Internet-based, customizable clinical information system

Abstract

An Internet-based, or Web-based, customizable clinical (patients' records and care) information system (“CIS”) is provided. More specifically, the clinical information system is Web/Internet based, whether it utilizes a browser-type user interface or a distributed application-type user interface; the clinical information system may include automatic disease staging and associated treatment planning and/or scheduling; the clinical information system may track certain events/submissions and sort such events/submissions into a physician's in-box for on-line approval by the physician, where such approval causes the event/submission to become an addendum to the patient's record; the clinical information system may be customizable by an administrator; the clinical information system may establish, and make available for on-line review and approval, patient care or standing orders over a weekend; the clinical information system may utilize patients' photographs to ensure accurate identification and proper treatment; and the clinical information system may create and store an audit trail record for all significant events.

1 . A method for operating a computerized clinical information system for a healthcare facility comprising the steps of: 
 providing a clinical information system including a plurality of user computers operatively coupled to a computer network, and at least one computer server operatively coupled to the computer network, the computer server having access to at least one clinical information memory source, and being operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computers over the computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data;    providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records;    associating a patient chart record with a primary physician;    entering an event for submission to the patient chart record, by a user other than the primary physician, using the software tool on a first one of the user computers;    encrypting data pertaining to the event by the software tool on the first one of the user computers;    transmitting the encrypted data to the memory source via the server;    decrypting the data;    storing the data in the memory source;    in automatic response by the clinical information system to the step of entering the event for submission to the patient chart record, placing in a queue for viewing by the primary physician an electronic message pertaining to the event;    accessing the data pertaining to the event by the primary physician using a second one of the user computers, whereby the primary physician requests the data from the memory source, the memory source encrypts the data and transmits the encrypted data to the second one of the user computers via the server, and the software tool on the second one of the user computers decrypts the encrypted data;    reviewing and approving the event by the primary physician using the software tool on the second one of the user computers; and    adding the approved event to the patient chart record.    
     
     
         2 . The method of  claim 1 , wherein information pertaining to the queuing, accessing, reviewing, and approving steps is recorded automatically by the clinical information system in a database along with a cryptographic hash of at least part of the information, the information including one or more of the following: 
 an identity of the user using the software tool on the first one of the user computers;    a date of entry of the event;    a time of entry of the event;    a copy of the event as entered by the user using the software tool on the first one of the user computers;    an identity of the primary physician;    a date of approval of the event by the primary physician;    a time of approval of the event by the primary physician;    a copy of the event as approved by the primary physician.    
     
     
         3 . The method of  claim 1 , wherein the reviewing and approving steps include the step of modifying the event by the primary physician.  
     
     
         4 . The method of  claim 3 , wherein versions of the event existing before and after the modifying step are stored in a database.  
     
     
         5 . The method of  claim 1 , wherein the electronic message identifies a document for consideration by the primary physician, and the method further comprises the step of forwarding, with the assistance of the computerized clinical information system, the document to a third party destination.  
     
     
         6 . The method of  claim 1 , wherein the electronic message identifies a document for consideration by the primary physician, and the method further comprises the step of faxing, with the assistance of the computerized clinical information system, the document to a third party.  
     
     
         7 . The method of  claim 1 , wherein the event is a diagnosis and the method further comprises the step of automatically establishing a treatment program by the clinical information system, in automatic response to the approval of the diagnosis by the primary physician in the reviewing and approving step, for the treatment of the diagnosed disease; 
 and wherein the step of automatically establishing a treatment program further includes the step of automatically establishing a treatment schedule by the clinical information system, in automatic response to the establishment of the treatment program, for implementing the treatment program.    
     
     
         8 . The method of  claim 7 , wherein the clinical information memory source includes a plurality of use schedules for a corresponding plurality of the healthcare facility's resources, and the step of, in automatic response to the establishment of the treatment program, automatically establishing the treatment schedule includes the steps of automatically updating the use schedules by the clinical information system to reserve the healthcare facility's resources in accordance with the treatment schedule.  
     
     
         9 . The method of  claim 7 , wherein the method further includes the step of adding the treatment schedule to the patient chart record.  
     
