WO1988004073A1

WO1988004073A1 - A touch screen oriented lexicon dependent computer system

Info

Publication number: WO1988004073A1
Application number: PCT/US1987/002908
Authority: WO
Inventors: George M. Starken
Original assignee: The Johns Hopkins University
Priority date: 1986-11-26
Filing date: 1987-11-06
Publication date: 1988-06-02

Abstract

Touch-screen (18, 20) oriented, lexicon dependent computer system for use by specialists to produce routine professional reports expressed in a restricted vocabulary or lexicon.

Description

A TOUCH SCREEN ORIENTED LEXICON DEPENDENT COMPUTER SYS E::

STATEMENT OF GOVERNMENTAL INTEREST

The Government has rights in this invention pursuant to Contract No. N00024-85-C-5301 awarded by the Department of the Navy. BACKGROUND OF THE INVENTION

This invention relates in general to an apparatus and method for preparing routine reports using a standardized vocabulary or lexicon. These reports are produced by specialists who make and document professional judgments which can be diagnostic, analytic and/or technical in nature.

Typically, the professional report is produced by an alpha numeric keyboard device through the intermediary of a transcriptionist or stenographer. However, efforts have been made to produce equipment allowing the specialist to generate written reports without the use of an intermediary or the standard keyboard.

An early device was manufactured by Siemens Aktiengesellschaft, of the Federal Republic of Germany, for use by radiologists to produce diagnostic reports derived from their analysis and evaluation of patients' X-rays. Called SIREP, for Siemens' reporting system, it incorporated a radiology lexicon developed at The Johns Hopkins University Hospital.

SIREP can be thought of as a kind of a specialized word processor. The keys of this device are labelled with 6000 words, phrases or icons comprising the radiological lexicon. Typically, the icons are stylized representations of anatomical features, for instance, a hand or a colon. One hundred and sixty eight 35mm photographic transparencies contain logically grouped overlapping subsets of the lexicon. Under control of a microprocessor, anyone of these transparencies can be rear projected onto a touch-sensitive screen with 19 horizontal rows by 19 vertical columns of touch sensitive areas or touch points. Some of these 361 touch points cause , appropriate words or phrases to be added to the text of the diagnostic report. Others cause a shift to another transparency and some do both. As the X-rays are being examined, the radiologist can rapidly and directly compose a diagnostic paragraph by touching appropriate words or icons. When he is satisfied with a diagnostic text, as displayed on a conventional video monitor, the report can be printed locally.

This Siemens device is based on the electromechanical display and computer technology of the early 1970's and inherently requires dedicated, hard-to-modify hardware and software. For example, the touch screan, using a photographic transparency, requires elaborate, expens^'ive, special-purpose electromechanics and optics.

A related apparatus, called DARC, has been produced by Southwest Scientific, Inc. incorporating a software generated touch screan display derived from the same lexicon as SIREP. However, the display is presented on the surface of a cathode ray tube (CRT) which is curved. Since the curved surface of the CRT also operates as the touch surface, the radiologist using DARC experiences problems of optical parallax if he is not positioned directly in front of the screen at all times. The parallax problem causes an apparent shift of the touch point. Furthermore, the alterations made to The John Hopkins University lexicon and display rendered the display confusing and unreadable.

A system and technique for automated medical history taking are described in the United States patent 4,130,881. A software generated display- contains questions to be answered by the patient. Mechanical buttons near the display allow the patient to respond in a yes/no fashion to up to five questions.

United States patent 4,513,295 relates to a method for recording medical information on a strip chart associated with a fetal monitoring device. By depressing the appropriate location on a switching membrane, a clinician can cause pertinent medical information to be recorded on the strip chart.

An industrial process control system is disclosed in United States patent 4,413,314, comprising a CRT visual display device and a transparent touch responsive panel on the CRT display screen. Although the display is computer generated, it is displayed on a curved CRT screen and, as DARC discussed above, presents parallax problems.

United States patent 3,187,321 discloses a CRT having a-touch panel mounted in proximity thereto. The touch panel graphics are on a plurality of interchangeable cards which are physically placed on the surface of the touch panel by the operator. The graphics are keyed to different types of displays projected on the CRT screen.

A calculator/touch screen associated with a numerical display is the subject of the United States patent 4,575,804.

Other references showing the combination of a touch screen associated with a separate CRT display are: United States patents 4,310,839, 4,516,112 and 4,517,559.

OBJECTS OF THE INVENTION It is the object of the present invention to provide an apparatus and method for the rapid preparation of routine reports expressed in a specialized and standardized vocabulary or lexicon. In particular, it is object of the present invention to provide an apparatus and method for a specialist to produce these reports without the use of a transcriptionist or a stenographer.

