Patent Publication Number: US-2013231961-A1

Title: Method of Providing Web Based Access To Clinical Records

Description:
FIELD OF THE INVENTION 
     The invention relates to the access of clinical data. Specifically, the invention relates to systems and methods for accessing clinical data and records via the web using a thin client. 
     BACKGROUND OF THE INVENTION 
     Clinical data in hospitals and other medical facilities is often stored in a central server or set of servers located on-site at the facility. The central server is primarily accessed via computer terminals at the facility. These computer terminals are referred to a thick clients because data retrieved from the central server is processed on the computer terminal. The data stored on the system is acquired from a multitude of sources, such as the hospital&#39;s information system, billing system, and other, more specialized, data repositories. 
     A disadvantage of such known systems is that it is inconvenient for physicians and other medical staff working at the hospital to access clinical data stored on the central server or servers because they must log on to an on-site computer terminal to view the clinical data. 
     Another disadvantage of such known systems is that software for processing and receiving the clinical data executes on each on-site computer terminal. Such a system is expensive to maintain because each computer terminal must be addressed individually. 
     Another disadvantage of such known systems is that they do not enable a person outside the medical staff to access clinical data stored on the system. Patients, for example, cannot access their own clinical data. 
     Another disadvantage of such known systems is that they do not allow a physician who has referred a patient to the hospital where the patient&#39;s data is stored to access the data stored on the system. 
     There is a desire therefore for a system and method for providing access to clinical data that overcomes the limitations of the prior art. 
     SUMMARY OF THE INVENTION 
     It is accordingly an object of the present invention to provide a system and method that that overcomes the limitations of the prior art. 
     It is another object of the present invention to provide a system and method that provides hospital staff and physicians access to medical data from any electronic device connected to the Internet, or other network. 
     It is yet another object of the present invention to provide a web-based client to allow for the external viewing of medical data located on a hospital server. 
     It is another object or the present invention to provide a system and method that provides patient access to clinical data from any electronic device connected to the Internet, or other network. In some embodiments of the present invention patient access is limited to clinical data related to the patient. 
     It is yet another object of the present invention to provide a system and method that allows a physician, for example a referring physician, to access clinical data stored on the hospital server, thereby providing wide access to the system. In some embodiments of the present invention physician access is limited to clinical data related to one or more patients of the physician. 
     It is yet another embodiment of the present invention to employ tailored limitations and restrictions of access to individual patients or groups of patients based on patient permissions. In such embodiments, the central data server is no longer an insulated intramural closed system that neither patients nor referring physicians have access to. 
     It is yet another object of the present invention to provide a system and method that displays clinical data stored on a central hospital server to a thin client (e.g., desktop, notebook, tablet PC, handheld device, etc.). A thin client in some embodiments is a device that primarily handles input (e.g., user interaction) and output (e.g., displaying), while data processing is done on a separate server remote from the thin client. This is as opposed to a thick client, in which processing is done on the thick client device itself. While some of the devices listed above (desktop, notebook, etc.) can also act as thick clients, in some embodiments these devices act as thin clients. 
     It is yet another object of the present invention to provide a system and method for access to centrally stored clinical data wherein maintenance of the data processing software need only be implemented on software executing on the server. 
     It is yet another object of the present invention to provide a system and method for the display clinical data stored on a central hospital server on a browser on a thin client, wherein the interface within the browser allows the creation of multiple windows or panes which can be individually sized and individually positioned within the browser. In some embodiments, the number of individual panes can vary from one or two up to eight or more. The panes are variably sized in some embodiments, and multiple windows can have differing sizes. 
     It is yet another object of the present invention to provide a central server facility that servers multiple hospitals in multiple geographic locations, thereby improving the efficiency of server maintenance and upgrading, and application upgrading at both the server level and the client level. 
     It is yet another object of the present invention to employ remote hosting to hospitals on a subscription basis that allows hospitals to forego the high costs of hardware installation and on-site maintenance. 
     These and other objects of the present invention are achieved by a system and method for providing web access to clinical data including a server, a database in communication with the server, the database having a plurality clinical data sets. The system further includes a thin client, a communication link between the server and the Internet, and a communication link between the thin client and the Internet. Software executing on the server receives a request for one or more clinical data sets, retrieves the requested clinical data sets, and transmits the clinical data sets to the thin client. 
     In some embodiments of the present invention, software executing on the server generates a dashboard for display on the thin client. The dashboard comprises one of more window panes for displaying the clinical data sets on the thin client. 
