Patent Publication Number: US-2006015368-A1

Title: Portable method and device for personal medical record compilation and retrieval

Description:
BACKGROUND  
      This application claims the benefit of U.S. Provisional Application No. 60/587,566, filed Jul. 13, 2004. U.S. Provisional Application No. 60/587,566 is incorporated herein by reference in its entirety.  
      The following relates to the medical information and data arts. It especially relates to apparatuses for medical record compilation, storage, and retrieval in the for rapid retrieval during emergency medical situations, and will be described with particular reference thereto. However, the following will also find application in conjunction with other like applications.  
      Emergency medical personnel refer to the first hour after a heart attack, stroke, automobile accident, or other catastrophic medical trauma as the “golden hour” during which the rapidity and quality of medical care often determines the outcome. Children with special medical needs, elderly with chronic medical illnesses, and other persons with special medical conditions or needs are at enhanced risk in the initial hour or hours after a traumatic medical event, because emergency medical personnel may be treating the injured person without knowledge of those special medical conditions or needs. For example, a hemophiliac injured in an automobile accident can expire due to internal bleeding unless appropriate preventative measures are immediately taken. Such concerns are enhanced when the injured person is traveling, when the injury occurs at night, or at other times or places in which access to the person&#39;s medical records is likely to be delayed or prevented.  
      Even if the injury occurs close to home, rapid access to key medical records may be hindered. Under federal mandates established by the Health Insurance Portability and Accountability Act (HIPAA), access to a critically injured person&#39;s medical records by a remote care facility may be denied or substantially delayed. HIPAA also encourages health care providers (such as hospitals, home health care providers, pharmacies, clinics, physician&#39;s offices, and so forth) to encrypt medical records identifiable with an individual when they are transmitted or communicated. Thus, even if medical records are physically available to emergency medical personnel, privacy-related encryption or other electronic security measures may delay or bar access to the information contained in those records.  
      Lack of ready access to medically-related legal documents, such as treatment consent authorization, power of attorney, and living will documents, may cause emergency medical personnel to hesitate to apply appropriate interventional procedures or may lead emergency medical personnel to perform unwanted extraordinary life-saving interventions.  
      Approaches for conveying medically related information rapidly and reliably to emergency medical personnel have heretofore been less than fully satisfactory. Medical alert bracelets and similar items are worn by persons with special medical conditions to alert emergency medical personnel to those special medical conditions in the event of a medical emergency. However, the amount of information that can be conveyed by such items is limited. Another approach is for the person with special medical needs to carry paper copies of key medical records. While this enables more information to be carried, it is inconvenient for the person. Additionally, paper copies are prone to damage or destruction.  
     BRIEF SUMMARY  
      According to one aspect, a medical information device is disclosed. A portable non-volatile digital memory device is adapted for detachable connection with a computer. At least one current medical profile data file is stored unencrypted and without password protection on the portable non-volatile digital memory device. The at least one current medical profile data file contains information relevant to delivering emergency aid to an associated person in the event of a medical emergency.  
      According to another aspect, a medical information device is disclosed. A portable USB memory drive is adapted for detachable connection with a USB port of a computer. A current medical profile Portable Document Format (PDF) file is stored on the portable USB memory drive and contains information relevant to delivering emergency aid to an associated person in the event of a medical emergency. Visual indicia are coupled with the portable USB memory drive to alert emergency personnel that the portable USB memory drive contains information relevant to delivering emergency aid to the associated person  
      According to another aspect; a medical information retrieval method is disclosed. A portable non-volatile digital memory device adapted for detachable connection with a computer is carried. The portable non-volatile digital memory device stores a current medical profile data file unencrypted and without password protection. The current medical profile data file contains information relevant to delivering emergency aid to an associated person carrying the portable non-volatile digital memory device in the event of a medical emergency. Responsive to a medical emergency, the portable non-volatile digital memory device is connected with a computer. After the connecting, the stored current medical profile data file is opened using a general-application software program not residing on the portable non-volatile digital memory device. 
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       FIG. 1  shows a medical information device including a non-volatile digital memory device storing a current medical profile data file and having coupled visual indicia alerting emergency personnel that the portable non-volatile digital memory device stores information relevant to delivering emergency aid to the associated person.  
       FIG. 2A  shows a computer including a USB port before connecting the medical information device of  FIG. 1 .  
