US20100092937A1 - Interactive Patient Education and Informed Consent System - Google Patents
Interactive Patient Education and Informed Consent System Download PDFInfo
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- US20100092937A1 US20100092937A1 US12/642,290 US64229009A US2010092937A1 US 20100092937 A1 US20100092937 A1 US 20100092937A1 US 64229009 A US64229009 A US 64229009A US 2010092937 A1 US2010092937 A1 US 2010092937A1
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B19/00—Teaching not covered by other main groups of this subclass
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- G—PHYSICS
- G09—EDUCATION; CRYPTOGRAPHY; DISPLAY; ADVERTISING; SEALS
- G09B—EDUCATIONAL OR DEMONSTRATION APPLIANCES; APPLIANCES FOR TEACHING, OR COMMUNICATING WITH, THE BLIND, DEAF OR MUTE; MODELS; PLANETARIA; GLOBES; MAPS; DIAGRAMS
- G09B19/00—Teaching not covered by other main groups of this subclass
- G09B19/0076—Body hygiene; Dressing; Knot tying
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- This application pertains to interactive patient education for use in a medical or dental setting and, more specifically, relates to computer-implemented, interactive multimedia educational tools.
- the primary tool for patient education is direct communication, i.e. talking between the provider and the patient. Often times the provider uses demonstrations, such as by using previously prepared or contemporaneously prepared images to supplement the discussion.
- Written materials such as brochures, handouts, and other written material can also be provided to the patient.
- Audiovisual material such as videos can sometimes be provided to the patient, or given to the patient to watch in their own homes, or in a waiting room or lobby.
- Orasphere provides a variety of still images and animations for use in dentistry, see www.orasphere.com. While these materials may include good quality images, the content is passive; it cannot be changed or adapted to a specific patient's needs or situation.
- FIGS. 13A and 13B show examples of content from a dental collection. These icons launch pre-recorded animations. Again, the content cannot be altered in real time.
- CAESY system is a collection of multimedia content delivered on DVD.
- a viewing system can be set up in a dental office operatory or reception area for patient use. The patient can select content to view as desired. The content is all pre-recorded and fixed in the DVD.
- Embodiments of the invention address these and other limitations in the prior art.
- a computer driven, interactive, multi-media patient education system uses, creates and stores a variety of digital content such as photos, x-rays, movies and computer animations for selective presentation to a patient before, during or after consultation with a healthcare professional.
- digital content such as photos, x-rays, movies and computer animations
- the patient or dentist can pause the animation. This action automatically makes a copy of a still image corresponding to the frame where the animation paused. In one embodiment, this copy can be revised or marked up for better communication with the patient.
- the still image is electronically marked up using a stylus in combination with a pen-enabled display screen and suitable software.
- the screen is integral with a tablet or slate PC. Still images that are created by pausing the animation, along with their markups, are automatically saved as part of an electronic record of the session.
- the electronic session record provides content for creating a custom report, which in turn can be forwarded, printed, emailed etc for reference.
- the user creates the custom report, including selection of digital content, by means of a simple user-interface, preferably comprising a pen-enabled screen.
- the patient, as well, can virtually sign the record using a stylus.
- a “history panel” is displayed. Each time the current animation is paused, a still image is created by the software automatically and stored. Each such still image is represented by a corresponding icon or thumbnail in the history panel. These thumbnails can be selected (clicked, tapped, etc.) at any time to display the corresponding image.
- the history thumbnails also serve to “skip” to the corresponding frame in the animation from which they were created. The user can resume playing the animation from that spot using the play button. In this way, the history panel enables the user to skip around quickly between points of interest in the animation.
- FIG. 1 shows a first view of a display screen 100 reflecting interactive operation in accordance with the present invention.
- FIG. 2 shows a second view of display screen 100 reflecting interactive operation in accordance with the present invention.
- FIG. 3 shows a third view of display screen 100 reflecting interactive operation in accordance with the present invention.
- FIG. 4 shows a fourth view of display screen 100 reflecting interactive operation in accordance with the present invention.
- FIG. 5 shows a fifth view of display screen 100 reflecting interactive operation in accordance with the present invention.
- FIG. 6 shows a sixth view of display screen 100 reflecting interactive operation in accordance with the present invention.
- FIG. 7 shows a seventh view of display screen 100 reflecting interactive operation in accordance with the present invention.
- FIG. 8 shows an eighth view of display screen 100 reflecting interactive operation in accordance with the present invention.
- FIG. 9 shows a ninth view of display screen 100 reflecting interactive operation in accordance with the present invention.
- FIG. 10 shows a tenth view of display screen 100 reflecting interactive operation in accordance with the present invention.
- FIG. 11 is an enlarged view of the toolbar 110 of FIGS. 1-10 .
- FIG. 12 illustrates pop-up expansion of toolbar buttons.
- FIGS. 13A-13B illustrate prior art passive content.
- FIG. 14 shows detail of an output selection panel.
- Embodiments of the invention include animated interactive models that can be manipulated to show organ structure, how body parts work together, how incisions or other invasive techniques will affect the involved structures, etc. Voice over and video can be added to the model if desired.
- These teaching models can be viewed on any modern computer display, such as a CRT, LCD, Plasma, etc.
- One advantage to particular embodiments of the invention is that the animation may be available on a portable computer and easily carried. Although it is possible to display such animations on Palm computers, having screens that are roughly 3′′ ⁇ 5,′′ more dramatic results can be achieved from using larger computers, such as those on a “laptop” computer. Further, for portability and ease of use, tablet PCs, often called “slate style” computers are an excellent platform for displaying the animations.
- slate-style PCs that can be used with embodiments of the invention are the “Motion” line of Tablet PCs, from Motion Computing.
- Wacom® is a provider of pen sensor components to Microsoft IHVs (independent hardware vendors) for Tablet PC solutions.
- So-called “pen-enabled” products provide a simple, convenient and intuitive user interface for both the dentist and patient.
- interaction with the computer or display is done with a pen-like stylus.