     In some embodiments, because the application that is provided to the thin client runs on the server, modifications to the application need only be implemented in the central location rather than on each thin client device. This greatly simplifies the updating and maintenance of the application. Some embodiments do not permit caching of any data on the thin client. Other embodiments only permit the standard sort of caching that is associated with typical web applications and allowed by standard web browsers like Firefox and Internet Explorer. 
     In some embodiments, the web-based application allows patients to see their own records without being required to download software onto their computer. Such embodiments are restricted such that the patient (in contrast to healthcare workers associated with the hospital or other facility) will have access only to their own personal medical record and not to the entire list of patients in the hospital. Some embodiments associate a particular patient&#39;s password with that particular patient&#39;s medical record, and only allow the patient to view that particular record. In such embodiments, patients do not have the ability to browse other medical records within the facility. This security step is critical for privacy and HIPAA (Health Insurance Portability and Accountability Act) compliance. 
     In some embodiments, the web access similarly facilitates the reviewing of patient records by referring physicians who are not on-site in the hospital or even on the medical staff of the hospital. Such physicians might want to easily access the records of patients who they referred to the hospital. Some embodiments restrict access of a particular physician to only patients that have given permission for that particular physician to view their records. Accordingly, physicians who are not on the medical staff will not have the ability to view all of the medical records within the facility at will in such embodiments, but rather only those of the patients who have granted them permission to see their records. The ability of patients and referring physicians to easily view pertinent medical records within a hospital system is an extension of that system that will bring the healthcare infrastructure a step closer to being universally accessible. 
     In some embodiments, the server that runs the web-based application is hosted remotely rather than installed in the hospital. In such embodiments, all that is required is a network (e.g., Internet) link between the central server facility and the client hospital, which can be geographically distant. In some embodiments, the central server facility serves multiple hospitals in multiple geographic locations, thereby improving the efficiency of server maintenance and upgrading, and application upgrading at both the server level and the client level. Some embodiments that employ remote hosting provide the remote hosting to hospitals on a subscription basis that allows the hospitals to forego the high costs of hardware installation and on-site maintenance. 
     Some embodiments allow patients and referring physicians to view patient hospital records, thereby providing wide access to the system. Some embodiments employ tailored limitations and restriction of access to individual patients or a group of patients based on patient permissions. In such embodiments, the central data server is no longer an insulated intramural closed system that neither patients nor referring physicians have access to. 
     These and other objects and advantages of the present invention will become more apparent from the following detailed description considered with reference to the accompanying drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  illustrates a system and method for providing web based access to clinical records according to one embodiment of the present invention. 
         FIG. 2  illustrates a system for providing web based access to clinical records according to one embodiment of the present invention. 
         FIG. 3  illustrates a method according to one embodiment of the present invention. 
         FIG. 4  illustrates a system for providing web based access to clinical records according to one embodiment of the present invention, wherein a central server provides clinical data access over the Internet to one or more hospitals in a geographical location distinct from the server. 
         FIG. 5A  illustrates a dashboard for display on a thin client according to one embodiment of the present invention. 
         FIG. 5B  illustrates a dashboard for display on a thin client according to one embodiment of the present invention. 
         FIG. 5C  illustrates a dashboard for display on a thin client according to one embodiment of the present invention. 
         FIG. 5D  illustrates a dashboard for display on a thin client according to one embodiment of the present invention. 
     
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     This Application is related to U.S. Patent Application entitled “Drill Down Clinical Information Dashboard,” filed on Feb. 24, 2008 and having application Ser. No. 12/036,281. That application is incorporated by reference herein. 
     This Application is related to U.S. Patent Application entitled “Intelligent Dashboard,” filed on Feb. 24, 2008 and having application Ser. No. 12/036,287. That application is incorporated by reference herein. 
       FIG. 1  illustrates a system  10  for providing access to clinical data over a network according to one embodiment of the present invention. The system  10  includes a server  20  accessible by one or more thin clients  50  via a communication network  30 . In some embodiments, the server  20  may be a personal computer that is accessible (via the communications network  30  or directly) by one or more thin clients  50 . In other embodiments the server  20  may be a plurality of servers  20  connected together. In some embodiments the communication network  30  is a communication link over the Internet, and in other embodiments the communication network  30  may be a communication link over a private or closed network. 
     The system  10  further includes one or more databases  12  for storing clinical data. Clinical data may include any data related to the treatment and care of a patient, for example data related to the condition of a patient, billing and payment history, and a patient&#39;s medical history. For the purposes of this application clinical data also refers to severity scores, and data trends calculated to monitor and evaluate one or more patients. Clinical data is collected through a variety of systems and methods and stored in the database  12  connected to the server  20 . The database  12  provides the system  10  with clinical data for a number of patients. 
