Abstract:
A computer system for registering and tracking a patient in a designated treatment area of a medical facility comprises input means for receiving data items including personal, treatment, and logistical information about the patient. Memory means are operably connected to the input means for storing the data items, and a processor is operably connected to the input means and the memory means for creating a record of the data items. the processor also configures the data items into a data structure that permits interactive tracking of the patient while admitted to the treatment area. A user interface is operably connected to the processor and displays the data items from the data structure. The user interface also allows a user to control the processor for and manipulate the data structure, thereby providing real-time logistical tracking of the patient.

Description:
TECHNICAL FIELD  
         [0001]    The present invention relates generally to tracking a patient and information related to the patient in a medical facility, and more specifically to a user friendly computer system and method for interactively tracking a patient and related information while the patient is admitted to the medical facility.  
         BACKGROUND  
         [0002]    Hospitals are an integral part of a community that provide a great service. Particularly, a hospital provides medical care to the people so they can carry on healthy and productive lives. The particular type of health care that each person in the community requires from the hospital is different. Some people who are treated at hospitals have medical conditions that develop gradually and are admitted to the hospital after examination from a doctor. Other people suddenly receive an injury or suddenly become ill. These people require emergency care. Thus, hospitals have emergency rooms where people are brought in order to receive immediate medical attention.  
           [0003]    Because urban areas are often densely populated, hospital emergency rooms in these areas must have the capacity to treat a large number of people. Treating a large volume of patients in the fast-paced setting of an emergency room is very difficult and requires a tremendous amount of organization. Nevertheless, an emergency room must still provide high quality health care in an efficient manner.  
           [0004]    In order to provide quality health care in an efficient manner, an emergency room must maintain different types of logs in order to track the patients. For example, emergency rooms need to register patients that are admitted and record various types of information until the patient is discharged. The emergency room must also keep track of those patients that have not yet been treated and identify the next patient that should get treatment when a doctor becomes available. To this end, a large hospital will also need to track the location of the patient so that the doctor can quickly identify him/her and provide medical care.  
           [0005]    As stated above, a hospital must track various types of information related to each patient. Tracking this information is important so that the hospital management can analyze the performance of the emergency room and make informed management decisions that maintain or improve the quality of the health care. The information is also important because the Joint Commission on the Accreditation of Health Care Organizations (JCAHO), a federally recognized agency that is charged with hospital accreditation, requires each hospital to file reports in order to maintain its medicare and medicaid accreditation. A hospital that loses this accreditation can no longer receive reimbursements from these health care programs. The particular type of information that must be reported includes each patient&#39;s name, the name of the treating physician for each patent, the patient&#39;s initial complaint, the patient&#39;s diagnosis, the patients medical category and classification, the patient&#39;s disposition, the patient&#39;s admission and discharge times, and the hospital&#39;s identification number. This information must be tracked for each individual patient, which places a burden on the hospital and detracts from the need to provide efficient and quality health care.  
           [0006]    Current methods for tracking patients as well as information about each patient are very crude and time consuming. Most emergency rooms use a combination of different systems in order to track the location of a patient as well as the various types of information related to the patient. An emergency room might have a chalk board for identifying patients that have not been treated and separate paper records for tracking the location of the patient. A whole separate system is required for registering the patient into the emergency room. Finally, there is no system for keeping track of the information that the hospital must report to the government. Most of this information is kept in the files and charts for each individual patient. Thus, an administrator must manually go through all of the records to compile the information for reporting purposes.  
           [0007]    The current procedures for tracking patients and information related to the patients have many shortcomings. For example, a full-time administrative employee is often needed to compile information from the patients records and charts in order to complete and file the reports that are required by the government. The result is additional overhead that burdens the financial resources of the hospital. Another shortcoming is the time that is required to update the various tracking and record keeping systems, many of which require redundant information. The extra time required to coordinate information between the various tracking and record keeping systems takes time away from the patients. The results is that the efficiency and quality of health care is adversely affected. The need to keep different charts and tracking systems also results in discrepancies between the various records, which results in confusion. Again, this confusion affects the efficiency and quality of health care provided by the emergency room.  
           [0008]    Therefore, there is a need for a system and method of tracking patients and information that removes administrative and time burdens from the emergency room. More particularly, there is a need for a single interactive system that is capable of tracking a patient from the time he/she is admitted to an emergency room until the time the patent is discharged. Such a system would also track information related to each patient&#39;s visit and thus provide a single, automated source compiling the information that the emergency room must file with the government.  
         SUMMARY  
         [0009]    One embodiment of the present invention provides a computer system for registering and tracking a patient in a designated treatment area of a medical facility. One possible designated treatment area includes an emergency room of a hospital. The computer system receives data items including personal, treatment and logistically information about the patient and stores these data items in a memory device. A processor creates a record for organizing the data items and then configures the data items into a data structure that permits interactive tracking of the patient while admitted to the treatment area. The computer system further includes a user interface that displays the data items from the data structure and also allows a user to control the processor. Controlling the processor to manipulate the data structure, thereby providing real time logistical tracking of the patient.  
           [0010]    The present invention also provides a method of registering and tracking a patient on a computerized system in a designated treatment area of a medical facility. An example of the type of the treatment area that the method of this invention can be used, is the emergency room in the hospital. The initial step of the method is receiving the data items including personal, treatment and logistical information about the patient. These data items are then stored and a record for organizing the data items is created. The next step is configuring the data items into a data structure that permits interactive tracking of the patient while admitted to the treatment area. Next, the data items from the data structure are displayed, and a user is then allowed to manipulate the data structure, thereby providing real time logistical tracking of the patient.  
           [0011]    These and other advantages and features which characterize the present invention are pointed out with particularity in the claims annexed hereto and forming of further part hereto. However, for a better understanding of the invention, its advantages, and objects obtained by its use, reference should be made (1) to the drawings that form a further part hereto; and (2) to the accompanying descriptive matter, which illustrates and describes a preferred embodiment of the present invention.  
