# Patent

## Title
Method and apparatus for providing a centralized medical record system

## Abstract

A method of creating and maintaining a centralized medical record system includes establishing, in a computer system, a record associated with an account of a client, the computer system being in communication with a network to which the client has access, receiving a copy of at least one medical record or item of data, from one or more of a multiplicity of health care entity sources, sent to the centralized medical record system, producing an electronic representation of each copy received from each of the multiplicity of health care entity sources, and storing, in the centralized medical record system, the representation received and logically associating, with each representation, client information related to the client. The method also includes providing the client with access, via a web page, to each of the representations over the network, each of the representations constituting an accessible entry in the web page, such that the client can review the representations, wherein the web page includes a facility by which the client can provide information describing each representation, the information being stored in logical association with the representation so as to permit subsequent access to and retrieval thereof via the web page, the information including a client-described label that is used in identifying the representation on the web page.

## Background
CROSS-REFERENCE TO RELATED APPLICATIONS
The present application is a continuation of U.S. patent application Ser. No. 11/122,254, filed May 3, 2005, which claims priority from U.S. Provisional Application No. 60/567,736, filed May 3, 2004, and U.S. Provisional Application No. 60/645,062, filed Jan. 18, 2005, the disclosures of which are incorporated by reference herein in their entirety.


TECHNICAL FIELD
The present invention relates to medical record keeping and, more particularly, to a method and apparatus for providing a centralized medical record system.
BACKGROUND ART
It is known that typically a healthcare facility, such as a doctor's office, clinic or hospital, collects medical data related to each particular subject or patient that is treated at the facility. Such medical data is usually stored at the facility as a medical record for the particular patient. If the patient or subject is treated at more than one medical facility, a number of medical records may exist with respect to the patient. If a first healthcare facility involved in treating the patient requires the patient's medical data or records associated with treatment the patient received at second healthcare facility, the patient must request that medical data or records kept at the second facility be sent to the first facility. Such a process for is time consuming and costly. Further, the patient has little knowledge or control over what one healthcare facility sends another.
SUMMARY OF EMBODIMENTS
In accordance with one embodiment of the invention, a method of creating and maintaining a centralized medical record system includes establishing, in a computer system, a record associated with an account of a client, the computer system being in communication with a network to which the client has access, receiving a copy of at least one medical record or item of data, from one or more of a multiplicity of health care entity sources, sent to the centralized medical record system, producing an electronic representation of each copy received from each of the multiplicity of health care entity sources, and storing, in the centralized medical record system, the representation received and logically associating, with each representation, client information related to the client. The method also includes providing the client with access, via a web page, to each of the representations over the network, each of the representations constituting an accessible entry in the web page, such that the client can review the representations, wherein the web page includes a facility by which the client can provide information describing each representation, the information being stored in logical association with the representation so as to permit subsequent access to and retrieval thereof via the web page, the information including a client-described label that is used in identifying the representation on the web page.
In accordance with related embodiments, the health care entity source may be a physician, a clinic and/or a hospital. The method may further include providing the client with access to a letter template for generating a letter to request that the copy of the medical records and items of data be sent from a source. The information may include a date associated with the medical record or item of data, a name of a health care entity associated with the medical record or item of data and/or the client's comments regarding the medical record or item of data. Providing the client with access to each of the representations over the network may include providing the client with at least one set of passwords. Providing the client with access to each of the representations may include permitting another party to obtain access to the representation via a password previously forwarded to the client so that the client may grant access to the representation by communicating the password to the other party. The other party may be identified by the client as being in a category of authorized parties. The method may further include providing the client with an interface that enables the client to activate one or more emergency cards. The method may further include providing the client with an interface that allows the client to maintain a medical record diary that the client may enter medical information into on a regular basis, each entry of the medical information being dated and stored in the computer system. The interface may include a place for entry by the patient of a particular illness or condition. The account may include an adult account or a custodial account. Storing may include placing the representation in a review folder awaiting review by the client, wherein the representations in the review folder are only accessible to the client and not accessible to authorized parties viewing the centralized medical record system. The method may further include allowing the client to accept or reject the representation in the review folder. If the client accepts, moving the representation from the review folder to a medical record folder so that the representations are accessible to authorized parties viewing the centralized medical record system and if the client rejects, removing the representation from the centralized medical record system.
In accordance with another embodiment of the invention, a method of creating and maintaining a centralized medical record system includes establishing, in a computer system, a record associated with an account of a client, wherein the client is a patient or a guardian of the patient, the computer system being in communication with a network to which the client has access, receiving a copy of at least one medical record or item of data, from one or more of a multiplicity of health care entity sources, sent to the centralized medical record system, producing an electronic representation of each copy received from each of the multiplicity of health care entity sources, and storing, in the centralized medical record system, the representation received and logically associating, with each representation, client information related to the client. The method also includes providing the client with access, via a web page, to each of the representations over the network, each of the representations constituting an accessible entry in the web page, such that the client can review the representations, wherein the web page includes a facility by which the client can provide information describing each representation, such information being stored in logical association with such representation so as to permit subsequent access to and retrieval thereof via the web page, and providing the client with an interface that enables the client to accept or reject the association of the representations with the client.
In accordance with another embodiment of the invention, a method of accessing a patient's medical record or item of data in a centralized medical record system includes storing, in a computer system, copies of medical records and items of data collected from a multiplicity of health care entity sources, the medical records and items of data associated with the patient, the computer system being in communication with a network to which the patient has access, permitting the patient to provide information describing each copy and storing the information in logical association therewith, such information including a patient-described label that is used in identifying the copy on a graphical user interface, and accessing the copy via a the graphical user interface that displays the stored information.
In accordance with related embodiments, the method may further include allowing the patient to accept or reject the copy, and if the patient rejects, removing the copy from the centralized medical record system. The information may include at least one of a date associated with the medical record or item data, a name of a health care entity source associated with the medical record or item data, or the patient's comments regarding the medical record or item data.



