Classifications

• • G—PHYSICS
  • G06—COMPUTING OR CALCULATING; COUNTING
  • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
  • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
  • G06Q40/08—Insurance
• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H15/00—ICT specially adapted for medical reports, e.g. generation or transmission thereof
• • G—PHYSICS
  • G16—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
  • G16H—HEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
  • G16H20/00—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance
  • G16H20/40—ICT specially adapted for therapies or health-improving plans, e.g. for handling prescriptions, for steering therapy or for monitoring patient compliance relating to mechanical, radiation or invasive therapies, e.g. surgery, laser therapy, dialysis or acupuncture

Definitions

• Paper records cannot be searched easily. Electronic queries are extremely costly and time consuming, making them practically impossible to use to support patient care or business decisions. For example, it is difficult to locate in which particular patient a specific implant has been used, and in many cases the information simply does not exist in any form. In others, the data is so scattered and disjointed that the implant or patient cannot be economically tracked. Accordingly, even if surgical results and patient information have been recorded, due to the limitations of traditional EMR (electronic medical records), it is not feasible to track implants. In this way, if a vendor or government agency recalls a particular implant for safety reasons, it is most often impossible to contact or even identify the particular patients that have those faulty implants.
• the surgical system enables the medical personnel to graphically record and confirm key data, which then can be viewed and approved by the surgical team. In this way, the surgical system enables the near real time collection and presentation of surgical data, and ensures the data is accurate and complete.
• the surgical system is also constructed to avoid fraud and over-billing. For example, the surgical system has an intelligent anatomic rendering that restricts the placement and number of implants according to pre-defined rules. In this way, the system will not allow an excessive number of implants or parts to be used, and only parts that have been properly placed can be used to generate billings or invoices.
• the surgical system Since medical data, such as surgical data, is timely, completely, and accurately captured, the surgical system also enables a surgeon to quickly and efficiently generate an operative report, without waiting for transcription or form documents.. Indeed, since the doctor or surgeon can confirm, even while performing the medical procedure, that the parts, medical process, personnel, complications, and outcomes are accurately recorded, the surgeon can immediacy proceed to issue the surgical report or other completion report. Since the surgical system is also populated with billing codes and patient information, it can automatically assist with ICD10 hospital coding and billing, and generate the data to bill private insurance or government agencies in a timely manner. Implants and biomaterials are granularly tracked, so the data may be used to populate a complete and accurate implant registry, thereby enabling follow-up and identification in the case of recall. This can include data support for a "National Implant Registries" for all implanted products (inclusive of medical devices, biologies, or tissue), something which is mandated by the U.S government.
• FIG. 1 is a flowchart and data diagram for a medical data system in accordance with the present invention.
• FIG. 2 is a diagram of a medical data system in accordance with the present invention.
• FIGs. 3A and 3B are screen illustrations of a selection process for a medical data system in accordance with the present invention.
• Figs. 4 A and 4B show an input screen and flowchart for adding a patient to the medical data system in accordance with the present invention.
• FIG. 6 shows input screens for a medical data system in accordance with the present invention.
• FIGs. 8 A and 8B show input screens for disposables and biologicals for a medical data system in accordance with the present invention.
• Fig. 10 shows a graphical and tabular selection process for initiating a spinal surgery for a medical data system in accordance with the present invention.
• Fig. 12 shows a flowchart of a process for selecting spinal levels for a medical data system in accordance with the present invention.
• Fig. 14 shows spine remove images for a medical data system in accordance with the present invention.
• Fig. 15 is a flowchart of beginning a removal process for a medical data system in accordance with the present invention.
• Fig. 16 shows a series of flowcharts for selecting specific removal procedures for a medical data system in accordance with the present invention.
• FIG. 17 shows a flowchart for a removal procedure for a medical data system in accordance with the present invention.
• Fig. 18 shows a graphical layering system for performing reconstruction procedures for a medical data system in accordance with the present invention.
