WO1999044162A1 - Method and apparatus for the management of data files - Google Patents
Method and apparatus for the management of data files Download PDFInfo
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- WO1999044162A1 WO1999044162A1 PCT/CA1998/001198 CA9801198W WO9944162A1 WO 1999044162 A1 WO1999044162 A1 WO 1999044162A1 CA 9801198 W CA9801198 W CA 9801198W WO 9944162 A1 WO9944162 A1 WO 9944162A1
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- 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
- G06Q99/00—Subject matter not provided for in other groups of this subclass
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- 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
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- 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
- G16H10/65—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 stored on portable record carriers, e.g. on smartcards, RFID tags or CD
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- 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
- G16H40/00—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices
- G16H40/60—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices
- G16H40/67—ICT specially adapted for the management or administration of healthcare resources or facilities; ICT specially adapted for the management or operation of medical equipment or devices for the operation of medical equipment or devices for remote operation
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- 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
- G16H80/00—ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
Definitions
- TITLE METHOD AND APPARATUS FOR THE MANAGEMENT OF DATA FILES
- the present invention relates to the field of information distribution systems. More specifically, it pertains to a device and method for the electronic management of data files, for instance within the medical and health education domains .
- Client-Server Client-server computing implies that a single application is being jointly accomplished by two or more interdependent pieces of equipment, including software, hardware and interface. The client requests information and the server provides it, with each one assigned the portion of the job which is suitable to its capabilities. Client-server can be achieved in a local area network of personal computers and servers or by means of a link between a user system and a large host such as a mainframe. Typically, a client-server environment implies a many to one design, whereby multiple clients can make simultaneous requests of the server, allowing for server information sharing between clients.
- IP Internet Protocol
- WWW World Wide Web
- Intranet is any internal network (LAN or WAN) that supports Internet applications - primarily web (hypertext transfer protocol), but also other applications such as FTP (file transfer protocol). Intranets are used by many companies to deliver private corporate information to internal users.
- LAN local area network
- WAN wide area network
- a local area network is a private internal communication network that is confined to a small area, such as a single building or a small cluster of buildings. It is a general-purpose local network that car - serve a variety of devices, and is generally owned, used, and operated by a single organization.
- a wide area network is similar to a LAN in that it is also a communication network, but a WAN extends over a much broader area, interconnecting communication facilities in different parts of a country. A WAN may also be used as a public utility.
- Open System A system with the capability to cooperate with another system in the exchange of information and in the accomplishment of tasks, where the two systems may be implemented very differently. Every open system must conform to a minimal set of communication and protocol standards, as defined by the open- systems interconnection (OSI) model.
- OSI open- systems interconnection
- Standard Exchange Protocols A protocol is the set of rules or conventions governing the way in which two entities cooperate to exchange data.
- An example of such a protocol is the Internet
- IP Internet Protocol
- the medical archives and databases of the future will not only be locally archived medical-legal clinical documents, but also high-performance data banks of primary importance to the practice of medicine and health care everywhere within our network, all the while constituting a living core dedicated to clinical and scientific research and development.
- the data recorded in the medical files does not all have the same informational and discriminatory value in the long run.
- the data falls into three categories: data with strict medical-legal value, data with short term clinical value and data with historical value or a biological signature.
- the first category data with strict medical-legal value
- the third category makes up a very small portion of data recorded in the file. Therefore an integrated file management system which combines all of the information currently held in archived medical files would be extremely inefficient in terms of usage of space, thus impairing the extraction of information pertinent to a particular research.
- the background information herein clearly shows that there exists a need in the industry to provide a method for developing the information highway to allow for access to shared medical files in an enlarged health network and other external databases in order to increase the number of available sources of information for doctors and consultants.
- An object of the present invention is to provide a system and method for electronic management of data files.
- Another object of the invention is a computer readable storage medium containing a data structure that holds information.
- the invention provides a computer readable storage medium holding a data structure, said data structure comprising at least one record associated with a certain individual, said record including:
- pointer using the URL addressing system to indicate the address of a location containing data for the certain individual, said address being in a form such that a machine can access the location and import the data from the location;
- the computer readable storage medium is a database containing a large number of medical records for respective individuals .
- the information in each record includes at least one attributed identifier distinguishing one record from another one.
