Patent Publication Number: US-2009240525-A1

Title: Method and apparatus for sharing medical information

Description:
This application is a continuation-in-part of U.S. Provisional Patent Application No. 61/038,295 filed on Mar. 20, 2008 (pending). 
    
    
     FIELD OF THE INVENTION  
     The field of the invention relates to teleconferencing systems are more particularly to methods of using teleconferencing to diagnose medical conditions. 
     BACKGROUND OF THE INVENTION  
     Methods of teleconferencing are generally known in the art. Such methods are typically used by businesses to allow a number of people to simultaneously interact through a voice or audio/video connection in order to solve some particular problem. 
     In order to set up a teleconference connection, each person is typically given a telephone number associated with a conferencing bridge within the telephone network. As each person calls into the conferencing bridge, a processing unit combines the voice information from each caller, normalizes the volume and retransmits the combined and normalized voice signal to each conference participant. 
     Audio/video conferencing may also be accomplished through the Internet. In this case, an audio/video connection may be formed between two computers. A camera and microphone is connected to each computer. A conferencing application within the respective computers forms a packet connection between the computers. Once the connection is set up, audio and video from each end may be collected from the cameras and microphones, packetized and sent to the other end under a TCP/IP or streaming format. 
     While prior art methods are effective, they lack flexibility. Because such methods are intended primarily for voice or for voice and video, they are not able to handle information content that cannot easily be supplied through the camera or microphone. 
     Where the exchange of other information is needed, then other methods must be used (e.g., e-mail, fax, etc.). Because of the importance of communication a need exists for conferencing methods that are adaptable to the needs of the medical community. 
     SUMMARY  
     An apparatus and method is provided for treating a healthcare patient. The method includes the steps of establishing a audio/visual teleconference between a processor of the patient at a first location and a processor of a physician located at a second, remote location different from the first location and displaying a set of biometric parameters of the patient in real time to the physician at the remote location. 
     In another aspect, the apparatus includes a website, a conferencing application at the website that establishes a audio/visual teleconference between a processor of the patient at a first location and a processor of a physician located at a second, remote location different from the first location and a data processing application at the website that displays a set of biometric parameters of the patient in real time to the physician at the remote location. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS  
         FIG. 1  is a block diagram of a telemedicine system in accordance with an illustrated embodiment of the invention and 
         FIG. 2  is a flow chart of process steps that may be used by the system of  FIG. 1 . 
     
    
    
     DETAILED DESCRIPTION OF AN ILLUSTRATED EMBODIMENT 
       FIG. 1  is a block diagram of a medical conferencing system  10  shown generally in accordance with an illustrated embodiment of the invention.  FIG. 2  is a flow chart of method steps that may be used within the system  10 . 
     The system  10  may be used by a patient alone or by patient with the help of a caregiver to share health information with any of a number of healthcare consultants (e.g., physicians). The sharing of information by the system  10  is based upon the use of a website  16  within a host  24  that the patient or the patient and caregiver (the patient or patient and caregiver together hereinafter referred to as the “caregiver”) sign into. Signing into the system  10  may include verification  100  of a patient&#39;s identify through the use of a fingerprint scanner  20 . 
     Once a patient has signed into the system  10  using the fingerprint scanner  20 , the fingerprint of the patient may be compared with a file copy  74  to verify the identity of the patient. The registration or recognition of the patient is a prerequisite that allows the system  10  to begin  108  a conference between the caregiver  18  and one or more consultants. 
     The caregiver&#39;s computer  18  may be provided in any of a number of different forms (e.g., notebook computer, personal digital assistant (PDA), etc.) The caregiver&#39;s computer  18  may be used in conjunction with virtual private network (VPN) software including a FOB  14  attached to the computer  18  that allows the computer to securely sign into the website  16  within a VPN  12 . 
     The website or web portal allows the caregiver  18  to send text messages, medical images or other medical data via a chat functionality. The caregiver  18  and VPN  12  allow private chat conversations including video, audio and text. 
     Once the caregiver  18  signs into the system  10 , a data handling application  32  associated with the website  16  of the host  24  determines whether  102  the patient has previously registered with the system  10  and whether an electronic health record  72  exits for this patient. If not, then the application  32  creates  104  a record. As part of that creation, the patient is asked to insert his/her finger in the fingerprint scanner  20  to authenticate  106  the identity of the patient. 
