# US 8,751,256 B2 · Intelligent tokens for automated health care information systems

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- Number: US 8,751,256 B2
- Document ID: US8751256B2
- Status: Granted
- Kind: B2
- Application number: 12/658,698
- Filed: 2010-02-11
- Published: 2011-08-11
- Granted: 2014-06-10
- Earliest claimed: 2010-02-11
- Assignees: Allscripts Software, LLC
- Applicants: Richard P. Mansour
- Inventors: Richard P. Mansour
- Web page: https://patentgrep.com/patent/US8751256B2

## CPC

- G16H 10/60: for patient-specific data, e.g. for electronic patient records
- G06F 16/24564: {Applying rules; Deductive queries}
- G16H 50/20: for computer-aided diagnosis, e.g. based on medical expert systems
- G16Z 99/00: Subject matter not provided for in other main groups of this subclass
- G16H 70/20: relating to practices or guidelines
- G16H: HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G06F: ELECTRIC DIGITAL DATA PROCESSING (computer systems based on specific computational models G06N)
- G16Z: INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS, NOT OTHERWISE PROVIDED FOR

## Abstract

Methods and systems for accessing information stored in an electronic patient record are disclosed. A memory stores a set of medical logic instructions which code for retrieval of multiple items of information stored in the electronic patient record for a given patient. Optionally, the instructions code for a rules-based interpretation of information stored in the electronic patient record, such as instructions that apply criteria in a quality scoring system and generate a score. The medical logic instructions are associated with an “intelligent token”, i.e., a character string such as |DIABETES|, |ASTHMA| or |PROGRESS|. The invoking of the intelligent token triggers execution of the medical logic instructions and retrieval of the information from the database. The intelligent tokens can be embedded into document templates, or selected or entered by the user as part of a document creation process.

## Claims

### Claim 1

A health care computer network system in which the manual creation of patient documentation is facilitated by automatic inclusion of information in the patient documentation based on an electronic patient medical record of the patient, comprising:
(a) a server, by which electronic patient medical records are accessible; and
(b) at least one computing device configured to communicate electronically with the server for accessing, through the server, the electronic patient medical records;
(c) wherein the computing device comprises computer executable instructions contained in non-transitory computer readable medium which, when executed for generating patient documentation regarding an episode of health care services rendered to a particular patient,
(i) provide a user interface for receiving user input regarding the episode of health services rendered for the particular patient, the user input comprising,
(1) first user input identifying the particular patient for which the patient documentation is to be created, and
(2) second user input for construction of the patient documentation to be created regarding the episode of health care services rendered to the particular patient, wherein the second user input includes a token comprising a character string to be replaced with information determined based on the electronic patient medical record of the particular patient,
(ii) identify the token contained in the second user input, the token comprising a character string that is associated with a sequence of computer executable instructions for,
(A) accessing, through the server, the electronic patient medical record for the particular patient identified by the first user input,
(B) searching the accessed electronic patient medical record for the particular patient and identifying the existence of a chronic medical condition,
(C) determining a duration of the chronic medical disorder by comparing onset date information to current date information,
(D) identifying one or more associated conditions that may result from the chronic medical condition,
(E) performing a specific search of current medications that are used to treat the chronic medical condition,
(F) obtaining, from the electronic patient medical record, one or more recent measurement values for the patient for specific key performance indicators related to the chronic medical condition,
(G) correlating particular data obtained in (A) through (F) to additional data and applying rules-based medical logic associated with a quality scoring system to generate, based on the particular data obtained in (A) through (F), a new result that was not previously stored in the electronic patient medical record,
(H) inserting information including the new result in (G), in place of the identified token contained in the second user input, and
(iii) cause the sequence of computer executable instructions associated with an identified token to be executed, when invoked, for generating the patient documentation regarding the episode of health care services rendered to the particular patient.

### Claim 2 (depends on 1)

The health care computer network system of claim 1, wherein the inserted information comprises multiple items of information that is read from the electronic patient medical record of the identified patient.

### Claim 3 (depends on 1)

The health care computer network system of claim 1, wherein the inserted information comprises information that is generated as a function of information that is read from the electronic patient medical record of the identified patient.

### Claim 4 (depends on 1)

The health care computer network system of claim 1, wherein the inserted information comprises information that is provided from the execution of each of a plurality of other tokens.

### Claim 5 (depends on 1)

The health care computer network system of claim 1, wherein the server comprises a web server and the computing devices communicate with the web server over the Internet.

### Claim 6 (depends on 1)

The health care computer network system of claim 1, wherein the server comprises a database server in a computer network of a health care facility, and wherein the computing devices communicate with the database server over the computer network of the health care facility.

