Abstract:
The methods and systems described by the present invention enable managing a medical order provided to a patient, comprising:
   a) Receive a medical order provided to a patient that defines a plurality of medical activities to be performed in a predefined order.   b) Automatically create a list of a plurality of tasks for each medical activity, each task is assigned with a tracking status.   c) Automatically associate each task with at least one of a plurality of care providers.   d) Automatically notify the at least one care provider using a client terminal about the respective associated task.   e) Aggregate a plurality of input messages each indicative of a status of one of the tasks.   f) Automatically update the tracking status according to the input messages during the period of the medical order.   g) Outputting a dataset of the medical order which is indicative of the tracking status for each task.

Description:
BACKGROUND 
       [0001]    The present invention, in some embodiments thereof, relates to managing a medical order related to a treatment provided to a patient, and, more specifically, but not exclusively, to managing a medical order through an automated closed loop and real time system that assures correct workflow of a medical order, associates the medical order activities with relevant care providers, tracks progress of the workflow of the medical order, notifies and alerts the relevant care providers and logs the workflow of the medical order. 
         [0002]    Patient care in a controlled environment in which a series of events is initiated, managed and monitored by attending care providers. As patient care services and institutes are becoming more distributed and complex, many care provider entities, for example physicians, nurses, medical institutes, laboratories and/or imaging facilities are involved in the workflow of medical orders relating to a treatment provided to a single patient. This distributed environment requires the workflow of the medical order to be controlled, efficient and near real time in order to avoid lack of synchronization between a plurality of care providers, avoid redundancies, enable remote monitoring of the patient&#39;s condition, keep track of the medical order progress and medical activities status, associate a relevant care provider with the medical activities, alert the relevant care provider of a breach in the workflow of the medical order or other predefined events and maintain a log for the medical order workflow. A breach in the workflow of the medical order may be for example, failure to perform tasks in a predefined order failure to perform one or more tasks and/or cancellation of one or more of the tasks by a care provider. 
         [0003]    Reference is now made to  FIG. 1 , which is a schematic illustration of a workflow of an exemplary medical order. One or more care of the providers may initiate a medical order that relates to a treatment provided to the patient. The medical order may include a plurality of medical activities that are required by the medical order. Each of the plurality of medical activities is not a workflow by itself but rather a specific contained activity that needs to be performed as part of the workflow of the medical order. The plurality of medical activities may each include a plurality of tasks that are part of the medical activity. Each of the plurality of tasks may be assigned to one or more of the medical care providers. The plurality of tasks that are associated with each of the one or more medical activities are performed with respect to the patient. The results of the plurality of tasks may be reported back to the one or more of the care providers. 
         [0004]    Traditionally, the medical order is initiated manually by the one or more of the care providers after examining the patient and generating a hard copy medical record that includes the medical activities that need to be performed. Other care providers may be involved with the medical activities associated with the medical order. The medical order and its related medical activities are managed and monitored through the patient&#39;s medical record which is also used for logging the medical order. The medical order may be modified by an accountable care provider attending to the patient in person. As technology advances, the medical record may be available in electronic format, electronic medical record (EMR) replacing the hard copy record. 
         [0005]    The patient medical record both in hard copy and in electronic form fails to provide an efficient controlled, closed loop system due to the complex and distributed patient care environment. The patient medical record is susceptible to various flaws, for example, different care providers issuing conflicting and/or redundant orders, inability to provide real time information on the medical activities status and/or on the patient&#39;s condition, inability to alert a relevant care provider in the event of an emergency or a failure to perform the medical order, etc. 
