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Medical Patent Abstract
A medical communications and management system (MCMS) that is operative
to compile, store, retrieve and transmit digitized medical information
from a variety of medical imaging modalities, as well as digital
information such as scanned in images, digital photographs, audio
files, and digitized information corresponding to monitored physiological
conditions, such as heart rate and the like. The MCMS is further
operative to include personal patient identification information,
such as retinal scans and fingerprints, and is capable of being
archived to thus enable such digitized information to be readily
accessed. To that end, it is contemplated that the MCMS of the present
invention will be used in connection with an electronic medical
record and facilitate compliance with HIPAA.
Medical Patent Claims
What is claimed:
1. A medical communications and management system for facilitating
the generation, storage, retrieval and transmission of digitized
medical information comprising: a) at least one server system having
a database associated therewith, said server system and database
associated therewith being operative to receive, store, retrieve
and transmit medical image data generated by a medical image modality
selected from the group consisting of computerized tomography, magnetic
resonance imaging, positron emission tomography, digital x-ray,
ultrasound, nuclear medicine, angiography and nuclear magnetic resonance,
said server system and database associated therewith further being
operative to receive, store, retrieve and transmit digital data
corresponding to an item of digitized information selected from
the group consisting of an audio file, a scanned image and a digital
photograph, said server system and database associated therewith
having a single retrievable file for receiving, storing, and retrieving
computerized tomography, magnetic resonance imaging, positron emission
tomography, digital x-ray, ultrasound, nuclear medicine, angiography,
nuclear magnetic resonance, scanned images, digital photographs,
and digital audio; b) a communications link; and c) at least one
information retrieval device operatively coupled by said communications
link to said server system and database associated therewith, said
information retrieval device being selected from the group consisting
of a hospital information system, an e-mail server, a fax server,
and an archive server.
2. The medical communications and management system of claim 1
wherein the medical communications and management system is integrated
within an electronic medical records system.
3. The system of claim 1 wherein said server system and database
associated therewith are further operative to transmit said digitized
information in response to requests made by said information retrieval
device.
4. The system of claim 3 wherein said information retrieval device
further comprises a server or personal computer.
5. The system of claim 1 further comprising at least one medical
imaging modality operatively coupled via a communications link to
said server system with database associated therewith.
6. The system of claim 5 wherein said imaging modality comprises
a device operative to generate digital images selected from the
group consisting of computerized tomography, magnetic resonance
imaging, positron emission tomography, digital x-ray, ultrasound,
angiography and nuclear magnetic resonance.
7. The system of claim 5 wherein said server system and database
associated therewith are further operative to receive, store, retrieve
and transmit digital information corresponding to a monitored physiological
condition of a patient.
8. The system of claim 7 wherein said monitored physiological condition
is selected from the group consisting of breathing rate, heart rate,
blood-oxygen levels and sleep patterns.
9. A method for generating, storing, retrieving and transmitting
digitized medical information comprising the steps: a) generating
medical image data from a medical image modality selected from the
group consisting of computerized tomography, magnetic resonance
imaging, positron emission tomography, digital x-ray, ultrasound,
angiography and nuclear magnetic resonance; b) generating digitized
information corresponding to a digitized audio file, scanned in
image and digital photograph; c) transmitting said digitized data
in steps a) and b) to a server system having a dedicated database
associated therewith, said server system and database associated
therewith being operative to store, retrieve and transmit such digitized
data in a single retrievable file; d) providing a communications
link between said server system and database associated therewith
in step e) with an information retrieval device; and e) requesting
information from said information retrieval device through said
communications link to said server system with database associated
therewith, said server system and database associated therewith
being operative to retrieve and transmit said digitized data received
in steps a) and b) in response to said request made by said information
retrieval device.
10. The method of claim 9 wherein step e), said information retrieval
device comprises a hospital information system server, personal
computer, a viewer workstation, and a diagnostic workstation.
