CN1961321A - Method and system for providing medical decision support - Google Patents

Abstract

A medical information management system is disclosed comprising at least one patient record repository that includes information identifying treatments and corresponding outcomes for a plurality of different patients. The system further comprises a query generator for generating a message to acquire information concerning a medical condition of a particular patient from the record repository. The query message initiates the acquisition of information from the record repository including data identifying, (i) a group of patients and a number of patients in a group, (ii) those attributes of the patients in the group which are similar to attributes of the particular patient and, (iii) different treatments associated with a medical condition employed by the patients in the group. The system further includes a data analyzer for analyzing the information acquired by the query generator to provide analysis results including (1) mortality of the patients of the group, (2) the length of patient stay in a healthcare facility of the patients of the group and (3) the cost of treatment incurred by the patients of the group.

Description

The method and system that provide support for medical decision making

The cross reference of related application

This by Alexander Scarlat in the non-provisional application that on May 21st, 2004 submitted to, application number is 60/573,466 provisional application.

1, invention field

The present invention relates generally to the discriminatory analysis field.Particularly, the present invention relates in order to make with the illustration is the system and method that the medical decision making of basis provides support, this system and method comprises the statistical study in existing medical treatment/health care data storehouse, so that be provided at the objective basis of making one's choice between the different treatment methods to patient and/or medical personnel.

2, background of invention

In the whole process that patient administers, relevant its result that cures the disease such as aspects such as mortality ratio, survival period, expenses, will between various health care professional and patient thereof the problem that need make decisions appear progressively all.For instance, following point may appear, for example " with regard to a concrete patient and condition thereof, according to confirmed result, which kind of treatment is best suited for? " decision-making is difficult, because need consider a plurality of special and general factors simultaneously.And, to this questions answer often according to technology or intuition, and non-science.Typical case is: this decision-making by planless observation, out-of-date and usually unverified textbook prescription, general knowledge and doctor and patient kith and kin's personal experience institute about.Therefore, compare with statistical study and other possible quality index of strictness, it not is optimal results that this decision process may cause.

Nowadays clinical workflow, decision support system (DSS) (DSS) and be that the workload of affirmation, analysis, design and execution etc. is extremely huge according to the problem that real example is carried out medical treatment aspects such as (EBM).The work hours that are included in the doctor that comprised in the independent well run job flow process, nurse, statistician, IT professional are too high.

Owing to a plurality of reasons, existing infosystem does not provide enough decision supports, comprises that shortage gets back to the feedback (promptly getting back to patient and medical personnel) of medical care from database/data-carrier store.Therefore, medical personnel and patient do not know to have accumulated bulk information in existing database/data-carrier store, and a large amount of similar part that exists between other patient/conditions and patient's situation.Exist in the existing information system one problem further is between administrative, clinical and different ingredients such as laboratory diagnosis instrument, EBM and DSS, seldom and even not links up.Another problem of existing information system is, typically there is not automatism (promptly check and advise) in the horizontal one-level of data analysis, therefore, in order to carry out data analysis and to make a rule/workflow, the council that has to adopt doctor, nurse, statistician and IT expert by the high salary payment to form.A relevant problem is, the council is within certain hour, and at the quantitative aspects of the rule/workflow that can handle, efficient is very low.Therefore, the rule/workflow of formulation almost has no chance to cover extensive various medical conditions of appearance.The existing information system also has a problem to be, the rule/workflow that manually draws is not in light of the circumstances and specific, and is to feel that according to the participant of the council problem of certain interest works out on the contrary, is devious therefore.The existing information system also has another problem to be, the decision-making of the council typically is subjected to the restriction in its some areas, therefore is not suitable for other areas.Therefore effort and the consequent rule/workflow done in a place not transferablely are used for different geographic areas.In addition, rule and other decision support system (DSS) that the council that is made up of manpower draws are because the variation of demography, epidemic disease, prevention and therapeutic modality etc. was run ragged within a relatively shorter time limit.

