WO2001071469A1 - Method and system for accessing medical information - Google Patents

Method and system for accessing medical information

Info

Publication number
WO2001071469A1
WO2001071469A1 PCT/US2001/008562 US0108562W WO0171469A1 WO 2001071469 A1 WO2001071469 A1 WO 2001071469A1 US 0108562 W US0108562 W US 0108562W WO 0171469 A1 WO0171469 A1 WO 0171469A1
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WO
WIPO (PCT)
Prior art keywords
information
health
medical
topic
information level
Prior art date
Application number
PCT/US2001/008562
Other languages
French (fr)
Inventor
Jeffrey William Dahms
Original Assignee
Dahms Jeffrey Williams
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Dahms Jeffrey Williams filed Critical Dahms Jeffrey Williams
Priority to AU2001249240A priority Critical patent/AU2001249240A1/en
Publication of WO2001071469A1 publication Critical patent/WO2001071469A1/en

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Classifications

    • GPHYSICS
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H70/00ICT specially adapted for the handling or processing of medical references

Definitions

  • TITLE METHOD AND SYSTEM FOR ACCESSING MEDICAL INFORMATION
  • the present application focuses on the information needs of three specific groups of medical information users: (1) medical researchers and research readers, (2) health professionals and (3) community users.
  • the medical researchers include research physicians or basic scientists who are interested in a particular medical or health topic.
  • the medical researcher group may also include academic, government and institutional research scientists.
  • the members of this group are generally interested in relatively few publications addressing a very narrow research area or topic that is at the cutting edge of their chosen field of expertise or area of interest.
  • Medical research readers in contrast, are a much larger group and have much broader reading interests. They include specialists who are not "bench" researchers, medical generalists and those reading outside their own field, and the lay community who are sufficiently familiar with medical and scientific language. It is this latter under-provided group that is largely being catered for here.
  • the health professional group includes practicing physicians and other health care professionals who are actively engaged in the care and treatment of patients and who may need the latest information available in particular health topic areas.
  • the health professional group may also include such health care professionals as nurses, dentists, osteopaths, physician assistants, pharmacists and therapists who have specialized information needs.
  • the community user includes those consumers or other individuals who have a serious interest in a particular health or medical topic or who are simply browsing for health or medical information. In some situations, the community user may also be a researcher, clinical practitioner, or health care professional who is interested in updating a specific topic or getting up to speed in a new area.
  • the traditional search of medical literature can be a highly individualized exercise, which reflects the interests, intuition, knowledge and experience of the individual.
  • the literature search may involve a physical review of various literature indexes or an electronic search resource such as the National Library of Medicine's MEDLLNE.
  • This search may be supplemented or supported by a review of introductory or background information contained in traditional medical texts and other reference sources.
  • this method might be used by a cancer researcher who wants to keep abreast of other areas of cancer research, or by the clinical physician who desires to stay abreast of developments or improve his or her knowledge in a particular area.
  • the community user who is interested in a particular area would use this same method despite the lack of the knowledge and experience of the physician or researcher.
  • the busy practicing physician is simply unable to devote significant time or effort to the time consuming task of reviewing and evaluating the content of original research articles and data on a regular basis.
  • their difficulties may be further compounded by a need for timely and concise information on the broader range of health topics and medical issues that are presented in the typical clinical or community practice environments.
  • Many of the information sources traditionally relied upon by practicing physicians are incomplete, fragmented or hopelessly out of date.
  • the information needs of the typical community member or consumer range from general information about a broad health topic to more specific information about various treatments or therapies.
  • the individual community user has an increasing need for timely and authoritative medical and health information.
  • medicine has become more technical and specialized, the physician has less time to spend with patients.
  • the increasing importance of managed care and health maintenance organizations (HMOs) has also restricted the time available for traditional consultation. The patient is increasingly left to his or her own resources.
  • the community or consumer user is faced with the same barriers of complexity and accessibility faced by researchers and health practitioners.
  • the community user may also face the additional limitations imposed by education, accessibility and time.
  • consumer and community users even highly educated individuals can experience substantial difficulty in obtaining and evaluating timely and authoritative health or medical information.
  • the traditional medical information resources e.g., such as professional journals, general interest publications, broadcast media programming, and medical texts, each have their own individual strengths and weakness.
  • Medical and health related publication might often be three to five years out of date between inception and publication.
  • the electronic versions of standard medical texts are often twelve to eighteen months out of date.
  • the information available from published sources is of uneven quality and is often unreliable.
  • the information presented by traditional broadcast media is increasingly suspect as "infotainment" or "infomercials.”
  • the content and quality of this material is also uneven and can be seriously tainted by non- medical considerations.
  • the Internet has recently made considerable quantities of information more accessible and available.
  • the Internet with its proliferation of health and medical websites is not a solution to the information problems faced by the medical community.
  • the volume and diverse character of Internet information is itself part of the problem because evaluating the various collections and sources of information on the Internet is fraught with uncertainty and risk.
  • high quality and reliable information is certainly available, other information can be dangerously dated or wildly inaccurate.
  • Figure 1 is a schematic representation of one embodiment of the database illustrating the organization thereof.
  • Figure 2 is a schematic representation of one embodiment of the method of the present invention.
  • Figure 3 is an example of a web page relating to Asthma illustrating one organization of the medical information for the medical practitioner.
  • Figure 4 is a web page relating to Asthma illustrating the common organization with Figure 3 but intended for the community user.
  • Figure 5 is an example of a web page for the medical practitioner relating to Bladder Cancer illustrating an organization common to Figures 3 and 4 for a different health topic.
  • Figure 6 is a web page relating to Bladder Cancer illustrating the common organization with Figure 3, 4 and 5 but intended for the community user.
  • Figure 7 is a pictorial illustration of a three information level database, illustrating some of the links between various domains and domain components.
  • the present invention uses a method of data management and organization to allow different types of users to access a common and authoritative source of medical information.
  • the method provides a continuously updated, multi- tiered approach to the organization and distribution of medical and health information so as to provide accurate and reliable health information and data on a timely basis.
