Abstract:
The HIPAA Security Rule introduces problems that are solved by technical solutions including minimizing transactions among devices, reducing the number of times and places a captured image is stored, and transforming image data. Embodiments allow a user (e.g., a healthcare provider such as a physician or nurse) to use a computing device (e.g., a smart phone, a tablet, a personal digital assistant (PDA), or a personal computer) to capture an image and/or add an image (e.g., a photo of a rash), encrypt the image, transmit the encrypted image, decrypt the encrypted image, and insert the image directly into a patient medical data record while maintaining HIPAA Security Rule compliance. In embodiments, the selection of the patient medical data record may be based on a search of a user&#39;s patient list or the user&#39;s electronic appointment schedule that may be integrated into a workflow of the user&#39;s practice.

Description:
BACKGROUND 
       [0001]    1. Field 
         [0002]    This field is generally related to adding an image to an electronic health record. 
         [0003]    2. Background 
       Electronic Health Records 
       [0004]    Medical records related to a patient&#39;s health information are essential to the practice of medical care. Traditionally, medical records were paper-based documents. The emergence of electronic medical records (EMRs), which are a digital version of the paper chart that contains all of a patient&#39;s medical history from one medical practice, offers medical professionals and patients with new functionalities and efficiencies that paper-based medical records cannot provide. An EMR which can be incorporated into an electronic health record (EHR), is a collection of electronically stored information about an individual patient&#39;s medical history. EHRs may contain a broad range of data, including demographics, medical history, medication history, allergies, immunization records, laboratory test results, radiology images, vital signs, personal statistics like age and weight, and billing information. Many commercial EHR systems combine data from a number of healthcare services and providers, such as clinical care facilities, laboratories, radiology centers, and pharmacies. 
         [0005]    EHRs are a drastic improvement over paper-based medical records. Paper-based medical records require a large amount of physical storage space. Paper records are often stored in different locations, and different medical professionals may each have different and incomplete records about the same patient. Obtaining paper records from multiple locations for review by a healthcare provider can be time consuming, complicated, and sometimes impossible. In contrast, EHR data is stored in digital format, and thus are more secure and can be accessed from anywhere. EHR systems significantly simplify the reviewing process for healthcare providers. Because records in EHRs can be linked together, EHRs vastly improve the accessibility of health records and the coordination of medical care. 
         [0006]    EHRs also decrease the risk of misreading errors by healthcare professionals. Poor legibility is often associated with handwritten, paper medical records, which can lead to medical errors. EHRs, on the other hand, are inherently legible given that they are typically stored in typeface. In addition, EHRs enhance the standardization of forms, terminology and abbreviations, and data input, which help ensure reliability of medical records, and standardization of codesets and storage of EHR data means that data from different technical information systems can be displayed in a single, unified record. Further, EHRs can be transferred electronically, thus reducing delays and errors in recording prescriptions or communicating laboratory test results. 
         [0007]    The benefits of digitizing health records are substantial. Healthcare providers with EHR systems have reported better outcomes, fewer complications, lower costs, and fewer malpractice claim payments. But despite EHRs&#39; potential in drastically improving the quality of medical care, only a low percentage of healthcare providers use EHR systems. While the advantages of EHRs are significant, they also carry concerns, including high costs, lost productivity during EHR system implementation or computer downtime, and lack of EHR usability. 
         [0008]    The Health Insurance Portability and Accountability Act (HIPAA), enacted in the U.S. in 1996, and as amended, established rules for use and access of protected health information (PHI). HIPAA provides restrictions on disclosure of and access to protected health information to and by third parties. HIPAA applies to information in electronic medical records, such as health information doctors and nurses input, documented conversations between a doctor and a patient, and information use to process or facilitate medical billing claims and documents. The HIPAA Security Rule, effective on Apr. 20, 2005 for most covered entities, adds additional constraints to electronic data security and the storage and transmission of PHI. 
         [0009]    The high cost of EHR systems also significantly hinders EHR adoption. A large number of physicians without EHR systems have referred to initial capital costs as a barrier to adopting EHR systems. Cost concerns are even more severe in smaller healthcare settings, because current EHR systems are more likely to provide cost savings for large integrated institutions than for small physician offices. During the EHR system technology&#39;s setup and implementation process, productivity loss can further offset efficiency gains. The need to increase the size of information technology staff to maintain the system adds even more costs to EHR system usages. 