         DESCRIPTION OF THE DRAWINGS  
         [0012]    [0012]FIG. 1 shows the interactive computer system of the present invention.  
           [0013]    [0013]FIG. 2 shows the configuration of a terminal that forms a part of the computer system shown in FIG. 1.  
           [0014]    [0014]FIG. 3 shows the configuration of the memory and flow of information within the file server that forms a part of the computer system shown in FIG. 1.  
           [0015]    [0015]FIG. 4 shows the patient triage data structure and window that are created by the computer system shown in FIG. 1.  
           [0016]    [0016]FIG. 5 shows the patient registration window that are created by the computer system shown in FIG. 1.  
           [0017]    [0017]FIG. 6 shows the east bed assignments window and data structure that are created by the computer system shown in FIG. 1.  
           [0018]    [0018]FIG. 7 shows the west bed assignments window and data structure that is created by the computer system shown in FIG. 1.  
           [0019]    [0019]FIG. 8 shows the whose next board window and data structures that are created by the computer system shown in FIG. 1.  
           [0020]    [0020]FIG. 9 shows the east end log window and data structures that are created by the computer system shown in FIG. 1.  
           [0021]    [0021]FIG. 10 shows the west end log window and data structures that are created by the computer system shown in FIG. 1.  
           [0022]    [0022]FIG. 11 shows the clinic log window and data structures that are created by the computer system shown in FIG. 1.  
           [0023]    [0023]FIG. 12 shows the master log window and data structures that are created by the computer system shown in FIG. 1.  
           [0024]    [0024]FIG. 13 shows the east record window and data structure that are created by the computer system shown in FIG. 1.  
           [0025]    [0025]FIG. 14 shows the west record window and data structure that are created by the computer system shown in FIG. 1.  
           [0026]    [0026]FIG. 15 shows the clinic record window and data structure that are created by the computer system shown in FIG. 1.  
           [0027]    [0027]FIG. 16 shows the patient past visits window and data structures that are created by the computer system shown in FIG. 1.  
           [0028]    [0028]FIG. 17 shows the unsigned charts window and data structures that are created by the computer system shown in FIG. 1.  
           [0029]    [0029]FIG. 18 shows the main menu that is utilized by the computer system shown in FIG. 1.  
           [0030]    [0030]FIG. 19 shows an information window that is created by the computer system shown in FIG. 1.  
           [0031]    [0031]FIG. 20 shows a dialogue box that the user can access when the window shown in FIG. 8 is displayed by the computer system that is shown in FIG. 1. 
       
    
    
     DETAILED DESCRIPTION  
       [0032]    The invention will initially be described in general terms and the preferred embodiment of the invention will be described in detail with reference to the drawings, wherein like reference numerals represent like parts and assemblies throughout the several views. Reference to the preferred embodiment does not limit the scope of the invention, which is limited only by the scope of the claims that may be interpreted according to the doctrine of equivalents.  
         [0033]    The present invention provides a computer system and a method for interactively tracking patients in a treatment area of a hospital. The interactive system and method involve inter-related databases that store data items related to personal, treatment, and location information about each patient. The information for each patient&#39;s visit is stored in a separate record. A user interacts with the computer system in order to selectively create and view a data structure. Additionally, a user can edit data items that are contained in the data structure. Each data structure contains a certain combination of the data items stored in the record. This system and method provides flexibility to the medical staff so they can receive real time logistical information about each patient in a variety of formats. The system and method also provides a way to constantly update administrative information in a central location as certain events happen. Thus, the system and the method of the present invention provides a very powerful tool that permits the medical facility to operate much more efficiently.  
         [0034]    The remaining portion of the Detailed Description describes the invention as it is implemented in a hospital emergency room that has an east wing, west wing, and clinic. The clinic is for providing out-patient-type services and for treating very minor injuries and illnesses. One skilled in the art will recognize that the present invention can be implemented in any emergency room regardless of whether it has separate wings or a clinic. One skilled in the art will further realize that the present invention has many applications other than a hospital emergency room.  
         [0035]    Referring to FIG. 1, the computer system, generally shown as  100 , involves a centralized file server  102  and a plurality of remote terminals  104  that preferably are linked together by an ethernet data bus  106  on a Novell network. One skilled in the art will realize that other types of data bases and other types of networks may be used to link the file server  102  and the remote terminals  104 . The hospital&#39;s mainframe computer  105  that is used for general registration of patients is also linked to the ethernet data bus  106 . The interaction between the mainframe computer  105  and the rest-of the system is described in more detail below.  
         [0036]    The file server  102  includes a memory  108  for storing data. Preferably, the file server  102  has enough memory  108  to store data for all the patient&#39;s visits for the previous two years. One skilled in the art, however, will realize from the detailed description set forth below that the precise amount of required memory will vary depending on the number of patients treated by the emergency room in which the present invention is implemented. The file server also has a RAM  109 . Preferably the RAM is 16 megabytes.  
         [0037]    Referring to FIG. 2, each remote terminal  104  has a microprocessor  110 , clock  111 , monitor  112 , pointing device  114 , keyboard  116 , storage device  118 , and at least 4 megabytes of RAM  120 . The preferred microprocessor  110  is an Intel 80486 having a clock speed of 33 MHz or higher. Any type of pointing device  114  such as a mouse or light pen can be used, although a light pen is preferred. A monitor  112  with touch sensitive screen can also be used. In this instance, the pointing device  114  is not needed because the user&#39;s finger serves the function of the pointing device  114 . The remote terminals  104  are preferably placed in strategically located positions throughout the emergency room such as nurse&#39;s stations, doctor&#39;s lounges, and the registration desk. One skilled in the art will realize that other configurations and microprocessors can be used for the remote terminal  104 . A hospital, especially a smaller hospital, might choose to use the present invention with only a single stand alone terminal.  
