WO1993022735A1 - Procede et systeme d'optimisation axee sur le malade de la hierarchie des soins apportes, et carte d'identification de malades associee - Google Patents

Procede et systeme d'optimisation axee sur le malade de la hierarchie des soins apportes, et carte d'identification de malades associee Download PDF

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Publication number
WO1993022735A1
WO1993022735A1 PCT/NL1993/000092 NL9300092W WO9322735A1 WO 1993022735 A1 WO1993022735 A1 WO 1993022735A1 NL 9300092 W NL9300092 W NL 9300092W WO 9322735 A1 WO9322735 A1 WO 9322735A1
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WO
WIPO (PCT)
Prior art keywords
patient
care
data
card
identification card
Prior art date
Application number
PCT/NL1993/000092
Other languages
English (en)
Inventor
Leonardus Maria Althuizen
Johanna Maria Kemerink
Peter Louwen
Petrus Antonius Clemens Teunissen
Original Assignee
Pacing Management & Consultancy B.V.
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Pacing Management & Consultancy B.V. filed Critical Pacing Management & Consultancy B.V.
Priority to EP93913617A priority Critical patent/EP0638189A1/fr
Publication of WO1993022735A1 publication Critical patent/WO1993022735A1/fr

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Classifications

    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G16H10/65—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records stored on portable record carriers, e.g. on smartcards, RFID tags or CD
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08—Insurance
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records

