SYSTEM AND METHOD FOR RAPID RESULTS AND REPORTING OF DIAGNOSTIC TEST RESULTS
20230238088 · 2023-07-27
Inventors
Cpc classification
G16H10/40
PHYSICS
G06Q50/22
PHYSICS
International classification
Abstract
System and method for reporting test results for a sample. In an example implementation, patient information is received from a data entry interface. A patient identifier is generated by a software application operating on the data entry interface and associated with the patient information. The patient identifier and a test result generated by a point of care (POC) test instrument used to test a sample provided by the patient corresponding to the patient identifier are communicated to the system. The test result and the patient identifier are correlated with the patient information corresponding to the patient identifier. The data entry interface may be a mobile device having a barcode generating application for generating the patient identifier as a barcode. The data entry interface may also be implemented as a portal operating as an application on a computing device.
Claims
1.-20. (canceled)
21. A system comprising: a remote server; a data entry application including a data entry interface to be presented on a display screen of a mobile device; computer-readable instructions; and one or more processors to execute the computer-readable instructions to: cause, via the data entry application and responsive to receipt of patient information for a patient via the data entry interface, a patient identifier to be generated; cause the mobile device to transmit the patient identifier and the patient information to the remote server; cause a point-of-care test device to transmit the patient identifier and a test result generated for the patient by the point-of-care test device to the remote server from the point-of-care test device; and associate, at the remote server, the patient information and the test result based on the patient identifier.
22. The system of claim 21, wherein the one or more processors are to cause the remote server to transmit the test result and at least a portion of the patient information to a public health agency.
23. The system of claim 21, wherein the one or more processors are to cause the test result to be displayed at the mobile device via the data entry interface.
24. The system of claim 21, wherein the patient identifier includes encoded data.
25. The system of claim 24, wherein the patient identifier includes a barcode or a QR code.
26. The system of claim 21, wherein the remote server is separate from a laboratory information management system.
27. A system comprising: a patient data intake application executed on a mobile device, the patient data intake application to: receive patient information for a subject; generate a patient identifier responsive to the receipt of the patient information, the patient identifier different than the patient information; and output the patient identifier and the patient information for transmission via one or more communication networks; a test device to: access the patient identifier; perform a test involving a biological sample from the subject; generate a test result for the test; output the patient identifier and the patient information for transmission via the one or more communication networks; and a remote server in communication with the mobile device and the test device via the one or more communication networks, the remote server to: correlate the patient information with the test result based on (a) the patient identifier and the patient information received from the patient data intake application and (b) the patient identifier and the test result received from the test device; and transmit the test result and at least a portion of the patient information for receipt by a public health agency via the one or more communication networks.
28. The system of claim 27, wherein the test result is a first test result and the remote server is to: aggregate the first test result, the patient information, and a second test result for the subject to generate aggregated data for the subject; and transmit the aggregated data to the public health agency.
29. The system of claim 27, wherein the remote server is to adjust a format of one or more of the patient information or the test result for transmission to the public health agency based on a reporting format associated with the public health agency.
30. The system of claim 27, wherein the test device is to access the patient identifier via a scanner of the test device, the scanner to scan an image of the patient identifier presented by the patient data intake application.
31. The system of claim 27, wherein the patient data intake application is to output the test result for display at the mobile device.
32. The system of claim 27, wherein the test result is a first test result and the test device is to associate the first test result and a second test result with the patient identifier.
33. The system of claim 27, wherein the subject is a first subject, the test result is a first test result, the patient identifier is a first patient identifier, and the remote server is to: correlate patient information for a second subject with a second test result for the second subject based on a second patient identifier generated by the patient data intake application for the second subject; and transmit a report for receipt by the public health agency, the report including (a) the first test result and at least a portion of the patient information for the first subject and (b) the second test result and at least a portion of the patient information for the second subject.
34. A method comprising: generating, at a mobile device, a patient identifier for a patient, the patient associated with patient information received via a data entry application on the mobile device; transmitting, via the mobile device, the patient identifier and the patient information to a cloud-based database; detecting, at a test device for a biological sample, the patient identifier; transmitting, via the test device, the patient identifier and a test result for the patient to the cloud-based database; and correlating, at the cloud-based database, the test result with the patient information based on the patient identifier.
35. The method of claim 34, further including causing, via the test device, the test result to be displayed by the data entry application.
36. The method of claim 34, wherein the detecting of the patient identifier at the test device is based on a scanned image of the patient identifier.
37. The method of claim 34, further including: modifying, at the cloud-based database, a format of the patient information to generate formatted patient information; and generating aggregated data including the test result and at least a portion of the formatted patient information.
