Health Care

Modular health care information management system utilizing reusable software objects

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Health Care Abstract
A health care information management system that utilizes modular and reusable software objects to allow for user configuration. The disclosed information management system allows for the creation by the user of software objects representative of specific events and resources which will occur or be utilized during the provision of health care to patients. These user configured software modules then allow the user to track the provision of health care, the utilization of resources during the provision of health care, the allocation of resources to perform medical procedures and identify opportunities for enhancing efficiencies in the provision of health care services. In one embodiment of the invention described, the system allows for the user to create, manage and maintain software modules representing specific procedural pathways to be performed in a health care institution. The user creates these modules using user configurable software objects that function to represent containers, resources and data. The software objects are modular and re-usable and allow the user to select components for creation of the modules. The created modules may then be used to provide information management relating to the provision of the medical procedures represented by the procedural pathway modules.

Health Care Claims
What is claimed is:

1. A system for managing health care services, comprising:

a) computing means having;

i) input means for receiving patient health care information,

ii) storage means for storing data corresponding to the patient health care information,

iii) processing means for processing software objects corresponding to health care services management instructions and the patient health care information and producing health care services management output, and

iv) display means for visually presenting the health care services output,

b) the software objects including data software objects having;

i) means for receiving the patient health care information, and

ii) means for providing the patient health care information through a standardized interface,

c) the software objects including resource software objects for associating resources with information relating to the resources, including;

i) personnel resource software objects having;

(1) means for associating a health care personnel resource with information relating to the health care personnel resource, including at least one of a personnel resource billing rate, a personnel resource pay rate, and a personnel resource time requirement, and

(2) means for providing the information relating to the health care personnel resource through the standardized interface,

ii) equipment resource software objects having;

(1) means for associating a health care equipment resource with information relating to the health care equipment resource, including at least one of an equipment resource billing rate, an equipment resource cost, and an equipment resource time requirement, and

(2) means for providing the information relating to the health care equipment resource through the standardized interface, and

iii) supply resource software objects including;

(1) bundle supply resource software objects having;

(a) means for associating health care supply resources with information relating to health care supply resources, including at least one of a supply resource billing rate and a supply resource cost, and

(b) means for providing the information relating to health care supply resources through the standardized interface, and

(2) conditional bundle supply resource software objects having;

(a) means for associating health care supply resources with information relating to health care supply resources, including at least one of supply resource billing rates and supply resource costs, and

(b) means for selectively providing the information relating to health care supply resources through the standardized interface based at least in part on the patient health care information provided by at least one of the data software objects, and

d) the software objects including node software objects including at least a pathway node software object having;

i) means for selectively creating the data software objects,

ii) means for selectively creating the resource software objects,

iii) means for selectively linking the standardized interface of the data software objects and resource software objects into configurable procedural pathways associated with health care treatment plans,

iv) means for selectively adapting the information provided through the standardized interface of the data software objects, and resource software objects, and

v) means for providing the data software objects, and resource software objects, with a first set of functions specifically adapted to the pathway node software object.

2. The system of claim 1, further comprising container software objects having;

a) means for selectively associating groups of data software objects, resource software objects, and container software objects, and

b) means for associating the groups with information relating to at least one of a health care procedure and a health care resource kit.

3. The system of claim 1, wherein the node software objects further comprise a case node software object having:

a) means for receiving the procedural pathways from the pathway node software object and converting the procedural pathways into at least one of an open case software object and a closed case software object,

b) means for providing open case software objects and closed case software objects to the pathway node software object,

c) means for selectively adapting the information provided through the standardized interface of the data software objects and resource software objects, and

d) means for providing the data software objects and resource software objects with a second set of functions specifically adapted to the case node software object.

4. The system of claim 1, wherein the node software objects further comprise a model node software object having:

a) means for receiving the closed case software objects from the case node software object and converting the closed case software objects into analysis model software objects,

b) means for providing analysis model software objects to the case node software object,

c) means for selectively adapting the information provided through the standardized interface of the data software objects and resource software objects, and

d) means for providing the data software objects and resource software objects with a third set of functions specifically adapted to the model node software object.

5. The system of claim 4, wherein the node software objects further comprise a report node software object having:

a) means for receiving the analysis model software objects from the model node software object and converting the analysis model software objects into configurable report software objects

b) means for providing configurable report software objects to the model node software object,

c) means for selectively adapting the information provided through the standardized interface of the data software objects and resource software objects, and

d) means for providing the data software objects and resource software objects with a fourth set of functions specifically adapted to the model node software object.

6. The system of claim 1, wherein the node software objects further comprise a library node software object having;

a) means for selectively creating the data software objects,

b) means for selectively creating the resource software objects,

c) means for selectively creating container software objects,

d) means for selectively linking the standardized interface of the data software objects, resource software objects, and container software objects into configurable sets associated with the health care services,

e) means for selectively adapting the information provided through the standardized interface of the data software objects, resource software objects, and container software objects, and

f) means for providing the data software objects, resource software objects, and container software objects with a fifth set of functions specifically adapted to the model node software object.

7. The system of claim 1, further comprising means for scheduling health care services resources based at least in part on the health care services management output.

8. The system of claim 1, further comprising means for billing patients based at least in part on the health care services management output.

9. The system of claim 1, further comprising means for ordering supplies based at least in part on the health care services management output.

10. A system for managing health care services, comprising:

a) computing means having;

i) input means for receiving health care services information and health care services management instructions,

ii) storage means for storing data corresponding to the health care services information,

iii) processing means for selectively processing commands corresponding to the health care services management instructions based on the health care services information and producing health care services management output, and

iv) display means for visually presenting the health care services output,

b) data software objects having;

i) means for receiving patient health care information, and

ii) means for providing the patient health care information through a standardized interface,

c) resource software objects for associating resources with information relating to the resources, including;

i) personnel resource software objects having;

(1) means for associating a health care personnel resource with information relating to the health care personnel resource, including at least one of a personnel resource billing rate, a personnel resource pay rate, and a personnel resource time requirement, and

(2) means for providing the information relating to the health care personnel resource through the standardized interface,

ii) equipment resource software objects having;

(1) means for associating a health care equipment resource with information relating to the health care equipment resource, including at least one of an equipment resource billing rate, an equipment resource cost, and an equipment resource time requirement, and

(2) means for providing the information relating to the health care equipment resource through the standardized interface,

iii) supply resource software objects including;

(1) bundle supply resource software objects having;

(a) means for associating health care supply resources with information relating to health care supply resources, including at least one of a supply resource billing rate and a supply resource cost, and

(b) means for providing the information relating to health care supply resources through the standardized interface, and

(2) conditional bundle supply resource software objects having;

(a) means for associating health care supply resources with information relating to health care supply resources, including at least one of supply resource billing rates and supply resource costs, and

(b) means for selectively providing the information relating to health care supply resources through the standardized interface based at least in part on the patient health care information provided by at least one of the data software objects, and

d) container software objects having;

i) means for selectively associating groups of data software objects, resource software objects, and container software objects, and

ii) means for associating the groups with information relating to at least one of a health care procedure and a health care resource kit, and

e) node software objects including;

i) a pathway node software object having;

(1) means for selectively creating the data software objects,

(2) means for selectively creating the resource software objects,

(3) means for selectively creating the container software objects,

(4) means for selectively linking the standardized interface of the data software objects, resource software objects, and container software objects into configurable procedural pathways associated with health care treatment plans,

(5) means for selectively adapting the information provided through the standardized interface of the data software objects, resource software objects, and container software objects, and

(6) means for providing the data software objects, resource software objects, and container software objects with a first set of functions specifically adapted to the pathway node software object,

ii) a case node software object having;

(1) means for receiving the procedural pathways from the pathway node software object and converting the procedural pathways into at least one of an open case software object and a closed case software object,

(2) means for providing open case software objects and closed case software objects to the pathway node software object,

(3) means for selectively adapting the information provided through the standardized interface of the data software objects, resource software objects, and container software objects, and

(4) means for providing the data software objects, resource software objects, and container software objects with a second set of functions specifically adapted to the case node software object,

iii) a model node software object having;

(1) means for receiving the closed case software objects from the case node software object and converting the closed case software objects into analysis model software objects,

(2) means for providing analysis model software objects to the case node software object,

(3) means for selectively adapting the information provided through the standardized interface of the data software objects, resource software objects, and container software objects, and

(4) means for providing the data software objects, resource software objects, and container software objects with a third set of functions specifically adapted to the model node software object,

iv) a report node software object having;

(1) means for receiving the analysis model software objects from the model node software object and converting the analysis model software objects into configurable report software objects,

(2) means for providing configurable report software objects to the model 95 node software object,

(3) means for selectively adapting the information provided through the standardized interface of the data software objects, resource software objects, and container software objects, and

(4) means for providing the data software objects, resource software objects, and container software objects with a fourth set of functions specifically adapted to the model node software object, and

v) a library node software object having;

(1) means for selectively creating the data software objects,

(2) means for selectively creating the resource software objects,

(3) means for selectively creating the container software objects,

(4) means for selectively linking the standardized interface of the data software objects, resource software objects, and container software objects into configurable sets associated with the health care services,

(5) means for selectively adapting the information provided through the standardized interface of the data software objects, resource software objects, and container software objects, and

(6) means for providing the data software objects, resource software objects, and container software objects with a fifth set of functions specifically adapted to the model node software object.

11. An information management system for managing information relating to providing health care services, comprising:

a) a general purpose computer system having;

i) storage means for storing data corresponding to the information,

ii) processing means for processing management instructions,

iii) display means for visually presenting the information, and

iv) input means for receiving the management instructions and the information; and

b) information management software installed on the general purpose computer system and having software objects, each of the software objects providing a health care information management function and corresponding to an aspect of providing health care services, wherein the software objects are combined in procedural pathways corresponding to sets of health care procedures.

12. The information management system of claim 11, wherein the software objects further comprise node software objects for creating, altering characteristics of, and the management of the software objects.

13. The information management system of claim 12, wherein the characteristics of the software objects further comprise predefined options for modifying or manipulating a selected one of the software objects.

14. The information management system of claim 12, wherein the management of the software objects further comprises analyzing health care information associated with a selected one of the software objects.

15. The information management system of claim 11, wherein the software objects further comprise container software objects for containing the software objects, and corresponding to at least one of health care procedures, health care information, and health care resource groups.

16. The information management system of claim 15, wherein the container software objects further comprise care event container software objects for containing the software objects, and corresponding to health care procedures.

17. The information management system of claim 15, wherein the container software objects further comprise bundle container software objects for containing the software objects, and corresponding to health care resource groups.

18. The information management system of claim 11, wherein the software objects further comprise resource software objects corresponding to resources to be used in the provision of health care services.

19. The information management system of claim 18, wherein the resource software objects further comprise equipment resource software objects corresponding to equipment to be used in the provision of health care services.

20. The information management system of claim 18, wherein the resource software objects further comprise personnel resource software objects corresponding to personnel to be used in the provision of health care services.

21. The information management system of claim 18, wherein the resource software objects further comprise supply resource software objects corresponding to supplies to be used in the provision of health care services.

22. The information management system of claim 11, wherein the software objects further comprise data software objects corresponding to health care information associated with the provision of health care services.

23. The information management system of claim 11, wherein the software objects further comprise:

a) node software objects for creating, altering characteristics of, and managing the software objects,

b) container software objects for containing the software objects, and corresponding to at least one of health care procedures, health care information, and health care resource groups,

c) resource software objects corresponding to resources to be used in the provision of health care services, and

d) data software objects corresponding to health care information.

24. The information management system of claim 23, wherein the node software objects, container software objects, resource software objects, and data software objects are combined in cases corresponding to sets of health care procedures designated for a patient.

25. The information management system of claim 24, wherein the cases are selectively designated as open, corresponding to sets of health care procedures that are planned for a patient.

26. The information management system of claim 24, wherein the cases are selectively designated as closed, corresponding to sets of health care procedures that are completed for a patient.

27. The information management system of claim 23, wherein the node software objects, container software objects, resource software objects, and data software objects are combined in a library of predefined care event containers corresponding to predefined health care procedures.

28. The information management system of claim 23, wherein the node software objects, container software objects, resource software objects, and data software objects are combined in a library of predefined bundle containers corresponding to predefined health care resource groups.

29. The information management system of claim 23, wherein the node software objects, container software objects, resource software objects, and data software objects are combined in a library of procedural pathways having predefined care event containers corresponding to predefined health care procedures and predefined bundle containers corresponding to predefined health care resource groups, corresponding to predefined sets of health care procedures.

30. The information management system of claim 29, wherein at least a portion of the predefined bundle containers are selectively included based at least in part on the health care information in the data software objects.

31. The information management system of claim 23, wherein at least a portion of the resource software objects are selectively included within a procedural pathway node software object based at least in part upon user entered information in the data software objects.

32. An information management system for managing information relating to providing health care services, comprising:

a) a general purpose computer system having;

i) storage means for storing data corresponding to the information,

ii) processing means for processing management instructions,

iii) display means for visually presenting the information, and

iv) input means for receiving the management instructions and the information; and

b) information management software installed on the general purpose computer system and having software objects, each of the software objects providing a health care information management function and corresponding to an aspect of providing health care services, the software objects including;

i) node software objects for creating, altering characteristics of, and managing the software objects,

ii) container software objects for containing the software objects, and corresponding to at least one of health care procedures, health care information, and health care resource groups,

iii) resource software objects corresponding to resources to be used in the provision of health care services, and

iv) data software objects corresponding to health care information;

c) the node software objects, container software objects, resource software objects, and data software objects combined in procedural pathways corresponding to sets of health care procedures.

33. The information management system of claim 32, wherein at least a portion of the resource software objects are selectively combined within the procedural pathways based at least in part upon user entered information in the data software objects.

34. An information management system for managing information relating to providing health care services, comprising:

a) a general purpose computer system having;

i) storage means for storing data corresponding to the information,

ii) processing means for processing management instructions,

iii) display means for visually presenting the information, and

iv) input means for receiving the management instructions and the information; and

b) information management software installed on the general purpose computer system and having software objects, each of the software objects providing a health care information management function and corresponding to an aspect of providing health care services, the software objects including;

i) node software objects for creating, altering characteristics of, and managing the software objects,

ii) container software objects for containing the software objects, and corresponding to at least one of health care procedures, health care information, and health care resource groups,

iii) resource software objects corresponding to resources to be used in the provision of health care services, and

iv) data software objects corresponding to health care information; and

c) the node software objects, container software objects, resource software objects, and data software objects provided in a hierarchical form, corresponding to a sequential order of health care procedures to be performed, health care resources to be provided, and health care information to be gathered and recorded.

35. The information management system of claim 34, wherein at least a portion of the resource software objects are selectively provided based at least in part on the health care information recorded within the data software objects.

36. A method for managing health care services, comprising:

a) entering patient health care information into a computing means with an input means,

b) storing data corresponding to the patient health care information in a storage means,

c) processing software objects corresponding to health care services management instructions and the patient health care information on a processing means, and thereby producing health care services management output with the processing means, the processing further including;

i) selectively creating data software objects, equipment resource software objects, personnel resource software objects, bundle supply resource software objects, and conditional bundle supply resource software objects with a pathway node software object,

ii) receiving the patient health care information with the data software object,

iii) providing the patient health care information through a standardized interface,

iv) associating a health care equipment resource with information relating to the health care equipment resource with the equipment resource software object, the information relating to the health care equipment resource including at least one or an equipment resource billing rate, and equipment resource cost, and an equipment resource time requirement,

v) providing the information relating to the health care equipment resource through the standardized interface,

vi) associating a health care personnel resource with information relating to the health care personnel resource with the personnel resource software object, the information relating to the health care personnel resource including at least one of a personnel resource billing rate, a personnel resource pay rate, and a personnel resource time requirement,

vii)providing the information relating to the health care personnel resource through the standardized interface,

viii) associating health care supply resources with information relating to health care supply resources with the bundle supply resource software object, the information relating to health care supply resources including at least one of a supply resource billing rate and a supply resource cost,

ix) providing the information relating to the health care supply resources through the standardized interface,

x) associating health care supply resources with information relating to health care supply resources with the conditional bundle supply resource software object, the information relating to health care supply resources including at least one of supply resource billing rates and supply resource costs,

xi) selectively providing the information relating to health care supply resources through the standardized interface based at least in part on the patient health care information provided by at least one of the data software objects,

xii)selectively linking the standardized interface of the data software objects, equipment resource software objects, personnel resource software objects, bundle supply resource software objects, and conditional bundle supply resource software objects with the pathway node software object,

xiii) selectively adapting the information provided through the standardized interface of the data software objects, equipment resource software objects, personnel resource software objects, bundle supply resource software objects, and conditional bundle supply resource software objects with the pathway node software object, and

xiv) providing the data software objects, equipment resource software objects, personnel resource software objects, bundle supply resource software objects, and conditional bundle supply resource software objects with a first set of function specifically adapted to the pathway node software object, and

d) visually presenting the health care services output on a display means.

Health Care Description
FIELD OF THE INVENTION

This invention relates to the field of information systems for use in the health care environment and in particular to an information system incorporating software for supply, scheduling and resource utilization management in the health care environment. This specification includes a microfiche appendix of 50 slides with a capacity of 96 frames each, with a total of 1,450 frames. This application is a continuation in part of application 08/965,788, filed Nov. 7, 1997, entitled Modular Health-Care Information Management System Utilizing Reusable Software Objects, which issued on Nov. 30, 1999 as U.S. Pat. 5,995,937.

BACKGROUND OF THE INVENTION

One important consideration in the provision of health care is the allocation, utilization and consumption of resources such as labor, durable equipment, reusable supplies and disposable supplies. For example, one way for supplies to be obtained by hospitals is for a central supply service to order the individual supplies anticipated to be needed for a given time period. These supplies are maintained in a supply room until needed for a given procedure. Once a procedure is scheduled, a pick list (a list of supplies) is generated. A hospital employee then uses the pick list to withdraw the desired items from inventory and place them in the operating room where the procedure takes place. After the procedure is completed, unused supplies are returned to inventory, a list of used supplies is provided to the billing department, and the used supplies are disposed of or re-sterilized. However, this system is costly and inefficient.