BRIEF DESCRIPTION OF THE DRAWINGS
The foregoing features of the invention will be more readily understood by reference to the following detailed description, taken with reference to the accompanying drawings, in which:
FIG. 1 is a flow diagram illustrating a method for providing a centralized medical history over a network in accordance with an embodiment of the invention;
FIG. 2 is a flow diagram illustrating a registration process in accordance with the embodiment of FIG. 1;
FIG. 3 is a flow diagram illustrating a process by which medical records are collected and a medical history is maintained in accordance with the embodiment of FIG. 1;
FIG. 4 is a flow diagram illustrating a process by which medical records are included in the centralized medical history in accordance with the embodiment of FIG. 1;
FIG. 5 is a flow diagram illustrating a process by which medical records are edited in accordance with the embodiment of FIG. 1;
FIG. 6 is a flow diagram illustrating a process by which a client may navigate through a medical history in accordance with the embodiment of FIG. 1;
FIG. 7 is a flow diagram illustrating an overview of a method of providing a centralized medical history in accordance with another embodiment of the invention;
FIG. 8 is an illustration of a web page for providing a centralized medical history in accordance with another embodiment of the invention;
FIGS. 9-11 are illustrations of web pages whereby a client may create an account for a centralized medical history in accordance with the embodiment of FIG. 8;
FIGS. 12-15 are illustrations of web pages whereby the user may access a medical history in accordance with the embodiment of FIG. 8;
FIG. 16 is an illustration of a web page whereby the user may view critical patient information in accordance with the embodiment of FIG. 8;
FIGS. 17-18 are illustrations of web pages whereby the user may view physician office records in accordance with the embodiment of FIG. 8;
FIGS. 19-20 are illustrations of web pages whereby the user may view hospital records in accordance with the embodiment of FIG. 8;
FIG. 21 is an illustration of a web page whereby the user may view pharmaceutical records in accordance with the embodiment of FIG. 8;
FIG. 22 is an illustration of a web page whereby the user may view a medical diary in accordance with the embodiment of FIG. 8;
FIG. 23 is an illustration of a web page whereby the user may view unsorted medical records in accordance with the embodiment of FIG. 8;
FIG. 24 is an illustration of a web page whereby the user may access form letters in accordance with the embodiment of FIG. 8;
FIGS. 25-28 are illustrations of web pages whereby the user may view form letters in accordance with the embodiment of FIG. 24;
FIG. 29 is a flow diagram illustrating an overview of a method of providing a centralized medical history in accordance with another embodiment of the invention;
FIG. 30 is a flow diagram illustrating an overview of another method of providing a centralized medical history in accordance with another embodiment of the invention;
FIG. 31 is an illustration of a web page for providing a centralized medical history in accordance with the embodiment of FIG. 30;
FIG. 32 is an illustration of a web page for providing a client homepage in accordance with the embodiment of FIG. 30;
FIGS. 33-36 are illustrations of a web page for providing a critical health information summary in accordance with the embodiment of FIG. 30;
FIG. 37 is an illustration of a web page for providing a medical diary in accordance with the embodiment of FIG. 30;
FIG. 38 is an illustration of a web page for providing medical records to a client in accordance with the embodiment of FIG. 30;
FIG. 39 is an illustration of an EKG record that may be accessed in accordance with the web page of FIG. 38;
FIGS. 40-42 are illustrations of web pages whereby a client may edit a notation to, label of or comment on medical data and review, accept or reject a medical record or data in accordance with the embodiment of FIG. 30;
FIG. 43 is an illustration of a web page for allowing a client to maintain an account in accordance with the embodiment of FIG. 30;
FIGS. 44-45 are illustrations of a web page for allowing a client to set up an account in accordance with the embodiment of FIG. 30;
FIGS. 46-68 are illustrations of web pages for providing a client questionnaire in accordance with the embodiment of FIG. 30;
FIGS. 69-70 are illustrations of a web page for creating and maintaining one or more user name and password sets in accordance with the embodiment of FIG. 30;
FIG. 71 is an illustration of a web page for adding a new user name and password in accordance with the embodiment of FIG. 30;
FIG. 72 is an illustration of a web page for editing a user name and password in accordance with the embodiment of FIG. 30;
FIG. 73 is an illustration of a web page for creating and maintaining a physician list in accordance with the embodiment of FIG. 30;
FIGS. 74-75 is an illustration of web page for adding a physician to the physician list in accordance with the embodiment of FIG. 30;
FIGS. 76-77 is an illustration of a web page for editing physician information in accordance with the embodiment of FIG. 30;
FIGS. 78-79 are illustrations of web pages for creating and maintaining a facility list in accordance with the embodiment of FIG. 30;
FIGS. 80-82 are illustrations of web pages for creating medical record request letters in accordance with the embodiment of FIG. 30;
FIG. 83 is an illustration of a medical record request letter in accordance with the embodiment of FIG. 30;
FIG. 84 is a an illustration of a web page whereby a client may review and notate incoming medical records in accordance with the embodiment of FIG. 30;
FIGS. 85-89 are an illustration of web pages whereby a client may maintain, order, activate and de-activate an emergency access card in accordance with the embodiment of FIG. 30;
FIG. 90 is a an illustration of web page whereby a client may transfer an account in accordance with the embodiment of FIG. 30;
FIG. 91 is an illustration a web page whereby a client may terminate an account in accordance with the embodiment of FIG. 30; and
FIG. 92 is an illustration of a web page whereby a client may access help topics in accordance with the embodiment of FIG. 30.