Summary of the invention

The present invention is directed to the above-mentioned and other deficiency of prior art, providing a kind of is the medical decision support systems and the correlation technique of basis with the illustration, this system and method utilizes existing Database Systems, automatically draw information by specific inquiry and statistical study, thus with the information that draws near feeding back to the user in real time.Advantageously, the information through correcting process can help medical personnel or patient, goes up reliable, suitable and unbiased illustration according to statistics, makes a policy between different diagnosis and/or therapeutic modality.

It is the medical decision support systems of basis with the illustration that some typical embodiments of the present invention provides a kind of, and this system comprises at least one patient and writes down bunker, comprises a plurality of different patients' the diagnosis and treatment and the information of accordingly result; An inquiry generator, be used to produce following Query Information: from least a medical conditions of at least one bunker acquisition about a concrete patient, one group of patient that identification and concrete patient have at least a medical feature jointly, identify a son group from patient's group of having discerned, wherein each patient in each son group accepts a kind of common treatment; A data analyzer, the statistical significance that is used for the patient of child group that each has been discerned is analyzed, analyze concrete patient and each sub patient's who organizes the demography and the similar part of clinical attributes, each son group mortality in said patients, each son group patient is in the time of healthcare facility stop, each son group patient's medical expense, and the result that will analyze feeds back to the user.

In certain embodiments, may adopt additional quality indication, for instance, for example, the fate that the patient spends in special nursing, the fate of mechanical oxygen uptake, the fate of in certain critical point, having a fever, or the like.

In addition, in certain embodiments, except contrasting different therapeutic modalities as mentioned above, can also in addition or replace different diagnostic form is compared.But, should be understood that the structure that does not also have anything to receive an acclaim at present, be used for symptom, sign and the interests/risk ratio of different diagnostic form is classified.

Description of drawings

By following the detailed description and the accompanying drawings, can understand the potential of a wide series better

Embodiment, wherein:

Fig. 1 is for being the structural drawing of a typical embodiments of medical decision making support (EBMDS) system 1500 of basis with the illustration according to an embodiment;

Fig. 2 is the process flow diagram according to a typical embodiments of the method that is used for managed care information 2000 of an embodiment;

Fig. 3 illustrates a typical last statistics 3000 that is sent to the user according to an embodiment.

Definition

When following term used in this article, it was defined as follows:

Clinical---about present illness and situation (with ICD-9 or ICD-10 coded representation), mistake Journey (with the DRG coded representation), the treatment (with the same clan and the original plan representation that makes up a prescription of medicine, For example " low dosage β-blocking agent ") patient data.

Data-analyzing machine---module is used for calculating (1) concrete patient under consideration and every Statistical similarity between the individual subgroup of having identified, the difference between (2) different subgroups, example As, the difference aspect the result.

Database---one or more persistant datas in groups, common and software upgrades also together Data query together. A simple database can be a simple literary composition that comprises a plurality of records Part, wherein single record adopts identical field groups. Database can comprise a map, Wherein mark various symbols according to different key elements, for example identity, physical location, in network Position, function etc.

Demographic situation---about the patient data of basic characterising parameter, for example age, height, body weight, postcode, marital status, race.

Executable application program---be used to carry out the code or the machine readable instructions of predetermined function, comprise the instruction of operating system, health care information system or other information handling system, for example, respond the instruction of user instruction or input.

Executable program---a joint code (machine readable instructions), subroutine or other visibly different code joint or the executable application program of part, be used to finish one or more special processes and can comprise the input parameter that receives (or responding the input parameter that receives) is operated, and the output parameter that is produced is provided.

Information---data

Medical treatment attribute a---patient's a kind of medical characteristic, for example, the treatment that the patient accepts, comprise the main treatment intervention that the patient stands, for instance, for example coronary artery bypass graft surgery (CABG) or through skin through pipe coronary angioplasty (PTCA), the key property of perhaps relevant patient's medical treatment, for example age, sex, body weight etc.

Form---a kind of medical diagnosis or methods of treatment.

The connection of network---two or more information equipments is used for shared resource (for example printer or CD-ROM), swap file or allows to carry out electronic communication therebetween.The information equipment on the network can be undertaken by various Wirelines or wireless medium physically or communication on connection, for example cable, telephone wire, power lead, optical fiber, radiowave, microwave, ultrabroad band ripple, light beam etc.