38. The method of claim 37, further including transmitting, via a communication network, the aggregated data for receipt by a public health agency.
39. The method of claim 37, wherein the test result is a first result and the aggregated data includes a second test result for the patient.
40. The method of claim 34, wherein the patient identifier is a first identifier associated with the patient and further including detecting, from a second identifier associated with the patient and at the mobile device, at least a portion of the patient information based on data encoded in the second identifier.
Description
BRIEF DESCRIPTION OF THE DRAWINGS
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DETAILED DESCRIPTION
[0040] Disclosed herein are example apparatus, systems, methods, and articles of manufacture that enable entities or persons to comply with public health reporting laws for diagnostic tests. Example implementations disclosed herein may use diagnostic test devices, including automated diagnostic instruments, for providing test results. In particular, the diagnostics test devices may be point-of-care (“POC”) diagnostic testing devices where a diagnostic test is performed at or near the location where the sample was gathered from the user. Such locations may include for example, an in-field testing facility, a medical office or clinic, a patient's home, or ad hoc testing sites such as test sites built to address an emergency such as the COVID-19 pandemic. Ad hoc testing sites may include, for example, testing sites that may be setup in airports, in parking lots, at event venues, or other locations that present risks for which testing is necessary. It is noted that the COVID-19 pandemic and testing for the SARS-CoV-2 virus are used as an example background and pathogen for example implementations. Example implementations of the systems and methods described herein may also be used to address other emergencies involving other pathogens or types of pathogens.
[0041] The POC diagnostic instruments used to determine if patients' samples carry the SARS-CoV-2 virus are able to provide results in a short period of time. A remote data collection system is also leveraged to collect patient demographic data, answers to certain patient questions, in addition to the usual identifying information to overcome bottlenecks in the testing process and the mandated public health authority reporting process.
[0042] In an example implementation, each patient can be registered, or processed for a test order, at a test site using a remote data collection system. In one embodiment, the remote data collection system includes an interface for a user to input patient information that is stored at a remote server. The remote data collection system is also operable to receive diagnostic test results and store those test results at the remote server. In some embodiments, the remote data collection system is a reporting system that collects patient and diagnostic test data outside of a conventional laboratory information management system (LIMS). In other embodiments, the remote data collection system uses a LIMS system for data collection and reporting. In one example implementation, the remote data collection system may be configured to operate as a cloud service. The remote data collection interface for inputting patient data may be a mobile interface (“mobile interface”) configured to operate on a handheld device, such as for example, a smartphone (e.g. iPhone, etc.), a tablet device, or other similar handheld device. The interface to the remote data collection may also be a portal to the remote data collection system operating using, for example, a browser, which may then operate on any suitable computing device such as a desktop computer or a laptop or a smartphone. A test site may be any location having at least one POC diagnostic instrument configured to communicate with the remote data collection system, and an operator having at least one remote data collection interface to the remote data collection system. The embodiments described herein may be used in traditional diagnostic testing settings, such as for example, physicians' offices and diagnostic laboratories. In response to the high demand for testing created by the COVID-19 pandemic, the present invention may also be used with test sites that may now include pharmacies, department stores, and other ad hoc test sites of the type described above.
[0043] As noted, the patient data is collected using the remote data collection interface, which may be a mobile interface or a portal. The mobile interface (or portal) may be configured to prompt the operator for certain patient information (described in more detail below), which may include demographic information and any other type of information mandated by public health authorities. The mobile interface (or portal) may also be configured to generate a unique patient identifier that is associated with a particular patient's inputted data. The unique patient identifier distinguishes a patient data input entry from other patient data input entries and may take the form of a code or set of digits that is unique from any other code or set of digits in the remote data collection system. In one example, the patient identifier may be generated as a barcode, a 2-D barcode or a QR code. Other examples may use other types of codes or combinations of codes including, for example, other machine-readable codes.
[0044] In one embodiment, at least some data entry may be performed in an automated manner. In one example of this, certain jurisdictions issue identification cards, such as driver's licenses, that contain a machine-readable code, such as a barcode, that incorporates the card holder's identification information, such as name and address. The mobile interface may also interface with a camera or other optical reader to image the machine-readable code to scan demographic and patient information from an identification card having such information encoded to advantageously speeding the process of collecting the mandated information. In some examples, such as where a test site is connected to a LIMS, some or all of the patient data or demographic information may be available to the remote data collection where certain data was collected by healthcare providers at the physicians' offices for example. The mobile interface or portal may be configured to retrieve the patient data and demographic information electronically, associate it with the patient identifier, and communicate the patient data and demographic information with the patient identifier to the remote data collection system. Although the above data input process has been described in relation to a mobile interface, the above process can also be used with a portal.