- the record also contains one or more pointers, where these pointers use the URL addressing system in order to point to remote sites holding files that contain information in digitized form pertinent to the individual. That information may be blood tests, electrocardiograms among many other possibilities.
- Each pointer provides an address that is machine readable to import the data residing at the target location.
- a data field possibly stored in a mapping table in the memory of the NDSMR server, where this data field contains data indicative of the basic nature of the information held in the file or resource to which the pointer is directed.
- the term "associated" implies that the data field is either in a direct one- to-one mapping relationship with the pointer or, alternatively, is integrated with the pointer address to form the actual pointer data structure.
- Each record may also contain a collection of data elements which provide medical information that is intended to be stored in the record for easy retrieval. This information is typically data that is not likely to change during the lifetime of the individual.
- the data can include, among others, biological data pertinent to the individual, for instance blood type.
- the database can be remotely queried to extract the record associated with a certain individual.
- this operation can be performed over a network, where a client workstation requests the record from a server managing the database.
- the server will transfer over the network links the record that will be displayed on the client workstation.
- the information displayed includes the collection of data elements permitting to identify the person, as well as any medical data stored in the record, where this data is more or less of a static nature.
- the operator at the workstation typically a physician, will also observe one or more pointers to files holding additional medical data.
- the second part of each pointer, the data part indicates to the physician the basic nature of the data pointed to. He can therefore select the pointers of interest in the global set of pointers for that record and import the data through any appropriate data transfer protocol.
- This arrangement allows the establishment of an electronic medical file system of distributed nature where the bulk of the data is held at sites remote from the central database. Those remote sites are typically the locations where the data would be collected, such as hospitals. Accordingly, the system is very flexible as the records can be maintained even when a patient seeks medical attention and treatment at different sites. Take the example of a patient that visits Hospital A where an electrocardiogram is taken. The electrocardiogram is digitized, by simple optical scanning, and a file created in a local network of Hospital A. An archivist then accesses the remote database and adds a new pointer entry to the patient's record. If, at a later date, the patient visits another hospital, say Hospital B, for the same procedure, another file is created and the appropriate entry made in the patient's database record. Thus, the bulk of the medical data is retained in various locations, yet it can be easily accessed through the pointers' structure.
- Such a storage medium could be a portable memory device, of the so called "Smart Card” type.
- the portable memory device includes a single record, however, the data structure is the same, namely a collection of data elements of static, medical nature and at least one pointer toward a location containing additional medical information.
- a suitable reader it suffices to provide a suitable reader to extract the information contained therein and then to process the information accordingly, such as by remotely accessing and importing the data pointed to by the pointer (s) .
- the invention also provides a network server, including:
- - a processor - a memory including : a) a plurality of records associated with respective individuals, said record including: i) at least one unique identifier associated strictly with the respective individual; ii) at least one pointer, said pointer using the URL addressing system to indicate the address of a location containing data for the certain individual, said address being in a form such that a machine can access the location and import the data from the location; iii) at least one data field, said data field associated with said pointer, said data field being indicative of the basic nature of the data at the location pointed to by the said pointer.
- program element including individual instructions, said program element implementing a functional block comprising means responsive to a request to transfer a particular record of said plurality of records towards a client connected to said server through a data communication pathway for locating the particular record and transferring the record toward the client over the data communication pathway.
- the invention also provides a network system for distributed storage of records, said network system including:
- a server managing a database, said database containing a plurality of records of respective individuals, each record including : a) at least one unique identifier associated strictly with the respective individual ; b) at least one pointer, said pointer using the URL addressing system to indicate the address of a location containing data for the certain individual, said address being in a form such that a machine can access the location and import the data from the location; c) at least one data field, said data field associated with said pointer, said data field being indicative of the basic nature of the data at the location pointed to by the said pointer.
- nodes remote from said server, said nodes being connected to said server through data communication pathways, said nodes constituting locations pointed to by pointers in records of said database and including machine readable storage media holding the data pointed to by pointers in record of said database.
- FIG. 1 is a block diagram of a generic client-server environment, where clients and server are linked by a local area network (LAN) ;
- LAN local area network
- Figure 2 is a flowchart which describes the current diagnostic process that takes place in medical facilities
- FIG. 3 is a block diagram of the health inforoute integrated with the Network Distributed Shared Medical Record (NDSMR) System, in accordance with the invention
- Figure 4 is a flowchart which describes the diagnostic process which will take place in medical facilities under the NDSMR System
- Figure 5 is a block diagram of a general client-server architecture
- Figures 6A, 6B and SC represent the NDSMR document layout in accordance with a particular embodiment of this invention
- Figure 7 is a block diagram of a server in accordance with this invention.
