English:
[0001] There are many causes of medical errors, inconsistent care, sub-optimal care and prolonged durations of care. For example, medical errors and inefficiencies may result from information overload, overcrowdmg/understaffing, lack of a readily available specialist and the rapidly growing knowledge base in medicine. Evidence suggests that many medical errors and inefficiencies in healthcare can be avoided by standardizing clinical care through guidelines and protocols. Thus, clinical guidelines documenting a set of recommendations for healthcare professionals on how to optimally treat and manage patients with specific diseases and conditions have been developed by various medical professional organizations. Typically the recommendations by these organizations are not intended to be rigid rules, but rather are meant to be pieces of advice to guide their users .
[0002] Efforts have been made to computerize clinical guidelines and protocols since electronic versions are preferable to paper versions given the advantages of exchanging information easily with a hospital information system. Languages that specify computer-mterpretable guidelines (e.g., Asbru, EON, GLIF, New Guide, PRODIGY and PROforma) are interpreted by guideline execution engines (e.g., GLEE and Gaston) that interpret the computer-mterpretable guideline languages. Conventional guideline execution engines, however, restrict clinical users to a prescribed order of events. In order to overcome this limitation, case handling or work flow managing systems (e.g., FLOWer, ECHO, the Staffware Case Handler, the COSA Activity Manager) may be utilized.
[0003] Electronic guideline management systems, however, still have a number of limitations. Current systems do not account for the constantly changing tasks required in managing patients or for the importance of adapting individual workflow steps to particular situations. Additionally, these systems neither facilitate execution of the listed tasks nor give the users an opportunity to document tasks that have occurred out of the norm.
[0004] A method including receiving patient information entered via a user interface, processing the patient information to generate an initial worklist based on the patient information and a patient guideline, displaying the initial worklist, receiving a user input based on the initial worklist; processing the user input to generate an updated worklist based on the user input and displaying the updated worklist .
[0005] A system having a user interface to enter patient information and a user input, a memory storing a patient guideline, a processor generating a worklist based on one of the patient information and the user input along with a patient guideline, wherein the user input is based on a previously generated worklist and a display displaying the worklist.
[0006] A computer-readable storage medium including a set of instructions executable by a processor. The set of instructions operable to receive patient information entered via a user interface, process the patient information to generate an initial worklist based on the patient information and a patient guideline, display the initial worklist, receive a user input based on the initial worklist, process the user input to generate an updated worklist based on the user input and display the updated worklist.
[0007] Fig. 1 shows a schematic diagram of a system according to an exemplary embodiment.
[0008] Fig. 2 shows a schematic diagram of a structure of the system of Fig. 1.
[0009] Fig. 3 shows a flow diagram of a method according to the system of Fig. 1.
[0010] Fig. 4 shows a screen shot of an electronic guideline and a worklist of a patient who is likely having an ischemic stroke, according to the method of Fig. 3.
[0011] Fig. 5 shows a screen shot of an electronic guideline and a worklist of a non-stroke patient exhibiting some stroke- like symptoms, according to the method of Fig. 3.
[0012] The exemplary embodiments may be further understood with reference to the following description and the appended drawings wherein like elements are referred to with the same reference numerals. The exemplary embodiments relate to a system and method for interpreting a computer-readable representation of clinical guidelines. In particular, the exemplary embodiments provide a system and method for generating a user-specific list of patient-specific recommendations during a clinical routine. It will be understood by those of skill in the art that although the exemplary embodiments describe guidelines for stroke symptoms, the following systems and methods may be used to provide patient-specific recommendations for any type of symptom or clinical routine. It will also be understood by those of skill in the art that the following systems and methods may be applicable outside of the medical domain to generate recommendations based upon any accepted guideline or protocol.
