Health care data manipulation and analysis system

Abstract

Systems useful for analyzing data related to clinical pathways and performing actions based upon the analyses. A self-analyzing system for suggesting default clinical pathways for various procedures. A self-analyzing system for suggesting deviation from a current clinical pathway and entry into an alternative clinical pathway based upon historical information about the results of actions. Statistical analysis systems based on clinical pathways. A rating system for care providers or proposed pathways based on historical information. Systems for gathering clinical pathway information. Systems for tracking clinical pathway outcomes based on data collected post-treatment. A system for prequalification for appropriate discharge and post-discharge handling of and communication with a new class of patient, those requiring stable acute care. A questionnaire computer language and subsystem are used in various stages of the systems of the invention. Corresponding methods are also disclosed.

What is claimed is:  
     
         1 . A system for analyzing health care data, comprising: 
 (a) a database comprising a plurality of records, each record including: 
 (1) event data corresponding to a health-related event for a person,  
 (2) type data corresponding to the health-related event type,  
 (3) chronological data corresponding to a relative point in time that the health-related event occurred;  
   (b) processing means for performing the steps of: 
 (1) analyzing the database in order to identify correlations between the plurality of event data within the plurality of records, based upon the type data and chronological data in each record;  
 (2) modifying a selected series of records within the database in order to maximize the likelihood of occurrence of a desired health-related event having chronological data corresponding to a point in time later than the chronological data associated with the selected series of records.  
   
     
     
         2 . The system of  claim 1 , wherein the event data corresponds to a decision point among the plurality of records.  
     
     
         3 . The system of  claim 1 , wherein the selected series of records corresponds to a clinical pathway.  
     
     
         4 . The system of  claim 3 , wherein the clinical pathway corresponds to a medical procedure performed on the person.  
     
     
         5 . The system of  claim 1 , wherein the analyzing step is performed using a genetic algorithm.  
     
     
         6 . The system of  claim 1 , wherein the analyzing step is performed using actuarial analysis techniques.  
     
     
         7 . A system for analyzing health care data, comprising: 
 (a) an output device for providing output to a user;    (b) a database comprising a plurality of records, each record including: 
 (1) event data corresponding to a health-related event for a person,  
 (2) type data corresponding to the health-related event type,  
 (3) chronological data corresponding to a relative point in time that the health-related event occurred;  
   (c) processing means for performing the steps of: 
 (1) analyzing the database in order to identify correlations between the plurality of event data within the plurality of records, based upon the type data and chronological data in each record;  
 (2) identifying a selected series of records within the database that may be modified in order to maximize the likelihood of occurrence of a desired health-related event having chronological data corresponding to a point in time later than the chronological data associated with the selected series of records; and  
 (3) outputting to the user an identifier associated with the selected series of records.  
   
     
     
         8 . The system of  claim 7 , wherein the processing means further performs the steps of: 
 (4) prompting the user whether the selected series of records should be modified; and    (5) modifying the selected series of records.    
     
     
         9 . A process for analyzing health care data, comprising the steps of: 
 (a) storing a plurality of records, each record including: 
 (1) event data corresponding to a health-related event for a person,  
 (2) type data corresponding to the health-related event type,  
 (3) chronological data corresponding to a relative point in time that the health-related event occurred;  
   (b) analyzing the plurality of records to identify correlations between the plurality of event data within the plurality of records, based upon the type data and chronological data in each record;    (c) modifying a selected series of records in order to maximize the likelihood of occurrence of a desired health-related event having chronological data corresponding to a point in time later than the chronological data associated with the selected series of records.    
     
     
         10 . The process of  claim 9 , wherein the analyzing step is performed using actuarial analysis techniques.  
     
     
         11 . A system for manipulation and analysis of data related to clinical pathways, comprising: 
 (a) a clinical pathway database for storing: 
 (i) an initial procedure decision data element, corresponding to a decision point within the clinical pathway; and  
 (ii) at least one subsequent decision data element, corresponding to an available subsequent decision point within the clinical pathway;  
   (b) a historical clinical pathway database for storing previously selected subsequent decision data elements, selected corresponding to the initial procedure decision data element; and    (c) processing means, including a storage device, for performing the steps of: 
 (i) selecting one of the at least one subsequent decision data elements;  
 (ii) comparing the selected subsequent decision data element with the previously selected subsequent decision data elements stored in the historical clinical pathway database; and  
 (iii) based upon predetermined correlation criteria, modifying the at least one subsequent decision data element within the clinical pathway database.  
   