DETAILED DESCRIPTION OF EMBODIMENTS
Embodiments of the present invention provide a consumer-centric, client controlled process and system that provides a client with a tool that enables the client to manage the creation, acquisition, updating, retrieval and deletion of medical information and healthcare records in a centralized medical record system. Embodiments of the invention enable the client to initiate and approve of information and medical data as well as control access to the medical data.
FIG. 1 is a flow diagram illustrating a method for providing a centralized medical history over a network in accordance with an embodiment of the invention. In accordance with process 101, a client registers with a centralized medical record system service provider (the “CMRS” service provider). Note that the “CMRS service provider” and the “CMRS” are used somewhat interchangeably herein, since it will be appreciated that various tasks can be prepared, or caused to be prepared, automatically or manually in accordance with the business goals and system design constraints.
In accordance with this embodiment, the client registers over a computer network and the computer network may be a local area network or a wide area network. For example, in one embodiment of the invention, the wide area network is the Internet. The client may register via one or more graphical user interface, such as the graphical user interface shown in FIGS. 9-11. The graphical user interface may be a series of web pages associated with a website of the CMRS service provider such as the web page illustrated in FIG. 8. In accordance with the embodiment of FIG. 8, a client may click on the “Sign Up Now” hyperlink 801 and the centralized medical history service provider may provide one or more web pages whereby the client may create a centralized medical history account over the network.
FIG. 2 is a flow diagram illustrating a registration process which may be performed in accordance with the embodiment of FIGS. 1 and 8. The client accesses the home page of the CMRS service provider in process 201. In process 202, the client chooses from navigation options provided by the CMRS (such as the “Sign Up Now” hyperlink 801 discussed above). If the client chooses the hyperlink 801, the client may then navigate, via hyperlinks, to another web page, as shown in FIG. 9, whereby the client is provided with general information regarding how the CMRS service works. The client may then be provided, in process 203 with one or more web pages (such as that illustrated in FIG. 10) whereby the client may view a client agreement. In accordance with the client agreement, the client may view, in process 204, among other things, a contract, fee schedule, descriptions of the services provided by the CMRS service provider and descriptions of client obligations. The client may submit pertinent information about himself or herself via another web page, such as the web page shown in FIG. 11. If the client agrees to the terms of the client agreement, the client will required, in process 205, to choose an account type. For example, if the client is an adult and the account she wishes to create is for herself, the client will click on a hyperlink which will lead her to an user interface where, in process 206, she will enter data about herself such as her name, date of birth, email address, telephone numbers, billing address, credit card number, etc. If the client is a parent, she may wish to open an account for her child. In this case, she will click on a hyperlink that designates her as a parent/adult client and she will use one or more interfaces similar to that shown in FIG. 11 to enter, in process 207, data about herself and, in process 209, data about her child, including the child's name, date of birth, etc. If the client is a custodian, she may wish to open an account for her ward. In this case, she will click on a hyperlink that designates her as a custodian client and she will use one or more interfaces similar to that shown in FIG. 11 to enter, in process 208, data about herself and, in process 210, data about her ward, including the ward's name, date of birth, etc. Note that the CMRS service provider may poll, in process 211, the dates of birth of parent/child and guardian/child and automatically notify the parent or guardian when a child is approaching the age of 18. Note also that an adult may establish several different types of accounts (one for herself, one for her child, one for her ward) if she so desires. (Alternatively, account types may include an adult account and a custodial account and a parent may set up an account for his or her child as a custodian.) Upon selecting the type of account (or accounts) she wishes to establish, the client will be submit the information she has provided and arrange for payment methods in process 212.
The CMRS service provider processes the account order and generates an email to the client advising them of the username and primary password in process 213. All emails to the client from the CMRS may feature a hyperlink to a CMRS web page. If payment authorization fails, the order will not be processed and the client will be asked to re-enter payment information as shown in process 214. For example, if the client has chosen to pay for the service using a credit card and credit card authorization fails, the order will not be processed and the client will be asked to re-enter the credit card number or the enter another credit card number. The CMRS service provider may poll, in process 215, existing system accounts daily to find client activation dates that indicate that the account is about to expire. In this example an account will last 12 months, thus the CMRS service provider will poll the system for client accounts that are 11 months old. For those accounts that are 11 months old, the CMRS service provider may send a renewal notification some time prior to the expiration date, here four weeks, so that a client may renew his or her account. In accordance with this embodiment, renewal will require the client to again agree to the terms of the client agreement. The CMRS may reserve the right to terminate, in process 216, client accounts that are a predetermined amount of time overdue (here three months). In some cases, the CMRS service provider may permit continued access to the account without permitting additional updates of the account. In other cases, the CMRS service provider may not terminate the account.
Turning again to FIG. 1, the CMRS service provider creates, in process 102, a “home page” for the client whereby the client may access his or her medical history. FIG. 12-13 are illustrations of web pages whereby the user may access a medical history and FIG. 14 is an illustration of such a home page (the “client home page”) customized for a client for purposes of medical history access. The CMRS service provider also creates and mails, in process 103 of FIG. 1 an emergency card to the client. In accordance with the embodiment of FIG. 2, the CMRS staff is notified, in process 217, that an emergency card should be created and mailed to the client. The CMRS service provider provides, in process 218, an emergency card may be a wallet sized card that features a secondary CMRS generated password that permits access to the client's record in case of a medical emergency but does not allow the user edit the record. In a medical emergency, when an adult or child client is away from loved ones, the emergency access card will give care givers access to all the information they need to treat the patient, and reach next of kin. The emergency card is mailed to the client, in process 219 with instructions associated with emergency card use. The client is also asked to email the CMRS service provider to confirm that the client has received his or her emergency card. Confirmation of receipt of the emergency card will cause the secondary password associated with the card to be activated in the CMRS system. The CMRS may also generate, in process 220, an email a predetermined amount of time after mailing out the emergency card, such a one week later, advising the client to confirm receipt of his or her emergency card or to contact the CMRS service provider if the card was not received. If a client loses his or her emergency care, the CMRS service provider may, upon notification of the loss. The CMRS service provided the replacement card at no cost to the client or for a fee.
The CMRS service provider creates and maintains account for the client in process 104. In accordance with account maintenance, the client provides, in process 105, a client summary and emergency profile. As will be explained in more detail below, in accordance with one embodiment of the invention, each client answers a series of questions online, and a client health summary is generated. The summary delivers critical information about the patient in a concise format, and it can be updated at any time. The summary includes patient demographics such as name, address, age, occupation, etc. The summary also includes a patient health status, including information about medical allergies, prescription drugs, medical implants, and diagnosis, etc. The summary also includes contact information, including physician names and contact information, next or kin/emergency contact information, authority to contact for advance directive or living will, etc. The summary further includes patient comments. Patients can write a note to emergency care providers advising them of any issue or concern not addressed through our automated question system.
