WO2010117365A1

WO2010117365A1 - Method for automating a clinical appointment

Info

Publication number: WO2010117365A1
Application number: PCT/US2009/040124
Authority: WO
Inventors: Kashif Haqqi
Original assignee: Pragmedic Solutions, Llc
Priority date: 2009-04-09
Filing date: 2009-04-09
Publication date: 2010-10-14

Abstract

One embodiment of the claimed invention is directed towards an apparatus for scheduling medical appointments.

Description

METHOD FOR AUTOMATING A CLINICAL APPOINTMENT

TECHNICAL FIELD

Aspects of automating visits to medical clinics are described. More specifically, aspects of methods for automating patient check in, processing and checkout of medical appointments are described.

BACKGROUND ART

Visits to a medical facility, while being helpful to patients, can also provide unnecessary delays for the patient due to other required activities that must be completed at the office. These activities include checldng in, completion of medical insurance forms, providing background medical history, bill/invoice payment and patient checkout.

The activities that are completed at the physicians office are often complex and repetitive. Unfortunately, these activities are not automated such that the activities can be efficiently performed. The lack of automation of these tasks hampers medical offices around the globe. For individuals who go to physicians more regularly, such as the elderly, the inconvenience compounds many times. To combat the problems associated with the lack of automation, medical offices often employ large numbers of individuals whose primary job is to handle these repetitive tasks and try to speed the patients processing.

Employing large numbers of individuals to handle these tasks has significant disadvantages for medical facilities. First, the employment of large numbers of individuals is a significant overhead cost for the medical facilities. Second, the employed individuals must be trained to complete the forms, as necessary. If the employee terminates employment at the medical facility, then the terminated employee must be replaced by another individual, who often must be trained. The lack of consistency between individuals who are employed can lead to errors and inconsistent work product.

There is a medical facility need to provide an information technology solution to automate client visits to medical facilities. There is a further need to provide an information technology solution to minimize error in tasks performed at the medical facility.

There is also a need to provide a method and apparatus to minimize the number of individuals involved with the processing of patients through the medical facility.

DISCLOSURE OF INVENTION

It is an objective of an aspect of the invention to provide an information technology solution to automate client visits to medical facilities.

It is also an objective of an aspect of the invention to provide an information technology solution to minimize error in tasks performed at the medical facility.

It is a further objective of an aspect of the invention to provide an information technology solution to minimize the number of individuals involved with the processing of patients through the medical facility.

In one aspect, a method to automate a clinical appointment is presented comprising registering patient information at a kiosk, wherein a desired appointment time is transmitted to the system by the patient, checking the desired appointment time with a master schedule, wherein an appointment time to meet with a physician is made when no conflict between the master schedule and the desired appointment time is present and when a desired appointment time conflicts with the master schedule, requiring the patient to re-register and enter a new desired appointment time, generating an invoice for a patient visit after conclusion of an examination at the kiosk, paying the invoice at the kiosk; and discharging the patient.

In another aspect, a program storage device is presented that tangibly embodies a program of instructions executable by the machine to perform method steps to automate a clinical appointment, comprising registering patient information at a kiosk, wherein a desired appointment time is transmitted to the system by the patient, checking the desired appointment time with a master schedule, wherein an appointment time to meet with a physician is made when no conflict between the master schedule and the desired appointment time is present and when a desired appointment time conflicts with the master schedule, requiring the patient to re-register and enter a new desired appointment time, generating an invoice for a patient visit after conclusion of an examination at the kiosk, paying the invoice at the kiosk; and discharging the patient.

In another aspect, an apparatus for automating a clinical appointment is claimed. The apparatus comprises an input device permitting a user of the apparatus to input patient registration information and a desired appointment time into the apparatus, a scheduler for comparing the inputted desired appointment time to a master schedule of a clinical practitioner and confirming the desired appointment time if there is no conflict between the inputted desired appointment time and the master schedule, an invoice generator for generating an invoice for the appointment after conclusion of the appointment and a payment processor for receiving payments of the invoice.