It is a further object of the present application to provide a flat-faced surface which operates as both the display surface as well as the touch sensitive surface, which surface avoids the parallax problems associated with a standard CRT touch surface.

Another object of the present invention is to produce an apparatus and method for the rapid preparation of routine reports wherein a lexicon based display is software generated and the lexicon can be modified and enlarged easily and rapidly.

SUMMARY OF THE INVENTION

The invention relates to a touch screen oriented, lexicon dependent computer system for use by specialists to produce routine professional reports expressed in a restricted vocabulary or -lexicon. Typically, the lexicon consists of a collection of diagnostic, analytic or technical terms found in a particular area of technical expertise. For example, in many trouble and failure reporting (TFR) systems a technical specialist uses a standard or restricted vocabulary to compile his report.

Medical specialists, analyzing and reporting the results of standard tests, also use a standard restricted vocabulary to ensure uniformity in reporting a diagnosis. For example, a radiologist examining X-ray films, uses a standard radiological vocabulary or lexicon to prepare his diagnostic or analytic report.

The present reporting system incorporates a flat-faced touch screen display. Anyone of a plurality of displays can be presented on the touch screen, each display consisting of a variety of terms. Specialists merely touch the portion of the screen containing the desired word and that word becomes part of their report. Since a plurality of displays are available to the specialist, each individual display is provided with means to move from one display to another merely by touching the appropriate portion of the touch screen called a touch sensitive point or cell.

Each display is a computer generated image projected on to a flat-faced color CRT thus avoiding parallax problems caused by forming an image on the curved screen operates as both the image display surface and the touch sensitive surface.

The above, and other objects, features and advantages of this invention will become apparent from the following detailed description which is to be read in conjunction with the accompanying drawings. BRIEF DESCRIPTION OF THE DRAWINGS

Figure 1 is a diagram demonstrating the hardware system configuration of the present invention.

Figure 2 is a front view of the touch sensitive surface.

Figure 3 is a flow chart of the basic, software components of the present invention.

Figure 4 is a detailed flow chart of the software components of the sign-in module.

Figure 5 is a detailed flow chart of the software components of the administrative function processor.

Figure 6 is a detailed flow chart of the sofware components of the options handler.

Figure 7 is a detailed flow chart of the sofware components of the report locator module.

Figure 8 is a detailed flow chart of the sofware components of the report processor.

Figure 9 is a detailed flow chart of the sofware components of the report generator.

Figure 10 is a detailed flow chart of the sofware components of the print queue monitor. DETAILED DESCRIPTION OF A PREFERRED EMBODIMENT

The embodiment described is a diagnostic reporting system for use by radiologists to produce diagnostic reports based on their examination of patient X-rays.

Referring to the hardware system of Figure 1, software stored in the hard disk and the random access memory (RAM) of the personal computer (PC) generates a display on the flat-faced display screen. This display comprises words and/or symbols representing words (icons), for example, a representation of a femur, including its related ball joint.

The flat-faced screen acts as both the display surface and the touch sensitive surface. When the radiologist touches a touch sensitive point on the touch screen, a desired word or phrase appears on the PC monitor through the action of an input device. An alphanumeric keyboard is also provided to type in desired material which then appers on the PC monitor. When the report is complete, the radiologist will instruct the printer to provide a paper copy of his report and also may instruct the external interface to store the report where it may be accessioned by other retrieval systems. The RAM memory of the personal computer also stores these reports for up to one week.

The flat-faced display screen of the present application is provided with touch indicating means and is represented in Figure 2. In this particular embodiment any one of a plurality of individual displays or frames may appear on the flat-faced display screen. Each frame has approximately 380 cells for touch sensitive points 32, each cell containing an element from a standardized lexicon such as a word, a group of words, an icon, a portion of an icon or a function key. This particular lexicon is the radiology lexicon developed at The Johns Hopkins University Hospital. Touching a cell containing a function key results in a specific type of operation being performed, such as shifting from one frame to another. When a radiologist touches another touch sensitive point, a word or words representing the subject matter of that cell appear (s) on the PC monitor through the action of the input device. Thus, by touching the appropriate touch points, the radiologist is able to create a diagnostic report on the PC monitor. If the required words or terminology are not present in any of the frames displayed, an alphanumeric keyboard is provided to type in the desired material which then appears on the PC monitor. When the report is complete, the radiologist, by touching the appropriate point, may instruct the printer to provide a paper copy of his report and also may instruct the computer to store the report.