- Any acceptable display can be paired with a user interface that is extremely easy to use.
- the displays may be designed to be taken into the examining room or carried on hospital rounds.
- 3D animated procedures are coupled to the viewing device, a virtual tour of any organ or body part can be shown, as well as demonstrating the effect of surgery or other procedures.
- a combination of anatomically precise three-dimensional models and interactivity provides a perfect avenue for physicians or other knowledgeable persons to educate patients about their illness, explain surgical procedures, and respond to specific patient concerns.
- These interactive 3D models of human anatomy can be installed on portable PC tablets or slates and used in the doctor's office.
- Example embodiments of the invention combine one or more technologies to create a useful end product.
- An animation begins with a 3D model of the desired object to be animated. Organs, groups of organs, skin layers, muscles, bones, ligaments, arteries and veins, and any other material desired to be animated can be represented in a 3D model.
- 3D designs are typically a collection of polygon elements and may include a variety of “skins” to provide “texture” to the objects. Further, any supporting objects, such as instruments used in surgical procedures can be animated. Animated 3D models will explain surgical processes or anatomy functionality.
- the 3D models may be optimized to reduce the number of polygons by using, for example, one or more reducing tools such as 3D Studio max, Cult 3D, Cycore technology, and Stl reducers. Reducing the number of polygons reduces the ultimate amount of storage necessary to store the 3D animations. Of course, the number of polygons need not be reduced at all, but reducing them will typically enhance the performance of the display and the interaction.
- reducing tools such as 3D Studio max, Cult 3D, Cycore technology, and Stl reducers.
- smart models can be created that can be controlled to rotate, zoom, and animate.
- Tools for creating such interactions include Cult 3D and custom java/Macromedia director programming.
- Video may be shot on subjects that are appropriate. This video can aid in explaining information, such as medical information, to the patient. Relevant images and audio tracks can also be added to help convey information about the animation to the patient.
- Animations are created for an interactive environment. These animations can be controlled in real-time by a knowledge provider, such as a doctor, as further described below.
- the animations can be manipulated to demonstrate function and interaction between the different represented components. For example, the animations can be manipulated to show organ structure, how body parts work together and, how incisions or other invasive techniques will affect the involved structures.
- Software running on a computer which may be inside the display (as in a slate machine), displays content and allows the user to mark up images on the fly with a stylus, before, during, or after the animation is run.
- This “user interface” can be made to interact with any software that may be present on the video screen, such as active X and the technology driving the stylus. Macromedia products and Java scripting may be used. A preferred embodiment of a user interface is further described below.
- Animations may be designed specifically with the doctor-patient relationship in mind.
- One of the aims of uses for the invention is to increase patient understanding of conditions, leading to better treatment compliance and improved outcomes for both patients and healthcare professionals.
- Such a set of tools helps the patient understand complicated conditions and gives doctors a tool through which they can more easily explain medical concepts.
- animations can be pre-loaded on a server and available to be watched or run at their convenience. Access to such animations may be password protected.
- a record of the animations may be created during the animation itself, including real-time audio input from the instructor and student. Then, this stored animation becomes a new animation that can be viewed in playback. Either or both of the animations may be made available to the student—one animation that is interactive, and another that simply plays back the first animation directed by the instructor.
- an interactive patient education system for use in dental or medical applications is deployed in a tablet PC with a pen-enabled display screen.
- the tablet machine can be hand held by the doctor or patient while in use. Battery operation enables it to be un-tethered.
- the PC can be mounted on a repositionable support arm for hands-free use.
- a second screen can be connected for one of the users to view.
- menu selection of content serves as a starting point in an interactive session.
- IMPLANTS there is one category called IMPLANTS, and in that category, there are three content selections: two animations and one image.
- One animation is called “Implant Incisor”.
- the dentist wants the patent to understand this treatment option. Viewing the screen together, they see an initial screen display image similar to that shown in FIG. 1 .
- the screen display comprises a window 100 consisting of several frames.
- the window 100 includes, by way of illustration and not limitation, a content display window 102 , a menu window 104 , and a toolbar 110 .
- the dentist selected the Implants topic, which resulted in display of a list of content available under that topic.
- the following list illustrates one embodiment of content for an interactive dental patient education system.
- the left column shows the topic and the right column shows the medium:
- the user (hereinafter, the “user” refers to either the dentist or the patient) then selects the Implant Incisor video.
- the display is “pen-enabled” and the selection is made by touching a stylus to the display screen.
- Other user input devices are known and can be used.
- the Implant Incisor video is loaded and begins display in the display panel or frame 102 .
- FIG. 11 shows the toolbar 110 in greater detail. It includes buttons to rewind 124 , and to play/stop 126 the animation at any time.
- a slider bar 128 shows progress of the animation (or video or audio when such are playing). Moving the slider bar allows the user to quickly move to any desired point in the presentation. Other toolbar buttons are discussed shortly.
- the animation has progressed as indicated on the slider bar on toolbar 110 .
- the user taps the play/stop button ( 126 in FIG. 11 ) to pause the animation.
- the system immediately and automatically saves a still image corresponding to that point in the animation. That image is now displayed on the screen panel 102 .
- Visual indicia show that the animation is paused, for example the play/pause button is changed to an alternate state, indicated for example by shadow or color. Also, other tools now available for use are likewise changed to alternate states. Referring again to FIG.
- such tool buttons include a marker button 112 , color palette 114 , eraser 116 , as well as fast forward and rewind arrows 118 and 120 , respectively.
- the user can return to playing the animation at any time, simply by pressing the play/pause button once again.
- the user can mark up that image to facilitate discussion with and understanding by the patient.
- various user-input devices such as a mouse can be used, but we describe the pen-enabled preferred embodiment for illustration.
- the dentist selects the marker tool by touching that button 112 .
- the button 112 preferably “expands” or pulls up a selection of marker tools, which can be of various sizes, shown as buttons 112 A, 112 B, 112 C and 112 D in descending order of relative size.
