Note: Descriptions are shown in the official language in which they were submitted.
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SYSTEMS AND METHODS FOR INTERPRETING MEDICAL INFORMATION
CROSS-REFERENCES TO RELATED APPLICATIONS
[0001] US Continuation of 13/802,229 (filed 13 March 2013), which is a US
Continuation of
12/834,376 (filed 12 July 2010), which is a US Continuation of 09/705,198
(filed 2 November
2000) (U.S. Patent No. 7,756,721), which claims priority from Provisional
Application
60/163,520 (filed 4 November 1999), which is a Continuation-in-part of
08/818,155 (filed 14
March 1997) (U.S. Patent No. 6,256,613). The foregoing are incorporated by
reference in their
respective entireties.
BACKGROUND
[0002] Receiving a medical diagnosis can be a life altering event. A medical
diagnosis can
present emotional, physical, and financial challenges, and consequently, a
medical diagnosis can
drastically affect the quality of one's present and future life. When faced
with a diagnosis,
knowing which steps to take and identifying the right treatment plan is a
challenging task.
Identifying qualified physicians in an era defined by informational overflow
can be an even more
daunting mission.
[0003] Additionally, a definitive medical diagnosis can be elusive in clinical
cases with complex
symptoms. In such cases, a diagnosis can be confounded by a variety of
seemingly unrelated
medical symptoms, each symptom being somewhat unique. Moreover, although a
medical
provider in the payer's network can be specialized in performing a certain
complex treatment,
the patient having the medical symptom can require a different medical
provider that is focused
on a subset of a specialty of medicine. Unfortunately, patients do not
generally have broad
access to expert medical providers and information on those expert providers
can be located in
various parts of the country or in other countries.
SUMMARY OF THE INVENTION
[0004] In some embodiments, the invention provides a method of requesting an
interpretation of
a medical record, the method comprising: a) receiving a medical record
associated with a subject
by a computer system; b) searching based on the medical record a database of
health care
providers, wherein each healthcare provider in the database is independently
associated with a
specialty, to provide at least one qualified health care provider, wherein the
qualified health care
provider is qualified to interpret the medical record, wherein the computer
system comprises a
processor, wherein the searching is performed by the processor; c) requesting
from the qualified
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health care provider a requested interpretation of the medical record; d)
receiving the requested
interpretation of the medical record from the qualified health care provider;
and e) ranking the
requested interpretation against at least one alternative interpretation by a
different health care
provider to provide a ranking of interpretations.
[0005] In some embodiments, the invention provides a computer program product
comprising a
computer-readable medium having computer-executable code encoded therein, the
computer-
executable code adapted to be executed to implement a method comprising: a)
providing a
virtual health care system, wherein the virtual health care system comprises:
i) an input module;
ii) a database, wherein the database comprises a plurality of health care
providers; iii) a search
module; iv) a ranking module; v) a request module; and vi) an output module;
b) receiving an
electronic medical record from a user by the input module, whereupon the input
module
transmits information from the medical record to the search module; c)
searching, based on the
information, the database by the search module, whereby the search module
identifies in the
database a subset of health care providers associated with the information; d)
ranking by the
ranking module the subset of health care providers, whereby the ranking module
ranks each
health care provider in the subset of health care providers based on a level
of association with the
information to provide a set of ranked health care providers; e) requesting by
the request module
a requested interpretation of the medical record from at least one of the
ranked health care
providers; f) receiving by the request module at least one requested
interpretation; g) ranking by
the ranking module the received requested interpretation against at least one
alternative
interpretation to provide a set of ranked interpretations; and h) outputting
the set of ranked
interpretations via the output module.
BRIEF DESCRIPTION OF THE FIGURES
[0006] FIGURE 1 illustrates modules of an online physician community,
including a manage
cases module, a physician groups module, and a library of great cases module.
[0007] FIGURE 2 illustrates an example architecture of an on-line profile of
an expert.
[0008] FIGURE 3 is a block diagram illustrating a first example architecture
of a computer
system that can be used in connection with example embodiments of the present
invention.
[0009] FIGURE 4 is a diagram illustrating a computer network that can be used
in connection
with example embodiments of the present invention.
[0010] FIGURE 5 is a block diagram illustrating a second example architecture
of a computer
system that can be used in connection with example embodiments of the present
invention.
[0011] FIGURE 6 illustrates the typical architecture of a message received by
a qualified
physician with a request to interpret a medical record.
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[0012] FIGURE 7 illustrates an example architecture of a case description with
a clinical
summary presented to a qualified physician.
[0013] FIGURE 8 illustrates representative modules of a case summary as
presented to a
qualified health care provider.
[0014] FIGURE 9 illustrates representative modules of a virtual health care
system comprising a
physician community.
[0015] FIGURE 10 illustrates representative modules available to a qualified
physician to assist
in case management within a virtual health care system.
[0016] FIGURE 11 illustrates representative modules of a peer group community
within a
virtual health care system.
DETAILED DESCRIPTION
[0017] Great challenges exist in dealing with medical diagnoses. A singular
medical diagnosis
for instance, can not only affect the life of a patient, but can also impact
the lives of families,
physicians, nurses, and respective communities. The course-of-action and types
of treatments
chosen in treating a disease, a syndrome or a condition have a definitive
impact on the lives of
many, yet few families or individuals are sufficiently equipped to handle the
impact of receiving
a medical diagnosis. Furthermore, at one time or another, most people receive
an incorrect
diagnosis or see a doctor who is mystified by their symptoms. Learning how to
cope with a
diagnosis can be a difficult and emotional process, learning how to cope with
an incorrect
diagnosis can have devastating consequences in someone's life and the lives of
their loved ones.
[0018] Each year misdiagnosis cost an estimated 40,000 to 80,000 hospital
deaths. Misdiagnosis
can happen when physicians, often pressured by factors that can include
unyielding schedules,
institutional requirements, and multiple professional commitments, fail to
spend adequate time
learning about a patient's symptoms. Errors can also happen when physicians
disregard a
patient's description of their own symptoms, when physicians neglect the
medical history of a
patient, when physicians fail to verify the accuracy of medical test results,
and when physicians
neglect the possibility that they simply do not have enough information to
provide a definite
diagnosis, but still feel compelled to give a label for a patient's symptoms.
[0019] Provided herein is a system and a method that removes the burden of
uncertainty from the
shoulders of a patient, and their families, and creates a personal,
compassionate, and
comprehensive way to ensure that people get the best possible medical advice.
The present
invention helps patients and their families across the globe identify and form
a relationship with
the most capable physicians specializing in a plurality of fields.
[0020] Individuals and families no longer need to agonize over the prospect of
collecting
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medical records, searching, evaluating, ranking, identifying, reviewing,
contacting, and forming
a relationship with the most qualified health care providers upon receiving a
medical diagnosis.
The system and method of the invention streamlines the process on behalf of an
individual or a
family while employing a kind, considerate, knowledgeable, and effective
approach to medical
care.
[0021] The process of interpreting medical information can start with an e-
mail, a confidential
call, an in-person discussion, or a plurality of other communication methods.
A physician, a
nurse, a medical records specialist, or administrative personnel are all
members of a group that
can be alerted when a new request for medical interpretation is received.
Group members can
interact directly with the party requesting an interpretation of a medical
case. Personnel within
the group can be assigned to each case, and group members can become a
dedicated point-of-
contact for each medical case. Group members can generate an on-line personal
medical profile
of the subject requesting the medical interpretation within an on-line
platform of the invention.