The display screen of the present invention, described in Figure 2, basically consists of a variable display surface 20 surrounded by a fixed display surface 18. The display screen is divided into a plurality of touch sensitive points 32 each containing a word, phrase, icon or portion of an icon based on the lexicon or an instruction. The variable display 20 can present a plurality of computer generated displays or frames. Fixed display surface 18 presents a fixed display produced by back lighting a color transparency located behind glass bezel 16.

The touch indicating means is an infrared detector means for this particular example. However, anyone of several touch indicating means can be used such as a membrane switch and a sonic based touch system. The instant embodiment comprises horizontal transmitter 22, horizontal receiver 24, vertical transmitter 26 and vertical receiver 28. Both transmitters emit parallel light beams which cross the touch screen in straight lines. Two vertical beams 34 intersect with two horizontal beams 30 in each touch point cell, thus forming four intersections. At least three of the light beams must be interrupted to actuate the touch indicating means. When a light beam is interrupted, it is not received by its matching horizontal receiver 24 or vertical receiver 28 and, since the light beams form a grid across the touch surface, this causes a digital signal indicative of a touch point, to be sent back to the personal computer. The computer then takes this information, compares it to a list, of sensitive points, identifies the word, etc. in the cell and causes it to be transmitted to the conventional PC monitor as shown in Figure 1. By touching the appropriately labelled cells in the touch screen in an appropriate order, the specialist can construct a report which appears on the PC monitor. When the report is finished, the specialist can use the appropriate touch sensitive points 32 in fixed display 18 to instruct the computer to print or store the report.

The relationships, of the basic software components of the present invention, are shown in Figure 3. When the system is turned on, the operator must first sign in with the appropriate ID. The sign-in module provides for three system functions each having an appropriate ID. These functions are administrator, clerk and physician. If the system administrator function is desired, entry of the appropriate ID allows the operator to work in that part of the software means demonstrated in Figure 5a and 5b. If a clerical function is desired, the operator is given access to the options handler of Figure 6. A physician, providing the appropriate ID, is successively introduced to the report locator module 7, the report processor 8 and the report generator. When the power is turned off, the report material is sent to print queue monitor shown in Figure 10.

The sign-in module of Figure 4 demonstrates the sign-in procesure. The sign-in display is presented on the PC monitor screen. The user is requested to provide the appropriate user ID via the alphanumeric keyboard. This ID can be a system administrator, a data entry clerk or a physician, for example, each user having an individual user ID. The user ID is compared to the data file of user IDs and, if a match occurs, the user is admitted to the appropriate portion of the system. The user is given three requests for a correct ID, and, if none is provided, the system returns to the original sign-in request.

If the user ID is an administrator, the user is given access to the administrator function processor shown in Figures 5a and 5b. This software module, allows the administrator to add or change a user ID, list unfinished reports, archive or store old reports, view old reports or add and modify any individual frame of the variable display. A main benefit of the present invention resides in the administrative function processor wherein the administrator can easily amend the lexicon and thus alter the content of the corresponding display frame. With the passage of time, new words are added to standard lexicons while inappropriate ones are deleted. The administrative function processor provides for updating of the lexicon and frames, allowing the system to remain current with progressive developments in science and technology.

If the data entry clerk ID is entered, the system moves to the options handler represented in Figure 6. The options handler allows the clerical user to enter the patient ID, name and the type of exam or report to be prepared. The clerk can also locate any earlier stored reports provided for the same patient and add the new exam request to tha particular patient data file.

If the user is a physician, after sign—in, he begins his work in the locator module of Figure 7. This module gives the physician the ability to locate unfinished reports stored in the system as well as to select the type of exam. If no report is found, the user is sent to the options handler of Figure 6 where he can perform necessary clerial functions. The unfinished reports may be located either by name or patient ID. In operation, a medical clerk using the options handler of Figure 6, enters the standard type of medical data such as patient name, identification number, type of examination requested, etc. These are stored as "unreported exams". Through the report locator module, the physician locates these unreported exams, selects the appropriate exam selection from the selection menu and is sent to the next module, the report processor represented in Figure 8.

In the report, processor of Figure 8, the physician actually prepares his report. The individual frames or variable display surface 20 are presented on the variable display surface 20 of the flat-faced display screen provided with touch indicating means. As the appropriate touch-sensitive points or cells 32 are touched, the report is created and displayed on the monitor. When the report is created and finished, the physician can instruct the computer to store or print the report as demonstrated in the report generator of Figure 9.

The print queue monitor of figure 10 has been provided to insure, that after all reports are finished and the user turns the power off, the printer will remain on line until all reports have been printed.

The above description has been presented merely as an example. It is understood that the apparatus and process of the present invention can be used in any system for preparing reports based on a standardized lexicon without departing from the scope of the claims.

