CA2027000A1 - Point of care nursing system - Google Patents
Point of care nursing systemInfo
- Publication number
- CA2027000A1 CA2027000A1 CA002027000A CA2027000A CA2027000A1 CA 2027000 A1 CA2027000 A1 CA 2027000A1 CA 002027000 A CA002027000 A CA 002027000A CA 2027000 A CA2027000 A CA 2027000A CA 2027000 A1 CA2027000 A1 CA 2027000A1
- Authority
- CA
- Canada
- Prior art keywords
- care
- terminal
- patient
- point
- data
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Abandoned
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Classifications
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
- G16H40/63—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for local operation
-
- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/20—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the management or administration of healthcare resources or facilities, e.g. managing hospital staff or surgery rooms
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
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- Health & Medical Sciences (AREA)
- Engineering & Computer Science (AREA)
- Business, Economics & Management (AREA)
- General Business, Economics & Management (AREA)
- Biomedical Technology (AREA)
- General Health & Medical Sciences (AREA)
- Epidemiology (AREA)
- Medical Informatics (AREA)
- Primary Health Care (AREA)
- Public Health (AREA)
- Medical Treatment And Welfare Office Work (AREA)
- Measuring And Recording Apparatus For Diagnosis (AREA)
- Accommodation For Nursing Or Treatment Tables (AREA)
Abstract
ABSTRACT
A method of operating a point-of-care terminal comprising: establishing a specific patient related electronic kardex formed of data signals defining a group of individual patient care events, each care event being defined by a predetermined collection of possible attributes each attribute defining a characteristic of the event, displaying the care events with the selected attributes at a point-of-care terminal, whereby an individual care program specific to the patient is displayed to a care giver.
A method of operating a point-of-care terminal comprising: establishing a specific patient related electronic kardex formed of data signals defining a group of individual patient care events, each care event being defined by a predetermined collection of possible attributes each attribute defining a characteristic of the event, displaying the care events with the selected attributes at a point-of-care terminal, whereby an individual care program specific to the patient is displayed to a care giver.
Description
~ ~3 r~ ~ iJ ~3 1 01 FIELD OF T~IE INVENTION
Q2 This invention relates to data systems for 03 hospital operation and particularly to a method of 04 operating point of care data terminals.
05 BACKGROUND_OF THE INVE TION
06 Hospital administration staff have 07 attempted to control costs associated with operation 08 of hospitals by implementing computerized 09 administration systems, including bookkeeping systems, material control systems, etc. Such systems, however, 11 require manual input of data into computers from stock 12 control forms, equipment usage forms, time sheets, 13 etc. filled in by hospital staff. This has been prone 14 to error because it depends on the memories of fallible persons, sometimes imperfect diligence in 16 completing the forms by often over-worked personnel, 17 etc.
18 The main function of a hospital, that of 19 patient care, has resisted efficiency introducing machines. The patient care system typically operates 21 with a doctor prescribing tests and courses of 22 treatment, which are carried out by caregivers such as 23 nurses (hereinafter referred to generally as nurses).
24 In this case also, due to human fallability, the times of administration of treatment or testsl completion of 26 all tests, and erroneous recording of the results of 27 tests sometimes occurs, which can have dangerous 28 effects and legal consequences. The collection of 29 data tabulating the quantities of medicines used, the labor involved, and other costs associated with 31 specific patient care is done manually by the nurse 32 recording it on paper, which is prone to error.
33 The present invention substantially 34 automates the above functions providing to the nurse a portable electronic terminal, referred to herein as a 36 point-of-care terminal, that displays on command tests 37 and courses of treatment for an identified patient.
~ ~i h ~ J
01 ~rhe nu~se ~eL~oLms the tests and~or tLeatmerlts, and 02 enteLs the results o~ the tests directly into the 03 teLminal, the system recording the entered data in a 04 standardized format. The system can confiLm the 05 treatment steps and test results already entered, and 06 can warn her of entries outside of predetermined o7 thresholds. This can reduce the incidence of error in 08 tests and treatment, making the job of the nurse o9 easier. The data is recorded in a computer to which the portable terminal is connected and can be 11 collected by the hospital adrninistration computer.
13 A medical information system which 14 standardizes treatment steps is described in the article "Medical Data Dictionary for Decision Support 16 Applications" by S.M. Huff et al of AT~T Bell 17 Laboratories, pp 310-317, 1987 SCAMC, Inc. In this 18 system, precise names of functions performed by the 19 nurse or doctor, are input into a terminal. The article promotes the definition of a standard medical 21 dictionary for use in a medical care electronic 22 information system. The system described utilizes 23 individual pages defining events which are input from 24 a nursing station, each event being a "happening"
relating to a patient, such as writing an order for a 26 medication, the occurrence of pain, the birth of a 27 child, a surgical procedure, etc. Attributes are 28 associated with each event, which are qualitative and 29 quantitative descriptors of the event, with a time of occurrence of the event and a time of recording of the 31 event. Associated with each recorded event is the 32 name or definition of a particular patient or relative 33 of the patient. Operation of the system requires 34 positive recording of the event in the course of treatment of a patient at a central nursing station by 36 personnel who must be trained in the use of database 37 systems. The nurses must know the course of treatment ~ ù ~ J j ~
01 of a patient, which is descLibed to them in the 02 t~aditional of manner. The nurse simply inputs at the 03 nursing station what has occurred according to a 04 w~itten schedule of a course of treatment, or other 05 occurring events involving the patient, and from tests 06 and their results written on paper.
o7 The above-described system contains 08 several disadvantages. Firstly the system by which o9 the nurse gives care to the patient remains exactly as it has always been, that is, that the functions 11 performed by the nurse are recorded by spelling out 12 what functions have been performed. The recording is 13 done at a nursing station at a central location. The 14 nurse first records on paper the results of tests performed, which is then typed into the nursing 16 station computer. Therefore some tests can be missed 17 and errors can occur.
18 Secondly, and importantly, a standard 19 dictionary of terms must be used when the information is typed into the computer for the system to work 21 properly. Misspellings, non-standard (but otherwise 22 understandable) words used by the nurse, result in 23 data which is not accepted or if accepted by the 24 system, cannot be collected by a central computer which expects to receive standard terms. The learning 26 of a set of standard terms from which the nurse may 27 not deviate puts additional burden on the nurse, 28 rather than a relief from burden.
29 Thirdly, all of the data of a group of patients is input into one central location. This 31 provides a significant opportunity to make errors and 32 to miss the inputting of data since nurses are 33 typically busy and sometimes are subject to emergency 34 distractions. Therefore data recorded on paper by the nurse may not be entered into the central computer 36 until long after it is needed by an administration 37 computer, or it may be missed completely.
01 SUMMARY_OF_THE__NVEN_ION
02 The present system, as noted above, o3 includes a small portable point-of-care terminal 04 carried by the nurse which is used by the nurse to 05 input the test results data and treatment steps such 06 as quantities and types of medicines used right at the 07 location and the time of the tests or administration 08 of treatment. The nurse need not memorize or input 09 standard names of medicines or other medical terms.
Further, the nurse need not have a written description 11 of the course of treatment or test which she is to 12 administer on a patient. The exact list of treatment 13 and the exact tests prescribed by the doctor are 14 displayed on her portable terminal and she need merely fill in the blanks of numbers which are the results of 16 tests or quantitites of the medicines shown on her 17 display. She can also invoke and input standard 18 nursing notes. The data input for each treatment or 19 test and nursing notes are automatically transmitted to a central location, such as a nursing working 21 station, for central storage. Each input is stored in 22 association with an automatically generated time 23 entry. The entire sequence of tests, treatment and 24 results or specific categories thereof can be displayed at the point of care terminal so that the 26 nurse can see what tests have already been 27 administered, the results, and she can estimate trends 28 if necessary.
29 The course of treatment for each patient is obtained after inputting a patient code number, as 31 well as a security code associated with the nurse.
32 The same portable terminal can therefore be carried 33 from patient to patient, plugged into a local area 34 network having terminal connectors adjacent each patient bed, for transmission of patient-specific data 36 back to the central station. Therefore the number of 37 point of care terminals need be only equal to the IJ iJ v nl numt)eL of nUISeS on duty at any paLticula~ time, and 02 need no~ be equal in number to the vastly larger 03 numbeL of patients receiving tLeatment in the hospital 04 at a given time. Because the exact course of 05 treatment is available to the nurse at all times on 06 her local display using computer generated instruction o7 terms, and because the results of treatments or tests 08 are input directly into the portable terminal when o9 performed, the intermediate step of marking the results on paper, resulting in errors and missed 11 reports described earlier with respect to prior art 12 proposed systems is avoided.
13 Because all input data is stored in 14 association with a time indication, including separate corrections made to input data, a complete track of 16 patient treatment is permanently recorded, which may 17 be needed later formedical or legal purposes. Since 18 there is no intermediate paper marking step, the 19 possibility of losing or varying the origin document is avoided.
21 Because the exact course of treatment is 22 described by computer, and the quantities of 23 administered medicines and other supplies are directly 24 input on the portable point-of-care terminal, data identifying materials and medicines identification and 26 quantities, and labor involved in treatment of a 27 patient are clearly recorded automatically in a 28 standard format in the central computer. As noted 29 earlier this can be linked to the hospital administration computer, to obtain an accurate 31 inventory track and cost base for treatment of each 32 individual patient. This should substantially help in 33 control of hospital costs, and increase efficiency of 34 operation of the hospital.
The operation of the present invention is 36 based on a novel method of operating a point-of-care 37 terminal wherein there is a central library of 38 predefined patient tasks stored in a central memory.