         [0010]    Usability is another major factor that holds back adoption of EHR systems. It is particularly challenging to develop user-friendly EHR systems. There is a wide range of data that needs to be integrated and connected. Complex information and analysis needs vary from setting to setting, among healthcare provider groups, and from function to function within a healthcare provider group. To some providers, using electronic medical records can be tedious and time consuming, and the complexity of some EHR systems renders the EHR usage less helpful. Some doctors and nurses also complain about the difficulty and the length of time to enter patients&#39; health information into the system. 
         [0011]    Under-utilization of EHR systems, despite incentives and mandates from the government and the tremendous potential of EHR systems in revolutionizing the healthcare system, calls for better EHR systems that are secure, cost-effective, efficient, and user-friendly. 
         [0012]    Comprehensive EHR systems can provide capabilities far beyond simply storing patients&#39; medical records. Because EHR systems offer healthcare providers and their workforce members the ability to securely store and utilize structured health information, EHR systems can have a profound impact on the quality of the healthcare system. In Framework for Strategic Action on Health Information Technology, published on Jul. 21, 2004, the Department of Health &amp; Human Services (HHS) outlined many purposes for EHR services. The outlined purposes include, among other things, improving healthcare outcomes and reducing costs, reducing recordkeeping and duplication burdens, improving resource utilization, care coordination, active quality and health status monitoring, reducing treatment variability, and promoting patients&#39; engagement in and ownership over their own healthcare. 
         [0013]    Recent legislation has set goals and committed significant resources for health information technology (IT). One of the many initiatives of the American Recovery and Reinvestment Act of 2009 (ARRA) was “to increase economic efficiency by spurring technological advances in science and health.” The Health Information Technology for Economic and Clinical Health (HITECH) Act, passed as a part of ARRA, allocated billions of dollars for healthcare providers to adopt and meaningfully use EHR systems in their practices. HITECH also mandates the Office of the National Coordinator for Health Information Technology (ONC) to define certification criteria for “Certified EHR Technology.” 
         [0014]    EHR systems satisfying “Certified EHR Technology” criteria are capable of performing a wide range of functions, including: entry and storage, transmission and receipt of care summaries, clinical decision support, patient lists and education resources, generation of public health submission data, and patient engagement tools. Entry and storage is related to the ability to enter, access and modify patient demographic information, vital signs, smoking status, medications, clinical and radiology laboratory orders and results. Transmission and receipt of care summaries involve the ability to receive, incorporate, display and transmit transition of care/referral summaries. Clinical decision support features configurable clinical decision support tools, including evidence-based support interventions, linked referential clinical decision support, and drug-drug and drug-allergy interaction checks. Patient lists and education resources include the ability to create patient lists based on problems, medications, medication allergies, demographics and laboratory test result values, and the ability to identify patient-specific education resources based on such data elements. Generating public health submission data allows users to create electronic immunization and syndromic surveillance data files that can be submitted to public health agencies. Patient engagement tools allow medical professionals to grant patients with an online means to view, download and transmit their health information to a third party, provide patients with clinical summaries after office visits, and facilitate secure-doctor patient messaging. 
       Adding an Image to a Patient Medical Data Record 
       [0015]    When a doctor takes a picture of a patient&#39;s condition (e.g., a rash) and uploads the image to a patient medical data record, conventional methods involve a multitude of time-consuming steps (e.g., saving the image to a device memory, emailing the image, downloading the image to a desktop computer, logging into an EHR system, and uploading the image to the patient medical data record.) The above steps, when performed using conventional methods, incur many HIPAA Security Rule violations regarding the storage and transmission of private health information. 