  • the method also provides users of widely diverse ability, background and interest to access information from a common database that is organized and targeted to their specific needs, interest and capabilities.
  • the various medical topics are organized in a structural database that is specifically adapted for the particular needs of certain specified user groups. Because the individual members of each group have differing needs and capabilities, the information is organized and provided in a form that is specific to the needs and capabilities of each group of users.
  • the targeted users range from the most specialized medical researcher to the individual consumer of medical services.
  • the system and method performs the multiple tasks such as browsing, collecting and updating previously performed by the individual physician and health care professional, at a single click of the keyboard or mouse.
  • the first information level 100 contains information and resources for the researcher who is involved in basic or clinical research and has need for information regarding recent developments affecting a specific health topic or medical disorder.
  • the first information level also serves a much wider group as indicated above - specialists who are not "bench” researchers, medical generalists and those reading outside their won field, and the lay community who are sufficiently familiar with medical and scientific language.
  • the second information level 200 is targeted at those clinical practitioners and other health care professionals who may need current and authoritative information on specific health or medical topic. This level of information is typically the level at which a specialist would communicate with a fellow specialist or a generalist in a related or unrelated field, a complete understanding of the issues and decision making in the area in question.
  • the third information level 300 is targeted to the needs of the larger community who have an interest in a particular health or medical topic. Although each of these targeted user groups may have different objectives, interests and capabilities, they each share a common need for complete, authoritative and current information, and the method generally illustrated in Figure 2.
  • a plurality of individual health topics 10 to be included in the database are identified along with various medical disciplines or subcomponents 12 that are relevant to the selected health topics, such disciplines being further organized into sections such as The Disorder, Hospital Management, Research, Primary Care and Prevention. It should be noted that for the health topic being displayed at the top of the right-hand side pane of Figures 3 through 6, the three information levels, including electronic links to the two information levels not currently being displayed in the right-hand pane, appear underneath the corresponding health topic in the left-hand side pane.
  • a plurality of health topics will be identified 10.
  • a number of medical disciplines or subcomponent categories will be identified 12.
  • the identified medical disciplines may include such categories as epidemiology, etiology, genetics, pathology, natural history, history and physical examination, evaluation/differential diagnosis, diagnostics, laboratory tests, acute management, medical/surgical treatment,- hospital care, prognosis, best practice evidence base, treatments in development, chronic and long term care, psychological and social features, early detection and screening and risk factor evaluation and reduction.
  • Figure 2 illustrates one embodiment of the method. As illustrated in Figure 2, selected experts or specialists will initially select publications that are relevant to each identified health topic 14 and will provide a list of these research articles which are then made available in abstract and full text format at the three different information levels 16, 18, 20. A research guide (130 in Figure 1) that summarizes the idiosyncrasies and content of research in each identified research topic may also be prepared for research users.
  • health topic domain refers to a distinct medical topic or disorder such as heart disease or breast cancer.
  • Each health topic domain is further divided into a number of standardized components, twenty of which are illustrated in Figures 3 through 6. These components are selected to broadly match the organization and structure of the basic medical science and medical research literature and may be adjusted to accommodate the requirements of a specific database or user profile.
  • the first level 100 may contain a site index 110, a search engine 120, a one-page summary guide to research in each health topic 130, and the most important and relevant research for each identified health topic domain in full text and abstract format 140.
  • the content of the database will be continuously reviewed and updated so that new information will appear in the first information level of the database as articles are published.
  • links 150 will be provided to other electronic resources such as the above mentioned MEDLLNE and other selected websites, as well as to corresponding second and third level domain and domain components as discussed infra in connection with Figures 3 through 6.
  • the second level of information 200 is targeted to selected groups of medical and health care practitioners, with specific health topic information provided in at least two distinct formats.
  • One format is organized by specific topic domains and further subdivided into standardized domain components.
  • a second format presents the same material in a more user- friendly fashion with additional graphics. The contents of each health topic domain will be updated periodically so that recently published information will be incorporated into each domain and component domain as appropriate.
  • the third information level 300 is directed to the community user or consumer who will be able to access information on a broad medical topic such as heart disease or breast cancer.
  • the community level of information in the third information level will be distilled directly from the domain components that are provided to clinical practitioners and health care professionals on the higher information levels 100 and 200, e.g., an experienced primary care physician assisted by a communication specialist and a graphic artist may derive the substantive content of the third level domains and components directly from the content of the domains and components in the second level 200.
  • the common component structures of the second and third level domains, and the systematic editorial distillation of information, will facilitate the periodic and systematic updates of information and presentation in each domain and domain component.
  • the mapping of the community level domains and components to the domains and components of the higher information levels allows the electronic coupling of the information provided on the second and third information levels, and facilitates a component-by-component distillation, e.g., the etiology component domain of the Asthma domain at the third level of Figure 4 is linked directly to the corresponding etiology component of the second level Asthma domain illustrated in Figure 3.
  • the information provided to third information level 300 will be made available in at least two distinct presentation formats.
  • information will be organized by health topic domain and further subdivided into standard domain components.
  • the domain format the same material will be presented in a more user- friendly format containing additional explanatory text, graphics, models and diagrams. The appearance of the domain format will resemble traditional medical text.
  • the present invention allows each user to access a common medical database at a depth of detail and understanding that is most appropriate to the individual needs, interests and capabilities of the user.
  • the organization of the database permits the use of internal electronic cross-links that facilitate access to relevant information located elsewhere in the database.
  • electronic links will be provided between the various health topic domains and individual domain components of each of the information levels 100, 200 and 300. Additional links will also be provided from each health topic and component domain to corresponding health topic and domain components at the other information levels. The individual user may thus move easily between the different information levels of the database.
  • the information will be organized into an electronic database 22.
  • the database will contain at least three information levels, each level will have a plurality of topic domains and each topic domain will have a plurality of subdomains or domain components.
  • Each domain will be associated with a selected health topic 24.
  • the constituent subdomains or domain components will be associated with a selected medical discipline 25.
  • the abstracts will be entered into the selected domains and subdomains in the database 26.
  • appropriate electronic links will be provided throughout the database 28.
  • the database will be remotely accessible by the Internet and electronic networks 30.
  • While the information presented in the lower information level 300 is desirably presented in the English language and at a high school level, other languages may be provided in an expanded or alternative database in other embodiments.
  • Figure 3 illustrates an exemplary web page for the domain Asthma in the third and lowest information level. Links to each topic domain on the same information level are provided along the side of the page. By clicking on one of the listed domains, a link is provided to each of the other domains, where a screen will provide in a suitable conventional manner links to each of the other information levels for that domain. Alternatively, other links not shown for convenience may be provided so that the transition from one domain to any other domain may be accomplished in a single click.
  • a direct link may be provided to the next domain at the same level.
  • a link is provided to the component at the same information level.
  • the screen will provide in any suitable conventional manner a link to the other information levels for that specific component.
  • suitable conventional links may be provided from a component at one information level to the same component of any other domain at that information level.
  • the web page illustrated in Figure 4 shows how the domains and domain components may be organized for health professionals at the second information level. Note the similarities in the organization of the page and the links to other domains with a choice of information level and links to components of the domain at the same information level but with a choice of information levels.
  • the database of Figure 1 will be updated and revised on a predetermined, but not necessarily periodic, schedule.
  • the latest research is screened from all major medical, surgical and health services publications every two weeks and the content updated.
  • that update may serve as the source to be edited and formatted for use in the second information level and the content of that each domain and component of the second information level will be periodically updated.
  • this update will be every four weeks.
  • the updated information in the second information level may be used to update the abstracts in the third information level for community users, e.g., about every 6 weeks.
  • the present invention is intended to encompass the entire range of health and medical disciplines with the data contained within the major health topic domains addressing the needs and interests of a majority of medical professionals and consumers in the United States.
  • additional embodiments may readily be adapted to address the full range of global health and medical topics by increasing the number of domains and components.
  • the present invention is grounded in a very extensive fundamental consideration of the whole field of health information, both professional and community.
  • Information relating to specific health topics, such as breast cancer or coronary artery disease is divided into standardized components such as genetics, pathology, diagnostics, treatment, etc., which broadly match the natural divisions of the research literature.
  • the latest research screened from all the major medical, surgical and other health professional journals, is incorporated into the relevant domains and components of the database.
  • the various health topic domains and components may be continuously updated by minimal reconstruction and revision.
  • the use of internal electronic links between corresponding domains and components facilitates both use of the database and the updating thereof.
  • the medical community is adapting to the newly evolving cultural circumstance where patients are more actively involved in medical decision making.
  • This invention describes a shared information resource for the professional and community. At a single click, the individual user can access complete up to the minute information in a variety of presentation formats.
  • the database provides a common information resource that can be accessed by a broad mix of individuals.
  • the method will serve to reinforce the doctor-patient relationship and provide renewed support for quality doctor-patient relationships by providing a common point of reference. It is expected that the described method will redefine the field of health information and establish the de facto standard for a doctor/patient information resources.
  • the information in each information level is updated and revised on a time schedule that is coordinated with research and professional databases.
  • Community users are provided with timely updates of recent developments.
  • the community updates are provided within the same time frame as it becomes available to researchers, doctors and other health care professionals.
  • the system and method thus provides health care professionals and consumers with a common information resource that is readily accessible and comprehensive to users possessing vastly different needs, interests and capabilities.
  • the availability of a reliable and authoritative community information resource will greatly facilitate communication between the medical professional, the consumer and other interested parties, including HMOs, insurers and government agencies.
  • the integrated structure of the database provides a high degree of component synergy. Many of the database structures and objectives are possible only in the integrated database structure. For example, the twenty health topic domains of the preferred embodiment will address approximately 90% of major health problems in the developed world. Additional embodiments can be specifically targeted at more specialized national or international health issues, e.g., the content provided in the various information levels can be specifically tailored to the specialized educational needs and requirements of specific groups of health care professionals including doctors, osteopaths, chiropractors, optometrists, dentists, nurses, technicians, paramedics, pharmacists and other health care related occupations.
  • embodiments may be specifically tailored to fit the specialized needs and interests of government agencies and national and international public health organizations such as the World Health Organization.
  • the content of the health topic domains may be expanded to include additional specific medical conditions and topics. For example such an embodiment could focus on specific third world disease or health issues by a particular country or region.
  • the method and database structure may be adapted to the needs of veterinary researchers and practitioners.
  • the health topic domains of the first information level are specifically targeted to research in a particular medical specialty such as cardio-thoracic surgery.
  • a typical domain component could include specific information relating to mitral valve replacement procedures.
  • such a specialized databases could be produced, maintained and distributed in conjunction with the professional support of academic institutions, research facilities or various medical or professional associations.
  • the format of the individual domains and domain components facilitates efficient and cohesive upgrading of information.
  • the sequential editorial distillation of the tightly coupled information levels, domains and domain components reduces an otherwise overwhelming task to a straightforward and systematic procedure.
  • the process of scrupulous periodic reviews according to an established schedule provides assurance that the information provided is current and up to date.