[0045] During the patient registration process at the test site, the operator also takes a patient sample. The POC diagnostic instrument may be configured to input the patient id as an identifier corresponding to the patient's test results when the patient sample is loaded in the POC diagnostic instrument to run the test. In one implementation, the POC diagnostic instrument may include a barcode reader, which may be used to scan the patient identifier barcode from the mobile interface on the handheld device.
[0046] The mobile interface may be configured to upload the patient's data (including demographic data, and responses to questions to which public health authorities desire answers) to the remote data collection system. In one example, the patient data and patient identifier are uploaded independently of the communication of the patient identifier and the test results by the POC diagnostic instrument. The remote data collection system would then correlate the independently received patient data and test results. In another example, the mobile interface or the portal may include a data verification procedure in which the remote data collection interface checks the patient data to ensure that all mandated data for reporting is captured before a patient identifier is generated. The patient identifier may then be provided to the POC diagnostic instrument to identify the patient's test results once the patient's sample has been tested.
[0047] The remote data collection system may be configured to receive the patient data identified by the patient identifier from the mobile interface, and the patient test results identified by the patient identifier from the POC diagnostic instrument. The remote data collection system may correlate the patient data with the patient's test results based on the patient identifier. The patient data and test results may then be formatted for communication to the public health authorities. The remote data collection system may be implemented as mentioned above as a cloud service, which may then easily and securely transfer information to the public health authority database systems. As used herein, communication to the public health authority may be directly to the public health authority or may be through one or more intermediaries that delivers the results to the public health authority. In one example, the reporting to a public health agency includes the process of sending report data to AIMS (APHL Informatics Messaging Services) which then reports the data to the relevant public health agency. Although the present invention is described several times as communicating information with a public health agency, one of skill in the art will understand that testing and results related information can also be sent to non-public health entities such as other governmental institutions, employers, schools, public and private companies and non-profit organizations. For example, an employer may wish to screen and gather data from employees enrolled in a screening program.
[0048]
[0049] It is noted that the mobile devices 102, the portal 104, the remote data collection system 130, the cloud services 120, the POC test instruments 110 and the POC middleware 128 operate using at least one processor. Functions described below are understood to be performed by processors executing programmed computer instructions. It is further understood that the public health authorities 140 receive and transmit data over the Internet via servers and other processor-based components. The mobile devices 102 may be processor-controlled devices. The portal 104 may be implemented using a browser page or other programming element configured to communicate over the Internet, where the browser page or other programming element operate on a computer (e.g. laptop, desktop, etc.).
[0050] The mobile interface 102 may be implemented as a smartphone or handheld device application having data input screens (examples of which are described below with reference to
TABLE-US-00001 TABLE A Examples of Information Requested for Mandated Reporting Test Ordered Device Identifier Test Result Test Result Date Accession #/Specimen ID Patient Age Patient Race Patient Ethnicity Patient Sex Patient Residence Zip Code Patient Residence County Ordering Provider Name and NPI (as applicable) Ordering Provider Zip Performing Facility Name and/or CLIA number, if known Performing Facility Zip Code Specimen Source (e.g. provided using appropriate LOINC, SNOMED-CT, or SPM4 codes or equivalent detailed alternative codes Date test ordered Date specimen collected
[0051] In some implementations, the data input screens may include prompts for additional information such as for example demographics data elements that should also be collected and reported to state or local public health departments. Such demographic data elements may include information of the type listed in Table B below.
TABLE-US-00002 TABLE B Examples of Demographic Data Elements Patient name (Last name, First name, Middle Initial Patient street address Patient phone number with area code Patient DOB Ordering provider address Ordering provider phone number
[0052] In an example implementation for use in addressing the COVID-19 pandemic, the mobile interface may be configured with data input screens requesting special information. The data fields listed in Table C below are specific to SARS-CoV-2 and considered “ask on order entry” (AOE) questions for traditional Electronic Health Records or Laboratory Information Management Systems. These elements should be collected and be conformant with standard interfaces used to communicate with public health authorities (e.g. HL7 Version 2.5.1 Lab order Interface Implementation Guide):
TABLE-US-00003 TABLE C Examples of COVID-19 specific Data Elements First test (Y/N/U) Employed in healthcare? Y/N/U Symptomatic? Y/N/U and then Date of Symptom Onset mm/dd/yy Hospitalized? Y/N/U ICU? Y/N/U Resident in a long-term care facility (including skilled nursing facilities, nursing homes, long-term care for the developmentally disabled, and assisted living homes): (Y/N/U) Pregnant? Y/N/U P
[0053] In implementations at an ad hoc test site, such as for example, in a parking lot under a tent, the operator of the mobile interface 102 may enter the data manually on to the handheld device operating the mobile interface 102. The mobile interface 102 may be deployed for use in a test site in a traditional testing setting, such as for example, a physician's office. In another embodiment, the mobile interface 102 may be configured to interface with a LIMS system to retrieve patient related data. The mobile interface 102 may then retrieve patient data and other data of the type listed in Tables A, B, and C above via such an interface.