- the user can select the palette button 114 which will bring up a selection of color buttons, indicated by 114 A, for selection.
- thumbnails can be selected (clicked, tapped, etc.) at any time to display the corresponding image in panel 102 for review or further discussion among the users.
- the history thumbnails also serve to “skip” to the corresponding frame in the animation from which they were created. The user can scroll through a larger number of thumbnails using arrows 162 A- 162 B to march them along the history panel.
- the user can resume playing the animation from that spot using the play button.
- the history panel enables the user to skip around quickly between points of interest in the animation.
- a new image can be made at any time for further marking or study, again merely by pausing the presentation. Of course, an unwanted image can be deleted easily.
- the slider bar 128 indicates further progress of the animation, and again it is stopped as described above.
- Another still image is created automatically, corresponding to the place where the animation was paused, in other words, the corresponding “frame” of the animation is used to create a still image. That still image is displayed in panel 102 as before.
- the history panel 106 we see the first still thumbnail 152 and the second (current) thumbnail 154 .
- the dentist once again can add markings if desired.
- the dentist next invokes an import function, by selecting the IMPORT button on the screen, which in turn displays an image import panel or browser 200 .
- the import panel provides a browsing function to enable selection among existing files. These can be from any source, for example, they may be images of the present patient's dentition for comparison to the image 154 . Standard digital image formats can be imported, for example gif, tiff, jpeg, bmp, png, targa.
- FIG. 5 it shows the result of importing a digital image for display, namely an x-ray 156 A.
- the history panel below now shows the still thumbnails 152 , 154 , and 156 , the last one corresponding to the imported digital x-ray.
- These images shown in history panel 106 are forming a record of the present interactive session, complete with custom markings and other content. For example, an audio commentary by the user can be created and imported into the record. Details of digital audio recording are known and therefore omitted here.
- FIG. 5 a new display panel 170 (“Imports”) is opened, where imported files are listed, in this case the Upper Arch Bottom.jpg as shown. This panel allows easy selection at any time among imported files.
- the dentist marks up the digital image 156 A, circling points of interest on this image of the patient's upper teeth for discussion with the patient, using the marker tools as described above.
- the markups are stored automatically in, or in association with, the still image.
- the dentist now invokes an EXPORT button to display a save image file browser 202 , and here she selects the x-ray image file 160 A.
- the x-ray image is saved and can be emailed. Any image can be saved, with or without markings.
- FIG. 9 shows how the dentist has marked up the x-ray 160 A, using the same marker tools as described above.
- FIG. 10 a print panel 300 is invoked to prepare a custom record or printout. This is invoked by a print button 301 .
- FIG. 14 shows an enlargement of the print panel 300 . It includes a selection panel 302 that mirrors the history panel 106 , to provide for selection of any items from the history panel.
- the print panel also includes a “Select Page Layout” field 304 for selecting a desired layout for a report or record of the interactive session. Thumbnail 306 is an example of a comparison of bridges to implants can that be included in a report.
- the dentist could assemble a report at any time, without the patient present, either in preparation for meeting with the patient, or after an office examination.
- the dentist can simply select various images and other content by touching the desired icons or thumbnails. She can also select a layout for the report.
- the finished report can be saved, emailed, printed, etc. for further reference. It may be useful for insurance billing documentation.
- the dentist can select among various images, including standard or stock images, stock images marked up for the current patient, the patient's own images and or x-rays, in any combination. This powerful tool creates a record or printable presentation that is extremely effective for helping the patient understand the situation presented.
- Patient education is a key component of patient-physician communication; however, the average patient asks only two questions during an entire medical visit lasting an average of 15 minutes. Patients who are actively involved in decision-making are more satisfied, have a better quality of life and have better health outcomes. A meta-analysis of 41 research studies showed that giving patients more information is associated with increased patient satisfaction, better compliance, better recall and understanding of medical conditions.
- Physicians are the primary purveyors of medical information to patients. Given the documented value of patient education in improving outcomes, increasing patient satisfaction and avoiding malpractice, patient education should be a key tool for physicians and their staffs. Using embodiments of the invention can also reduce a number of malpractice claims, a significant portion of which extend from a lack of informed consent or failure to instruct the patient properly.
- Particular segments of the medical community may be prime candidates to benefit by using embodiments of the invention, such as Ob/GYN, surgery, such as orthopedic surgery, neurosurgery, pediatrics, neurology, oncology, and cardiology.
- surgery such as orthopedic surgery, neurosurgery, pediatrics, neurology, oncology, and cardiology.
- Embodiments of the invention combine 3D technology, audio, video, animation, logic/interface programming and the portability of a tablet PC.
- This combination of technology and portability allows the instructor to have personal interaction with the student (or patient) while interacting with three dimensional models of anatomy.
- the 3D anatomy models show with clarity procedures that are difficult to understand. Doctors can take snap shots of areas of interest as they spin the 3D models and zoom in on the area of the anatomy or procedure being discussed.
- the images that are created on the fly from the 3D interactive model, animation or video can then be marked up on the tablet using the stylus, as explained above, and then printed or emailed to the patient for reference.
- a signature area can be included where the patient signs to verify they understand what has been explained to them. Patients may also have the ability to interact with the tablet unattended by a nurse or doctor. They can look up areas of interest and interact with the educational content. The patient is given a URL with a password so they can view over the Internet much of the content explained to them using the tablet PC.
- custom 3D representations can be made. For instance, using information available from a variety of resources, custom representations can be made of particular organs of the body, or objects based on other custom measurements.
- the custom representations can be made from modifying existing, normalized versions of the particular object. Then, measurements of the particular object to be animated could be made. Such measurements could be made by scans, ultrasounds, magnetic imaging etc. The information obtained from these procedures is used to create a model from scratch, or a typical model may be modified. Measurements could be made of only a few important points, or from many points on the object to be imaged, depending on the level of customization desired.
- the created model may be fully animated, allowing it to be viewed from any angle or distance. This unique ability will enable the patient and doctor to communicate like never before.