         [0038]    The present invention preferably utilizes a database that operates in a windows environment and is preferably programmed in Superbase version 2.0, which is published by Software Publishing Corporation. The reference manual for Superbase version 2.0, which is entitled Reference Manual, describes the operations and functions in detail and is hereby incorporated by reference. One skilled in the art will realize that Superbase has Structured Query Language capabilities, and thus the present invention may interface with other database systems. One skilled in the art will further realize that the present invention could be programmed using other software packages and languages such as Microsoft Access version 2.0, Lotus Approach version 2.0, Foxpro, Paradox, R:base, Visual Basic, or Visual C++. The computer system  100  preferably uses Windows version 3.1 or higher. The source code that embodies the present invention is attached as Appendix A.  
         [0039]    Referring to FIG. 3, the computer system has at least two databases located within the memory  108 . The first database is called the Clients database  400  and stores personal information about each patient that visits the hospital emergency room. The data about each patient is organized into a record  402 , and each record includes: the patient&#39;s first, middle, and last name; the patient&#39;s date of birth; the patient&#39;s gender; the patient&#39;s hospital identification number; and a unique reference code that is used for cross-referencing information between the databases.  
         [0040]    The second database is called the Visit database  404  and stores information that is specific to each visit that the patient makes to the emergency room. Information about each visit is stored in a separate record  406 . Each record is cross-reference to the patient&#39;s personal information record  402  in the Clients database via the unique reference code.  
         [0041]    As an example, if a patient has made two visits to the emergency room, he/she will have one personal information record (R 1 ) in the Client database that contains his/her personal information. The patient will also have two records (R 11 , and R 12 ) in the Visit database. Both records in the Visit database will contain information that is specific to the particular visit and will be cross-referenced to the patient&#39;s record (R 1 ) in the Clients database.  
         [0042]    Each record in the Visit database contains fields for storing the following information related to the patient: the date the patient was admitted to the emergency room; a male/female flag to indicate the patient&#39;s gender; a code indicating the patient&#39;s financial class; a family/friends data flag indicating whether the patient has family or friends waiting; an ER flag that indicates whether the patient was taken to the emergency room; a clinic flag that indicates whether the patient was taken to the clinic for treatment; the number of the bed to which the patient is assigned; an E/W flag indicating whether the bed is in the east or west wing of the emergency room; the patient&#39;s initial complaint; the medical condition of the patient; the medical classification of the patient; the diagnosis of the patient; the code from the International Classification of Diseases (ICD) that denotes the particular diagnosis; the names of the medical staff members who are assigned to provide medical care to the patient; the area of medical specialty that was consulted during treatment of the patient, e.g., ophthalmology, cardiology, dermatology, etc.; a signature flag indicating whether the patient&#39;s medical chart was signed; the disposition of the patient, i.e., whether the patient is admitted, discharged, deceased, etc.; the destination of the patient after he/she is discharged, i.e., home, jail, the hospital, etc.; the status of the patient; a discharge time flag, which is set when the patient is discharged from the emergency room; a first time stamp indicating the time the patient was admitted to the emergency room; a second time stamp indicating when the patient was assigned to a bed; and a third time stamp indicating when the patient was discharged from the emergency room.  
         [0043]    One skilled in the art will realize that the ICD code is a list of codes that designates certain types of diseases and injuries. The ICD is established by the World Health Organization, an agency of the United Nations. The hospital emergency room must report the ICD codes to the party (insurance company Medicare, Medicaid, etc.) that pays the fees for each patient that it treats. One skilled in the art will further appreciate that the hospital emergency room must also report the financial classification of each of their patients as a part of the accreditation process for medicare and medicaid. The financial class code represents that classification. The possible codes are determined at the state level. The possible medical conditions are I-Critical, II-Emergent, III-Urgent, and IV-Follow Up. The possible medical classifications are NT-Adult Non-trauma, TT-Adult Trauma, PP-Pediatric Non-trauma, and PT-Pediatric Trauma. The possible statuses are P-the patient is registered and awaiting a bed assignment; A-the patient has a bed assignment; I-the patient was discharged, but has an incomplete record; and D-the patient was discharged and their bed needs to be cleaned.  
         [0044]    The names of the medical staff includes the initial physician who was first assigned to provide medical care to the patient (initial staff M.D.); if the initial primary physician did not complete the medical care for the patient, the name of the physician that completed the patient&#39;s treatment and is responsible for signing the patient&#39;s medical chart (sign-out staff); the name of the nurse that is primarily responsible for providing care to the patient; and the name of the resident or medical student that assists the physician during treatment of the patient (PA/resident or PA/G1). If a series of physicians are assigned to provide medical care, the most recent physician, after the initial staff M.D., is considered the sign-out staff. The meaning and purpose of the other data items that are not clear on their face will become readily apparent below.  
         [0045]    The patient&#39;s record in the Clients database  402  and record in the Visit database  404  that relates to that patient&#39;s particular visit are interrelated. Select combinations of information from the Records are configured into pre-determined data structures. Each data structure has a different combination of data items that allows a user to interactively track the patient or information related to the patient in a different way.  
         [0046]    The memory  108  also may contain several data arrays, each of which contains a list of pre-determined information that corresponds to a particular type of data item. For example, Consult data array  408  contains a list of the types of medical specialties that might be consulted during the treatment of a patient. Beds data array  410  lists the bed numbers for all of the beds that are located in the emergency room and clinic. FClass data array  412  lists the financial classes that describe the financial standing of the patient. ICDList data array  414  lists the possible ICD codes that can be assigned to a patient and the diagnosis that is represented by each code. RNList data array  416  lists the names of nurses on staff in the emergency room. PAList data array  418  lists the names of the residents and medical students on staff in the emergency room. MDList data array  420  lists the names of the doctors on staff in the emergency room. Disposition data array  422  lists the possible dispositions for a patient. Hospital data array  424  lists the possible hospitals to which a patient might be transferred. Clinic data array  426  lists the possible clinics to which a patient might be transferred.  
