US20140207488A1

US20140207488A1 - Medical Information Query System

Info

Publication number: US20140207488A1
Application number: US14/107,286
Authority: US
Inventors: Phyllis Gotlib; Ido Schoenberg; Roy Schoenberg
Original assignee: IMDSoft Ltd
Current assignee: IMDSoft Ltd
Priority date: 2003-01-31
Filing date: 2013-12-16
Publication date: 2014-07-24
Also published as: US20040153343A1; US8620678B2

Abstract

A query system is provided for retrieving information from a medical information system, or its databases. A user interactive query wizard facilitates creation of query scripts for retrieval of information from the medical information system. Queries may be performed across a set of patients, hospitals or clinical resources. Query results are presented via an output device, such as a computer display. These results may be exported to other applications, such as known office or desktop applications, or other systems, such as database systems.

Description

FIELD OF THE INVENTION

The inventive concepts relate to network computer systems and methods. More specifically, the present invention relates to systems and methods for creating, customizing and performing queries of medical data, such as patient, resource, or hospital data.

BACKGROUND

When an individual is admitted as a patient into a hospital, certain information about the patient must be acquired and made available to various members of the hospital staff. Such information includes, for example, the patient's identity, address, age and occupation, next of kin, medical history, conditions for which treatment is sought, preexisting conditions, and any medical insurance information.
During a patient's stay in a hospital, written information relating to his medical history, doctors' and nurses' observations and remarks, laboratory reports, diagnoses, doctors' orders, prescriptions and other notes by the medical team, including doctors, nurses, technicians, orderlies and the like, become part of the patient's file. Patients with chronic conditions or who are frequently hospitalized may have numerous files of substantial size which contain important historic, as well as current, information. The information that is necessary to provide a complete picture of the patient includes, for example, the patient's vital signs, fluid balance, respiratory function, blood parameters, electrocardiograms, x-rays, CT scans, MRI data, laboratory test results, diagnoses, prognoses, evaluations, admission and discharge notes, and patient registration information. This information originates from a variety of sources, including the patient, doctors, nurses, monitors connected to the patient, testing laboratories, the patient's medical records, and hospital administration records.
A massive amount of information about the patient is therefore generated in a relatively short time. Increasingly, this information is automatically recorded or manually entered into a computer-based medical information system. Critical care environments, such as hospital intensive care units, trauma units, emergency rooms and the like, are filled with state-of-the-art electronic equipment for monitoring of patients. Such systems include a plurality of patient monitoring devices that record information related to the patient's status. These systems may also capture information about the medical resources being consumed.
Furthermore, many hospitals have changed the way in which patients are billed for services. In the past, patients were typically billed on the basis of days hospitalized. With recent changes in health care management and practice, patients are now more likely to be billed on the basis of treatments received. Greater efficiency in the treatment of patients is therefore emphasized. As a consequence, hospitals now scrutinize the effect of a treatment on a patient more closely, with increased monitoring, observation and recordation of the patient's responses to treatment. The burden of entry of the increased amount of information that must be recorded about a patient has been reduced by increased automation.
Commonly owned U.S. Pat. No. 6,322,502 B1 entitled Medical Information System provides an example of a system for obtaining data and information from and about patients in a hospital, and making it immediately and selectively accessible to various members of the medical team in a hospital in accordance with the functions performed by those members. This information may be displayed, at least in part, on screen in a flowsheet. To date, systems and methods for the automated robust query of such data and information are not provided, but could be extremely useful. For example, the ability to search across a plurality of patients with respect to a given set of parameters would provide a useful analytical tool for clinicians and administrators. Searches based on hospital or clinical resources would also help analyze and improve efficient distribution and usage of such resources.

SUMMARY OF THE INVENTION

In accordance with the present invention, a system and method are provided that enable the creation, customization, and performance of queries (or searches) of information collected, obtained, or stored in a medical information system. The results of such queries assist clinicians in their research, analysis, treatment, resource utilization, and quality assurance activities. A query wizard tool is provided for retrieving information from a medical information system, or its databases. Queries may be performed across a set of patients, hospitals or clinical resources. Query results are presented via an output device, such as a computer display. These results may be exported to other applications, such as known office or desktop applications, or other systems, such as database systems. Among other things, the query wizard tool facilitates creation of scripts for retrieval of information from the medical information system.
A typical medical information system in a clinic, hospital, or other medical facility may be a networked computer system that collects, stores, analyzes and manages a variety of types of data referred to as “patient data”. Patient data may include dynamically changing data. Examples of dynamically changing patient data that may be monitored include a patient's heart rate, temperature, blood pressure, respiration rate, electrical brain activity, chemical balance or composition. Patient data may also include relatively static data, such as prior or current medical conditions, diagnosis, prognosis, statistics, and so on for one or more stays for each of a plurality of patients. These types of patient data are referred to as parameters, which may be grouped together as sets of related attributes. Many other types of patient data (or parameters) known in the art may also be collected or monitored. An account management system may be included as part of the medical information system, or it may be interfaced with the medical information system. The account management system typically stores patient account information, including patient name, address, telephone number, insurance information, billing and payment information, and the like, as static data.
Given the inclusion of dynamically changing patient data, monitors to collect in real-time or near real-time patient data during a patient's stay is also typically provided. Monitoring is typically accomplished, to some degree, using bedside units (BSUs), which are devices included in or configured to interface with the medical information system and posted proximate to the patient. BSUs may include output mechanisms such as display screens, printers, audible alarms, communication ports or some combination thereof, and input devices such as key pads, key boards, input ports, probes, sensors, cameras, recorders or interfaces to other data sources.
In accordance with the present invention, a query system is integral with or interfaced to the medical information system. The query system interfaces with the medical information system and various patient monitoring systems and devices. The monitoring systems and devices make data available to the query system (via the medical information system) for retrieving data according to the query script. The query system may include or may be configured for access by any of a variety of devices, such as a desktop computer, workstation, laptop, personal digital assistant (PDA), telephone, server, or other network enabled device or programs, modules or components of such devices. That is, in accordance with various embodiments, query scripts may be defined, queries may be launched, or query results may be provided to or accessed by any of the above devices.
The query system includes a query wizard that provides a user interface for the creation, running and analysis of queries and query results. The query wizard includes logic and instructions necessary for establishing a graphical user interface for user devices (e.g., a desktop computer, workstation, PDA, and so on), generating and defining query scripts, processing inputs and outputs, and interfacing with other relevant devices and programs (e.g., operating systems, desktop applications, and so on). The query wizard may include program code distributed across various devices, e.g., arranged in a client-server architecture, or implemented in other manners known in the art. Preferably, the query wizard generates a user interface in a Web browser context and implements commonly available and known Web browser features, such as radio buttons, toolbars, drop-down lists, menus, text entry fields, graphical linking and so on.
Using the query wizard, queries are created by constructing a user (e.g., clinician or administrator) defined script that utilizes patient data. The algorithm embodied in the script is comprised of query attributes and related parameters, which form parameter-based tests or conditions to be met. As an example, a statement may be defined as “if temperature>100 degrees, then . . . ”. Depending on the script, processing of patient data according to one or more statements returns certain results. The results may be provided on a display in a grid or table format, or they may be output in other forms, such as graphical plots or charts, audible speech or tones, dynamic video, of some combination thereof. Queries may be saved and attached to or embedded within other queries.
A set of filters may be defined and applied selectively to query attributes. For example, at least four types of filters may be applied to a given attribute: time, text, numeric, and checkbox. The time filter allows a user to apply specific time values to the selected query attribute(s). The text filter allows the user to include or exclude text values with or from the query. The numeric filter allows the user to include or exclude numeric values with or from the query and allows the application of statistical functions to filter data. The checkbox filter allows the user to apply “yes” or “no” values to query attributes.

BRIEF DESCRIPTION OF THE DRAWINGS

The drawing figures depict preferred embodiments by way of example, not by way of limitations. In the figures, like reference numerals refer to the same or similar elements.

FIG. 1A is a diagram of a system architecture including a query system in accordance with the present invention; FIG. 1B is a flowchart depicting a query method in accordance with the present invention.

FIG. 2A-2D are query wizard screens rendered on a workstation of the query system of FIG. 1.

FIG. 3A-3D are attribute filter screens rendered on a workstation by the query system of FIG. 1.

FIG. 4 is an exemplary export query screen rendered on a workstation by the query system of FIG. 1.

FIG. 5A-5B are exemplary screen shots related to use of statistical functions and rendered on a workstation by the query system of FIG. 1.

FIG. 6 is an exemplary screen shot of a grace period entry form rendered on a workstation by the query system of FIG. 1.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

A system and method in accordance with the present invention facilitate the creation, customization, and performance of queries (or searches) of information collected, obtained, or stored in a medical information system. The results of such queries assist clinicians in their research, analysis, treatment, resource utilization, and quality assurance activities. A query tool or wizard generates an interface for creating queries and retrieving information from a medical information system, or its databases. Through the query wizard a user can define a query by writing a script that indicates the types of attributes and parameters to be searched. Queries may be performed across a set of patients, hospitals or clinical resources. Query results are presented via an output device, such as a computer display. These results may be exported to other applications, such as known office or desktop applications, or other systems, such as database systems.
In the preferred form, a query system is used in conjunction with a medical information system, such as that described in U.S. Pat. No. 6,322,502B1. The medical information system may include or be used in conjunction with a clinical system that is used for administering clinical trials. In the preferred form, the medical information system includes bedside devices and systems (collectively “bedside units” (BSUs)) for patient monitoring and care. The medical information system provides a means for monitoring patients and collecting, storing, and maintaining patient data. Patient data may include a combination of relatively static and dynamically changing information related to a patient. Relatively static patient data may include the patient's name, address, and insurance information, as well information regarding the patient's medical history and prior care, diagnosis, prognosis, treatment and related information. Dynamically changing patient data may include a patient's heart rate, temperature, blood pressure, respiration rate, electrical brain activity, and chemical balance or composition.
The present invention may be implemented within the architecture depicted in FIG. 1A, as one possible embodiment. In this embodiment, a medical information system 110 comprises several workstations connected to a set of servers (not shown) via a network 115. The workstations and servers may be local, remote, or some combination thereof to each other. The medical information system 110 serves as the collector and maintainer of patient data, in a database system 112. The medical information system 110 includes a plurality of BSUs 140 that monitor patient status and collect patient data. In the preferred form, the BSUs also couple to network 115. Network 115 is depicted as a local area network (LAN) for simplicity. However, the present invention is not limited in this manner. Network 115 may by a LAN, wide area network (WAN), virtual private network (VPN), the Internet, World Wide Web or some combination thereof.
FIG. 1A shows a query system 120 in accordance with the present invention linked to medical information system 110 via network 115. There may additionally, or alternatively, be provided a wireless network link 135 between query system 120 and medical information system 110. The query system 120 may include its own database system 122 for storing information and data related to the queries (e.g., query scripts, algorithms, filter information and data) as well as results related data. In other embodiments, the query system 120 may be hosted on the same servers, workstations and computers as the medical information system 110 and may share at least a portion of database 112. Query system 120 and medical information system 110 may access, or may be accessed by, one or more remote systems 130, with their own database systems 132, for data access, exchange, or maintenance. For example, such remote systems 130 may include wired or wireless computers, servers, cellular telephones, pagers, personal digital assistants, e-mail devices, or other network, Web or Internet enabled systems or devices configured to create and launch queries and additionally, or alternatively, to receive query results. In the preferred embodiment, the query system 120 includes a query wizard 125 that facilitates the creation of query scripts using a scripting language, e.g., VB Script, although other programming languages may be used. In the preferred embodiment, a script is a VB Script function.
One embodiment of a query method in accordance with the present invention is depicted in the flowchart 180 of FIG. 1B. In this form, a user defines a question in step 182, selects initial query options in step 184, names and categorizes the query in step 186, selects the attributes and filters to be applied to the query in step 188, and may then execute the query in step 190.
FIG. 2A illustrates an embodiment of a query wizard main screen 200 in accordance with the present invention. The query wizard main screen 200 facilitates the creation and launching of queries and presentation of query results. The query wizard main screen 200 comprises an icon toolbar 202, which contains icons for creating, saving, running, and sorting queries. The query wizard main screen 200 includes three tabs that facilitate creating queries and viewing results: Query Wizard, Script, and Results. These tabs reveal corresponding windows and panes having certain information and functionality associated therewith.
A New Query (NQ) icon is used to create a new query and a Save Query (SQ) icon saves the current query, i.e., the query that is open in the query wizard composition window 230. As part of the save function, the user is prompted to name the query. If the name typed already exists, the user will be prompted to type an alternative name. The query may be saved to the database chosen by user and is displayed in the Saved Queries folder of initial query options pane 220, which also includes a set of predefined attributes (e.g. Patients). A saved query can be retrieved from the database in which it was saved. A Saved Query Filter (SQF) icon allows a user to filter the display of saved queries.
A Delete Query (DQ) icon allows a user to delete its own query, but it is not possible to delete queries created by other users, in the preferred embodiment. An Attributes Filter (AF) icon causes the display or hiding of query attributes that were not used in the current query. A Change Database (CD) icon allows a user to select the database of another department from a list of databases. A database is usually named for the department to which it corresponds and is listed by department name in the query wizard 125. The database list includes online and archived offline databases, providing they are a part of a master list of accessible databases. Note that, in the preferred embodiment, changing databases selection may require authentication of the user, e.g., login via entry of a valid username and password, if access to that database is controlled.
An Export Query (EQ) icon allows a user to place its query results into another applications, e.g., a Microsoft Office™ application. (Note, Microsoft Office™, Word™, Excel™ and Access™ are trademarks of Microsoft Corporation, Redmond, Wash.). The Export Query icon is enabled only if there were results returned by the query. A Run Query (RQ) icon allows a user to run the query. A query may run for several minutes if the database is large and the requested information is distributed over numerous tables, query attributes, databases or systems. In one form, the query results are displayed in a grid in the Results pane 250 (see FIG. 2C). A Stop (S) icon is enabled during the processing of a query, e.g., while the results are being written to the Results pane 250.
Selection of a Sort by Query Category (SC) icon causes the display of saved queries by Query Category. Selection of a Sort by User Name (SN) icon causes the display of saved queries by name of the user that created them. An Open note (ON) icon appears in the toolbar 202 after a Notes query has been run. The Open note icon allows a user to open a note (‘read-only’) of a Notes query. An Export all notes (EN) icon also appears in the icon toolbar 202 after a Notes query has been run. This icon is selected to export all the notes of the Notes query results page to an editable Microsoft Word™ document.
A Query Filter (QF) icon facilitates display of a query setup pane 260. The query setup pane 260 comprises several selection mechanisms. For example, a Display Fields area 262 provides a list of fields for selection by the user. Selected display fields are entered into query fields area 264; these are the fields to be displayed in the Query Results pane 250 when the query is run. The user may also define a name for its query from Query Name area 266 and choose a category from Query Category 268. Setup pane 260 is discussed in greater detail below, with regard to building a query.
A Query Wizard window 210 is comprised of two panes, an initial query options pane 220 and the composition pane 230. An Initial Query Options tree 222 is included in the initial query options pane 220 and a query attributes tree 232 is included in the query attributes pane 230. Initial query options are selected and “dragged” from the Initial Query Options tree 222 to composition pane 230 to yield the query attributes tree 232. The setup pane 260 is also included in query wizard screen 210, and includes different user selectable filter options.
The initial query options pane 220 is a source to help define the type of query to be performed by dragging an option into the composition pane 230. For example, a Patients query type retrieves data from the medical information system 110 patient files and discharge forms, known in the art. A Signals query type retrieves data from the medical information system 110 flowsheet. A User Attributes query type retrieves data from the medical information system 110 user list. A Parameter Attributes query type retrieves data from a parameter properties form. An Orders query type retrieves data from an order list, with some additional data from an order entry form. An Order components details query type retrieves data on specific order parameters. A Notes query type retrieves data from the Notes module of the query wizard. A Problems query type retrieves data from a problem list, or database.
Selection of the Script tab causes presentation of a Script pane 240, shown in FIG. 2B. The Script pane 240 includes VB script that represents the query that was created from the Query Wizard window 210. The script in Script pane 240 may also be used as a part of a MS Word™ or Excel™ template that produces a table similar to the one displayed in Results pane 250, shown in FIG. 2C. Results pane 250 includes the results of the query created in the composition pane 230, after it is run. In this example, the results are displayed in a table that includes columns with details from the display fields selected for the query from setup pane 260.
Building a Query
At a top level, the procedure for building a query includes of the following steps: (1) defining a query (i.e., the “first” and “second” part of the user's question); (2) dragging and dropping the appropriate options from Initial Query Option tree 222 into the composition pane 230; (3) naming the query and choosing an appropriate Query Category in setup pane 260; (4) defining the display fields; and (5) defining the query attributes and setting the appropriate filters. After the query is built, the user may continue by: (6) running the query; and (7) saving the query and/or export the query results. This process is depicted in the flowchart 200 of FIG. 1B.
At a more detailed level, queries may be built step-by-step starting from the query wizard main screen 200 shown in FIG. 2A. A new query may be created according to the following steps:
Step 1:
In this step, the user defines a query. The initial task in the query building process is the formulation of a query question. That is, the user must determine what it is that the user wants to know and exactly what type of results information is required. As an example (i.e., Example 1), suppose the user wants to know: “Which patients have had heart rate values between 150 and 250?” And, a definition of the required results information is “Display a list of patients that will include patient name and hospital number.” Formulation of this query for query wizard 125 would be “Retrieve a list of patients (names+hospital numbers) with heart rate values greater than 149 and less than 251 with their Heart Rate values displayed.”
Step 2:
In the second step, the user selects the desired initial query options by dragging and dropping the appropriate options from the Initial Query Option tree 222 of FIG. 2A into the composition pane 230, both of query wizard window 210. The initial query option is selected to reflect the first part of the original question, which in Example 1 was “Which patients . . . ?”. Once dropped into composition pane 230, a corresponding attributes tree 232 for the Patients query option is presented. For example, the attributes tree includes patient related attributes, such as Admission time, Admission weight, Admitted by. Therefore, continuing Example 1, since the user asked a question about “which patients”, the Patients option 213 is selected and dragged into the composition pane 230.
Step 3:
In the third step, the user names the query and chooses an appropriate query category. To accomplish this, the user enters a query name in the Query name field 266 of the setup pane 260. In the preferred form, by default, the name of the option selected from the Initial Query Options tree 222 is written into the Query name field 266, but can be overwritten by the user. Preferably, the user defined query name describes the contents of the query being created. Continuing with Example 1, assuming the category Patients has been selected, the user enters a user defined query name “HR 150-250” into Query name field 266.
To simplify the process of saving and finding queries, they must be saved in an existing query category. Referring to FIG. 2A, the user selects a query category from the Query category drop-down list 268. In the preferred form, the Query category drop-down list 268 may include a variety of categories, put the “Patient” category is shown as a representative category in FIG. 2A. Otherwise, the user can create a new category. To create a new category, the user can select the button 269 corresponding to the Query Category field 268; which causes a Customize Query Categories window to be presented. This window includes a text entry field for entering and saving a new category name.
Step 4:
In this step, the user selects the display fields for the query results. The display fields will dictate the determination and presentation of the query results. When the results are provided in a table or grid format, as is shown in FIG. 2C, the selected display fields become the names of the columns that will appear in the results table. Otherwise, the query results may be provided in other graphical, textual, audio or video forms, or some combination thereof.
Referring to FIG. 2A, the user can choose desired display fields from the Display field area 262 of the setup pane 260. To accomplish this, the user selects a desired display field (e.g., Patient name) and then selects the right arrow button (i.e., “>”), which causes the selected display field to be represented in the query fields area 264. In this manner, display fields may be selectively chosen, one-by-one. Otherwise, the user may select the double-arrow button (i.e., “>>”) to have all the display fields represented in the query fields area 264, in one action. To de-select display fields the user can select the display field from query fields area 264 to be removed and click the appropriate return arrow buttons (i.e., “<” or “<<”). Once all desired display fields are represented in the query fields area 264, the user selects the Apply button of setup pane 260 to associate the selected display fields with the query name. The query name and the display fields are then represented in the composition pane 230. Continuing Example 1, the user defines the Patient Name and Hospital Number display fields. And, the query attributes tree has a heading comprising the query name and display fields, i.e., Heart Rate 150-250 (Patient name, MR number). “MR” indicates a specific medical facility.
Step 5:
In this step, the user defines or selects the query attributes and sets the appropriate filters. This step relates to the second part of the original question (i.e., in Example 1: “ . . . heart rate values between 150 and 250?”). The requested parameters or attributes (e.g., Heart Rate) are represented in the medical information system database 122. Selecting the query attributes is accomplished by first choosing the appropriate attribute from the query attributes tree 232. As mentioned above, query attributes tree 232 includes attributes that are related to the option (e.g., Patients) initially selected from the Initial Query Options tree 222, and includes the heading Heart Rate 150-250 (Patient name, MR number).
As also mentioned above, query attributes tree 232 includes, Sets of attributes not particularly related to the initially selected query option. The Sets, may be represented as expandable folders or trees of attributes that are, for the most part, not found in the portion of the query attributes tree 232 related to the selected initial query option. When a Set is selected, it expands to a query attributes tree (or sub-tree) comprised of attributes for the given Set. In the embodiment of FIG. 2A-2D, the attributes represented in the query attributes tree 232 are predefined and vary depending on the selected initial query option.
If the user's desired attributes, given the user's question, are attributes related to the query option selected from the Initial Query Options tree 222, then the user selects the desired attribute(s) from the query attributes tree 232 of the composition pane 230. If not already open, filter pane 270 is opened to facilitate the selection and definition of filters related to the selected attribute, as discussed below. The filter pane may be opened by selection of the Query Filter icon of toolbar 202.
If the desired attributes are related to an option not initially selected from the Initial Query Options tree 222, then the user selects the attribute Set that includes the desired attributes from the end of the query attribute list 232. Selecting the attribute Set reveals a new query attribute tree or subtree. In order to use the Display fields of the selected Set, the user selects the Set and proceeds in selecting and applying query results fields as described with respect to Step 4 above. That is, the contents and choices of the Display fields area 264 are context sensitive with respect to the chosen attribute Set in the composition pane 230. From the presented query attribute tree 232 the user selects a desired query attribute to be applied to the user's named query. Again, the user can open the filter pane 270 using the Query Filter icon.
In addition to use of the Query Filter icon, the query wizard can be configured to automatically render filter pane 270 upon selection of an attribute from composition window 230. Filter pane 270 is used to select attribute parameters and comprises a Parameter category drop-down list 272, a Parameters list 274, and a selected parameter area 276. Selection of a parameter category yields a list of related parameters in Parameters list 274. Those parameters in Parameters list 274 are eligible for selection into selected parameters area 276, and then for application to the query attribute. As is shown in FIG. 2D, a parameter category CVS is selected and a related parameter 1.2 HR is also selected.
Again, continuing Example 1, the user can chose and apply attributes and related parameter to have heart rate values returned by the query. To accomplish this, the user conducts the following steps:
1. Select the Signals Set query option from the query attribute list 232.
2. From the Display fields area 262 revealed for the Signals Set query option, select Value (not shown).
3. Select the Heart Rate attribute from query attribute tree 232.
4. In the filter pane 270, select the parameter category from the Parameter Category drop-down list 272 that contains the Heart Rate is a parameter.
5. Select the HR parameter from the scrollable Parameters list 274.
6. Select the right arrow button 278 (i.e., “>”) to move the highlighted parameter to the selected parameter area 276.
7. Click Apply button.
As discussed above, for each selected attribute, filters can be defined and applied.
Filter types vary depending on the query attribute chosen. In the preferred embodiment there are four filter types available: time, text, numeric, and checkbox. A different filter form is revealed for each filter type, providing mechanisms that allow the user to define and apply the filter. The time filter type allows a user to apply relative time values to its query (for example, before or after), as is shown in the time filter pane 310 of FIG. 3A. The text filter type allows a user to include or exclude text values with or from its queries (for example, equals or is like), as is shown in text filter pane 320 of FIG. 3B. The numeric filter type allows a user to include or exclude relative numeric values to its queries (for example, equals to, greater than or less than), as is shown in the numeric filter pane of FIG. 3C. As discussed in greater detail below, statistical functions can be applied to numeric type filters using the statistical functions buttons 332. The checkbox filter allows a user to apply Yes or No values to query attributes, as is shown in checkbox filter pane 340 of FIG. 3D.
A user may combine several filter options by using the And or Or selection which appear within the filter pane 270. Additionally, other filters may be defined for specific attributes, such as a Problem Number filter type for the Problems initial query option. To set a filter, the user completes the filter forms of FIG. 3A, 3B, 3C, and/or 3D and then selects the Apply button. These steps are repeated for every additional query attribute that the user wishes to filter for its query. To clear a set filter the user selects the attribute item from the query attribute tree 232, which reveals the filter forms 310, 320, 330, and 340. The user then selects the Clear button in the appropriate filter form. To view only the attributes being used in the query, click the query Attributes Filter icon from the toolbar 202.
Continuing with Example 1, to filter heart rate values, click the Value query attribute (not shown) under the Heart Rate 150-250 (Patient name, MR number) of query attributes tree 232. The numeric filter 330 of FIG. 3C is set as follows: (1) In the Greater than field, enter 149 and choose Beats Per Minute from the units drop-down list 334; (2) In the Is less than field, enter 251 and choose Beats Per Minute from the drop-down list; (3) Select the AND option; and (4) Click Apply, a numeric filter indicator (e.g., 1.2) appears in bold text next to the selected query attribute in the composition window 230 (see FIG. 2A for examples). The query is now fully defined and can be run by selecting the Run Query icon.
As another example (i.e., an Example 2) a user may ask the questions “Which patients have received Dopamine at a dosage of less than 3 Mg/Kg/Min and when?” This query may be defined as follows: (1) Select the Patients option from Initial Query Options list 222 and drag it to the composition window 230; (2) Enter a name for the query in the Query name field of setup pane 260; (3) Select the Query category from the drop-down list 268; (4) Select the following display fields for the query: Patient Name and MR number; (5) Click Apply; (6) Select the attribute Set containing Orders information from the end of the query attributes tree 232 of composition window 230; (7) Select the following display fields for the Orders Set: Rate, Start time, End time, and Planned time; (8) Select the appropriate query attribute(s): To query the database for this specific dosage of Dopamine, select the Main substance query attribute from the query attribute tree 232; (9) The Order Parameter category field 272 (see FIG. 2F) then shows all the main substance categories; (10) Select the Orders Parameter category that contains Dopamine; (11) Select Dopamine from the Orders Parameters list 274 and click the right arrow to move it to the Selected orders parameters list 278; and (12) Click Apply. In response, the Dopamine attributes appear in the Main substance tree 232.
To filter the Dopamine rate values: (1) Select the Rate attribute from Main substance tree 232; (2) To set the filter choose the Query Filter icon from icon toolbar 202, which reveals the filter panes of FIGS. 3A, 3B. 3C, and 3D; (3) Enter 3 in the Is less than field of the numeric filter pane 330 and choose Mg/Kg/Min from the drop-down list; and (4) Click Apply. In response, the filter icon appears in bold text next to the selected query attribute.
Order parameters in the query system 120 depend upon the customization of the database being queried, e.g., medical information system database 122. For example, a user can query Albumin as an ingredient as well as a main substance or a mixed solution. Should the user have any problems locating the substance to be queried, a search for the substance in a medical information order entry form (known in the art), or database, can be conducted using the query wizard 125.
Once defined, as discussed above, a query can be run by actuating the Run Query icon of icon toolbar 202 (see FIG. 2A). Results are viewed in Results pane 240.
Queries can also be saved by selecting the Save Query icon of icon toolbar 202. Once saved, the query is available in the Saved Queries folder of the Initial Query Options tree 222. The user can filter the display of the saved queries by clicking the Saved Query Filter display options in the icon toolbar 202. By filtering the display of saved queries, it is meant that a subset of the saved queries can be culled from the full set of saved queries.
As previously mentioned, query results can be exported to other applications, e.g., to a Microsoft Word™ or Excel™ file or to a Microsoft Access™ database. The results may then be further processed, if desired. To export query results:
1. Select the Export Query icon to open the Export Query dialog box 400 of FIG. 4.
2. Choose one of the three Microsoft Office™ applications from the application icon buttons 402 of dialog box 400.

- a) To export to Word™ or Excel™, select the appropriate Word™ or Excel™ icon from dialog box 400 and then select the Ok button 404. The query results appear in the appropriately formatted document.
- b) To export to Access™, select the Access™ icon. Then, select the browse (or “ . . . ”) button 406. Browse to and select one existing Access™ databases (i.e., files with a “mdb” extension). Otherwise, type the name of an existing or new table for storing the results in text entry field 408 and then select the Ok button 404. After exporting the query, it may be printed from the application to which it was exported.

Using the query wizard 125, a user can build complex queries by combining multiple queries. To accomplish this, the user can add one or more saved queries to a query under composition in the composition window 230 of FIG. 2A. For instance, the user can:
1. Select the New Query icon from icon toolbar 202.
2. Drag an option from the Initial Query Options tree 222 to the composition window 230.
3. Define and name the new query, as previously described.
4. Drag a saved query from the Initial Query Options tree 222 over the Sets (not shown) in the composition window 230; the compatible Sets will be highlighted.
5. Drop the saved query in one of the compatible Sets.
The user is then presented with the option of attaching or embedding the saved query to or in the new query. Attaching the query creates a link between the saved query and the new query. Any changes that are made to the saved query will directly influence the new query. Embedding the query adds a copy of the saved query to the new query. Whenever changes to an attached query are made, the query will automatically be updated. Changes made to an embedded query will not affect the previously saved version of the embedded query.
In accordance with the present invention, beyond the functions that enable the creation, running, and saving queries, statistics functions may also be included. Preferably, the query wizard 125 includes an option for using three levels of statistical functions. The first level enables a user to perform statistical functions or calculations upon the query results. The second level enables a user to apply statistical filters as a part of the query. The statistical calculations apply to all values. And, the third level lets a user define the group of values or the sample of patients on which the user wants to perform the statistical calculations.
Statistical Functions.
A display statistical functions utility allows a user to make statistical calculations based on the results of the query (such as average Heart Rate (HR) for a specific patient). This function may also be used to display the results of a statistical function applied to all values (for example, the average HR for all patients). In the case of our Example 1, for patients with HR between 150-250, the display statistical functions utility enables one to add the average age of these patients to the display fields, for example. To display statistical functions:
1. Choose the Display fields 262 (sec FIG. 5A) intended for use with the statistical calculation.
2. Select a function from the Statistical Functions drop-down list 502 associated with the Display fields list 262.
3. Select the central arrow 504 to move the display field to the window display fields pane 264.
4. Select Apply.
Other typical statistical functions known in the art may also be defined and included.
Statistical Filters.
The numeric filter pane 330 of FIG. 3C includes statistical functions, which a user can choose from the drop-down list of the statistics button 334 beside each field of a filter. This filtering function enables the user to view values above or below the average, min/max values, and so forth. The user can, for example, use this statistical filter to display all patients who have had FIR above average by using the statistical functions key 334, in FIG. 3C. In the preferred form, the Statistical Function filters (e.g., average value) are calculated from the entire database upon which the user is working. However, the display statistical function is calculated only for the results of the query.
To apply statistical function filters: (1) select the statistics button 332 beside the desired field (e.g., Greater than, Less than, etc.) in the numeric filter pane 330; (2) choose the required statistical function filter from the drop-down list presented; the statistical function filter appears in the field besides the statistics button 332 and the units field 334 disappears; and (3) select the Apply button.
Statistical Function Set.
The Statistical function set allows a user to perform statistical calculations only on selected groups of values, such as values without error or validated values. Any filter applied to this set defines the sample on which the statistical calculations are performed. Referring to FIG. 5B, in the Patients 512 initial query option, every definition in the Statistical function set 514 determines the relevant sample of patients. For instance, defining Age>60 as a Statistical function set will determine which patients are used for the query Height>AVG(Height). The average will be the average height of patients over 60 years old.
Setting a Statistical function set is done as any other set: (1) Select the Statistical function set. An additional query attribute tree opens, as part of the existing query attributes tree, containing the same attributes as the initial query option being worked on; (2) Select the desired query attribute from the new query attributes tree; (3) Set the required filters, as previously discussed; and (4) Select the Apply button.
If the user builds a query that looks for HR>AVG (HR) in the statistical function filter, and define HR>100 in the Statistical function set, the average HR in this query will be calculated only from those HR signals that are greater than 100. However, if the user defines the Statistical function set as HR>100, and then build a query that looks for HR>90 and HR<110, the user will still see values under 100, since the Statistical function set only defines the sample for statistical functions, not for all types of queries. In addition, when the user defines the Statistical function set for a specific parameter, it will only affect the statistical calculations of that parameter. Thus, defining HR>100 as a Statistical function set will have no affect on the query BP>AVG(BP).
Time-Related Parameters.
The time-related parameters function allows querying of signals and orders that have a relationship in time, e.g., within the same time frame. The time-related attribute defines the point or period in time on which the whole query is based.
As an Example 3, to find the Blood Pressure values at around the time the Heart Rate was over 150:
1. Under Parameters set (not shown), which is located with the other Sets found at the end of the query attributes tree, choose Parameters.
2. In the filter pane 270, select the Parameter category that contains the Blood Pressure parameter.
3. Select the Blood Pressure parameter.
4. Under Time related parameters, choose Parameters.
5. In the filter pane 270, select the Parameter category that contains the Heart Rate parameter.
6. Select the Heart Rate parameter. The HR value appears in the composition window 230.
7. Highlight the Value query attribute from Display field 262 (see FIG. 5). A numeric filter pane 330 is rendered in the filter pane 270.
8. Define HR>150 in the numeric filter pane 330.
9. Highlight the Grace period query attribute. A grace period filter 600 of FIG. 6 appears in filter pane 270.
10. Enter a grace period of 5 minutes forward and backwards.
This query will look for blood pressure values from 5 minute before and after each value of HR greater then 150.
As an Example 4, to find out how much Potassium was given during the hour following a lab result of K⁺<3.5. Define parameter K⁺ under the Time related attribute as K⁺<3.5, with a grace period of 1 hour forward. The query will look for the amount of potassium given during the hour following that lab result.
While the foregoing has described what are considered to be the best mode and/or other preferred embodiments, it is understood that various modifications may be made therein and that the invention or inventions may be implemented in various forms and embodiments, and that they may be applied in numerous applications, only some of which have been described herein. As used herein, the terms “includes” and “including” mean without limitation. It is intended by the following claims to claim any and all modifications and variations that fall within the true scope of the inventive concepts.

Claims

1. A query system, configured to access or obtain patient data from a medical information system comprising a set of electronic devices including means for monitoring patients, wherein said query system comprises:

A. a query script generator for defining one or more query scripts, each of said query scripts comprising a set of query attributes associated with elements of a subset of patient data;

B. a query script executor, configured to apply said query script to said patient data and to generate query results comprising said elements of said subset of patient data; and

C. an output generator, configured to output said query results.

2.-34. (canceled)