Target---comprise a data grouping, executable instruction when using herein, or the combination of the two, or an executable program.

Patient---the predetermined people who is medically treated, has been admitted to hospital or has been medically treated.

Processor---the processor that uses herein is an equipment and/or the one group of machine readable instructions that is used to finish the work.When using herein, processor comprises in hardware, firmware and/or the software any one, or their combination.A processor acts on information by an executable program or a station information equipment, information is operated, analyzes, revises, is changed or transmission information, and/or information is delivered to output device.A processor can use controller or microprocessor, perhaps has this two performance.

The inquiry generator---be set at the module that an existing database is produced inquiry, with the similarity between the patient of a patient in definite research and a super group.

Bunker---storer and/or database.

Similarity---two or multinomial between a kind of common situation or shared characteristic, can go up the statistical calculated value that calculates at arbitrary scale (1～10) by one and represent, the similarity degree between the concrete patient in pointing out to study and each the fixed son group.

Server---a kind of information equipment and/or software for other information equipments that has connected by network, provides some service.

Statistical significance---measure with p value and/or fiducial interval (CI).

User---patient's medical personnel.

User interface---be used for delivering information and/or requiring to provide a kind of instrument or the equipment of information by the user to the user.User interface comprises a kind of in text, diagram, audio frequency, video and animated element at least.

Web browser---be used for searching a kind of software application with display web page.

The website---share the set of the webpage of a URL, for example www.ibm.com.

Describe in detail

The system that sets up according to principle of the present invention has reduced the various importance that contain factor with prejudice in the medical decision making process, and the information of the correct statistics that draws automatically the data that the healthcare information system (for example administrative, financial, clinical IT system) from existing employing diagnostic analysis that replaces is accumulated.Native system is regardless of identification ground and helps medical personnel and patient, according to sound, suitably, do not contain the illustration of prejudice on the statistics, make the higher decision-making of information content, thereby between data that existing medical information system has been accumulated and daily medical practice, set up the bridge of communication.

Native system and method are derived information automatically, these information be regardless of identification ground help medical personnel and patient different, between based on the medical diagnosis of statistical study case and/or therapeutic modality, make decisions.The user can obtain the two or more diagnosis or the statistical of therapeutic modality, by relatively, last user can recognize and anyly in several treatments considered or the diagnostic mode preponderating aspect following at least three core parameters: mortality ratio, the residence time, expense.In several different embodiments, outside three core parameters, can also add some parameters in addition, for example the time that stops a critical medical care unit, the time of mechanical oxygen uptake, other quality index of patient satisfaction etc.

Here, native system is described under the background of medical treatment and nursing, and discusses as an example.Being skillful in this operator is bound to please oneself: native system can be applied to require according to correct statistics, suitably, not contain the illustration of prejudice, and uses the data that accumulated, any actual conditions of making the higher decision-making of information content.

Except above-mentioned various characteristics, native system is compared with prior art system, also have some concrete feature and advantage, part is listed below: for what carry out on medical care center or the network such as the Internet is that the curative activity (EBM) of basis facilitates with the illustration, thereby improve the oeverall quality of medical care, and reduction expense; Eliminate human input in the decision process about the medical illustration of employing in EBM, thereby reduce expense in a large number; Compare with the council that forms with manpower, significantly increase the quantity of illustration, decision-making, rule, workflow, sizable a group patient degree similar to patient on statistics improved greatly; The elimination nature is present in the artificial prejudice in illustration/decision-making/rule/workflow inventory; Improve the quality of decision-making; Automatically increased all discoveries, illustration, rule or the workflow conspicuousness aspect quantity statistics; Patient's experience of presenting to system is increased to automatically in the database of system and goes, progressively to increase the diagnosis capability of improvement system; With different locale languages and/or in different cultural environments, carry out native system, and do not need special form or otherwise designed; Comprised the different diseases and the coded system of process, and needn't design again, coding or test more again; On different hardware, operating system, database platform, implement native system, and do not need to carry out a large amount of design again or technological transformation; The glad degree of decision support system (DSS) (DSS) that adopts of user increases, and shows just and objective to data and data analysis simultaneously.