- This very clear 3D model will educate a patient about their condition including treatment options.
- These custom models will have the ability to be shared online, in print (via printer or email). The same process will update the 3D models as the patient undergoes a treatment regimen. The doctors can also use these simplified models to communicate with other physicians.
- a library of variety of similar objects can be stored.
- a library of 10-200 or more different hearts animation images can be individually stored, each of which represents a particular problem or feature, such as size, or having clogged arteries.
- the closest model representing the patient's particular condition can be selected, and used to communicate, educate, and log the progress of the patient's medical condition.
- the model can also be utilized to demonstrate corrective procedures, giving a very comprehensive understanding of diagnosis, treatment and follow up protocol.
Abstract
Interactive patient education system for use in operatory or office settings, provides interactive 3-D animations, graphics and other media, enabling real-time markup and customization to better illustrate and communicate not only generic information, but the individual patient's physiology, treatment options, and anticipated outcomes. Preferred embodiments are portable, computer-implemented, interactive multimedia educational tools. Import of patient-specific graphics, video and audio contributes to full-custom educational content to optimize patient understanding and to facilitate obtaining and recording a patient's informed consent.
Description
- This application is a continuation of, and claims priority under 35 U.S.C. §120 to, copending U.S. patent application Ser. No. 11/082,233, entitled “Interactive Patient Education System,” listing Jeffery L. Jackson as inventor and filed on Mar. 15, 2005, which claims priority under 35 USC §119(e) to U.S. Provisional Application Ser. No. 60/554,630, listing Jeffrey L. Jackson as inventor and filed on Mar. 18, 2004, both of which are incorporated herein by reference in their entirety.
- © 2004-2005 Reality Engineering, Inc. A portion of the disclosure of this patent document contains material that is subject to copyright protection, including without limitation the drawing figures submitted herewith. The copyright owner has no objection to the facsimile reproduction by anyone of the patent document or the patent disclosure, as it appears in the Patent and Trademark Office patent file or records, but otherwise reserves all copyright rights whatsoever. 37 CFR §1.71(d).
- This application pertains to interactive patient education for use in a medical or dental setting and, more specifically, relates to computer-implemented, interactive multimedia educational tools.
- Studies of patient education provided during diagnosis and treatment have demonstrated time savings and cost reductions as well as improvements in patient satisfaction, better health outcomes, better compliance, more empowered patient decision making, and reduced medical malpractice. In a healthcare environment where there is relentless pressure to reduce costs, the value of patient education as a cost savings tool is appreciated.
- The market for patient education tools is very large. On average, Americans visit their doctor 3.5 times per year—totaling approximately 985 million patient encounters per year. 40 million people have surgery each year. Each of these encounters or procedures generates an opportunity for patient education.
- Currently physicians and hospitals use a variety of methods for patient education. The primary tool for patient education is direct communication, i.e. talking between the provider and the patient. Often times the provider uses demonstrations, such as by using previously prepared or contemporaneously prepared images to supplement the discussion. Written materials, such as brochures, handouts, and other written material can also be provided to the patient. Audiovisual material, such as videos can sometimes be provided to the patient, or given to the patient to watch in their own homes, or in a waiting room or lobby.
- Each of these methods has an associated cost in time or materials, and limitations. In present healthcare provider settings, providers often do not have enough time to fully explain diagnoses or procedures to patients. Materials that are previously prepared may not explain the particular details that make a particular patient's procedure different than one that is common or routine. Audiovisual materials, with nothing further, do not provide ability for the patient to ask questions.
- One example of commercially available materials for dental practice are those offered by Orasphere. Orasphere provides a variety of still images and animations for use in dentistry, see www.orasphere.com. While these materials may include good quality images, the content is passive; it cannot be changed or adapted to a specific patient's needs or situation.
FIGS. 13A and 13B show examples of content from a dental collection. These icons launch pre-recorded animations. Again, the content cannot be altered in real time. - Another example of the prior art is called the CAESY system, which is a collection of multimedia content delivered on DVD. A viewing system can be set up in a dental office operatory or reception area for patient use. The patient can select content to view as desired. The content is all pre-recorded and fixed in the DVD.
- Embodiments of the invention address these and other limitations in the prior art.
- A computer driven, interactive, multi-media patient education system in accordance with the invention uses, creates and stores a variety of digital content such as photos, x-rays, movies and computer animations for selective presentation to a patient before, during or after consultation with a healthcare professional. During display of an animation, the patient or dentist, for example, can pause the animation. This action automatically makes a copy of a still image corresponding to the frame where the animation paused. In one embodiment, this copy can be revised or marked up for better communication with the patient.
- In one embodiment, the still image is electronically marked up using a stylus in combination with a pen-enabled display screen and suitable software. In one embodiment, the screen is integral with a tablet or slate PC. Still images that are created by pausing the animation, along with their markups, are automatically saved as part of an electronic record of the session.
- The electronic session record provides content for creating a custom report, which in turn can be forwarded, printed, emailed etc for reference. In one embodiment, the user creates the custom report, including selection of digital content, by means of a simple user-interface, preferably comprising a pen-enabled screen. The patient, as well, can virtually sign the record using a stylus.
- In one embodiment, a “history panel” is displayed. Each time the current animation is paused, a still image is created by the software automatically and stored. Each such still image is represented by a corresponding icon or thumbnail in the history panel. These thumbnails can be selected (clicked, tapped, etc.) at any time to display the corresponding image. The history thumbnails also serve to “skip” to the corresponding frame in the animation from which they were created. The user can resume playing the animation from that spot using the play button. In this way, the history panel enables the user to skip around quickly between points of interest in the animation.
- Additional aspects and advantages will be apparent from the following detailed description of preferred embodiments, which proceeds with reference to the accompanying drawings.