       SUMMARY 
       [0006]    According to some embodiments of the present invention, there are provided systems and methods for managing a plurality of medical orders associated with treatments provided to a plurality of patients. Managing the plurality of medical orders enables a tightly controlled, patient centric, closed loop and near real time workflow for a plurality of medical orders that are part of a treatment provided to a plurality of patients. One or more of a plurality of care providers may issue the medical order relating to a treatment provided to one of the plurality of patients. The medical order is received and a list of one or more medical activities is automatically generated according to a pre-defined template that details the medical activities that are required with respect to the medical order. Each of the plurality of medical activities is not a workflow by itself but rather a specific contained activity that needs to be performed as part of the workflow of the medical order. Each of the required medical activities is further divided to a plurality of singular tasks and a tasks list is automatically generated according to a pre-defined template that details the tasks that are required with respect to each medical activity. Each of the plurality of tasks is assigned with a tracking status and each of the plurality of tasks is associated with one or more of the care providers. The tracking status may include a plurality of condition rules that may be used for alerting one or more of the care providers. A notification message containing the tasks(s) information is transmitted to the one or more of the care providers using a plurality of client terminals for example desktop, laptop, tablet, phone and/or beeper. The notification message may be sent using one or more networks, for example, wireless, cellular and/or internet. During the period from issuing the medical order and to the completion of the medical order, input messages are received indicating the status of each of the plurality of tasks. Each of the plurality of tasks is tracked and the tracking status of each of the plurality of tasks is updated according to the received input messages. Alerts may be generated and transmitted to the one or more of the care providers using the plurality of client terminals, according to the progress of the plurality of tasks. The workflow of the medical order is recorded and a log is generated to reflect the plurality of tasks progress. 
         [0007]    Optionally, monitoring information is collected from one or more of a plurality of medical monitoring instruments capable of transmitting data over the one or more networks. 
         [0008]    More optionally, monitoring information is collected over the one or more networks from one or more care providers using the plurality of client terminals. 
         [0009]    More optionally, monitoring information is collected over the one or more networks from the patient using the plurality of client terminals. 
         [0010]    More optionally, monitoring information is available to one or of the care providers using the plurality of client terminals. 
         [0011]    More optionally, monitoring information is recorded in the log of the medical order. 
         [0012]    More optionally an alert message is transmitted to one or more of the plurality of care providers in case a condition rule is fulfilled. 
         [0013]    More optionally, one or more of a plurality of medical records databases is accessed to retrieve medical history of the patient to be used during the period of the medical order. The plurality of medical records databases may be available in a plurality of different formats and/or storage systems. Retrieved data from one or more medical records databases may be synchronized to provide a comprehensive, detailed and up to date description of the patient medical history. 
         [0014]    More optionally, the medical history of the patient is available to one or more of the care providers using the plurality of client terminals. 
         [0015]    More optionally, the status of the plurality of tasks is available to one or more of the care providers using the plurality of client terminals. 
         [0016]    More optionally, the monitoring information of the patient is available to one or more of the care providers using the plurality of client terminals. 
         [0017]    More optionally, one or more of a plurality of resource management system of the care providers is accessed to retrieve availability information of one or more of the care providers. Availability information may include for example, expertise, care provider ranking and/or, location of treatment. 
         [0018]    More optionally, the availability information is used to identify an accountable care provider that is available and suitable for performing a certain task of the plurality of tasks and the accountable care provider is notified of the task information. 
         [0019]    More optionally, the availability information is used to identify and alert an accountable care provider that is available to receive a certain alert of a plurality of alerts that includes alert condition information. 
     
    
     
       BRIEF DESCRIPTION OF THE SEVERAL VIEWS OF THE DRAWINGS 
         [0020]    Some embodiments of the invention are herein described, by way of example only, with reference to the accompanying drawings. With specific reference now to the drawings in detail, it is stressed that the particulars shown are by way of example and for purposes of illustrative discussion of embodiments of the invention. In this regard, the description taken with the drawings makes apparent to those skilled in the art how embodiments of the invention may be practiced. 
           [0021]    In the drawings: 
           [0022]      FIG. 1  is a schematic illustration of a workflow of an exemplary medical order; 
           [0023]      FIG. 2  is a schematic illustration of an exemplary management system for a medical order and entities the system is interacting with, according to some embodiments of the present invention; 
           [0024]      FIG. 3  is a flowchart of an exemplary process for managing a medical order, according to some embodiments of the present invention; 
           [0025]      FIG. 4  is a schematic illustration presenting notifications and alerts associated with an exemplary medical order work flow, according to some embodiment of the present invention; 
           [0026]      FIG. 5  is a schematic illustration of modules contained in an exemplary system for managing a medical order, according to some embodiment of the present invention; and 
           [0027]      FIG. 6  is a schematic illustration of a workflow of a medical order in an exemplary medical environment implementing a system for managing a medical order, according to some embodiment of the present invention. 
