FR2819319A1 - Device of collection and processing of medical information by processing of handwritten information has manual data entry device that may enter part to primary information - Google Patents

Abstract

An electronic case (12) includes on its front face (13) a device for receiving and positioning of a handwritten slip (2) of given format of a primary information (24). A device (16) may automatically read of at least a part of the primary information from the handwritten slip. A manual data entry device (18-20) may enter a part to the primary information. The case (12) contains information recording-processing device.

Description

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 The present invention relates to a device for collecting and processing information of a medical nature, this device being in particular intended for use in a hospital environment.

 In a hospital, medical prescriptions are ordered by a responsible doctor, according to a process that is fairly specific to the hospital environment. The doctor's decisions are handwritten on a slip, which is then managed by a nurse or another person from the healthcare team. This person transcribes the medical instructions of the doctor on documents, themselves of various nature according to the prescribed prescription. For example, she writes injectable type prescriptions on red sheets, oral prescriptions on green leaves, para-clinical exam prescriptions, etc. on yellow sheets. Then, this set of documents will be used to fill in a prescription sheet for the patient, as well as schedules for the scheduling of specialized examinations, specific care to be administered to the patient, etc.

médicament peut être augmentée ou diminuée. A chaque fois, la nouvelle instruction, aussi simple soit-elle, suit le même processus de gestion que la prescription initiale. Tout ceci aboutit à faire en sorte que le traitement prescrit soit bien délivré au patient, ou qu'une décision d'examen ou de soin particulier soit bien exécutée. During the patient's hospital stay, the doctor's prescription may itself change; for example, the dosage of a

medication can be increased or decreased. Each time, the new instruction, as simple as it is, follows the same management process as the initial prescription. All this results in ensuring that the prescribed treatment is delivered to the patient, or that a decision of examination or special care is well executed.

 This traditional system of prescription and management is based on handwritten documents, and it remains purely manual, which makes its use tedious and incompatible with modern means of electronic data processing.

 To date, IT solutions have also been proposed, allowing the physician's prescription to be entered directly on a computer keyboard or the like, or on a touch screen. As an example, US Pat. Nos. 4,281,330 and US Pat. No. 4,293,845 can be cited. These systems are very difficult to implant in hospitals, due to practical problems and also reluctance, in particular by doctors, to adopt an all-computer system.

 In this regard, it is recalled that the written document, signed by the doctor and the nurse, remains to this day the only real means

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 allowed to authenticate a prescription and keep track of it over time, as forensic evidence. The electronic signature is not always accepted in the medical environment and, in any case, it is not easy to implement in the hospital environment.

 The present invention aims to avoid the drawbacks of the two existing systems, one purely manual and the other purely computer, mentioned above, while benefiting from their respective advantages. In other words, this invention proposes to provide a new system which, while preserving written documents on the basis of the prescription, makes it possible to benefit from the capacities offered by a computer processing, in order to lighten and simplify the tasks. Management.

pour utilisation en milieu hospitalier, pour la transcription d'une information primaire manuscrite, telle que prescription médicale, en une information de type électronique, le dispositif comprenant essentiellement un boîtier électronique comportant, sur sa face supérieure, d'une part des moyens de réception et de positionnement d'un bordereau manuscrit de format préétabli, portant l'information primaire, et d'autre part des moyens de lecture automatique d'au moins une partie de l'information primaire portée par le bordereau manuscrit et/ou des moyens pour l'entrée manuelle de données correspondant au moins pour partie à ladite information primaire, le boîtier renfermant des moyens d'enregistrement de cette information et de ces données.

To this end, the subject of the present invention is a device for collecting and processing information of a medical nature, in particular

for use in a hospital environment, for the transcription of handwritten primary information, such as a medical prescription, into electronic information, the device essentially comprising an electronic unit comprising, on its upper face, on the one hand reception means and positioning a handwritten slip of pre-established format, carrying the primary information, and on the other hand means for automatic reading of at least part of the primary information carried by the handwritten slip and / or means for manual data entry corresponding at least in part to said primary information, the box containing means for recording this information and this data.