     
     
         12 . The system of  claim 11 , further comprising means for storing the selected subsequent decision data element in the storage device.  
     
     
         13 . The system of  claim 11 , wherein the clinical pathway database subsequent decision data elements further comprise default subsequent decision data elements and wherein the processing means modifies the default subsequent decision data elements.  
     
     
         14 . The system of  claim 11 , wherein the clinical pathway database further comprises a medical procedure data element corresponding to the initial and subsequent decision data elements for a particular medical procedure.  
     
     
         15 . The system of  claim 14 , wherein the medical procedure corresponds to the stable acute care of a patient.  
     
     
         16 . The system of  claim 11 , wherein the processing means further comprises means for, prior to modifying the at least one subsequent decision data element within the clinical pathway database, querying the user for authorization to make the modification.  
     
     
         17 . The system of  claim 11 , wherein at least one of the at least one subsequent decision data elements corresponds to an appropriate discharge of a patient and wherein the processing means further comprises means for comparing the selected subsequent decision data element with predetermined appropriate discharge criteria and, based upon the comparison, generating a signal corresponding to the appropriateness of discharging the patient.  
     
     
         18 . The system of  claim 14 , wherein the historical clinical pathway database further comprises a medical procedure data element corresponding to the initial and subsequent decision data elements for a particular medical procedure and wherein the processing means further comprises: 
 (iv) means for storing the medical procedure data element, and the modified at least one subsequent decision data element within the historical clinical pathway database;    (v) means for correlating the modified at least one subsequent decision data elements in the historical clinical pathway database with the medical procedure data element;    (vi) means for querying the historical clinical pathway database and generating a signal corresponding to the at least subsequent decision data element corresponding to a particular medical procedure; and    (vii) means for outputting the signal to a signal processing means.    
     
     
         19 . The system of  claim 11 , wherein the clinical pathway database further comprises a patient identification data element corresponding to the initial and sub sequent decision data elements for a particular patient.  
     
     
         20 . The system of  claim 19 , wherein the clinical pathway database further comprises at least one patient visit data element corresponding to the patient identification data element.  
     
     
         21 . The system of  claim 20 , wherein the clinical pathway database further comprises a time stamp data element corresponding to each of the a least one patient visit data elements, and wherein the processing means further comprises: 
 (ix) means for comparing the time stamp data element to predetermined criteria; and    (x) means for generating a signal corresponding to the result of the comparison and outputting the signal to a signal processing means.    
     
     
         22 . The system of  claim 11 , further comprising a database for storing follow-up information and wherein the comparing means of the processing means is further responsive to the stored follow-up information in the follow-up information database.  
     
     
         23 . A client/server system for manipulation and analysis of data related to clinical pathways, comprising: 
 (a) a communication network;    (b) a client workstation in communication with the communication network, wherein the client workstation comprises: 
 (i) means for generating at least one signal corresponding to a clinical pathway decision and transmitting the at least one decision signal over the communication network; and  
 (ii) means for receiving at least one signal corresponding to a clinical pathway modification from the communication network; and  
 (iii) means for outputting the at least one modification signal to a signal processing means;  
   (c) a server on the communication network, wherein the server comprises: 
 (i) a clinical pathway database for storing: 
 (1) an initial procedure decision data element, corresponding to a decision point within the clinical pathway; and  
 (2) at least one subsequent decision data element, corresponding to at least one available subsequent decision point within the clinical pathway; and  
 
 (ii) a historical clinical pathway database for storing previously selected subsequent decision data elements, selected corresponding to the initial procedure decision data element; and  
   (d) processing means, in communication with the communication network, the client workstation, and the server, for performing the steps of: 
 (1) receiving the at least one decision signal from the communication network;  
 (2) based on the received decision signal, selecting one of the at least one subsequent decision data elements;  
 (3) comparing the selected subsequent decision data element with the previously selected subsequent decision data elements stored in the historical clinical pathway database;  
 (4) based upon predetermined correlation criteria, modifying the at least one subsequent decision data elements within the clinical pathway database;  
 (5) generating at least one signal corresponding to a clinical pathway modification of the subsequent decision data elements in the clinical pathway database; and  
 (6) transmitting the at least one clinical pathway modification signal over the communication network to the receiving means of the client workstation.  
   