       
    
    
     DETAILED DESCRIPTION 
       [0028]    According to some embodiments of the present invention, there are provided systems and methods for managing a plurality of medical orders associated with treatments and/or procedures provided to a plurality of patients. A medical order is received from one or more of a plurality of care providers, and a list of one or more medical activities is automatically generated. The medical activities list is generated using a pre-defined template that describes medical activities that are associated with the medical order. Each of the one or more medical activities is not a workflow by itself but rather a specific contained activity that needs to be performed as part of the workflow of the medical order. A tasks list is generated for each of the one or more of the medical activities, where the tasks list includes a plurality of singular tasks required for the medical activity. The tasks list is automatically generated according to a pre-defined template. A tracking status is assigned to each of the plurality of tasks and each task of the plurality of tasks is associated with one or more of the care providers. A notification message is transmitted to the associated one or more of the care providers using a plurality of client terminals for example desktop, laptop, tablet, phone and/or beeper. The notification message includes the associated task(s) information. The notification message may be sent using one or more networks, for example, wireless, cellular and/or internet. Input messages are received during the period from issuing the medical order to the completion of the medical order, where the input messages indicate the status of each of the plurality of tasks. Completion of the medical order may be for example, completion of all tasks, cancellation of medical order, postponement of the medical order, cancellation of remaining unperformed one or more of the plurality of tasks associated with the medical order and/or postponement of remaining unperformed one or more of the plurality of tasks associated with the medical order. The tracking status of each of the plurality of tasks is updated according to the received input messages. Alert may be generated and alert message may be transmitted to an accountable one or more of the care providers according to the progress of the plurality of tasks. The workflow of the medical order is recorded and a log is generated to reflect the plurality of tasks progress. 
         [0029]    Reference is now made, once again, to  FIG. 1 . Managing the medical order  103  involves interaction with a plurality of entities. A plurality of care providers  101  may be responsible for performing the required actions to complete the medical order  103 , for example, medical personnel, medical facilities and/or other medical and non-medical resources. As a plurality of patients are provided with treatment at any given time, managing and monitoring of the medical orders is crucial. 
         [0030]    Reference is now made to  FIG. 2  which is a schematic illustration of an exemplary management system for a plurality of medical orders  103  and entities the system is interacting with, according to some embodiment of the present invention. A system  200  includes a processing unit that executes one or more software modules for managing and monitoring a plurality of medical orders  103 , for example, personal computer, server, and/or a distributed processing system that includes a plurality of processing nodes. The system  200  interacts with one or more of the plurality of care providers  101  using the plurality of client terminals for receiving the medical order  103  which is a part of a treatment provided to the patient  102 . The system  200  transmits notification and alert messages to one or more of the care providers  101  using the plurality of client terminals over the one or more networks. The notification and alert messages are transmitted according to a plurality of rules, for example, availability of the care providers  101 , contact method of the care providers  101 , patient condition and/or progress of the medical order  103 . 
         [0031]    Optionally, the system  200  receives monitoring information of the condition of the patient  102  from a plurality of medical monitoring instruments  230  that are monitoring the patient  102  and are capable of transmitting monitoring information using the one or more networks. 
         [0032]    More optionally, the system  200  receives monitoring information of the condition of the patient  102  from a plurality of the care providers  101  using the plurality of client terminals over the one or more networks. 
         [0033]    More optionally, the system  200  receives monitoring information of the condition of the patient  102  from the patient  102  using the plurality of client terminals over the one or more networks. 
         [0034]    More optionally, the system  200  accesses one or more resources records  210  of the care providers  101  to retrieve information on one or more service providers  101 . 
         [0035]    More optionally, the system  200  accesses one or more patient history records  220  of the patient  102  to retrieve information on medical history of the patient  102 . The plurality of medical records databases  220  may be available in a plurality of different formats and/or storage systems. Retrieved data from one or more medical records databases may be synchronized to provide a comprehensive, detailed and up to date description of the patient medical history. 
         [0036]    More optionally, the patient medical records  220  include a plurality of EMR systems. 
         [0037]    Reference is now made to  FIG. 3  which is a flowchart of an exemplary process for managing a medical order, according to some embodiment of the present invention. As shown at  301 , a process  300  for managing the medical order  103  is started by receiving the medical order  103  issued by one or more of the care providers  101  using the plurality of client terminals. 