11. The method of claim 9 wherein said communications link provided
in step d) comprises an Internet connection.
12. The method of claim 9 wherein said communications link provided
in step d) comprises an Intranet connection.
13. The system of claim 1 wherein said server system having said
database associated therewith is further operative to receive, store,
retrieve and transmit digital data corresponding to an item of digitized
information selected from the group consisting of a scanned image
of a fingerprint and a retinal scan.
14. The method of claim 9 wherein step b) further comprises the
step generating digitized information corresponding to an individual's
fingerprints or an individual's retinal scan.
Medical Patent Description
CROSS-REFERENCE TO RELATED APPLICATIONS
Not Applicable
STATEMENT RE: FEDERALLY SPONSORED RESEARCH/DEVELOPMENT
Not Applicable
BACKGROUND OF THE INVENTION
This invention relates to a medical media file management system
and method, and more particularly, to an improved system for generating,
storing, retrieving and transmitting a plurality of medical data
in a digital format, including but not limited to text, charts,
still images, animation, graphics, video and audio, derivable from
a variety of media image sources, such as computer data base files,
hard copy print media, photographs, audio cassettes, video cameras,
medical imaging equipment and medical monitoring equipment.
Medical imaging data, as derived from a variety of imaging modalities,
is an essential component of health care and is often vital to properly
assess a given patient's condition. In this regard, a number of
complex imaging modalities are available which can generate digital
images, including computerized tomography (CT), magnetic resonance
imaging (MRI), positron emission tomography (PET), digital X-ray,
ultrasound, nuclear medicine, angiography, and nuclear magnetic
resonance (NMR). Other images can be converted into digital form
through the use of a film digitizer or scanner for images obtained
by more traditional X-ray radiography such as chest X-rays or mammograms,
images taken through endoscopes, and physiological monitoring systems
including wave patterns recorded in cardiology EKGs and in fetal
monitoring. Each of these modalities complement one another depending
on the type of diagnosis or monitoring being undertaken, so the
systems are often used in conjunction with each other. However,
each of these image acquisition devices typically operate as stand-alone
devices with relatively small local storage capacity. Each modality
is usually designed for the acquisition and subsequent analysis
of a specific type of data and the images produced are optimized
for a particular medical procedure. Consequently, each modality
generates images with different levels of resolution and cannot
communicate with another modality's data, resulting in inefficient
storage and poor correlation of diagnostic data. These obstacles
can prevent the timely and accurate diagnosis of disease. Although
it is typically possible to "export" the images from a
proprietary radiology (imaging) modality workstation to an industry-standard
format such as "Digital Imaging Communications in Medicine"
(DICOM) 3.0, several limitations remain as discussed subsequently.
In practice, viewing of radiology medical images typically requires
a different proprietary "workstation" for each manufacturer
and the manufacturer specific Picture Archival and Communications
System (PACS) typically extends its use only for the viewing and
diagnosis of the radiology-specific images. Even more archaic, and
perhaps the more conventional practice is to bundle the various
types of imaging data, such as developed X-ray films, ultrasound
photographs, and the like, with the actual physical patient file.
Similarly, from a monitoring standpoint, breathing rate, heart
rate, and blood-oxygen levels are also essential and can be recorded
on an ongoing basis using patient monitoring equipment. Furthermore,
monitoring data are generated during EKG tests, treadmill endurance
tests, fetal monitoring during labor, sleep research on REM cycles
or sleep apnea, and blood sugar level information from diabetes
tests. Despite the ability to generate and store such information
digitally, in standard practice much of the data is recorded on
long strips of paper, which uses significant resources and becomes
difficult and bulky to store in the patient files in paper form.
In addition to medical imaging and monitoring data that must be
generated and stored, substantial patient data must also typically
be collected and retained. Currently, during most hospital check
in procedures, a patient may need to fill out numerous forms providing
proof of identity and of insurance, as well as forms relating to
medical history. While many medical facilities are moving toward
computer records of the textual information, there is no efficient
way to keep copies of photographs and other media files containing
images pertinent to the patient file without actually pulling the
paper file from the records office, which can be at a remote location.
