Source: http://www.google.fr/patents/US8092380
Timestamp: 2013-05-23 12:24:40
Document Index: 300020428

Matched Legal Cases: ['Application No. 60', 'art 1', 'art 2', 'art 100', 'arts 100', 'art 100', 'arts 100']

Brevet US8092380 - System and method for improving hospital patient care by providing a ... - Google�BrevetsRecherche Images Maps Play YouTube Actualit�s Gmail Drive Plus » Recherche avanc�e dans les brevets | Historique Web | Connexion Recherche avanc�e dans les brevets BrevetsA system for improving hospital patient care by generating a Health Score. The system includes an interface module for receiving incoming medical data from a patient, a transformation module for transforming each of the medical datum into a transformed Health Score value, and a combination module for...http://www.google.fr/patents/US8092380?utm_source=gb-gplus-shareBrevet US8092380 - System and method for improving hospital patient care by providing a continual measurement of health Num�ro de publicationUS8092380 B2Type de publicationOctroi Num�ro de demande11/362,450 Date de publication10 janv. 2012 Date de d�p�t24 f�vr. 2006 Date de priorit�28 f�vr. 2005Autre r�f�rence de publicationCA2599387A1EP1872290A2EP1872290A4US20060206013US20120108913WO2006093807A2WO2006093807A3 InventeursMichael RothmanSteven Rothman Cessionnaire d'origineRothman Healthcare CorporationPerahealth, Inc.Rothman Healthcare Research, LlcMichael Rothman & Associates Classification aux �tats-Unis600/300600/301705/3705/2 Classification internationaleG06Q50/00A61B5/00G06Q10/00 Classification coop�rativeG06Q50/22G06F19/322G06F19/3487G06F19/327G06Q50/24G06F19/3431 Classification europ�enneG06F 19/32CG06F 19/32GG06F 19/34GG06F 19/34PG06Q 50/22G06Q 50/24R�f�rencesCitations de brevets (28)Citations hors brevets (128) R�f�renc� par (2)Liens externesUSPTO Cession USPTO EspacenetSystem and method for improving hospital patient care by providing a continual measurement of healthUS 8092380 B2 R�sum� A system for improving hospital patient care by generating a Health Score. The system includes an interface module for receiving incoming medical data from a patient, a transformation module for transforming each of the medical datum into a transformed Health Score value, and a combination module for combining the transformed Health Score values corresponding to each of the medical datum into a single Health Score. A presentation and comparison module displays the Health Score as a Health Score plot over a predetermined time frame, such that a user may identify health trends in a patient by evaluating said Health Score plot.
RELATED APPLICATION This application is related to and claims the benefit of priority from U.S. Provisional Patent Application No. 60/657,365, filed on Feb. 28, 2005, the entirety of which is incorporated herein by reference.
FIELD OF THE INVENTION The present invention relates to a system and method for improving hospital patient care. More particularly, the present invention relates to a system and method for providing a continual measurement and display of each patient's health.
BACKGROUND One of the major problems in delivery of effective medical treatment in hospitals is the quality and continuity of patient care. A typical patient, undergoing a serious procedure in a hospital, may easily see five or more physicians during a stay, and also many nurses and other supporting personnel. Maintaining a complete medical record for each patient (�charting�) swallows huge amounts of nursing time without providing any guidance to the medical staff on how to improve the patient's care. The present state of the art in medical care within hospitals makes very little use of the medical record, which is so bulky and awkward that it can only be quickly perused by doctors on their rounds. Such reading of the chart makes it almost impossible to evaluate treatment modalities, or to detect a patient's declining health in time for intervention (before a crisis).
OBJECTS AND SUMMARY The present invention overcomes the drawbacks associated with the prior art by providing a system and method for continually tracking the health of a patient in a hospital. One advantage of such a system is, in general, to allow physicians and nurses and clinical researchers to provide more effective health care for each patient, especially those spending several days in a hospital. A second advantage is that hospitals can avoid errors and reduce crisis management by using the invention's capability to detect trends in a patient's health before the patient reaches a crisis point. Recognizing a serious decline soon enough to administer proper treatment is a life-saving benefit. A third advantage is that such a system gives physicians and nurses a way in which to get the �big picture� of a patient's condition and absorb in a glance perhaps 100 pages of a patient's medical records. This deeper understanding, along with this new capability to detect health trends, both short-term (over the space of hours), and long-term (over the space of days), is extremely important in delivery of effective medical care. A fourth advantage is to enable an entirely new field of scientific study, where medical and surgical treatments can be evaluated by the new measurements provided by this invention.
