JP2009512010A - System and method for rule-based context management in a medical environment - Google Patents

Abstract

Certain embodiments of the present invention provide improved diagnostic reading and workflow methods and systems in a medical environment using rule-based context management. In one embodiment, the system includes a plurality of information sources, each of the plurality of information sources including information. The system further includes a rules engine that includes at least one rule that governs at least one of information availability and presentation. In addition, the system includes a context manager that obtains information from a plurality of information sources based on the query and filters the information based on at least one rule. In one embodiment, the information source includes, for example, an information system and / or an imaging system.
[Selection] Figure 1

Description

  The present invention relates generally to context management in a medical environment. In particular, the present invention relates to the use of rule-based context management to improve diagnostic reading and workflow in a medical environment.

  The clinical or medical environment is a crowded and harsh environment and can benefit from improved organization and ease of use of imaging systems, data storage systems, and other devices used in medical environments . A medical environment such as a hospital or clinic encompasses a large number of professionals, patients and devices. Medical facility personnel need to manage multiple patients, systems, and tasks in order to provide quality services to patients. Medical personnel can face numerous difficulties or obstacles in their workflow.

  Various obstructions in the clinical environment can frequently interfere with medical personnel and interfere with their work. Furthermore, a work space such as a radiation work space can be cluttered with various monitors, data input devices, data storage devices, and communication devices, for example. Messy workspaces can lead to inefficient workflows and services to clients, which can affect patient health and safety, or can be detrimental to medical equipment. Data entry and access is also complicated by common medical facilities.

  Thus, managing multiple and disparate devices used to perform daily tasks that are already deployed in a crowded environment is difficult for medical or insurance personnel. Furthermore, the lack of interoperability between devices increases the delay and inconvenience associated with using multiple devices in a medical workflow. Utilization of multiple devices can also include managing multiple logons within the same environment. It would be highly desirable to have a system and method that improves ease of use and interoperability between multiple devices in a medical environment.

  In a medical environment involving a wide range of interactions between multiple devices such as keyboards, computer mouse devices, image probes, and surgical devices, repetitive motion disorder often occurs. In order to minimize the damage of repetitive actions, a system and method that eliminates some repetitive actions would be highly desirable.

  A medical environment such as a hospital or clinic includes a medical information system such as a hospital information system (HIS) and a radiation information system (RIS) and a storage system such as an image storage communication system (PACS). The stored information may include, for example, patient medical history, image data, test results, diagnostic information, management information, and / or scheduling information. Information may be stored in the center or may be divided into multiple locations. Medical personnel may wish to access patient information or other information at various points in the medical workflow. For example, during a surgical procedure, medical personnel may access patient information such as, for example, patient anatomy images stored in a medical information system. Alternatively, medical personnel may enter new information, such as history, diagnostic or treatment information, into the medical information system during an ongoing medical treatment.

  In modern information systems such as PACS, information is entered or retrieved using a local computer terminal with a keyboard and / or mouse. During medical treatment or other time in a medical workflow, the physical use of a keyboard, mouse, or similar device is impractical (eg, in a different room) and / or non-hygienic (ie, Violation of personal sterile field preservation). For example, it is impractical for medical personnel to re-sterilize after using a local computer terminal in an operating room, which may make the medical personnel reluctant to access a medical information system. Accordingly, systems and methods that provide access to medical information systems without physical contact would be highly desirable to improve workflow and maintain sterile fields.

  Imaging systems are complex to configure and operate. Medical personnel often acquire patient images, attempt to view or update patient records or diagnoses, and may indicate additional tests or results. Accordingly, there is a need for a system and method that facilitates the operation and interoperability of an imaging system and related devices by an operator.