In another aspect, a method of automating a clinical appointment is claimed. The method comprises receiving patient information at an apparatus, as provided above and receiving a desired appointment time transmitted to the system by a user of the apparatus. The method further provides for checking the desired appointment time with a master schedule, wherein an appointment time to meet with a clinical practitioner is made when no conflict between the master schedule and the desired appointment time is present and when a desired appointment time conflicts with the master schedule, requesting that a new desired appointment time be inputted into the apparatus. The method further provides for generating at the apparatus an invoice for the appointment after conclusion of the appointment and receiving payment of the invoice at the apparatus.

In another example embodiment, the payment of the invoice at the apparatus is with a financial transaction card.

In another example embodiment, the receiving of the patient information is performed at a smart card reader.

hi another example embodiment, the inputting of the information on patient visit is done at a kiosk by one of a physician and an assistant. In another example embodiment, the method may further comprise providing a copy of the input into the apparatus by one of a physician and an assistant to the physician to the patient.

In another aspect, a computer program configured to cause data processing apparatus to perform the method described above is claimed.

BRIEF DESCRIPTION OF DRAWINGS

Figure 1 is a method for automating a clinical visit in accordance with an example embodiment of the invention.

Figure 2 is an arrangement of components used perform the method according to Figure 1.

MODES FOR CARRYING OUT THE INVENTION

Referring to Figure 1, a method for automation for medical appointments is illustrated 100. First, a patient is registered at a kiosk 302 by the patient himself/herself or by a person at a front desk 102. In the illustrated embodiment, the method 100 is performed at a kiosk 302 that is equipped to accept and provide information related to the medical examination and procedures for payment. The acceptance of information may be through Smart Card technology, described later, through on-screen typing, an attached keyboard, or through voice commands. The kiosk 302 is a stand alone unit that allows for input and output of information to patients of the medical office. The kiosk 302 may be placed in the patient waiting area to allow them to easily access the kiosk 302, as needed. A separate ldosk 302 may also be provided outside the doctor's office, allowing patients to access and schedule doctors appointments on off-hours. The ldosk 302 may additionally be configured with an internet connection and interface, allowing patients to interface with the system 300 as needed, from home for example. Through actions of the patient in one of these input modes, the patient is scheduled for a meeting with an attending physician 104. The patient is queried as to the preferred meeting time with the physician. The method 100 reviews the master schedule for the physician for the day that the meeting is to be completed and allows a patient to select a meeting time that both the patient and the doctor will be available. In the illustrated embodiment, the master schedule is maintained on a computer system 300 that may be accessed by the kiosk 302. During the scheduling of the meeting at the kiosk 302 by the patient or afterwards, the physician has the ability to amend the master schedule and interact with the kiosk 302 on a real-time or extended basis. During the input phase with the system 300, the system 300 may be configured to recognize patient symptoms that are more problematic and potentially life threatening than routine medical needs. The system 300 may also be configured with an emergency button that will summon individuals within the medical office upon activation. The system 300 can also immediately alert a physician, if necessary, to the needs of the patient, allowing immediate physical attention to those patients in need for such services. Thus, the system 300 has the ability to prioritize the needs of patients, as chosen through interaction with the physician. The kiosk 302 is further configured such that if the master schedule has been changed by the physician at a time after entry of the information by the patient, the patient may be notified, for example, by email or telephone call alerting them to the changed schedule. Although described as a kiosk, any stand-alone arrangement may be used to accept and dispense information to the patient. Likewise, the system 300 may be any type of arrangement of equipment to perform the integration of data.

The interaction between the system 300 and the patient may be performed through a wireless network, through, for example, a Personal Digital Assistant (PDA) or cell phone. After entry of the necessary information at the kiosk 302, the registration of the patient is completed 106. The registration may include, but not be limited to, input of insurance information, descriptions of physical ailments to be diagnosed, and medications currently prescribed. The physician then meets with the individual 108 in the office. In the described embodiment, the activities occur in a private medical office, however the system 300 and method 100 may be used at other offices, such as at a hospital, a dentist office, or other medical professional that would need to provide scheduling and billing coordination.

