System and method for integrating data with guidelines to generate displays containing the guidelines and data

A system and method for automatically integrating data with guidelines to generate displays containing the guidelines and data. The automated system and method can integrate patient data with treatment guidelines to assist a healthcare provider, such as a physician or the like, in providing treatment to the patient. The system and method employ a data storage component, adapted to store guideline data representing guidelines for assessing a condition of an entity, guidelines for taking action on the entity, or both, and to store feature data representing at least one feature of the entity. The system and method further employ an output device, adapted to output at least one diagram representing the guideline data, with the diagram including at least one component representing a relationship of at least a portion of the feature data to at least a portion of the guideline data.

BACKGROUND OF THE INVENTION

Field of the Invention

The present invention relates to a system and method for automatically integrating data with guidelines to generate displays containing the guidelines and data. More particularly, the present invention relates to a system and method that employs a database that is capable of receiving data, such patient data, statistical data, and the like, from local or remote locations and integrating the data in a database along with guidelines, such as treatment guidelines used by medical providers, to generate displays containing the guidelines which are enhanced by the integrated data to provide information pertaining to the guidelines and recommendations for following the guidelines.

Description of the Related Art

As the population in the United States continues to increase, especially among the aging, the ability for traditional healthcare providers, such as hospitals and doctors' offices, to effectively provide treatment becomes increasingly challenging. In addition, as the average age of the population continues to increase, the number of people requiring care for long-term illnesses, such heart disease, diabetes and the like also increases.

Accordingly, alternatives to traditional health providers are being developed to accommodate these greater healthcare needs. Also, more effective and efficient systems are being developed to attempt to reduce the number of medical personnel necessary to treat or monitor patients. Specifically, systems are being developed that enable patients to have their conditions monitored at home, such as by themselves or a visiting nurse, and to provide data related to various tests, such blood pressure measurement, temperature, weight, blood glucose level, and the like, to a centralized database. These systems are then capable of organizing the data in an appropriate manner, and providing the data in an appropriate format to a healthcare provider, such a physician, who can review the data and determine whether the plan of care for the patient is sufficient or should be modified.

An example of a healthcare data manipulation and analysis system is described in U.S. Pat. No. 6,230,142 to Benigno, the entire content of which is incorporated herein by reference. According to the Benigno system, a healthcare provider, such as a nurse can obtain patient data during a visit with the patient at, for example, the patient's home. This patient data is entered into a database that compares the data to treatment guidelines for the particular patient's disease, and provides a recommended course of treatment for the patient. Other examples of this type of system are described in U.S. Pat. Nos. 5,953,074 and 5,583,758, both to McGilroy, the entire content of both of these patents being incorporated herein by reference.

Although the patents cited above describe systems which attempt to gather and analyze patient data and provide some recommended plan of treatment, these systems are not configured to outline different options of patient care. These systems also are not effective in illustrating to the care provider a comparison between other variations of care plans that could be followed based on variations in the patient data. Therefore, healthcare providers may find these types of systems insufficient because they provide only a specific result for the patient based on the specific patient test data, and not different options that could be provided to the patient were the test data to be different.

A technique known as Staged Diabetes Management (SDM) exists that uses diagrams or decision paths to illustrate to a healthcare provider different courses of treatment for a diabetes patient. An example of the staged diabetes management technique is described in a book by Roger S. Mazze, Ph.D. et al.,Staged Diabetes Management—A Systematic Approach(International Diabetes Center, 2000), the entire content of which is incorporated herein by reference. The Staged Diabetes Management technique described in this book is intended to provide a systematic approach to diabetes care that can significantly reduce average glycosylated hemoglobin A1C, reduce overall lower extremity amputation, and reduce adverse fetal and prenatal outcomes associated with Type 1 diabetes and pregnancy. SDM provides a comprehensive program that offers scientifically based guidelines for the prevention, detection and treatment of diabetes and its complications, and has proven to enhance the quality of patient care when compared to standard treatment approaches for diabetes.

Specifically, the SDM technique uses diagrams referred to as decision paths that incorporate research findings in Type 1 diabetes, Type 2 diabetes, and diabetes in pregnancy, and translates them into techniques usable for clinical practice. Over the past decade, the program has been adapted successfully by more than 10,000 practitioners in 200 diabetes treatment centers worldwide.

