WO2002071304A2

WO2002071304A2 - A system and method for providing pathological test results

Info

Publication number: WO2002071304A2
Application number: PCT/GB2002/000837
Authority: WO
Inventors: Donald Saum
Original assignee: Wwa.Sysmed Limited
Priority date: 2001-03-01
Filing date: 2002-02-26
Publication date: 2002-09-12
Also published as: WO2002071304A3; GB0105106D0

Abstract

A system for providing pathology results to a user, preferably, a clinician, the system comprising means for storing a pathology test result, together with an indicator; means for interpreting the indicator; and means for automatically sending a message to a predetermined electronic address, when the indicator is interpreted as meeting pre-determined criteria.

Description

A SYSTEM AND METHOD FOR PROVIDING PATHOLOGICAL TEST

RESULTS

The present invention relates to a system and method for providing pathological test results, in particular a system and method for providing easy access to such results for clinicians.

As is well known, in order to check for medical conditions, samples are often taken from patients and, in many cases, sent to pathology laboratories, where tests are conducted. Once test results are obtained, they are typically entered into a computer-based data storage system. One such system is WinPath, which is provided by William Woodard Associates Ltd, which was devised to assist lab professionals to record and in some cases analyse test data.

Whilst WinPath and other such products are useful in a limited lab environment, there are disadvantages. For example, the results are only accessible by scientists in the pathology labs. In order to communicate test results to clinicians, they have to be sent via post or fax or be given over the telephone. This means that there can be a significant delay between the completion of tests and the receipt of results by the clinician.

According to one aspect of the present invention, there is provided a system for providing pathology results to a user, preferably, a clinician, the system comprising: means for storing a pathology test result; means for interpreting the pathology test result, and means for automatically sending a message to a predetermined electronic address, when the pathology test result is interpreted as meeting predetermined criteria.

The test result may include an indicator, preferably a flag, and the means for interpreting the test result data may be operable to interpret the indicator. Preferably, the indicator is indicative of whether the result is outside a normal range.

Preferably, the pre-determined criteria define an abnormal range of results. In this way, the system is operable to check whether the test result is abnormal and if it is, automatically generate and send a message to, for example, the clinician who requested the test. This means that the clinician is provided with abnormal test results at an early stage. This is highly advantageous for both the clinician and the patient, because some medical conditions may require immediate treatment.

The pre-determined electronic address may be an e-mail address. The predetermined electronic address may be a fax number. The pre-determined electronic address may be a telephone number.

The message may be a text based message. The message may indicate the presence of the test results. The message may include a link to the test results. The message may include the test results. The message may include an indication of the patient to whom the results are relevant.

Means may be provided for receiving a download of information from a test result data source, for example the WinPath system. Preferably, receipt of the downloaded information triggers the means for inteφreting to interpret the test results, so that a clinician can be notified of any abnormal results at the earliest possible stage.

According to another aspect of the present invention, there is provided a method of providing pathology results^* to a user, preferably, a clinician, the method comprising: storing a pathology test result; interpreting the pathology test result; and automatically sending a message to a predetermined electronic address, when the result is inteφreted as meeting pre-determined criteria.

Preferably, the test result includes an indicator, preferably a flag, and the means for inteφreting the test result data are operable to interpret the indicator. Preferably, the indicator is indicative of whether the result is outside a normal range.

Preferably, the pre-determined criteria define an abnormal range of results.

According to a still further aspect of the present invention, there is provided a computer program, preferably on a data carrier or a computer readable medium, for providing pathology results to a user, preferably, a clinician, the computer program comprising instructions for: storing a pathology test result; inteφreting the pathology test result; and automatically sending a message to a predetermined electronic address, when the pathology test result is inteφreted as meeting pre-determined criteria.

Preferably, the pre-determined criteria define an abnormal range of results.

Various aspects in which the present invention is embodied will now be described with reference to the following drawings, of which:

Figure 1 shows a computer-based network for allowing clinicians to test results; Figure 2 shows the hierarchy of the data used in the system of Figure 1 ;

Figure 3 shows an example of a results web page;

Figure 4 shows an example of a web page showing results for a patient;

Figure 5 shows an example of a screen that is presented when the

"document" icon of the screen of Figure 3 is clicked, and Figure 6 is an example of a screen that is presented to a clinician by clicking an entry in the table of Figure 5.

Figure 1 shows a plurality of user terminals 10 each connected to a central system server 12 via the internet. Of course, the user terminals 10 could be connected to the server 12 via any other telecommunications network such as a LAN. Included in the server 12 is a processor 14, which includes the main system application 16, and a memory 18 for storing details of pathology tests and the corresponding results. The system application 16 is operable to provide a pathology test result web site that can be accessed via a web browser, thereby to allow test results to be viewed on line by, for example, clinicians.