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Epidemiology (AREA)
  • General Health & Medical Sciences (AREA)
  • Medical Informatics (AREA)
  • Primary Health Care (AREA)
  • Public Health (AREA)
  • Medical Treatment And Welfare Office Work (AREA)

Abstract

A method and system for identifying, organizing, referencing, distributing and accessing a unified source of medical information by groups and individuals each possessing varying levels of technical knowledge, capability and interests (100, 200, 300). The information is provided and formatted for use by targeted groups of users (220, 320). Medical information from various original sources is integrated into a database using a common organizational format. The information in the database is updated and edited at predetermined intervals and users of the database may be electronically linked (150, 230, 330) to specific health topic domains and selected sub-categories within the database.

Description

TITLE: METHOD AND SYSTEM FOR ACCESSING MEDICAL INFORMATION
RELATED APPLICATION
This application claims priority from U.S. Provisional Patent Application, Serial No. 60/189,980 filed March 17, 2000.
BACKGROUND OF INVENTION
The traditional systems and methods for distributing medical and health information to medical professionals and medical consumers are increasingly inadequate to meet the demands of modem medical practice. The systems and methods that are currently used for accessing and distributing medical information were largely developed during a period when medical knowledge was limited and otherwise slow to change. Despite the rapidly increasing pace of medical developments, the method used by doctors to keep up to date has remained essentially unchanged from fifty or a hundred years ago. Most doctors retain a personal store of clinical information which they update by taking continuing education courses, browsing selected journals, attending conferences and talking with colleagues.
In the traditional model of medical practice, the physician served as the gatekeeper of medical knowledge and provided appropriate information to his or her patients, largely on a need-to-know basis. For many years, this system worked to everyone's apparent satisfaction. However, the virtual explosion of medical and health information has presented an increasing challenge to the viability of the traditional model. In recent years, doctors and other health care professionals have been faced with a dramatic restructuring of the traditional health care model. The recent changes that have occurred in the structure of professional practice, health care financing and government health policy have tended to place increased emphasis on efficiency and fiscal accountability. At the same time, individual consumers have either demanded or been asked to assume more individual responsibility for health care delivery and medical decision-making. The community of medical consumers has thus been moving progressively toward a more active role in health care management and decision-making. However, as medical and health care decision-making has become more complex and consumer oriented, health care professionals and information have become much less accessible to the individual consumer.
The present application focuses on the information needs of three specific groups of medical information users: (1) medical researchers and research readers, (2) health professionals and (3) community users.
The medical researchers include research physicians or basic scientists who are interested in a particular medical or health topic. The medical researcher group may also include academic, government and institutional research scientists. The members of this group are generally interested in relatively few publications addressing a very narrow research area or topic that is at the cutting edge of their chosen field of expertise or area of interest. Medical research readers, in contrast, are a much larger group and have much broader reading interests. They include specialists who are not "bench" researchers, medical generalists and those reading outside their own field, and the lay community who are sufficiently familiar with medical and scientific language. It is this latter under-provided group that is largely being catered for here.
The health professional group includes practicing physicians and other health care professionals who are actively engaged in the care and treatment of patients and who may need the latest information available in particular health topic areas. The health professional group may also include such health care professionals as nurses, dentists, osteopaths, physician assistants, pharmacists and therapists who have specialized information needs.
The community user includes those consumers or other individuals who have a serious interest in a particular health or medical topic or who are simply browsing for health or medical information. In some situations, the community user may also be a researcher, clinical practitioner, or health care professional who is interested in updating a specific topic or getting up to speed in a new area.
These various groups of users share a common interest in timely, accessible, and authoritative medical information. The members of each group are faced with the literally hundreds of thousands of articles and publications that potentially impact a major health topic area. Moreover, the various areas of medical research are often organized and structured in a highly idiosyncratic fashion. The sheer volume and complexity of available medical information can be overwhelming, even to the trained researcher or medical professional.
The traditional search of medical literature can be a highly individualized exercise, which reflects the interests, intuition, knowledge and experience of the individual. The literature search may involve a physical review of various literature indexes or an electronic search resource such as the National Library of Medicine's MEDLLNE.
This search may be supplemented or supported by a review of introductory or background information contained in traditional medical texts and other reference sources. In practice, this method might be used by a cancer researcher who wants to keep abreast of other areas of cancer research, or by the clinical physician who desires to stay abreast of developments or improve his or her knowledge in a particular area. The community user who is interested in a particular area would use this same method despite the lack of the knowledge and experience of the physician or researcher.
Regardless of their background, the conscientious searcher of medical literature is faced with the following information management problem:
• The increasing rate of progress in medicine, and the time delay in publication of medical texts, means that traditional medical texts and references are declining in usefulness.
Because even the best "on-line" medical texts are updated only at widely spaced intervals, e.g., annually, the content may be as much as two years out of date in spite of the occasional 'supplements'. The updating of these sources can be arduous.
• The major online texts are texts of internal medicine, and further supplemental text material is needed from surgical texts, primary care texts, screening and preventive care texts, and best practice, clinical trial and drug databases. • Information in traditional medical texts is often poorly structured for ease of access and efficient usage.
Updating a research base from a search resource like Medline can be numbingly complex, with a search on a single health topic yielding a quarter of a million abstract titles. Clearly, the identification and distillation of current, relevant and authoritative information from the enormous reservoir of basic and applied research publications is a demanding and time consuming task. As a practical matter, many health professional and virtually all community users lack the time, training, or aptitude to comb the literature for specific information. Doctors and medical professionals who are involved in the various types of clinical or community practice face the same practical difficulties as researchers. As a practical matter, very few doctors practicing in a hospital, clinical or community environment have the time or resources to do justice to the task. The busy practicing physician is simply unable to devote significant time or effort to the time consuming task of reviewing and evaluating the content of original research articles and data on a regular basis. In fact, their difficulties may be further compounded by a need for timely and concise information on the broader range of health topics and medical issues that are presented in the typical clinical or community practice environments. Many of the information sources traditionally relied upon by practicing physicians are incomplete, fragmented or hopelessly out of date. The information needs of the typical community member or consumer range from general information about a broad health topic to more specific information about various treatments or therapies. The individual community user has an increasing need for timely and authoritative medical and health information. As medicine has become more technical and specialized, the physician has less time to spend with patients. The increasing importance of managed care and health maintenance organizations (HMOs) has also restricted the time available for traditional consultation. The patient is increasingly left to his or her own resources.