         [0047]    As explained in greater detail below, the user can copy information from any of the data arrays into the patient&#39;s record  406  in the Visit database  408 . Each data array  400 - 426  preferably forms a separate database so that a user or system administrator can easily update the information contained in the data array. Alternatively, any of the data arrays  400 - 426  can be a set of variable values that are programmed into the source code itself. One skilled in the art will realize that the information stored in the data arrays  400 - 426  can vary depending on the particular application of the present invention.  
         [0048]    [0048]FIG. 4 represents the patient triage data structure, generally shown as  124 , which is displayed in the patient triage window  126 . Using this figure as an example, the data items from each data structure are formatted in a unique, pre-determined window  286  that is displayed by the monitor  112  of the remote terminals  104 . More specifically, each window contains data boxes similar to the data boxes  288   a - 288   e , which are areas in the user interface where the data items are displayed. Each window also contains command buttons similar to the command buttons  290   a - 290   i , which are boxes in the window  286  that the user can activate with the pointing device  114 . Some data boxes can contain only a single data item and some data boxes can contain several data items. As described below, the precise number of data boxes and command numbers varies from window to window.  
         [0049]    If a particular data item is not yet entered into the memory  108  as a part of a patient Visit record  406 , the data box  288   a - 288   e  designated to display that data item remains empty when displayed in the window  286 . One skilled in the art will realize that a user can edit or enter data by activating any of the data boxes  288   a - 288   e  with the pointing device  114  and then entering the new data items or edits to the existing data items on the keyboard  116 . If the remote terminal  104  has a touch sensitive monitor, the user can activate the data boxes  288   a - 288   e  by simply touching that portion of the screen. Data items in some windows are displayed on the monitor, but are not in a data box. The user cannot edit these data items.  
         [0050]    Activating certain data boxes, as identified below, will cause the computer system  100  to display a dialogue box. An example is shown in FIG. 20. The dialogue box  331  includes additional data boxes  333   a  and  333   b  that the user can activate to enter or edit information. Each data box  333   a  and  333   b  also contains an expansion button  335   a  and  335   b , respectively. Rather than typing data into one of the data boxes  333   a  or  333   b , the user can activate the associated expansion button  335   a  or  335   b , respectively, with the pointing device  114 . This action causes the computer system to retrieve and display the related data array  408 - 426  that contains the possible data items that the user may enter into the main data box. The user can than activate the appropriate data item from the reference list, which causes the computer system to copy that data item into the patient&#39;s Client or Visit record  402  or  408 , respectively, and display that data item accordingly. For purposes of brevity and clarity these types of data boxes will be called expandable data boxes. One skilled in the art will realize that when a data box is referred to as an “expandable data box” the user can enter information using this procedure.  
         [0051]    For purposes of clarity, the Figures for the remaining data structures and windows are not given reference numerals unless the reference numerals are necessary for understanding. In most instances, the description and figures provide reference numerals for the data items that are displayed in the windows. Additionally, the command buttons are identified by the name of the function that they execute when activated by the pointing device  114 .  
         [0052]    Regarding the specific details of the triage data structure  124 , the triage window  126  displays the following data items: the patient&#39;s first name  128 , middle name  130 , and last name  132 ; the patient&#39;s identification number  134 , which is called the “A Number”; the patient&#39;s birth date  136 ; the patient&#39;s complaint  138 ; the patient&#39;s financial class  140 ; the family/friends flag  142 ; the ER data flag  143 ; and the clinic flag  144 . The triage window  126  also includes the following command buttons: New  146 , Edit  148 , Delete  150 , Find  152 , West Beds  154 , East Beds  156 , Register  158 , Help  160 ; and Record  161 . The function of these command buttons and the triage data structure  124  will be described below.  
         [0053]    Referring to FIG. 5, the registration data structure, generally shown at  162 , is displayed in the registration window  164 , which includes the following data items: the patient&#39;s first name  128 , middle name  130 , and last name  132 ; the patient&#39;s identification number  134 ; the patient&#39;s birth date  136 ; and the male/female flag  166 . The registration window  164  also includes the following command buttons: New  146 , Edit  148 , Delete  150 , Find  152 , Triage  168 , and Help  160 . The function of these command buttons and the registration data structure  162  will be described below.  
         [0054]    Referring to FIG. 6, bed assignments data structures  266   a - 266   j  are displayed in the east bed assignments window  268 . Each data structure  266   a - 266   j  is displayed on a different line and corresponds to a patient that has been taken to the east wing or west wing, for treatment, rather than the clinic. Each data structure  266   a - 266   j  includes the following data items: the patient&#39;s first name  128 , middle name  130 , and last name  132 ; the patient&#39;s medical condition  270 ; the patient&#39;s bed number  178 ; and the patient&#39;s status  272 . The east bed assignments window  268  also includes the following command buttons: East Log  274 , Triage  168 , Help  160 , First Page  186 , Page Up  188 , Page Down  190 , Last Page  192 , and West Bed  276 . The function of these command buttons and the Bed Assignments data structure  266   a - 266   j  will be described below.  
         [0055]    Although only ten data structures  266   a - 266   j  are displayed in the window at one time, the user can scroll the data structures in order to see data items from additional patients who are in the east wing of the emergency room awaiting a bed assignment. One skilled in the art will realize that scrolling through the data structures is accomplished by activating the First Page  186 , Page Up  188 , Page Down  190 , and Last Page  192  command buttons.  
         [0056]    Referring to FIG. 7, the west bed assignments window  280  is substantially identical to the east bed assignments window  268 . The primary difference is that the West bed command button  276  and the East log command button  274  are replaced with the East Bed command button  282  and the West Log command button  284 .  
         [0057]    Patients that are taken to the emergency room for treatment have their bed assignment data structure appear in both the east bed assignment window  268  and the west bed assignment window  280 . As described in more detail below, the user can then assign the patient to a bed in either wing. When the patient is assigned a bed in either the east or west wing, the patient&#39;s bed assignment data structure will remain displayed in the respective bed assignment window  268  or  280  and will no longer appear in the other bed assignment window  280  or  268 , respectively.  