Definitions

  • the invention relates to a method for patient-oriented optimization of an order of care treatments offered by care provider, wherein the degree of utilization of all means at the disposal of the care provider, which together with many afore-mentioned orders of care treatments con ⁇ stitute, in their mutual dependence, the care process, is maximized.
  • the invention further relates to a system for patient- oriented optimization of an order of care treatments offered by care provider, wherein the degree of utilizat ⁇ tion of all means at the disposal of the care provider, which together with many afore-mentioned orders of care treatments constitute, in their mutual dependence, the care process, is maximized.
  • the invention relates furthermore to a patient iden ⁇ tification card for use in such a method and in such a system.
  • the term 'patient' covers all of the following terms: patient, client, user, consumer, resident and insured person in as far as applied within the social service sector.
  • the term 'care provider' includes all providers of care such as general practitio ⁇ ners, pharmacists, specialists, nurses, paramedics, insti ⁇ tutions providing care and the like.
  • the patient is not made to become actively involved in planning his own care process.
  • This type of planning mechanism causes an accumulation of waiting periods for the patient.
  • the patient will be in a state of uncertainty during a certain period, his private and business life becoming subordinated to the planning proce- dure of the care provider concerned.
  • These 'costs' have never been defined as health care costs but they run into billions of guilders every year. What is meant here are costs which are shifted onto individuals or onto a group of people collectively, such as for instance the Sickness Benefit System or the Disablement Insurance Act/ General Disablement Act. It would therefore be beneficial to the patient to make this period last as short as possible. Apart from this, it would be advantageous to him if the period between the first and the last care treatment is fixed as early as possible.
  • the care provider too benefits from fixing periods of different treatments of a patient at as early a date as possible, since it will then be possible to make an early assessment of the equipment which will be required for these care treatments.
  • Such requirements are, for in ⁇ stance, certain care providers for a care treatment, the location at which a care treatment will take place, the aids and drugs needed for the care treatment.
  • the available means can be used to their fullest extent.
  • the invention is characterized by a method and a system which optimizes the stream of patients of a care provider consisting of a multitude of an order of care treatments to be carried out per patient, by rendering these treatments interdependent by means of the permission given by the patient to carry out these care treatments, wherein said optimization consists of a mini ⁇ mization of length of time between first and last care treatment of an order of care treatments and a maximazat- ion of the degree of utilization of the means at the disposal of the care provider, consisting of care workers, aids, equipment, space and stocks of goods and drugs.
  • the invention is characterized by a method and a system which collects and manages data con- cerning the state of health of the patient, wherein all these date are the property of the patient and relate to care treatments, irrespective of the fact, that these have been carried out or are being carried out by different care providers, and the patient possesses an information carrier with a unique combination of personal data which provides him sole access to the date concerning his state of health which are present in the system.
  • the invention is characterized by a method and a system which contains the means offered by the care provider and the care treatments offered by the care providers and which can express these in units of time, costs or price per units of time, weight or volume, wherein the system determines the costs, price and dura- tion of a future order of care treatments, after the patient has given permission for them to be carried out.
  • the invention is characterized by a patient identification card, owned by every resident of a country in which the care provider concerned is situated, said card functioning as a key, by means of which permis ⁇ sion is granted for care treatment or order of care treat- ments on the owner and which provides the owner with sole access to an integral survey of his personal medical data.
  • the card also functions as key to the system which con ⁇ tains a combination of personal data which is unique for that person, so that it is of no use and/or value to people other than himself.
  • the invention is characterized by a computer programme which has, using hardware equipment suitable for this purpose, sole access to the data con ⁇ tained on the patient identification card.
  • the sixth aspect of the invention is characterized in that the system is continuously generating developing criteria which render the quality of care measurable and asses ⁇ sable, so that it will be possible, in some cases, to immediately compensate injured parties without having to look at the question of guilt, by which not only the patient is spared additional suffering, but by which the providers of care too, are given the opportunity to con ⁇ tinuously adjust and improve their care programmes.
  • the seventh aspect is characterized by the built-in pos ⁇ sibility of obtaining a payment guarantee beforehand by coupling permissions to packages of care for which the patient is insured.
  • the eighth aspect is characterized by the possibility of using the patient identification card as drug card, donor card or for the benefit of (alterable) expressions of a person's will in case of coma, incompetence, the matter of euthanasia, etc.
  • the invention concerns an automatized planning system, which determines the order of care ac ⁇ tivities to be provided by care providers for the benefit of the treatment of a patient in such a way, that the duration of the order of care activities is as short as possible and the quality of the care offered is as high as possible and that the means required for this are used as efficiently as possible, wherein this automatized planning system uses a unique means of identification which belongs to the patient, by means of which the patient authorizes the user of the automatized planning system to carry out care activities for the benefit of the patient. Because it is the care treatments, which are the same the world over in their systematics, which are taken as a starting point, the planning system can be used in any care system.
  • the invention provides a method of patient-oriented optimization of an order of care treat- ments offered by a care provider, comprising:
  • the present invention moreover provides a system for patient-oriented optimization of care treat ⁇ ments offered by a care provider, comprising a patient identification card having a module with indelible patient data and an access code and further modules with variable data, and a computer programme loaded into a computer to which the patient identification card has sole access by means of the access code, the computer programme having access, after the access code has been read by means of reading equipment, to the further modules and to central data files, said computer programme being suitable to optimize the care treatments.
  • the system for data management consists of a computer programme describing a care provider as a process flow chart and a collection of information-carrying patient identification cards, wherein the computer programme has sole access to the data stored on the patient identifi ⁇ cation card and the patient identification card has sole access to the date stored in the files of the system concerning the state of health of the owner of this card.
  • the computer programme is stored in a main memory to which personal computers are coupled by means of known tech ⁇ niques such as networks, said personal computers being located anywhere in the care institution where care treat ⁇ ments are performed. All personal computer are coupled in situ to equipment which is capable of reading information from and filing it on the patient identification card. According to known techniques, this information can be in an optical, magnetic or electronic form, or a combination of these forms.
  • a central system according to the invention is present in a care institution which contains all previously men ⁇ tioned means of the care institution and their mutual dependence, then it will be possible to create, while optimizing the degree of utilization, a planning per individual means.
  • Such a system ensures that all means for a certain care treatment are present at the desired time and place, after a working schedule has been drawn up per individual means prior to the time at which the care treatment takes place. The result of this is that every care provider connected to such a care institution will know what his planning for the day, week or month will be, thus making it possible to minimize unproductiveness during his periods of presence at the institution.
  • the system which couples the means required for carrying out all individual care treatments to these treatments and which knows the cost price per means per unit of time, will moreover be able to immediately determine the costs of a future order of care treatments during a certain period.
  • the invention also provides a patient identification card provided with a carrier containing modules with indelible patient date and access code and further modules with a memory capacity for variable data, which is eminently suitable for use in the method and the system according to the invention.
  • the patient possesses an information-carrying card which serves as a means of identification for the system and which provides sole access to his medical files stored in this system, it is essential that this card also con ⁇ tains some data of a personal nature which do not vary and which can be extremely relevant to certain care treat ⁇ ments. Examples of this are blood group, tissue typifica- tion, certain allergic reactions and for the future one might think of fingerprints or DNA-code.
  • the card could also contain data of ' a personal data which could have far-reaching consequences for the treatment but which could change during a person's life.
  • a donor card persons who are the patient's con- fidants and who should be consulted in case of coma, expressions of a person's will (euthanasia) , etc.
  • the information-carrying identification card contained data concerning the in ⁇ surance package of the patient and data as to whether or not there are general or specific personal liabilities, so that the care provider, by obtaining the permission of the care provider to carry out a certain order of care treat ⁇ ments, will also have a guarantee that the care provider will be paid for his exertions.
  • Cards and equipment which can be used for the purposes stated above are known in themselves. They could, for instance, be so-called smart cards, optical cards of magnetic strip cards, or a combination of these, which can be read in and out by equipment which is for sale in the shops. Because some goods are provided with standardized barcodes, the reading equipment should be able to read barcodes as well. This equipment can be coupled to per- sonal computers in a known way.
  • Figure 1 shows a structure of the computer programme to be used in the method and the system according to the inven ⁇ tion
  • Figures 2A en B respectively, show the front and the back of a patient identification card
  • Figure 3 shows a schematic process chart of a care insti ⁇ tution.
  • the computer programme 3 uses central data files 2, containing information about the means at the disposal of the care institution. All means are present in the form of variabels. Examples of these means are:
  • the variabels are rendered interdependent, in as far as this applies in the care institution concerned, and/or provided with specific preconditions (such as for instance care workers who work specific hours and can therefore generate different costs) . All variables possess a code to which a length of time and costs per unit and price per unit are coupled. This interdependence leads to a collec ⁇ tion of possible processes which together represents the care package offered by the care institution in the shape of a process flow which can be passed through by the patient. .An example of this is represented in tabel 1.
  • Each process starts with reading the patient iden ⁇ tification card 5 (figure 2) .
  • This has a module 6 with the following data in indelible form: a. an identification number consisting of a main number and a serial number which are composed as follows:
  • the main number is the national insurance number and the serial number is zero.
  • the main number is the national insurance number of the natural person or legal body which represents them (for instance parent, guardian, curator, government insti ⁇ tution) and the serial number is between 1 and 999999999 (children, inhabitants of special institutions) .
  • the main number is the national insurance number of the domestic authority responsible for him or an identification number of a foreign authority and the serial number is between 1 and 999999999. This would include, for instance, centres for persons seeking alle, foreign travel insurers or countries. Each care provider is handed their own serial numbers for these cases. These numbers can also be used in those cases in which, for some reason, residents are (temporarily) not in possession of their card and in which immediate medical treatment is imperative: a so-called wild card.
  • the blood group of the patient possibly complemented with other unvarying data such as tissue typification, finger print, DNA-code, allergies or specific disorders.
  • an access code consisting of, for instance, 10 digits.
  • the computer programme 3 After reading module 6 , the computer programme 3 genera ⁇ tes an output signal (i.e. the key/password) by ' which other modules, for instance 7, 8 and 9 of the patient identification card 5, become suitable to be read by the computer programme 3.
