Patent Abstract:
A system processes document and associated ancillary information and includes a repository associating a first term with ancillary information and associating a second term with a subset of the ancillary information. A parser parses document formatting information associated with the document to determine whether the first and second terms are present in the formatting information. A data processor uses the repository to locate the subset of ancillary information and incorporates that subset of ancillary information in data representing at least a portion of a document associated with said formatting information, in response to a determination that the first and second terms are present in the associated formatting information.

Full Description:
[0001]     This is a non-provisional patent application of provisional application Ser. No. 60/485,890, filed by C. P. McDonough et al. on Jul. 9, 2003. 
     
    
     FIELD OF THE INVENTION  
       [0002]     The present invention relates generally to the field of data processing, and more specifically to a system for processing a document containing data that includes ancillary information.  
       BACKGROUND OF THE INVENTION  
       [0003]     Computer accessible electronic storage systems have long existed which have the capability of housing large databases. An example of such a database storage scheme is a Laboratory Information System which provides access to numerous files, documents and related data. A Laboratory Information System typically includes records relating various medical data to patients. Documents are generated, containing specific desired patient medical data, for various entities related to the provision of healthcare services, such as patients, doctors, guarantors, insurance companies, and so forth. While such systems are programmed to provide storage for the standard medical data which is likely to be required, it is sometimes required that individual healthcare organizations store ancillary data of a type or types that was not foreseen, or was unforeseeable, by the system vendor, and that, thus, has not been programmed into the standard installation. A need exists for a user of such a database to be able to modify the database to hold data of a desired type, and to be able to place data of that type on a document.  
         [0004]     In one example, the identity of the patient is uniquely specified in medical records using one or more of a predefined set of patient identifier types or fields, for example, medical record numbers, social security numbers and/or corporate account numbers. While the standardized protocol, format and/or content of this predetermined set of identifiers may meet the needs of users in some states and localities, the predefined identifier set often does not meet the needs of users in other countries or in other markets where, for example, individual provinces or jurisdictions have their own requirements for protocols, formats or codes for uniquely identifying patients.  
         [0005]     Some prior database management systems have the ability to save, print and/or display customer or user-defined patient identifiers. However, in such systems the customer does not have actual control of the custom identifier implementation. Instead, such systems require the intervention of a computer programmer at installation time to implement the unique userdefined identifiers on behalf of each customer requesting them. Requiring a customer to seek the intervention and services of a programmer makes custom identifier implementation a cumbersome, inefficient and time consuming aspect of the actual information system installation process. A need exists for a user-defined identifier system that is directly accessible and controllable by the user without the need for intervention by or consultation with a professional database system manager or computer programmer.  
         [0006]     In another example, sometimes, these reports require some form of attachment, such as a EKG record, an X-Ray or a sonogram. These attachments are generally saved in the form of a file. Because a vendor cannot know which attachments will be available in any patient&#39;s record, the vendor cannot at installation time know which reports a user will generate nor what medical data will be included in a report. The vendor, thus, cannot program data fields into the database to hold references to them. A need exists for a system which allows a user to include an attachment to a medical report.  
       SUMMARY OF THE INVENTION  
       [0007]     In accordance with principles of the present invention, a system processes document and associated ancillary information and includes a repository associating a first term with ancillary information and associating a second term with a subset of the ancillary information. A parser parses document formatting information associated with the document to determine whether the first and second terms are present in the formatting information. A data processor uses the repository to locate the subset of ancillary information and incorporates that subset of ancillary information in data representing at least a portion of a document associated with said formatting information, in response to a determination that the first and second terms are present in the associated formatting information. 