Although the SDM technique has been very successful, it is somewhat difficult to implement in a practical sense because of the need to manually integrate patient data with the SDM guidelines. That is, when a healthcare provider uses the known SDM technique, the healthcare provider must manually compare the patient data, such as test measurements and the like, with the questions and criteria set forth in the decision paths. Based on this comparison, the healthcare provider manually determines the course of treatment to provide to the patient in view of the guidelines outlined in the decision path. Again, although this technique is successful in achieving the desired results, it may be somewhat difficult for a healthcare provider to use in a practical sense.

Accordingly, a need exists for a system and method capable of integrating patient data with SDM guidelines, to provide an overall improved SDM technique.

SUMMARY OF THE INVENTION

An object of the present invention is to provide a system and method for automatically integrating data with guidelines to generate displays containing the guidelines and data.

Another object of the present invention is to provide an automated system and method for integrating patient data with treatment guidelines to assist the healthcare provider, such as a physician or the like, in providing treatment to the patient.

A further object of the present invention is to provide a system and method that is capable of receiving data, such patient data, statistical data, and the like, from local or remote locations and integrating the data in a database along with guidelines, such as treatment guidelines used by medical providers, to generate displays containing the guidelines which are enhanced by the integrated data to provide information pertaining to the guidelines and recommendations for following the guidelines.

Another object of the present invention is to provide a system and method for automatically incorporating patient data with a staged disease management technique to provide integration between the patient data and the decision pathways for treatment to the healthcare provider.

These and other objects are substantially achieved by providing a system and method for integrating guidelines with data. The system and method each employ a data storage component, which is adapted to store guideline data representing guidelines for assessing a condition of an entity, guidelines for taking action on the entity, or both, and which is further adapted to store feature data representing at least one feature of the entity. The system and method further employ an output device, adapted to output a diagram representing the guideline data. The diagram includes at least one component representing a relationship of at least a portion of the feature data to at least a portion of the guideline data. Specifically, the output device includes a display which adapted to display the diagram, or a printer which is adapted to print the diagram. The entity can be a person, in which event the feature data can represent at least one physical condition of the person, and the guideline data can represent medical information.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

FIG. 1illustrates a network100employing a system and method for integrating data, such as patient data, with guidelines, such as healthcare guidelines, according to an embodiment of the present invention. The network100employs a centralized computer network102including a database104for storing information pertaining to patients as well as healthcare guidelines as discussed in more detail below. The network100further includes a plurality of workstations106which, in this example, are healthcare provider workstations. These workstations106can include desktop computer terminals or the like that are capable of accessing the centralized computer network102and database104via, for example, the Internet108or in any other suitable fashion.

The network100further includes a plurality of patient terminals110that can be used by, for example, the individual patients or a healthcare provider, such a home care nurse, to record and enter patient data, such as vital statistics, test results, and so on, into the centralized database104. The patient terminals110can access the centralized database104via, for example the Internet108or in any other suitable manner in order to provide the data to the centralized database104. The centralized database104is shown in more detail inFIG. 2.

Specifically, the database104is capable of receiving patient specific data entry sets112via the patient terminals110or by any other suitable method. That is, the patient can take his or her own vital signs and perform other self-administered tests, such as measuring blood glucose level and so on, and enter this information on-line via his or her patient terminal110. Alternatively, this data can be obtained by a visiting nurse, technician or the like. Also, this data need not be entered via the patient terminal110, but can be obtained manually and entered into the database104via another workstation at, for example, the facility in which the database104is present, or in any other suitable manner. Furthermore, instruments such as a sphygmomanometer, blood glucose measuring device, and so on, can be coupled to the patient terminal110to automatically input the patient's readings and measurements directly to the patient terminal110without the need for manual or electronic entry by the patient, nurse, and so on. The terminal110can then be used to provide this data to the database104in any of the manners described above.

It should be noted that the database104need not be configured as a centralized database to store the data discussed above, such as that pertaining to the guidelines and patient data. For example, the guideline data and patient data can be stored locally in the workstations106and patient terminals110, respectively, and integrated as appropriate as discussed in more detail below. Furthermore, even if the guideline data and patient data are stored in separate databases or data storage locations, those separate databases or data storage locations can be referred to generally as a data storage component.