- FIG. 8 is a flowchart of the program element in accordance with this invention.
- FIG. 9 is a flowchart of the update process performed by the archivists on the NDSMRs , in accordance with this invention.
- Figure 10 is a block diagram of the search engine (query) process implemented by the NDSMR system.
- FIG. 1 illustrates a generic client-server environment, enabled by a local area network (LAN) .
- Client-server computing is a cooperative relationship between one or more clients and one or more servers.
- the clients 104, 106, 108 and 110 submit requests to the server 102, which processes the requests and returns the results to the clients.
- the processing is initiated by the client (s)
- both client (s) and server cooperate to successfully execute an application. Therefore, the interaction between the client and the server processes is a transactional exchange in which the client is proactive and the server is reactive.
- the third essential component of the client-server environment is the network.
- Client-server computing is distributed computing. In other words, users, applications, and resources are distributed in response to business requirements and are linked by a single LAN 100 or by an Internet of networks .
- Figure 2 depicts an example of the current state of responsibilities faced by medical facilities. Assume an ambulance delivers an unconscious patient to the ER at step 200. At step 202, the doctor makes an initial diagnosis, but needs access to the patient's medical history in order to prevent any misdiagnosis .
- the doctor has no other recourse but to administer a treatment at step 208 based on a diagnosis that is potentially inaccurate because it has been established strictly on the patient's current medical condition, without taking into account his/her previous medical history. If the patient does have an identification of some kind, it can be used to cross-reference all of the hospital's medical files, archived locally and/or at assigned external archives, at step 206. The patient's file will only be found if the patient was previously treated at the same hospital and already has a file stored in the network server's database. If the file is not found, the doctor is back to step 208. Even if the file is found, it is often incomplete and inaccurate as it lacks the information concerning treatment (s) administered in other medical facilities. Therefore, at step 212 the doctor must make a final diagnosis and perform the corresponding treatment .
- FIG. 3 depicts an integrated health network embodying the principles of this invention.
- integrated implies the implementation of internetwork communication between all of the various medical facility LANs, as well as with external sources such as the global Internet, the pharmaceutical network, on-line medical libraries and journals, among many other possibilities.
- An important component of this network is a Network Distributed Shared Medical Record (NDSMR) system that includes two main components, a server 300 and a NDSMR database 302, with the potential for each LAN within the health network to be connected to the server 300.
- the system may include more than one server, all operating inter- cooperatively in order to manage the NDSMR database, a resource shared by all of the servers.
- NDSMR Network Distributed Shared Medical Record
- Figure 4 is a flowchart depicting the improved diagnosis process as a result of the present invention. Assume that an ambulance delivers an unconscious patient to Hospital A. Also assume that the patient is a network user of the health network, and therefore has a personal file stored in the NDSMR database. After the doctor makes his initial diagnosis at step 402, the patient is checked for identification.
- identifier consists of the patient's medical insurance number such as the one available in a number of countries of the world, including Canada.
- the identifier may consist of the patient's social insurance number, Smart Card, or any other network attributed identification.
- a Smart Card is an integrated circuit based card containing individual specific medical information, to be read from and written to by appropriate electronic means, and offers several implementation alternatives to the NDSMR system, to be described in more detail below. If the patient does not have identification, his/her biological signature can be obtained as a universal identifier at step 406.
- such an identifier consists of a fingerprint derived signature.
- the technology needed for the implementation of system user identification via a fingerprint derived biological signature could be software similar to that created by and available from delSecur, a Montreal based company.
- the identifier may consist of a patient's retinal or genetic derived signature, or any other type of biological signature.
- the doctor sits down at workstation 304 and logs onto the server 300, as will be discussed below.
- the doctor uses the identifier obtained at either step 406 or step 408 in order to request the patient's NDSMR from the server 300.
- the record is transmitted from the NDSMR database 302 to the doctor's workstation. Once the doctor has read the pertinent medical information found in the record, he/she can scan a list of
- pointers appended to the record represent various significant medical documents (such as x-rays, surgical reports, etc.), and by their textual or visual representation allow the doctor to determine which of the pointers refer to documents pertinent to the patient's current medical condition.
- the doctor decides at step 414 that a pointer referring to the most recent electrocardiogram taken at Hospital B would be helpful for diagnosis, and at step 416 he/she activates the corresponding pointer. Consequently, the document is downloaded over the health network from Hospital B's LAN to the doctor's workstation.
- FIG. 5 is a general representation of the client-server architecture that implements the NDSMR system.
- the system includes three main components, notably the client 304, the server 300 and the NDSMR database 302.
- the basic software is an operating system running on the hardware platform.
- the platforms and the operating systems of the client and server may differ.
- a key component of the NDSMR system is that through client-server computing a multitude of different types of operating systems may exist within the various medical facility LANs.
- the client 304 and server 300 share the same communication exchange protocols and support the same applications, the lower-level differences are irrelevant. It is the communications software which enables clients and server to interoperate .
- the communication exchange protocol adopted will be an open, non-proprietary protocol, for instance the Internet Protocol, a standard exchange protocol in client-server networking, or any other similar progressive communication exchange protocol.
- the term interoperate implies, among other things, the ability of different system users (clients) to share server information and have on-line consultations, in both real and delayed time.
- Real-time computing is defined as the type of computing in which the correctness of the system depends not only on the logical result of the computation but also on the time at which the results are produced. Real-time tasks therefore attempt to control or react to events that take
- the server 300 is responsible for maintaining the NDSMR database, for which purpose a database management system module is required.
- a variety of different applications that make use of the database may be housed on the client machines.
- the operative relationship that ties clients, such as client 304, and server 300 together is software that enables a client to make requests to the server 300 for access to the NDSMR database 302. It is important to note that the division of work between a client 304 and server 300 may be allocated in a number of ways.
- the system implements cooperative processing, whereby the application processing is performed in an optimized manner by taking advantage of the strengths of both client and server machines and of the distribution of data.
- the system may be implemented with server-based processing or client-based processing.
- server-based processing the most basic class of client-server configuration, the client is mainly responsible for providing a user-friendly interface, whereas nearly
- FIG. 14 is a more detailed block diagram of a preferred embodiment of the server 300, which has the responsibility of managing, sorting and searching the NDSMR database 302.
- the server is provided with a memory 720, high-speed processor/controllers 708, 710 and 712 (assume for this example that there are three) , and a high-speed input/output (I/O) architecture.
- the I/O architecture consists of the interfaces 702, 704 and 706.
- An internal system bus 711 interconnects these components, enabling data and control signals to be exchanged between them.
- the server has 6 ports, identified as port A, port B, port C, port D, port E and port F. These ports connect the server to physical links 1, 2 and 3, allowing data to be transported to and from various clients within the network.
- ports A, B and C are input ports on the physical links 1, 2 and 3, respectively, while ports D, E and F are the output ports on those same physical links.
- the input ports are designed to receive data from their associated physical links, while the output ports are designed to transmit data over their associated physical links.
- the interfaces 702, 704 and 706 interconnect various input and output ports to the physical links 1, 2 and 3, respectively. Their function is to transmit incoming data packets to the internal system bus 711 for transport to the memory 720 where they can be processed by one of the processors. On the output side, the interfaces are designed to accept data packets from the system bus 711 and impress the necessary electrical signals over the respective physical links so that the signal transmission can take effect. It is not deemed necessary to discuss this standard
- the memory 720 contains a program element that controls the operation of the server. That program element is comprised of individual instructions that are executed by the controllers, as will be described in detail below.
- the program element includes several functional blocks that manage several tasks. One of those functional elements is the Database Management System (DBMS) 714 which provides efficient and effective use and maintenance of the NDSMR database 302.
- DBMS Database Management System
- the memory also holds the usual routing table that maps the destination addresses of incoming IP data packets (inherent to the IP communications exchange protocol) to the server output ports . It is not deemed necessary to discuss the structure of the routing table here because this component is not critical for the success of the invention and also it would be well known to a person skilled in the technological field to which the present invention belongs.
- the memory also provides random access storage, capable of holding data elements such as data packets that the processors manipulate during the execution of the program element .
- Another component stored in the memory 720 is a validation table, which maps all of the registered user IDs to a corresponding passwords. The table is used to validate clients logging on to the server, for security purposes.