     
         10 . A method for operating a computerized clinical information system for a healthcare facility comprising the steps of: 
 providing a clinical information system including a plurality of user computers operatively coupled to a computer network, and at least one computer server operatively coupled to the computer network, the computer server having access to at least one clinical information memory source, and being operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computers over the computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data, the clinical information memory source including a plurality of use schedules for a corresponding plurality of the healthcare facility's resources;    providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records;    associating a patient chart record with a primary physician;    entering a diagnosis for submission to the patient chart record by a user other than the primary physician using the software tool on a first one of the user computers;    encrypting data pertaining to the event by the software tool on the first one of the user computers;    transmitting the encrypted data to the memory source via the server;    decrypting the data and storing the data in the memory source;    in automatic response by the clinical information system to the step of entering the event for submission to the patient chart record, placing in a queue for viewing by the primary physician an electronic message pertaining to the event;    accessing the data pertaining to the event by the primary physician using a second one of the user computers, whereby the primary physician requests the data from the memory source, the memory source encrypts the data and transmits the encrypted data to the second one of the user computers via the server, and the software tool on the second one of the user computers decrypts the encrypted data;    reviewing and approving the diagnosis by the primary physician using the software tool on the second one of the user computers;    adding the approved diagnosis to the patient chart record; and    automatically establishing a treatment program by the clinical information system for the treatment of the diagnosed disease.    
     
     
         11 . The method of  claim 10 , further comprising the step of automatically establishing a treatment schedule by the clinical information system for implementing the treatment program.  
     
     
         12 . The method of  claim 11 , further comprising the step of automatically checking the use schedules for openings by the clinical information system and automatically filling openings in the use schedules by the clinical information system according to the treatment program; wherein the step of automatically establishing the treatment schedule includes creating the treatment schedule based on the openings in the use schedule.  
     
     
         13 . The method of  claim 11 , further comprising the step of automatically establishing a medication schedule by the clinical information system according to the treatment program.  
     
     
         14 . The method of  claim 13 , wherein the clinical information memory source includes a medication inventory for the healthcare facility and the step of automatically establishing a medication schedule includes the step of automatically updating the medication inventory by the clinical information system in automatic response to the establishment of the medication schedule.  
     
     
         15 . The method of  claim 10 , further comprising the step of automatically establishing a treatment program by the clinical information system for the treatment of the diagnosed disease, the step of automatically establishing a treatment program for the treatment of the diagnosed disease including the step of automatically applying a set of electronically stored expert rules against the diagnosed disease by the clinical information system.  
     
     
         16 . A method for operating a computerized clinical information system for a healthcare facility comprising the steps of: 
 providing a clinical information system including a plurality of user computers operatively coupled to a computer network, and at least one computer server operatively coupled to the computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computers over the computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data;    providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records and a plurality of use schedules for a corresponding plurality of the healthcare facility's resources;    associating a patient chart record with a primary physician;    entering a diagnosis for submission to the patient chart record by a user other than the primary physician using the software tool on a first one of the user computers;    encrypting data pertaining to the event by the software tool on the first one of the user computers;    transmitting the encrypted data to the memory source via the server;    decrypting the data and storing the data in the memory source;    in automatic response by the clinical information system to the step of entering the event for submission to the patient chart record, placing in a queue for viewing by the primary physician an electronic message pertaining to the event;    accessing the data pertaining to the event by the primary physician using a second one of the user computers, whereby the primary physician requests the data from the memory source, the memory source encrypts the data and transmits the encrypted data to the second one of the user computers via the server, and the software tool on the second one of the user computers decrypts the encrypted data; reviewing and approving the diagnosis by the primary physician using the software tool on the second one of the user computers; and    adding the approved diagnosis to the patient chart record; and    automatically establishing a treatment program by the clinical information system for the treatment of the diagnosed disease;    wherein the diagnosed disease includes a stage of the diagnosed disease and the method further comprises the steps of: 
 providing a disease staging software tool on one of the user computers, wherein the disease staging software tool includes a plurality of condition fields pertaining to diagnosed or recorded conditions of a patient and includes a set of expert rules for determining a stage of the disease based upon the diagnosed or recorded conditions of the patient;  
 completing the condition fields on the disease staging software tool by a user on the one of the user computers; and  
 automatically processing the completed condition fields against the set of expert rules by the clinical information system to determine the stage of the disease in response to the step of completing the condition fields on the disease staging software tool by the user on the one of the user computers;  
 wherein the step of automatically establishing a treatment program by the clinical information system for the treatment of the diagnosed disease, automatically establishes a treatment program according to the determined stage of the disease.  
   