For example, a relatively large inventory of supplies has to be maintained, particularly for standard items such as drapes, sponges, sutures, clamps, etc., which could be used in a large variety of procedures. The inventory of such items has to be large in order to insure that sufficient quantities are on hand for every procedure. Furthermore, the act of picking items for surgery and, later, restocking unused items, is onerous and expensive since relatively highly skilled labor is utilized to insure that the proper items were collected and that the restocked items are placed in the proper location. In particular, the restocking of unused items is a substantial burden on the hospital. Each item pulled from inventory has to be either used and billed for, or restocked and not billed for. If an item is not used during the procedure and is billed for anyway, the billing for that product could be considered fraud on the reimburser. Since items are often individually wrapped, the restocking procedure could be very time consuming, particularly where sufficient quantities of items are picked from inventory to cover any situation during surgery. For example, it is not uncommon to withdraw ten clamps from inventory and use only three or four, except in situations where heavy bleeding is encountered, which might necessitate the use of all ten.

What is needed, therefore, is an integrated information system for use in healthcare institutions for managing, optimizing and analyzing the use of resources within that institution.

SUMMARY OF THE INVENTION

The above and further objects are met in the exemplar embodiment of the present invention, having an information management system for managing information relating to providing health care services, including a general purpose computer system having storage means for storing data corresponding to the information, processing means for processing management instructions, display means for visually presenting the information, and input means for receiving the management instructions and the information. Information management software is installed on the general purpose computer system, which software includes software objects, where each of the software objects provides a health care information management function and corresponds to an aspect of providing health care services.

In various preferred embodiments the software objects include software objects of many different types. Node software objects are for creating, altering characteristics of, and the management of the software objects. Container software objects are for containing the software objects, and correspond to at least one of health care procedures, health care information, and health care resource groups. Types of container software objects include care event container software objects for containing the software objects, and which correspond to health care procedures, and bundle container software objects to contain the software objects, which correspond to health care resource groups.

Resource software objects correspond to resources to be used in the provision of health care services, and also are of several types. Equipment resource software objects correspond to equipment to be used in the provision of health care services. Personnel resource software objects correspond to personnel to be used in the provision of health care services, and supply resource software objects correspond to supplies to be used in the provision of health care services. Finally, data software objects correspond to health care information associated with the provision of health care services.

The node software objects, container software objects, resource software objects, and data software objects may be combined in different structures, including procedural pathways corresponding to sets of health care procedures, cases corresponding to sets of health care procedures designated for a patient, and libraries. The cases may be selectively designated as open, corresponding to health care procedures that are planned for a patient, or selectively designated as closed, corresponding to health care procedures that are completed for a patient. The libraries may be of predefined care event containers corresponding to predefined health care procedures, or predefined bundle containers corresponding to predefined health care resource groups, or a combination of the two. Libraries can also include predefined data software objects, corresponding to the predetermined sets of health care information to be gathered and recorded.

Further, the node software objects, container software objects, resource software objects, and data software objects may be combined in a library of procedural pathways having predefined care event containers corresponding to predefined health care procedures and predefined bundle containers corresponding to predefined health care resource groups, which procedural pathways correspond to predefined sets of health care procedures. The procedural pathways may contain data objects, corresponding to health care information to be gathered and recorded. The data objects may be used to selectively include a portion of the predefined bundle containers.

The node software objects, container software objects, resource software objects, and data software objects may be provided in a hierarchical form, corresponding to a sequential order of health care procedures to be performed, health care resources to be provided, and health care information to be gathered and recorded.

In an alternate embodiment of a system for managing health care services, a computing means has input means for receiving patient health care information, storage means for storing data corresponding to the patient health care information, processing means for processing software objects corresponding to health care services management instructions and the patient health care information and producing health care services management output, and display means for visually presenting the health care services output.

The software objects include data software objects, resource software objects, and node software objects. The data software objects have means for receiving the patient health care information and means for providing the patient health care information through a standardized interface.

The resource software objects associate resources with information relating to the resources, and are of several different types. Personnel resource software objects have means for associating a health care personnel resource with information relating to the health care personnel resource, including at least one of a personnel resource billing rate, a personnel resource pay rate, and a personnel resource time requirement, and means for providing the information relating to the health care personnel resource through the standardized interface.

Equipment resource software objects have means for associating a health care equipment resource with information relating to the health care equipment resource, including at least one of an equipment resource billing rate, an equipment resource cost, and an equipment resource time requirement, and means for providing the information relating to the health care equipment resource through the standardized interface.

Supply resource software objects include bundle supply resource software objects and conditional bundle supply resource software objects. The bundle supply resource software objects have means for associating health care supply resources with information relating to health care supply resources, including at least one of a supply resource billing rate and a supply resource cost, and means for providing the information relating to heath care supply resources through the standardized interface. The conditional bundle supply resource software objects have means for associating health care supply resources with information relating to health care supply resources, including at least one of supply resource billing rates and supply resource costs, and means for selectively providing the information relating to health care supply resources through the standardized interface based at least in part on the patient health care information provided by at least one of the data software objects.

The node software objects include at least a pathway node software object having means for selectively creating the data software objects and means for selectively creating the resource software objects. Means selectively link the standardized interface of the data software objects and resource software objects into configurable procedural pathways associated with health care treatment plans. Means also selectively adapt the information provided through the standardized interface of the data software objects, and resource software objects. Means further provide the data software objects and resource software objects with a first set of functions specifically adapted to the pathway node software object.

In a preferred embodiment, container software objects are also included, having means for selectively associating groups of data software objects, resource software objects, and container software objects, and means for associating the groups with information relating to at least one of a health care procedure and a health care resource kit.

BRIEF DESCRIPTION OF THE DRAWINGS

The foregoing embodiments of the present invention may be best understood with reference to the following Detailed Description of the Preferred Embodiments and the drawings, wherein:

FIG. 1 is a block diagram showing the generic form of the present invention;

FIG. 2 is a tree diagram showing the organization of a preferred form of the present invention, and

FIGS. 3-147 are screen shots of a computer program of an exemplar embodiment of the present invention.

DETAILED DESCRIPTION OF THE PREFERRED EMBODIMENTS

DeRoyal Industries, Inc., the assignee of U.S. patent application Ser. No. 08/846,798, filed Apr. 30, 1997, entitled, Method and System for the Tracking and Profiling of Supply Usage in a Health Care Environment, U.S. patent application Ser. No. 08/936,780, filed Sep. 24, 1997, entitled Method for the Analysis and Standardization of Bills of Resources, and U.S. application Ser. No. 08/889,948, filed Jul. 10, 1997, entitled Method for the Supply of Medical Supplies to a Health care Institution Based on a Nested Bill of Materials on a Procedure Level, which is a continuation-in-part of U.S. Pat. No. 5,682,728, issued Nov. 4, 1997, entitled Method for the Supply of Medical Supplies to a Health care Institution Based on a Nested Bill of Materials on a Procedure Level, the entire disclosures of which are hereby incorporated by reference thereto as if fully set forth herein, has been developing a resource utilization paradigm based upon the concept of the procedural pathway.

In the provision of medical services, the process by which medical services are provided may be described as a procedural pathway. Any given treatment regimen or clinical procedure may be easily described as a related series of care events. Each care event has some relation to at least one of either the preceding or the following care events that is logical and reasonable. For example, take a simple procedure such as suturing a wound. The task of suturing a wound can be described as a series of care events: 1) examination of the wound; 2) cleansing of the wound; 3) anesthesia; 4) suturing of the wound; and 5) dressing the sutured wound. Thus, each of these related care events make up a procedural pathway for the procedure of suturing a wound. Each of the care events could be broken down into a more detailed series of sub care events, thus, the concept of the procedural pathway is scaleable; that is, any given care event may be made of a series of care events and can therefore be described as a procedural pathway.

The concept of the procedural pathway may also be expanded to more involved procedures. For example, a patient might go to her doctor complaining of particular symptoms. The doctor might then make an examination or order tests. Based upon the result of the examination or tests, the doctor makes a diagnosis and prescribes a treatment regimen. The treatment regimen may include a surgical procedure to be performed in a hospital, as well as follow up care. In this case, the procedural pathway might look like: 1) patient induction (basic administration getting the patient into the doctor's system); 2) examination; 3) testing; 4) diagnosis; 5) prescription of treatment; 6) admission to the hospital; 7) pre-surgical testing; 8) pre-operative preparation; 9) anesthesia; 10) surgery; 11) post operative recovery; 12) discharge from hospital; 13) follow up treatment; 14) final discharge. Once again, each care event in the given example might be further broken down into smaller incremental care events, and thus represent a procedural pathway of its own. For example, the surgery could be broken down into each step associated with the surgery from the initial incision until the incision is closed.

Each care event represents the provision of some type of medical (or administrative) service, and each care event may also require the allocation of some type of resources in order to be performed. These resources may be in the form of labor (doctor, nurse, technician, data clerk, etc.), equipment (x-ray machine, respirator, vital signs monitors, etc.), or supplies (sponges, surgical instruments, drapes, x-ray film, sutures, medications, etc.). Thus, for each care event it is possible to identify the allocation of resources necessary for completion of the care event. For example, for the examination step described in the second example, the allocation of resources could be: 15 minutes of doctor's time, use of a specimen collector, use of a specimen container, and the use of a blood collection kit. Likewise, the testing step might include the use of an imaging device (such as an x-ray or MRI machine), thirty minutes of technician's time, use of x-ray film, use of an x-ray developer and associated chemical supplies, and fifteen minutes of a radiologist's time to interpret the images.

By describing events in the context of a procedural pathway, a framework is provided which allows for the systematic classification of the steps necessary to treat a particular patient as well as identifying the resource allocation necessary to properly complete the procedural pathway.

