IES20130090A2 - A method and system for improving patient compliance with a prescribed medical regime - Google Patents

Abstract

A networked method/system (200) in which patient devices (201) such as handheld devices including tablets and smartphones are communicable with physiotherapist databases at a cloud computing server (202) via the internet or other communication method (203) to communicate patient prescriptions (300) and reminders between the patient device (201) and the physiotherapist so that the patient can receive prescriptions, prescription reminders, updates, articles and other information from the physiotherapist and communicate compliance with the prescription to the physiotherapist. <Figure 4>

Description

A Method And System For Improving Patient Compliance With A Prescribed Medical Regime Introduction This invention relates to a method and system for improving compliance and, in particular, to a method and system for improving prescription compliance by patients.

Background of the Invention It is known that many patients exhibit poor compliance with prescriptions issued by health professionals. Such prescriptions include drug regimes prescribed by doctors and exercise or similar regimes prescribed by physiotherapists, physical therapists, osteopaths, chiropractors, sports scientists and the like hereinafter referred to collectively as physiotherapists. Failure to adhere to or comply with drug regimes prescribed by doctors or exercise regimes prescribed by physiotherapists can result in negative or poor outcomes for patients.

Lack of compliance with the performance of exercises prescribed by physiotherapists is particularly common and it has been estimated that approximately 70% of patients fail to perform exercises prescribed by their physiotherapist between visits. Failure to comply can be attributed to many factors including the manner in which the prescribed exercises are communicated to patients and/or difficulty in recalling how to correctly perform the exercises and forgetfulness on the part of the patient.

| J. .1 θ 0 9 q In general, physiotherapists attempt to assist patients in complying with prescribed exercises by providing the patient with a list of printed exercises from exercise software such as Physiotools (Trade Mark) or, more basically, by drawing the prescribed exercises for the patient. However, despite the best attempts of physiotherapists, non-compliance levels remain at about 70%.

An object of the invention is to overcome at least some of the problems of the prior art.

Summary of the Invention According to the invention there is provided a method for improving prescription compliance by a patient comprising: prescribing a regime for the patient; automatically issuing a reminder to the patient to adhere to the regime, and monitoring adherence to the regime in accordance with a response received from the patient to the reminder.

Suitably, the prescribed regime is communicable to a patient device Preferably, the patient device is selected from the group comprising a mobile phone, a smartphone, a computer, a tablet or a handheld device. Suitably, the patient device comprises a smartphone.

In a preferred embodiment of the invention, the prescribed regime is communicable to a patient smartphone via an app. Ο Ο 9 ο Preferably, the prescribed regime is a drug treatment regime ar an exercise regime. Mere preferably, the prescribed regime is an exercise regime. Most preferably, the exercise regime is prescribed by a health practitioner. Advantageously, the health practitioner is a physiotherapist. Alternatively, the health practitioner can be a physical therapist, an osteopath, a chiropractor, a sports scientist or similar.

In a preferred embodiment of the invention, the prescribed regime ss an exercise prescription prescribed by a physiotherapist io Suitably, the exercise prescription is selectable from an exercise list. Preferably, the exercise list comprises set exercises. More preferably, the set exercise list is editable by the health practitioner to include additional exercises.

Preferably, the reminder to the patient to adhere to the regime is communicable via 1.5 the mobile phone app. Alternatively or in addition, the reminder to the patient to adhere to the regime is communicable by email.

Suitably, the reminder demands a response from the patient. Preferably, the response is recorded and collated to determine compliance.

In a preferred embodiment of the invention, the method for improving prescription compliance by a patient is operated in a cloud computing environment.

The invention also extends to a system incorporating the method as hereinbefore defined.

