GB1603767A

GB1603767A - Processing of medical data

Info

Publication number: GB1603767A
Application number: GB24111/78A
Authority: GB
Original assignee: LEAF F
Current assignee: LEAF F
Priority date: 1978-05-30
Filing date: 1978-05-30
Publication date: 1981-11-25

Description

(54) PROCESSING OF MEDICAL DATA (71) 1, FRANCIS JOHN LEAF, a British Subject of 53, Cliffe Park Crecent, Leeds LS12 4XA, do hereby declare the invention, for which I pray that a Patent may be granted to me, and the method by which it is to be performed, to be particularly described in and by the following statement:- This invention relates to the processing of medical data.

When patients are subjected to medical examinations, medical treatments or other medical procedures, information concerning observations made and treatment performed or prescribed by medical personnel may be recorded usually in writing, by such personnel. The information contained in these written records is however not usually in a readily accessible form whereby such information cannot readily be assessed for example for epidemiological reasons, to determine effectiveness or adverse indications of particular types of treatment, to disclose drug abuse by patients, to determine ill advised or outdated procedures by medical practitioners, and the like.

With a view to making such information more readily accessible, there have been proposals for entering such information in automated data processing equipment.

In particular it has been proposed to link a central computer with computer terminals located at surgeries of medical practitioners whereby information can be entered into and retrieved from the computer via such terminals. This arrangement is not however satisfactory in so far as it necessitates the presence of appropriately skilled personnel at the surgeries or requires medical practitioners to acquire appropriate further skills which is prohibitively expensive anchor inconvenient.

An object of the present invention is to render medical data readily accessible in a simple and convenient manner.

According to the invention therefore there is provided a medical data processing system comprising digital data recording and processing means at a central location, and a plurality of like card elements on each of which are provided a plurality of like zones in which any desired medical information may be entered by hand and in respect of each zone one of a plurality of like sets of alphabetic and numeric characters, which characters can be selectively machine readably marked to define said information thereon in accordance with a predetermined notation, and optical reading means adapted to read the selectively marked characters on such card element and to feed data corresponding to the selectively marked characters to the said data recording and processing means.

With this arrangement it will be appreciated that medical personnel on subjecting patients to medical procedures such as examinations, courses of treatment or the like, can enter information pertaining to or arising from such procedure in the requisite manner on such elements, whereupon the information can then be stored and processed after reading of the elements by the machine reading means The medical personnnel are only required to enter such information on the elements by hand so that the benefits arising from the use of data recording and processing means can be obtained in a simple manner without causing undue inconvenience to the medical personnel and in particular without requiring the presence of additional skilled personnel at medical establishments such as surgeries and without requiring medical personnel to acquire extensive additional skills.

With regard to the manner in which information is entered by hand on the elements the elements have thereon a plurality of zones in which, in use, marks are entered by the medical personnel for example in the form of ball-point pen lines, such marks being read by the machine reading means by means of an optical mark recognition (OMR) technique of conventional form. Alternatively or additionally information may be entered by hand or machine in other ways, for example, by entering characters which can be read by conventional optical character recognition (OCR) techniques.

The aforesaid zones in which the marks are entered may take any suitable form or combination of forms. Preferably however at least some of said zones are defined by a series, matrix or other arrangement of alphabetical and/or numerical characters whereby in use marks are entered by crossing through, outlining or otherwise selectively marking or indicating selected ones of said alphabetic and numeric characters. The nature of the alphabetic and numeric characters and the manner in which these are marked may be in accordance with a simple code whereby, for example, information identifying a word is entered by marking the characters (particularly alphabetical characters) corresponding to one or more letters in predetermined positions in such word, particularly starting and final letters of the word. lhis code is particularly simple and convenient to use. Such code most preferably is supplemented by indicating the number of letters in the word, for example, by writing out the full word so that the letters can be counted by the machine reading means.

Additionally to the use of alphabetic and numeric characters, zones may be defined by boxes, shapes, signs or the like.

Preferably, said zones are arranged in a plurality of sections each such section relating to a particular respective item of information to be entered. Said sections may be differentiated by use of different forms or arrangements of zones or otherwise. Alternatively or additionally at least some sections may be of a like kind, an appropriate mark being entered in use in predetermined juxtaposition to each said section to indicate the nature of the information entered in the section.

