Healthcare information system with clinical information exchange

Abstract

A system for distributed computing in a health care environment includes at least one clinical exchange server programmed to maintain a separate patient record for each patient. Each patient record includes an event registry indicating the application that recorded the event and event summary data. When a query is received including information usable to identify an event in the event registry, the query and the event registry are used to identify the event and an application that recorded the event. A second query is generated that specifies the identified event, and the second query is transmitted to the identified application.

1 . In a system for distributed computing in a health care environment in which multiple different applications are in use connected on a common computer network, the improvement comprising:
 at least one clinical exchange server on the network, the clinical exchange server including memory, the clinical exchange server programmed to perform the steps of:   (i) maintaining a separate patient record for each of a plurality of patients wherein each patient record includes an event registry including separate event data subsets for each event recorded by any of the different applications where each event data subset indicates the application that recorded the event and event summary data wherein the event summary data is less than all of the data recorded by the application that recorded the event;   (ii) receiving a first query from the first application for patient information associated with a first patient where the first query includes information usable to identify an event in the event registry;   (iii) using the information in the first query and the event data subsets in the event registry to identify an event in the event registry associated with the first query, the event identified being an identified event;   (iv) identifying an application that recorded the identified event from the event data subset associated with the identified event, the application identified being an identified application;   (v) generating a second query that specifies the identified event; and   (vi) transmitting the second query to the identified application.   
     
     
         2 . The system as claimed in  claim 1  wherein the clinical exchange server also maintains an abstract about the events sent to it to facilitate exchange of information between the applications. 
     
     
         3 . The system as claimed in  claim 1  wherein the clinical exchange server also stores health insurance information about each patient so that such health insurance information can easily be accessed by any of the applications. 
     
     
         4 . The system of  claim 1  wherein each patient record further includes an identification cross reference table that includes a list of applications on the network and, for each application, an application unique patient identifier used by the application wherein first and second different applications use first and second different patient identifiers for a first patient, respectively, the step of receiving a first query including receiving a query that identifies the first patient via the first patient identifier, the clinical exchange server further programmed to perform the step of using the first patient identifier to identify a first patient record associated with the first patient, the step of using the information in the first query and the event data subsets in the event registry to identify an event in the event registry associated with the first query including the step of identifying an event in the event registry of the first patient record, the clinical exchange server further programmed to perform the step of using the identification cross reference table to identify the second patient identifier, and the step of generating a second query including generating a second query that specifies the identified event and the second patient identifier. 
     
     
         5 . The system as claimed in  claim 4  wherein the reference table includes a master patient index identification code assigned to the patient as well as an application specific identification number assigned to the patient by each application. 
     
     
         6 . A computer network for operation by a healthcare delivery enterprise, the network including a plurality of servers operating a plurality of application programs, the network comprising:
 a clinical exchange server including a storage device, the clinical exchange server programmed to perform the steps of:   (i) storing in the storage device a reference table including a list of application programs, and any identifying code used for a first patient by any of the application programs wherein the identifying codes are application distinct patient identifying codes for the first patient, wherein the application distinct patient identifying codes for the first patient include a first patient identifying code used by a first application and a second patient identifying code used by a second application where the second patient identifying code is different than the first patient identifying code, so that the identifying code used by an application for the first patient can be found by accessing the reference table;   (ii) receiving a first query from the first application identifying the first patient using the first patient identifying code;   (iii) using the first patient identifying code from the first query to identify the first patient information in the reference table wherein the first patient information includes the second patient identifying code;   (iv) forming a second query using the second patient identifying code; and   (v) transmitting the second query to the second application.   
     
     
         7 . The computer network of  claim 6  wherein the clinical exchange server also maintains a table of events associated with patients, the table of events including identifying information about the events and the identification of the application holding information about the event. 
     
     
         8 . The computer network of  claim 7  wherein the event table also includes an abstract about each of the events. 
     
     
         9 . The computer network of  claim 6  wherein the clinical exchange server also maintain health insurance information about the patient that can be access by another application. 
     
     
         10 . In a system for distributed computing in a health care environment in which multiple different applications are in use connected on a common computer network, the improvement comprising:
 a clinical exchange server on the network, the clinical exchange server including memory, the clinical exchange server programmed to perform the steps of:   (i) maintaining a separate patient record for each of a plurality of patients wherein each patient record includes:
 (a) an identification cross reference table that includes a list of applications on the network and, for each application, an application unique patient identifier used by the application wherein first and second different applications use first and second different patient identifiers for a first patient, respectively; 
 (b) an event registry including separate event data subsets for each event recorded by any of the different applications where each event data subset indicates the application that recorded the event and event summary data wherein the event summary data is less than all of the data recorded by the application that recorded the event; 
   (ii) receiving a first query from the first application for patient information associated with a first patient where the first query identifies the first patient via a patient identifier used by the first application and where the first query also includes additional information usable to identify an event in the event registry;   (iii) using the first patient identifier to identify a first patient record associated with the first patient;   (iv) using the additional information in the first query and the event data subsets in the event registry of the first patient record to identify an event in the event registry associated with the first query, the event identified being an identified event;   (v) identifying an application that recorded the identified event from the event data subset associated with the identified event, the application identified being an identified application;   (vi) using the identification cross reference table to identify the patient identifier for the first patient that is used by the identified application;   (vii) generating a second query that specifies the identified event and the identified patient identifier; and   (viii) transmitting the second query to the identified application.   
     