         [0038]    As shown at  302 , the received medical order  103  is processed and a monitor list may be generated that includes required monitoring information of the patient  102  and/or a plurality of monitor rules. The monitor list is generated automatically according to a pre-defined template that includes the monitoring parameters required for the medical order  103 , for example, blood pressure, blood count and/or heart beat. The monitor rules may describe the required monitoring information with respect to the patient  102 , for example, blood pressure range, blood count range and/or heart beat range that in case of deviation from the specified range, an alert message is transmitted. 
         [0039]    Optionally, the monitor list is modified by one or more of the care providers  101  according to the condition of the patient  102 . 
         [0040]    More optionally, the monitor list is automatically modified according to the medical history of the patient  102  that is retrieved from the patient history records  220 . 
         [0041]    More optionally, the each one of the plurality of monitor rules has an escalation field to handle escalation in the condition of the patient  102 . The escalation field specifies two or more of the care providers  101 , each of the two or more of the care providers  101  is associated with a different level of criticality of the monitoring information. This is done to assure raising the attention of the accountable one or more of the care providers  101  of an escalation in the condition of the patient  102  and to verify a proper and timely action is taken with respect to the patient  102 . 
         [0042]    As shown at  303 , the received medical order  103  is processed and an activities list is generated which describes the medical activities  104  that need to be performed in order to carry out the medical order  103 . The activities list is generated automatically according to a pre-defined template that includes the medical activities  104  that are required for the medical order  103 . 
         [0043]    Optionally, the activities list is modified by one or more of the care providers  101  according to the condition of the patient  102 . 
         [0044]    More optionally, the activities list is automatically modified according to the medical history of the patient  102  that is retrieved from the patient history records  220 . 
         [0045]    As shown at  304 , the activities list is further divided to one or more tasks lists comprising a plurality of singular tasks  105  required by each activity  104 . The tasks lists are generated automatically according to a pre-defined template that includes the tasks  105  that are required for the corresponding activity  104 . Each of the tasks  105  is assigned with a tracking status to allow the system  200  to track the task&#39;s progress. 
         [0046]    Optionally, the tracking status for each task  105  includes a plurality of condition rules which include conditions for alerting one or more of the care providers  101  with regard to the task  105 . 
         [0047]    More optionally, the tracking status for each task  105  has an escalation filed in which at least two of the care providers  101  may be specified, each associated with a different level of criticality and/or urgency of the status of the task  105  with respect to the patient  102 . This is done to assure raising the attention of a higher ranking accountable one or more of the care providers  101  to the progress of the plurality of tasks  105  associated with the medical order  103 . An escalation situation may be preconfigured in the plurality of task condition rules and may include for example, failure to complete one or more tasks within a predefined time period, failure to report on the progress of one or more tasks and/or failure to perform tasks in predefined order. 
         [0048]    As shown at  305 , each task  105  is associated with one or more of the care providers  101 . Association of each of the plurality of tasks  105  to the one or more of the care providers  101  is done according to a pre-defined list of the care providers  101 . 
         [0049]    Optionally, association of the task  105  to the one or more of the care providers  101  is done dynamically by accessing the resources records  210  and identifying a one or more of the care providers  101  that are currently available. Availability may constitute of a plurality of parameters, for example, expertise, responsibility and/or location. Contact information for the accountable one or more of the care providers  101  may be retrieved from the resources records  210 , for example, phone number, internet protocol (IP) address and/or email address. 
         [0050]    As shown at  306 , a notification message for every task  105  is sent over the one or more networks to each one or more of the care providers  101  that is associated with the task  105 . The notification message is a push message in nature, meaning the notification message is automatically transmitted to the one or more of the care providers  101  using the plurality of client terminals with no need for the one or more of the care providers  101  to initiate a query on standing notification messages. 
         [0051]    Optionally, the notification message is persistent according to task  105  progress, retransmitting the notification message to the one or more of the care providers  101  according to preconfigured settings, for example, at predefined intervals, at task start, at task completion, cancellation of task by one or more of the care providers  101 , at modification of task by one or more of the care providers  101 , at identification of failure during task execution, at identification of failure to complete task within a predefined time period, according to task progress, and/or at completion of medical activity and/or medical order. 