When a doctor or nurse conducts an interview of the patient, the
notes are placed in the file. Although it is not current typical
practice, an audio recording of the interview may be useful if there
was a simple and efficient means for storing the audio information
rather than dealing with loose bulky tapes in the patient file that
could inadvertently become erased.
Further problematic is when the patient's primary physician orders
tests to monitor the patient's physiological results, which in turn
causes the admissions process to be repeated at the monitoring facility.
Depending on the duration of the monitoring tests, limited sections
of the patient's monitoring response are printed out and marked
to highlight areas requiring attention and are folded into a file
for the doctor to view at a later time. In cases with sleep studies
or recovery from surgery, monitoring may be conducted for several
hours or days.
If the patient's primary physician orders an imaging-based test
to diagnose or assess disease, the admissions process is likewise
repeated at the imaging facility. Typically days after the imaging
procedure, the patient's primary physician receives a written report
generated by a specialist physician who has interpreted the images
but who is unlikely to understand the patient's clinical history
and is unaware of any other test results. The patient's primary
physician typically does not view the images directly but rather
makes a treatment decision based entirely on written reports generated
by one or more specialist physicians. The current process raises
several limitations on efficient diagnosis and treatment of patients.
The primary physician does not see the images unless they are printed
to film or the doctor travels to another department and makes a
request. Each proprietary modality workstation at a separate location
requires training in how to use the software to view the images,
and images from the same patient but different modalities cannot
be viewed side-by-side, even using proprietary workstations. The
primary physician cannot show the patient his/her images in the
physician's office while explaining the diagnosis; and the patient
cannot transport his/her images to another physician's office for
a second opinion.
As if such practices were not already burdensome, recently implemented
legislation has made the ability for hospitals and physicians to
generate and assess patient information, and in particular, medical
imaging data even more difficult. Specifically, The Health Insurance
Portability and Accountability Act (HIPAA) of 1996, signed into
law on Aug. 21, 1996, sets forth numerous regulations related to
the practice of medicine, particularly with respect to the handling
of healthcare-related information, that are intended to reduce the
administrative costs of healthcare. Essentially, HIPAA sets forth
provisions related to the development and implementation of standardized
electronic transactions and the implementation of privacy and security
procedures to insure confidentiality and prevent the misuse of patient
information. With respect to the former, namely, standardized transactions,
the same are to be used no later than Oct. 16, 2003.
Among the many requirements set forth in HIPAA is that any medical
practice that electronically sends or receives certain transactions
must send and receive them in a standard format. Such transactions
expressly include claims, remittance and payment advice, claims
status, enrollment and dis-enrollment in a health plan, premium
payments, eligibility inquiries and responses, referral certifications
and authorization, coordination of benefits, first reports of injury,
and claims attachments. In this regard, it is contemplated that
a medical practice will be able to submit a claim for a patient,
irrespective of the payor involved (e.g., insurance company, health
maintenance organization, etc.). As a result, it is contemplated
that all transactions will be standardized in nature, which will
include the uniform use of codes typically associated with conventional
billing practices, such as diagnosis codes (i.e., ICD-9-CM), procedure/service
codes (CPT-4), drug codes (NDC), and other service codes (HCPCS),
among others.
With respect to imaging data, however, particularly when generated
and stored in physical patient files and not otherwise kept in a
format that can facilitate the electronic transmission of data,
is operative to defeat the entire legislative purpose behind HIPAA.