Alternatively, a subject can generate an on-line personal profile of oneself
or on behalf of
another.
[0022] The group receives and evaluates medical records associated with each
medical case. In
a preferred embodiment, subjects can submit a plurality of case records,
images, and test samples
to the system of the invention through a computer program product adapted to
be able to receive,
search, rank, categorize, and classify medical records. Alternatively, group
members can collect
a plurality of case records, images, and test samples on behalf of a patient.
The group can
systematically organize, categorize, classify, and search the medical records
for information that
is relevant to a diagnosis. A computer program product can systematically
organize, categorize,
classify, and search the medical records for information that is relevant to a
diagnosis.
[0023] The invention searches a database of health care providers based on the
medical record,
and identifies at least one or a cohort of qualified health care providers
with relevant expertise
for a particular case. The invention facilitates the selection of the very
best nationally-
recognized physicians and/or specialists, and requests from a select group of
qualified health care
providers a comprehensive analysis of all medical information associated with
a medical case.
[0024] Furthermore, the system and methods of the invention deliver to both
the party requesting
an interpretation of a medical record, and their treating physician, an expert
report tailored to the
case. The report serves as a clinical roadmap comprising recommendations on
diagnosis and
treatments. The team provided by the invention also interacts with individuals
and families at
major milestones to assess progress and address any new issues. Treating
physicians are pleased
with the new insight that expert advice can offer to a case. Patients and
families can make
confident decisions regarding treatment options, and feel reassured by having
access to ranked
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physicians. The process comprises a personal, pragmatic, and compassionate
method to ensure
individuals and families are finding the best available care.
[0025] Furthermore, patients and families do not have to travel or deal with
the healthcare
system on their own. Within the convenience of their home, individuals and
families can receive
the answers they need and the peace of mind they seek. This aspect of the
invention can
alleviate many barriers to the delivery of optimal patient care in some
settings faced with scarcity
of physicians, limited availability of specialty physicians, geographic
isolation, distance, limited
access to care, resource limitations, technology, and financial challenges.
The invention offers a
comprehensive and analytical approach to understanding and addressing the need
of many
communities and the problems facing both individuals receiving a medical
diagnosis, and
physicians providing medical interpretations.
Requesting an Interpretation of a Medical Record.
[0026] The system and methods of the invention provide an in-depth
interpretation of a medical
diagnosis and treatment plan by a qualified health care provider. A medical
interpretation can be
requested on behalf of a subject. A subject can be, for example, an elderly
adult, an adult, an
adolescent, a pre-adolescent, a child, a toddler, or an infant.
[0027] The method for interpreting a health care request can commence when a
system of the
invention receives a medical record associated with a subject by a computer
system. A medical
record can be received by the invention, for example, when a subject provides
information to an
on-line personal medical profile. An on-line personal medical profile of the
subject can
comprise a plurality of medical records, for example, exam and test results,
medical history, and
an assessment and treatment regimen by a treating physician. In some
embodiments, the medical
record comprises a preliminary diagnosis. In some embodiments, the medical
record is received
via a health request from the subject.
[0028] The computer system searches based on the medical record a database of
health care
providers. In some embodiments, the search identifies a plurality of qualified
health care
providers, and each qualified health care provider is ranked to provide a
ranked set of qualified
health care providers ordered from a highest rank to a lowest rank. The system
and methods of
the invention can request from a qualified health care provider an
interpretation of the medical
record, and the qualified health care provider is given the opportunity to
review each case
thoroughly. In some embodiments, the qualified health care provider has an
expertise associated
with the medical record. For example, a subject who has been grappling with
lower back pain
can provide a magnetic resonance imaging (MRI) indicating spine degenerative
changes, mild
disc buldges, and borderline nerve changes. The system and methods of the
invention can
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request an interpretation of the medical record from a neurosurgeon who is an
expert in spinal
instability.
[0029] The medical expertise of a health care provider can be used by the
system and methods of
the invention in searching a database of health care providers and identifying
at least one
qualified health care provider qualified to interpret the medical record. In
some embodiments,
the requested interpretation can be ranked based on a level of expertise of
the health care
provider. For example, a subject with symptoms including shortness of breath,
leg swelling, and
exercise intolerance can be suspected to be at risk for congestive cardiac
failure.
Echocardiographs and blood tests can be used by a treating physician to
diagnose congestive
cardiac failure. A treating physician of the subject can recommend a treatment
that includes
surgery to implant a medical device, such as a pacemaker or ventricular assist
device, in the
patient's heart. Prior to committing to surgery, the subject can seek a second
medical opinion.
The subject can utilize the system and method of the invention to submit a
request for an
interpretation of the subject's medical record. The invention can, for
example, rank the
interpretation based on a minimum level of expertise required to provide the
interpretation, such
as expertise in cardiac surgery, general cardiology, and cardiac
electrophysiology.
[0030] In some embodiments the requested interpretation is based on virtual
collaboration
among the qualified health care provider and at least an additional health
care provider. For
example, a subject with a diagnosis of congestive cardiac failure can receive
an expert
interpretation that comprises a virtual collaboration between a qualified
cardiac
electrophysiology specialist reviewing medical media associated with the
diagnosis, such as
echocardiographs, and a cardiac surgeon, who is providing an expert opinion on
the best surgical
procedure, in this example implanting a pacemaker or a ventricular assist
device. In some
embodiments, the qualified health care provider and the additional health care
provider are
anonymous to one another.
[0031] A plurality of interpretations of a medical record can be evaluated by
a method of the
invention. An interpretation of a medical record can be, for example, a first
interpretation by a
treating physician comprised within the request for an interpretation. An
interpretation can, for
example, be provided by at least one qualified health care provider associated
with the invention.
Interpretations can, for example, be provided by multiple qualified health
care providers
associated with the invention. In some embodiments, the invention identifies a
plurality of
qualified health care providers, and each qualified health care provider of
the plurality is ranked
to provide a ranked set of qualified health care providers ordered from a
highest rank to a lowest
rank.
[0032] A plurality of ranking criteria can be used to identify a ranked set of
qualified physicians.
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For example, the invention can search a database of health care providers
based on a request
comprising MRI records indicating debilitating back, head, and neck
degeneration. The invention
can identify a plurality of neurosurgeons as qualified health care providers.
The invention can
rank the neurosurgeons based on the length of the careers, the familiarity of
the neurosurgeon
with MRI records similar to the record comprised within the request, and/or
the geolocation of
the neurosurgeon. In some embodiments, requesting an interpretation of a
medical record
comprises querying the qualified health care providers in the ranked set in an
order beginning
with the qualified health care provider with the highest rank. In some
embodiments, requesting
an interpretation of a medical record comprises querying the qualified health
care providers in
the ranked set in a random order.
[0033] Criteria used to identify a ranked set of physicians can be found
directly or indirectly in
the medical record. For example, a pediatric subject diagnosed with structural
malformation of
the heart can provide a medical record comprising a cardiac computed
tomography (CT) with the
request for an interpretation. The invention can search the medical record and
the invention can
note that the cardiac CT highlights the heart's anatomy and coronary
circulation. The invention
can search a database of health care providers based on information directly
found on the
medical record, such as "cardiac CT", and "pediatric cardiology." The
invention can search a
database of health care providers based on information indirectly found on the
medical record,
for example, the invention can search for "cardiovascular surgeons" as
qualified health care
providers based on a medical record comprising a cardiac CT.
