CN1846214A - Method and system for direct and persistent access to digital medical data - Google Patents

Abstract

The invention provides direct and persistent access to digital data, in particular to digital medical data. Based upon the identity of the user (10), a list of relevant medical data is presented to the user (12) by accessing a repository of attributes relating to the digital medical data. In order to generate the list a user profile is consulted (11). The user profile dictates the items within the list on the basis of a rule-based comparison between the user profile and the attributes. The user selects from the list the medical data which should be presented, and the requested medical data is subsequently presented to the user (15).

Description

Method and system for direct and continuous access to digital medical data

technical field

The present invention relates to providing direct and continuous access to digital data. In particular, the present invention relates to providing direct and continuous access to digital medical data.

Background technique

Digital medical images are currently obtained from different image modalities such as 3D or volumetric scanners such as: Computed Tomography (CT), Magnetic Resonance Imaging (MRI), Ultrasound (US), Electron Emission Tomography (PET) and Single Photon Emission computed tomography (SPECT) and 2D scanners such as computed radiography (CR) and digitally controlled radiography (DR). This image data, along with patient information and records, is currently created and stored on disparate electronic database systems that are customized to handle image data, patient demographic information, laboratory requests and results, pharmacy data, and healthcare resources (beds, procedures, etc.) reservations and appointments. Several computer-based systems have emerged to process various patient-related data. These include image management systems under the broad category of picture archiving and communication systems (PACS systems), which apply digital imaging and communication in medical standards (DICOM standards), and systems for administrative and non-graphical data, which apply such The International Health Information Interchange Standard Layer 7 (HL7) standard, the Electronic Data Interchange for Administration, Commerce and Transport (EDIFACT) standard, and the International Health Exchange (IHE) framework.

PACS systems are typically dedicated client/server based systems that require hospital users to log into client workstations and then perform queries to retrieve relevant patient image data for viewing. Such image data may also necessitate user-driven manipulations in order to obtain the desired correct observation or analysis. Likewise, non-graphical patient data is often accessed through dedicated applications or workstations, requiring query and search to locate and view relevant data. In fact, in most full-service healthcare settings, hospital users must navigate a process that includes tens to hundreds of individual computer user interface interactions to obtain the necessary electronic information for a given patient.

And with many existing systems, once a collection of patient-related data has been collected, there is no easy way to electronically re-access these collected data at another time or location. The steps followed initially must be performed again.

In US Patent 6,260,021 a system is disclosed for distributing medical images from an existing image storage system to a plurality of different kinds of client workstations. The system includes one or more interface engines for providing a uniform structure to image objects regardless of the type of existing system in which they are stored, and image server middleware for managing distribution of image objects.

A system for customizing the content and presentation of content for computer users is disclosed in US Patent 6,014,638. The system monitors and records user needs and preferences for subsequent computer display in connection with electronic vending. Customize the display according to the user's needs and preferences.

Contents of the invention

The object of the present invention is to provide a method for direct and continuous access to digital medical data.

According to a first form, the invention discloses a method for providing medical data relating to an individual, said method comprising the steps of:

access to the user profile of the requesting user,

access a repository of attributes related to the medical data,

Based on a rule-based comparison between user profiles and attributes, a set of data objects is produced, wherein each data object represents a data group associated with an individual,

produce a list of data objects presented to the user, and

Whenever the user makes a single request for a data object on the request list, the requested medical data is displayed for the selected data object.

The medical data may be any type of medical data, but is preferably medical image data obtained in conjunction with medical scans of a patient. Preferred medical data include graphical medical data, such as image data, and text-based data, such as information relating to demographic data, diagnoses, and the like.

Medical data is stored on a computer-based system that includes a first device and at least one second device. Preferably, the invention is implemented on a system employing a client/server network system, whereby the first device may be a server or may be a central computer, or central group of computers. The first means may comprise any type of computer or group of computers having the total storage capacity necessary to store very large data sets, eg resulting from scanning a large number of patients in a hospital. The first device should further be equipped with the necessary computing power capable of handling the demanding task of analyzing and manipulating large 3D data sets (eg 3D images of human head, chest, etc.).