         [0052]    As shown at  307 , monitoring information of the condition of the patient  102  may be collected and made available to care providers  101 . As aforementioned the monitoring information may be received from a plurality of medical monitoring instruments  230  capable of transmitting monitoring information, from a plurality of care providers  101  using the plurality of client terminals and/or from the patient  102  using the plurality of client terminal. Monitoring information is received using the one or more networks. 
         [0053]    As shown at  308 , each of the tasks  105  relating to each of the medical activities  104  of the medical order  103  is continuously tracked. Care providers  101  using the plurality of client terminal send over the one or more networks, task progress information for the tasks  105  they are assigned with. The task progress information is used for tracking the plurality of tasks  105 . 
         [0054]    Optionally, tasks  105  tracking information and progress status is available to the care providers  101 . 
         [0055]    As shown at  309 , an alert may be transmitted over the one or more networks to one or more of the care providers  101  using the plurality of client terminals to indicate a plurality of events as defined by the task rules. Task rules may include, for example, start of task, completion of a task, incompletion of a task within a predefined time period, incompletion of task by the time the patient  102  is discharged, escalation in tasks execution, etc. The alert message is of push message in nature, meaning the alert message is automatically transmitted to the one or more of the care providers  101  using the plurality of client terminals with no need for the one or more of the care providers  101  to initiate a query on standing alert messages. 
         [0056]    Optionally, an alert is transmitted to one or more of the care providers  101  at the event of a condition of one or more of the plurality of monitor rules is fulfilled for example, escalation in the condition of the patient  102 . 
         [0057]    More optionally, the alert message is persistent according to the progress of the task  105 , retransmitting the alert message to the one or more of the care providers  101  according to preconfigured settings, for example, at predefined intervals, at task start, at task completion, at cancellation of task by one or more of the care providers  101 , at modification of task by one or more of the care providers  101 , at identification of failure during task execution, at identification of failure to complete task within a predefined time period, according to task progress and/or at completion of medical activity and/or medical order. 
         [0058]    The workflow of the medical order  103  is continuously tracked and monitoring information is collected until the medical order completes. Completion of the medical order  103  may be decided by the accountable one or more of the care providers  101  and may be based on several parameters, for example, completion, addition, repetition and/or cancellation of medical activities  104  and their related tasks  105  that are required by the medical order  103  and/or termination and/or postponement of the medical order  103 . 
         [0059]    Reference is now made to  FIG. 4  which is a schematic illustration presenting notifications and alerts associated with an exemplary medical order work flow, according to some embodiment of the present invention. The medical order  103  is initiated and split to one or more medical activities  104 . The one or more medical activities  104  are each further divided to a plurality of tasks  105  and each task  105  is associated with one or more of the care providers  101 . For each task  105  the system  200  transmits a notification to the accountable one or more of the care providers  101 . During the execution of the plurality of tasks  105 , the system  200  may transmit a plurality of alerts to the accountable one or more of the care providers according to the task rules defined in the system  200 , for example, start of task execution, completion of task execution and/or incompletion of task execution within a pre-defined time period. 
         [0060]    According to some embodiments of the present invention, there are provided a system  200  that manages and monitors a medical order, the system  200  receives the medical order  103 , automatically generates a list of medical activities  104  required to perform the medical order  103 , associates the medical activities  104  with relevant one or more of the care providers  101 , notifies the relevant one or more of the care providers  101  of the medical activities  104 , tracks the progress of the medical order  103 , alerts the relevant one or more of the care providers  101  of events in the medical order  103  and logs the medical order  103 . 
         [0061]    Reference is now made to  FIG. 5  which is a schematic illustration of modules included in an exemplary system for managing a medical order, according to some embodiment of the present invention. 
         [0062]    An input module  500  receives the medical order  103  that is issued by one or more of the care providers  101  using the plurality of client terminals. The received medical order  103  is forwarded to an activities list generation unit  501  and a monitor list generation unit  502 . 
         [0063]    The activities list generation module  501  splits the medical order  103  into one or more medical activities  104  according to a pre-defined template that includes the medical activities  104  that are required for the medical order  103 . 
         [0064]    The monitor list generation module  502  generates a monitor list according to a pre-defined template that includes the monitoring information required for the medical order  103  with respect to the patient  102 . The monitor list may include a plurality of conditional monitor rules that may be used for alerting one or more of the care providers  101  in the event a condition is fulfilled. 