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FIG. 1 shows a first view of adisplay screen 100 reflecting interactive operation in accordance with the present invention. -
FIG. 2 shows a second view ofdisplay screen 100 reflecting interactive operation in accordance with the present invention. -
FIG. 3 shows a third view ofdisplay screen 100 reflecting interactive operation in accordance with the present invention. -
FIG. 4 shows a fourth view ofdisplay screen 100 reflecting interactive operation in accordance with the present invention. -
FIG. 5 shows a fifth view ofdisplay screen 100 reflecting interactive operation in accordance with the present invention. -
FIG. 6 shows a sixth view ofdisplay screen 100 reflecting interactive operation in accordance with the present invention. -
FIG. 7 shows a seventh view ofdisplay screen 100 reflecting interactive operation in accordance with the present invention. -
FIG. 8 shows an eighth view ofdisplay screen 100 reflecting interactive operation in accordance with the present invention. -
FIG. 9 shows a ninth view ofdisplay screen 100 reflecting interactive operation in accordance with the present invention. -
FIG. 10 shows a tenth view ofdisplay screen 100 reflecting interactive operation in accordance with the present invention. -
FIG. 11 is an enlarged view of thetoolbar 110 ofFIGS. 1-10 . -
FIG. 12 illustrates pop-up expansion of toolbar buttons. -
FIGS. 13A-13B illustrate prior art passive content. -
FIG. 14 shows detail of an output selection panel. - Embodiments of the invention include animated interactive models that can be manipulated to show organ structure, how body parts work together, how incisions or other invasive techniques will affect the involved structures, etc. Voice over and video can be added to the model if desired. These teaching models can be viewed on any modern computer display, such as a CRT, LCD, Plasma, etc. One advantage to particular embodiments of the invention is that the animation may be available on a portable computer and easily carried. Although it is possible to display such animations on Palm computers, having screens that are roughly 3″×5,″ more dramatic results can be achieved from using larger computers, such as those on a “laptop” computer. Further, for portability and ease of use, tablet PCs, often called “slate style” computers are an excellent platform for displaying the animations.
- One particular type of slate-style PCs that can be used with embodiments of the invention are the “Motion” line of Tablet PCs, from Motion Computing. Wacom® is a provider of pen sensor components to Microsoft IHVs (independent hardware vendors) for Tablet PC solutions. So-called “pen-enabled” products provide a simple, convenient and intuitive user interface for both the dentist and patient. In one embodiment of the present invention, interaction with the computer or display is done with a pen-like stylus.
- Any acceptable display can be paired with a user interface that is extremely easy to use. The displays may be designed to be taken into the examining room or carried on hospital rounds. When such 3D animated procedures are coupled to the viewing device, a virtual tour of any organ or body part can be shown, as well as demonstrating the effect of surgery or other procedures.
- A combination of anatomically precise three-dimensional models and interactivity provides a perfect avenue for physicians or other knowledgeable persons to educate patients about their illness, explain surgical procedures, and respond to specific patient concerns. These interactive 3D models of human anatomy can be installed on portable PC tablets or slates and used in the doctor's office.
- Example embodiments of the invention combine one or more technologies to create a useful end product. An animation begins with a 3D model of the desired object to be animated. Organs, groups of organs, skin layers, muscles, bones, ligaments, arteries and veins, and any other material desired to be animated can be represented in a 3D model.
- Artists can “mock up” the 3D design in well known computer programs, such as 3D studio Max, Maya, Alias, Pro-Engineer, AutoCad, Catia, or Solid Works, for example. 3D designs are typically a collection of polygon elements and may include a variety of “skins” to provide “texture” to the objects. Further, any supporting objects, such as instruments used in surgical procedures can be animated. Animated 3D models will explain surgical processes or anatomy functionality.
- The 3D models may be optimized to reduce the number of polygons by using, for example, one or more reducing tools such as 3D Studio max, Cult 3D, Cycore technology, and Stl reducers. Reducing the number of polygons reduces the ultimate amount of storage necessary to store the 3D animations. Of course, the number of polygons need not be reduced at all, but reducing them will typically enhance the performance of the display and the interaction.
- Once the number of polygons is settled, smart models can be created that can be controlled to rotate, zoom, and animate. Tools for creating such interactions include Cult 3D and custom java/Macromedia director programming.
- Next, animations are created that can play back without interaction. Video may be shot on subjects that are appropriate. This video can aid in explaining information, such as medical information, to the patient. Relevant images and audio tracks can also be added to help convey information about the animation to the patient.
- Other animations are created for an interactive environment. These animations can be controlled in real-time by a knowledge provider, such as a doctor, as further described below. The animations can be manipulated to demonstrate function and interaction between the different represented components. For example, the animations can be manipulated to show organ structure, how body parts work together and, how incisions or other invasive techniques will affect the involved structures.
- Software running on a computer, which may be inside the display (as in a slate machine), displays content and allows the user to mark up images on the fly with a stylus, before, during, or after the animation is run. This “user interface” can be made to interact with any software that may be present on the video screen, such as active X and the technology driving the stylus. Macromedia products and Java scripting may be used. A preferred embodiment of a user interface is further described below.
- In combination, this blend of advanced engineering design, Digital Mockup, 3D modeling, animation, multimedia and web module development allows for increased education, and importantly, improved understanding.
- Animations may be designed specifically with the doctor-patient relationship in mind. One of the aims of uses for the invention is to increase patient understanding of conditions, leading to better treatment compliance and improved outcomes for both patients and healthcare professionals. Such a set of tools helps the patient understand complicated conditions and gives doctors a tool through which they can more easily explain medical concepts.
- In some embodiments, animations can be pre-loaded on a server and available to be watched or run at their convenience. Access to such animations may be password protected. In other embodiments, a record of the animations may be created during the animation itself, including real-time audio input from the instructor and student. Then, this stored animation becomes a new animation that can be viewed in playback. Either or both of the animations may be made available to the student—one animation that is interactive, and another that simply plays back the first animation directed by the instructor.