     
         11 . A method for use with a system for distributed computing in a health care environment in which multiple different applications are in use connected on a common computer network, the method comprising the steps of:
 providing a computer programmed to perform the steps of:   (i) maintaining a separate patient record for each of a plurality of patients wherein each patient record includes an event registry including separate event data subsets for each event recorded by any of the different applications where each event data subset indicates the application that recorded the event and event summary data wherein the event summary data is less than all of the data recorded by the application that recorded the event;   (ii) receiving a first query from the first application for patient information associated with a first patient where the first query includes information usable to identify an event in the event registry;   (iii) using the information in the first query and the event data subsets in the event registry to identify an event in the event registry associated with the first query, the event identified being an identified event;   (iv) identifying an application that recorded the identified event from the event data subset associated with the identified event, the application identified being an identified application;   (v) generating a second query that specifies the identified event; and   (vi) transmitting the second query to the identified application.   
     
     
         12 . The method of  claim 11  wherein the computer also maintains an abstract about the events sent to it to facilitate exchange of information between the applications. 
     
     
         13 . The method of  claim 11  wherein the computer also stores health insurance information about each patient so that such health insurance information can easily be accessed by any of the applications. 
     
     
         14 . The method of  claim 11  wherein each patient record further includes an identification cross reference table that includes a list of applications on the network and, for each application, an application unique patient identifier used by the application wherein first and second different applications use first and second different patient identifiers for a first patient, respectively, the step of receiving a first query including receiving a query that identifies the first patient via the first patient identifier, the clinical exchange server further programmed to perform the step of using the first patient identifier to identify a first patient record associated with the first patient, the step of using the information in the first query and the event data subsets in the event registry to identify an event in the event registry associated with the first query including the step of identifying an event in the event registry of the first patient record, the clinical exchange server further programmed to perform the step of using the identification cross reference table to identify the second patient identifier, and the step of generating a second query including generating a second query that specifies the identified event and the second patient identifier. 
     
     
         15 . A method for use with a healthcare delivery enterprise, the method comprising the steps of:
 providing a computer programmed to perform the steps of:   (i) maintaining a reference table including a list of application programs, and any identifying code used for a first patient by any of the application programs wherein the identifying codes are application distinct patient identifying codes for the first patient, wherein the application distinct patient identifying codes for the first patient include a first patient identifying code used by a first application and a second patient identifying code used by a second application where the second patient identifying code is different than the first patient identifying code, so that the identifying code used by an application for the first patient can be found by accessing the reference table;   (ii) receiving a first query from the first application identifying the first patient using the first patient identifying code;   (iii) using the first patient identifying code from the first query to identify the first patient information in the reference table wherein the first patient information includes the second patient identifying code;   (iv) forming a second query using the second patient identifying code; and   (v) transmitting the second query to the second application.   
     
     
         16 . The method of  claim 15  wherein the server also maintains a table of events associated with patients, the table of events including identifying information about the events and the identification of the application holding information about the event. 
     
     
         17 . The method of  claim 16  wherein the event table also includes an abstract about each of the events. 
     
     
         18 . The method of  claim 15  wherein the clinical exchange server also maintain health insurance information about the patient that can be access by another application. 
     
     
         19 . A system for distributed computing in a health care environment, the system comprising:
 a computer network;   a first application run on the network that uses a first patient identifier to reference a first patient;   a second application run on the network that uses a second patient identifier to reference the first patient where the second patient identifier number is different than the first patient identifier;   a clinical exchange server on the network, the clinical exchange server including memory, the clinical exchange server programmed to perform the steps of:   (i) maintaining a separate patient record for each of a plurality of patients wherein each patient record includes:
 (a) an identification cross reference table that includes a list of applications on the network and, for each application, an application unique patient identifier used by the application, the table including the first and second patient identifiers; 
 (b) an event registry including separate event data subsets for each event recorded by any of the different applications where each event data subset indicates the application that recorded the event and event summary data wherein the event summary data is less than all of the data recorded by the application that recorded the event; 
   (ii) receiving a first query from the first application for patient information associated with the first patient where the first query identifies the first patient via the first patient identifier and where the first query also includes additional information usable to identify an event in the event registry;   (iii) using the first patient identifier to identify a first patient record associated with the first patient;   (iv) using the additional information in the first query and the event data subsets in the event registry of the first patient record to identify an event in the event registry associated with the first query, the event identified being an identified event;   (v) identifying an application that recorded the identified event from the event data subset associated with the identified event, the application identified being an identified application;   (vi) using the identification cross reference table to identify the patient identifier for the first patient that is used by the identified application;   (vii) generating a second query that specifies the identified event and the identified patient identifier; and   (viii) transmitting the second query to the identified application.