[0013] As shown in Fig. 1, a system 100 according to an exemplary embodiment generates a dynamic worklist of tasks including recommendations for a specific patient at a particular point in his/her management. The recommendations are based on existing clinical guidelines and/or protocols. The system 100 comprises a processor 102 that is capable of processing user inputs via a user interface 104 to generate the dynamic patient and/or user specific worklist. A user inputs patient information through the user interface 104 to generate an initial worklist, which is based on the guidelines and/or protocols and includes gathering patient information. Subsequent user input may optionally include user preferences and/or changes to patient information such that the processor 102 may generate an updated worklist. The system 100 further comprises a display 106 for displaying the worklist and/or a guideline flowchart and a memory 108 for storing guidelines, protocols and/or rules, which are used to generate the worklist. User input and patient information are entered via the user interface 104, which may include a mouse to point and click on items on the display 106, a touch display and/or a keyboard.
[0014] As shown in Fig. 2, the system 100, as described above, generates a dynamic worklist via software applications including a worklist manager 110 and a guideline manager 112, which are processed by the processor 102 to produce a worklist and a guideline representation, respectively, that are displayed on the display 106. Patient information is entered and stored in a patient information database 122, which is stored in the memory 108. The guideline manager 112 communicates with the patient information database 122 and a guideline database 120 to generate a guideline representation based on the patient information. The guideline database 120 includes healthcare industry-accepted guidelines and protocols that are searchable by patient information (e.g., symptoms, conditions, diseases) . The guideline representation is generated via user selection by recalling a guideline from the guideline database 120. It will be understood by those of skill in the art that the accepted guidelines and protocols may be adapted for a specific site such that the guidelines and protocols may be hospital or department- accepted guidelines and protocols. The generated guideline representation includes a flowchart comprising nodes corresponding to possible steps based on the patient information .
[0015] Using the recalled guideline representation, the worklist manager 110 generates a worklist, including a list of recommended tasks, based on the patient's specific information. Both the worklist and the guideline representation are displayed via a worklist viewer 114 and a guideline viewer 116, respectively, on the display 106. Based on the displayed worklist and/or guideline representation, the user may enter user input via the user interface 104 to generate an updated worklist and/or generate a guideline representation. The user input indicates, for example, a completed task of the worklist, a request for re-ordering of the list of tasks and/or selection of a specific node of the guideline. Depending on a type of user input entered, the worklist manager 110 may communicate with one of the guideline manager 112 and/or a rules engine 118. The rules engine 118 re-orders the list of recommended tasks, as desired. The rules engine 118 consults a rules database 124, which includes a previously established set of rules that determined how to rank one task relative to another to re-order the list of recommended tasks according to the desired re¬ordering. The rules database 124 is stored in the memory 108 and is consulted by the rules engine 118, as necessary. Accordingly, the worklist manager 110 is able to communicate with the guideline manager 112 and/or the rules engine 118 such that the processor 102 generates an updated worklist and/or guideline representation to be displayed on the display 106 via the worklist viewer 114 and the guideline viewer 116, respectively.
[0016] Fig. 3 shows an exemplary method 200, in which the system 100 generates a dynamic worklist, which may be continuously or iteratively updated based on changing information or specific requests. The method 200 includes entering and/or storing patient information, in a step 210. The patient information includes information such as, demographic information, the patient's symptoms, known conditions, diseases and patient findings (e.g., blood pressure, temperature) . The patient information is stored in the patient information database 122 so that all of the known patient information is readily accessible by the system 100. Based on the patient information from the patient information database 122 and healthcare industry-accepted guidelines and protocols from the guideline database 120, the guideline manager 112 recalls an initial guideline representation, in a step 220. It will be understood by those of skill in the art, however, that more than one guideline representation may be recalled depending on the patient information.
[0017] The worklist manager 110 is then able to communicate with the guideline manager 112, to generate an initial worklist, based on patient-specific information and the generated guideline representation, in a step 230. The guideline may include binary decision points such that inputs for these decision points generate a list of recommended tasks for the initial worklist. Thus, the user is able to interact with the guideline via the worklist. Alternatively, the worklist manager 110 also optionally evaluates patient findings such that the worklist includes tasks for treating the finding. For example, where the user enters a systolic blood pressure of 200, the worklist manager 110 is able to determine whether the value is within a pre-defined pathological range, indicating normal, high or low values. It will be understood by those of skill in the art that the pre-defined pathological range may be defined and/or modified by the user. In one example, the worklist manager 110 determines that the systolic blood pressure value of 200 is very high such that the worklist includes a task recommending administration of an anti-hypertensive medication. As a further alternative, the worklist is user specific such that it includes a list of tasks for a specific user such as, for example, a nurse or surgeon.
