WO2001037190A2 - Communication system for the interaction between medical laboratories and medical treatment centers - Google Patents
Communication system for the interaction between medical laboratories and medical treatment centers Download PDFInfo
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- WO2001037190A2 WO2001037190A2 PCT/EP2000/011313 EP0011313W WO0137190A2 WO 2001037190 A2 WO2001037190 A2 WO 2001037190A2 EP 0011313 W EP0011313 W EP 0011313W WO 0137190 A2 WO0137190 A2 WO 0137190A2
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H10/00—ICT specially adapted for the handling or processing of patient-related medical or healthcare data
- G16H10/40—ICT specially adapted for the handling or processing of patient-related medical or healthcare data for data related to laboratory analysis, e.g. patient specimen analysis
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- G—PHYSICS
- G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
- G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
- G16H80/00—ICT specially adapted for facilitating communication between medical practitioners or patients, e.g. for collaborative diagnosis, therapy or health monitoring
Definitions
- the invention relates to a communication system for the interaction of medical laboratories and medical treatment facilities.
- a medical laboratory is usually operated centrally.
- a laboratory is often in the form of a laboratory community, while university clinics and hospitals operate a central laboratory with several specialist areas.
- the invention is therefore based on the object of specifying a communication system for the stated purpose, which allows the optimization and acceleration of order processing and the equalization of the workload.
- the required patient and examination data are recorded on a recording module of a data input device at the commissioning treatment facility and coordinated via the laboratory central database 1 to the responsible laboratory or laboratory area via data output devices in the commissioned laboratory or laboratory area,
- the samples to be examined in the treatment facilities are marked and / or coded according to predetermined criteria via the acquisition modules and sent to the responsible laboratory or laboratory area, - the pre-booked test orders are activated when the samples arrive in the laboratory or laboratory area and
- the examination data after completion of the examinations are stored in the laboratory central database 1 and transmitted to the commissioning treatment facility via data transmission devices 6.
- FIG. 2 network environment of a local laboratory location.
- the client requests the determination of parameters from the laboratory.
- the laboratory In order to be able to determine these parameters, the laboratory must carry out tests on the sample materials sent in. The samples are distributed from the material reception to the respective laboratory location. Here it is checked in as available. The client is then immediately informed of the result of the test by data transfer.
- an integrative laboratory central database 1 This database can be located on a single database server 3. However, it can also be advantageous that the laboratory central database is present in several identical copies 2 on different servers 3, all of which are connected to a data transmission network 6. These copies 2 each provide full functionality. All information about changes that are made to a copy 2 are transmitted to all other copies via the data transmission network 6, so that it is ensured that all copies 2 have the same information and data. For this reason, only one virtual laboratory central database 1 is mentioned in the case of copies distributed over several servers.
- the workflow is, for example, as follows:
- Each client 5, ie each client station or client doctor's office has a recording module that is networked with the laboratory central database 1 in the laboratory.
- the necessary patient and order data are entered on the acquisition module.
- the data is transferred from the acquisition module to the laboratory.
- direct ISDN connections, WAN connections via ISDN, internet connection or e-mail can be considered.
- the labels required for the samples are printed out.
- Pre-analysis is the treatment of the samples before the examination. That can affect the refer to the pure storage of the samples or to their preparation for the following tests.
- the requirements module After entering suspected diagnoses or diagnoses according to the classification ICD 9 and ICD 10 (International Criteria of disease) or DRG (Diagnosis Related Groups), the requirements module recognizes stored laboratory diagnostic guidelines and suggests a standardized request behavior of laboratory tests arranged according to main and secondary diagnoses. This leads to a verifiable process with a set quality standard in the prevention, detection and treatment of diseases. Analyzes that are not indicated for the selected disease are avoided. Necessary analyzes for prevention, diagnosis and therapy are not forgotten. The patient identification system also takes over the function of checking laboratory results that have not changed in a defined interval. The requester is informed of results that have already been determined, even if he was not the initiator of the analyzes. Findings on co-treatment are therefore available "online" to every participating medical institution.
- the acquisition module expediently runs on an IBM-compatible PC. Documents accompanying the order can, for example, be scanned.
- the order can be confirmed or put on hold immediately. Deferred orders are collected in an order queue and can be confirmed at a later time. If necessary, another laboratory can be selected that can take over the job. Expediently label printing only follows after the order confirmation, so that all laboratory data can be taken into account.
- the workplaces can be concentrated at one laboratory location; however, it can also be advantageous for them to be located in distributed laboratory locations.
- the system is suitable for supplying health regions (hospital, medical network, rehabilitation clinic, nursing home, private doctor's office) with laboratory analyzes.
- the most important feature is that the database 1 assigns all the findings to the patient.
- This electronic patient record can be viewed by any healthcare partner who is part of the healthcare network and when the patient's consent is available. Duplicate examinations are avoided and the course of treatment or diagnosis is accelerated and qualitatively optimized.
- the laboratory central database described above, which is distributed over several servers, is advantageously used in such complex systems. In this case, the special advantage of the invention comes into effect because the integrative laboratory central database 1 optimizes the processes in this complex system.
- the laboratories when placing the order, are selected according to their technical suitability for the required examinations and according to the respective temporary workload, transport routes and travel routes are optimized in terms of economy and time. Appropriate laboratories are selected and new orders integrated into inexpensive delivery routes. For special or emergencies, the optimal facilities are automatically created determined because the institutions involved are listed in a hierarchical structure.
- the laboratory activates the pre-booked order when the material arrives.
- Samples e.g. B. intended for a clinical or hematological laboratory can be directed directly to the appropriate laboratory location.
- a sample In order to be checked in in the laboratory, a sample only needs to be held with the label in front of a barcode reader, after which the data associated with the sample are displayed on a monitor.
- the transferred patient data are transferred to a patient identification module.