(J ~) ., 01 ~rhe library is comprised of electronic data storage 02 defining all expected possible tasks involving care of 03 a patient. Each of those tasks is herein called an 04 event (which is distinguished in definition from the 05 form of "event" defined in the aforenoted article).
06 Each event contains a set of attributes. Out of this 07 pool of events, specific events relating to the care 08 of a particular patient forming a group of events, is 09 selected to define the care to be given to a specific patient in an electronic kardex. That group of 11 events, or one or more groups of groups of events, is 12 provided to the point-of-care terminal. The nurse 13 need merely display the list of events specific to an 14 identified patient on the terminal and input the results of tests carried out at times prescribed by 16 the doctor and listed in the list of events shown on 17 the display of the terminal.
18 Stored event definitions required by 19 several patients are used in common. Attribute definitions, defining the events themselves, are used 21 in common by plural events.
22 To provide the above, an embodiment of the 23 invention is a method of operating a point of care 24 terminal comprising storing in an electronically accessable memory associated with a central computer 26 terminal a library of data defining a large number of 27 generic patient care events. Data correspondin~ to 28 certain ones of the care events specific to the care 29 of a particular patient is selected from the libary.
A signal corresponding to an identifier of the 31 particular patient is input into a point of care 32 terminal which is in electronic communication with the 33 central computer terminal. At least one group of the 34 selected data specific to the patient is provided to the point-of-care terminal from the central computer 36 terminal in response to the inputting step. The at 37 least one group of data is displayed at the 0l point-of-care terminal, which defines a group of care 02 events. After per~orming tests on the patient 03 corresponding to the events displayed, the nurse 04 inputs data resulting from the tests into the 05 point-of-care terminal relating to at least certain 06 ones of the group of data defining the group of care 07 events. The data is transmitted to the central 08 terminal, and is stored at the central terminal for o9 subsequent access.
Another embodiment of the invention is a 11 method of operating a point of care terminal 12 comprising establishing a specific patient related 13 electronic kardex formed of data signals defining a 14 group of individual patient care events, each care event being defined by a predetermined collection of 16 possible attributes therefor, each attribute defining 17 a characteristic of the event, selecting particular 18 attributes for a corresponding event related to the 19 specific patient, and displaying the care events with the selected attributes at a point-of-care terminal, 21 whereby an individual care program specific to the 22 patient is displayed to a care giver.
24 A better understanding of the invention will be obtained by reference to the detailed 26 description below, in conjunction with the following 27 drawings, in which:
28 Figure 1 is a block diagram of a system 29 incorporating the invention, Figure 2 is a more detailed block diagram 31 of specific parts of the system illustrated in Figure 32 1 for illustrating the invention, 33 Figure 3 is a plan view of a point-of-care 34 terminal preferred to be used to operate the invention, and 36 Figure 4 is a block digram of the 37 point-of-care terminal of Figure 3.
01 DE8CRIPTION OF_~HE pRE-E-RREn-ElMBoD-IMENT
Q3 Figure 1 is a block diagram used to 04 illustrate the invention. A centLal computer station o5 1 which is used as a nursing station, has a printer 2 06 connected to it in a well known manner and is 07 comprised of a memory 3, 3A. The computer station is 08 connected to a local area network 4. Bridges 5 o9 connect the local area network to branch local area networks 6, which are terminated at connectors 7, each 11 one preferably adjacent the bed of a patient. The 12 branch local area networks are preferably organized by 13 ward, so that the representative branch local area 14 network 6 at the left of the drawing serves e.g. a nursing ward 1 while the branch local area network 6 16 at the right of the drawing serves representative 17 nursing ward 2.
18 Each nurse carries a point-of-care 19 terminal 8, which has a plug 9 that ean be plugged into any of the connectors 7.
21 A hospital administration computer 10 can 22 be connected to the local area network 4 to 23 communieate with station 1.
24 As a nurse makes her rounds, or otherwise takes care of a patient, she plugs her point-of-care 26 terminal 8 into connector 7 adjacent the patient. A
27 list of care events is displayed. She administers 28 medicines, performs tests, and enters the amount of 29 medicine and results of the tests into point of care terminal 8. In the list of care events, a schedule of 31 medicines and tests appears on a display of the point 32 of care terminal, which the nurse can call up by 33 depressing predetermined buttons on the terminal. The 34 amount of medieines and results of tests are similarly entered by pushing buttons on the terminal. This data 36 is transmitted to terminal 1 for storage in memory 3.
37 A block diagram showing certain of the ~ .J t ~
01 abo~e elements is illustrated in ~igure 2, in block 02 diagram at the top with certain elements in more 03 detail below. A nursing work station 1 having an 04 associated memory 3, 3A is connected to point of care 05 terminal 8. The nursing work station is connected to 06 printer 2, which can generate reports 10 under control o7 of the nursing work station 1, which can be a printout 08 of the entire treatment schedule oE a patient, o9 including the times when administered and quantities of various medicines used from data stored in memory 11 3A. The data supporting the report is also made 12 available to the hospital administration computer 13 which is also connected to the nursing work station 1 14 through the local area network 4, so that identification and quantities of medicine, amount of 16 nursing and other labor, equipment used, etc. can be 17 tabulated for administration purposes.
18 An important aspect of the present 19 invention is the organization of the memory 3. This provides means whereby the nurse can be efficiently 21 instructed as to the care events to be undertaken and 22 whereby she can enter the aforenoted results from 23 storage without resorting to memorizing and inputting 24 of standard medical nonenclature. The organization thus provides for efficient use of the point-of-care 26 terminal. The memory 3 is divided into memory 27 elements 12, each of which contains a data signal 28 identifying a patient care event. The total of these 29 elements define a care element library 11 which contains data signals identifying all possible care 31 events. These events define the smallest meaningful 32 unit of care or work involving a patient that can be 33 performed. Each event is comprised of a set of 34 attributes which describe individual characteristics of an event, as well as standard nursing notes, as 36 will be described later.
37 Examples of care events are pulse, blood 38 _ 9 _ ~!J ~ J ~) 01 pressul-e, oncology assessment, psycho-social 02 assessment, diqestive system, heat and cold 03 application, cardiovascular system, hemotology system, 04 neurologic system, oxygen saturation etc.
05 The memory 3 also contains memory elements 06 12A containing data signals defining generic o7 attributes, represented by attribute library 13. The 08 attribute library memory elements contain data 09 representing e.g. site, temperature, degree of assistance, duration, frequency, test name, altered 11 body image, volume of feeding, frequency of feeding, 12 method of delivery, food record frequency, patient 13 position, volume ingested etc. ~ach care element 14 is linked to usually plural attribute elements which define the care element. By maintaining a generic 16 library of care element attributes, many of which are 17 used in common to define particular care elements, a 18 massive library defining each care element and each 19 attribute, separately defined for each patient, is not required. Since each separate care element and each 21 separate attribute for each patient need not be 22 defined, the risk of error in definition is 23 substantially avoided.
24 As an example of the association of standard care elements with standard care element 26 at~ributes, for the care element "temperature", site 27 is the care attribute. For the care element "blood 28 pressure", the attributes are "diastolic" (pressure), 29 "systolic" (pressure) and "site" (of measurement).
The attribute definitions for diastolic and systolic 31 pressures indicate that these pressures require 32 numeric values in a specific range. The attribute 33 definition for site includes alist of possible sites 34 to be used.
When a patient is admitted to the 36 hospital, his course of treatment is prescribed by a 37 doctor. The nurse at nursing work station 1 reserves ~ ~,9 ~ ,J j f' 01 a poLtion of memo~:y 3, lefeLLed to herein as a patient 02 electronic kardex 14. FOL example, if a patient A iS
03 admitted ~or a gallbadder operation, an electronic 04 kardex 14 Leserved for and specific to that patient A
05 is established by control from the nursing work 06 station. FiguL-e 2 also illustrates kardexes for 07 patients B and C.
08 The work station nurse, reading the 09 prescribed course of treatement from the doctor's notes, enters in one memory cell of the kardex for 11 that patient a data signal identifying the first care 12 element, e.q. special preoperative nutrition, which 13 would have the attributes definitions defining food 14 diet. The second care element specified might be hourly psychological assessment, the third might be 16 blood pressure every four hours, the fifth might be a 17 special medicinal tranquilizer to be administered 18 6:00 a.m. the day of the operation, the seventh might 19 be transport to operating room 7:00 a.m., the next might be observation of patient at 10 minute intervals 21 following the operation for the first three hours, the 22 next take blood pressure every half hour for first 23 three hours, etc.
24 Thus a portion of the memory 3 is dedicated to the specific course of treatment of a 26 patient, which course of treatment is formed of care 27 elements, each one of which is formed of care 28 attributes selected from the care element library 11 29 and care attribute library 13 used in common by each patient kardex particular care elements. The result 31 is that each patient is assigned a separate electronic 32 kardex. The memory elements in each of the kardexes 33 14 can simply contain pointers to memory elements 12 34 which define the specific care elements. Each care element defined by memory element 12 can be comprised 36 of pointers to various care attributes defined by data 37 in elements 12A in the attribute library 13. In this 38 - 11 ~
01 manne~ theLe is substantially conservation of memory 02 space and at the same time each patient can have its 03 own individual course of treatment uniquely specified.
04 In operation, the nurse plugs her 05 point-of-care terminal 8 into the network, as 06 described earlier with respect to Figure 1, and enters o7 certain identification indicia, as will be described 08 in more detail below, of the particular patient to be o9 treated, and her passcode identifier. In response the nursing work station 1 accesses the memory 14, and 11 causes display of the care event list relating to the 12 identified patient on the point-of-care terminal 13 display 8. The nurse can thus see which tests are to 14 be administered.