That at least one second device may be any type of computer equipped with a screen for graphical display. The term display should be interpreted to include 2D display and 3D display. The at least one second device may eg be a thin client, wireless handheld device such as a Personal Digital Assistant (PDA), personal computer (PC), laptop, tablet or workstation. The at least one second device may only function as a graphics terminal for the first device. The at least one second device is capable of receiving a request action from a user and transmitting the request to the first device, as well as receiving and displaying a screen image generated by the first device.

However, the invention is not limited to implementation on client/server type systems. For example, it can be executed on any type of system, including a workstation or PC, or a program that communicates with the Internet to implement it.

For example, the user may be a clinician, a nurse, or the user may be a research scientist such as a researcher (eg, research medicine, psychology, psychiatry, human biology, biophysics, etc.). A user may gain access to the system through a computer interface connected to at least one second device, such as a screen, keyboard, and pointing device (eg, a computer mouse). The system may contain discreet information about the patient, and therefore only authorized personnel can gain access. Users can gain access to the system in several ways. For example, access can be gained by inserting an ID card into a card reader, or by presenting the card to a card reader that can detect the card's identity at a distance. Cards such as cards with an electronic chip integrated into the card, cards with a magnetic strip, cards with an optically readable pattern, or other types of cards may be used. Access can also be gained by typing a user name and password in a manner similar to how computer users typically gain access to a computer or computer network. Additionally, medical data transferred between the first and at least one second device may be encrypted.

Once the user has been identified, the system accesses the user profile matching the requesting user. The user profile is preferably stored on the first device. The user profile may be an individual user profile, ie a user profile valid only for the requesting user, or it may be a group of user profiles valid for two or more users. The system then accesses a library of attributes associated with the medical data. In the case of medical data following the DICOM standard, this attribute is standardized and can be found as part of the header of each data object. For example, a data object may be a three-dimensional image of a patient scan. In this case, the header may include attributes related to information related to the characteristics of the scanned image, the date and time of the scan, the number of data points, and the like.

After the user profile has been accessed, a set of data objects is generated based on a rule-based comparison between the user profile and the attributes. For example, a user profile may specify that the list should include all patients scanned within the last 24 hours, then only patient data scanned within the last 24 hours is included in the generated set of data objects. Produces a list where each entry represents a data object. After the list has been generated, the list is automatically presented to the user. Lists can be presented on the computer screen graphically or textually, such as icon lists or text lists. The list may include entries representing all data objects for which a match was found in the attribute repository based on the user profile. Thus, the list may be a list of data objects, ie image objects representing patient data, such as data obtained from a medical scan of the patient. By activating an entry on the list by a single request action, such as clicking on the corresponding icon or text element with a computer mouse, the selected personal medical data are displayed on the screen. Thus, "one-click" access to relevant patient data can be obtained instead of extensive user interaction that would otherwise be necessary.

A user profile may include information about user-specific preferences. For example, if the user prefers a grayscale display rather than a color display. Or if the user prefers to view images from a certain angle, virtually any setting can be included in the user profile.

The invention may include a software implemented application providing a method for analyzing configuration files to determine user preferences so that the method of displaying data on the screen of at least one second device may be customized according to user needs and preferences. Thus, users are provided with a system for gaining direct access to medical data that is standardized in the overall functionality of the program, but whose display of accessible data and accessed data can be customized to the individual user.

A user-specific log can be saved along with the user profile. When a user logs into the system, a user-specific log can be used to record all user events, and session state related to all user events. User-specific logs can be recorded by any means that may record user events. User-specific logs may be recorded in the computer cache of the computer connected to the user interface (i.e., the computer that records all user interactions), or may be saved as computer files to disk or any other type of storage medium. User-specific logs can be retained even if the user logs off and deactivates the system. If the user then starts a new session within the system, the user will have the option to start at the exact stage where the user left off. Thus, at the beginning of a new session, the user may be presented on the screen of the at least one second device with exactly the same screen image as at the end of the previous session. When starting a new session, the user can choose between continuing the previous session or starting a new one. In embodiments where the system runs from a central server via a local client, the session state does not even depend on the user's geographic location. Thus, a user can start a session at a location such as the user's office. Then log out of the system. Change location, then start a new session at another time and continue the session exactly where the user left off. By including all past user events, or including a large number of past user events, such as the last 20 user events, the last 50 user events, or the last 100 user events, the recovery function used in the new session Actions and past session actions are still accessible. Thus, the method provides continuous access to digital medical data in addition to direct access to digital medical data. Ongoing visits can be very appropriate for health care workers, who often do not have a fixed work location, need to respond quickly to health problems in their environment, and patients are also within the same hospital and Move between different health care facilities.