As further illustrated inFIG. 2and as discussed in more detail below, the network102generates stage disease management pathways114that are integrated with the decision data sets116and reference content118, which includes the patient-specific data, to generate clinical decision pathways120. As also shown inFIG. 2and discussed in more detail below, the database104can be controlled by the computer network102to generate educational material122and outcome reports124that take into account the patient-specific data.

FIGS. 3 and 4illustrate an example of the manner in which the operations involving the database104, workstations106and patient terminals110shown inFIGS. 1 and 2can address and eliminate the problems associated with conventional stage disease management techniques discussed in the Background section above. For example, the data entry sets can be provided by keyboard entry via the patient workstations110. The data entry sets can also be provided to the database104via datasheets that are manually completed and scanned into electronic format, which is then forwarded to the database104. The data entry sets can also be remotely downloaded to the database104in any fashion, and can also involve electronic medical records (EMR) interfacing to input the data to the database104.

As further illustrated inFIGS. 3 and 4, the decision data sets facilitate comparison of the existing patient state against the pathway model as described in more detail below. The pathways are navigable links and are therefore easy to use by a healthcare provider. The reference content is hyperlinked to the pathways and data sheets to facilitate timely access by the healthcare provider. The clinical decision aspects of the database104provide outcomes reporting capability which can be used by healthcare providers, and the educational material aspects provide the patient with Internet access or clinician-generated materials to enable the patient to study information about his or her condition.

The manner in which an example of a system and method according to an embodiment of the present operates will now be described with reference toFIGS. 1, 2, and5-24. Specifically, after the patient information has been entered into the database104in any of the manners described above, the network102can be controlled to generate treatment, pathways or guidelines that take into the account this particular patient's data to enable a healthcare provider to diagnose and prescribe treatment of the patient. When the healthcare provider accesses the database104via, for example, a healthcare provider workstation106, the computer102can access the database104and provide data to the workstation106that enables the workstation106to generate a display130on its display screen as shown inFIG. 5. In this example, the guidelines and pathways generated relate to the diagnosis and treatment of diabetes. However, it can be appreciated that this type of system and method can be employed to provide treatment pathways and guidelines for any type of disease, or can have any other medical or non-medical application.

As shown inFIG. 5, the display130includes an alphabetic listing of patient names. In this example, only two names are shown, but the list can have as many names as the database104is capable of supporting.

If the healthcare provider is interested in using the system and method to obtain a diagnosis and treatment for the patient “Sandra Dee”, the healthcare provider can use, for example, the mouse at his or her workstation106to click on the name “Sandra Dee.” This action causes the web browser running on the workstations106to provide the necessary data to network102, which results in the network102retrieving the appropriate data from database104and providing that data back to the web browser on the workstation110. As illustrated inFIG. 6, this data causes the workstation110to generate a display132illustrating a screening and diagnosis pathway for the patient “Sandra Dee.” This pathway is referred to as a diagram, which includes the type of pictorial display as illustrated.

In this example, the display132includes a button column133that enables the healthcare provider to generate various displays as discussed in more detail below. For example, the healthcare provider can click on the button entitled “Screening & Diagnosis Data” to display various boxes or components that show different guidelines that enable a healthcare provider to determine, based on the data entered into database104pertaining to “Sandra Dee”, whether or not the patient “Sandra Dee” has any form of diabetes. For example, box134displays the types of risk factors for diabetes, along with the symptoms being experienced by the patient “Sandra Dee” and the capillary blood glucose (BG) readings that would indicate that the patient is suffering from a form of diabetes. It is noted that in box134, the risk factors that the patient “Sandra Dee” meets are included. For example, the risk factors pertaining to dyslipidemia, ethnicity and family history are included. Also, symptoms such a blurred vision, UTI, dry/itchy skin, and so on are included. Furthermore, the results of the fasting blood glucose test as being greater than 100 mg/dL is highlighted.

As further illustrated inFIG. 6, box136highlights to the healthcare provider that the test performed was a fasting plasma glucose (FPG) reading, as opposed to a casual plasma glucose (CPG) reading. Box138highlights to the healthcare provider those diagnostic tests that were performed on the patient to indicate that the patient may have a form of diabetes.

Boxes140,142and144similarly illustrate the different pathways that the diagnoses can take depending on the results of the patient's test. For example, box144indicates that the FPG of the patient was determined to be 149 on Oct. 10, 2000, and thus, this portion of box144is highlighted. Since box144is highlighted, the healthcare provider can then follow the path to box146to see the readings of the patient pertaining to the urine ketone. It is noted that box146indicates that the results of the urine ketone test were negative on Oct. 11, 2000. The healthcare provider is therefore instructed to box148to repeat the FPG test in seven days. The healthcare provider is not instructed to proceed to box150to provide a diagnosis for Type 1 diabetes.