The client may begin collecting medical records and data in process 106. The client may also create or edit a client diary in process 107. The client diary accommodates any type of information that the client wises to record, and automatically dates the entries. The diary can be updated at any time. In accordance with one embodiment, a client may create or edit one or more disease-specific diaries to follow the progression of any particular illness or condition.
FIG. 3 is a flow diagram illustrating a process by which a client account is created, medical records are collected and a medical history is maintained. The client accesses, in process 300, an account maintenance hyperlink provided on an appropriate web page, an on-line tutorial will be provided to the client in process 301. The on-line tutorial may include instructions related to use of the CMRS system, access to the CMRS system, information regarding medical emergencies, information regarding mining or searching a medical history, and information on categorizing and labeling medical data. Via the maintenance hyperlink, procedures for setting up an emergency profile, collecting medical records and data and updating medical records and data (such records and data may include, but are not limited to a paper document or an electronic version of a paper document or other data, for example .pdf or .ehr (electronic health record) documents) will be provided in process 302. Further, if a physician or healthcare facility or entity keeps electronic versions of its patient records, the client may request that the physician or healthcare facility or entity transfer the electronic record to the CMRS service provider. The CMRS service provider may create web-page views of electronic records in whatever format they are provided.
Procedures that may be provided to the client may include procedures for using an online medical diary (process 303) (or a disease-specific online diary) and procedures for sending client medical records and data to the CMRS service provider (process 304). For example, clients may submit, in process 312, any medical records or data that the client has collected for scanning by the CMRS service provider. In accordance with this embodiment, to submit such data in the form of one or more page documents, the document may be accompanied by a CMRS record submission form. The form may require the client to provide a page count and identification of a file (such as hospital record, physician office record, etc.) that the client wants the document to be stored in. The record submission form may also be scanned as a cover page of the document.
Other procedures that may be provided to the client include procedures for securing records and data from pharmacies (process 305), procedures for securing records and data from hospitals (process 306), and/or procedures for securing medical records and data from physicians' offices (process 307). Hyperlinks may be provided, in process 308, that permit the client to contact state medical boards and search for information related to physicians (such as a client's former physician's address). The CMRS service provider may also provide, in process 309, letter templates for the client to use to initially request a physician, hospital, pharmacy, laboratory or clinic to forward medical data to the CMRS service provider. Similarly, the CMRS service provider may provide, in process 310, letter templates that a client may use to request that follow-up medical data be forwarded to the CMRS service provider or to remind a physician, hospital, pharmacy, laboratory or clinic to forward records to the CMRS service provider. A letter template may cause the letter to be imprinted with a machine readable code identifying at least the client. The code may in addition, or in the alternative, identify the source of the medical data. Such letter templates may include code which may be scanned, such as bar code, which identifies the client, the health care entity, the letter, the purpose of the letter, the contents of the letter or other information associated with the letter.
FIG. 24 is an illustration of a web page whereby the user may access form letters in accordance with the embodiment of FIGS. 1 and 8. Similarly, FIGS. 25-28 are illustrations of web pages whereby the user may view form letters in accordance with the embodiment of FIG. 24. In accordance with such form letters, the client may be prompted, in process 311, to enter a physical (or other medical facility) name and address. In accordance with this embodiment, each letter clearly states that correspondence concerning the client should be sent to the client (or to the client “in care of” the CMRS). The CMRS service provider may also instruct the client as to how to fill out the fields related to a return address and such fields may include a number which identifies the client so that data received from a physician or other medical facility or entity as a result of the letter in not assigned to the wrong account when the data is received by the CMRS service provider. Such an identifier may be part of the client's user name. The client may then print the letter out and mail it to the physician or other medical facility.
In process 108 of FIG. 1, the CMRS service provider scans any medical records or data provided by the client or provide as a result of the client's request to a physician, hospital, pharmacy, laboratory or clinic so that such medical records and data may be included in the client's centralized medical history. For example, the CMRS service provider may provide the client with a means to secure a copy of his or her medical records from the client's primary care provider or hospital one a regular basis, for example, once a year. The client's primary care physician's records may be complete with hospital discharge summaries and correspondence to and from any medical specialist that the client has been referred to that year. A client may be entitled to a free medical record scan, with no page limit, on a such periodic basis. Additional scanning of documents of any size may be provided at any time. The medical records or data are reviewed and labeled and placed into an electronic folder (which may describe, for example, a source of the record or data such as physician, hospital, clinic, pharmacy or other source) by the client in process 109.
FIG. 4 is a flow diagram illustrating a process by which medical records are included in the centralized medical history. In process 401, medical records and data are received by the CMRS service provider. The client's name and identifier number are noted, in process 402, from the mailing package or from client's email. Pages of documents containing the medical records or data are scanned, in process 403, by the CMRS service provider. The scanned page count is compared or matched, in process 405, with the page count of the document prior to scanning and the pages are inspected visually for focus and alignment. If necessary, the pages may be re-scanned in process 406. The scanned pages are placed, in process 407, in a staging area such as an “unclassified documents” folder on the client's home page and may be labeled with a scan date and/or time and/or other pertinent information. FIG. 23 is an illustration of a web page whereby the user may view unsorted medical records.
Such an unclassified documents folder may be accessible by the client's primary password or by a secondary password. An email is sent to the client, in process 408, whereby the client is notified of a medical record update. The client may click on a hyperlink in the email to view the updated information. Upon viewing the updated information, the client may select one of several hyperlinks to indicate, for example, that the record should not be included in the client's medical history because it does not belong to the client or that the record does belong to the client and that the labeling process should proceed.
The client may make notations with respect to and/or label the updated information with the appropriate physician, hospital, laboratory, clinic or other name, and categorize the updated information as desired. During the labeling process, the client may be prompted by the CMRS to provide an online description of the medical record or data and a service date. In process 409, the labeled information the client may place the updated information in an appropriate folder in accordance with the client's system of categorization.
