Patent Publication Number: US-2011071849-A1

Title: System and method for obtaining medical records

Description:
TECHNICAL FIELD 
     This disclosure relates to medical records and, more particularly, to the management of medical records. 
     BACKGROUND 
     Patients are often treated by a multiplicity of medical professionals. For example, a patient may use a general practitioner for routine medical care. Additionally, the patient may use several specialized practitioners to treat various ailments. Examples of such specialized practitioners may include but are not limited to neurologists, cardiologists, and oncologists. 
     Often, when a patient is referred to a specialized practitioner from a general practitioner, the specialized practitioner may request a copy of the various medical records concerning the patient. For example, if the general practitioner referred the patient to a cardiologist due to the patient failing a stress test, the cardiologist may request a copy of the medical records associated with the stress test so that the patient does not have to undergo duplicative testing procedures. 
     Typically, the responsibility of obtaining copies of the patient&#39;s medical records is often placed on an administrator or assistant within the office of the specialized practitioner. Unfortunately, this task often proves difficult due to the high existing workloads of administrators/assistants and the lack of existing business relationships between the office of the specialized practitioner and the office of the general practitioner. 
     The responsibility for obtaining copies of the patient&#39;s medical records may also fall on the patient. This can cause significant additional stress to the patient, particularly since it is during a time of ill health. Furthermore, patients typically do not have the training to validate that the records they are collecting are the correct ones, and if they show up at the specialized practitioner without their records, or the incorrect ones, they may have to cancel the appointment and reschedule, causing further stress to the patient, and unrecoverable costs to the specialist. 
     SUMMARY OF DISCLOSURE 
     In one implementation of this disclosure, a computer-implemented method includes obtaining a first medical record for a first patient from a first image provider within a health information exchange, and obtaining a second medical record for a second patient from a second image provider within the health information exchange. The availability of the first medical record and the second medical record is enabled to a medical services provider. 
     One or more of the following features may be included. The medical services provider may be required to authenticate their identity. Enabling the availability may include enabling the availability of an electronic view of the first medical record and an electronic view of the second medical record to the medical services provider. The electronic view of the first medical record may be streamed to the medical services provider. The electronic view of the second medical record may be streamed to the medical services provider. 
     Obtaining the first medical record for the first patient may include retrieving the first medical record for the first patient via a first image server of the first image provider. Obtaining the second medical record for the second patient may include retrieving the second set of medical records for the second patient via a second image server of the second image provider. 
     A request for a third medical record for a third patient from a third image provider within the health information exchange may be received. The request for the third medical record for the third patient from the third image provider within the health information exchange may be processed. The third medical record for the third patient from the third image provider within the health information exchange may be obtained. The availability of the third medical record to the medical services provider may be enabled. One or more of the first and second medical records may be an image-based medical record. The medical services provider may be chosen from the group consisting of: a general clinician; and a specialized clinician. 
     In another implementation of this disclosure, a computer program product resides on a computer readable medium and has a plurality of instructions stored on it. When executed by a processor, the instructions cause the processor to perform operations including obtaining a first medical record for a first patient from a first image provider within a health information exchange, and obtaining a second medical record for a second patient from a second image provider within the health information exchange. The availability of the first medical record and the second medical record is enabled to a medical services provider. 
     One or more of the following features may be included. The medical services provider may be required to authenticate their identity. Enabling the availability may include enabling the availability of an electronic view of the first medical record and an electronic view of the second medical record to the medical services provider. The electronic view of the first medical record may be streamed to the medical services provider. The electronic view of the second medical record may be streamed to the medical services provider. 
     Obtaining the first medical record for the first patient may include retrieving the first medical record for the first patient via a first image server of the first image provider. Obtaining the second medical record for the second patient may include retrieving the second set of medical records for the second patient via a second image server of the second image provider. 
     A request for a third medical record for a third patient from a third image provider within the health information exchange may be received. The request for the third medical record for the third patient from the third image provider within the health information exchange may be processed. The third medical record for the third patient from the third image provider within the health information exchange may be obtained. The availability of the third medical record to the medical services provider may be enabled. One or more of the first and second medical records may be an image-based medical record. The medical services provider may be chosen from the group consisting of: a general clinician; and a specialized clinician. 
