RU2586854C1 - Method of providing data relating to the patients of medical institution - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method is intended to provide data relating to patients of medical institution. For each of several patients medical institution data set is generated. For each formed data set first and second access codes are assigned. At that, each of first codes is brought in compliance with one of formed set of data. Second code is brought in compliance with more than one formed data set. First code consists of first code word of patient identifying patient, and second code word of patient. At that, second code word together with first code word of patient makes access right to data set of medical institution patient. Generated data set is introduced in database containing data on medical institution patients. Access to database is provided by database control server of medical institution. Data archive is generated characterizing state of medical institution patient's health. For each medical institution patient additionally queried medical institutions, in which patient is registered. Latest by time data is obtained, which characterise state of patient's health. Third access code is generated. At that, third access code together with first access code identifies part of formed medical institution patient data. And third access code together with second access code gives access right to part of medical institution patients set of data.

EFFECT: higher efficiency due to automation of providing user with corresponding data depending on its authorities to obtain access to data portions of medical institution patient, as well as provision of simultaneous access to unlimited number of users.

1 cl, 10 dwg

Description

The present invention relates to systems for automatic control of data transmission in medicine. It is designed to provide access to medical data and can be used to build automated data reporting systems for clinics, medical hospitals and emergency medical services to improve the quality of patient care.

A known method of access to medical information [1], in which the patient by entering a code from a specialized card gets access to medical information regarding his health condition.

The disadvantage of this method is the use of special means of access to medical information, as well as the fact that medical personnel cannot be notified of the critical state of the patient’s health, for example, if the patient does not have a card or specialized equipment for processing it, and take measures to ensure adequate patient treatment. In addition, this method does not provide the ability to access medical information of third parties that can provide emergency medical care in an emergency, for example, when the patient is in an unconscious state.

A known method of providing data related to patients of a medical institution selected as a prototype is known, which consists in the fact that for each of several patients of a medical institution, a set of data is generated that characterizes the health status of the corresponding patient of the medical institution, containing information sufficient to determine the patient's medical

institutions that correspond to the generated data set, each generated data set is assigned the first and second access codes to the data set, each of the first codes is assigned to one generated data set, and the second code is associated with more than one generated data set, the first code consists of a first patient codeword identifying the patient to which the data set belongs, and a second patient codeword giving Together with the first code word of the patient, the right of access to the patient’s data set of the medical institution, the generated data sets are entered into the database containing information about the patients of the medical institution, access to which is provided by the medical institution database management server, and the patient data archive is created.

As follows from the description, the essence of the known method of providing data related to patients of a medical institution is that the user has only two types of access to data related to patients of a medical institution:

- the user using the first code word gets access to the entire data set of one patient;

- together with the second code word - full access to all data sets related to patients of a medical institution.

In addition, from the description of the known method it follows that it is possible to simultaneously access the data set of one patient by several clients.

The drawings illustrate a well-known method of providing data related to patients of a medical institution.

The figure 1 shows the algorithm diagram of a known method of providing data related to patients of a medical institution.

The figure 2 shows a structural diagram of a well-known medical information system (MIS) providing data related to patients of a medical institution.

The figure 3 shows the possible types of access of the known method of providing data related to patients of a medical institution.

The figure 4 shows a schematic diagram of the organization of a two-tier client-server architecture.

The figure 5 shows an illustration of the interaction of IIA clients in a known way of providing data related to patients of a medical institution.

The method of providing data related to patients of a medical institution is as follows (see figure 1):

- form a set of data characterizing the state of health of the corresponding patient of a medical institution;

- form the first and second access codes to the generated data set;

- entry of the generated data set into the database;

- form an archive of patient data.