     
     
         24 . A system for manipulation and analysis of data related to clinical pathways, comprising: 
 (a) a clinical pathway database for storing: 
 (i) an initial procedure decision data element, corresponding to a decision point within the clinical pathway; and  
 (ii) at least one subsequent decision data element corresponding to at least one available subsequent decision point within the clinical pathway;  
   (b) a historical clinical pathway database for storing previously selected subsequent decision data elements, selected corresponding to the initial procedure decision data element; and    (c) processing means, including a storage device, for performing the steps of: 
 (i) selecting one of the at least one subsequent decision data elements;  
 (ii) comparing the selected subsequent decision data element with the previously selected subsequent decision data elements stored in the historical clinical pathway database; and  
 (iii) based upon predetermined correlation criteria, modifying the at least one subsequent decision data elements within the clinical pathway database.  
   
     
     
         25 . A system for assessing utilization of medical resources based upon manipulation and analysis of statistical data related to clinical pathways, comprising: 
 (a) a clinical pathway database for storing: 
 (i) an initial procedure decision data element, corresponding to a decision point within the clinical pathway; and  
 (ii) at least one subsequent decision data element corresponding to at least one available subsequent decision points within the clinical pathway;  
   (b) a historical clinical pathway database for storing: 
 (i) previously selected subsequent decision data elements, selected corresponding to the initial procedure decision data element; and  
 (ii) for each of the previously selected subsequent decision data elements, a utilization value corresponding to the decision data element;  
   (c) processing means, including a storage device, for performing the steps of: 
 (i) selecting one of the at least one subsequent decision data elements;  
 (ii) comparing the selected subsequent decision data element with the previously selected subsequent decision data elements stored in the historical clinical pathway database; and  
 (iii) based upon predetermined correlation criteria, modifying the at least one subsequent decision data elements within the clinical pathway database; and  
   (d) statistical processing means, in communication with the clinical pathway database and the historical clinical pathway database, for performing the steps of: 
 (i) accessing the historical clinical pathway database;  
 (ii) computing pathway utilization value based on the accessed utilization values in the database;  
 (iii) generating at least one signal corresponding to the pathway utilization value; and  
 (iv) outputting the at least one utilization value signal to a signal processing means.  
   
     
     
         26 . A system for rating medical care based upon manipulation and analysis of data related to clinical pathways, comprising: 
 (a) a clinical pathway database for storing: 
 (i) an initial procedure decision data element, corresponding to a decision point within the clinical pathway; and  
 (ii) at least one subsequent decision data elements, corresponding to available subsequent decision points within the clinical pathway;  
   (b) a historical clinical pathway database for storing: 
 (i) previously selected subsequent decision data elements, selected corresponding to the initial procedure decision data element; and  
 (ii) for each of the previously selected subsequent decision data elements, a rating value;  
   (c) processing means, including a storage device, for performing the steps of: 
 (i) selecting one of the at least one subsequent decision data elements;  
 (ii) comparing the selected subsequent decision data element with the previously selected subsequent decision data elements stored in the historical clinical pathway database; and  
 (iii) based upon predetermined correlation criteria, modifying the at least one subsequent decision data elements within the clinical pathway database; and  
   (d) statistical processing means, in communication with the clinical pathway database and the historical clinical pathway database, for performing the steps of: 
 (i) accessing the historical clinical pathway database;  
 (ii) computing a pathway rating value based on the accessed rating values in the historical database;  
 (iii) generating at least one signal corresponding to the pathway rating value; and  
 (iv) outputting the at least one rating signal to a signal processing means.  
   
     
     
         27 . The system of  claim 26 , wherein the historical database further stores the identity of the medical care provider determining the selection subsequent decision element and wherein the computing means is further responsive to the identity.  
     