     The details of one or more implementations are set forth in the accompanying drawings and the description below. Other features and advantages will become apparent from the description, the drawings, and the claims. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a diagrammatic view of a record management process executed in whole or in part by a computer coupled to a distributed computing network; 
         FIG. 2  is a flowchart of the record management process of  FIG. 1 ; 
         FIG. 3  is a diagrammatic view a personal digital assistant configured to access the record management process of  FIG. 1 ; and 
         FIG. 4  is a diagrammatic view of a cellular telephone configured to access the record management process of  FIG. 1 . 
     
    
    
     DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS 
     System Overview: 
     Referring to  FIGS. 1 &amp; 2 , there is shown a record management process  10 , which may be a server-based application resident on (in whole or in part) and executed by (in whole or in part) management computer  12  (e.g., a single server computer, a plurality of server computers, or a general purpose computer, for example). As will be discussed below in greater detail, record management process  10  may obtain  100  first medical record  14  for first patient  16  from first image provider  18  within a health information exchange. Record management process  10  may obtain  102  second medical record  20  for second patient  22  from second image provider  24  within the health information exchange. Examples of first and second medical records  14 ,  20  may include but are not limited to image-based medical records. Record management process  10  may enable  104  the availability of first medical record  14  and the second medical record  16  to medical services provider  26 . 
     Management computer  12  may be coupled to network  28  (e.g., the Internet). Management computer  12  may be, for example, a web server running a network operating system, examples of which may include but are not limited to Microsoft Windows 2008 Server™, or Redhat Linux™. 
     Management computer  12  may also execute a web server application, examples of which may include but are not limited to Microsoft IIS™, or Apache Webserver™, that allows for HTTP (i.e., HyperText Transfer Protocol) or HTTPS (i.e. Hypertext Transfer Protocol Secure) access to management computer  12  via network  28 . Network  28  may be coupled to one or more secondary networks (e.g., network  30 ), such as: a local area network; a wide area network; or an intranet, for example. Additionally/alternatively, management computer  12  may be coupled to network  28  through secondary network  30 , as illustrated with link line  32  (shown in phantom). 
     The instruction sets and subroutines of record management process  10 , which may be stored on a storage device  34  coupled to management computer  12 , may be executed by one or more processors (not shown) and one or more memory architectures (not shown) incorporated into management computer  12 . Storage device  34  may include but is not limited to a hard disk drive, a tape drive, an optical drive, a RAID array, a random access memory (RAM), or a read-only memory (ROM). 
     Medical services provider  26  (or additional medical services providers  36 ,  38 ) may access record management process  10  (directly through network  28  or through secondary network  30 ) using various client electronic devices, examples of which may include but are not limited to: provider computer  40 , personal digital assistant  42 , data-enabled cellular telephone  44 , laptop computers (not shown), and dedicated network appliances (not shown), for example. Examples of medical services providers  26 ,  36 ,  38  may include but are not limited to general clinicians and specialized clinicians. 
     The various client electronic devices may be directly or indirectly coupled to network  28  (or network  30 ). For example, provider computer  40  is shown directly coupled to network  28  via a hardwired network connection. Further, personal digital assistant  42  is shown wirelessly coupled to network  28  via a wireless communication channel  46  established between personal digital assistant  42  and wireless access point (i.e., WAP)  48 , which is shown directly coupled to network  28 . Additionally, cellular telephone  44  is shown wirelessly coupled to cellular network/bridge  50 , which is shown directly coupled to network  30 . 
     WAP  48  may be, for example, an IEEE 802.11a, 802.11b, 802.11g, 802.11n, Wi-Fi, and/or Bluetooth device that is capable of establishing secure communication channel  46  between personal digital assistant  42  and WAP  48 . 