As further illustrated inFIG. 6, box151of the pathway indicates to the healthcare provider that the FPG testing of the patient was 160 mg/dL on Oct. 11, 2000, which is greater than the guideline of 126 mg/dL. The pathway therefore indicates in box152that the healthcare provider should diagnose the patient with Type 2 diabetes. It is also noted that because the FPG level was greater than the guideline set forth in box150, the healthcare provider is not instructed to proceed to box154to diagnose the patient with impaired glucose homeostasis. Also, because the patient's FPG level falls within the guidelines set forth in box144, the pathway instructed the healthcare provider to proceed along the boxes subsequent to box144. The healthcare provider is not instructed to proceed to box141which instructs the healthcare provider to diagnose the patient as having no diabetes.

In box152, the healthcare provider is instructed to generate a master decision path for the patient. By using the mouse on his or her workstation110to click on the term “Type 2 master decision path”, the web browser sends data to the network102which, in response, retrieves the appropriate data from database104and provides that data to the web browser at workstation110. The workstation110thus displays a display screen160as shown inFIG. 7. The boxes in the display screen160provide the healthcare provider with various types of recommendation for diet, exercise, and medication. For example, box162outlines a criteria for the FPG being less than 200 mg/dL. Because the FPG of the patient is indicated as being 160 mg/dL on Oct. 11, 2000, box162indicates to the healthcare provider to proceed to box164where the healthcare provider is instructed to prescribe a food plan and exercise for the patient. By clicking on the term “food plan and exercise stage” in box164, the healthcare provider can control the web browser to provide an instruction to the network102to retrieve the appropriate data from database104. The network102provides this data to workstation110, which causes the web browser to display a display186as shown inFIG. 8.

As further shown inFIG. 8, the display186includes boxes188through204, which indicate to the healthcare provider recommendations for diet and exercise. For example, the diagnosis box188proceeds to box190which indicates to the healthcare provider that the records of the patient's medical visit should be reviewed. The healthcare provider can review the medical visit records by clicking on the medical visit term in box190to cause the web browser on the workstation110to display the medical visit display screen191as shown inFIG. 9, into which information pertaining to the patient's medical visit or visits can be entered. As further shown inFIG. 8, box192provides information to the healthcare provider for obtaining a registered dietician, while box194provides SMBG targets for the patient at different stages throughout the day.

Box196which follows box190also provides information for diet and exercise for the patient, while box198provides medical nutrition therapy guidelines. Box200indicates to the healthcare provider the periods of time in which the patient's medical condition should be reviewed and when the patient's recommended diet should also be reviewed. Box202provides a sample food plan that can be prescribed to the patient. Box204, which follows box200, allows the healthcare provider to adjust the food plan and exercise that was prescribed to the patient if deemed necessary after performing the follow-ups recommended in box200.

Returning now toFIG. 7, it is noted that diagnosis boxes166and170are displayed to the healthcare provider at workstation110to enable the healthcare provider to determine whether the patient has reached the oral agent stage or the insulin stages. For example, if the patient FPG is within the guidelines as recommended in box166, then the pathway indicates in box168that the healthcare provider should prescribe oral agents to the patient for treatment of his or her diabetes. Box172indicates a combination of oral agents that can be prescribed to the patient. In addition, box170indicates guidelines for FPG which would lead to the healthcare provider prescribing insulin for treatment of the patient. That is, box176indicates the recommendation and guidelines for prescribing a combination of oral agent and insulin to the patient. Boxes180-184provide recommendations for different doses of insulin depending on the stage of the patient's diabetes. Boxes174and178display types of medications that are typically prescribed, and also provide comments to the healthcare provider.

Based on the recommendations box170, if the healthcare provider determines that the patient has reached insulin stage 2 indicated in box180, the healthcare provider can click on the term “insulin stage 2” in box180to-display insulin stage 2 start screen as shown inFIG. 10. Insulin stage 2 start screen210includes boxes212through226which provides guidelines and recommendations for prescribing insulin to the patient. For example, box212sets forth guidelines concerning the patient's FPG at diagnosis, while box214sets forth guidelines for a patient who is undergoing oral agent or combination therapy. If these conditions in boxes212and214are met, the pathway in box216recommends to the healthcare provider that the patient's medical history be examined. The healthcare provider can achieve this by clicking on the medical visit term in box216to cause the web browser of workstation110to display the medical visit display screen as shown inFIG. 9.

