WO2006002465A1 - Procede, appareil, systeme et produit de programme informatique pour detecter des grappes - Google Patents

Procede, appareil, systeme et produit de programme informatique pour detecter des grappes Download PDF

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Publication number
WO2006002465A1
WO2006002465A1 PCT/AU2005/000954 AU2005000954W WO2006002465A1 WO 2006002465 A1 WO2006002465 A1 WO 2006002465A1 AU 2005000954 W AU2005000954 W AU 2005000954W WO 2006002465 A1 WO2006002465 A1 WO 2006002465A1
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WO
WIPO (PCT)
Prior art keywords
cluster
computer program
care
point
data
Prior art date
Application number
PCT/AU2005/000954
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English (en)
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WO2006002465A8 (fr
Inventor
Geoffrey Patrick Sayer
Original Assignee
Health Communication Network Limited
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
Priority claimed from AU2004903643A external-priority patent/AU2004903643A0/en
Application filed by Health Communication Network Limited filed Critical Health Communication Network Limited
Publication of WO2006002465A1 publication Critical patent/WO2006002465A1/fr
Publication of WO2006002465A8 publication Critical patent/WO2006002465A8/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
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/80—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for detecting, monitoring or modelling epidemics or pandemics, e.g. flu
    • 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
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/70—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for mining of medical data, e.g. analysing previous cases of other patients