Furthermore, it is practically impossible and cost-prohibitive to
duplicate Radiology Film Storage when the Films are not in a Digital
Format, thus making the task of HIPAA required back-ups and disaster
recovery meaningless. Accordingly, there is a substantial need in
the art for a medical media file management system and method that
is operative to not only facilitate the collection, storage, retrieval
and transmission of medical imaging data capable of being generated
from a wide variety of imaging modalities, but further is operative
to facilitate the collection, storage, retrieval and transmission
of other types of patient data, such as digital photographs, scanned
in images of patient identification and insurance information, and
recorded audio (e.g., transcription) files, to thus enable all such
information to be retained in an efficient digital format. There
is further a need for such a system and method that can be readily
integrated with virtually all types of medical imaging modalities,
as well as conventional devices, such as digital cameras, that can
enable all information derived thereby to be stored and retained
in a digitized format. There is still likewise a need in the art
for such a system and method that can be incorporated as part of
an existing electronic medical record (EMR) which can thus greatly
reduce the amount of physical storage associated with storing personal
files, as well as facilitate the handling and exchange of patient
information and transactions related thereto, especially in compliance
with HIPAA. There is still further a need in the art for such a
system and method that can be constructed utilizing existing technology,
is of low cost, is exceptionally efficient and can be integrated
into virtually all types of existing medical and hospital practices
and procedures.
BRIEF SUMMARY OF THE INVENTION
The present invention specifically addresses and alleviates the
above-identified deficiencies in the art. In this regard, the present
invention is directed to a Media Communications and Management System
(MCMS) that is operative to serve as the basis of an enterprise-wide
image, document, recording and file management facility for any
healthcare provider. Various imaging modalities can be directly
captured and linked to the patient record in the Hospital Information
System (HIS) utilizing the industry standard HL/7 protocols. The
imaging modalities may include CT, MR, Ultrasound, and radiography
images and movies, and may also include other patient specific documentation
such as photographs of the patient or copies of the patient's drivers
license, Social Security Card, and insurance card. Additional media
may also be stored including sound files from cardiac and fetal
ultrasounds, voice recordings, and retinal scans.
The MCMS can be manipulated by a Mini-PACS Diagnostic Workstation
and/or any Network attached Windows Workstation as a medical viewer
workstation. The system may be used to convert medical information
from a plurality of media formats in to an integrated format. The
invention also relates to methods to manipulate digital medical
media in such a way that multiple media modalities from multiple
different vendors can be assembled into a single database without
loss of diagnostic information. The MCMS can integrate non-conventional
image/digital data, such as digital photographs and audio files,
as part of a patient's digitized medical information, as well as
data such as retinal scans and fingerprints, to thus enable a patient's
medical information to be comprehensively collected, stored, retrieved
and transferred.
FIGURE DESCRIPTION
These as well as other features of the present invention will become
more apparent upon reference to the drawings.
FIG. 1 diagrammatically illustrates the overall architecture of
an embodiment of the Media Communications and Management System.
DETAILED DESCRIPTION OF THE INVENTION
The detailed description set forth below is intended as a description
of the presently preferred embodiment of the invention, and is not
intended to represent the only form in which the present invention
may be constructed or utilized. The description sets forth the functions
and sequences of steps for constructing and operating the invention.
It is to be understood, however, that the same or equivalent functions
and sequences may be accomplished by different embodiments and that
they are also intended to be encompassed within the scope of the
invention.
The present invention resides in an interface of medical media
data storage, retrieval and communication components with the integration
of media image and audio manipulation control mechanisms that enable
a user of the system to both efficiently store multiple types of
information from diverse media, and to rapidly access, copy, transmit
and/or store any such stored media image for analysis. The structure,
control and arrangement of these components and control mechanisms
have been illustrated in the drawings that illustrate the systems
and methods of the present invention.