The various parts that shown described herein can comprise hardware components (for example discrete electronic circuit), software section (for example computer programming), perhaps this any combination of two kinds.System of the present invention can carry out on any suitable computing machine of operation such as UNIX, Windows NT, operating systems such as Windows 2000, WindowsXP.Obviously, along with the change of technology, in the future may other computing machines of more glad usefulness and/or operating system.Can adopt the instrument that to research and develop on the commodity, and be equipped with special plug-in card program, implement system described herein.

Operating environment

Refer now to Fig. 1, what show here is to be the medical decision support systems (EBMDS) (after this reference number is a system 1500) of basis with the illustration.System 1500 comprises inquiry generator 106, statistical analyzer 108, communication processor 110.As shown in the figure, system 1500 can arrange to import from reception data such as a plurality of subscriber equipmenies 104,105 simultaneously, operates each user's browser (for example microsoft the Internet detector).Client applications the 16, the 17th couples together and can communicate by letter, for example, and through communication processor 110, by the 111 arrival systems 1500 of the network such as the Internet.System 1500 is connected to an existing data-carrier store 109, and this storer comprises a plurality of existing medical treatment/health care data storehouse, promptly administrative database 119, financial database 121, clinical database 123.Other embodiments may comprise different database combinations, be by the application program decision-making.

Mode of operation

When operation, a user 102 is positioned at other customer equipment 104 of a branch, is that patient's (not shown) is made patient parameter data and patient data 20.Here, user 102 has clearly stipulated medical personnel.Patient parameter data and patient data 20 comprises demography and clinical data.The consensus data may comprise for example age, sex, body weight, height, postcode.Clinical data may comprise for example medical diagnosis, existing treatment, existing diagnosis, physical condition classification.Existing patient diagnosis may comprise that for example the patient suffers from pectoralgia (ICD code 786.50), angina pectoris (ICD code 413.9), chronic ischemic heart disease (ICD code 414.9) now, and suffers from diabetes (ICD code 250.02), fat (ICD code 278.00), hypertension (ICD code 401.1) in addition.

Patient's supplemental characteristic 20 is delivered to inquiry generator 106 on network 111, network 111 can be wired or wireless network, or its certain combination.In one embodiment, network 111 is the Internets.Should be noted that, at least a part of supplemental characteristic 20 of patient can be stored in the existing data-carrier store 109 in advance, in the case, in order from thesaurus 109, to visit the patient parameter data and patient data 20 of storage in advance, user 102 needs to connect same suitable patient's identifier (for example social security number) together, transmits supplementary data.In case on inquiry generator 106, received patient's supplemental characteristic, just patient parameter data and patient data 20 is analyzed, produce multiple specific inquiry 25 (for example inquiry (1), inquiry (2) ...), inquiry 25 returns existing data-carrier store 109, (for example inquiry (1) → Query Result (1) is inquired about (2) → Query Result (2) to draw corresponding ad hoc inquiry result 35 ...).Ad hoc inquiry result 35 has determined super a group of patient that has similar demographic attributes to the patient, and further is divided into a plurality of son groups with fixed super group according to main treatment intervention.For example, the patient who is made up of a son may stand coronary artery bypass graft surgery (CABG), as a kind of form of main treatment intervention, and the patient of second son group may stand through skin through pipe coronary angioplasty (PTCA), as second kind of form of main treatment intervention.The 3rd group of patient may not stand any main treatment intervention, is called " only healing with medicine " (promptly without any program surgery or invasive) here.

In case receive ad hoc inquiry result 35, statistical analyzer engine 108 is just made two mensuration.First mensuration relates between patient and the fixed son group and has or not similarity at aspects such as demography and clinical attributes statistics.Demographic statistics similarity can be added up with regard to for example attribute of aspects such as height, body weight, postcode and sex.The clinical statistics similarity can be added up with regard to the attribute of aspects such as medical diagnosis for example, present treatment and health classification.

By second mensuration that statistical analyzer engine 108 is made, be to determine whether the diagnosis/therapeutic modality of a specific child group is better than the diagnosis/therapeutic modality of other son groups.