The nurse also select specific categories 16 of care elements defined in kardex 14 to be displayed 17 on her point-of-care terminal, as will be described 18 below.
19 Figure 3 illustrates a preferred form of 20 point-of-care terminal 8 for use in the invention. It 21 is preferably comprised of liquid crystal display 15 22 and a plurality of pushbuttons, e.g. formed of 23 calculator type keys 16 and specialized function keys 24 17 and 18.
When a nurse plugs the point-of-care 26 terminal 8 into a connector adjacent a patient and has 27 initiated communications as described earlier, and 28 will be described in more detail below, and pushes the 29 button of the group of buttons 18 labelled "VITALS", a predetermined data code formed of signals stored in a 31 ROM (read only memory) within the point of care 32 terminal is transmitted to the nursing station 1. The 33 nursing station computer accesses certain of the 34 memory elements in the kardex 14 which are associated with "vitals" care elements for the identified 36 patient. Data for display of "VITALS" is transmitted 37 by the nursing station 1 via the networks 4 and 6 to ~ iJ ~
01 the point-of~caLe terminal 8, which displays only the 02 "VI~ALS" tests from the particulal- patient's kardex 14 03 on the display 15.
04 For example, as may be seen on the display 05 15, the vitals tests of blood pressure (BP), pulse, 06 temperature (temp) and respiration are displayed, 07 coupled with their corresponding attributes, shown as 08 left (L) brachial lying ###.### Hg, left radial o9 ###/min normal, oral ###.###C., ###/min regular 10 eupnea. The nurse recognizes that she is to take the 11 blood pressure at the left brachial position with the 12 patient lying and is to enter the pressure numerically 13 in millimeters of mercury of both dyastolic and 14 systolic measurements. The pulse is to be taken at 15 the left radial position and entered numerically as 16 pulses per minute. The temperature is to be orally 17 taken and entered numerically as C. She is to check 18 the respiration rate and enter it numerically as 19 breaths per minute.
The results of all of the above is entered 21 at screen cursor positions defined by the # indicia 22 using the keypad 16. The particular positions on the 23 screen of the cursor where the values are entered 24 (which may simply be a shading of the particular 25 attribute selected) are controlled by a four direction 26 cursory key 17, which controls the position of the 27 cursor (or a shading) on the display screen.
28 It is preferred that the display screen 29 should be split into three panes. The top pane is 30 preferred to identify the patient by name, sex and 31 identification code, and the name of the doctor, the 32 data of which is sent to the point-of-care terminal 33 from the nursing station after acceptance of the nurse 34 identification (passcode).
The second, middle pane is preferred to 36 display the instructions information and care elements 37 from the memory at the nursing work station, and is 01 used to enteL data such as the results of tests as 02 noted above. It is also used to initially request the 03 identification code of the nurse and of the patient 04 after the point-of-care terminal is plugged into the 05 network to identify a request to communicate.
06 The third, bottom pane is referred to as a o7 dialog pane, and is preferred to provide information 08 to the nurse as to the previous series of tests, such o9 as the data and time a particular selected even~ was last performed, the name of the nurse, the planned 11 frequency of the test, and other information entered 12 at the workstation. The third pane is preferred to be 13 typically used only as an information pane to the 14 nurse.
In the event the nurse wishes to obtain a 16 list of medications to be administered for the already 17 identified patient, she pushes the "MEDS" button, 18 which, as described above, sends a code to the nursing 19 station 1. The nursing station in response accesses the medications care event memory locations in the 21 specific patient's kardex, and transmits those care 22 elements with attributes back to the point of care 23 terminal 8. The list is displayed on display 15 in a 24 manner similar the display of vitals shown in Figure 3, and the nurse can administer the medicines, 26 immediately enter the quantities that have been 27 administered at the corresponding # indicia, etc. In 28 this manner various specific groups of care elements 29 from the electronic kardex of a particular patient can be selected for view by the nurse and entry of the 31 results of tests, etc. The entered data is 32 temporarily stored in a local memory of the 33 point-of-care terminal, and is transmitted to the 34 nursing workstation 1 by the nurse pushing the Tx button on the point-of-care terminal 8.
36 The preferred groups of care elements that 37 can be called up by function button and displayed on 01 the point oF caLe teLminal R is indicated as VITALS, 02 MEDICATIONS, ADL, ASSESSMENT, PArIENT PROFILE, an~
o3 TESTS.
04 A "CALC" key is pushed to convert the 05 numeric keypad into use as a calculator, by invoking a 06 microprogram stored in the local ROM of the terminal 07 8, whereupon the entered numbers and result of 08 calculation can be displayed, e.g. in the lower o9 right-hand corner of the middle pane.
When the nursing workstation 1 receives 11 the various data from the point-of-care terminal 8, it 12 stores it in a patient stack in association with 13 locally generated time and date data, which can be 14 formulated into a report and printed on printer 2 using well known techniques.
16 A preferred structure of the point of care 17 terminal 8 is shown in a block diagram in Figure 4. A
18 microprocessor 20 is connected via address and data 19 buses 21 to a read only memory, shown as EPROM 22, and to a random access memory 23.
21 Keypad 24, which provides the numeric key 22 input functions of keys 16, cursor key 17 and special 23 function keys 18 is connected to the microprocessor.
24 Also connected to the microprocessor is a liquid crystal display controller 25, to which a liquid 26 crystal display 15 is connected.
27 A bar code reader 26 is connected to a bar 28 code wand controller 27, which is connected to a bar 29 code decoder 28, which is itself connected to the buses 21. A serial communication controller 29 is 31 connected to plug 9.
32 The point of care terminal can be powered 33 in one of several ways. For example a power supply 30 34 can contain rechargeable batteries, which are charged by plugging the power supply into a source of primary 36 power. Alternatively a power supply 30 can be 37 connected to a power plug 31 which connects to a low ~, 8 ~
0I voltage (e.q. 24-26 volts DC) Leliable hospital power 02 distribution network. Power supply 30 functions to 03 provide the appropriate voltages to microprocessor 20 04 and other elements in the point-of-care terminal.
o5 The point-of-care terminal operates as 06 follows. Upon plugging the plug 9 into connector 7 at o7 a patient location, and upon applying power via power 08 supply 30 either from a local battery or from a o9 hospital power source via power plug 31, the microprocessor is powered up and accesses an 11 initiation program stored in EPROM 22. The 12 microprocessor sends a signal to LCD controller 25 13 which causes liquid crystal display 15 to display the 14 three panes on the display. The microprocessor also transmits a signal to the nursing computer station 1.
16 In return, the nurse is prompted by the computer to 17 enter the patient's numeric code, e.g. #47836, and her 18 own passcode on keypad 24. ThiS prompt is received by 19 microprocessor 20, which causes display on display 15 through LCD controller 25 of the prompt. The nurse 21 enters the patient code and her own passcode on the 22 keypad. The point-of-care terminal stores the entered 23 data in RAM 23. It is preferred that the patient 24 code, but not the nursels passcode, should be echoed on the display.
26 The nurse then pushes the TX button on 27 keypad 24, which causes microprocessor 20 to access a 28 transmit program from the EPROM 22, and to transmit 29 the data entered by the nurse and stored in RAM 23 through serial communication controller 29, along the 31 LAN to the nursing workstation 1. The nursing 32 workstation registers the data in its memory 3A
33 (Figure 2), and operates a program which checks the 34 validity of the passcode and if it is correct, transmits a validation signal back to the 36 point-of-care terminal through controller 29, which is 37 displayed under control of microprocessor 20 through 01 LCD cont~olleL 25 on display l5.
02 Each nl~rse's code can be maintained at the 03 nuLsing work station in association with one or plural 04 doctors' names, i.e. authorizing only certain nurses 05 receive a list of care elements to perform the care 06 elements on the patient associated with that 07 particular doctor. This provides further security for 08 the patient, in that only certain of the secret 09 nursing codes would be authorized for that particular patient.
11 After forwarding an authorization signal 12 to the point-of-care terminal, which code can be 13 stored in RAM 23, microprocessor 20 is enabled thereby 14 to allow operation of the special function keys 18 to request an outline list or special function list of 16 care elements from the nursing workstation 1 from the 17 patient kardex portion of memory 14 as described 18 earlier. Upon request by a function key being pushed, 19 causing a code stored in EPROM 22 to be sent to the nursing workstation, the so designated memory elements 21 in memory 14 are accessed, and the resulting care 22 elements and attributes data is transmitted along the 23 local area network from workstation 1 through serial 24 communication controller 29 to microprocessor 20, for display via LCD controller 25 on the middle pane of 26 display 15. As described earlier the nurse, after 27 viewing the list displayed on the middle pane, can 28 select by means of function keys 18 any grouped kinds 29 of care elements such as VITALS, MEDS, ADL, ACCESS, PROFILE, or TESTS. When groups of care elements are 31 selected by pressing a function key on keypad 24, 32 microprocessor 20 accesses a specific corresponding 33 code from EPROM 22 and causes it to be transmitted 34 through serial communication controller 29 to the nursing workstation 1. The nursing workstation, as 36 described earlier, selects the specific kinds of care 37 elements with the element attributes from the Ol e1ectronic katdex 14 and 1ibLaLies ll and 13 defined 02 by memoLy 3 as described earlier, and transmits the 03 code back through serial controller 29 for display, 04 also as described earlier, on display 15 at the 05 point-of-care terminal.