Referring now to FIG. 1, there is shown an overall flow diagram
of the Media Communications and Management System (MCMS) 10. The
key input technology components of MCMS 10 include various media
modalities 12, including but not limited to computerized tomography
(CT) 14, magnetic resonance imaging (MRI) 16, positron emission
tomography (PET) 18, digital X-ray 20, ultrasound 22, nuclear medicine
24, angiography 26, and nuclear magnetic resonance (NMR) 28. Other
non-digital images 30 can be converted into digital form through
the use of a film digitizer or scanner 30. These images may include
more traditional X-ray radiography such as chest X-rays or mammograms,
or images taken through endoscopes. The output from physiological
monitoring systems 32 such as wave patterns recorded in cardiology
EKGs, sleep clinic REM or sleep apnea measurements, or in fetal
monitoring can also be captured by the system. Images, movies, and
sound may be recorded from any device 34, including but not limited
to digital cameras, camcorders, camera cell phones, and the like.
Photocopies or scanned images 36 of drivers licenses, social security
cards, and other identification, as well as virtually any document
can also be digitized through the scanner. Retinal scans 38, fingerprint
data, and audio recordings 40 also provide input to the MCMS.
The data flow from the various Radiology (Imaging) input components
is directed via a communications link 43 to one or more system servers
44 having one or more databases associated therewith, including
a Digital Imaging Communications in Medicine (DICOM) format caching
server 46, a mail server 56, a fax server 60, all of which are linked
to one or more information retrieval devices, such as a diagnostic
workstation with mini-Picture Archiving and Communication System
(mini-PACS) 50, a viewer workstation 48 connected through an Intranet
connection 68 to a Hospital Information System (HIS) server 52 via
HL/7 standards 54, a set of user files including office files and
transcriptions 58, a store/archive management system 62, an Intranet/Internet
connections 66, 68 to facilitate Web-based access. Conventional
mail 70 and fax 72 capabilities are also integrated as part of the
information distribution capabilities of the present invention.
The storage/archive management system 62, which stores and readily
retrieves media files, is linked to a Storage System, which in turn
is linked to an archive to facilitate back-ups and disaster recovery.
It is likewise contemplated that such media files can be accessed
by a personal computer or content requesting server via wireless
and/or web access 64 through an Internet communications link 66.
In a preferred embodiment, the radiology imaging modalities have
the DICOM format capability and are linked with an Intel based Server
with either an attached or peripheral file storage capability. The
MCMS software may consist of various applications and systems including
DICOM Server, DICOM Viewer, Windows SQL 2000, Windows 2000 Server,
and Storage Management. The network communications can follow a
TCP/IP Network and DICOM 3.0 protocol. Optional interfaces include
HL/7 to HIS/RIS and HL/7 to the various modality software systems.
The integration process uses modalities that are configured to
capture consistent patient examination data. The modalities are
configured to auto-send patient index and image files over the TCP/IP
network to the Windows 2000/DICOM Server. The images are stored
as individual files located on the file storage on the DICOM Server
along with a Patient Record Index. The Patient Record Index will
preferably consist of the following Data Elements: Physician Name,
Patient Identification, Patient Name, date of birth, sex, examination
type, image number, image date, modality, modality manufacturer,
modality model, and the like. Images are accessed by any workstation
with DICOM-based viewing software using any of the Patient Record
Index data elements. In addition, for diagnostic viewing, images
can be accessed from a Radiology Diagnostic work station with any
third party diagnostic software. Image file management is controlled
through storage management software based rules, which can be programmed
to archive based on data elements, such as date of exam, calendar
days or file size to optimize the cost of the overall storage media.
The same architecture also forms the foundation for capture of other
media including scanned documents. All the file elements are attached
to the core patient management system to form the electronic information
folder for the patient information.