[0034] In some aspects, the invention provides a system and a method for
identifying a qualified
physician based on the description of a condition. In some embodiments, the
invention further
comprises searching a database of medical resources based on information in
the medical record,
thereby identifying a relevant resource, and providing the relevant medical
resource to the
qualified health care provider upon requesting the requested interpretation.
[0035] The system and method of the invention can receive a plurality of
requested
interpretations from a plurality of qualified health care providers. A
plurality of criteria can be
combined to provide a ranking of interpretations of a medical record. The
invention can, for
example, rank all interpretations that recommend surgery as a proposed
treatment based on the
qualifications of the physician providing the interpretation. The invention
can, for example, rank
all interpretations based on the order in which the requested interpretation
of the medical record
is received from a qualified health care provider.
[0036] The system and method of the invention can request a plurality of
interpretations from a
plurality of qualified health care providers. Qualified providers can accept
the request to provide
an interpretation of a medical record. Qualified providers can deny the
request to provide an
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interpretation of a medical record. The invention can for example, request an
interpretation of a
medical record from a qualified health care provider after at least one other
qualified health care
provider replied to the request affirmatively.
[0037] A subject, a physician, a nurse, a medical records specialist, or
administrative personnel
can seek a second opinion on an interpretation provided by a qualified health
care provider. In
some embodiments, the method for requesting an interpretation of a medical
record further
comprises soliciting from a physician a second opinion of the ranking of
interpretations.
[0038] In some embodiments, an authorized user can be granted access to the
ranking of
interpretations provided by the invention. Users of the system can be, for
example, a custodian
of the subject, a health care provider, a treating physician, a specialist, a
family member, a friend,
or the subject.
[0039] An interpretation of a medical record can comprise, for example, a
diagnosis, a treatment
recommendation, a review of an existing diagnosis, a review of a treatment
recommendation to
provide a second opinion diagnosis, a referral to a specialist, and/or a
review of a clinical case by
an expert.
Virtual Health Care System.
[0040] Another aspect of the present invention relates to a method for
providing a virtual health
care system. A virtual health care system can comprise an on-line community
wherein qualified
health care providers can manage and/or be associated with clinical cases they
are associated
with, participate in physician groups, participate in professional networking
groups, and access a
library of notable cases shared by their peers. A virtual health care system
can comprise a
computer-readable medium having computer executable code adapted to be
executed to
implement a method comprising providing a virtual health care system
[0041] A virtual health care system can comprise an input module, a plurality
of databases,
structured in a plurality of different architectures, comprising a plurality
of health care providers,
a search module, a ranking module, a request module, and an output module. In
some
embodiments, a virtual health care system comprises an on-line community of
physicians. In
some embodiments, the online community comprises a subset of physicians.
[0042] A health care provider can access an on-line physician community
(FIGURE 1, 100).
The qualified physician can, for example, choose a preferred language for
viewing the website
101. The qualified physician can access links for managing cases 102, viewing
and participating
in physician groups 103, and viewing and participating in a library assembling
noteworthy
medical cases 104.
[0043] A health care provider that is associated with an on-line physician
community within a
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virtual health care system can be identified within the system of the
invention by an expert on-
line profile as illustrated in FIGURE 2, 201. The expert on-line profile can
comprise
information such as the expert's first name 202a, the expert's last name 202b,
the expert's e-mail
address and phone number 202c, the expert's specialty 202d, the expert's sub-
specialty 202e, the
expert's grade 202f, such as the expert's title as an attending physician,
chair of a department, or
chief or surgery, the expert's affiliation 202g, such as the expert's
affiliation with a hospital or a
private practice, a map 202h of a preferred physical professional address of
the expert, the
expert's involvement in philanthropic activities 2021, and additional
information provided by the
expert 202j.
[0044] The system and method of the invention can receive personal health
information for entry
into an on-line subject profile. Personal health information of a subject can
comprise general
information about the subject, medical history, medical encounter history,
existing disease
information, and pertinent information associated with recent activities of a
subject. Non-
limiting examples of personal health information include, age, sex, blood
type, family history,
height, weight, diet, BMI, risk for diabetes mellitus (DM) and pre-DM, family
history, risk for
pre-hypertension (HTN), systolic and diastolic blood pressure measurements,
salt intake,
microscopic urinalysis, proteinuria, serum blood urea nitrogen, creatinine
levels, calcium levels,
thyroid-stimulating hormone (TSH) levels, blood glucose, HDL and LDL
cholesterol levels,
triglycerides, hematocrits, electrocardiograms, and/or chest radiographs,
metabolic syndrome,
hyperlipidemia, risk of infection, decreased immune system, compromised
circulation,
compromised skin integrity, repeated contact with contagious agents, cancer
screening, CAT
scans, and MRIs.
[0045] A subject can contribute to an on-line personal medical profile of the
subject within a
virtual health care system on a regular basis. A subject can, for example,
access an on-line
profile to update information relevant to the request for a medical
interpretation, such as a
symptom. A subject can, for example, access an on-line profile to upload
recent medical files.
[0046] The system and method of the invention can receive a request for
interpretation of a
medical record associated with an on-line profile of a subject. A virtual
health care system can
associate a plurality of qualified health care providers with a received
request for the
interpretation of a medical record. A virtual health care system can rank a
list of qualified health
care providers based on a level of association with the information provided
in the medical
record. A level of association can be, for example, a set of professional
qualifications required
for the interpretation of the medical record, such as board qualification,
surgical expertise, area
of expertise, length of career, reputation among peers, and prior
achievement(s). A virtual health
care system can prioritize the ranking of a request as, for example, urgent,
time-sensitive,
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critical, trivial, and requiring multiple areas of expertise.
[0047] A virtual health care system of the invention provides a database of
medical resources
and a medical resource search module to qualified health care providers. A
virtual health care
system can comprise an effective method for requesting a medical
interpretation from a qualified
health care provider. A virtual health care system can categorize and
associate a request for a
medical interpretation submitted by a subject based on the information
comprised within a
subject on-line profile. A virtual health care system can associate a subset
of health care
providers with a request for an interpretation based on, for example, a
specialty or a geographic
location associated with the subset of health care providers. A virtual health
care system of the
invention can rank a plurality of health care providers in regards to, for
example, the health care
provider's qualifications (including board qualifications), area of expertise,
length of career,
reputation among peers, and prior achievement(s).
[0048] A virtual health care system can search, based on the information
comprised within the
request for a medical interpretation, a database that identifies a subset of
health care providers
associated with the information. In some embodiments, a health care provider
in the subset of
health care providers can be identified based on, for example, a referral from
a member of the
virtual community, the number of cases wherein the provider reviewed medical
records that are
similar to medical records associated in a new request for medical
interpretation, and/or hospital
affiliation. In some embodiments, a health care provider in the subset of
health care providers is
independently associated with the information based on a specialty. For
example, a hematologist
can be identified in the database comprising a subset of health care providers
as a physician with
expertise associated in treating blood disorders.