The structural diagram of the data presentation system (see figure 2) contains: database 1; database management server 2; means of access to the server 3; local access means 4; workstation 5; terminals 6.7; totals of patient data of a medical institution 8, 9, 10 related to different access levels; communication channel 11. Database 1 is intended for storing data sets of patients of a medical institution related to different access levels. The database management server (DBMS) 2 is designed to control access to the database 2. Means of access to the server 3 and local access means 4 are designed to ensure the interaction of external users and users of the local network of the medical institution with the database

data 1, respectively. Automated workplace of the doctor 5 is intended for the diagnosis of the patient. The terminals — telephone set 6 and computer 7 — are intended to provide users with access to database 1. Records of patient data of a medical institution 8, 9, 10 relating to different access levels are intended for storing data corresponding to different access levels. Communication channel 11 is intended for connecting users of a data reporting system to a local network of a medical institution and for connecting users of a local network of a medical institution with the global Internet.

At the same time, an DBMS is created by means of DBMS 2, which stores the names and passwords of users who can access the data of patients in a medical institution. For example, there are 3 types of users: doctors, registries, and patients. The former have all rights; the second - with access rights to the general list of patients, the attending physician, some registration numbers, and also have the opportunity to add new patients with fields available to them; third - access rights only to their treatment methods (see figure 3). When entering the data presentation system, the user name and password are requested. Then they are compared with the names available in the administration base, and with full coincidence, the user type is determined and a certain level of access is provided.

To do this, for each of the patients of the medical institution, a database 1 is filled out, consisting of several records 8, 9, 10, in each of which identification data 12 is recorded, characterizing the patient’s health status and provided to users with different access levels. Additionally, the date of entry of information is indicated. In addition, the first 13 and second 14 codewords are entered into database 1. Thus, in database 1, for each patient, several records 8, 9, 10 are made corresponding to different access levels, each of which reflects the user identification code of the corresponding access level 14,

data 12 and patient code 13. Access to database 1, input, deletion and adjustment of data is carried out under the control of DBMS 2, and data from the database can be stored on the hard disk of server 2 or in another form.

To obtain information regarding a patient of a medical institution, a person who is aware of the first code (a client of a medical institution or his authorized representative) establishes a connection with funds 3. The need for medical information may arise if necessary, medical assistance outside the service area of a medical institution, for example, during a patient’s vacation or business trip or when a patient visits a doctor according to a profile of activities that are not related to the activities of a medical institution, for example, a dentist and whether a homeopath.

To establish a connection, terminals 6 and 7 (telephone sets or computers equipped with modems) can be used, connected to means 3 through an automatic telephone exchange or nodes of a global computer network. To establish a connection, a person who is aware of the first code performs the operations necessary to establish a terminal connection with means 3, for example, dials the corresponding phone number or indicates the URL (unified indicator of the location of the resource on the Internet) or IP (Internet protocol) address of the means 3 on the Internet . After establishing a connection with means 3, the user, upon request of the indicated means, either independently dials by turning the telephone dialer of the telephone set or by pressing the corresponding keys of the telephone set or computer keyboard, the first code that is transferred to means 3. After the user transfers the first code, means 3 are informed that the corresponding patient found. Then, the user is prompted to enter a second code to continue the communication session. This code is entered from the computer keyboard or from the telephone dialer. If the second code does not match either

one of the codes, the user is prompted to re-enter the password, or means 3 is disconnected from the user (the end signal is given).

When transmitting information over a telephone line to an individual telephone set, information can be converted into speech form using software and hardware for speech synthesis using means 3, and information can also be transferred to a fax machine in the format (standard) of fax communication or to a computer modem in the appropriate format.

The transmitted second code can provide the user with access to several patient accounts of the medical institution for which the corresponding second code has been indicated. In this case, the user needs to enter a request with a list of necessary information to continue transmitting information, and further interaction with means 6 is carried out in a mode similar to the above. The preferred form of communication in this case is to obtain information on a computer network.

In the case when the user does not know all or all of the first codeword, the relevant information can be obtained from the telecommunications system operator, which may be the individual or family attending physician of the patient. Such information may be required in case of emergency, for example, in the event of an accident, heart attack or other emergency. In this case, information can be obtained through the operator of a medical institution, which, for example, can be a family or attending physician of a medical institution.