       BRIEF SUMMARY 
       [0016]    The HIPAA Security Rule introduces problems that are solved by technical solutions including minimizing transactions among devices, reducing the number of times and places that the image is stored, and transforming image data. Embodiments allow a user (e.g., a healthcare provider such as a physician or nurse) to use a computing device (e.g., a smart phone, a camera, a tablet, a personal digital assistant (PDA), or a personal computer) to capture an image and/or add an image (e.g., a photo of a rash), encrypt the image, transmit the encrypted image, decrypt the encrypted image, and insert the image directly into a patient&#39;s electronic medical record while maintaining HIPAA Security Rule compliance. In embodiments, the selection of the patient&#39;s electronic medical record may be based on a search of a user&#39;s patient list or the user&#39;s electronic appointment schedule that may be integrated into a workflow of the user&#39;s practice. 
         [0017]    Embodiments include a computer-implemented method, a computer program product, and a system for inserting an image into a patient medical data record. Embodiments include receiving from a user a request to add or insert the image to the patient medical data record. When the request is received from an interface of the patient medical data record, for example, the patient medical data record to which the user desires to add an image, embodiments further include obtaining the image; encrypting the image; saving the encrypted image; transmitting the encrypted image from the temporary storage to the server; receiving from the server, a confirmation that the image has been added to the patient medical data record; and deleting the saved encrypted image from the temporary storage on the client device. 
         [0018]    Further embodiments, features, and advantages, as well as the structure and operation of the various embodiments, are described in detail below with reference to accompanying drawings. 
     
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         [0019]    The accompanying drawings, which are incorporated herein and form part of the specification, illustrate the present disclosure and, together with the description, further serve to explain the principles of the disclosure and to enable one of ordinary skill in the art to make and use the disclosure. 
           [0020]      FIG. 1A  illustrates an interface that presents a patient medical data record, according to an embodiment. 
           [0021]      FIG. 1B  illustrates an interface on a computing device that presents a selectable indicator for adding an image to a patient medical data record. 
           [0022]      FIG. 2  is a diagram illustrating an example system for adding an image to a patient medical data record, according to an embodiment. 
           [0023]      FIG. 3  is a flowchart illustrating an example method for adding an image to a patient medical data record, according to an embodiment. 
           [0024]      FIG. 4  is a diagram illustrating an example computing device, according to an embodiment. 
           [0025]      FIG. 5  illustrates a conventional patient medical data record interface. 
           [0026]      FIG. 6  is a flow chart illustrating a conventional method for adding an image to a patient medical data record. 
       
    
    
       [0027]    The drawing in which an element first appears is typically indicated by the leftmost digit or digits in the corresponding reference number. In the drawings, like reference numbers may indicate identical or functionally similar elements. 
       DETAILED DESCRIPTION 
     Overview 
       [0028]    When a patient visits a healthcare provider, the healthcare provider typically reviews the patient&#39;s medical records.  FIG. 5  illustrates a conventional patient medical data record interface. The patient medical data record mimics a patient chart, in that it contains various types of information about a particular patient, from basic facts to more detailed medical information. Disparate types of information may be separated into various tabs, as illustrated in  FIG. 5 . For example,  FIG. 5  has a home screen for the patient that includes tabs for “messages” and “documents.” There is also a “Start a chart note” button that may be selected when a healthcare provider wishes to add new information into the record. 
         [0029]    However, when the healthcare provider wants to add an image of the patient&#39;s condition to the patient medical data record, there is no simple way to do this using conventional methods. As a result, the healthcare provider often performs multiple time-consuming steps that typically incur many HIPAA Security Rule violations.  FIG. 6  is a flow chart illustrating a conventional method for adding an image to a patient medical data record. In this example, the healthcare provider is the user of the EHR system. 
         [0030]    Method  600  begins at step  610  where the user captures an image of the patient&#39;s condition with a mobile device. For example the user may take a photo of a patient&#39;s condition such as a rash using the mobile device, such as a phone or a camera. As the mobile device is likely not HIPAA compliant, this action may constitute a HIPAA violation. 
         [0031]    At step  620 , the user transfers the image to a computing device such as a desktop computer with access to an EHR system. For example, the user may attach the image to an email message and send the email message to an email account that is accessible from the desktop computer. Depending on the type of email provider used (e.g., whether it is a cloud-based email provider, and/or an unsecured email provider), this action may constitute one or multiple HIPAA violations. 
         [0032]    At step  625 , the email is opened from the desktop computer, and the user may save the attached image to the desktop computer in preparation for uploading the image into a patient medical data record, possibly constituting another HIPAA violation. Or, if a camera is used to capture the image, the user may transfer the image from the camera&#39;s memory card to the desktop computer, also potentially constituting a HIPAA violation. 
         [0033]    At step  630 , the user searches for the patient medical data record in the EHR system (e.g., the user sends via the computing device, a request for the patient medical data record to the EHR system). If the user is not already logged into the EHR system, the user first enters login credentials to gain access to the EHR system. 
         [0034]    At step  635 , the user finds the patient medical record (e.g., the computing device receives the patient medical record from the EHR system). 
         [0035]    At step  640 , the user uploads the captured image saved on the desktop computer to the patient medical data record (e.g., the computing device sends the captured image to the EHR system), possibly constituting another HIPAA violation, and method  600  ends. 
         [0036]    The conventional method is highly time-consuming for the user, and violates many medical data privacy protection laws in the HIPAA Security Rule. 
         [0037]    Embodiments address the problems introduced by the HIPAA Security Rule and provides a technical solution that minimizes transactions among devices, reduces the number of times and places that the image is stored, and transforms the image data. Embodiments include a method, computer program product, and system for quickly adding an image that is encrypted and transmitted. The encrypted image is decrypted and the image is inserted directly into a patient medical data record, while protecting the privacy of the patient&#39;s medical information and complying with the HIPAA Security Rule. 
         [0038]    In the detailed description that follows, references to “one embodiment”, “an embodiment”, “an example embodiment”, etc., indicate that the embodiment described may include a particular feature, structure, or characteristic, but every embodiment may not necessarily include the particular feature, structure, or characteristic. Moreover, such phrases are not necessarily referring to the same embodiment. Further, when a particular feature, structure, or characteristic is described in connection with an embodiment, it is submitted that it is within the knowledge of one of ordinary skill in the art to effect such feature, structure, or characteristic in connection with other embodiments whether or not explicitly described. 
       Adding an Image to a Patient Medical Data Record 
       [0039]    During a visit with a healthcare provider, the healthcare provider may review a patient medical data record, a patient&#39;s electronic medical record. The patient&#39;s electronic medical record may be visible on a computing device, which includes but is not limited to a smart phone, a tablet, a personal digital assistant (PDA), a laptop, or a desktop computer. The healthcare provider may want to capture an image of a condition (e.g., a rash) to monitor the condition&#39;s progress over time, for example. This may allow the healthcare provider to look at images from past appointment visits to determine whether a prescribed medicine is resulting in a positive outcome. 
         [0040]      FIG. 1A  illustrates an interface  100  that presents a patient medical data record, according to an embodiment. In contrast to the conventional interface shown in  FIG. 5 , interface  100  includes a selectable indicator  110 , such as a button or link, for the healthcare provider to select from the computing device displaying the patient medical data record. Selectable indicator  110  is not limited to a particular location on a patient medical data record interface.  FIG. 1B  illustrates an interface  150  on computing device  140  that presents selectable indicator  160  for adding an image to an patient medical data record. Interface  150  may include other items such selectable indicator  170  for a camera. In other embodiments, selectable indicator  110  is located on an interface presenting an ERR system home page. Once the selectable indicator is selected, the EHR system may retrieve a patient medical data record based on the healthcare provider&#39;s electronic appointment schedule, or the user may search for and/or request a patient medical data record to which the image is to be added. For example, the patient medical data record may be identified based on a search of the healthcare provider&#39;s list of patients. 
         [0041]    When the healthcare provider selects selectable indicator  110  from a patient medical data record, or selectable indicator  160 , the computing device may prompt the healthcare provider to obtain the image by using a capability or combination of capabilities of the computing device. Such capabilities include but are not limited to a touchscreen, a camera/scanner, a location determiner (e.g., a Global Positioning System (GPS) determiner), a speech recognizer, a voice recorder, an augmented reality module, a gyroscope, and a gesture recognizer. In an embodiment, the healthcare provider may adjust the image using the computing device. Such adjustments include but are not limited to one or more of cropping, editing, adding a note, adding an audio note, adding a caption, and adding a location. Once obtained, the image or adjusted image is added to the patient medical data record. 