The display screen210shown inFIG. 10also gives SMBG targets in box218to assist the healthcare in making the diagnosis. Box220, which follows box216, provides a dose calculator to enable the healthcare provider to prescribe a recommended amount insulin based the patient's weight. That is, box220displays the patient's weight (i.e., 61.36 kgs) and the recommended dosage (i.e., 0.3 U/kg) for that weight. Box221also displays the recommended dosage, while the remainder of box220breaks down that recommended dosage for morning, midday and evening for the patient, to arrive at the total daily units for the patient. It is noted that if the recommend dosage changes to, for example, 0.4 U/kg, the healthcare provider can use the arrow in box221to adjust the dosage, which will change the breakdown of the dosage in the subsequent boxes for time of day and total daily units.

Box222inFIG. 10provides LP considerations that can be reviewed by the healthcare provider. Box224, which follows box220, provides recommendations for a follow-up in a patient's medical condition and so on. Box226, which follows box224, enables the healthcare provider to adjust the stage to insulin dosage if deemed necessary from the follow-up in box224.

That is, if the healthcare provider determines that the insulin for stage should be adjusted, the healthcare provider can use the mouse at his or her workstation110to click on the “insulin stage 2” adjust term in box226. By doing so, the web browser of the workstation110displays a stage 2 adjust screen230as shown inFIG. 11. Stage 2 adjust screen230includes boxes232through252which provide recommendations to the healthcare provider to change the insulin based on certain conditions.

For example, box234takes into account the patient's interim history and physical conditions, as well as the laboratory results, while box236provides recommendations for considering different insulin stages. Box238considers whether the patient's SMBG is within the target range. If so, box240provides a recommendation that the patient maintain the stage to insulin dosage. Box242considers the patient's monthly assessment which, if improvement is shown, indicates that the recommendations in box244should be followed. If improvement is not shown, the guidelines recommended in box246that the patient's day-to-day management be assessed, and box248provides guidelines to determine whether the patient's dosage is sufficient. Box250enables the healthcare provider to provide a recommended adjustment to the patient's insulin dosage. Box252provides recommendations for changing the patient's dosage to follow the insulin stage 3 or insulin stage 4 recommendations.

Returning toFIG. 7, if the healthcare provider determines from the diagnosis in box170that the patient should be given insulin stage 3A dosage, the healthcare provider can use the mouse at his or her workstation110to click on the insulin stage 3A term in box182. In doing so, the browser on workstation110will display the insulin stage 3A start display screen260as shown inFIG. 12. The display screen250includes boxes262through276which are similar to boxes212through226in display screen210shown inFIG. 10and which will not be described in detail here. Returning toFIG. 7, if the healthcare provider determines from the guidelines set forth in box170that the patient should enter insulin stage 4A, the healthcare provider can use the mouse at his or her workstation110to click on the term insulin stage 4A in box184to cause browser to display an insulin stage for a start screen280as shown inFIG. 13. Screen280includes boxes282through296which are similar to boxes262through276shown inFIG. 12and boxes212and226shown inFIG. 10, and thus will not be described in detail here. Also, box276inFIG. 12and box296inFIG. 13enable the healthcare provider to provide insulin stage 3A adjustment and insulin stage 4A adjustment, respectively, in a manner similar to the insulin stage 2A adjustment as shown in the display screen230set forth inFIG. 11.

It is also noted that the various buttons in the button column133on the displays discussed above which are displayed on the display screen of the workstation110can be used to generate additional display screens pertaining to the patient. For example, if the healthcare provider clicks on the global patient data button, a group of additional buttons can be displayed as shown inFIG. 14. The healthcare provider can thus click on these additional buttons to cause the workstation110to display, for example, a screen showing the patent's history in present illness (HPI), as well as ambulatory blood pressure (BP) as shown in display screen300inFIG. 15, and the patient's medicines and allergy information which can be entered in display screen302as shown inFIG. 16. The healthcare provider can also click on the data entry button to cause the workstation to display a patient data entry screen304as shown inFIG. 17. The healthcare provider can also click on any of the other buttons to display screens for performing additional tasks.