[0049] The system of the invention can search a plurality of databases of
medical resources,
constructed with a plurality of architectures, and supported by a plurality of
different data
management systems, including, for example: a) graph databases; b) hypermedia
databases; c)
hypertext databases; d) in-memory database; e) document-oriented databases,
wherein the
database stores, retrieves, and manages document-oriented, or semi-structured
data, for example,
a subject's medical history can be accessed by the system of the invention
from a document-
oriented database; f) cloud databases, wherein the database and a data
management system reside
remotely; g) data warehouses, wherein the data warehouses archive data from
operational
databases and data can undergo transformation on their way into the warehouse,
getting
summarized, and reclassified; h) active databases, wherein the database can
respond to
conditions both inside and outside the database in real-time; i) distributed
databases, wherein the
database includes a plurality of modules that can include modules shared by
multiple sites, and
modules specific to one site and used only locally in that site, for example a
database used and
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shared by local medical-groups, departments at regional hospitals, branch
hospitals, and other
hospital management locations; j) embedded databases, wherein the database is
a database
management system which is tightly integrated with application software that
requires access to
stored data in a way that the database management system is hidden from the
application's end-
user, for example, the invention can receive medical records from a medical
records platform
that is a database management system; k) end-user databases, wherein the end-
user database
consists of data developed by individual end-users, examples of these are
collections of
documents, spreadsheets, presentations, multimedia, and other files developed
by the subject; 1)
federated databases and multi-databases, wherein a federated database is an
integrated database
that comprises several distinct databases, each with its own data management
system; m)
knowledge-based databases, wherein the database provides the tools for the
computerized
collection, organization, and retrieval of knowledge, for example, data
representing collections
of problems and related experiences; n) operational databases, wherein the
database process
relatively high volumes of updates including medical media; o) spatial
databases, wherein the
database can store data with multidimensional features; p) temporal databases,
wherein the
database includes built-in time aspects, examples include a valid-time and
behavior occurrence-
time; and q) unstructured-databases, wherein the database is constructed to
store in a manageable
and protected way diverse objects that do not fit naturally and conveniently
in common
databases, including, for example, email messages, documents, journals, and
multimedia objects.
[0050] A virtual health care system can, based on the information comprised
within the request
for a medical interpretation, rank a plurality of health care providers that
are associated with the
request. A virtual health care system can, based on the information comprised
within the request
for a medical interpretation, rank a plurality of interpretations provided by
qualified health care
providers. In some embodiments, a system of the invention can correlate the
ranked set of
qualified health care providers with the ranked set of interpretations
provided.
[0051] A system and a method of the invention can provide access to the
medical record and the
requested interpretation of the same to an on-line community of physicians
over a virtual health
care system of the invention.
Health Care Providers.
[0052] A qualified health care provider can be, for example, an acupuncturist,
an addiction
psychiatrist, an adolescent medicine specialist, an allergist, an
immunologist, an allopathic
physician, an anatomic and clinical pathology specialist, an anatomic
pathology specialist, an
anesthesiologist, an athletic trainer, an audiologist, an ayurvedic medicine
specialist, a bariatric
medicine specialist, a bariatric surgery specialist, a blood banking
transfusion medicine
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specialist, a cardiac electrophysiologist, a cardiac surgeon, a cardiac
surgery specialist, a
cardiologist, a certified diabetes educator, a certified nursing assistant, a
chemical pathologist, a
Chinese medicine specialist, a chiropractor, a clinical and laboratory
immunology specialist, a
clinical biochemical genetics specialist, a clinical cardiac electrophysiology
specialist, a clinical
cytogenetics specialist, a clinical genetics specialist, a clinical lipidology
specialist, a clinical
neurophysiology specialist, a clinical nurse specialist, a clinical pathology
specialist, a colorectal
surgeon, a colon and rectal specialist, a coroner, a counselor, a critical
care medicine, a critical
care surgery, a cytopathologist, a cytotechnologist, a dental hygienist, a
dentist, a dermatologist,
a dermatopathologist, a developmental pediatrician, a diabetologist, a
dietician, an ear-nose-
throat specialist, an emergency medical technician, an emergency medicine
specialist, an
endocrinologist, an endodontist, an eye specialist, a family practitioner, a
fertility specialist, a
forensic pathologist, a forensic psychiatrist, a gastroenterologist, a
gastrointestinal surgeon, a
geneticist, a genetic counselor, a geriatric medicine specialist, a geriatric
psychiatrist, a
gynecologist, a gynecological oncologist, a hearing/speech specialist, a
hematologist, a
hepatologist, a holistic medicine specialist, a hospice care and palliative
medicine specialist, a
homeopathic specialist, an immunologist, an immunopathologist, an infectious
disease specialist,
an internist, an iridologist, a kinesiotherapist, a laryngologist, a
maxillofacial surgeon, a medical
assistant, a medical examiner, a medical geneticist, a medical oncologist, a
medical toxicologist,
a midwife, a molecular genetic pathologist, a mental health specialist, a
neonatal-perinatal
specialist, a nephrologist, a neurologist, a neuroradiologist, a neurosurgeon,
a nuclear medicine
specialist, a nurse, a nurse practioner, an obstetrician, an oncologist, an
ophthalmologist, an
optometrist, an oral pathology specialist, an oral surgeon, an orthodontist,
an orthopedic
specialist, an otolaryngologist, an otologist, a pain management specialist, a
pathologist, a
pediatrician, a perfusionist, a periodontist, a physical therapist, a plastic
surgeon, a podiatrist, a
proctologist, a prosthetic specialist, a psychiatrist, a public health
specialist, a pulmonologist, a
radiologist, a reproductive endocrinologist and infertility specialist, a
rheumatologist, a
rhinologist, a sleep disorder specialist, a sonographer, a speech specialist,
a surgeon, a thoracic
specialist, a transplant specialist, a urogynecologist, a urologist, a
vascular specialist, and a
vascular surgeon.
Medical Records.
[0053] The present invention pertains to a system and a method of requesting
an interpretation of
a medical record. In some embodiments, a medical record associated with a
subject is received
by a computer system, and the computer system utilizes information comprised
within the
medical record to search a database of healthcare providers.
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[0054] A medical record can comprise one or a compilation of documents
describing medical
information of a subject. A medical record can comprise the complete medical
history and care
of a subject across a period of time, or a medical record can comprise a
single event in a patient's
medical history. A medical record can describe major and minor diseases, a
surgical history, an
obstetric history, medications and medical allergies, family history, social
history, habits,
immunization history, growth and developmental history.
[0055] A subject's medical record can refer to a medical history of what has
happened to the
subject since birth. For example, medical history can be a record of diseases,
major and minor
illnesses, and/or growth landmarks. A medical record can describe a chief
complaint, a history
of the present illness, a physical examination, an assessment of a clinical
case, and a proposed
course of action to treat a condition. In some embodiments, a medical record
received by the
system and method of the invention comprises a preliminary diagnostic. In some
embodiments,
interpreting a medical record comprises a review of the record to provide a
diagnosis.
[0056] A subject's medical history can comprise surgical history. Surgical
history can describe
surgery performed on a subject, for example, dates of operations, operative
reports, and/or the
detailed narrative of what a surgeon performed.
[0057] Medical history can comprise obstetric history. Obstetric history can
comprise prior
pregnancies, pregnancy outcomes, and/or pregnancy complications. In some
embodiments,
medical history can comprise medications and medical allergies, for example, a
subject's current
and previous medications and/or medical allergies.
[0058] In some embodiments, medical history can comprise family history.
Family history can
comprise one or more lists of immediate family members' health status, for
example, causes of
death, diseases common in the subject's family or found only in one sex or the
other, and/or a
pedigree chart.
[0059] In some embodiments, medical history can comprise social history.
Social history can
comprise one or more chronicles of a subject's human interactions, for
example, relationships of
the subject, a subject's careers, trainings, schooling, and/or religious
training. In some
embodiments, social history can provide information regarding community
relationship support
that the subject can expect for a particular disease, provide information that
can explain one or
more behaviors of a subject in relation to one or more illnesses or losses,
and/or can provide
information to aid in a determination of one or more causes of one or more
illnesses, for
example, occupational exposure to asbestos. In some embodiments, medical
history can
comprise habits which can impact a subject's health. Habits which impact
health can comprise,
for example, tobacco use, alcohol intake, exercise, diet, sexual habits,
and/or sexual orientation.