• Fig. 19 shows a graphical layering system and associated rules for use with a graphical overlay system for a medical data system in accordance with the present invention.
• Fig. 21 shows a flowchart for performing reconstruction using a graphic overlay system for a medical data system in accordance with the present invention.
• Fig. 23 shows an anatomical representation having overlaid hardware for a reconstraction process for a medical data system in accordance with the present invention.
• Fig. 24 shows an input screen for a reconstruction process for a medical data system in accordance with the present invention.
• Fig. 25 shows a reconstraction process for a medical data system in accordance with the present invention.
• Fig. 26 A shows a flowchart of a graphical data collection system for a medical data system in accordance with the present invention.
• Fig. 26B shows a flowchart for a reconstruction process for a medical data system in accordance with the present invention.
• Fig. 27 shows input screens for fluids and surgeon notes for a medical data system for a medical data system in accordance with the present invention.
• Fig. 29 shows an input screen for identifying complications in a medical data system in accordance with the present invention.
• Fig. 30 shows additional input screens for inputting data into a medical data system in accordance with the present invention.
• Fig. 32 shows an input screen for obtaining patient or legal consents in a medical data system in accordance with a medical data system in accordance with the present invention.
• Fig. 34 shows another example of a type of surgery that may be done with the medical data system in accordance with the present invention.
• a medical data system 10 includes a graphical data collection system 1 1 for accurately collecting medical procedure data in real time or near real time concurrently with the performance of the medical procedure.
• the data collected from the real time graphical data collection system 1 1 is then used to provide information and data to support various aspects of the medical data system 10.
• the graphical data collection system 11 may collect data in the medical environment where the medical procedure is being performed, and provide a real time or near real time reporting 12 of that information.
• the graphical data collection system 1 1 may include a touch screen, keyboard, mouse, tablet computer, display, or other graphical data input device.
• the real time reporting 12 may be accomplished using a display, graphical display, lights, alarms, or other device to present medical data into the environment where the medical procedure is being performed.
• the graphical data collection system 11 is used by a surgical nurse in an operating room for real time collection of surgical data. Information reflected in the surgical procedure is then displayed in real time 12 to members of the surgical team. It will be appreciated that other real time or near real time reporting may be made to others outside the area where the medical procedure is being performed, for example.
• the data may be used to drive certain reports and business aspects 18 of the medical data system.
• the data may be used to automatically generate operative reports, detect fraud in real time, manage vendors, provide for highly efficient invoicing and billing, provide for inventory management for the hospital or medical provider, may support a national implant registry, may provide for patient access to medical data, may provide analytics to evaluate the effectiveness and medical procedures, or may provide medical business support for the medical practitioner or hospital. It will be understood that other uses of the data may be found. Importantly, it is the timely, accurate, and complete collection of data by using the graphical data collection system 11 that enables the efficient and effective management of the medical business, as well as facilitating improved delivery of healthcare to the patient.
• the system 10 can accurately collect and present the medical procedure performed and what the clinician or medical provider actually did; what products were use in the procedure, including any implants or medical devices used; the cost of the products used; the outcome of care and how well the patient did during and after treatment; cost metrics of the provider, the hospital, or the specific procedure; and the overall effectiveness of medical procedures. It will be appreciated that other applications may be used consistent with this disclosure.
• the timely and accurate process of collecting data on the front end is the foundation for the medical data system 10 and related business models it supports.
• the system 10 allows for nearly unlimited analytics and data management.
• the medical data system 10 revolutionizes the process of data collection and allows for the "real time” or near real time collection of medical procedure information and stores this into a specifically designed storage infrastructure, which allow for flexible analytics, searchability of data within a hospital or related to a single patient, and also throughout the entire network of treatment facilities, including any number of patient or analytic parameters.
• the medical data system presents structured information and instructions through the graphical data collection to guide the operators through the data entry process and to assure that data is consistently and uniquely identified.