     In reference to  FIG. 2  an embodiment of the present invention is shown. A thin client  50  may include, but is not limited to, a desktop computer  152 , a notebook computer  164 , a tablet computer  154 , a personal digital assistant  162 , and a mobile phone  166 . A thin client  50  in some embodiments is a device that primarily handles input (e.g., user interaction) and output (e.g., displaying), while processing is done on a separate server. This is as opposed to a thick client, in which processing is done on the client device itself. While some of the devices listed above (desktop, notebook, etc.) can also act as thick clients, in some embodiments these devices act as thin clients  50 . Thin clients  152 ,  154  are in communication with the server  120  via private communication networks  132 ,  134  respectively. Thin clients  162 ,  164 ,  166  are in communication with the server  120  via public communication networks  142 ,  144 ,  146  respectively, for example the Internet. 
     In further reference to the embodiment shown in  FIG. 1  the thin client  50  is in communication with the server  20  via a communication network  30 . In some embodiments the thin client  50  is connected to the Internet via a communication link. The thin client  50  may include a web browser for communicating with said server  20  via said communication network  30 . It should be understood that in some embodiments of the present invention the thin client  50  is in communication with the server  20  via a private network. It should further be understood that in some embodiments of the present invention one or more thin clients  50  are in communication with the server  20  via a wireless network. 
     The server  20  includes software for processing clinical data stored in the database  12 . In reference to  FIG. 1  the software executing on the server  20  is referred to as a Medical Data Manager Application  22 . It should be understood that the Medical Data Manager Application  22  includes a plurality of software modules for processing clinical data stored in the database  12 , and that the Medical Data Manager Application  22  may be referred to throughout this description as software  22 . 
     In further reference to  FIG. 1 , software  22  executing on the server  20  receives a command  42  from said thin client  50 . In the embodiments shown in  FIG. 1  the command  42  is a request for clinical data  44 . It should be understood that the server  20  may receive many different commands, for example a command to process clinical data, or a command to present clinical data in a different manner. Software  22  executing on the server  20  retrieves the requested clinical data  44  from the database  12  in response to the command  42 . Software  22  executing on the server  20  transmits the requested clinical data  44  to the thin client  50  via the network communication link  30 . The requested clinical data  44  is displayed on a user interface on the thin client  50 . 
     In some embodiments of the present invention the system includes software  22  executing on the server  20  for generating a user interface (or dashboard). In reference to  FIGS. 5A-D  various examples of the user dashboards  500 ,  600 ,  700 ,  800  are shown. The thin client  50  displays the dashboard  500  generated by software  22  executing on the sever  20 . The dashboard  500  is typically displayed in the user interface of the thin client  50 . For example the dashboard  500  may be displayed inside a web browser running on the thin client  50 . Each dashboard  500 ,  600 ,  700 ,  800  includes multiple window panes, such as the window panes  510 ,  520 ,  530 ,  540  shown on dashboard  500  in  FIG. 5A . The various window panes of the dashboards display clinical data. For instance, the window pane  520  shows clinical data regarding a first patient. 
     In some embodiments, the dashboard includes a patient list window, such as the patient list window  540  of dashboard  500 . The patient list window  540  provides a list of the patients, recorded clinical data regarding each patient, computed scores generated from patient clinical data, and trends associated with the recorded data and generated scores. In some embodiments, the patient list window  540  is editable, selectable, or clickable. 
     In reference to the embodiment shown in  FIG. 5A , the dashboard  500  further includes a menu bar  550 . The menu bar  550  has one or more menu options, for example vitals, labs, scans, and nursing. When a menu bar option is selected (via appropriate input on the thin client  50 ), the menu “pulls down”, revealing a list of menu items or options. These options enable the user to perform various actions within the dashboard  500  and allow the user to request one or more clinical data sets. In some embodiments, a user can configure a dashboard  500 . For example, the user can configure one or more of a size of a window pane, the number of window panes, and the type of data displayed in a window pane. The system  10  can further save a dashboard configuration for later use. 
     In reference to  FIG. 1  software  22  executing on the server  20  generates a first dashboard  500  having a first plurality of window panes  510 ,  520 ,  530 ,  540 . Software  22  executing on the server  20  transmits the first dashboard  500  to a thin client  50  for display on the thin client  50 . In some embodiments of the present invention software executing  22  on the server  20  displays the clinical data  44  in one or more of the first plurality of window panes  520  of the first dashboard  500 . For example, in reference to  FIG. 5A  the system  10  displays the dashboard  500  on a thin client  50 . A user of the thin client  50  may request clinical data, for example, by selecting a patient name on the patient list window pane  540 . The software  22  executing on the server  20  receives the request  42  for the clinical data, retrieves the requested clinical data  44  from the database  12 , and transmits the requested clinical data  22  to the thin client  50  for display in a window pane  520  of the dashboard  500 . 