     As is known in the art, all of the IEEE 802.11x specifications use Ethernet protocol and carrier sense multiple access with collision avoidance (i.e., CSMA/CA) for path sharing. The various 802.11x specifications may use phase-shift keying (i.e., PSK) modulation or complementary code keying (i.e., CCK) modulation, for example. As is known in the art, Bluetooth is a telecommunications industry specification that allows e.g., mobile phones, computers, and personal digital assistants to be interconnected using a short-range wireless connection. 
     Client Software: 
     Provider computer  40  may execute provider application  52 , examples of which may include but are not limited to a web browser application (e.g., Microsoft Internet Explorer™ and Netscape Navigator™), an email client (Microsoft Outlook™, Lotus Notes™, and Novell Groupwise™), a data viewing application (e.g., Citrix Access Gateway™), and a specialized interface that allows e.g., medical services provider  26  to access and configure record management process  10 , view (to be discussed below) first medical record  14  and/or second medical record  20 , and request additional medical records. Provider computer  40  may execute an operating system, examples of which may include but are not limited to Microsoft Windows Vista™ or Redhat Linux™. 
     The instruction sets and subroutines of provider application  52 , which may be stored on a storage device  54  coupled to provider computer  40 , may be executed by one or more processors (not shown) and one or more memory architectures (not shown) incorporated into provider computer  40 . Storage device  54  may include but is not limited to a hard disk drive, a tape drive, an optical drive, a RAID array, a random access memory (RAM), or a read-only memory (ROM). 
     Personal digital assistant  42  and/or cellular telephone  44  may execute provider applications  56 ,  58  (respectively), examples of which may include but are not limited to a web browser application (e.g., Microsoft Internet Explorer™ and Netscape Navigator™), an email client (Microsoft Outlook™, Lotus Notes™, and Novell Groupwise™), a data viewing application (e.g., Citrix Access Gateway™), or a specialized interface that allows e.g., medical services providers  36 ,  38  (respectively) to access and configure record management process  10 , view (to be discussed below) first medical record  14  and/or second medical record  20 , and request additional medical records. 
     Personal digital assistant  42  and/or cellular telephone  44  may execute an operating system, examples of which may include but are not limited to Microsoft Windows Mobile™, Redhat Linux™, Palm OS™, iPhone, or a device-specific (i.e., custom) operating system. 
     The instruction sets and subroutines of provider applications  56 ,  58 , which may be stored on a storage device  60 ,  62  (respectively) coupled to personal digital assistant  42  and/or cellular telephone  44  (respectively), may be executed by one or more processors (not shown) and one or more memory architectures (not shown) incorporated into personal digital assistant  42  and/or cellular telephone  44 . Storage device  60 ,  62  may include but are not limited to a hard disk drive, a tape drive, an optical drive, a RAID array, a random access memory (RAM), a read-only memory (ROM) a Compact Flash (CF) card, a Secure Digital (SD) card, a SmartMedia card, a Memory Stick, and a MultiMedia card, for example. 
     First image provider  18  may provide first medical record  14  for first patient  16  to management computer  12  via first image server  64 . First image server  64  may execute image server application  66  that effectuates the transfer of first medical record  14  to management computer  12  (via network  28  and/or network  30 ). First image server  64  may execute an operating system, examples of which may include but are not limited to Microsoft Windows Vista™ or Redhat Linux™. 
     The instruction sets and subroutines of image server application  66 , which may be stored on a storage device  68  coupled to first image server  64 , may be executed by one or more processors (not shown) and one or more memory architectures (not shown) incorporated into first image server  64 . Storage device  68  may include but is not limited to a hard disk drive, a tape drive, an optical drive, a RAID array, a random access memory (RAM), or a read-only memory (ROM). 
     Second image provider  24  may provide second medical record  20  for second patient  22  to management computer  12  via second image server  70 . Second image server  70  may execute image server application  72  that effectuates the transfer of second medical record  20  to management computer  12  (via network  28  and/or network  30 ). Second image server  70  may execute an operating system, examples of which may include but are not limited to Microsoft Windows Vista™ or Redhat Linux™. 