Brief Description of the Drawings ill 3ΰ The invention will now be described, by way of example only, with reference to the accompanying drawing in which: Figure 1 is a block diagram of a computing device adapted to implement the method and system of the invention for improving prescription compliance: Figure 2 is a block diagram of a system for improving prescription compliance in which patient devices such as handheld devices including tablets and smartphones or similar, and laptops or the like, are in communication with their respective physiotherapists' (A, B and C) databases via the internet or other communication method; Figure 3 is a general flow diagram of a first embodiment of the mothod of improving patient prescription compliance of the invention in which the prescription is created by the physiotherapist and communicated to the patient by email and/or a smartphone app; Figure 4 is a detailed flow diagram of the method of Figure 3 in which the patient is diagnosed and a prescription prepared and communicated to the patient by email; Figure 5 is a detailed flow diagram of the steps performed by a physiotherapist to create a new patient record as outlined in Figure 4: IE? 3 0 0 9 0 Figure 6 is a detailed flow diagram of the steps performed by a physiotherapist to create a new exercise for prescribing purposes; s Figure 7 is detailed flow diagram of the of the steps performed by a physiotherapist to create a new article on the database; Figure 8 is a detailed flow diagram of the steps performed by a physiotherapist to create a personalised exercise grid from which exercises can be io later selected during prescribing operations and communicated to a patient handheld device such as a smartphone; Figure 9 is a general flow diagram of the patient compliance functionality of the method and system of the invention; is Figure 10 is detailed flow diagram of the manner in which prescription compliance is monitored by the physiotherapist; Figure 11 is a partial screenshot of a list of exercises available for selection by 20 the physiotherapist for prescriptions; Figure 12 is a screenshot of a prescription made up of two selected exercises for a notional patient; ΙΕ ΐ 3 δ 0 9 ο Figure 13 is a screenshot of the exercise grid of all exercises available for selection by the physiotherapist for the notional patient; Figure 14 is a screenshot of the screen of the preview available to the physiotherapist of the hip rotation exercise prescribed for the notional patient prior to communication to the patient, and Figure 15 is a screenshot of a screen for sample tags for ‘office worker exercises1’ and “general flexibility for older people1’ as created by the physiotherapist.

Detailed Description of the Invention in the drawings and the following description, the term user refers to a physiotherapist or other prescriber or an employee of the prescriber. Moreover, in the following description the invention is described in terms of a physiotherapistpatient relationship. However, as indicated above and as will be appreciated by those skilled in the art, the invention should not be construed as being limited to physiotherapist-patient relationships and has application in a range of prescriberprescribee relationships.

Figure 1 is a block diagram of a computing device 100 adapted to implement the method and system of the invention for improved patient prescription compliance. The computing device 100 is made up of a processor 101, RAM 102, ROM 103, memory 104 and an input/output module 105 for operating the computing device 100.

IE 1 3 0 0 9 0 Application data in accordance with the invention is stored in RAM 162 in the form of tasks or applications 106 when the computing device 100 is in operation and software tasks are being performed by the computing device 100. The computing device 100 can include various forms of computer readable media.

Applications 107, an operating system 108 and data 109 can be stored in the memory 104.

As will be appreciated by those skilled in the art the computing device 100 is suitable for use in a cloud computing environment Figure 2 is a block diagram of a networked system 200 of the invention in which patient devices 201 such as handheld devices including tablets and smartphones or similar, and laptops or the like, adapted to implement the systems and methods of the invention as outlined further below are in communication with their respective physiotherapists’ (A; B and C) databases at a cloud computing server 202 via the internet or other communication method 203.

As shall be explained more fully below, a patient prescription and compliance software application in accordance with the method of the invention, cummunicable with the cloud computing server 202, can be installed on each patient device 201 so that the patient can receive prescriptions, prescription reminders, updates, articles and other information from their physiotherapist and communicate compliance with the prescription to the physiotherapist.

IE 1 3 0 0 5 0 Prescriptions and patient data can be stored on the cloud computing server 202 and transmissible to a user computer 204 in an easily readable form also via a network or internet 203 so that the user has instantaneous access to patient records and prescription compliance.

Figure 3 is a general flow diagram of a first embodiment of the rnothocl oi improving patient prescription compliance of the invention in which a prescription 300 is created by a user and communicated to a patient by email 301 and/or a smartphone app w 302.

As shown in the drawing., in order to edit a prescription 300; the user first either creates a new patient record 302 or retrieves an existing patient record 303 from the system. The user then edits the prescription 300 by choosing specific exercises and/or exercise tags 304 appropriate to the patient and then setting the frequency 305 with which the chosen specific exercises and/or exercise tags must be performed by the patient. As shall be explained more fully below, exercise tags are made up of groups of selected exercises which are collectively appropriate to a particular treatment prescription.

If desired, the user can also include a message to the patient 306.

The user then selects the method of delivering or communicating 307 the prescription to the patient - by email 301 or via a smartphone app 302 as outlined 25 above. Communication to the patient by email can be set as required to be repeated IE 1 3 0 0 9 0 by periodic emails 301 or smartphone messages 302 as required to optimise patient compliance with the prescription. If desired, the user can also print the prescription 308 for the patient.