In use, the MCMS 10 will be operative to provide a comprehensive
database of digitally stored information that greatly facilitates
the ability of medical information to be compiled, stored, retrieved
and transferred. It is contemplated that through such system, a
digital patient file can be created that can enable all pertinent
information related to a patient that has not heretofore been capable
of being digitized, and much less digitized from a variety of image
modalities, to be compiled in a single retrievable file. For example,
it is contemplated that a patient entering a hospital implementing
the MCMS will be able to provide identification information and
proof of insurance, such as through drivers licenses, Social Security
card, insurance cards, and the like that can be scanned in, along
with any other pertinent patient information. The MCMS will further
be operative to allow further input of information during a patient
examination, such as digital photographs, recorded patient interviews,
recorded statements by the treating physician or other hospital
staff, or any other information that may be pertinent to the treatment
of a given patient, such as medical histories provided by relatives
and/or in the case of accidents, statements from witnesses or law
enforcement officials. Along these lines, it is contemplated that
other data specific to the patient, such as finger prints and a
generation of a retinal scan can be included within the patient's
file to thus serve as a basis of identifying a particular individual.
In this regard, such uniquely identifying features may be included
as part of a database that can enable the medical records generated
through the MCMS of the present invention to be readily accessed
and forwarded to a hospital, physician or any other type of medical
facility to thus provide a readily retrievable medical history for
that specific individual.
In addition to the digitized information above, it is further contemplated
that any and all imaging data as referenced herein may further be
included as part of the patient's diagnosis. As discussed above,
imaging modalities such as X-rays, ultrasound and the like can be
digitized and stored within a patient's specific file. Advantageously,
such process thus eliminates the need to store such image data,
such as X-ray films and the like, that are known in the art to be
costly, space inefficient and exceptionally difficult to archive
and access. Moreover, by virtue of having the capability to store
image data in a digitized format, the MCMS of the present invention
is operative to uniformly store and make accessible image data irrespective
of the type of image data that is warranted, whether CT, MRI, PET,
EKG or Scanned Images, for example.
Due to the simplicity by which the compiled digitized information
is compiled through the MCMS of the present invention, it is contemplated
that the MCMS may either be operative to exist as either a stand
alone electronic record (EMR) system or otherwise be incorporated
as part of a conventional EMR system with HL/7-based interfaces
to the HIS 52.
As is well-known in the art, a variety of commercial software products
are available for generating electronic medical records, as well
as facilitating electronic claims filing and other medical management
tasks that, in addition to increasing the efficiency of conventional
health care practices, further help ensure compliance with HIPAA
regulations by enhancing the security associated with patient information
and utilizing all applicable standard formats necessary to conduct
and codify electronic transmissions. By complementing such systems
with the ability to capture not only medical imaging data but other
pertinent patient information, the MCMS of the present invention
is operative to greatly enhance the capability of such conventional
EMR systems to not only provide greater efficiency but also comply
with HIPAA.
In a related application, it is contemplated that the MCMS will
further be operative to facilitate the ability to create archives
of patient histories that, as discussed above, can be readily accessed
as necessary. To that end, it is contemplated that the MCMS of the
present invention will be operative to create redundancy of patient
information such that a patient's specific medical record can be
stored in multiple archives and thus not be limited to a single
patient file that can be subjected to damage or misplacement. In
this respect, it is contemplated that once a sufficiently large
database of patient files has been created, the same can be accessed
as may be necessary in the event of natural disasters, acts of war
or terrorism and the like to thus enable medical records for one
or more patients to be readily accessed at a treating facility by
simply accessing such information via the Internet. Accordingly,
it should be understood that the MCMS of the present invention has
wide spread application for use in not only facilitating the ability
to generate, to store, retrieve and transmit medical information
in a digital format, but as well as facilitate the ability of health
care providers to have continuous access to patient information
that is constantly kept up to date and is capable of being identified
with a specific individual. Moreover, because of the digitized format
by which the information is retained via the MCMS of the present
invention, such information can be readily communicated via conventional
communication lines, and especially the Internet, which thus provides
an extremely efficient manner that such information can be readily
accessed.
Additional modifications and improvements of the present invention
may also be apparent to those of ordinary skill in the art. Thus,
the particular combination of parts and steps described and illustrated
herein is intended to represent only certain embodiments of the
present invention, and is not intended to serve as limitations of
alternative devices and methods within the spirit and scope of the
invention.
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