     
         28 . The system of  claim 26 , wherein the historical database further stores a rating for each of the historical clinical pathways in the database, and wherein the computing means is further responsive to the historical pathway ratings.  
     
     
         29 . A method for manipulation and analysis of data related to clinical pathways, the method comprising the steps of: 
 (a) providing a clinical pathway database for storing: 
 (i) an initial procedure decision data element, corresponding to a decision point within the clinical pathway; and  
 (ii) at least one subsequent decision data element, corresponding to an available subsequent decision point within the clinical pathway;  
   (b) providing a historical clinical pathway database for storing previously selected subsequent decision data elements, selected corresponding to the initial procedure decision data element;    (c) selecting one of the at least one subsequent decision data elements;    (d) comparing the selected subsequent decision data element with the previously selected subsequent decision data elements stored in the historical clinical pathway database; and    (e) based upon predetermined correlation criteria, modifying the at least one subsequent decision data element within the clinical pathway database.    
     
     
         30 . The method of  claim 29 , further comprising storing the selected subsequent decision data element in a storage device.  
     
     
         31 . The method of  claim 29 , wherein the clinical pathway database subsequent decision data elements further comprise default subsequent decision data elements and wherein the method further comprises modifying the default subsequent decision data elements.  
     
     
         32 . The method of  claim 29 , wherein the clinical pathway database further comprises a medical procedure data element corresponding to the initial and subsequent decision data elements for a particular medical procedure.  
     
     
         33 . The method of  claim 32 , wherein the medical procedure corresponds to the stable acute care of a patient.  
     
     
         34 . The method of  claim 29 , further comprising, prior to modifying the at least one subsequent decision data element within the clinical pathway database, querying the user for authorization to make the modification.  
     
     
         35 . The method of  claim 29 , wherein at least one of the at least one subsequent decision data elements corresponds to an appropriate discharge of a patient and wherein the method further comprises comparing the selected subsequent decision data element with predetermined appropriate discharge criteria and, based upon the comparison, generating a signal corresponding to the appropriateness of discharging the patient.  
     
     
         36 . The method of  claim 32 , wherein the historical clinical pathway database further comprises a medical procedure data element corresponding to the initial and subsequent decision data elements for a particular medical procedure and wherein the method further comprises: 
 (f) storing the medical procedure data element, and the modified at least one subsequent decision data element within the historical clinical pathway database;    (g) correlating the modified at least one subsequent decision data elements in the historical clinical pathway database with the medical procedure data element;    (h) querying the historical clinical pathway database and generating a signal corresponding to the at least subsequent decision data element corresponding to a particular medical procedure; and    (i) outputting the signal to a signal processing means.    
     
     
         37 . The method of  claim 29 , wherein the clinical pathway database further comprises a patient identification data element corresponding to the initial and subsequent decision data elements for a particular patient.  
     
     
         38 . The method of  claim 37 , wherein the clinical pathway database further comprises at least one patient visit data element corresponding to the patient identification data element.  
     
     
         39 . The method of  claim 38 , wherein the clinical pathway database further comprises a time stamp data element corresponding to each of the a least one patient visit data elements, and wherein the method further comprises: 
 (f) comparing the time stamp data element to predetermined criteria; and    (g) generating a signal corresponding to the result of the comparison and outputting the signal to a signal processing means.    
     
     
         40 . The method of  claim 29 , further comprising a database for storing follow-up information, wherein the comparing step is further responsive to the stored follow-up information in the follow-up information database.  
     
     
         41 . A client/server method for manipulation and analysis of data related to clinical pathways, the method comprising the steps of: 
 (a) providing a communication network;    (b) providing a client workstation in communication with the communication network, wherein the client workstation comprises: 
 (i) means for generating at least one signal corresponding to a clinical pathway decision and transmitting the at least one decision signal over the communication network; and  
 (ii) means for receiving at least one signal corresponding to a clinical pathway modification from the communication network; and  
 (iii) means for outputting the at least one modification signal to a signal processing means;  
   (c) providing a server on the communication network, wherein the server comprises: 
 (i) a clinical pathway database for storing: 
 (1) an initial procedure decision data element, corresponding to a decision point within the clinical pathway; and  
 (2) at least one subsequent decision data element, corresponding to at least one available subsequent decision point within the clinical pathway; and  
 