Basing an information system around the procedural pathway, as opposed to just tying services, supplies and other resources used to the patient, with no real relation to the pathway, provides an inherent ability to use the information more efficiently and to allow for greater cost accountability in the provision of medical services.

To illustrate the efficiency of the procedural pathway, it is best to analyze generally a hospital stay for a given patient. Initially, the patient will be admitted, have some blood work done, be assigned a room, possibly be subject to some diagnostic screenings, possibly have a surgical procedure done, spend a period of time recovering from the procedure and be discharged. Also, the procedural pathway may extend beyond the hospital stay and include follow up care such as periodic check ups or rehabilitation. Each step along the procedural pathway can be broken down into increasingly fine detail as series of more and more detailed sub procedures. For example, the surgical procedure can be further broken down into surgical preparation, anesthesia, the surgical procedure itself, closing and post operative anesthesia recovery. Each of these sub procedures could be further broken down into specific tasks to be performed at each stage.

As can be seen from the procedural pathway model, each stage of the procedural pathway is going to require the utilization of resources. These resources may be labor resources, consumable supply items, durable equipment, reusable supply items, particular rooms (i.e. patient rooms, OR's, recovery rooms, etc.) or services. For example, the blood work will require a technician to draw the blood, the disposable equipment for drawing blood, a labor resource to deliver the blood to the laboratory, the consumable and reusable supplies for handling and testing the blood, durable medical equipment for testing the blood, labor resources for testing the blood and generating the report, and a labor resource for providing the report to the patient's chart. As can be seen, each resource can be analyzed and tied to a particular care event along the procedural pathway.

Each procedural pathway is going to have some unique characteristics which will vary based upon the reason the patient is in the health care facility (the type of procedure), the doctor performing the procedure and the characteristics of the patient. The procedural pathway is preferably different for someone having heart bypass surgery from someone having out patient orthopedic surgery. Likewise, preferences vary from one doctor to another in performing the same surgery; i.e. one doctor may prefer the feel of one brand of scalpel while another doctor may prefer another. Finally, the patient will often dictate variation within a given procedure; i.e. one patient may have certain physical characteristics that require using certain supplies and equipment and another patient may require different supplies and equipment.

The present invention provides an information system for use in the health care environment that utilizes the procedural pathway paradigm for the input of data, the organization of data, the retrieval of data and the analysis of the data. In addition to storing unique data for each procedural pathway (historical data), the present invention also provides for the development of procedural pathways for certain medical procedures which have been analyzed and standard pathways developed. These procedural pathways, which are created from modular software objects configured by the user of the software associate the anticipated resource allocation to a given procedure and allow for the anticipation of resource consumption for each upcoming standard procedure.

For example, if a procedural pathway is developed for a hip replacement surgery, the procedural pathway for a given patient coming in for hip surgery is easily developed from the template. The information system user merely enters the identifying information about the patient and the surgeon performing the procedure, and the standard template generates a procedural pathway showing the resources required for that patient. At a further level of detail, departure points from the standard template can be identified and the alternate resource allocation for the departure points may also be provided in the information system.

For example, in co-pending application Ser. No. 08/846,798, the disclosure of which has been incorporated by reference, this feature is described as a conditional bundle. For example, in the hip replacement surgery described above, variations in resource requirements may vary from doctor to doctor because of differing techniques, requirements and subjective preferences. Thus, the standard template for a hip replacement surgery may be substantially the same for two different doctors, but vary on a few items. The conditional bundles can be used to account for the departure from the standard template for each doctor and, by entering the doctor performing the procedure, the information system can automatically associate the appropriate conditional bundle with the standard template to form the procedural pathway for a given patient.

In terms of resource management, there are two basic types of resources which will be needed to perform a medical procedure at a given location: 1) those resources which will need to be brought in from outside the location for the procedure and 2) those resources which are maintained by the location and which must be scheduled for a given procedure (for the purposes of this application, although doctors are not usually employed by the hospital, we will assume that they are resources associated with the location, since they are typically driving the scheduling of a procedure at a location). The management of outside and inside resources requires the consideration of two different sets of problems. Typically, the outside resources will primarily include the supplies which must be ordered from outside vendors, be delivered to the location and be provided at the appropriate time and place for the performance of the procedure. The inside resources will include the labor resources, equipment owned and maintained by the location and facilities at the location such as OR's, radiology, laboratories, etc.

In managing the outside resources there are two competing interests, the desire to have sufficient quantities of everything readily available, which necessitates a large inventory of supplies along with skilled personnel to maintain the inventory and deliver it for performance of the procedure, and the desire to minimize inventory, which minimizes inventory carrying costs, the risk that inventory will expire before use, tied up capital and the skilled labor necessary to maintain the inventory and pull it for each procedure.

In managing inside resources the goal is to maximize the utilization of each available resource while carrying only the minimum amount of required resources to get the job done. Management of these resources necessitates that efficient resource allocation tools be used so that the location is not carrying costs associated with labor, equipment and facilities which are not being fully used, while insuring that all of the procedures can be performed in a timely fashion. For example, idle employees, equipment, OR's, etc. all carry a substantial cost. However, overworked employees, overused equipment and overbooked facilities reduce the efficiency and efficacy of the performance of the procedures and result in additional costs. Thus, precise scheduling and resource utilization management software is necessary to allow for the maximum productivity from resources, while minimizing inefficiency caused by overbooked resources and overworked employees. Additionally, software which allows for the detailed analysis of historical resource utilization will allow for the prediction of when new labor and other resources will be needed and allow for the most effective way of acquiring those resources, often saving money as opposed to the last minute recognition and rush acquisition of such resources.

Description of the Preferred Embodiment

In the preferred embodiment, the information management system consists of a series of software objects implemented using Microsoft ActiveX controls which may be configured and linked by a user to build a custom configured health care information management system. Preferably, the information system is implemented on a Windows NT or Windows 95 based personal computer, which may or may not be networked. In order to maintain a database of information related to this information system, a database program such as Microsoft SQL/Server or Microsoft Access is used in background. The information system of the preferred embodiment generates data and communicates through an interface compatible with the background database program. Typically, the software objects which will be described are coded in Visual C++ or Visual Basic, and adhere to the framework of ActiveX or OLE controls so as to maintain the ability to be implemented as compatible software objects in a component based software architecture.

In general, the software provides a number of "nodes," each of which correspond to a particular function of the information system. For example, if the system will have functions for developing and maintaining software based procedural pathways, maintaining and logging resource consumption on a case by case basis, and studying resource consumption for logged cases, each of these functions represent one node. Each of these nodes uses the feature of ActiveX controls to allow objects created in one node to provide necessary information or form the basis for a new object in another node. The interaction of objects from one node to another will be described more fully hereinafter.

Referring now to FIG. 1, each node 200, as described, provides for a particular information management function in the present invention. Also, each node 200 represents a software object which will allow the user to perform certain functions and tasks relative to the information system function provided for the node 200. In general, the function of each node will be to allow the user to generate specific templates, or software object modules 202 which will organize additional software objects into custom configurations representative of the information to be managed. Under each node 200, the user will have access to further software objects, by copying from previously generated templates, by creating the objects or copying them from an object library, in order to access the functionality of the node 200.

The software objects available to the user will be of three specific types: 1) container objects 204, 2) resource objects 206 and 3) data objects 208. Each of these objects represent ActiveX software objects which function as miniature software programs to perform a specific function. Container objects 204 function as receptacles of other objects and act to organize the other objects in accordance with the user's specifications. Additionally, container objects 204 will be customized by the input of data from the user based upon what the container object 204 is designed to hold, the specific use to which the container object is subjected by the user and other usage specific data which the user will provide.

Resource objects 206 are software objects which represent resources to be utilized in the provision of the health care. Resource objects 206 typically represent supplies, or kits of supplies, equipment, personnel, pharmaceuticals, or any other resource which will be utilized during the provision of health care. Each resource object 206 will be populated with data relevant to that object and will communicate that information as required.

Data objects 208 are software objects which will be used by the user to collect specific information for use by the template or the information system. For example, it may be necessary to gather certain procedure specific information at some point in a procedural pathway and a data object 208 may be inserted at that point in a module 202 to collect such data and make it available to the appropriate software objects.

Use of the software objects is best understood by a general reference to one function of the information system. Referring now to FIG. 2, the first node 210 of the software represents the function of generation, modification and maintenance of software templates for procedural pathways using the objects previously described. This node 210 allows the user to create software modules 212, made up of user selected objects, which represent in software a health care procedure or procedural pathway. In general, as described previously, the procedural pathway will be broken down into a series of related care events, representing discrete sub procedures along the procedural pathway. Using the functionality provided by the procedural pathway node 210, the user develops a new module 212 by making an appropriate selection from the menu of the software. The user is prompted to input information relevant to the procedural pathway generally, such as the name of the procedural pathway, any hospital or other codes used to identify the type of procedure, doctors who perform that type of procedure, etc.

Once the module 210 is defined and created, the user breaks the procedure down into a series of care events. For example, if the procedure is a heart bypass operation, then various care events can be identified such as 1) anesthesia care event, 2) draping care event and 3) the operative care event. Each of these care events is implemented in the procedural pathway module 212 by the selection or creation of care event container objects corresponding to each care event 214, 216, and 218. These objects require the input of information relevant to the care event and function as containers for additional container, resource, or data care events.