  In many situations, imaging system operators may experience difficulties in scanning a patient or other subject using the imaging system console. For example, the use of an imaging system such as an ultrasound imaging system for extremity examination, compression examination, carotid artery examination, neonatal head examination, and portable examination can be difficult with a normal system control console. The operator may not physically reach both the console and the scanned location. In addition, the operator may not be able to adjust the patient being scanned and operate the system at the console at the same time. An operator may not reach the phone or computer terminal to access information or to direct examination or medical examination. Providing an additional operator or assistant to assist with the inspection increases the cost of the inspection and can result in errors and unusable data due to mutual failure between the operator and assistant. Accordingly, a method and system that facilitates the operation of the imaging system and related services by individual operators would be highly desirable.

  Reading, such as reading of radiation or heart treatment, is the act of a medical person such as a radiologist or cardiologist viewing a digital image of a patient. Medical personnel make a diagnosis based on the contents of the diagnostic image and report the results electronically (eg, using dictation or otherwise) or in documents. Medical personnel, such as a radiologist or cardiologist, typically use other tools to make a diagnosis. Some examples of other tools include pre and related pre (historical) tests and their results, laboratory tests (such as blood tests), allergies, pathology results, drugs, warnings, document images, and other Is a tool. For example, a radiologist or cardiologist examines other systems such as clinical information, electronic medical records, and medical information when reading test results.

  Currently, medical personnel need to log on to different systems and search for patients to obtain information about the patient from the system. For example, if a patient complains of chest pain, a chest x-ray is taken. The radiologist then logs on to another system to search for the patient and investigate detailed health conditions and symptoms associated with the patient. Thus, a large amount of information for viewing by the radiologist can be presented.

  Depending on the vendors and systems utilized by medical personnel, medical personnel such as radiologists or cardiologists have very few options for browsing available tools. First, requests for information from available tools can be made in document form. Second, medical personnel can search for patients and investigate information electronically, such as a radiologist information system (RIS), an image storage communication system (PACS), an electronic medical record (EMR), a medical information system. (HIS), and different applications such as Clinical Information System (LIS) may be used.

  In the first case, the healthcare professional shifts his or her focus from the reading workstation and often scans and scans documents containing multiple papers per patient. This slows the pace of medical professionals and creates the possibility of mistakes due to the vast amount of documents. Accordingly, a system and method that reduces the amount of documents viewed and prepared by medical personnel would be highly desirable.

  In the second case, electronic information systems often fail to communicate well across different systems. Therefore, medical personnel need to log on to each system separately and search for patients and tests on each system. Such a cumbersome task introduces significant delays and potential for mistakes. Accordingly, systems and methods that improve communication and interaction between multiple electronic information systems would be highly desirable.

  In addition, even if the system is integrated with a medical personnel using a mechanism such as a Clinical Context Object Work Group (CCOW) to provide a unified patient context across multiple systems, the medical personnel will still look through. Excessive information is provided. Excess information from different applications is provided at the same time, slowing the pace of reading and analysis. There is a need to filter out application components that the user does not need in the recurring workflow. Accordingly, a system and method for managing information provided by multiple systems would be highly desirable.

  Further, when a technician performs a radiation or heart treatment, for example, the technician typically accesses multiple applications to obtain information prior to treatment. In the digital environment, information resides in multiple disparate systems such as RIS and PACS. Currently, technicians need to access each system and search for information by clicking on a number of tabs and buttons before accessing all of the information necessary to initiate treatment. Such efforts by technicians to obtain information about treatment often result from reduced productivity due to time consuming and / or time consuming to perform a complete search. Reduce the quality of information. Accordingly, systems and methods that improve searchability and access to data would be highly desirable.

In addition, referring physicians utilize a number of computerized applications for patient care. In radiology, a physician may review information from, for example, RIS, PACS, EMR, and computer physician order entry (CPOE). The referring physician typically accesses multiple applications to obtain all necessary information before, during and / or after patient consultation and follow-up. For example, in a digital environment, a referring physician refers to a web-based image viewer such as PACS to view current treatments, RIS regarding results from previous treatments, and / or any current or previous images. The physician may access the CPOE to direct any follow-up examination. The referring physician opens RIS, PACS, and CPOE to search for information by clicking on a number of tabs and buttons before accessing the information. Accordingly, there is a need for systems and methods that improve searchability and access to data.
WO0248865A

  Accordingly, there is a need for systems and methods that improve diagnostic reading and workflow in a medical environment.