 (ii) a historical clinical pathway database for storing previously selected subsequent decision data elements, selected corresponding to the initial procedure decision data element; and  
   (d) receiving the at least one decision signal from the communication network;    (e) based on the received decision signal, selecting one of the at least one subsequent decision data elements;    (f) comparing the selected subsequent decision data element with the previously selected subsequent decision data elements stored in the historical clinical pathway database;    (g) based upon predetermined correlation criteria, modifying the at least one subsequent decision data elements within the clinical pathway database;    (h) generating at least one signal corresponding to a clinical pathway modification of the subsequent decision data elements in the clinical pathway database; and    (i) transmitting the at least one clinical pathway modification signal over the communication network to the receiving means of the client workstation.    
     
     
         42 . A method for manipulation and analysis of data related to clinical pathways, the method comprising the steps of: 
 (a) providing a clinical pathway database for storing: 
 (i) an initial procedure decision data element, corresponding to a decision point within the clinical pathway; and  
 (ii) at least one subsequent decision data element corresponding to at least one available subsequent decision point within the clinical pathway;  
   (b) providing a historical clinical pathway database for storing previously selected subsequent decision data elements, selected corresponding to the initial procedure decision data element; and    (c) selecting one of the at least one subsequent decision data elements;    (d) comparing the selected subsequent decision data element with the previously selected subsequent decision data elements stored in the historical clinical pathway database; and    (e) based upon predetermined correlation criteria, modifying the at least one subsequent decision data elements within the clinical pathway database.    
     
     
         43 . A method for assessing utilization of medical resources based upon manipulation and analysis of statistical data related to clinical pathways, the method comprising the steps of: 
 (a) providing a clinical pathway database for storing: 
 (i) an initial procedure decision data element, corresponding to a decision point within the clinical pathway; and  
 (ii) at least one subsequent decision data element corresponding to at least one available subsequent decision points within the clinical pathway;  
   (b) providing a historical clinical pathway database for storing: 
 (i) previously selected subsequent decision data elements, selected corresponding to the initial procedure decision data element; and  
 (ii) for each of the previously selected subsequent decision data elements, a utilization value corresponding to the decision data element;  
   (c) selecting one of the at least one subsequent decision data elements;    (d) comparing the selected subsequent decision data element with the previously selected subsequent decision data elements stored in the historical clinical pathway database;    (e) based upon predetermined correlation criteria, modifying the at least one subsequent decision data elements within the clinical pathway database;    (f) accessing the historical clinical pathway database;    (g) computing pathway utilization value based on the accessed utilization values in the database;    (h) generating at least one signal corresponding to the pathway utilization value; and    (i) outputting the at least one utilization value signal to a signal processing means.    
     
     
         44 . A method for rating medical care based upon manipulation and analysis of data related to clinical pathways, the method comprising the steps of: 
 (a) providing a clinical pathway database for storing: 
 (i) an initial procedure decision data element, corresponding to a decision point within the clinical pathway; and  
 (ii) at least one subsequent decision data elements, corresponding to available subsequent decision points within the clinical pathway;  
   (b) providing a historical clinical pathway database for storing: 
 (i) previously selected subsequent decision data elements, selected corresponding to the initial procedure decision data element; and  
 (ii) for each of the previously selected subsequent decision data elements, a rating value;  
   (c) selecting one of the at least one subsequent decision data elements;    (d) comparing the selected subsequent decision data element with the previously selected subsequent decision data elements stored in the historical clinical pathway database;    (e) based upon predetermined correlation criteria, modifying the at least one subsequent decision data elements within the clinical pathway database;    (f) accessing the historical clinical pathway database;    (g) computing a pathway rating value based on the accessed rating values in the historical database;    (h) generating at least one signal corresponding to the pathway rating value; and    (i) outputting the at least one rating signal to a signal processing means.    
     
     
         45 . The method of  claim 44 , wherein the historical database further stores the identity of the medical care provider determining the selection subsequent decision element and wherein the comparing step is further responsive to the identity.  
     
     
         46 . The method of  claim 44 , wherein the historical database further stores a rating for each of the historical clinical pathways in the database, and wherein the comparing step is further responsive to the historical pathway ratings.