[0018] In a step 240, the initial guideline and/or the initial worklist are displayed on the display 106 via the guideline viewer 116 and the worklist viewer 114, respectively. It will also be understood by those of skill in the art that other information such as user information and/or patient information may also be displayed on the display 106, concurrently or otherwise. Although the displayed guideline may be a general, healthcare industry-accepted guideline or protocol based on patient symptoms, the worklist, which is continuously updated over the course of the patient's hospitalization, is based on patient-specific information. For example, Fig. 4 shows a guideline and worklist for a first patient. The first patient exhibits typical stroke systems (e.g., hemiparesis, visual field deficit, aphasia) . The user inputs the symptoms, which are part of the patient information 122, into the system 100 and the patient information 122 is stored in the memory 108. Additionally, an ECG reveals atrial fibrillation, a common cause of ischemic stroke. Based upon the user inputted information, the worklist recommends tasks that are focused on obtaining a brain image as soon as possible, as the guideline indicates that the brain image is considered an essential step in the management of an acute ischemic stroke patient. In another example, however, as shown in Fig. 5, a patient exhibits similar symptoms such as mild slurred speech, tingling in the arm and slight dizziness. However, by the time the ECG is done, the symptoms have improved. In this case, although the guideline remains substantially the same as the guideline of Fig. 4, the list of tasks of the worklist focus on clarifying the cause of the symptoms than on obtaining a brain image since this patient is less likely to have an ischemic stroke.
[0019] In a step 250, the user enters a user input, via the user interface 104, based on the displayed initial guideline and initial worklist. The user input includes, for example, a step taken, a request for sorting the list of tasks, entering additional information about the patient such as test results and/or a request for more information or details regarding a specific node of the displayed guideline. The worklist manager 110 has a default setting, which lists the tasks in a particular order. For example, the list of tasks may be listed according to a first in - first out principle. However, the needs of a patient may change during the course of management, which may require the list to be re-ordered and sorted accordingly. The worklist may be sorted, for example, by importance, information gained, costs or risks. Sorting by importance is particularly useful if the patient has more than one medical emergency. For example, if the patient had an atrial fibrillation and a stroke episode, diagnostic steps of the stroke guideline may take precedence over an administration of a blood thinner. Additionally, the list of tasks may be sorted according to invasiveness, patient preferences or a combination of factors. It will be understood by those of skill in the art that the sorting criteria may be user-selectable, in ascending or descending order and can be reverted back to the default order suggested by the guideline. It will also be understood by those of skill in the art that the default setting for sorting may be changed by the user, as desired.
[0020] Alternatively, the user may select a specific node of the displayed guideline and/or a specific task of the displayed worklist to obtain details or further information regarding the task. For example, an explanation of the task may be shown to the user in a tool tip box. Explanations include, for example, the nature of the task, the reason why the task is on the worklist, and the reason why the item has a particular weight or importance. The explanation may further include text, pictures, and links to relevant documents and/or websites. It will be understood by those of skill in the art that the user may select the explanation option via the user interface 104 by selecting the tool tip box or hovering the mouse over an item.
[0021] The user input is then processed to generate an updated guideline representation and/or worklist based on the user input entered in the step 250. For example, in a step 260, the user input is transmitted to the worklist manager 110, which determines a step needed to update the initial worklist as indicated by the user input. Where the user input indicates a step taken, the worklist manager 110 automatically removes the completed task from the worklist. It will be understood by those of skill in the art, however, that the user may not be able to update the worklist after each task is completed. The user then simply indicates a current point in the guideline and/or worklist. The worklist manager 110 will be able to automatically infer from the current point, which tasks have been completed. It will be understood by those of skill in the art that a status of each of the tasks may be stored in the memory 108 such that the user may switch between guideline and worklists for different patients. Thus, as the user enters the user input, the status may be updated.