     
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0008]      FIG. 1  is a block diagram of a document processing system constructed according to the principles of the present invention;  
         [0009]      FIG. 2  is an example of a report template according the principles of the present invention;  
         [0010]      FIG. 3  is a graphical user interface used to facilitate implementation of the present invention; and  
         [0011]      FIG. 4  is an example of a report produced according to the principles of the present invention. 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0012]     The term ‘executable application’ as used herein comprises code or machine readable instruction for implementing predetermined functions including those of an operating system, healthcare information system or other information processing system, for example, in response user command or input. The term ‘processor’ as used herein is a device and/or set of machine-readable instructions for performing tasks. A processor comprises any one or combination of, hardware, firmware, and/or software. A processor acts upon information by manipulating, analyzing, modifying, converting or transmitting information for use by an executable procedure or an information device, and/or by routing the information to an output device. A processor may use or comprise the capabilities of a controller or microprocessor, for example. An object as used herein comprises a grouping of data, executable instructions or a combination of both or an executable procedure. A display processor or generator is a known element comprising electronic circuitry or software or a combination of both for generating display images or portions thereof.  
         [0013]     In a healthcare enterprise environment, systems according to invention principles provide for storing, printing and/or displaying of user-defined keywords. That is, the system inherently supports the ability to add keywords to a patient report template. This mechanism may be used, in a manner to be described below, to implement one or more user-defined data types defining ancillary data. That is, data types which are not preprogrammed into the healthcare enterprise database and ancillary data which is not stored in the database. This enables user-created and defined data types and associated ancillary patient data to appear on the printed, displayed or transmitted report.  
         [0014]     One such user-defined data type may be user-defined patient identifiers. Such user-defined patient identifier types may be used like any of the existing system-defined patient identifier types. The user-defined patient identifiers may be used to supplement the system-defined patient identifier types, or may be used as the primary identifier type for an institution. They may be sent and received during interface transactions, they may be used for searching for a patient record, and/or they may be displayed or printed on a report that generally includes patient identifiers. The system, thus, supports the displaying, printing or transmitting of an unlimited number of identifier types, including user-defined identifier types, on a patient report.  
         [0015]     Another such user-defined data type may be attachment, or link to an attachment file. This may be used to track attachment files and to make them available to be included with documents generated based on patient data. Once attached to a patient document, the attachments may be displayed, printed or transmitted along with the remainder of the document.  
         [0016]      FIG. 1 , illustrates one embodiment of a document processing system  1 . The system  1  includes a data processor  6  which may be accessed by a user via a workstation  10  which is capable of sending and receiving information via various means such as a keyboard  50 , a displayed image  9  and/or a mouse  52  or other pointing device (not shown). The data processor  6  may also communicate with other processors or a network via a communications link  154 . The data processor  6  executes executable applications that are part of a Laboratory Information or Laboratory Assistant computer program that is used to facilitate the collection and exchange of information in a laboratory environment. The embodiment illustrated in system  1  is adapted to facilitate the automation of the patient admissions and tracking process by a healthcare provider.  
         [0017]      FIG. 2  illustrates an example of a document template  48  containing formatting information that specifies the presentation layout of a report or document  15  ( FIG. 1 ). In  FIG. 2 , the document comprises two pages: page  1 ,  48 ( 1 ), in  FIG. 2   a  and page  2 ,  48 ( 2 ), in  FIG. 2   b . The document template  48  specifies the location on the report or document  15  ( FIG. 1 ) of patient data that is commonly collected, stored and used by a healthcare provider for each patient who is receiving service. In  FIG. 2   a , the document template  48 ( 1 ) includes indicia indicating the location and content of fixed and generalized text, such as, for example, labels “Title”  14 , “State”  26 , “Work Phone”  16  and “Married”  17 . The document template  48 ( 1 ) also includes indicia indicating the location at which patient information is to be displayed for, and/or supplied or updated by, the user. For example fields  18  (to contain the patient&#39;s title),  19  (to contain the patient&#39;s state) and  20  (to contain the patient&#39;s work phone number) indicate the location of the specified patient information. The document template  48 ( 1 ) also includes keyword fields  29  and  30 ,  50  and  51 , and  52  and  53  along with respective label text  28 ,  54  and  55 .  