  Certain embodiments of the present invention provide improved diagnostic reading and workflow methods and systems in a medical environment using rule-based context management. In one embodiment, the system includes a plurality of information sources, each of the plurality of information sources including information. The system further includes a rules engine that includes at least one rule that governs at least one of information availability and presentation. In addition, the system includes a context manager that obtains information from a plurality of information sources based on the query and filters the information based on at least one rule. In one embodiment, the information source includes, for example, an information system and / or an imaging system.

  The system further includes an authentication module for authenticating access to at least one of the context manager and at least one of the plurality of information sources. In one embodiment, the system further includes a plurality of perspectives, each perspective storing a relationship with at least one of the plurality of information sources. The medical perspective manager associates the perspective with at least one information source and uses the perspective to allow the user to access at least one associated information source.

  In one embodiment, the rules engine includes multiple sets of rules for multiple populations. The rules engine may adapt one (or more) rules based on previous measurements and / or user input. In one embodiment, the context manager includes multiple rule-based contexts for multiple populations.

  Certain embodiments of a method for rule-based context management in a medical environment include sharing a context between information systems to connect multiple disparate information systems, and at least one of the information systems based on a request. Obtaining information from one and filtering the information based on at least one rule. The method includes defining a set of rules for filtering information from the information system. Further, the method may include, for example, adapting a set of rules based on previous measurement results and / or user input. Further, the method can include selecting a context for obtaining information. The method may include selecting a perspective for obtaining information. In one embodiment, the method includes authenticating access to the information.

  Certain embodiments of a method for providing rule-based context management in a medical environment generate at least one context for obtaining information from at least one information source and at least one for processing information Defining a set of rules and enabling the acquisition of information in one (or more) contexts using one (or more) rules. The method may further include selecting a context from a plurality of contexts for obtaining information. Further, the method can include selecting a set of rules from a plurality of rules for processing the information. The method may include, for example, adapting at least one rule based on previous measurement results and / or user input. The method may further include selecting a perspective for organizing the acquired information.

  In one embodiment, a computer readable storage medium includes a set of instructions for a computer. The set of instructions forms a context management routine for defining a context that coordinates multiple information sources, a rule engine routine for defining rules for processing information, and a query for information in that context. And an information acquisition routine for filtering information based on the rules. The set of instructions may further include a perspective routine for organizing information for the user.

  The foregoing summary, as well as the following detailed description of certain embodiments of the present invention, will be better understood when read in conjunction with the appended drawings. For the purpose of illustrating the invention, certain embodiments are shown in the drawings. However, it should be understood that the invention is not limited to the arrangements and instrumentality shown in the attached drawings.

  FIG. 1 illustrates a rule-based context management system 100 used in accordance with one embodiment of the present invention. The system 100 includes a rules engine 110, a context manager 120, and a plurality of information systems 130, 131, 132, 133. Information systems 130-133 may include, for example, a radiation information system (RIS) 130, an image archiving communication system (PACS) 131, a clinical information system (LIS) 132, and / or an electronic medical record (EMR) 133. The context manager 120 may be, for example, a clinical context object work group (CCOW) context manager. The components of system 100 may communicate via wired and / or wireless connections on one or more processing devices such as computers, medical systems, storage devices, custom processors, and / or other processing devices. In one embodiment, the components of system 100 are integrated into a single unit.

  The system 100 can be used to provide an integrated solution for application execution and / or information retrieval based on rules and context sharing. For example, context sharing allows information and / or configuration selection / setting to be shared, for example, between system environments. For example, rules may be defined dynamically and / or loaded from a library to filter and / or process information generated from information systems and / or applications.

