Patent Publication Number: US-2015081315-A1

Title: Method for selecting medical imaging protocols

Description:
FIELD OF THE INVENTION 
     The present invention relates in general to a method for facilitating communication between a physician and radiologist and, more specifically, to a method for facilitating the ability of a physician and radiologist to determine appropriate patient protocols for medical imaging using various modalities. 
     BACKGROUND OF THE INVENTION 
     Creating various images of the human body for medical purposes, otherwise know as medical imaging, is well known in the art. Medical imaging can involve different modalities, such as computed axial tomography (CAT scan), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), ultrasound, and others. Each modality has a particular protocol for a generating a particular medical image. A protocol may include such specifications as scanning speed, contrast, focal point, rotation rate, etc. 
     To manage images generated through these various modalities and protocols, medical centers often create internal databases. Such databases are useful for storing and retrieving medical images, but they are less useful for providing guidance as to which modalities and protocols may be most appropriate for a new patient. While a physician could recall a similar image taken of a previous patient, retrieve that image, and order the same protocol for a new patient, such a process would be cumbersome, and would be unlikely to result in an optimized protocol for a given patient. 
     Many modalities come with a database of known protocols. Medical centers can provide physicians access to these databases, allowing the physician to search for a particular protocol for a given modality. One drawback associated with such databases is that they are often modality specific. If a physician wants to order protocols using three different modalities, the physician may have to search three separate databases to find the three desired protocols. It would be desirable to provide a single database containing all protocols for the medical center&#39;s modalities. 
     It is known to use a standard protocol database, such as the American College of Radiology (ACR) Appropriateness Criteria (AC) to search a wide range of protocols associated with various modalities. One drawback associated with such standardized databases is that they do not include custom protocols that the medical center may have developed for their own modalities. Another drawback is that such prior art databases do not maximize collaboration between the physician and the radiologist regarding protocol appropriateness and do not warn when a particular protocol is out of specification for the particular modality or patient history. It would be desirable to provide a database that allowed for the inclusion of custom protocols, better facilitated collaboration between the physician and the radiologist regarding protocol appropriateness, and warned if the ordered protocol is out of specification. The difficulties encountered in the prior art heretofore are substantially eliminated by the present invention. 
     SUMMARY OF THE DISCLOSED SUBJECT MATTER 
     In an advantage provided by this invention, a method for customizing medical imaging protocols is provided. 
     In an advantage provided by this invention, a method for searching medical imaging protocols is provided. 
     In an advantage provided by this invention, a method for facilitating collaboration between a physician and a radiologist is provided. 
     In an advantage provided by this invention, a method for warning of out of specification protocols is provided. 
     The present invention relates to a method for generating radiological images. A physician examines a patient and submits the client history to a computer system. The system selects protocols associated with modalities accessible to the patient and ranks them in order of appropriateness. The physician selects the desired protocol and orders the protocol. A radiologist receives the protocol and the ranked protocols and decides if the protocol is appropriate. The radiologist may accept the protocol, select a different protocol, collaborate with the physician regarding the appropriate protocol and/or generate a new protocol in view of the patient history. The radiologist then orders the protocol. A technician runs the protocol to generate a radiological image. The radiologist receives the image, generates a report and makes the report and radiological image available to the physician. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
       The present invention will now be described, by way of example, with reference to the accompanying drawings in which: 
         FIG. 1  is a block diagram of the medical imaging system of the present invention; 
         FIG. 2  is a block diagram of a webpage showing client history; and 
         FIG. 3  is a block diagram of a webpage showing a plurality of protocols ranked according to appropriateness. 
     
    
    
     DETAILED DESCRIPTION OF THE DRAWINGS 
     As shown in  FIG. 1 , a method for selecting medical imaging protocols is shown generally as  10 . To begin the process, a physician  12  examines a patient  14  and generates a history  16  in a manner such as that known in the art ( FIGS. 1-2 ). Preferably, the history  16  is recorded on a client  18 . The client  18  may include a variety of different computing devices. Examples of client devices are personal computers, digital assistance, personal digital assistance, mobile phones, smart phones, tablet devices, notebook devices, or laptop computers. In the preferred embodiment, the client  18  is a tablet device  20  having a screen  22  and a keyboard  24 , which, in the preferred embodiment, is displayed on the screen  22 . If after the physician  12  has collected the patient history  16  and the physician  12  determines that medical imaging is indicated, the physician  12  uses the client  18  to execute a browser  26  that connects to a server  28  via a network  30 . The network  30  is typically the Internet, but may also be any network, including, but not limited to, a LAN, MAN, WAN, a mobile, a wired or wireless network, a private network, or a virtual private network. Although only a single client  18  and browser  26  are shown, it is to be understood that any desired number of clients or browsers may be supported and can be in communication with the server  28  at any given time. If desired, multiple servers may be used. 