- This module can return several results:
- the patient data contained in the order are checked for completeness. If the data is sufficient, a new patient record is created and the order is processed immediately. If the data is insufficient, a message is issued so that an individual data acquisition in the laboratory, e.g. B. after telephone demand, must be made.
- the results are transmitted to the communication system and subjected to a delta check.
- the delta check compares the measured value with the patient's previous value, the normal value range and / or a fixed technical limit. If errors occur, they are dealt with immediately in special workplaces. Under um- a follow-up examination can be scheduled automatically during the delta check. All results that are in a release area are released. Some results also require medical validation by a specialist.
- the laboratory doctor has access to the patient's medical file via the communication system, since the patient's medical history provides important information about the possible diagnosis and the treatment strategy. At least data on diagnoses, medication and chronic diseases of the patient should be accessible.
- the examination result expediently contains an editable part, into which the laboratory doctor can insert comments.
- the result of an investigation is used to decide whether and which others Investigations are necessary, which can then be carried out automatically if necessary.
- Some diseases are reportable by law. If such a disease of a patient is found in the laboratory, a report is made to the health department and the treating doctor. The same applies to highly infectious germs. If this is proven, a report is sent to the ward or the doctor so that preventive measures can be initiated immediately.
- the data transfer from the laboratory central database 1 takes place via e-mail, network printer, fax or LDT.
- the transmission via LDT should be possible as an attachment to an e-mail or directly via ISDN.
- Several transmission paths can also be provided in parallel.
- An individual report layout can be defined for each ward or doctor's office. B. a certain sequence and arrangement of the diagnostic parameters is selected.
- a user (doctor in the hospital or in the practice) triggers a laboratory order.
- the database books the order and prints out appropriate material labels at the client. If the client has the If the patient's diagnosis is entered according to the International Diagnostic Code ICD or DRG, the client will be given a corresponding proposal for the analyzes to be commissioned. The client will also be informed of possible acceptance and transport conditions.
- the order is activated in the system and the database plans according to a predetermined hierarchy at which workstation (laboratory A, B, C ...) the examinations are to be carried out.
- the condition of the device plays a decisive role here. This special order scheduling significantly optimizes the laboratory process and the result is returned to the customer faster than usual.
- the advantage of the communication system is that both the requestor and the laboratory always have an up-to-date overview of the status of upcoming, activated and finished examination orders and can react accordingly in good time. If there are material problems, you can act close to the patient.
- the database reacts automatically to critical test results after appropriate technical approval, reports immediately to the laboratory requester and, if necessary, initiates further tests. Together with the clinically active colleague, a complex finding can be worked out across locations on the screen, possibly directly on the patient's bed.
- the system also helps to minimize the flood of information and the costs associated with managing it. All data is stored centrally and is available for follow-up examinations and to display the medical history, possibly also for those other than the original client.
- a warehouse management module is integrated into the system, which "deducts" consumables and reagents for each examination cycle and manages the delivery to the workplace by managing minimum inventory levels based on the workplace. Order volume and order height discounts can be managed optimally across the network laboratory.
- the module also organizes the supply of laboratory requisites with blood collection systems and other aids.
- the station is delivered by checking in the materials per sender. In this way, transaction data can be generated automatically and the inventory at the customer can be determined.
- the equipment of a local laboratory location advantageously also includes laboratory workstations 9, which are connected via device drivers 12 to other devices, such as, for. B. card readers 18 or online devices 19 are connected.
- a communication server 7 controls the data exchange between fax machine 14, printer 15, station workstations 17 and others Devices for file transfer 16.
- the basic equipment advantageously includes a diagnosis server 11 and mini-computers connected to the laboratory database 1 via a special server 10.
- the invention is not restricted to the exemplary embodiments shown here. Rather, it is possible to implement and implement further embodiment variants by combining and modifying the means and features mentioned, without leaving the scope of the invention.
- Station workstation 18. Card reader
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Abstract
Description
Kommunikationssystem für das Zusammenwirken von medizinischen Laboratorien und ärztlichen Behandlungseinrichtungen Communication system for the interaction of medical laboratories and medical treatment facilities
Beschreibungdescription
Die Erfindung betrifft ein Kommunikationssystem für das Zusammenwirken von medizinischen Laboratorien und ärztlichen Behandlungseinrichtungen.The invention relates to a communication system for the interaction of medical laboratories and medical treatment facilities.
Bedingt durch einen hohen materiellen sowie personellen Aufwand wird ein medizinisches Labor in der Regel zentral betrieben. Für niedergelassene Ärzte besteht ein solches Labor deshalb häufig in Form einer Laborgemein- schaft, während Universitätskliniken und Krankenhäuser ein zentrales Labor mit mehreren Fachbereichen betreiben.Due to the high material and personnel expenditure, a medical laboratory is usually operated centrally. For resident doctors, such a laboratory is often in the form of a laboratory community, while university clinics and hospitals operate a central laboratory with several specialist areas.
Viele Labore sind bereits dazu übergegangen, die Unter- suchungsergebnisse so zur Verfügung zu stellen, daß sie von der beauftragenden Station bzw. Arztpraxis per Datenübermittlung abgerufen werden können. Das beschleunigt zwar die Übermittlung der fertigen Untersuchungs- daten, die Auf ragsannahme und -abwicklung geschieht aber nach wie vor in herkömmlicher Weise. Ein Labor kann deshalb seine Arbeit nach wie vor nur ungenügend planen, da erst beim Eintreffen des Auftrages zusammen mit den dazugehörigen Probenmaterialien über die Auftragsabwicklung, also die nötigen Untersuchungen, die dazu benötigten Geräte und Materialien usw. entschieden werden kann. Nicht selten müssen Aufträge an ein weiteres, spezialisiertes Labor weitergegeben werden oder können wegen eines erhöhten Arbeitsanfalls nicht sofort in Angriff genommen werden, was die Auftragsbearbeitung, oft zum Nachteil eines Patienten, verzögert.Many laboratories have already started to make the test results available in such a way that they can be called up by the commissioning ward or doctor's office via data transfer. Although this speeds up the transmission of the finished examination data, the acceptance and processing of orders still takes place in a conventional manner. A laboratory can therefore still only insufficiently plan its work, because only when the order arrives, together with the associated sample materials, does the order processing, i.e. the necessary examinations, the necessary equipment and materials, etc., decide can be. It is not uncommon for orders to be passed on to another, specialized laboratory or cannot be started immediately due to an increased workload, which delays order processing, often to the detriment of a patient.