         [0018]     A document  15  ( FIG. 1 ) is derived from the document template  48  and includes the fixed and generalized text and stored patient information at the locations indicated in the document template  48 . More specifically, many, if not all, of the fixed text entries are followed by fields, such as, for example, fields  18 ,  19  and  20 . The fields are used to display previously entered patient information. Referring to  FIG. 1 , patient data is stored in a storage device  4  in a known database arrangement. The processor  6  places data representing the fixed text within data representing at least a portion of the document associated with the formatting information so that the fixed text is displayed at the appropriate locations in the document  15 . The processor  6  also accesses the patient database  4  to extract the patient data required by the fields in the document template  48  and places data representing the patient data within data representing at least a portion of the document associated with the formatting information so that the patient data is displayed in corresponding fields at the appropriate locations in the document  15 .  
         [0019]     The completed document  15 , with fixed text and patient information, may be displayed on the display device  9  via the display generator  7  in the workstation  10 , may be printed on the printer  8  and/or may be sent in a message to another location via the communications link  154 . In addition, the user at the workstation  10  may provide or update patient information in the fields ( 18 ,  19 ,  20 ) using input devices such as the keyboard  50  and/or mouse  52 . For example, the user may see, and/or may enter or update the patient&#39;s work phone number in the field  20  associated with the label  16 , and so forth. The processor  6  will display any changes made to the field  20  in the document  15  displayed on the display device  9  and will also update the patient data in the patient database  4  with that updated data. Similarly, keyword fields  29  and  30 ,  50  and  51 , and  52  and  53  may be displayed next to their respective labels  28 ,  54  and  55  on the document  15  derived from the document template  48  and keyword data may be entered or updated by the user.  
         [0020]     Document templates  48  can be accessed and edited by the user to produce a variety of documents  15  having different layouts fulfilling different requirements of respective users. Using known editing techniques, a user may enter fixed and generalized text and available data fields, and arrange their location in the document or report  15  until they are satisfactory.  
         [0021]      FIG. 3  illustrates a graphical user interface  21  that may be displayed via the display generator  7  on the display device  9  ( FIG. 1 ) that permits a user to specify characteristics of the document template  48 . One such characteristic is the insertion of data representing data fields into the formatting information in the document template  48  to contain patient data in the document  15 . The “Fields” tab in the user interface  21  allows a user to select and insert a data field for patient data of a designated type. The available patient data field types are listed alphabetically in a menu on the “Fields” tab. For example, selecting the menu item “Patient Identifier—Corporation ID”  13  and pressing the “Insert” button, inserts a data field into the document template  48  to contain the corporation ID for the selected patient. The user may then resize and/or move this field to the desired location.  
         [0022]     This mechanism may be used to insert user-defined data fields, for holding ancillary data, that is, data which is not preprogrammed into the patient database  4  ( FIG. 1 ), into the document template  48 . A plurality of different user-defined ancillary data types may be defined. As described above, keyword fields may be used to provide this function. A keyword used for this function is partitioned into a first portion containing a first term and a second portion containing a second term. In the illustrated embodiment, these two terms are user-determinable character strings. The value of the first term identifies the keyword as representing a user-defined ancillary data type and specifies the ancillary data type. The second term defines which particular data item of the selected data type, or which portion of such a data item, is represented by that keyword.  
         [0023]     For example, the graphical user interface illustrated in  FIG. 3  may be used by a user to add a user-defined patient identifier field to a document template  48  ( FIG. 1 ,  FIG. 2 ), to augment or replace the system-supplied patient identifier fields. In this case, the user selects the menu item “Patient Identifier—User-defined ID”  25 . When the User-Defined ID menu item  25  is selected, the user interface  21  includes or activates a textbox  31 . The user enters within the textbox  31  the name, abbreviation or mnemonic describing the type of the identifier  25 . For example, in  FIG. 3 , the user-defined ID type  32  is designated by the user as “DOD”, which may stand for the Department of Defense. The user may then press the “Insert” button to insert a data field into the document template  48  to contain patient identification data of the user-defined type. The system  1  provides the ability to display an unlimited number of patient ID types, both predefined such as identifier types  13  and user-defined such as  25 .  