[0022] If, however, further processing is required, the worklist manager 110 communicates with one of the guideline manager 112 and the rules engine 118, in a step 270, depending on the user input entered. For example, if the user requests a sorting of the tasks, the worklist manager 110 communicates with the rule engine 118 to sort the list of tasks based on the rules 124. Alternatively, where the user enters additional patient information, the worklist manager 110 communicates with the guideline manager 112, which stores the additional information in the patient database 122 and updates the guideline representation based on the guidelines 120 and the additional patient information. This updated guideline representation is then communicated to the worklist manager. Further, the completion of a task may activate other tasks in the same or in another application.
[0023] In a step 280, the worklist manager 110 generates an updated worklist based on the communication between worklist manager 110 and one of the guideline manager 112 and/or the rules engine 118. The updated worklist may be updated such that the list of tasks is sorted according to a user preference or to include a new list of tasks based on additional patient information, etc. The worklist manager 110 also generates an audit trail indicating all of the tasks that have been completed thus far. In a step 290, this updated worklist and/or the updated guideline representation, if available, is then displayed on the display 106 via the worklist viewer 114 and the guideline viewer 116, respectively. Options for viewing the audit trail, patient information or other information based on the user input may also be displayed. It will be understood by those of skill in the art that the method 200 may return to the step 250 so that the user may continue to enter a user input based on the displayed guideline and/or worklist to continuously update the displayed worklist with new information or requests.