     
     
         17 . A method for operating a computerized clinical information system for a healthcare facility comprising the steps of: 
 providing a clinical information system including a plurality of user computers operatively coupled to a computer network, and at least one computer server operatively coupled to the computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computers over the computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data;    providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records;    diagnosing a stage of a patient's disease with the assistance of the software tool on a first one of the user computers, the patient having a chart record in the electronic patient chart database;    adding the diagnosed disease stage to the patient's chart record using the software tool on the first one of the user computers by a user; and    automatically establishing a treatment program by the clinical information system for the treatment of the diagnosed disease stage.    
     
     
         18 . The method of  claim 17  wherein the diagnosing step further comprises the steps of: 
 providing a disease staging graphical user interface by the software tool, the graphical user interface including a plurality of condition fields pertaining to diagnosed or recorded conditions of a patient, the software tool including a first set of expert rules for determining a stage of the disease based upon, at least in part, the diagnosed or recorded conditions of the patient entered into the graphical user interface;    automatically obtaining, by the software tool on the first one of the user computers, information pertaining to the patient's diagnosed or recorded conditions from the patient's chart record;    entering information pertaining to the patient into the condition fields on the graphical user interface by a user on the one of the user computers;    processing the information obtained from the patient's chart record and the completed condition fields against the first set of expert rules to determine the stage of the disease; and    displaying the diagnosed stage of the disease on at least one of the user computers.    
     
     
         19 . The method of  claim 18 , wherein the step of automatically establishing a treatment program further includes the step of, in automatic response to the establishment of the treatment program, automatically establishing a treatment schedule by the clinical information system for implementing the treatment program.  
     
     
         20 . The method of  claim 18 , wherein the condition fields provided by the graphical user interface are controlled by a set of stage diagnosis procedure rules, and the method further includes the steps of: 
 logging into the computerized clinical information system using the software tool on a second one of the user computers by an administrator;    customizing the stage diagnosis procedure rules by the administrator using the software tool on the second one of the user computers.    
     
     
         21 . The method of  claim 18 , wherein the step of automatically establishing a treatment program for the treatment of the diagnosed disease stage includes the step of automatically applying a second set of expert rules against the diagnosed disease stage by the clinical information system.  
     
     
         22 . The method of  claim 21 , further comprising the steps of: 
 logging into the computerized clinical information system using the software tool on a second one of the user computers by an administrator;    customizing at least one of the first and second sets of expert rules by the administrator using the software tool on the second one of the user computers.    
     
     
         23 . The method of  claim 17 , wherein the step of automatically establishing a treatment program further includes the step of automatically establishing a treatment schedule by the clinical information system for implementing the treatment program.  
     
     
         24 . A method for operating a computerized clinical information system for a healthcare facility comprising the steps of: 
 providing a clinical information system including a plurality of user computers operatively coupled to a computer network, and at least one computer server operatively coupled to the computer network, the computer server having access to at least one clinical information memory source, and operative to communicate with the user computers and exchange clinical data between the clinical information memory source and the user computers over the computer network in a secure manner, each of the user computers operating a software tool allowing a user to view and modify at least certain of the clinical data;    providing an electronic patient chart database on the clinical information memory source, the electronic patient chart database having a plurality of patient chart records;    associating a patient chart record with a primary physician;    entering at least one request taken from a group consisting of a new prescription and an order for approval by the primary physician by a user taken from a group consisting of a pharmacist, a pharmacy technician, a nurse, a non-primary physician and a pharmacy assistant using the software tool on a first one of the user computers;    in automatic response to the entering of the new prescription or order, automatically checking a requested dosage of the new prescription or order against safety guidelines by the clinical information system;    in automatic response by the clinical information system to the step of entering the new prescription or order, placing in a queue for viewing by the primary physician an electronic message pertaining to the request;    reviewing and approving the request by the primary physician using the software tool on a second one of the user computers; and    adding the approved new prescription or order to the patient chart record.    
     
     
         25 . The method of  claim 24 , wherein the step of automatically checking a requested dosage of the new prescription or order against safety guidelines includes the step of automatically providing a minimum and maximum dosage for at least one of a patient's body weight and a patient's condition by the clinical information system in automatic response to the entering of the new prescription or order.