       FIG. 2B  shows the computer of  FIG. 2A  after connecting the medical information device of  FIG. 1  and opening the current medical profile data file.  
       FIG. 3  diagrammatically shows the computer and the medical information device including representations of selected software and data file components.  
       FIG. 4  shows an example front page displayed by the opened current medical profile data file, showing a critical care protocol and medical insurance card.  
       FIG. 5  shows PDF bookmarks of an example current medical profile data file having a PDF format.  
       FIG. 6  shows an example list of medications suitably contained in the current medical profile data file.  
       FIG. 7  shows an example list of allergies suitably contained in the current medical profile data file.  
       FIG. 8  shows an example radiological image and associated annotations suitably contained in the current medical profile data file.  
       FIG. 9  shows portions of an example living will suitably contained in the current medical profile data file. 
    
    
     DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS  
      With reference to  FIG. 1, 2A ,  2 B, and  3 , a medical information device  8  includes a portable non-volatile digital memory device  10  adapted for detachable connection with a computer  12 , such as a laptop computer carried by an emergency medical service (EMS) ambulance, a hospital computer, or another computer accessible by emergency medical personnel. The portable non-volatile digital memory device  10  stores at least one current medical profile data file  14  pertaining to an associated person who carries the medical information device  8 . The current medical profile data file  14  contains information relevant to delivering emergency aid to the associated person in the event of a medical emergency. Optionally, the portable non-volatile digital memory device  10  stores other files, such as an optional independent educational program (IEP) file  15 .  
      To facilitate emergency medical personnel recognizing the medical information device  8 , the medical information device  8  preferably includes visual indicia  18  alerting emergency personnel that the portable non-volatile digital memory device stores information relevant to delivering emergency aid to the associated person. For example, the illustrated visual indicia  18  include textual information  18   1  and a recognized medical symbol  18   2 . In some embodiments, the visual indicia may include a trademark or other proprietary symbol having acquired significance that the marked device stores information relevant to delivering emergency aid to the associated person. In the illustrated embodiment, the visual indicia  18  comprise a label, engraving, or other visual indicia directly coupled with the portable non-volatile digital memory device  10 . In other embodiments, the visual indicia may be coupled with the non-volatile digital memory device  10  more indirectly. For example, the non-volatile digital memory device  10  may include a key ring hole  20  for securing the non-volatile digital memory device  10  to a lanyard, key ring, or so forth (not shown), and suitable visual indicia may be disposed on or with the lanyard, key ring, or other secured item.  
      To facilitate ready access by emergency medical personnel to the information contained in the current medical profile data file  14 , the current medical profile data file  14  is preferably stored on the portable non-volatile digital memory device  10  unencrypted and without password protection. Further, the portable non-volatile digital memory device  10  preferably employs standard interfacing hardware for connecting with the computer  12 . In the illustrated embodiment, the portable non-volatile digital memory device  10  includes a Universal Serial Bus (USB) interface  22  for detachably connecting with a USB port  24  of the computer  12 . However, the use of other standard interfacing hardware is also contemplated. The illustrated portable non-volatile digital memory device  10  is a USB FLASH memory drive. In other embodiments, the portable non-volatile digital memory device may be a small portable hard disk drive with detachable USB connector, or so forth.  
      In operation, the associated person carries the medical information device  8  on his or her person, for example on a lanyard around the associated person&#39;s neck, on the associated person&#39;s key ring, in a pocket of the associated person, or so forth. In the event of a medical emergency, arriving emergency medical personnel recognize the medical information device  8  based on the visual indicia  18 , and insert the USB memory drive  10  into the USB port  24  of the available computer  12 . For example, the ambulance or other emergency response vehicle may carry a laptop computer with one or more USB ports, or the emergency room may include a computer with one or more USB ports. The current medical profile data file  14  is preferably stored in a non-proprietary format such as Portable Document Format (PDF), hypertext markup language (HTML), or so forth, and is preferably unencrypted and without password protection. Such non-propnretary unencrypted and non-password protected files are readily accessible by emergency medical personnel using a general-application software program. For example, in the illustrated embodiment the current medical profile data file  14  is an unencrypted PDF file without password protection, and is readily readable by the computer  12  using a copy of Adobe PDF Reader  26  executed by the computer  12 . Adobe PDF Reader is a free program available from Adobe Systems Inc. (San Jose, Calif.) that can be downloaded for free via the Internet (see http://www.adobe.com/). Because of the ubiquity of PDF formatted files and the free availability of Adobe PDF Reader, most medical computers include the capability of reading PDF files. Similarly, most medical computers include Internet Explorer (available from Microsoft Corp., Redmond, Wash.), Netscape Navigator (available from Netscape Communications Corp., Mountain View, Calif.), or another web browser capable of reading HTML files. In other embodiments, the current medical profile data file  14  is stored in a proprietary but widely available general-application format such as Microsoft Word (available from Microsoft Corp., Redmond, Wash.), which is a proprietary word processing application program that is installed on many medical computers. Using a proprietary application platform such as Microsoft Word has the disadvantage of limiting accessibility of the current medical profile data file  14  to those emergency medical care providers who have purchased or otherwise obtained the proprietary application software.  