Figure 4 is a more detailed flow diagram of the method of Figure 3 in which the patient is diagnosed and a prescription prepared and communicated to the patient by email. As shown in the drawing, a physiotherapist user makes a diagnosis 400 in the usual way and then determines whether the patient is an existing patient 401 by searching the patient database of the system of the invention according to patient name or email address 402. if the patient is a new patient, a new patient record 403 is created as outlined further below in Figure 5.

The patient record is then displayed 404.

In accordance with the diagnosis, the user can then select exercise tags 405 and or individual exercises 406 from an exercise menu or grid as required. The user then sets the daily frequency and duration of the exercises 407 and can append a patient note to the exercises if desired.

The patient prescription is then generated 408 in accordance with the user's selections. The system then queries whether the patient requires a printout of the prescription 409. if so, the prescription is printed 410.

The user is also prompted as to whether the patient requires periodic reminder emails to assist in compliance 411. If so, the periodic emails are scheduled 412 IE 1 3 0 0 9 0 usually in consultation with the patient. The periodic emails can be timed in a patient-unique manner as required in accordance with a number of factors such as the prescription, exercise frequency required and the patient’s lifestyle such as working day; shift requirements, travel commitments and the like. s Following completion of the above mentioned steps, an email is sent 413 to the patient’s email address to include the prescribed exercises, any appended notes and the frequency with which the exercises are to be performed. As outlined further below, the prescribed exercises can include photographs of the exercises to assist io patients in performing the prescribed exercises thereby further increasing compliance levels. Where the patient is a new patient, the transmitted email 413 can also be in the form of a welcome email.

Figure 5 is a more detailed flow diagram of the steps performed by a user to create a is new patient record as outlined in Figure 4. As shown in the drawing, the user opens a new patient record via a new patient button 500 to display blank text fields 501 which are populated with the patient’s details including name, address, email address, telephone numbers etc. The user then saves the data to store tlie information in the database. The system of the invention queries any errors in the 20 data 503 in the usual way. In the event of art error, the error is highlighted and displayed by the system 504 for the user to correct 505.

In the event that the new patient record is created correctly by the user a full patient grid is displayed listing all patients including the new patient 505. The new patient IE 1 3 0 0 9 0 can then be selected from the full patient grid and exercises prescribed for the new patient in the usual way.

Figure 6 is a detailed flow diagram of the steps performed by a user to create a new exercise for prescribing purposes. The user simply selects a new exercise button in the system 600 to display blank text fields 601 for completion by the user The user simply populates the blank text fields with details of the new exercise. Photographs or other visual aids to the new exercise can be included if desired. The user then saves the new exercise 602. As with the new patient record above, the system queries the new exercise for errors 603 and displays any errors in the data entered 604 which can then be corrected 605 by the user.

The system then displays a complete exercise list 606 including the new exercise from which exercises can be selected by the user for prescribing purposes. 1.5 Figure 7 is detailed flow diagram of the steps performed by a user to create a new article on the database which can be included in patient prescriptions tor educational purposes as required. As shown in the drawings, the user selects a new article button in the system 700 to open a blank template 701 adapted to receive the article title or name for listing purposes together with an area for receiving the article content in html format. The new article is then saved by the user and added to the physiotherapist's article list 702 for selection during prescribing operations and inclusion in prescriptions 703 as required. The patient can receive any number of articles as desired by the user - even between prescriptions. Accordingly, where a user wishes to communicate a new relevant article to an existing patient having a IE 1 3 0 0 9 0 pre-existing prescription, the user can forward the new article to the patient by simply refreshing the prescription 704. Upon receipt of an article, the article is automatically added to the patient’s article list on the patient’s smartphone, laptop or other device 705.

Figure 8 is a detailed flow diagram of a function fora user to create a personalised exercise grid from which exercises can be later selected during prescribing operations and communicated to a patient handheld device such as a smartphone. As shown in the drawing, the user first selects an exercise from the exercise grid 800. The user is then prompted to select a pre-installed system exercise or a user exercise 801. In the event that the user selects a system exercise, the exercise content is displayed for the user in read only format 802. The user then copies or clones the read only exercise 803 and the exercise details are then copied into the user’s account 804 and displayed in an editable format 805 together with an image ''drop target”.

In the event that the user selected an already created user exercise 80 rhe user exercise is similarly displayed in editable format 805 together with an image drop target1’.

If desired, tags can be selected to allocate the exercise to various exercise group tags 806 as previously described and as outlined further below.

The image drop target’1 is then dropped from the users desktop to the target and uploaded to the server and, where necessary, scaled for smartphone display 807.

IE 1 3 0 0 9 0 The image is loaded into the relevant browser and additional drop targets can be added to the page as required. One of the images can be designated as representative of the exercise if desired 808 for display on a single image list for the exercises prescribed for the patient e.g, on the patient's smartphone.