In some embodiments, medical history can comprise immunization history.
Immunization
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history can comprise a history of a subject's vaccinations, and/or blood tests
providing immunity
data.
[0060] In some embodiments, medical history can comprise one or more growth
charts and
developmental history. For example, if the subject is a child or teenager,
growth charts and
developmental history can comprise one or more charts documenting a subject's
growth and/or a
comparison to data of other subjects of the same age. In some embodiments,
growth charts and
developmental history can provide information for the cause of an illness
because many diseases
and social stresses can affect growth and development of a subject. In some
embodiments,
growth charts and developmental history can comprise information regarding a
child's behavior,
for example, timing of talking, and/or timing of walking, and/or a comparison
to other children
of the same age.
[0061] Pharmacy medical records (PMR) can relate to records pertaining to a
subject's
pharmacological history. In some embodiments, pharmacological history can
comprise a
subject's prescription history, current prescription regimen, and side effect
information, for
example, dosage information, length of time a subject has been taking a
prescription, and other
drugs known to cause negative side effects with a subject's current
prescription regimen.
[0062] Electronic Medical Records (EMRs) can relate to records obtained and
stored by a
subject's doctor, clinician, insurance company, hospital and/or other
facilities where a subject is
a patient. In some embodiments, a health care provider can include a medical
doctor, a dentist,
an optometrist, a therapist, a chiropractor, and anyone who provides
healthcare services to the
subject. Electronic medical records (EMR) can comprise, for example, CAT
scans, MRIs,
ultrasounds, blood glucose levels, diagnoses, allergies, lab test results,
EKGs, medications, daily
charting, medication administration, physical assessments, admission nursing
notes, nursing care
plans, referrals, present and past symptoms, medical history, life style,
physical examination
results, tests, procedures, treatments, medications, discharges, history,
diaries, problems,
findings, immunizations, admission notes, on-service notes, progress notes,
preoperative notes,
operative notes, postoperative notes, procedure notes, delivery notes,
postpartum notes, and
discharge notes.
[0063] In some embodiments, data delivery of an expert review of a medical
record is compliant
with the Health Insurance Portability and Accountability Act (HIPAA)
standards.
[0064] In some embodiments, medical records received by the invention can be
available for
peer-review within a virtual health care system comprising an on-line
community with access to
the medical record. A virtual health care system can comprise a database of
medical resources
and a medical resource search module. Qualified health care providers,
including broader groups
of physicians, such as a group of oncologists, and a subset of physicians,
such as a group of
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neurology surgical oncologists, can have access to an on-line portal within an
on-line community
of the invention. The on-line portal can provide health care providers with
access to a database
of medical resources, a library of noteworthy cases within the community, an
on-line community
of colleagues, and access to medical records pertaining to a medical case the
provider is
associated with.
[0065] In some embodiments, the on-line community within the virtual health
care system
further comprises a medical imaging module. The medical imaging module can
provide, for
example, physicians, nurses, and specialist's access to medical images
associated with the
medical record. The medical images within the medical imaging module can be
associated with
at least one text description(s) detailing an existing reading or
interpretation of the medical
media. The medical images can be deprived of any prior reading or
interpretation of the medical
media.
[0066] In some aspects, the invention comprises a system and a method for
understanding a
medical record comprising the description of a condition. Qualified physicians
that provide, for
example, clear, logical, fact-based, and comprehensible explanations of a
clinical case can be
further queried in regards to the same case, or in regards to similar cases.
In some embodiments,
whereupon receiving the requested interpretation of a medical record from a
qualified health care
provider, the computer system of the invention places the qualified health
care provider on a
queue to receive future health care requests associated with the condition.
Medical Diagnosis.
[0067] Medical diagnosis can refer to both the process of attempting to
determine or attempting
to identify a possible disease, disorder, or condition, and to the diagnostic
opinion reached by
this process. A medical diagnosis can indicate either degree of abnormality on
a continuum or a
medical diagnosis can indicate abnormality in a classification. A medical
diagnosis can
comprise a brief summation or an extensive evaluation of a patient's medical
record. A medical
diagnosis can describe a condition that requires surgery as a preferred
treatment option.
[0068] A medical diagnosis can refer, for example, to any disease, syndrome or
condition that
causes pain, irregularity, dysfunction, physical, emotional, or psychological
distress, social
problems, and/or death to the person afflicted. Conditions can include
injuries, disabilities,
disorders, syndromes, infections, isolated symptoms, deviant behaviors,
atypical variations of
normal cellular structure and function, atypical variations of normal bodily
structure and
function, pathogenic diseases, deficiency diseases, hereditary diseases, and
physiological disease.
[0069] A medical diagnosis can comprise naming a disease, lesion, dysfunction
or disability. A
medical diagnosis can be a management-naming or prognosis-naming exercise. A
medical
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diagnosis can be uncertain and provisional. In some embodiments, a medical
diagnosis is
comprised within the interpretation of the medical record. A medical diagnosis
can, for example,
provide a subject with a recommendation of a therapeutic intervention.
[0070] A medical diagnosis can be, for example, cancer. Non-limiting examples
of cancers that
can be associated with a medical record by the system of the invention
include: acute
lymphoblastic leukemia, acute myeloid leukemia, adrenocortical carcinoma, AIDS-
related
cancers, AIDS-related lymphoma, anal cancer, appendix cancer, astrocytomas,
basal cell
carcinoma, bile duct cancer, bladder cancer, bone cancers, brain tumors, such
as cerebellar
astrocytoma, cerebral astrocytoma/malignant glioma, ependymoma,
medulloblastoma,
supratentorial primitive neuroectodermal tumors, visual pathway and
hypothalamic glioma,
breast cancer, bronchial adenomas, Burkitt lymphoma, carcinoma of unknown
primary origin,
central nervous system lymphoma, cerebellar astrocytoma, cervical cancer,
childhood cancers,
chronic lymphocytic leukemia, chronic myelogenous leukemia, chronic
myeloproliferative
disorders, colon cancer, cutaneous T-cell lymphoma, desmoplastic small round
cell tumor,
endometrial cancer, ependymoma, esophageal cancer, Ewing's sarcoma, germ cell
tumors,
gallbladder cancer, gastric cancer, gastrointestinal carcinoid tumor,
gastrointestinal stromal
tumor, gliomas, hairy cell leukemia, head and neck cancer, heart cancer,
hepatocellular (liver)
cancer, Hodgkin lymphoma, Hypopharyngeal cancer, intraocular melanoma, islet
cell carcinoma,
Kaposi sarcoma, kidney cancer, laryngeal cancer, lip and oral cavity cancer,
liposarcoma, liver
cancer, lung cancers, such as non-small cell and small cell lung cancer,
lymphomas, leukemias,
macroglobulinemia, malignant fibrous histiocytoma of bone/osteosarcoma,
medulloblastoma,
melanomas, mesothelioma, metastatic squamous neck cancer with occult primary,
mouth cancer,
multiple endocrine neoplasia syndrome, myelodysplastic syndromes, myeloid
leukemia, nasal
cavity and paranasal sinus cancer, nasopharyngeal carcinoma, neuroblastoma,
non-Hodgkin
lymphoma, non-small cell lung cancer, oral cancer, oropharyngeal cancer,
osteosarcoma/malignant fibrous histiocytoma of bone, ovarian cancer, ovarian
epithelial cancer,
ovarian germ cell tumor, pancreatic cancer, pancreatic cancer islet cell,
paranasal sinus and nasal
cavity cancer, parathyroid cancer, penile cancer, pharyngeal cancer,
pheochromocytoma, pineal
astrocytoma, pineal germinoma, pituitary adenoma, pleuropulmonary blastoma,
plasma cell
neoplasia, primary central nervous system lymphoma, prostate cancer, rectal
cancer, renal cell
carcinoma, renal pelvis and ureter transitional cell cancer, retinoblastoma,
rhabdomyosarcoma,
salivary gland cancer, sarcomas, skin cancers, skin carcinoma merkel cell,
small intestine cancer,
soft tissue sarcoma, squamous cell carcinoma, stomach cancer, T-cell lymphoma,
throat cancer,
thymoma, thymic carcinoma, thyroid cancer, trophoblastic tumor (gestational),
cancers of
unkown primary site, urethral cancer, uterine sarcoma, vaginal cancer, vulvar
cancer,
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Waldenstrom macroglobulinemia, and Wilms tumor.