         [0042]    In embodiments, as will be discussed in further detail below, interface  100  is simply an instantiation of an EMR on a browser or other application connected to a server, where the EMR is stored on the server (not locally). Because interface  100  is an instantiation of the EMR located on the server, rather than a local copy of the EMR, the image, when entered via the interface, is incorporated directly into the network-based EMR. 
       System 
       [0043]      FIG. 2  is a diagram illustrating an example system  200  for adding an image to an patient medical data record, according to an embodiment. System  200  includes computing device  210  and EHR system  230  connected by one or more networks  220 , such as the Internet. EHR system  230  includes at least EHS server  240  and medical records database  250 . 
         [0044]    Computing device  210  may be any type of computing device, such as and without limitation, a personal computer, a mobile phone, a tablet, a PDA, a workstation, an embedded system, a game console, a television, a set top box, or any other computing device. In an embodiment, the user may interface with computing device  210  through image adding application  215 . Image adding application  215  communicates with EHR server  240  in EHR system  230 . An example of establishing communications between a computing device and an EHR system is in U.S. patent application Ser. No. 14/318,492, filed on Jun. 27, 2014, entitled Physician Device Integration into Electronic Health Record System, which is incorporated herein by reference in its entirety. 
         [0045]    Image adding application  215  may be a native application that is specific to a particular computing device platform, such as but not limited to the iOS platform produced by Apple Inc. of Cupertino, Calif., the Android platform produced by Google Inc. of Mountain View, Calif., the Windows platform produced by Microsoft Corp. of Redmond, Wash., the Blackberry platform produced by Blackberry Ltd. of Ontario, Calif., or the open-source Linux platform. In an embodiment, image adding application  215  may have access to the capabilities of the computing device that may include but not are not limited to a touchscreen, a camera/scanner, a location determiner (e.g., a GPS determiner), a speech recognizer, a voice recorder, an augmented reality module, a gyroscope, or a gesture recognizer. Once the image is obtained, the image is transmitted to EHR system  230  and inserted into the patient medical data record avoiding multiple HIPAA Security Rule violations, as will be described below. Computing device  210  may include local temporary memory  217  as well as permanent memory  219 . Local temporary memory  217  may be random access memory (RAM), that may temporarily store an image that can be deleted from a user device as soon as a transaction is complete, in accordance with HIPAA Security Rule restrictions. Permanent memory  219  may be for example, a hard disk drive. 
         [0046]    EHR system  230  includes at least EHR server  240  coupled to a medical records database  250 . EHR server  240  may be implemented on one or more different computing devices having server capabilities. Such a computing device may include, but is not limited to, a device having a processor and memory, including a non-transitory memory, for executing and storing instructions. The memory may tangibly embody the data and program instructions. Software may include one or more applications and an operating system. Hardware can include, but is not limited to, a processor, memory, and graphical user interface display. The computing device may also have multiple processors and multiple shared or separate memory components. For example, the computing device may be a part of or the entirety of a clustered computing environment or server farm. 
         [0047]    Medical records database  250  may be any type of structured data store, including a relational database. 
       Method 
       [0048]    To respond to a request from a user to add an image to a patient medical data record, image adding application  215  on computing device  210  and EHR system  240  may operate as described below with respect to  FIG. 3  to capture, encrypt, and insert an image into a patient medical data record to reduce the number of times and places the image is stored, thereby avoiding multiple HIPAA Security Rule violations as described in  FIG. 6 .  FIG. 3  is a flowchart illustrating an example method  300  for adding an image to a patient medical data record, according to an embodiment. For ease of discussion and not limitation, method  300  is described with reference to elements from  FIGS. 1A, 1B, 2, and 6 . 
         [0049]    Method  300  begins at step  305 , when image adding application  215  receives an input from the user requesting to add an image to a patient medical data record. A determination is made whether the user selected selectable indicator  110  on a patient medical data record as shown in  FIG. 1A , selectable indicator  160  as shown in  FIG. 1B , or elsewhere, for example, on a home page of EHR system  230 . When selectable indicator  110  is located on a patient medical data record, method  300  continues to step  307 . Otherwise, method  300  proceeds to step  350 . 