- the identification table associates with each user a unique user profile that specifies permissible operations and NDSMR accesses, in order to limit access to data
- the table is used to identify between clients with different user privileges, for instance clients with archivist status as opposed to basic user status. Archivist status accords the client with read and write status, including editing and modifying privileges, for updating the NDSMRs . User status limits the client to NDSMR read status only.
- the memory 720 contains a request queue which is a buffer memory space of the FIFO type, although alternative types of buffer memory space may also be used, that can hold data packets to be sent to one of the controllers for processing.
- the physical configuration of the buffer does not need to be described in detail because such a component is readily available in the marketplace and the selection of the appropriate buffer mechanism suitable for use in the present invention is well within the reach of a person skilled in the art.
- the NDSMR database 302 is part of the memory 720 of the server 300, as shown in Figure 7.
- the NDSMR database 302 is actually on a separate storage medium, such as a non-volatile medium interconnected through a high speed data bus with the memory 720 so the record set from the database 302 can be quickly loaded in the random access memory 720 for processing.
- the collection of data which makes up the NDSMR database 302 may be stored remotely on one or a set of physical storage device (s), for instance a disk. In such a case, one of the server's device drivers would be responsible for communicating directly with the peripheral device (s) in order to access the database.
- Figure 8 provides a complete flowchart illustrating an example of the operation of the program element stored in the memory 720, and executed by any one of the processor/controllers, that regulates the operation of the server 300, specifically its interaction with the clients as well as with the NDSMR database 302.
- the server program is running at all times, if no clients are logged on to the server then it is in an effective perpetual wait state, shown at step 800.
- control is passed to the validation functional bloc that is part of the program element in order to ensure that the client
- the server waits for a request from any of the logged on clients at step 806. When a request does occur, it arrives as a flow of data packets at interface 702, 704 or 706, over physical link 1, 2 or 3 , respectively.
- the request is stored in the request queue found in memory 720, to await its turn for processing.
- the program element next releases a request from the queue (the oldest request) to any non-busy processor. If all of the processors are occupied, the release step is held-up until such a time where any of the three processors is available .
- the program element reaches step 814, whereby the requesting client is identified by the identification logic stored in memory 720.
- the identification logic first reads the request data packet header in order to determine the destination address for the response to the request, specifically the address of the requesting client which is read from the source field, and second assigns correct status to the client (user, archivist or other status). This status is determined by the user profile, read from the identification table stored in memory 720.
- Step 814 also includes routing logic, whereby the routing table is accessed in the memory 720 in order to determine the correct output port for transmitting a database response to the particular client.
- the processor must determine the search parameters specified by the request. These parameters consist in a patient's identifier and/or a list of other qualifiers (for instance a particular treatment, medical condition, age group, sex, etc) . Control is passed to the DBMS logic at step 818, at which
- the search is performed on the NDSMR database.
- the DBMS not only performs the search on all data contained within the NDSMR database, but also controls access to specific records or even portions of records within the database, ensuring that confidential data or specific confidential parts of the data being accessed is masked when returned to the client, based on the user profile determined at step 814.
- the data returned by the NDSMR database search is transmitted over the pre-determined output port and to the appropriate client at step 820.
- an aspect of the current invention is the user-friendly interface provided at the client workstation 304. This interface facilitates the user's attempts at making requests of the server, through easy to follow prompts and an on-line knowledge system to help the user with any questions or problems.
- the interface allows the user to perform searches or queries on the NDSMR database, using information filters to simplify the extraction of pertinent data from what may be hundreds of thousands of network distributed shared medical records.
- the interface also allows the user to perform keyword-based Internet-wide searches, transparent to the user. For example, a workstation user could initiate an Internet search for all documents relating to a particular medical condition by simply inputting the name of the medical condition as the keyword, the search results returned to the user being a list of hypertext links to all corresponding Internet documents .
- the software used to implement this interface feature has been previously created by the University of Quebec at Montreal (UQAM) , and is marketed under the name of Manitou or SV3.
- the interface offers text processing tools, necessary to the editing, publication and merging of all data received from both the Internet and the server 300.
- Future variations to the NDSMR system may include a more progressive interface at the client workstation. Specifically, a three- dimensional view of the human body may be available to doctors and consultants logged on to the NDSMR server, used for making requests, medical enquiries and searches.
- the Network Distributed Shared Medical Record itself is another element .