An important feature of the present invention is that, in addition to gaining access to medical data, access can also be gained to computer applications selected from a library of computer applications so that medical data can be visualized, analyzed and manipulated. The computer application may be a three-dimensional display and analysis program that may enable the user to rotate and zoom scanned three-dimensional images of selected patient data, or to view two-dimensional slices of the patient. The computer application may be stored on and run from the first device, or may be stored on and run from a device connected to the first device through a computer network connection.

The user profile may also include information about which computer application the selected patient data should be given. For example, if the user is a brain surgeon, the user profile may include information such that the user may always be given an application for MRI scans, while a plastic surgeon may be given a CT scan application. User-specific logging records the application used and all user events within that application. Thus, even if the user does log out of the system, change location, and then log in again, the system can provide a continuation of work within the exact same state of the application. The choice of computer application is usually based on the type of medical data, so if the user is requesting CT data, the data is displayed with a specific application for CT data.

The user profile may additionally include information about the user's location and the time of day of the request. Based on a user profile, combined with location, time, or both, the system can determine the task at hand for that user. This may be useful if the user needs or wants to present different data based on the user's geographic location or time. The user location may be determined from the location of the computer the user uses to access the server. Where the computer is a stationary computer such as a workstation, thin client or PC, the location may be determined from the computer's known location. Alternatively, the location of the computer may be determined based on the access point of the computer network. This is especially true if the computer is a mobile device such as a handheld device (eg a PDA or laptop).

A user profile may also include information related to a user's calendar stored in another software application. For example, user profiles may even be associated with digital personal organizers, such as Microsoft Outlook ^(TM) or hand-held organizers such as Palm Pilot ^(TM) .

The user profile may also include information related to attributes of previously requested graphical medical data. If the user primarily retrieves certain image types, the user profile can be dynamically updated so that such images are given in a list that the user can access with a single request action. Other types of information can also be dynamically updated, such as user preferences. In addition to, or alternatively, updating user profiles dynamically, user profiles may also be manually updated. An administrator such as a superuser, or any person or group of people with specific authorization to update user profiles can manually update user profiles. Users can also update user profiles. For example, by using a dedicated profile management application provided to the user to perform processing.

Access data obtained by the current method may be data including graphical medical data. For example image data obtained in association with a medical scan of a patient. Preferably, the image data may follow the DICOM standard implemented on the PACS system. In particular, the graphical medical data may be three-dimensional graphical medical data such as data from MRI, CT, US, PET and SPECT and two-dimensional graphical medical data such as data from CR and DR. In addition to being displayed, graphical medical data can be manipulated and analyzed according to standard operating and analysis procedures. An operation can be any standard manipulation of data, such as rotating, zooming in and out, clipping a region or subset of data, and so on. An operation can also be a non-standard operation, or it can be a specific operation specially developed for this system.

In addition to graphical data, access to textual medical data related to selected individuals can also be obtained. Preferably, the textual medical data is based on data following the HL7 standard or the EDIFACT standard. A feature such as a button to press, a menu point to select may be enabled such that when this feature is activated, the textual medical data stored for the patient associated with the displayed data object is retrieved from the first device. Interchange of graphics and/or medical data may be based on IHE architecture for data interchange.

According to a second form of the invention, a computer system for providing medical data relating to an individual is disclosed, the system comprising:

a first device and at least one second device, wherein the first device and at least one second device are connected together in a computer network,

at least one second means comprising input means and display means capable of accepting the requested action,

requesting a user profile for the user, wherein the user profile is stored on and accessible from the first device, and

a library of attributes related to the medical data is stored on and accessible from the first device,

wherein a set of data objects based on a rule-based comparison between user profiles and attributes is generated, wherein each data object represents a data group associated with an individual, and a list of data objects is generated and presented to the user,

Thus, as soon as the user requests one data object on the list with a single request action, the requested medical data of the selected data object are displayed on the display means.