         [0050]    At step  307 , a determination is made regarding whether the desired patient medical data record is being displayed on the computing device  210 . If no patient medical data record is being displayed, or if the displayed patient medical data record is not the desired patient medical data record, method  300  proceeds to  355 . 
         [0051]    If the desired patient medical data record is displayed, method  300  proceeds to step  310 . If the desired patient medical data record is displayed among several patient medical data records, the user may select the desired patient medical data record, and method  300  proceeds to step  310 . 
         [0052]    At step  310 , image adding application  215  may prompt the user to obtain an image. For example, image adding application  215  allows the user to access the capabilities of computing device  210  to obtain the image to be added to the patient medical data record. As discussed above, capabilities of computing device  210  may include but not are not limited to: a touchscreen, a camera/scanner, a location determiner, a speech recognizer, a voice recorder, an augmented reality module, a gyroscope, and a gesture recognizer. For example, when computing device  210  is a smart phone running a secure EHR application, the user may use a smart phone&#39;s capabilities, such as a touchscreen, camera, and a speech recognizer, to capture an image that includes a date, a time, a location, and a smart phone identifier. In another example, when computing device  210  is personal computer or laptop running a secure EHR application, the user may use an onboard camera and keyboard to capture the image. Capturing the image using the capabilities of computing device  210  minimizes transactions among devices, thereby avoiding one or multiple HIPAA violations such as step  620  of  FIG. 6 , where an image captured by a first device (e.g., a smart phone) is transmitted (e.g., emailed) to a second device (e.g., a desktop computer). 
         [0053]    In an embodiment, the image may be a still image, a video, or a combination thereof. In another embodiment, the user may adjust the image using the one or more capabilities of computing device  210 . For example, the user may adjust the image by cropping, editing, adding a note, adding an audio note, adding a caption, adding a location, adding augmented reality features to highlight particular areas of concern or a combination thereof. In an embodiment, the user may make a copy of the image that is then adjusted accordingly to allow the user to readily compare the image and the adjusted copy of the image. 
         [0054]    Alternatively, the user may receive an unsolicited image provided by the patient, for example, as an email attachment, if the patient is not aware of or waives the HIPAA Security Rule. 
         [0055]    At step  315 , the image is encrypted and saved in local temporary memory  217 . The image is saved in local temporary memory  217 , such as RAM, so that the image can be deleted from the user device as soon as the transaction is complete. This avoids a HIPAA violation that may occur if the image is stored, for example, in the permanent memory  219  of the user device as described in steps  610  (e.g., permanent memory in a camera or a smart phone) and  625  (e.g., permanent memory on a desktop computer) of  FIG. 6 . For example, image adding application  215  transforms the image by encrypting the image and saves the encrypted image in a local temporary memory  217 . In an embodiment, the encryption is a symmetric encryption. In an embodiment, the image is encrypted based on Secure Sockets Layer (SSL) encryption. Alternatively the image may be encrypted based on the user&#39;s login credentials for accessing EHR system  230 . For example, a user&#39;s login credentials may include a username and a password. The username and password may be hashed to generate an encryption key. The username and/or password may also be used to generate a salt as part of the encryption key, as would be understood by one of ordinary skill in the art. 
         [0056]    At step  320 , image adding application  215  transmits the encrypted image to EHR server  240 . Transmitting the encrypted image securely is an improvement that avoids a possible HIPAA violation as described in step  640  of  FIG. 6 . 
         [0057]    At step  325 , EHR server  240  receives and decrypts the encrypted image. For example, if the encryption was a symmetric encryption based on SSL encryption or alternatively based on the user&#39;s login credentials, EHR server  240  decrypts the encrypted image accordingly. 
         [0058]    At step  330 , EHR server  240  adds the image to the patient medical data record. The image may be added to the patient medical data record in-line or otherwise on a same document as other information in the patient medical data record for a particular patient, for example. Or, in another example, the image may be stored with other images in an image database portion of the patient medical data record. 