- the NDSMR is an evolving summary medical document
- the NDSMR includes at least one universal or network attributed identifier, distinguishing one record from another, and a dynamically updated list of biological data pertinent to the individual, accessible by pointers referring to the local network where the data is actually being stored.
- This biological data consists of significant medical documents in an electronic format such as laboratory tests, x-rays, surgical reports, electrographic data, etc.
- other embodiments of the NDSMR may also include a variety of other medical information pertinent to the individual.
- Figures 6A, 6B and 6C display a possible layout for the NDSMR as a WWW document, presenting several categories of medical information pertinent to an individual, in this example John Doe. The individual's identifier is indicated at the top of the record, as seen in Figure 6A.
- Figures 6B and 6C display other categories of information, including: • administrative medical data (date of birth, home and work address and phone number, emergency contact, regular physician, etc);
- the final category seen in Figure 6C consists of the dynamically updated links to other biological data.
- the eight pointers listed refer to other medical documents pertinent to John Doe which are maintained in different local networks, and which can be downloaded from another network site to the client workstation by invoking the downloading operation embedded in the pointer, thus specifying the address of the site (and if necessary of a particular file at that site) .
- the NDSMR could also offer access to complementary external sources of information, transparent to the workstation client. Potential sources could be pharmacy networks, medical libraries or journals, accessible to the doctor or consultant via references within the NDSMR seen on their workstation.
- the NDSMR system will automatically generate user authorization in order to access an Internet published Medical Library that may be held on an Internet site containing this information, thus allowing the consultant to look up the specifics concerning John Doe's current medication.
- the data structure of the pointer allows the workstation user, such as a doctor or consultant, to determine the general nature of the information to which the pointer is referring.
- the doctor can tell by simply looking at the pointer whether it points to a medical document concerning a pulmonary x-ray, an electrocardiogram, allergy tests, etc.
- the pointer representation as seen on the screen of the client workstation, is as seen in Figure 6C.
- the textual representation of the pointer indicates clearly to the user the medical document or information to which the pointer points, whether it be the most recent or a previous electrocardiogram,
- the pointers may be of a graphical representation, small icons used to specify relevant body parts and illustrate medical treatments.
- the scope of this invention also includes all other variations of a pointer representation implementation which reveals the nature of the information to which it points . Transparent to the user is the actual address, hidden beneath the physical representation, which is the actual device needed for contacting and downloading from various external LANs and other sources, to be discussed in more detail below.
- the NDSMR record is data structure that contains two types of elements, namely a collection of medical data elements about the individual and one or more pointers that allow additional information to be downloaded, this additional information being of a medical nature and complementing the data held in the collection of medical data elements.
- these pointers adopt the URL (Universal Resource Locator) addressing system, allowing to point to a specific file in a directory, where that file and that directory can exist on any machine on the integrated health network and can be served via any of several different methods, specifically the Internet technologies such as ftp, http, gopher, etc.
- the URL addressing system is well documented and very well known to those skilled in the art, and therefore will not be described in more detail.
- Each pointer provides an address which may consist in the entire address information of the file pointed to by the pointer or in a reference to the address information, where the reference may be an index in a table that contains the address information.
- a data field possibly stored in a mapping table in the memory of the NDSMR server, where this data field contains data indicative of the basic nature of the information held in the file or resource to which the pointer is directed.
- the term "associated" implies that the data field is either in a direct one- to-one mapping relationship with the pointer or, alternatively, is integrated with the pointer address to form the actual pointer data structure.
- the data field possibly stored in a mapping table in the memory of the NDSMR server, where this data field contains data indicative of the basic nature of the information held in the file or resource to which the pointer is directed.
- the term "associated" implies that the data field is either in a direct one- to-one mapping relationship with the pointer or, alternatively, is integrated with the pointer address to form the actual pointer data structure.
- the pointer 22 associated with the pointer can contain codes normally used by physicians to categorise treatment events that they have administered to patients. Those codes are normally used for remuneration purposes, however, they can be employed here in a satisfactory manner as indicators of the nature of the medical data.
- the data field associated with the pointer may also contain the date and time at which the pointer was created
- the display of the pointers may be organized and enhanced to enable the user to easily grasp the meaning of the data without the necessity to refer to lists cross-referencing codes with the basic nature of the medical data.
- the pointers related to the same information for instance containing the address of files that hold electrocardiograms, may be displayed on the client workstation in a separate window and arranged in that window in chronological order.