With regard to the nature of the information to be entered, most preferably, this will include personal details relating to the patient, i.e. name, address, date of blrth, sex and the like. Also it is visualised that the invention will find particular application in the context of prescribing drugs whereby information identifying prescribed drugs will be entered. Alternatively or additionally, the information may include one or more of the following: 1. diagnostic information; 2. information on treatment; 3. referral information; 4. observed adverse reactions to tr ent; . ination details; 6. anatomical information.

The invention is not of course intended to be limited to this information and other information may alternatively or additionally be included.

The machine reading means is preferably at the same location as the data recording and processing means, although if desired it may be at a different location and means may be provided for the transmission of data between such locations. The elements with information entered thereon may be conveyed to the location of the reading means in any suitable manner, but in the case where an element has information relating to a prescribed pharmaceutical product thereon, such element is preferably taken by the patient or his representative to an establishment such as a pharmacy whereat the product is dispensed and the element is then forwarded from the pharmacy to the location of the machine reading means.

In this respect it is visualised that the elements may be used in substitution for present British National Health Services prescription foms although it will be understood that the elements may be used in a more versatile manner than such forms in so far as they may be used to record a wide range of information resulting from a patient-niedical practitioner encounter in addition to prescription details. Also, in this case, it will be appreciated that costing of prescriptions to determine pharmacist remuneration and also in order to check on prescribing costs generally and also in relation to specific medical practitioners can be effected in a simple and convenient manner utilising the central processing and recording means.

The data recording and processing means may be in the form of a conventional digital computer programmed to interpret data fed thereto from the machine reading means in terms of the information conveyed by such data. Said data may be stored in relation to names of patients and names of medical practitioners to provide a medical record system. Retrieval of information may be possible only at said central location.

Preferably however a terminal of suitable kind may be provided at a suitably remote location, for example, at a medical practitioner's surgery whereby the medical practitioner can retrieve information preferably in the form of a print-out which Is automatically transmitted at an appropriate time in the day, say at night time when transmission can be effected inexpensively, to enable the practitioner to update his own records. In this way no particular expertise is required nor is any inconvenience involved with regard to the retrieval of information. However, if desired, alternatively or additionally, such terminal may provide a v.d.u. or other display and retrieval at such terminal may be on request, and/or may provide continuously updated information.

As mentioned above, in the case where the data fed to the data recording and processing means relates to prescribed pharmaceutical products, said means is preferably programmed to effect pricing of such products and provide appropriate output information in relation to remuneration of pharmacists.

The data fed to the recording and processing means, and the programming of such means are also preferably such as to provide some assessment of the diagnostic and prescribing activities of individual medical practitioners. Thus, output information may be provided in relation to cost of drugs prescribed by individual medical practitioners, amounts of drugs prescribed to individual patients, types of treatment prescribed by individual practitioners, whereby for example warning can be given in the event that in a particular case prescription costs exceed a predetermined figure, or a patient is prescribed excessive quantities of a dangerous drug, or a practitioner prescibes a form of treatment no longer thought to be desirable, or the like. Such warning may be given at the central location and/or at a terminal at a medical practitioner's surgery or otherwise.

It will also be appreciated that the arrangement may be such that the recording and processing means may be capable of providing output information of an epidemiological nature.

Further, the system may facilitate medical practitioner activities with regard to for example, appointments, repeat prescriptions and the like in that the patient may be able to arrange such an appointment, repeat prescription or the like via the said central location, for example by contacting personnel at such central location.

The invention will now be described further by way of example only and with reference to the accompanying drawings in which: Figure 1 shows the front side of a card for use in a system in accordance with one embodiment of the invention; Fig. 2 shows the rear side of the card; Figs. 3 and 4 are diagrammatic illustrations of the system.

The system utilises a plurality of cards as shown in Figs. 1 and 2.

Each side of the card has a plurality of sections each consistin8tof a row or rows of letter or numbers selected'ones of which can be crossed through in accordance with a predetermined coding system to record information on the card. There are also spaces adjacent the said sections in which words and/or numbers can be written.