Definitions

  • the present invention relates to a method and apparatus for detecting clusters of events in time and space from patient data in the healthcare domain and more particularly to reporting such clusters to external entities such as a health agency.
  • PMS Patient Management System
  • DSS Decision Support System
  • An example of such a system is Medical DirectorTM, provided by Health Communication Network Limited of Level 4, 39-41 Chandos Street, St Leonards NSW 2065, Australia, which comprises a computer software program for execution on a Personal Computer (PC) under an operating system such as Microsoft WindowsTM NT or MicrosoftTM Windows XP Professional.
  • the healthcare domain as a whole is characterised by distributed patient information over a substantial number of points of care.
  • a need thus exists for methods, apparatuses, systems and computer program products that enable significant information to be detected at distributed points of care and reported to external entities for triggering relevant responses.
  • An aspect of the present invention provides a method for detecting a cluster comprising a commonality of events in time and space.
  • the method comprises the steps of: processing data relating to healthcare patients; detecting existence of a cluster based on the data; and reporting detection of the cluster via a communications network to an external agency.
  • the apparatus comprises a communications interface for transmitting and receiving data, a memory unit for storing data and instructions to be performed by a processing unit and a processing unit coupled to the communications interface and the memory unit.
  • the processing unit is programmed to execute the steps of the foregoing method for detecting a cluster comprising a commonality of events in time and space.
  • Another aspect of the present invention provides a computer program product comprising a computer readable medium comprising a computer program recorded therein for detecting a cluster comprising a commonality of events in time and space.
  • the computer program product comprises computer program code for executing the steps of the foregoing method for detecting a cluster comprising a commonality of events in time and space.
  • Another aspect of the present invention provides a computer program product comprising a computer readable medium comprising a computer program recorded therein for detecting a cluster comprising a commonality of events in time and space.
  • the computer program product comprises: a Clinical Software Platform comprising computer program code for processing data relating to clinical patients; a first Knowledge Object comprising computer program code for automatically detecting existence of a cluster based on the data; a second Knowledge Object comprising computer program code for communicating with an external agency via a communication network; and a Knowledge Deployment System (KDS) client comprising computer program code for interfacing the Knowledge Objects to the Clinical Software Platform; wherein a detected cluster is reported substantially without delay to the external agency in response to detection of a cluster.
  • KDS Knowledge Deployment System
  • Another aspect of the present invention provides a method for remotely managing events at one or more points of care.
  • the method comprises the steps of: receiving notification of a cluster detected at a point of care via a communications network, the cluster comprising a commonality of events in time and space; and sending a protocol via the communications network, the protocol defining an appropriate action to be taken at a point of care.
  • Another aspect of the present invention provides a system for remotely managing events at one or more points of care that comprises: a plurality of remote apparatuses for detecting a cluster comprising a commonality of events in time and space, wherein each apparatus is disposed at a point of care; and a central apparatus, comprising: a communications interface for transmitting data to and receiving data from the plurality of remote apparatuses via a communication network; a memory unit for storing data and instructions to be performed by a processing unit; and a processing unit coupled to the communications interface and the memory unit, the processing unit programmed to: receive, via the communications interface and the communications network, notification of detection of a cluster by any one or more of the plurality of remote apparatuses; and transmit, via the communications interface and the communications network, a protocol to one or more of the plurality of remote apparatuses, the protocol defining an appropriate action to be taken at a location of one or more of the remote apparatuses.
  • Another aspect of the present invention provides a computer program product comprising a computer readable medium comprising a computer program recorded therein for remotely managing events at one or more points of care.
  • the computer program product comprises: computer program code for receiving, via a communications network, notification of a cluster detected at a remote point of care, the cluster comprising a commonality of events in time and space; and computer program code for sending, via a communications network, a protocol to at least one remote point of care, the protocol defining an appropriate action to be performed at the at least one remote point of care.
  • Fig. 1 is a block diagram of an apparatus for detecting clusters in accordance with embodiments of the present invention
  • Fig. 2 is a schematic representation of an environment wherein cluster detection according to embodiments of the present invention can be practised;
  • Fig. 3 is a flow diagram of a method for detecting a cluster;
  • Fig. 4 is another flow diagram of a method for detecting a cluster;
  • Fig. 5 is a flow diagram of a method for remotely managing events at one or more points of care;
  • Fig. 6 is a schematic representation of a computer system with which embodiments of the present invention can be practised.
  • Embodiments of methods, apparatuses, systems and computer program products are described herein for detecting clusters in healthcare patient data.
  • a cluster is a commonality of events in time and space.
  • existence of a significant cluster may be indicative of an infectious disease or epidemic such as an outbreak of Severe Acute Respiratory Syndrome (SARS), a medical misadventure, medication use, or symptoms of a medical condition.
  • SARS Severe Acute Respiratory Syndrome
  • Fig. 1 shows a block diagram of an apparatus and system for cluster detection.
  • a point of care system 100 comprises a Clinical Software Platform (CSP) 110, a Knowledge Deployment System (KDS) client 120, and Knowledge Objects (KO 1 and KO 2 ) 132 and 134.
  • CSP Clinical Software Platform
  • KDS Knowledge Deployment System
  • KDS client 120 and the KOs 132 and 134 make up a Knowledge Deployment System that may be hosted by the CSP 110.
  • a CSP is a Patient Management System (PMS) for use by clinicians or healthcare professionals at a point of care.
  • PMS Patient Management System
  • a CSP may be used to prescribe, prepare/retrieve medication charts, order diagnostic tests, write letters, provide decision support, and store and retrieve medical records from a data repository.
  • the CSP 110 is a software application that comprises a patient database 112, a Decision Support System (DSS) 114, and a product user interface (not shown).
  • DSS Decision Support System