     In some embodiments of the present invention a first dashboard  500  generated by software  22  executing on the server  20  is displayed on the thin client  50 . The user of the thin client  50  requests clinical data via an input on the first dashboard  500 . Software  22  executing on the server  20  receives the request, and retrieves the requested clinical data  44 . Software  22  executing on the server  20  then generates a second dashboard  600  having a second plurality of window panes and transmits the second dashboard  600  to the thin client  50  for display on the thin client  50 . In some embodiments the first dashboard  500  includes a link  542 , for example a patient name in the patent list window pane  540 . When the link  542  is activated, for example by a user input at the thin client  50 , software  22  executing on the server  20  generates a second dashboard  600 , and includes clinical data  44  in one or more window panes on the second dashboard  600 , wherein the clinical data  44  is related to the patient associated with the link  542 . In this way the user of a thin client  50  can toggle between a general dashboard  500  in which clinical information related to a plurality of patients is displayed, to a more specialized dashboard  600  in which additional patient specific clinical information is displayed. 
     In other embodiments of the present invention a first dashboard having a first set of window panes displays a first set of clinical data related to a first aspect of a patient, for example general clinical data associated with the patient. A second a second dashboard having a second set of plurality of windows displays clinical data related to a second aspect of a patient, for example clinical data related to a specific condition for which medical staff intends to treat. It should be understood that in some embodiments the first and second dashboards may display identical clinical data, while in other embodiments the first and second dashboards display different clinical data. 
     In some embodiments software executing the server  20  provides a web browser in a window pane  530  of the dashboard  500 . A user of the thin client  50  can access the World Wide Web through the browser provided in the window pane  530 . For example, a user accessing the system through a thin client  50  connected to a private network or closed network can access the World Wide Web via the browser window pane  530 . 
     In some embodiments, the web-based application allows doctors, patients, and other individuals located outside of a hospital to access clinical data sets stored on the system. In such embodiments it is preferred that access to clinical data is restricted to persons with authorization to access such clinical data. For example, a patient is authorized to access her own clinical data, but is restricted from accessing clinical data of other patients. Such embodiments are restricted such that the patient (in contrast to healthcare workers associated with the hospital) have access only to their own personal clinical data and not to the entire list of patients in the hospital. In other embodiments a referring doctor will have access only to patients of the doctor. This security step is critical for privacy and HIPAA (Health Insurance Portability and Accountability Act) compliance. 
     In reference to  FIG. 3 , a method for restricting access to clinical data is illustrated. First, the server receives a clinical data request from a thin client  202 . Each clinical data request is associated with a unique identifier related to the one or more of thin client through which the request was made, or the user making the request through the thin client. Further, the clinical data stored in the database  12  is also associated with one or more identifies. Software  22  executing on the server  20  receives the clinical data request from the thin client. Software  22  executing on the server  20  determines whether one or more of the thin client  50  and thin client user are authorized to access the clinical data requested based on one or more of the unique identifiers. If the system determines that it is an authorized request, software executing on the server will retrieve the requested data  212 , and transmit the clinical data to the thin client  214 . If the system determines that it is an unauthorized request, software executing on the server will generate a notice of unauthorized request, transmit the notice of unauthorized request to the thin client  210 , and block access to the requested data. It should be understood that many different variations of determining clinical data access are possible, and the above description is intended for illustration purposes only. For example, a data authorization protocol may vary depending on the system, the number of users, the type of user, and the location of the user among others. 
     In reference to  FIG. 4 , an alternative embodiment of the present invention is illustrated wherein the server that runs the web-based application is in a geographic location remote from one more medical care facilities. For example the server location may in a different city, county, state or country. In this embodiment the server  320  is located in a geographical location remote from the hospital  354 ,  344 ,  334 . The server  320  and associated database  312  fulfill data storage and processing for a plurality of hospitals. A user at a hospital accesses data stored on the server. The server processes the data and transmits the data to the hospital. In some embodiments, a hospital may also maintain a local network. Some embodiments that employ remote hosting provide the remote hosting to hospitals on a subscription basis that allows the hospitals to forego the high costs of hardware installation and on-site maintenance. 
     Although the invention has been described with reference to a particular arrangement of parts, features and the like, these are not intended to exhaust all possible arrangements or features, and indeed many modifications and variations will be ascertainable to those of skill in the art.