06 AS noted earlier, data input via keypad 24 07 is temporarily stored in RAM 23 by microprocessor 20, 08 and is transmitted to nursing station l upon pushing 09 the TX key. A microprogram stored in EPROM 22 causes microprocessor 20 to access the stored data in RAM 23 ll and to transmit it to nursing station l where it is 12 stored (stacked) in local memory 3A, from where it can 13 later be formulated into a report and printed.
14 To speed, make easier, and avoid mistakes in entering the patient code, nurse passcode and 16 doctor number (if the system is set up to accept 17 doctor designation) on the keypad 16, a bar code 18 reader wand 26 is preferred to be used. A barcode l9 wand 26 is connected to bar code wand controller 27.
The nurse can thereby read the patient's code (and 21 doctor's code, if used) from bar code on the patient's 22 wrist band, and her own number from her own 23 identification badge. A bar code decoder 28 decodes 24 the bar code from controller 27 that was applied from reader 26, translating it into parallel bus signals 26 and applying it to bus 21 for reception by 27 microprocessor 20 in place of a code keyed in from the 28 keypad.
29 General operation of a microprocessor and its peripherals is known in the art, and is described 31 in the publication Microcomputer Primer by Mitchell 32 W. Waite and Michael Pardee, published by Howard W.
33 Sams & Co. Inc., Indianapolis, Indiana. The specific 34 programs to provide the algorithms described in this patent application can thus be prepared by such person 36 skilled in the art without the exercise of inventive 37 ingenuity, once the description of the invention 01 herein is understood.
02 In addition to providing a display such as 03 that shown in Figure 3, various more detailed displays 04 can be provided. For example by entering 05 predetermined numeric codes or by providing other 06 special function keys, the nurse can obtain, by o7 prompting the nursing workstation, a list of all of 08 the blood pressure readings for a patient over a o9 course of treatment, listed by date and time. This can allow her to estimate whether the patient has been 11 exhibiting significant variations, or a fairly 12 constant blood pressure over a given period. The 13 attributes which form the various care elements can 14 contain upper and lower limits or thresholds so that when the data transmitted to the working nurse station 16 is received, it can be compared with the limits and an 17 error signal or an alarm signal can be generated for 18 transmittal back to the point-of-care terminal. This 19 can prompt the nurse to reenter the data correctly, or to be alerted to a reading which designates an 21 emergency condition.
22 A list of standard comments can also be 23 provided from the nursing workstation to the 24 point-of-care terminal which can be selected by cursor and/or number and which can be recorded as an 26 integrated nursing note with the set of readings 27 (e.g. "patient uncooperative"). An example of the 28 nursing note ("PATIENT UNCOOPERATIVE") can be seen on 29 the display in Figure 3.
The nurse, by means of a predetermined 31 entry code, can request help instructions stored in 32 the memory at the workstation 1 in association with a 33 particular care element, in order to prompt her as to 34 test procedures, or if she is unsure as to an unusual displayed prescribed dosage, to reassure herself as to 3Ç the range of acceptable dosages, etc.
37 Thus the point-of-care terminal described ~; ~ , "' ~, !, ' Ol helein and the method of operation of the system 02 utilizing that terminal augments and eases the nursing 03 function. It displays a prescribed course of 04 treatment for the patient and aids her in recording of 05 data at the time that it is to be first recorded. It 06 provides the nurse with a complete list of prescribed o7 care elements required for a particular patient, 08 allows her to select specific ones of those care 09 elements for display (thus forming a reminder system), 10 and facilitates entry, as performed, of the results of 11 tests and the nature and amounts of medicines 12 administered with no intermediate recording step on 13 paper, thus avoiding accidental misrecording or 14 accidental duplicate administration of tests.
15 warnings can be provided to the nurse as to out of 16 range entries, out of range test results, etc. which 17 provides an early warning to her of possible errors in 18 administration of care elements, thus increasing the 19 reliability of patient care.
The point of care terminal can be used by 21 a single nurse to administer many patients, thus 22 avoiding the requirement to have one terminal per 23 patient, thus keeping cost to a minimum.
24 Because of the standardized library of 25 care elements and care attributes used universally and 26 recorded in the memory for all nurses and throughout 27 the hospital, there is no possibility of misentering 28 names of tests or medicines, since their designations 29 are automatically generated. All of the above 30 advantages are obtained due to the formation of the 31 memory, wherein electronic kardexes specific to each 32 patient are set up upon prescription of the course of 33 treatment by the physician, and formation of the 34 kardexes out of a library or pool of standard care 35 elements, whi~h themselves are made up of a pool of 36 standard attribute designations. As various care 37 elements are used by many patients in common, and care ~J '~J ~ sJij:~
01 elements use the va~-ious att~ibutes in common, 02 substantial economy o~ memory usage is achieved using o3 the standard predefined and preentered care elements 04 and attributes, allowing a sophisticated, easy to use, oS error avoiding, economical hospital administration 06 system and method of instructing nurses as to care of 07 patients and gathering of test results to be achieved.
08 With the input of data by the nurse in a o9 very easy manner at the point of conducting the tests, administering medicines and other care functions, and 11 since standard care elements and attributes are used, 12 without the requirement of the nurse to spell out what 13 care functions she has performed, the hospital 14 computer system can gather from the nursing work lS station quantities and lists of actual materials used, 16 actual medications used, actual procedures used, 17 accept increments of labor, etc. from the memory 3A of 18 the nursing workstation using predetermined standard 19 designations. This can allow the hospital information system to create standard costs, to input data into a 21 billing system, to calculate labor and material cost 22 of treatment of each patient based on actual 23 procedures performed, and to perform variance analysis 24 of actual vs planned expenditures. It can also facilitate materials ordering, and management of 26 materials, medication and labor flow.
27 A person understanding this invention may 28 now conceive of alternative structures or variations 29 in design which use the principles of this invention.
~11 are considered to be within the sphere and scope 31 of the invention as defined in the claims appended 32 hereto.
Q2 This invention relates to data systems for 03 hospital operation and particularly to a method of 04 operating point of care data terminals.
05 BACKGROUND_OF THE INVE TION
06 Hospital administration staff have 07 attempted to control costs associated with operation 08 of hospitals by implementing computerized 09 administration systems, including bookkeeping systems, material control systems, etc. Such systems, however, 11 require manual input of data into computers from stock 12 control forms, equipment usage forms, time sheets, 13 etc. filled in by hospital staff. This has been prone 14 to error because it depends on the memories of fallible persons, sometimes imperfect diligence in 16 completing the forms by often over-worked personnel, 17 etc.
18 The main function of a hospital, that of 19 patient care, has resisted efficiency introducing machines. The patient care system typically operates 21 with a doctor prescribing tests and courses of 22 treatment, which are carried out by caregivers such as 23 nurses (hereinafter referred to generally as nurses).
24 In this case also, due to human fallability, the times of administration of treatment or testsl completion of 26 all tests, and erroneous recording of the results of 27 tests sometimes occurs, which can have dangerous 28 effects and legal consequences. The collection of 29 data tabulating the quantities of medicines used, the labor involved, and other costs associated with 31 specific patient care is done manually by the nurse 32 recording it on paper, which is prone to error.
33 The present invention substantially 34 automates the above functions providing to the nurse a portable electronic terminal, referred to herein as a 36 point-of-care terminal, that displays on command tests 37 and courses of treatment for an identified patient.
~ ~i h ~ J
01 ~rhe nu~se ~eL~oLms the tests and~or tLeatmerlts, and 02 enteLs the results o~ the tests directly into the 03 teLminal, the system recording the entered data in a 04 standardized format. The system can confiLm the 05 treatment steps and test results already entered, and 06 can warn her of entries outside of predetermined o7 thresholds. This can reduce the incidence of error in 08 tests and treatment, making the job of the nurse o9 easier. The data is recorded in a computer to which the portable terminal is connected and can be 11 collected by the hospital adrninistration computer.
13 A medical information system which 14 standardizes treatment steps is described in the article "Medical Data Dictionary for Decision Support 16 Applications" by S.M. Huff et al of AT~T Bell 17 Laboratories, pp 310-317, 1987 SCAMC, Inc. In this 18 system, precise names of functions performed by the 19 nurse or doctor, are input into a terminal. The article promotes the definition of a standard medical 21 dictionary for use in a medical care electronic 22 information system. The system described utilizes 23 individual pages defining events which are input from 24 a nursing station, each event being a "happening"
relating to a patient, such as writing an order for a 26 medication, the occurrence of pain, the birth of a 27 child, a surgical procedure, etc. Attributes are 28 associated with each event, which are qualitative and 29 quantitative descriptors of the event, with a time of occurrence of the event and a time of recording of the 31 event. Associated with each recorded event is the 32 name or definition of a particular patient or relative 33 of the patient. Operation of the system requires 34 positive recording of the event in the course of treatment of a patient at a central nursing station by 36 personnel who must be trained in the use of database 37 systems. The nurses must know the course of treatment ~ ù ~ J j ~
01 of a patient, which is descLibed to them in the 02 t~aditional of manner. The nurse simply inputs at the 03 nursing station what has occurred according to a 04 w~itten schedule of a course of treatment, or other 05 occurring events involving the patient, and from tests 06 and their results written on paper.
o7 The above-described system contains 08 several disadvantages. Firstly the system by which o9 the nurse gives care to the patient remains exactly as it has always been, that is, that the functions 11 performed by the nurse are recorded by spelling out 12 what functions have been performed. The recording is 13 done at a nursing station at a central location. The 14 nurse first records on paper the results of tests performed, which is then typed into the nursing 16 station computer. Therefore some tests can be missed 17 and errors can occur.