     Once signed in, one or more conferencing applications  42 ,  44  within the caregiver&#39;s computer  18  may begin exchanging information with other parties to the conference through the website  16 . In addition, a data collection application  30  within the caregiver&#39;s computer  18  may begin sending copies of biometric information appearing on the caregiver&#39;s computer screen  36  and/or changes to the biometric information to the website. A corresponding data handling application (e.g.,  32 ) associated with the website  16  may begin saving the screens from the caregiver&#39;s computer into an archive database  34 . The database  34  may maintain a file  72  of saved information for each patient. 
     The saving of the caregiver&#39;s screens allows the caregiver to locally connect the caregiver&#39;s computer to any of a number of different diagnostic equipment  38 ,  40  that may be used to display biometric parameters  42  of the patient within a display window  36 . Since the communication application  30  copies the information within the window  36 , the software supplied with the diagnostic equipment may be used without modification to share and archive the patient&#39;s biometric information. 
     The diagnostic equipment  38 ,  40  may be selected from any of a number of different medical imaging and/or testing devices. Examples include heart rate monitors, portable ultrasound probes, portable X-ray machines, glucose monitors, chemical dependency test systems, infection disease test systems, blood analysis systems, spirometers, digital weight scales, digital thermometers, blood pressure monitors, exercise monitors, digital peak flow meters, pulse oximeters, digital stethoscopes, high resolution medical cameras, high resolution ophthalmology cameras, high resolution ear, nose and throat camera and apparatus, digital range of motion devices used on flexible joints or digital infection detection test devices. 
     In addition to archiving  110  the patient&#39;s biometric information, the conferencing applications  42 ,  44  allow the caregiver to set up video conferences with one or more healthcare professionals (physicians) for purposes of consulting. Consulting in this case means viewing the biometrics of the patient in real time while also conversing in real time with the healthcare provider and/or patient. In order to preserve patient privacy, a consultant  26  may also be required to identify himself/herself  116  to the consultant&#39;s computer  26  via a fingerprint scanner  28 . 
     The fingerprint scanners or readers  20 ,  28  authenticate the patient, home heathcare worker and healthcare professional at a login prompt presented by the website  18 . The software of the computer  18 ,  26  allows participants to share and view their respective computer desktops with all or selected participants. The software also allows the content of the conference to be recorded and stored on a central data repository system  34 . The website  16  and associated processes of the central data repository are used to collect, process and store the electronic heath records for each patient within a respective file  72 . Stored data may include, but is not limited to, medical images, physician&#39;s notes, video, audio and text and may be stored within (or in conjunction with) each patient&#39;s record. Once a patient&#39;s fingerprint has been identified to the system  10 , the patient&#39;s existing electronic health records (EHR) and electronic medical records (EMR) can be retrieved and correlated to a current session of stored information. 
     The system  10  also automatically generates and processes an electronic bill to the patient&#39;s healthcare provider  22  for prompt payment. This can be accomplished using the physician&#39;s fingerprint and digital signature for authentication purposes. The system  10  can access and update a patient&#39;s medical records with strict access rights and privileges. The secure data base  34  may process and store medical records including, but not limited to magnetic resonance imaging data, computed tomography image data, X-ray imaging data, positron emission image data, ultrasound image or sonography data, heart rate data, blood glucose data, body weight data, body mass index data, date of birth, patient identification number, personal contact information, allergy information, medication history, family/personal physician&#39;s name, family/personal car physician&#39;s identification number, recorded telemedicine virtual visit sessions (conferences), asthma data, pulse oximeter data, blood analysis data, body temperature, blood analysis data, physician notes, referring physician notes, medical specialist notes and medical history data. 
     The caregiver&#39;s computer  18  may also provide preconfigured documentation templates  82 ,  84 , including procedural notes, real-time vital sign diagnostic flow sheets and graphs, summaries and care plans for commonly encountered problems in chronic disease management which may also, in turn, require critical care, emergency care, ambulatory care and acute care physician visits. Temples  82 ,  84  may be accessed through the website  16  for use during conferences between participants. 
     Each caregiver (by specialty) can easily configure these templates  82 ,  84  generated by the computer  18  to meet specific needs and can create standardized and scalable electronic health and electronic medical records. Based upon care plans and protocols, embedded physician and nursing documentation on medical conditions and treatment options can function to prompt caregivers as they navigate through pathways of care and alert them to tasks needing action prospectively. Physician documentation or resources available through the website  16  may ask for or prompt the physician with E&amp;M coding that shows the documentation level of each visit. The system  10  may also recommends an appropriate CPT code to ensure timely and accurate billing. 
     The actual consultations with physicians or other healthcare workers may be recorded to allow future caregivers to review the video and audio in conjunction with the documentation templates. The recordings serve as a back-up to reduce the number of patient errors, fraud and to improve overall efficiency. 
     Communication between the caregiver&#39;s computer  18  and website  18  may occur using a broadband access device, DSL, dial-up or cable internet through the world wide web. Once a secure internet connection is set up, the caregiver and the patient are able to access the website  18  to conduct a teleconference medical (telemedicine) consultation through the VPN  12 . 
     The system  10  may use voice recognition software  86  to transcribe the health provider&#39;s spoken words into written text. The recorded voice and text may both be saved into the patient&#39;s medical records  72 . 
     The database  34  may also contain identifying information of every known medication listed in the Physician&#39;s Desk Reference  88 . Both PDR illustrations and explanations of each medication are accessible through the website  16  to the physician, patient, pharmacist and other health care professional that use the system  10 . Using proprietary image processing software  90 , each medication is recognized by the camera  14  and a list of medications along with each PDR picture of the medication is retrieved to verify the accuracy of the medication presented by the patient and/or home health care provider assisting the patient. An image or identifier of each recognized medication may be saved to the file  72 . 
     The caregiver computer  18  may be installed in emergency vehicles, cars, trucks, recreational vehicles, airplanes, military vehicles and helicopters. The system  10  can also be installed in public areas for emergency access by a physician or other emergency health care professional. 
     The system  10  can be used by homebound patients, hospitals, dialysis centers, or skilled nursing centers from anywhere in the world. This availability is fostered by access through the internet and allows telemedicine sessions to be conducted from anyplace in the world. 
     Data transmission and storage in the system  10  is 256 bit data encrypted to protect the patient&#39;s privacy. Additionally, data stored on the secure data base repository system  34  is backed up as shown in  FIG. 1  through the use of a redundant data base system stored at a separate secure location. Patient data can only be retrieved by authorized medical professionals, patients and family members. 
     In order to conference in a consultant, the healthcare provider may use a process similar to WebX for conferencing. In this case, however, the conference may be set up using a real time message (e.g., a chat message) through the website. 
     In order to invite a consultant to join the conference, the healthcare provider may select consultants from a menu of consultants and activate an invite softkey for each consultant to be added to the conference. Upon activation of the invite softkey, the conferencing application  42 ,  44  opens a respective consultant viewing window  46 ,  48 ,  50 ,  52 ,  54  and sends a chat message to the website  16  identifying the consultants and a respective audio/video port within the caregiver&#39;s computer for use during that consultation. The website  16 , in turn, may activate a respective conference handling application  56 ,  58  for each consultant and forward the message to a respective computer  26  of the selected consultants. 
     A tracking application  62  associated with the website  16  may also maintain a tracking list  64  of consultants. In addition to maintaining a tracking list of consultants, the tracking application  62  may also assign a unique identifier to the conference and associate that unique identifier with the identifier of the patient. 
     If the consultant accepts the conferencing offer, a corresponding communication application  60  within a computer  26  of the consultant may send an acceptance message to the website  16 . The invite message from the website  16  to the consultant may identify a communication audio/video port of the conferencing application  56 ,  58  for use during the conference. The acceptance message from the consultant returned to the website  16  may identify a corresponding communication port within the conferencing application  60  of the consultant. Upon receipt of the acceptance message from the consultant by the website, the website may send an acceptance message to the caregiver&#39;s computer identifying an audio/video port on the activated conferencing application  56 ,  58  associated with the consultant. The identified port of the consultant is also added to the tracking list  64 . 
     In addition to responding to the invite, the consultant&#39;s computer may also activate a video camera and microphone. Once activated, the consultant&#39;s computer may begin sending audio and video packets to the identified port of the respective conference handling application  56 ,  58 . The conferencing application  56 ,  58  may receive the audio and video packets from the consultant and forward them to the identified port of the conferencing application  42 ,  44  within the caregiver&#39;s computer  18 . In addition to forwarding the audio and video packet to the caregivers computer  18 , the respective conferencing application  56 ,  58  also forwards the audio and video packets to the respective receive ports of any other consultant present within the tracking list  64 . 
     Similarly, once the consultant viewing application  42 ,  44  within the caregiver&#39;s computer begins receiving audio/video from the consultant  26 , the conferencing application  42 ,  44  may open a viewing window  46 ,  48 ,  50 ,  52 ,  54  and begin displaying video from the consultant in the opened window. The caregiver computer may also activate a video camera and microphone and begin collecting audio/video information regarding the caregiver and/or patient. The collected audio/video is transferred through the identified port of the caregiver&#39;s computer to the corresponding identified port of the conferencing application  56 ,  58  of the website. The website in turn forwards the audio/video to the consultant&#39;s computer and two-way audio/video communication is established. 
