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System and method for standardizing care in a hospital environment
7403902 System and method for standardizing care in a hospital environment
Patent Drawings:Drawing: 7403902-10    Drawing: 7403902-11    Drawing: 7403902-12    Drawing: 7403902-13    Drawing: 7403902-14    Drawing: 7403902-15    Drawing: 7403902-16    Drawing: 7403902-17    Drawing: 7403902-18    Drawing: 7403902-19    
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Inventor: Rosenfeld, et al.
Date Issued: July 22, 2008
Application: 11/061,715
Filed: February 18, 2005
Inventors: Rosenfeld; Brian A. (Baltimore, MD)
Breslow; Michael (Lutherville, MD)
Assignee: VISICU, Inc. (Baltimore, MD)
Primary Examiner: Morgan; Robert W
Assistant Examiner:
Attorney Or Agent: Roberts Mardula & Wertheim, LLC
U.S. Class: 705/2; 600/300
Field Of Search: 705/2; 705/3; 600/300
International Class: G06Q 10/00
U.S Patent Documents:
Foreign Patent Documents: WO 98/29790; WO 99/13766; 00/79466
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Thomas D. East, Ph.D., Susan Henderson, B.A., Alan H. Morris, M.D., Reed M. Gardner, Ph.D., Implementation Issues and Challenges for Computerized Clinical Protocols for Management of Mechanical Ventilation in ARDS Patients, LDS Hospital, Salt LakeCity, UT. cited by other.
C. Gregory Elliott, M.D., Deon Simmons, R.R.T., C. Duwayne Schmidt, M.D., Kip Enger, B.S., C.R.T.T., Loren Greenway, B.S., R.R.T., and Reed M. Gardner, Ph.D., Computer-Assisted Medical Direction of Respiratory Care, Respiratory Management, vol. 19,No. 2. cited by other.
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Karen E. Bradshaw, Ph.D., Dean F. Sittig, Ph.D., Reed M. Gardner, Ph.D., T. Allan Pryor, Ph.D., and Marge Budd, R.N., M.S., Computer-Based Data Entry for Nurses in the ICU, Clinical Computing, Nov. 1988. cited by other.
Robert A. Larsen, M.D., R. Scott Evans, Ph.D., John P. Burke, M.D., Stanley L. Pestonik, R.Ph., Reed M. Gardner, Ph.D., David C. Classen, M.D., Improved Perioperative Antibiotic Use and Reduced Surgical Wound Infections Through Use of ComputerDecision Analysis, Computer Applications for Surgical Prophylaxis/Larsen et al. cited by other.
R. M. Gardner, Computers in the ICU and Surgery-Keeping Real-Time Patient Records for Decision-Making. cited by other.
Thomas D. East, Ph.D., Alan H. Morris, M.D., Terry Clemmer, M.D., James F. Orme, M.D., C. Jane Wallace, B.S.N., Susan Henderson, B.A., Dean F. Sittig, Ph.D., Reed M. Gardner, Ph.D., Development of Computerized Critical Care Protocols--A StrategyThat Really Works!, 1990 LDS Hospital, Salt Lake City, UT. cited by other.
R. Scott Evans, Ph.D., John P. Burke, M.D., Stanley L. Pestonik, R.Ph., David C. Classen, M.D., Ronald L. Menlove, Ph.D., and Reed M. Gardner, Ph.D., Prediction of Hospital Inflections and Selection of Antibiotics Using an Automated HospitalDatabase, 1990, SCAMC, Inc. 663-667. cited by other.
Susan E. Henderson, B.A., Robert O. Crapo, M.D., Thomas D. East, Ph.D., Alan H. Morris, M.D., C. Jane Wallace, R.N., Reed M. Gardner, Ph.D., Computerized Clinical Protocols in an Intensive Care Unit: How Well are They Followed?, 1990, SCAMC, Inc.,LDS Hospital, Salt Lake City, UT. cited by other.
Reed M. Gardner, PhD, Russell K. Hulse, RPH, MBA, Keith G. Larsen, RPH, Accessing the Effectiveness Of A Computerized Pharmacy System, 1990, SCAMC, Inc., 668-672. cited by other.
Reed M. Gardner, "Patient-Monitoring Systems", Medical Informatics: Computer Applications in Health Care, E.H. Shortliffe and L.E. Perrealt (eds.), G. Wiederhold and L.M. Fagan (assoc. eds.) (Reading, MA: Addison-Wesley, 1990. cited by other.
Reed M. Gardner, Olaf K. Golubjatnikov, R. Myron Laub, Julie T. Jacobson, and R. Scott Evans, Computer-Critiqued Blood Ordering Using the HELP System, Computers and Biomedical Research 23, 514-528, 1990, Academic Press, Inc. cited by other.
Karen E. Tate, Ph.D., Reed M. Gard'ner, Ph.D., and Lindell K. Weaver, M.D., A Computerized Laboratory Alerting System, Clinical Computing, 1990, vol. 7, No. 5, 296-301. cited by other.
Dean F. Sittig, Reed M. Gardner, Alan H. Morris, and C. Jane Wallace, Clinical Evaluation of Computer-Based Respiratory Care Algorithms, International Journal of Clinical Monitoring and Computing 7, 1990, 177-185, Kluwer Academic Publishers,Netherlands. cited by other.
R. Scott Evans, Stanley L. Pestotnilc, John P. Burke, Reed M. Gardner, Robert A. Larsen, and David C. Classen, Reducing Tile Duration Of Prophylactic Antibiotic Use Through Computer Monitoring Of Surgical Patients, DICP, The Annals ofPharmacotherapy, April 1990, vol. 24, 351-354, Harvey Whitney Books Company, Cincinnati, OH. cited by other.
Reed M. Gardner, and M. Michael Shabot, Computerized ICU Data Management: Pitfalls and Promises, International Journal of Clinical Monitoring and Computing 7: 99-105, 1990, Kluwer Academic Publishers, Netherlands. cited by other.
Stanley L. Pestotnik, R.Ph., R. Scott Evans, Ph.D., John P. Burke, M.D., Reed M. Gardner, Ph.D., David C. Classen, M.D., Therapeutic Antibiotic Monitoring: Surveillance Using a Computerized Expert System, The American Journal of Medicine, Jan. 1990,vol. 88, 43-48. cited by other.
Gil Kuperman, MD, Brent James, MD, MSTAT, Julie Jacobsen, MT (ASCP), Reed M. Gardner, PhD, Continuous Quality Improvement Applied To Medical Care: Experiences At LDS Hospital, Medical Decision Making, Oct.-Dec. 1991, 60-65, vol. 11, No. 4. cited byother.
Susan Henderson, Robert O. Crapo, C. Jane Wallace, Thomad D. East, Alan H. Morris, & Reed M. Gardner, Performance Of Computerized Protocols For The Management Of Arterial Oxygenation In An Intensive Care Unit, International Journal of ClinicalMonitoring and Computing 8, 1992, 271-180, Kluwer Academic Publishers, Netherlands. cited by other.
Reed M. Gardner, Ph.D., William L. Hawley, Thomas D. East, Ph.D., Thomas A. Oniki, B.S., Hsueh-Fen W. Young, B.S., Real Time Data Acquisition: Experience With the Medical Information Bus (MIB), LDS Hospital, University of Utah, Salt Lake City, UT.cited by other.
Eric F. Lepage, MD, Reed M. Gardner, PhD, R. Myron Laub, MD, Julie T. Jacobson, MT(ASCP), Assessing The Effectiveness Of A Computerized Blood Order Consultation System, LDS Hospital, 1992, 33-37, AMIA, Inc. cited by other.
R. Scott Evans, Ph.D., Stanley L. Pestotnik, R.Ph., David C. Classen, M.D., Sheron B. Bass, B.S.N. Ronald L. Menlove, Ph.D., Reed M. Gardner, Ph.D., and John P. Burke, M.D., Development Of A Computerized Adverse Drug Event Monitor, LDS Hospital andUniversity of Utah, Salt Lake City, UT. cited by other.
E. Lepage, R. Traineau, Ph. Marchetti, M. Benbunan, R. M. Gardner, Development Of A Computerized Knowledge Based System Integrated To A Medical Workstation: Application To Blood Transfusion, MEDINFO, 1992, 585-590, Elsevier Science Publishers B.V.cited by other.