[0025] It will be apparent to those skilled in the art that various modifications may be made to the disclosed exemplary embodiments and methods and alternatives without departing from the spirit or the scope of the disclosure. Thus, it is intended that the present disclosure cover modifications and variations provided they come within the scope of the appended claims and their equivalents.
[0026] It is also noted that the claims may include reference signs/numerals in accordance with PCT Rule 6.2 (b) . However, the present claims should not be considered to be limited to the exemplary embodiments corresponding to the reference signs/numerals .

中文:
[0001]导致医疗差错、不一致的护理、次优的护理以及延长的护理持续时间的原因很多。例如,可能由信息过载、过度拥挤/人员不足、缺乏随叫随到的专家以及快速增长的医学知识库导致医疗差错和低效。证据表明,可以通过经由指南和规程使临床护理标准化而避免健康护理中的许多医疗差错和低效。因此,已经由各种医疗专家组织开发了临床指南,该指南记载针对健康护理专家关于如何最优地治疗和管理具有特定疾病和状况的患者的一组建议。通常,这些组织的建议并非旨在成为硬性规定,而是意在成为指导其用户的一条条建议。
[0002]鉴于与医院信息系统容易交换信息这一优势,电子版本比纸质版本更为优选,因此已经在使临床指南和规程的计算机化方面做出了努力。由解释计算机可解释的指南语言的指南执行引擎(例如,GLEE和Gaston)解释指明了计算机可解释的指南(例如,Asbru、EON、GLIF、New Guide、PRODIGY和PROforma)的语言。然而,常规的指南执行引擎将临床用户限制在规定顺序的事件中。为了克服这一局限,可以利用病例处理或工作流管理系统(例如,FLOWer、ECHO、Staffware病例处理器(the Staffware Case Handler)、COSA活度管理器(the COSA Activity Manager))。
[0003]然而,电子指南管理系统仍然具有若干局限。当前的系统没有考虑到在管理患者时所需的经常改变的任务,或者没有考虑到针对特定情况调整个人工作流步骤的重要性。此外,这些系统既没有促进列表任务的执行,也没有使用户有机会记载规范以外发生的任务。
[0004]一种方法,包括:接收经由用户接口输入的患者信息;处理患者信息以基于患者信息和患者指南生成初始工作列表;显示初始工作列表;基于初始工作列表接收用户输入;处理用户输入以基于用户输入生成经更新的工作列表;以及显示经更新的工作列表。
[0005]一种系统,具有:用户接口,其用于输入患者信息和用户输入;存储器,其存储患者指南;处理器,其基于患者信息和用户输入连同患者指南中的一个生成工作列表,其中,所述用户输入基于先前生成的工作列表;以及显示器,其显示工作列表。
[0006]一种计算机可读存储介质,其包括可以由处理器执行的指令集。所述指令集用于接收经由用户接口输入的患者信息;处理患者信息以基于患者信息和患者指南生成初始工作列表;显示初始工作列表;基于初始工作列表接收用户输入;处理用户输入以基于用户输入生成经更新的工作列表;以及显示经更新的工作列表。
[0007]图1示出了根据示范性实施例的系统的示意图。
[0008]图2示出了图1的系统的结构的示意图。
[0009]图3示出了根据图1的系统的方法的流程图。
[0010]图4示出了根据图3的方法的可能患有缺血性卒中的患者的电子指南和工作列表的截屏。
[0011]图5示出了根据图3的方法的表现出一些类似卒中症状的非卒中患者的电子指南和工作列表的截屏。
[0012]参考以下描述和附图可以进一步理解示范性实施例,其中,以相同的参考标记指代相似元件。示范性实施例与用于解释临床指南的计算机可读表示的系统和方法有关。具体而言,示范性实施例提供用于在临床日常程序期间生成患者特异性建议的用户特异性列表的系统和方法。本领域技术人员应当理解的是,尽管示范性实施例描述针对卒中症状的指南,但以下系统和方法可以用于针对任何类型的症状或者临床日常程序提供患者特异性建议。本领域技术人员还应当理解的是,以下系统和方法可以应用于医学领域以外,以基于任何接受的指南或规程生成建议。