[0071] A medical diagnosis can identify, for example, a genetic disorder. Non-
limiting
examples of genetic disorders include: undiagnosed conditions, cystic
fibrosis, Duchenne
muscular dystrophy, Haemochromatosis, Tay-Sachs disease, Prader-Willi
syndrome, Angelman
syndrome, neurofibromatosis, phenylketonuria, Canavan disease, Coeliac
disease, Acid beta-
glucosidase deficiency, Gaucher, Charcot¨Marie¨Tooth disease, color blindness,
Cri du chat,
polycystic kidney disease, acrocephaly, familial adenomatous polyposis,
adrenal gland disorders,
amyotrophic lateral sclerosis (ALS), Alzheimer's disease, Parkinson's disease,
anemia, ataxia,
ataxia telangiectasia, autism, bone marrow diseases, Bonnevie-Ullrich
syndrome, brain diseases,
von Hippel-Lindau disease, congenital heart disease, Crohn's disease,
dementia, myotonic
dystrophy, Fabry disease, fragile X syndrome, galactosemia, genetic emphysema,
retinoblastoma, Pendred syndrome, Usher syndrome, Wilson disease,
neuropathies, Huntington's
disease, immune system disorders, gout, X-linked spinal-bulbar muscle atrophy,
learning
disabilities, Li-Fraumeni syndrome, lipase D deficiency, Lou Gehrig disease,
Marfan syndrome,
metabolic disorders, Niemann-Pick, Noonan syndrome, Osteopsathyrosis, Peutz-
Jeghers
syndrome, Pfeiffer syndrome, porphyria, progeria, Rett syndrome, tuberous
sclerosis, speech and
communication disorders, spinal muscular atrophy, Treacher Collins syndrome,
trisomies, and
monosomies.
Computer Architectures.
[0072] Various computer architectures are suitable for use with the invention.
FIGURE 3 is a
block diagram illustrating a first example architecture of a computer system
300 that can be used
in connection with example embodiments of the present invention. As depicted
in FIGURE 3,
the example computer system can include a processor 302 for processing
instructions. Non-
limiting examples of processors include: Intel Core i7Tm processor, Intel Core
i5 processor,
processor,
Intel Core i3 processor, processor, Intel XeonTm processor, AMD OpteronTm
processor, Samsung 32-bit
RISC ARM 1176JZ(F)-S v1.0 processor, ARM Cortex-A8 Samsung S5PC100Tm
processor,
ARM Cortex-A8 Apple A4 processor, processor, Marvell PXA 930Tm processor, or a
functionally-
equivalent processor. Multiple threads of execution can be used for parallel
processing. In some
embodiments, multiple processors or processors with multiple cores can be
used, whether in a
single computer system, in a cluster, or distributed across systems over a
network comprising a
plurality of computers, cell phones, and/or personal data assistant devices.
[0073] As illustrated in FIGURE 3, a high speed cache 301 can be connected to,
or incorporated
in, the processor 302 to provide a high speed memory for instructions or data
that have been
recently, or are frequently, used by processor 302. The processor 302 is
connected to a north
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bridge 306 by a processor bus 305. The north bridge 306 is connected to random
access memory
(RAM) 303 by a memory bus 304 and manages access to the RAM 303 by the
processor 302.
The north bridge 306 is also connected to a south bridge 308 by a chipset bus
307. The south
bridge 308 is, in turn, connected to a peripheral bus 309. The peripheral bus
can be, for example,
PCI, PCI-X, PCI Express, or other peripheral bus. The north bridge and south
bridge are often
referred to as a processor chipset and manage data transfer between the
processor, RAM, and
peripheral components on the peripheral bus 309. In some architectures, the
functionality of the
north bridge can be incorporated into the processor instead of using a
separate north bridge chip.
[0074] In some embodiments, system 300 can include an accelerator card 312
attached to the
peripheral bus 309. The accelerator can include field programmable gate arrays
(FPGAs) or other
hardware for accelerating certain processing.
[0075] Software and data are stored in external storage 313 and can be loaded
into RAM 303
and/or cache 301 for use by the processor. The system 300 includes an
operating system for
managing system resources; non-limiting examples of operating systems include:
Linux,
Windows, MACOSTm, BlackBerry OS', iOSTm, and other functionally-equivalent
operating
systems, as well as application software running on top of the operating
system.
[0076] In this example, system 300 also includes network interface cards
(NICs) 310 and 311
connected to the peripheral bus for providing network interfaces to external
storage, such as
Network Attached Storage (NAS) and other computer systems that can be used for
distributed
parallel processing.
[0077] FIGURE 4 is a diagram showing a network 400 with a plurality of
computer systems
402a, and 402b, a plurality of cell phones and personal data assistants 402c,
and Network
Attached Storage (NAS) 401a, and 401b. In some embodiments, systems 402a,
402b, and 402c
can manage data storage and optimize data access for data stored in Network
Attached Storage
(NAS) 401a and 402b. A mathematical model can be used for the data and be
evaluated using
distributed parallel processing across computer systems 402a, and 402b, and
cell phone and
personal data assistant systems 402c. Computer systems 402a, and 402b, and
cell phone and
personal data assistant systems 402c can also provide parallel processing for
adaptive data
restructuring of the data stored in Network Attached Storage (NAS) 401a and
401b. FIGURE 4
illustrates an example only, and a wide variety of other computer
architectures and systems can
be used in conjunction with the various embodiments of the present invention.
For example, a
blade server can be used to provide parallel processing. Processor blades can
be connected
through a back plane to provide parallel processing. Storage can also be
connected to the back
plane or as Network Attached Storage (NAS) through a separate network
interface.
[0078] In some embodiments, processors can maintain separate memory spaces and
transmit data
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through network interfaces, back plane, or other connectors for parallel
processing by other
processors. In some embodiments, some or all of the processors can use a
shared virtual address
memory space.
[0079] FIGURE 5 is a block diagram of a multiprocessor computer system using a
shared
virtual address memory space. The system includes a plurality of processors
501a-f that can
access a shared memory subsystem 502. The system incorporates a plurality of
programmable
hardware memory algorithm processors (MAPs) 503a-f in the memory subsystem
502. Each
MAP 503a-f can comprise a memory 504a-f and one or more field programmable
gate arrays
(FPGAs) 505a-f. The MAP provides a configurable functional unit and particular
algorithms or
portions of algorithms can be provided to the FPGAs 505a-f for processing in
close coordination
with a respective processor. In this example, each MAP is globally accessible
by all of the
processors for these purposes. In one configuration, each MAP can use Direct
Memory Access
(DMA) to access an associated memory 504a-f, allowing it to execute tasks
independently of,
and asynchronously from, the respective microprocessor 501a-f. In this
configuration, a MAP
can feed results directly to another MAP for pipelining and parallel execution
of algorithms.