Reed M. Gardner, Ph.D. and R. Scott Evans, Ph.D., Computer-Assisted Quality Assurance, Group Practice Journal, May/Jun. 1992, 41(3), 8-11. cited by other.
Thomas D. East, Ph.D., W. Hsueh-Fen Young, M.S. and Reed M. Gardner, Ph.D., Digital Electronic Communication between ICU Ventilators and Computers and Printers, Respiratory Care, Sep. 1992, vol. 37 No. 9, 1113-1123. cited by other.
Reed M. Gardner, Computers in Critical Care, Wellcome Trends in Hospital Pharmacy, Jul. 1992. cited by other.
T. Allan Pryor, Reed M. Gardner and W. Clinton Day, Computer System for Research and Clinical Application to Medicine, AFIPS--Conference Proceedings, vol. 33, 1968, 809-816. cited by other.
Homer R. Warner, M.D., Reed M. Gardner and Alan F. Toronto, M.D., Computer-Based Monitoring of Cardiovascular Functions in Postoperative Patients, Supplement II to Circulation, Apr. 1968, vols. 37 & 38, 68-74. cited by other.
Russell M. Nelson, Homer R. Warner, Reed E. Gardner and J. D. Mortensen, Computer Based Monitoring of Patients Following Cardiac Surgery, Computers in Cardiology, Jul.-Aug. 1969, vol. 5, No. 4, 926-930. cited by other.
Reed M. Gardner, Computerized Patient Monitoring at LDS Hospital--An Evaluation, Proceedings of the San Diego Biomedical Symposium, 1971, vol. 10, 151-159. cited by other.
Reed M. Gardner, Monitoring of Physiological Data in a Clinical Environment, Annual Review of Biophysics and Bioengineering, 1972, vol. 1, 211-224. cited by other.
Reed M. Gardner, Computerized Intensive Care Monitoring at LDS Hospital--Progress and Development, 97-105. cited by other.
Reed M. Gardner, Donald R. Bennet, and Richard B Vorce, Eight-Channel Data Set for Clinical EEG Transmission Over Dial-Up Telelphone Network, IEEE Transactions on Biomedical Engineering, May 1974, vol. BME-21, No. 3, 246-249. cited by other.
Reed M. Gardner, George H. Cannon, Alan H. Morris, Kenneth R. Olsen, W. Gary Price, Computerized Blood Gas Interpretation and Reporting System, Computer Magazine, Jan. 1975, 39-45. cited by other.
Russell K. Hulse, Stephen J. Clark, J. Craig Jackson, Homer R. Warner and Reed M. Gardner, Computerized Medication Monitoring System, American Journal of Hospital Pharmacy 33, Oct. 1976, 1061-1064. cited by other.
Reed M. Gardner, Ph.D., Computers in the ICU, Medical Electronics, Jun. 1984, 129-135. cited by other.
Robert D. Andrews, M.S., M.T., Reed M. Gardner, Ph.D., Sandy M. Metcalf, R.R.T., and Deon Simmons, R.R.T., Computer Charting: An Evaluation of a Respiratory Care Computer System, Respiratory Care, Aug. 1985, vol. 30, No. 8, 695-707. cited by other.
Reed M. Gardner, Ph.D., Computerized Data Management and Decision Making in Critical Care, Symposium on Critical Care, Aug. 1985, vol. 65, No. 4, 1041-1051. cited by other.
Reed M. Gardner, David P. Scoville, Blair J. West, Beth Bateman, Robert M. Cundick, Jr., Terry P. Clemmer, Integrated Computer Systems for Monitoring of the Critically Ill, 1977, 301-307. cited by other.
T. Allan Pryor, Reed M. Gardner, Paul D. Clayton, Homer R. Warner, A Distributed Processing System for Patient Management, Computers in Cardiology, Sep. 1978, 325-328. cited by other.
Reed M. Gardner, Ph.D., Terry P. Clemmer, M.D., Keith G. Larsen, R.Ph., and Dickey S. Johnson, R.N., Computerized Alert System Use in Clinical Medicine, IEEE Session 6, 1979, 136-140. cited by other.
T. Allan Pryor, Homer R. Warner, Reed M. Gardner, HELP--A Total Hospital Information System. cited by other.
T. P. Clemmer, R. M. Gardner, J. F. Orme, Jr., Computer Support in Critical Care Medicine, 1980. cited by other.
Scott R. Cannon, and Reed M. Gardner, Experience with a Computerized Interactive Protocol System Using HELP, Computers and Biomedical Research 13, 1980, 399-409, Academic Press, Inc. cited by other.
T. Allan Pryor, Paul D. Clayton, Reed M. Gardner, Randy Waki, and Homer R. Warner, HELP--A Hospital-Wide System for Computer-Based Support of Decision-Making, Jan. 1981. cited by other.
T. A. Pryor, R. M. Gardner, P. D. Clayton and H. R. Warner, The HELP System, Proceedings of the Sixth Annual Symposium on Computer Applications in Medical Care, Oct.-Nov. 1982, 19-27, IEEE. cited by other.
Reed M. Gardner, Information Management--Hemodynamic Monitoring, Seminars in Anesthesia, Dec. 1983, vol. 2, No. 4, 287-299. cited by other.
T. A. Pryor, R. M. Gardner, P. D. Clayton, H. R. Warner, The HELP System, Journal of Medical Systems, 1983, vol. 7, No. 2, 87-102. cited by other.
Reed M. Gardner, Blair J. West, T. Allan Pryor, Distributed Data Base and Network for ICU Monitoring, IEEE Computers in Cardiology, Sep. 18-24, 1984, 305-307. cited by other.
Reed M. Gardner, T. Allan Pryor, Paul D. Clayton, and R. Scott Evans, Integrated Computer Network for Acute Patient Care, Symposium on Computer Applications in Medical Care, Nov. 4-7, 1984. cited by other.
Reed M. Gardner, Tomorrow's Electronic Hospital is Here Today, IEEE Spectrum, Jun. 1984, 101-103. cited by other.
Karen E. Bradshaw, Reed M. Gardner, Terry P. Clemmer, Jams F. Orme, Frank Thomas, and Blair J. West, Physician Decision Making--Evaluation of Data Used in a Computerized ICU, International Journal of Clinical Monitoring and Computing 1, 1984, 81-91.cited by other.
Terry P. Clemmer, M.D., and Reed M. Gardner, Ph.D., Data Gathering, Analysis, and Display in Critical Care Medicine, Respiratory Care, Jul. 1985, vol. 30, No. 7, 586-601. cited by other.
Reed M. Gardner, Ph.D., and William L. Hawley, Standardizing Communications and Networks in the ICU, Patient Monitoring and Data Management, 1985, 59-63. cited by other.
R. Scott Evans, Reed M. Gardner, Allan R. Bush, John P. Burke, Jay A. Jacobson, Robert A. Larsen, Fred A. Meier, and Homer R. Warner, Development of a Computerized Infectious Disease Monitor (CIDM), Computers and Biomedical Research 18, 1985,103-113. cited by other.
Reed M. Gardner, Ph.D., Susan M. Monis, Paul Oehler, Monitoring Direct Blood Pressure: Algorithm Enhancements, 607-610. cited by other.
R. Scott Evans, PhD, Robert A. Larsen, MD, John P. Burke, MD, Reed M. Gardner, PhD, Frederick A. Meier, MD, Jay A. Jacobson, MD, Marlyn T. Conti, BSN, Julie T. Jacobson, MT, Russell K. Hulse, RPH, Computer Surveillance of Hospital-AcquiredInfections and Antibiotic Use, Journal of the American Medical Association, Aug. 22-29, 1986, vol. 256, No. 8, 1007-1011. cited by other.
Reed M. Gardner, Computerized Management of Intensive Care Patients, Images, Signals, and Devices, 1986, vol. 3, No. 1. cited by other.
R. Whiting, L. Hayes, The Practice of Telemedicine--The TARDIS Perspective, Informatics in Healthcare--Australia, Jul./Aug. 1997, vol. 6, No. 3, 103-106. cited by other.
Monique Frize, Robin Walker, Clinical Decision-Support Systems for Intensive Care Units Using Case-Based Reasoning. cited by other.