[0013]如图1所示,根据示范性实施例的系统100生成任务的动态工作列表,其包括针对特定患者在其管理的具体点处的建议。所述建议基于现有的临床指南和/或规程。系统100包括处理器102,其能够处理经由用户接口104的用户输入以生成动态患者和/或用户特异性工作列表。用户通过用户接口104输入患者信息,以生成初始工作列表,初始工作列表基于指南和/或规程并且包括收集患者信息。随后的用户输入可以任选地包括用户偏好和/或对患者信息的改变,从而使得处理器102可以生成经更新的工作列表。系统100还包括用于显示工作列表和/或指南流程图的显示器106以及用于存储用于生成工作列表的指南、规程和/或规则的存储器108。经由用户接口104输入用户输入和患者信息,所述用户接口104可以包括指向并且点击显示器106上的项目的鼠标、触摸显示器和/或键盘。存储器108可以为任何已知类型的计算机可读存储介质。本领域技术人员应当理解的是,系统100例如是个人计算机、服务器或任何其他处理布置。
[0014]如图2所示,如以上描述的系统100经由包括工作列表管理器110和指南管理器112的软件应用程序生成动态工作列表,所述软件应用程序由处理器102处理以分别产生在显示器106上显示的工作列表和指南表示。将患者信息输入并且存储在患者信息数据库122中,所述数据库存储在存储器108中。指南管理器112与患者信息数据库122和指南数据库120通信以基于患者信息生成指南表示。指南数据库120包括健康护理行业接受的指南和按患者信息(例如,症状、状况、疾病)可搜索的规程。经由用户选择通过从指南数据库120调用指南而生成指南表示。本领域技术人员应当理解的是,接受的指南和规程可以针对特定场所进行调整,从而使得指南和规程可以是医院或部门接受的指南和规程。生成的指南表示包括包含节点的流程图,所述节点与基于患者信息的可能步骤对应。
[0015]工作列表管理器110使用调用的指南表示生成工作列表,所述工作列表包括基于患者特异性信息的推荐的任务的列表。分别经由工作列表观看器114和指南观看器116在显示器106上显示工作列表和指南表示两者。基于所显示的工作列表和/或指南表示,用户可以经由用户接口104输入用户输入以生成经更新的工作列表和/或生成指南表示。用户输入例如指示工作列表中完成的任务、对任务列表重新排列的请求和/或对选择指南的特定节点的请求。根据所输入的用户输入的类型,工作列表管理器110可以与指南管理器112和/或规则引擎118中的一个通信。规则引擎118按需要重新排列所推荐的任务的列表。规则引擎118查询规则数据库124,所述数据库包括先前建立的规则组,所述规则组确定如何排列一个任务相对于另一任务从而根据预期的重新排列来重新排列所推荐的任务的列表。将规则数据库124存储在存储器108中,并且需要时由规则引擎118进行查询。因此,工作列表管理器110能够与指南管理器112和/或规则引擎118通信,从而使得处理器102生成将分别经由工作列表观看器114和指南观看器116在显示器106上显示的经更新的工作列表和/或指南表示。
[0016]图3示出了示范性方法200,其中,系统100生成动态工作列表,基于变化的信息或特定的请求连续更新或者迭代更新所述动态工作列表。方法200包括在步骤210输入和/或存储患者信息。患者信息包括诸如人口统计学信息、患者症状、已知状况、疾病和患者数据(finding)(例如,血压、温度)的信息。将患者信息存储在患者信息数据库122中,以便系统100容易地访问所有已知的患者信息。基于来自患者信息数据库122的患者信息和来自指南数据库120的健康护理行业接受的指南和规程,指南管理器112在步骤220调用初始指南表示。然而,本领域技术人员应当理解的是,可以根据患者信息调用多于一个的指南表示。
[0017]然后在步骤230中工作列表管理器110能够与指南管理器112通信以基于患者特异性信息和所生成的指南表示生成初始工作列表。指南可以包括二元决策点,从而使得针对这些决策点的输入生成针对初始工作列表的推荐的任务的列表。因此,用户能够经由工作列表与指南交互。备选地,工作列表管理器110还任选地评估患者数据,从而使得工作列表包括用于处置数据的任务。例如,在用户输入为200的收缩血压时,工作列表管理器110能够确定该值是否在指示正常、高或低值的预定义的病理范围内。本领域技术人员应当理解的是,可以由用户定义和/或修改预定义的病理范围。在一个示例中,工作列表管理器110确定为200的收缩血压值是非常高的,从而使得工作列表包括推荐施予抗高血压药物的任务。作为另一备选,工作列表是用户特异性的,从而使得其包括针对诸如护士或外科医师的特定用户的任务列表。