In this case, the user - an emergency medical doctor or other person - establishes a connection with the operator by phone or computer network, indicates the reason for calling the operator and transmits data that allows identification

patient of a medical institution. Such data may be, in particular, passport data or anthropometric data.

To provide a call to the operator of a medical facility, a patient can be given a high-strength storage medium (for example, a steel bracelet or locket) with a telephone, or URL, or IP address. To facilitate patient identification, either the patient identification data (name) or part of the code, for example, the first codeword, is applied to the information carrier. Next to the contact information and identification number, it is indicated that these codes should be used in case of emergency. After establishing a connection with the operator, the operator, on the basis of the received identification data, makes a request to the database, which is processed either using local tools 4 or using server 2, and, if necessary, requests clarification of the identification data. If the patient is successfully identified, the operator enters the second code and requests from the server 2 through local means 3 the data corresponding to the identification patient, and transmits the information necessary for emergency medical care.

The disadvantages of the known method of providing data related to patients of a medical institution are:

1) the impossibility of sampling part of the data relating to patients of a medical institution;

2) low reliability of access to data related to patients of a medical institution, due to a collision or uncertain waiting for access to data due to the simultaneous use of one communication channel by several users

We show the disadvantages of the known method of providing data related to patients of a medical institution.

The analysis of figure 3 shows that in the known method of providing data for one patient, one set of data is generated, respectively, using the first code word, access to the entire set of data of one patient is provided, i.e. access to part of the data within one record is not possible.

According to the authors of the proposed invention, the user should be able to carry out his work in an environment containing in his workspace data selected at his own discretion, but within the framework of his privileges.

Thus, in the known method of providing data related to patients of a medical institution, access to a part of user data is not provided.

1. From the description of the known method of providing data, it follows that the requirements for reliability and fault tolerance are not fulfilled at the level necessary for an MIS of this type.

The well-known MIS, which implements the known method of providing data related to patients of a medical institution, is based on a two-tier client-server architecture (see figure 4). A two-tier client-server architecture is used to create small single and multi-rank networks [3]. Addressing a client directly to the server does not provide a large number of simultaneous connections. Show it. Suppose N is the data of one patient stored in the database, and ΔN _i are the changes made by the i-th client. Then, as follows from the description of the known method of providing data, the entry in the MIS database is as follows:

This formula shows that changes made to the database occur directly. In the case of the simultaneous appeal of the nth number of clients to the same record N, the entry in the MIS database will look like this:

It follows that the data is either overwritten each time, which leads to the loss of all information except the last entered, or to a collision of data, the result of which is impossible to predict.

The structural diagram of the implementation of the known method of providing data related to patients of a medical institution is organized according to a two-tier client-server architecture. This is a fundamental drawback of the well-known MIS (see figure 2): Failure of the MIS server leads to the FAILURE of the entire data access system. Therefore, the use of a two-tier client-server architecture does not guarantee stable and safe operation. For example, as shown in FIG. 5A, while requesting three different users (5, 6 and 7) at the same time, a collision of the data is observed in the known method (see FIG. 5B). In the known method of providing data to MIS patients (due to the use of a two-tier architecture), the data is not differentiated by time, and therefore cannot be recorded simultaneously from different terminals without error. In figure 2, the numbers 5, 6 and 7 show clients accessing, via a single communication channel 11, directly to the means of access to the server 3. At the same time, simultaneous access to the data leads to the following:

- firstly, to the collision of data - data from different clients (see figure 5A), relating to the same patient, recorded at the same time, will lead to an unpredictable result (see figure 5B);

- secondly, to an indefinite waiting time for a data access session — when one of the clients uses the data of the i-th patient, this data automatically becomes unavailable for other clients to change.

Thus, in the known method for providing data related to patients of a medical institution, the requirements for reliability and fault tolerance are not fundamentally provided.

The invention is aimed at improving the quality of medical care for patients by expanding functional capabilities and increasing structural reliability.