[0080] The above computer architectures and systems are examples only, and a
wide variety of
other computer, cell phone, and personal data assistant architectures and
systems can be used in
connection with example embodiments, including systems using any combination
of general
processors, co-processors, FPGAs and other programmable logic devices, system
on chips
(SOCs), application specific integrated circuits (ASICs), and other processing
and logic
elements. Any variety of data storage media can be used in connection with
example
embodiments, including random access memory, hard drives, flash memory, tape
drives, disk
arrays, Network Attached Storage (NAS) and other local or distributed data
storage devices and
systems.
[0081] In example embodiments, the computer system can be implemented using
software
modules executing on any of the above or other computer architectures and
systems. In other
embodiments, the functions of the system can be implemented partially or
completely in
firmware, programmable logic devices such as field programmable gate arrays
(FPGAs) as
referenced in FIGURE 5, system on chips (SOCs), application specific
integrated circuits
(ASICs), or other processing and logic elements. For example, the Set
Processor and Optimizer
can be implemented with hardware acceleration through the use of a hardware
accelerator card,
such as accelerator card 312 illustrated in FIGURE 3.
EXAMPLES
EXAMPLE 1: Requesting an Interpretation of a Medical Record.
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[0082] A subject is informed by a treating physician of a proposed treatment
strategy for the
subject's condition. The subject seeks a second medical opinion, and the
subject accesses an
online platform of the invention. The subject creates a subject profile within
the online platform
of the invention, and the subject uploads the subject's electronic medical
records, including the
subject's case media. The subject submits a request for an interpretation of
the uploaded medical
record to the invention described herein.
[0083] The system and methods of the invention receive the request and assign
select group
members as dedicated point-of-contact support associates for the case. A
computer program
product of the invention searches, based on the uploaded medical record of the
subject, a
database of qualified health care providers that comprise qualified health
care professionals
proficient in providing an interpretation of a medical record. The computer
program product
ranks the qualified health care providers based on their specialty, the length
of their expertise,
medical reputation, and/or referrals by other physicians. A dedicated group
member assigned to
the case utilizes the computer program product of the invention to request an
interpretation of the
received medical record by at least one of the identified qualified health
care providers.
[0084] A qualified physician receives a message from a dedicated group member
assigned to the
invention (FIGURE 6, 601) inviting the qualified physician to submit an
interpretation of the
medical record. The message describes a new case in a physician's group 602.
The physician
opens the description of the new case 603, and the physician is presented with
a brief summary
of the case, including the topic and scope of the request. The physician
clicks on a link to the
new case 603a, which forwards the physician to a secure online location within
the invention
comprising a more comprehensive description of the diagnosis of stage IV
signet ring
adenocarcinoma of the appendix in this patient. The message also provides the
physician with
information describing the date, month, and year of the last update by the
subject 603b, and the
physician can choose to delete 604a or close the message 604b.
[0085] The qualified physician clicks on the link to the new case 603a
describing the diagnosis
of stage IV signet ring adenocarcinoma of the appendix in this patient. FIGURE
7 illustrates the
architecture of an online page comprising a more comprehensive case
description 701 which the
qualified physician has now accessed. A clinical summary 702 of the case
includes all medical
records, medical information, and medical history provided by the subject
seeking a medical
interpretation. The clinical summary 702 of the subject diagnosed with stage
IV signet ring
adenocarcinoma of the appendix includes the subject's medical history, exam
and test results, the
subject's treating physician's assessment and plan, questions from the
subject, and a placeholder
for reviews by at least one expert. The case media 703 for the subject
diagnosed with stage IV
signet ring adenocarcinoma of the appendix includes CT scans of abdomen and
pelvis with
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contrast, CT scans of abdomen and pelvis without contrast, coronal body
related media, and
sagittal body related emdia, and information pertaining to the same. The
qualified physician
reviewing the request for a medical interpretation can access case comments
and questions
posted, for example, by the subject 704. The qualified physician reviewing the
request for a
medical interpretation can view a summary of patient information, including
age and gender, and
the qualified physician can access a link 705a comprising further patient
information. Based on
the case, the qualified physician can choose to provide an expert review of
the case 706, or the
qualified physician can choose not to provide an expert review of the case.
[0086] The qualified physician is an oncologist with extensive expertise in
adenocarcimas. The
qualified physician chooses to provide an expert review of the case. By
accepting to review the
case, the qualified physician gains access to an expert case summary 801
secure location within
the website of the invention. The qualified physician is now referred to as an
expert associated
with case. The expert can review links to the patient's medical history 802a,
exam and test
results 802b, treating physicians assessment and plan 802c, questions 802d,
and the qualified
expert can review expert reviews provided by other qualified physicians 802e.
When reviewing
a case, the expert can refer to additional insight, comments, and expert
opinion 802f of additional
expert physicians authorized to review the particular case.
[0087] The qualified physician then proceeds to provide his assessment of the
diagnosis of stage
IV signet ring adenocarcinoma of the appendix in this patient 803. The
qualified physician
provides recommendations that include a new diagnosis, and the qualified
physician proposes a
different course of treatment.
EXAMPLE 2: Modules of a Virtual Health Care System.
[0088] An on-line physician community is accessed from a virtual on-line
community by a
physician. A module of a virtual health care system is a great cases library
(FIGURE 9, 901).
The online community provides the physician with access to an on-line location
comprising a
great cases library 902. The physician seeks to assess a medically relevant
case in the library
902. The physician inspects the cases currently listed in the library 902. The
physician seeks to
create a new post about a particular case and the physician clicks an on-line
link that provides the
physician with the tools to create a new post 902a. The physician is
interested in the cases
currently comprised within the library 902, and the physician decides not to
click on the
unsubscribe 902b link associated with any of those cases.
[0089] The physician inputs information on the virtual location 903 that
provides the physician
with the tools to create a new post. The physician seeks additional feedback
from peers and
colleagues, and the physician chooses to make the case visible to select group
users 903a.
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Authorized physicians and group users post comments on a physician group news
904 associated
with the case, on a plurality of cases 905 associated with the library, on a
plurality of case media
906 associated with the library, and on a plurality of files 907 associated
with the library. Some
authorized physicians and group users further provide links to associated
files 908 of
similar/relevant cases that can be of interest when viewed in light of the
newly created post.
[0090] A module of a virtual health care system is a manage cases module
(FIGURE 10, 1001).
A physician seeks to manage a request for a medical interpretation within a
virtual health care
system through a manage cases 1001 module. A physician accesses a manage cases
module
1001 and a physician visualizes the active consultations the physician has
agreed to review 1001.
The physician also visualizes the active cases within the physician's group. A
physician clicks
on an active consultation 1001. A physician visualizes information associated
with the clicked
active case 1002. Information associated with the active case includes the
name of the case
1002a, date of last update 1002b, status of the case 1002c, comments 1002d,
physician's role
1002e, services 1002f, and actionable items 1002g. The physician sees that an
actionable item
requires the physician to write an expert report. The physician proceeds into
writing the expert
report.