Once the care event containers 214, 216 and 218 are created in the module 212, the user fills out each of the associated care events for the module. For example, a patient history data object 220 might be associated with the module 212, which prompts the user to obtain patient specific data when the procedural pathway is used relative to a particular patient. Resources are then associated with each care event.

For example, the Anesthesia Care Event container 214 may contain an anesthesia supply bundle container 222, which in turn can contain resources such as anesthesia drugs 224 and an airway circuit 226. Other resources, provided by a resource object, such as an anesthesiologist 228 and patient monitor 230, which are related to the anesthesia care event 214 are also associated with the anesthesia care event 230. In the example, the anesthesia drugs resource 224 represents a pharmaceutical resource object, which contains certain information relevant to the specific drugs to be delivered, while the airway resource 226 represent specific supplies to be used in the anesthesia care event object 214.

These two items, because they will be used together, are combined in a supply bundle container 222 which may be reused for other procedures, which include an anesthesia care event. The anesthesiologist resource 228 represents a personnel resource object and will contain information concerning the anesthesiologist, including identification, time to be allotted for the procedure and scheduling information. The patient monitor resource object 230 represents an equipment resource, which contains information about its availability and utilization.

This process is repeated until each of the remaining care events 216 and 218 for the procedural pathway is completed (a more complete description of a procedural pathway, including examples of multiple care events which have been completed is provided in the Description of an Exemplar Embodiment below). The user of the information system then has a software module 212 configured for the heart bypass procedural pathway, which consists of container, resource and data objects. Each of the software objects encapsulates information particular to that object and communicates that information via a standard interface to other software objects as such information is required.

For example, after constructing a particular procedural pathway module, the user might desire to schedule a procedure for a particular patient using the procedural pathway. By utilizing a node designed to manage information for individual cases, the user could select the appropriate procedural pathway module, which transfers the data from the procedural pathway module for that procedure into a case module. The case module then contains all of the information from the objects from the selected procedural pathway module and provides a ready listing of resources to be utilized in performing the procedure. With this information, schedules of supplies, equipment, etc. could be generated in order to facilitate the performance of the procedure.

Additionally, as will be described more fully hereinafter, by creating a case module, the user has available the case node functionality which allows for the tracking of resource utilization in performing the procedure and creation of a consumption record for use in analyzing resource utilization, generating cost information for cost recovery and allows the user to perform other case node specific functions. Also, to the extent that objects created in the procedural pathway have utility for other procedural pathways, the created objects may be reused to develop additional procedural pathways.

As will be described in greater detail below, the various types of objects are predefined in the overall software system. Container objects are available to represent care events, supply bundles and conditional supply bundles. Each type of container may then be configured by the user to reflect the particulars of the procedural pathway to be represented. Care event containers will be configured with specific information for each care event in the procedural pathway and will contain information relevant to that care event. Supply bundles will be provisioned with supply resource objects and will have information specific to that supply bundle contained therein. Conditional supply bundles will be provisioned with supplies and a condition, which will determine if that conditional supply bundle will be used; for example, a conditional supply bundle may be developed for a particular surgeon and will have supplies used only by that surgeon provided therein. Then, if the condition is met when a case is scheduled, such as the particular surgeon is assigned to the case, that conditional bundle will automatically be added to the list of objects associated with that case.

Similarly, various types of resource objects are provided as standard templates for configuration by the user. Examples of such types of resource objects are supplies, kits (which are pre-packaged groups of supplies), equipment, personnel and pharmaceuticals. When configuring resource objects for a procedural pathway, the user selects the appropriate supply type for the resource to be represented and inputs the prompted information. For example, the user might be able to look up a database of listed supplies and select a particular supply for inclusion in the procedural pathway. Alternatively, the user could create a new supply from scratch by inputting prompted information to create a new supply resource object. The type of information varies from resource type to resource type, but a standard template is provided for each resource type to prompt the user to input the appropriate information for each resource to be added.

Additionally, while the user has the option to create various container, resource and data objects from scratch for use in the information system, the user, to the extent appropriate, can reuse previously created objects. For example, the user might create a library of standard pre-configured objects which are frequently re-used in various procedural pathways. Thus, when a new pathway is being created, these library objects may be selected for inclusion in the new pathway. Likewise, information concerning a variety of resources may be maintained in various database systems maintained by a health care institution. The supply department may maintain a database of available supplies, or dealers may provide databases of available supplies, by providing standard database program interfaces for these sources of information. Data from these source may then be automatically read into the present system in order to configure resource software objects for use therein.

As described, the use of software objects to represent events, bundles, resources and data objects in a health care information management system allows the user to readily create software modules which represent specific health care procedures which are much more functional then with traditional health care database systems. Furthermore, the module object approach to the system makes it more readily customizable for particular installations. For example, if the standard configuration of any software object is not readily adapted for a particular installation, a programmer will not be required to modify a monolithic source code listing to implement the new configuration. For customization, the user will only have to reconfigure a particular object. As long as the standardized data interface for the object is retained, there will not need to be any change in configuration in the remaining source code for the system.

Additionally, the use of the software object framework allows for the ready implementation of new functionality, without requiring the rewrite of the majority of the code for the system. For example, if a new functionality is required, a new functional node may be added which will utilize, to the extent possible, already existing software objects. One example might be to add a scheduling node to the above described software to allow for the ready scheduling of personnel, equipment, supplies, etc. Most of the scheduling information for any given procedure will be available in the procedural pathway module for that procedure. Thus, to create a scheduling node, the user creates a software object that queries existing objects for data relevant to scheduling and organizes that data in a useful manner. In the context of the present invention, such a node could create scheduling objects for various resources indicating their utilization schedule (as received from the object representing such resources) which would automatically query scheduled resources, check their availability and establish a calendar for each. Other functionality could be created by the creation of other nodes.

For example, the functionality of tracking resource utilization in the manner described in application Ser. No. 08/846,798, filed Apr. 30, 1997, entitled Method and System for the Tracking and Profiling of Supply Usage in a Health Care Environment, may be provided as a functional node software object. In implementing such a node, each individual procedural pathway as described in that application may be copied from a procedural pathway constructed as described above with reference to FIG. 2. A further type of node functionality is described in U.S. patent application Ser. No. 08/936,780, filed Sep. 24, 1997, entitled Method for the Analysis and Standardization of Bills of Resources, which provides from the conversion of case software module objects into models which could then be analyzed for resource utilization efficiency and the standardization of bills of resource. Furthermore, the output of the node functionality described in application Ser. No. 08/936,780, could then be used to create an optimized procedural pathway under the procedural pathway node described with reference to FIG. 2.

The functionality described above is implemented in the Meridian.TM. information management system marketed by DeRoyal Business Systems, 200 DeBusk Lane, Powell, Tenn., 37849, which is an affiliate of the assignee hereof, DeRoyal Industries, Inc.

Description of an Exemplar Embodiment

The foregoing functionality may be best described with reference to the following exemplar embodiment. The exemplar embodiment is available as the Meridian.TM. software package available from the assignee hereof, DeRoyal Industries, Inc. The software of the exemplar embodiment hereof is preferably run under the Windows 95 or Windows NT operating systems and interfaces with a SQL compliant database such as Microsoft SQL/Server or Microsoft Access. Much of the information maintained by the exemplar embodiment described herein will be maintained in tables which are created and managed using the background database software.

Referring now to FIG. 3, there is shown the Meridian.TM. Browser window 250. The Browser window 250 is similar in appearance to the Windows Explorer window provided in the Windows 95 and Windows NT environments and maintains similar functionality. To the left of the window 250 is a Nested Tree view 252, which allows the user to see the Meridian.TM. nodes, depicted as folders, and other objects. In the top right of the window 250 is a Second Tree view 254, which provides similar functionality. The provision of the dual tree views 252 and 254 is to allow the user to move items from one location in the tree to another location, using drag and drop, in the event that the two locations are separated by more than one window's distance (in the instance where the source folder and destination folder are not both displayed in the same window). Furthermore, this dual tree view allows the user to look at different items at the same time. In the lower right hand side of the window 250 is the List view 256, which displays the contents of whatever item is highlighted in the tree view 252 or 254. It should be further noted that the mouse functionality of Windows 95 or Windows NT is maintained in the Meridian.TM. software; that is, the standard features of highlighting selected folders, files or objects, dragging and dropping and right clicking are retained.

At the top of the Browser window 250 are drop down menus File 258, Edit 260, view 262, Log 264, Maintenance 266 and Help 268. The File 258, Edit 260, view 262 and Help 268 drop down menus maintain the standard functionality of any Windows.TM. program with some Meridian.TM. specific features. The remaining drop down menus deal with functions specific to the exemplar embodiment.

Below the drop down menus is the Meridian.TM. tool bar 270 which is provisioned with buttons to allow shortcut implementation of common functions which are also provided in the drop down menus and other menus. However, the cut 272, copy 274, paste 276 and paste shortcut 278 buttons function in the standard Windows.TM. environment.

In the tree views 252, 254, the top level is the Meridian.TM./RCL software itself 280, under this level are functional nodes relating to various information management functions to be performed by the software. The nodes shown in this embodiment are Resource Plans 282, Open Cases 284, Closed Cases 286, Standardization Reports 288, Models 290 and Libraries 292. Each node represents a different functionality or acts as a folder for storing various information. Functional nodes (as opposed to mere folders) are provided as software objects. In most cases, the function of the node software objects is to allow for the creation, management and maintenance of additional software objects which perform specific information management tasks.