      In some embodiments, the portable non-volatile digital memory device  10  does not store a copy of the Adobe PDF reader program or other computer executable instructions for accessing the at least one unencrypted medical data file. Rather, the Adobe PDF reader program  26  is stored on a hard disk drive the computer  12 , or on a hospital network, or on another non-volatile memory device other than the portable non-volatile memory device  10 . In some embodiments, the portable non-volatile digital memory device  10  does not store any files containing computer executable instructions. In this way, the emergency medical personnel are reassured that the portable non-volatile digital memory device  10  does not contain a virus or other malignant executable code that could damage an emergency medical computer with which the portable non-volatile digital memory device  10  is connected. This reassurance further increases the likelihood that emergency medical personnel will open and access the current medical profile data file  14  containing information relevant to delivering emergency aid to the associated person in the event of a medical emergency. Moreover, in some embodiments the portable non-volatile digital memory device  10  does not store any files other than the current medical profile data file  14 . By storing only the current medical profile data file  14  on the portable non-volatile digital memory device  10 , emergency medical personnel have only one selection option and are assured of selecting the right file to access the medical information. In other embodiments, other data files may be stored, such as the optional independent educational program (IEP) file  15  providing the current independent educational program for the associated person if the associated person is a handicapped child. An individualized IEP is mandated by federal and some state laws for each handicapped child, and typically provides information such as: the child&#39;s assessed level of educational performance; educational goals specific to the handicapped child; special educational, service, or aid requirements; and so forth. Because the IEP is mandated to be readily accessible to the child&#39;s educators, the IEP  15  is optionally also stored on the portable non-volatile digital memory device  10 . If additional files are included on the portable non-volatile digital memory device  10 , then the filenames for the current medical profile data file  14  and for the IEP  15  or other additional files should clearly identify the current medical profile data file  14  as containing information relevant to delivering emergency aid to the associated person in the event of a medical emergency, so that emergency medical personnel can readily identify which file contains the relevant information in an emergency situation.  
      In the illustrated embodiment in which the portable non-volatile digital memory device  10  is a USB FLASH memory drive, or in embodiments in which the portable non-volatile digital memory device  10  is a small portable hard disk drive with detachable USB connector, the USB connector  22  is inserted into the USB port  24  of the computer  12 . When inserted, the USB FLASH memory drive or portable hard disk drive appears on the computer  12  as a removable drive containing the unencrypted current medical profile data file  14  without password protection.  FIG. 2A  shows the computer  12  including the USB port  24 ;  FIG. 2B  shows the computer  12  with the portable non-volatile digital memory device  10  connected, after the user has opened the current medical profile data file  14 .  
      Because the current medical profile data file  14  is in a non-proprietary format such as PDF without encryption or password protection, emergency medical personnel can open the current medical profile data file  14  using substantially any suitable file-opening technique. For example, emergency medical personnel can load a copy of Adobe PDF Reader  26  and then use it to open the current medical profile data file  14 , or can open Internet Explorer, Netscape Navigator, or another program that accepts Adobe PDF Reader  26  as a “plug-in” software component, and open the current medical profile data file  14  using that program. In another approach, emergency medical personnel can use Windows Explorer or another folders browser to select the current medical profile data file  14 , upon which selection the computer  12  automatically recognizes the current medical profile data file  14  as a PDF file and opens the current medical profile data file  14  using Adobe PDF Reader  26 . In other example embodiments, the current medical profile data file  14  is an HTML file which is suitably opened by a browser such as Internet Explorer, Netscape Navigator, or so forth. The HTML file can also be opened by selecting it in Windows Explorer or another folders browser, upon which selection the computer automatically recognizes the current medical profile data file as an HTML file and opens it using the computer&#39;s default browser.  