Claims

What is claimed is:

1. An apparatus for preparing reports using a standardized lexicon, said apparatus comprising:

a personal computer; software means; a computer monitor; a flat-faced display screen provided with touch indicating means comprising touch sensitive points; and

wherein the software means instructs the operator to produce a software generated display on the display screen, said display comprising at least one of words and icons representing word from the standardized lexicon, each of said at least one being associated with a touch sensitive point; and

wherein touching appropriate sensitive points instructs the computer to present words from the lexicon on the monitor so as to compose a written report.

2. An apparatus according to claim 1, also comprising an alphanumeric keyboard and wherein operating the alphanumeric keyboard instructs the computer to present other wordss, not found in the lexicon, on the monitor.

3. An apparatus according to claim 2, wherein the flat-faced display screen comprises a variable display portion and a fixed display portion.

4. An apparatus according to claim 3, wherein only the variable display portion is generated by the software means.

5. An apparatus according to claim 3, wherein a plurality of individual frames, each corresponding to a portion of the lexicon, can be generated, one at a time, on the variable display screen.

6. An apparatus according to claim 3, wherein the variable display portion is surrounded by the fixed display portion.

7. An apparatus according to claim 3, wherein the fixed display portion is generated from a transparency.

8. An apparatus according to claim 3, wherein the words and icons appearing in the fixed portion are lexicon words commonly used to prepare standardized reports.

9. An apparatus according to claim 2, wherein the display also comprises touch sensitive points associated with specific functions and wherein touching a specific function touch sensitive point instructs the computer to perform the specific function.

10. An apparatus according to claim 2, wherein the specific functions comprise instructions to:

change the frame, print the report, and store the report.

11. An apparatus according to claim 2, also comprising a printer and wherein the software means instructs the computer to produce a printed version of the monitor written report.

12. An apparatus according to claim 2, also comprising memory means and wherein the software means instructs the computer to store the written report in the memory means and also wherein the written report is retrieved for at least one of review, modification, printing and accessioning by other retrieval systems.

13. An apparatus according to claim 2, wherein the touch indicating means is one of infrared means, sonic means and membrane switch means.

14. An apparatus according to claim 2, wherein the touch indicating means comprises:

a horizontal transmitter to emit parallel horizontal infrared beams across the flat-faced display screen, a horizontal receiver to receive the horizontal beams, a vertical transmitter to emit parallel vertical infrared beams across the flat-faced display screen;

a vertical receiver to receive the vertical beams; and

wherein the parallel horizontal beams and parallel vertical beams form a grid on the surface of the display screen;

wherein two horizontal and two vertical beams intersect for each touch sensitive point; and wherein when at least three of the light beams in a specific touch sensitive point are interrupted by touching, a signal indicative of the touch point instructs the computer.

15. An apparatus according to claim 5, wherein the software means includes means to modify content of the lexicon and means to modify the content of the corresponding frame of the variable display.

16. An apparatus according to claim 5, wherein the software means includes means to expand the content of the lexicon and means to create new frames of the variable display to represent the expanded content of the lexicon.

17. A process for preparing reports using a standardized lexicon, said process comprising:

providing:

(a) a personal computer,

(b) a computer monitor,

(c) a flat-faced display screen provided with indicting means comprising touch sensitive points,

(d) software means operationally connecting a) -c) above; and

instructing the computer to produce a software generated display on the display screen, said display comprising at least one of words and icons representing words from the standardized lexicon, each of said at least one being associated with a touch sensitive point; and,

composing a written report by instructing the computer to present words from the lexicon on the computer monitor by touching the appropriate touch sensitive points.

18. A process according to claim 17, including:

instructing the computer to present on the monitor other words, not found in the lexicon, by operating an alphanumeric keyboard operationally connected to a)-c) by the software.

19. A process according to claim 18, wherein the provided flat-faced screen comprises a variable display portion and a fixed display portion.

20. A process according to claim 19, including generating a display on variable portion by software means.

21. A process according to claim 20, including successively generating a plurality of individual frames, each corresponding to a portion of the lexicon, by software means on the variable display portion.

22. A process according to claim 19, including generating a fixed display on the fixed display portion by projecting through a transparency.

23. A process according to claim 21, wherein the fixed display portion comprises touch sensitive points associated with specific functions and including:

touching a specific function touch sensitive point to instruct the computer to perform a specific function.

24. A process according to claim 23, including,

touching to instruct the computer to at least one of:

change the frame, print the report, and store the report.

25. A process according to claim 18 including:

instructing a printer to produce a printed version of the monitor written report.

26. A process according to claim 18 including:

instructing a memory means to store the monitor written report, and

retrieving the report from the memory means for at least one of review, modification, printing and accessioning by other retrieval systems.