• the ability to collect one of many types of surgical procedures including but not limited to: spine, cardiac surgery, interventional cardiology, hip surgery, and knee surgery from various treatment locations or hospitals and being able to use local or wide area networks to link these into a single "Patient Medical Profile" is unique to the medical data system.
• Graphic interactive displays may assist technicians to place and to record surgical implants contributing to a more complete and accurate surgical record.
• the process of the transfer graphic interface modifications or surgical representation into a text form i.e. operative, clinical, or business reports) and describe the procedure or implant or medical device and or location in a text form is unique to the medical data system.
• the collected medical and surgical data may be stored in a local or wider area computing system and can be accessed anywhere at any time. Accessible relational tables, if used, can afford strong search capabilities.
• Today, records and EMR are stored as "flat / pdf ' type images which are scanned and stored after the surgery has been completed. These images are static and limited in their abilities for searchable, report creation, analytics and any customized data specific queries because they are not digitally indexed. That is, there is no practical way to provide relationships between documents and files.
• methods and process enable the unlimited analytic and search ability of any point of data, as the data may be stored electronically into a web -based database system at the time of surgery as an individual piece of data. This process and method is advantageous as the web allows for the linking of all individuals patient data into global patient records. It will be understood that other storage and access architectures may be used consistent with this disclosure.
• the medical data system can enable the implantation of an efficient implant registry and can finally make surgical implants searchable based on their lot and part numbers, and provide detailed surgical information, including their location in a patient's body.
• the medical data system has the capability to track and link the following via an electronic and or web/cloud based system: patient
• any other implant identification the location of the implant in the body, the source of the implant and the sterilization history of the implant. It will be appreciated that other information may be stored and accessed as needed. Any recalls sent from the registry may be sent to the hospitals that performed the actual surgery. The hospital and patient will have the only access to the patient's personal data, and can contact the patient consistent with established privacy constraints.
• the implant registry can be used by government, hospitals, patients, vendors, manufacturers, and tissue banks to enable the effective identification of newly recalled or revised implants, and remove them from inventories prior to being used. Additionally, this type of registry would allow vendors, manufacturers, and tissue banks to inform treatment facilities of recalls and other product-related issues or information and provide a set of identifiers to the hospital or doctor that would enable them to contact the specific patient with the faulty implant.
• Vendors will now have the ability to track medical devices, eliminate fraud, and improve business processes.
• Today implant providers are unable to effectively tracking implants and link part numbers, lot numbers, or patients. Under present systems, a surgery might cost $300,000, with $50,000 or more in hardware, medical devices and implants placed in the patient's body.
• the medical data system includes the inter-operative capability of collecting implant information - biological and hardware, medical devices of any kind - in an electronic and real time capture and database storage with the ability to accurately and effectively track, link, and identify all of implants and medical devices put in any patient.
• the computer operator selects a particular surgery to be performed from a set of surgery types available in the system database 21. Responsive to the selected surgery type, the display 24 shows a graphical representation of the surgery target, such as a spine portion or a heart. Information specific to the patient is also accessed, which may also be displayed to the surgical team.
• Figure 2 shows a standard computer configuration, it will be understood that other devices, such as laptops, wireless appliances, smartphones, or PDA's may be used as part of the system.
• information specific to the surgery is collected. For example, information may be collected regarding the location of the operating room and personnel present for the surgery.
• the biomaterial, implants, and tools for the surgery may be identified and confirmed as being properly sterilized and handled.
• the computer operator annotates the graphical representation to show tissue removal, reconstruction, and placement of implants or parts.
• the annotations are done graphically or with the use of guided input screens.
• the display builds a graphical representation of the surgery.
• the surgical team can view the display as the image is annotated, so they can provide immediate confirmation that surgical information is being accurately captured.
• the surgical system maintains a list of parts, implants, and biomaterials that may be used for the selected surgery type, so the system assures that only authorized parts, implants, and biomaterials can be used.
• the graphical annotation is also intelligent, that is, the surgical system only allows parts, implants, and biomaterials to be placed in defined quantities and at defined places.