In process 110 of FIG. 1, the medical records or data may be edited by the client. FIG. 5 is a flow diagram illustrating a process by which medical records are edited. In accordance with the embodiment of FIG. 5, if a client believes that information contained in a file is misleading or inaccurate, the client may visually tag, in process 501, the relevant page or pages as pages that should not be used by a healthcare provider. The client may also contact, in process 502, the appropriate healthcare provider to secure revised or amended medical records or data. The CMRS service provider, in process 503, may provide a procedure and/or a form letter template for the client to use to send the CMRS service provider an amendment after the client has secured such an amendment from the healthcare provider. The CMRS may also link, in process 504, any amended medical record or data to the original medical record or data that has been amended. Such revisions may be placed, in process 505, in a “miscellaneous/errata” file or folder. Dental and/or optical records or data may also be placed in this folder.
Alternatively, when the client receives an email is notifying him or her of a medical record update, the client may view the updated information and select a hyperlink to indicate, for example, that the record should not be included in the client's medical history because it does not belong to the client or that the record does belong to the client and that the labeling process should proceed. In this manner, if the updated information is inaccurate or misleading, the client may prevent the information from being included in his or her history. In this case, information on advance directives may be found in the client's health summary and the client is not able to edit or tag the record itself.
The medical records and/or data may be retrieved and prepared for healthcare encounters in process 111 of FIG. 1 and the client may update his or her client diary in process 107. FIG. 6 is a flow diagram illustrating a process by which a client may navigate through a medical history to retrieve medical records or data. In process 600, the client accesses the CMRS home page and chooses, in process 620, navigation options. In process 601, the client must enter a user name (such as a first initial, last name, and/or alphanumeric code) as well as his or her primary password. FIG. 13 is an illustration of a web page that provides a graphical user interface whereby a client by submit his or her user name and password for medical record or data retrieval. The client will be allowed access, in process 602, to his or her client home page such as the client home page illustrated in FIG. 14. The client may access an account maintenance file or folder, in process 603, via his or her home page. Further, the CMRS service provider may provide a folder that allows a client to store any type of document he or she wishes to be included in the online file. In accordance with one embodiment, access to such a file may be provided to the client via the client's primary password. Similarly, the client may access other medical resources, in process 604, via his or her home page. When the client or other user accesses these resources, the CMRS may provide, in process 616, physician and hospital finder tools, such as hyperlinks that allow the client or user to connect to state boards of medicine and search for information about physicians (such as a former physician's address). The CMRS may also provide, in process 618, links to foundations, associations and instructions relating to standards of care and treatment regimens.
The client may further access his or her medical history via his or her home page. For example, if the client would like to access the critical information about herself, she may do so through hyperlink 1401. If the client would like to access physician office records related to her healthcare, she may do so through hyperlink 1402. Similarly, if the client would like to access hospital or other healthcare facility or entity records (such as records from laboratories and/or clinics) the client may do so via hyperlink 1403. Alternatively, both physician and hospital records may be accessed via one hyperlink.
If the client would like to access pharmacy records, the client may do so via hyperlink 1404. Alternatively, such information may be access via the client health summary. There may also be hyperlinks whereby the client may access any miscellaneous and errata data and his or her client diary. When the client clicks on one of these hyperlinks, the CMRS will provide another graphical interface, such as shown in FIG. 15, to notify the user that access to the medical records or data is restricted to the client or a user designated by the client. The CMRS may then require the user to provide his or her user name and either the primary password or the secondary password described above in relation to the emergency card. (Note that the patient's primary care physician or other healthcare provider may also be designated as a user and be given a secondary password if the client so desires.)
The client (or other designated user) may then access, in process 605 his or her patient summary page and/or emergency profile. If the client chooses access his or her patient summary page, as in process 611, the CMRS service provider may provide, in process 612, a page that features fields that the client fills in to create a patient summary. The fields may include a “name” field and an “address”, an “age” field, one or more “allergies” fields, one or more “medication” fields, one or move “medical implants” fields, one or more “chronic health issues” fields one or more “physician name” fields, one or more “physician specialty” fields and one or more “emergency contact name” and “emergency contact number” fields. The fields may also include one or more “emergency reach telephone number” fields as well as one or more fields for supplying a link to an “advanced directive” and one or more fields for “attorney contact” information or “executor of directive contact” information. The fields may also include field for “notes” to emergency care personnel. Some fields may be automatically populated by the CMRS, the information may be organized in an easy to view format, and the CMRS may permit the client or other user to easily print the page. FIG. 16 is an illustration of a web page whereby the user may view such critical patient information.
A client or other user may access, in process 606, information provided by a physician or a physician's office. FIGS. 17-18 are illustrations of web pages whereby the user may view such physician records or data. For example, the user may click on the hyperlink labeled by the date of the record and the physician's name shown at 1701. The CMRS service provider will provide the scanned record, as shown in FIG. 18, for the client or other user to view. Similarly, the user may access, in process 607, hospital or other healthcare facility or entity records (such as records from laboratories and/or clinics). FIGS. 19-20 are illustrations of web pages whereby the user may view such records. For example, the client or other user may click on the hyperlink labeled by the date of the record and the name of the hospital as shown at 1901. The CMRS service provider will provide the scanned record as shown in FIG. 20 for the client to view. The user may access, in process 608, information associated with a pharmacy or pharmaceuticals. FIG. 21 is an illustration of a web page whereby the user may view such records or data. (Note that data provided by physicians or physician offices, hospitals, clinic, laboratories or pharmacies may not be edited by the client or other user directly. To make amendments the client must use the process discussed in relation to FIG. 5).
The client may also access his or her client diary for viewing and editing in process 609. The CMRS will provide, in process 613, pages sorted chronologically by entry date. The CMRS may also provide, in process 614, an online notebook for recording observations, questions for physicians, or recording information such as glucose levels for diabetics, adverse reactions to medications, etc. FIG. 22 is an illustration of a web page whereby the client may view his or her diary. In process 610, the client or other user may also view miscellaneous or errata information. The client or other user may also access, in process, 615, any advance directives, living wills, corrections to records, or dental or optical records or data.
To aid the client in preparing for a physician visit, the CMRS may provide, in process 617, instructions and checklists related to what a client should do to prepare for various healthcare encounters. For example, the CMRS may provide instructions for preparing for a visit to a specialist, preparing for a visit to a hospital for surgery, preparing for a visit to a physician for a second opinion, and preparing for a visit to the client's primary care physician.
FIG. 7 is a flow diagram illustrating an overview of a method of providing a centralized medical history in accordance with another embodiment of the invention, and FIG. 29 is a flow diagram illustrating an overview of a method of providing a centralized medical history in accordance with another embodiment of the invention.