         [0059]    At step  335 , EHR server  240  transmits a confirmation to image adding application  215  that the image has been added to the patient medical data record. 
         [0060]    At step  340 , image adding application  215  receives the confirmation that the image has been added to the patient medical data record. 
         [0061]    At step  345 , image adding application  215  deletes the encrypted image from the local temporary memory  219  to avoid a HIPAA violation as described in steps  610  and  625  of  FIG. 6 , where an image is stored in permanent memory; method  300  ends. 
         [0062]    Returning to step  305 , it may be that the patient medical data record specific to the patient at issue was not displayed on the display interface, for example, when selectable indicator  110  was selected. For example, selectable indicator  110  may have been selected on a home page of EHR system  240  without identifying a specific patient, or selectable indicator  160  may have been selected from interface  150  of computing device  140  as shown in  FIG. 1B . In such an instance, method  300  proceeds to step  350 . 
         [0063]    At step  350 , image adding application  215  transmits a request to add an image to EHR server  240 , without identifying a specific patient. 
         [0064]    At step  365 , EHR server  240  receives the request to add an image to a patient medical data record. Since no patient identification information is included in the request, a determination is made whether a patient can be identified and a patient medical data record can be retrieved based on the user&#39;s electronic appointment schedule. In an embodiment, such an indication is included in the request. When the patient medical data record can be retrieved based on the user&#39;s electronic appointment schedule, method  300  proceeds to step  375 . Otherwise, method  300  proceeds to step  355 . 
         [0065]    At step  375 , EHR server  240  retrieves one or more patient medical data records from medical records database  250  based on a user&#39;s appointment schedule, or retrieves the desired patient medical data record based on patient data received from the user. When the patient medical data record retrieval is based on the user&#39;s electronic appointment schedule, one or more patients may be scheduled so one or more corresponding patient medical data records may be retrieved. EHR server  240  transmits one or more patient medical data records to image adding application  215 , and method  300  proceeds to step  360 . 
         [0066]    At step  360 , image adding application  315  receives one or more patient medical data records from EHR server  240 . Method  300  then proceeds to step  307 , described above. 
         [0067]    Turning now to step  355 , at step  355  patient data is received from the user. Method  300  may arrive at step  355  for a variety of reasons. For example, the patient may be making an emergency visit without an appointment, or perhaps the patient is visiting outside of normal office hours such that no patient is listed in the user&#39;s schedule as having an appointment, or if the user&#39;s schedule is inaccessible in step  365 , then patient information will need to be received at step  355 . Further, if a patient medical data record previously provided by EHR server  240  in step  375  is not the desired patient medical data record, then the user will need to provide information at step  355  so that the correct patient medical data record can subsequently be retrieved. 
         [0068]    The patient data may be received from the user in a variety of ways. In one example, the user may search for a patient using a searching capability built into EHR system  230 . Image adding application  215  may receive from the user one or more of, for example and without limitation, a last name, a first name, a birth date, a social security number, an insurance policy number, an identifier that uniquely identifies the patient medical data record, etc. When image adding application  215  receives patient data from the user, method  300  proceeds to step  370 . At step  370 , EHR server  240  receives the patient data from image adding application  215 , and method  300  proceeds to step  375 , described above. 
       Computing Device 
       [0069]    An example computing device is illustrated in  FIG. 4 .  FIG. 4  is a diagram illustrating a computing device  400  that accesses a network  220  over a network connection  410  that provides computing device  400  with telecommunications capabilities. Computing device  400  uses an operating system  420  as software that manages hardware resources and coordinates the interface between hardware and software. Operating system  420  may include but is not limited to for example, iOS, Android, Windows, Blackberry, or Linux. 
         [0070]    In an embodiment, computing device  400  contains a combination of hardware, software, and firmware constituent parts that allow it to run an applications layer  430 . Computing device  400 , in embodiments, may be organized around a system bus  408 , but any type of infrastructure that allows the hardware infrastructure elements of computing device  400  to communicate with and interact with each other may also be used. 