     The instruction sets and subroutines of image server application  72 , which may be stored on a storage device  74  coupled to second image server  70 , may be executed by one or more processors (not shown) and one or more memory architectures (not shown) incorporated into second image server  70 . Storage device  74  may include but is not limited to a hard disk drive, a tape drive, an optical drive, a RAID array, a random access memory (RAM), or a read-only memory (ROM). 
     Record Management Process: 
     As discussed above, record management process  10  may obtain  100  first medical record  14  for first patient  16  from first image provider  18  within a health information exchange. Record management process  10  may obtain  102  second medical record  20  for second patient  22  from second image provider  24  within the health information exchange. Record management process  10  may enable  104  the availability of first medical record  14  and second medical record  16  to medical services provider  26 . 
     For illustrative purposes, assume that first image provider  18  is a medical image service provider that provides x-ray image services. Further assume that first patient  16  is being treated by medical services provider  26 , who referred patient  16  to first image provider  18  for x-ray services. Accordingly, x-ray images of first patient  16  were generated. These x-ray images may be in a native digital format or converted into a digital format. Once digitized, these x-ray images (in the form of first medical record  14 ) may be provided (via network  28  and/or network  30 ) to management computer  12  via first image server  64  that (as discussed above) executes image server application  66 . 
     The manner in which first medical record  14  is provided to management server  12  may vary depending on the way in which record management process  10  and/or image server application  66  is configured. For example, once digitized, first medical record  14  may be placed into a queue resident on/accessible by e.g., first image server  64 . First medical record  14  may only be provided to management server  12  (and record management process  10 ) upon record management process  10  retrieving  106  first medical record  14 . Accordingly, record management process  10  and/or image server application  66  may be configured in a “pull” fashion, in that record management process  10  pulls information (i.e., first medical record  14 ) from first image server  64 . 
     Alternatively, once digitized, first image server  64  may provide first medical record  14  to management server  12  (and record management process  10 ) without record management process  10  needing to request first medical record  14 . Accordingly, record management process  10  and/or image server application  66  may be configured in a “push” fashion in that the information (i.e., first medical record  14 ) is pushed from first image server  64  to record management process  10 . 
     For illustrative purposes, assume that second image provider  24  is a medical image service provider that provides MRI image services. Further assume that second patient  22  is being treated by medical services provider  36 , who referred patient  22  to second image provider  24  for MRI services. Accordingly, MRI images of second patient  22  were generated. These MRI images may be in a native digital format or converted into a digital format. Once digitized, these MRI images (in the form of second medical record  20 ) may be provided (via network  28  and/or network  30 ) to management computer  12  via second image server  70  that (as discussed above) executes image server application  72 . 
     The manner in which second medical record  20  is provided to management server  12  may vary depending on the way in which record management process  10  and/or image server application  72  is configured. For example, once digitized, second medical record  20  may be placed into a queue resident on/accessible by e.g., second image server  72 . Second medical record  20  may only be provided to management server  12  (and record management process  10 ) upon record management process  10  retrieving  108  second medical record  20 . Accordingly, record management process  10  and/or image server application  72  may be configured in a “pull” fashion, in that record management process  10  pulls information (i.e., second medical record  20 ) from second image server  70 . 
     Alternatively, once digitized, second image server  70  may provide second medical record  20  to management server  12  (and record management process  10 ) without record management process  10  needing to request second medical record  20 . Accordingly, record management process  10  and/or image server application  72  may be configured in a “push” fashion in that the information (i.e., second medical record  20 ) is pushed from second image server  70  to record management process  10 . 
     Once record management process  10  obtains  100 ,  102  medical records  14 ,  20 , record management process  10  may store medical records  14 ,  20  on e.g., storage device  34  coupled to management computer  12 . 
     Once e.g., medical records  14 ,  20  are available via record management process  10 , medical services providers  26 ,  36 ,  38  may access medical records  14 ,  20 . For example, record management process  10  may enable  104  the online availability of an electronic view of first medical record  14  and an electronic view of second medical record  20  to e.g., medical services providers  26 ,  36 ,  38 . For example, an electronic view of first medical record  14  and/or second medical record  20  may be streamed  110  to the medical services providers (e.g., medical services providers  26 ,  36 ,  38 ) from management computer  12 . 