         [0058]    Referring to FIG. 8, the who&#39;s next board data structures  170   a - 170   j  are displayed in the who&#39;s next board window  172 . Each data structure  170   a - 170   j  is displayed on a different line and corresponds to patients that have been admitted to the east or west wing of the emergency room, but have not yet been assigned an initial staff M.D., i.e., a treating physician. A who&#39;s next data structure is not created for patients that are admitted to the clinic because their injury or illness is only minor.  
         [0059]    Each data structure  170   a - 170   j  includes the following data items: the patient&#39;s first name  128 , last name  132 , and initial from his/her middle name  130 ; the patient&#39;s initial complaint  138 ; the patient&#39;s medical condition  174 ; the identity of the resident or medical student who will assist the treating physician  176 ; the number of the bed to which the patient is assigned  178 ; and the E/W flag  180 . The who&#39;s next board window  172  also includes the following command buttons: Unsigned  182 , Log  184 , Help  160 , First Page  186 , Page Up  188 , Page Down  190 , and Last Page  192 . The function of these command buttons and the who&#39;s next board data structures  170   a - 170   j  will be described below.  
         [0060]    The who&#39;s next board window  172  includes the who&#39;s next board data structures  170   a - 170   j  from all of the patients who are admitted to the emergency room, but have not yet been assigned a physician for treatment. Although only ten data structures  170   a - 170   j  are displayed in the window at one time, the user can scroll the data structures in order to see data items from additional patients. Scrolling is accomplished as described above.  
         [0061]    Referring to FIG. 9, the log data structures  202   a - 202   j  are displayed in the east end log window  204 . Each data structure  202   a - 202   j  is displayed on a different line and corresponds to a patient that was assigned a bed in the east wing of the emergency room for treatment as opposed to the west wing or the clinic. Each data structure  202   a - 202   j  includes the following data items: the patient&#39;s status  206 ; the bed number to which the patient is assigned  178 ; the patient&#39;s first name  128 , middle name  130 , and last name  132 ; the patient&#39;s initial complaint  138 ; the identity of the resident or medical student assigned to assist the physician  126 ; and the initial staff M.D.  200 . The east end log window  196  also includes the following command buttons: Unsigned  182 , Beds  208 , Who  210 , First Page  186 , Page Up  188 , Page Down  190 , Last Page  192 , and Help  160 . The function of these command buttons and the Log data structures  202   a - 202   j  will be described below.  
         [0062]    Although only ten data structures  202   a - 202   j  are displayed in the window at one time, the user can scroll the data structures in order to see data items from additional patients who are in the east wing of the emergency room. Scrolling is accomplished as described above.  
         [0063]    [0063]FIG. 10 represents the west end log window  214 , which is substantially identical to the east end log window  196 . The primary difference is that the west end log window  214  displays the data structures  202   k - 202   u  that correspond to patients who were assigned a bed in the west wing of the emergency room rather than the east wing.  
         [0064]    [0064]FIG. 11 represents the clinic log window  218 , which is substantially identical to the east end log window  196  and the west end log window  214 . The primary difference is that the clinic log window  218  displays data structures  202   v - 202   ae  that correspond to patients who were sent to the clinic for treatment rather than the east or west wings of the emergency room. The clinic log data structure does not include the bed data item and the clinic log window  214  does not have an area to display such information. Additionally, the clinic log window  218  does not include either the Beds command button  208  or the Who command button  210 .  
         [0065]    Referring to FIG. 12, the master log data structures  220   a - 220   j  are displayed in the master log window  222 . Each master log data structure  220   a - 220   j  is displayed on a different line and corresponds to a different patient that has been admitted to the emergency room for treatment. Thus, the master log window  222  provides a historical list of the patients that have been treated in the emergency room. In order to conserve space in the memory  108 , the master log window  222  might include only patients who were admitted after a certain date.  
         [0066]    Each master log data structure  220   a - 220   j  includes the following data items: the bed number to which the patient is assigned  178 ; the patient&#39;s first name  128 , middle name  130 , and last name  132 ; the patient&#39;s initial complaint  138 ; the identity of the resident or medical student assigned to assist the physician  126 ; the initials  294  of the initial staff M.D.; and the log number  296  of the patient that identifies the order in which that patient was admitted to the emergency room, e.g., whether the patient was the first, tenth, or twenty-second patient admitted. The master log window  222  also includes the following command buttons: Unsigned  182 , Find  152 , First Page  186 , Page Up  188 , Page Down  190 , Last Page  192 , and Help  160 . The function of these command buttons and the master log data structures  220   a - 220   j  will be described below.  
         [0067]    The master log window  222  only displays ten of the master log data structures  220   a - 220   j  at one time. The user can scroll through the data structures in order to see data items from additional patients. Scrolling is accomplished as described above.  
         [0068]    Referring to FIG. 13, the record data structure, generally shown as  224 , is displayed in the east record window  226 . The record data structure  224  provides comprehensive information about a patient that is being treated in the east wing of the emergency room and includes the following data items: the patient&#39;s first name  128 , middle name  130 , and last name  132 ; the patient&#39;s identification number  134 ; the patient&#39;s initial complaint  138 ; the patient&#39;s age  228 , which the processor  110  calculates by comparing the patient&#39;s birth date with the current date as it is determined by the clock  111 ; the patient&#39;s financial class  140 ; the gender flag  166 ; the bed number to which the patient is assigned  178 ; the family/friends flag  142 ; the primary nurse assigned to treat the patient  230 ; the identity of the resident or medical student assigned to assist the physician  176 ; the name of the initial staff M.D.  200 ; the name of the sign-out staff  232 , if any; the area of medical specialty that was consulted during treatment of a patient  234  (up to three specialties may be listed); the patient&#39;s diagnosis  236 ; the patient&#39;s disposition  238 ; the signature flag  240 , which indicates whether the physician has signed the patient&#39;s medical charts; the discharge time flag  242 ; the first time stamp  244 ; the second time stamp  246 ; and the third time stamp  248 . The east record window  226  includes the following command buttons: Past  250 , Find  152 , Unsigned  182 , Print  252 , Delete  150 , Help  160 , Log  254 , and Triage  168 . The function of these command buttons and the records data structure  224  will be described below.  