Referring now to FIG. 4, the Resource Plans software node 282 is highlighted and its menu functions activated by a right click of the mouse. As shown in FIG. 4, by right clicking on the Resource Plans node 282, the Resource Plans menu 294 is activated. The user may then select one of the menu functions, either New Pathway Folder 296 or New Pathway 298, to activate a function. In FIG. 4, the user has selected the New Pathway Folder 296 function, depicted as inverted text.

Referring now to FIG. 5, after the user has selected the New Pathway Folder function 296 of FIG. 4, a Custom Folder window 300 is presented, which allows the user to enter the name for the new pathway folder. The name of the new folder is entered into the description window 302 and the user then selects the OK button 304 to finish the creation of the new folder.

Referring now to FIG. 6, it can be seen that the new Cardiac Procedures folder 306 has appeared under the Resource Plans node 282. In FIG. 6, the user has right clicked on the Cardiac Procedures folder 306 and activated the Resource Plans node menu 294 and has selected the New Pathway function 298, which will allow the user to create a new procedural pathway module software object.

In FIG. 7, the Create New Resource Plan window 307 has appeared in response to the user selection of the New Pathway function 298 described in FIG. 6. The Create New Resource Plan window 307 prompts the user to input information concerning the software module to be created. In the Item No. field 308, the user inputs the desired identifying number for the new pathway (or, alternatively, the software will provide the next number in sequence which has not yet been used). In the Description field 310, the user types in the desired description for the pathway. Other fields which may be completed are the Date Created field 312 (the default date will be the current date) and the Created By field 314. Finally, the Procedure Attributes field 316 is provided which will allow the user to select standardized procedure codes, such as the AMA IC9 code and description, for the procedure to be represented by the pathway.

This function is provided with a database search capability, by the Search button 318, which allows the user to search a pre-configured procedure code database for the appropriate procedure information. The Remove button 320 allows the user to remove selected procedure codes from the Procedure Attributes field 316 if an inappropriate selection is made. The OK button 322 allows the user to approve the input and exit the Create New Resource Plan window 307 while saving the information. The Cancel button 324 allows the user to exit the Create New Resource Plan window 307 without saving the information. The Apply button 326 serves to update database records concerning the new pathway upon activation. In the present case, the user, upon completion of the information, selects the OK button 322 to exit the Create Resource Plan window 307 and return to the Browser window 250.

Once the new procedure is added, an Open Heart icon 328 appears under the appropriate Cardiac Procedures folder 306 to indicate the new Open Heart procedural pathway software module as is seen in FIG. 8. In FIG. 8 the user has selected the Open Heart icon 328 and right clicked on the mouse to call up the Procedural pathway module menu 330, which provides functions related to the creation, management and maintenance of the various procedural pathway software modules created by the user. In FIG. 8 the user has selected the Add function 332 from the Procedural pathway module menu 330, which will allow the user to add items to the Open Heart procedural pathway 328.

As described previously, using the procedural pathway paradigm, a medical procedure is broken down into a series of related care events. Typically, the user of the present invention first adds the various care events to the pathway software module and provisions them later. The following description provides a walk through of how to add various care event containers to the pathway.

Referring now to FIG. 9, the Maintain Container Resource window 334 appears in response to selecting the Add function 332 from the Procedural pathway module menu 330. The Maintain Container Resource window 334 has Header Information 336 which provides the user with information specific to the procedural pathway module which is being maintained. The remaining portions of the Maintain Container Resource window 334 are devoted to the creation and searching of available container resources for addition to the procedural pathway module.

In FIG. 10, the user has selected the designation of Containers in the Class field 338 and the designation of Care Event in the Item Type field 340, and selected the New function 342 (depicted in FIG. 9). These selections cause the Create a Care Event window 344 to appear. The Create a Care Event window 344 allows the user to input information into the Item No. field 346, Description field 348 and select the type of the new care event to be added to the procedural pathway module in the Type field 350. As shown in FIG. 11, the user has entered the appropriate information into the fields, and by selecting the OK button 352 may proceed.

After selecting the OK function 352, the user is returned to the Maintain Container Resource window 334, shown in FIG. 12. As can be seen in FIG. 12, the newly created open heart anesthesia care event information is provided in the Item No. field 354 and Description field 356. Other user configurable fields, Quantity Consumed field 358 and C/P field 360 allow the user to select the number of the selected items which will appear in the component listing. By selecting the Add New Component button 362, as depicted in FIG. 13, the Open Heart Anesthesia Care Event 364 appears in the Component Listing field 366, shown in FIG. 14. This process may be repeated as required for new care events to provision the procedural pathway module.

As seen in FIG. 15, an additional new care event called the Open Heart Operative Care Event may be created in the same manner by selecting the New button 342 in the Maintain Container Resource window 334 and entering the appropriate information in the Create a Care Event window 344. This new care event can then be added to the Open Heart Procedural pathway 328 as described previously for the open heart anesthesia care event.

Each created care event is a software object of the container type. As such, each care event is a self contained module relating to the specific care event and is designed to hold additional container, resource and data objects relating to that particular care event. As a software object, once created, care events may be re-used where appropriate. For example, if the user has created a standard anesthesia care event, and desires to use it in other procedural pathway software modules, it may be selected and used without the step of creating a new care event. In fact, the user may create libraries of re-usable software objects which allow for the faster and easier creation of new procedural pathways.

Referring now to FIG. 16, the Browser window 250 shows the Open Heart module 328 including the added Open Heart Anesthesia Care Event object 364 and Open Heart Operative Care Event object 370 in the Nested Tree view 252. In the Second Tree view 254 the user has selected the Libraries node 292, and the List view 256 shows the items and subfolders available under the Libraries node 292. Shown in the List view 256 are subfolders for Resources 374 and Containers 376 and the Product Category Tree 378, which is a hierarchical taxonomy of products classified by type. In FIG. 17, the Containers folder 376 is expanded to show additional subfolders of different types of containers: 1) Care Events 380, 2) Conditional Bundles 382 and 3) Resource Bundles 384.

In FIG. 18, the Care Events subfolder 380 is expanded to show the pre-configured care event objects which are available. In FIG. 19, the user has selected the Pre-Operative Care event 386 for addition to the Open Heart procedural pathway 328. By dragging and dropping using the mouse, the user may copy the Pre-Operative Care Event 386 into the Open Heart procedural pathway 328 where it appears in FIG. 20. This procedure has allowed the user to select a pre-configured care event software object and add it to a procedural pathway module without requiring the creation of a new care event from scratch. The library of pre-configured software objects allows the user to maintain a set of re-usable objects representing standard items for inclusion in procedural pathways.

In FIG. 21, the user has selected the Open Heart procedural pathway 328 and called up the Procedural pathway module menu 330 and selected the Resequence function 388. This function allows the user to change the order of the items shown under the Open Heart procedural pathway 328. By selecting the Resequence function 388, the user is presented with the Resequence Components window 390, shown in FIG. 22. This window 390 shows the items under the Open Heart procedural pathway 328 and by selecting the desired care event, such as the Pre-Operative Care Event 386, and using the arrow keys to the right of the window 390 the user may move the selected care event 386 to the desired location, shown in FIG. 23. Once the desired sequence is achieved, the user exits the Resequence Components window 390 by selecting the OK button 394. As shown in the Browser window 250 of FIG. 24, the new care event sequence has appeared under the Open Heart procedural pathway 328 with the Pre-Operative Care Event object 386 appearing first, followed by the Open Heart Anesthesia Care Event object 364 and the Open Heart Operative Care Event object 370.

Containers may be added by using the database search functions of the Maintain Container Resource window 334 as well. Shown in FIG. 25, the user has entered the Maintain Container Resource window 334 as previously described. The Maintain Container Resource window 334 displays the care events which are added to the Open Heart procedural pathway 328 in the Component Listing field 366. From the Maintain Container Resource window 334, the user may search the database related to the information system to add components which have already been created, by selecting the Query mode button 398. By selecting the class of the object in the Class field 338 and the item type of the object in the Item Type field 340 the user may search the database for all objects having those attributes by selecting the Search button 318. The results of the query appear in the Query Results window 400 shown in FIG. 26.

The Query Results window 400 shows all objects which meet the search criteria entered into the Maintain Container Resource window 334. The user may then highlight a desired object, in this case the Post Operative Care Event 402, in the Query Results window 400, as shown in FIG. 27. The user adds the desired Post Operative Care Event 402 by selecting the Add New Component button 362 as previously described. As shown in FIG. 28, the newly selected Post Operative Care Event 402 is then copied to the Open Heart Procedural pathway 328 and shows up in the Component Listing window 366. As is seen in FIG. 29, the new Post Operative Care Event 402 appears under the Open Heart procedural pathway 328.

One of the features of the exemplar embodiment is the fact that each of the containers, resources and data software objects, once created, are reusable with other software module objects, or even other functional nodes. For example, in the previous description, the Pre-Operative Care Event 386 and the Post Operative Care Event 402 each maintain their contained information upon addition to the Open Heart Procedural pathway 328.