Point out the information of the diagnosis/therapeutic modality of each height group, feed back to the user 102 who is positioned at customer equipment 104, as the final statistics 72 (as shown in Figure 1) of a cover, together with above-mentioned two mensuration, the closed loop of formation information is carried out method feasible on the statistics of diagnosis/treatment thereby offer user 102 (being medical personnel) for the patient.Show a complete set of final statistics 72 and statistical significance (be shown in Fig. 3, and be described below) thereof to user 102./ clinical statistical significance demographic except determining, statistical analyzer engine 108 also is identified for the relevant p value of comprehensive α and β error.The p value is well-known and a generally acknowledge statistical parameter, relatively each the group between difference the time, the p value quantizes (to see Intuitive Biostatistics (ISBU 0-19-508607-4) to the statistical probability of accepting false supposition or the correct hypothesis of refusal, Harvey Motulsky work, Copyright 1995, Oxford University Press Inc.).For instance, do not add up difference when existing, accepting has a statistics difference between two son groups; Perhaps opposite, accept not add up difference between the son group, and in fact have a statistics difference to exist.The comprehensive definition of probability of the statistical error of these types is the p value.Can be used to measure other statistical parameters of similarity and difference according to principle of the present invention.

Example

According to process flow diagram shown in Figure 2, describe native system and method for example now, this process flow diagram is the top level flow of a typical embodiments that is used for the method 2000 of managed care information.

In movable 205, the patient runs into a health care supplier or has the individual of research interest.During the meeting, a kind of in two kinds of situations appearred.In first kind of situation, the pith of known required patient information is stored in the available data storer 109 in advance, in this case, provides side information by the patient when meeting with.Under second kind of situation, patient information is not stored in the existing storer 109 in advance, but is input to system 1500 by other customer equipment 104 of a branch when meeting with.Information of collecting from the patient when meeting with and/or the information that finds from available data storer 109 comprise demographic and Diagnostic parameters (for example special diagnosis sign indicating number).Typical Diagnostic parameters comprises the special ICD9 diagnosis sign indicating number that is used for minor illness, for example obesity, Non-Insulin Dependent Diabetes Mellitus, hypertension and stable angina pectoris.

In movable 210, the patient information that employing activity 205 provides, 1500 pairs of available data storeies of system, 109 first ad hoc inquiries of operation, i.e. inquiry (1) has the patient of similar demography to the patient and Clinical symptoms " super group " with identification.Typical first inquiry is as follows:

Inquiry (1) → retrieval similarly super group of patient aspect patient's demographic data, for example the patient is in analog year age group (+/-5 years old), identical sex, similar financial position, lives in (for example postcode) in the zone of reasonably approaching the patient, has similar height and body weight (+/-10%), and have at least a following clinical problem: obesity, hypertension, Non-Insulin Dependent Diabetes Mellitus, stable angina pectoris, and with the drug therapy of β-blocking agent, nitrate and ACE inhibitor combination.

In movable 215 " really stator pack ", super group of in movable 210, producing of utilization, second ad hoc inquiry of 1500 pairs of available data storeies of system, 109 operations, i.e. inquiry (2), " super group " is divided into two or more son groups, a feature during the main treatment that each son group is lived through with patient in " super group " is intervened as the son group.For example, one child group can be called " only healing with medicine " son group, and another height group can be called " through skin through the pipe coronary angioplasty " son group, and the 3rd child group can be called " cononary artery bypass " son group.It is as follows to be used to divide an example that surpasses second inquiry organizing:

Inquiry (2) is super component a plurality of son groups according to main treatment intervention.

Carry out second inquiry, i.e. inquiry (2), the result produce the child group comprise patient's subclass from original super group.For example, " cononary artery bypass " child group can be made up of 3110 patients, and " through skin through the pipe coronary angioplasty " child group can form by 3775 patients, " only healing with medicine " child group can comprise 5822 patients.

Second Query Result, be Query Result (2), the result who is provided preferably also comprises: for example, and patient's quantity, the upper and lower bound at age, mean age and intermediate ages, standard deviation, the upper and lower bound of body weight/height, average and middle body weight and height in the son group.For cause clearly, these additional parameters are not shown among Fig. 3.