After the examination by the physician, the physician charges/invoices an appropriate amount based upon the services performed and orders, as applicable, follow- up activities, including laboratory work, radiology work, prescription(s), and provides a scheduling order, patient education courses or a referral to another doctor 110, if necessary. The invoicing can be performed at the kiosk 302 itself or through a connected billing system that interfaces with the kiosk 302 in real time. The system 300 then interacts with a bill/invoice generator, to produce an invoice/bill for the patient based upon the services provided at the meeting with the individual 112. hi the example embodiment, a standardized value for the services provided is included in the system 300 such that after the services are completed by the physician, the correct amount of fee is charged. The physician may also override the standardized value charged by the system 300 in the instance where the services performed are greater in complexity or reduced in complexity than a standardized service. The physician can also remotely identify the materials used during the services rendered so an accurate invoice is presented regarding the materials produced.

After the medical services are provided, the patient returns to the kiosk 302. The kiosk 302 questions the patient for identity and then provides a collection screen where payment is to be performed. The identity may be confirmed, for example, through use of a smart card at the original check in and after the patient examination or through a password previously provided to the medical provider by the patient. The payment may be in the form of cash or submitted through a financial transaction card. The kiosk 302 is configured to accept different forms of financial transaction cards, such as prepaid cards, credit cards, and debit cards in order to allow a user to pay for services received. As such, the system 300 is configured with a magnetic stripe reader to transfer the required information to the system 300. Accordingly, the system 300 is configured to interact with financial transaction card payment systems through dedicated and non-dedicated transmission lines for payment to occur. The system 300 is further configured to allow for quickly transacting the financial payment from the patient to the doctor's office using conventionally known technologies. The kiosk 302 or person attending the front desk of the physician's office then acknowledges receipt of payment 114. A checkout procedure is then initiated such that all required forms are completed and the individual is discharged 116. A print-out of the bill and the services received are provided to the patient, as well as generation of required paperwork for filing by the physician 118. The kiosk 302 is further configured to provide paperwork to the individual such that follow-up visits are scheduled as necessary. The kiosk 302, therefore, is configured to interface with other kiosks at other medical facilities to perform accurate scheduling of patient visits.

The kiosk 302 and method 100 performed by the kiosk 302 are configured to interact with other systems to provide seamless flow of information to and from differing computer programs. The kiosk 302 and method 100 also allow for retrieval of medical records and allows those records to be provided to the physician in a timely basis. The records, for example, can be provided to the physician wirelessly through a PDA or cell phone that the physician maintains throughout the work period upon commencement of the meeting with the patient, thereby minimizing down time for the physician. The records may be provided in an encoded format to minimize risk of interception of the records by unauthorized personnel. Both the PDA/cell phone and the system 300 may be configured to both encode and decode confidential information to maintain the security of the patient's information. The PDA may furthermore be configured to interact with prescription writing software, as required by specified jurisdictions, to minimize the chance of misappropriating prescription medications.

The kiosk 302 and method 100 are also configured to provide an integrated health network electronic interchangeability feature where electronic records are maintained for future review. This electronic network allows for physicians and associated staff to efficiently and securely manage patient health records including patient charting. The kiosk 302 and method 100 are further configured to organize communications and chart information within a practice such that if a specific physician attends to a patient during one visit, the results of the visit are reviewable to others in the practice group at a later date so continuity of care is preserved.

The kiosk 302 and method 100, in the example embodiment, provides for charge capturing and provider notes capability. Additionally, the kiosk 302 and method 100 are configured to generate customized reports for the patient. These customized reports may be provided to others through an email and fax utility capability. The kiosk 302 is configured to operate totally paperless, minimizing costs and record storing space. The kiosk 302 and method 100 are further enabled to manage workflow throughout the office, wherein personnel that may be necessary to perform a more specialized medical procedure are ensured to be present for the appointment. This workflow management capability allows for greater operational efficiency of the office, thereby maximizing care for patients.

The kiosk 302 and method 100 are also enabled with an Alert Manager such that physicians are alerted to numerous conditions, such as abnormal test results received from laboratories and the need to order specialized tests or equipment not present at the medical facility or that are in short supply.

