Cross discipline disease management system

Abstract

A middleware device or software may be placed in communication with one or more testing instruments and a lab information system. As samples are collected from patients and tested with the testing instruments, test results pass through the middleware and are analyzed in context with other data, such as patient history, testing instrument history, and test results from other tests of the sample, in order to determine whether a particular result is acceptable, whether retesting is needed, whether additional sample collection or testing is needed, and whether currently ordered testing is still necessary. When the middleware determines a need for additional testing or retesting it may automatically create orders for such testing in order to reduce delays in manual review of testing results.

1 . An information system for managing medical testing comprising:
 (a) a computing server on a communication path between at least one laboratory instrument and at least one external patient data information system, the at least one external patient data information system configured to receive patent data from one or more sources other than through the computing server;   (b) an instrument communication interface communicatively coupled with the computing server and configured to provide a data communication between the computing server and the at least one external laboratory instrument;   (c) an information system interface communicatively coupled with the computing server and configured to provide a further data communication between the computing server and the at least one external patient data information system, wherein the at least one external patient data information system is configured to maintain a patient data set comprising a set of test orders and a history data set;   wherein the computing server comprises:   (i) a first receiving section configured to receive an instrument data set from the at least one external laboratory instrument via the instrument communication interface;   (ii) a second receiving section configured to receive the history data set from the at least one external patient data information system via the information system interface;   (iii) a test management section configured to build a test management data set based on the instrument data set received from the at least one external laboratory instrument and based on the history data set received from the at least one external patient data information system;   (iv) a rules engine configured to apply a set of test management rules to the test management data set to generate a testing task, wherein the set of test management rules comprises at least one rule operable to generate the testing task as detecting sepsis or monitoring sepsis; and   (v) an updating section configured to update a set of test orders of a patient data set maintained by the at least one external patient data information system based upon the testing task;
 wherein the instrument data set comprises test results associated with a patient; and 
 wherein the history data set comprises at least one of biographical and historical information associated with the patient. 
   
     
     
         2 . The system of  claim 1 , wherein the at least one rule operable to generate the testing task of detecting sepsis or monitoring sepsis is configured to generate the testing task of detecting sepsis or monitoring sepsis based upon one or more of:
 (a) a patient's temperature;   (b) a patient's pulse;   (c) a patient's blood oxygenation;   (d) a previous test result of the patient comprising one or more of PCT, IL-6, CRP or ESR.   
     
     
         3 . The system of  claim 1 , wherein the at least one rule operable to generate the testing task of detecting sepsis or monitoring sepsis is configured to generate the testing task of detecting sepsis or monitoring sepsis as performing a test on the sample, wherein the test to be performed on the sample is a test for one or more inflammation marker, said inflammation marker being selected from the group consisting of ESR, CRP, IL-6 and PCT. 
     
     
         4 . The system of  claim 1 , wherein the rules engine of the computing server is further configured to apply the set of test management rules to the test management data set in response to a change in the test management data set, wherein the change in the test management data set is associated with one or more of:
 (a) a new patient diagnosis in the history data set;   (b) a change in the set of test orders;   (c) a change in the set of test management rules.   
     
     
         5 . The system of  claim 1 , wherein the rules engine is configured to generate the testing task based upon a new piece of data in the test management data set; and
 wherein the testing task is selected from the group consisting of a new test order and a new sample and test order.   
     
     
         6 . The system of  claim 1  further comprising an analytics component, wherein the analytics component is configured to receive a set of performance data from the computing server, wherein the set of performance data comprises information describing an input and an output of the rules engine, and
 wherein the analytics component is further configured to provide a modification to the rules engine based upon the set of performance data. 
 
     
     
         7 . The system of  claim 1 , wherein the computing server is selected from the group consisting of:
 (a) a cloud based computing environment;   (b) a dedicated server; and   (c) a software process on a multi-function server.   
     
     
         8 . A method for operating an information system for managing medical testing, the method comprising the steps of:
 (a) placing, on a communication path between an external patient data information system and at least one external laboratory instrument, a computing server, wherein, prior to placement of the computing server on the communication path, the external patient data information system was configured to communicate directly with the at least one external laboratory instrument;   (b) receiving, with the computing server, an instrument data set from the at least one external laboratory instrument via an instrument communication interface;   (c) receiving, with the computing server, a history data set from the external patient data information system via an information system interface;   (d) building, with the computing server, a test management data set based on the received instrument data set and based on the received history data set;   (e) generating, with the computing server, a testing task based on applying a set of test management rules to the test management data set, wherein the testing task is detecting sepsis or monitoring sepsis; and   (f) updating, with the computing server, a set of test orders of a patient data set maintained by the external patient data information system based on the generated testing task;
 wherein the instrument data set comprises test results associated with a patient; and 
 wherein the history data set comprises at least one of biographical and historical information associated with the patient. 
   