  • the CSP 110 communicates with the KDS client 120 by triggering events and by supplying and updating data when requested through a Product Interface (PI).
  • PI Product Interface
  • the patient database 112 comprises an electronic database for storing information and events relating to patients, which may be structured according to a database format such as Structured Query Language (SQL) or DataBase Format (DBF).
  • the DSS 114 is an electronic software application or interface for processing and delivering information to clinicians for patient care.
  • the DSS 114 can be used by a clinician to source information by searching knowledge bases such as guidelines, books, and journals.
  • the DSS 114 may also be automatically triggered by events and/or patient characteristics such as age, sex, medication history, and disease status to locate and present related information to a clinician. For example, headache symptoms recorded against patients listed in the patient database 112 may cause a clinician to search for possible causes of headaches in electronic guidelines.
  • the DSS 114 may automatically generate screen prompts to remind the clinician of the possibility of meningitis in a current patient. If the point of care system 100 detects a cluster of meningitis then the automatically generated prompt is more relevant and salient than the searching facility. However, if a cluster or outbreak of meningitis is not apparent, the use of automatic prompts in relation to patients with headaches may be irrelevant and thus undervalued by a clinician.
  • the KDS client 120 is a part of a distributed KDS system comprising one or more KDS servers (not shown) that provide a framework for deploying, executing, exchanging data with, and managing KOs at a point of care.
  • the KDS system employs a standardised data schema and a communication and information/knowledge channel using web services technology.
  • the KDS system facilitates development of third party software applications (i.e., KOs) without the need for customising each KO to a particular CSP.
  • APIs Application Programmer Interfaces
  • a single PI has to be established for each CSP.
  • a single KO can function across many different CSPs.
  • a CSP can interface with many different KOs through the one PL
  • KOs Knowledge Objects
  • Some examples of KOs are software applications that interact through a KDS client with a CSP. Some examples of KOs are a simple prompt, a data extraction routine, a patient management and data collection protocol, a routine for populating a patient's medical record with clinically relevant data (e.g., pathology results), and a routine for adding additional KOs.
  • the CSP 110 is interfaced to Knowledge Objects (KO 1 , KO 2 ) 132 ' and 134 via the Knowledge Deployment System (KDS) client 120.
  • KDS Knowledge Deployment System
  • the number of KOs is not necessarily limited to two, as shown in the embodiment of Fig. 1, but may comprise any integer number.
  • KO 2 134 is coupled to an external health agency 140 via a communications network (not shown in Fig. 1). Examples of external health agencies are the Royal North Shore Hospital in Sydney, Australia and the Centre for Disease Control (CDC) in Atlanta, Georgia, United States of America.
  • an event occurs (e.g., a patient's clinical records are opened). Each such event is passed to and processed by the KDS client 120. Processing of an event includes dispatch of the event to all applicable KOs, which are determined from a KO register. The applicable KOs typically perform an appropriate action in response to a particular event.
  • the KO 1 132 performs real time monitoring and/or processing 151 of patient data in the patient database 112 to detect clusters that are significant.
  • the KO 1 132 typically comprises statistical algorithms and reference data that are used to determine significant clusters (statistically or clinically) of events at the point of care. The statistical algorithms may use previous data events that occurred at the point of care for comparative purposes and/or predetermined threshold values based on statistical tolerance for specific conditions.
  • Reporting 152 of a detected cluster triggers the DSS 114, which enables a user of the point of care system 100 to be made aware of the cluster and the related patients. Relevant local protocols may also be initiated in the CSP 110, if appropriate. An example of such a local protocol is a recall of patients suffering from headaches, in the case of detection of a meningitis cluster, to undergo further and/or closer examination. Reporting 154 of a detected cluster to the external health agency 140 notifies the location of the cluster and triggers current or update protocols 155 for the duration of the cluster, if appropriate.
  • Clinical or response protocols 153 and 155 are relayed to the CSP 110 via the KO 2 134 in response to reporting 154 of a cluster.
  • the clinical or response protocols 153 may cause appropriate action at the point of care such as updating of the patient database 112 and a recall of patients for further evaluation.
  • Fig. 2 shows an environment wherein cluster detection can be practiced.
  • the point of care systems 210, 212..., 214 are coupled to processing systems of one or more external health agencies 230, 232..., 234 via a communications network 220.
  • the point of care systems 210, 212..., 214 may correspond to the point of care system 110 in Fig. 1.
  • Each of the point of care systems and processing systems of the external health agencies comprise computer systems, examples of which are described in this specification.
  • the numbers of point of care systems and external health agencies are largely unlimited in that any number may participate in a cluster detection system.
  • multiple point of care systems are coupled to a single external health agency via a . communication network.
  • the communication network preferably comprises the Internet but may comprise any other public or private network linked by a communications medium such as cable, wireless, optical fibre, etc.
  • Fig. 3 shows a flow diagram of a method for detecting a cluster, hi particular, the method of Fig. 3 may be performed by the point of care system 100 of Fig.
  • step 310 data relating to healthcare patients is processed to detect any clusters of events.
  • processing is typically performed at a clinical point of care (e.g., a doctor's practice) by a Knowledge Object (KO) software application that interrogates one or more patient databases coupled to a Clinical Software Platform (CSP).
  • a clinical point of care e.g., a doctor's practice
  • KO Knowledge Object
  • CSP Clinical Software Platform
  • a cluster is detected at step 320 and is reported to at least one remote entity at step 330.
  • An example of a remote entity is an external health agency such as the Royal North Shore Hospital in Sydney, Australia or the Centre for Disease Control (CDC) in Atlanta, Georgia, United States of America.
  • Information provided with such a report typically comprises identification of the location of the cluster (e.g., the location of the CSP or point of care), the number of patients the cluster relates to, and the starting time of the cluster.
  • the starting time of a cluster is the time of the earliest event that comprises a cluster.
  • Fig. 4 shows a flow diagram of another method for detecting a cluster, hi particular, the method of Fig. 4 may be performed by the point of care system 100 of Fig. 1 or any of the point of care systems 210, 212..., 214 of Fig. 2.
  • a patient database is continuously monitored to detect any significant clusters of events.