      As shown in  FIG. 2B , when the current medical profile data file  14  is opened using Adobe PDF Reader  26  or another PDF reading program, the computer  12  displays a front page  30 . In the illustrated embodiment, the front page includes a photograph or other image of the associated person so as to enable emergency medical personnel to verify that the current medical profile data file  14  is for the patient under emergency care, along with text below the picture providing information for immediate consideration by emergency medical personnel.  
      With reference to  FIG. 4 , other examples of information that is optionally displayed on the front page for immediate consideration by emergency medical personnel may include an emergency aid protocol  32  specifically tailored to the associated person. The example critical care protocols  32  identify the associated person (that is, the person under emergency medical care) as (for example) “JOHN SMITH”, identify in important medical condition (hemophilia, for example) of immediate interest to emergency medical personnel, provide a first aid protocol—“HEMOPHILIA: FACTOR 8 FIRST” which is tailored to the special condition of the associated hemophiliac person, and identify drug allergies—“ALLERGIES: ZOMAX, AUGMENTIN” that should be recognized when giving emergency medical care to the associated person. It is noted that this information is not a complete medical history, which would overwhelm emergency medical personnel with too much information; rather, the emergency aid protocol  32  provides the information of which emergency medical personnel should be immediately aware so as to ensure that they provide care appropriate to the medical conditions, allergies, or other characteristics of the associated person under emergency medical care. With continuing reference to  FIG. 4 , the front page may display other information that emergency medical personnel may want to immediately access, such as a copy of the associated person&#39;s medical insurance card  34 .  
      The front page, such as the examples of  FIGS. 2A and 4 , provides information, such as patient identification, important medical conditions (such as hemophilia, drug allergies, and so forth), medical insurance information, and so forth, that should be brought to the immediate attention of emergency medical personnel.  
      With reference to  FIG. 5 , the current medical profile data file  14  includes other information which in PDF format embodiments is suitably indexed using PDF bookmarks  40 . The current medical profile data file  14  including PDF bookmarks can be readily created using Adobe Acrobat (available from Adobe Systems Inc., San Jose, Calif.) or other commercially available software. Adobe Acrobat includes a plug-in “PDFwriter” printer driver for numerous word processing, presentation, and other application software programs. Using this approach, the current medical profile data file  14  is created in PDF format by scanning, typing, or otherwise generating or capturing electronic medical records or other medical information and “printing” the digitized or captured information to a PDF file using suitable application software and the “PDFwriter” printer driver. Because PDF is an open standard, other programs are commercially available for producing the current medical profile data file  14  in PDF format including the PDF bookmarks  40  from digitized or otherwise electronically captured or generated information about the associated person.  
      In other example embodiments, the current medical profile data file  14  is in HTML format, and is indexed by a set of hyperlinks defming a menu or the like. Such an indexed current medical profile data file  14  in HTML format can be created, for example, by various application software programs that allow saving in HTML format. Alternatively, an HTML editor can be used to generate the current medical profile data file  14  in HTML format including a menu of hyperlinks. In some contemplated embodiments in which the at least one current medical profile data file  14  is stored as HTML on the USB memory drive  10 , the at least one current medical profile data file  14  includes image, text, and/or data files stored in a directory or file folder of the USB memory drive  10 , and an HTML file in the root directory of the USB memory drive  10  which contains hyperlinks to the files in the directory or file folder. In this way, emergency medical personnel are likely to select the single HTML file in the root directory, which will then provide rapid indexed access to the image, text, and/or data files stored in a directory or file folder of the USB memory drive  10 .  