         [0024]     For a user-defined patient ID, the first term has a value which indicates that this keyword represents a user-defined patient ID. The second term has a value which indicates which user-defined patient ID type is represented by the keyword. In response to pressing the “Insert” button, a keyword field, and the associated keyword representative data item is placed in the document template  48 , where it may be further manipulated by the user as described above. More specifically, when the “Patient Identifier—User Defined ID”  25  field is inserted into a document template  48  ( FIG. 1 ,  FIG. 2 ), the processor  6  generates a keyword representative data item in which the first term has the value specifying that this keyword represents user-defined patient ID ancillary data. The ID type  32  specified in the text box  31  is used to generate the second term for the keyword representative data item and indicates that this keyword represents a DOD patient identifier. This keyword representative data item is associated with the data field when it is inserted into the document template  48 .  
         [0025]     Referring again to  FIG. 2 , three keywords are illustrated in the upper left hand portion of the document template  48 . A first keyword is preceded by a label  28  and is represented by respective first and second terms  29  and  30 ; a second keyword is preceded by a label  54  and is represented by respective first and second terms  50  and  51 ; and a third keyword is preceded by a label  55  and is represented by respective first and second terms  52  and  53 . These keywords may be configured to represent user-defined patient identifiers in the manner described above, and the labels may be changed to better reflect the type of user-defined patient identifier. Continuing the above example, label  28  may be changed to “DOD identification” and the keyword  29 , 30  may hold the DOD patient ID.  
         [0026]     Referring now to  FIG. 2   b , page  2  of the document template  48 ( 2 ) also includes indicia indicating the location and content of fixed text: “Chest X-Ray:”  202 . The document template  48 ( 2 ) also includes indicia indicating the location at which attachment information is to be displayed. In  FIG. 2   b , this is a frame  206  within which an image of a chest X-Ray is intended to be displayed. The document template  48 ( 2 ) also includes keyword fields  29  and  30 ,  50  and  51 , and  52  and  53  along with respective label text  28 ,  54  and  55 . these keyword fields contain the same information as those illustrated on page  1  of the document template  48 ( 1 ). They are present to display patient ID information on page  2  of the document template  48 ( 2 ) and the corresponding page of the report  15  based on the document template  48 .  
         [0027]     The graphical user interface  21  ( FIG. 3 ) may be used in the same manner described above to insert a field to display ancillary information representing an attachment. In this case, the user may select a menu item in the “Fields” tab describing the desired attachment. For example, a menu item (not shown) may be “Attachment—User-Defined”, or may be more specific, such as “Attachment—X-Ray—User-defined” or “Attachment—Laboratory Report—User-defined”. These menu entries, although not illustrated would be listed at the appropriate alphabetical position in the list of fields displayed in the menu under the “Fields” tab. When the user selects one of the ‘attachment’ menu entries and presses the “Insert” button, a data field is inserted into the document template  48  to contain the attachment related to the selected patient.  
         [0028]     As described above, keywords are used to implement this function. In this case, the first term has a value which indicates that this keyword represents attachment ancillary information. The second term has a value which indicates which type of attachment is represented by the keyword. When the “Attachment—User-Defined” menu item is selected, the text box  31  is again included or activated. The user enters the name, abbreviation or mnemonic describing the type of attachment. Continuing this example, “Chest X-Ray” may be entered into text box  31  as the attachment type  32 . A second text box  56  may also be displayed or activated to accept a file name and/or location of the attachment, if it is known at the time the document template  48  is created.  
         [0029]     Alternatively, a portion of an attachment may be indicated. For example, if the attachment is large, such as a textual patient medical record, then a portion of that medical record may be specified to be displayed. This may be done by specifying a date range, or a portion of the medical record relating to one medical condition, and so forth. In this case, “Medical Record” may be entered into the text box  31  as the attachment type  32 , and a date range or other search criteria (specifying the medical condition) may be entered into the text box  56 .  
