AU2014100250A4 - An application program for recording medical consultation data on a portable computer device - Google Patents

Abstract

H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171_ .doc-17/03/2014 - 18 Abstract An application program for recording medical consultation data on a portable computer device, said program for performing the steps of displaying a list of patients for a medical 5 practitioner on a display of the portable computing device; receiving user input representing selection of one of said patients; displaying a patient graphical user interface on the display of the portable device showing data representing a medical summary of said one of said patients for viewing by the medical practitioner; receiving user input representing the practitioner's medical diagnosis for said one of said patients; generating 10 predefined sets of medical data associated with the medical diagnosis, said sets including one or more of the following a list of symptoms associated with the diagnosis; a list of examination findings associated with the diagnosis; list of investigations associated with the diagnosis; list of treatments associated with the diagnosis; and a list of referrals associated with the diagnosis; displaying said predefined sets of data in the patient 15 graphical user interface; receiving user input representing one or more selections of items within said predefined sets of data; generating a medical record including data representing a unique identifier for the patient; the medical diagnosis for the patient; and the user input representing one or more selections of items within said predefined sets of medical data; and saving the medical record in computer readable data storage. Str 100 3/5 Load application No First use? 108 Send request for updates to Yes 102 remote server 110 Send request for registration to Receive and store remote server 14updates12 Receive confirmation of Receive appointments registration from server14 Generate GUI with Receive and store medical data Eappointments listed from the remote server No tAppointment selected? Yes 116 [Generate patient GUI 18 A} 118 Receive user input representing selection of a diadnosis ,1 120 Generate predefined sets of data associated with selected diagnosis12 Receive user selections 12 Generate and save medical record in database 126 Generate prescriptions and/or referals Fnri Fiaure 3

Description

H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171 L.doc-17/03/2014 AN APPLICATION PROGRAM FOR RECORDING MEDICAL CONSULTATION DATA ON A PORTABLE COMPUTER DEVICE Field of Invention 5 An application program for recording medical consultation data on a portable computer device. Background of Invention 10 Typically, existing electronic medical record (EMR) applications rely on a fairly standard interface, utilising tabs, scrolling tables, radio buttons and so forth for navigation and a keyboard and mouse to input data. This process is frequently time consuming, difficult to navigate, prone to incorrect/incomplete entries and distracts the practitioner from their 15 patient. This inefficiency can also lead to reduced numbers of patients seen. With the advent of devices such as the iPad@ and iPhone@ which utilise a touch interface and which also allow for high portability, the possibility arose to create a new type of EMR. However, this type of touch interface is a two edged sword, its make selection and 20 scrolling easy, however typing/data entry can be difficult for large amounts of information, unless you connect an external keyboard which then defeats the purpose of the device. What is needed is a tool that takes advantage of the tablet style of touch interface as well as its inherent portability without the disadvantages. 25 It is generally desirable to overcome or ameliorate one or more of the above described difficulties, or to at least provide a useful alternative. Summary of Invention 30 In accordance with the invention, there is provided an application program for recording medical consultation data on a portable computer device, said program for performing the steps of: H:\tld\Interwoven\NRPortbl\DCC\TLD\61001711 .doc-17/03/2014 -2 (a) displaying a list of patients for a medical practitioner on a display of the portable computing device; (b) receiving user input representing selection of one of said patients; (c) displaying a patient graphical user interface on the display of the portable device 5 showing data representing a medical summary of said one of said patients for viewing by the medical practitioner; (d) receiving user input representing the practitioner's medical diagnosis for said one of said patients; (e) generating predefined sets of medical data associated with the medical diagnosis, 10 said sets including one or more of the following: (i) a list of symptoms associated with the diagnosis; (ii) a list of examination findings associated with the diagnosis; (iii) a list of investigations associated with the diagnosis; (iv) a list of treatments associated with the diagnosis; and 15 (v) a list of referrals associated with the diagnosis; (f) displaying said predefined sets of data in the patient graphical user interface; (g) receiving user input representing one or more selections of items within said predefined sets of data; (h) generating a medical record including data representing: 20 (i) a unique identifier for the patient; (ii) the medical diagnosis for the patient; and (iii) the user input representing one or more selections of items within said predefined sets of medical data; and (i) saving the medical record in computer readable data storage. 25 Preferred embodiments of the invention seek to provide an application that is capable of: a. maximising the benefits of the tablet interface; b. minimising the time spent by the user to record the greatest amount of information 30 with the highest level of accuracy; and c. minimising any break in the personal patient to doctor interface.