The user can also scale, rotate, remove or change an image or its order in a range of innages associate with the exercise as required 809.

The user can then save the completed editing actions 810 and then display 811 the complete exercise grid including all modifications.

Figure 9 is a general flow diagram of the patient compliance functionality of the method and system of the invention as outlined above. The patient compliance functionality is made up of a physiotherapist or user interface 900 and a patient interface 901 communicable with the user interface 900. The user can --eview patient compliance 902 at the user interface 900. Where the patient employs a smartphone to communicate with the system of the invention, patient compliance 902 is optimised by communicating smartphone alerts 903 to the patient smartphone. The frequency of smartphone alerts can be determined and set by the user during the prescribing process as outlined above, Typically, the frequency of alerts corresponds with the frequency with which the prescribed exercises must be performed.

In order to demonstrate compliance and communicate compliance to the user and system, upon receipt of the smartphone alert the patient completes the prescribed IE 1 3 0 0 9 0 exercises and marks or ticks the individual prescribed exercises as completed 904. The compliance data is then transmitted to the user for review 902. Completion of the exercises then causes the system count down to the next smartphone alert or alarm 906 and the process is repeated.

Figure 10 is a more detailed flow diagram of patient compliance functionality of the system of the invention as described in Figure 9. Upon receipt of the smartphone alert 1001, the patient marks off the completed exercises and saves the data 1002. The data is then received by the server 1003 which can be reviewed 1004 by the user e.g. during a second or subsequent visit by the patient to the physiotherapist. For example, in the event that the user regularly monitors patient the compliance data communicated to the server and observes poor compliance, the user can contact the patient and suggest a visit to discuss the poor compliance with a view to optimising compliance.

If necessary, the user can consider changing the prescription 1005 If a prescription change is required, the user can edit the prescription 1006 as described above or alternatively continue with the existing prescription 1007.

It will appreciated by those skilled in the art that in place of a smartphone app, the method and system of the invention as described above can be used by a patient employing computers, laptops, tablets and other handheld devices in place of a smartphone.

IE 1 3 Ο Ο 9 Ο Figures 11 to 15 show a range of sample screenshots of the method and system of the invention as implemented on a user computer in communication with a server as previously described Figure 11 is a partial screenshot of a desktop 1101 list of user exercises 1102 available for selection by the user for prescriptions. The desktop 1101 is adapted to open a number of screens by selecting appropriate buttons including patients 1103. exercises 1104, tagsl 105, articles 1106, your details 1107 and contact us 1108. The screens display the userand patient information described above. io In addition, the user can create new exercises as previously described via a new exercise button 1109 or a pre-programmed system exercise button 1110.

The user exercise list in the present example includes brief descriptions of the is exercises - for example ''knee flexibility exercises*', “hip rotations'' and the like which can be selected for prescription purposes. The appropriate exercises can bo selected by highlighting a star icon 1111 adjacent each brief description.

Figure 12 is a screenshot of a patient prescription record made up of two selected exercises for a notional patient ''David Fennoly'. In the present example, the prescription comprises two exercises namely hip rotations and knee flexibility 1200 to be performed at a frequency 1201 of three times daily. The prescription is also adapted to receive a message or “note to patient*' 1202 as previously described The user can also edit the prescription 1203, observe compliance data 1204 and email logs 1205 and edit the patient data 1206 from the prescription.

IE 1 3 0 0 9 0 Figure 13 is a screenshot of the exercise grid of all exercises available for selection for the notional patient of Figure 12 in which the prescription is being edited via the edit prescription function 1203 of Figure 12 to include shoulder stretches. Mere particularly, the exercise list 1102 is fully displayed from which the modified prescription can be derived. The note to patient text box 1202 and tags 1105 are also fully expanded. In the present example, the optional tags relate to exercises for General Exercises For Older People1’ and Office Worker Exercises.

Figure 14 is a screenshot of a preview available to the physiotherapist of the hip rotation exercise prescribed for the notional patient prior to communication to the patient which includes a description 1400 of the manner in which the hip rotation exercise should be performed and Figure 15 is a screenshot of the list of tags as created by and available to the user for prescription purposes namely tags for 'office worker exercises'* and general flexibility for older people’1. As shown, a new tag can be created by selecting a new tag button 1501 which brings the user to the exercise list from which exercises can be selected for the new tag.