As can be seen the sections include the following; 1. A patient-identifying section having three rows of letters each such line consisting of the 26 letters of the alphabet.

In use, the name of a patient is written in a space above such lines of letters and one letter is crossed through in each row, such crossed-through letters being respectively the first two and last one letter of the person's surname.

2. A further patient-identifying section having three rows of numbers and an adjacent space. The patient's date of birth is written in the space and appropriate ones of the numbers are crossed through in accordance with such date of birth.

3. A further patient-identifying section having rows of numbers and letters and an adjacent space. The patient's address is written in the space and appropriate ones of, the letters and numbers are crossed through in accordance with the patient's post-ce.

4. A parameter section having rows ot numbers. Observed numerical parameters such as body temperature, pulse rate, blood pressure and the like can be noted by crossing through appropriate ones of the numbers.

5. A date-identifying section having a row of numbers and an adjacent space. The date is written in the space and appropriate ones on the numbers are crossed through 6. A medical-practitioner identifying section. This section may have a pre-printed code identifying the medical practitioner to whom the cards are allotted.

7. A pharmacist-identifying section for completion by a pharmacist.

8. Multiple prescription sections each having rows of letters, each consisting of the 26 letters of the alphabet, followed by rows of numbers, and having an adjacent space.

A drug prescribed is written in the space of one such section and one letter is crossed through in each said row, such crossedthrough letters being respectively the first twd and last two letters of the drug name.

Selected ones in the rows of numbers are appropriately crossed through to indicate information such as the amount of the drug prescribed, numbers and sites of tablets, frequency of administration and the like.

Provision may be made for entering other information on the card, such as observed drug side effects, of recognised and also unrecognised kinds, disease-identifying information, anatomical information specifying disease site, and the like. Such other information may be entered in the multiple prescription sections using an entry code like that used for entering the prescribed drugs. To indicate that such different information has been entered in the prescription sections, a mark is made in an appropriate one of a number of small boxes alongside each section, such small boxes being labelled to indicate their respective identification functions.

Provision may of course be made for entering other information.

In use, when a patient is seen by a medical practitioner, such practitioner enters appropriate information on a card of the kind so far described. In the event that the medical practitioner prescribes a drug this is entered on the card and the patient then takes the card to a pharmacist. The pharmacist dispenses the drug, enters his identification code in the appropriate section and sends the card to a central location. If no drug is prescribed as a result of the patient/practitioner encounter, the card may be sent direct to the central location by the practitioner.

At the centrallocation the card, with other like cards is fed into a machine reading means which scans the rows and columns on the card with optical scanning means of the OMR/OCR kind. Information entered on the card is converted to binary form and is stored and processed. Such processing is effected by a digital computer in accordance with stored programmes and involves identification of the drugs and other data corresponding to the coded information in the multiple prescribing sections of the cards. The identification involves assessment of the marked letters and also assessment of the number of letters in the or each word entered in the pertaining spaces of the sections. In this latter respect, it will be noted that such spaces are divided into letter compartments. The presence or absence of a mark in any of the adjacent boxes is also assessed. Other factors may also be assessed for identification purposes, e.g. the indicated dosage of a drug. The computer also identifies in like manner the information entered in the sections other than the prescription sections and also any information permanently applied to the card.

In the event that identification of information cannot be made, for example due to wrong entry of same, the card is rejected to be read by appropriate personnel.

The system therefore tails safe.

The computer processes the information for example by recording information against names of patients to produce record details. Such record details are transmitted at intervals, for example each night, to print out terminals, at surgeries of medical practitioners so that such practitioners can appropriately update their own records.

The computer can also provide drug pricing details in relation to particular pharmacists and also in relation to the activities of particular medical practitioners, it can provide epidemiological details; it can provide details of notifiable diseases and the like; it can check prescribing of dangerous drugs with a view to identifying overprescribing to particular patients due for example to abuse by such patients; it can provide details of treatment techniques of individual medical pracitioners; and so on.

Such further details may be made available only at the central location. Alternatively or additionally however, the computer may be arranged to transmit information to the remote terminals particularly in urgent cases for example n cases where drug abuse is detected.

The computer may also be arranged to assist in the production of repeat prescriptions and in the arrangement of appointments for medical practitioners. In these cases, a patient requiring a repeat prescription or an appointment contacts the central location. Personnel at such location feed appropriate information into the computer and the computer transmits information to the appropriate practitioners terminal so that an appropriate prescription card can be prepared at the practitioner's surgery for signature by the practitioner and collection by the patient, or an appointment can be entered into the practitioner's appointment list.

With the arrangement described above it will be appreciated that the considerable benefits of computer processing can be made available in relation to medical data in an extremely simple manner and without causing appreciable inconvenience to the medical practitioner.

It is of course to be understood that the invention is not intended to be restricted to the details of the above embodiment which are described by way of example only.

In particular, the foregoing description is specifically concerned with the entry of a single word representative of the name of a drum in each of the multiple prescription sections. However, if desired, provision may be made for entering the multiple words. In this case the words may be entered consecutively in the compartmentalised spaces, one letter for each compartment and one empty compartment being left between adjacent words. The same four rows of alphanumeric letters are used to code the words, one letter being crossed through in each row, and the four crossedthrough letters being: for two words: the first and last letter of each word for three words: the first letters of the first two words and the first and last letters of the last word for four words: the first letters of the four words.

Word identification will then be effected by the computer in accordance with the letters crossed through, in accordance with the letter count for each word, and in accordance with the number and positioning of spaces between the words.

Such multiple word entry may apply to drugs, diseases, anatomical sites or any other information. In the case where the information is anything other than a prescribed drug an appropriate one of a range of symbols (the letters R SE C D and/or the small side boxes in Fig. 2) is crossed through to identify the nature of the information (i.e. a disease, an anatomical site, etc.). Others of said symbols may provide other instructions or information e.g.

1. suspend substitution or deletion of repeat drug regime; 2. erase section; 3. repeat prescription; 4. stop repeat prescription; 5. link (cause or association) indicated between entered information (e.g. Penicillin and Urticaria).

Alternatively or additionally to crossing through said symbols, information may be imparted by entering the first word at different starting positions in the compartmentalised space (e.g. starting with the first compartment for a drug, starting with the second compartment for a disease and so on).

In each comparmentallised space the initial main entry (i.e. the word or words identifying the drug or disease etc.) may be followed by further related words. Thus, if a drug is not followed by any words it is to be assumed that the drug is in tablet form. If any other form is to be specified (e.g.

ointment, suppository, etc.) this will be written in the compartmentalised space leaving two or more compartments between this and the main entry. At the same time the first letter of the word (e.g. 0 for ointment) is crossed through in each of the four rows. The computer identifies the word in accordance with this column of crossedthrough letters in conjunction with a letter count for the word, in accordance with the recognised spacing between such word and the first entry, and in accordance with the nature of the first entry (i.e. whether a drug or not). Similarly, disease entries may be followed by qualifying words e.g. acute, pain, chronic etc., and anatomical entries may be followed by words such as upper, lower, frontal, etc.

In the case where there are two or more words following the said initial main entry such words will be spaced by a single compartment. A second such word may provide information different from and possibly qualifying the information of the first such word in which case such second word may be coded by crossing through the first letter of the word in three, particularly the first three, of the four alphabetical rows. Thus, for example "acute left" may be entered, a column of four as and a column of three Is being crossed through.

The rows of numbers will be interpreted as relating to quantities when a drug is specified. When a disease or anatomical site is specified, the numbers may be used for other purposes e.g. to indicate severity on an arbitrary scale, to indicate location e.g.

the 2nd vertebra or a stye at 6 o'clock.

WHAT I CLAIM IS: 1. A medical data processing system comprising digital data recording and processing means at a central location, and a plurality of like card elements on each of which are provided a plurality of like zones in which any desired medical information may be entered by hand and in respect of each zone one of a plurality of like sets of alphabetic and numeric characters, which characters can be selectively machine readably marked to define said information thereon in accordance with a predetermined notation and optical reading means adapted to read the selectively marked characters on such card element and to feed data corresponding to the selectively marked characters to the said data recording and processing means.

2. A system according to claim 1, wherein said data recording and processing means is operative to identify a word contained in said information by utilisation of said data relating to said selectively marked alphabetic characters which represent one or more letters in predetermined positions in such words.

3. A system according to claim 2, wherein said predetermined positions are starting and/or end positions of the word.

4. A system according to claim 3 wherein word identification is effected also utilising data relating to the number of letters in said word written adjacent said characters.

5. A system according to claim 1 substantially as hereinbefore described by way of example.

6. A method of processing medical data comprising entering by hand any desired medical information on at least one of a plurality of like card elements in at least one of a plurality of like zones thereon, and in respect of each zone having information entered therein, machine readably marking selected ones of alphabetic and numeric

**WARNING** end of DESC field may overlap start of CLMS **.

Claims

**WARNING** start of CLMS field may overlap end of DESC **. two words and the first and last letters of the last word for four words: the first letters of the four words. Word identification will then be effected by the computer in accordance with the letters crossed through, in accordance with the letter count for each word, and in accordance with the number and positioning of spaces between the words. Such multiple word entry may apply to drugs, diseases, anatomical sites or any other information. In the case where the information is anything other than a prescribed drug an appropriate one of a range of symbols (the letters R SE C D and/or the small side boxes in Fig. 2) is crossed through to identify the nature of the information (i.e. a disease, an anatomical site, etc.). Others of said symbols may provide other instructions or information e.g. 1. suspend substitution or deletion of repeat drug regime; 2. erase section; 3. repeat prescription; 4. stop repeat prescription; 5. link (cause or association) indicated between entered information (e.g. Penicillin and Urticaria). Alternatively or additionally to crossing through said symbols, information may be imparted by entering the first word at different starting positions in the compartmentalised space (e.g. starting with the first compartment for a drug, starting with the second compartment for a disease and so on). In each comparmentallised space the initial main entry (i.e. the word or words identifying the drug or disease etc.) may be followed by further related words. Thus, if a drug is not followed by any words it is to be assumed that the drug is in tablet form. If any other form is to be specified (e.g. ointment, suppository, etc.) this will be written in the compartmentalised space leaving two or more compartments between this and the main entry. At the same time the first letter of the word (e.g. 0 for ointment) is crossed through in each of the four rows. The computer identifies the word in accordance with this column of crossedthrough letters in conjunction with a letter count for the word, in accordance with the recognised spacing between such word and the first entry, and in accordance with the nature of the first entry (i.e. whether a drug or not). Similarly, disease entries may be followed by qualifying words e.g. acute, pain, chronic etc., and anatomical entries may be followed by words such as upper, lower, frontal, etc. In the case where there are two or more words following the said initial main entry such words will be spaced by a single compartment. A second such word may provide information different from and possibly qualifying the information of the first such word in which case such second word may be coded by crossing through the first letter of the word in three, particularly the first three, of the four alphabetical rows. Thus, for example "acute left" may be entered, a column of four as and a column of three Is being crossed through. The rows of numbers will be interpreted as relating to quantities when a drug is specified. When a disease or anatomical site is specified, the numbers may be used for other purposes e.g. to indicate severity on an arbitrary scale, to indicate location e.g. the 2nd vertebra or a stye at 6 o'clock. WHAT I CLAIM IS:

1. A medical data processing system comprising digital data recording and processing means at a central location, and a plurality of like card elements on each of which are provided a plurality of like zones in which any desired medical information may be entered by hand and in respect of each zone one of a plurality of like sets of alphabetic and numeric characters, which characters can be selectively machine readably marked to define said information thereon in accordance with a predetermined notation and optical reading means adapted to read the selectively marked characters on such card element and to feed data corresponding to the selectively marked characters to the said data recording and processing means.

characters provided in the respective one of a plurality of like sets thereof, so as to defame said information in accordance with a predetermined notation, and presenting said marked card element or elements to an optical reading means adapted to read said selectively marked characters and to feed data corresponding to the selectively marked characters to a digital data recording and processing means at a central location.

7. A method of processing medical data substantially as hereinbefore described.