The kiosk 302 and method 100 are further enabled to provide integrated Smart

Card usage, wherein a specific card is used to identify a patient and provide the patient with the ability to carry health care information with them. This capability allows the patient to receive more standardized care if the patient travels from one facility to another.

The Smart Card used may be a pocket-sized card with an integrated circuit that can process data. The card may be configured to transmit, receive and store data, as necessary. In one embodiment, the Smart Card is configured with an integrated circuit that interacts with the kiosk 302 such that information may be transmitted to and from the smart card and the kiosk 302. In the illustrated embodiment, the card is made of plastic. Different types of plastic may be used, including polyvinyl chloride. The card may be equipped with tamper protection devices such as fingerprint scanners and holograms. Additionally, the Smart Card may be equipped with a signature section such that individuals signatures may be verified upon presentation of the card. The kiosk 302 may be configured such that the digitized signature on the Smart Card is required to be matched with a digitized signature that the bearer of the card must input into the kiosk 302 for verification.

The kiosk 302 is configured to interact with a clinical data repository (CDR) that acts as a database to consolidate data from various sources. Sources may be clinical or patient generated sources of information such that subsequent treatment of the patient takes into account information contained within the clinical data repository. The clinical data repository allows physicians to input and retrieve data for a patient or group of patients in order to facilitate management of the treatment for the individual. Clinical data repository data types may include, but not be limited to, clinical laboratory test results, patient demographics, pharmacy and prescription information, radiology reports and images, discharge summaries and pathology reports.

hi the illustrated embodiment, a security system is placed within the Smart Card such that tamper resistant features are presented. Such tamper resistant properties include a secure file system that is only accessible through submission of an access code, and secure crypto processor functions.

hi an alternative configuration, the Smart Card may be configured as a contactless Smart Card that interacts with the kiosk 302 in a wireless fashion. Information from Smart Card may be read by the kiosk 302 wherein the individual presenting the card does not need to run the card through a scanning system.

hi embodiments where a contact Smart Card is presented, a standard for defining the overall configuration of the card may be used. This can be, for example, ISO/IEC 7816 and ISO/IEC 7810. In the contact Smart Card embodiment, the Smart Card may be configured with a rechargeable battery or energy may be supplied by a card reader.

hi the embodiment where a contactless Smart Card is used, a chip on the card may communicate with the card reader through RFID induction technology, hi the illustrated embodiment, a Smart Card can communicate with the kiosk 302 using ISO/IEC 14443 standard. Communication protocols used may be, for example, governed by ISO/IEC 7816-3, as a non-limiting embodiment.

hi an alternative configuration, the Smart Card may be provided with or may be linked to a bank account such that payment of fees for the medical procedure may be automatically deducted from a bank account based upon authorization of a patient.

In further example embodiment, information on the Smart Card may be downloaded into the kiosk 302 such that failure of the Smart Card will not compromise data retention for the patient. Thus, the Smart Card may be "backed up" every time the Smart Card is used with the kiosk system 302. Therefore, if the Smart Card experiences a failure, breakage or is discharged, the patient does not lose valuable medical data placed upon the card.

In an example embodiment of the invention, a liquid crystal display is provided to the kiosk 302 such that viewing input and output of information is possible. The liquid crystal display is an electo-optical amplitude modulated unit that is configured as a thin, flat display screen. In the illustrated embodiment provided, a colour liquid crystal display is used, however other types may be incorporated such as those using monochrome crystals. In the illustrated embodiment, due to the large number of pixels needed for display, the display is multiplexed. In an embodiment using multiplex displaying, electrodes from one side of the display are wired together, such as in columns, and each group is provided its own voltage source. Electrodes for the liquid crystal display may also be grouped in rows. The groups are designated so each pixel has a unique combination of voltage source.