This is achieved by the fact that the method of providing data related to patients of a medical institution, namely, that for each of several patients of a medical institution, a set of data is generated that characterizes the state of health of the corresponding patient of the medical institution, containing information sufficient to determine the patient of the medical institution who corresponds to the generated data set, each generated data set is assigned the first and second access codes stupid to the data set, with each of the first codes matching one generated data set, and the second code matching more than one generated data set, the first code consisting of the first patient code word identifying the patient to which the data set belongs, and the second codeword of the patient, giving, together with the first codeword of the patient, the right of access to the patient data set of the medical institution, the generated data sets are entered into a database containing information about the patients of the medical institution, access to which is provided by the database management server of the medical institution, form an archive of data characterizing the state of health of the patient of the medical institution, characterized in that for each patient of the medical institution, the medical institutions in which the patient is registered are additionally interviewed receive the latest in time data characterizing the patient’s state of health, form a third access code that corresponds to forges parts of the formed population

data, moreover, the third access code together with the first access code identifies part of the generated set of patient data of the medical institution to which the data set belongs, and the third access code together with the second access code gives access to part of the data set of patients of the medical institution.

Thanks to the introduced actions, the quality of medical care for patients is increased due to:

- providing access to part of the data relating to patients of a medical institution;

- elimination of potential conflicts of access to data relating to patients of a medical institution, as a result of which reliability indicators are increased, and the waiting time of IIA clients is minimized.

The essence of the invention lies in access to any part of the latest in time data relating to patients of a medical institution. This is ensured by organizing asynchronous access to data through the use of a three-tier client-server architecture and a distributed database.

The figure 6 shows a diagram of the algorithm of the proposed method for providing data related to patients of a medical institution.

The figure 7 shows the proposed types of data access.

The figure 8 shows the structural diagram of the proposed medical information system (MIS) for the provision of data related to patients of a medical institution.

The figure 9 shows an illustration of the interaction of MIS clients in a known method of providing data.

The figure 10 shows a schematic diagram of a three-tier client-server architecture.

We show the work of the proposed method of providing data (see figure 6) related to patients of a medical institution, using the example of its implementation of the proposed IIA.

First, a set of patient data is formed through questionnaires and physiological measurements. After that, the system interrogates all medical institutions and, based on the received reports, the latest patient data is generated. Further, according to the received patient data, the first, second and third access codes to the patient data are generated. The obtained data set is the last in time patient data set and, together with the generated three code words, is entered into the database to form an archive of patient data. The figure 7 shows the proposed types of data access. The first codeword provides access to the entire population of patient data (Figure 7A), the second codeword provides full access to the database (Figure 7B), and the third codeword, together with the first codeword, provides access to the part of the patient data identified by the first codeword ( Figure 7C).

The distributed database of the proposed medical information system (MIS) is designed to provide reliable long-term storage of standardized electronic medical documents (EMS) and information in the electronic medical record (EMC) containing both structured and slightly structured data.

The register of identifiers of subjects of the EMSD is intended for registration and storage of records containing identifiers of patients of medical institutions, as well as to maintain links with the centralized registry of EMSD and external medical organizations.

The structural diagram of the proposed system for the provision of data (proposed MIS) relating to patients of a medical institution, is shown in figure 8. She

contains: database 1; database management server 2; means of access to the server 3; local funds 4; workstation 5; terminal: telephones 6; terminal: computers equipped with modems 7; records of patient data of a medical institution relating to different access levels 8, 9, 10; communication channel 11; data 12; patient code 13; user code 14; data stack 15; application server 16; communications stack data and application server 17; communication channel of MIS servers with the application server. At the request of the client 5, 6 or 7 (or all at the same time), the application server 16 searches and collects all patient data: inside the MIS server, the DBMS 2 requests data from the database 1 and transmits data to the application server 16 via the access means 3 through channel 18. Next, the application server 16 sends data to the data stack 15.

In the proposed method of access to MIS patients, the interaction of clients with the database is implemented as follows.

1. When a client requests patient N data, this data is pushed onto the stack in an amount equal to the current number of active clients.

where N _c is the data in the stack.