H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171 L.doc-17/03/2014 -3 To facilitate this, a custom interface has been constructed that is dependent on the most crucial moment in a consultation - the diagnosis. Using a typical medical record a doctor enters information obtained from the patient in a standardised format, which typically ends 5 with the diagnosis followed by any investigations and/or treatment. The clinician selects a diagnosis and the application then presents the clinician with all the relevant data which the user can quickly select relevant to the particular patient. It also has the added advantage that if the clinician has incorrectly diagnosed a condition they can see 10 that the symptoms and examination for example may not match their findings sufficiently, forcing a rethink. Advantageously, preferred embodiments of the invention provide rapid, accurate data recording with minimal room for error. Minimal disturbance of doctor/patient interaction. 15 Portability - useful in nursing homes, hospitals, and patient home visits. Data security via a 'cloud' environment. Minimal need for training by utilising an intuitive interface. Whilst other software exists, the closest which appears to be being a server based model, this invention preferably instead moves the primary application onto the iPad@ providing 20 relative independence from a server and maximising portability, and rather than generating data for the user, is already populated and ready to use. By creating and pre-populating a number of large interrelated databases, and designing a custom interface this new software allows the user to select from a predefined set of 25 symptoms, examination findings, investigations, treatments and referrals - the majority of data as such is not entered, but selected, directly linked to the diagnosis entered by the user. It also means data entry errors are minimised as only data relevant to a particular diagnosis is ever presented to the user. 30 By applying standardised industry algorithms such as Most Recently Used (MRU) or Most Frequently Used (MFU) on the databases utilised by the iPad@, the database(s) are H:\tld\Interwoven\NRPortbl\DCC\TLD\6100171 L.doc-17/03/2014 -4 reordered based on usage. For example, the list of diagnoses is reordered within each subgroup of diagnoses listed under its starting letter, the more times you select Asthma more likely it is the application will present it as option to start the process off, much like typing a text message on a mobile phone, it preempts based on a MFU model. 5 As the consultation proceeds, the system builds a patient record based purely on data selected from a pre-existing set of data, a medical record is then created, no notes are created as in a traditional model, only a data set. 10 The more mundane tasks of making a patient appointment, inputing patient demographics, scanning of correspondence, and importing of digital data relating to pathology and radiology are handled by the front office secondary software, which then adds them to the existing patient record. 15 Administrative staff also can install database updates when available for use by all registered users through the secondary application. Brief Description of the Drawings 20 Preferred embodiments of the present invention are hereafter described, by way of non limiting example only, with reference to the accompanying drawings, in which: Figure 1 is a schematic diagram showing a system for recording medical consultation data; Figure 2 is a schematic diagram showing data flow between component parts of the system 25 shown in Figure 1; Figure 3 is a flow diagram showing steps performed by application software running on the portable computer device shown in Figure 1; Figure 4 is a diagrammatic illustration of a graphical user interface generated by application software running on the portable device shown in Figure 1; and 30 Figure 5 is a work flow diagram for the application software being executed by the portable device shown in Figure1.

H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171 L.doc-17/03/2014 -5 Detailed Description of Preferred Embodiments of the Invention The system 10 shown in Figures 1 and 2 includes a portable computer device 12 in communication with a second computer device 14 over a communications network 16 5 using standard communications protocols. The second computer device 14 is preferably a server in electronic communication with the portable computer device over a wireless communications network. Alternatively, the server 14 is a cloud computer network in wireless communication with the portable computer device. 10 The portable computer device 12 includes: a. a central processing unit 18; b. an input/output controller 20; c. a display 22; 15 d. a user control interface 24; and e. non-transient data storage 26 including stored thereon an application program 28 comprising a plurality of instructions for execution by the central processing unit 18. 20 The portable computer device 12 is preferably an iPadTM and the application program is preferably downloaded from the iTunesTM store onto the iPadTm using standard techniques. The computer program 28 includes a plurality of instructions that, when executed by the one or more processors 18 of the portable computer device 12, cause the computer device 25 to perform the steps shown in Figure 3. A detailed description of the processes performed by the system are set out below. As shown in Figure 3, when the program 28 is loaded, at step 100, for the first time, the program sends, at step 102, a request to the server 14 to register the new application. 30 During this step, the program 28 sends the server 14 details of the application program and the registered owner of the program. The application 28 receives, at step 104, confirmation of successful registration from the server 14. The application 28 then H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171 L.doc-17/03/2014 -6 receives, at step 106, a plurality of predefined sets of medical data associated with diagnoses from the server 14. The sets of medical data are associated with medical diagnoses. For each diagnosis, the associated plurality of predefined sets of medical data includes one or more of the following: 5 a. a list of symptoms associated with the diagnosis; b. a list of examination findings associated with the diagnosis; c. a list of investigations associated with the diagnosis; d. a list of treatments associated with the diagnosis; and 10 e. a list of referrals associated with the diagnosis. The application program 28 saves the a plurality of predefined sets of medical data associated with diagnoses in the data storage 26 for later use. 15 If the application 28 is not being loaded for the first time, the program 28, at step 108, sends the server 14 a request for updates. At step 110, the program 28 receives any updates from the server 14 including any changes or modifications to the predefined sets of medical data. The program 28 then receives, at step 112, a list of patients from the server 14. The list of patients represents a schedule of appointments for that day for the medical 20 practitioner, for example. The application program 28 then generates, at step 114, the appointment graphical user interface (not shown) including a list of the practitioner's appointments for that day. The program displays the appointment graphical user interface on the display 22. The program 25 28 receives user input representing selection of one of the patients and generates, at step 116, a patient graphical user interface 200 shown in Figure 4 and displays it on the display 22. The patient graphical user interface 200 shows data representing a medical summary 202 of the selected patient for viewing by the medical practitioner. The medical summary 202 includes one or more of the following: 30 (a) past medical diagnoses 204; H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171 L.doc-17/03/2014 -7 (b) medications 206; and (c) family history 208. The patient graphical user interface 200 includes a section 210 for the current appointment 5 which includes a list of diagnoses 212 for the patient. Preferably, the list 212 includes all known diagnoses for the practitioner to select from. At step 118, the program 28 receives user input representing the practitioner's medical diagnosis for the patient. On receipt of this input, the program generates, at step 120, predefined sets of medical data associated with the selected medical diagnosis. The program 28 displays the predefined sets of 10 medical data associated with the selected medical diagnosis in the patient graphical user interface. The sets include one or more of the following: a. a list of symptoms associated with the diagnosis 214; b. a list of examination findings associated with the diagnosis 216; 15 c. a list of investigations associated with the diagnosis 218; d. a list of treatments associated with the diagnosis 220; and e. a list of referrals associated with the diagnosis 222. The practitioner is able to quickly scroll through the predefined sets of medical data to 20 select options that best fit the information derived by the practitioner during the consultation with the patient. The preselected list of symptoms 214, for example, includes symptoms that are associated with the diagnosis selected by the practitioner. Selection of one or more of the predefined symptoms 214 allows the practitioner to quickly record this information. 25 The program 28 receives, at step 122, user input representing one or more selections of items within the predefined sets of data. When the above-described recordal process has been completed, the program generates, at 30 step 124, a medical record including data representing: H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171 L.doc-17/03/2014 a. a unique identifier for the patient; b. the medical diagnosis for the patient; and c. the user input representing one or more selections of items within said predefined sets of medical data. 5 The program 28 then saves the medical record in computer readable data storage 26. The program preferably sends the medical record to the computer device 14 external to the portable computer device 12 for storage thereon. The record is preferably transferred to the cloud for storage. 10 The data representing the medical summary 202 of the patient is preferably displayed on one third of the patient graphical user interface 200. The predefined sets of medical data associated with the medical diagnosis are preferably displayed on two thirds 210 of the patient graphical user interface. 15 The program preferably performs the step of generating data representing one or more selections of referrals associated with the diagnosis. Further, the program preferably performs the step of generating data representing one or more selections of treatments associated with the diagnosis. 20 Preferred embodiments of the invention are below described, with reference to Figure 5, by way of reference to the program 28 being a primary application program installed on a portable computer device 12 and a secondary application running on a cloud server 14. 25 How the flow works between the primary and secondary applications, as well as the work flow within the primary application. Each step is labelled with a digit with brackets eg (3). (1) primary application. This is the application loaded on the users iPad@. Initially it 30 cannot perform any functions, requiring registration with the secondary application, followed by a once off upload of all the database information it will use. This database consists of many thousands of diagnoses, each with its own set of symptoms, examination H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171 L.doc-17/03/2014 -9 findings, investigations, treatments and appropriate referral options. (2) secondary application. This application is used for scheduling appointments, storing patient files, importing digital and hardcopy correspondence. It is also responsible for 5 registering and uploading the initial database populating of (1). (3) initial database populating step. This is a one off step, however updates can be pushed from the (2) to (1) when needed. 10 (4) synchronising of appointments. This informs the user of the days patients, in addition (2) uploads the patients files, ready for use. (5) once step 4 is completed the opening screen is divided divided into 1/3 left, 2/3 right appointments are displayed on the left, a summary of patient data such as blood pressure, 15 previous consultations and ongoing treatments - selectable are scrolling tables, with rows being 'clickable' allowing the user to preview information prior to starting an appointment. (6) next the user selects a patient and starts the consultation. 20 (7) opening patient screen, 1/3 left - displays ongoing and closed appointments, ongoing and closed treatments, allergies, social history, family history, and Pap smears. Entries in these zones are clickable allowing the user to drill into more detailed past entries, and to update information. Medications can also be clicked and prescriptions quickly printed. Along the bottom edge are buttons allowing access to past consultations and past 25 investigations. The right 2/3 of the screen is the main work area (the screen splits can switch for left handed users). A select diagnosis buttons is displayed and once the user has completed taking a verbal history, and examining the patient they then select a diagnosis. An option also exists to change the diagnosis, with the application retaining the information already entered and copying it across to the new diagnosis symptoms 30 examination findings etc..

H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171 L.doc-17/03/2014 - 10 (8) If this is the first time the patient is seen the user can take the opportunity to enter missing information into the zone of the left. (9) A diagnosis is now selected. The user is presented with a on screen keyboard. Once a 5 character is selected the top 5 diagnoses under that particular character is presented, along with the option to search using preemptive, most frequently or most recently used methodology. Once a diagnosis is selected this results in all relevant data being presented to the user, accessed via buttons at the bottom of the 2/3 split screen, which they select by touching the screen. The data presented is diagnosis specific. 10 (10-13) The user can access any of the primary data selection points at any time, by selecting a button on the bottom of the right 2/3 page, taking them to symptoms (10), examination (11), investigation (12) or treatment (13). The ability to edit these data sets, to add new items also exists. 15 (10) if first button is touched symptoms are shown in work area, this is also the default start screen. The duration of each symptom can also be entered for each symptom. (11) if the second button is touched the examination screen is displayed in the work area, at 20 the top is an area to enter vital signs, with selections listed below this and an area for selecting and drawing on a body image. The option is also available to select Left and Right. (12) if the third button is touched the investigation screen is displayed in the work area. 25 Default pathology, radiology, and referrals options are presented for selection. Referrals are template filled by the data selected by the user in the preceding entries. Suppliers can also selected at this screen. (13) if the fourth button is touched treatment options are displayed. This will include 30 medication and non-medication treatments. The medication fields allow entry of dosage, frequency, route of administration, quantity, repeats and other specialised fields. The H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171 L.doc-17/03/2014 - 11 treatments also utilise most frequently used and most recently used and or preemptive entry methods to populate the fields. Prescription(s) can also be printed or emailed. (14) button at top left of work area permits an additional diagnosis(es) to be entered. 5 (15) button at top right of work area permits a change in diagnosis, with retention of data common to both diagnoses automatically entered to save the user re-entering information already entered. 10 (16) When the consultation is completed the user closes the consultation with the option to select it as ongoing and also a follow-up period. The total application consists of 2 applications - a server which administers all appointments, stores all patient records, and most importantly holds all the databases 15 which are uploaded to registered device users which are used by the iPad application. The iPad application when first used synchronises with the server, this in turn pushes database data to the iPad application. Once populated, the application is driven by appointments entered through the server application. 20 Appointments are pushed to the iPad application and the user can then select the patient when required. Once a consultation is started, the application displays information relating to past and 25 current: conditions, medications, and social history on the left 1/3 of the screen. The user can select any of the displayed information and this in turn displays information related to prior appointments. The right 2/3 is the main work area. These areas are reversed for left handed persons. 30 To start entering information regarding a new consultation a diagnosis must be selected.