     Prior to accessing medical records  14 ,  20 , medical services providers  26 ,  36 ,  38  may be required to authenticate  112  their identity. For example, medical services provider  26  may be required to provide record management process  10  with one or more unique identifiers assigned to medical services provider  26 , examples of which may include but are not limited to an account number, a customer number, a password, and a PIN (i.e., personal identification number) code, for example. For example, upon submitting an electronic request  76  to record management process  10 , medical services provider  26  may be required to enter a confidential customer number. 
     Electronic request  76  may be prepared by medical services provider  26  via provider application  52 . As discussed above, examples of provider application  52  may include but are not limited to a web browser application (e.g., Microsoft Internet Explorer™ and Netscape Navigator™), an email client (Microsoft Outlook™, Lotus Notes™, and Novell Groupwise™), a data viewing application (e.g., Citrix Access Gateway™), or a specialized interface. When preparing request  76 , an electronic request template (not shown and populatable by provider application  52 ) may be used to define the data fields required for a complete request. For example, the electronic request template may include a patient name field, a patient address field, a patient social security number field, a patient birth date field, and a requested medical records field, for example. 
     Additionally, when contacting data management process  10 , medical services providers  26 ,  36 ,  38  may be required to provide sufficient information to identify the patient in question and the specific medical records desired. For example, medical services provider  26  may provide record management process  10  with e.g., the name of the patient, the address of the patient, the social security number of the patient and/or the birth date of the patient, for example. Additionally, medical services provider  26  may define the specific medical records desired from record management process  10 . 
     Continuing with the above stated example, assume that medical services provider  26  requests (via electronic request  76 ) medical records  14 ,  20  from record management process  10 . Upon receiving electronic request  76 , data management process  10  may process  114  (e.g., approve/reject) electronic request  76 . 
     If approved, data management process  10  may enable  104  medical services provider  26  to access first medical record  14  and the second medical record  20 . For example, data management process  10  may provide medical services provider  26  with a secure link (e.g., a uniform resource locator) that allows medical services provider  26  to access first medical record  14  and the second medical record  20 . Alternatively, first medical record  14  and the second medical record  20  may be added to a list of medical records accessible to medical services provider  26 , as defined within a secure remotely-accessible common directory within management computer  12 . Further and as discussed above, management computer  12  may execute a web server application that allows for HTTP or HTTPS access to management computer  12  via networks  28 ,  30 . Accordingly, management computer  12  may serve a web-based portal (not shown) for medical services provider  26 . Therefore, access to medical records  14 ,  20  may be effectuated via this web-based portal (not shown). When accessing the web-based portal (not shown), medical services provider  26  may be presented with a plurality of links (e.g., uniform resource locators) that point to various medical records available for various patients. For example, the web-based portal (not shown) may include a first link that allows medical services provider  26  to access first medical record  14  and a second link that allows medical services provider  26  to access second medical record  20 . 
     Once medical records  14 ,  20  are accessible by medical services provider  26 , the manner in which medical services provider  26  obtains the requested medical records (e.g., medical records  14 ,  20 ) may vary depending on the manner in which data management process  10  is configured. For example, data management process  10  may be configured to allow medical services provider  26  to download a copy of the requested medical records (e.g., medical records  14 ,  20 ) from management computer  12  to e.g., provider computer  40 . 