18 Secondly, and importantly, a standard 19 dictionary of terms must be used when the information is typed into the computer for the system to work 21 properly. Misspellings, non-standard (but otherwise 22 understandable) words used by the nurse, result in 23 data which is not accepted or if accepted by the 24 system, cannot be collected by a central computer which expects to receive standard terms. The learning 26 of a set of standard terms from which the nurse may 27 not deviate puts additional burden on the nurse, 28 rather than a relief from burden.
29 Thirdly, all of the data of a group of patients is input into one central location. This 31 provides a significant opportunity to make errors and 32 to miss the inputting of data since nurses are 33 typically busy and sometimes are subject to emergency 34 distractions. Therefore data recorded on paper by the nurse may not be entered into the central computer 36 until long after it is needed by an administration 37 computer, or it may be missed completely.
01 SUMMARY_OF_THE__NVEN_ION
02 The present system, as noted above, o3 includes a small portable point-of-care terminal 04 carried by the nurse which is used by the nurse to 05 input the test results data and treatment steps such 06 as quantities and types of medicines used right at the 07 location and the time of the tests or administration 08 of treatment. The nurse need not memorize or input 09 standard names of medicines or other medical terms.
Further, the nurse need not have a written description 11 of the course of treatment or test which she is to 12 administer on a patient. The exact list of treatment 13 and the exact tests prescribed by the doctor are 14 displayed on her portable terminal and she need merely fill in the blanks of numbers which are the results of 16 tests or quantitites of the medicines shown on her 17 display. She can also invoke and input standard 18 nursing notes. The data input for each treatment or 19 test and nursing notes are automatically transmitted to a central location, such as a nursing working 21 station, for central storage. Each input is stored in 22 association with an automatically generated time 23 entry. The entire sequence of tests, treatment and 24 results or specific categories thereof can be displayed at the point of care terminal so that the 26 nurse can see what tests have already been 27 administered, the results, and she can estimate trends 28 if necessary.
29 The course of treatment for each patient is obtained after inputting a patient code number, as 31 well as a security code associated with the nurse.
32 The same portable terminal can therefore be carried 33 from patient to patient, plugged into a local area 34 network having terminal connectors adjacent each patient bed, for transmission of patient-specific data 36 back to the central station. Therefore the number of 37 point of care terminals need be only equal to the IJ iJ v nl numt)eL of nUISeS on duty at any paLticula~ time, and 02 need no~ be equal in number to the vastly larger 03 numbeL of patients receiving tLeatment in the hospital 04 at a given time. Because the exact course of 05 treatment is available to the nurse at all times on 06 her local display using computer generated instruction o7 terms, and because the results of treatments or tests 08 are input directly into the portable terminal when o9 performed, the intermediate step of marking the results on paper, resulting in errors and missed 11 reports described earlier with respect to prior art 12 proposed systems is avoided.
13 Because all input data is stored in 14 association with a time indication, including separate corrections made to input data, a complete track of 16 patient treatment is permanently recorded, which may 17 be needed later formedical or legal purposes. Since 18 there is no intermediate paper marking step, the 19 possibility of losing or varying the origin document is avoided.
21 Because the exact course of treatment is 22 described by computer, and the quantities of 23 administered medicines and other supplies are directly 24 input on the portable point-of-care terminal, data identifying materials and medicines identification and 26 quantities, and labor involved in treatment of a 27 patient are clearly recorded automatically in a 28 standard format in the central computer. As noted 29 earlier this can be linked to the hospital administration computer, to obtain an accurate 31 inventory track and cost base for treatment of each 32 individual patient. This should substantially help in 33 control of hospital costs, and increase efficiency of 34 operation of the hospital.
The operation of the present invention is 36 based on a novel method of operating a point-of-care 37 terminal wherein there is a central library of 38 predefined patient tasks stored in a central memory.
(J ~) ., 01 ~rhe library is comprised of electronic data storage 02 defining all expected possible tasks involving care of 03 a patient. Each of those tasks is herein called an 04 event (which is distinguished in definition from the 05 form of "event" defined in the aforenoted article).
06 Each event contains a set of attributes. Out of this 07 pool of events, specific events relating to the care 08 of a particular patient forming a group of events, is 09 selected to define the care to be given to a specific patient in an electronic kardex. That group of 11 events, or one or more groups of groups of events, is 12 provided to the point-of-care terminal. The nurse 13 need merely display the list of events specific to an 14 identified patient on the terminal and input the results of tests carried out at times prescribed by 16 the doctor and listed in the list of events shown on 17 the display of the terminal.
18 Stored event definitions required by 19 several patients are used in common. Attribute definitions, defining the events themselves, are used 21 in common by plural events.
22 To provide the above, an embodiment of the 23 invention is a method of operating a point of care 24 terminal comprising storing in an electronically accessable memory associated with a central computer 26 terminal a library of data defining a large number of 27 generic patient care events. Data correspondin~ to 28 certain ones of the care events specific to the care 29 of a particular patient is selected from the libary.
A signal corresponding to an identifier of the 31 particular patient is input into a point of care 32 terminal which is in electronic communication with the 33 central computer terminal. At least one group of the 34 selected data specific to the patient is provided to the point-of-care terminal from the central computer 36 terminal in response to the inputting step. The at 37 least one group of data is displayed at the 0l point-of-care terminal, which defines a group of care 02 events. After per~orming tests on the patient 03 corresponding to the events displayed, the nurse 04 inputs data resulting from the tests into the 05 point-of-care terminal relating to at least certain 06 ones of the group of data defining the group of care 07 events. The data is transmitted to the central 08 terminal, and is stored at the central terminal for o9 subsequent access.
Another embodiment of the invention is a 11 method of operating a point of care terminal 12 comprising establishing a specific patient related 13 electronic kardex formed of data signals defining a 14 group of individual patient care events, each care event being defined by a predetermined collection of 16 possible attributes therefor, each attribute defining 17 a characteristic of the event, selecting particular 18 attributes for a corresponding event related to the 19 specific patient, and displaying the care events with the selected attributes at a point-of-care terminal, 21 whereby an individual care program specific to the 22 patient is displayed to a care giver.
24 A better understanding of the invention will be obtained by reference to the detailed 26 description below, in conjunction with the following 27 drawings, in which:
28 Figure 1 is a block diagram of a system 29 incorporating the invention, Figure 2 is a more detailed block diagram 31 of specific parts of the system illustrated in Figure 32 1 for illustrating the invention, 33 Figure 3 is a plan view of a point-of-care 34 terminal preferred to be used to operate the invention, and 36 Figure 4 is a block digram of the 37 point-of-care terminal of Figure 3.
01 DE8CRIPTION OF_~HE pRE-E-RREn-ElMBoD-IMENT
Q3 Figure 1 is a block diagram used to 04 illustrate the invention. A centLal computer station o5 1 which is used as a nursing station, has a printer 2 06 connected to it in a well known manner and is 07 comprised of a memory 3, 3A. The computer station is 08 connected to a local area network 4. Bridges 5 o9 connect the local area network to branch local area networks 6, which are terminated at connectors 7, each 11 one preferably adjacent the bed of a patient. The 12 branch local area networks are preferably organized by 13 ward, so that the representative branch local area 14 network 6 at the left of the drawing serves e.g. a nursing ward 1 while the branch local area network 6 16 at the right of the drawing serves representative 17 nursing ward 2.
18 Each nurse carries a point-of-care 19 terminal 8, which has a plug 9 that ean be plugged into any of the connectors 7.
21 A hospital administration computer 10 can 22 be connected to the local area network 4 to 23 communieate with station 1.
24 As a nurse makes her rounds, or otherwise takes care of a patient, she plugs her point-of-care 26 terminal 8 into connector 7 adjacent the patient. A
27 list of care events is displayed. She administers 28 medicines, performs tests, and enters the amount of 29 medicine and results of the tests into point of care terminal 8. In the list of care events, a schedule of 31 medicines and tests appears on a display of the point 32 of care terminal, which the nurse can call up by 33 depressing predetermined buttons on the terminal. The 34 amount of medieines and results of tests are similarly entered by pushing buttons on the terminal. This data 36 is transmitted to terminal 1 for storage in memory 3.
37 A block diagram showing certain of the ~ .J t ~
01 abo~e elements is illustrated in ~igure 2, in block 02 diagram at the top with certain elements in more 03 detail below. A nursing work station 1 having an 04 associated memory 3, 3A is connected to point of care 05 terminal 8. The nursing work station is connected to 06 printer 2, which can generate reports 10 under control o7 of the nursing work station 1, which can be a printout 08 of the entire treatment schedule oE a patient, o9 including the times when administered and quantities of various medicines used from data stored in memory 11 3A. The data supporting the report is also made 12 available to the hospital administration computer 13 which is also connected to the nursing work station 1 14 through the local area network 4, so that identification and quantities of medicine, amount of 16 nursing and other labor, equipment used, etc. can be 17 tabulated for administration purposes.
18 An important aspect of the present 19 invention is the organization of the memory 3. This provides means whereby the nurse can be efficiently 21 instructed as to the care events to be undertaken and 22 whereby she can enter the aforenoted results from 23 storage without resorting to memorizing and inputting 24 of standard medical nonenclature. The organization thus provides for efficient use of the point-of-care 26 terminal. The memory 3 is divided into memory 27 elements 12, each of which contains a data signal 28 identifying a patient care event. The total of these 29 elements define a care element library 11 which contains data signals identifying all possible care 31 events. These events define the smallest meaningful 32 unit of care or work involving a patient that can be 33 performed. Each event is comprised of a set of 34 attributes which describe individual characteristics of an event, as well as standard nursing notes, as 36 will be described later.