- In a presently preferred embodiment, an interactive patient education system for use in dental or medical applications is deployed in a tablet PC with a pen-enabled display screen. The tablet machine can be hand held by the doctor or patient while in use. Battery operation enables it to be un-tethered. Alternatively, the PC can be mounted on a repositionable support arm for hands-free use. In one embodiment, a second screen can be connected for one of the users to view.
- In one embodiment, menu selection of content serves as a starting point in an interactive session. In the list below, there is one category called IMPLANTS, and in that category, there are three content selections: two animations and one image. One animation is called “Implant Incisor”. In our illustrative interactive session, the dentist wants the patent to understand this treatment option. Viewing the screen together, they see an initial screen display image similar to that shown in
FIG. 1 . - Referring to
FIG. 1 , the screen display comprises awindow 100 consisting of several frames. Thewindow 100 includes, by way of illustration and not limitation, acontent display window 102, amenu window 104, and atoolbar 110. In themenu window 104, the dentist selected the Implants topic, which resulted in display of a list of content available under that topic. - The following list illustrates one embodiment of content for an interactive dental patient education system. The left column shows the topic and the right column shows the medium:
-
Media Content □ DRAW TOOLS image Maxillary Anterior image Maxillary Left image Maxillary Right image Maxillary Occlusal image Mandibular Anterior image Mandibular Left image Mandibular Right image Mandibular Occlusal image Full Mouth Front image Full Mouth Right image Full Mouth Left image Charting View image Front Minus Soft Tissue image □ HYGIENE Proxy Brush animation Cavity Cross Section animation Decay Stages animation Flossing animation Flossing Close-up animation Floss Aid animation Brushing Close-up animation Brushing animation Brush Upper animation Brush Lower animation Sealant animation Fluoride Treatment animation Gingival Recession animation Gingival Stimulation animation □ INTRACORONAL RESTORATION Class I animation Class III animation Class IV animation Class V animation MOD Amalgam animation MOD Composite animation □ CROWNS Crown Process animation Reason for Crown (large cavity) image Reason for Crown (cracked) image Reason for Crown (large filling) image Reason for Crown (stain) image Cracked Tooth animation □ BRIDGES Bridges animation Bridge Flossing animation □ VENEERS Veneer Malformed Tooth animation Fracture image Proximal Decay image Severe Stain image □ IMPLANTS Implant Molar animation Implant Incisor animation Compare Implant to Partial image □ BLEACHING Trays animation Strips animation □ PERIODONTICS Periodontitis Stages animation Stage 1 Healthy Gums image Stage 2 Gingivitis image Stage 3 Mild Periodontitis image Stage 4 Moderate Periodontitis image Stage 5 Severe Periodontitis image Gingival Recession animation Gingivitis animation Crown Lengthening animation □ ENDODONTICS Root Canal animation □ HIGH TECH Digital X-Ray animation Air Abrasion animation Cerec animation □ DENTURES Partial animation Over Denture animation Compare Implant to Partial image □ TMJ TMJ animation □ CHILDRENS DENTISTRY Fluoride Treatment animation Gingivitis animation Plaque Buildup animation Sealant animation Digital X-Ray animation Impressions animation Mouth Guard animation Space Maintainer animation Baby Bottle Decay animation Cavity Stages animation Crowns animation Flossing animation Pulpectomy animation Teeth and Skull Development animation Brusher Bailey animation Seal the Deal Animation animation - The above list is merely illustrative and it could vary, for example, depending upon the practitioner's areas of practice or specialization. The Implant Incisor animation (highlighted above) will be used to further describe the invention below.
- Referring again to
FIG. 1 , the user (hereinafter, the “user” refers to either the dentist or the patient) then selects the Implant Incisor video. In a presently preferred embodiment, the display is “pen-enabled” and the selection is made by touching a stylus to the display screen. Other user input devices are known and can be used. Upon selection, the Implant Incisor video is loaded and begins display in the display panel orframe 102. - The observant reader will see that an incisor tooth is missing at
location 130 in the animation at the point shown inFIG. 1 , i.e. at the beginning of the animation.FIG. 11 shows thetoolbar 110 in greater detail. It includes buttons to rewind 124, and to play/stop 126 the animation at any time. Aslider bar 128 shows progress of the animation (or video or audio when such are playing). Moving the slider bar allows the user to quickly move to any desired point in the presentation. Other toolbar buttons are discussed shortly. - Turning now to
FIG. 2 , the animation has progressed as indicated on the slider bar ontoolbar 110. Here the user taps the play/stop button (126 inFIG. 11 ) to pause the animation. When the animation is stopped, the system immediately and automatically saves a still image corresponding to that point in the animation. That image is now displayed on thescreen panel 102. Visual indicia show that the animation is paused, for example the play/pause button is changed to an alternate state, indicated for example by shadow or color. Also, other tools now available for use are likewise changed to alternate states. Referring again toFIG. 11 , such tool buttons include amarker button 112,color palette 114,eraser 116, as well as fast forward and rewindarrows - Returning to
FIG. 2 , while the animation is paused and the still image displayed, the user can mark up that image to facilitate discussion with and understanding by the patient. (Again, various user-input devices such as a mouse can be used, but we describe the pen-enabled preferred embodiment for illustration.) The dentist selects the marker tool by touching thatbutton 112. Referring toFIG. 12 , thebutton 112 preferably “expands” or pulls up a selection of marker tools, which can be of various sizes, shown asbuttons palette button 114 which will bring up a selection of color buttons, indicated by 114A, for selection. - Having now selected a desired marker and marker color, we return to
FIG. 2 where the dentist marks up the still image using the stylus. At 135, she circled the site of interest and wrote “6 months healing”. Applying the stylus will cause corresponding markings to display on the image, consistent with the selected marker size and color. Errors can be removed by selecting theeraser button 116 and again applying the stylus in an intuitive manner. In thedisplay panel 102 ofFIG. 2 , the dentist circled the site of interest, and wrote “6 months healing” to better explain the image. - Notice here the “history panel” 106 below the toolbar. Each time the current animation is paused, as noted above, a still image is created by the software automatically and stored. Each such still image is represented by a corresponding icon or thumbnail in the