In movable 220, for the child group of having been discerned in above-mentioned movable 215, inquiry generator 106 search available data storeies 109 are searched correlated results.Correlated results is defined as herein at least with three core parameters: the minimum value of mortality ratio, the residence time, expense is represented.For example, be defined as (i) mortality ratio in 1 year, 3 years, 5 years for a correlated results of child group according to the child group, the time that (ii) in hospital facility, stops, mean value, intermediate value and upper and lower bound with fate are weighed, the (iii) mean value of expense, intermediate value and upper and lower bound, dollar with each patient (and annual) cost in every month calculates, and expense is by diagnosis and treatment measure decision-making.But, should be noted that in other embodiments, except that three core parameters, may adopt other parameters, for instance, for example, the antibiotic fate of intravenous injection, the fate of spending in critical care is to the fate of patient with the pipe feeding, the composite factor of patient satisfaction, the fate that the patient spends on lung ventilator, or the like.

In movable 225, the similarity degree for the clinical and demographic situation aspect between patient clear and definite in the activity 215 and each the height group quantizes.In one embodiment, this degree can be unified numeral, and for instance, for example, a numeral in 1 to 10 scale wherein, does not have similarity between 1 patient who represents in patient and the son group, and 10 representatives are all similar.

In movable 230, the statistical significance of the difference between the different son groups is analyzed.Specifically,, with regard to its statistical significance, whether be better than the relevant diagnosis/therapeutic modality of each son group, will make resolution at this with other for relevant with a concrete child group determining in movable 215 a concrete treatment and/or diagnostic mode.For example, if determine to find a son group 3774 patients are arranged, mortality ratio is 1.3%, and another height group has 3110 patients, and mortality ratio is 1.6%, then constitutes 0.3% difference, is important on statistics.Difference and middle groups and the inner variation difference of organizing between each son group and the contained individual quantity thereof considered in this analysis.This analysis can be carried out in plural son group, and net result indicates a son group and is different from other each son groups.The simplest net result is to find difference between each son group or big, or little.

In movable 235, by communication processor 110 feedbacks, on user interface, for example customer equipment 104 from system 1500 for diagnosis/therapeutic modality, and near delivering user 201 in real time, its form is for the image that shows and/or report, and/or e-file.In addition, analysis result can be because of various objectives, and appends on other medical informations, and its purpose includes, but are not limited to, and communication, shows and stores.In different embodiments, analysis result can or append on other medical datas automatically, perhaps adds for the instruction of responding the user.Analysis result also can be arranged for concrete diagnosis and/or metacheirisis to the patient, and appends on other medical informations.

Fig. 3 is illustrated under the situation of three son groups determining in movable 215, by typical case's output 3000 of system's 1500 generations.These three son groups fixed according to a main treatment intervention characteristics (promptly " only heal with medicine ", " through skin through managing coronary angioplasty ", " coronary artery bypass graft surgery ").

In typical case's output shown in Figure 3, the patient can be advised by the user, on other treatment, selection is treated through the pipe coronary angioplasty through skin, this is because demonstrate relatively mortality ratio of the best (minimum) through skin through the pipe coronary angioplasty, promptly 1.3%, this statistics connotation after 5 years is tangible.It is the shortest that " through skin through the pipe coronary angioplasty " son group also demonstrates the fate of spending in hospital, and promptly 3.2 days, and also full payment is minimum, and promptly 21000 dollars.Being noted that when the information that provides is measured less than 0.05 (statistical error less than 5% comprehensive probability) with the p value, is important on statistics.

The patient can learn that also " through skin through the pipe coronary angioplasty " is available up-to-date treatment in existing three options, and it is 8.4 years that the patient follows the trail of.But, notice that also similarity degree of patient and " cononary artery bypass " group is the highest, still, so, perhaps the patient is without access to the patient's of " through skin through the pipe coronary angioplasty " son group success ratio.Though invention has been described with reference to specific embodiment, should understand, under the situation that does not break away from the spirit and scope of the present invention that propose in the accessory claim, can also take a plurality of variation schemes.Therefore, instructions and accompanying drawing be just as example, rather than be used for limiting the claims scope.