         [0069]    [0069]FIG. 14 represents the west record window  258 , which is substantially identical to the east record window  226 . The primary difference is that the west record window  258  displays the record data structures, generally shown as  256 , for the patients that are treated in the west wing of the emergency room rather than the east wing.  
         [0070]    [0070]FIG. 15 represents the clinic record window  227 , which is also substantially identical to the east record window  226 . The primary difference is that the clinic record window  227  displays the record data structure, generally shown as  257 , for the patients that are treated in the clinic of the emergency room rather than the east or west wings.  
         [0071]    Referring to FIG. 16, the patient past visits data structures  260   a - 260   j  are displayed in the patient past visits window  262 . The patients past visits window  262  also displays the patient&#39;s first name  128 , middle name  130 , last name  132 , and identification number  134 .  
         [0072]    As discussed above, each visit of a patient has a different Visit record  406  from which the patient past visits data structures  260   a - 260   j  are created. Each patient past visits data structure  260   a - 260   j  are displayed on a different line. According to FIG. 3, the hypothetical patient Rex Harrison had one past visit that is identified by the patient past visits data structure  260 . If the patient had any other past visits, the corresponding patient past visit data structures would have been displayed in the other data boxes  288   i - 288   q . Each patient past visits data structure  260  includes the following data items: the date the patient was admitted to the emergency room  198 ; the E/W flag  180 ; the name of the initial staff M.D.  200  that treated the patient; and the patient&#39;s diagnosis  136 . The patient past visits window  262  also includes the following command buttons: Log  184 , Help  160 , Find  152 , First Page  186 , Page Up  188 , Page Down  190 , and Last Page  192 . The function of these command buttons and the patient past visits data structure  260  will be described below.  
         [0073]    The patient past visits window  268  does not display more than ten data structures at any one time. Thus, if a patient has more than ten past visits to the emergency room, the user can scroll the data structures in order to see data items from other past visits. Scrolling is accomplished as described above.  
         [0074]    Referring to FIG. 17, the unsigned charts data structures  194   a - 194   j  are displayed in the unsigned charts window  196 . Each data structure  194   a - 194   j  is displayed on a different line and corresponds to the patients whose medical charts were not signed by a physician. Each of the data structures  194   a - 195   j  includes the following data items: the E/W flag  180 , the date  198  the patient was admitted to the emergency room, the patient&#39;s first name  128 , middle name  130 , and last name  132 ; and the name of the sign-out staff  232 . The unsigned charts window  196  also includes the following command buttons: Log  184 , Help  160 , First Page  186 , Page Up  188 , Page Down,  190 , and Last Page  192 . The function of these command buttons and the unsigned charts data structures  194   a - 194   j  will be described below.  
         [0075]    The computer system  100  organizes the unsigned charts data structure according to physician. Thus, the unsigned chart window  196  will display only the Unsigned Chart data structures  194  from the patients that were treated by a particular sign-out staff. As described in more detail below, enabling the Unsign command button  182  enables the user to display the unsigned charts data structures  194  for patients that were treated by a different physician. Although only ten data structures  194   a - 194   j  are displayed in the window at one time, the user can scroll the data structures in order to see data items from additional patients who have not yet had their charts signed. Scrolling is accomplished as described above.  
         [0076]    [0076]FIG. 18 represents the main menu, generally shown as  312 , of computer system  100 , which is displayed in menu window  314 . The main menu includes the following command buttons: Triage  168 , Registration  310 , Who&#39;s Next  298 , Unsign  182 , East Log  274 , West Log  276 , Clinic Log  300 , Master Log  302 , About  304 , Census  306 , Administration  308  and Help  160 . The functions of the command buttons is as follows. Each command button serves the same function regardless of the window in which it is displayed.  
         [0077]    Referring to main menu  312 , activating the Triage command button  168  causes the computer system  100  to display the triage window  126  on the monitor  112 . Activating the Registration command button  310  causes the computer system  100  to display the Registration window  164  on the monitor  112 . The Registration command button  310  and Register command button  158  serve the same function. Activating the Who&#39;s Next command button  298  causes the computer system  100  to display the Who&#39;s Next board window  172  on the monitor  112 . The Who&#39;s Next command button and the Who command button  210  serve the same function. Activating the Unsigned button  182  causes the computer system  100  to display the unsigned charts window  196  on the monitor  112 . Activating the East Log command button  274 , or Master Log command button  276 , Clinic Log command button  300 , or Master Log command button  302  causes the computer system  100  to display the east end log window  204 , west end log window  214 , clinic log window  218 , or master log window  222 , respectively, on the computer system  100 . Activating the About command button  304  causes the computer system  100  to display a window that provides information about the present invention including the names of the census inventors and a copyright notice. Activating the Census command button  306  causes the computer system  100  to count the number of Visit records  406  that were opened that day and display that number on the monitor  112 . Activating the Administration command button  308  enables the user to access administration information and perform administrative functions. The function of the Administration command button  308  is described in more detail below. One skilled in the art will appreciate that activating the Help command button  160  will cause the computer system  100  to display a help screen on the monitor  112 .  
         [0078]    Referring to FIGS. 4 and 18, the user will activate the Triage command button  168  from the main menu  312  in order to register a patient who comes into the emergency room. Referring now to FIG. 4, the user activates the New command button  146  and then types the first four letters of the patient&#39;s last name and strikes the enter key. The computer system  100  will then generate a list of previous patients that have last names that begin with the same first four letters. The user will then activate the patient&#39;s name with the pointing device  114 . This action will cause the computer system  100  to automatically display the patient&#39;s first name  128 , middle name  130 , last name  132 , birthdate  136 , identification number  134 , and financial class  140  in the triage window  126 . The user must also activate the ER flag  143  if the patient is sent to either the east wing or west wing for treatment, the Clinic flag  144  if the patient is sent to the clinic for treatment, and the Family/Friends flag  142  if the patient has family or friends waiting. All of these flags toggle on and off by activating their respective data box with the pointing device  114 . Finally, the user must enter the patient&#39;s complaint—the reason the patient came to the emergency room. The user preferably enters the information exactly as it was conveyed by the patient.  
         [0079]    Once all of the information is entered into the computer system  100 , the user activates the Record command button  316 , which creates the Visit record  406  in the visit database, cross-references the Visit record  406  to the patient&#39;s record in the Client database, and inserts the displayed data items into the Visit record  122 . Activating the Record command button  316  also causes the clock  111  and the processor  110  to create the first time stamp  244  and date stamp  318  that records the day that patient was registered. These additional data items are also inserted into the Visit record  406 .  
         [0080]    The West Beds command button  154  and the East Beds command button  156  causes the computer system  100  to display the West Bed Assignments window  280  or the East Bed Assignment windows  268 , respectively. One skilled in the art will realize the function of the Edit command button  148 , Delete command button  150 , and Find command button  152 . The Edit command button  148  enables the user to edit information that is contained within the triage window  126 . The Delete command button  150  allows a patient to delete the record for the patient that is displayed in the triage window  126 . The Find command button  152  allows the user to execute queries in order to find certain information within the memory  108 . The function of the Help command button  160  is described above.  
         [0081]    The registration procedure is slightly more complex if the person was not previously a patient at the emergency room. In this situation, the user must cancel the search through the records in the Clients database. The user then registers the new patient in the hospital&#39;s main registration system  105 . A record  402  in the Clients database  400  will automatically be created and the mainframe will then download the appropriate information into the newly created record  402 . The user can then reactivate the new command button  290   a  and follow the registration procedure that is outlined above.  
         [0082]    If the mainframe is not operating or the link between the mainframe  105  and the ethernet data bus  106  fails, the user must activate the registration command button  310  in order to admit the patient. Activating the registration command button  310  causes the computer system  100  to display the registration window  164  as shown in FIG. 5. The user then manually enters the person&#39;s first name  128 , middle name  130 , last name  132 , birthdate  136 , financial class  140 , and the appropriate gender flag  166 . Once this information is entered, the user activates the Triage command button  168 , which causes the Triage window  126  to reappear on the monitor  112 . The user then enters the remaining data items and activates the appropriate flags. Upon completion of the above steps, the user activates the Record command button  316 , which will also create a record  402  in the Clients database. The function of the other command buttons that are included within the registration window  164  were described above.  
         [0083]    The user can access either the west bed assignments window  280  or the east bed assignments window  268  from the triage window  126 . As described above, the patient&#39;s bed assignment data structure will appear in both the east bed assignments window  268  and the west bed assignments window  280  until a bed is assigned. In order to assign a bed, the user will display the appropriate window depending on whether he/she means to assign a bed in the east or west wing of the emergency room. For purposes of example, assume the user plans to assign the patient to a bed in the east wing of the hospital. Once the east bed assignment window  268  is displayed, the user can activate the data box with the patient&#39;s name and an information window  320  will appear cascaded over the east bed assignments window  268 . The Information window is represented in FIG. 19. The Information window contains six dialogue boxes  322 ,  324 ,  326 ,  328 ,  330  and  332  and three command buttons  334 ,  336  and  338 .  
         [0084]    The first dialogue box  322  lists the beds data array  340  that contains all of the bed assignments. The user can activate the number of the bed to which the patient is assigned with the pointing device  114 . The bed number then appears in the bed data box  342  in the east bed assignments window  268 .  
         [0085]    The second dialogue box  324  lists the patient&#39;s first name  128 , middle name  130 , last name  132 , and complaint  138 . The user cannot edit this information. The third dialogue box  326  contains data boxes  344  and  346  that indicate whether the ER flag  143  or the clinic flag  144 , respectively, is set. The user can set the appropriate flag  143  or  144  if it was not set at the time of registration.  
         [0086]    The fourth dialogue box  328  contains the possible medical conditions, which were described above, and a data box  348 ,  350 ,  352 , and  354  that corresponds to each medical condition. The user can activate the data box  348 ,  350 ,  352 , or  354  that corresponds to the appropriate medical condition for the patient. The medical condition then appears and the condition data box  356  of the east bed assignments window  268 .  
         [0087]    The fifth dialogue  330  box contains the possible medical classifications, which were described above, and a data box  358 ,  360 ,  362 , and  364  that corresponds to each medical classification. The user can activate the data box  358 ,  360 ,  362 , or  364  that corresponds to the appropriate medical classification for the patient. The medical classification does not appear in the east bed assignments window  268 .  
         [0088]    The sixth dialogue box  332  contains an expandable data box  366  in which the user can enter the name of the primary nurse, which is the nurse that is responsible for attending to the patient and assisting the physician. As described above, the user can activate the Expand button  368  in order to access the RNList data array that lists all of the nurses on staff.  
         [0089]    After all of the necessary information is entered, the user can activate the Save command button  334  to insert the information into the patient&#39;s record  122  and exit the information window  320 ; activate the Cancel command button  336 , which will disregard the information and exit the information window  320 ; or activate the Erase Bed command button  338 , which will cause the computer system  100  to erase the bed number assigned the patient so that the user can assign a different bed number.  
         [0090]    An identical method is used if the patient is assigned a bed in the west wing of the emergency room. The only difference is that the user activates the west bed command button  276  in the triage window  126  rather than the east bed command button  282 .  