The community or consumer user is faced with the same barriers of complexity and accessibility faced by researchers and health practitioners. The community user may also face the additional limitations imposed by education, accessibility and time. Among consumer and community users, even highly educated individuals can experience substantial difficulty in obtaining and evaluating timely and authoritative health or medical information.
The traditional sources of medical information are simply not responsive to the needs of modern health care. In the present situation, only a limited number of research specialists are able to remain fully current with the most recent research while clinical practitioners often may fall well behind, even in their own specialty. Timely and authoritative information is beyond the reach of most community users. The consequences of this information shortfall can raise serious concerns about the reliability, efficiency and competence of medical care.
The traditional medical information resources, e.g., such as professional journals, general interest publications, broadcast media programming, and medical texts, each have their own individual strengths and weakness. Medical and health related publication might often be three to five years out of date between inception and publication. The electronic versions of standard medical texts are often twelve to eighteen months out of date. The information available from published sources is of uneven quality and is often unreliable. The information presented by traditional broadcast media is increasingly suspect as "infotainment" or "infomercials." The content and quality of this material is also uneven and can be seriously tainted by non- medical considerations.
The Internet has recently made considerable quantities of information more accessible and available. However, the Internet, with its proliferation of health and medical websites is not a solution to the information problems faced by the medical community. Indeed, the volume and diverse character of Internet information is itself part of the problem because evaluating the various collections and sources of information on the Internet is fraught with uncertainty and risk. Although high quality and reliable information is certainly available, other information can be dangerously dated or wildly inaccurate. Again, as with other types of information resources, it is generally difficult for the individual to evaluate information for its accuracy, quality or timeliness.
The rise of multi-disciplinary medicine also means that doctors and patients need to be familiar with the many ways that the various areas of medicine increasingly interact. The domain of relevant medical knowledge is no longer defined by a practitioner's particular area of specialty. In the modern world, a much larger field of medical knowledge now interacts with a practitioner's own working field. The general practice physician may need to know about current surgical options. The emergency room physician may need to know about advanced diagnostic, medical and surgical treatment options so that patients can be quickly triaged and appropriately treated. At a time when command of their own medical specialties is very difficult, the knowledge bar has been raised to the level where a working knowledge of many other fields is necessary.
The rapid pace of medical change and development further exacerbates the problem. Some fields of medicine and surgery are moving so swiftly that being a few months behind the research can be very significant. As previously discussed, the sheer complexity of the updating task and severe time constraints means that often only certain research specialists can stay well up with a particular field. Those doctors engaged in routine clinical practices, including specialty practices, are unable to remain current on the latest research, even in their own fields. A recent report by the Institute of Medicine states that it can take 17 years for important medical discoveries to be accepted and used by the average doctor. The information lag is sufficient to seriously concern the medical and surgical colleges, raising issues of competence not just information currency.
One problem with existing information sources and methods is that existing information sources have tremendous variation in terms of timeliness, accuracy, quality and accessibility. Another problem is that the available medical information may often be out of date. The reliance on untimely or out dated health information can lead to poor treatment choices or the avoidance of necessary treatment altogether.
Still another problem is the volume of information. Recent developments in information technology have dramatically increased the availability and accessibility of information. The sheer volume of data can be overwhelming. The individual often has little time to review, evaluate and digest the current literature for relevant information.
Yet another problem is the quality of information provided by currently available information methods and resources. The quality of the information that is now available on the Internet and from other sources is extremely variable and lacks any substantial means of quality control or assurance.
An additional problem is the accessibility of authoritative information by various groups. The information that is contained in professional research journals and publications is often physically inaccessible or otherwise indecipherable to the community user. Indeed, given the dramatic increase in medical specialization and complexity, even trained professionals can have difficulty understanding and interpreting primary research sources.
Accordingly, it is an object of the present invention to obviate many of the problems associated with existing medical information systems, methods and resources and provide a novel method and database that will improve the quality and efficiency of health care related communication and treatment.
It is also an object of the present invention to identify and organizing authoritative medical information for use by specified groups of users.
It is another object of this invention to provide a method and electronically accessible database that contains certain specific health topics and which is further organized by specified sub-category or domain component.
It is a further object of this invention to provide a method and system of distributing authoritative medical information to researchers, medical professionals and community users in a common format and structure.
It is yet another object of this invention to provide a novel method and system of selecting evaluating, organizing, updating and distributing authoritative medical and health specialized information to groups of users of vastly different capabilities and interest.
It is yet a further object of this invention to provide an efficient and user- friendly method for different groups of users to access and utilize a common electronic database of medical information.
It is still a further object of this invention to describe a method and database with electronic cross-links of information between related medical topics within a larger information database.
It is yet still a further object of this information to present selected medical information using a variety of selected electronic formats that are adapted to the needs and capabilities of specific users. It is an object of this invention to provide a method and system for updating a comprehensive database of medical information.
These and many other objects and advantages of the present invention will be readily apparent to one skilled in the art to which the invention pertains from a perusal of the claims, the appended drawings and the following detailed description of the preferred embodiments.
BRIEF DESCRIPTION OF THE DRAWINGS
Figure 1 is a schematic representation of one embodiment of the database illustrating the organization thereof.
Figure 2 is a schematic representation of one embodiment of the method of the present invention.
Figure 3 is an example of a web page relating to Asthma illustrating one organization of the medical information for the medical practitioner.
Figure 4 is a web page relating to Asthma illustrating the common organization with Figure 3 but intended for the community user.
Figure 5 is an example of a web page for the medical practitioner relating to Bladder Cancer illustrating an organization common to Figures 3 and 4 for a different health topic.
Figure 6 is a web page relating to Bladder Cancer illustrating the common organization with Figure 3, 4 and 5 but intended for the community user.
Figure 7 is a pictorial illustration of a three information level database, illustrating some of the links between various domains and domain components.
DESCRIPTION OF PREFERRED EMBODIMENTS
In one aspect, the present invention uses a method of data management and organization to allow different types of users to access a common and authoritative source of medical information. The method provides a continuously updated, multi- tiered approach to the organization and distribution of medical and health information so as to provide accurate and reliable health information and data on a timely basis. The method also provides users of widely diverse ability, background and interest to access information from a common database that is organized and targeted to their specific needs, interest and capabilities.
In the embodiment illustrated in Figure 1, the various medical topics are organized in a structural database that is specifically adapted for the particular needs of certain specified user groups. Because the individual members of each group have differing needs and capabilities, the information is organized and provided in a form that is specific to the needs and capabilities of each group of users.