Thus, the proposed system keeps handwritten slips, on which the doctor will initially formulate his prescriptions, in particular by filling in a handwritten way a certain zone, and by also specifying certain elementary instructions for example by checking boxes, this set of data constituting the primary information. The slip, in paper, is pre-formatted in correspondence with the electronic box on which this slip, once filled, will be placed for the computer recording of the data, by a transcription which can be partially manual and partially automatic.

 To this end, the electronic unit advantageously comprises, on its upper face, wedging means for immobilizing the

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 handwritten slip in a predetermined position, matching the various areas of said slip with the automatic reading means or the manual data entry means, provided on the upper face of the electronic unit. The means for wedging the handwritten slip can be constituted by a lug, peg or the like, provided on the upper face of the electronic unit itself or on a separate frame intended to be applied in a predetermined position on said unit.

de lecture automatique, portés par le boîtier électronique, comprennent des moyens de reconnaissance des marques d'identification portées par le bordereau. En effet, il est important de pouvoir identifier le patient luimême, pour lui associer les prescriptions le concernant personnellement. Preferably, the handwritten slip bears identification marks, in particular of identification of a patient, and the means

automatic reading, carried by the electronic unit, include means for recognizing the identification marks carried by the slip. In fact, it is important to be able to identify the patient himself, to associate the prescriptions concerning him personally.

 According to a preferred embodiment of the invention, the electronic unit has on its upper face, in addition to a keyboard and / or specific and / or customizable buttons or keys, at least one screen usable for the input of primary information. and other data, and / or for the display of processed information.

 Advantageously, the screen of the electronic unit is a touch screen, designed for direct manual entry of data and / or instructions.

 The screen of the electronic box, and the positioning of the handwritten slip on said box, can be such that at least a part of the slip covers at least a part of the screen, so as to allow the transfer of at least a part primary information directly from the slip on the screen.

peut être aussi prévu pour la lecture de l'information primaire, portée par la zone du bordereau débordante sur l'écran, par pression exercée en des points de cette zone. In the latter case, and if the screen is a touch screen, this screen

may also be provided for reading the primary information, carried by the area of the overflowing slip on the screen, by pressure exerted at points in this area.

As a variant, or in addition, the device is intended to be used with a slip comprising one or more cutouts or windows in its projecting zone on the screen of the electronic unit, for entering data and / or instructions through this or these cutouts or windows.

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 Preferably, the electronic unit also comprises, on its upper face, a pressure-sensitive or optically sensitive support, on which is able to rest at least part of the slip.

 Advantageously, the upper face of the electronic unit, more particularly the screen and / or the sensitive support, comprises a dynamic backlight, to identify lines or areas for entering data or instructions.

In all cases, the previously defined provisions facilitating the transcription of the handwritten primary information into electronic information, either by automatic reading of at least part of this information, or by semi-automatic reading (manual pressure on a zone, in cooperation with a touch screen), either by manual action but assisted or at least guided, for example by the cutouts or windows of the slip, or by the backlight, or by the screen itself may display suggestions to allow the nurse to complete the purely handwritten information initially given by the doctor. Transcription operations are thus simplified and made as secure as possible.

Once the primary handwritten information has been transcribed into electronic data or instructions, it is no longer necessary to re-enter this primary information and the system will be able to process this data and instructions, using appropriate software, by identifying and planning the care and medication to be administered to the patient, duly identified.

 To perform these tasks, the electronic unit can contain means for the remote transmission of data to a computer server, and / or for receiving external data, capable of supplementing the data directly received by the unit and allowing their processing.

In any case, the invention will be better understood with the aid of the description which follows, with reference to the appended schematic drawing representing, by way of example, an embodiment of this device for collecting and processing information medical:
Figure 1 is a front view of a handwritten slip, usable with the device of the present invention;

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Figure 2 représente, en perspective, le boîtier électronique de ce dispositif recevant un bordereau manuscrit ; Figure 3 est un organigramme illustrant l'utilisation et le fonctionnement du dispositif objet de la présente invention.