- Another possibility is to display besides each pointer an icon or text box with the suitable data. This can be accomplished by providing the clients workstation with a table that maps the code in the pointer identifying the basic nature of the medical data with the type of information to be displayed to the user.
- the list of pointers is identified and scanned to extract from them the codes identifying the basic nature of the medical data.
- the codes are then cross-referenced through the table with the corresponding information to be displayed. The information is then displayed on the screen of the user.
- Another aspect of this invention is the update of the NDSMRs, following the creation of new medical data. This task could be effected by a NDSMR administrator, be it a medical archivist, webmaster or some other administrative appointee, also responsible
- Figure 9 illustrates an example of a procedure to be followed by medical facility archivists in order to update the NDSMRs.
- the archivist within a particular medical facility receives on a regular basis a list of recent medical acts performed at the facility, as well as supporting documents for these acts.
- the archivist updates the facility's local Intranet medical files and creates updated hospitalization summaries.
- the archivist's next step is to log on to the NDSMR server, using an archivist assigned password, at step 904.
- the server and its DBMS will recognize the archivist password and profile and assign privileges accordingly, as described above for steps 804 and 818 of the NDSMR server program element.
- a request must be made in order to retrieve the appropriate NDSMR.
- the request is made on the basis of the particular patient's identifier, submitted to the NDSMR server at step 906.
- the NDSMR is downloaded to the archivist's workstation, at which point the archivist is capable of modifying and updating certain sections of the data contained in the NDSMR, for instance the Significant Antecedents, Current Medical Condition and Links To Other Biological Data categories as seen in Figure 6C .
- the archivist refers to the updated list to update the NDSMR in order to reflect the individual's most recent and pertinent medical information, treatments and corresponding pointers. For example, assume that one of the archivist's list entries is that Mr. John Doe has undergone a new electrocardiogram at Hospital E. The archivist
- the structure of the pointer addresses consists in a combination of a local network and machine address (or domain name), a patient's identifier, and a code taken from a published manual of medical act codes adopted by a state or national medical insurance company.
- a local network and machine address or domain name
- a patient's identifier or a patient's identifier
- a code taken from a published manual of medical act codes adopted by a state or national medical insurance company There do exist alternatives to the specific nomenclature and pointer structure used by the NDSMR system, and the scope of this invention includes all other such variations whereby consistency is assured within the system.
- Yet another feature of this invention is its use as a search/query engine. Not only can a user perform searches for or queries on NDSMRs within his/her own local Intranet, but also within external sources. NDSMR searches and queries may be performed on two different types of data, and therefore databases: nominative and non-nominative . Non-nominative medical data and databases are accessible to all authorized users, but do not require authorization from the patient whose personal data is being consulted. Nominative medical data and databases require search authorization from both the workstation client, typically a doctor or consultant, and the concerned patient, with the exception of situations where emergency medical care is required. The search requester will be prompted for this authorization through the workstation interface described above, the authorization comprising
- the NDSMR Database Management System (DBMS) will automatically mask any nominative data found in the database response before transmitting it to the client workstation.
- DBMS NDSMR Database Management System
- the NDSMR system permits the delay-free consultation of pertinent information found within different local files and, for authorized users, offers an integrated research motor which allows for non-nominative research, by object or by concept, on the whole of the accessible databases.
- Figure 10 displays the query usage allowed by the NDSMR system. From a client workstation, a user may make an initial query of the server 300.
- the server's DBMS and database logic allow the NDSMR database 302 to be searched rapidly and efficiently.
- the database logic is what allows the server to not only retrieve records on behalf of the client but also to perform searches on behalf of the client.
- an initial query returned 300 possible NDSMRs.
- the system allows the user to send out a second, more narrow query, with a resulting 25 NDSMRs returned. The system is therefore very efficient, especially for massive searches performed across all accessible databases.
- the query style offered by the workstation interface will be one of relational data searches, such as the style currently offered by the Alta Vista (Trade mark) web browser.
- the query style will not be described in detail as it is very well known to a person skilled in the art.
- many other query styles could be incorporated into the NDSMR search engine, for instance an object- oriented search style.
- the structure of the pointers as described above, where both an address part and an associated data part form a pointer allows the NDSMR system to perform searches on all of the pointers contained within the NDSMR database, representing medical files archived at all of the various local networks connected within the extended health network.