As illustrated in Figure 1, the targeted users range from the most specialized medical researcher to the individual consumer of medical services. The system and method performs the multiple tasks such as browsing, collecting and updating previously performed by the individual physician and health care professional, at a single click of the keyboard or mouse.
The first information level 100 contains information and resources for the researcher who is involved in basic or clinical research and has need for information regarding recent developments affecting a specific health topic or medical disorder. The first information level also serves a much wider group as indicated above - specialists who are not "bench" researchers, medical generalists and those reading outside their won field, and the lay community who are sufficiently familiar with medical and scientific language.
The second information level 200 is targeted at those clinical practitioners and other health care professionals who may need current and authoritative information on specific health or medical topic. This level of information is typically the level at which a specialist would communicate with a fellow specialist or a generalist in a related or unrelated field, a complete understanding of the issues and decision making in the area in question. The third information level 300 is targeted to the needs of the larger community who have an interest in a particular health or medical topic. Although each of these targeted user groups may have different objectives, interests and capabilities, they each share a common need for complete, authoritative and current information, and the method generally illustrated in Figure 2. As shown in Figures 3 through 6, a plurality of individual health topics 10 to be included in the database are identified along with various medical disciplines or subcomponents 12 that are relevant to the selected health topics, such disciplines being further organized into sections such as The Disorder, Hospital Management, Research, Primary Care and Prevention. It should be noted that for the health topic being displayed at the top of the right-hand side pane of Figures 3 through 6, the three information levels, including electronic links to the two information levels not currently being displayed in the right-hand pane, appear underneath the corresponding health topic in the left-hand side pane.
As shown in Figure 2, a plurality of health topics will be identified 10. For each selected health topic, a number of medical disciplines or subcomponent categories will be identified 12. The identified medical disciplines may include such categories as epidemiology, etiology, genetics, pathology, natural history, history and physical examination, evaluation/differential diagnosis, diagnostics, laboratory tests, acute management, medical/surgical treatment,- hospital care, prognosis, best practice evidence base, treatments in development, chronic and long term care, psychological and social features, early detection and screening and risk factor evaluation and reduction.
Figure 2 illustrates one embodiment of the method. As illustrated in Figure 2, selected experts or specialists will initially select publications that are relevant to each identified health topic 14 and will provide a list of these research articles which are then made available in abstract and full text format at the three different information levels 16, 18, 20. A research guide (130 in Figure 1) that summarizes the idiosyncrasies and content of research in each identified research topic may also be prepared for research users.
As discussed above, the information in each information level will be organized by health topic domain and specific component domain categories. As used herein, the term "health topic domain" refers to a distinct medical topic or disorder such as heart disease or breast cancer. Each health topic domain is further divided into a number of standardized components, twenty of which are illustrated in Figures 3 through 6. These components are selected to broadly match the organization and structure of the basic medical science and medical research literature and may be adjusted to accommodate the requirements of a specific database or user profile.
As illustrated in Figure 1, the first level 100 may contain a site index 110, a search engine 120, a one-page summary guide to research in each health topic 130, and the most important and relevant research for each identified health topic domain in full text and abstract format 140. The content of the database will be continuously reviewed and updated so that new information will appear in the first information level of the database as articles are published. In addition, links 150 will be provided to other electronic resources such as the above mentioned MEDLLNE and other selected websites, as well as to corresponding second and third level domain and domain components as discussed infra in connection with Figures 3 through 6.
With continued reference to Figure 1, the second level of information 200 is targeted to selected groups of medical and health care practitioners, with specific health topic information provided in at least two distinct formats. One format is organized by specific topic domains and further subdivided into standardized domain components. A second format presents the same material in a more user- friendly fashion with additional graphics. The contents of each health topic domain will be updated periodically so that recently published information will be incorporated into each domain and component domain as appropriate.
With continued reference to Figure 1, the third information level 300 is directed to the community user or consumer who will be able to access information on a broad medical topic such as heart disease or breast cancer. The community level of information in the third information level will be distilled directly from the domain components that are provided to clinical practitioners and health care professionals on the higher information levels 100 and 200, e.g., an experienced primary care physician assisted by a communication specialist and a graphic artist may derive the substantive content of the third level domains and components directly from the content of the domains and components in the second level 200. The common component structures of the second and third level domains, and the systematic editorial distillation of information, will facilitate the periodic and systematic updates of information and presentation in each domain and domain component.
As shown in Figures 3 through 6, the mapping of the community level domains and components to the domains and components of the higher information levels allows the electronic coupling of the information provided on the second and third information levels, and facilitates a component-by-component distillation, e.g., the etiology component domain of the Asthma domain at the third level of Figure 4 is linked directly to the corresponding etiology component of the second level Asthma domain illustrated in Figure 3.
In the preferred embodiment, the information provided to third information level 300 will be made available in at least two distinct presentation formats. In the component format, information will be organized by health topic domain and further subdivided into standard domain components. In the domain format the same material will be presented in a more user- friendly format containing additional explanatory text, graphics, models and diagrams. The appearance of the domain format will resemble traditional medical text.
The present invention allows each user to access a common medical database at a depth of detail and understanding that is most appropriate to the individual needs, interests and capabilities of the user. The organization of the database permits the use of internal electronic cross-links that facilitate access to relevant information located elsewhere in the database. In preferred embodiments, electronic links will be provided between the various health topic domains and individual domain components of each of the information levels 100, 200 and 300. Additional links will also be provided from each health topic and component domain to corresponding health topic and domain components at the other information levels. The individual user may thus move easily between the different information levels of the database.
The information will be organized into an electronic database 22. The database will contain at least three information levels, each level will have a plurality of topic domains and each topic domain will have a plurality of subdomains or domain components. Each domain will be associated with a selected health topic 24. In each domain, the constituent subdomains or domain components will be associated with a selected medical discipline 25. The abstracts will be entered into the selected domains and subdomains in the database 26. As shown in Figures 3 through 6, appropriate electronic links will be provided throughout the database 28. As shown in Figure 2, the database will be remotely accessible by the Internet and electronic networks 30.
While the information presented in the lower information level 300 is desirably presented in the English language and at a high school level, other languages may be provided in an expanded or alternative database in other embodiments.