         [0091]    The computer system  100  automatically creates the who&#39;s next board data structure  170  when the bed number  178  and medical condition  270  are assigned to the patient. The who&#39;s next board data structures  170   a - 170   j  are displayed in a hierarchical order. The patients whose medical condition is emergent are placed on the top of the list. If there is more than one patient with an emergent medical condition, the patients are listed according to time of registration with the most recently registered patients being below the other patients with emergent medical conditions. All of the other patients are treated in order of registration. Thus, the most recently registered patients are placed at the bottom of the list.  
         [0092]    A physician who finishes treatment of a patient will activate the Who&#39;s Next command button  298  from the main menu  312 . The physician can also access the who&#39;s next board window  172  by actuating the Who command button  210  in either the east end log window  204  or the west end log window  214 . The computer system  100  will display the who&#39;s next board window  172  on the monitor. The doctor then signs up to treat the patient that is on the top of the list.  
         [0093]    Referring to FIG. 20, the doctor accomplishes this task by activating the data box  370  that contains the patient&#39;s name. This action causes a dialogue box  371  to appear on the monitor  112 . The dialogue box  371  contains the expandable data box  333   a  for entering the physician&#39;s name and the expandable data box  333   b  for entering the resident&#39;s and medical student&#39;s name. The dialogue box  371  also displays the patients name, complaint, and bed number. However, the user cannot edit this information within the dialogue box  371 . Once the name of the physician, resident, or student is entered, the user can activate either the save button to enter the information into the patients visit record or the cancel button to omit any changes to the data contained within the expandable data boxes  333   a  or  333   b.    
         [0094]    Depending on whether the patient is located in the east wing, west wing, or clinic, the user can access and view the east end log window  204 , west end log window  214 , or clinic log window  218  to view information related to a patient. The user can also enter the status of a patient into the status data boxes  206 ,  207 , and  209  contained in the east log window  204 , west log window  214 , and clinic log window  218 , respectively. The meaning of these status indicators is described above.  
         [0095]    If the user needs to review additional information about the patient, he/she can activate the elongated data box that contains the patient&#39;s name. This action will cause the computer system  100  to display either the east record window  227 , the west record window  258 , or clinic record window depending on whether the patient&#39;s bed is in the east wing, west wing, or clinic, respectively. These windows are discussed in more detail below. Activating the Beds command button  398  will cause the computer system  100  to display a dialogue box that contains the East Bed command button  156  and the West Bed command button  154 .  
         [0096]    The user can also view information through the master log window  222 , which displays all of the master log data structures  220  for all patients that have been admitted to the hospital emergency room. The user can the record data structure  224  from a patient&#39;s particular visit in a manner identical to viewing the record data structure from the east log window  204 , west log window  214 , or clinic log window  218 .  
         [0097]    In order to view even more detailed information about a patient, the user can access either the east record window  226 , west record window  258 , or clinic record window, depending on the location of the patient. Within each of these windows, the user cannot edit the patient&#39;s name, identification number, age, financial class, complaint, or the gender flag from this window. The user can edit or enter information related to the bed assignment, the nursing staff, the resident or medical student, the initial staff, the sign out staff, the medical condition of the patient, the medical classification of the patient, the consultant (type of medical specialist consulted during treatment of the patient), the disposition of the patient, or diagnosis of the patient, by activating the appropriate data box.  
         [0098]    The user can toggle the family/friends data flag by activating the family waiting data box. The user can also toggle the signature data flag by activating the MD signature data box with the pointing device  114 . Finally, the user can toggle the discharge time data by activating the discharge time data box. The user toggles on the discharge time data flag when the patient&#39;s bed is cleaned after discharge from the emergency. Toggling the discharge time data flag causes the clock  111  and processor  110  to create the third time stamp, which is stored in the patient&#39;s record and displayed in the East Record window.  
         [0099]    The user can access the patient&#39;s past visits window  262  to view historical information about a particular patient. This window  262  displays the patient&#39;s past visits data structure  260  from each of the patient&#39;s previous records. If the user desires to view additional information about the previous visit, he/she can use the pointing device  114  to activate the data box that displays relevant patient past visits data structure. This action will cause the computer system  100  to display the record data structure from that previous visit.  
         [0100]    Referring to FIG. 17, the user can view a list of patients treated by a particular physician that do not have signed charts. This list is organized by the initial staff M.D. unless a different physician completed the treatment of the patient. In this situation, the patient is listed under the sign-out staff. One skilled in the art will realize that the hospital cannot bill a patient unless the medical charts are signed.  
         [0101]    The user can access the listing of unsigned charts by activating the Unsigned command button  182 . Referencing to FIG. 21, this action causes the computer system  100  to cascade an Information window that enables the user to enter the name of the doctor for which he/she wants to list the patients that the doctor has treated but has not yet signed their charts. The window contains a first dialogue box  428  that lists the names of the physicians on staff and a second, empty dialogue box  430 . The user can either activate the name of a doctor in the first dialogue box  428  with the pointing device  114  or type in the name of the doctor in the second dialogue box  430 . The user must activate the O.K. button  434  to the patients whose charts have yet been signed. One skilled in the art will appreciate that he/she can activate any of the buttons  432   a - 432   f  in order to scroll names of the physicians listed in the first dialogue box  428 .  
         [0102]    Upon activation of the O.K. button  434 , the computer system  100  will display the unsigned chart data structures  194  for each patient that was treated by that physician and who does not have the signature flag  240  in his/her Visit record  406  activated. The physician can then review and sign the charts for each of the listed patients and access the record data structure  224  from those patients and activate the signature flag  240  within that patient&#39;s record  122 . This procedure was described above. If the user activates the cancel button  436 , the system will erase the information window from the monitor  112  and display a refreshed Main Menu window  303 .  
         [0103]    While the invention has been described in conjunction with a specific embodiment thereof, it is evident that different alternatives, modifications, and variations will be apparent to those skilled in the art in view of the foregoing description. Accordingly, the invention is not limited to these embodiments or the use of the elements and the specific configurations as presented herein.