         [0065]    A tasks lists generation module  503  further divides the activities list to a plurality of singular tasks  105  according to a pre-defined template that includes the tasks  105  that are required for each activity  104 . The plurality of tasks  105  are initiated and maintained in the system  200 . The tasks lists generation module  503  associates each of the plurality of tasks  105  with an accountable one or more of the care providers  101 . The tasks lists generation module  503  transfers the information of each of the plurality of tasks  105  and the information of the one or more of the care providers  101  associated with task  105  to a notification module  505 . 
         [0066]    The notification module  505  transmits a notification message over the one or more networks to one or more of the care providers  101  using the plurality of client terminals. The notification message includes the information of the one or more of the care providers  101  that are assigned with the task  105 . 
         [0067]    A monitoring module  507  monitors the monitoring information for the patient  102  as dictated by the monitor list that is generated by the monitor list generation module  502 . The plurality of tasks  105  are continuously tracked by a tracking module  506 . The tracking module  506  holds an accurate status for each of the plurality of tasks  105 . In case a condition is fulfilled for one or more of the monitor rules, the monitoring module  507  transfers the condition information to an alert module  304 . In case a condition is fulfilled for one or more of the task rules, the tracking module  506  transfers the condition information to the alert module  304 . 
         [0068]    The alert module  304  transmits an alert message over the one or more networks to one or more of the care providers  101  using the plurality of client terminals. The alert message is transmitted according to a pre-defined list of care providers  101  and includes the information on the monitor rule and/or task(s) rule conditions that are identified. 
         [0069]    The logging module  508  logs the tracking status information for the plurality of tasks  105  and/or monitoring information that is collected during the workflow of the medical order  103 . The logged information may be available to one or more of the care providers  101  using the plurality of client terminals during and after the time of execution of the medical order  103 . 
         [0070]    Optionally, the tasks lists generation module  503  accesses the resources records  210  to retrieve the accountable one or more of the care providers  101  that are available to perform the task  105  according to a plurality of availability parameters, for example, expertise, responsibility and/or location. The tasks lists generation module  503  may retrieve contact information for the accountable one or more of the care providers  101 . 
         [0071]    More optionally, the monitoring module  507  receives monitoring information of the patient  102  from a plurality of medical monitoring instruments  230  that are capable of transmitting monitoring information using the one or more networks. 
         [0072]    More optionally, the monitoring module  507  receives monitoring information of the patient  102  from one or more of the care providers  101  using the plurality of client terminals using the one or more networks. 
         [0073]    More optionally, the monitoring module  507  receives monitoring information of the patient  102  from the patient  102  using the plurality of client terminal using the one or more networks. 
         [0074]    More optionally, the monitoring module  507  makes the monitoring information of the patient  102  available to one or more of the care providers  101  using the plurality of client terminals using the one or more networks. 
         [0075]    More optionally, the tracking module  506  makes the status information for each one of the plurality of tasks  105  available to one or more of the care providers  101  using the plurality of client terminals using the one or more networks. 
         [0076]    More optionally, the alerting module  304  accesses the resources records  210  to retrieve the accountable one or more of the care providers  101  that are available to receive the alert according to a plurality of availability parameters. The alerting module  304  may retrieve contact information for the accountable one or more of the care providers  101 . 
         [0077]    Some embodiments of the present invention, are presented herein by means of an example, however the use of this example does not limit the scope of the present invention in any way. The example presents a workflow of the medical order  103  in an exemplary medical environment employing a system  200  for managing the medical order  103 . 
         [0078]    Reference is now made to  FIG. 6  which is a workflow of a medical order in an exemplary medical environment implementing a system for managing a medical order, according to some embodiment of the present invention. A medical environment  600  employs a system that maintains closed loop control with feedback for performing medical activities, for example, treatments and/or procedures provided to the patient  102 . The medical environment  600  includes the plurality of care providers  101 , a healthcare organizational structure  601 , the plurality of medical monitoring instruments  230 , the plurality of patient medical records  220 , a monitoring unit  605 , a medical messaging unit  603 , a tracking unit  604  and a medical documentation system  602  all focused on the patient  102 . 