Claims (12)

1, medical information management system comprises:

At least one patient record repository, in this record repository relevant for identification a plurality of different patients' the treatment situation and the information of accordingly result thereof;

An inquiry generator is used for for from described at least one storage vault, obtains about the information of a concrete patient medical situation and proposes a query messages, and described query messages is set about acquisition of information and comprised the data that are used for determining following situation,

A plurality of patients in one group of patient and this group,

Described patient in the described group attribute similar that have to attribute described concrete patient,

The relevant different treatments of medical conditions with described patient's group;

A data analyzer is used for described acquired information is analyzed by parameter, so that analysis result to be provided, comprises

Mortality in said patients described in described group,

The time span that the patient stops in health care facility described in described group,

Patient's medical expense described in described group.

2, a medical decision support systems comprises

At least one patient record repository is wherein relevant for a plurality of different patients' of identification the treatment situation and the information of accordingly result thereof;

An inquiry generator is used to produce query messages, for:

(i) obtain demography and clinical information from described at least one storage vault about described concrete patient,

(ii) discern one group of patient with the total at least a medical attribute of described concrete patient,

(iii) identification patient is organized from the patient who has identified organizes, and wherein, each patient during a son is organized accepted a kind of common treatment;

A data analyzer is used for:

(i) first statistical significance of similarity between described concrete patient of analysis and the single child group that has identified, described similarity relates to the demography and the clinical attributes of a described concrete patient and a single son group;

(ii) analyze second statistical significance of similarity between at least two child groups of having discerned, described similarity relates to:

(a) the described mortality in said patients in each described son group,

(b) time span that the described patient during described single son is organized stops in health care facility,

(c) medical expense of the described patient in the described single son group;

(iii) respond first and second statistical significance analyses, analysis result is provided.

3, according to the system of claim 2, comprising:

A communication processor is used for described analysis data are delivered the user, is according to following a kind of form at least: (a) display image, and (b) report, (c) e-file, wherein

The data that comprise identification age, sex, height, body weight, postcode, socioeconomic status, marital status, race about described concrete patient's described demographic information.

4, according to the system of claim 2, wherein

Described clinical information about described concrete patient comprises Diagnostic parameters.

5, according to the system of claim 2, wherein

Described particular diagnostic parameter comprises ICD9 diagnosis sign indicating number.

6, according to the system of claim 2, wherein

Described similarity about described clinical attributes comprises: medical diagnosis, current treatment and health classification.

7, according to the system of claim 2, wherein

According to the described similarity between described patient and the described single child group of having discerned, determine that the concrete child group of having discerned the child group that all have been discerned with other compares, whether more effective diagnosis/therapeutic modality is provided.

8, according to the system of claim 2, wherein

Described patient's group of having discerned is exactly that main treatment is intervened with the described main medical characteristics that described concrete patient is had jointly.

9, according to the system of claim 2, comprising:

The user interface that one or more display images are provided, this display image comprise user's optional image element, make the user can set about showing described analysis result, wherein

Described analysis result is attached on following at least a other medical informations: (a) communication, (b) show, (c) stores.

10, according to the system of claim 9, wherein

Described analysis result is at least: (a) additional automatically or (b) be attached in the answer to user's instruction.

11, a kind of medical information management system comprises:

At least one patient record repository is wherein relevant for a plurality of different patients' of identification the treatment situation and the information of accordingly result thereof;

An inquiry generator is used for for from described at least one storage vault, obtains about the information of a concrete patient's medical conditions and proposes a query messages, and described query messages is set about acquisition of information, comprises the data of discerning following various situations,

A plurality of patients in many group patients and one single group,

The described patient attribute similar in described each group to described concrete patient's attribute,

The relevant different treatments of medical conditions with described each patient's group; With

A data analyzer is used for the described information of having obtained is analyzed by parameter, comprising:

With single group of relevant mortality ratio in described many groups,

With the single group of time span that relevant patient stops in health care facility in described many groups,

With single group of relevant medical expense in described many groups.

12, according to the system of claim 11, wherein

Described data analyzer adopts statistical method, quantizes the similarity degree of patient and each described patient's group, and described data analyzer determines according to described fixed statistical significance whether the difference of the parameter between each single group in described many groups is important.

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