Referring to FIGS. 30 and 31, the Post Operative Care Event 402 is expanded to show its contents. Unlike the Open Heart Anesthesia Care Event 364 and the Open Heart Operative Care Event 370, since the Post Operative Care Event 402 is retrieved from the list of pre-configured care events 380 in the Second Tree view 254, it has contents that were added at the time that this care event was created. Shown in FIG. 30 is an expanded view of the Post Operative Care Event 402 showing its contents, which include three bundle container objects, the Dealer Supply Bundle 408, the Pharmacy Supply Bundle 410 and the Personnel bundle 412. Each of these container objects, as will be described later, are configured by the user to group resource objects, which are commonly used together.

As shown in FIG. 31, the various bundles 408, 410 and 412 are expanded to show their contents. The Dealer Supply Bundle 408 contains a Warming Blanket resource object 414, the Pharmacy Supply Bundle 410 contains a pharmacy resource object 416, which is a 30 milligram tablet of Percocet, and the Personnel bundle 412 contains a Post Operative Nurse personnel resource object 418. The objects that form the content of the Post Operative Care Event 402 all maintain their original contents from their creation by the user, and by copying the care event container to the Open Heart Procedural pathway object 328, the contents of the container are included as well.

With respect to created care event containers, once the container objects are created, the user then populates the containers with other container, resource and data objects related to the particular care event. Referring now to FIG. 32, the user has selected the Open Heart Anesthesia Care Event object 364 and right clicked to call up the Care Event Menu 420 and has selected the Add function 422. This function will allow the user to add other objects to the selected care event container. As is shown in FIG. 33, selecting the Add function 422 from the Care Event Menu 420 will provide the user with the Maintain Container Resource window 334. Previously, this window 334 was described with respect to the Open Heart Procedural pathway 328. Since the Open Heart Anesthesia Care Event object 364 was selected at the time the Maintain Container Resource window 334 was opened, the Open Heart Anesthesia Care Event object 364 information is reflected in the Header Information 336.

In this example of FIG. 33, the user has selected the class type of Containers in the Class field 338 and the item type of Bundle in the Item Type field 340. The user then selects the New button 342 which causes the Create New Bundle window 424 to appear. This window 424 allows the user to create a new bundle container object to hold other related objects. In the example, the user provides the item number and the bundle description in the Item No. field 426 and Description field 428, and by selecting the OK button 430 creates the new bundle object. As shown in FIG. 34, the Open Heart Anesthesia Supplies bundle object 432 appears in the Component Listing field 366.

Referring now to FIG. 35, once the new Open Heart Anesthesia Supplies bundle object 432 is created and added to the Open Heart Anesthesia Care Event container object 364, the new bundle object 432 appears under the care event object 364 in the Nested Tree view 252 of the Browser window 250, By selecting the Open Heart Anesthesia Supplies bundle object 432 and right clicking, the user can call up the Bundle Object Menu 434 in order to maintain the bundle object 432. In the example of FIG. 35, the user selects the Add function 436, which allows the user to maintain the contents of the Open Heart Anesthesia Supplies bundle object 432. Selecting the Add function 436 calls up the Maintain Container Resource window 334, with the Header Information 336 reflecting the maintenance of the Open Heart Anesthesia Supplies bundle object 432, as shown in the Description field 348, as depicted in FIG. 36.

The user may then proceed with provisioning the bundle object 432 with resource objects relating to the provision of anesthesia in the open heart procedure. In the example of FIG. 36, the user has selected the class of objects as resources in the Class field 338 and the item type of equipment in the Item Type field 340. By selecting the Query mode button 398 and selecting the Search button 318 the user retrieves a list of all previously created equipment resource objects, which allows the user to utilize pre-configured equipment resource objects in the Open Heart Anesthesia Supplies bundle object 432.

FIG. 37 shows the results of the database search in the Query Results window 400. By selecting the desired equipment object, in this case a General Anesthesia Unit 438, the relevant information will appear in the Item No. field 354 and Description field 356 in the Maintain Container Resource window 334. By then selecting the Add New Component button 362 the General Anesthesia Unit object 438 will appear in the Component Listing field 366, as shown in FIG. 38.

Referring now to FIG. 39 the addition of other objects to the Open Heart Anesthesia supplies bundle container object 432 will be described. In FIG. 39 the Item Type field 340 and the supplies object type are selected. Clicking on the New button 342 brings up the supply object Default Information window 440, as depicted in FIG. 40. In this window 440 the desired supply object can be called up by either entering an existing supply object item number in the Item Number field 442, or entering an existing supply object description in the Description field 444. Alternately, a new item number is entered or automatically assigned in the Item Number field 442, and the name of a new supply object is entered into the Description field 444. In the example depicted in FIG. 40, the new supply object is given the name of "Anesthesia Prep Kit," which is entered into the Description field 444.

The information management system of the exemplar embodiment automatically prompts the user for all of the information necessary and desirable to fully specify the new supply object. The windows to provide this information are invoked by the user by pressing the Next button 446, which causes the display of the Inventory Information window 448, as depicted in FIG. 41. The item number and description of the supply object are automatically carried forward from the Default Information window 440, depicted in FIG. 40, to the Inventory Information window 448, depicted in FIG. 41, and are displayed within the persistent Item Number field 442 and Description field 444.

The management information system user may enter specific inventory management information about the supply object using the Inventory Information window 448. For example, a patient charge number and catalog number may be entered, as well as other information that may be necessary for the proper tracking of the supply object. The Inventory Information window 448 also displays other information about the supply object, which information cannot be edited by the user at this point. However, if the information is already entered, it is displayed in the Inventory Information window 448. When the desired user editable information has been entered into the Inventory Information window 448, the user proceeds by pressing the Next button 450.

FIG. 42 depicts the Secondary Information window 452, in which further information about the supply object is entered. For example, a short description of the supply object may be entered. If the supply object has a shelf life, the inactive date of the supply object may also be entered. Other inventory tracking information, such as storage location, cost center, department, site, and other information may also be entered. When the user has entered all of the desired information into the Secondary Information window 452, the data entry process for the supply object is resumed by pressing the Next button 454.

The next step of data entry for the supply object in the exemplar embodiment is depicted in FIG. 43, in which the Hospital Cost History window 456 is displayed. In this window, information as to the cost to the hospital of purchasing the supply object is entered. When this information has been entered, the user continues the data entry process for the supply object by pressing the Next button 458, which brings up the Patient Cost History window 460, as depicted in FIG. 44. In this window, information as to the cost to the patient of purchasing the supply object is entered. Thus, by using the data entered on these two windows, the user is able to track the cost of specific supply objects used in the various procedures developed and specify at what cost the supply objects will be billed out to the patients who use them.

Data entry for the supply object is completed by pressing the Finish button 462, which redisplays the Default Information window 440, as depicted in FIG. 45. The Anesthesia Prep Kit supply object is then added to the Open Heart Anesthesia Supplies Bundle container object 432 by pressing the Finish button 464. The completed Anesthesia Prep Kit supply object 466 is displayed in the Component Listing field 366, as depicted in FIG. 46. Returning to the Browser window 250, as depicted in FIG. 47, the two new supply objects 438 and 466 are displayed under the Open Heart Anesthesia Supplies container object 364.

FIG. 48 depicts the Maintain Container Resource window 334 for the Open Heart Anesthesia Care Event 364. The Maintain Container Resource window 334 has been opened from the Browser window 250 as described several times above, the procedure for which will not be rehearsed at this point. The next series of figures depicts the creation of a new bundle object, which is to be made a part of the Open Heart Anesthesia Care Event 364. This process is initiated by selecting the Containers class within the Class field 338 and the Bundle type within the Item Type field 340, and pressing the New button 342.

This action causes the display of the Create New Bundle window 424, as depicted in FIG. 49. As previously described, the Item Number field 426 initially contains an automatically assigned item number or, alternately, a new or existing item number can be entered, which will either create a new bundle object or pull up an existing bundle object, as described above at length. In the example of FIG. 49, the automatically assigned new item number is displayed in the Item Number field 426, and the new bundle object is given the name of "Dr. Anderson Open Heart" in the Description field 428. Thus, the new bundle object to be created is a bundle object that is specific to a specific doctor, and may contain the items which this doctor desires to have for the specified procedure.

Therefore, the information management system of the exemplar embodiment provides for the preferences of individual doctors. For example, the supplies which are common to all doctors may be put into one bundle object for a given procedure, and then the additional and varying supplies that may be requested by various doctors may be provided in additional bundle objects that are specific to each doctor. Of course, this is just one example of how the information management system adapts to the particular needs and procedures of a hospital, and the user of the information management system may adapt the system according to the various methods described above as suits him best.

The newly described bundle object is created by pressing the OK button 430, which enters the item number for the bundle object in the Item Number field 354 and the name of the bundle object in the Description field 356 of the Maintain Container Resource window 334, as depicted in FIG. 50. The Add New Component button 362 is pressed as depicted in FIG. 51, and the Dr. Anderson Open Heart bundle object 468 is entered into the Component Listing field 366 of the Maintain Container Resource window 334, as depicted in FIG. 52. By pressing the Close button 469 the user is returned to the Browser window 250 depicted in FIG. 53, where the newly created Dr. Anderson Open Heart bundle object 468 is depicted as an element of the Open Heart Anesthesia Care Event 364 of the Open Heart procedural pathway 328.