[0018]在步骤240中,分别经由指南观看器116和工作列表观看器114在显示器106上显示初始指南和/或初始工作列表。本领域技术人员还应当理解的是,也可以同时地或以其他方式在显示器106上显示诸如用户信息和/或患者信息的其他信息。尽管所显示的指南可以是基于患者症状的一般的、健康护理行业接受的指南或规程,但是在患者住院治疗过程期间连续更新的工作列表基于患者特异性信息。例如,图4示出了针对第一患者的指南和工作列表。所述第一患者表现出典型的卒中系统(例如,偏瘫、视野缺陷、失语症)。用户将作为患者信息122的一部分的症状输入到系统100中,并且将患者信息122存储到存储器108中。此外,ECG揭露出心房颤动,这是缺血性卒中的常见原因。基于用户输入的信息,工作列表推荐重点在于尽快获得大脑图像的任务,这是因为指南指示在急性缺血性卒中患者的管理中大脑图像被视为必要步骤。然而,在如图5所示的另一示例中,患者表现出相似的症状,诸如轻微言语不清、手臂抖动以及轻微眩晕。然而,在完成ECG时,症状得到了改善。在这种情况下,尽管指南与图4的指南基本保持一致,但工作列表的任务列表关注于弄清症状的原因而非获得大脑图像,这是因为该患者不太有可能具有缺血性卒中。
[0019]在步骤250,用户经由用户接口104基于所显示的初始指南和初始工作列表输入用户输入。用户输入包括:例如已执行的步骤、对任务列表排序的请求、输入诸如测试结果的关于患者的附加信息和/或对有关显示的指南的具体节点的更多信息或细节的请求。工作列表管理器110具有默认设置,其以具体顺序列出任务。例如,可以根据“先进先出”的原则列出任务列表。然而,在管理过程期间患者需求可能改变,因此可能需要对列表进行重新排列和排序。例如,可以按重要性、得到的信息、成本或风险对工作列表排序。当患者具有多于一个的医疗紧急情况时,按重要性排序是特别有用的。例如,当患者有过心房颤动和卒中发作时,卒中指南的诊断步骤可以优先于施予血液稀释剂。此外,可以根据侵袭度、患者偏好或各因素的组合对任务列表排序。本领域技术人员应当理解的是,排序标准可以是用户可选择的,以递升或递降的顺序并能够恢复返回至指南建议的默认顺序。本领域技术人员还应当理解的是,用户可以按照需要改变排序的默认设置。
[0020]备选地,用户可以选择所显示的指南的特定节点和/或所显示的工作列表的特定任务,以获得有关任务的细节或进一步的信息。例如,可以在工具提示框中向用户示出任务的解释。解释包括:例如,任务的性质、任务在工作列表中的原因、以及项目具有特定权重或重要性的原因。解释可以进一步包括文本、图片以及与相关文档和/或网站的链接。本领域技术人员应当理解的是,用户可以经由用户接口104通过选择工具提示框或者将鼠标悬停在项目上而选择解释选项。
[0021]然后处理用户输入以基于在步骤250输入的用户输入生成经更新的指南表示和/或工作列表。例如,在步骤260,将用户输入传输到工作列表管理器110,工作列表管理器110根据用户输入的指示确定需要更新初始工作列表的步骤。在用户输入指示已经执行了一步骤时,工作列表管理器110自动从工作列表中移除完成的任务。然而,本领域技术人员应当理解的是,用户可能无法在完成每个任务之后更新工作列表。则用户简单地指示指南和/或工作列表中的当前点。工作列表管理器110将能够从当前点自动推导哪些任务已经完成。本领域技术人员应当理解的是,每个任务的状态可以存储在存储器108中,从而使得用户可以针对不同患者在指南和工作列表之间切换。因此,当用户输入用户输入时,可以更新状态。
[0022]然而,当需要进一步处理时,在步骤270中,根据用户输入的用户输入,工作列表管理器110与指南管理器112和规则引擎118中的一个通信。例如,当用户请求对任务排序时,工作列表管理器110与规则引擎118通信从而基于规则124对任务列表排序。备选地,在用户输入附加患者信息的情况下,工作列表管理器110与指南管理器112通信,所述指南管理器112将附加信息存储在患者数据库122中并基于指南120和附加患者信息更新指南表示。然后所述经更新的指南表示被传送到工作列表管理器。此外,任务的完成可以激活相同应用或另一应用中的其他任务。
[0023]在步骤280中,工作列表管理器110基于工作列表管理器110与指南管理器112和/或规则引擎118中的一个之间的通信生成经更新的工作列表。可以对经更新的工作列表进行更新,从而使得根据用户偏好对任务列表排序,或者包括基于附加患者信息的新的任务列表,等等。工作列表管理器110还生成审查(audit)追踪,其指示目前已经完成的所有任务。在步骤290,然后将所述经更新的工作列表和/或经更新的指南表示(如果可获得的话)分别经由工作列表观看器114和指南观看器116在显示器106上显示。还可以显示用于基于用户输入的观看审查追踪、患者信息或其他信息的选项。本领域技术人员应当理解的是,方法200可以返回到步骤250,使得用户可以继续基于所显示的指南和/或工作列表输入用户输入,从而以新的信息或请求连续更新所显示的工作列表。
[0025]对本领域技术人员显而易见的是,可以对公开的示范性实施例和方法以及备选方案作出修改而不脱离本公开的精神或范围。因此,旨在使本公开覆盖修改及变型,只要它们落入权利要求以及与其等价的范围内。
[0026]还应当注意的是,根据PCT细则6.2(b)权利要求可以包括参考标记/数字。然而,不应当将本权利要求视为限于与参考标记/数字对应的示范性实施例。