The preferred embodiment of the method anticipates making the information available on the Internet in the form of a web site. One possible format of the individual web pages is identified in accompanying Figures 3 through 6. For example Figure 3 illustrates an exemplary web page for the domain Asthma in the third and lowest information level. Links to each topic domain on the same information level are provided along the side of the page. By clicking on one of the listed domains, a link is provided to each of the other domains, where a screen will provide in a suitable conventional manner links to each of the other information levels for that domain. Alternatively, other links not shown for convenience may be provided so that the transition from one domain to any other domain may be accomplished in a single click. As shown in the upper right hand corner of the page illustrated in Figure 3, a direct link may be provided to the next domain at the same level. By clicking on one of the components on the right hand side of the page, a link is provided to the component at the same information level. Once at that component, the screen will provide in any suitable conventional manner a link to the other information levels for that specific component. In addition, suitable conventional links may be provided from a component at one information level to the same component of any other domain at that information level.
The web page illustrated in Figure 4 shows how the domains and domain components may be organized for health professionals at the second information level. Note the similarities in the organization of the page and the links to other domains with a choice of information level and links to components of the domain at the same information level but with a choice of information levels.
Other exemplary pages for the Bladder Cancer domain are provided in Figures 5 and 6, with Figure 5 at the second information level and Figure 6 at the third information level. Links are provided as described above.
With reference to Figure 7 where some of the links have been omitted for clarity, it is apparent that links are provided:
(a) vertically between the information levels within each domain;
(b) vertically between like components at each information level within each domain;
(c) horizontally between the components within each information level for each domain;
(d) horizontally between like components at the same information level but different domains; and
(e) between each domain and its associated components within each information level.
The database of Figure 1 will be updated and revised on a predetermined, but not necessarily periodic, schedule. In the preferred embodiment, the latest research is screened from all major medical, surgical and health services publications every two weeks and the content updated. Once the top level is updated, that update may serve as the source to be edited and formatted for use in the second information level and the content of that each domain and component of the second information level will be periodically updated. In the preferred embodiment, this update will be every four weeks. In turn, the updated information in the second information level may be used to update the abstracts in the third information level for community users, e.g., about every 6 weeks.
The scheduled update of the various information levels results in the addition of relevant and authoritative information reflecting the latest research developments is available to clinical practitioners within four weeks of publication, and at the community level two weeks later. It will be apparent to one skilled in the art that other schedules may be desirable for different uses of the database.
The present invention is intended to encompass the entire range of health and medical disciplines with the data contained within the major health topic domains addressing the needs and interests of a majority of medical professionals and consumers in the United States. However, additional embodiments may readily be adapted to address the full range of global health and medical topics by increasing the number of domains and components.
The present invention is grounded in a very extensive fundamental consideration of the whole field of health information, both professional and community. Information relating to specific health topics, such as breast cancer or coronary artery disease, is divided into standardized components such as genetics, pathology, diagnostics, treatment, etc., which broadly match the natural divisions of the research literature. According to a predetermined cycle, the latest research, screened from all the major medical, surgical and other health professional journals, is incorporated into the relevant domains and components of the database. In this fashion, the various health topic domains and components may be continuously updated by minimal reconstruction and revision. The use of internal electronic links between corresponding domains and components facilitates both use of the database and the updating thereof.
The medical community is adapting to the newly evolving cultural circumstance where patients are more actively involved in medical decision making. This invention describes a shared information resource for the professional and community. At a single click, the individual user can access complete up to the minute information in a variety of presentation formats. The database provides a common information resource that can be accessed by a broad mix of individuals. The method will serve to reinforce the doctor-patient relationship and provide renewed support for quality doctor-patient relationships by providing a common point of reference. It is expected that the described method will redefine the field of health information and establish the de facto standard for a doctor/patient information resources.
The information in each information level is updated and revised on a time schedule that is coordinated with research and professional databases. Community users are provided with timely updates of recent developments. The community updates are provided within the same time frame as it becomes available to researchers, doctors and other health care professionals. The system and method thus provides health care professionals and consumers with a common information resource that is readily accessible and comprehensive to users possessing vastly different needs, interests and capabilities. The availability of a reliable and authoritative community information resource will greatly facilitate communication between the medical professional, the consumer and other interested parties, including HMOs, insurers and government agencies.
The integrated structure of the database provides a high degree of component synergy. Many of the database structures and objectives are possible only in the integrated database structure. For example, the twenty health topic domains of the preferred embodiment will address approximately 90% of major health problems in the developed world. Additional embodiments can be specifically targeted at more specialized national or international health issues, e.g., the content provided in the various information levels can be specifically tailored to the specialized educational needs and requirements of specific groups of health care professionals including doctors, osteopaths, chiropractors, optometrists, dentists, nurses, technicians, paramedics, pharmacists and other health care related occupations.
Other embodiments may be specifically tailored to fit the specialized needs and interests of government agencies and national and international public health organizations such as the World Health Organization. In yet another embodiment, the content of the health topic domains may be expanded to include additional specific medical conditions and topics. For example such an embodiment could focus on specific third world disease or health issues by a particular country or region.
In yet other embodiments, the method and database structure may be adapted to the needs of veterinary researchers and practitioners.
The organizational and structural principles of the method and system may be applied to the needs of specific medical specialties and sub-specialties. In one such embodiment, the health topic domains of the first information level are specifically targeted to research in a particular medical specialty such as cardio-thoracic surgery. A typical domain component could include specific information relating to mitral valve replacement procedures.
In one possible embodiment such a specialized databases could be produced, maintained and distributed in conjunction with the professional support of academic institutions, research facilities or various medical or professional associations.
The format of the individual domains and domain components facilitates efficient and cohesive upgrading of information. The sequential editorial distillation of the tightly coupled information levels, domains and domain components reduces an otherwise overwhelming task to a straightforward and systematic procedure. Moreover, even in areas where no significant data changes occur, the process of scrupulous periodic reviews according to an established schedule provides assurance that the information provided is current and up to date.
While the preferred embodiments of the present invention have been described, it is to be understood that the embodiments described are illustrative only and the scope of the invention is to be defined solely by the appended claims when accorded a f, full range of equivalents, many variations and modifications naturally occurring to these of skill in the art from a perusal hereof.