H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171_ .doc-17/03/2014 - 12 This is the reverse of the traditional way of recording diagnostic information. The iPad application then draws upon its custom database, allowing the user to select symptoms, examination findings, investigations, treatments and referrals specific to the 5 diagnosis. More than one condition can be entered during each consult. The iPad application also allows the user to print prescriptions and referrals. 10 The iPad application makes use of recently used ordering of databases to ensure maximum efficiency. With reference to Figure 5, there is provided a software method that records medical consultation data on a touch sensitive computer device, the primary software (PS) and a 15 'cloud' located secondary software (SS), operating as: said PS linking to a SS application that stores all the required databases used by the PS to be uploaded to the PS device when a user is first registered (in addition to a master list of databases held by the developer which may be periodically updated by the developer using data entered by themselves or data that has been forwarded to the developer by end 20 users), medical appointment lists, and storage of completed patient data sent from the PS when a consultation ends to an offsite 'cloud' environment; said PS acts independently from the SS server during a consultation, other than having appointments, and the patient files to be used on a given day being 'pushed' to it when required prior to any consultation or when the PS database needs updating, for 25 example with new medication data; said PS does not interact with the SS software during the consultation in relation to the active patient, permitting mobile use of the PS device; said PS presents the user with an appointment list which has been synchronised from the server and SS, and once a patient appointment is selected the PS displays a 30 summary of medical information comprising of past medical diagnoses, medications and details of alcohol, smoking, illicit drug use, family history and Pap smear information on H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171 L.doc-17/03/2014 - 13 1/3 of the screen with the remaining 2/3 being reserved for the current consultation - said information may have been entered at a prior appointment or may be altered during a consultation; said PS then requires the user to select a diagnosis from its self-contained diagnosis 5 database to 'drive' the remainder of the data entry process, there is no dependency on an individual patients parameters such as age or sex; said PS presents the user, through the pressing of on screen buttons, with lists of diagnosis specific symptoms, examination findings, investigation options, treatments, and referral options (rather than a generic set of lists) relevant to the diagnosis, that are selected 10 by the user, after which prescriptions and referrals may be printed, follow up times determined and the process for additional diagnoses repeated if required; said PS then culminates with the user closing the consultation, and the data being transmitted to the secondary application for storage and future retrieval. 15 The diagnosis database comprises of diagnoses, symptoms, examination findings, investigations, treatments and referral options encompassing all recognised medical fields held in either a single database or multiple linked databases used during a consultation that reside on the PS device and is not dependent on an external server for its operation, once a patients file has been uploaded. The software preferably does not automatically generate 20 data in relation to the consultation, it presents only pre-installed data relevant to a specific diagnosis, and requires the physician to select each piece of data to be stored at the time of the consultation within the PS. The PS resides on an Apple@ iPad@ utilising a primarily a keyboardless design, however 25 use of the devices software driven keyboard is available for text input. The PS will reorder its diagnosis and treatment databases using a Most Frequently Used (MFU) algorithm. The SS through its 'cloud' server stores all default databases ready for initial uploading to registered iPad@ users, patient medical records transmitted from the iPad@, as well as 30 digital and scanned copies of correspondence relevant to a given patient, and all appointment information.