  • the content of these modules 7, 8 and 9 can be altered by the patient and/or an authorized person.
  • Donor code and other information connected with this as well as other expressions of a person's will, such as authorized persons, euthanasia, etc.
  • Data concerning the insurance package such as the name of the insurance company, the policy number, the standard package, the presence of general and specific personal liability, supplementary packages, etc.
  • the patient identification card After the patient identification card has been read, the patient authorizes the carrying out of an order of care treatments relating to himself.
  • the nature (of the treatment) in the form of a code or combination code, constitutes the input fed to the computer programma by a care provider or by variable modules of the patient identification card. The latter is the case if this information was already stored in these modules as a consequence of a previous programme output.
  • the programme generates the following data 4 according to the schedule concerning the order of care treatments represented in figure 1:
  • M The costs of the location per care treatment.
  • N The total costs of the order of care treatments.
  • the patient receives a print-out of a part of the output (A., B. , C. , 0., P., Q.,) as well as of the nature of the order of care treatments, while this information is also stored on a module of his patient identification card.
  • the care provider could receive a print-out of this information once a week, so that he will be in possession of his schedule before the working week starts. It will also be possible for him to gain access to this file by means of a personal pass word, so that he can see what his schedule looks like at any given time.
  • the computer programme Because the goods, equipment and drugs to be used (E. , F.) as well as the quantities thereof are filed in specific files (see figure 1) and because the system also knows what the minimum amounts per item should be (the so-called critical stock) , the computer programme also generates the information as to at what time a specified amount of a certain good, aid of drug should be ordered. In this case too, this can be followed up by a letter being sent to the person responsible for purchases, or the person can read this for himself in the files concerned by means of a pass word. In this manner, the system can manage the stocks and supplies.
  • the system retains all data concer- ning care treatments, it is possible to use the system as an instrument for forming a judgement on the quality of care offered per care provider, per ward, per piece of equipment, per location, etc.
  • the patient has access at all times to his own medical file, so that he will not need permission for this from the care provider.
  • the patient himself owns this file.
  • the system reveals the codes stored on the patient identi- fication card, so that the system as it were manages the file for the patient.
  • Another module can contain the insurance data, it will be possible to determine the costs of certain care treatments before they are carried out and also before reading the card for the benefit of planning. It will also be possible to determine how much of the costs will be paid by the insurance company and how much the patient will have to pay himself. These data could lead to a preference for different care activities, thus enlarging the range of options for the patient.
  • the price of the care offered can immediately be stored on this module or, if desired, on paper. Payment can then take place immediately after the last care treat ⁇ ment by the patient or his insurance company. At present, payment does not take place until at least 60 days after the last treatment.
  • patient identifi ⁇ cation card Although the shape and quality of the patient identifi ⁇ cation card is such that it can easily be carried around by its owner, there will be patient identification cards of the wild card type for non-residents in each institu ⁇ tion and in each mobile care unit.
  • the patients having the highest priority are these requiring semi-urgent care.
  • a fur- ther selection can be made on the basis of the length of time a patient has been on a waiting list. It will also be possible to sort the remaining patients per specialty on the basis of the length of time that they have been on the waiting list. 2. Fill up the time available in the operating theatre and the available beds per specialism with patients appearing on the sorted list in order of priority.
  • the operations can be divided into three groups on the basis of duration, operations of a short, medium or long duration.
  • the patient with the lowest priority who is to undergo a small operation is selected.
  • This patient is replaced by the patient who has not yet been selected, who has to undergo a long operation and who has the highest priority.
  • no action takes place at yet. ⁇ 3. -allocating the selected patients to ⁇ the wards.
  • a patient visiting the clinical consulting-hour receives the following letter at the end of the consultation, with the following contents: 1. Dear Sir/Madam, date and diagnosis
  • the sur ⁇ geon receives a survey from the admissions department, containing the following information:
  • the system is very user-friendly because it minimizes many activities which are at present a constant source of irritation to the staff. These effects are aimed at moti ⁇ vating the staff to switch over from a product/production oriented style of work to a market/client-oriented style. Time will become available for staff to concentrate on the essentials of their work. The amount of time gained comes from drastically reducing administrative procedures, reducing the number of useless actions and reducing the understaffing of the staff (and patient) .
  • the invention has the following effects on the following groups of people concerned:
  • the patient will always take his medical file with him. In this file, it will be automatically recor ⁇ ded that the medical activity has taken place.
  • the management will receive concrete and manageable information concerning costs and yields per opera ⁇ tion/diagnosis and concerning products and statis ⁇ tical data on all possible variables.
  • the data will enable the management to pursue a strategic management style, which is necessary in a health care sector which is being subjected to more market forces.
  • the access of the card to the computer programma can not only take place via an access code represented in digits, for instance magnetic, optical or bar code digits, but that this can be done in many dif ⁇ ferent ways.
  • the card prefferably has an access code in the form of a coating which only reflects light in a certain colour, in the form of a coating which becomes transparent in a certain electro-magnetic field, in the form of a surface of the card having a certain roughness, in the form of a certain form of outline of the card or for instance in the form of cut-away sections in the card.