### Claim 7 (depends on 1)

The health care computer network system of claim 1, wherein the user interface for receiving the second user input comprises a user interface for entering text by a user, and wherein a token is manually typed by a user when entering text.

### Claim 8 (depends on 7)

The health care computer network system of claim 7, wherein each computing device is further configured to parse the text of the second user input entered by a user for identifying a token contained therein.

### Claim 9 (depends on 1)

The health care computer network system of claim 1, wherein the user interface for receiving the second user input comprises a user interface for receiving text entered by a user, wherein the user interface presents a list of tokens that may be included in the second user input, and wherein a token is inserted into the second user input upon a user selecting the token from a list of tokens.

### Claim 10 (depends on 1)

The health care computer network system of claim 1, wherein the sequence of computer executable instructions is invoked upon selection by the user of a control of the user interface for generating patient documentation.

### Claim 11 (depends on 1)

The health care computer network system of claim 1, wherein the sequence of computer executable instructions is invoked upon the user causing the token to be contained in the second user input.

### Claim 12 (depends on 11)

The health care computer network system of claim 11, wherein the sequence of computer executable instructions is invoked upon the user typing the character string of the token as part of the second user input.

### Claim 13 (depends on 11)

The health care computer network system of claim 11, wherein the sequence of computer executable instructions is invoked upon the user typing a shorthand character string representing the token as part of the second user input.

### Claim 14 (depends on 1)

The health care computer network system of claim 1, wherein the user interface that is provided further enables creation of tokens.

### Claim 15 (depends on 1)

The health care computer network system of claim 1, wherein the user interface that is provided further enables creation of templates, each comprising a patient documentation construction including at least one token contained therein.

### Claim 16 (depends on 15)

The health care computer network system of claim 15, wherein each token contained in the patient documentation construction of each template is invoked upon selection of the template by the user.

### Claim 17 (depends on 1)

The health care computer network system of claim 1, wherein the patient documentation is in the context of physician progress notes for inpatient and ambulatory care and the user is a physician.

### Claim 18 (depends on 1)

The health care computer network system of claim 1, wherein the token is associated with a disorder, and wherein the inserted information comprises a combination of at least two of: a duration of the disorder; one or more specific treatments for the disorder; one or more performance indicators associated with the disorder; and one or more grading scores.

### Claim 19 (depends on 1)

The health care computer network system of claim 1, wherein the sequence of computer executable instructions associated with the token comprises the step of obtaining the latest measurement and date for specific key performance indicators.

### Claim 20 (depends on 1)

The health care computer network system of claim 1, wherein the sequence of computer executable instructions associated with the token perform a review of the electronic patient medical record of the identified patient and wherein the inserted information comprises results of the review.

### Claim 21 (depends on 1)

The system of claim 1, wherein the computer executable instructions contained in the non-transitory computer readable medium of the computing device are executed for each particular patient out of a plurality of patients in order to generate patient documentation regarding a respective episode of health care services rendered to each particular patient out of the plurality of patients.

### Claim 22 (depends on 1)

The system of claim 1, wherein, for each particular patient out of a plurality of patients to whom health care services have been rendered, the computer executable instructions contained in the non-transitory computer readable medium of the computing device are executed following the rendering of health care services to the particular patient in order to generate the patient documentation regarding the episode of health care services rendered to the particular patient.

### Claim 23 (depends on 1)

The system of claim 1, wherein the user interface comprises a text box for receiving the second user input in the form of text, which text defines a construction of the patient documentation to be created regarding the episode of health care services rendered to the particular patient.

### Claim 24 (depends on 23)

The system of claim 23, wherein the text that is received in the text box for receiving the user input is typed on a keyboard by the user.

### Claim 25 (depends on 24)

The system of claim 24, wherein the text that is received in the text box for receiving the user input is programmatically generated in response to a selection by the user of a control of the user interface.