In an additional variant of the invention, the kiosk 302 may be operated through voice commands. The use of voice commands to operate the kiosk 302 allows individuals who have poor visual acuity to input and receive information without need for visual confirmation. Accordingly, the kiosk 302 is configured with a speaker system that allows users to input information into the system 300. hi an embodiment that provides for voice commands to be used, the user may either speak into a built in microphone into the kiosk system 302 or speak through an attached microphone system. The attached microphone system allows placement of the microphone in a more direct arrangement to the user thereby allowing more accurate reading of the voice commands. The kiosk 302, in the illustrated embodiment, allows for visual/auditory help to be provided to those individuals that need assistance with possible commands to be spoken into the system 300.

Referring to Figure 2, a system 300 for conducting the method of Figure 1 is presented. The system 300 has a kiosk 302 that allows individuals, as previously described, to input and receive information. The kiosk 302, in the illustrated embodiment, is provided with an integrated printer to allow forms and other printed material to be distributed to the patient. The kiosk 302 is configured with a wireless transmitted such that the kiosk 302 may connect to the internet 316 or to a physician 314 who carries, for example, a personal digital assistant (PDA).

The kiosk 302 may be connected directly to other medical facilities 312 or data may be transferred through the internet connection 316. The kiosk 302 can also be connected directly or through the internet 316 to a pharmacy 306, a laboratory 304, a radiology facility 308. The ldosk 302 is configured to accept smart card technology to input and transfer information to and from a patient in a secured transaction mode so that the patient may carry necessary information with them from medical facility to medical facility.

In the embodiment illustrated, the method and arrangement of the system 300 may provide for ERP/CRM capabilities for the office. This will allow office managers to provide estimates to clients. The system 300 also provides encrypted communications between systems within the office and external to the office. Such encrypted communications may be performed with systems that archive and retrieve information from computer systems.

In the embodiment provided, the method 100 and arrangement of the system 300 provide for superior inventory accounting for materials within the office. The inventory accounting allows the user, for example a doctor or office manager, to take inventory of current stocks of materials into some prospectively identify future needs, based upon upcoming visits scheduled into the system 300. This functionality allows the doctor to minimize standstill inventory increased profitability.

In addition to Smart Card technology used by the system 300, the system 300 may interface with not only a personal digital assistant, but also with a cell phone. In the instance of interface with a cell phone, the interconnection allows a doctor to receive notification of information changes within the system 300. The cell phone may interface with the system 300 to allow a user to see an upcoming schedule of activities and materials currently on hand at the office. The connection method between the personal digital assistant, the pocket application, or cell phone may be through a WiFi connection, a wired connection, GSM connection or other similar method.

All connections between the system 300 and either the personal digital assistant, pocket application or cell phone may be through, for example, a centralized repository for the office to allow more than one individual to access information contained on the system 300. The system 300 may be configured to provide an outpatient system for the clinic therefore allowing easy ingress and egress from the facility in a timely manner.

In the embodiment provided, the system 300 allows for use of Smart Card technology. The Smart card may be one single card held by an individual that contains all relevant and necessary information for interface with the system 300. In one embodiment, the Smart Card may be a driver's license of an individual that is encoded with additional medical information and insurance information to minimize the number of cards that an individual has to carry during the day. The Smart Card technology may be modifiable such that the Smart Card may be programmed and reprogrammed with information as it changes over time. The Smart Card technology used by the system 300 may also allow for quick scanning of the Smart Card either by bar code or by radiofrequency transmission minimizing the necessary input by the patient into the ldosk 302 of the system 300. Information may be downloaded onto the Smart Card from one doctor to another therefore allowing the patient to transfer necessary medical records from one medical office to another without the necessity of the medical office using separate encrypted communication technologies between doctor's offices. The information contained on the Smart Card may be encrypted such that each of the doctor's offices uses an identical encryption format. This allows for interchange of medical information between doctor's offices that do not use a system that is compatible with the method and system described herein.

In addition to providing information into the kiosk 302 through the Smart Card technology, the Smart Card technology may also include financial information to allow a user to pay for medical services received from the doctor's office. A user may allow for transfer of financial funds into the system 300 or may separately pay for the services rendered at the option of the user. The system 300 is provided with an inventory control system to allow for inventory control to be not only be monitored, but evaluated, over time. This evaluation over time will allow a doctor's office to accurately predict future needs for medical devices and materials. The system 300, thus, can minimize the amount of ordering of products and materials into the office as it can be predicted to a relative degree of certainty the amounts and types of materials that the office will use over time. In an example embodiment, the system 300 may also be configured to automatically place orders for material to establish vendors thereby further minimizing office worker interaction on tasks that are not high value.