Der Erfindung liegt daher die Aufgabe zugrunde, ein Kommunikationssystem für den angegebenen Zweck anzugeben, das die Optimierung und Beschleunigung der Auftragsbearbeitung und die Vergleichmäßigung des Arbeitsanfalls erlaubt.The invention is therefore based on the object of specifying a communication system for the stated purpose, which allows the optimization and acceleration of order processing and the equalization of the workload.
Die Aufgabe wird erfindungsgemäß gelöst durch die Merkmale im kennzeichnenden Teil des Anspruchs 1 im Zusammenwirken mit den Merkmalen im Oberbegriff. Zweckmäßige Ausgestaltungen der Erfindung sind in den Unteransprü- chen enthalten.The object is achieved by the features in the characterizing part of claim 1 in cooperation with the features in the preamble. Appropriate embodiments of the invention are contained in the subclaims.
Danach sind alle an dem Kommunikationssystem beteiligten Laboratorien und deren Laborfachbereiche einerseits und ärztliche Behandlungseinrichtungen andererseits über Datenübertragungseinrichtungen 6 mit einer integrativen Laborzentraldatenbank 1 vernetzt. Über die Laborzentraldatenbank 1 werdenThereafter, all laboratories involved in the communication system and their laboratory specialist areas on the one hand and medical treatment facilities on the other hand are networked with an integrative laboratory central database 1 via data transmission devices 6. Via the laboratory central database 1
- die benötigten Patienten- und Untersuchungsdaten an einem Erfassungsmodul einer Dateneingabeeinrichtung bei der beauftragenden Behandlungseinrichtung erfaßt und über die Laborzentraldatenbank 1 koordiniert dem zuständigen Labor oder Laborbereich über Datenausgabeeinrichtungen im beauftragten Labor oder Laborbereich avisiert,the required patient and examination data are recorded on a recording module of a data input device at the commissioning treatment facility and coordinated via the laboratory central database 1 to the responsible laboratory or laboratory area via data output devices in the commissioned laboratory or laboratory area,
- die zu untersuchenden Proben in den Behandlungseinrichtungen über die Erfassungsmodule nach vorgegebenen Kriterien gekennzeichnet und/oder kodiert und dem zuständigen Labor oder Laborbereich zugestellt, - die bereits vorgebuchten Untersuchungsaufträge beim Eintreffen der Proben im Labor oder Laborbereich aktiviert und- the samples to be examined in the treatment facilities are marked and / or coded according to predetermined criteria via the acquisition modules and sent to the responsible laboratory or laboratory area, - the pre-booked test orders are activated when the samples arrive in the laboratory or laboratory area and
- die Untersuchungsdaten nach Abschluß der Untersuchungen in der Laborzentraldatenbank 1 gespeichert und über Datenübertragungseinrichtungen 6 an die beauftragende Behandlungseinrichtung übermittelt .- The examination data after completion of the examinations are stored in the laboratory central database 1 and transmitted to the commissioning treatment facility via data transmission devices 6.
Die Erfindung soll nachstehend anhand von zumindest teilweise in den Figuren dargestellten Ausfüh- rungsbeispielen näher erläutert werden.The invention is to be explained in more detail below on the basis of exemplary embodiments shown at least partially in the figures.
Es zeigen:Show it:
Fig. 1 Darstellung des Kommunikationssystems, Fig. 2 Netzwerkumgebung eines lokalen Labor- standortes .1 representation of the communication system, FIG. 2 network environment of a local laboratory location.
Der Auftraggeber fordert beim Labor die Bestimmung von Parametern an. Um diese Parameter bestimmen zu können, muß das Labor Untersuchungen an den eingesandten Pro- benmaterialien vornehmen. Die Proben werden von der Materialannahme an den jeweiligen Laborplatz verteilt. Hier wird es als vorhanden eingecheckt. Das Untersuchungsergebnis wird dem Auftraggeber anschließend so- fort per Datenübermittlung mitgeteilt .The client requests the determination of parameters from the laboratory. In order to be able to determine these parameters, the laboratory must carry out tests on the sample materials sent in. The samples are distributed from the material reception to the respective laboratory location. Here it is checked in as available. The client is then immediately informed of the result of the test by data transfer.
Alle Daten, die während dieses Prozesses entstehen - von der Anfrage, über die Auftragserteilung, die Untersuchungsbefunde bis hin zu Informationen über Behandlungsmethoden bzw. früheren Erkrankungen werden patientenbezogen in einer integrativen Laborzentral - datenbank 1 gespeichert . Diese Datenbank kann sich auf einem einzelnen Datenbank-Server 3 befinden. Es kann aber auch vorteilhaft sein, daß die Laborzentral- datenbank in mehreren identischen Kopien 2 auf verschiedenen Servern 3, die alle an einem Datenübertragungsnetz 6 angeschlossen sind, vorhanden ist. Diese Kopien 2 stellen jede die vollständige Funktionalität zur Verfügung. Über das Datenübertragungsnetz 6 werden alle Informationen über Veränderungen, die an einer Kopie 2 vorgenommen werden, an alle anderen Kopien übermittelt, so daß gewährleistet ist, daß alle Kopien 2 über die selben Informationen und Daten verfügen. Aus diesem Grunde wird auch im Falle der auf mehrere Server verteilten Kopien von nur einer virtuellen Laborzentraldatenbank 1 gesprochen.All data that arise during this process - from the inquiry, the placing of the order, the examination results to information about treatment methods or previous illnesses - are saved in an integrative laboratory central database 1. This database can be located on a single database server 3. However, it can also be advantageous that the laboratory central database is present in several identical copies 2 on different servers 3, all of which are connected to a data transmission network 6. These copies 2 each provide full functionality. All information about changes that are made to a copy 2 are transmitted to all other copies via the data transmission network 6, so that it is ensured that all copies 2 have the same information and data. For this reason, only one virtual laboratory central database 1 is mentioned in the case of copies distributed over several servers.
Im einzelnen ist der Arbeitsablauf beispielsweise fol- gendermaßen:The workflow is, for example, as follows:
Jede Client 5, d. h. jede auftraggebende Station bzw. jede auftraggebende Arztpraxis verfügt über ein Erfassungsmodul, das mit der Laborzentraldatenbank 1 im Labor vernetzt ist . Bei Auftragsauslösung werden die nötigen Patienten- und Auftragsdaten am Erfassungsmodul eingegeben. Dazu gehören: Auftraggeber, Patient, alle an der Probe zu bestimmenden Parameter, ggf. auch die Diagnose und die zur Bestimmung der Parameter nötigen Untersuchungen und Geräte, an denen die Untersuchungen durchzuführen sind. Vom Erfassungsmodul werden die Daten an das Labor übertragen. Dazu kommen direkte ISDN-Verbindungen, WAN-Verbindungen über ISDN, Internet-Verbindung oder E-Mail in Betracht. Gleichzeitig werden die für die Proben benötigten Etiketten ausgedruckt. Zusätzlich können hierbei Bemerkungen zur Präanalytik, zum Fertigstellungstermin u. ä. aufgenommen werden. Präanalytik ist die Behandlung der Proben vor der Untersuchung. Das kann sich auf die reine Aufbewahrung der Proben oder auf deren Vorbereitung für die folgenden Untersuchungen beziehen.Each client 5, ie each client station or client doctor's office has a recording module that is networked with the laboratory central database 1 in the laboratory. When an order is triggered, the necessary patient and order data are entered on the acquisition module. This includes: Client, patient, all parameters to be determined on the sample, possibly also the diagnosis and the examinations and devices necessary to determine the parameters on which the examinations are to be carried out. The data is transferred from the acquisition module to the laboratory. In addition, direct ISDN connections, WAN connections via ISDN, internet connection or e-mail can be considered. At the same time, the labels required for the samples are printed out. In addition, comments on preanalytics, the completion date, etc. Ä. Be included. Pre-analysis is the treatment of the samples before the examination. That can affect the refer to the pure storage of the samples or to their preparation for the following tests.
Das Anforderungsmodul erkennt nach der Eingabe von Verdachtsdiagnosen bzw. Diagnosen nach der Klassifikation ICD 9 und ICD 10 (International Criteria of disease) oder DRG (Diagnosis Related Groups) hinterlegte Labordiagnostikleitlinien und schlägt ein nach Haupt- und Nebendiagnosen geordnetes standardisierte Anforderungverhalten von Laboruntersuchungen vor. Dies führt zu einem überprüfbaren Prozess mit festgesetztem Qualitätsstandard in der Prävention und Erkennung sowie Behandlung von Erkrankungen. Nicht bei der gewählten Erkrankung indizierte Analysen werden vermieden. Für die Prävention, Diagnose und Therapie zwingend notwendige Analysen werden nicht vergessen. Weiter übernimmt das Patientenidentifikationssystem die Funktion der Überprüfung in einem festgelegten Intervall sich nicht veränderter Laborergebnisse. Der Anforderer wird über bereits feststehende Ergebnisse informiert, auch wenn er nicht Veranlasser der Analysen gewesen ist. Befunde zur Mitbehandlung stehen somit folglich "online" jeder sich beteiligenden ärztlichen Einrichtung zur Verfügung.After entering suspected diagnoses or diagnoses according to the classification ICD 9 and ICD 10 (International Criteria of disease) or DRG (Diagnosis Related Groups), the requirements module recognizes stored laboratory diagnostic guidelines and suggests a standardized request behavior of laboratory tests arranged according to main and secondary diagnoses. This leads to a verifiable process with a set quality standard in the prevention, detection and treatment of diseases. Analyzes that are not indicated for the selected disease are avoided. Necessary analyzes for prevention, diagnosis and therapy are not forgotten. The patient identification system also takes over the function of checking laboratory results that have not changed in a defined interval. The requester is informed of results that have already been determined, even if he was not the initiator of the analyzes. Findings on co-treatment are therefore available "online" to every participating medical institution.
Das Erfassungsmodul läuft zweckmäßig auf einem IBM-kompatiblen PC. Auftragsbegleitende Dokumente können beispielsweise eingescannt werden.The acquisition module expediently runs on an IBM-compatible PC. Documents accompanying the order can, for example, be scanned.
Nach der Erfassung kann der Auftrag sofort bestätigt oder zurückgestellt werden. Zurückgestellte Aufträge werden in einer Auftragswarteschlange gesammelt und können zu einem späteren Zeitpunkt bestätigt werden. Gegebenenfalls kann auch ein anderes Labor ausgewählt werden, das den Auftrag übernehmen kann. Zweckmäßig er- folgt der Etikettendruck erst nach der Auftragsbestätigung, so daß hierfür alle Labordaten mitberücksichtigt werden können.After the entry, the order can be confirmed or put on hold immediately. Deferred orders are collected in an order queue and can be confirmed at a later time. If necessary, another laboratory can be selected that can take over the job. Expediently label printing only follows after the order confirmation, so that all laboratory data can be taken into account.
Bei diesem Verfahren können die Arbeitsplätze an einem LaborStandort konzentriert sein; es kann aber auch vorteilhaft sein, daß sie an verteilten Laborstandorten lokalisiert sind.With this method, the workplaces can be concentrated at one laboratory location; however, it can also be advantageous for them to be located in distributed laboratory locations.
Das System ist geeignet, Gesundheitsregionen (Krankenhaus, Ärztenetz, Reha-Klinik, Pflegeheim, Niedergelassene Arztpraxen) mit Laboranalysen zu versorgen. Wichtigstes Merkmal dabei ist, daß die Datenbank 1 alle Befunde dem Patienten zuordnet . Diese elektronische Patientenakte kann jeder Partner im Gesundheitswesen einsehen, der dem Versorgungsnetz angehört und wenn die Einverständniserklärung des Patienten vorliegt. Doppeluntersuchungen werden vermieden und der Behandlungsabiauf bzw. die Diagnosestellung beschleunigt und qualitativ optimiert. In solchen komplexen Systemen kommt vorteilhafterweise die oben beschriebene auf mehrere Server verteilte Laborzentraldatenbank zum Einsatz . In diesem Falle kommt der besondere Vorteil der Erfindung zur Wirkung, denn die integrative Laborzentraldatenbank 1 optimiert die Abläufe in diesem komplexen System. Durch die Erfindung werden bei der Auftragserteilung die Laboratorien nach gerätetechnischer Eignung für die geforderten Untersuchungen und nach der jeweiligen, temporären Auslastung ausgewählt, Transportwege und Fahrtrouten werden nach wirtschaftlichen und zeitlichen Gesichtspunkten optimiert. Nahe geeignete Laboratorien werden ausgewählt und neue Aufträge günstigen Lieferrouten eingegliedert. Für Spezial- oder Notfälle werden automatisch die optimalen Einrichtungen ermittelt, da die beteiligten Einrichtungen in einem hierarchischen Aufbau erfaßt sind.The system is suitable for supplying health regions (hospital, medical network, rehabilitation clinic, nursing home, private doctor's office) with laboratory analyzes. The most important feature is that the database 1 assigns all the findings to the patient. This electronic patient record can be viewed by any healthcare partner who is part of the healthcare network and when the patient's consent is available. Duplicate examinations are avoided and the course of treatment or diagnosis is accelerated and qualitatively optimized. The laboratory central database described above, which is distributed over several servers, is advantageously used in such complex systems. In this case, the special advantage of the invention comes into effect because the integrative laboratory central database 1 optimizes the processes in this complex system. With the invention, when placing the order, the laboratories are selected according to their technical suitability for the required examinations and according to the respective temporary workload, transport routes and travel routes are optimized in terms of economy and time. Appropriate laboratories are selected and new orders integrated into inexpensive delivery routes. For special or emergencies, the optimal facilities are automatically created determined because the institutions involved are listed in a hierarchical structure.
Das Labor aktiviert beim Eintreffen des Materials den bereits vorgebuchten Auftrag. Proben, die z. B. für ein klinisches oder hämatologisches Labor bestimmt sind, können so direkt zum entsprechenden Laborplatz geleitet werden.The laboratory activates the pre-booked order when the material arrives. Samples, e.g. B. intended for a clinical or hematological laboratory can be directed directly to the appropriate laboratory location.
Um im Labor eingecheckt zu werden, braucht eine Probe nur mit dem Etikett vor ein Barcodelesegerät gehalten zu werden, wonach die zur Probe zugehörigen Daten auf einem Monitor angezeigt werden.In order to be checked in in the laboratory, a sample only needs to be held with the label in front of a barcode reader, after which the data associated with the sample are displayed on a monitor.
Die übergebenen Patientendaten werden an ein Patien- tenidentifikationsmodul übergeben. Dieses Modul kann mehrere Ergebnisse zurückliefern:The transferred patient data are transferred to a patient identification module. This module can return several results:
Wurde der Patient eindeutig identifiziert, wird der Auftrag umgehend bearbeitet .If the patient has been clearly identified, the order will be processed immediately.
Wurde kein Patient identifiziert, werden die im Auf- trag enthaltenen Patientendaten auf Vollständigkeit überprüft. Sind die Daten ausreichend, wird ein neuer Patientendatensatz angelegt und der Auftrag umgehend bearbeitet. Sind die Daten nicht ausreichend, so erfolgt eine Meldung, so daß zunächst eine individuelle Datenerfassung im Labor, z. B. nach telefonischer Nachfrage, vorgenommen werden muß.If no patient has been identified, the patient data contained in the order are checked for completeness. If the data is sufficient, a new patient record is created and the order is processed immediately. If the data is insufficient, a message is issued so that an individual data acquisition in the laboratory, e.g. B. after telephone demand, must be made.
Nach Durchführung der Untersuchungen werden die Ergebnisse an das Kommunikationssystem übertragen und einem Delta-Check unterzogen. Beim Delta-Check wird der gemessene Wert mit dem Vorwert des Patienten, dem Normwertbereich und/oder einer festen technischen Grenze verglichen. Treten hierbei Fehler auf, werden diese an speziellen Arbeitsplätzen sofort bearbeitet. Unter Um- ständen kann während des Delta-Checks automatisch eine Folgeuntersuchung angesetzt werden. Alle Ergebnisse, die dagegen in einem Freigabebereich liegen, werden freigegeben. Einige Ergebnisse bedürfen darüber hinaus noch einer medizinischen Validierung durch einen Fach- arzt.After the investigations have been carried out, the results are transmitted to the communication system and subjected to a delta check. The delta check compares the measured value with the patient's previous value, the normal value range and / or a fixed technical limit. If errors occur, they are dealt with immediately in special workplaces. Under um- a follow-up examination can be scheduled automatically during the delta check. All results that are in a release area are released. Some results also require medical validation by a specialist.
Der Laborarzt hat dazu über das Kommunikationssystem Zugriff auf die Krankenakte des Patienten, da die Krankheitsgeschichte des Patienten wichtige Infomatio- nen über die mögliche Diagnose und die Behandlungsstrategie liefert. Mindestens sollten Daten über Diagnosen, Medikamente und chronische Krankheiten des Patienten zugänglich sein.For this purpose, the laboratory doctor has access to the patient's medical file via the communication system, since the patient's medical history provides important information about the possible diagnosis and the treatment strategy. At least data on diagnoses, medication and chronic diseases of the patient should be accessible.
Häufig kommt es vor, daß ein Patient in verschiedenen Einrichtungen behandelt wird. Die in das Kommunikationssystem eingebundenen Einrichtungen (Krankenhäuser, Arztpraxen, Laboratorien, Pflegeheim, ...) können nun vorteilhaft die elektronische Patientenakte einsehen, da die integrative Laborzentraldatenbank 1 alle Informationen über den gesamten Behandlungsablauf patientenbezogen ablegt. Es liegt ein Kumulativbefund aller ambulanter und stationärer Leistungen vor. Diese Transparenz der Ereignisse unterstützt die Diagnosefindung und kann die Therapie und deren Erfolg beschleunigen .It often happens that a patient is treated in different facilities. The facilities integrated into the communication system (hospitals, doctor's surgeries, laboratories, nursing homes, ...) can now advantageously view the electronic patient file, since the integrative laboratory central database 1 stores all information relating to the entire treatment process in relation to the patient. There is a cumulative finding of all outpatient and inpatient services. This transparency of events supports diagnosis and can accelerate therapy and its success.
Der Untersuchungsbefund enthält zweckmäßig einen editierbaren Teil, in den der Laborarzt Bemerkungen einfü- gen kann.The examination result expediently contains an editable part, into which the laboratory doctor can insert comments.
Bei einigen Parametern wird anhand des Ergebnisses einer Untersuchung entschieden, ob und welche weiteren Untersuchungen notwendig sind, die dann ggf. automatisch angesetzt werden können.For some parameters, the result of an investigation is used to decide whether and which others Investigations are necessary, which can then be carried out automatically if necessary.
Einige Krankheiten sind per Gesetz meldepflichtig. Wird eine solche Erkrankung eines Patienten im Labor festge- stellt, so erfolgt eine Meldung an das Gesundheitsamt und an den behandelnden Arzt. Ähnliches gilt für hochinfektiöse Keime. Werden diese nachgewiesen, erfolgt eine Meldung an die Station bzw. den Arzt, um umgehend präventive Maßnahmen einleiten zu können.Some diseases are reportable by law. If such a disease of a patient is found in the laboratory, a report is made to the health department and the treating doctor. The same applies to highly infectious germs. If this is proven, a report is sent to the ward or the doctor so that preventive measures can be initiated immediately.
Die Datenübermittlung von der Laborzentraldatenbank 1 erfolgt über E-Mail, Netzdrucker, Fax oder LDT. Die Übertragung per LDT soll als Anhang einer E-Mail oder direkt per ISDN vorgenommen werden können. Es können auch mehrere Übermittlungswege parallel vorgesehen werden .The data transfer from the laboratory central database 1 takes place via e-mail, network printer, fax or LDT. The transmission via LDT should be possible as an attachment to an e-mail or directly via ISDN. Several transmission paths can also be provided in parallel.
Alle Übertragungen der Untersuchungsbefunde werden zweckmäßig geloggt. Es sollten Uhrzeit, Laborbereich, Art des Befundes u. ä. festgehalten werden.All transmissions of the test results are appropriately logged. The time, laboratory area, type of finding and the like Ä. are recorded.
Für jede Station bzw. jede Arztpraxis kann ein individuelles Befundlayout definiert werden, in welchem z. B. eine bestimmte Reihenfolge und Anordnung der Befundpa- rameter gewählt ist.An individual report layout can be defined for each ward or doctor's office. B. a certain sequence and arrangement of the diagnostic parameters is selected.
Der prinzipielle Ablauf läßt sich, unabhängig davon, ob nur ein Labor bzw. Laborgemeinschaft oder eine ganze Gesundheitsregion das KommunikationsSystem nutzt, zusammenfassend folgendermaßen darstellen:The basic process can be summarized as follows, regardless of whether only one laboratory or laboratory community or an entire health region uses the communication system:
Ein Anwender (Arzt im Krankenhaus oder in der Praxis) löst einen Laborauftrag aus . Die Datenbank bucht den Auftrag und druckt beim Auftraggeber entsprechende Materialetiketten aus . Wenn der Auftraggeber die Diagnose des Patienten nach dem Internationalen Diagnoseschlüssel ICD oder DRG eingibt, wird dem Auftraggeber ein entsprechender Vorschlag für die in Auftrag zu gebenden Analysen gemacht . Weiter wird der Auftraggeber über mögliche Abnahme- und Transport- bedingungen informiert .A user (doctor in the hospital or in the practice) triggers a laboratory order. The database books the order and prints out appropriate material labels at the client. If the client has the If the patient's diagnosis is entered according to the International Diagnostic Code ICD or DRG, the client will be given a corresponding proposal for the analyzes to be commissioned. The client will also be informed of possible acceptance and transport conditions.
Nach der Auftragserteilung wird der Auftrag im System aktiviert und die Datenbank plant nach einer vorgegebenen Hierarchie an welchem Arbeitsplatz (Labor A, B, C ...) die Untersuchungen durchgeführt werden. Hierbei spielt der Zustand des Gerätes (Auslastung, Qualität) eine entscheidende Rolle. Durch diese spezielle Auftragsdisposition wird der Laborablauf entscheidend optimiert und das Ergebnis schneller als üblich an den Auftraggeber rückübermittelt.After the order has been placed, the order is activated in the system and the database plans according to a predetermined hierarchy at which workstation (laboratory A, B, C ...) the examinations are to be carried out. The condition of the device (utilization, quality) plays a decisive role here. This special order scheduling significantly optimizes the laboratory process and the result is returned to the customer faster than usual.