Ho Sung Lee, Seung Hun Park, and Eung Je Woo, Remote Patient Monitoring Service Through World-Wide Web, Proceedings--19.sup.th International Conference--IEEE/EMBS, Oct. 30-Nov. 2, 1997, 928-931. cited by other.
Betty L. Grundy, M.D., Pauline Crawford, R.N., Paul K. Jones, Ph.D., May Lou Kiley, Ph.D., Arnold Reisman, Ph.D., Yoh-Han Pao, Ph.D., Edward L. Wilkerson, M.D., J. S. Gravenstein, M.D., Telemedicine in Critical Care: An Experiment in Health CareDelivery, Oct. 1977, 6:10. cited by other.
Betty Lou Grundy, M.D., Paul K. Jones, Ph.D., and Ann Lovitt, M.D., Telemedicine in Critical Care: Problems in Design, Implementation, and Assessment, Critical Care Medicine, Jul. 1982, vol. 10, No. 7, 471-475. cited by other.
Geraldine Fitzpatrick, TARDIS Evaluation: Report on Final Usage Evaluation of the TARDIS Telehealth System, Jul. 24, 1998, Issue No. 1.0. cited by other.
Abstract Marie Delima, R.N., M. Michael Shabot, M.D., FACS, FCCM, FACMI, Karen Morris, R.N, Janet Mould, R.N., Eden Torre-Javier, R.N., Mark Lobue, B.A. and Jeannie Chen, Pharm.D., Successful Implementation of a Multiple-ICU Clinical InformationSystem in a Tertiary Care Medical Center. cited by other.
Xin Li, Daniel J. Valentino, George J. So, Robert Lufkin, Ricky K. Taira, A World WIde Web Telemedicine System, SPIE vol. 2711, 427-439. cited by other.
Stephen M. Ayres, M.D., F.C.C.M., Ake Grenvik, M.D., Ph.D., F.C.C.M., Peter R. Holbrook, M.D., F.C.C.M., William C. Shoemaker, M.D., F.C.C.M., Textbook of Critical Care, 3.sup.rd Edition, 1995, Harcourt Brace & Company. cited by other.
Karen B. Tate, Ph.D., Reed M. Gardner, Ph.D., Kurt Scherting, Nurses, Pagers, and Patient-Specific Criteria; Three Keys to Improved Critical Value Reporting, 1995, 164-168, AMIA, Inc. cited by other.
Karen E. Tate, Ph.D., Reed M. Gardner, Ph.D., Computers, Quality, and the Clinical Laboratory: A Look at Critical Value Reporting, 17.sup.th Annual Symposium on Computer Applications in Medical Care, Oct. 30-Nov. 3, 1993, 193-197. cited by other.
Peter J. Haug, Reed M. Gardner, Karen E. Tate, R. Scott Evans, Thomas D. East, Gilad Kuperman, T. Allan Pryor, Stanley M. Huff, and Homer R. Warner, Decision Support in Medicine: Examples from the HELP System, Computers and Biomedical Research 27,1994, 396-418. cited by other.
Thomas D. East, Ph.D., C. Jane Wallace, R.N., M.S., Alan H. Morris, M.D., Reed M. Gardner, Ph.D., and Dwayne R. Westenskow, Ph.D., Computers in Critical Care, New Technologies in Critical Care, Jun. 1995, vol. 7, No. 2, 203-216. cited by other.
Reed M. Gardner, Ph.D., Bette B. Maack, R.R.A., R. Scott Evans, Ph.D., and Stanley M. Huff, M.D., Computerized Medical Care: The HELP System at LDS Hospital, Journal of AHIMA, Jun. 1992, 63(6):68-78. cited by other.
Reed M. Gardner, Ph.D., Integrated Computerized Records Provide Improved Quality of Care with Little Loss of Privacy, Journal of the AMIA, Jul./Aug. 1994, vol. 1, No. 4, 320-322. cited by other.
S Reddy, M Niewiadomska-Bugaj, Y V Reddy, H C Galfalvy, V Jagannathan, R Raman, K. Srinivas, R. Shank, T. Davis, S. Friedman, MD, B. Merkin, MD, M. Kilkenny,MD, Experience with ARTEMIS--An Internet-Based Telemedicine System, AMIA, 1997, 759-763.cited by other.
Patrick R. Norris, M.S., Benoit M Dawant, Ph.D., Antoine Geissbuhler, M.D., Web-Based Data Integration and Annotation in the Intensive Care Unit, 1997. cited by other.
H. C. Galfalvy, M.S., S. M. Reddy, Ph.D., M. Niewiadomska-Bugaj, Ph.D., S. Friedman, M.D., Evaluation of Community Care Network (CNN) System in a Rural Health Care Setting, 1995, AMIA Inc., 698-702. cited by other.
K. Major, M. Shabot, S. Cunneen, Wireless Critical Alerts and Patient Outcomes in the Surgical Intensive Care Unit; The American Surgeon, 2000; p. 1057-1060. cited by other.
M. Shabot, M. Lobue, Cedars-Sinai Medical Center Critical Alerting System, Feb. 2004; p. 1-16. cited by other.
Shabot MM, LoBue M, Leyerle BJ, Dubin SB. Inferencing strategies for automated ALERTS on critically abnormal laboratory and blood gas data, SCAMC 1989; 13:54-57. cited by other.
APACHE.RTM. III Equation Update (Version III-J) 2002, pp. 1-22. cited by other.
APACHE.RTM. III Equation Update (Version III-I) 2003, pp. 1-13. cited by other.
O. Kostopoulau, M. Wildman, Sources of Variability in Uncertain Medical Decisions In the ICU: A Process Tracing Study, Qual. Saf. Health Care 2004, 13:272-280. cited by other.
A. Seiver, Critical Care Computing: Past, Present, and Future; Critical Care Clinics, vol. 16, No. 4, Oct. 2000, pp. 1-17. cited by other.
J. Fisher, S. Harbarth, A. Agthe, A. Benn, S. Ringer, D. Goldmann, and S. Fancani, Quantifying Uncertainty: Physicians' Estimates of Infection in Critically Ill Neonates and Children; Clinical Infection Diseases 2004:38, pp. 1383-1390. cited byother.
N. Halpern, S. Pastores, R. Greenstein, Critical Care Medicine in the United States 1985-2000: An Analysis of Bed Numbers, Use, and Cost; Critical Care Medicine 2004, vol. 32, No. 6, pp. 1254-1259. cited by other.
J.Mrus, Getting Beyond Diagnostic Accuracy: Moving Toward Approaches That Can Be Used in Practice; Clinical Infectious Diseases 2004:38, pp. 1391-1393. cited by other.
B. Leyerle, M. Shabot, Integrated Computerized Databases for Medical Data Management Beyond the Bedside, International Journal of Clinical Monitoring and Clinical Computing 1990:7, pp. 83-89. cited by other.
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M. Shabot, M. Lobue, Real-Time Wireless Decision Support Alerts on a Palmtop PDA; Proc. Ann. Symp. Compt Appl. Med Care 1995, pp. 174-179. cited by other.
G. Kuperman, D. Sittig, M. Shabot, J.Teich, Clinical Decision Support for Hospital and Critical Care, pp. 174-179. cited by other.
W. Bates, M. Cohen, L. Leape, J. Overhage, M. Shabot, T. Sheridan, Reducing the Frequency of Errors In Medicine, J. American Medical Informatics Assn. 2001:8 pp. 299-308. cited by other.
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Abstract: A system and method for standardizing care in a hospital environment. Information concerning the latest care and practice standards for a given condition is provided to a decision support module. The decision support module comprises decision support algorithms that reflect a standardize guideline of practice for a particular medical condition. The general categories of cardiovascular, endocrinology, general, gastrointestinal, hematology, infectious diseases, neurology, pharmacology, pulmonary, renal, surgery, toxicology, trauma all have guidelines and practice standards associated with them. Patient data and user input are inputted to the decision support algorithm. The user may be prompted for user input, and an assessment is made of the patient so as provide patient care advice for the patient. Examples of patient care advice are a diagnosis, a method of treatment, and a laboratory protocol.
Claim: We claim:

1. A decision support system for standardizing treatment to hospitalized patients comprising: a telecommunication network; monitoring stations comprising monitoring equipment, whereinthe monitoring equipment comprises instructions for monitoring data elements from geographically dispersed hospitalized patients and sending the monitored data elements to a remote command center via the telecommunications network, wherein the remotecommand center comprises instructions for: receiving the monitored data elements from the geographically dispersed hospitalized patients; accessing patient data elements indicative of a medical condition associated with each of the geographicallydispersed hospitalized patients; establishing patient-specific rules associated with each of the geographically dispersed hospitalized patients; and applying the patient-specific rules continuously and simultaneously using a rules engine comprisinginstructions for: selecting data elements from the monitored data elements and the patient data elements associated with a hospitalized patient; applying a patient-specific rule associated with the hospitalized patient to the selected data elements; determining in an automated fashion 24 hours per day 7 days per week at the remote command center whether the patient-specific rule for the hospitalized patient has been contravened; and in the event the patient-specific rule for the hospitalizedpatient has been contravened, determining in an automated fashion whether intervention is warranted; and a decision support module comprising instructions for, in the event the patient-specific rule for the hospitalized patient has been contravened:accessing a decision support algorithm; applying the decision support algorithm to the selected patient data elements of the hospitalized patient; and providing patient care guidance formulated to return the medical condition of the patient tocompliance with the patient specific rule, whereby the treatment of hospitalized patients is standardized.