         [0030]     As described above, the processor  6  generates keyword representative data item in which the first term has the value specifying that this keyword represents a user-defined attachment ancillary data. The attachment type specified in the text box  31  and file name, if known, or desired portion of an attachment specified in text box  56  are used to generate the second term for the keyword representative data item. This keyword representative data item is associated with the attachment data field when it is inserted into the document template  48 .  
         [0031]     Referring again to  FIG. 1 , if the user-defined ID type has not been previously defined, then it is added to the system  1 . A storage device  3  contains the ancillary information. The memory in the storage device  3  is partitioned into respective portions to hold data of the plurality of different user-defined data types. For example, in  FIG. 1 , memory in the storage device  3  is partitioned to hold patient data of the defined ancillary data types. More specifically, a partition  302  of the memory in the storage device  3  is allocated to hold user-defined patient IDs. The user-defined patient ID information  302  comprises the plurality of user-defined patient identifiers for the patients represented in the system  1 . Similarly, a second partition of the memory in the storage device  3  is allocated as a repository  304  to hold patient data of the attachment type. The attachment repository  304  comprises the plurality of attachments related to the patients, either holding the attachments themselves or links to files containing the attachments in another storage device.  
         [0032]     When an ancillary data type is newly defined, the processor  6  sends data representing the newly defined ancillary data type to the ancillary information storage device  3 . The storage device  3  is configured to store ancillary data of the newly defined type. For example, memory space may be allocated to hold the newly defined type of ancillary data structured in a table-like manner in which each patient is represented by a row. Memory may then be allocated within the table to contain data representing the specific new user-defined ancillary type by adding a new column to the table.  
         [0033]     For example, a column is allocated in a user-defined patient ID table to hold the DOD patient identifier data. The DOD patient identifier of a patient is stored in that column of the table in the row associated with the patient. Similarly, a column is allocated in an attachment table to hold either a chest X-ray image, or a link to a file containing data representing that image. One skilled in the art of data storage will understand that other data storage arrangements are possible in the ancillary information storage device  3  and will understand how to select and implement an appropriate arrangement. For example, a single table may be formed with rows representing patients and columns representing each type of ancillary information. Alternatively, storage arrangements other than tables may be used.  
         [0034]     Referring still to  FIG. 1 , a user may supply data, e.g. representing a desired report or document type and a patient, to the processor  6  through the input devices  50  or  52  to condition the processor  6  to generate a document  15 . The processor  6  supplies this data to an interface processor  11 . The interface processor  11  controls selection of a document template  48  from among the plurality of available document templates  48 , which will generate a document  15  of the desired document type. A parser  5  includes a selection processor  12  which selects the desired document template  48  under the control of the interface processor  11 . As described above, the document template  48  includes formatting data specifying location and content of fixed text and data fields. The parser  5  analyzes this data in the selected document template  48  to determine what fixed text is to be placed in the document  15  and where it is to be placed. The parser  5  also analyzes what data fields are in the document template  48  and where they are to be placed. The results of the analysis performed by the parser  5  is supplied to the processor  6 .  
         [0035]     In response, the processor  6  generates a document  15  by placing data representing the fixed text and data fields within data representing at least a portion of the document associated with the formatting information in the document template  48  so that the specified fixed text and data fields are placed at the appropriate locations in the document  15  image. The processor  6  also retrieves patient data from the patient database  4  and places data representing that retrieved patient data within data representing at least a portion of the document associated with the formatting information in the document template  48  so that the retrieved patient data is displayed in the corresponding data fields at appropriate locations in the document  15  image. The display processor  7  processes this data to generate a document image on the display device  9 .  