     Alternatively, downloading may be prohibited and data management process  10  may be configured to only allow the requested medical records (e.g., medical records  14 ,  20 ) to be streamed  110  from management computer  12  to e.g., provider computer  40 . Specifically, by prohibiting the downloading of the medical records (e.g., medical records  14 ,  20 ) and only allow the user of data management process  10  to view the remotely-stored medical records (e.g., medical records  14 ,  20 ), the security and privacy of the medical records (e.g., medical records  14 ,  20 ) is enhanced. Typically, when the requested medical records (e.g., medical records  14 ,  20 ) are streamed  110  from e.g., management computer  12  to provider computer  40 , only a real-time view of the medical records is provided to provider computer  40 , and a copy of the requested medical records (e.g., medical records  14 ,  20 ) is never downloaded directly to provider computer  40 . Examples of a provider application (e.g., provider applications  52 ,  56 ,  58 ) that allow for such data streaming  110  may include, but are not limited to: Citrix Access Gateway™ available from Citrix Systems™ of Fort Lauderdale, Fla.; and eHealthViewer™ available from eHealth Global Technologies, Inc. of Rochester, N.Y. 
     When streaming  110  the requested medical records (e.g., medical records  14 ,  20 ) from e.g., management computer  12  to provider computer  40 , the resolution of the image streamed may be initially reduced to the maximum resolution of the device upon which the user is viewing the image or the resolution of the application window through which the user is viewing the image. For example, if the resolution of an image included within medical record  20  is 2,048×2,048 pixels and this image is being streamed to and viewed on personal digital assistant  42  (which has a maximum screen resolution of 320×320 pixels), the resolution of the image included within medical record  20  may be reduced to 320×320 pixels to allow for faster viewing of the image. However, through the use of provider application  56 , medical services provider  36  may be able to zoom in on a specific portion of the image included within medical record  20  and that portion of the image may be provided in the original resolution of the image. 
     Data management process  10  may be configured to process the requested medical records (e.g., medical records  14 ,  20 ) prior to streaming  110  the requested information from e.g., management computer  12  to provider computer  40 . For example, assume that the image included within medical record  20  includes a plurality of discrete images representative of individual slices within a three-dimensional MRI image. Accordingly and through the use of provider application  56 , medical services provider  36  may be able to request that data management process  10  assemble those discrete individual slices into a three-dimensional MRI image. Accordingly, data management process  10  and management computer  12  may perform the necessary processing to generate the three-dimensional MRI image and then a view of that three-dimensional MRI image may be streamed to personal digital assistant  42  of medical services provider  36 . Therefore, personal digital assistant  42  is not required to do the processor-intensive calculations required to generate the three-dimensional image, thus allowing for the use of light-weight client devices. 
     In addition to the requested medical records (e.g., medical records  14 ,  20 ) being accessible via e.g., provider computer  40 , the requested medical records (e.g., medical records  14 ,  20 ) may be available via one or more mobile devices, examples of which may include but are not limited to personal digital assistant  42  and cellular telephone  44 . As discussed above, personal digital assistant  42  and cellular telephone  44  may execute provider applications  56 ,  58  (respectively) to facilitate access to record management process  10 , and view the medical records (e.g., medical records  14 ,  20 ) stored on e.g., management computer  12 . Accordingly, medical services provider  36  may use personal digital assistant  42  to access e.g., image  150  of an X-ray (as shown in  FIG. 3 ) included within the requested medical records (e.g., medical records  14 ,  20 ) and/or medical services provider  38  may use cellular telephone  44  to access image  200  of an X-ray (as shown in  FIG. 4 ) included within the medical records (e.g., medical records  14 ,  20 ). 
     There may be occasions in which a medical services provider is looking for a medical record that is not currently available via data management process  10 . For example, an indication that the medical record is available may be due to e.g., a radiology expert being listed as an image provider for a particular patient, although no such medical record is shown as being available. Accordingly, data management process  10  may allow the medical services provider to request the “missing” medical record (via e.g., electronic request  76 ). Data management process  10  may process  114  the received request and obtain  100 ,  102  the “missing” medical record by contacting the appropriate image server application (e.g., image server application  66 ,  72 ). 
     While data management process  10  is described above as being a stand-alone service, this is for illustrative purposes only and is not intended to be a limitation of this disclosure, as other configurations are possible. Specifically, data management process  10  may be a web service included within a larger system, such as a health information exchange software system. 
     A number of implementations have been described. Nevertheless, it will be understood that various modifications may be made. Accordingly, other implementations are within the scope of the following claims.