at the service provider system, communicating the order results data to a encounter management system located at a remote ambulatory facility, and communicating an order status associated with the order data to a facilitator accounting system. In addition, a computer readable media may include computer-implemented instructions for performing such a method.
In an additional exemplary embodiment, a computational system includes an encounter management server located at an ambulatory medical facility, and a service provider system in communication with the encounter management server. The service provider system located at a separate and remote facility.
In a further exemplary embodiment, a method of generating a medical order includes providing an order interface to receive order data associated with a patient. The order interface includes a control to receive finding selection data. The method also includes communicating the order data and select findings to a service provider. The select findings associated with the finding selection data.
In an additional exemplary embodiment, a method of facilitating an order for a medical service includes providing a list of service providers to a medical encounter management system located at an ambulatory medical facility. The list of service providers is associated with order fulfillment for the medical service. The method also includes communicating accounting data with a service provider system located at a service provider location.
In a particular embodiment, a computational system includes a communication interface to an input device and storage. The storage includes computer implemented instructions operable to display an discrete findings entry interface, computer implemented instructions operable to display an order interface configured for entry of order data, and computer implemented instructions operable to display a select findings interface configured for selection of findings data to be included with the order data. In an embodiment, the select findings interface is configured to permit selection of a level of findings. In another embodiment, the select findings interface is configured to permit selection of a finding from a set of entered findings. The set of entered findings may be associated with a current patient visit. Alternatively, the set of entered findings may be associated with stored findings. Further, the computational system may include computer-implemented instructions operable to display a list of service providers associated with the order data. In an additional embodiment, the computational system may include a communication interface to a service provider system. The computational system may be configured to communicate the order data and findings data to the service provider system. Also, the computational system may include a communication interface to an accounting system. The system may be configured to communicate an order initiation to the accounting system based at least in part on the order data.
The above-disclosed subject matter is to be considered illustrative, and not restrictive, and the appended claims are intended to cover all such modifications, enhancements, and other embodiments, which fall within the true scope of the present invention. Thus, to the maximum extent allowed by law, the scope of the present invention is to be determined by the broadest permissible interpretation of the following claims and their equivalents, and shall not be restricted or limited by the foregoing detailed description.
The present application claims priority from U.S. Provisional Patent Application No. 60/763,124, filed Jan. 27, 2006, entitled “SYSTEMS AND METHODS FOR FACILITATING MEDICAL ORDER FULFILLMENT,” naming applicants Randolph B. Lipscher and Eric Wohl, which application is incorporated by reference herein in its entirety.
Number | Date | Country | |
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60763124 | Jan 2006 | US |