  The context manager 120 may be used to generate patient and / or examination context sharing between the information systems 130-133. The context manager 120 may be an integrated or stand-alone software and / or hardware manager for context sharing between the information systems 130-133. Manager 120 may provide relevant information within the context of the patient and / or examination based on the rules. The context manager 120 may be a context manager such as CCOW that utilizes the HL7 standard to support user and patient context sharing, or other context manager system. Context sharing allows information from multiple systems to be combined into a single context or configuration. For example, information about a particular patient can be extracted from RIS, PACS, and EMR. Manager 120 may be associated with rules engine 110 to extract information from systems 130-133 using, for example, extensible markup language (XML), simple object access protocol (SOAP), and / or other protocols. Function. Manager 120 and / or rules engine 110 may include a user interface such as a graphical or voice command user interface to allow a user to access the components and functions of system 100.

  In one embodiment, context manager 120 includes and / or communicates with an authentication unit. The authentication unit may include software and / or hardware to verify a user's authority to access one or more of the manager 120, information systems 130-133, and / or the rules engine 110. In one embodiment, authentication via context manager 120 allows a user to connect to related information systems 130-133 and other applications. When a user logs on on the system running the context manager 120, rules for logging on on a given information system 130-133 may be generated and stored for the user to access preferred information.

  For example, a physician may prefer to examine clinical, allergies and drugs. Thus, when the physician logs on to the system 100, rules are generated to log on on the LIS and HIS for clinical, allergies and drugs. Applications such as LIS and HIS are moved to the correct patient context. According to the context and based on the rules, the LIS and HIS display relevant information about the patient. For example, the application displays all clinical results for the patient for a particular date. The application further displays all complete blood count (CBC) data for the patient for that date. In another example, rules may filter patient alert data for specific date ranges and / or specific disease types. Thus, from the same workstation utilizing system 100, all based on context sharing and rules, the user examines the RIS for the associated previous report, searches the PACS for the associated previous image, And / or LIS and / or HIS may be investigated for specific information. As a result, diagnostics and diagnostic reports can be reached more quickly and more accurately.

  The rules for the context manager 120 can be generated in various ways. For example, rules may be automatically generated by the rules engine 110 based on preset parameters and / or measurement data. Rules can also be generated by a system administrator or other user. The rules can be modified to provide different information about the diagnosis. The rules can also be adapted manually and / or automatically based on experience. Applicable rules from the rule engine 110 are sent to the context manager 120.

  A user can log on to any one of the connected systems and access information found in all of the connected systems via context sharing. This information can be filtered for easier and more effective browsing. Thus, the user can access the desired information from multiple systems with unwanted information removed.

  In operation, a user such as a radiologist or cardiologist accesses the context manager 120 via, for example, a RIS / PACS system. RIS and PACS systems can be integrated into a single system, for example, using a shared patient and study context. Thus, the user has access to related previous history (eg, images and reports) about the patient. For example, a radiologist may log on on a RIS / PACS system that acquires and integrates information from different systems based on EMR numbers. Automatic login to one or more systems / applications may be achieved via context management.

  However, large amounts of data can arise from such context sharing. All information may be linked at the patient level, for example. The context manager 120 provides related previous history and other information based on, for example, rules from the rules engine 110. Rules can be applied to images, reports, and other data.

  Rule-based context management allows information to be provided to medical personnel about a patient based on predetermined rules. Rules can be used by medical personnel and / or systems to define context for information. For example, if the radiologist wants to see only the clinical results for two months, a rule may be generated at the rules engine 110 to provide only the clinical results for the past two months to the radiologist. Rules can be generated based on time period, examination type, disease type, system type, and the like. The rules may be predefined and / or generated on the fly by medical personnel. Rules may further be automatically generated and / or modified by the rules engine 110 based on, for example, usage patterns and / or preferences of medical personnel.