• the intelligent anatomical display permits placement of only authorized types of screws, and a certain quantity of screws at any predefined locations. If the operator attempts to position too many screws at a location, or place a screw in an
• the system can be set to generate fraud warnings. Further, the immediate visibility on display 24 of any annotation to the surgical team also acts to reduce the occurrence of fraud.
• the surgical team may also capture information regarding pharmaceuticals, complications, and outcomes during the surgery.
• the surgeon signs off on the surgery completion before leaving the operating room.
• the surgeon or doctor can complete the surgical report in an automated way using the complete and accurate information collected in the surgical room.
• the anatomical image, annotations, and data inputs all become part of the permanent record for that patient.
• the medical data system 20 may use a wide-area network 27, such as the Internet, to enable interested and authorized parties 30 to access data, and to organize and view medical information reports 32.
• the wide area network may also interface an implant registry 28 for facilitating implant and tissue tracking.
• the hospital can use the information to re-order parts from vendors, pay vendors for the parts used, communicate invoices and billing
• the information regarding implants may be stored in a registry 28 in a manner that is compliant with privacy regulations, such as HIPPA in the US, but that still enables a hospital to know the specific implants it has consumed, and the specific patient that received the implant or biomaterial.
• privacy regulations such as HIPPA in the US
• the vendor can determine which hospitals have used the defective part, and the hospital can identify which specific patient has the implant.
• the data can provide key analytics and metrics for the medical industry, such as treatment efficacy, costs, and quality control.
• a hospital can use the repository 29 to understand if its doctors are performing to industry standards or evaluate whether patients are satisfied with outcomes. The hospital may readily identify doctors that are underperforming, or that need training to perform procedures in a more cost effective way.
• the data can be used to evaluate and compare the effectiveness of drugs or treatments.
• selection (i.e. "Removal of Lamina”). But on the Operative Report of other report generation this "selection” would have the ability to be described differently: (i.e. "L2 bilateral removal of lamina”).
• the surgical system eliminates the extensive and costly manual charting by leveraging the power and accessibility of local and wide area networks to automate and bring forth advanced surgical data collection and functionality.
• Specific web-based applications may function as a clinical and business database creating a readily accessible portal accepting all patient pertinent information associated with a surgical procedure from the time of entering the hospital to the time of leaving the operating room.
• the surgical system may function as a clinical and business database creating a readily accessible portal accepting all patient pertinent information associated with a surgical procedure from the time of entering the hospital to the time of leaving the operating room.
• the medical data system 20 is capable of efficiently and accurately providing time sensitive information.
• the system can generate electronic operative reports concurrent with a medical procedure, and may include graphical representations of the selected aspects of the procedure.
• FIG. 3 through 33 an exemplary embodiment of a medical data system is illustrated.
• the medical system described in the following figures is similar to the general medical data systems 10 and 20 described with reference to Figures 1 and 2.
• the exemplary embodiment described in the following figures describes a medical procedure in the form of a surgery. It will be appreciated that other medical procedures may be used in accord with the claimed invention.
• the particular example illustrated uses a graphical computer input system positioned within the confines of a surgical room. Typically, the computer input is done by a surgical nurse or other medical personnel.
• a graphical display is also positioned within the surgical room for presenting the collected data to personnel in the surgical environment. '
• the specific surgery is in the form of a spinal surgery.
• initial screen 40 for a medical data system is illustrated.
• initial screen 40 allows an administrator or other medical personnel to begin a medical procedure such as a surgery.
• Entry screen 40 has selection boxes 42 divided into four categories. It will be appreciated that the specific arrangement and selection of the functions may be set according to application specific requirements.
• input screen 40 allows for management of the medical procedure under the heading of "intelligent medical records.” It enables hospital administrators to manage vendors, inventory, and perform analytics under the heading of "hospital applications.”
• Input screen 40 further allows the end user to communicate with the data system manager through the "customer service” tab.