         [0071]    Processing tasks in the embodiment of  FIG. 4  are carried out by one or more processors  402 . Processor  402  may comprise suitable logic, circuitry, dedicated circuits, and/or code that may enable processing data and/or controlling operations of computer system  400 . However, it should be noted that various types of processing technology may be used here, including multi-core processors, multiple processors, or distributed processors. Additional specialized processing resources such as graphics, multimedia, or mathematical processing capabilities may also be used to aid in certain processing tasks. These processing resources may be hardware, software, or an appropriate combination thereof. For example, one or more of processors  402  may be a graphics-processing unit (GPU). In an embodiment, a GPU is a processor that is a specialized electronic circuit designed to rapidly process mathematically intensive applications on electronic devices. The GPU may have a highly parallel structure that is efficient for parallel processing of large blocks of data, such as mathematically intensive data common to computer graphics applications, images and videos. 
         [0072]    To manipulate data in accordance with embodiments describe herein, processors  402  access a memory  404  via system bus  408 . Memory  404  is non-transitory memory, such as random access memory (RAM), and may include for example, local temporary memory  217  of  FIG. 2 . Memory  404  may include one or more levels of cache. Memory  404  has stored therein control logic (e.g., computer software) and/or data. For data that needs to be stored more permanently, processors  402  access persistent storage  404  via system bus  408 . Persistent storage  406  may include, for example, a hard disk drive and/or a removable storage device or drive. Persistent storage  406  may include for example, permanent memory  219  of  FIG. 2 . A removable storage drive may be an optical storage device, a compact disc drive, flash memory, a floppy disk drive, a magnetic tape drive, tape backup device, and/or any other storage device/drive. 
         [0073]    Processors  402 , memory  404 , and persistent storage  406  cooperate with operating system  420  to provide basic functionality for computing device  400 . Operating system  420  provides support functionality for applications layer  430 . 
         [0074]    Network connection  410  enables computer device  400  to communicate and interact with any combination of remote devices, remote networks, remote entities, etc. For example, network connection  410  may allow computer device  400  to communicate with remote devices over network  404 , which may be a wired and/or wireless network, and which may include any combination of LANs, WANs, the Internet, etc. Control logic and/or data may be transmitted to and from computer device  400  via network connection  410 . 
         [0075]    Computing device  400  also includes input/output/display devices  440 , such as a touchscreen, a camera/scanner, a location determiner (e.g., a Global Positioning System (GPS) determiner), a speech recognizer, a voice recorder, an augmented reality module, a gyroscope, a gesture recognizer, monitors, keyboards, pointing devices, Bluetooth devices, etc. 
         [0076]    Applications layer  430  may house various components that perform method  300  as described in  FIG. 3  when computing device  400  is used as image adding application  215 , or when computing device  400  is used as EHR server  240 . 
         [0077]    It should be noted that computer-readable medium embodiments may include any physical medium which is capable of encoding instructions that may subsequently by used by a processor to implement methods described herein. Example physical media may include floppy discs, optical discs (e.g. CDs, mini-CDs, DVDs, HD-DVD, Blu-ray), hard drives, punch cards, tape drives, flash memory, or memory chips. However, any other type of tangible, persistent storage that can serve in the role of providing instructions to a processor may be used to store the instructions in these embodiments. 
       CONCLUSION 
       [0078]    Embodiments of the present invention have been described above with the aid of functional building blocks illustrating the implementation of specified functions and relationships thereof. The boundaries of these functional building blocks have been arbitrarily defined herein for the convenience of the description. Alternate boundaries can be defined so long as the specified functions and relationships thereof are appropriately performed. 
         [0079]    The foregoing description of specific embodiments will so fully reveal the general nature of the invention that others can, by applying knowledge within the skill of the art, readily modify and/or adapt for various applications such specific embodiments, without undue experimentation, without departing from the general concept of the present invention. Therefore, such adaptations and modifications are intended to be within the meaning and range of equivalents of the disclosed embodiments, based on the teaching and guidance presented herein. It is to be understood that the phraseology or terminology herein is for the purpose of description and not of limitation, such that the terminology or phraseology of the present specification is to be interpreted by the skilled artisan in light of the teachings and guidance. 
         [0080]    The breadth and scope of the present invention should not be limited by any of the above-described exemplary embodiments, but should be defined only in accordance with the following claims and their equivalents.