DE19901438A1 - Patient data file management system with patient access - Google Patents

Abstract

The invention relates to a patient data file management system comprising a notably centralized electronic archive. The management system serves to create, store, process and exchange in a computer-compatible manner digital patient data files containing data relating to examination findings and the patient's medical history, including image-based and graphic data such as X-ray images, computer tomographs, magnetic resonance images, etc. The archive contains at least information showing which patient data are stored in which sub-archives. patient-controlled exchange of patient data files, which exchange is protected by an access code, is effected notably between patients, hospitals and doctors' offices by means of a communications network. The patient data can be retrieved by a patient via a central computer which also gives the patient access to his files.

Description

The invention relates to a patient data file management system for creating, Storage and computer-compatible preparation of digital patient data files with Findings and patient data.

Patient data file management systems in which the patient also has access to his patient data files have so far neither become known nor implemented been. In European and especially Central European health care institutionalized structures and advertising bans provide a certain amount of Wi stands for a technically revolutionary development of systems for the center national, regional or global exchange of medical pati data. Also in the USA and on a private basis Healthcare is built due to its heavy weight on local, urban areas healthcare structures are not centralized, at least for the time being tes patient data file management system conceivable.

To meet the rapid cost increases in healthcare, set up the establishment of privatwirt in the USA from around the mid-80s hospital mergers while in Germany Up to this point, approximately 80% of all hospitals and clinics in public hand.

In the prior art previously used terms such as. B. Teleradiology, Te lecardiology, video consultations already involve an exchange of for example treatment results, d. that is, also to a certain extent from  Patient data. However, this exchange was only for medical specialists or so-called information-collecting organizations such as B. American Me dical Informatics Association and their European counterpart European Me dical Informatics Association or also International Medical Informatics Asso ciation limited. The patient was in the known data exchange systems in no way involved. Nor do these systems include creating and Storage of central patient data files.

On the Internet, for example, on the PACS website under the heading "Societies- Telemedicine, Teleradiology "stated that 41 American and European medical organizations deal exclusively with interdisciplinary Deal with communication. For example, the company Microsoft with its Product "Microsoft Healthcare Users Group" offered a software package, wel only to provide better communication among doctors should, however, without this for practical work on or with patient data files, although the patient is not included in this application is.

Also the "Healthcare Information and Management Systems Society", which represents the largest association of healthcare organizations in the world Data exchange only in the field of training and improvement medical knowledge for doctors and related industries.

The Germany-based multimedia health online service (Bertelsmann, Burda and Springer) offers an electronic collection of printed media from the field of medicine, but does not make any demands on you Interaction for purposes of sharing patient data as well as not involving the patient in such a system.

The technical problem to be solved with the invention is therefore a To create patient data file management system, which is largely under  Using existing communication systems digital archiving of patient data in an electronic patient data file as well as a world wide access to and exchange of patient data involving and Responsibility of the patient. This means that the task of the He is directed to a digital patient record in the hands of the patient with worldwide access and data exchange between all patient data patients, doctors, clinics and institutions connected to the system enable.

This problem is solved by a patient data file management system with the Features according to claim 1 or 3, by a system for such a pati Entdatenfile management system with the features of claim 22, by a system of such plants with the features according to claim 23 and solved by a keyboard with the features of claim 25.

Appropriate developments are in the respective dependent claims Are defined.

In order to be able to implement such a system, it is necessary that a sy schematic provision of patient data files on a technical Standardization of the data to be stored and on a unilateral application must be based on this standard. The use of the variety so far in the Medicine used different standards or their adaptation internally tionally on a common system or on a common standard a path that is not feasible from the point of view of costs and implementation is important for the patient data file management system according to the invention further that only the patient himself has the universal access decision to the Can call up his data.

According to the invention, the patient data file management system has a central one electronic archive for creation, storage, computer-compatible processing  and exchange of central digital patient data files. The central pati Data files show demographic patient data or patient persons data as well as findings and patient data, in particular pictorial and graphic Data (images) such as X-rays, computer tomograms etc. and / or Information about the decentralized subarchives in which an Ab the corresponding patient data has been saved. About a commun cation network, especially an existing communication network are Pa Access data protected from the corresponding patient data files only accessible by a patient (user) via a central computer, whereby the central computer gave the patient access to his patient data file tet.

Since patients usually have examinations or findings from different cli own or from various private doctors and the clinics in accordance with the current legal situation at least in Germany the findings or patient data are required by law According to the invention, the number of years to be kept is the central role of the Patients in the creation and updating of its central Patient data files realized via a central computer (operator). Means the central computer is then an access using preferably from appropriate access codes to the respective patient files switched. In order to it is possible to join subarchives in the system or within the sy clinics registered and clinics registered in the system To use doctors. According to the invention, the system has a central rake ner with a central archive in which patient data files are created or from placed, updated and updated. These patient data files included sen at least demoscopic or personal data of the patients, whereby later individual or all in other clinics or units that have joined the system Findings created in the direction can be added. However, it is also possible lich that the findings in subarchives in system-registered clinics, in which the patient has received treatment can be saved.  

In the context of the patient data file management system, it is only the responsibility of the patient enter the patient data file management system via the central computer log in, protecting the patient from his patient data file is opened or it is given to him where his data is, so that he via a corresponding menu-controlled system, for example Can control subarchives via the central computer.