FIG. 30 is a flow diagram illustrating an overview of another method of providing a centralized medical history in accordance with another embodiment of the invention. In accordance with the embodiment of FIG. 30, a client registers with a CMRS service provider over a computer network via a registration process described below. Again, the client may register via one or more graphical user interfaces which may be a series of web pages associated with a website of the CMRS service provider such as the web page illustrated in FIG. 31 and the software associated with the CMRS service will create a client homepage and create and begin processing an emergency card to be sent to the client. From the client homepage, the client may create and maintain a his or her account, create and access a critical health information summary and client diary, make arrangements to collect medical data and records (which will be scanned by the CMRS service provider), review and label the medical data collected, record client comments related to the medical data, and retrieve medical data in preparation of healthcare encounters.
In accordance with the embodiment of FIG. 30, the client accesses the home page of the CMRS service provider and chooses from navigation options provided by the CMRS (such as the “Sign Up Now” hyperlink discussed above). The client may then navigate, via hyperlinks, to another web page, whereby the client is provided with general information regarding how the CMRS service works. The client may then be provided with one or more web pages whereby the client may view a client agreement. Such an agreement (or contract) may include a fee schedule, descriptions of services, description of client obligations, etc. Upon acceptance of the agreement (e.g., by clicking on a hyperlink labeled “accept”), the client may proceed to payment for the CMRS service. Payment for the CMRS service may be processed using Verisign Payflo Pro which is accessed through the CMRS web site. During the payment process, client demographic data may be collected and used to populate the client's account.
In accordance with the embodiment of FIG. 30, the client will required to choose either an adult or a custodial account and parents will complete a custodial account for their children. If the client is a custodian he or she will click on a hyperlink that designates him or her as a custodian client and use one or more interfaces similar to that shown to enter data about herself or himself as well as data about his or her child or ward including the name, date of birth, etc. The CMRS service provider may poll the dates of birth of each child/ward and automatically notify the parent or guardian when a child/ward is approaching the age of 18. Again, an adult may establish several different types of accounts (one for herself, one for her child, one for her ward) if she so desires. If the client is setting up an adult account and the name on the account is different than the name on a credit card used for payment, the adult must enter data about him or herself (i.e., date of birth, e-mail address, telephone numbers, billing address, etc.).
The CMRS service provider processes the account order and generates an email to the client advising them of a primary username and password in which permits read and write access. Again, all emails to the client from the CMRS may feature a hyperlink to a CMRS web page. The CMRS service provider may poll existing system accounts daily to find client activation dates that indicate that the account is about to expire. (As above, in this embodiment, an account will last 12 months, thus the CMRS service provider will poll the system for client accounts that are 11 months old. For those accounts that are 11 months old, the CMRS service provider may send a renewal notification some time prior to the expiration date, here four weeks, so that a client may renew his or her account. In accordance with this embodiment, renewal will require the client to again agree to the terms of the client agreement. (Client accounts may also be renewed automatically using a feature of Verisign. That is, if the client does not terminate his or her account and if his or her credit card is valid, the account may be auto-renewed. In this case, the client may notified of any changes to the client agreement by e-mailing a new agreement to client and giving him or her an opportunity to terminate their accounts if the agreement is not acceptable.) The CMRS service provider tracks client accounts, membership terms, renewal dates and overdue accounts. The CMRS service provider may reserve the right to terminate client accounts that are a predetermined amount of time in arrears. In some cases, the CMRS service provider may permit continued access to the account without permitting additional updates of the account.
The CMRS service provider creates a homepage for the client, such as the homepage illustrated in FIG. 32, whereby the client may access his or her critical health information summary (an example of which is illustrated in FIGS. 33-36), medical diary (an example of which is illustrated in FIG. 37), and medical data or records (such as the EKG shown in FIG. 39 accessed via a web page such as that illustrated in FIG. 38). The CMRS staff is notified that an emergency card should be created and mailed to the client. The emergency card may be a wallet sized card that features a secondary CMRS password that permits access to the client's record in case of a medical emergency but does not allow the user edit the record. The emergency card is mailed to the client with instructions associated with emergency card use.
The client is also asked to email the CMRS service provider to confirm that the client has received his or her emergency card. In accordance with this embodiment, the emergency card is sent inactive and the client must activate it by going into their account with the primary username and password set, going to the account maintenance folder and clicking on the emergency card maintenance folder. There they can activate their new card and/or terminate an old card, and or order a new card. When a new card is activated the old card is automatically inactivated unless the client had previously inactivated the card. FIGS. 85-89 are illustrations of web pages whereby a client may maintain, order, activate and de-activate an emergency access card in accordance with the embodiment of FIG. 30.
FIGS. 69-70 are illustrations of a web page for creating and maintaining one or more user name and password sets in accordance with the embodiment of FIG. 30. Note that the client authorizes the password sets as well as the access to that each password set provides. For example, FIG. 71 is an illustration of a web page for adding a new user name and password in accordance with the embodiment of FIG. 30. In accordance with FIG. 71, the client may use the pull down menu 7100 to select the access he or she wants the username and password set to supply. Access options associated with the pull down menu may include “read only” (or “record reader”), “read and write” (or “master”), etc. FIG. 72 is an illustration of a web page for editing or updating a username and password in accordance with the embodiment of FIG. 30.
The CMRS may generate an email a predetermined amount of time after mailing out the emergency card, such a one week later, advising the client to confirm receipt of his or her emergency card or to contact the CMRS service provider if the card was not received. If a client loses his or her emergency card, the CMRS service provider may, upon notification of the loss, provide are placement card.
The client creates and maintains an account via the CMRS. In accordance with the embodiment of FIG. 30, the client may set up or create and maintain an account by accessing an account maintenance module via a web page as shown in FIG. 43. FIGS. 44-45 is an illustration of a web page whereby a client may set up an account. To set up an account, a client fills out a new client questionnaire (accessed via a web page such as that shown in FIG. 46). An example of a new client questionnaire is shown in FIGS. 47-68. Once the new client questionnaire is completed and submitted, a critical health information summary (such as, for example, the critical health information summary shown in FIGS. 33-36) is generated by the CMRS based on the data collected in the questionnaire.
The account maintenance module may provide the client with an on-line tutorial that includes instructions related to use of the CMRS system, access to the CMRS system, information regarding medical emergencies, information regarding mining or searching a medical history, information regarding labeling medical data, and procedures for using the medical diary (or a disease-specific on-line diary). Procedures and tools for collecting medical records and data and updating medical records and data are also provided by the account maintenance module. These may include procedures for securing data from primary care physicians, specialists, hospitals and clinics. Procedures and tools for emergency card maintenance, billing, account transfers, password maintenance and account termination (see FIG. 43) may also be provided.