2. The system of claim 1, wherein the decision support algorithm comprises a guideline selected from the list consisting of: Acalculous Cholecystitis, Acute Pancreatitis Algorithms, Acute Renal Failure-Diagnosis, Acute Renal Failure-Management& Treatment, Adrenal Insufficiency. Agitation and Anxiety, Depression & Withdrawal, Aminoglycoside Dosing and Therapeutic Monitoring, an Amphotericin-B Treatment Guidelines, Analgesia, Antibiotic Classification & Costs, Antibiogranis Algorithm,Antibiotic associated Colitis Algorithm, ARDS: Hemodynamic Management, ARDS: Steroid Use, ARDS: Ventilator Strategies, Asthma, Bleeding Patient, Bloodstream Infections, Blunt Cardiac Injury, Bradyarrhythmias, Brain Death, Bronchodilator Use in VentilatorPatients, Bronchoscopy & Thoracentesis Guidelines, Candiduria, Cardiogenic Shock, CardioPulmonary Resuscitation Guideline, Catheter Related Septicemia, a Catheter Replacement Strategies, Cervical Cord Injury, Congestive Heart Failure, COPD Exacerbation &Treatment, CXR (Indications), Dealing with Difficult patients and families, Diabetic Ketoacidosis, Dialysis, Diuretic Use, Drug Changes with Renal Dysfunction, Emergency Cardiac Pacing, Endocarditis Diagnosis and Treatment, Endocarditis Prophylaxis, Endof Life Decisions, Endotracheal Tubes & Tracheotomy, Ethical Guidelines, Febrile Neutropenia, FUO, Fluid Resuscitation, Guillain-Barre Syndrome, Heparin, Heparin-Induced Thrombocytopenia, Hepatic Encephalopathy, Hepatic Failure, HIV+Patient Infections,Hypercalcemia Diagnosis and Treatment, Hyperglycemia Insulin Treatment, Hyperkalemia: Etiology & Treatment, Hypernatremia: Etiology & Treatment, Hypertensive Crisis, Hypokalemia: Etiology & Treatment, Hyponatremia: Etiology & Treatment, Hypothermia,Identification of Cervical Cord Injury, Implantable Cardlo-defibrillator, Intra-Aortic Balloon Device, Intracerebral Hemorrhage, Latex Allergy, Magnesium Administration, Management of Hypotension, Inotropes, Management of Patients with Ascites, EmpiricMeningitis, Meningitis, a Myasthenia Gravis, Myocardial Infarction, Myocardial Infarction with left bundle branch block, Necrotizing Soft Tissue Infections, Neuromuscular Blockers, Neuromuscular Complications of Critical Illness, Non-Infectious Causes ofFever, Non-Traumatic Coma, Noninvasive Modes of Ventilation, Nutritional Management, Obstetrical Complication, Oliguria, Open Fractures, Ophthalmic Infections, Organ Procurement Guidelines, PA Catheter Guideline and Troubleshooting, Pancreatitis,Penetrating Abdominal Injury, Penetrating Chest Injury, Penicillin Allergy, Permanent Pacemaker and Indications, Pneumonia Community Acquired, Pneumonia Hospital Acquired, Post-Op Bleeding, Post-Op Hypertension, Post-Op Management of Abdominal Post-OpManagement of Carotid, Post-Op Management of Open Heart, Post-Op Management of Thoracotomy, Post-Op Myocardial Ischemia (Non-Cardiac Arrhythmias after Cardiac Surgery), Post-Op Power Weaning, Pressure Ulcers, Pulmonary Embolism Diagnosis, PulmonaryEmbolism Treatment, Respiratory Isolation, Sedation, Seizure, Status Epilepticus, Stroke, Sub-Arachnoid Hemorrhage, Supra-Ventricular Tachyarrhythmia, Supra-Ventricular Tachycardia, Wide Complex QRS Tachycardia, Therapeutic Drug Monitoring,Thrombocytopenia, Thrombolytic Therapy, Transfusion Guidelines, Traumatic Brain Injury, Assessment of Sedation, Sedation, Septic Shock, Bolus Sliding, Scale Midazolam, Short Term Sedation Process, Sinusitis, SIRS, Spinal Cord Injury, Steroid ReplacementStrategy, Thyroid Disease, Transplant Infection Prophylaxis, Transplant Related Infections, Treatment of Airway Obstruction, Unknown Poisoning, Unstable Angina, Upper GI Bleeding Stress Prophylaxis, Vancomycin, Upper GI Bleeding Non-Variceal, Upper GIBleeding Variceal, Use of Hematopoietic Growth Factors, Ventilator Weaning, Ventilator Weaning Protocol, Venous Thrombosis Diagnosis and Treatment, Venous Thromboembolism Prophylaxis, Ventricular Arrhythmia, Warfarin, Warfarin Dosing, and Wound HealingStrategies.