Das KommunikationsSystem hat den Vorteil, daß sowohl der Anforderer als auch das Labor immer einen aktuellen Überblick über den Stand kommender, aktivierter und fertiger Untersuchungsaufträge haben und entsprechend rechtzeitig reagieren können. Bei Materialproblemen kann patientennah gehandelt werden.The advantage of the communication system is that both the requestor and the laboratory always have an up-to-date overview of the status of upcoming, activated and finished examination orders and can react accordingly in good time. If there are material problems, you can act close to the patient.
Die Datenbank reagiert auf kritische Untersuchungsergebnisse nach entsprechender technischer Freigabe auto- matisch, meldet sich unverzüglich beim Laboranforderer und veranlaßt ggf. weitere Untersuchungen. Gemeinsam kann mit dem klinisch tätigen Kollegen ein Komplexbefund standortübergreifend am Bildschirm, ggf. unmittelbar am Patientenbett, erarbeitet werden.The database reacts automatically to critical test results after appropriate technical approval, reports immediately to the laboratory requester and, if necessary, initiates further tests. Together with the clinically active colleague, a complex finding can be worked out across locations on the screen, possibly directly on the patient's bed.
Wiederholungsuntersuchungen werden vermieden. Das System hilft darüber hinaus, die Informationsflut und die zu deren Beherrschung verbundenen Kosten zu minimieren. Alle Daten werden zentral gespeichert und stehen für Folgeuntersuchungen und zur Darstellung der Krankeits- geschichte, ggf. auch für andere als den ursprünglichen Auftraggeber, zur Verfügung.Repeat examinations are avoided. The system also helps to minimize the flood of information and the costs associated with managing it. All data is stored centrally and is available for follow-up examinations and to display the medical history, possibly also for those other than the original client.
In das System ist ein Lagerverwaltungsmodul integriert, das pro Untersuchungsgang Verbrauchsmaterialien und Reagenzien "abbucht" und die Belieferung des Arbeitsplatzes über die Verwaltung von Mindestlagerbe- ständen arbeitsplatzbezogen verwaltet. Netzlaborweit können so Bestellvolumen und Auftragshöhenrabatte optimiert verwaltet werden. Zusätzlich organisiert das Modul die Belieferung der Laboranforderer mit Blutabnah- mesystemen und anderen Hilfsmitteln. Die Belieferung der Station erfolgt über das Einchecken der Materialien pro Einsender. So können automatisch Bewegungsdaten erzeugt werden und die Lagerbestände beim Auftraggeber ermittelt werden.A warehouse management module is integrated into the system, which "deducts" consumables and reagents for each examination cycle and manages the delivery to the workplace by managing minimum inventory levels based on the workplace. Order volume and order height discounts can be managed optimally across the network laboratory. The module also organizes the supply of laboratory requisites with blood collection systems and other aids. The station is delivered by checking in the materials per sender. In this way, transaction data can be generated automatically and the inventory at the customer can be determined.
Zur Ausstattung eines lokalen Laborstandortes gehören neben der Laborzentraldatenbank 1 bzw. einer lokalen Kopie der Datenbank 2, dem Datenbank-Server 3 und dem Replication-Server 4 vorteilhafterweise auch Labor- Workstations 9, die über Gerätetreiber 12 mit weiteren Geräten, wie z. B. Kartenleser 18 oder Online-Geräten 19, verbunden sind. Der Zugriff auf die Labordatenbank 1 von außen, beispielsweise von einer Station 20, Praxis 21 oder zur Fernbefundung 22, erfolgt über einen Web Access Server 8. Ein Kommunikationsserver 7 steuert den Datenaustausch zwischen Faxgerät 14, Drucker 15, den Stations-Workstations 17 und anderen Geräten zum Dateitransfer 16. Des weiteren gehören zur Grundausstattung vorteilhafterweise ein Befundserver 11 und über einen SpezialServer 10 mit der Labordatenbank 1 verbundene Mini-Computer . Die Erfindung ist nicht beschränkt auf die hier dargestellten Ausführungsbeispiele. Vielmehr ist es möglich, durch Kombination und Modifikation der genannten Mittel und Merkmale weitere Ausführungsvarianten zu realisie- ren, ohne den Rahmen der Erfindung zu verlassen. In addition to the laboratory central database 1 or a local copy of the database 2, the database server 3 and the replication server 4, the equipment of a local laboratory location advantageously also includes laboratory workstations 9, which are connected via device drivers 12 to other devices, such as, for. B. card readers 18 or online devices 19 are connected. Access to the laboratory database 1 from outside, for example from a station 20, practice 21 or for remote diagnosis 22, takes place via a web access server 8. A communication server 7 controls the data exchange between fax machine 14, printer 15, station workstations 17 and others Devices for file transfer 16. Furthermore, the basic equipment advantageously includes a diagnosis server 11 and mini-computers connected to the laboratory database 1 via a special server 10. The invention is not restricted to the exemplary embodiments shown here. Rather, it is possible to implement and implement further embodiment variants by combining and modifying the means and features mentioned, without leaving the scope of the invention.