     Once the two-way audio/video connection is established, the caregiver/patient may begin conversing with the consultant  26 . As noted above, the conferencing application (e.g.,  42 ) opens a first consultant window (e.g.,  46 ) on the display of the caregiver&#39;s computer. Within the first consultant window  46 , the consultant viewing application displays video from the consultant&#39;s computer while at the same time routing audio from the consultant to a sound card within the caregiver&#39;s computer  18 . At the same time the video camera and microphone collects audio/video of the caregiver/patient and forwards the audio/video to the consultant. 
     In addition to displaying audio and video from the caregiver/patient  18 , each consultant  26  also displays audio and video from any other consultant  26  that has accepted an invitation from the caregiver/patient  18 . In this case, the audio and video from each consultant  26  is forwarded to any other consultant present within the tracking list  64 . Upon receipt of audio and video from other consultants  26 , a new conferencing application  62  and window  65 ,  66 ,  68 ,  70 ,  72  is opened so that each consultant would hear and observe any other consultant that is added by the caregiver/patient  18  to the conference. 
     During the conversation, the consultant or caregiver may determine that further biometric information may need to be collected from the patient. In this case, the caregiver may connect one or more biometric parameter collection devices  38 ,  40  to the caregiver&#39;s computer  18 . In this case, the connection to the biometric parameter collection device  38 ,  40  may be established through an appropriate connection (e.g., serial, parallel, USB, firewire, etc.) on the caregiver&#39;s computer  18 . Software associated with the biometric parameter collection device  38 ,  40  may open a window  36  on the caregiver&#39;s computer  18  that displays the biometric parameters to the caregiver. 
     The opening of the window  36  for display of the biometric parameters of the patient is independent of the consultant windows  46 ,  48 ,  50 ,  52 ,  54  displaying audio/video from the consultants. The caregiver may adjust the size of the biometric window  36  as appropriate for viewing convenience. 
     Once the biometric window  36  has been opened, the caregiver may also activate the data collection application  30 . Once activated, the data collection application  30  captures  112  any information presented within the window  36  and forwards the captured information to the data collection application  32  where the captured information is associated  114  with the patient file  72 . The captured information is archived as discussed above and is also sent to any consultant present within the tracking list  64 . In this regard, the receipt of captured data from the data handling application causes the activation of a corresponding data display application  63  and the opening of a data display window  65  on the consultant&#39;s computer. 
     The captured information from the biometric window  36  may be archived in the database  34  in the patient file  72  or under the unique identifier assigned by the tracking application  62  for use in conjunction with the patient data file  72 . The tracking application may also save the audio and video of the caregiver/patient  18  and of each consultant  26  under that same identifier as well as save the start and ending times of the conference and identifiers of the individual consultants. 
     Also associated with each consultant terminal  26  (or website  16 ) is a billing application  78 . Periodically, the consultant may activate the billing application  78  and enter an identifier of a patient or the unique identifier of the conference assigned by the tracking application  62 . In response, the billing application  78  may retrieve an identifier  76  of an insurance carrier (or other responsible party) and the time spent by the consultant during conferences with the identified patient. The billing application  78  may also retrieve the audio and video from the conference for viewing by the consultant in the case where the consultant no longer remembers the subject matter of the conference. 
     The billing application  78  may also process  120  the file  72  and generate an invoice or bill  78  pre-populated with the relevant information including the patient name, the physician&#39;s name and identifier and conference times. The consultant  26  may enter the appropriate billing codes (e.g., evaluation and maintenance (E&amp;M) codes, current procedural terminology (CPT) codes, etc.)  80 . Once an invoice is completed, the billing application  78  may automatically submit the invoices to the insurer  22  or other responsible party for payment. 
     The system  10  offers significant advantages over prior art systems. In the case of bedridden patients, the system  10  allows one or more consultants to converse and view biometric parameters of the patient without having to be in the same room as the patient. Similarly, consultants can join a conference from whatever location is convenient for the consultant. 
     Similarly, the biometric window  66  allows any of a number of different biometric parameters to be viewed in real time. Alternatively, past recordings of biometric parameters can be retrieved from a patient record  72  for comparison with current readings. 
     A specific embodiment of method and apparatus for conferencing consultants has been described for the purpose of illustrating the manner in which the invention is made and used. It should be understood that the implementation of other variations and modifications of the invention and its various aspects will be apparent to one skilled in the art, and that the invention is not limited by the specific embodiments described. Therefore, it is contemplated to cover the present invention and any and all modifications, variations, or equivalents that fall within the true spirit and scope of the basic underlying principles disclosed and claimed herein.