WO2001077896A1

WO2001077896A1 - Electronic record system

Info

Publication number: WO2001077896A1
Application number: PCT/SG2001/000057
Authority: WO
Inventors: Choon Yong Loo
Original assignee: Dr. World Pte Ltd.
Priority date: 2000-04-07
Filing date: 2001-04-06
Publication date: 2001-10-18
Also published as: AUPQ678000A0

Abstract

The present invention provides a record keeping system for storing information records, and a method for providing and controlling access to such records, each of which pertains to a respective individual and comprises a plurality of sub-records, the system having: a data storage means for storing the records; data input means for inputting information into the data storage means and amending the information; access control means for controlling read access and write access to the data storage means and operable to allocate read access, write access, or both read and write access for each of the sub-records and to grant read access, write access, or both read and write access for each of the sub-records in response to the provision of one or more correct user authorization codes; wherein each of the records includes at least one sub-record to which read access, write access, or both read and write access is granted by the access control means upon receipt of a plurality of the user authorization codes by the access control means.

Description

ELECTRONIC RECORD SYSTEM

The present invention relates to electronic record systems, in particular, in the use of the electronic medical records in a Healthcare environment, via a computer or other communications network.

BACKGROUND TO THE INVENTION

Healthcare providers have large quantities of information pertaining to patients that are recorded manually, either by being written as paper based records or by manual entering into a database. When a patient visits a clinic, hospital, and laboratory, a record of the patient's visit is made. Each facility keeps its own records of the patient. Accessing a patient's medical information pertinent to a particular condition is often difficult, as that information may be stored remotely or as paper-based records. In the latter case, the information may take a considerable time to be transported to the facility where the patient is in attendance.

Medical records have become more complex, including more information, all of which must be stored, retrieved and transmitted on demand. Historically, in addition, handwritten records lacked sufficient clarity, were difficult to search and contained non-standard abbreviations or terminology.

Some existing attempts to standardize medical records have been poorly received by Healthcare providers. Electronic medical record systems have accommodated the characteristics of the computers than the needs or demands of the users, typically the physicians, nurses and patients. Emphasis on efficiency has resulted in systems that are not user- friendly. Many of the existing manual practices have been preserved as an adjunct to such systems, actually adding a level of redundancy and inefficiency. Further, existing systems lack simplicity.

U.S. Patent No. 5,924,074 teaches a generic electronic medical record system that allows access, storage and retrieval of electronic records in a computer environment via local or wide area network via portable computers . The interface to the record is via touch screen, pen-based computers and wireless network.

U.S. Patent No. 5,974,389 discloses a patient medical record system that looked at improved workflow procedures, allowing multiple access to the record by different care providers based on a predetermined set of rules .

SUMMARY OF THE INVENTION

Accordingly, therefore, the present invention provides a record keeping system for storing information records each of which pertains to a respective individual and comprises a plurality of sub-records, the system having: data storage means for storing said records; data input means for inputting information into said data storage means and amending said information; access control means for controlling read access and write access to said data storage means and operable to allocate read access, write access, or both read and write access for each of said sub-records and to grant read access, write access, or both read and write access for each of said sub-records in response to the provision of one or more correct user authorization codes; wherein each of said records includes at least one sub-record to which read access, write access, or both read and write access is granted by said access control means upon receipt of a plurality of said user authorization codes by said access control means.

Preferably said individual is a natural person, and more preferably a patient. Thus, a single record includes separate sub-records, each for storing different types of information, and each with a separate read and write access, but at least one of these sub-records requires the provision of at least two user authorization codes. Consequently, these codes can be given to separate users so that that sub-record can only be accessed when both or all those users provide their authorization codes. This is particularly valuable when each record pertains to a patient: the two users can then be the patient and the patient's physician.

A user authorization code can comprise data from any suitable authentication technique or combination of techniques, such as a password, biometric data, a pin number, or any combination of two or more of these.

Preferably said access control means is operable to allocate read and write access in respect of a first sub- record of a respective record to said individual, and said system is operable by said individual or by a system administrator to allocate to at least one further individual read and write access to a second sub-record of said respective record, whereby said access control means allocates read access to said further individual in respect of said first sub-record, grants said read and write access to said first sub-record when an authorization code corresponding to said individual is provided and grants said read and write access to said second sub-record and read access to said first sub-record to said further individual when said individual's authorization code and an authorization code corresponding to said further individual are provided.

Thus, where the individual is a patient and the further individual is a physician, the patient can read and write his or her own notes in the first sub-record, while the physician can read and write his or her own notes in the second sub-record and view the patient's notes, but both the patient's and physician's authorization codes must be provided to the access control means before the system will allow the physician to view either sub-records.

More preferably said access control means is operable to grant to said individual said read and write access to said first sub-record and to grant to said further individual said read and write access to said second sub-record and read access to said first sub-record upon the provision of only one of said individual's authorisation code and said further individual's authorization code provided that an emergency authorization code is provided, whereby said access control means will grant subsequent access only after the other of said individual's authorization code and said further individual's authorization code has been provided.

In one embodiment said at least one further person comprises a plurality of persons.

Thus, although the sub-records together constitute a single record, access to each is restricted to specific persons. It should be noted that each person may be a natural person or a legal person.

Preferably said first sub-record is in the form of a diary.

Preferably said system is a medical record keeping system, and said information records are medical records pertaining to said individual.

The present invention also provides a method for providing and controlling access to a record keeping system employing the system described above. The present method still further provides a method for providing and controlling access to information records each of which pertains to a respective individual and comprises a plurality of sub-records, the method involving: storing said records in a data storage means; controlling read access and write access to said data storage means, whereby read access and write access is controlled for each of said sub-records in response to the provision of one or more correct user authorization codes; and granting read access, write access, or both read and write access to at least one sub-record upon receipt of a plurality of said user authorization codes.

Preferably said individual is a natural person, and more preferably a patient.

Preferably said method includes allocating read and write access in respect of a first sub-record of a respective record to said individual, allocating to at least one further individual read and write access to a second sub- record of said respective record, whereby read access is allocated to said further individual in respect of said first sub-record, said read and write access is granted to said first sub-record when an authorization code corresponding to said individual is provided and said read and write access is granted to said second sub-record and read access to said first sub-record to said further individual when said individual's authorization code and an authorization code corresponding to said further individual are provided.

More preferably said method includes granting to said individual said read and write access to said first sub- record and granting to said further individual said read and. write access to said second sub-record and read access to said first sub-record upon the provision of only one of said individual's authorisation code and said further individual's authorization code provided that an emergency authorization code is provided, whereby said method includes granting subsequent access only after the other of said individual's authorization code and said further individual's authorization code has been provided.

Preferably said first sub-record is in the form of a diary.

Preferably said information records are medical records pertaining to said individual .

BRIEF DESCRIPTION OF THE DRAWING

In order that the present invention may be more clearly ascertained, a preferred embodiment will now be described, by way of example, with reference to the accompanying drawing, in which:

Figure 1 is a schematic representation of an electronic medical record according to a preferred embodiment of the present invention;

Figure 2 is a schematic representation of the electronic patient diary of the record of figure 1;

Figure 3 is a flow chart illustrating how access is gained to the physician's notes of the electronic medical record of figure 1;

Figure 4 is a schematic representation of the electronic diagnosis and treatment summary of the record of figure 1;

Figure 5 is a flow chart illustrating how access is gained by a patient to the patient's notes and diagnosis and treatment summary of the electronic medical record of figure 1; and

Figure 6 is a flow chart illustrating how access is gained by a patient and physician to the patient's notes, the physician's notes and the diagnosis and treatment summary of the electronic medical record of figure 1. DETAILED DESCRIPTION OF THE PREFERED EMBODIMENT An electronic medical record (EMR) system according to a preferred embodiment of the present invention comprises an electronic computer database divided into multiple records, each corresponding to a separate patient. An example of such a record when displayed on the screen of a computer is illustrated schematically at 10 in figure 1. The system allows the identity of the patient and that patient's physician to be recorded against the record pertaining to that patient. The record 10 is record is further divided into a number of sub-records corresponding to a patient diary 12, a physician's notes 14 and a diagnosis and treatment summary 16. These sub-records can only be displayed, however, when a user has provided, typically by using the computer's usual input system (such as a keyboard, or over some network) , identification so that the system can determine whether the user should be granted access to the requested record. If the user is the patient, and provides the correct authorization code in the form of a password, biometric data or personal identification number (or combination of these) , the system automatically grants that user exclusive read and write access to that user or patient's patient diary 12. Alternatively, if the identification and password identify a physician, the user must then enter a password or personal identification number provided by the patient in order to gain access to that patient's record. If this is done, the user (i.e. physician) is granted initially exclusive read and write access to any physician's notes 14 requested by the user pertaining to that patient, read access to that patient's patient notes 10, and read and write access (described below) to any diagnosis and treatment summary 16.

The system is operable to permit a patient to annotate his or her conditions over time in patient diary 12, each entry automatically including - if desired - the date and time the entry was made. The patient diary 12 itself is also operable to display an appointment schedule for that patient (not shown) . The physician can add to or amend information in the physician's notes 14, also by means of any suitable input device, including a keyboard or a pressure sensitive pad and a handwriting recognition software system. The physician's notes 14 can generally only be inspected by the physician, but the physician can amend his or her exclusive access to allow colleagues or other authorised parties access as required, as can the system administrator.

The diagnosis and treatment summary 16 comprises a summary of the condition of the patient, and is augmented during or after each time the patient is seen by the physician (again, provided that the patient supplies the appropriate sign-in details) . This section 16 includes details of the treatment and prescription of drugs for that patient.

The system can be accessed remotely, and the above functions performed, provided that each user (patient or physician) provides the necessary identification and password. This means that a patient can arrange for his or her physician to give a physician in another clinic or even country access to any needed medical records .

Figure 2 schematically illustrates generally at 18 the patient diary 12, which itself includes multiple fields including calendar 20, annotations of personal medical conditions 22 and appointment scheduler 24. This allows the patient to record notes of how he or she feels on particular days (i.e. in the calendar 20), schedule appointments to see a physician by means of appointment scheduler 24, and provide access to the patient's account of his or her conditions to other Healthcare providers. As mentioned above, the physician's notes 14 are generally only accessible by the physician. The physician's notes 14 are accessed by an interface for the physician to input information that can only be accessed by the physician. The physician will be able to scribble notes concerning the diagnosis and treatment of the patient, by means of a pen- based device, a keyboard or a voice recognition interface. As described above, however, the physician can grant access to the notes to others. In group practice, for example, where a group of physicians is working as one organisation, the physician or group can grant access to the physician's notes to all the other physicians in the same practice. Figure 3 is a flow chart illustrating this feature 26: when a physician attempts to gain access 28 to a patient's records, the system determines the access to those records by first enquiring 30 of its own records if this patient is being cared for by a group practice. If the answer is no, only the patient's individual physician is granted access 34 to the physician's notes 14. If the answer is yes, all physicians in the group practice are granted access 34.

Figure 4 schematically illustrates generally at 36 the diagnosis and treatment summary 16, where write access is given only to qualified Healthcare providers (generally the physician) and not to the patient. The patient, and physician who has entered this information and other Healthcare providers have read access to the diagnosis and treatment summary 16 for each visit. Although the physician's notes 14 are placed in the same medical record 10, each physician will have exclusive access to his/her own notes 14. To share notes with other Healthcare professionals on a more open basis, the diagnosis and treatment summary 16 - as well as including actual details of diagnoses and treatments 38, includes details of prescriptions 40, a memo pad 42 in which the physician can provide a summary of the medical condition(s) , and details of the patient's previous visits 44. This facilitates better care for the patient, as each Healthcare provider has ready access to details of medical conditions being treated by more than one physician.

Thus, the system allows convenient reference to past attendances by each patient. The physician can access details of any visits made by any of his or her patients to other physicians, and ascertain the treatment that was given on those occasions.

The system can be used to provide point of care consultations to the patient by the physician, and for the patient to provide an account of the patient's medical history, both as recorded by the patient and as recorded by other Healthcare providers in their respective areas. In particular, the system also allows the monitoring of a patient's health remotely via wide-area networks or wireless networks. Annotations made by the patient on the patient's health can be captured by the patient in the patient's diary 12. In addition, specific questions and readings can be entered by the patient into the system as guided and determined by Healthcare providers.

The system also includes diagnosis software, operable to infer the health conditions of a patient by comparing the medical information entered by patient and physician (s) with a medical database according to recognized rules, and weighted according to whether the information comprises subjective impressions of the patient or the diagnoses of the physician(s) . The system is configured to then alert the relevant physician or Healthcare giver to the medical conditions of the patient.

A scenario where a patient is accessing the system is illustrated in flow chart 46 in figure 5, in which the patient is accessing the system from a remote location 48. The patient must first provide sign-in details 50 so that - li ¬

the system can authenticate the patient's identity. If the details provided are incorrect, the system enquires 52 if the details have been forgotten. If so, procedures for the patient to recover the sign-in information are provided 54. If the correct details are provided and of the patient is verified, the patient's record is displayed 56. As described above, the patient is then given read access 58 to the patient's diary 12 and the diagnosis and treatment summary 16 and write access 60 to the patient's diary 12. No access is granted to the physician's notes 14. After completing the session, the patient indicates that the access should be terminated 62.

The interaction of the patient with a physician during a visit to the Healthcare facility is illustrated in flow chart 64 shown in figure 6. During or following the visit 72, the physician must identify himself or herself 74 to the system in gain access to use the system. All physicians accessing the system must have been pre- registered with the system. If not signed in, the system prompts 76 the physician for sign in details; once signed in, the systems prompts for patient sign-in details 78: when a patient arrives, he or she will supply sign-in details so that the physician can identify and access that patient's record. If incorrect patient details are entered, the system enquires 80 as to whether the details have been forgotten. If so, the physician can override 82 this and - to ensure that the system does not result in unnecessary access by Healthcare providers - the system will check with the patient at a later stage that the physician's access has been legitimate. From this point, once appropriate sign-in/over-ride details have been provided, access is granted 84. The physician has read access 86 to the patient's diary 12, and read and write access 88 to that physician's notes 14 and to the diagnosis and treatment summary 16. The system allows Healthcare providers and patients to keep a record of the patient's medical conditions, and Healthcare providers and patients to be alerted on the basis of appointment schedules, health monitoring and medical conditions. The medical record system is accessible by patients, physicians and other Healthcare professionals to whom access has been granted.

Access to the patient's records can be done remotely using any means of transmission such as wide area network, wireless network and with any devices, not limiting to such devices like mobile telephones, personal digital assistant, computers and dedicated monitoring devices. With such access, transaction capabilities will be made possible such as appointment scheduling, appointment alerts, health conditions, laboratory results, alerts of any nature pertaining to visits made to physicians, laboratories, pharmacies, and any other Healthcare facilities.

The advantage of the present invention is its practicality in implementing an electronic medical record system that gives power to the patient to assign rights to a Healthcare giver. The system allows the Healthcare provider to accept inputs that are both proprietary and public. The system thus provides significant benefits to both the patient and the Healthcare provider, allowing each to access and interact with the system resulting in efficient health record management. The system will provide Healthcare providers with a summary of the medical conditions of the patient based on the information entered over time. With this more accessible information, physicians will be able to consult each other through the sharing of the physician's notes and memos, as well as any access granted by the patient. Physicians will be able to refer the patient to more specialized care when required.

With comprehensive records of the patient's medical conditions, the system will also be able to advise the patient on the patient's diet and provide health tips based on the medical conditions captured. Personalised health advice will be formulated and patient will be able to access the advice when needed.

The system can therefore provide personalized information to Healthcare facilities, providers and products that can assist the patient in managing his or her own medical conditions. The system allows the patient to search for information that relates to the patient's conditions.

Another advantage is that the system can provide worldwide care providers access to the patient's record that will assist any Healthcare giver in providing medical aid to the patient.

The features and advantages described here are not all- inclusive, and particularly, many additional features and advantages may be apparent to one of ordinary skills in the art in view of the drawings, specifications and claims. Those skilled in the art may practise the principles of the present invention in other forms without departing from its spirit or essential characteristics. The described embodiment is merely illustrative and does not serve to limit the scope of the invention set forth.

Claims

CLAIMS :

1. A record keeping system for storing information records each of which pertains to a respective individual and comprises a plurality of sub-records, the system having: data storage means for storing said records; data input means for inputting information into said data storage means and amending said information; access control means for controlling read access and write access to said data storage means and operable to allocate read access, write access, or both read and write access for each of said sub-records and to grant read access, write access, or both read and write access for each of said sub-records in response to the provision of one or more correct user authorization codes; wherein each of said records includes at least one sub-record to which read access, write access, or both read and write access is granted by said access control means upon receipt of a plurality of said user authorization codes by said access control means.

2. A record keeping system as claimed in claim 1, wherein said individual is a natural person.

3. A record keeping system as claimed in claim 1, wherein said individual is a patient.

4. A record keeping system as claimed in claim 1, wherein each of said user authorization codes comprises data from any suitable authentication technique or combination of techniques .

5. A record keeping system as claimed in claim 4, wherein each of said user authorization codes comprises a password, biometric data, a pin number, or any combination thereof.

6. A record keeping system as claimed in any one of the

..-r-mM ΛΛΓM preceding claims, wherein said access control means is operable to allocate read and write access in respect of a first sub-record of a respective record to said individual, and said system is operable by said individual or by a system administrator to allocate to at least one further individual read and write access to a second sub-record of said respective record, whereby said access control means allocates read access to said further individual in respect of said first sub-record, grants said read and write access to said first sub-record when an authorization code corresponding to said individual is provided and grants said read and write access to said second sub-record and read access to said first sub-record to said further individual when said individual's authorization code and an authorization code corresponding to said further individual are provided.

7. A record keeping system as claimed in claim 6, wherein said access control means is operable to grant to said individual said read and write access to said first sub- record and to grant to said further individual said read and write access to said second sub-record and read access to said first sub-record upon the provision of only one of said individual's authorisation code and said further individual's authorization code provided that an emergency authorization code is provided, whereby said access control means will grant subsequent access only after the other of said individual's authorization code and said further individual's authorization code has been provided.

8. A record keeping system as claimed in either claim 6 or 7, wherein said at least one further person comprises a plurality of persons.

9. A record keeping system as claimed in any one of the preceding claims, wherein said first sub-record is in the form of a diary.

10. A record keeping system as claimed in any one of the preceding claims, wherein said system is a medical record keeping system, and said information records are medical records pertaining to said individual .

11. A method for providing and controlling access to a record keeping system by means of the system claimed in any one of the preceding claims .

12. A method for providing and controlling access to information records each of which pertains to a respective individual and comprises a plurality of sub-records, the method involving: storing said records in a data storage means; controlling read access and write access to said data storage means, whereby read access and write access is controlled for each of said sub-records in response to the provision of one or more correct user authorization codes; and granting read access, write access, or both read and write access to at least one sub-record upon receipt of a plurality of said user authorization codes.

13. A method as claimed in claim 12, wherein said individual is a patient.

14. A record keeping system as claimed in claim 12, wherein each of said user authorization codes comprises data from any suitable authentication technique or combination of techniques.

15. A record keeping system as claimed in claim 14, wherein each of said user authorization codes comprises a password, biometric data, a pin number, or any combination thereof.

16. A method as claimed in any one of claims 12 to 15, including allocating read and write access in respect of a first sub- ecord of a respective record to said individual, allocating to at least one further individual read and write access to a second sub-record of said respective record, whereby read access is allocated to said further individual in respect of said first sub-record, said read and write access is granted to said first sub-record when an authorization code corresponding to said individual is provided and said read and write access is granted to said second sub-record and read access to said first sub-record to said further individual when said individual's authorization code and an authorization code corresponding to said further individual are provided.

17. A method as claimed in claim 16, including granting to said individual said read and write access to said first sub-record and granting to said further individual said read and write access to said second sub-record and read access to said first sub-record upon the provision of only one of said individual's authorisation code and said further individual's authorization code provided that an emergency authorization code is provided, whereby said method includes granting subsequent access only after the other of said individual's authorization code and said further individual's authorization code has been provided.

18. A record keeping system as claimed in either claim 16 or 17, wherein said at least one further person comprises a plurality of persons.

19. A method as claimed in any one of claims 12 to 18, wherein said first sub-record is in the form of a diary.

20. A method as claimed in any one of claims 12 to 19, wherein said information records are medical records pertaining to said individual.