Abstract:
A computerized method for composition of medical data sets for presentation to at least one panel of medical specialists uses a rule-based system for efficient composition of the medical data set. The use of a rule-based system for automatic generation of presentation documents for a medical panel unburdens medical personnel from the (in part) manual composition of the presentation documents, and a more effective workflow of the diagnostic processing in the framework of a presentation to a medical panel is therewith enabled.

Description:
BACKGROUND OF THE INVENTION 
       [0001]    1. Field of the Invention 
         [0002]    The present n concerns a computerized method for compiling medical data sets for presentation to a panel of medical practitioners, such as medical specialists, as well as a rule-based system for efficiently compiling a medical data set. 
         [0003]    2. Description of the Prior Art 
         [0004]    Workflows in a hospital place highly complex demands on specialized personnel, so the workflows must precisely coordinate different work procedures that must also coordinate the competency and specialties of the individual specialists. 
         [0005]    Due to high operating and personnel costs, an effective process workflow composed of multiple individual work processes is particularly important for medical diagnostics. For example, the primary activity of a radiologist concerns the appraisal and evaluation of radiological image exposures. All further activities, such as the preparation of a presentation of a patient finding in a clinical conference with medical specialists, lie outside of this actual primary focus activity and thus reduce the effectiveness of workflows at a radiological station. Since the requirements for a presentation, moreover, can differ significantly depending on the type and requirements of the panel receiving the presentation, a competent radiologist must first learn the specific requirements for the presentation to the respective panel and then (in part) manually determine, and possibly prepare and compose, the necessary documents for the presentation in a very time-consuming manner. 
         [0006]    Methods for supporting the workflows for data preparation of patient findings are known in the art. DE 101 25 504 B4 discloses a method for workflow management of diagnostic workflows at a number of computerized diagnostic and processing workstations. As disclosed therein, after the input and classification of medical image data, a template is associated with the image data dependent on the classification, the template establishing the respective processing of the image data in one or more processing steps and generating a corresponding job file with data for identification of the individual processing steps. The processing steps can be implemented by different processors at different computerized workstations, so the method coordinates and monitors the individual workstations so as to build on one another. 
         [0007]    This known method has the disadvantage that the operators at the respective workstations receive no further support for his or her diagnostic work and, given difficult or complex patient findings, the operator/diagnostician must coordinate, conscript and (in part manually) determine and compose the medical data to be examined in the conference in the form of a data set. 
       SUMMARY OF THE INVENTION 
       [0008]    An object of the present invention is to unburden medical specialist personnel in the composition of relevant medical data for a presentation of the medical data in the framework of a medical panel presentation. 
         [0009]    The object is achieved in accordance with the invention by a computerized method for compilation of a medical data set for presentation to at least one panel of medical practitioners, such as medical specialists wherein after classification of a finding in a patient record as being relevant for the presentation, relevant rules are determined (selected) from an existing rule base and the relevant rules are composed into a relevant rule set dependent on the relevant entries in the patient record or relevant conditions for the composition of the medical data set. The relevant rule set in determined in this manner is subsequently applied to the entries in the patient record and the medical data set is extracted from the entries of the patient record on the basis of the relevant rule set, thereby composing the medical data set necessary for the presentation. After the composition of the medical data set, the medical data set is communicated to the panel or a reference (in particular a “link”) to the data set is stored via which the panel can access the data set. 
         [0010]    Entries of a patient record in the sense of the invention are all data for the diagnostic, therapeutic and organizational support of a particular patient as well as the economic costs associated therewith, such as, for example, findings, incompatibilities, therapy plans, medical images, admission to a hospital, daily costs, current, electronically-detected position of the patient, age of the patient, type of health insurance or desires of the patient during his or her hospital residence. 
         [0011]    All necessary data extracted from the entries of the patient record (such as, for example, medical images, incompatibilities) for the respective presentation to a medical panel are designated as a medical data set in the sense of the present invention. 
         [0012]    All meetings and pollings of medical specialists with regard to the assessment of medical facts are understood as a panel. The panel can be assembled within a hospital, within a network of medical specialists, or in the framework of a scientific presentation such as a medical congress. 
         [0013]    The invention enables an effective workflow for the initiation and the preparation of the presentation of a patient finding to a medical panel, the workflow being focused on the respective operating field of the medical specialists. The workflows of the processor, in particular of the diagnostically active radiologist, are not adversely affected by the automatic generation of the presentation documents, and simultaneously ensure a high quality standard for the presentation, by the continuous fulfillment of the presentation standards for the medical data set generated by the relevant rule set. The operator is thereby freed from the task of composing the medical data sets and can concentrate on his or her primary diagnostic task. The usage of the existing and relevant rule base ensures that various differing requirements for the medical data sets and their presentations are also taken into account, even for varying panels. The inventive method enables an automated composition of even highly different patient data into a medical data set for presentation to a panel, such that the radiologist entrusted with the diagnosis can concentrate on the actual workflows of the diagnosis, while effective workflows outside of the diagnosis are simultaneously ensured. 