37 Examples of care events are pulse, blood 38 _ 9 _ ~!J ~ J ~) 01 pressul-e, oncology assessment, psycho-social 02 assessment, diqestive system, heat and cold 03 application, cardiovascular system, hemotology system, 04 neurologic system, oxygen saturation etc.
05 The memory 3 also contains memory elements 06 12A containing data signals defining generic o7 attributes, represented by attribute library 13. The 08 attribute library memory elements contain data 09 representing e.g. site, temperature, degree of assistance, duration, frequency, test name, altered 11 body image, volume of feeding, frequency of feeding, 12 method of delivery, food record frequency, patient 13 position, volume ingested etc. ~ach care element 14 is linked to usually plural attribute elements which define the care element. By maintaining a generic 16 library of care element attributes, many of which are 17 used in common to define particular care elements, a 18 massive library defining each care element and each 19 attribute, separately defined for each patient, is not required. Since each separate care element and each 21 separate attribute for each patient need not be 22 defined, the risk of error in definition is 23 substantially avoided.
24 As an example of the association of standard care elements with standard care element 26 at~ributes, for the care element "temperature", site 27 is the care attribute. For the care element "blood 28 pressure", the attributes are "diastolic" (pressure), 29 "systolic" (pressure) and "site" (of measurement).
The attribute definitions for diastolic and systolic 31 pressures indicate that these pressures require 32 numeric values in a specific range. The attribute 33 definition for site includes alist of possible sites 34 to be used.
When a patient is admitted to the 36 hospital, his course of treatment is prescribed by a 37 doctor. The nurse at nursing work station 1 reserves ~ ~,9 ~ ,J j f' 01 a poLtion of memo~:y 3, lefeLLed to herein as a patient 02 electronic kardex 14. FOL example, if a patient A iS
03 admitted ~or a gallbadder operation, an electronic 04 kardex 14 Leserved for and specific to that patient A
05 is established by control from the nursing work 06 station. FiguL-e 2 also illustrates kardexes for 07 patients B and C.
08 The work station nurse, reading the 09 prescribed course of treatement from the doctor's notes, enters in one memory cell of the kardex for 11 that patient a data signal identifying the first care 12 element, e.q. special preoperative nutrition, which 13 would have the attributes definitions defining food 14 diet. The second care element specified might be hourly psychological assessment, the third might be 16 blood pressure every four hours, the fifth might be a 17 special medicinal tranquilizer to be administered 18 6:00 a.m. the day of the operation, the seventh might 19 be transport to operating room 7:00 a.m., the next might be observation of patient at 10 minute intervals 21 following the operation for the first three hours, the 22 next take blood pressure every half hour for first 23 three hours, etc.
24 Thus a portion of the memory 3 is dedicated to the specific course of treatment of a 26 patient, which course of treatment is formed of care 27 elements, each one of which is formed of care 28 attributes selected from the care element library 11 29 and care attribute library 13 used in common by each patient kardex particular care elements. The result 31 is that each patient is assigned a separate electronic 32 kardex. The memory elements in each of the kardexes 33 14 can simply contain pointers to memory elements 12 34 which define the specific care elements. Each care element defined by memory element 12 can be comprised 36 of pointers to various care attributes defined by data 37 in elements 12A in the attribute library 13. In this 38 - 11 ~
01 manne~ theLe is substantially conservation of memory 02 space and at the same time each patient can have its 03 own individual course of treatment uniquely specified.
04 In operation, the nurse plugs her 05 point-of-care terminal 8 into the network, as 06 described earlier with respect to Figure 1, and enters o7 certain identification indicia, as will be described 08 in more detail below, of the particular patient to be o9 treated, and her passcode identifier. In response the nursing work station 1 accesses the memory 14, and 11 causes display of the care event list relating to the 12 identified patient on the point-of-care terminal 13 display 8. The nurse can thus see which tests are to 14 be administered.
The nurse also select specific categories 16 of care elements defined in kardex 14 to be displayed 17 on her point-of-care terminal, as will be described 18 below.
19 Figure 3 illustrates a preferred form of 20 point-of-care terminal 8 for use in the invention. It 21 is preferably comprised of liquid crystal display 15 22 and a plurality of pushbuttons, e.g. formed of 23 calculator type keys 16 and specialized function keys 24 17 and 18.
When a nurse plugs the point-of-care 26 terminal 8 into a connector adjacent a patient and has 27 initiated communications as described earlier, and 28 will be described in more detail below, and pushes the 29 button of the group of buttons 18 labelled "VITALS", a predetermined data code formed of signals stored in a 31 ROM (read only memory) within the point of care 32 terminal is transmitted to the nursing station 1. The 33 nursing station computer accesses certain of the 34 memory elements in the kardex 14 which are associated with "vitals" care elements for the identified 36 patient. Data for display of "VITALS" is transmitted 37 by the nursing station 1 via the networks 4 and 6 to ~ iJ ~
01 the point-of~caLe terminal 8, which displays only the 02 "VI~ALS" tests from the particulal- patient's kardex 14 03 on the display 15.
04 For example, as may be seen on the display 05 15, the vitals tests of blood pressure (BP), pulse, 06 temperature (temp) and respiration are displayed, 07 coupled with their corresponding attributes, shown as 08 left (L) brachial lying ###.### Hg, left radial o9 ###/min normal, oral ###.###C., ###/min regular 10 eupnea. The nurse recognizes that she is to take the 11 blood pressure at the left brachial position with the 12 patient lying and is to enter the pressure numerically 13 in millimeters of mercury of both dyastolic and 14 systolic measurements. The pulse is to be taken at 15 the left radial position and entered numerically as 16 pulses per minute. The temperature is to be orally 17 taken and entered numerically as C. She is to check 18 the respiration rate and enter it numerically as 19 breaths per minute.
The results of all of the above is entered 21 at screen cursor positions defined by the # indicia 22 using the keypad 16. The particular positions on the 23 screen of the cursor where the values are entered 24 (which may simply be a shading of the particular 25 attribute selected) are controlled by a four direction 26 cursory key 17, which controls the position of the 27 cursor (or a shading) on the display screen.
28 It is preferred that the display screen 29 should be split into three panes. The top pane is 30 preferred to identify the patient by name, sex and 31 identification code, and the name of the doctor, the 32 data of which is sent to the point-of-care terminal 33 from the nursing station after acceptance of the nurse 34 identification (passcode).
The second, middle pane is preferred to 36 display the instructions information and care elements 37 from the memory at the nursing work station, and is 01 used to enteL data such as the results of tests as 02 noted above. It is also used to initially request the 03 identification code of the nurse and of the patient 04 after the point-of-care terminal is plugged into the 05 network to identify a request to communicate.
06 The third, bottom pane is referred to as a o7 dialog pane, and is preferred to provide information 08 to the nurse as to the previous series of tests, such o9 as the data and time a particular selected even~ was last performed, the name of the nurse, the planned 11 frequency of the test, and other information entered 12 at the workstation. The third pane is preferred to be 13 typically used only as an information pane to the 14 nurse.
In the event the nurse wishes to obtain a 16 list of medications to be administered for the already 17 identified patient, she pushes the "MEDS" button, 18 which, as described above, sends a code to the nursing 19 station 1. The nursing station in response accesses the medications care event memory locations in the 21 specific patient's kardex, and transmits those care 22 elements with attributes back to the point of care 23 terminal 8. The list is displayed on display 15 in a 24 manner similar the display of vitals shown in Figure 3, and the nurse can administer the medicines, 26 immediately enter the quantities that have been 27 administered at the corresponding # indicia, etc. In 28 this manner various specific groups of care elements 29 from the electronic kardex of a particular patient can be selected for view by the nurse and entry of the 31 results of tests, etc. The entered data is 32 temporarily stored in a local memory of the 33 point-of-care terminal, and is transmitted to the 34 nursing workstation 1 by the nurse pushing the Tx button on the point-of-care terminal 8.
36 The preferred groups of care elements that 37 can be called up by function button and displayed on 01 the point oF caLe teLminal R is indicated as VITALS, 02 MEDICATIONS, ADL, ASSESSMENT, PArIENT PROFILE, an~
o3 TESTS.
04 A "CALC" key is pushed to convert the 05 numeric keypad into use as a calculator, by invoking a 06 microprogram stored in the local ROM of the terminal 07 8, whereupon the entered numbers and result of 08 calculation can be displayed, e.g. in the lower o9 right-hand corner of the middle pane.
When the nursing workstation 1 receives 11 the various data from the point-of-care terminal 8, it 12 stores it in a patient stack in association with 13 locally generated time and date data, which can be 14 formulated into a report and printed on printer 2 using well known techniques.
16 A preferred structure of the point of care 17 terminal 8 is shown in a block diagram in Figure 4. A
18 microprocessor 20 is connected via address and data 19 buses 21 to a read only memory, shown as EPROM 22, and to a random access memory 23.
21 Keypad 24, which provides the numeric key 22 input functions of keys 16, cursor key 17 and special 23 function keys 18 is connected to the microprocessor.
24 Also connected to the microprocessor is a liquid crystal display controller 25, to which a liquid 26 crystal display 15 is connected.
27 A bar code reader 26 is connected to a bar 28 code wand controller 27, which is connected to a bar 29 code decoder 28, which is itself connected to the buses 21. A serial communication controller 29 is 31 connected to plug 9.