history panel 106. Here, the still image in 102 is represented by thethumbnail 152 in the history panel. These thumbnails can be selected (clicked, tapped, etc.) at any time to display the corresponding image inpanel 102 for review or further discussion among the users. The history thumbnails also serve to “skip” to the corresponding frame in the animation from which they were created. The user can scroll through a larger number ofthumbnails using arrows 162A-162B to march them along the history panel. The user can resume playing the animation from that spot using the play button. In this way, the history panel enables the user to skip around quickly between points of interest in the animation. A new image can be made at any time for further marking or study, again merely by pausing the presentation. Of course, an unwanted image can be deleted easily. - Referring now to
FIG. 3 , theslider bar 128 indicates further progress of the animation, and again it is stopped as described above. Another still image is created automatically, corresponding to the place where the animation was paused, in other words, the corresponding “frame” of the animation is used to create a still image. That still image is displayed inpanel 102 as before. In thehistory panel 106 below, we see the first still thumbnail 152 and the second (current)thumbnail 154. In still 154, the dentist once again can add markings if desired. - Referring now to
FIG. 4 , the dentist next invokes an import function, by selecting the IMPORT button on the screen, which in turn displays an image import panel orbrowser 200. The import panel provides a browsing function to enable selection among existing files. These can be from any source, for example, they may be images of the present patient's dentition for comparison to theimage 154. Standard digital image formats can be imported, for example gif, tiff, jpeg, bmp, png, targa. - Referring now the
FIG. 5 , it shows the result of importing a digital image for display, namely anx-ray 156A. Note that the history panel below now shows the still thumbnails 152, 154, and 156, the last one corresponding to the imported digital x-ray. These images shown inhistory panel 106 are forming a record of the present interactive session, complete with custom markings and other content. For example, an audio commentary by the user can be created and imported into the record. Details of digital audio recording are known and therefore omitted here. - Note also in
FIG. 5 that a new display panel 170 (“Imports”) is opened, where imported files are listed, in this case the Upper Arch Bottom.jpg as shown. This panel allows easy selection at any time among imported files. Referring now toFIG. 6 , the dentist marks up thedigital image 156A, circling points of interest on this image of the patient's upper teeth for discussion with the patient, using the marker tools as described above. The markups are stored automatically in, or in association with, the still image. - Referring now to
FIG. 7 , in one embodiment, the dentist now invokes an EXPORT button to display a saveimage file browser 202, and here she selects thex-ray image file 160A. The x-ray image is saved and can be emailed. Any image can be saved, with or without markings.FIG. 9 shows how the dentist has marked up thex-ray 160A, using the same marker tools as described above. - Referring now to
FIG. 10 , aprint panel 300 is invoked to prepare a custom record or printout. This is invoked by aprint button 301.FIG. 14 shows an enlargement of theprint panel 300. It includes aselection panel 302 that mirrors thehistory panel 106, to provide for selection of any items from the history panel. The print panel also includes a “Select Page Layout”field 304 for selecting a desired layout for a report or record of the interactive session.Thumbnail 306 is an example of a comparison of bridges to implants can that be included in a report. - Alternatively, the dentist could assemble a report at any time, without the patient present, either in preparation for meeting with the patient, or after an office examination. The dentist can simply select various images and other content by touching the desired icons or thumbnails. She can also select a layout for the report. The finished report can be saved, emailed, printed, etc. for further reference. It may be useful for insurance billing documentation. For content, the dentist can select among various images, including standard or stock images, stock images marked up for the current patient, the patient's own images and or x-rays, in any combination. This powerful tool creates a record or printable presentation that is extremely effective for helping the patient understand the situation presented.
- Patient education is a key component of patient-physician communication; however, the average patient asks only two questions during an entire medical visit lasting an average of 15 minutes. Patients who are actively involved in decision-making are more satisfied, have a better quality of life and have better health outcomes. A meta-analysis of 41 research studies showed that giving patients more information is associated with increased patient satisfaction, better compliance, better recall and understanding of medical conditions.
- Physicians are the primary purveyors of medical information to patients. Given the documented value of patient education in improving outcomes, increasing patient satisfaction and avoiding malpractice, patient education should be a key tool for physicians and their staffs. Using embodiments of the invention can also reduce a number of malpractice claims, a significant portion of which extend from a lack of informed consent or failure to instruct the patient properly.
- Surgeons demonstrate a much greater usage of patient education in their patient interactions than the typical physician. Almost one-half of patient-surgeon visits are dedicated to patient education and counseling by surgeons. Out of a average 13-minute visit, surgeons spent an average of 5.5 minutes educating and counseling the patient. Surgeons improve productivity with the introduction of time-saving patient education techniques.
- Particular segments of the medical community may be prime candidates to benefit by using embodiments of the invention, such as Ob/GYN, surgery, such as orthopedic surgery, neurosurgery, pediatrics, neurology, oncology, and cardiology.
- Hospitals are under pressure to reduce inpatient length of stay since the introduction of reimbursement based on diagnostically related groupings (DRG). Under the DRG system, used by Medicare, the hospital is paid an established fee based on the average length of stay associated with a diagnosis and/or procedure. By improving patient education, hospitals will benefit in producing better outcomes. In addition, nurses tend to spend a large portion of their time providing patient education. Interactive animated patient education on portable PC tablets, as well as other embodiments of the invention has a potential to meet hospital needs in several ways.
- Embodiments of the invention combine 3D technology, audio, video, animation, logic/interface programming and the portability of a tablet PC. This combination of technology and portability allows the instructor to have personal interaction with the student (or patient) while interacting with three dimensional models of anatomy. The 3D anatomy models show with clarity procedures that are difficult to understand. Doctors can take snap shots of areas of interest as they spin the 3D models and zoom in on the area of the anatomy or procedure being discussed. The images that are created on the fly from the 3D interactive model, animation or video can then be marked up on the tablet using the stylus, as explained above, and then printed or emailed to the patient for reference.