         [0014]    In one embodiment of the computerized method, the classification of the finding as relevant for the presentation is done by the operator, or automatically through a computer-aided query of relevant entries of the patient file (patient record). It is thus ensured that the initiation of the inventive method is possible either based on the current necessity of the presentation of a patient finding within a selected panel, or presentations at regular intervals can be provided for the responsible panel based on determined workflows within a diagnostic department. 
         [0015]    An advantage is that every rule of the present rule set is defined by an association between necessary conditions for the respective rule, and method steps are defined with these by conditions. By the use of a simple rule design in the sense of a classical “IF-THEN” association, it is possible to form complex rule circumstances with simple rules. The rules can hereby be generated via a computer system based on current circumstances or be generated simply and quickly by an operator. 
         [0016]    In another embodiment of the computerized method, the rule set is generated by the operator, or automatically through a computer-aided query while taking into account the entries of the patient file, with the availability of the medical specialists, the requirements of the medical data set for the presentation, the infrastructure of a hospital and/or the infrastructure of a medical department being associated with the patient file. For example, the existing rule base can be generated by a computer system on the basis of the current presence of medical specialists or based on the capacities of the medical panel, and can be used as a basis for the automated composition process of the medical data sets. In connection with the simple rule syntax of the respective rules, the existing (and thus relevant) rule base can be generated very simply by an operator or by a computer system under consideration of the current requirements and conditions for the presentation to the panel. 
         [0017]    Every rule of the existing rule base is applied to all or selected entries of the patient file classified as being relevant so that upon the fulfillment of the necessary condition of a rule by at least one entry in the patient record, this rule is classified by means of a positive Boolean value and this rule is thereby defined as part of the relevant rule set. The fulfillment criterion of each rule is advantageously characterized with “TRUE” or “FALSE”, such that the rules characterized as “TRUE” can be generated as relevant and so can be collected a relevant rule set. The rule syntax is advantageously provided by the Boolean variable of a rule being altered as part of the rule for the particular case of the established relevance. 
         [0018]    The medical data set formed by means of the relevant rule set preferably is checked with regard to the requirements for the presentation and is supplemented if necessary. Through a suitable plausibility check it is ensured that the requirements for the presentation of the already-generated medical data set are always satisfied, in the event of the rule set being incomplete and/or insufficiently relevant. For example, a specification of the residence of the patient may be necessary as a requirement for the presentation to a specific panel, but this may not have been ensured by a rule in the existing rule base and/or in the relevant rule set. Through a final plausibility check as to whether the medical data set generated by the relevant rule set has satisfied all specific requirements for the presentation to a particular panel, medical data set can be supplemented to address the absence of a necessary specification in the medical data set, so a consistently high quality standard of the generated medical data sets can be ensured for the presentations. 
         [0019]    At least two medical data sets are advantageously merged into a presentation, and thus the presentation as well as the assessment of multiple medical data sets are efficiently enabled for the medical personnel who will be present at a meeting date of the panel. 
         [0020]    The present invention can be realized in the form of hardware, software or a combination of hardware and software. Any type of rule-based computer system or other computational device set up for execution of the inventive method is suitable. A typical combination of hardware and software could be a universal computer system with a computer program that is loaded into the universal computer system to execute and control the computer system to implement the rule-based method described here. The present invention can also be integrated into a computer program product which comprises all features that enable it to realize the computer-aided method described here and which is in the position to execute this method after the loading into a computer system. 
         [0021]    As used herein, “computer program” means any expression, in any computer language, code or notation, of a set of instructions that enables a computer system to process data and thus to execute a specific function. The computer program can be run on the computer system either directly or after a conversion into another language, code, notation or via a presentation in another material form. 
     
     
       DESCRIPTION OF THE DRAWINGS 
         [0022]      FIG. 1  is a flow chart of the basic steps of an embodiment of the inventive method. 
           [0023]      FIG. 2  is a block diagram that schematically illustrates the generation of a rule according to the inventive method. 
           [0024]      FIG. 3  illustrates an advantageous rule syntax of the inventive method. 
       
    
    
     DESCRIPTION OF THE PREFERRED EMBODIMENTS 
       [0025]    Figure  FIG. 1  shows a flow chart of an embodiment of the inventive method. After the initiation of the method, in a comparison operation  100  it is checked whether a patient file  110   a  (not shown) or a partial data set thereof that is present in the patient databank  110  is to be classified as relevant for a presentation to a panel. This can ensue either via an automatic query of all patient files  11   a  in the patient databank  110 . The method is continued for this patient file  11   a  only given the fulfillment of specific conditions for a patient record  110   a . The classification of the patient record  110   a  as relevant for the presentation can likewise be effected by a processor. In this case the comparison operation  100  already runs through the further method given the presence of a corresponding classification decision and no loop with the comparison operator  100  (as illustrated in  FIG. 1 ) is necessary. 