- the data structure of the pointers allows the nature of the information to which they point to be determined, either directly from the data structure
- the Smart Card can be used at the client workstation in order to access the NDSMR database. For example, upon attempting to log onto the NDSMR system, the client, most likely a physician, will be prompted by the NDSMR system server (through the user-friendly interface seen at the workstation) to insert the patient's Smart Card into the workstation's appropriate electronic means. These electronic means read the information contained on the card and can extract the patient's identification.
- the NDSMR server's program element then passes control to its validation functional bloc in order to ensure that the patient is a server registered user, as described above.
- the NDSMR system server may prompt the client workstation user for two Smart Cards, both the physician's and the patient's, thereby increasing the security of the system.
- the Smart Card may provide more than simple user identification.
- a patient's Smart Card contains medical information specific to the patient.
- the NDSMR system includes the Smart Card as a storage medium for system user information, with the NDSMR database records consisting strictly in at least one
- the patient's Smart Card would contain all other medical information pertinent to the individual, for instance that shown in Figures 6A, 6B and 6C (minus the Links To Other Biological Data) .
- the medical information stored on the patient's Smart Card would appear on the client workstation, along with the list of pointers downloaded from the patient ' s record in the NDSMR database.
- a patient's nominative information could all be stored on the Smart Card, with only the patient's non- nominative information stored in the NDSMR database along with the identifier (s) and the list of pointers. This particular implementation of the system would ensure that no queries/searches performed on the NDSMR database revealed any confidential, nominative patient information.
- a patient's Smart Card may also be used to store and maintain all or a portion of the data found in the particular patient's NDSMR, where this data may be nominative, non- nominative, static or dynamic.
- the NDSMR server offers a continuously available means of update for the Smart Card, the update consisting in reading the latest information from the NDSMR and writing it to the Smart Card via the appropriate electronic means, without changing any of the static or nominative data stored on the card.
- This implementation would allow a physician, at a hospital external to the NDMSR system's integrated health network, to have access to the individual's pertinent and most recent medical information, the only requirement being that the hospital must have the appropriate electronic means to read the individual's Smart Card.
- NDSMR system implementations also exist, distributing the whole of the patients' medical information between database records and patient Smart Cards or other such portable computer readable storage media, and are included within the scope of this invention.
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- Engineering & Computer Science (AREA)
- Health & Medical Sciences (AREA)
- Medical Informatics (AREA)
- Epidemiology (AREA)
- General Health & Medical Sciences (AREA)
- Primary Health Care (AREA)
- Public Health (AREA)
- Biomedical Technology (AREA)
- General Business, Economics & Management (AREA)
- Business, Economics & Management (AREA)
- Pathology (AREA)
- Physics & Mathematics (AREA)
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- Information Retrieval, Db Structures And Fs Structures Therefor (AREA)
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
EP98963301A EP1057133A1 (en) | 1998-02-24 | 1998-12-22 | Method and apparatus for the management of data files |
AU18655/99A AU1865599A (en) | 1998-02-24 | 1998-12-22 | Method and apparatus for the management of data files |
Applications Claiming Priority (6)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
CA2,231,019 | 1998-02-24 | ||
CA002231019A CA2231019A1 (en) | 1998-02-24 | 1998-02-24 | Medical files management method and apparatus |
CA002233794A CA2233794C (en) | 1998-02-24 | 1998-04-01 | Method and apparatus for the management of medical files |
CA2,233,794 | 1998-04-01 | ||
CA002239015A CA2239015C (en) | 1998-02-24 | 1998-05-29 | Method and apparatus for the management of data files |
CA2,239,015 | 1998-05-29 |
Publications (1)
Publication Number | Publication Date |
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WO1999044162A1 true WO1999044162A1 (en) | 1999-09-02 |
Family
ID=27170642
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/CA1998/001198 WO1999044162A1 (en) | 1998-02-24 | 1998-12-22 | Method and apparatus for the management of data files |
Country Status (4)
Country | Link |
---|---|
EP (1) | EP1057133A1 (en) |
AU (1) | AU1865599A (en) |
CA (1) | CA2239015C (en) |
WO (1) | WO1999044162A1 (en) |
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Also Published As
Publication number | Publication date |
---|---|
CA2239015A1 (en) | 1999-08-24 |
CA2239015C (en) | 2005-12-20 |
EP1057133A1 (en) | 2000-12-06 |
AU1865599A (en) | 1999-09-15 |
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