### Claim 26

A health care computer network system in which the manual creation of patient documentation by a health care provider is facilitated by automatic inclusion of information in the patient documentation based on an electronic patient medical record of the patient, comprising:
(a) a server, by which electronic patient medical records are accessible; and
(b) a computing device used by the health care provider at the point of care and configured to communicate from the point of care electronically with the server for accessing, through the server, the electronic patient medical records;
(c) wherein the computing device comprises computer executable instructions contained in non-transitory computer readable medium which, when executed for generating at the point of care patient documentation regarding an episode of health care services rendered to a particular patient at the point of care,
(i) provide a user interface for receiving at the point of care user input from the health care provider regarding the episode of health services rendered for the particular patient, the user input comprising,
(A) first user input identifying the particular patient for which the patient documentation is to be created, and
(B) second user input for construction of the patient documentation to be created regarding the episode of health care services rendered to the particular patient, wherein the second user input includes a token comprising a character string to be replaced with information determined based on the electronic patient medical record of the particular patient,
(ii) identify at the point of care the token contained in the second user input, the token comprising a character string that is associated with a sequence of computer executable instructions for,
(A) accessing from the point of care, through the server, the electronic patient medical record for the particular patient identified by the first user input,
(B) searching the accessed electronic patient medical record for the particular patient and identify the existence of a chronic medical condition,
(C) determining a duration of the chronic medical disorder by comparing onset date information to current date information,
(D) identifying one or more associated conditions that may result from the chronic medical condition,
(E) performing a specific search of current medications that are used to treat the chronic medical condition,
(F) obtaining, from the electronic patient medical record, one or more recent measurement values for the patient for specific key performance indicators related to the chronic medical condition,
(G) correlating particular data obtained in (A) through (F) to additional data and applying rules-based medical logic associated with a quality scoring system to generate, based on the particular data obtained in (A) through (F), a new result that was not previously stored in the electronic patient medical record,
(H) inserting information including the new result in (G), in place of the identified token contained in the second user input, and
(iii) cause the sequence of computer executable instructions associated with an identified token to be executed, when invoked, for generating at the point of care the patient documentation regarding the episode of health care services rendered to the particular patient.

### Claim 27 (depends on 26)

The system of claim 26, wherein the computing device is a hand-held computing device.

### Claim 28 (depends on 26)

The system of claim 26, wherein the computing device is a workstation computer.

### Claim 29 (depends on 26)

The system of claim 26, wherein the computing device is a laptop computer.

### Claim 30 (depends on 26)

The system of claim 26, wherein the health care provider is a physician.

### Claim 31 (depends on 26)

The system of claim 26, wherein the health care provider is a nurse.

### Claim 32 (depends on 26)

The system of claim 26, wherein the health care provider is a physician's assistant.

### Claim 33

A health care computer network system in which the manual creation of patient documentation by a health care provider is facilitated by automatic inclusion of information in the patient documentation based on an electronic patient medical record of the patient, comprising:
(a) a server, by which electronic patient medical records are accessible; and
(b) a computing device used by the health care provider and configured to communicate electronically with the server for accessing, through the server, the electronic patient medical records;
(c) wherein the computing device comprises computer executable instructions contained in non-transitory computer readable medium which, when executed for generating patient documentation regarding an episode of health care services rendered to a particular patient,
(i) provide a user interface for receiving user input from the health care provider regarding the episode of health services rendered for the particular patient, the user input comprising,
(A) first user input identifying the particular patient for which the patient documentation is to be created, and
(B) second user input for construction of the patient documentation to be created regarding the episode of health care services rendered to the particular patient, wherein the second user input includes a token comprising a character string to be replaced with information determined based on the electronic patient medical record of the particular patient,
(ii) identify the token contained in the second user input, the token comprising a character string that is associated with a sequence of computer executable instructions for,
(A) accessing, through the server, the electronic patient medical record for the particular patient identified by the first user input,
(B) searching the accessed electronic patient medical record for the particular patient and identify the existence of a chronic medical condition,
(C) determining a duration of the chronic medical disorder by comparing onset date information to current date information,
(D) identifying one or more associated conditions that may result from the chronic medical condition,
(E) performing a specific search of current medications that are used to treat the chronic medical condition,
(F) obtaining, from the electronic patient medical record, one or more recent measurement values for the patient for specific key performance indicators related to the chronic medical condition,
(G) correlating particular data obtained in (A) through (F) to additional data and applying rules-based medical logic associated with a quality scoring system to generate, based on the particular data obtained in (A) through (F), a new result that was not previously stored in the electronic patient medical record,
(H) inserting information including the new result in (G), in place of the identified token contained in the second user input, and
(iii) cause the sequence of computer executable instructions associated with an identified token to be executed, when invoked, for generating the patient documentation regarding the episode of health care services rendered to the particular patient,
(iv) display on the computing device for review by the health care provider the generated patient documentation regarding the episode of health care services rendered to the particular patient, and
(v) write the generated patient documentation to the server as part of the electronic patient medical record of the patient.

### Claim 34 (depends on 33)

The system of claim 33, wherein the health care provider is a physician.

### Claim 35 (depends on 33)

The system of claim 33, wherein the health care provider is a nurse.

### Claim 36 (depends on 33)

The system of claim 33, wherein the health care provider is a physician's assistant.