An essential inventive aspect is that with the fiction patient data file management system a centralized patient data file is created for which the patient alone can gain access. One The patient only gets access to his patient data if he has access via the Central computer was requested and issued by the central computer. The invention patient data file management system thus works reliably and comprehensive in the context of all patients integrated or registered in the system doctors, clinics and other possible organizations. The direct data flow via the central computer ensures that all necessary Data of the patient arrive in the corresponding patient data file, so that that for a reliable functioning of the patient data according to the invention File management system required updating of the patient data files via the Central computer is guaranteed.

The user-controlled or user-controlled off preferably takes place exchange of patient data from the corresponding patient data files in particular communication between patients, clinics and doctor's offices network.

According to a further development, the patient data file management system has a Input device for entering and / or digitizing patient data in the archive or a sub-archive, a reading device for user-controlled  Reading out the patient data from the respective patient data files, and a Data transmission system for user-controlled exchange (sending / emp field) of patient data. This ensures that the central computer is able to register in the patient data file where the patient data are stored: either in a central archive in this one tens of patient data files or in several parts of the patient data file in each case league subarchives.

According to the patient data file management system is constructed in such a way that digital patient data files with findings and patient data created, saved and can be prepared in a computer-friendly way, with the patient data files Contain patient data, in particular pictorial and graphic data such as X-rays, computer tomograms, magnetic resonance imaging, sonography images, laboratory results, which are referred to with the collective term "Images" will include. The patient data file management system according to the invention tem also enables user-controlled patient exchange data files especially between patients, clinics and doctor's surgeries using an egg communication network, and it has: an electronic one in particular centralized archive for storing patient data files; an input Direction for entering, in particular scanning and / or digitizing in particular in particular of graphic and image data; a reader to the user controlled reading of patient data from the respective patient data file the archive; and a data transmission system with which at least parts of the respective patient data files, in particular via the user network can be transferred or exchanged in a controlled manner. User is the pati ent or a person commissioned by him. Access to and exchange The patient data is always carried out by the patient via a central computer ner (operator) to the archive and / or a sub-archive.  

The patient data file management system preferably has a processing processing device for optimal preparation and storage of the entered Patient data in the electronic archive.

Such a patient data file management system according to the invention has numerous advantages, which with none of the previously known, he mentioned systems can be achieved. So the pati according to the invention offers entdatenfile management system a comprehensive and complete system, wel It enables the patient to have his / her medical data or medical records in an egg to store a digital archive, which is preferably central, under certain However, circumstances may also be decentralized. Furthermore, it is with the patient data file management system according to the invention the doctor or the Hospital, wherever they are geographically, enables findings, Medical reports and corresponding image data immediately after or after them File creation in this digital patient data file. Because the storage in the archive digitally and in such a form that later modifications Such a creation is and should be excluded Management of patient data files regardless of considerations and prior writings of different origins, which a temporary or perma nent archiving on site, at the doctor or in the hospital is desirable pay attention or prescribe.

Furthermore, there is an advantage of the patient data file according to the invention. Management system in that it is the patient and owner of the patient data files is partially or completely accessible, wherever the Patient. To retrieve his patient data or his patient data files, the patient only needs a telephone and a conventional PC, where the interaction of the patient when accessing the Internet even without a modem is possible with the patient data file management system.  

It is also advantageous that in the patient data file according to the invention Management system of the affiliated doctors and clinics of the Pati worldwide Data file retrieval or the re-storage of findings and digitized Recordings using either the patient's own or a doctor's and / or clinic own so-called additional "Smart Card" is enabled. That too is misuse of patient data is largely excluded.

Another significant advantage of the patient data file according to the invention Management system is that the patient or the treating doctor Findings and digitized images from a geographical location in the shortest possible time point to another geographical point on earth, for example to For the purpose of a second diagnosis or for the purpose of a supporting diagnosis can send, which makes the second diagnosis considerably easier and additional che costs for possible new recordings are avoided. In this To in connection with this, there are serious positive cost-reducing effects on the medical service structure. As a result, Ver avoidance of nonsensical double examinations, reduction of misdiagnoses and also reducing the radiation exposure for the patient with radiation exposure constant investigations considerable cost savings can be achieved. Open It is also evident that the patient data file management according to the invention system can be used in an emergency to save life, namely especially in situations where the patient and / or the attending physician are located in remote areas of the world, in which one immediate transfer to life-saving specialists, surgeons etc. not possible is. Without the presence of corresponding expensive medical diagnosis facilities in such distant areas, it is thus possible to diagnose have available test results.

The patient data file management system according to the invention also contributes to this that, for example, chronically ill patients with greater certainty Rei  You can do this because, if necessary, you can quickly edit your patient data You can also call up time at the hotel, for example.

It is with the patient data file management system according to the invention for example, also advantageously possible for airlines for example, if a patient experiences problems during a flight important life-saving information, e.g. B. an EKG, from the aircraft carry this immediately to a cardiologist or to the patient's hospital forward, the doctor on duty then immediately by phone to the Flight crew on the plane can give instructions while the doctor looks at the Patient history visualized on the screen. Furthermore or in addition In addition to this, it is possible for the patient to display his medical patient data on Destination airport either at the airline ground station or possibly even existed in the emergency hospital.