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  • Engineering & Computer Science (AREA)
  • Business, Economics & Management (AREA)
  • Health & Medical Sciences (AREA)
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  • General Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
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Abstract

Procédé et système d'optimisation axée sur le malade de la hiérarchie des soins proposés par l'organisme responsable, et carte d'identification de malades associée. Le procédé consiste à lire un code d'accès au moyen d'un programme informatique chargé dans un ordinateur, ce code d'accès étant incorporé à un module de données ineffaçables sur la carte d'identification d'un malade; à produire un signal de sortie après l'identification positive du code d'accès par le programme informatique; à lire les modules de données variables sur la carte d'identification du malade, au moyen du programme informatique et grâce au signal de sortie; à traiter les fichiers centraux de données classés dans la mémoire centrale de l'ordinateur par le programme informatique, lesquels fichiers concernent les soins apportés et/ou le malade, et à traiter les données lues sur la carte d'identification du malade, de manière à produire une hiérarchie de soins axée de manière optimisée sur le malade; ainsi qu'à mettre à jour les données variables stockées sur la carte d'identification du malade, et à mettre à jour les fichiers centraux de données une fois que le malade a reçu les soins.
PCT/NL1993/000092 1992-05-01 1993-05-03 Procede et systeme d'optimisation axee sur le malade de la hierarchie des soins apportes, et carte d'identification de malades associee WO1993022735A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP93913617A EP0638189A1 (fr) 1992-05-01 1993-05-03 Procede et systeme d'optimisation axee sur le malade de la hierarchie des soins apportes, et carte d'identification de malades associee

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
NL9200793 1992-05-01
NL9200793A NL9200793A (nl) 1992-05-01 1992-05-01 Werkwijze en systeem voor zorgvragergerichte optimalisering van zorghandelingenvolgorde en zorgvrageridentificatiekaart voor gebruik in een dergelijke werkwijze of dergelijk systeem.

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Publication Number Publication Date
WO1993022735A1 true WO1993022735A1 (fr) 1993-11-11

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EP (1) EP0638189A1 (fr)
AU (1) AU4358593A (fr)
NL (1) NL9200793A (fr)
WO (1) WO1993022735A1 (fr)

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EP0696006A3 (fr) * 1994-08-04 1997-04-02 Osamu Sugiyama Système de réception automatique des patients pour hÔpitaux
WO2000067188A2 (fr) * 1999-04-30 2000-11-09 Bauer Karl Heinz Procede et dispositif pour coordonner plusieurs types de therapie et partenaires de therapie impliques dans le traitement de patients
US9069887B2 (en) 2000-05-18 2015-06-30 Carefusion 303, Inc. Patient-specific medication management system
US9307907B2 (en) 2004-08-25 2016-04-12 CareFusion 303,Inc. System and method for dynamically adjusting patient therapy
US9427520B2 (en) 2005-02-11 2016-08-30 Carefusion 303, Inc. Management of pending medication orders
US9600633B2 (en) 2000-05-18 2017-03-21 Carefusion 303, Inc. Distributed remote asset and medication management drug delivery system
US9741001B2 (en) 2000-05-18 2017-08-22 Carefusion 303, Inc. Predictive medication safety
US9984415B2 (en) 2009-09-24 2018-05-29 Guidewire Software, Inc. Method and apparatus for pricing insurance policies
US10029047B2 (en) 2013-03-13 2018-07-24 Carefusion 303, Inc. Patient-specific medication management system
US10062457B2 (en) 2012-07-26 2018-08-28 Carefusion 303, Inc. Predictive notifications for adverse patient events
US10353856B2 (en) 2011-03-17 2019-07-16 Carefusion 303, Inc. Scalable communication system
US10430554B2 (en) 2013-05-23 2019-10-01 Carefusion 303, Inc. Medication preparation queue
US10867265B2 (en) 2013-03-13 2020-12-15 Carefusion 303, Inc. Predictive medication safety
US11087873B2 (en) 2000-05-18 2021-08-10 Carefusion 303, Inc. Context-aware healthcare notification system
US11182728B2 (en) 2013-01-30 2021-11-23 Carefusion 303, Inc. Medication workflow management
US12001981B2 (en) 2020-11-24 2024-06-04 Carefusion 303, Inc. Predictive medication safety

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WO1991006917A1 (fr) * 1989-10-24 1991-05-16 Garcia Angela M Systeme de stockage centralise de donnees concernant un patient y compris des notes medicales et des resultats de tests et de programmation du suivi et des soins a donner a un patient
FR2659768A1 (fr) * 1990-03-14 1991-09-20 Sextant Avionique Procede de codage et de decodage de cartes a memoire prepayees.
FR2660089A1 (fr) * 1990-03-20 1991-09-27 Cupa Michel Procede et appareil pour acquerir des donnees au cours d'une anesthesie et les ecrire sur un support, et support pour stocker de telles donnees.
WO1991015817A1 (fr) * 1990-04-09 1991-10-17 Alcott William D Iii Serveur a gestion d'assurances et a renseignement medical en temps reel

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Cited By (30)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
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AU4358593A (en) 1993-11-29
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