Description of drawings

Preferred embodiments of the invention will now be described in detail with reference to the accompanying drawings, in which:

Figure 1 shows an overview of a preferred embodiment;

Figure 2 shows a flow chart of the steps involved in a preferred embodiment of the present invention;

Figure 3 shows a data structure and information hierarchy scheme that allows direct access to desired patient data;

Figure 4 illustrates direct access to patient data including CT images;

Figure 5 shows an example of a user log; and

Figure 6 illustrates the functionality of the user log.

Detailed ways

The present invention provides methods and systems that can rapidly gain access to medical data. The invention is described below with reference to a preferred embodiment, wherein the invention is implemented as a software program on a client/server network computer system. The server is part of the PACS system and the medical data is stored, manipulated and processed on the server (or a device connected to the server through a computer network connection) as well as the application programs for display and analysis. The software application runs on a central computer server system, but all users who interact with it communicate through client devices connected to the server. In a preferred embodiment, the client device can only accept requested actions from the user, transmit the request to the server, and thereafter receive data from the server as a result of the request and present it on the screen in contact with the client. The disclosed method of gaining access to medical data is not limited to work within a single institution, as the client and server may be connected, for example, via the Internet or via any other type of network connection.

An overview of a preferred embodiment of the system is shown in FIG. 1 . Medical image data are obtained eg by using a medical scanner, and are then stored on the image server 1 as part of the PACS system, so access to the images can be established at any time thereafter. A large number of clients 3 can be connected to the server through a network connection 2 . The network 2 may be any type of network, which in a preferred embodiment is an intranet such as Ethernet or the Internet. As is well known from networking systems, clients and servers can communicate with each other over both an intranet and the Internet.

The client 3 may be any type of computer equipped with a screen for a graphical display, and means for recording requested actions, such as a keyboard and a computer mouse. A client may be, for example, a thin client, a wireless handheld device such as a personal digital assistant (PDA), a personal computer (PC), or the like.

In addition to the medical data, a set of software applications 4 for data analysis and display are stored on and run from the server. The set of application programs can also be stored on and run from a device connected to a server through a computer network connection. The server is equipped with the necessary computing power to be able to handle the demanding task of analyzing and manipulating large three-dimensional objects, such as three-dimensional images of human head, chest, etc. All data and data applications for display and analysis are stored, manipulated and processed on the server. The handling of the session and all events related to it are done by the control software 5 . The control software receives user requests, retrieves data from the medical server, invokes the appropriate software application from the set of available applications, processes user configuration files, keeps a log of user events and session state, and so on.

Figure 2 shows a flowchart of the steps involved in the preferred embodiment of the present invention. Figure 2 is explained in connection with a preferred embodiment where the user is a clinician with various tasks. The clinician is connected to the radiology department and the patients he deals with are patients who have undergone medical scans such as CT scans. Patients can then undergo surgery based on the images obtained in conjunction with medical scans.

As the first task of a given day, the clinician may join a group of other clinicians for a morning meeting in which the team discusses the patients currently being treated, such meetings are common in hospitals. A typical subject for discussion in a morning meeting might be a patient who has undergone a medical scan within the last 24 hours. To facilitate this discussion, a thin client equipped with a projector is placed in the conference room.

The first step 10 in identifying the user (ie the clinician) is to insert the identification card into the card reader. Once the user identity is confirmed, a first consultation 11 of the clinician's user profile is completed. A clinician's user profile includes a rule that states that if the clinician is making a request from a conference room, a list of patients that have undergone a scan within the last 24 hours should be generated. The list yields 12 and is rendered on the screen. The clinician now selects an entry on the list. This entry represents the data object related to the patient that should be discussed and an image of the requested data object related to the selected patient is displayed 15 on the screen by a single request action 13 , ie clicking on the entry. In order to display the requested data object, a second query 14 of the user profile is made. In more detail, the request is sent to the server, the server interprets the request and obtains the relevant image data from the storage medium it is connected to, and then displays the image data on the client device.

Clinicians can use a number of 3D graphics procedures, such as rotation, scaling, etc., for example to gain an understanding of the location of the target to be manipulated.

Thus, the user is presented with a list of relevant patients simply by logging into the system, followed by a single request action to retrieve the selected patient's data. Such systems save valuable time for clinicians with heavy schedules. The data can also be presented in the manner prescribed by the user profile, which is the reason for the second consultation, so the clinician does not need to manipulate the data further before the discussion can begin.