3. The system of claim 1, wherein the patient care guidance is a diagnosis.

4. The system of claim 1, wherein the patient care guidance is a method of treatment.

5. The system of claim 1, wherein the patient care guidance is a laboratory protocol.

6. The system of claim 1, wherein the decision support module further comprising instructions for accessing an order writing module, and wherein the patient care guidance comprises an order issued from the order writing module.

7. The system of claim 6, wherein the order comprises authorization to administer medication to the hospitalized patient.

8. The system of claim 6, wherein the order comprises authorization to subject the hospitalized patient to a diagnostic procedure selected from the group consisting of a laboratory protocol, a ventilator protocol, a hemodynamic protocol, and aradiology test.

9. The system of claim 6, wherein the order comprises authorization to subject the hospitalized patient to a treatment procedure selected from the group consisting of a radiological procedure and a surgical procedure.

10. The system of claim 1, wherein the selected data elements comprise a physiological data element of the hospitalized patient and a clinical data element of the hospitalized patient.

11. The system of claim 10, wherein the physiological data element is selected from the group consisting of heart rate, systolic pressure, diastolic pressure, pulmonary artery wedge pressure, central venous pressure, mixed venous oxygensaturation, oxygen saturation, tidal volume, inspiratory pressure, positive end expiratory pressure, respiration rate, electroencephalography and bispectral index.

12. The system of claim 10, wherein the clinical data element is selected from the group consisting of patient history, caregiver notes, laboratory reports, venous pressure, and urine output.

13. The system of claim 1, wherein the selected data elements comprise a physiological data element of the hospitalized patient and a medication data element of the hospitalized patient.

14. The system of claim 1, wherein the selected data elements comprise a physiological data element of the hospitalized patient and a laboratory data element of the hospitalized patient.

15. The system of claim 1, wherein the selected data elements comprise a clinical data element of the hospitalized patient and a laboratory data element of the hospitalized patient.

16. The system of claim 1, wherein the selected data elements comprise a physiological data element of the hospitalized patient and another physiological data element of the hospitalized patient.

17. The system of claim 1, wherein the selected data elements comprise at least two data elements of the hospitalized patient selected from the group consisting of a physiological data element, a clinical data element of the hospitalizedpatient, a medication data element of the hospitalized patient, and a laboratory data element of the hospitalized patient.