2. If it is necessary to change data, the client works with an individual copy of the data specially created for him, without overwriting the reference data. In the process of working with data, based on the reference copy, the introduced changes ΔN _{i are formed} :

3. With a certain frequency specified by the application server, the changes ΔN _i are summed up, forming a total change N _o :

4. Based on the total changes of N _o and the reference copy N by replacement, a record N _c is formed containing all the changes N _o applied to the reference data N:

5. The obtained data N _{c is} entered from the database, after which the reference data N is archived.

From the above it follows that the generated data is entered into the database for one iteration even when several clients are working, in contrast to the known method of accessing the data of patients of a medical institution (MU), where each client works with the database individually.

Thus, in the proposed method, along with the provision of multiple simultaneous access to data on patients with MU, one of the key disadvantages of the prototype is eliminated - data collision. The figure 9 presents a timing diagram illustrating the absence of a collision of data when entering data related to one patient of a medical institution in the database by several clients at the same time.

The method proposed by the authors uses a three-tier client-server architecture (see figure 10) and a distributed database [4], the use of which increases the reliability and fault tolerance of the entire system as a whole. This is achieved by using cloud-based mirroring and version control systems [5]. Using a cloud mirroring system allows you to have special databases (so-called mirrors) in a system of related databases that will replace the main database in case of failure. The client does not contact the database directly, but through the stack and application server. The principle of using the application server is to divide the application into several components, each of which implements a certain set of services. Components

such an application can run on different computers, performing server or client functions. This increases the reliability, security and performance of network applications and the network as a whole.

Such a database organization is a distinctive feature of the three-tier client-server architecture, which allows the client-side version control system to provide simultaneous access to MIS patient data, and, in case of a stack failure, to save all the changes made. The cloud mirroring system is used only in systems with a three-tier client-server architecture.

Thus, as a result of consideration of the implementation of the method of providing data related to patients of a medical institution, it is shown that the user, after checking his credentials and authenticity, gets access to part of the patient’s data of the medical institution intended only for him, and one of the key disadvantages of the prototype is eliminated - collision data.

The technical result achieved by the implementation of the proposed method for providing data is to automate providing the user with the data corresponding to him, depending on his authority and providing simultaneous access to an unlimited number of users.

Bibliography:

1. Personalized display of health information: US patent No. 6032119 / Stephen J. Brown, Erik K. Jensen / 02.29.2000 - 10 p.

2. The method of providing data related to patients of a medical institution: RF patent No. 2171492 / Khazanov M.E. / July 27, 2001.

3. Sneijder J. Effective TCP / IP Programming. Programmer's library. - St. Petersburg: Peter, 2002 .-- 320 p.

4. M. Tamer Ozsu, Patrick Valduriez Distributed and parallel database systems, ACM Computing Surveys (CSUR), Vol. 28 Issue 1, 1996 - pp. 125-128.

5. Monks D. N., Monks H. B., Pronchev B. B., Kuzmenkov D. A. Cloud technologies. Theory and Practice, MAKS Press Moscow, Moscow State University, 2013 - 128 p.

Claims (1)

A method of providing data relating to patients of a medical institution, which consists in the fact that for each of several patients of a medical institution, a set of data is generated that characterizes the health status of the corresponding patient of the medical institution, containing information sufficient to determine the patient of the medical institution to which the generated data set corresponds, each generated data set is associated with the first and second access codes to the data set s, with each of the first codes matching one generated data set, and the second code matching more than one generated data set, the first code consists of the first patient code word identifying the patient to which the data set belongs, and the second code word the patient, giving, together with the first codeword of the patient, the right of access to the patient data set of the medical institution, the generated data sets are entered into a database containing information about the patients of the medical institution, access to which is provided by the database management server of the medical institution, form an archive of data characterizing the state of health of the patient of the medical institution, characterized in that for each patient of the medical institution the medical institutions in which the patient is registered are additionally questioned time data characterizing the patient’s health state form a third access code that corresponds to the part of the generated th set of data, the third security code together with the first part of the access code identifies formed together patient data medical institution to which the set of data, and a third access code with the second access code enables access to a portion of data set medical institution patients.

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