H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171_ .doc-17/03/2014 - 14 Throughout this specification and the claims which follow, unless the context requires otherwise, the word "comprise", and variations such as "comprises" and "comprising", will be understood to imply the inclusion of a stated integer or step or group of integers or 5 steps but not the exclusion of any other integer or step or group of integers or steps. The reference in this specification to any prior publication (or information derived from it), or to any matter which is known, is not, and should not be taken as an acknowledgment or admission or any form of suggestion that that prior publication (or information derived 10 from it) or known matter forms part of the common general knowledge in the field of endeavour to which this specification relates.

Claims (15)

1. An application program for recording medical consultation data on a portable computer device, said program for performing the steps of: 5 (a) displaying a list of patients for a medical practitioner on a display of the portable computing device; (b) receiving user input representing selection of one of said patients; (c) displaying a patient graphical user interface on the display of the portable device showing data representing a medical summary of said one of said patients 10 for viewing by the medical practitioner; (d) receiving user input representing the practitioner's medical diagnosis for said one of said patients; (e) generating predefined sets of medical data associated with the medical diagnosis, said sets including one or more of the following: 15 (i) a list of symptoms associated with the diagnosis; (ii) a list of examination findings associated with the diagnosis; (iii) a list of investigations associated with the diagnosis; (iv) a list of treatments associated with the diagnosis; and (v) a list of referrals associated with the diagnosis; 20 (f) displaying said predefined sets of data in the patient graphical user interface; (g) receiving user input representing one or more selections of items within said predefined sets of data; (h) generating a medical record including data representing: 25 (i) a unique identifier for the patient; (ii) the medical diagnosis for the patient; and (iii) the user input representing one or more selections of items within said predefined sets of medical data; and (i) saving the medical record in computer readable data storage. 30

2. The program claimed in claim 1, including the step of receiving the list of patients H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171_ .doc-17/03/2014 - 16 from a computer device external to the portable computer device.

3. The program claimed in claim 1 or claim 2, including the step of receiving the predefined sets of medical data for a plurality of medical diagnoses from a computer 5 device external to the portable computer device and saving the predefined sets of medical data for a plurality of medical diagnoses in computer readable data storage on the portable computer device.

4. The program claimed in claim 2 or claim 3, wherein the external computer device 10 is a server in electronic communication with the portable computer device over a wireless communications network.

5. The program claimed in claim 3, wherein the server is a cloud computer network. 15

6. The program claimed in any one of claims 2 to 4, including the step of sending the medical record to the computer device external to the portable computer device for storage thereon.

7. The program claimed in any one of claims 1 to 6, wherein the medical summary 20 includes one or more of the following: (a) past medical diagnoses; (b) medications; and (c) family history. 25

8. The program claimed in any one of claims 1 to 7, wherein the data representing the medical summary of said one of said patients is displayed on one third of the patient graphical user interface.

9. The program claimed in any one of claims 1 to 8, wherein the predefined sets of 30 medical data associated with the medical diagnosis are displayed on two thirds of the patient graphical user interface. H:\tld\Intrwovn\NRPortbl\DCC\TLD\6100171_ .doc-17/03/2014 - 17

10. The program claimed in any one of claims 1 to 9, including the step of generating data representing one or more selections of referrals associated with the diagnosis. 5

11. The program claimed in any one of claims 1 to 10, including the step of generating data representing one or more selections of treatments associated with the diagnosis.

12. The program claimed in any one of claims 1 to 11, wherein the list of patients is a schedule of appointments for the medical practitioner for a given day. 10

13. The program claimed in any one of claims 1 to 12, including the step of generating a list of diagnoses and displaying said list on the display of the portable computer device.

14. The program claimed in claim 13, wherein the step of receiving user input 15 representing the practitioner's medical diagnosis for said one of said patients includes the step of the practitioner selecting a diagnosis from said list of diagnoses.

15. The program claimed in any one of claims 1 to 14, wherein the portable computer device is an iPadTm. 20