• the input screen 40 may contain links to third party registries for managing tissues, biometrics, and implants beneath the "national registry” heading. It will be understood that not all of these functions need to be implemented to have a medical data system operating in accord with this disclosure.
• FIG. 3B Input screen 50 has several input buttons 52, each indicating a particular type of surgery.
• Screen 50 illustrates several types of surgeries including spine, cardiac, vascular, breast, pregnancy, hip, knee, shoulder, lung, eye, brain, as well as others. It will be appreciated that other types of surgery procedures may be included, as well as non-surgical procedures.
• the surgical data system can accommodate many surgery types.
• the illustrated surgical data system allows surgery types such as spine, cardiac, breast, hip, and knee. It will be appreciated that nearly any type of surgery may be contemplated within the scope of the surgical data system.
• each of the surgery types links to a database containing predefined anatomical representations supportive of the selected surgery. For example, if spine is selected as the surgery type, a set of anatomical representations of the spine may be presented to a medical operator for further selection. In a similar manner, if cardiac is selected as the surgery type, then and anatomical representation of a heart or a portion of a heart may be presented.
• a database which may be stored locally or on a local or wide area network, also holds information regarding the specific surgery patient area. It will be appreciated that the database may be the same or separate from the database storing information related to the surgery types. Typically, the patient will be identified by an identification number, which associates the patient with known medical history, as well as information for the proposed surgery. Once a patient has been selected and a surgery type indicated, the anatomical representations become part of that patient's medical record. As will be described later, annotations and image representations are made on the anatomical representation corresponding to the surgical and medical procedures performed. Advantageously, this near real time and graphical collection of surgical data accurately and immediately becomes part of the patient medical record.
• the surgery patient when starting a surgery, can be identified by name, ID, or other indicator.
• the system allows a search screen 60 for selection of an existing patient. It will be understood that certain information regarding a patient may be preexisting in the system, or may be accessible through automated access processes.
• Flowchart 70 illustrates one process for creating a new surgery.
• the user selects to create a new surgery 71
• the user is allowed to select a patient 73 using a patient ID, name, or other criteria.
• the patient information will pre-exist in a patient database 78 maintained or accessible by the medical provider.
• a new data record 75 is generated for the specific surgery and locally stored 79.
• this new record holds information regarding the surgery type, patient information, and holds the information collected are captured during the surgery.
• this new record acts to temporarily maintain a complete record of the individual surgery, that allow the doctor to verify and confirm the information prior to the record being released into the wider medical data system.
• the process of verifying and confirming the surgery procedures and outcomes is highly automated and efficient.
• a doctor or person in charge of the medical procedure generates a surgical report that provides detail regarding the surgical procedure.
• the surgical data system substantially automates the process for generating this surgical report, thereby enabling the doctor to verify and finalize his or her authorizations promptly upon completion of the surgery.
• the system allows for entry of data specific to that surgery, as illustrated in box 77.
• the doctor may include a pre-operative diagnosis as well as make pre-selections for expected implants, biomaterials, parts, or tools to be used during surgery.
• Other parts of the operative report creator are reliant upon the real time data collected during the surgery or medical process.
• much of the real time surgical information is collected as graphical information associated with an anatomical representation of the surgery area.
• Other textural information or comments may also be collected.
• the operative report creator 80 also allows the doctor or medical manager to include post surgical information for the report. It will be appreciated that the particular items for selection on the operative report creator 80 will vary depending upon the type of medical procedure or surgery selected.
• the surgical data input selections 82 allow for entry of patient information such as comorbidities to be attached to the patient record.
• Comorbidities are important to track as many insurance companies or governmental providers allow increased payments for patients having other indications such as diabetes.
• Figure 5 shows morbidity information being input in the operative report creator, such information may be extracted from prior medical records or input by another prior to the surgery.
• the operative report creator is divided into over 20 major input sections 84. It will be appreciated that more or fewer input sections may be used depending upon the particular procedure performed. It will also be appreciated that the categories may be adjusted according to application-specific needs.