BezugszeichenlisteLIST OF REFERENCE NUMBERS
1. (virtuelle) integrative Laborzentraldatenbank1. (virtual) integrative laboratory central database
2. lokale Datenbank 3. Datenbank-Server2. local database 3. database server
4. Replication-Server4. Replication server
5. Client5. Client
6. Datenübertragungseinrichtung6. Data transmission device
7. Kommunikationsserver 8. Web Access Server7. Communication server 8. Web access server
9. Labor-Workstation9. Laboratory workstation
10. Spezialserver10. Special server
11. Befundserver11. Findings server
12. Gerätetreiber 13. Mini-Computer12. Device driver 13. Mini computer
14. Faxgerät, -Software14. Fax machine, software
15. Drucker15. Printer
16. Dateitransfer16. File transfer
17. Stations-Workstation 18. Kartenleser17. Station workstation 18. Card reader
19. Online-Gerät19. Online device
20. Station20th station
21. Praxis21. Practice
22. Fernbefundung 22. Remote diagnosis
Claims
Priority Applications (3)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| AU25057/01A AU2505701A (en) | 1999-11-15 | 2000-11-15 | Communication system for the interaction between medical laboratories and medical treatment centers |
| CA002390879A CA2390879A1 (en) | 1999-11-15 | 2000-11-15 | Communication system for the interaction between medical laboratories and medical treatment centers |
| EP00988705A EP1232467A2 (en) | 1999-11-15 | 2000-11-15 | Communication system for the interaction between medical laboratories and medical treatment centers |
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| DE19955729.2 | 1999-11-15 | ||
| DE19955729A DE19955729A1 (en) | 1999-11-15 | 1999-11-15 | Communication system for the interaction of medical laboratories and medical treatment facilities |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| WO2001037190A2 true WO2001037190A2 (en) | 2001-05-25 |
| WO2001037190A3 WO2001037190A3 (en) | 2002-06-06 |
Family
ID=7929642
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/EP2000/011313 WO2001037190A2 (en) | 1999-11-15 | 2000-11-15 | Communication system for the interaction between medical laboratories and medical treatment centers |
Country Status (5)
| Country | Link |
|---|---|
| EP (1) | EP1232467A2 (en) |
| AU (1) | AU2505701A (en) |
| CA (1) | CA2390879A1 (en) |
| DE (1) | DE19955729A1 (en) |
| WO (1) | WO2001037190A2 (en) |
Cited By (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2003021525A3 (en) * | 2001-09-05 | 2004-03-18 | Ams Engineering Sticht Ges M B | Method for taking a sample from a system |
| EP1564648A2 (en) * | 2004-02-14 | 2005-08-17 | Universitätsklinikum Düsseldorf Anstalt des öffentlichen Rechts | Method for monitoring laboratory samples |
| EP1978110A1 (en) * | 2000-09-06 | 2008-10-08 | Transnetyx, Inc. | System, method and apparatus for transgenic and targeted mutagenesis screening |
| EP2685397A1 (en) * | 2012-07-10 | 2014-01-15 | Labor Krone GbR | System for the fast and optimised processing of medical samples |
Families Citing this family (2)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| AT413791B (en) * | 2001-09-05 | 2006-06-15 | Ams Engineering Sticht Ges M B | Method for taking a sample from a system, e.g. a medical sample, whereby an order placer connects to the analyzing organizations' database to transfer relevant data and receive sampling instructions back |
| DE102008018489A1 (en) * | 2008-04-11 | 2009-10-22 | Kisielinski, Kajetan Stefan, Dr. med. | Computer-aided device for use in clinical laboratory e.g. microbiology laboratory, establishes automatic communication with physician to communicate critical value of patient to physician, when value reaches or exceeds predetermined limit |
Family Cites Families (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US4893270A (en) * | 1986-05-12 | 1990-01-09 | American Telephone And Telegraph Company, At&T Bell Laboratories | Medical information system |
| US5920871A (en) * | 1989-06-02 | 1999-07-06 | Macri; Vincent J. | Method of operating a general purpose digital computer for use in controlling the procedures and managing the data and information used in the operation of clinical (medical) testing and screening laboratories |
| US5366896A (en) * | 1991-07-30 | 1994-11-22 | University Of Virginia Alumni Patents Foundation | Robotically operated laboratory system |
| EP0599022A3 (en) * | 1992-11-23 | 1995-02-22 | Emtek Health Care Inc | Method for viewing the results of microbiological tests. |
| US5841975A (en) * | 1996-12-10 | 1998-11-24 | The Regents Of The University Of California | Method and apparatus for globally-accessible automated testing |
| US6322502B1 (en) * | 1996-12-30 | 2001-11-27 | Imd Soft Ltd. | Medical information system |
| DE19736470C2 (en) * | 1997-08-21 | 2001-02-22 | Ulrich Schenck | Data processing-compatible microscopy sample carrier and method for the analysis of microscopic samples |
-
1999
- 1999-11-15 DE DE19955729A patent/DE19955729A1/en not_active Ceased
-
2000
- 2000-11-15 AU AU25057/01A patent/AU2505701A/en not_active Abandoned
- 2000-11-15 WO PCT/EP2000/011313 patent/WO2001037190A2/en active Search and Examination
- 2000-11-15 EP EP00988705A patent/EP1232467A2/en not_active Withdrawn
- 2000-11-15 CA CA002390879A patent/CA2390879A1/en not_active Abandoned
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP1978110A1 (en) * | 2000-09-06 | 2008-10-08 | Transnetyx, Inc. | System, method and apparatus for transgenic and targeted mutagenesis screening |
| WO2003021525A3 (en) * | 2001-09-05 | 2004-03-18 | Ams Engineering Sticht Ges M B | Method for taking a sample from a system |
| GB2397417A (en) * | 2001-09-05 | 2004-07-21 | Ams Engineering Sticht Ges M B | Method for taking a sample from a system |
| EP1564648A2 (en) * | 2004-02-14 | 2005-08-17 | Universitätsklinikum Düsseldorf Anstalt des öffentlichen Rechts | Method for monitoring laboratory samples |
| EP1564648A3 (en) * | 2004-02-14 | 2006-05-24 | Universitätsklinikum Düsseldorf Anstalt des öffentlichen Rechts | Method for monitoring laboratory samples |
| EP2685397A1 (en) * | 2012-07-10 | 2014-01-15 | Labor Krone GbR | System for the fast and optimised processing of medical samples |
Also Published As
| Publication number | Publication date |
|---|---|
| DE19955729A1 (en) | 2001-05-23 |
| AU2505701A (en) | 2001-05-30 |
| WO2001037190A3 (en) | 2002-06-06 |
| CA2390879A1 (en) | 2001-05-25 |
| EP1232467A2 (en) | 2002-08-21 |
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