         [0036]     If the parser  5  determines that the selected document template  48  includes a keyword field representing ancillary information, i.e. if the parser determines that a keyword including first and second terms is present in the formatting information in the document template  48 , the processor  6  conditions the interface processor  11  to retrieve the data which represents that ancillary information. The interface processor  11  supplies the first term of the keyword to the repository  2 . This portion has a predetermined value which specifies the type of ancillary information that this keyword field represents. For example, the first term may indicate that this keyword represents user-defined patient IDs, or an attachment, or some other type of ancillary information.  
         [0037]     The repository  2 , in turn, accesses the ancillary information storage device  3  and returns ancillary information of the specified type. The ancillary information returned to the interface processor  11  by the repository  2  comprises the ancillary information of the specified type for the selected patient. That is, if the keyword specifies user-defined patient identifiers, then the user-defined patient identifiers which have been defined for the selected patient are returned. Similarly, if the keyword specifies an attachment, then the attachments defined for the patient are returned. The interface processor  11  then selects a subset of that ancillary information, i.e. the particular user-defined patient identifier, the particular attachment, or the specified portion of the particular attachment, represented by the data field, by analyzing the second term portion of the keyword. Data representing the specified ancillary information (user-defined patient ID, attachment or portion of an attachment) is incorporated into data representing at least a portion of the document associated with the formatting information from the document template  48  by the processor  6 .  
         [0038]     In the case of an attachment, the attachment, or specified portion of the attachment, is placed in the appropriate location in a manner which depends on the type of the attachment. For example, if the attachment is an image, such as an X-ray, then the image is displayed in the frame defined in the document template  48 . Alternatively, if the attachment is textual, such as a laboratory report, then the text, or specified portion of the text, is displayed in the frame defined in the document template  48 . If the attachment is a sound, then an audio player is displayed in the frame defined in the document template  48  so that the user may control the playback of that sound. In such cases, the attachment is displayed in a manner appropriate for the type of attachment file defined.  
         [0039]     The generated document  15  may then be displayed on the display device  9  via the display generator  7 . The user may then see the patient data and associated fixed text, e.g. labels. As described above, the user may also supply or change data in data fields using the input devices  50  and/or  52 . Supplied and/or changed data is updated in the appropriate one of the ancillary information store  3  and patient database  4 . The user may also condition the processor  6  to print the document  15  on the printer  8  or send the document  15  to another location via the communications link  154 .  
         [0040]     An example of a report  15  produced by the document template  48  is illustrated in  FIG. 4 . This document  15  corresponds generally to the document template  48  illustrated in  FIG. 2 . On page  1  of the report  15 ( 1 ) and also on page  2  of the report  15 ( 2 ), one of the keywords  29 ,  30  ( FIG. 2 ) present in the document template  48  ( FIG. 1 ) represents a first user-defined patient identifier with textual label  30 : “User defined ID Number  1 ”. The contents of the field  22  contains text which represents the value of this patient identifier for the selected patient to which this document  15  is related as received from the ancillary information storage device  3  via the repository  2  and interface processor  11  ( FIG. 1 ). Two other user-defined patient identifier fields,  47  and  49  are adjacent to respective labels  51  an  53 . On page  1  of the report  15 ( 1 ), the data fields  18 ,  19 , and  20  contain textual data representing the patient data for the selected patient from the patient database  4 . Similarly, on page  2  of the report  15 ( 2 ), the attachment frame  206  is adjacent the label  202 : “Chest X-Ray”. An image  204  of a chest X-ray is displayed in the frame  206 . This image is received from the ancillary information storage device  3  via the repository  2  and interface processor  11 .  
         [0041]     The system described above allows a user to create documents and/or reports having a customized format that serves the needs of the user. The system also gives the user the ability to decide which and how many user-defined ancillary data types are included in, and where the data are placed on, the report. The configuration of this data is customizable to meet the needs of the recipient of the report.  
         [0042]     A number of modifications to the embodiment just described are possible. Therefore, the present invention is not limited to the particular embodiment shown, and many different embodiments and modifications are included within the scope of the appended claims.

Technology Classification (CPC): 6