Another advantage of the patient data file management according to the invention systems exists especially for those doctors who are modern and patient move compliant in this system, d. H. are registered in it, that it is them secures additional income. The patient will turn to those doctors who relying not only on their own knowledge and feeling, but also on second lives Request and consult with colleagues. This is with the Invention according to the patient data file management system online also in the presence of the Patients without lengthy sending back and forth of X-rays, for example pictures or computer tomograms etc. possible.

There is also an advantage of the patient data file manager according to the invention ment systems in that there is a new form of "patient migration", namely allows the so-called "patient tourism" because it is in principle on every geo graphical point of the earth with minimal cost is possible, second opinions to be able to catch up with other colleagues. This is particularly important for Patients who are in low or untreated parts of the Third World  for whom and for which it makes more sense, in some cases possibly even is life-saving, treatments are not in their own country, but in countries undergo full medical care. The patient walk has but also the other way around, with regard to the movement of patients from the developed countries to the so-called tourism countries. In these Tourism countries becomes a large part of the medical services to foreigners accomplished. This service provision will be better and more useful if the treating doctors who do not speak the language of their patients, at least the factual information such as previous diseases, blood tests, ECGs and radiological recordings etc. are available. Because this information is worldwide are recorded in medical terminology is such patient data file management system even a prerequisite for satisfactory medical care African patient care.

The above benefits become even clearer when you consider that so far no central, digital, nationwide, Europe-wide or worldwide tales patient data file management system including image data (Images) exists, which is also accessible to the patient and whose ver Spreading and forwarding is ultimately controlled by the patient.

In accordance with yet another aspect of the invention is an apparatus for a patient Data file management system provided, which the creation, storage and computer-compatible preparation of digital patient data files with findings and patient data (patient data). The patient data in particular close visual and graphic data such as X-ray images, computer tomograms, Magnetic resonance imaging, sonography images, laboratory results (images). Of the system also serves for the patient data file management system for exchanging patient data files, especially between patients, Hospitals and medical practices using a communication network. To the system has, in particular, a central electronic archive for storage the patient data files, an input / output and processing device for  Enter or output, prepare and save the patient data in the archive and a data transmission system for exchange, d. H. for sen and / or receiving at least parts of the patient data files in particular on the communication network.

According to another aspect of the invention is a system with a plurality provided by such facilities, in which for health problems or questions of a patient important or relevant institutions in particular Hospitals and / or medical practices each have at least one such facility in is installed, the individual systems are networked with each other. With a complete such system or a system with a variety of suchi systems, it is technically possible and commercially affordable that Set up patient data file management system for the benefit of the patient and exchange patient data files wherever a patient is located or wherever he has to undergo medical treatment.

The patient data of the patient data files are preferably already over standing communication networks such. B. Telephone, with a digital transmission gung, a transmission with ISDN, over GSM or over satellite, Internet and / or E-mail is done. The advantage of using existing communications on networks for data transmission, d. H. to replace at least parts of the Patient data files consist in that for realizing the invention Existing patient data management system can be used without that own communication networks have to be created. The construction itself communication networks would doubtlessly spread rapidly worldwide without being in the way.

In order to spread the inventions quickly, easily and cost-effectively, even globally to be able to implement the patient data file management system according to the invention, the systematic provision of the patient data files on a technical standard of the data to be stored and on a unilateral basis  application of this standard. Furthermore, it is necessary that only the Patient himself the universal access decision to retrieve his patient end ten cases. The input device of the patient data file is preferably Management system trained in the DICOM3 standard. DICOM stands for "Digi tal Imaging and Communication in Medicine ". The DICOM standard consists of a set of rules that allow medical imaging (Images) between, for example, diagnostic instruments, computers, patients houses and other institutions can be exchanged. This standard creates a common language and forms the basis for an egg medical image generated by a particular medical device on the display belonging to another examiner's workstation device can be displayed.

The DICOM standard has changed particularly in recent years mood between software engineers from all major companies, which deal with image processing, and computer companies (which represent the National Electrical Manufacturer Associations NEMA) and Medical representatives of the main professional societies developed, such as B. that American College of Radiology, the American Society of Echoradiography and the American College of Cardiology. It should be noted that DICOM from finally for easier handling, scanning, editing, processing and Storage etc. of image data (images) has been developed.

The images in particular have so far been stored in respective filing cabinets or ar archives stored decentrally in the respective medical facilities, in which they have been made for the corresponding patient. In the As a rule, these images remain in the respective hospitals in the archives and incur high archiving costs even when the patient is after in all likelihood will never enter this hospital again.  

The archiving of images within the hospital is done in different ways Countries still required by law for a defined number of years different. In addition, the bulky large format of many images is not special well suited for patients to have these images at home in their own homes keep longer term. The patient data according to the invention is now set here file management system new standards. It is important that the patient data files can be stored in a central archive in particular. In the usual order a certain medical examination is first carried out on the patient. It A finding is created, whereby, of course, old findings are subsequently added in the patient data file can be recorded. If applicable a second finding in a certain hospital or by a be agreed doctor, whereby the hospital or the doctor is not the family doctor or the Hospital where a family doctor may be practicing or the pati transferred to ducks. Accordingly, images such as B. X-ray images, magnetic resonance tomographs, computer tomograms etc. created, which either visible on a screen and thus evaluable, or in forth conventionally printed out as hard copies. These findings are now available preferably digitally by the doctor in the central archive to the concerned Patient data file sent. It is of course also possible that the data are given to the patient as hard copies, which are sent by courier sends the archive or sub-archive or personally brings them there, whereby the data in the archive or sub-archive from an entry point then in the patient data file can be entered.

Document data is preferably entered in the patient data file via a DICOM document scanner if the patient data is in the form of hard copies or copiable originals. If the patient data, d. H. these findings can already be digitized, these patients can data of course via the input device using a DICOM3 port via GATEWAYS directly to the respective patient data file in the archive become. This new and previously unrealized use of the DICOM  Standards has the further advantage that it is a tamper-proof, digi Talentized archiving of patient data is possible because after scanning hard copies no longer, for example, text files, but tamper-proof Graphics files are available. A later correction or addition of findings is largely excluded. This means that the digital patient tenfiles are not subject to fading, as is the case with conventional ones Hard copy documents is the case and that they can be accessed from any location at any time is connected to the patient data file management system. The images are preferably digitized directly in the corresponding one Recording device that connects directly to the archive via the DICOM3 port that is. This makes it possible to view the images or findings in original quality at any time accessibility. Another advantage of the patient data file according to the invention Management system also consists of the fact that findings or images appear at any time the corresponding patient data file can be entered (scanned), where the patient data is preferably tabular, chronological and / or be are deposit-specific. This is from every doctor who is the patient data file management system is connected every time the patient is treated also the chronology of the treatment or the chronology of the patient traceability traces what his diagnostic options for the benefit of the Patients improved significantly.

According to a development of the invention, the images in the archive are digital in the Patient data file can be saved so that it can be individually or completely PC-supported are available. By using a PC, for example, the patient with the patient end tenfile management system connected via an existing communication network is possible for the patient, even from his own PC his patient retrieve data or arrange for this patient data to correspond to a the PC on which the patient is currently working or in the area he is currently in.  

It is to simplify the use of the patient data file management system preferably provided that a keyboard with a special patient data file access key such as B. one of the function keys is provided, which with egg nem special logo, in particular a Äskulapstab is marked by means of which the patient himself has access to his patient data file. Alternatively the user receives a diskette from the system operator, by means of which the user user loads the call system into his PC and thus the icon (Äskulapstab) appears on the screen. Clicking the icon has the same effect as that Press the access key. This enables the patient to use the multi-media Standard of his PC also to extend to his medical data. To ensure that the patient data files are secured against unauthorized access is in the patient data file management system according to the invention Encoding device is provided, by means of which the patient data in front of a Exchange can be coded in such a way that this external access can be prevented. For this purpose, preferably in the context of the so-called "firewall" technology, i. H. the establishment of certain access or protection zones, a lock key seen. The patient or one can only use this locking key person authorized by him, which the treating doctor or a family member link, access to the respective patient data file in the archive is missing safe to use. To rule out misuse or abusive so-called data retrieval from the respective patient data file, the patient data files are protected with an access code which is too at least one of the access codes patient name, registration number, personal Password, security password. It goes without saying that the more the Access codes in the personal access code sequentially or hierarchically are related, the greater can abuse of patient data from one Patient data file by third parties, unauthorized persons excluded the. The access code preferably consists of patient name, registration number mer, personal password and security password.  

According to a further exemplary embodiment, the patient data file has Management system further a compression device, by means of wel The patient data is compressed before it is saved in the archive to make maximum use of the storage capacity of the archive. Preferably is furthermore the compression device with a coding device ver ties.

According to a development of the patient data file manager according to the invention access to the respective patient data file is fee-based. The fees can preferably be debited in particular from a chip card. Of course, it is also possible that other criteria such. B. Duration of Access, duration of transmission, amount of data transmitted etc. the fees determine.

The call, retrieval, storage and / or processing is preferably carried out the patient data through the patient data file according to the invention Management system affiliated institutions, especially hospitals and doctors using the so-called JAVA Technology, by means of which the viewed, edited and also viewed data on a corresponding display can be supplemented without being able to manipulate the finding itself. Any addition or addition of new or additional patient data is then, after appropriate digitization, the respective patient data file as a new document representing part of the patient data file in the archive fed.

"JAVA" is a computer language on the basis of which network software is built, which enables every user worldwide, for example via the Internet access the archive and retrieve patient data files from there which the respective user is authorized to do without the user the complicated data-rich software on his PC or on his worksta tion must load. This means that the JAVA applications are purely so-called  "Plug-in" software programs. If the patient himself out of his patient View patient data file using JAVA on his own PC patient data, Be Finding and printing out finds and images is a big plus next to the PC high resolution screen, a large storage capacity such as B. 5 GB and one high quality laser printer required. For calling all other patients A conventional Pentium II processor is sufficient.

The patient data file management system preferably has a plurality of so-called EVS stations (External Viewing Stations), which in particular at airports, ground stations of airlines, train stations, at Hilfsorga organizations such as B. Red Cross, Maltese relief service and at rescue stations are installed. Due to the large number of these EVS, the patient is able to may trap his patient data regardless of the geographical position file from the archive.

According to a further exemplary embodiment, the patient according to the invention Data file management system constructed so that the patient data files also me include medical diagnoses, which are made using the patient data file Management system or are interchangeable within its framework. So that has Patient data file management system has a decisive positive impact professional medical diagnosis. Patients for whom one abroad Computed tomography or an x-ray can still be made during the recording activity is part of the patient data file management connect systems to a specialist clinic in your home country. It is therefore possible that at least two geographically different Po selected patient data viewed simultaneously, especially by doctors and can be evaluated, provided the doctors communicate system internally with each other via the patient data file management system, whereby one time difference of up to approx. 5 minutes due to data transmission is still referred to as simultaneous. That means the examining doctor the same images on his display as his colleague, for example, in one  other clinic or abroad and thereby created an opportunity fen is to jointly create an optimal diagnosis for the patient. In order to In many cases, operations on site and the patient can be dispensed with immediately brought to a connected clinic by plane. Still before if the patient arrives in the clinic or in a special clinic, the operati start preparations based on all available patient data, and there is even enough time that the operating doctor with his Team that can discuss patient information. This saves valuable time saves, which benefits the patient, because after arrival in the special clinic Operation can begin immediately.

The system also offers the opportunity to contribute to cost savings since Duplicate exams can be avoided by cost-intensive second admission are not required, but simply as part of the patient data file Management system can be exchanged. In addition, a patient is at for example in the case of x-ray examinations of a lower dose of x-ray exposed to rays.

The patient data file management system is subject to a permanent center len updating and central patient data file maintenance via the central computer. This patient data file maintenance is carried out centrally by an operator of the Systems made via the central computer, and there is therefore no local Updating, as access to the updated patient data file in the zentra len archive is done.

According to a further aspect of the invention, there is an installation for a patient tenfile management system, which allows creating, saving and computer-compatible processing and user-controlled exchange digita patient data files with findings and patient data (patient data) finally pictorial and graphic data such as x-rays, computer tomos grams, magnetic resonance imaging, sonography images, laboratory results (images)  serves. This user-controlled exchange of patient data files takes place in the special between patients, clinics and medical practices by means of a communication cation network. The facility has a central electronic archive in particular for saving the patient data files, an input / output and processing device for user-controlled input / output, processing and Ab save the patient data and a data transmission device for the user controlled exchange (sending / receiving) at least of parts of the Pati data files in particular via the communication network. Preferably is the input / output and processing device DICOM3 standard designed to be compatible, either in graphical form Examination results directly from the examination facility to the patient data file in digitized form or an initially created one Hardcopy of the examination result scanned and then the pati is sent to the data file. A compression device is preferred provided that the data com before saving in the patient data file primed. Appropriate encodings ensure that access is only authorized sied persons is permitted.

According to another aspect of the invention is a system with a plurality created of such systems, in which in such institutions, which directly or indirectly for the benefit of the patient and the rapid exchange of his Patient data files are important, especially hospitals and / or Medical practices each have at least one such system installed, the individual NEN systems with each other via a communication network such. B. Telephone, Inter net, etc. are networked.

With the patient data file management system, the system for such Patient data file management system, the system with a variety of sol systems and the keyboard for the patient data file management system is the technical realization of a central patient-controlled patient data file archiving and usage. A patient can from one  medically relatively underserved area of the third world its medizini patient data via e-mail or other telecommunications worldwide Log in the active central archive. The existing one in the central archive Access-protected patient data files are used, for example, for a second assessment to an appropriate clinic in a desired country such as B. Germany, Forwarded to Europe or USA and re-assessed there. At the same time Framework of the patient data file management system operations and treatment Named options and confirmed surgery dates.

Since the time spent in operations in modern clinics is only a few days, in Extreme cases include a few hours, it is increasingly the case that patients in in the shortest possible time after an operation to a professionally equipped Rehabilitation clinic to be forwarded. In such a case, too Patient data file management system of outstanding importance and offers the rehabilitation doctor the possibility of immediate access to all Patient data including the operation data and also on all distress agile preoperative patient data. This is a process that is for successful rehabilitation is of paramount importance. In addition leads the patient data file management system worldwide to a more meaningful and better utilization of rehabilitation facilities.

In addition, the patient data file management system according to the invention offers practical technical solutions for the benefit of the patient when traveling both in developed countries as well as third world countries. It is too considerate the total number of travelers worldwide (train, flight, bus, car) is estimated to be at least about a billion people a year. This under eliminates the need to ensure optimal medical Care, treatment, diagnosis and diagnosis even in relatively remote geographical areas. All of the patient data file management systems connected hospitals, clinics, doctors etc. are just like that General practitioner or the patient is able to save the patient data files as desired,  geographic location and need to call. Especially people who through chronic conditions such as B. heart attack, diabetes and others so far Had to forego travel or their travel options were severely restricted using the patient data file management system of the present invention with a clear conscience also undertake longer trips, since the patient data file management system according to the invention is not just that But ensures patient access to his medical data it is connected to the patient data file management system via the patient doctors also the possibility of a more comprehensive and accurate diagnosis offers for the benefit of the patient.

Further advantages, features and possible uses of the invention which is now explained in detail with reference to the accompanying drawing.

In the figure is the basic structure including the exchange options for patient data between archives, clinics, private doctors and affiliated organizations.

The block in the figure above shows that the patient data file Management system according to the invention, which also acts as a central patient supported file communication system (CEPCO = Central Patient-based File Communication System) is technically designated by an operator is maintained and operated. The operator provides the provider for the exchange of the medical service data and operates, updates and organizes the central Patient data file archive. For example, the operator does the same the interaction between patient, doctor and / or clinic. The CEPCO provides the first European and worldwide patient data file management system, where the patients have access to their own files over ISDN and Internet. The outer large double arrows illustrate that all access to patient data and their exchange patients controlled by the operator / central computer.  

The operator is responsible for updating, function, billing etc. regarding the central digital archive, one connected to the archive central database, communication between user / patient and Operator and communication on the Internet or via e-mail, regarding the User-controlled exchange and collection of second assessments and other services.

About this technical operation of the patient data file according to the invention Management system by the operator / via the central computer Exchange to a large number of general practitioners (in the figure is representing a number of doctors with the numbers 1 to 9999) either directly or indirectly through a certain number of clinics (the Kli niken are representative of the numbers 1 to 1000), which in turn again, for example, support more than 100 doctors per clinic. The indi Right exchange of patient data files from the operator archive via the clinics to the respective doctor treating the patient is through the little dop arrows indicated.

Central core of the patient data file management system for Europe and worldwide to a large extent are private users and consumers, i. H. the patients, d. H. the System-registered users (more than 1,000,000 in number), which with the above 1000 clinics and 10,000 doctors about the Patient data file management system are connected.

In addition, within the patient data file management system patient data exchange controlled by the patient also with supportive and accompanying, for example as part of the patient's travel activity for its health-related worldwide care can be implemented by important organizations. Such organizations are, for example, insurance companies, travel organizers, credit card operators, company card and smart card operators,  private associations or organizations such as B. automobile clubs, in which Be users / patients are organized and official and government-like or semi official organizations.

From the figure it is clear that the patient-controlled Pati data file management system (CEPCO) high flexibility, usability and has numerous advantages, with the CEPCO being a central one for the patient Position in storage, retrieval, administration and archiving offers or grants its patient data.

For the huge group of private patients, i. H. Users or customers of the operator, which is the lowest level of the structure hierarchy according to the figure access to your own patient data file only works by calling and mediation of the operator / central computer. As work software language JAVA Technology is used. So there is the possibility without download extensive software packages to the respective workstation for the exchange of patient data files directly telephone networks (digital, ISDN, GSM, Satellites), the Internet and e-mail. A Tasta is patient-friendly tur, by means of which by pressing a specially marked and reser fourth key (e.g. the F10 key) direct automatic access of the patient to his patient data file via the central computer is. Alternatively, one can use software stored on a floppy disk Icon can be generated on the screen, by means of which the same function as that specially labeled button is realized.

To prevent improper access, the access is through Zu Handle codes secured, which consist of a) patient name, b) patient registration number, c) personal password and d) security password. Here are the Data from the patient data file only for view (view only), if this the PC, according to its capacity, is allowed and provided via the Internet or Accessible to the central archive from anywhere in the world. The patient  Data file management system is designed and constructed in such a way that Editio , deletions, additions or access to an unauthorized person Patient data file, a doctor file or a hospital file is not permitted are.

The minimum technical requirement is currently a Pentium II Processor, 200 MHz, storage capacity 64 MB, being used for a fast image representation 128 MB are recommended, 3 GB hard drive, one for the images Screencard (SCSI) is mandatory. As indicated above, a keyboard is used Keyboard with a specially marked key for direct access to the Patient data file or for direct logging into the patient data file Management system. Of course, it belongs to a professional system at least one 17 "or 21" screen to display the images such as B. X-ray gene images, computer tomograms etc., this for private use is not mandatory. There is also a significant advantage of the patient data file management system according to the invention in that no Modem or similar device is required because the JAVA Technology Anwen finds.

For the 10,000 and more resident doctors who are the next higher level In the structure hierarchy as shown in the figure, patient data works file management system such that an interactive call, save, edit Read and read about the doctor's own operator bank file within the central Database of the operator about the patient, which contains all patient data files of the Contains doctors, are enabled.

JAVA Technology serves as the call tool, the call via direct telephone network, internet or via e-mail.  

Access is only possible via appropriate access codes, such as B. a) Name of the doctor, b) operator bank file number of the doctor, c) personal password the doctor's and d) security password.

The doctors are responsible and authorized to operate their own data-protected To create bank files. Furthermore, the doctors are authorized, digital patients create data files including data from old previous files, digital pati save data files in the central digital operator archive, all controlled medical data and images of all of their patients to control patients open and save and others within the patient data file Management system connected and registered with the operator or Hospitals for the purpose of emergency consultations through simultaneous viewing of data and images while viewing that data over ISDN between the calling doctor and the consulted doctor or institute ISDN and / or a video conference as well as for a secondary medical care attention when using the Internet for his own patient and directly with the Operator registered patients are exchanged.

The doctor has no access to administrative data of the system registered patient (a patient who is part of the patient data file Management system is registered and thus authorized), such as. B. payments, Insurance coverage and others. Furthermore, the doctor has no access to Patient data files that are different from those that are involved in this delenden doctor are registered, this rule except by the patient himself Can be set by using the personal security code overwrites and overcomes the so-called firewalls.

As ver in the patient data file management system used by the doctors technology used is a fully interactive JAVA workstation, wel currently works on the basis of Windows 95, 98 or Windows NT, wel it enables the doctor to save and read the corresponding patient data,  to edit and change as well as display in 3D. Furthermore is a fully active document scanning station is provided, by means of which Do documents in the digital patient data file via a DICOM3 document Scanner can be saved, the document written anything nes, handwritten or graphic document can be wel medical reports, diagnoses, laboratory tests, comments from the surgeon etc. may contain.

A technical requirement is a workstation with at least one Penti around II processor, 300 MHz, memory capacity 64 MB or more, at least a 5 GB hard drive, an Internet 10/100 BaseT card, a Windows system 95, 98 or NT, a 17 "or 21" screen, a SCSI card (graphics card), a 128 kbit ISDN line and a CESCO ISDN router.

For the more than 1000 clinics and universities provided according to the figure hospitals, which follow the hierarchy of structures arranged above the doctors form the figure, there is the function of the patient data file according to the invention. Management system in it, a system for an interactive call, an interac saving, editing and reading from a clinic's own operator To create or use bank files within the central database contains all patient data files of the clinic. The call is in turn realized via JAVA Technology and takes place directly via telephone, Internet or E-Mail.

Access is again via required codes, with codes a) Kli nikname, b) clinic bank file number, c) personal password of the authorized Doctor's and d) security password are provided.

The clinics or university hospitals are authorized, clinic-owned, there Protected operator bank files to create new digital patient data files including creating data from old previous files, digital patient data  save files in the central digital archive, medical reports and Images of all patients in the clinic and all doctors and patient data files fen and save, which in the medical sense of responsibility of the Are subordinate to the hospital. Furthermore, the clinics and universities authorized hospitals, other doctors or hospitals operating within the Patient data file management system registered through the operator to To call or be called by emergency consultations by viewing data and images simultaneously, while the same over ISDN between the calling doctor and the consulted doctor or institute ISDN and / or a video conference can be exchanged and discussed. The Clinics and university hospitals are also authorized, a medi cinical second assessment for internet use for your own doctors and To request patients as well as a service for every third doctor or patient or create.

The clinics and university hospitals have access to administrative Data from system-registered patients such as payments, insurance contracts ge and others as well as for any patient data files which are different from the doctor-registered patient data files are refused, but this is only possible through the Patient can be overridden by the patient Overwrites security codes, which overcomes the so-called firewalls become.

Technically, one is complete in the clinics and university hospitals Interactive JAVA workstation provided, which is based on Windows NT works, which enables the clinic to save patient data read, edit and change and display in 3D. Furthermore a complete imaging and scanning station is provided, by means of which Images such as B. X-ray examinations, computed tomography, nuclear magneti cal resonance spectrograms, mammography examinations, ultrasound Save examinations, videos and others in a digital patient data file  are searchable. Saving is done either by direct digital storage via a DICOM3 standard directly from the clinic's own image device via a DICOM3 port or by scanning Developed film hard copies via a DICOM3 film scanner and, in the case of documents, via a DICOM3 document scanner, the document any kind of written, handwritten or graphic documentation elements, which medical reports, diagnoses, laboratory tests, Comments from the surgeon etc. included.

Technically, a workstation with at least one Pentium II processor, 300 MHz, with a storage capacity of 128 MB or more, at least 5 GB fixed plate, Internet 10/100 Basel card, Windows NT, a SCSI card (graphic card), 128 kBit ISDN with the option on four ISDN lines if required fast transmission and instantaneous (lifelike) ultrasound image tion or the like.

Regarding the supporting and affiliated organizations, which are can also log into the CEPCO via the operator is an example on the insurance companies referred to, the function of Pati entdatenfile management system is provided in that the Versi Insurance companies look into administrative data for the insurance company Patients can log into the central database. The login again takes place via JAVA Technology, which can be called up direct telephone or Internet are provided.

Access is again via appropriate codes, where a) the name of the insurer, b) the insurer's operator file number, c) a identifying password, which guarantees limited access, and d) an on limited password is required for the insured patient.  

Insurance companies are authorized to access individual demoscopic patient data, the frequency of calls / inspections of the Patient data files and administrative details of all services that relating to payment by the insurance company, if the patient is insured with the insurance company and has a payment for membership by the insurance company with the operator has been made.

Access to medical data is restricted to the insurance companies refuses unless required by law or by contract. The Versi Insurance companies don't have access to doctor or clinic files, either not on administrative data.

The insurance companies' access to the operator / central computer depends from the contract with both the operator and the patient and is subject the rules set by data protection laws.

The principles set out above with regard to the insurance company have been described, of course apply to all others, in Service companies shown in the figure, which in the patient data file Management system are involved. The medical patient data files are absolutely protected while accessing administrative parts of the files under conditions of a corresponding contract between all concerned Parties may be possible.

Claims (26)

1. Patient data file management system with a central electronic Archive for creating, saving, computer-compatible processing and Exchange of central digital patient data files, which patient Personal data as well as findings and patient data, especially pictorial and graphic data (images), and / or information at least about which data is stored in which decentralized subarchives are stored, patient data from a communication network the patient data files access code protected only by a patient (User) can be called up via a central computer and the central computer switches the patient access to his patient data file. 2. Patient data file management system according to claim 1, wherein the User-controlled exchange of patient data from the patient data files in particular between patients, clinics and doctor's surgeries using of the communication network. 3. patient data file management system according to claim 1 or 2, at wel chem an input device for entering and / or digitizing Patient data in the archive or a sub-archive, a reading device for user-controlled reading of patient data from the respective gene patient data files and a data transmission system to the user controlled exchange (sending / receiving) of patient data are seen.   4. Patient data file management system for creating, storing and computer-compatible preparation of digital patient data files with findings, laboratory results and patient data (patient data) including pictorial and graphical data such as X-ray images, computer tomograms, magnetic resonance imaging, sonography images, etc.) and for user-controlled Exchanging patient data files, in particular between patients, clinics and medical practices, using a communication network, comprising:
an electronic archive for storing patient data files; an input device for entering and / or digitizing patient data the archive;
a reading device for user-controlled reading out of the patient data from the respective patient data files from the archive; and
a data transmission system for user-controlled exchange (sending / receiving) at least of parts of the patient data files, in particular via the communication network, the user being the patient in particular and at least the patient data being exchanged via a central computer. 5. patient data file management system according to one of claims 1 to 4, in which the transmission of patient data via telephone (digital, ISDN, GSM, satellite), Internet and / or e-mail can be realized. 6. patient data file management system according to one of claims 1 to 5, in which a processing device for optimal preparation of the provided by the input device patient data is. 7. patient data file management system according to one of claims 3 to 6, in which the input device is designed in the DICOM3 standard.   8. patient data file management system according to claim 7, wherein the Patient data from the input device using a DICOM3 port directly to the respective patient data files can be fed into the archive. 9. patient data file management system according to claim 7, wherein the Patient data are available as hard copies and by means of a DICOM3- Film scanners or DICOM3 document scanners to the respective pati data files can be fed into the archive. 10. patient data file management system according to one of claims 1 to 9, where the images in the archive are stored digitally in the patient data file Can be saved that they can be called up individually or completely PC-supported. 11. The patient data file management system according to claim 10, wherein provide a keyboard with a special patient data file access key , which is particularly marked with an Aesculapian rod, by means of which the patient himself has access to his patient data file. 12. patient data file management system according to one of claims 1 to 11, in which the patient data in the patient data file chronologically and / or can be filed depending on the findings. 13. Patient data file management system according to one of claims 1 to 12, in which a coding device is provided, by means of which before an exchange, the patient data can be coded in such a way that it is foreign access can be prevented. 14. Patient data file management system according to one of claims 1 to 13, in which a lock key (firewall) is provided, by means of wel chem on the part of the patient or a person commissioned by him (be  acting doctor) access to the respective patient file in the archive abuse-proof. 15. The patient data file management system according to claim 14, wherein the patient data file is protected with an access code which is too at least one of patient name, registration number, personal passport word and security password. 16. Patient data file management system according to one of claims 1 to 15, in which the patient data is saved before being stored in the archive be compressed by a compression device. 17. Patient data file management system according to one of claims 1 to 16, in which access to the patient data file is fee-based, the fees can be debited in particular from a chip card. 18. Patient data file management system according to one of claims 1 to 17, in which JAVA for retrieval and further processing ("Call Tool") Technology is provided, by means of which the patient data from the Archives can be called up, displayed on a display device and by means of the Input device are editable. 19. Patient data file management system according to one of claims 1 to 18, which has a variety of EVS (External Viewing Stations) especially at airports, ground stations, airlines, train stations in aid organizations (Red Cross, Maltese) and rescue station NEN, over which a geographically essentially independent Access to the respective patient data file in the archive can be realized. 20. Patient data file management system according to one of claims 1 to 19, by means of which medical diagnoses are interchangeable.   21. Patient data file management system according to one of claims 1 to 20, which is networked in such a way that at least two geographically below different positions simultaneously selected patient data in particular doctors can assess which systems communicate with each other internally are connected. 22. System for a patient data file management system for creating, storing and computer-compatible preparation of digital patient data files with findings and patient data (patient data) including pictorial and graphical data such as X-ray images, computer tomograms, magnetic resonance imaging, sonography images, laboratory results (images) etc. as well for the user-controlled exchange of patient data files, in particular between patients, hospitals and doctor's surgeries using a communication network, comprising:
a particularly central electronic archive for storing the patient data files;
an input / output and processing device for user-controlled input or output, preparation and storage of the patient data; and
a data transmission device for user-controlled exchange (sending / receiving) of at least parts of the patient data files, in particular via the communication network. 23. A system with a plurality of systems according to claim 22, wherein in Institutions in particular hospitals and / or medical practices each at least one is installed and the individual systems together are networked. 24. The system of claim 23, wherein the facilities national, supernatio nal and / or globally networked.   25. keyboard with an access key, in particular one of its function keys, for a patient data file management system, which is an icon, in particular which has a Äskulapstab, and by means of which patient data one Patient data files of the patient data file management system can be activated in a controlled manner. 26. The keyboard of claim 25, wherein the access key with a to handle code is coupled.