         [0079]    The monitoring unit  605  which may employ the monitoring module  507  and/or the monitor list generation unit  502  of the system  100  collects monitoring information with respect to the patient  102 . The monitoring information may be collected from the plurality of medical monitoring instruments  230  that are monitoring the patient  102 , from one or more of the care providers  102  that are attending the patient  102  and/or from the patient  102 . The plurality of monitoring instruments  230  may be mobile or stationary, and the monitoring information the plurality of monitoring instruments  230  produce may be automatically transmitted by the monitoring instruments  230  using the one or more networks, reported by one or more of the plurality of care providers  101  using the plurality of client terminals and/or be reported by the patient  102  using the plurality of client terminal. The monitoring unit  605  automatically generates a monitor list (watch list) according to a pre-define template that dictates the monitoring information required with respect to the medical order  103  for the patient  102 . The monitor list also includes condition rules for generating an alert message in the event of a medical situation identified through the monitor list condition rules. The monitor list condition rules may include escalation rules to identify an escalation in the condition of the patient  102  and generate an escalation event. The monitor list may be modified by one or more of the care providers  101  to adapt to the condition of the patient  102 . The monitoring unit  605  may access the plurality of patient medical records  220  located at a plurality of locations and present in a plurality of formats for retrieving medical history of the patient  102  and use it for providing a complete medical view of the patient  102 . The patient medical records  220  may further include the plurality of EMR systems. The medical history of the patient  102  may be used to interpret monitoring information and/or manipulate monitoring requirements and monitor list for the patient  102 . The monitoring information may include events identified by the monitor list condition rules, for example, escalation in the condition of the patient  102 . The monitoring unit  605  forwards the collected monitoring information to the medical messaging unit  603 . 
         [0080]    The medical messaging unit  603  may include the task lists generation module  503 , the notification module  505  and/or the alerting module  504 . The medical messaging unit  603  associates the plurality of tasks  105  with one or more of the plurality of care providers  101 , where the plurality of tasks  105  are required by the medical activities  104  which are derived from the medical order  103 . The medical messaging unit  603  informs the accountable one or more of the plurality of the care providers  101  when attention is needed to the patient  102 . The medical messaging unit  603  may handle escalation in the condition of the patient  102  as reported by the monitoring unit  605 . In the event of escalation one or more messages may be transmitted to one or more of the care providers  101  to raise attention to the escalation situation. The medical messaging unit  603  may access the healthcare organizational structure  601  for retrieving availability of the one or more of the care providers  101  from the resources records  210 . The availability information for the plurality of the care providers  101  allows the medical messaging unit  603  to dynamically identify a suitable accountable one or more of the care providers  101  in real time. Availability information parameters may include for example expertise, ranking in the healthcare organization and/or location of treatment. 
         [0081]    The tracking unit  604  which is the final unit in the workflow of the medical order within the medical environment  600  performs tracking on the tasks related to the medical order  103 . The tracking unit  604  may employ the activities list generation module  501 , the tasks lists generation module  503 , the tracking module  506  and/or the alerting module  504 . The tracking unit  604  tracks the progress of the plurality of tasks  105  that are initiated with respect to the medical activities  104  associated with the medical order  103 . The tracking unit  604  may access the healthcare organizational structure  601  for retrieving availability of the one or more of the care providers  101  from the resources records  210 . The availability information for the plurality of the care providers  101  allows the tracking unit  604  to dynamically identify an accountable one or more of the care providers  101  in real time. Availability information parameters may include for example expertise, ranking in the healthcare organization and/or location of treatment. The tracking unit  604  is coupled with the medical messaging unit  603  for transmitting alert messages to the accountable one or more of the care providers  101  with respect to status of the plurality of tasks  105  and/or with respect to the condition of the patient  102  as reported through the monitoring information. 
         [0082]    The documentation unit  602  logs the workflow of the medical order  103  and stores the generated information, for example, status and progression of the plurality of tasks  105  and/or monitoring information of the patient  102 . The documentation unit  602  may employ the logging module  508 . The stored log data may be used for long and short term uses, for example, to be recorded in the medical history record of the patient  102  and/or to be inserted back into the workflow of the medical order  103  to initiate additional medical activities that may be required according to the condition of the patient  102 . 
         [0083]    The terms “client terminal” relates to any device and/or apparatus which may be used for input and/or output of data thorough a human interface, for example desktop computer, laptop, tablet, telephone, mobile phone and/or beeper. The term “human interface” relates to any form of human-machine interface for example, keyboard, touch screen, microphone, speaker and/or motion sensor.