     When the physician  12  uses the client  18  and the browser  26  to contact the server  28 , the server returns a webpage  32 , as shown in  FIG. 2 . As used herein, the term “webpage” means any system providing content, and is not limited to those systems supporting content provided via the Internet or http protocol. In general, functions described herein as being performed on the server side may also be performed on the client side, as appropriate. 
     As shown in  FIG. 2 , the webpage  32  presents the physician  12  with an interface  34  with several prompts  36  soliciting the physician  12  to enter information from the client history  16 . The webpage  32  may include instructions  38 , clickable responses  40  such as a yes/no indicator, drop down menus  42  to indicate the body part involved, and text fields  44  to provide a primary indication  46 , a secondary indication  48 , and keywords  50 . The webpage  32  also includes a search database button  52  that allows the physician  12  to search a protocol database  54  associated with the server  28 . Clicking the search database button  52  pulls up another webpage (not shown) allows the physician  12  to search the protocol database  54  by location, modality, patient history, body part, or any other desired search parameters. The webpage  32  is also provided with a search database button  56  that initiates a search of the protocol database  54  using the client history  58  input by the physician  12  onto the webpage  32 . 
     Once the physician  12  clicks the search database button  56 , the client  18  sends the patient history  16  across the network  30  to the server  28 , which receives the client history  16 . A central processing unit  60  associated with the server  28  uses computer executable code  62  to search the protocol database  54  for protocols associated with the patient history  16 . Preferably, the software  62  uses an algorithm that sorts protocols in the database  54  by appropriateness, selecting a predetermined number of protocols, such as  10  in the preferred embodiment, via the network  30  to the client  18  for display on the screen  22  of the tablet  20 , ranked in order of appropriateness. Preferably, the clicking on the search database button  52  also sends to the server  28  across the network  30 , metadata indicating the location of the medical center or facility associated with the tablet  20 , physician  12 , and/or patient  14 . Preferably, the protocol database  54  has information associated with the modalities available at the medical center at which the patient  14  will be examined. The central processing unit  60  of the server  28  uses the software  62  to return only those protocols from the database  54  associated with modalities available at the medical center at which the patient  14  will be examined. Additionally, the database  54  also contains custom protocols associated with either the physician  12 , the medical center, and/or a radiologist  64  associated with the medical center, physician  12 , or patient  14 . If desired, the database  54  may be propagated with existing protocols and modalities provided by modality manufacturers or third parties, such as the American College of Radiology (ACR) Appropriateness Criteria (AC) for any custom protocol selected by the medical center and/or any other desired protocols. 
     Once the server  28  has used the software  62  to select from the protocol database  54 , a plurality of protocols associated with a plurality of modalities associated with the patient history  16  and medical center and the one or more protocols has been received by the client  18  across the network  30 , the browser  36  displays the webpage  66 , displaying not only the highest rated protocol  68 , but the second  70 , third  72 , fourth  74 , and fifth  76  highest rated protocols associated with the medical center and the patient history  16 . The physician  12  doing the webpage  66  may use the client  18  to click on any of the displayed protocols  68 ,  70 ,  72 ,  74 , or  76 , click on the revise search button  78 , or the help button  80 . If the physician  12  does not find any of the ranked protocols  68 ,  70 ,  72 ,  74 , or  76  appropriate for the patient  14 , the physician  12  clicks on the revise search button to display a webpage (not shown) which allows the physician  12  to add additional client history, remove client history, search protocols in the database  54  directly, or add additional search criteria, such as changing the location of the medical center at which the patient  14  is to be treated, to increase the number and type of modalities searched. If the physician  12  finds one of the ranked protocols  68 ,  70 ,  72 ,  74 ,  76  appropriate, the physician  12  selects the desired protocol by clicking on the protocol on the webpage  66 . 
     Upon clicking on the desired protocol, the client  18  sends information regarding the protocol to the server  28  across the network  30 . The client  18  may also send metadata associated with the protocol, such as the patient information, patient history  16 , location of the medical center, and any other desired information. The server  28  uses the software  68  associated therewith, to send the desired protocol to a client  82  associated with the radiologist  64 . Like the client  18 , the client  82  is preferably a tablet  86 , having a screen  88  and a keyboard  90  provided on the screen  88 . The tablet  86  is also provided with a browser  92 . Preferably, the browser  92  receives from the server  28  across the network  30 , a webpage (not shown) displaying the protocol selected by the physician  12 . 
     The radiologist  64  reviews the protocol selected by the physician  12  and has several options. The radiologist  64  may approve of the protocol by clicking on an approval button (not shown) on the webpage. Alternatively, the radiologist  64  may contact the physician  12  to discuss the appropriateness of the protocol in light of the patient history  16 . Alternatively, the radiologist  64  may modify the protocol or may input a completely new protocol into the system  10 . Preferably, in the event that the radiologist  64  refuses or modifies the protocol selected by the physician  12 , the radiologist  64  will contact the physician  12  to discuss any issues the radiologist  64  has with the protocol selected by the physician  12 . 
     Once the radiologist  64  has approved of the protocol, the radiologist  64  indicates their approval by clicking on an approve button (not shown) or similar indication on the webpage (not shown) indicating that the protocol has been approved. The webpage may be designed such that by clicking on the approval button associated with the protocol, the system  10  automatically orders the protocol or there may be a separate button allowing the radiologist  64  to approve the protocol without ordering it. An example of where the radiologist  64  may wish to approve the protocol without ordering it may be where additional approval such as insurance or a second opinion is desired before the protocol is ordered. Once all the desired approvals have been obtained, the radiologist  64  clicks the approval button associated with the webpage, causing the software  62  associated with the server  28  to order the protocol by sending the protocol to a client  94  associated with a diagnostic imaging technician  96 . Preferably, the client  94  is a tablet  98 , having a screen  100  and a keyboard  102  displayed on the screen. The technician  96  views a webpage (not shown) displayed on the client  94  to determine the specifications to which to adjust the diagnostic imaging system  104  of modality associated with the protocol. Preferably, all the needed specifications associated with the protocol and modality are provided in the approved protocol. While the diagnostic imaging system  104  may be of any type known in the art, in the preferred embodiment, the modality of preferably computed axial tomography (CAT scan), computed tomography (CT), magnetic resonance imaging (MRI), positron emission tomography (PET), or ultrasound. 
     Once the technician experienced with the modality sets the modality to the appropriate specification such as scanning speed, contrast, focal point, rotation rate, etc., the technician  96  acquires a radiological image using the approved protocol. In the preferred embodiment, the radiological image or images are in a digital format stored on the computer. Preferably, the image or images are in a Digital Imaging and Communications in Medicine (DICOM) format to facilitate handling, storing, printing, and transmitting the radiological images. Once the radiological images have been acquired, the technician  96  uses the client  94  to upload the images to a database  106  associated with a Radiology Information System (RIS)  108  associated with a Hospital Information System (HIS)  110 . The database  106 , RIS  108 , and HIS  110  may be of any type well known in the art. 
     Alternatively, the technician  96  may use the client  94  to upload the images to the database  54  or another database (not shown) associated with the server  28  by sending the images across the network  30 . However, some administrators may wish to avoid transmitting sensitive patient information, such as the medical images, over the network  30  to maintain compliance with various laws and internal protocols. 
     As shown in the  FIG. 1 , the client  18  associated with the physician  12  and the client  82  associated with the radiologist  64  are also connected to the RIS  108  and HIS  110 , thereby allowing the physician  12  and radiologist  64  to access the medical images acquired of the patient  14  by the technician  96 . Preferably, before the physician  12  examines the images, the radiologist  64  will use the client  82  to download the image from the database  106  associated with the RIS  108  so that the radiologist  64  may examine the image and generate or prepare a radiological exam of the image. Preferably, the radiologist  64  inputs the radiological exam into the client  82  which the system associates with a medical image in the database  106  of the RIS  108 . After the radiologist  64  has generated the exam and uploaded the exam to the database  106 , the physician  12  may download the radiological image and exam to the client  18  for use in diagnosis and/or treatment of the patient  14 . 
     Although the invention has been described with respect to a preferred embodiment thereof, it is to be understood that it is not to be so limited since changes and modifications can be made therein which are within the full, intended scope of this invention as defined by the appended claims.