Test data can be introduced into the system memory 18 via various means, but is typically transferred or downloaded into the system memory 18 in real-time from a test result data source, for example, WinPath. Of course, the data could be entered directly into the system by the scientist conducting the test in the pathology lab. Test data is input into the system from a plurality of different labs, so that clinicians can access all of their test results using a single portal.

A typical data hierarchy for the test result data is shown in Figure 2. Each test that is conducted is allocated a request number (request_no). This is stored in an Index Table that is used to index all of the test result and patent information in the system. Included in the Index Table is the following:

req_no - the unique number allocated to the test request dept_no - a unique department number for identifying, e.g. the pathology department with which the sample is associated lab_no - a unique number associated with request for the test dob - date of birth of the patient clinician_code - a unique code associated with, e.g. a practice of doctors source_code - a unique source code for identifying the specific doctor who sent in the sample (could be a member of a group practice) request_date - date the request was made master_roll_no this is a unique number that is given to the patient nhs_no - the patient's nhs number name_key - a name key ref no - a system reference number

Linked to the Index Table via the request number, is a Request Table, that includes the following information:

req_no - as before lab_no as before surname - the surname of the patient forename - the forename of the patient title - the title of the patient sex - the sex of the patient dob - the date of birth of the patient > age - the age of the patient clinician_name - name of a group practice source_name - name of the specific clinician cc_clinician_code a unique code for a group to which the results can be copied cc_source_code - a unique code for a specific doctor to whom the results can be copied request_date - date of request sample_date - date on which the sample was sent to lab reported_date - date on which the test results are reported sample_type - nature of the sample taken sample_text - a brief description of the sample fasting - indication as to whether the patient fasted prior to the sample being taken ref no - the reference number master roll io - as before nhs no - the nhs number for the patient on call - indication as to whether the sample results are required out of hours telephone_results - indication as to whether the clinician wishes results by telephone patient_category - categorisation of the patient patient_flagl - this is a flag that is indicative of specfic patient information, e.g. patient has blood group antibodies or suffers from specifc allergy patient_flag2 a flag for specifying further patient information

sample_flags specifies specific sample details, e.g. sample may be frozen or a may include, for example, an anti- coagulent booked_in_date day the sample arrives at the lab price_scale - indication as to the price account to - account identifier total_fee - indication as to the total fee comments - other comments

Linked to the Index Table via the department number (deptjno) is a Department Table that includes further details of the department from which the request originated. This table typically includes a dept no, e.g. a number for the haemotology department; a dept_code - a code for each specific department; a deptjtiame - a name for the department, e.g. haematology department; a dept_drive - this defines the computer on which the department data is provided.

Also linked to the Index Table via the source_code is a Source Table that includes the source_code; the sourcejname, e.g. the personal name of the doctor; address 1 - a first address for the doctor; address2 - a second address for the doctor; address3 - a third address for the doctor; post code; telephone_no; fax_no; report_copies; classification.

Additionally linked to the Index Table via the clinician code is a Clinician Table that includes details of the group that requested the test. Included in this table is the clinician_code; clinicianjtiame; speciality name - an indication of the group speciality; speciality_sub_div - a more detailed indication of speciality; source_code, which as before is associated with a specific individual within the group and an account_code, which is provided for accounting puφoses.

Returning to the main Request Table, this is linked via the request number to various other tables for example a Test Table, an AddressTable and a Test Results Table. Included in the Test Table is the following information the reqjtio; a tlc_no, which is a test library code number; a test_lib_code, which is a test library code; a test_lib_desc, which is a brief description of the test; urg, which indicates the urgency with which the results are needed; and charge, which is an indication of the cost of the test. Included in the Address Table is the req_no; the type of test requested; the name of the patient; various addresses (address 1, address2, address3) to which the results should be sent and the relevant post code.

The Test Results Table is where details of the results of the tests conducted are stored. This typically includes the following:

req_no section code this defines particular sections within departments, for example for haematology, this could be the clotting sub-division, etc res_line_no status - this indicates whether the test is completed or not test_form_code - test_name test_form_fh test_form_flags result units ref_range_text abnormal_flag - this is only present for test results that are deemed abnormal, but do not require immediate action to be taken abnormal alert this is only present for test results that are deemed abnormal, but do require immediate action to be taken sample_flag_marker sample_flag_comment

Linked to the Results Table via the section_code is a Sections Table, which includes the following a section_code and description thereof. This defines In more detail the sub-division of the department that requested the test. Also linked to the Results Table via the req io and the res_line_no is a WFT Table, which additionaly includes a wftjres, which defines a text format.