Figure 2 shows, in perspective, the electronic unit of this device receiving a handwritten slip; Figure 3 is a flowchart illustrating the use and operation of the device object of the present invention.

Dans l'exemple illustré, le bordereau 2 possède, le long de l'un de ses quatre côtés, une série de perforations 3 disposées en ligne. Il s'agit, dans cet exemple, de perforations 3 circulaires, au nombre de six, séparées les unes des autres par des intervalles croissants. Figure 1, to which reference will first be made, shows a pre-formatted slip 2, of generally rectangular outline, made of paper.

In the example illustrated, the slip 2 has, along one of its four sides, a series of perforations 3 arranged in a line. In this example, there are six circular perforations 3, separated from each other by increasing intervals.

 Intended for use in a hospital environment, the slip 2 includes, on its front face and in its upper part, a zone 4 in the form of an elongated horizontal strip, intended for the recording of general information: date, time, name of the patient, bed number, etc.

 Below zone 4, the slip 2 comprises, on its right side, several rectangular zones 5, superimposed, intended for the handwritten recording of medical prescriptions, in the broadest sense: drug treatments, other types of care, examinations paraclinical, etc ... Next to each zone 5, on its left side, the slip 2 comprises other zones 6, each divided into a series of ranges 7 of dimensions adapted to be designated (by being ticked) and activated individually for example by pressing a finger.

Each range 7 corresponds to a predefined type of prescription.

 In its lower part, the slip 2 comprises another zone 8 in the form of an elongated horizontal strip, constituting a validation zone and handwritten signatures.

 On its rear face, the slip 2 comprises, for example in the interval between two successive perforations 3, an area 9 for automatic identification, receiving identification marks not shown in detail, for example marks of the bare code type.

 Finally, as illustrated in dotted lines, the slip 2 may include, for example in its lower right part, a cutout 10, of the window type, authorizing an action through the slip 2, without having to remove the latter.

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 The form 2 described above, essentially intended to be filled in by hand, is designed to be used in combination with an electronic unit 12, shown in FIG. 2.

 Generally rectangular in shape, with a relatively small thickness, the electronic unit 12 has, on its upper face 13, a certain number of equipment.

 In its upper part (with reference to FIG. 2), the upper face 13 of the electronic unit 12 includes a display 14 of the date and time, and a display or screen 15 for identifying the patient.

 In its central part, the upper face 13 of the electronic unit 12 comprises, for example on the left, a support 16 sensitive by pressure and / or optically, of the sensitive slab type, and for example on the right, a screen 17 which can be a screen touch.

 In its lower part (with reference to FIG. 2), the upper face 13 of the electronic unit 12 comprises, for example on the left, an alphanumeric keyboard 18 of a standard type, which is supplemented, for example on the right, by a series specific keys 19, and by a series of customizable keys 20.

 In a manner not shown, the electronic unit 12 also comprises an internal and / or external energy source, in particular achievable in the form of a rechargeable battery. This electronic unit 12 also includes means for recording and processing information and data.

 The upper face 13 of the electronic unit 12 comprises, for example along its left edge, a series of pins or pins 22, the number and distribution of which correspond to the perforations 3 of a slip 2. Finally, as symbolized by frame 23 in dashed lines in FIG. 2, the electronic unit 12 includes, in the region of its sensitive support 16, a dynamic backlight, making it possible to successively illuminate selected areas of said sensitive support 16.

 For the use of the device described above, a slip 2 assigned to a patient is previously filled in and signed by hand by the authorized hospital staff (doctor), so as to convey so-called primary information, which in practice represents a medical prescription. This primary information is entered, according to

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 the importance of the prescription, on one or more of the superimposed zones 5 of the slip 2, as symbolized at 24.

 In addition, the doctor ticks off the relevant ranges 7 of zones 6 of the slip 2, to designate the types of prescriptions desired.

 The slip 2, thus filled in by hand, is brought to the electronic unit 12. More particularly, this handwritten slip 2 is placed flat on the sensitive support 16, the perforations 3 of the slip 2 being engaged on the pins or pins 22, which thus secure the said slip 2, that is to say its immobilization in a predetermined position, on the upper face 13 of the electronic unit 12.

 In the example illustrated by FIG. 2, the slip 2, thus positioned, completely covers the sensitive support 16. In addition, this slip 2 has, on its right side, an area 2a projecting over the screen 17. It will be noted that the cutout 10 of the slip 2 is located in this overflowing zone 2a.

être automatiquement lue et reconnue, par des moyens de lecture et de reconnaissance (non représentés) que comporte le boîtier électronique 12. Once the handwritten slip 2 positioned on the electronic box 12, the system allows the transcription of the primary information, carried by this slip 2, into electronic type information, recorded and processed in the box 12. This transcription has several aspects (usable in all combinations):
On the one hand, the identification mark 9 of the slip 2 can

be automatically read and recognized by reading and recognition means (not shown) that the electronic unit 12 includes.

 On the other hand, the operator (nurse) transcribes the handwritten primary information 24, this transcription being done manually but being assisted by the functions of the electronic unit 12.

 More particularly, to transcribe the handwritten information 24, the operator uses the alphanumeric keyboard 18 and the touch screen 17, this operation being carried out successively for the different zones 5 actually filled with the slip 2, which constitute as many successive lines. The dynamic backlight 23 makes it possible to clearly identify the line on which the operator is working, at a given instant.

 The operator also exerts, on the ticked areas 7 of the slip 2, for example a finger pressure which is detected by the

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support sensible 16, pour l'enregistrement et la prise en compte des informations correspondantes (type de prescriptions).

sensitive medium 16, for recording and taking into account the corresponding information (type of prescriptions).

Screen 17 has a transcription assistance function, in particular by proposition and selection, in relation to the above; for example :
In a certain hospital service, this or that paraclinical examination, for example a brain scanner, is more frequently requested. In this service, when the doctor has checked the area 7 corresponding to a paraclinical examination, the proposal which will be made by the box 12 to the operator, this by display on the screen 17, will give priority to brain scan.

caractérise la prescription d'un produit injectable. Ceci permet à l'opérateur d'accéder automatiquement à une liste des médicaments injectables, excluant tout autre type de médicament (non injectable). Là encore, les produits injectables peuvent apparaître sur l'écran 17 dans un ordre qui est fonction de la fréquence avec laquelle ils sont prescrits habituellement. In another situation, the doctor will have checked the range 7 which

characterizes the prescription of an injectable product. This allows the operator to automatically access a list of injectable drugs, excluding any other type of drug (not injectable). Again, the injectables can appear on screen 17 in an order which is a function of the frequency with which they are usually prescribed.

 The keys 19 control functions specially adapted to the hospital environment. For example, certain keys 19 may include, as symbols, clearly visible arrows, signifying in their sense an increase or a decrease in dosage; other keys 19 may include a symbol representing an infusion bottle, which itself may be composed of several products.

 As for the customizable keys 20, these are in particular keys adaptable to the particular needs of the hospital service concerned, these keys 20 being in particular what is commonly known, in the computer field, shortcut keys.

 For the execution of these various functions, the electronic unit 12 can use tables, or databases which are either internal or external depending on their volume. In particular, the box 12 may include a connection 25 to an external network, allowing it to receive external data, and conversely to transmit data remotely to a computer server (not shown) for centralized operation.

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The flowchart in Figure 3 illustrates the use and operation of the device described above. The references 26, 27 and 28 designate tables or databases, previously mentioned, internal or external to the electronic unit.