Claims

I Claim:
1. A method for accessing medical information comprising the steps of:
(a) identifying a plurality of health topics;
(b) identifying a plurality of medical disciplines that are relevant to at least one of said health topics;
(c) selecting publications relevant to each health topic;
(d) abstracting at least one of the selected publications at a first information level appropriate for research subscribers interested in the health topic;
(e) abstracting at least one of the selected publications at a second information level appropriate for a health care professional interested in the health topic;
(f) abstracting at least one of the selected publications at a third information level appropriate for a lay person interested in the health topic;
(g) creating a database organized into three information levels, each level having a plurality of domains and each domain having a plurality of subdomains;
(h) associating each of the domains with one of the identified health topics; (i) associating each of the subdomains with a one of the identified medical disciplines; (j) entering into the database each of the abstracts into selected domains and subdomains; (k) providing electronic links between the abstracts in all domains in the same information level to thereby facilitate access to medical information relating to different health topics;
(1) providing electronic links between the abstracts in all domains in the three information levels for the same health topic;
(m) providing electronic links between the abstracts in all subdomains in the same information level to thereby facilitate access to medical information relating to the different disciplines relevant to the same health topic as well as medical information relevant to the same discipline for different health topics; and
(n) providing electronic links between the abstracts in all subdomains in different information levels within the domain to thereby facilitate access to medical information at different information levels relevant to the same discipline relevant to the same health topic.
2. The method of Claim 1 wherein step (e) is replaced with:
(el) abstracting the abstract in step (d) at a second information level appropriate for a health care professional interested in the health topic;
3. The method of Claim 2 wherein step (f) is replaced with:
(fl) abstracting the abstract in step (el) at a third information level appropriate for a lay person interested in the health topic;
4. The method of Claim 1 wherein the abstracts of selected publications include both text and associated pictorial data.
5. The method of Claim 1 including the step wherein, at a predetermined interval, selected abstracts contained in the domains and subdomains are updated and abstracts for additional publications are added to selected domains and subdomains.
6. The method of Claim 5 wherein said predetermined interval is about two weeks.
7. The method of Claim 5 wherein said predetermined interval is different for each information level.
8. The method of Claim 7 wherein the predetermined interval for the first information level is about two weeks.
9. The method of Claim 8 wherein the predetermined interval for the second information level is about four weeks.
10. The method of Claim 9 wherein the predetermined interval for the third information level is about six weeks.
11. The method of Claim 1 wherein the presentation format of the abstract is different for each of the three information levels.
12. The method of Claim 1 including the step of accessing the data base via the Internet.
13. The method of Claim 12 including the step of providing electronic links from at least one domain in at least one information level to other online databases.
14. The method of Claim 1 wherein each health topic includes an introduction to the domain.
15. The method of Claim 1 including the step of entering an essentially verbatim copy of each selected publication into the data base; and wherein each of the health topic domains includes a listing of the entered publications with electronic links to the publication.
16. The method of Claim 1 including the step of providing a concise guide to using the database.
17. The method of Claim 1 wherein said plurality of medical disciplines are comprised of the following: epidemiology, etiology, genetics, pathology, natural history, treatment, prevention.
18. The method of Claim 17 wherein said plurality of medical disciplines are additionally comprised of the following: history and physical examination, evaluation/differential diagnosis, diagnostics, laboratory tests, acute management, medical/surgical treatment, hospital care, prognosis, best practice evidence base, treatments in development, primary care, chronic and long term care, psychological and social features, early detection and screening, risk factor evaluation and reduction.
19. The method of Claim 1 wherein the plurality of health topics is about twenty.
20. The method of Claim 1 wherein the plurality of health topics is about five hundred.
21. The method of Claim 1 wherein the plurality of medical disciplines is about twenty.
22. The method of Claim 1 wherein the plurality of publications relevant to at least one health topic is three hundred.
23. The method of Claim 1 including the following steps:
(e)(1) abstracting each selected publication at a second information level appropriate for a medical student interested in the health topic; (e)(2) abstracting each selected publication at a second information level appropriate for a nurse or physiotherapist interested in the health topic; (e)(3) abstracting each selected publication at a second information level appropriate for a third world health care professional interested in the health topic;
24. The method of Claim 2 including the following steps:
(el)(l) abstracting each selected publication at a second information level appropriate for a medical student interested in the health topic; (el)(2) abstracting each selected publication at a second information level appropriate for a nurse or physiotherapist interested in the health topic; (el)(3) abstracting each selected publication at a second information level appropriate for a third world health care professional interested in the health topic;
25. The method of Claim 3 including the following steps:
(el)(l) abstracting each selected publication at a second information level appropriate for a medical student interested in the health topic;
(el)(2) abstracting each selected publication at a second information level appropriate for a nurse or physiotherapist interested in the health topic; (el)(3) abstracting each selected publication at a second information level appropriate for a third world health care professional interested in the health topic; 26. The method of Claim 1 including means for displaying the abstracts in at least one of the three information levels for at least one of the domains in a format similar to a medical text.
PCT/US2001/008562 2000-03-17 2001-03-19 Method and system for accessing medical information WO2001071469A1 (en)

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