  For example, a referral doctor preparing for a patient examines the requested treatment, the patient's previous clinical symptoms, the protocol from the radiologist, and the related previous images, current reports and current images. The rules engine 110 may, for example, provide physicians with rules for testing to provide treatment and report information from the RIS, clinical symptoms from the EMR, protocols from the RIS, and current and related previous images from the PACS. Allows to set. When the physician meets the patient, the rules engine 110 may trigger the context manager 120 with information that determines the context. This context is relayed to the physician's desktop by the context manager 120 driven by the connected application. Thus, by selecting a test, the referring physician sees various information.

  For example, a computed tomography (CT) technician preparing a patient scan reviews the requested treatment, the patient's preclinical symptoms, the protocol from the radiologist, and associated previous images. Technicians may utilize rules engine 110 to define rules for CT examination to provide treatment information from RIS, clinical symptoms from EMR, protocol from RIS, and related images from PACS. . If the technician chooses to initiate therapy, the rules engine 110 starts the context manager 120 with information that determines the context for the exam. This context is driven by the context manager 120 to the connected application and associated with the technician's desktop so that the technician can access the relevant information by selecting the exam.

  In one embodiment, manager 120 may work with a perspective management system to process multiple applications and workflows. This perspective management system allows various perspectives to be defined that store workflow steps and other information about a particular user. Perspectives can be used, for example, to store visual component positioning information and interactions based on a workflow. The perspective allows the user to be shown relevant information. An example of a perspective management system is described in a US patent application filed October 1, 2004 entitled "System and Method for Handling Multiple Radiology Applications and Workflows" invented by Prakash Mahesh and Mark Richard. Which is incorporated herein by reference in its entirety.

  FIG. 2 shows a flow diagram of an improved diagnostic reading and workflow method 200 using rule-based context management according to one embodiment of the present invention. First, at step 210, one or more rules are defined. A rule may be, for example, for a particular user or group of users (eg, surgeon, radiologist, cardiologist, etc.), for a particular application or group of uses (eg, image guided surgery, radiation reading, structured reporting). , Examination, etc.), for particular modalities (eg X-ray, ultrasound, magnetic resonance imaging, etc.) and / or for specific platforms (eg PACS, integrated RIS / PACS, And imaging systems, etc.). The rules may be defined, for example, by software, by a user, and / or by a system administrator. New rules may be generated and / or existing rules may be modified.

  Next, at step 220, the user initiates access to a system such as an information system or medical workstation. Access to the system may include authentication with the system and / or authentication with additional connected systems. Authentication may be performed manually and / or automatically based on information entered or stored.

  Next, at step 230, the user queries the system for information. For example, the user queries the system regarding the patient. In step 240, context sharing is utilized to obtain information about queries from various connected systems. For example, context sharing is utilized to obtain patient information from EMR, PAC, RIS, HIS and LIS.

  Next, at step 250, the queried information is filtered based on defined rules applicable to the user. That is, for example, rules defined for users, user populations, modalities, and / or platforms are used to improve and customize the data delivered to the users. Information may be filtered with rules before and / or after the information is obtained from multiple information sources. Accordingly, relevant requested information is presented to the user. The filtered information may be displayed, stored, and / or transferred to another program, for example, for a user. In one embodiment, a user may organize information presented based on perspectives that preserve visual component positioning and interactions based on, for example, a workflow.

  At step 260, the rules may be modified based on instructions executed in the system and / or manual modification by the user. For example, the rules may be automatically improved by the context manager 120 and the rules engine 110 based on the measured request and the choices selected by the user. Further, for example, the user may manually add, delete, and / or modify rules stored in the rules engine 110.

  Thus, certain embodiments unify various information systems and other applications. Certain embodiments filter information available to a user based on rules. Certain embodiments provide rule-based context sharing among multiple systems including RIS, PACS, CVIS (Cardiovascular Information System), EMR, LIS, HIS, and / or other applications. Certain embodiments facilitate improved productivity of radiologist, cardiologist, or other user reading tests that utilize relevant information from other information systems. Improved productivity includes the speed at which the diagnosis is made and the accuracy of reports generated based on the diagnosis.