         [0026]    The existing rule base is subsequently extracted from a rule base databank  130 . This can ensue by means of an automatic access to the rule base databank  130  with automatic further processing, or the present rule base can be generated by an operator (for example by means of pull-down menus on a graphical user interface). Each rule  130   a  (not shown) of the of the present rule set is then checked with a comparison operation against the selected patient file  110   a  with regard to its relevance for the selected patient file  110   a . In the case of a detected relevant rule  130   a , this is associated with a relevant rule set via an association process  150 . The relevant rule set is subsequently applied to the data of the patient file  110   a  and the relevant data of the patient file  110   a  are extracted in step  150 , and are read out from the patient databank  110  or are made accessible via referencing. 
         [0027]    A concluding plausibility check  170  ensures that all data composed via the relevant rule set correspond to the requirements of the medical data set  200  (not shown) to be presented. In the event that this is not ensured, the still-missing data in the medical data set  200  are determined from the patient databank  110  via a supplemental operation  180  and are added to the medical data set  200 . It is possible, for example, that the listing of the previous treating physicians of the patient is viewed as a necessary presentation condition for the presentation to a particular panel. If this requirement was not implemented in the present or relevant rule set, it is ensured through the concluding plausibility check that the presentation requirements established for each panel are fulfilled by the medical data set  200 . The medical data set  200  composed in this manner is subsequently communicated in step  190  to the panel. The medical data set  200  can either be directly sent to all previously-determined members of the panel or be stored on a provided server and be automatically retrieved and presented to the panel as needed or on the scheduled presentation date. 
         [0028]    An exemplary rule structure according to the inventive method can be seen from  FIG. 2 . The basic structure of an “IF-THAN” instruction includes two basic operators for the necessary conditions of the respective rule (designated as COND. 1  and COND. 2  in  FIG. 2 ) and two result operators for the events linked with the necessary conditions and the necessary information for the sending of the medical data set  200  to the corresponding panel. 
         [0029]    The necessary conditions can be retrieved and selected, for example, as pull-down menus on a graphical user interface. This graphical editing function can be used in the generation of the present rule set; for the generation of the relevant rule set; for the application of the relevant rule set for extraction of the relevant entries from the patient file  110   a ; and/or for the classification of a patient file  110   a  as relevant for a presentation. 
         [0030]      FIG. 2  shows an exemplary generation of a rule in accordance with the inventive method. A processor can select the necessary fields (such as, for example, COND. 1  or COND. 2 ) by means of a graphical user interface. For this purpose, the respective fields are connected with a wide range of different databanks such as, for example, the patient databank  110  or the rule databank  130 . The participation of specific medical specialists in the framework of a field selection can likewise be taken into account. For example, the presenters in the panel can be selected as a first necessary condition (COND. 1 ) for the current rules to be generated. The currently present physicians can be selected as a second necessary condition (COND. 2 ). Given the selection of a specific physician (for example “leading senior physician”) as COND. 2 , it is defined as a result that the composed medical data set  200  is to be archived given the selection “leading senior physician” for the case of a private insurance of the patient treated by the leading senior physician and given an age of the patient over 60 years. At the same time the medical data set  200  is to be presented to the panel “computer tomography” in this case. The presentation requirements for the panel “computer tomography” are the presentation of the previous CT exposures of the patient in connection with the tabular listing of the previous documented course of illness of the patient. 
         [0031]    Upon the completion of the rules, the computer system determines all necessary links and storage locations of the data necessary for satisfaction of the rule  130   a  and connects this storage address with the respective rule  130   a . With this rule  130  generated in such a manner, it is possible for the rule-based system to independently generate the necessary data for the presentation of the respective medical data set  200  and to therewith automatically compose the presentation documents. 
         [0032]    The listing in  FIG. 3  exemplarily illustrates a rule specifications according to the inventive method. The rule syntax for general presentation follows (conforms to) the programming language C, this rule syntax merely being selected for exemplary presentation and does not represent a limitation to this rule structure. Rather, the rule  130   a  can be defined as a set of instructions in any arbitrary computer language, code or in any machine-readable form. 
         [0033]    With the initiation  131  of the respective rule  130   a , the respective rule comprises an introductory name association  132 . The necessary conditions  133 ,  134  of the rule  130   a  are subsequently read out from a databank  110 ,  130  in SQL format and are connected with one another with a selectable link  134 . The rule  130   a  also includes a Boolean variable that indicates the relevance  136  of the respective rule for a patient file  110   a . The Boolean variable of this rule  130   a  can hereby be set to “TRUE” in the event of a relevance and thus be selected as a portion of the relevant rule set given a subsequent retrieval of this rule  130   a . The events connected with the necessary conditions  133 ,  134 ,  135  of this rule  130   a  are stored in the rule elements  137 . The rule  130   a  also includes continuative information instructions  138  of the appertaining panel. 
         [0034]    Although modifications and changes may be suggested by those skilled in the art, it is the intention of the inventor to embody within the patent warranted hereon all changes and modifications as reasonably and properly come within the scope of his contribution to the art.