32 The point of care terminal can be powered 33 in one of several ways. For example a power supply 30 34 can contain rechargeable batteries, which are charged by plugging the power supply into a source of primary 36 power. Alternatively a power supply 30 can be 37 connected to a power plug 31 which connects to a low ~, 8 ~
0I voltage (e.q. 24-26 volts DC) Leliable hospital power 02 distribution network. Power supply 30 functions to 03 provide the appropriate voltages to microprocessor 20 04 and other elements in the point-of-care terminal.
o5 The point-of-care terminal operates as 06 follows. Upon plugging the plug 9 into connector 7 at o7 a patient location, and upon applying power via power 08 supply 30 either from a local battery or from a o9 hospital power source via power plug 31, the microprocessor is powered up and accesses an 11 initiation program stored in EPROM 22. The 12 microprocessor sends a signal to LCD controller 25 13 which causes liquid crystal display 15 to display the 14 three panes on the display. The microprocessor also transmits a signal to the nursing computer station 1.
16 In return, the nurse is prompted by the computer to 17 enter the patient's numeric code, e.g. #47836, and her 18 own passcode on keypad 24. ThiS prompt is received by 19 microprocessor 20, which causes display on display 15 through LCD controller 25 of the prompt. The nurse 21 enters the patient code and her own passcode on the 22 keypad. The point-of-care terminal stores the entered 23 data in RAM 23. It is preferred that the patient 24 code, but not the nursels passcode, should be echoed on the display.
26 The nurse then pushes the TX button on 27 keypad 24, which causes microprocessor 20 to access a 28 transmit program from the EPROM 22, and to transmit 29 the data entered by the nurse and stored in RAM 23 through serial communication controller 29, along the 31 LAN to the nursing workstation 1. The nursing 32 workstation registers the data in its memory 3A
33 (Figure 2), and operates a program which checks the 34 validity of the passcode and if it is correct, transmits a validation signal back to the 36 point-of-care terminal through controller 29, which is 37 displayed under control of microprocessor 20 through 01 LCD cont~olleL 25 on display l5.
02 Each nl~rse's code can be maintained at the 03 nuLsing work station in association with one or plural 04 doctors' names, i.e. authorizing only certain nurses 05 receive a list of care elements to perform the care 06 elements on the patient associated with that 07 particular doctor. This provides further security for 08 the patient, in that only certain of the secret 09 nursing codes would be authorized for that particular patient.
11 After forwarding an authorization signal 12 to the point-of-care terminal, which code can be 13 stored in RAM 23, microprocessor 20 is enabled thereby 14 to allow operation of the special function keys 18 to request an outline list or special function list of 16 care elements from the nursing workstation 1 from the 17 patient kardex portion of memory 14 as described 18 earlier. Upon request by a function key being pushed, 19 causing a code stored in EPROM 22 to be sent to the nursing workstation, the so designated memory elements 21 in memory 14 are accessed, and the resulting care 22 elements and attributes data is transmitted along the 23 local area network from workstation 1 through serial 24 communication controller 29 to microprocessor 20, for display via LCD controller 25 on the middle pane of 26 display 15. As described earlier the nurse, after 27 viewing the list displayed on the middle pane, can 28 select by means of function keys 18 any grouped kinds 29 of care elements such as VITALS, MEDS, ADL, ACCESS, PROFILE, or TESTS. When groups of care elements are 31 selected by pressing a function key on keypad 24, 32 microprocessor 20 accesses a specific corresponding 33 code from EPROM 22 and causes it to be transmitted 34 through serial communication controller 29 to the nursing workstation 1. The nursing workstation, as 36 described earlier, selects the specific kinds of care 37 elements with the element attributes from the Ol e1ectronic katdex 14 and 1ibLaLies ll and 13 defined 02 by memoLy 3 as described earlier, and transmits the 03 code back through serial controller 29 for display, 04 also as described earlier, on display 15 at the 05 point-of-care terminal.
06 AS noted earlier, data input via keypad 24 07 is temporarily stored in RAM 23 by microprocessor 20, 08 and is transmitted to nursing station l upon pushing 09 the TX key. A microprogram stored in EPROM 22 causes microprocessor 20 to access the stored data in RAM 23 ll and to transmit it to nursing station l where it is 12 stored (stacked) in local memory 3A, from where it can 13 later be formulated into a report and printed.
14 To speed, make easier, and avoid mistakes in entering the patient code, nurse passcode and 16 doctor number (if the system is set up to accept 17 doctor designation) on the keypad 16, a bar code 18 reader wand 26 is preferred to be used. A barcode l9 wand 26 is connected to bar code wand controller 27.
The nurse can thereby read the patient's code (and 21 doctor's code, if used) from bar code on the patient's 22 wrist band, and her own number from her own 23 identification badge. A bar code decoder 28 decodes 24 the bar code from controller 27 that was applied from reader 26, translating it into parallel bus signals 26 and applying it to bus 21 for reception by 27 microprocessor 20 in place of a code keyed in from the 28 keypad.
29 General operation of a microprocessor and its peripherals is known in the art, and is described 31 in the publication Microcomputer Primer by Mitchell 32 W. Waite and Michael Pardee, published by Howard W.
33 Sams & Co. Inc., Indianapolis, Indiana. The specific 34 programs to provide the algorithms described in this patent application can thus be prepared by such person 36 skilled in the art without the exercise of inventive 37 ingenuity, once the description of the invention 01 herein is understood.
02 In addition to providing a display such as 03 that shown in Figure 3, various more detailed displays 04 can be provided. For example by entering 05 predetermined numeric codes or by providing other 06 special function keys, the nurse can obtain, by o7 prompting the nursing workstation, a list of all of 08 the blood pressure readings for a patient over a o9 course of treatment, listed by date and time. This can allow her to estimate whether the patient has been 11 exhibiting significant variations, or a fairly 12 constant blood pressure over a given period. The 13 attributes which form the various care elements can 14 contain upper and lower limits or thresholds so that when the data transmitted to the working nurse station 16 is received, it can be compared with the limits and an 17 error signal or an alarm signal can be generated for 18 transmittal back to the point-of-care terminal. This 19 can prompt the nurse to reenter the data correctly, or to be alerted to a reading which designates an 21 emergency condition.
22 A list of standard comments can also be 23 provided from the nursing workstation to the 24 point-of-care terminal which can be selected by cursor and/or number and which can be recorded as an 26 integrated nursing note with the set of readings 27 (e.g. "patient uncooperative"). An example of the 28 nursing note ("PATIENT UNCOOPERATIVE") can be seen on 29 the display in Figure 3.
The nurse, by means of a predetermined 31 entry code, can request help instructions stored in 32 the memory at the workstation 1 in association with a 33 particular care element, in order to prompt her as to 34 test procedures, or if she is unsure as to an unusual displayed prescribed dosage, to reassure herself as to 3Ç the range of acceptable dosages, etc.
37 Thus the point-of-care terminal described ~; ~ , "' ~, !, ' Ol helein and the method of operation of the system 02 utilizing that terminal augments and eases the nursing 03 function. It displays a prescribed course of 04 treatment for the patient and aids her in recording of 05 data at the time that it is to be first recorded. It 06 provides the nurse with a complete list of prescribed o7 care elements required for a particular patient, 08 allows her to select specific ones of those care 09 elements for display (thus forming a reminder system), 10 and facilitates entry, as performed, of the results of 11 tests and the nature and amounts of medicines 12 administered with no intermediate recording step on 13 paper, thus avoiding accidental misrecording or 14 accidental duplicate administration of tests.
15 warnings can be provided to the nurse as to out of 16 range entries, out of range test results, etc. which 17 provides an early warning to her of possible errors in 18 administration of care elements, thus increasing the 19 reliability of patient care.
The point of care terminal can be used by 21 a single nurse to administer many patients, thus 22 avoiding the requirement to have one terminal per 23 patient, thus keeping cost to a minimum.
24 Because of the standardized library of 25 care elements and care attributes used universally and 26 recorded in the memory for all nurses and throughout 27 the hospital, there is no possibility of misentering 28 names of tests or medicines, since their designations 29 are automatically generated. All of the above 30 advantages are obtained due to the formation of the 31 memory, wherein electronic kardexes specific to each 32 patient are set up upon prescription of the course of 33 treatment by the physician, and formation of the 34 kardexes out of a library or pool of standard care 35 elements, whi~h themselves are made up of a pool of 36 standard attribute designations. As various care 37 elements are used by many patients in common, and care ~J '~J ~ sJij:~
01 elements use the va~-ious att~ibutes in common, 02 substantial economy o~ memory usage is achieved using o3 the standard predefined and preentered care elements 04 and attributes, allowing a sophisticated, easy to use, oS error avoiding, economical hospital administration 06 system and method of instructing nurses as to care of 07 patients and gathering of test results to be achieved.
08 With the input of data by the nurse in a o9 very easy manner at the point of conducting the tests, administering medicines and other care functions, and 11 since standard care elements and attributes are used, 12 without the requirement of the nurse to spell out what 13 care functions she has performed, the hospital 14 computer system can gather from the nursing work lS station quantities and lists of actual materials used, 16 actual medications used, actual procedures used, 17 accept increments of labor, etc. from the memory 3A of 18 the nursing workstation using predetermined standard 19 designations. This can allow the hospital information system to create standard costs, to input data into a 21 billing system, to calculate labor and material cost 22 of treatment of each patient based on actual 23 procedures performed, and to perform variance analysis 24 of actual vs planned expenditures. It can also facilitate materials ordering, and management of 26 materials, medication and labor flow.
27 A person understanding this invention may 28 now conceive of alternative structures or variations 29 in design which use the principles of this invention.
~11 are considered to be within the sphere and scope 31 of the invention as defined in the claims appended 32 hereto.