      The bookmarked or otherwise indexed information can include, for example: patient photo (such as is shown in  FIG. 2B ); patient medical ID (such as the medical insurance card  34 ); patient physician information (optionally including primary physician, specialist physicians, or so forth); therapist information (such as a physical therapist, a dietary therapist, a psychologist, a psychiatrist, or so forth); a list of medications; a list of allergies (optionally including drug allergies, food allergies, or so forth); in-patient nurse notes from recent hospitalizations; recent hospital admission and/or discharge summaries; dietary needs; religious or needs (such as a kosher diet, vegetarian diet, or so forth adhered to by the associated person); learning needs; family medical history; cardiac stress test data; radiological images; other medical test results; and so forth. The content of the current medical profile data file  14  is optionally limited to recent medical history and other information providing a current medical profile of information of greatest relevance to providing emergency medical care. In this way, emergency medical personnel are not overwhelmed by dated or otherwise less relevant information. Additionally, by limiting the information to current material that is relevant to providing emergency medical care for the associated person, potentially embarrassing and irrelevant information contained in the associated person&#39;s complete medical history can be omitted from the unencrypted current medical profile data file  14 .  
       FIGS. 6, 7 , and  8  provide some examples of suitable content of the current medical profile data file  14 .  FIG. 6  shows a table of medications  42  currently being taken by the associated person. With brief reference back to  FIG. 5 , the medications table  42  is suitably accessed by emergency medical personnel by selecting a “MEDICATIONS” bookmark  44  of the PDF bookmarks  40 . Because the table of medications  42  is often of immediate importance to emergency medical personnel, the “MEDICATIONS” bookmark  44  is optionally displayed in red, boldfaced, or otherwise highlighted. Similarly,  FIG. 7  shows a list of allergies  48  that is accessed by an “ALLERGIES” bookmark  50  of the PDF bookmarks  40 . Again, in view of the potentially immediate importance of allergies to emergency medical personnel, the “ALLERGIES” bookmark  50  of the PDF bookmarks  40  is optionally displayed in red, boldfaced, or otherwise highlighted.  FIG. 8  shows a radiological image  54 , in the illustrated example a chest x-ray, along with annotations  56  identifying the radiological image  54 . Images such as the radiological image  54  are readily incorporated into PDF files. In the case of HTML, images are typically incorporated as a separate file connected with the main HTML file by a hyperlink. The radiological image  54  and associated annotations  56  may be accessible through a general bookmark such as the “Discharge Summaries” bookmark  58  of the PDF bookmarks  40 , or may be indexed under a designated bookmark such as a “Radiological images” bookmark (not included in  FIG. 5 ).  
      With returning reference to  FIG. 5 , the bookmarked or otherwise indexed information can also optionally include a bookmark  59  (entitled “Learning Needs” in the example PDF bookmarks  40  of  FIG. 5 ) to the IEP file  15 . The bookmarked or otherwise indexed information can also optionally include one or more legal documents including a signature of the associated person authorizing selected actions in delivering emergency aid to the associated person. For example, the example PDF bookmarks  40  include links to: a consent to treat authorization; a Health Insurance Portability and Accountability Act (HIPAA) information release authorization; and a living will. Other legal documents that may be included include a durable power of attorney authorizing another to make medical decisions for the associated person in the event the associated person is unconscious or otherwise unable to communicate.  
      With reference to  FIG. 9 , a selected portion of an example living will  60  is shown, which is accessible via the “Living Will” bookmark  62  of the PDF bookmarks  40  shown in  FIG. 5 . The living will includes a digital image of a signature  66  of the associated person and a digital image of a witness&#39; signature  68 . In addition to or instead of witnessing, the legal document can be notarized. Moreover, it is contemplated that some of the stored legal documents may be neither witnessed nor notarized. Instead of the illustrated digital images of handwritten signatures  66 ,  68 , it is also contemplated to employ digital signatures or “e-signatures” to validate legal documents contained in the current medical profile data file  14 .  
      In the illustrated embodiments, the contents of the current medical profile data file  14  are displayed on a display of the computer  12 . In some embodiments, it is also contemplated to employ audio dictation output. For example, Adobe PDF Reader version 6 includes audio dictation capability. In such embodiments, selected contents of the current medical profile data file  14  are suitably “read aloud” by the computer  12 , thus freeing emergency medical personnel to tend to the emergency of the associated person while listening to the computer  12  dictate the selected contents of the current medical profile data file  14 .  
      The invention has been described with reference to the preferred embodiments. Obviously, modifications and alterations will occur to others upon reading and understanding the preceding detailed description. It is intended that the invention be construed as including all such modifications and alterations insofar as they come within the scope of the appended claims or the equivalents thereof.  
      The appended claims follow: