WO2002027569A1 - A method of supplying information relating to the care of a patient - Google Patents

A method of supplying information relating to the care of a patient Download PDF

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Publication number
WO2002027569A1
WO2002027569A1 PCT/IB2001/001484 IB0101484W WO0227569A1 WO 2002027569 A1 WO2002027569 A1 WO 2002027569A1 IB 0101484 W IB0101484 W IB 0101484W WO 0227569 A1 WO0227569 A1 WO 0227569A1
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WO
WIPO (PCT)
Prior art keywords
patient
information relating
information
user
database
Prior art date
Application number
PCT/IB2001/001484
Other languages
French (fr)
Inventor
John Anthony Fagan
Renate Hahn
Original Assignee
Aventis Pharma (Pty) Ltd
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Aventis Pharma (Pty) Ltd filed Critical Aventis Pharma (Pty) Ltd
Priority to AU2001277643A priority Critical patent/AU2001277643A1/en
Publication of WO2002027569A1 publication Critical patent/WO2002027569A1/en

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Classifications

    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00—Administration; Management
    • G06Q10/10—Office automation; Time management
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
    • G16H10/60—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for patient-specific data, e.g. for electronic patient records
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/30—ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment
    • G—PHYSICS
    • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H70/00—ICT specially adapted for the handling or processing of medical references
    • G16H70/60—ICT specially adapted for the handling or processing of medical references relating to pathologies

Definitions

  • THIS invention relates to a method of supplying useful information relating to the care of a patient.
  • a doctor treating a patient at a hospital, or as an outpatient does not always have all the necessary information at his or her fingertips.
  • any treatment given to the patient is often a component approach rather than a preferred integrated approach.
  • the doctor may have all the necessary information available in a format which is not very user friendly and they therefore do not become aware of this information when they should.
  • the present invention seeks to address this problem by bringing information to the attention of the user rather than waiting for the user to notice the information.
  • a method of supplying useful information relating to the care of a patient comprising the steps of:
  • data relating to one or more of the group of information comprising: information relating to the patient's physical health, information relating to the drugs being used by the patient, information relating to the medical history of the patient, and information relating to the personal details of the patient;
  • a plurality of users may be given access to the data fields to enter data via a communications network.
  • Data may be transferred over the communication network for indication to a user via the graphical interface if predetermined data is contained in the data fields.
  • the invention extends to a machine readable medium comprising instructions which, when executed by a machine, cause the machine to perform the method of the present invention.
  • the Figure is a flowchart illustrating the steps carried out by the software of the present invention.
  • the present invention will be described with reference to a patient who is afflicted with diabetes. However, it will be appreciated that the present invention could equally be applied to a patient afflicted with any other type of disease.
  • the database may be accessed via a stand-alone computer, such as a typical personal computer (PC).
  • a stand-alone computer such as a typical personal computer (PC).
  • PC personal computer
  • the database may be connected to a plurality of computers located at various medical institutions via a network.
  • the patient's information can be accessed and updated from any of these medical institutions so that the information relating to the patient is simultaneously available to a plurality of users.
  • the information captured relating to the patient can be categorised into four general categories, namely information relating to the patient's physical health, information relating to the drugs being used by the patient, information relating to the medical history of the patient and information relating to the personal details of the patient.
  • the first type of information captured is the patient's personal details which enables a user of the database to identify the patient correctly, such as the patient's full name, postal address, telephone number and medical aid number.
  • This information includes hospitalisation for diabetic ketoacidosis or hypoglycemia, for example.
  • the year of first diagnosis of diabetes is also captured and stored.
  • Information relating to the patient's physical health is also captured and stored.
  • this information includes blood glucose levels from different types of tests such as home glucose monitoring, laboratory monitoring and glycosylated Hemoglobin (HbA-
  • a lipid profile of the patient is also stored in the database.
  • the lipid profile includes total cholesterol (mmol/l), LDL-C (mmol/l), HDL-C (mmol/l) and triglycerides (mmol/l) together with whether or not the patient is dyslipidaemic.
  • the urinal functioning of a diabetic person is also particularly important and so information relating to the renal functioning of the patient is stored, including the level of microalbuminuria, macroproteinuria, albumin/creatinine ratio, serum creatinine clearance, potassium, serum uric acid and serum urea.
  • microvascular and macrovascular complications such as diabetic retinopathy, diabetic nephropathy, peripheral neuropathy, autonomic neuropathy, sexual dysfunction or diabetic foot ulcers, myocardial infarction, angina pectoris, heart failure, stroke, or coronary artery bypass graft, are stored in another field in the database.
  • the next section of information relates to the drugs being used by the patient.
  • These drugs not only include any oral antidiabetic agents and the amount and type of insulin being used, but also if the patient uses any other medication. For example, medications used for hypertension or dyslipidaemia.
  • the database is also updated from time to time with further information, depending on changes in the patient's condition and/or medication. It will also be appreciated that for a different disease, the captured information relating to the patient's physical health and medication will be different.
  • Software running on a computer associated with the database continually queries the database and analyses the information therein to supply a user of the database, via a graphical interface, with useful information relating to the care of the patient.
  • a plurality of logical links between various data fields are set up so that if predetermined data appears in data fields which are linked, this is indicated to a user of the database.
  • the logical links are between data fields within different categories of information are between data fields within the same category of information.
  • CV cardiovascular
  • a diabetic patient with one risk factor such as smoking may decrease the risk of renal or cardiovascular disease using an ACE-inhibitor (Angiotensin converting enzyme inhibitor).
  • ACE-inhibitor Angiotensin converting enzyme inhibitor
  • a link between the data field indicating that the patient smokes and the data field indicating whether or not ACE- inhibitors are used is set up so that if the link does not exist, a user of the database is notified.
  • a Type 2 diabetic patient being treated on the maximum dosage of oral anti-diabetic medication with a glycosylated hemoglobin greater than 7.0% (diabetes control not in the normal range), should
  • a diabetic patient with uncontrolled dyslipidaemia has a high risk of a myocardial infarction.
  • a link is set up between the data field indicating the type of diabetes and the lipid profile.
  • a link is formed between different kinds of disease so that the progression of the diabetes can be monitored. For example, if a patient is flagged as having microalbuminuria and diabetic nephropathy, and is subsequently flagged as having proteinuria, which is also linked to diabetic nephropathy, the user is notified of this. In so doing, the user is shown the progression of the complication of diabetic nephropathy.
  • the database can also be used to warn a user when the results of a patient test falls outside safe parameters, eg:
  • warning levels may be different depending on some other criteria, such as the patient's general health or whether or not the patient has contracted any other diseases.
  • FIG 1 illustrates the method steps carried out by the software prototype of the present invention.
  • the software was implemented using Lotus NotesTM.
  • the software tests, in step 10, what type of diabetes the patient has. If the patient has a Type 2 diabetes, step 12, the software checks the HbA 1c test result 14 and the Metformin usage 16.
  • the software checks the database for OAD/Amaryl usage 18. If the patient is on one or more OAD's including Amaryl, the software checks the database for insulin usage 20. If the patient is not on insulin, a first warning message is displayed. All of the displayed messages are listed in annexure A. If the patient is on an OAD except Amaryl, message 3 is displayed 24.
  • the software checks the database for any cardiovascular related disease 26. If the patient has a cardiovascular disease, message 2 is displayed 28. Whether the patient is a Type 1 or Type 2 diabetic, the software checks the data in the database for other information.
  • the software checks whether the patient is a smoker 30, and if the patient smokes message 4 is displayed 32.
  • the software also checks the body mass index (BMI) test results 34. If the body mass index test result is greater than 25 the software checks if the patient is seeing a dietician 26. . If the patient is not seeing a dietician, message 5 is displayed 38.
  • BMI body mass index
  • the total cholesterol test results are checked by the software 40, and if it is greater than 5mmol/l, message 6 is displayed 42. Similarly, the software checks the Thglycerides test result 44. If the triglyceride test result is greater than 1.5mmol/l, message 6 is displayed 42.
  • the present invention is not merely a database storing information relating to a patient which can be later analysed, but is

Abstract

A method of supplying useful information relating to the care of a patient includes the capturing of information relating to the patient's physical health, drugs used by the patient (20), medical history of the patient and the personal details of the patient in the database. A plurality of links are created between the various data fields and if predetermined data appears in data fields which are linked, a message is displayed to a user to prompt them to give the correct care.

Description

A METHOD OF SUPPLYING INFORMATION RELATING TO THE CARE OF
A PATIENT
BACKGROUND OF THE INVENTION
THIS invention relates to a method of supplying useful information relating to the care of a patient.
At present, a doctor treating a patient at a hospital, or as an outpatient, does not always have all the necessary information at his or her fingertips. Thus any treatment given to the patient is often a component approach rather than a preferred integrated approach.
Alternatively, the doctor may have all the necessary information available in a format which is not very user friendly and they therefore do not become aware of this information when they should.
The present invention seeks to address this problem by bringing information to the attention of the user rather than waiting for the user to notice the information. SUMMARY OF THE INVENTION
According to the invention there is provided a method of supplying useful information relating to the care of a patient, the method comprising the steps of:
storing, in predetermined data fields, data relating to one or more of the group of information comprising: information relating to the patient's physical health, information relating to the drugs being used by the patient, information relating to the medical history of the patient, and information relating to the personal details of the patient;
querying the database to determine if predetermined data is contained in at least one of the data fields; and
indicating to a user via a graphical interface if predetermined data is contained in the data fields.
A plurality of users may be given access to the data fields to enter data via a communications network.
Data may be transferred over the communication network for indication to a user via the graphical interface if predetermined data is contained in the data fields.
The invention extends to a machine readable medium comprising instructions which, when executed by a machine, cause the machine to perform the method of the present invention. DESCRIPTION OF DRAWING
The Figure is a flowchart illustrating the steps carried out by the software of the present invention.
DESCRIPTION OF AN EMBODIMENT
The present invention will be described with reference to a patient who is afflicted with diabetes. However, it will be appreciated that the present invention could equally be applied to a patient afflicted with any other type of disease.
When the patient first comes into contact with a doctor or medical institute such as a hospital or day clinic, details of the patient are captured and stored in a database.
The database may be accessed via a stand-alone computer, such as a typical personal computer (PC).
Alternatively, the database may be connected to a plurality of computers located at various medical institutions via a network. In this case, the patient's information can be accessed and updated from any of these medical institutions so that the information relating to the patient is simultaneously available to a plurality of users.
The information captured relating to the patient can be categorised into four general categories, namely information relating to the patient's physical health, information relating to the drugs being used by the patient, information relating to the medical history of the patient and information relating to the personal details of the patient. The first type of information captured is the patient's personal details which enables a user of the database to identify the patient correctly, such as the patient's full name, postal address, telephone number and medical aid number.
Other personal details such as the patient's sex/gender, date of birth, ethnic group and family medical history are also captured. In the case of diabetes, information relating to whether or not any other family member has diabetes or a cardiovascular disease is captured and stored in the database.
If the patient has a prior history of diabetes, information relating to this history is also captured. This information includes hospitalisation for diabetic ketoacidosis or hypoglycemia, for example.
The year of first diagnosis of diabetes is also captured and stored.
Not only does the abovementioned information enable a user of the database to identify the patient, but this information is also used in conjunction with other information when the links are established, as will be described in more detail below.
Information relating to the patient's physical health is also captured and stored. For a diabetic patient, this information includes blood glucose levels from different types of tests such as home glucose monitoring, laboratory monitoring and glycosylated Hemoglobin (HbA-|C).
Information relating to the blood pressure of the patient, including systolic and diastolic measurements together with whether or not the patient is hypertensive is captured. A lipid profile of the patient is also stored in the database. The lipid profile includes total cholesterol (mmol/l), LDL-C (mmol/l), HDL-C (mmol/l) and triglycerides (mmol/l) together with whether or not the patient is dyslipidaemic.
The urinal functioning of a diabetic person is also particularly important and so information relating to the renal functioning of the patient is stored, including the level of microalbuminuria, macroproteinuria, albumin/creatinine ratio, serum creatinine clearance, potassium, serum uric acid and serum urea.
Whether or not the patient smokes together with the patient's average alcohol consumption per day is also stored, as this is relevant to the patient's physical health.
Any microvascular and macrovascular complications such as diabetic retinopathy, diabetic nephropathy, peripheral neuropathy, autonomic neuropathy, sexual dysfunction or diabetic foot ulcers, myocardial infarction, angina pectoris, heart failure, stroke, or coronary artery bypass graft, are stored in another field in the database.
The next section of information relates to the drugs being used by the patient.
These drugs not only include any oral antidiabetic agents and the amount and type of insulin being used, but also if the patient uses any other medication. For example, medications used for hypertension or dyslipidaemia.
It will be appreciated that all of the above information can be captured at the time the patient's details are first input into the database. The database is also updated from time to time with further information, depending on changes in the patient's condition and/or medication. It will also be appreciated that for a different disease, the captured information relating to the patient's physical health and medication will be different.
Software running on a computer associated with the database continually queries the database and analyses the information therein to supply a user of the database, via a graphical interface, with useful information relating to the care of the patient.
To achieve this, a plurality of logical links between various data fields are set up so that if predetermined data appears in data fields which are linked, this is indicated to a user of the database.
These logical links are implemented in the software running on the computer associated with the database.
The logical links are between data fields within different categories of information are between data fields within the same category of information.
The following is a list of some examples of both of these kinds of logical links:
a) The database field indicating whether or not the patient has a cardiovascular (CV) disease is linked with a diabetic treatment using Metformin which is contra-indicated in patients with cardiovascular disease.
b) A diabetic patient with one risk factor such as smoking may decrease the risk of renal or cardiovascular disease using an ACE-inhibitor (Angiotensin converting enzyme inhibitor). Thus a link between the data field indicating that the patient smokes and the data field indicating whether or not ACE- inhibitors are used is set up so that if the link does not exist, a user of the database is notified. c) A Type 2 diabetic patient being treated on the maximum dosage of oral anti-diabetic medication with a glycosylated hemoglobin greater than 7.0% (diabetes control not in the normal range), should
i) either have his/her treatment changed to add insulin to his/her present treatment; or
ii) change his/her treatment to insulin therapy to improve diabetes control.
Thus a link is established between the data field indicating a Type 2 diabetes with glycosylated hemoglobin and the drug data field indicating the use of an oral anti-diabetic medication with insulin.
d) A diabetic patient with uncontrolled dyslipidaemia has a high risk of a myocardial infarction. To warn a user of this, a link is set up between the data field indicating the type of diabetes and the lipid profile.
e) A link is formed between different kinds of disease so that the progression of the diabetes can be monitored. For example, if a patient is flagged as having microalbuminuria and diabetic nephropathy, and is subsequently flagged as having proteinuria, which is also linked to diabetic nephropathy, the user is notified of this. In so doing, the user is shown the progression of the complication of diabetic nephropathy.
The database can also be used to warn a user when the results of a patient test falls outside safe parameters, eg:
a) Diabetes control:
- green when HbA1c < 7.0%
- red when HbA1c > 7.0% b) Blood Pressure Control in diabetic patients: green when < 130/85 mmHg - red when > 130/85 mmHg
c) Lipid Control - Total Cholesterol: green when < 5 mmol/l red when > 5 mmol/l
Using the links between data fields, these warning levels may be different depending on some other criteria, such as the patient's general health or whether or not the patient has contracted any other diseases.
Figure 1 illustrates the method steps carried out by the software prototype of the present invention. The software was implemented using Lotus Notes™.
The software tests, in step 10, what type of diabetes the patient has. If the patient has a Type 2 diabetes, step 12, the software checks the HbA1c test result 14 and the Metformin usage 16.
If the HbA1c test result is above 7.0%, the software checks the database for OAD/Amaryl usage 18. If the patient is on one or more OAD's including Amaryl, the software checks the database for insulin usage 20. If the patient is not on insulin, a first warning message is displayed. All of the displayed messages are listed in annexure A. If the patient is on an OAD except Amaryl, message 3 is displayed 24.
Referring back to the test for Metformin usage 16, if the patient is treated with Metformin, the software checks the database for any cardiovascular related disease 26. If the patient has a cardiovascular disease, message 2 is displayed 28. Whether the patient is a Type 1 or Type 2 diabetic, the software checks the data in the database for other information.
The software checks whether the patient is a smoker 30, and if the patient smokes message 4 is displayed 32.
The software also checks the body mass index (BMI) test results 34. If the body mass index test result is greater than 25 the software checks if the patient is seeing a dietician 26. . If the patient is not seeing a dietician, message 5 is displayed 38.
The total cholesterol test results are checked by the software 40, and if it is greater than 5mmol/l, message 6 is displayed 42. Similarly, the software checks the Thglycerides test result 44. If the triglyceride test result is greater than 1.5mmol/l, message 6 is displayed 42.
The software tests for hypoglycemia 46. If the patient is experiencing hypoglycemia the software tests for NPH insulin 48. If the patient is using a Protaphane or Humulin N (NPH insulin), message 7 is displayed 50.
The software tests for a cardiovascular disease 52, and if a cardiovascular disease is present, the software tests for usage of an ACE inhibitor 54. If the patient is not on an ACE inhibitor, message 8 is displayed 56.
The above flow diagram is obviously only an example of some tests the software could carry out and many other such tests could be easily implemented.
It will be appreciated that the present invention is not merely a database storing information relating to a patient which can be later analysed, but is