Specific items, such as those required by "Dr. Anderson," are added to the Dr. Anderson Open Heart bundle object 468 by right clicking on the Dr. Anderson Open Heart bundle object 468, which brings up the Bundle menu 470, as depicted in FIG. 54. By selecting the Add function 472, the Maintain Container Resource window 334 is displayed, as depicted in FIG. 55. Thus, the next series of figures depicts how specific supplies are added to the bundle object that was created.

In FIG. 56 the Resources class has been entered into the Class field 338 and the Supplies item type has been entered into the Item Type field 340. Further, the word "Suture" has been entered by the user into the Description field 348. By depressing the Query Mode button 398, the Search button 318 is enabled. By then pressing the Search button 318, a search is activated which will search for all previously existing supply objects that contain the word "suture" in their assigned descriptions.

The results of the search are displayed in the Query Results window 400, as depicted in FIG. 57. In this example, the Suture Ethilon 5-0 P-3 BLK 474 is selected. This Suture 474 is added to the bundle object by pressing the Add New Component button 362 in the Maintain Container Resource window 334, which enters the Suture 474 into the Component Listing field 366, as depicted in FIG. 58. Additional sutures may also be selected from the Query Results window 400, such as the Suture Ethilon 3/0 PSL NDL 476, which is also added to the Component Listing field 366 by pressing the Add New Component button 362 as described above. The Query Results window 400 is closed by pressing the Close button 477, and the two sutures 474 and 476 are displayed in the Component Listing field 366 as depicted in FIG. 59.

Beginning with FIG. 60, the steps for adding a personnel resource object to the Open Heart Anesthesia Care Event object 364 are described. As described above, the Open Heart Anesthesia Care Event object 364 is selected from the Browser window 250, the Care Event menu 420 is invoked by right clicking, the Add function 422 is selected, and the Maintain Container Resource window 334 is displayed, as depicted in FIG. 60.

The Component Listing field 366 displays the Open Heart Anesthesia Supplies bundle object 432 and the Dr. Anderson Open Heart supply bundle object 468 previously created. The Resources class is selected in the Class field 338 and the personnel item type is selected in the Item Type field 340. By pressing the New button 342, the Default Information window 478 is displayed, as depicted in FIG. 61.

As described above, a new default value for the item number is automatically presented in the Item Number field 479, and the user may enter a name for the new personnel resource object in the Description field 481. In this example, the new personnel resource object is given the name of Anesthesia Tech. Other information may also be entered into the Default Information window 478, such as the amount of time that should be scheduled for the anesthesia technician to perform the care event being defined in the pathway. The entry of information is continued by pressing the Next button 480.

FIG. 62 depicts the Inventory Information window 482. As before, the item number assigned and the description entered are carried along through the various windows in the Item Number field 479 and the Description field 481, respectively. In the Inventory Information window 482, additional information relative to the proper and orderly inventory management of the described personnel resource is entered, such as a patient charge number and a catalog number. The entry of information is continued by pressing the Next button 484.

FIG. 63 depicts the Secondary Information window 486, in which other information relative to the personnel object being defined is entered. The information entry process is continued by pressing the Next button 488, which displays the Hospital Cost History window 490, as depicted in FIG. 64. In this window, information relative to the cost to the hospital of the personnel resource object is entered. Pressing the Next button 492 continues the data entry process.

The Patient Cost History window 494 is next displayed, as depicted in FIG. 65. As described above, the Patient Cost History window 494 allows the information management system user to enter information about the personnel resource object relative to the billing rate of the resource or, in other words, the amount that the hospital will charge the patient for the consumed resource.

The data entry process is completed by pressing the Finish button 496, which returns the user to the Default Information window 478, depicted in FIG. 66. Pressing the Finish button 498 returns the user to the Maintain Container Resource window 334, as depicted in FIG. 67. In the Maintain Container Resource window 334, the newly created Anesthesia Tech personnel resource object 500 is now listed in the Component Listing field 366. Pressing the Close button 502 returns the user to the Browser window 250.

Beginning with FIG. 68, methods of adding objects that have already been defined to container objects are described. In a first method of adding predefined objects, the Query button 506 on the Tool Bar 270 is pressed, bringing up the Query window 504. The Query window 504 is used to initiate searches on predefined objects located within the Libraries folder 292.

As depicted in FIG. 69, the query operation can be restricted in a variety of different ways. For example, typing a specific item number into the Item field 516 will search for a specific item number. In addition, the Query Operators 518 are used in association with the item number typed into the Item field 516, or any of the other fields mentioned below, to enable greater flexibility in the query operation. For example, the wildcard character "%" is used to represent any value that is within the position where the wildcard character is placed. Thus, performing a query on the item number 12345% finds item numbers 123450-123459. The wildcard character can be placed in other positions within the item number as well, and can also be placed in multiple positions within a single item number. Other Query Operators 518 include a Greater Than operator ">" that returns all item numbers greater than the item number entered, and a Less Than operator "<" that returns all item numbers less than the item number entered.

The query operation can also be restricted by the description of the object, which is entered in the Description field 514, the class of the object, which is entered in the Class field 508, or the type of the object, which is entered in the Type field 510. As mentioned above, the Query Operators 518 are used in conjunction with any or all of these fields. In addition, query restrictions may be entered within several of the fields described, providing a wide breadth of ability to finely restrict the query operation to just those objects desired.

In the example depicted in FIG. 69, two query criteria have been entered into the Query window 504. The class of the objects for which the query is being performed is restricted to the resources class by selecting Resources from the drop down menu within the Class field 508. In addition, the type of the objects for which the query is being performed is restricted to the personnel class by selecting Personnel from the drop down menu within the Type field 510. When the desired query criteria have been entered, the query operation is initiated by pressing the Query button 512.

FIG. 70 depicts the Query Results window 520, from which two objects, the Scrub Nurse personnel resource object 522 and the Circulating Nurse personnel resource object 524, are selected as depicted in FIG. 71. Pressing the OK button 526 confirms the addition of the selected objects to the container object previously selected in the Nested Tree view 252. By pressing the OK button 526, the Referenced Item window 528 is invoked, as depicted in FIG. 72, and the user is given the opportunity to add the selected objects as either custom or standard objects to the previously selected container object.

By pressing the Yes button 530, the selected objects are added as standard objects to the container. When added in this manner, any changes made to the general template for the selected objects will be reflected in the objects as they reside within the container to which they have been added. By pressing the No button 532, the selected objects are added as custom objects to the container. When added in this manner, any changes made to the general template for the selected objects will not be reflected in the objects as they reside within the container to which they have been added. By pressing the Cancel button 534, the operation of adding the selected objects to the container is cancelled.

In the example depicted in FIG. 72, the Yes button 530 of the Referenced Item window 528 is pressed, which causes the display of the Enter In Quantity window 536, as depicted in FIG. 73. In the Enter In Quantity window 536, the user is presented with the opportunity to indicate the quantity desired for the specific object to be added to the container. In the example depicted in FIG. 73, the first object to be added to the container is a personnel resource object, thus, the quantity to be designated is the number of minutes for which the person indicated by the personnel resource object will be required for the operative care event container object. A value is entered by the user into the Quantity field 538, and the Close button 540 is pressed.

In the current example, because two objects have been selected for addition to the container, pressing the Close button 540 invokes a second occurrence of the Enter In Quantity window 536, and the user is presented with an opportunity to enter the desired quantity for the second object in the Quantity field 538, as depicted in FIG. 74. Pressing the Close button 540 again accepts the added object with the designed quantity. If a third object had been selected for addition to the container, then a third occurrence of the Enter In Quantity window 536 is invoked. Thus, the number of Enter In Quantity windows 536 invoked is preferably equal to the number of objects selected for addition to the container. FIG. 75 depicts the previously selected Open Heart Operative Care Event container object 370 with the newly added Scrub Nurse personnel resource object 522 and Circulating Nurse personnel resource object 524.

Beginning with FIG. 75, a second method of adding previously defined objects to a container object is described. In this example, new resource objects are added to the Open Heart Operative Care Event container object 370. This second method is commenced by opening the Resources folder 374 in the Second Tree view 254 of the Browser window 250. The Resources folder 374 contains different types of predefined resources, which in the example depicted in FIG. 75 include Supplies 542, Personnel 544, Equipment 546, and Pharmacy/Medications 548. All of these different resource types are preferably contained within folders.

In FIG. 76, the Supplies folder 542 has been selected and opened, revealing the various supply resource objects located within the folder. These supply resource objects are displayed both in a hierarchical tree view within the Second Tree view 254, and in a list view within the List view 256. The desired supply resource object depicted in the Second Tree view 254 to be added to the container object depicted in the Nested Tree view 252 is selected. In the example depicted in FIG. 77, the desired supply resource object is a COBE Oxygenator 550. The List view 256 depicts the contents of the previously selected container object, which in this example is the Open Heart Operative Care Event container object 370. Thus, the List view 256 depicts the Scrub Nurse personnel resource object 522 and the Circulating Nurse personnel resource object 524 that were previously added to the Open Heart Operative Care Event container object 370.

The COBE Oxygenator supply resource object 550 is copied from the Second Tree view 254 to the Nested Tree view 252 by dragging it with the mouse to the Open Heart Operative Care Event container object 370, and dropping it there. Upon doing so, the Referenced Item window 528 appears, previously described during the recitation of the first method for adding predefined objects to a container, and the user is given the opportunity to add the selected object as either a custom or a standard object to the previously selected container object, as depicted in FIG. 78.

By pressing the