Later that same clinician can go round the ward for the day, bringing a personal digital assistant (PDA) with him to speak with the patient or to facilitate the patient's understanding of their condition. Clinicians log into the system before starting their rounds, and since ward rounds are recurring events, the system automatically determines the clinician's tasks upon login based on the time of day. The list of relevant patients is presented to the clinician. The list could even be updated based on the clinician's location, so the list only includes patients in the clinician's room.

In the afternoon, the clinician may be preparing to operate on a patient that has been discussed in the morning meeting. The clinician is in the clinician's office, and the user profile includes a rule to specify that all patients assigned by the clinician should be presented to the clinician, who selects the patients discussed in the morning meeting. After the data has been retrieved, the clinician has the option to resume the session from the end of the morning session, and then the clinician chooses to resume the session of the meeting. By doing so, the clinician has access to all operations performed on the data during the session.

In Fig. 3, a scheme 30 of data parameters and information hierarchies is shown, which provides direct access to desired patient data. Three levels 31, 32 and 33 of information must be provided. However, most of the information is already available for this system. The first level 31 includes information related to the user. This information is provided upon login. The second level 32 includes information related to the patient. Since all list entries represent specific patient data objects, this is selected when the action is requested. The third level 33 includes information related to configuration file rules. These rules are part of the user profile.

As soon as a single request action is made, data objects related to the patient are rendered. Applications used to present data objects are often referred to as Clinical Application Modules, or CAMs. A CAM is a software application that can be started in a particular state with a single initiating action, such as a mouse click, or more typically a single program call. The specific state is specified by data parameter 30. CAM can be any type of program, such as a 3D display program. The exact parameters for starting a CAM vary with the nature of the CAM, however for each type of CAM there is a well-defined list of parameters that define the initial state.

In FIG. 4 are given two screenshots taken in connection with the computer implementation of the preferred embodiment of the present invention. A first screenshot 40 shows a list of data objects, ie patient images presented to the user after user identification. The list is generated using the user profile whenever the user is logged in. The user may click on a selected data object 47 to display the data object. The second screenshot presents an example of a data object displayed using CAM for 3D display of CT data. The screenshot shows the patient's chest in the upper left corner 43 . Furthermore, a reference three-dimensional coordinate system 48 is shown. The remaining three parts of the screenshot show three cut planes of the chest: xy plane 44 , xz plane 45 and yz plane 46 .

In Figure 5, an example of a user log and corresponding screen images is presented. Contact undo and redo functionality to illustrate user logging. The image in the upper left corner 50 shows a screenshot of a particular data set. This initial state is recorded in the user log. The screenshot is divided into four parts as in Figure 4. The top left corners 500, 510, 520 and 530 of all screenshots are three-dimensional views of the CT object shown. In the upper right corners of screenshots 501 , 511 , 521 and 531 are cut planes taken along the xy plane shown and in the lower left corners 502 , 512 , 522 and 532 are cut planes taken along the xz plane shown , while in the lower right corners 503, 513, 523, and 533 are slices taken along the yz plane shown.

Shown in the second image 51 is a possible next user step: the user zooms in on the volume data (510 changed relative to 500). Record result status. The user can undo at any time to obtain the preceding step 50 . Thereafter, the user changes the position of the displayed xy plane 52 (521 changes relative to 511). The result is logged again in the user log. The user can again undo at any time to obtain the previous step 51 . Finally, the color setting is changed on all the plans, causing the three tiles 531, 532 and 533 to go black. An undo/redo feature allows the user to step back and forward through all these states at will.

Figure 6 illustrates the user log and how it is used for the save state functionality. During a first session 60, 61, 62, the clinician logs in 60, finds the correct data set and prepares the observation data by zooming in 61, 62. The user saves this state and then perhaps starts a second session 600, 601 at a different location. Instead of having to go through all the steps again, the user can simply load the saved state and continue working from the same state the user left after session #1. Thus, session state is persistent in time and location. Persistence of state is illustrated here for fairly simple data changes. In many cases, however, series of changes can be quite long and tedious to the point of impossible to reproduce without the assistance of the method disclosed here.

While this invention has been described in connection with preferred embodiments, it is not intended to be limited to the specific forms set forth herein. Rather, the scope of the present invention is limited only by the appended claims.

Claims (32)

1. A method for providing medical data relating to an individual, said method comprising the steps of: access to the user profile of the requesting user, Access to property libraries related to medical data, A rule-based comparison between user profiles and attributes results in a set of data objects, wherein each data object represents a data group associated with an individual, produce a list of data objects presented to the user, and As soon as the user makes a single request action to request a data object on the list, the requested medical data for the selected data object is displayed. 2. The method of claim 1, wherein the medical data is graphical medical data. 3. A method according to any preceding claim, wherein the user's actions and session state are logged in a user-specific log. 4. A method according to any preceding claim, wherein previous actions of the user within the same or past sessions are accessible through an undo function. 5. A method according to any preceding claim, wherein the medical data is displayed by means of a computer application selected from a set of applications. 6. A method according to any preceding claim, wherein the selection of the computer application is based on a user profile. 7. A method according to any preceding claim, wherein the selection of the computer application is based on the type of medical data. 8. A method according to any preceding claim, wherein medical data is presented according to user-specific preference settings. 9. A method according to any preceding claim, wherein medical data is presented at the beginning of a new session as the end of a previous session and the state of the new session is created on the experience of the user-specific log. 10. A method as claimed in any preceding claim, wherein the user profile includes information relating to the user's location. 11. A method as claimed in any preceding claim, wherein the location of the computer is determined based on the computer's access point to the computer network. 12. A method as claimed in any preceding claim, wherein the user profile includes information relating to the time of day of the request. 13. A method according to any preceding claim, wherein the user profile includes information relating to attributes of previously requested medical data. 14. A method as claimed in any preceding claim, wherein the user profile includes information relating to the user's calendar. 15. A method as claimed in any preceding claim, wherein the user profile is dynamically updated. 16. A method according to any one of claims 2 to 15, wherein the graphical medical data is based on data complying with the DICOM standard implemented on a PACS system. 17. The method according to any one of claims 2 to 16, wherein the graphical medical data is three-dimensional graphical medical data such as data from MRI, CT, US, PET and SPECT, and data such as from CR and DR 2D graph of data medical data. 18. A method as claimed in any one of claims 1, 3 to 15, wherein the data comprises textual medical data relating to the selected individual. 19. The method of claim 18, wherein the textual medical data is based on data conforming to the HL7 standard. 20. The method of claim 18, wherein the textual medical data is based on data compliant with the EDIFACT standard. 21. The method according to claim 16 or 18, wherein the exchange of graphics and/or medical data is based on an IHE framework for data exchange. 22. A method according to any one of claims 2 to 17, wherein the graphical medical data, in addition to being displayed, can be manipulated and analyzed according to standard manipulation and analysis procedures. 23. A method according to any preceding claim, wherein medical data is encrypted. 24. A computer program adapted to perform the method of claims 1 to 23 when said program is run on a computer network system. 25. A computer-readable data carrier carrying the computer program according to claim 24. 26. A computer system for providing medical data relating to an individual, said system comprising: a first device and at least one second device, wherein the first device and the at least one second device are interconnected by a computer network, at least one second means comprising input means and display means capable of accepting the requested action, requesting a user profile for the user, wherein the user profile is stored on and accessible from the first device, and a library of attributes related to medical data stored on and accessible from the first device, wherein, based on a rule-based comparison between user profiles and attributes, a set of data objects is generated, wherein each data object represents a data group associated with an individual, and a list of data objects is generated and presented to the user, Thus, as soon as the user requests one data object on the list with a single request action, the requested medical data of the selected data object are displayed on the display means. 27. The computer system of claim 26, wherein the computer system is a client/server system. 28. A computer system according to claim 27, wherein the server in the computer system comprises software adapted to process graphical data objects, and wherein the client comprises a display device for displaying graphical data objects. 29. A system according to any one of claims 26 to 28, wherein the first device further comprises means for encrypting data to be transmitted over a computer connection between the first device and at least one second device, And wherein, at least one of the second means includes means for decrypting the received data. 30. The system of any one of claims 26 to 29, wherein at least one of the second device and the first device communicate over a common network connection. 31. A system as claimed in any one of claims 26 to 30, wherein the first means is a computer server system. 32. The system of any one of claims 26 to 31, wherein the at least one second device is a thin client, a workstation second device, a PC, a laptop computer or a wireless handheld device.

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