[0091] A module of a virtual health care system is a peer group module (FIGURE
11, 1101). A
physician seeks to interact with colleagues and peers within a virtual health
care system and a
physician accesses a link to a peer groups module 1102. The physician clicks
on a link to a peer
groups 1103 entry page and the physician visualizes descriptions posted by
peers of the
physician, such as a medical oncology case. The physician also visualizes
comments posted by
peers on a surgical case previously posted by the physician within the peer
groups link 1103.
Within the peer group module 1103 the physician visualizes a range of
guidelines for reminders
and notes 1103a that pertain to posted cases. The physician chooses to click
on an additional
link that allows for the visualization of a sub-group within the peer
community 1103b.
EMBODIMENTS
[0092] The following non-limiting embodiments provide illustrative examples of
the invention,
but do not limit the scope of the invention.
[0093] Embodiment 1. A method of requesting an interpretation of a medical
record, the method
comprising: a) receiving a medical record associated with a subject by a
computer system; b)
searching based on the medical record a database of health care providers,
wherein each
healthcare provider in the database is independently associated with a
specialty, to provide at
least one qualified health care provider, wherein the qualified health care
provider is qualified to
interpret the medical record, wherein the computer system comprises a
processor, wherein the
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search is performed by the processor; c) requesting from the qualified health
care provider a
requested interpretation of the medical record; d) receiving the requested
interpretation of the
medical record from the qualified health care provider; and e) ranking the
requested
interpretation against at least one alternative interpretation by a different
health care provider to
provide a ranking of interpretations.
[0094] Embodiment 2. The method of Embodiment 1, wherein the qualified health
care provider
has an expertise associated with the medical record.
[0095] Embodiment 3. The method of any one of Embodiments 1 and 2, wherein the
requested
interpretation is ranked based on a level of the expertise.
[0096] Embodiment 4. The method of any one of Embodiments 1-3, wherein the
requested
interpretation is based on virtual collaboration among the qualified health
care provider and an
additional health care provider.
[0097] Embodiment 5.The method of any one of Embodiments 1-4, wherein the
qualified health
care provider and the additional health care provider are anonymous to one
another.
[0098] Embodiment 6. The method of any one of Embodiments 1-5, wherein the
interpretation
of the medical record comprises a diagnosis.
[0099] Embodiment 7. The method of any one of Embodiments 1-6, wherein the
interpretation
of the medical record comprises a treatment recommendation.
[00100] Embodiment 8. The method of any one of Embodiments 1-7, wherein the
interpretation
of the medical record comprises a review of a diagnosis to provide a second
opinion.
[00101] Embodiment 9. The method of any one of Embodiments 1-8, wherein the
interpretation
of the medical record comprises a review of a treatment recommendation to
provide a second
opinion.
[00102] Embodiment 10. The method of any one of Embodiments 1-9, further
comprising
providing access to the ranking of interpretations to a user.
[00103] Embodiment 11. The method of any one of Embodiments 1-10, wherein the
medical
record comprises a condition, and wherein upon receiving the requested
interpretation from the
qualified health care provider, the computer system places the qualified
health care provider on a
queue to receive future health care requests associated with the condition.
[00104] Embodiment 12. The method of any one of Embodiments 1-11, further
comprising
searching a database of medical resources based on an information in the
medical record, thereby
identifying a relevant medical resource, and providing the relevant medical
resource to the
qualified health care provider upon requesting the requested interpretation.
[00105] Embodiment 13. The method of Embodiment 12, wherein the relevant
medical resource
is added to an on-line personal medical profile of the subject.
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[00106] Embodiment 14. The method of any one of Embodiments 1-13, further
comprising
soliciting from a physician a second opinion of the ranking of
interpretations.
[00107] Embodiment 15. The method of any one of Embodiments 1-14, further
comprising
providing access to the medical record and the requested interpretation to an
on-line community
of physicians over a virtual network.
[00108] Embodiment 16. The method of any one of Embodiments 1-15, wherein the
medical
record is received via a health care request from the subject.
[00109] Embodiment 17. The method of any one of Embodiments 1-16, wherein the
medical
record is received from an on-line personal medical profile of the subject.
[00110] Embodiment 18. The method of any one of Embodiments 1-17, wherein the
medical
record comprises a preliminary diagnosis.
[00111] Embodiment 19. The method of any one of Embodiments 1-18, wherein the
searching
identifies a plurality of qualified health care providers, and each qualified
health care provider of
the plurality is ranked to provide a ranked set of qualified health care
providers ordered from a
highest rank to a lowest rank.
[00112] Embodiment 20. The method of Embodiment 19, wherein the requesting
comprises
querying the qualified health care providers in the ranked set in an order
beginning with the
qualified health care provider with the highest rank.
[00113] Embodiment 21. The method of any one of Embodiments 19 and 20, wherein
the
requesting comprises querying the qualified health care providers in the
ranked set in a random
order.
[00114] Embodiment 22. The method of any one of Embodiments 1-21, wherein a
qualified
health care provider is queried after at least one other qualified health care
provider replied to the
request affirmatively.
[00115] Embodiment 23. The method of any one of Embodiments 1-22, further
comprising
providing to the subject a therapeutic intervention associated with the
requested interpretation.
[00116] Embodiment 24. A computer program product comprising a computer-
readable medium
having computer-executable code encoded therein, the computer-executable code
adapted to be
executed to implement a method comprising: a) providing a virtual health care
system, wherein
the virtual health care system comprises: i) an input module; ii) a database,
wherein the database
comprises a plurality of health care providers; iii) a search module; iv) a
ranking module; v) a
request module; and vi) an output module; b) receiving an electronic medical
record from a user
by the input module, whereupon the input module transmits information from the
medical record
to the search module; c) searching, based on the information, the database by
the search module,
whereby the search module identifies in the database a subset of health care
providers associated
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with the information; d) ranking by the ranking module the subset of health
care providers,
whereby the ranking module ranks each health care provider in the subset of
health care
providers based on a level of association with the information to provide a
set of ranked health
care providers; e) requesting by the request module a requested interpretation
of the medical
record from at least one of the ranked health care providers; f) receiving by
the request module at
least one requested interpretation; g) ranking by the ranking module the
received requested
interpretation against at least one alternative interpretation to provide a
set of ranked
interpretations; and h) outputting the set of ranked interpretations via the
output module.
[00117] Embodiment 25. The computer program product of Embodiment 24, wherein
each
health care provider in the subset of health care providers associated with
the information of step
c) is independently associated with the information based on a specialty.
[00118] Embodiment 26. The computer program product of any one of Embodiments
24 and 25,
wherein the ranking of the set of ranked interpretations of step g) correlates
to the ranking of the
set of ranked health care providers.
[00119] Embodiment 27. The computer program product of any one of Embodiments
24-25,
wherein the virtual health care system of step a) further comprises a database
of medical
resources and a medical resource search module, wherein the medical resource
search module
searches the database of medical resources based on the information to
identify a relevant
medical resource, wherein the relevant medical resource is provided to the
ranked health care
provider in the requesting by the request module.
[00120] Embodiment 28. The computer program product of any one of Embodiments
24-26,
wherein the virtual health care system further comprises an on-line portal,
wherein the on-line
portal provides an on-line community with access to the medical record.
[00121] Embodiment 29. The computer program product of Embodiment 28, wherein
the online
community comprises a subset of physicians.
[00122] Embodiment 30. The computer program product of any one of Embodiment
28 and 29,
wherein the virtual health care system further comprises a medical imaging
module, wherein the
medical imaging module provides the on-line community with access to medical
images
associated with the medical record.