It goes without saying that the invention is not limited to the sole embodiment of this device for collecting and processing information of a medical nature which has been described above, by way of example; on the contrary, it embraces all of the variant embodiments and applications respecting the same principle. Thus, in particular, that ion would not depart from the scope of the invention: - by adapting the device to all formats of handwritten slips; - by carrying out the positioning means of the slip in any form, and with any arrangement, for example by modifying the number and the intervals of the pins, or by carrying out the latter with mechanical or optical means of automatic recognition of the presence of a slip; - by providing for the positioning of the slip, at the upper face of the electronic unit, but under a transparent film, which may be a pressure-sensitive film; - by producing the electronic unit in the form of two separable parts, one of which is a mobile part which is self-sufficient in energy and designed to receive the slip, which can be connected to the other part; - by incorporating or adding to said electronic box all accessories such as magnetic card reader or smart card reader for identification, printer, etc ...

Claims (13)

 1-Device for collecting and processing information of a medical nature, in particular for use in a hospital environment, for the transcription of handwritten primary information, such as a medical prescription, into information of electronic type, characterized in that it essentially comprises an electronic unit (12) comprising, on its upper face (13), on the one hand means for receiving and positioning a handwritten slip (2) of predetermined format, carrying the primary information (24), and on the other hand, means (16,17) for automatic reading of at least part of the primary information (24) carried by the handwritten slip (2) and / or means (18,19, 20) for manual data entry corresponding at least in part to said primary information, the box (12) containing means for recording and processing this information and these data.  2-Device according to claim 1, characterized in that the electronic unit (12) comprises, on its upper face (13), wedging means (22) for the immobilization of the handwritten slip (2) in a predetermined position.  3-Device according to claim 2, characterized in that said wedging means are constituted by at least one lug, pin or the like (22), provided on the upper face (13) of the electronic unit (12) itself or on a separate frame intended to be applied in a predetermined position on said housing (12).  4-Device according to claim 3, characterized in that the wedging means, such as lugs, pins or the like (22), are provided with means for automatically recognizing the presence of a slip (2).  5-Device according to any one of claims 1 to 4, characterized in that the handwritten slip (2) carries identification marks (9), in particular of identification of a patient, and in that

 the automatic reading means, carried by the electronic unit (12), comprise means for recognizing the identification marks (9) carried by the slip (2).  6-Device according to any one of claims 1 to 5, characterized in that the electronic unit (12) has on its face <Desc / Clms Page number 11>  upper (13), in addition to a keyboard (18) and / or specific buttons or keys (19) and / or customizable (20), at least one screen (17) usable for the input of primary information and other data, and / or for the display of processed information.  7-Device according to claim 6, characterized in that the screen (17) of the electronic unit (12) is a touch screen (17), designed for direct manual entry of data and / or instructions.  8-Device according to claim 6 or 7, characterized in that the screen (17) of the electronic unit (12), and the positioning of the handwritten slip (2) on said housing (12), are such that at least one part (2a) of the form (2) covers at least part of the screen (17), so as to allow the transfer of at least part of the primary information directly from the form (2) to the screen ( 17).  9-Device according to all of claims 7 and 8, characterized in that the screen (17) of the electronic unit (12) is provided for reading the primary information, carried for the area (2a) of the slip ( 2) overflowing on the screen (17), by pressure exerted at points in this zone.  10-Device according to all of claims 7 and 8, characterized in that it is intended to be used with a slip (2), comprising one or more cutouts or windows (10) in its zone (2a) projecting over the 'screen (17) of the electronic unit (12), for entering data and / or instructions through this or these cutouts or windows (10).

11-Device according to any one of claims 1 to 10, characterized in that the electronic unit (12) comprises, on its upper face (13), a support (16) sensitive by pressure and / or optically, on which is able to rest at least part of the slip (2).

12-Device according to any one of claims 5 to 11, characterized in that the upper face of the electronic unit (12), more particularly the screen (17) and / or the sensitive support (16), comprises a retro- dynamic lighting (23) for identifying lines or zones (5) for entering data or instructions.  13-Device according to any one of claims 1 to 12, characterized in that the electronic unit (12) contains means (25) for the remote transmission of data to a server <Desc / Clms Page number 12>  computer and / or to receive external data, capable of supplementing the data directly received by the housing (12) and allowing their processing.