As mentioned previously, the test data can be introduced into the system memory 18 via various means, for example it can be transferred or downloaded into the system memory 18 in real-time from a test result data source or entered directly into the system by the lab doing the test. In any case, when the data of the Results Table is received, the system application 16 automatically checks or inteφrets it to determine whether the abnormal alert flag is set and so whether an abnormal alert process has to be started. The abnormal alert flag may be set when, for example, the patient's blood sugar levels exceed a pre-determined maximum. If the abnornal alert flag is set, the application 16 searches for details of the clinician associated with the test result and automatically sends a warning message to a predetermined electronic address, for example, the clinician's e-mail address or fax number. Alternatively, the message may be a text based message that is sent to the clinician's mobile telephone or may be a signal that is sent to the clinician's bleeper. The message may indicate the presence of the test results or include a link to the test results. Alternatively, the message may include the actual test results. In this way, the clinician is notified as soon as possible of any abnormal event that may suggest that immediate treatment is necessary for the patient.

All of the data in the various tables of Figure 2 can be used to provide on-line information to clinicians via the system web site. To access the data, the opening page of the system web site includes a data entry field to allow a clinician to log on. When clinicians join the system at the start, they are asked to identify how they would prefer to receive immediate notification of abnormal results. The clinician can select for example to receive the abnormal result message via e-mail or via fax or via an SMS message or via a bleeper. Whichever option is selected, the clinician is asked to provide the relevant electronic address, to which the message is to be sent. Of course, messages could be sent to more than one specified address.

Each authorised clinician has login name and a password that are both needed to give access to the system. When this is entered, the system application searches the memory to identify all requested tests that are associated with that clinician. The clinician is then presented with a list of all of the results for his patients, as shown in Figure 3.

It should be noted that each doctor only has access to the results of his own patients, other records are not accessible. The system software is, however, adapted to allow group access to patient records to enable members of the same practice or department to access records of patient of their colleagues. To do this a group log in name and password are allocated and provided to each of the group members. When a single member of the group logs on with the group name and password, the results for all of the patients in the group are then presented. In addition to the "All patients" option, the system ia adapted to allow clinicians to limit the search in various other ways. For example, the search could be limited to tests of particular types or for patients of a specified age group. In this case, the search would be conducted on both the clinician's name (e.g sourcejtiame) and additionally on a description of the test (test_desc) or the patient's age ("age"). Many other search options are available, for example, the memory could be searched on sex or a patient's name or the date on which the test was requested or the type of sample or the patient's nhs number. In addition, the clinician could opt to search for test results within a predetermined range, by for example defining a search for all patients, selecting the type of test and setting the range of results of interest. For example, the clinician may opt for details of all tests for blood glucose levels that have a result in the range of greater than, say, 12. This functionality is useful, as the clinician can group together patients who have had the same test and with similar results, thereby to try to determine patterns. Another advantage of this is that it can provide a useful mechanism to help doctors remember to ask patients to come in for follow up appointments.

Once the clinician selects the search criteria, the system application searches the results to identify data having the specified criteria. The information found is then is presented to the clinician in the form of a list, that is similar to that of Figure 3.

Each entry of the list of Figure 3 includes the name of the clinician, the name of the patient, the date on which the request for the test was made, the date of birth of the patient and the lab number assigned to the test. Also provided is an indication as to whether or not the results found have already been read by the clinician - those read are marked with an icon in the review ed column. Also provided is an ATT column, in which is shown an icon for those results to which additional information is attached.

The results of Figure 3 are presented in a specific order, with results that indicate an abnormality that suggests immediate action has to be taken being presented first; results that suggest an abnormality that is out of the ordinary, but does not require immediate attention being presented second and those that suggest there is no immediate cause for concern being presented last. The results are ordered in this way by searching on the "abnormality_flags" and the "abnormality_alert" flags that are provided in the Results Table.

By selecting an entry of the list, for example by double clicking, details of the test conducted and the results are presented for the selected patient are presented on screen to the clinician. An example of the results screen is shown in Figure 4.

In addition to providing access to test result, the screen of Figure 3 includes a documents icon, which when selected allows the clinician to view additional data on the patient that is attached to the result data. For example, the additional data could be medical notes that may have been entered or other attachments, for example pictures of the sample taken or of an X-ray of the patient. Clicking on the document icon causes the system to display a list of attachments that are associated with the patient test, as shown in Figure 5. Clicking on one of the entries in the list, for example "A bit of a picture" causes the attachment to be opened. An example of this attachment is shown in Figure 6. Being able to access additional documents relating to the patient is advantageous.