### Claim 37

A health care computer network system in which the manual creation of patient documentation by a health care provider is facilitated by automatic inclusion of information in the patient documentation based on an electronic patient medical record of the patient, comprising:
(a) a server, by which electronic patient medical records are accessible; and
(b) a hand-held computing device used by the health care provider and configured to communicate electronically with the server for accessing, through the server, the electronic patient medical records;
(c) wherein the hand-held computing device comprises computer executable instructions contained in nontransitory computer readable medium which, when executed for generating patient documentation regarding an episode of health care services rendered to a particular patient,
(i) provide a user interface for receiving user input from the health care provider regarding the episode of health services rendered for the particular patient, the user input comprising,
(A) first user input identifying the particular patient for which the patient documentation is to be created, and
(B) second user input for construction of the patient documentation to be created regarding the episode of health care services rendered to the particular patient, wherein the second user input includes a token comprising a character string to be replaced with information determined based on the electronic patient medical record of the particular patient,
(ii) identify the token contained in the second user input, the token comprising a character string that is associated with a sequence of computer executable instructions for,
(A) accessing, through the server, the electronic patient medical record for the particular patient identified by the first user input,
(B) searching the accessed electronic patient medical record for the particular patient and identify the existence of a chronic medical condition,
(C) determining a duration of the chronic medical disorder by comparing onset date information to current date information,
(D) identifying one or more associated conditions that may result from the chronic medical condition,
(E) performing a specific search of current medications that are used to treat the chronic medical condition,
(F) obtaining, from the electronic patient medical record, one or more recent measurement values for the patient for specific key performance indicators related to the chronic medical condition,
(G) correlating particular data obtained in (A) through (F) to additional data and applying rules-based medical logic associated with a quality scoring system to generate, based on the particular data obtained in (A) through (F), a new result that was not previously stored in the electronic patient medical record,
(H) inserting information including the new result in (G), in place of the identified token contained in the second user input, and
(iii) cause the sequence of computer executable instructions associated with an identified token to be executed, when invoked, for generating the patient documentation regarding the episode of health care services rendered to the particular patient.

### Claim 38 (depends on 37)

The system of claim 37, wherein the health care provider is a physician.

### Claim 39 (depends on 37)

The system of claim 37, wherein the health care provider is a nurse.

### Claim 40 (depends on 37)

The system of claim 37, wherein the health care provider is a physician's assistant.

### Claim 41

A health care computer network system in which the manual creation of patient documentation by a health care provider is facilitated by automatic inclusion of information in the patient documentation based on an electronic patient medical record of the patient, comprising:
(a) a server, by which electronic patient medical records are accessible; and
(b) a hand-held computing device used by the health care provider and configured to communicate electronically with the server for accessing, through the server, the electronic patient medical records;
(c) wherein the hand-held computing device comprises computer executable instructions contained in non-transitory computer readable medium which, when executed for generating patient documentation regarding an episode of health care services rendered to a particular patient,
(i) provide a user interface for receiving user input from the health care provider regarding the episode of health services rendered for the particular patient, the user input comprising,
(A) first user input identifying the particular patient for which the patient documentation is to be created, and
(B) second user input for construction of the patient documentation to be created regarding the episode of health care services rendered to the particular patient, wherein the second user input includes a token comprising a character string to be replaced with information determined based on the electronic patient medical record of the particular patient,
(ii) identify the token contained in the second user input, the token comprising a character string that is associated with a sequence of computer executable instructions for,
(A) accessing, through the server, the electronic patient medical record for the particular patient identified by the first user input,
(B) searching the accessed electronic patient medical record for the particular patient and identify the existence of a chronic medical condition,
(C) determining a duration of the chronic medical disorder by comparing onset date information to current date information,
(D) identifying one or more associated conditions that may result from the chronic medical condition,
(E) performing a specific search of current medications that are used to treat the chronic medical condition,
(F) obtaining, from the electronic patient medical record, one or more recent measurement values for the patient for specific key performance indicators related to the chronic medical condition,
(G) correlating particular data obtained in (A) through (F) to additional data and applying rules-based medical logic associated with a quality scoring system to generate, based on the particular data obtained in (A) through (F), a new result that was not previously stored in the electronic patient medical record,
(H) inserting information including the new result in (G), in place of the identified token contained in the second user input, and
(iii) cause the sequence of computer executable instructions associated with an identified token to be executed, when invoked, for generating the patient documentation regarding the episode of health care services rendered to the particular patient,
(iv) display on the computing device for review by the health care provider the generated patient documentation regarding the episode of health care services rendered to the particular patient, and
(v) write the generated patient documentation to the server as part of the electronic health care medical record of the patient.

### Claim 42 (depends on 41)

The system of claim 41, wherein the computing device is used by the health care provider at the point of care at which the episode of health care services are rendered to the particular patient following the rendering of the episode of health care services.

### Claim 43 (depends on 41)

The system of claim 41, wherein the health care provider is a physician.

### Claim 44 (depends on 41)

The system of claim 41, wherein the health care provider is a nurse.

### Claim 45 (depends on 41)

The system of claim 41, wherein the health care provider is a physician's assistant.