     
     
         9 . The method of  claim 8 , wherein the testing task is detecting sepsis or monitoring sepsis by performing a test on a sample, wherein the test to be performed on the sample is a test for one or more inflammation marker, said inflammation marker being selected from the group consisted of ESR, CRP, IL-6 and PCT. 
     
     
         10 . The method of  claim 8 , wherein the testing task of detecting sepsis or monitoring sepsis is generated based upon one or more of:
 (a) a patient's temperature;   (b) a patient's pulse;   (c) a patient's blood oxygenation;   (d) a previous test result of the patient comprising one or more of PCT, IL-6, CRP or ESR.   
     
     
         11 . The method of  claim 8 , wherein the set of test management rules are applied in response to a change in the test management data set, wherein the change in the test management data set is associated with one or more of:
 (a) a new patient diagnosis in the history data set;   (b) a change in the set of test orders;   (c) a change in the set of test management rules.   
     
     
         12 . The method of  claim 8 , wherein generating the testing task is based on a new piece of data in the test management data set; and
 wherein the testing task is selected from the group consisting of a new test order and a new sample and test order.   
     
     
         13 . The method of  claim 8  further comprising:
 (a) receiving a set of performance data from the computing server, wherein the set of performance data comprises information describing an input and an output of a rules engine used to generate the testing task, and 
 (b) based on the set of performance data, generating a modification to the rules engine. 
 
     
     
         14 . The method of  claim 8 , wherein the computing server is selected from the group consisting of:
 (a) a cloud based computing environment;   (b) a dedicated server; and   (c) a software process on a multi-function server.   
     
     
         15 . A non-transitory computer readable medium having stored thereon instructions operable to, when executed, cause a computing server to perform a method comprising:
 (a) receiving an instrument data set from at least one external laboratory instrument via an instrument communication interface;   (b) receiving a history data set from an external patient data information system via an information system interface;   (c) building a test management data set based on the received instrument data set and based on the received history data set;   (d) generating a testing task based on applying a set of test management rules to the test management data set, wherein the testing task is detecting sepsis or monitoring sepsis; and   (e) updating a set of test orders of a patient data set maintained by the external patient data information system based on the generated testing task;
 wherein the instrument data set comprises test results associated with a patient; and 
 wherein the history data set comprises at least one of biographical and historical information associated with the patient. 
   
     
     
         16 . The computer readable medium of  claim 15 , wherein the testing task is detecting sepsis or monitoring sepsis by performing a test on a sample, wherein the test to be performed on the sample is a test for one or more inflammation marker, said inflammation marker being selected from the group consisted of ESR, CRP, IL-6 and PCT. 
     
     
         17 . The computer readable medium of  claim 15 , wherein the medium stores instructions for generating the testing task of detecting sepsis or monitoring sepsis based on test management rules which generate the testing task based upon one or more of:
 (a) a patient's temperature;   (b) a patient's pulse;   (c) a patient's blood oxygenation;   (d) a previous test result of the patient comprising one or more of PCT, IL-6, CRP or ESR.   
     
     
         18 . The computer readable medium of  claim 15 , wherein the instructions comprise instructions to apply the set of test management rules in response to a change in the test management data set, wherein the change in the test management data set is associated with one or more of:
 (a) a new patient diagnosis in the history data set;   (b) a change in the set of test orders;   (c) a change in the set of test management rules.   
     
     
         19 . The computer readable medium of  claim 15 , wherein the instructions comprise instructions to generate the testing task based on a new piece of data in the test management data set; and
 wherein the testing task is selected from the group consisting of a new test order and a new sample and test order.   
     
     
         20 . The computer readable medium of  claim 15 , wherein the method further comprises:
 (a) receiving a set of performance data, wherein the set of performance data comprises information describing an input and an output of a rules engine used to generate the testing task, and   (b) based on the set of performance data, generating a modification to the rules engine.