Further, via the account maintenance module the client may create and maintain a physician of healthcare facility or entity list as illustrated in FIG. 73. FIGS. 74-75 is an illustration of web page for adding a physician to the physician list. FIGS. 76-77 is an illustration of a web page for editing physician information associated with the list and FIGS. 78-79 are illustrations of web pages for creating and maintaining a facility list.
Physician and hospital finder tools may be provided via the account maintenance module, as well as hyperlinks that allow clients to connect to state boards of medicine and search for the address of former physicians. Procedures for sending client medical records and data to the CMRS service provider and for using a record submission form may be provided. For example, clients may submit any medical records or data that the client has collected (in, for example, in a file called a “safety deposit box”) for scanning by the CMRS service provider. To submit such data in the form of one or more page documents, the document may be accompanied by a CMRS record submission form. As mentioned above with respect to FIG. 3, the form may require the client to provide a page count and identification of a file (such as hospital record, physician office record, etc.) that the client wants the document to be stored in. The record submission form may also be scanned as a cover page of the document.
The CMRS service provider may also provide letter templates (or letters that are generated automatically subsequent to identification of the recipient) for the client to use to initially request that medical data be forwarded to the CMRS service provider. As noted above, a letter template may cause the letter to be imprinted with a machine readable code identifying at least the client. The code may in addition, or in the alternative, identify the source of the medical data. Such letter templates may include code which may be scanned, such as bar code, which identifies the client, the health care entity, the letter, the purpose of the letter, the contents of the letter or other information associated with the letter.
FIGS. 80-82 are an illustrations of a web pages whereby the user may access and/or create a record (or medical data) request letters in accordance with the embodiment of FIG. 30. Physician and hospital information captured in the online questionnaire that the client completes when they open their new account is stored and once that information is in the system, the client simply has to choose a recipient physician or healthcare facility or entity form a drop down menu 8100. The CMRS populates the letter with a unique client identifier and appropriate information for the client, be it an adult, or child/custodial account. A letter to that physician or healthcare facility or entity is automatically generated by clicking on an appropriate link (here the “Make a Letter” link) The client may then print the letter out, sign it and mail it to the physician or facility. FIG. 83 is an illustration of a letter automatically generated by the CMRS requesting medical data from a physician. The recipient may be directed to send record(s) to client Care Of the CMRS.
Medical records and data are received by the CMRS service provider. The client's name and identifier number are noted from the mailing package or from client's email. Pages of documents containing the medical records or data are counted manually or mechanically and scanned. The scanned page count is compared or matched with the page count of the document prior to scanning and the pages are inspected visually for focus and alignment. If necessary, the pages may be re-scanned. The scanned pages are placed in a folder identified as the “review incoming medical records” folder and may be labeled with a scan date and/or time and/or other pertinent information. FIG. 84 is an illustration of a web page whereby a client may review, notate and label incoming medical data or records. Incoming medical data or records may be reviewed by the client using only the primary read/write username and password set.
FIGS. 40-42 are illustrations of web pages whereby a client may edit a notation to, label of or comment on medical data and review, accept or reject a medical record or data in accordance with the embodiment of FIG. 30. If a client rejects medical data, he or she may be asked to explain why they are rejecting the record. The CMRS service provider may review rejections to ensure that a mistake has not been made. Note, that in accordance with this embodiment, any medical data or record not approved by the client is not moved from the “review medical record folder” to the medical record and is thus not visible to a user with read only access.
Again, an email is sent to the client whereby the client is notified of a medical record update. The client may click on a hyperlink in the email to view the updated information. Upon viewing the updated information, the client may opt to review, reject, or accept the data (as shown in FIGS. 40-42). If the client chooses to review the data, the data stays in the review file. If the client chooses to reject the data, data or record is deleted and the CMRS service provider receives an error report complete with the client's reason for rejection. The CMRS operations staff may follow-up with the client if necessary. If the client chooses to accept the medical data, the client may be allowed a predetermined number of data/file scan(s) per year and the CMRS service provider may track the number of scans for each client.
The client may make notations or comments with respect to and/or label the updated information with the appropriate physician, hospital, laboratory, clinic or other name. During the labeling process, the client may be prompted by the CMRS to provide an online description of the medical record or data and a service date. After labeling and commenting is complete, the medical data or record is placed on the client homepage in the “medical records” folder or, alternatively, in the aforementioned safety deposit box. (For each record, the client, may be asked to identify the proper filing location, such as “medical record” or “safety deposit box.” The client may then be prompted to date the document using a dropdown menu, name the document in an open text field, and enter the name of the physician associated with the data in another text field. The client may also be given an opportunity to comment on the record to draw attention to a part of it, or note something additional.
The medical records and/or data may be retrieved and prepared for healthcare encounters. A client may navigate through a medical history to retrieve medical records or data by accessing the CMRS homepage and choosing, navigation options. The client must enter a user name (such as a first initial, last name, and/or alphanumeric code) as well as his or her primary password (see FIG. 31). The client will be allowed access to his or her client home page such as the client home page illustrated in FIG. 32. The client may access an account maintenance file or folder via his or her homepage. Further, the CMRS service provider may provide a folder that allows a client to store any type of document he or she wishes to be included in the online file. Access to such a file may be provided to the client via the client's primary password. As mentioned above, the client may access other medical resources via his or her home page. When the client or other user accesses these resources, the CMRS may provide, physician and hospital finder tools, such as hyperlinks that allow the client or user to connect to state boards of medicine and search for information about physicians (such as a former physician's address). The CMRS may also provide links to foundations, associations and instructions relating to standards of care and treatment regimens.
FIG. 90 is an illustration of web page whereby a client may transfer an account in accordance with the embodiment of FIG. 30. For example, if the child of a custodial client turns 18, the custodial client may transfer the child's medical data or record to an account that the (now adult) child has set up in the CMRS. The custodial client submits the new user account name created by the child via field 9001, clicks on the “transfer account” hyperlink and the child's new account will be populated with medical data and information once associated with the custodial account.
FIG. 91 is an illustration a web page whereby a client may terminate an account in accordance with the embodiment of FIG. 30 and FIG. 92 is an illustration of a web page whereby a client may access help topics in accordance with the embodiment of FIG. 30.
While the invention has been described in connection with specific embodiments thereof, it will be understood that it is capable of further modification. This application is intended to cover any variation, uses, or adaptations of the invention and including such departures from the present disclosure as come within known or customary practice in the art to which invention pertains.