[0054] The mobile interface 102 may also interface with, or include functions for, a barcode reader to read data from a barcode. In one example, a barcode reader may be used to scan information encoded as barcode on a patient's identification card 150. Many jurisdictions have mandated that identification cards, such as driver's licenses, encode the identifying and demographic information on the identification cards in barcode (e.g. PDF 417 barcodes). The ID card barcode 150 may be used to retrieve a portion of the required data reducing the amount of data that is manually input by the operator.
[0055] The patient identifier generator may be a barcode generator, or any other suitable identification generator configured to encode a data element that is used for identification. The patient identifier may be generated in machine readable and barcode formats, which may include, for example, QR codes, Code 128, and 3of9, as some examples.
[0056] As noted above, the test site may be in a traditional testing location, which may provide the operator with data connectivity for the mobile interface 102 and the POC test instruments 110. In ad hoc sites, the mobile interface 102 and the POC test instrument 110 may be provided with a Wi-Fi interface to a Wi-Fi access point, cellular access point or other suitable data interface with the Internet in order to connect to the cloud-based services 120. For POC instruments connected in this manner, cloud-based services can include POC instrument related middleware 128 that communicates further with the remote data collection system 130. The POC middleware 128 may be any suitable networking devices that may be used to facilitate communication between the POC instruments 110 and the remote data collection system 120. Multiple POC test instruments 110 may be connected over a network interface (wireless or wired) with a bridge or gateway to the Internet. In one example, RALS™ Link, available from Abbott Laboratories, provides a communication gateway that includes a cellular connection to the Internet, to connect POC instruments to remote servers such as cloud-based servers. Further, in one example, different institutions or companies can use their own POC test instruments 110 to run tests and submit the relevant patient and test data to a public health authority. In this regard, with respect to
[0057] The POC middleware 128 may include connections to one or more POC instruments 110 at a single testing location. Each POC instrument 110 may be a testing site and one or more POC middleware 128 devices may be provided at a single test location. The POC middleware 128 may be deployed in any suitable location worldwide providing the remote data collection system 130 with the ability to collect patient data and test results from anywhere in the world.
[0058] In locations supporting multiple test sites (e.g. multiple POC test instruments, multiple operators, etc.), a portal 104 may be provided as another data entry mechanism, or as an interface for requesting and viewing information regarding the testing location. The portal 104 may be configured to communicate with the POC test instruments 110 used at the testing location and with the remote data collection system 130. The portal 104 may be configured to collect patient data, such as for example, any data in Tables A, B, or C. The portal 104 may also request test results, or quality control information related to the operators or the POC test instruments 110.
[0059] The system 100 described above with reference to
[0060]
[0061] The data entry step at 152 may include prompts or forms for obtaining information such as an order physician name, patient demographics information, and the type of information used by public health agencies, such as for example the type of data collected under the CARES Act mandate. The mobile device 102 may be programmed to generate a patient ID, which may be displayed on the mobile device display in the form of a barcode. Either before, after or contemporaneously with the data entry, a patient sample may be collected at step 154. At step 156, the patient sample may be loaded into a testing system, such as for example, a POC test instrument 110 (in
[0062]
[0063] At step 168, the remote data collection system 130 (in
[0064] At step 170, a data dashboard may be provided to provide access to patient data from different organization testing sites. The text block 171 in
[0065]
[0066] The process may typically begin at step 202 in
[0067] At step 210, the remote data collection system 130 correlates the patient's test results with the patient data collected in step 202. The data and test results are formatted appropriately for reporting to the public health authorities at step 212.
[0068]
[0069] The mobile device 102 (in
[0070] When patient data is to be entered, a patient ID may be generated during the data entry process. The patient ID may be displayed on a barcode generation screen 320 as a barcode 322.