• the operative report generator input screen 82 allows input or confirmation of patient information such as
• the diagnosis section allows for capture of the doctors pre-operative diagnosis, as well as input for post-operative plan. Obviously, the pre-operative diagnosis may be done prior to the surgery, while the post-operative diagnosis is something typically done after completion of the surgery.
• the system also allows the surgical plans to be modified in near real time during a medical procedure to reflect the actual condition of the patient.
• the system also allows input or verification of the sterilization history for parts and tools, as well as tracking for biologicals and implants. Some of this information may be input prior to the surgery, some collected real time during the surgery, and some verified or input after the surgery is complete.
• the next section provides for review and supplementation of the near real time capture of surgical data.
• the surgical data system allows for near real time capture of surgical procedures using an anatomical graphical representation.
• the doctor is able to review the collected information and confirm that the capture of data was complete and accurate.
• Other more textual operative data may also be collected, such as hospital and surgery room information, personnel performing the procedures, medications or other pharmaceuticals used during the surgery, any complications that arose during surgery, and even a transcript of surgeon or doctor comments. It will be appreciated that some of this information may be input prior to the surgery, some collected in real time during the surgery, and some added or supplemented during preparation of the operative report.
• the surgeon may print out and review and upper report, and then commit the report as a permanent record.
• the temporary record is transferred in to the patient's permanent medical record, and no further changes can be made to this surgery report or information.
• an input screen 90 allows for input of input of specific comorbidity information 94, which is presented in a form for immediate use in billing and insurance purposes. By including industry codes, and restricting the operator to authorized comorbidities, more effective insurance and billing is facilitated. Due to the large number of standard comorbidities, a structured search screen 92 may be used to narrow the number of choices presented through input screen 94. The accurate collection and tracking of comorbidity information is important for patient care as well as proper billing for surgical services.
• the surgical data system has a database of known comorbidities, and provides an indexed, searchable database of comorbidities both by common description and by industry standard coding numbers. In this way, a doctor or nurse may search for and identify a comorbidity by the common medical name, and the surgical data system will automatically attach and track the particular insurance or governmental code required for billing.
• an input screen 100 allows for input of specific preoperative 104 and post-operative 106 data.
• the surgical data system allows the doctor or medical manager to use a consistent interface and selection process for defining and capturing both the pre-operative diagnosis and the post-operative diagnosis.
• the surgical data system allows for both a pre-surgery injury of diagnosis, as well as near real time input of diagnosis during surgery. For example, once the surgeon begins the operation, if the surgeon makes further diagnoses, that diagnosis can be added in near real time during the surgery.
• the surgeon or medical manager may add a post-operative diagnosis. Again, as the user interfaces are consistent, the adding, adjusting, and supplementing diagnoses is a simplified and automated process.
• an input screen 110 allows for input of specific disposable information 100 or for biological information 120.
• the medical data system allows detailed tracking of disposables, parts or tools that are used during the surgery but that do not remain in the patient's body after surgery. It is important that the sterilization history for every disposable be understood and verified before use, and a history of sterilization maintained in the patient's record. Some of the information regarding sterilization may be entered prior to the surgery, but since the particular tools and disposables being used during surgery often are not known until the surgery is underway, the surgical data system enables a simple interface for identifying new disposables and confirming sterilization information.
• a disposable is selected for use, its sterilization history is immediately presented to those in the surgical room, and an improperly sterilized disposable can be identified and excluded from use.
• biologicals are tracked and verified prior to use in the surgery. For example, some biologicals have an expiration date, which is presented to those in the surgery room prior to the biological being used. An expired or questionable biological can be excluded.
• the surgical data system may be pre-populated with expected disposables and biologicals.
• the surgical data system has an interface to the hospital or medical center database and the information regarding disposables, sterilization, and biologicals may be retrieved from existing database information.