The present invention generates a new measurement of health, herein termed the patient �Health Score� which is continually plotted and displayed to show each patient's medical progress during his hospital stay. This invention may prove to be a vital aid for improving the quality and continuity of medical care.
DETAILED DESCRIPTION In one embodiment of the present invention, a Health Score system 10 is provided for generating and presenting a Health Score chart. The newly invented Health Score is a medical reference �figure-of-merit� that is used by a physician or nurse to track the patient's health before, during or after a medical procedure or illness, in order to assist in preventing that patient from reaching a health crisis. When used in this manner, the Health Score chart enables the attending physicians and nurses to detect trends in the patient's health over time, particularly in evaluating post-operative recovery in the hospital. It also provides a statistically significant �outcome� for both clinical studies and retrospective studies of the relative efficacies among various surgical procedures or techniques, and among medical treatments and drugs.
Transformation module 16 is configured to transform each of the pieces of medical data obtained from collection module 14 into a numerical quantity at step 210. The transformation performed by module 16 may include any number of mathematical or logical operations. Transformations may also take multiple inputs to produce a single transformed output. Multiple inputs may include historical data for this patient or for any given class of patients. For example, if the patient's pulse is greater then one standard deviation above that expected for a certain group of patients at this stage of their recovery, then the value of �High Pulse� is one, otherwise it is zero. An example of a transformation for diastolic blood pressure (TDBP) would be:
The following serves as an example of a list of typical conversions of raw medical data into numerical form (�transformed numbers�) by transformation module 16, for use by system 10 in developing a patient Health Score:
if diastolic blood pressure<50 then Transformed Diastolic BP=2 diastolic between 50 and 89, then . . . 0 diastolic between 90 and 99, then . . . 1 diastolic>99, then . . . 2 all nursing assessments . . . Met=0 . . . or Not Met=1 multiply cardiac, neurological, pain, peripheral vascular, psychosocial, respiratory and skin/tissue assessments by 2 if Braden score<18, then . . . 1 if Braden score greater or equal to 18, then . . . 0 if systolic blood pressure<70, then . . . 3 if systolic>69 and <81, then . . . 2 if systolic>80 and less than 101, then . . . 1 if systolic>100 and <200, then . . . 0 if systolic>199, then . . . 2 if heart rate<40, then . . . 2 if heart rate>39 and <51, then . . . 1 if heart rate>50 and <101, then . . . 0 if heart rate>100 and <111, then . . . 1 if heart rate>110 and <130, then . . . 2 if heart rate>129, then . . . 3 if respiration<9, then . . . 2 if respiration>8 and <15, then . . . 0 if respiration>14 and <21, then . . . 1 if respiration>20 and <30, then . . . 2 if respiration>29, than . . . 3 if temperature<95, then . . . 2 if temperature>94 and <101.1, then . . . 0 if temperature greater or equal to 101.1, then . . . 2 If the monitored heart pattern is �atrial fibrillation�, �sinus rhythm�, �sinus tachycardia� or �paced� then . . . 1 If the monitored heart pattern is �sinus bradycardia� then . . . 2 If the monitored heart pattern is �atrial flutter� OR �heart block� then . . . 3 If the monitored heart pattern is �junctional rhythm� then . . . 4 If the monitored heart pattern is �ventricular tachycardia� then . . . 5 Or if the monitored heart pattern is �ventricular fibrillation� then . . . 5.