## Claims

1. A method of creating and maintaining a centralized medical record system comprising:
establishing, in a computer system, a record associated with an account of a client, wherein the client is a patient or a guardian of the patient, the computer system being in communication with a network to which the client has access;
receiving a copy of at least one medical record or item of data, from one or more of a multiplicity of health care entity sources, sent to the centralized medical record system;
producing an electronic representation of each copy received from each of the multiplicity of health care entity sources;
storing, in the centralized medical record system, the representation received and logically associating, with each representation, client information related to the client; and
providing the client with access, via a web page, to each of the representations over the network, each of the representations constituting an accessible entry in the web page, such that the client can review the representations, wherein the web page includes a facility by which the client can provide information describing each representation, the information being stored in logical association with the representation so as to permit subsequent access to and retrieval thereof via the web page, the information including a client-described label that is used in identifying the representation on the web page.

2. A method according to claim 1, wherein at least one health care entity source is at least one of a physician, a clinic or a hospital.

3. A method according to claim 1, further comprising:
providing the client with access to a letter template for generating a letter to request that the copy of the medical records and items of data be sent from a source.

4. A method according to claim 1, wherein the information includes a date associated with the medical record or item of data.

5. A method according to claim 1, wherein the information includes a name of a health care entity associated with the medical record or item of data.

6. A method according to claim 1, wherein the information includes the client's comments regarding the medical record or item of data.

7. A method according to claim 1, wherein providing the client with access to each of the representations over the network includes providing the client with at least one set of passwords.

8. A method according to claim 1, wherein providing the client with access to each of the representations includes permitting another party to obtain access to the representation via a password previously forwarded to the client so that the client may grant access to the representation by communicating the password to the other party.

9. A method according to claim 8, wherein the other party has been identified by the client as being in a category of authorized parties.

10. A method according to claim 1, further comprising providing the client with an interface that enables the client to activate one or more emergency cards.

11. A method according to claim 1, further comprising:
providing the client with an interface that allows the client to maintain a medical record diary that the client may enter medical information into on a regular basis, each entry of the medical information being dated and stored in the computer system.

12. A method according to claim 11, wherein the interface includes a place for entry by the patient of a particular illness or condition.

13. A method according to claim 1, wherein the account includes an adult account or a custodial account.

14. A method according to claim 1, wherein storing includes placing the representation in a review folder awaiting review by the client, wherein the representations in the review folder are only accessible to the client and not accessible to authorized parties viewing the centralized medical record system.

15. A method according to claim 14, further comprising:
allowing the client to accept or reject the representation in the review folder;
if the client accepts, moving the representation from the review folder to a medical record folder so that the representations are accessible to authorized parties viewing the centralized medical record system; and
if the client rejects, removing the representation from the centralized medical record system.

16. A method of creating and maintaining a centralized medical record system comprising:
establishing, in a computer system, a record associated with an account of a client, wherein the client is a patient or a guardian of the patient, the computer system being in communication with a network to which the client has access;
receiving a copy of at least one medical record or item of data sent to the centralized medical record system;
producing an electronic representation of each copy received;
storing, in the centralized medical record system, the representation received and logically associating, with each representation, client information related to the client;
providing the client with access, via a web page, to each of the representations over the network, each of the representations constituting an accessible entry in the web page, such that the client can review the representations, wherein the web page includes a facility by which the client can provide information describing each representation, such information being stored in logical association with such representation so as to permit subsequent access to and retrieval thereof via the web page; and
providing the client with an interface that enables the client to accept or reject the association of the representations with the client.

17. A method according to claim 16, wherein storing includes placing the representation in a review folder awaiting review by the client, wherein the representations in the review folder are only accessible to the client and not accessible to authorized parties viewing the centralized medical record system.