• the surgical team uses only items authorized by the hospital and administrative team. Using any process or part that is not part of the pre-authorized database may result in a warning to the surgery and administrative teams, and the unauthorized action can be investigated, reducing the opportunity for fraud or mistakes.
• Sterilization information is maintained, tracked, and verified down to the individual part as illustrated in the input screen 130 of Figure 9 A. Often, sterilization is done on a tray-by-tray basis, so sterilization also includes information on the particular tray to be used. As illustrated in Figure 9A, detailed information as to the type of part, the sterilizer used, and the date and type of sterilization process may be maintained. Also, an expiration date for sterilization may be provided. [0095] The surgical data system also contemplates collecting global procedures data using input screen 140 as illustrated in Figure 9B, which are medical or surgical procedures that are not specific to a particular surgery or patient location. It will be appreciated that many other types of global procedures are contemplated.
• the surgical data system accesses a surgery type database and retrieves anatomical representations for that selected surgery type.
• a surgery type may be specific to the actual surgery site, while in other cases the selected surgery type may require multiple levels of selection prior to finding the precise anatomical representation for the surgery at hand.
• Figure 10 shows an initial screen 150 after a spinal surgery type has been selected. In the case of a spinal surgery type, and anatomical representation of an entire human spine 151 is first displayed. Medical personnel then select which spina] levels the operation is to be performed, using either the graphical 151 or tabular 152, 154 inputs. Once the operator has selected the proper range, he or she commits 155 the process and an anatomical representation of the selected surgical site is then presented to the surgical team.
• the anatomical representation 170 includes a full spinal display 172 comprising individual levels, such as level 173.
• each spinal level is individually generated and then arranged with other illustrations of spinal levels to build the final spinal representation 172.
• this anatomical representation of the spine becomes a base graphical layer for enabling real time capture of surgical or medical procedure data.
• each spinal level such as level 175, comprises a set of individual graphic elements as illustrated in block 177.
• each individual spinal level is divided into 24 separate graphical images, such as image block 179.
• image block 179 It will be appreciated that the number of image blocks used, their size, and their relative size, can be selected according to application specific requirements.
• the image blocks at the top and bottom are made smaller than those in the middle.
• an image control process 181 determines which specific graphic is displayed in the anatomical representation. The image control 181 is able to select a specific image from an image database. For each block, such as block 179, a series of available images may be stored.
• the image database 182 holds a base image 184 for each of the 24 image blocks. Additionally, there may be images specific to particular procedures as shown in blocks 185 and 187. For example, a block may be prepared in advance and stored in the database that is indicative of a bone removal procedure. In this way, if bone were removed, for example, at image block 179, the base image of block 184 would be replaced by the image 185 or 187 containing a Crosshatch or other indicator of removal. It will be appreciated that not all image blocks will have alternative function images.
• the surgical data system is constructed such that the anatomical representation for the specific spine section is built only after the specific surgery site has been selected.
• the medical operator selected a start point and end point on the spine and then activated the commit button.
• the anatomical representation for the specific spine section is built only after the specific surgery site has been selected.
• representation for each level is extracted from an existing database and the anatomical representation for the full surgical range is created. This is saved and stored along with the temporary surgery information for use and annotation during the surgery.
• the medical data system has a spine select process 190 that is used for displaying the particular spine levels for a surgery 192.
• the operator selects a range of spine levels to operate on as shown in block 194.
• the user would select a stalling level and a stopping level.
• the user hits a commit button 196, which then drives the process of displaying the specific anatomical representation of the surgical area.
• the controlling software collects the starting and ending level at 198 and then extracts images from a database to create the representation of every level, with each level comprising an image matrix as illustrated in box 202.
• an operator uses the tab boxes 217, 218 and 219, as illustrated in Figure 13, to specify the spine level that is being worked on, and then the specific type of removal or procedure performed on that level.
• the system selects the appropriate graphical image to represent the specific surgical task selected, and replaces one or more of the 24 portions to annotate what the surgeon did.
• the operator has selected a specific bone removal procedure using the tab boxes 219.