  In certain embodiments, rules allow information and workflow to be filtered. The user may remember and switch between contexts and rule sets. In certain embodiments, the user may switch between sets of rules without touching the keyboard or mouse using techniques such as voice commands and / or eye tracking. Alternatively, the user may switch between rules that utilize a single click from a mouse device or button. Thus, certain embodiments allow a user to see only the information he or she wants in the workflow he or she wants. Certain embodiments allow a user to manage the number of applications that are accessed at a given time. Certain embodiments provide rules and contexts based on integration between information systems and applications.

  Although the invention has been described in connection with certain embodiments, those skilled in the art will recognize that various changes may be made and equivalents may be substituted without departing from the scope of the invention. You will understand. In addition, many modifications may be made to adapt a particular situation or material to the teachings of the invention without departing from the scope of the invention. Therefore, it is intended that the invention not be limited to the specific embodiments disclosed, but nevertheless it is intended that the invention include all embodiments that fall within the scope of the appended claims.

1 is an illustration of a rule-based context management system used in accordance with one embodiment of the present invention. FIG. 2 is a flow diagram of an improved diagnostic reading and workflow method using rule-based context management, according to one embodiment of the present invention.

Claims (20)

A plurality of information sources each containing information;
A rules engine comprising at least one rule governing at least one of information availability and presentation;
A context manager that obtains information from the plurality of information sources based on a query and filters the information based on the at least one rule;
Rule-based context management system including The system of claim 1, further comprising an authentication module for authenticating access to at least one of the context manager and at least one of the plurality of information sources. The system of claim 1, wherein the plurality of information sources includes at least one of an information system and an imaging system. The system of claim 1, wherein the rule engine includes a plurality of sets of rules for a plurality of populations. The system of claim 1, wherein the rule engine adapts the at least one rule based on at least one of previous measurement results and user input. The system of claim 1, wherein the context manager includes a plurality of rule-based contexts for a plurality of populations. A plurality of perspectives each storing a relationship with at least one of the plurality of information sources;
A medical perspective manager for associating a perspective with at least one information source, the medical perspective manager using the perspective to allow a user to access the at least one associated information source; The system of claim 1, comprising: A method of rule-based context management in a medical environment,
Sharing a context between information systems to connect multiple disparate information systems;
Obtaining information from at least one of the information systems based on a request;
Filtering the information based on at least one rule;
Including a method. 9. The method of claim 8, further comprising defining a set of rules for filtering information from the information system. 9. The method of claim 8, further comprising adapting the set of rules based on at least one of previous measurement results and user input. 9. The method of claim 8, further comprising selecting a context for obtaining the information. The method of claim 8, further comprising selecting a perspective for obtaining the information. The method of claim 8, further comprising authenticating access to the information. A method for providing rule-based context management in a medical environment, comprising:
Generating at least one context for obtaining information from at least one information source;
Defining at least one set of rules for processing information;
Enabling acquisition of information in the at least one context using the at least one rule;
Including a method. 15. The method of claim 14, further comprising selecting a context from a plurality of contexts for obtaining information. 15. The method of claim 14, further comprising selecting a set of rules from a plurality of rules for processing information. 15. The method of claim 14, further comprising adapting at least one rule based on at least one of previous measurement results and user input. 15. The method of claim 14, further comprising selecting a perspective for organizing the acquired information. A computer readable storage medium comprising a set of instructions for a computer, wherein the set of instructions is
A context management routine for defining a context for coordinating multiple information sources;
A rule engine routine for defining rules for processing information;
An information acquisition routine for forming a query for information in the context and filtering the information based on the rules;
A computer readable storage medium comprising: 20. The set of instructions of claim 19, further comprising a perspective routine for organizing information for the user.

Images