In addition to downloading and viewing attachments, the system application is adapted to allow clinicians to add further notes to the attachments. In addition, the software also allows clinicians to create further attachments. Again this enhances the overall functionality of the system and makes it a useful information resource for medical professionals.

It should be noted that it is intended at this stage that only authorised clinicians will have access to the system, but as will be appreciated, the system could be extended to allow patients to have access to their own test results.

The system and method in which the invention is embodied provide clinicians with a centralised access mechanism to all of their test results. The system is interactive and is able to pro-actively send information out to alert the clinicians as soon as possible to any potentially harmful conditions. This is advantageous to both the clinician and the patient.

A skilled person will appreciate that variations of the disclosed arrangements are possible without departing from the invention. Accordingly, the above description of several embodiments is made by way of example and not for the puφoses of limitation. It will be clear to the skilled person that minor modifications can be made without significant changes to the operation described above.

Claims

1. A system for providing pathology results to a user, preferably, a clinician, the system comprising means for storing a pathology test result; means for inteφreting the test result; and means for automatically sending a message to a predetermined electronic address, when the test result is inteφreted as meeting pre-determined criteria.

2. A system as defined in claim 1, wherein the pre-determined criteria define an abnormal range of results.

3. A system as claimed in claim 1 or claim 2, wherein the test result includes an indicator and the means for inteφreting are operable to inteφret the indicator.

4. A system as claimed in claim 3, wherin the indicator is indicative of whether the result is outside a normal range.

5. A system as claimed in claim 3 or claim 4, wherein the indicator is a flag.

6. A system as claimed in any one of the preceding claims, wherein the predetermined electronic address is an e-mail address.

7. A system as claimed in claim 6, wherein the message includes an electronic link to the test results.

8. A system as claimed in any one of the preceding claims, wherein the predetermined electronic address is a fax number.

9. A system as claimed in any one of the preceding claims, wherein the pre- determined electronic address is a telephone number.

10. A system as claimed in any one of the preceding claims, wherein the message is indicative of the presence of the test results.

11. A system as claimed in any one of the preceding claims, wherein the message includes the test results.

12. A system as claimed in any one of the preceding claims, wherein means are provided for receiving test result data from a remote data source, for example the WinPath system.

13. A system as claimed in claim 12, wherein means are provided to trigger the means for inteφreting to start inteφreting the test result data, on receipt of the test result data.

14. A system as claimed in any one of the preceding claims, wherein means are provided for allowing the clinician to set the pre-determined criteria.

15. A method of providing pathology results to a user, preferably, a clinician, the method comprising storing a pathology test result; inteφreting the indicator; and automatically sending a message to a predetermined electronic address, when the test result is inteφreted as meeting pre- determined criteria.

16. A method as defined in claim 15, wherein the pre-determined criteria define an abnormal range of results.

17. A method as claimed in claim 15 or claim 16, wherein the test result includes an indicator and the means for interpreting are operable to inteφret the indicator.

18. A method as claimed in claim 17, wherin the indicator is indicative of whether the result is outside a normal range.

19. A method as claimed in claim 17 or claim 18, wherein the indicator is a flag.

20. A method as claimed in any one of claims 15 to 19, wherein the predetermined electronic address is an e-mail address.

21. A method as claimed in claim 20, wherein the message includes an electronic link to the test results.

22. A method as claimed in any one of claims 15 to 19, wherein the predetermined electronic address is a fax number.

23. A method as claimed in any one of claims 15 to 22, wherein the pre- determined electronic address is a telephone number.

24. A method as claimed in any one of claims 15 to 23, wherein the message is indicative of the presence of the test results.

25. A method as claimed in any one of claims 15 to 24, wherein the message includes the test results.

26. A method as claimed in any one of claims 15 to 25, comprising receiving test result data from a remote data source, for example the WinPath system.

27. A system as claimed in claim 26, comprising triggering the step of inteφreting the test result data on receipt of that data.

28. A computer program, preferably on a data carrier or a computer readable medium, for providing pathology results to a user, preferably, a clinician, the computer program comprising instructions for storing a pathology test result; interpreting the test result; and automatically sending a message to a predetermined electronic address, when the test result is inteφreted as meeting pre-determined criteria.

29. A user terminal adapted to receive messages from the system and method defined in any one of the preceding claims.

30. A electronic signal that includes a message derived from the system and method of any one of the preceding claims.

31. A method of providing pathology results comprising transmitting a message from a system as defined in any one of claims 1 to 14.

32. A system subtsantially as described hereinbefore with reference to the accompanying drawings.

33. A method subtsantially as described hereinbefore with reference to the accompanying drawings.

34. A computer program subtsantially as described hereinbefore with reference to the accompanying drawings.

35. A web site subtsantially as described hereinbefore with reference to the accompanying drawings.