Part 1 �Health Sum�=Diastolic Blood Pressure+Temperature+Respiration+Systolic Blood Pressure+Heart Rate+Braden Score+Cardiac Assessment+Food Assessment+Gastrointestinal Assessment+Genitourinary Assessment+Heart Rhythm+Musculoskeletal Assessment+Neurological Assessment+Pain Score+Pain Assessment+Peripheral Vascular Assessment+Psycho-Sociological+Respiratory Assessment+Safety/Fall Assessment+Skin/Tissue Assessment
Part 2 Health Score=100*(30−�Health Sum�)/30
Health Score=100*(30−�Health Sum�)/30=100*(30−9)/30=70
In another embodiment, presentation and comparison module 20 may also alter Health Score chart 100 to obtain certain kinds of slope information. Even though trends are usually easy to spot by eye upon looking at Health Score plot 106, an automatic �simple� slope calculation may also be useful. Mathematically, this is the first derivative of the Health Score as a function of time. Due to the �noisiness� of typical Health Score plots 106, some averaging methods may be employed as well. If the slope is positive, the patient is probably getting better; if it is approximately zero, then the patient is staying the same; and if it is negative, then the patient is probably getting worse. Slope lines 116 may be added to the Health Score plot 106, as shown in FIG. 10. Such slope information may help identify trends in Health Score plot 106, particularly, when plot 106 is �noisy� due to large variations between each Health Score measurement. Although normally �staying the same� would not be considered a negative, in the situation where the patient is expected to be recuperating, �staying the same� may be quite worrisome. In the present example, although the most recent Health Scores on plot 106 are constant at about a level of 70, the slope line 116 shows a negative slope, taking into account prior points, including a time early on day 4 when the score was closer to 90.
Presentation and comparison module 20 of system 10 may also compute �rate of change� of the simple slope. For instance, although the patient is still getting better, the rate of improvement may be decreasing. This slow-down in recovery could be evidence of a problem just beginning to develop. Mathematically, this curvature information is the second derivative of Health Score as a function of time. Similar to the slope data 116, due to the �noisiness� of the curves, averaging is included in the computation. It is understood that attending physicians can adjust the slope calculation to include more or less reference Health Scores from plot 100 depending on the time span over which the physician intends to analyze.
As such, the above-described system 10 and accompanying generated Health Score charts 100 provide a convenient means for monitoring patient health status, particularly in hospital post-operational situations. It allows doctors to get a feel for the overall health of the patient and to detect trends in the patient's health. Such information is particularly useful in preventing crisis situations from arising in patients, where the worsening condition (of a patient of adequate, yet deteriorating health) is overlooked until it is too late. The creation of the Health Score chart 100, by the present invention, helps in alerting attending physicians, nurses, or �rapid response teams� to deteriorating conditions, even when a spot check of the patient's health would seem to show the patient to be in an adequate state of health.
For example, a procedure is often evaluated in terms of mortality rate, length of hospital stay, or number of re-admissions to the hospital. These measures are all significant, but at the same time are all rather crude measures. For example, if �Procedure A� has a mortality rate of 0.5% and �Procedure B� has a mortality rate of 0.7%, it may be very difficult to judge one the superior of the other, using only these mortality statistics. However, if patients discharged after Procedure A have an average Health Score of 80, and those discharged after Procedure B have an average Health Score of 60, there may be a real and meaningful difference between the two procedures in terms of overall efficacy in treating the patient. Thus, system 10 may provide a more sensitive measurement of health than any other available measure, since it is not based solely on major �outcomes� (like discharge or death), but rather on a more subtle combination of overall health factors. A medical study using the Health Score, which this invention makes readily available for every patient, would find earlier and easier and more meaningful �statistical significance� than a similar study that needed to wait for eventual mortality outcomes.
An additional feature of Health Scores generated by system 10 is that the Health Score can be used as a predictor to assist in determining which patients require the most care. Although individual symptoms and raw medical data may be varied, the amalgamated Health Score, as shown on Health Score charts 100, tends to be an accurate predictor of patient outcome. For instance, using Health Score data generated post facto, FIG. 12 shows actual graphic correlation between Health Scores from system 10 (computed at transfer to the ICU from a regular ward of the hospital) versus the rate of predicted expiration after an ICU stay. The chart shows a precipitous decline in survival rates when the patient has, incoming to the ICU, an overall Health Score below 65. In such instances, ICU units admitting patients with Health Scores below 65 may choose to divert additional resources to these patients, in order to reduce morbidity and mortality rates. The Health Score is a sensitive new tool for the ICU use. In this example, patient �A� with a Health Score of 65, versus patient �B� with a Health Score of 75, might not exhibit obviously different symptoms, and thus the patients might be treated similarly if the Health Score were not available. But when the doctors know that there is a statistically significant decline in survival rate when the Health Score is 65, patient �A� may get the additional care that would save his life.
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