AU of the methods provided above may be integrated into a program storage device that is readable by machine, for example, on a computer. The readable instructions may be executable by the machine/computer to automate clinical appointments. The program storage device may be, for example, a computer flash memory device, a computer compact disk or other readable medium.

In the foregoing specification, the aspects of the invention have been described with reference to specific embodiments thereof. It will, however, be evident that various modifications and changes may be made thereunto without departing from the broader spirit and scope of the invention as set forth in the appended claims. The specification and drawings are accordingly to be regarded in an illustrative rather than in a restrictive sense.

AU of the above U.S. patents, U.S. patent application publications, U.S. patent applications, foreign patents, foreign patent applications and non-patent publications referred to in this specification and/or listed in the Application Data Sheet, are incorporated herein by reference, in their entirety.

Claims

1. Apparatus (300) for automating a clinical appointment, the apparatus (302) comprising: an input device (302) permitting a user of the apparatus (300) to input patient registration information and a desired appointment time into the apparatus; a scheduler for comparing the inputted desired appointment time to a master schedule of a clinical practitioner and confirming the desired appointment time if there is no conflict between the inputted desired appointment time and the master schedule; an invoice generator for generating an invoice for the appointment after conclusion of the appointment; and a payment processor for receiving payment of the invoice.

2. Apparatus according to claim 1 wherein the input device is selected from the group comprising a smart card reader, a touch screen, a keyboard and a voice command recognition system.

3. Apparatus according to claim 1 wherein the apparatus is configured to recognise patient information inputted to the apparatus that is indicative of a problematic medical condition.

4. Apparatus according to claim 4 wherein the apparatus is configured to trigger an alert condition if patient information indicative of a problematic medical condition is recognised.

5. Apparatus according to claim 1 further comprising a computer system on which the master schedule is maintained, the computer system being accessible by the scheduler.

6. Apparatus according to claim 1 further comprising a record generation system which is configured to generate a record of the appointment and to provide the record to the patient and to the clinical practitioner.

7. Apparatus according to claim 6 wherein the record generation system is configured to provide the record to the patient by transmitting the record to a smart card.

8. Apparatus according to claim 1 wherein the apparatus is configured electronically to retrieve a patient file from a database and transmit the patient file to the clinical practitioner.

9. A method of automating a clinical appointment, the method comprising: receiving patient information at an apparatus; receiving a desired appointment time transmitted to the system by a user of the apparatus; checking the desired appointment time with a master schedule, wherein an appointment time to meet with a clinical practitioner is made when no conflict between the master schedule and the desired appointment time is present and when a desired appointment time conflicts with the master schedule, requesting that a new desired appointment time be inputted into the apparatus; generating at the apparatus an invoice for the appointment after conclusion of the appointment; and receiving payment of the invoice at the apparatus.

10. The method according to claim 9 wherein the patient information is received by an input device selected from the group comprising a smart card reader, a touch screen, a keyboard and a voice command recognition system.

11. The method according to claim 9 further comprising analysing the patient information inputted to the apparatus to identify information that is indicative of a problematic medical condition.

12. The method according to claim 11 further comprising triggering an alert condition if patient information indicative of a problematic medical condition is identified.

13. The method according to claim 9 wherein the master schedule is maintained on computer system, the method comprising accessing the computer system to check the desired appointment time with the master schedule.

14. The method according to claim 9 further comprising generating a record of the appointment and providing the record to the patient and to the clinical practitioner.

15. The method according to claim 14 wherein the record is provided to the patient by transmitting the record to a smart card.

16. The method according to claim 9 further comprising electronically retrieving a patient file from a database and transmitting the patient file to the clinical practitioner.

17. A computer program configured to cause data processing wherein the apparatus performs the method of claim 9.