• the system retrieves "removal" function images from the database for portions 18 and 19, and replaces the base anatomical image with
• Figure 14 shows an anatomical representation 248 of the C4 to C7 spinal section.
• the anatomical representation is associated with a tabular display 240 identifying the available procedures for each spine level.
• information may be provided graphically on the anatomical representation, and additional detail may be collected using the drop-down box selections. Indeed, a relationship exists between items selected on the tabular drop-down boxes and graphical display.
• the surgeon has indicated that there will be a particular removal procedure done in the C6 section of the spine, as captured in area 242.
• the anatomical representation may activate a removal layer that enables the computer operator to graphically indicate the specific areas of bone removed.
• the graphical representation may be automatically updated responsive to the specific removal selected in the drop down boxes, 244, 245, and 246.
• the boxes are arranged in a hierarchical arrangement that allows the operator to first select the broad type of procedure that is being performed 244, and then make more granular selections using boxes 245 and 246. This acts to simplify the interface to the user, and to keep the number of specific procedures to a usable level. It will be understood that more or fewer levels can be used in the hierarchical presentation.
• the particular type of removal is illustrated as a Crosshatch.
• reconstruction, or placement of implants may be indicated in whole or in part in a tabular form, which then may activate the appropriate layer for that function, thereby enabling a graphical positioning and representation of the surgical procedure.
• the system searches an image-change database and if the identifier of the selected procedure matches an identifier in the image-change database, bone images in the matrix with be replaced with images that represent the actual bone removal.
• a removal process 272 starts by having the operator define a spinal level start position and a spinal level end position using either tabular input or a graphical selection from a presented anatomical representation as shown in block 274.
• the individual spine levels are separate graphical structures, and each one is extracted from a graphical database and presented sequentially as illustrated in box 277.
• the graphical images for each level may be stored as sets of graphical images as described in block 279.
• Other level data may be stored and used as shown in block 275. This information may be for example information regarding prior surgeries, prior removals, or prior hardware already existing in the selected areas.
• the first step of method 540 involves identifying a specific surgery target as indicated in box 541.
• the surgery target may be selected using textural input means, or may use a graphical input system. Both a tabular and graphical input of a spinal surgery selection was illustrated, for example, with reference to Figure 10.
• the surgery target as described earlier may be, for example, a portion of a spine. It will be appreciated that many other types of surgeries are contemplated.
• the surgical process 540 can apply to other medical procedures other than surgery.
• the system displays an anatomical representation of the surgery target as illustrated in 542. Such an anatomical representation may be, for example, a section of spine 412 as illustrated in Figure 18.
• the operative report is the primary document used by the doctor and the medical facility to document the specific procedures, and is used to drive the billing, inventory, invoicing, and business needs of the medical facility.
• the operative report 700 may include hospital information 701, comorbidity information 702, specific personnel relevant to providing the medical procedure 703, the physician's pre-operative diagnosis 704, and the post-operative diagnosis 705.
• the operative report may provide the specific DRG code for billing and inventory purposes, along with indications 712 and consents 713.
• the operative report also identifies data such as global procedures 714, and then gives specifics about the surgery performed 715.
• the medical data system is useful for other types of medical procedures or surgeries.
• an anatomical representation of a heart or pulmonary system may be illustrated.
• selection of a specific aspect from a graphical or tabular representation of the heart system may be retrieved or built and an anatomical representation of that specific portion can be displayed that represents the target of the surgery.
• this Figure 34 shows that a particular aspect of the heart system has been selected for a medical procedure.
• an anatomical representation of the surgical site is presented, and an operator selects and places a stint to represent the actual surgical procedure performed.
• the anatomical representation of the heart is annotated in near real time to reflect occurrences in the operating room.
• the anatomical representation of the heart has been annotated to reflect the type size, and location for a cardiac stint.

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• 2013
  • 2013-01-21 WO PCT/US2013/022367 patent/WO2013110025A2/fr not_active Ceased

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