[0071] In
[0072] The user may also be presented with a form 336 for entering the requested data. Data may be entered directly into the phone. Alternatively, the scanning device may be programmed to receive the scanned data and fill the patient form with the scanned data. The screen 330 may include basic user interface navigation controls, such as a next and previous button to proceed to another section of the form. For example, the user may press a Next button 337 to proceed to another form, such as a pre-screen questionnaire form 340 in
[0073]
[0074] The portal functions may include administrative functions. For example, the portal may include a data manager mode that uses a user listing component to allow the user to view the data entered by other users. The site user data screen 364 in
[0075] The data manager may also display a patient data screen 368 generated by a patient data component for listing each patient that has had patient data entered as shown in
[0076] Referring back to
[0077]
[0078] At step 404, the POC instrument receives the patient ID entered into the POC test instrument at step 306. In one example, the patient ID is read by a barcode reader connected to the POC test instrument. In other examples, the patient ID may be received via manual entry using, for example, a keypad or touch display panel, if one is part of the POC test instrument. The POC test instrument is configured to correlate the patient ID with the test sample for which an assay is to be run. At step 406, the POC test instrument is controlled to run the assay, and to provide a test result. The test result may be displayed or provided in a message for display on the mobile device used for the mobile interface, or on the portal. The test result is also correlated with the patient ID and communicated to the remote data collection system 130 (in
[0079]
[0080] It is noted that the example described here with reference to
[0081] The data receiver may correlate the patient data with the test results based on the patient identifier at step 504. At step 506, the remote data collection system may identify and format the specific patient data elements to be reported and aggregate the selected patient data with the test result corresponding to the patient identifier. The data may be formatted into a report in any form suitable for use by the public health agency that requires the data. At step 508, the report may be communicated to the public health agency electronically. As described above, communication to the public health authority may be directly to the public health authority or may be through one or more intermediaries that delivers the results to the public health authority. In one example, the reporting to a public health agency includes the process of sending report data to AIMS (APHL Informatics Messaging Services) which then reports the data to the relevant public health agency.
[0082] The present invention also includes a data manager portal that allows managers associated with the remote data collection system 130 to manage the system and view reports associated with the operation and results of the system. In this data manager portal, a manager of the system creates and manages users of the system, create and manage approved instruments for the system and populate some data available to a user such as ordering physician information. The manager may also be able to view and query patent testing data. For COVID-19 data for example, the manager may view & query all COVID-19 patient testing data from the organization sites enabled for manager and/or user access, loads the last 20 days of data by default, query data and export to Excel spreadsheets. The manager may also be able to view a dashboard that provides summaries of patient and/or testing data. For COVID-19 data for example, the manager may view a dashboard of all COVID-19 patient testing data from the organization sites enabled for manager and/or user access, load the last seven days of patient and/or test data by default and view such data refreshed hourly.
[0083] In some examples, the present invention provides a reporting format for PHA for traditional LIMS systems. In this case, the LIMS system aggregates the relevant patient and test data and puts it into an appropriate report format for public health reporting. The PH data can then be conveniently provided to the PHA by sending PH report data from the LIMS system to the remote data collection system which then transfers the information to the PHA.
[0084] In example implementations, a convenient conduit and system for reporting data to PHA's are provided as described herein. In this regard, patient and test data information can be received by the remote data collection center from sources other than as described above, but example implementations of systems and methods described herein can aggregate, format and/or send the data to a PHA as described herein. In some examples, a reporting format is provided for PHA for traditional LIMS systems. In this case, the LIMS system aggregates the relevant patient and test data and puts it into an appropriate report format for public health reporting. The PH data can then be conveniently provided to the PHA by sending PH report data from the LIMS system to the remote data collection system which then transfers the information to the PHA. In other examples, example systems and methods described herein provide a reporting format for PHA for traditional LIMS systems, such as those in hospitals and hospital healthcare systems, in an additional manner. In this case, the remote data collection center receives patient and test data information from the hospital or hospital healthcare system, aggregates the relevant patient and test data, puts it into an appropriate report format for public health reporting and then transfers the information to the PHA. In this case, the patient and test data may already be correlated with each other by the LIMS prior to sending the data to the remote data collection center or the remote data collection center may correlate the data. In another example, patient and test data information can be received from other POC testing than that described herein or from in-home testing. In both cases, patient and test data information can be collected from POC or in-home testing systems and stored in a database. The remote data collection center receives patient and test data information from the database that may already have been correlated with each other, aggregates the relevant patient and test data, puts it into an appropriate report format for public health reporting and then transfers the information to the PHA. In this case, the patient and test data may already be correlated with each other by the database prior to sending the data to the remote data collection center or the remote data collection center may correlate the data.
[0085] The disclosure provided herein describes features in terms of preferred and exemplary embodiments thereof. Numerous other embodiments, modifications and variations within the scope and spirit of the appended claims will occur to persons of ordinary skill in the art from a review of this disclosure.