18. The system of claim 1, wherein the remote command center further comprises: an external network interface, wherein the external network interface comprises instructions for connecting to an external network; and instructions for providinga health care provider access to the remote command center via the external network.

19. The system of claim 18, wherein the external network is selected from the group consisting of a wired network, a wireless network, a cable network, a fiber optic network, and the Internet.

20. The system of claim 18, wherein the health care provider is selected from the group consisting of a physician, a nurse, a clinician, a diagnostician, and a intensivist.

21. The system of claim 18, wherein the remote command center further comprises instructions for sending the health care provider an alert if the patient-specific rule for the hospitalized patient has been contravened.

22. The system of claim 1, wherein the telecommunications network is selected from the group consisting of a wired network, a wireless network, a cable network, a fiber optic network, and the Internet.

23. A method for standardizing care provided to hospitalized patients comprising: receiving at a remote command center monitored data elements from geographically dispersed hospitalized patients via a telecommunications network; accessingpatient data elements indicative of a medical condition associated with each of the geographically dispersed hospitalized patients; establishing patient-specific rules associated with each of the geographically dispersed hospitalized patients; selecting data elements from the monitored data elements and the patient data elements associated with a hospitalized patient; applying a patient-specific rule associated with the hospitalized patient to the selected data elements; making adetermination in an automated fashion at the remote command center whether the patient-specific rule for the hospitalized patient has been contravened; and in the event the patient-specific rule for the hospitalized patient has been contravened:determining in an automated fashion 24 hours per day 7 days per week whether intervention is warranted; and accessing a decision support algorithm; applying the decision support algorithm to the selected patient data elements of the hospitalizedpatient; and providing patient care guidance formulated to return the medical condition of the patient to compliance with the patient specific rule, whereby the treatment of hospitalized patients is standardized.

24. The method for standardizing care provided to hospitalized patients of claim 23, wherein the decision support algorithm comprises a guideline selected from the list consisting of: Acalculous Cholecystitis, Acute Pancreatitis Algorithms,Acute Renal Failure-Diagnosis, Acute Renal Failure-Management & Treatment, Adrenal Insufficiency, Agitation and Anxiety, Depression & Withdrawal, Aminoglycoside Dosing and Therapeutic Monitoring, an Amphotericin-B Treatment Guidelines, Analgesia,Antibiotic Classification & Costs, Antibiograms Algorithm, Antibiotic associated Colitis Algorithm, ARDS: Hemodynamic Management, ARDS: Steroid Use, ARDS: Ventilator Strategies, Asthma, Bleeding Patient, Bloodstream Infections, Blunt Cardiac Injury,Bradyarrhythmias, Brain Death, Bronchodilator Use in Ventilator Patients, Bronchoscopy & Thoracentesis Guidelines, Candiduria, Cardiogenic Shock, CardioPulmonary Resuscitation Guideline, Catheter Related Septicemia, a Catheter Replacement Strategies,Cervical Cord Injury, Congestive Heart Failure, COPD Exacerbation & Treatment, CXR (Indications), Dealing with Difficult patients and families, Diabetic Ketoacidosis, Dialysis, Diuretic Use, Drug Changes with Renal Dysfunction, Emergency Cardiac Pacing,Endocarditis Diagnosis and Treatment, Endocarditis Prophylaxis, End of Life Decisions, Endotracheal Tubes & Tracheotomy, Ethical Guidelines, Febrile Neutropenia, FUG, Fluid Resuscitation, Guillain-Barre Syndrome, Heparin, Heparin-InducedThrombocytopenia, Hepatic Encephalopathy, Hepatic Failure, HIV+Patient Infections, Hypercalcemia Diagnosis and Treatment, Hyperglycemia Insulin Treatment, Hyperkalemia: Etiology & Treatment, Hypernatremia: Etiology & Treatment, Hypertensive Crisis,Hypokalemia: Etiology & Treatment, Hyponatremia: Etiology & Treatment, Hypothermia, Identification of Cervical Cord Injury, Implantable Cardio-defibrillator, Intra-Aortic Balloon Device, Intracerebral Hemorrhage, Latex Allergy, Magnesium Administration,Management of Hypotension, Inotropes, Management of Patients with Ascites, Empiric Meningitis, Meningitis, a Myasthenia Gravis, Myocardial Infarction, Myocardial Infarction with left bundle branch block, Necrotizing Soft Tissue Infections, NeuromuscularBlockers, Neuromuscular Complications of Critical illness, Non-Infectious Causes of Fever, Non-Traumatic Coma, Noninvasive Modes of Ventilation, Nutritional Management, Obstetrical Complication, Oliguria, Open Fractures, Ophthalmic Infections, OrganProcurement Guidelines, PA Catheter Guideline and Troubleshooting, Pancreatitis, Penetrating Abdominal Injury, Penetrating Chest Injury, Penicillin Allergy, Permanent Pacemaker and Indications, Pneumonia Community Acquired, Pneumonia Hospital Acquired,Post-Op Bleeding, Post-Op Hypertension, Post-Op Management of Abdominal Post-Op Management of Carotid, Post-Op Management of Open Heart, Post-Op Management of Thoracotomy, Post-Op Myocardial Ischemia (Non-Cardiac Arrhythmias after Cardiac Surgery),Post-Op Power Weaning, Pressure Ulcers, Pulmonary Embolism Diagnosis, Pulmonary Embolism Treatment, Respiratory Isolation, Sedation, Seizure, Status Epilepticus, Stroke, Sub-Arachnoid Hemorrhage, Supra-Ventricular Tachyarrhythmia, Supra-VentricularTachycardia, Wide Complex QRS Tachycardia, Therapeutic Drug Monitoring, Thrombocytopenia, Thrombolytic Therapy, Transfusion Guidelines, Traumatic Brain Injury, Assessment of Sedation, Sedation, Septic Shock, Bolus Sliding, Scale Midazolam, Short TermSedation Process, Sinusitis, SIRS, Spinal Cord Injury, Steroid Replacement Strategy, Thyroid Disease, Transplant Infection Prophylaxis, Transplant Related Infections, Treatment of Airway Obstruction, Unknown Poisoning, Unstable Angina, Upper GI BleedingStress Prophylaxis, Vancomycin, Upper GI Bleeding Non-Variceal, Upper GI Bleeding Variceal, Use of Hematopojetic Growth Factors, Ventilator Weaning, Ventilator Weaning Protocol, Venous Thrombosis Diagnosis and Treatment, Venous ThromboembolismProphylaxis, Ventricular Arrhythmia, Warfarin, Warfarin Dosing, and Wound Healing Strategies.