For example, the healthcare provider can click on the outcomes reporting button to display reports on patient progress. More particularly, the outcomes reporting button could be clicked on to display population data reports, such as NCQA, HEDIS or JCAHO reports, which are of critical importance to Health Care Organizations in securing and maintaining various forms of accreditation, and show a compilation of different patient data that can be provided to those organizations. The healthcare provider can click on the orders and referrals button to view medical orders and referrals that have been given to the patient. These orders and referrals can include templates or letters into which the patient data and diagnosis data can be automatically entered by the system, thereby obviating the need for redundant documentation by the clinician. That is, if the referral is a referral letter to a type of specialist, such as a nutritionist, the patient diagnosis (e.g., Type 2 diabetes) and patient data (e.g., SBGL readings) can be automatically inserted into the letter simply by the nature of the actions that the user takes while navigating the pathway screen(s) for the purpose of managing their patient or entity.

The healthcare provider can also click on any of the other buttons in button column133to display the desired display screens. For example, clicking on the patient documentation button will display the patient information such as the data that is in a patient's chart. Clicking on the screen and diagnose button will display the screen and diagnose display screen132as shown inFIG. 6, and clicking on the start food plan and exercise button will display the food plan and exercise display screen186as shown inFIG. 8. Clicking on the start insulin display screen button will enable the healthcare provider to display the selected insulin display screen as shown inFIGS. 10, 12 and 13, and clicking on the adjust insulin display screen will show an insulin adjustment display screen as shown inFIG. 11. Clicking on the start oral or start/manage pump buttons will display appropriate pathways similar to those shown inFIGS. 10, 12 and 13but which pertain to oral or pump-administered medications. Clicking on the SOAP (subjective objective assessment and plan) button will display a display screen into which the healthcare provider can enter additional SOAP notes, beyond those automatically generated by the system in conjunction with the user's use of the system, as can be appreciated by one skilled in the art. Clicking on the select therapy button displays the master pathway as shown inFIG. 7. Clicking on the print button will enable the healthcare provider to print the displayed screen, and clicking on the home button returns the display to that shown inFIG. 5.

In addition, an appropriate button, such as the education button, can be clicked on to display self-management and adherence assessment display screen310as shown inFIG. 18that includes boxes312through334which provide questions for the patient to answer and recommendations for the patient and will process those questions. Furthermore, the healthcare provider can click on the complications buttons to be able to diagnose whether or not the patent is developing any complications and then treatment pathways can provide guidance on their treatment For example, by clicking on the complication button, the workstation110can display a hypertension and diagnosis display screen340as shown inFIG. 19. The hypertension diagnosis display screen340includes boxes342through362which assist a healthcare provider in determining whether or not the patient is developing hypertension. For example, box342indicates that the patient with Type 1 or Type 2 diabetes can be suffering from hypertension, and subsequent box344instructs the healthcare provider to measure blood pressure and review previous blood pressure values. Box346provides blood pressure measurement guidelines. In addition, if the healthcare provider clicks on the box “R” in box346, the workstation will display a dropdown box showing normal blood pressure range and diabetes blood pressure ranges as shown inFIG. 20.

The additional boxes in display screen340similarly ask the healthcare provider questions to assist the healthcare provider with the diagnosis. If the healthcare provider reaches box362, a recommendation is give to diagnose the patient with hypertension. The healthcare provider can then click on the hyper tension-start treatment term in box362to display a hypertension drug therapy start display screen370as shown inFIG. 21. The hypertension drug therapy start display screen370includes boxes372through384which provide recommendation for hypertension therapy treatment to the healthcare provider. The healthcare provider can also click on a hypertension drug therapy adjust term in box380to cause the workstation110to display a hypertension drug therapy adjustment screen (not shown) to adjust the hypertension therapy drugs and treatment.

Returning toFIG. 6, the button column133also enables the healthcare provider to display a diagnosis screen as shown inFIG. 22, a patient basic intake screen is drawn inFIG. 23, and a print screen as shown inFIG. 24.

FIGS. 25 and 26illustrate variations in the manner in which the system and method according to another embodiment of the present invention can control the workstation110to display display screens having different arrangements of the information and pathways discussed above. For example, when the healthcare provider accesses the database104via, for example, a healthcare provider workstation106, the computer102can access the database104and provide a data to the workstation106that enables the workstation106to generate a display400on its display screen as shown inFIG. 25.

Similar to the display130shown inFIG. 5, the display400includes a listing of patient names. However, unlike display130, display400lists the names chronologically by order of appointment time. In addition, display provides certain patient information associated with the patient's name. For example, the patient's HbAlc, blood pressure and LDL readings are displayed) if known), along with an indication as to whether the patient is a smoker. The display400can be configured to include any other patient-related information as deemed appropriate.

As with screen130, if the healthcare provider is interested in using the system and method to obtain a diagnosis and treatment for a particular patient, the healthcare provider can use, for example, the mouse at his or her workstation106to click on the name of interest. This action causes the web browser to generate a display402illustrating a screening and diagnosis pathway for the patient, as shown inFIG. 26. In this example, display402shows a “Type 2 Insulin Adjust” pathway for illustrative purposes. However, it should be understood that the system and method can be configured so that the web browser initially displays, for example, a screening and diagnosis display screen, or any other suitable type of display and pathway.

As indicated, display402includes a pathway section404which, like the other pathways described above, includes a pathway comprising a plurality of boxes406through422setting forth guidelines that assist a health care provider is treating the patient. Also, like the other pathways described above, pathway section404highlights the patient's conditions based on the patient data. In other words, pathway section404also integrates the patient data with the guidelines. For example, because the patient has nocturnal hypoglycemia, the term “nocturnal hypoglycemia” is conscripted by a highlighted rectangle in box406as a consequence of the SMBG data presented on the left side of the screen. Likewise, because the patient's SMBG and/or HbAlc is within the target range, the term “in target range” is conscripted by a highlighted rectangle in box412. The health care provider can therefore use this information in the guidelines in conjunction with the actual values, to determine a course of treatment for the patient in a manner similar to that discussed above.

In addition, display402includes a patient data section408that displays patient data such as the patient's HbAlc reading, blood pressure (BP) reading, and so on. Display402also includes a data views section410that provides an indication of the type of data view that is currently being displayed in the data view section412. In this example, the data view being displayed is a 30 day Modal of SMBG, as indicted. The healthcare provider can click on one of the other options, such as the “7 day logbook”, in the data views section410to display the 7 day logbook relating to the patient in the data view section412. The Diagnosis & Pathways section414indicates the type of pathway that is being displayed in the pathway section404. In this case, the Type 2 Insulin Adjust pathway is being displayed, as indicated. The healthcare provider can select a different pathway for display, such as the “Complication 1” pathway, and so on, by clicking on the appropriate term in the Diagnosis & Pathways section414. The Current Therapies section416indicates the type of therapy (e.g., insulin) that the patient is undergoing.

As further shown inFIG. 26, the display402includes buttons including the terms “Type 1 Diabetes”, “Gestational”, and so on, which extend vertically on opposite sides of the pathway section404. As with the buttons in button column133as discussed above, the healthcare provider can click on any of these buttons to display a pathway pertaining to the term indicated on the button being selected. For example, if the healthcare provider clicks on the “Type 1 Diabetes” button, the display402will display a pathway showing guidelines for treating Type 1 diabetes. In this event, the terms displayed in the Diagnosis & Pathways section414will also change to reflect the pathway being displayed in the pathway section404. Additionally, the data variables being presented on the left screen half may also change to those relevant specifically to the new flow chart Pathway being accessed.

As further indicated inFIG. 26, display402includes an Education Checklist section418that can include a list of education that any patient should have for any pathway. For example, for the Type 2 Insulin Adjust pathway being displayed in pathway section404, the healthcare provider can click on the Education Checklist section418to display a dropdown menu indicating recommended patient education, such as self-monitoring education, for that particular pathway. The display402also includes a subjective-objective assessment and plan (SOAP) section in which can be displayed notes that are entered by the healthcare provider, along with patient data, and so on.

As stated above the above system and method deem not be limited to the treatment of diabetes, but rather can be applied to any medical treatment as can be appreciated by one skilled in the art.

Although only a few exemplary embodiments of this invention have been described in detail above, those skilled in the art will readily appreciate that many modifications are possible in the exemplary embodiments of that material and departing from the novel teachings and advantages of this invention. Accordingly, all such modifications are intended to be included within the scope of this invention as defined in the following claims.