Claims

more dynamic in that a user is supplied with important information without having to look for the information, and the user is prompted to use the appropriate best clinical practices.
Thus the present invention facilitates a clinical profile of patients against accepted international published clinical guidelines. In so doing it identifies and measures patient risk and calls for appropriate best clinical practice interventions as per published referenced clinical guidelines.
In managing the information relating to a patient in this unique holistic fashion, a user can enhance the quality and effectiveness of the health care being delivered to the patient.
PCT/IB2001/001484 2000-09-27 2001-08-17 A method of supplying information relating to the care of a patient WO2002027569A1 (en)

Priority Applications (1)

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AU2001277643A AU2001277643A1 (en) 2000-09-27 2001-08-17 A method of supplying information relating to the care of a patient

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ZA200005184 2000-09-27
ZA2000/5184 2000-09-27

Publications (1)

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Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5974389A (en) * 1996-03-01 1999-10-26 Clark; Melanie Ann Medical record management system and process with improved workflow features
US5991729A (en) * 1997-06-28 1999-11-23 Barry; James T. Methods for generating patient-specific medical reports

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US5974389A (en) * 1996-03-01 1999-10-26 Clark; Melanie Ann Medical record management system and process with improved workflow features
US5991729A (en) * 1997-06-28 1999-11-23 Barry; James T. Methods for generating patient-specific medical reports

Also Published As

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