25. The method for standardizing care provided to hospitalized patients of claim 23, wherein the patient care guidance is a diagnosis.

26. The method for standardizing care provided to hospitalized patients of claim 23, wherein the patient care guidance is a method of treatment.

27. The method for standardizing care provided to hospitalized patients of claim 23, wherein the patient care guidance is a laboratory protocol.

28. The method for standardizing care provided to hospitalized patients of claim 23, wherein providing patient care guidance formulated to return the medical condition of the patient to compliance with the patient specific rule comprises:accessing an order writing module; and issuing an order from the order writing module.

29. The method for standardizing care provided to hospitalized patients of claim 28, wherein the order comprises authorization to administer medication to the hospitalized patient.

30. The method for standardizing care provided to hospitalized patients of claim 28, wherein the order comprises authorization to subject the hospitalized patient to a diagnostic procedure selected from the group consisting of to a laboratoryprotocol, a ventilator protocol, a hemodynamic protocol, and a radiology test.

31. The method for standardizing care provided to hospitalized patients of claim 28, wherein the order comprises authorization to subject the hospitalized patient a treatment procedure selected from the group consisting of a radiologicalprocedure and a surgical procedure.

32. The method for standardizing care provided to hospitalized patients of claim 23, wherein selecting data elements from the monitored data elements associated with a hospitalized patient and the patient data elements associated with ahospitalized patient comprises selecting a physiological data element of the hospitalized patient and a clinical data element of the hospitalized patient.

33. The method for standardizing care provided to hospitalized patients of claim 32, wherein the physiological data element is selected from the group consisting of heart rate, systolic pressure, diastolic pressure, pulmonary artery wedgepressure, central venous pressure, mixed venous oxygen saturation, oxygen saturation, tidal volume, inspiratory pressure, positive end expiratory pressure, respiration rate, electroencephalography and bispectral index.

34. The method for standardizing care provided to hospitalized patients of claim 32, wherein the clinical data element is selected from the group consisting of patient history, caregiver notes, laboratory reports, venous pressure, and urineoutput.

35. The method for standardizing care provided to hospitalized patients of claim 23, wherein selecting data elements from the monitored data elements associated with a hospitalized patient and the patient data elements associated with ahospitalized patient comprises selecting a physiological data element and a medication data element of the hospitalized patient.

36. The method for standardizing care provided to hospitalized patients of claim 23, wherein selecting data elements from the monitored data elements associated with a hospitalized patient and the patient data elements associated with ahospitalized patient comprises selecting a physiological data element of the hospitalized patient and a laboratory data element of the hospitalized patient.

37. The method for standardizing care provided to hospitalized patients of claim 23, wherein selecting data elements from the monitored data elements associated with a hospitalized patient and the patient data elements associated with ahospitalized patient comprises selecting a clinical data element of the hospitalized patient and a laboratory data element of the hospitalized patient.

38. The method for standardizing care provided to hospitalized patients of claim 23, wherein selecting data elements from the monitored data elements associated with a hospitalized patient and the patient data elements associated with ahospitalized patient comprises selecting a physiological data element of the hospitalized patient and another physiological data element of the hospitalized patient.

39. The method for standardizing care provided to hospitalized patients of claim 23, wherein selecting data elements from the monitored data elements associated with a hospitalized patient and the patient data elements associated with ahospitalized patient comprises selecting at least two data elements of the hospitalized patient selected from the group consisting of a physiological data element, a clinical data element of the hospitalized patient, a medication data element of thehospitalized patient, and a laboratory data element of the hospitalized patient.

40. The method for standardizing care provided to hospitalized patients of claim 23 further comprising: interfacing with an external network; providing a health care provider access to the remote command center via the external network.

41. The method for standardizing care provided to hospitalized patients of claim 40, wherein the external network is selected from the group consisting of a wired network, a wireless network, a cable network, a fiber optic network, and theInternet.

42. The method for standardizing care provided to hospitalized patients of claim 40, wherein the health care provider is selected from the group consisting of a physician, a nurse, a clinician, a diagnostician, and a intensivist.

43. The method for standardizing care provided to hospitalized patients of claim 40 further comprising sending the health care provider an alert if the patient-specific rule for the hospitalized patient has been contravened.

44. The method for standardizing care provided to hospitalized patients of claim 23, wherein the telecommunications network is selected from the group consisting of a wired network, a wireless network, a cable network, a fiber optic network,and the Internet.
Description:
 
 
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