Claims (14)
1. A method of operating a point-of-care terminal comprising:
(a) storing in an electronically accessable memory associated with a central terminal a library of data defining a large number of generic patient care events, (b) selecting data corresponding to certain ones of said care events specific to the care of a particular patient from the library, (c) inputting a signal corresponding to an identifier of a group of said care events for said particular patient into a point-of-care terminal which is in electronic communication with the central terminal, (d) providing at said group of said selected data specific to said patient to the point-of-care terminal from the central terminal in response to the inputting step, (e) displaying said group of data at the point-of-care terminal defining said group of care events, (f) inputting response data resulting from the performance of defined care events into the point-of-care terminal relative to at least certain ones of said group of care events, (g) transmitting said response data to the central terminal, and (h) storing the response data at the central terminal for subsequent access.
(a) storing in an electronically accessable memory associated with a central terminal a library of data defining a large number of generic patient care events, (b) selecting data corresponding to certain ones of said care events specific to the care of a particular patient from the library, (c) inputting a signal corresponding to an identifier of a group of said care events for said particular patient into a point-of-care terminal which is in electronic communication with the central terminal, (d) providing at said group of said selected data specific to said patient to the point-of-care terminal from the central terminal in response to the inputting step, (e) displaying said group of data at the point-of-care terminal defining said group of care events, (f) inputting response data resulting from the performance of defined care events into the point-of-care terminal relative to at least certain ones of said group of care events, (g) transmitting said response data to the central terminal, and (h) storing the response data at the central terminal for subsequent access.
2. A method as defined in claim 1 including storing a library of data corresponding to patient care event attributes in said memory, and selecting ones of said attributes to define each of said patient care events.
3. A method as defined in claim 1 including automatically generating a time of entry signal each time said response data is received by the central terminal and storing said time of entry with the response data.
4. A method as defined in claim 3 including inputting corrected response data into the point-of-care terminal in addition to the former response data and separately storing data corresponding to the corrected response data with their time and date of entry at the central terminal, when said corrected response data is received by the central terminal.
5. A method as defined in claim 4 including storing a library of data corresponding to patient care event attributes in said memory, and selecting ones of said attributes to define each of said patient care events.
6. A method as defined in claim 3 including generating a request signal at the point-of-care terminal defining a request for a history listing relating to at least one care event, transmitting the request signal to the central terminal, retrieving at the central terminal a time sequential group of said response data relating to said one care event, transmitting from the central terminal signals corresponding to said sequential group of said data and corresponding times of entry, and displaying at the point-of-care terminal said sequential group of said response data and corresponding times of entry in order of time of input entry.
7. A method as defined in claim 1 including selecting a group of groups of data to define a super event, and providing data signals defined by at least said super event to the point-of-care terminal in response to the inputting of said identifier whereby several events defining several associated tests to be performed on a patient are displayed at the point-of-care terminal.
8. A method as defined in claim 1, including providing from the central terminal to a hospital information system, computer data from said stored response data corresponding to at least one of medication, materials, and labor relating to care events individual to each patient, for hospital management.
9. A method of operating a point-of-care terminal comprising:
(a) establishing a specific patient related electronic kardex formed of data signals defining a group of individual patient care events, each care event being defined by a predetermined collection of possible attributes each attribute defining a characteristic of the event, (b) displaying said care events with said selected attributes at a point-of-care terminal, whereby an individual care program specific to said patient is displayed to a care giver.
(a) establishing a specific patient related electronic kardex formed of data signals defining a group of individual patient care events, each care event being defined by a predetermined collection of possible attributes each attribute defining a characteristic of the event, (b) displaying said care events with said selected attributes at a point-of-care terminal, whereby an individual care program specific to said patient is displayed to a care giver.
10. A method as defined in claim 9, in which the electronic patient related kardex is established by selecting said patient care events from a library of care events stored in a central memory.
11. A method as defined in claim 9, in which each event is comprised of at least one predefined attribute selected of a group of pooled attributes.
12. A method as defined in claim 9, including inputting into the point-of-care terminal in response to the display, response data relating to patient response to tests corresponding to the event attributes in the individual care program, and storing the response data with a time associated with the input of the response data.
13. A method as defined in claim 9 including selecting groups of particular care events for display at the point of-care terminal by operating switches on the point-of-care terminal which are generic to particular kinds of care events.
14. A method as defined in claim 13 in which said particular kinds of care events are at least one of VITALS, MEDICATION, ADL, TESTS and ASSESSMENT.
Priority Applications (6)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA002027000A CA2027000A1 (en) | 1990-10-05 | 1990-10-05 | Point of care nursing system |
| AU85500/91A AU8550091A (en) | 1990-10-05 | 1991-10-01 | Point of care nursing system |
| GB9121072A GB2249851A (en) | 1990-10-05 | 1991-10-03 | Point-of-care medical computer system |
| JP25801991A JPH05101123A (en) | 1990-10-05 | 1991-10-04 | Critical-care-point nursing system |
| DE4132951A DE4132951A1 (en) | 1990-10-05 | 1991-10-04 | METHOD FOR CARING FOR PATIENTS IN A HOSPITAL |
| FR9112496A FR2667709A1 (en) | 1990-10-05 | 1991-10-04 | Methods for operating a treatment ventilation terminal |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CA002027000A CA2027000A1 (en) | 1990-10-05 | 1990-10-05 | Point of care nursing system |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CA2027000A1 true CA2027000A1 (en) | 1992-04-06 |
Family
ID=4146118
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002027000A Abandoned CA2027000A1 (en) | 1990-10-05 | 1990-10-05 | Point of care nursing system |
Country Status (6)
| Country | Link |
|---|---|
| JP (1) | JPH05101123A (en) |
| AU (1) | AU8550091A (en) |
| CA (1) | CA2027000A1 (en) |
| DE (1) | DE4132951A1 (en) |
| FR (1) | FR2667709A1 (en) |
| GB (1) | GB2249851A (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7490049B2 (en) | 2002-03-29 | 2009-02-10 | Medco Health Solutions, Inc. | Patient oriented point of care system and method |
Families Citing this family (11)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB9312849D0 (en) * | 1993-06-22 | 1993-08-04 | Richards John | Data acquisition and processing system |
| GB2301685A (en) * | 1995-06-03 | 1996-12-11 | Simmon Hill | Patient database for hospital records |
| DE19544294C2 (en) * | 1995-11-28 | 1999-09-23 | Udo Simon | Medication monitoring system and method for operating such |
| DE19747353A1 (en) * | 1997-10-27 | 1999-04-29 | Axel Laumer | Patient treatment supervision system |
| DE19822022C2 (en) * | 1998-05-15 | 2002-12-19 | Siemens Ag | Medical system |
| DE19825191A1 (en) * | 1998-06-05 | 1999-12-09 | Karl Heinz Eischer | Patient data management arrangement |
| DE19825978A1 (en) * | 1998-06-10 | 1999-12-23 | Wolf Dieter Goedecke | Data acquisition device |
| DE19922793B4 (en) * | 1999-05-18 | 2004-02-12 | Siemens Ag | Medical device system |
| JP2004174067A (en) * | 2002-11-28 | 2004-06-24 | Hitachi Electronics Service Co Ltd | Measuring device with telecommunication function |
| US7966678B2 (en) * | 2005-12-07 | 2011-06-28 | General Electric Company | Infant care bed with evaluation capabilities |
| CN105232017A (en) * | 2015-10-22 | 2016-01-13 | 韩恭祝 | Critical patient nursing system in department of cardiology |
Family Cites Families (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO1987000659A1 (en) * | 1985-07-19 | 1987-01-29 | Clinicom Incorporated | Patient identification and verification system and method |
| US5101476A (en) * | 1985-08-30 | 1992-03-31 | International Business Machines Corporation | Patient care communication system |
| US4857713A (en) * | 1986-02-14 | 1989-08-15 | Brown Jack D | Hospital error avoidance system |
| US4839806A (en) * | 1986-09-30 | 1989-06-13 | Goldfischer Jerome D | Computerized dispensing of medication |
| EP0283752A3 (en) * | 1987-03-24 | 1990-03-07 | Hewlett-Packard Company | Portable terminal |
| EP0290683A3 (en) * | 1987-05-01 | 1988-12-14 | Diva Medical Systems B.V. | Diabetes management system and apparatus |
| US4878175A (en) * | 1987-11-03 | 1989-10-31 | Emtek Health Care Systems | Method for generating patient-specific flowsheets by adding/deleting parameters |
| NL8902554A (en) * | 1989-10-16 | 1991-05-16 | Nedap Nv | INFORMATION STORAGE AND MONITORING SYSTEM FOR HEALTH CENTERS. |
-
1990
- 1990-10-05 CA CA002027000A patent/CA2027000A1/en not_active Abandoned
-
1991
- 1991-10-01 AU AU85500/91A patent/AU8550091A/en not_active Abandoned
- 1991-10-03 GB GB9121072A patent/GB2249851A/en not_active Withdrawn
- 1991-10-04 JP JP25801991A patent/JPH05101123A/en active Pending
- 1991-10-04 DE DE4132951A patent/DE4132951A1/en not_active Withdrawn
- 1991-10-04 FR FR9112496A patent/FR2667709A1/en active Pending
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US7490049B2 (en) | 2002-03-29 | 2009-02-10 | Medco Health Solutions, Inc. | Patient oriented point of care system and method |
Also Published As
| Publication number | Publication date |
|---|---|
| FR2667709A1 (en) | 1992-04-10 |
| AU8550091A (en) | 1992-04-09 |
| GB2249851A (en) | 1992-05-20 |
| GB9121072D0 (en) | 1991-11-13 |
| JPH05101123A (en) | 1993-04-23 |
| DE4132951A1 (en) | 1992-05-14 |
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| Date | Code | Title | Description |
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| FZDE | Discontinued |