- A signature area can be included where the patient signs to verify they understand what has been explained to them. Patients may also have the ability to interact with the tablet unattended by a nurse or doctor. They can look up areas of interest and interact with the educational content. The patient is given a URL with a password so they can view over the Internet much of the content explained to them using the tablet PC.
- In other embodiments of the invention, custom 3D representations can be made. For instance, using information available from a variety of resources, custom representations can be made of particular organs of the body, or objects based on other custom measurements.
- In one method, the custom representations can be made from modifying existing, normalized versions of the particular object. Then, measurements of the particular object to be animated could be made. Such measurements could be made by scans, ultrasounds, magnetic imaging etc. The information obtained from these procedures is used to create a model from scratch, or a typical model may be modified. Measurements could be made of only a few important points, or from many points on the object to be imaged, depending on the level of customization desired.
- The created model may be fully animated, allowing it to be viewed from any angle or distance. This unique ability will enable the patient and doctor to communicate like never before. This very clear 3D model will educate a patient about their condition including treatment options. These custom models will have the ability to be shared online, in print (via printer or email). The same process will update the 3D models as the patient undergoes a treatment regimen. The doctors can also use these simplified models to communicate with other physicians.
- In other embodiments, a library of variety of similar objects can be stored. For example, a library of 10-200 or more different hearts animation images can be individually stored, each of which represents a particular problem or feature, such as size, or having clogged arteries. Instead of custom measuring the patient's particular heart, the closest model representing the patient's particular condition can be selected, and used to communicate, educate, and log the progress of the patient's medical condition. The model can also be utilized to demonstrate corrective procedures, giving a very comprehensive understanding of diagnosis, treatment and follow up protocol.
- It will be obvious to those having skill in the art that many changes may be made to the details of the above-described embodiments without departing from the underlying principles of the invention. The scope of the present invention should, therefore, be determined only by the following claims.
Claims (20)
1. A computer program product comprising at least one computer-readable medium storing one or more sequences of instructions, wherein execution of the one or more sequences of instructions by one or more processors causes the one or more processors to execute a computer-implemented method for patient education, the computer-implemented method comprising:
creating a display on an electronic display screen;
responsive to a user input, commencing display of a selected animation on the display screen;
responsive to a pause input, pausing the animation at a selected frame of the animation and generating a still image that is a copy of the selected frame;
presenting the still image on the display screen; and
responsive to receiving marking on the still image, saving the still image and the marking.
2. The computer program product of claim 1 further comprising:
enabling marking of the still image on the display screen with an input device.
3. The computer program product of claim 2 wherein said marking is received via a user interface device.
4. The computer program product of claim 3 wherein said marking comprises freehand drawing on to the still image by applying a stylus over a pen-enabled screen.
5. The computer program product of claim 1 further comprising:
associating a digital audio recording with the still image.
6. The computer program product of claim 1 further comprising:
enabling importing of an image and marking of the imported image.
7. The computer program product of claim 6 wherein the imported image is a patient-specific image.
8. The computer program product of claim 1 further comprising:
presenting on the display screen a history panel comprising a reduced-size image of the saved still image.
9. A computer program product comprising at least one computer-readable medium storing one or more sequences of instructions, wherein execution of the one or more sequences of instructions by one or more processors causes the one or more processors to execute a computer-implemented method for facilitating and recording a patient's informed consent, the computer-implemented method comprising:
creating a display on an electronic display screen;
responsive to a user input, commencing display of a selected animation on the display screen; and
enabling a user to record an acknowledgement of the patient's informed consent.
10. The computer program product of claim 9 wherein the step of enabling a user to digitally record an acknowledgement of the patient's informed consent comprises:
recording at least one of a verbal acknowledgement and a written acknowledgement; and
associating the recorded acknowledgement with the selected animation.
11. The computer program product of claim 10 wherein the acknowledgement is a written acknowledgement and the step of recording at least one of a verbal acknowledgement and a written acknowledgement comprises:
responsive to a pause input, pausing the animation at a selected frame of the animation and generating a still image that is a copy of the selected frame;
presenting the still image on the display screen; and
responsive to receiving the written acknowledgement on the still image, saving the still image and the written acknowledgement.
12. The computer program product of claim 11 further comprising:
enabling importing of an image and marking of the imported image.
13. The computer program product of claim 12 wherein the imported image is a patient-specific image.
14. The computer program product of claim 11 further comprising:
presenting on the display screen a history panel comprising a reduced-size image of the saved still image.
15. The computer program product of claim 10 wherein the acknowledgement is a verbal acknowledgement and the step of recording at least one of a verbal acknowledgement and a written acknowledgement comprises:
recording the patient's verbal acknowledgement during the display of the selected animation.
16. A method for facilitating patient education and recording a patient's consent comprising:
presenting content directed to a topic of interest on a display screen;
recording at least one of a verbal acknowledgement of the patient's consent and a written acknowledgement of the patient's consent; and
associating the recorded acknowledgement with at least a portion of the content.
17. The method of claim 16 wherein the acknowledgement is a written acknowledgement and the step of recording at least one of a verbal acknowledgement of the patient's consent and a written acknowledgement of the patient's consent comprises:
pausing the content at a selected portion and generating a still image that is a copy of the selected portion;
presenting the still image on the display screen; and
responsive to receiving the written acknowledgement on the still image, saving the still image and the written acknowledgement.
18. The method of claim 17 wherein the content is an animation and the selected portion is a frame of the animation.
19. The method of claim 17 wherein the content is an image that is a patient-specific image.
20. The method of claim 16 wherein the acknowledgement is a verbal acknowledgement and the step of recording at least one of a verbal acknowledgement of the patient's consent and a written acknowledgement of the patient's consent comprises:
recording the patient's verbal acknowledgement during the display of the content.
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US7658611B2 (en) | 2010-02-09 |
US20050233290A1 (en) | 2005-10-20 |
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