  • Such monitoring is typically performed by a Knowledge Object (KO) software application that processes data in one or more patient databases coupled to a Clinical Software Platform (CSP) that is located at a point of care (e.g., a doctor's practice).
  • KO Knowledge Object
  • CSP Clinical Software Platform
  • Relevancy of an external health agency is determined with respect to one or more specialities of the particular external health agencies.
  • Such reporting typically occurs in real-time, that is, immediately after a cluster is detected.
  • Information provided in such a report typically comprises one or more of identification of the location of the cluster, the number of patients the cluster relates to, and the starting time of the cluster.
  • the starting time of a cluster is the time of the earliest event that comprises a cluster.
  • Current or update protocols may be received from an external health agency over the duration of a cluster as more information comes to hand or decisions are made. If a protocol is received from an external health agency at step 450 (Y), an appropriate action is performed at step 460, if necessary. Examples of such actions are updating of data in the patient database at the point of care and a recall of patients to undergo further testing and/or closer examination.
  • processing returns to step 420, wherein it is determined whether the cluster is still in existence and whether any other clusters exist.
  • a cluster may be terminated, for example, on the authorisation of an external health agency or local authority.
  • Fig. 5 shows a flow diagram of a method for remotely managing events at one or more points of care.
  • a notification of a cluster detected at a point of care is received via a communications network at step 510.
  • a protocol defining an appropriate action to be taken at a point of care is sent via the communications network.
  • the notification is preferably received substantially without delay after detection of the cluster and the protocol may be sent substantially without delay after receiving the notification.
  • the protocol may define one or more actions to be taken at a point of care such as providing a notification to an operator, providing instructions to an operator, amending rules for cluster detection, executing a software program code, and receiving downloaded software program code.
  • the protocol can define an" appropriate action to be performed at more than one point of care, including a point of care that has not detected a cluster. Accordingly, management of events at one or more points of care can be remotely performed by a central KDS server located at an external agency in response to detection of a cluster, thus enabling management of epidemics, potential epidemics and natural disasters.
  • the KDS server can selectively download and/or remotely activate cluster response software programs or systems at multiple sites or points of care, some of which may not actually be experiencing a cluster.
  • the targeted sites or points of care may relate to a specific geographical area or a specific jurisdictional area controlled by authority rights.
  • Fig. 6 is a schematic representation of a computer system 600 that can be used to practice embodiments described herein.
  • the computer system 600 is provided for executing computer software that is programmed to assist in performing a method for detecting a cluster comprising a commonality of events in time and space. More specifically, the computer system 600 provides a means for executing software application programs that perform the functions of Clinical Software Platforms, Knowledge Deployment System clients and Knowledge Objects as described hereinbefore.
  • the computer software executes under an operating system such as MS Windows XPTM or MS Windows NTTM installed on the computer system 600.
  • the computer software involves a set of programmed logic instructions that may be executed by the computer system 600 for instructing the computer system 600 to perform predetermined functions specified by those instructions.
  • the computer software may be expressed or recorded in any language, code or notation that comprises a set of instructions intended to cause a compatible information processing system to perform particular functions, either directly or after conversion to another language, code or notation.
  • the computer software program comprises statements in a computer language.
  • the Clinical Software Platform may be written in a software programming language such as C++, VB.net or Java.
  • the computer program may be processed using a compiler into a binary format suitable for execution by the operating system.
  • the computer program is programmed in a manner that involves various software components, or code means, that perform particular steps of the methods described hereinbefore.
  • the components of the computer system 600 comprise a computer 620, input devices 610, 615 and a video display 690.
  • the computer 620 comprises a processing unit 640, a memory unit 650, an input/output (I/O) interface 660, a communications interface 665, a video interface 645, and a storage device 655.
  • the computer 620 may comprise more than one of any of the foregoing units, interfaces, and devices.
  • the processing unit 640 may comprise one or more processors that execute the operating system and the computer software executing under the operating system.
  • the memory unit 650 may comprise random access memory (RAM), read-only memory (ROM), flash memory and/or any other type of memory known in the art for use under direction of the processing unit 640.
  • the video interface 645 is connected to the video display 690 and provides video signals for display on the video display 690.
  • User input to operate the computer 620 is provided via the input devices 610 and 615, comprising a keyboard and a mouse, respectively.
  • the storage device 655 may comprise a disk drive or any other suitable non ⁇ volatile storage medium.
  • Each of the components of the computer 620 is connected to a bus 630 that comprises data, address, and control buses, to allow the components to communicate with each other via the bus 630.
  • the computer system 600 may be connected to one or more other similar computers via the communications interface 665 using a communication channel 685 to a network 680, represented as the Internet.
  • the computer software program may be provided as a computer program product, and recorded on a portable storage medium.
  • the computer software program is accessible by the computer system 600 from the storage device 655.
  • the computer software may be accessible directly from the network 680 by the computer 620.
  • a user can interact with the computer system 600 using the keyboard 510 and mouse 615 to operate the programmed computer software executing on the computer > 620.
  • the computer system 600 has been described for illustrative purposes. Accordingly, the foregoing description relates to an example of a particular type of computer system suitable for practising the methods and computer program products described hereinbefore. Other configurations or types of computer systems can be equally well used to practise the methods and computer program products described hereinbefore, as would be readily understood by persons skilled in the art. For example, the methods and computer program products described hereinbefore can be practiced using a handheld computer such as a Personal Digital Assistant (PDA).
  • PDA Personal Digital Assistant

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  • Data Mining & Analysis (AREA)
  • Pathology (AREA)
  • Databases & Information Systems (AREA)
  • Biomedical Technology (AREA)
  • Epidemiology (AREA)
  • General Health & Medical Sciences (AREA)
  • Primary Health Care (AREA)
  • Management, Administration, Business Operations System, And Electronic Commerce (AREA)
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Abstract

L'invention concerne des procédés, des appareils, des systèmes et des produits de programmes informatiques permettant de détecter une grappe comprenant des événements communs au niveau temporel et spatial. Des données se rapportant à des patients de soins de santé sont traitées en vue de détecter des grappes (310, 320). Les grappes détectées sont signalées à un organisme externe par le biais d'un réseau de communication (330), lesdites données pouvant comprendre l'identification de l'emplacement de la grappe, le nombre de patients auxquels la grappe se rapporte, et l'heure de démarrage de ladite grappe. Un protocole qui définit une action appropriée à exécuter à un moment des soins peut être reçu d'un organisme externe. D'autres événements se rapportant à la grappe peuvent également être détectés et signalés à l'organisme externe en question par le biais du réseau de communication.
PCT/AU2005/000954 2004-07-02 2005-06-29 Procede, appareil, systeme et produit de programme informatique pour detecter des grappes WO2006002465A1 (fr)

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AU2004903643 2004-07-02
AU2004903643A AU2004903643A0 (en) 2004-07-02 Method, Apparatus, System and Computer Program for Cluster Detection

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WO2006002465A8 WO2006002465A8 (fr) 2006-03-30

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US11749388B1 (en) 2012-05-01 2023-09-05 Cerner Innovation, Inc. System and method for record linkage
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