As outlined in the following example, where the method and system of the invention is implemented on patient devices such as computers, handheld devices, smartphones and the like so that the user can receive alerts, it has been found that surprisingly dramatic increases in prescription compliance are achieved.

IE 1 3 0 0 9 0 Example A significant improvement in physiotherapy patient prescription compliance using the method and system of the invention as compared to conventional prescription methods was demonstrated as follows.

Two groups of four physiotherapy patients were provided with identical physiotherapy prescriptions by a physiotherapist. Each member cf the first control group was provided with a hard copy print-out of the prescribed exercises to be performed over a three week period in the conventional manner, The second group of four patients were each provided with a smartphone on which an app in accordance with the method and system of the invention as hereinbefore described was installed. The patients were prescribed exercises as outlined above and alerts were transmitted to the patients in accordance with the user's instructions Patients communicated compliance with the prescribed exercises to the physiotherapist via the app.

Following expiration of the three week period, the control group were eaca questioned on their level of compliance with the prescription. This data was compared with the compliance data received from the smartphones.

It was found that the average compliance by patients prescribed exercises employing the method and system of the invention was 63% while patients in the group had an average compliance rate of 0.32% employing conventional prescribing techniques.

IE 1 3 0 0 9 0 Accordingly, the method and system of the invention succeeded in optimising patient compliance with physiotherapy prescriptions thus significantly enhancing the likelihood of a favourable outcome for those patients.

In addition to optimised patient compliance, the advantages of the method and system of the invention are many.

Using cloud computing methods, a user such as physiotherapist can employ web interfaces to manage patient records, exercise lists and prescriptions. The prescriptions generated are easy for patients to use and replicate as they are made up of exercise descriptions and images which can include video if desired.

The method and system of the invention can be supplied with pre-installed extensive lists of the most common physiotherapy exercises but is also provided with a function whereby users can create their own exercises if desired.

Exercises can be tagged and sorted by users into ad hoc sets for easier prescription and management e.g. Lower Back Exercises1'which would include all exercises relevant to lower back exercise thereby allowing the user to simply prescribe a tag for the patient to be instructed in all relevant exercises.

In short, as described above, users can, inter alia, create and edit exercises, tag exercises to make them easier to prescribe, add new patient records with ease, prescribe an exercise list, monitor and view patient compliance with prescriptions.

IEf 3 0 ο 9 ο automatically issue alerts and reminders to patients and create and edit articles for communication to patients.

As indicated above, data can be stored in a cloud database to facilitate easy and remote access as required.

The method and system of the invention can be implemented using known technologies such html, css and javascript and Java (Trade Mark).

Where the method and system of the invention is employed with Android smartphones, patients can simply download an app which retrieves data from the server. As indicated above, the app reminds the patient to perform their exercises, displays articles entered by the user and also provides access to the user's contact details to facilitate rapid direct contact with the user as required via phone or email.

A similar app can be employed with iPhones (Trade Mark) and other platforms as req ulred.

The method and system of the invention is also adapted to transmit periodic reminder emails to patients to comply with their prescriptions. The emails can contain a link to a mobile html application which can be used on any phone - or even a desktop.

In a further embodiment of the invention, it is also envisaged that the method and system of the invention could also be networked between patients to gamefy IE 1 3 0 0 9 0 exercises thereby allowing patients to compete when completing prescribed exercises. This could find particular application with sportspeople prescribed exercises by trainers, sports scientists and the like. Similarly, the method and system of the invention could be employed in various forums such as weight loss programmes where participants could be reminded of exercises, demonstrate compliance and optimise weight loss.

The invention is not limited to the embodiments herein described which may be varied in construction and detail without departing from the scope of the invention.

Claims (5)

Claims

1. A method for improving prescription compliance by a patient to an exercise regime prescribed by a health practitioner comprising: prescribing the exercise regime for the patient; automatically issuing a reminder to a patient device to adhere to the prescribed exercise regime, and monitoring adherence to the prescribed exercise regime in accordance with a response received from the patient device to the reminder.

2. A method as claimed in Claim 2 wherein the prescribed exercise regime is an exercise prescription prescribed by a physiotherapist.

3. A method as claimed in Ciaim 2 wherein the patient device is selected from the group comprising a mobile phone, a smartphone, a computer, a tablet or a handheld device.

4. A method as claimed in Claim 3 wherein the exercise prescription, the reminder to adhere to the prescribed exercise regime and the response received from the patient device to the reminder is communicable via a mobile phone app.

5. A method for improving prescription compliance by a patient to an exercise regime prescribed by a health practitioner substantially as hereinbefore described with reference to or as shown in the accompanying drawings.